In India, the most widely prevalent stage of iron deficiency is
Q22
Consider the following statement : "The people should seek to preserve their traditional eating patterns and lifestyles associated with low levels of Coronary Heart Disease (CHD)." Which level of prevention is implied in this statement?
Q23
Raju is 30 years of age. He has been working in the ceramic and pottery industry for the last 10 years. Which one of the following conditions should he be screened for?
Q24
Which of the following publications is/are brought out by the World Health Organization?
1. CD Alert
2. Morbidity and Mortality Weekly Report
3. Weekly Epidemiological Record
Select the correct answer using the code given below.
Q25
Which one of the following best represents the correct sequence of phases in a normal nuclear family?
1. Contraction
2. Dissolution
3. Extension
4. Formation
Select the correct answer using the code given below.
Q26
Which among the following are characteristics of health education, rather than propaganda?
1. Knowledge actively acquired, rather than instilled
2. Appeals to emotion, rather than reason
3. Behaviour centred, rather than information centred
4. Arouses and stimulates primitive desires, rather than disciplines them
Select the correct answer using the code given below.
Q27
As per the basic model of a nuclear family life cycle, which of the following represent the phases of family expansion and contraction?
1. Contraction
2. Dissolution
3. Extension
4. Formation
Select the correct answer using the code given below.
Q28
Consider the following statements regarding the Central Drugs Standard Control Organization (CDSCO) in India :
1. The CDSCO is headed by the Drugs Controller General (India) at the Centre.
2. The CDSCO is a part of the Directorate of Director General of Health Services.
3. The CDSCO is under the Ministry of Chemicals and Fertilizers, Government of India.
4. The CDSCO has a network of several port offices for monitoring the import and export of drugs. Which of the statements given above are correct?
Q29
In the National Malaria Control Programme, Indoor Residual Spray (IRS) is the primary method of vector control in rural setting. Which one of the following is the 'insecticide of choice'?
Q30
Consider the following statements with regard to selection of Accredited Social Health Activist (ASHA) under NRHM :
1. ASHA must be a woman preferably of age 18 to 25 years.
2. ASHA should be married.
3. ASHA must be a resident of the village.
4. ASHA may be a married, widowed or divorced woman. Which of the statements given above are correct with regard to process of selection of ASHA?
UPSC-CMS 2024 - Community Medicine UPSC-CMS Practice Questions and MCQs
Question 21: In India, the most widely prevalent stage of iron deficiency is
A. decreased iron stores without any other detectable abnormalities (Correct Answer)
B. fall in percentage saturation of transferrin
C. decrease in the concentration of circulating haemoglobin
D. overt iron deficiency with impaired haemoglobin synthesis
Explanation: ***decreased iron stores without any other detectable abnormalities***
- This stage represents **latent iron deficiency (Stage 1)**, where the body's iron reserves are depleted (↓ serum ferritin), but hemoglobin and transferrin saturation remain normal.
- According to the **epidemiological "iceberg" principle**, subclinical deficiency is always more prevalent than clinically apparent disease in populations.
- This is the **most widely prevalent stage** in India, as many individuals with depleted iron stores have not yet progressed to frank anemia, representing the largest segment of the iron deficiency spectrum.
- Seen commonly in **nutritionally vulnerable groups** due to inadequate dietary iron intake and chronic blood loss.
*fall in percentage saturation of transferrin*
- A fall in **transferrin saturation** (<16%) indicates **Stage 2: iron deficient erythropoiesis**, where iron availability for red blood cell production becomes limited.
- This occurs after iron stores have been significantly depleted and represents a more advanced stage than simple store depletion.
- While common, it is less prevalent than Stage 1 as not all individuals with depleted stores progress to this stage.
*decrease in the concentration of circulating haemoglobin*
- This signifies **Stage 3: iron deficiency anemia**, where iron deficiency is severe enough to impair hemoglobin synthesis, leading to clinical anemia (Hb <12 g/dL in women, <13 g/dL in men).
- Although highly prevalent in India (NFHS-5 data shows 57% anemia in women), it represents a later manifestation that affects fewer individuals than the earlier subclinical stages.
- This is the most **commonly detected** stage due to routine Hb screening, but not the most **prevalent** stage overall.
*overt iron deficiency with impaired haemoglobin synthesis*
- This also describes **Stage 3: iron deficiency anemia**, characterized by microcytic, hypochromic red blood cells due to insufficient iron for heme synthesis.
- This is a clinically diagnosable stage with functional impairment, representing the "tip of the iceberg" of the total iron deficiency burden in the population.
Question 22: Consider the following statement : "The people should seek to preserve their traditional eating patterns and lifestyles associated with low levels of Coronary Heart Disease (CHD)." Which level of prevention is implied in this statement?
A. Primary
B. Primordial (Correct Answer)
C. High risk
D. Secondary
Explanation: ***Primordial***
- **Primordial prevention** aims to prevent the development of risk factors themselves by addressing underlying social, economic, and environmental determinants of health before they emerge in populations.
- Preserving traditional eating patterns and lifestyles associated with **low CHD risk** prevents the adoption of modern unhealthy lifestyles, thereby stopping risk factors from developing in the first place.
- This is the most upstream level of prevention, maintaining conditions of low risk in entire populations.
*Primary*
- **Primary prevention** targets individuals or populations who are healthy but may already have risk factors, aiming to prevent disease onset.
- Examples include **vaccination**, promoting healthy diets to those at risk, and exercise programs.
- Unlike primordial prevention, primary prevention assumes risk factors might already exist and works to prevent disease development.
*High risk*
- The **high risk approach** is a strategy within primary prevention that focuses interventions on individuals identified as having high probability of developing disease.
- This statement addresses population-level strategies before risk factors are established, which is broader than targeting high-risk individuals.
- This approach comes into play after risk factors have already emerged in some population segments.
*Secondary*
- **Secondary prevention** focuses on early detection and prompt treatment of existing disease to prevent progression and complications.
- Involves **screening programs** (e.g., lipid profile screening, ECG) and early intervention once disease or risk factors have manifested.
- This is clearly not applicable as the statement addresses prevention before any disease or risk factors develop.
Question 23: Raju is 30 years of age. He has been working in the ceramic and pottery industry for the last 10 years. Which one of the following conditions should he be screened for?
A. Asbestosis
B. Anthracosis
C. Byssinosis
D. Silicosis (Correct Answer)
Explanation: ***Silicosis***
- Working in the **ceramic and pottery industry** involves significant exposure to **silica dust**, making silicosis the most relevant occupational lung disease.
- **Silicosis** is a chronic, progressive fibrotic lung disease caused by inhaling crystalline silica, common in mining, quarrying, and pottery.
*Asbestosis*
- **Asbestosis** is caused by the inhalation of **asbestos fibers**, typically found in construction, insulation, and shipbuilding.
- While an occupational lung disease, it is not directly linked to the ceramic and pottery industry.
*Anthracosis*
- **Anthracosis** is commonly known as **coal workers' pneumoconiosis** and results from inhaling coal dust.
- This condition is specifically associated with coal mining and not pottery work.
*Byssinosis*
- **Byssinosis** is an occupational lung disease caused by inhaling **cotton dust**, often seen in textile workers.
- It is unrelated to exposure in the ceramic and pottery industry.
Question 24: Which of the following publications is/are brought out by the World Health Organization?
1. CD Alert
2. Morbidity and Mortality Weekly Report
3. Weekly Epidemiological Record
Select the correct answer using the code given below.
A. 3 only (Correct Answer)
B. 2 only
C. 2 and 3
D. 1 and 2
Explanation: ***3 only***
- The **Weekly Epidemiological Record (WER)** is the only publication in this list brought out by the **World Health Organization (WHO)**.
- WER provides up-to-date information on **epidemiological events globally** and serves as an essential tool for **public health surveillance**.
- **CD Alert** is published by the **National Centre for Disease Control (NCDC), India**, not WHO.
- **Morbidity and Mortality Weekly Report (MMWR)** is published by the **U.S. Centers for Disease Control and Prevention (CDC)**, not WHO.
*2 only*
- The **MMWR** is a publication of the **CDC, USA**, not the WHO.
- This option incorrectly attributes a CDC publication to WHO.
*2 and 3*
- While the **Weekly Epidemiological Record** is correctly a WHO publication, the **MMWR** is published by the **CDC, not WHO**.
- This option is incorrect because it wrongly includes MMWR as a WHO publication.
*1 and 2*
- **CD Alert** is published by the **NCDC, India** (not WHO), and **MMWR** is published by the **CDC, USA** (not WHO).
- This option is incorrect as neither publication is brought out by the WHO.
Question 25: Which one of the following best represents the correct sequence of phases in a normal nuclear family?
1. Contraction
2. Dissolution
3. Extension
4. Formation
Select the correct answer using the code given below.
A. 1 → 2 → 3 → 4
B. 4 → 1 → 2 → 3
C. 1 → 3 → 4 → 2
D. 4 → 3 → 1 → 2 (Correct Answer)
Explanation: ***4 → 3 → 1 → 2***
- The correct sequence represents the **Duvall's Family Life Cycle** for a nuclear family.
- The cycle begins with **Formation** (marriage/establishment of family), followed by **Extension** (birth and child-rearing), then **Contraction** (children leaving home - empty nest phase), and finally **Dissolution** (death of parents).
- This is the standard sequence taught in family life cycle models in Community Medicine.
*1 → 2 → 3 → 4*
- This sequence is incorrect as it starts with **Contraction** and ends with **Formation**, which reverses the natural progression of family development.
- Family life cycles logically progress from formation to dissolution, not the other way around.
*4 → 1 → 2 → 3*
- This order is incorrect because **Contraction** (children leaving home) must occur after the **Extension** phase (children growing up in the home).
- Skipping the extension phase contradicts the natural developmental sequence of family life.
*1 → 3 → 4 → 2*
- This sequence is incorrect as it begins with **Contraction** before **Formation**, which is logically impossible.
- A family cannot contract before it has been formed and extended.
Question 26: Which among the following are characteristics of health education, rather than propaganda?
1. Knowledge actively acquired, rather than instilled
2. Appeals to emotion, rather than reason
3. Behaviour centred, rather than information centred
4. Arouses and stimulates primitive desires, rather than disciplines them
Select the correct answer using the code given below.
A. 2 and 3
B. 1 and 2
C. 1 and 3 (Correct Answer)
D. 3 and 4
Explanation: ***1 and 3***
- **Health education** empowers individuals to make informed decisions by facilitating the **active acquisition of knowledge**, promoting understanding over mere instillation of facts.
- It is inherently **behavior-centered**, aiming to translate knowledge into practical actions and sustainable healthy habits, rather than just disseminating information.
*2 and 3*
- While health education is behavior-centered (point 3), it primarily appeals to **reason and critical thinking**, not emotion (point 2).
- Propaganda, in contrast, often appeals to emotions to manipulate beliefs without necessarily fostering genuine understanding.
*1 and 2*
- **Health education** involves active knowledge acquisition (point 1) but does not primarily appeal to emotion (point 2).
- Appealing to emotion is a characteristic more aligned with propaganda, which seeks to bypass critical thought.
*3 and 4*
- **Health education** is behavior-centered (point 3) but aims to **discipline behaviors** through informed choice, rather than arousing primitive desires (point 4).
- The arousal of primitive desires is a manipulative tactic often associated with propaganda, not legitimate health education.
Question 27: As per the basic model of a nuclear family life cycle, which of the following represent the phases of family expansion and contraction?
1. Contraction
2. Dissolution
3. Extension
4. Formation
Select the correct answer using the code given below.
A. 1 and 2
B. 2 and 3
C. 1 and 3 (Correct Answer)
D. 2 only
Explanation: ***1 and 3***
- The **extension/expansion phase** involves the addition of new members to the family through **birth or adoption** of children, representing family growth.
- The **contraction phase** occurs when children leave the **parental home** (empty nest phase), leading to a reduction in household size.
- Together, these represent the dynamic phases of family expansion and contraction in the nuclear family life cycle.
*1 and 2*
- While contraction is correct, the **dissolution phase** refers to the final stage (death of spouse/parents), not a phase of active family expansion or contraction.
- This option incorrectly includes dissolution instead of extension.
*2 and 3*
- The **dissolution phase** is the terminal stage of the family life cycle, not a phase of expansion or contraction.
- This option incorrectly includes dissolution and omits contraction.
*2 only*
- **Dissolution** is the final stage of the family life cycle when the family unit ends due to death of spouse(s).
- This option completely misses both the **extension** (expansion) and **contraction** phases, which are the core dynamic phases of family size change.
Question 28: Consider the following statements regarding the Central Drugs Standard Control Organization (CDSCO) in India :
1. The CDSCO is headed by the Drugs Controller General (India) at the Centre.
2. The CDSCO is a part of the Directorate of Director General of Health Services.
3. The CDSCO is under the Ministry of Chemicals and Fertilizers, Government of India.
4. The CDSCO has a network of several port offices for monitoring the import and export of drugs. Which of the statements given above are correct?
A. 1 and 3
B. 2 and 4 only
C. 1, 2 and 4 (Correct Answer)
D. 1 and 2 only
Explanation: ***Correct Option: 1, 2 and 4***
The **Central Drugs Standard Control Organization (CDSCO)** has the following characteristics:
**Statement 1 (Correct):** The CDSCO is indeed headed by the **Drugs Controller General (India)** at the Centre. This is the apex regulatory authority for pharmaceuticals and medical devices in India.
**Statement 2 (Correct):** The CDSCO operates as a part of the **Directorate General of Health Services (DGHS)** under the Ministry of Health & Family Welfare.
**Statement 3 (Incorrect):** The CDSCO falls under the **Ministry of Health & Family Welfare**, NOT the Ministry of Chemicals and Fertilizers. The Ministry of Chemicals and Fertilizers is responsible for policies related to the production and pricing of chemicals and fertilizers, but drug regulation is under the health ministry.
**Statement 4 (Correct):** The CDSCO has an extensive network of **port offices** (located at major ports and airports) responsible for overseeing the **import and export of drugs**, ensuring compliance with safety and quality standards.
*Incorrect Option: 1 and 3*
- While statement 1 is correct, statement 3 is incorrect as explained above. This combination includes a false statement about the ministry under which CDSCO operates.
*Incorrect Option: 2 and 4 only*
- This option correctly identifies two true statements but **omits statement 1**, which is the fundamental fact that CDSCO is headed by the Drugs Controller General (India). This is incomplete.
*Incorrect Option: 1 and 2 only*
- This option correctly identifies the organizational structure but **fails to include statement 4** about the crucial role of CDSCO's port offices in regulating the import and export of drugs, which is a key regulatory function.
Question 29: In the National Malaria Control Programme, Indoor Residual Spray (IRS) is the primary method of vector control in rural setting. Which one of the following is the 'insecticide of choice'?
A. Synthetic pyrethroid (Correct Answer)
B. Temephos
C. DDT
D. Malathion
Explanation: ***Synthetic pyrethroid***
- **Synthetic pyrethroids** are the **insecticide of choice** for Indoor Residual Spraying (IRS) in many national malaria control programs due to their **rapid knockdown effect** and good residual activity.
- They are effective against various mosquito species and have a **relatively low toxicity** to humans at recommended concentrations.
*Temephos*
- **Temephos** is primarily used as a **larvicide**, often applied to waterbodies to control mosquito larvae.
- It is **not suitable for IRS** as it lacks the necessary residual effect on surfaces to control adult mosquitoes effectively.
*DDT*
- **DDT** was historically a very effective insecticide for malaria control but is now **restricted or banned** in many countries due to its **environmental persistence** and potential health concerns.
- While still used in some specific contexts, it is generally **not the primary insecticide of choice** for new or ongoing programs due to these restrictions and growing **insecticide resistance**.
*Malathion*
- **Malathion** is an **organophosphate insecticide** that can be used for IRS, but it generally has a **shorter residual effect** compared to synthetic pyrethroids.
- It may also have issues with **odor** and require more frequent reapplication, making it a less preferred option than pyrethroids in many programs.
Question 30: Consider the following statements with regard to selection of Accredited Social Health Activist (ASHA) under NRHM :
1. ASHA must be a woman preferably of age 18 to 25 years.
2. ASHA should be married.
3. ASHA must be a resident of the village.
4. ASHA may be a married, widowed or divorced woman. Which of the statements given above are correct with regard to process of selection of ASHA?
A. 1 and 2 only
B. 2 and 3 only
C. 3 and 4 only (Correct Answer)
D. 1, 2, 3 and 4
Explanation: ***3 and 4 only***
- An ASHA worker must be a **resident of the village** she serves to ensure local knowledge and trust, making statement 3 correct.
- The criteria specify that an ASHA may be **married, widowed, or divorced**, making statement 4 correct and reflecting inclusivity in selection.
*1 and 2 only*
- While ASHA candidates are typically women, the age criteria are usually **25 to 45 years**, not 18-25, making statement 1 incorrect.
- Being married is not a mandatory criterion; **single, widowed, or divorced women** are also eligible, making statement 2 incorrect.
*2 and 3 only*
- As explained earlier, being married (statement 2) is **not a mandatory requirement**, as eligibility extends to widowed or divorced women.
- While being a resident of the village (statement 3) is correct, statement 2 is incorrect, so this option is not entirely correct.
*1, 2, 3 and 4*
- This option includes statements 1 and 2, which are **incorrect**. Statement 1 refers to an incorrect age range, and statement 2 incorrectly states that ASHA must be married.