Under the Pradhan Mantri Surakshit Matritva Abhiyan, the beneficiaries are being provided with a minimum package of antenatal care including certain investigations and drugs on a fixed day of every month. Which day of the month is specified for this purpose?
Q22
In the most widespread calculation of Stillbirth Rate, the numerator is defined as foetal deaths weighing 'X' grams or more at birth, during the year. Which one of the following is the correct value for 'X'?
Q23
While performing triage in response to a disaster emergency, commonly an internationally accepted four-colour code system is used. Which one among the following four-colour categories represents the highest priority for emergency response ?
Q24
Consider the following statements with regard to Ice-Lined Refrigerator (ILR) employed for storing vaccines at the sub-district level :
I. These types of refrigerators are top-opening.
II. Based on the temperature zone, the inside of ILRs can be divided into 3 parts.
III. The upper part of ILR is cooler compared to the lower part.
IV. Vaccines should never be kept directly on the floor of the ILR as they can get damaged.
Which of the statements given above are correct?
Q25
Which one of the following terms is an "all-or-none phenomenon" and is best described as termination of all transmission of infection by extermination of the infectious agent?
Q26
"Objectives are set forth for different units and subunits, each of which prepares its own plan of action, usually on a short-term basis." The definition best sums up which one among the following terms?
Q27
In the context of rural healthcare delivery in India, the Panchayati Raj system plays a crucial role in implementing health programs at the grassroots level. Consider the following bodies and their involvement in village-level health initiatives:
I. Gram Sabha - Village health planning and monitoring
II. Gram Panchayat - Implementation of health schemes and sanitation
III. Nyaya Panchayat - Health-related dispute resolution
IV. Panchayat Samiti - Block-level health program coordination
Which of the above bodies are present and actively involved in healthcare delivery at the village level?
Q28
Many patients with unexplained rash and fever were reported from a village close to the Primary Health Centre (PHC). What is the first step in initiating the investigation of such an epidemic?
Q29
John Snow's discovery that cholera is a waterborne disease was the outcome of which type of study?
Q30
A study was conducted to evaluate the diagnostic accuracy of ECG for detecting myocardial infarction. The results are shown in the 2x2 table below:
Myocardial Infarction
Present Absent Total
ECG Positive 45 8,000 8,045
ECG Negative 5 32,000 32,005
Total 50 40,000 40,050
Consider the following statements:
I. Sensitivity is 90%.
II. Specificity is 80%.
Which of the statements given above is/are correct?
UPSC-CMS 2025 - Community Medicine UPSC-CMS Practice Questions and MCQs
Question 21: Under the Pradhan Mantri Surakshit Matritva Abhiyan, the beneficiaries are being provided with a minimum package of antenatal care including certain investigations and drugs on a fixed day of every month. Which day of the month is specified for this purpose?
A. 1st day of the month
B. 9th day of the month (Correct Answer)
C. 7th day of the month
D. 15th day of the month
Explanation: ***9th day of the month***
- The **Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA)** specifies the **9th of every month** as the day for providing comprehensive antenatal care to pregnant women.
- This fixed day ensures that women can reliably access free antenatal health check-ups and necessary services.
*1st day of the month*
- The 1st day of the month is not designated for the PMSMA check-ups; a specific date was chosen to streamline the program's implementation.
- While other health initiatives may occur on the 1st, **antenatal care under PMSMA** is not among them.
*7th day of the month*
- The 7th day of the month is not the designated date for the **PMSMA antenatal care package**.
- No specific national maternal health program utilizes the 7th day for regular check-ups.
*15th day of the month*
- The PMSMA program does not specify the 15th day for its antenatal care services; the focus is on a consistent, predictable schedule for beneficiaries.
- While mid-month check-ups are generally important, this specific initiative uses a distinct date.
Question 22: In the most widespread calculation of Stillbirth Rate, the numerator is defined as foetal deaths weighing 'X' grams or more at birth, during the year. Which one of the following is the correct value for 'X'?
A. 750
B. 1500
C. 1000 (Correct Answer)
D. 500
Explanation: ***1000***
- The international standard for defining a **stillbirth**, for statistical purposes, often uses a cutoff of **1000 grams** or **28 weeks of gestation**.
- This weight threshold helps to standardize reporting across different regions and healthcare systems for calculating the **Stillbirth Rate**.
*750*
- While some classifications might use similar weights for specific research or local definitions, **750 grams** is not the universally accepted weight for stillbirth reporting in the most widespread calculations.
- This weight is sometimes used as a lower threshold for viability or extreme prematurity, but not typically for the primary stillbirth definition.
*1500*
- A weight of **1500 grams** would exclude a significant number of stillbirths that are included under the more widely accepted 1000-gram definition.
- This higher threshold would lead to an underestimation of the true stillbirth rate in a population.
*500*
- A threshold of **500 grams** is often used in the definition of a **fetal death** but not specifically for the widespread calculation of the **Stillbirth Rate**.
- Foetal deaths below 1000 grams are often considered early fetal deaths and may be reported separately or not included in the primary stillbirth rate, depending on the specific reporting system.
Question 23: While performing triage in response to a disaster emergency, commonly an internationally accepted four-colour code system is used. Which one among the following four-colour categories represents the highest priority for emergency response ?
A. Green
B. Red (Correct Answer)
C. Black
D. Yellow
Explanation: ***Red***
- The **red** category is assigned to patients with **immediate, life-threatening injuries** who have a high probability of survival with prompt medical intervention.
- This color signifies the **highest priority** for medical treatment and transport to maximize their chances of survival.
*Green*
- The **green** category is for patients with **minor injuries** that are not life-threatening and can wait for medical attention.
- These individuals are often referred to as walking wounded and can typically self-evacuate or wait for more critical patients to be treated.
*Black*
- The **black** category is reserved for patients who are either **deceased** or have injuries so severe that survival is unlikely, even with immediate medical care.
- In a mass casualty situation, resources are generally not allocated to these individuals to prioritize those with a higher chance of survival.
*Yellow*
- The **yellow** category is for patients with **significant injuries** that are not immediately life-threatening but require definitive medical care within a few hours.
- These patients are considered "delayed" and their treatment can be postponed until after red-category patients have been managed.
Question 24: Consider the following statements with regard to Ice-Lined Refrigerator (ILR) employed for storing vaccines at the sub-district level :
I. These types of refrigerators are top-opening.
II. Based on the temperature zone, the inside of ILRs can be divided into 3 parts.
III. The upper part of ILR is cooler compared to the lower part.
IV. Vaccines should never be kept directly on the floor of the ILR as they can get damaged.
Which of the statements given above are correct?
A. I and IV
B. II and III (Correct Answer)
C. III and IV
D. I and II
Explanation: ***II and IV***
- **Statement II is correct**: ILRs can be divided into **3 temperature zones** based on cold air distribution:
- **Upper zone** (near door): Warmest area
- **Middle zone**: Optimal temperature (2-8°C) for vaccine storage
- **Lower zone/floor**: Coldest area with risk of freezing
- **Statement IV is correct**: Vaccines should **never be placed directly on the floor** of the ILR as this is the coldest zone where temperatures can drop below 0°C, causing **freeze damage** to vaccines like DPT, Hepatitis B, and TT which are freeze-sensitive.
*I and III*
- **Statement I is incorrect**: ILRs used at sub-district level in India's Universal Immunization Programme are **front-opening** (not top-opening) refrigerators. Top-opening freezers may be used for ice-pack preparation, but vaccine storage ILRs are front-opening.
- **Statement III is incorrect**: The **lower part is cooler** than the upper part, not the opposite. Cold air sinks, making the floor area the coldest zone (prone to freezing), while the upper area near the door is relatively warmer.
Question 25: Which one of the following terms is an "all-or-none phenomenon" and is best described as termination of all transmission of infection by extermination of the infectious agent?
A. Disease surveillance
B. Disease elimination
C. Disease eradication (Correct Answer)
D. Disease control
Explanation: ***Disease eradication***
- **Eradication** means the permanent reduction to zero of the worldwide incidence of infection caused by a specific agent as a result of deliberate efforts, with no risk of reintroduction.
- It is an "**all-or-none phenomenon**" because the infectious agent is completely exterminated globally, signifying a definitive end to transmission.
*Disease surveillance*
- **Disease surveillance** is the ongoing systematic collection, analysis, interpretation, and dissemination of health data essential to the planning, implementation, and evaluation of public health practice.
- It does not involve the termination or extermination of an infectious agent but rather monitors its spread and impact.
*Disease elimination*
- **Elimination** refers to the reduction to zero of the incidence of a specified disease in a defined geographical area as a result of deliberate efforts.
- While local transmission is stopped, the infectious agent may still exist elsewhere, meaning there is still a risk of reintroduction.
*Disease control*
- **Disease control** involves ongoing public health efforts to reduce the incidence, prevalence, morbidity, and mortality of an infectious disease to a locally acceptable level.
- It focuses on managing and reducing the burden of disease, not necessarily eradicating the causative agent.
Question 26: "Objectives are set forth for different units and subunits, each of which prepares its own plan of action, usually on a short-term basis." The definition best sums up which one among the following terms?
A. Management by objectives (Correct Answer)
B. Input-Output analysis
C. Personnel management
D. Work sampling
Explanation: ***Management by objectives***
- This definition directly describes **Management by Objectives (MBO)**, where clear objectives are set at various levels, and action plans are developed to achieve them.
- MBO emphasizes a **participative approach** where employees and managers collaborate to set realistic and achievable goals, often on a short-term basis.
*Input-Output analysis*
- **Input-Output analysis** studies the interdependencies within an economy, detailing how the output of one industry serves as input for another.
- It does not focus on goal-setting and planning for different organizational units.
*Personnel management*
- **Personnel management** deals with the administrative aspects of employee relations, such as recruitment, training, compensation, and employee welfare.
- While it involves setting objectives related to human resources, it is not the overarching definition for setting objectives across different units and subunits with associated action plans.
*Work sampling*
- **Work sampling** is a method used to determine the proportion of time spent by workers on different tasks over a period.
- It is a tool for **measuring work activities** and efficiency, not a framework for objective setting and action planning within an organization.
Question 27: In the context of rural healthcare delivery in India, the Panchayati Raj system plays a crucial role in implementing health programs at the grassroots level. Consider the following bodies and their involvement in village-level health initiatives:
I. Gram Sabha - Village health planning and monitoring
II. Gram Panchayat - Implementation of health schemes and sanitation
III. Nyaya Panchayat - Health-related dispute resolution
IV. Panchayat Samiti - Block-level health program coordination
Which of the above bodies are present and actively involved in healthcare delivery at the village level?
A. I, II and III
B. III and IV only
C. II, III and IV
D. I and II only (Correct Answer)
Explanation: ***I and II only***
- The **Gram Sabha** is responsible for **village health planning** and monitoring, ensuring community participation in health initiatives.
- The **Gram Panchayat** undertakes the **implementation of health schemes** and plays a vital role in sanitation and environmental health at the village level.
*I, II and III*
- While I and II are correct, the **Nyaya Panchayat** is primarily involved in **justice delivery and dispute resolution**, not active healthcare delivery.
- Its role in healthcare is indirect, often related to settling disputes arising from health-related issues, rather than direct program implementation.
*III and IV only*
- **Nyaya Panchayat** (III) is not directly involved in healthcare delivery at the village level.
- **Panchayat Samiti** (IV) operates at the **block level**, not the village level, though it coordinates health programs that impact villages.
*II, III and IV*
- The **Nyaya Panchayat** (III) does not have a direct role in healthcare delivery.
- The **Panchayat Samiti** (IV) functions at the **block level**, not the village level.
Question 28: Many patients with unexplained rash and fever were reported from a village close to the Primary Health Centre (PHC). What is the first step in initiating the investigation of such an epidemic?
A. Defining the population at risk
B. Confirm existence of epidemic (Correct Answer)
C. Rapid search for all cases
D. Verification of diagnosis
Explanation: ***Confirm existence of epidemic***
- The initial and crucial step in any epidemiological investigation is to **verify if a true epidemic exists**, which involves comparing current disease incidence with expected levels.
- This step helps to differentiate between a real outbreak and a normal fluctuation in disease occurrence or an artifact of increased reporting.
*Defining the population at risk*
- While important, identifying the **population at risk** comes after confirming an epidemic and is essential for calculating attack rates and understanding disease spread.
- This step helps in understanding who might be exposed or susceptible, allowing for targeted interventions.
*Rapid search for all cases*
- A **rapid search for all cases** is a critical component of case finding once an epidemic has been confirmed and a case definition established.
- This step helps in understanding the magnitude of the outbreak and identifying patterns of transmission.
*Verification of diagnosis*
- **Verification of diagnosis** is crucial for ensuring that reported cases meet the established case definition and to exclude other conditions.
- This process helps to ensure the accuracy of data collected during the investigation and precedes further epidemiological analysis.
Question 29: John Snow's discovery that cholera is a waterborne disease was the outcome of which type of study?
A. Risk factor trial
B. Uncontrolled trial
C. Natural experiment (Correct Answer)
D. Trial of aetiological agent
Explanation: ***Natural experiment***
- John Snow's investigation of the 1854 cholera outbreak in London specifically involved observing the effects of **different water sources** on cholera rates among distinct populations.
- This constituted a **natural experiment** because the exposure (water source) was not manipulated by the researcher but rather occurred naturally within the population.
*Risk factor trial*
- A risk factor trial would involve **deliberately exposing** or changing exposure to a risk factor in different groups to observe outcomes, which is unethical and was not done by Snow.
- This type of study is usually **interventional** and aims to determine causality by actively managing variables.
*Uncontrolled trial*
- An uncontrolled trial typically involves an intervention but without a **comparison group**, making it difficult to attribute observed effects solely to the intervention.
- Snow's study, conversely, involved comparing outcomes between groups (those using different water pumps).
*Trial of aetiological agent*
- A trial of an aetiological agent would involve **intentionally introducing** or removing the suspected disease-causing agent (e.g., cholera bacteria) to observe its effects.
- John Snow did not perform such an interventional study; his work was observational, identifying associations in natural settings.
Question 30: A study was conducted to evaluate the diagnostic accuracy of ECG for detecting myocardial infarction. The results are shown in the 2x2 table below:
Myocardial Infarction
Present Absent Total
ECG Positive 45 8,000 8,045
ECG Negative 5 32,000 32,005
Total 50 40,000 40,050
Consider the following statements:
I. Sensitivity is 90%.
II. Specificity is 80%.
Which of the statements given above is/are correct?
A. Both I and II (Correct Answer)
B. Neither I nor II
C. II only
D. I only
Explanation: **Both I and II**
- **Sensitivity** = True Positives / (True Positives + False Negatives) = 45 / (45 + 5) = 45/50 = **0.90 or 90%** ✓
- **Specificity** = True Negatives / (True Negatives + False Positives) = 32,000 / (32,000 + 8,000) = 32,000/40,000 = **0.80 or 80%** ✓
- Both calculations are correct based on the 2×2 contingency table
- **Sensitivity** measures the ability of the test to correctly identify those with disease (true positive rate)
- **Specificity** measures the ability of the test to correctly identify those without disease (true negative rate)
*I only*
- Incorrect because Statement II (Specificity = 80%) is also correct, not just Statement I
*II only*
- Incorrect because Statement I (Sensitivity = 90%) is also correct, not just Statement II
*Neither I nor II*
- Incorrect because both statements are mathematically correct based on the given data