UPSC-CMS 2024 - Community Medicine Practice Questions

Q: Consider the following statements regarding dengue : 1. The mosquito becomes infective after an extrinsic incubation period of 8-10 days. 2. Once it becomes infective, the mosquito remains infective for life. 3. The genital tract of the mosquito does not get infected. Which of the statements given above are correct?

1 and 2 only. ***1 and 2 only*** - The **extrinsic incubation period** for dengue in mosquitoes (Aedes aegypti and Aedes albopictus) is indeed **8-10 days** at optimal temperatures, after which the mosquito becomes infective. - Once infected, the mosquito's salivary glands harbor the virus, making it capable of transmitting dengue for the **rest of its life**. *2 and 3 only* - While statement 2 is correct, statement 3 is incorrect. The **genital tract of the mosquito can be infected**; vertical transmission (from infected female mosquito to offspring via eggs) is a known but less common route of spread. *1 and 3 only* - Statement 1 is correct, but statement 3 is incorrect as the **genital tract can be infected**, leading to vertical transmission in mosquitoes. *1, 2 and 3* - This option is incorrect because statement 3 is false. The dengue virus can infect the **genital tract** of the mosquito, allowing for **vertical transmission** to its offspring.

Q: A researcher has obtained the country-level data on the average Body Mass Index (BMI) and the average sugar intake for 100 countries. Which among the following will be best suited to present the relationship between BMI and sugar intake in the 100 countries?

Scatter diagram. ***Scatter diagram*** - A **scatter diagram** is ideally suited for visualizing the relationship or **correlation** between two continuous variables, in this case, average BMI and average sugar intake per country. - Each point on the diagram represents a single country, with its coordinates determined by its corresponding BMI and sugar intake values, allowing for easy identification of patterns or trends. *Frequency polygon* - A **frequency polygon** is used to display the **frequency distribution** of a single continuous variable, showing the shape of the data. - It is not designed to show the relationship between two different variables. *Bar chart* - A **bar chart** is typically used to compare **categorical data** or show changes in a **single variable over time**. - It does not effectively display the relationship or correlation between two continuous variables like BMI and sugar intake. *Pie diagram* - A **pie diagram** is used to represent **proportions** or percentages of a whole for a single categorical variable. - It is not suitable for visualizing the relationship between two continuous quantitative variables.

Q: Frontline health workers are employed to record the births and deaths in countries which have made slow progress in the development of a comprehensive vital registration system. This approach is known as

lay reporting. ***lay reporting*** - **Lay reporting** involves non-medical or community health workers collecting basic health information, such as births and deaths, especially in regions with inadequate formal registration systems. - This method is valuable for gathering **community-level data** and improving the reach of health surveillance where professional healthcare infrastructure is limited. *census* - A **census** is a complete enumeration of a population at a specific point in time, usually conducted by the government to collect demographic and socioeconomic data. - While it counts individuals, it does not typically involve the continuous recording of **vital events** like births and deaths by frontline health workers. *registration of vital events* - **Registration of vital events** refers to the official and continuous recording of births, deaths, marriages, and divorces by civil authorities, which is part of a comprehensive vital registration system. - The question describes a scenario where this comprehensive system is underdeveloped, necessitating an alternative like **lay reporting**. *sample registration system* - A **sample registration system** involves collecting vital statistics from a representative sample of the population rather than the entire population. - While it's used to estimate demographic indicators, it typically involves more structured data collection methods and is distinct from utilizing **frontline health workers** for primary recording in underserved areas.

Q: While calculating the ‘total dependency ratio’, which one of the following is used in the denominator?

Population 15 to 64 years. ***Population 15 to 64 years*** - The **total dependency ratio** is calculated by dividing the sum of the **dependent population** (ages 0-14 and 65+) by the **working-age population** (ages 15-64). - Therefore, the **denominator** represents the segment of the population that is generally considered to be in their most productive working years. *Midyear population* - The **midyear population** refers to the population at the midpoint of a given year and is often used as a general denominator for various rates (e.g., birth rates, death rates). - However, in the context of the dependency ratio, a specific age group—the **working-age population**—is required in the denominator to reflect economic burden. *Population 14 to 70 years* - This age range does not accurately represent the standard definition of the **working-age population** or the traditional age groups used for calculating dependency ratios. - The internationally accepted age range for the working population is typically **15-64 years**. *Population 0 to 65 years* - This range includes both **dependent children** (0-14) and potentially some of the **elderly dependent population** (65 and over), thus it does not represent the **working-age population** for the denominator. - The denominator for the dependency ratio specifically excludes these dependent age groups.

Q: As per the United Nations definition of a vital events registration system, ‘vital events’ include which of the following? 1. Foetal deaths 2. School admissions 3. Legal separations 4. College graduations Select the correct answer using the code given below.

1 and 3. ***Correct: 1 and 3*** According to the **United Nations Principles and Recommendations for a Vital Statistics System (Rev. 3)**, vital events are demographic events that have significant impact on an individual's legal status and population statistics. **Foetal deaths (1)** are explicitly included as vital events because they impact **reproductive health statistics** and **population data**. They represent crucial demographic outcomes related to pregnancy and birth outcomes. **Legal separations (3)** are recognized vital events as they fundamentally **alter the civil/marital status** of individuals and must be recorded in vital statistics systems. They fall within the category of marriage-related vital events (marriages, divorces, annulments, legal separations). ### Core vital events per UN definition: - Live births - Deaths (including foetal deaths) - Marriages - Divorces - Legal separations - Adoptions - Legitimations - Recognitions - Annulments *Incorrect: 2 and 3* While **legal separations (3)** are vital events, **school admissions (2)** are NOT considered vital events. School admissions are **administrative processes** related to education, not fundamental demographic or legal changes that affect civil status or population dynamics. *Incorrect: 2 and 4* Neither **school admissions (2)** nor **college graduations (4)** are vital events per UN definition. These are **educational milestones and administrative records** for educational purposes. They do not represent changes in vital status or core demographic events like births, deaths, marriages, or divorces. *Incorrect: 1 and 2* While **foetal deaths (1)** are vital events, **school admissions (2)** are not. School admissions are administrative educational records that do not represent demographic events or changes in an individual's legal/civil status that would be captured in a vital statistics system.

Q: Consider the following statements regarding Kyasanur Forest Disease (KFD): 1. It is transmitted by ticks. 2. It was originally called 'pig disease' because of the association with dead pigs. 3. It was first recognized in Karnataka State. How many of the statements given above are correct?

Only two of the statements. ***Only two of the statements*** - Statement 1 is **correct**: KFD is a **tick-borne viral hemorrhagic fever**, primarily transmitted by infected *Haemaphysalis spinigera* ticks - Statement 3 is **correct**: KFD was first identified in the **Kyasanur Forest of Karnataka, India** in 1957 - Statement 2 is **incorrect**: KFD was originally called **'monkey disease' or 'monkey fever'**, not 'pig disease', because of its strong association with **monkey deaths** which serve as an early warning sign *All the three statements* - Incorrect because Statement 2 is false - the disease was associated with monkeys, not pigs *None of the statements* - Incorrect because statements 1 and 3 are both factually accurate regarding **tick-borne transmission** and **geographical origin in Karnataka** *Only one of the statements* - Incorrect because two statements (1 and 3) are correct, not just one

Q: In countries with low levels of measles transmission, what should be the appropriate age for starting immunization with measles-containing vaccine (MCV)?

12 months. ***12 months*** - In countries with **low measles transmission**, the recommended age for the first dose of **Measles-Containing Vaccine (MCV)** is **12 months** (or 12-15 months). - In low-transmission settings, **maternal antibodies persist longer** due to reduced natural boosting from circulating virus, so vaccination can be safely delayed to 12 months for optimal immune response. - This timing ensures maternal antibodies have waned sufficiently while avoiding interference with vaccine effectiveness. *9 months* - The 9-month schedule is recommended for countries with **high measles transmission** where the risk of early infection is greater. - In low-transmission settings, vaccinating at 9 months would mean giving the vaccine when maternal antibodies may still interfere with seroconversion. - WHO recommends 9 months only in high-burden countries or outbreak situations. *15-18 months* - This age range is typically reserved for the **second dose** of the measles vaccine (MCV2) to ensure long-term immunity and catch up children who didn't respond to the first dose. - Starting immunization at this age would leave a significant period of vulnerability to measles infection. - The two-dose schedule provides approximately 97% protection when completed. *6 months* - Administering MCV at 6 months is generally not recommended as maternal **antibodies** are still high and can significantly interfere with the vaccine's effectiveness, leading to poor immune response. - Vaccination at this age might be considered only in very high-risk situations like **outbreaks**, during international travel to endemic areas, or in emergency humanitarian settings. - When given at 6 months, it is not counted as part of the routine schedule, and the child still needs doses at 9 and 15 months.

Q: The method of combined disposal of refuse and night soil is known as

composting. ***Composting*** - Composting is a biological process where **organic matter**, including refuse and night soil, **decomposes** under controlled conditions to produce a **nutrient-rich humus**. - This method effectively **stabilizes waste**, reduces pathogens, and recycles valuable resources back into the environment. *Incineration* - Incineration involves the **combustion of waste at high temperatures** to reduce its volume and weight, often producing energy. - It is primarily used for **solid waste disposal** and is not typically combined with night soil due to the high moisture content and potential for air pollution. *Dumping* - Dumping refers to the **unregulated disposal of waste** in open areas, leading to environmental pollution and health hazards. - This method provides **no treatment** or control for refuse or night soil and is an unsanitary practice. *Controlled tipping* - Controlled tipping, or **sanitary landfilling**, involves depositing waste in a systematic manner, covering it with soil daily to minimize environmental impact. - While it's an improved waste disposal method, it doesn't involve the **biological breakdown and resource recovery associated with combining night soil with refuse**.

Q: Consider the following statements about working of septic tanks : 1. They are recommended for large communities, rather than small communities. 2. There should be no air space between the level of liquid in the tank and the undersurface of the cover. 3. Liquid effluent from the outlet pipe is free from all pathogens. How many of the statements given above are correct?

Only one of the statements. ***Only one of the statements*** - **This is correct.** Only statement 2 is accurate regarding septic tank operation. **Analysis of each statement:** **Statement 1 (Incorrect):** Septic tanks are recommended for **small communities and individual households**, NOT large communities. Large communities require centralized sewage treatment plants with higher capacity and more sophisticated treatment processes. Septic tanks are ideal for rural areas, scattered housing, and small institutions where centralized sewage systems are not feasible. **Statement 2 (Correct):** There should be **no air space** (or minimal air space) between the liquid level and the cover undersurface to maintain **anaerobic conditions** essential for septic tank functioning. The anaerobic bacteria that decompose organic matter require an oxygen-free environment. This design principle ensures proper digestion of sewage solids in the tank. **Statement 3 (Incorrect):** Liquid effluent from septic tanks is **NOT free from all pathogens**. The septic tank provides only primary treatment, removing settleable solids and partially digesting organic matter. The effluent still contains pathogenic bacteria, viruses, and parasites. This is why the effluent requires further treatment through soak pits, leach fields, or secondary treatment before safe disposal. *All the three statements* - Incorrect because statements 1 and 3 are false. *Only two of the statements* - Incorrect because only statement 2 is accurate. *None of the statements* - Incorrect because statement 2 about maintaining anaerobic conditions is correct.

Question 1

Consider the following statements regarding dengue :

1. The mosquito becomes infective after an extrinsic incubation period of 8-10 days.
2. Once it becomes infective, the mosquito remains infective for life.
3. The genital tract of the mosquito does not get infected. Which of the statements given above are correct?

Accepted Answer

1 and 2 only

Answer

2 and 3 only

Answer

1 and 3 only

Answer

1, 2 and 3

Question 2

A researcher has obtained the country-level data on the average Body Mass Index (BMI) and the average sugar intake for 100 countries. Which among the following will be best suited to present the relationship between BMI and sugar intake in the 100 countries?

Accepted Answer

Scatter diagram

Answer

Frequency polygon

Answer

Bar chart

Answer

Pie diagram

Question 3

Frontline health workers are employed to record the births and deaths in countries which have made slow progress in the development of a comprehensive vital registration system. This approach is known as

Accepted Answer

lay reporting

Answer

census

Answer

registration of vital events

Answer

sample registration system

Question 4

While calculating the ‘total dependency ratio’, which one of the following is used in the denominator?

Accepted Answer

Population 15 to 64 years

Answer

Midyear population

Answer

Population 14 to 70 years

Answer

Population 0 to 65 years

Question 5

As per the United Nations definition of a vital events registration system, 
‘vital events’ include which of the following? 
1. Foetal deaths 
2. School admissions 
3. Legal separations 
4. College graduations 
Select the correct answer using the code given below.

Accepted Answer

1 and 3

Answer

2 and 3

Answer

2 and 4

Answer

1 and 2

Question 6

Consider the following statements regarding Kyasanur Forest Disease (KFD):

1. It is transmitted by ticks.
2. It was originally called 'pig disease' because of the association with dead pigs.
3. It was first recognized in Karnataka State.

How many of the statements given above are correct?

Accepted Answer

Only two of the statements

Answer

All the three statements

Answer

None of the statements

Answer

Only one of the statements

Question 7

In countries with low levels of measles transmission, what should be the appropriate age for starting immunization with measles-containing vaccine (MCV)?

Accepted Answer

12 months

Answer

9 months

Answer

15-18 months

Answer

6 months

Question 8

Raju, a 6-year-old boy, was returning home from school. At the gate, he was scratched by a dog and there was some bleeding from the wound. Which option should be followed for the post-exposure prophylaxis?

Accepted Answer

Wash the wound, vaccinate with ARV and administer immunoglobulin

Answer

Wash the wound and vaccinate with ARV only

Answer

Wash and apply antiseptic to the wound

Answer

Wash the wound and administer a shot of tetanus toxoid

Question 9

The method of combined disposal of refuse and night soil is known as

Accepted Answer

composting

Answer

incineration

Answer

dumping

Answer

controlled tipping

Question 10

Consider the following statements about working of septic tanks :

1. They are recommended for large communities, rather than small communities.
2. There should be no air space between the level of liquid in the tank and the undersurface of the cover.
3. Liquid effluent from the outlet pipe is free from all pathogens. How many of the statements given above are correct?

Accepted Answer

Only one of the statements

Answer

All the three statements

Answer

Only two of the statements

Answer

None of the statements

UPSC-CMS 2024 — Community Medicine