UPSC-CMS 2009 Practice Questions

Q: Consider the following statements : 1. The deficiency of thiamine leads to the accumulation of pyruvic and lactic acids in the body. 2. Riboflavin deficiency impairs the optimal utilization of pyridoxine. Which of the statements given above is/are correct ?

Both 1 and 2. ***Both 1 and 2*** - **Statement 1 is correct**: Thiamine (vitamin B1) as **thiamine pyrophosphate (TPP)** is an essential coenzyme for the **pyruvate dehydrogenase complex** and **α-ketoglutarate dehydrogenase**. Deficiency blocks pyruvate conversion to acetyl-CoA, causing accumulation of **pyruvic acid** and its reduction product **lactic acid**, leading to metabolic acidosis seen in **beriberi** and **Wernicke-Korsakoff syndrome**. - **Statement 2 is correct**: Riboflavin (vitamin B2) as **FMN** serves as a cofactor for **pyridoxine 5'-phosphate oxidase**, the enzyme that converts pyridoxine 5'-phosphate and pyridoxamine 5'-phosphate to the active form **pyridoxal 5'-phosphate (PLP)**. Riboflavin deficiency impairs this conversion, leading to **functional vitamin B6 deficiency** even with adequate dietary pyridoxine intake. *1 only* - This option is incorrect because it ignores the well-established biochemical relationship between riboflavin and pyridoxine metabolism. Both statements are factually accurate. *2 only* - This option is incorrect because statement 1 is definitively correct. Thiamine deficiency is a classic cause of **pyruvic and lactic acid accumulation** due to impaired oxidative decarboxylation. *Neither 1 nor 2* - This option is incorrect as both statements are medically and biochemically accurate, reflecting established vitamin interdependencies and metabolic pathways.

Q: Other than cataract, which one among the following is the highest prevalent cause of blindness in the world ?

Glaucoma. ***Glaucoma*** - **Glaucoma** is the **second leading cause of blindness globally** after cataract, accounting for approximately 12-15% of all cases of blindness worldwide. - It is a group of eye conditions that damage the optic nerve, often due to elevated intraocular pressure, leading to **irreversible vision loss**. - Unlike cataract, glaucoma-induced blindness is **irreversible**, making it a major public health concern. - The prevalence is particularly high in older populations and varies by type (primary open-angle, angle-closure, etc.). *Corneal opacity* - **Corneal opacity** is an important cause of blindness, especially in developing countries, resulting from infections (corneal ulcers), trauma, vitamin A deficiency, and trachoma sequelae. - While significant, it accounts for approximately 4-5% of global blindness, ranking **below glaucoma** in overall prevalence. - Prevention through nutrition programs and timely treatment of infections has reduced its burden. *Trachoma* - **Trachoma**, caused by *Chlamydia trachomatis*, is a chronic keratoconjunctivitis and was historically a leading infectious cause of blindness. - Due to WHO's GET2020 (Global Elimination of Trachoma by 2020) initiative and SAFE strategy (Surgery, Antibiotics, Facial cleanliness, Environmental improvement), its prevalence has **declined significantly**. - It now accounts for less than 3% of global blindness. *Diabetic retinopathy* - **Diabetic retinopathy** is a growing cause of blindness, particularly in developed countries and among working-age adults, due to the diabetes epidemic. - It accounts for approximately 5% of global blindness. - While its prevalence is increasing, it remains **below glaucoma** as a cause of global blindness.

Q: In a programme, analysis of results in comparison to cost is known as

Cost benefit analysis. ***Cost benefit analysis*** - In **cost-benefit analysis**, the **benefits of a program** are quantified in monetary terms and then compared directly with the **monetary cost** of the program. - This method is used to determine if the **monetary gain (or benefit)** from a program outweighs its monetary expenditure. *Cost effective analysis* - **Cost-effectiveness analysis** compares the **costs of alternative programs** with their effectiveness, usually measured in natural units suitable for the health outcome (e.g., lives saved, cases cured). - It does not assign a monetary value to the health outcome but rather identifies the intervention that achieves the **desired outcome at the lowest cost** or the maximum outcome for a given cost. *Management by objectives* - **Management by objectives (MBO)** is a strategic management model that aims to improve organizational performance by clearly defining objectives that are agreed to by both management and employees. - This concept is primarily about **setting goals and tracking performance** within an organization, not about analyzing program costs versus outcomes. *Cost utility study* - A **cost-utility analysis (CUA)** is a type of cost-effectiveness analysis where the health outcome is measured in **quality-adjusted life years (QALYs)** or disability-adjusted life years (DALYs). - It accounts for both the **quantity and quality of life**, but it still does not express benefits in direct monetary terms.

Q: The degree to which a specific health care intervention achieves its objectives, when applied in a given population, is termed as its

Effectiveness. ***Effectiveness*** - **Effectiveness** measures how well an intervention performs in a **real-world setting** under usual conditions in a given population [1] - It assesses the degree to which a healthcare intervention achieves its **intended objectives** when applied in actual practice (as opposed to controlled trial conditions) [1] - Key distinction: effectiveness = real-world performance; efficacy = performance under ideal/controlled conditions [1] *Sensitivity* - **Sensitivity** is a diagnostic test parameter measuring the proportion of actual positive cases correctly identified by the test - It relates to **test accuracy**, not to the achievement of intervention objectives in a population *Impact* - **Impact** refers to the broader, longer-term consequences of an intervention on **health outcomes** or population health status - While related to effectiveness, impact is a more **comprehensive measure** that includes indirect effects and long-term changes, not just the direct achievement of specific intervention objectives [1] *Efficiency* - **Efficiency** relates to the relationship between **resources used** (cost, time, personnel) and **results achieved** - It addresses whether an intervention achieves its objectives with **optimal resource utilization**, focusing on cost-effectiveness rather than simply whether objectives are met

Q: ICDS Scheme does not include

Primary school children. ***Primary school children*** - The **Integrated Child Development Services (ICDS) Scheme** primarily targets vulnerable groups like children under **six years of age**, pregnant women, and lactating mothers for integrated health, nutrition, and early learning services. - **Primary school children** (typically aged 6 and above) fall outside the core beneficiary group of the ICDS Scheme, as they are covered by other educational and health programs. *Pregnant women* - **Pregnant women** are a key beneficiary group under ICDS, receiving nutritional supplements, health check-ups, and health and nutrition education. - These services aim to improve maternal health outcomes and the health of the unborn child. *Children in the age group of 0-6 years* - **Children aged 0-6 years** are the primary beneficiaries of the ICDS Scheme, receiving supplementary nutrition, immunization, health check-ups, and pre-school education. - This age group is critical for growth and development, making them a central focus of the program. *Lactating women* - **Lactating women** are a crucial beneficiary group under ICDS, similar to pregnant women, receiving nutritional support, health services, and counseling on infant and young child feeding practices. - Support for lactating mothers is essential for ensuring proper nutrition for both the mother and the breastfeeding infant.

Q: Which one of the following is the correct chronological sequence in which the national programs were launched in India for the given diseases ?

Malaria, Filaria, TB, Anemia. **Correct Answer: Malaria, Filaria, TB, Anemia** - The correct chronological order of program launches is **National Malaria Control Programme (1953)**, **National Filaria Control Programme (1955)**, **National Tuberculosis Programme (1962)**, and **National Anaemia Prophylaxis Programme (1970)**. - This sequence reflects the historical public health priorities and disease burden observed in India during the mid-20th century. - Malaria and Filaria were among the earliest major disease control initiatives in post-independence India. *Incorrect: Malaria, Anemia, Filaria, TB* - This option incorrectly places **Anemia** (1970) before **Filaria** (1955) and **TB** (1962). - The National Anaemia Prophylaxis Programme was launched much later than the Filaria and TB control programs. *Incorrect: Anemia, Filaria, TB, Malaria* - This sequence is incorrect as **Anemia** (1970) is placed first, while the National Malaria Control Programme (1953) was actually one of the earliest major disease control initiatives. - Malaria was a primary focus of public health efforts in the early post-independence era. *Incorrect: Anemia, TB, Malaria, Filaria* - This option is completely incorrect as **Anemia** (1970) is placed first instead of last. - The actual sequence shows Malaria (1953) and Filaria (1955) were addressed much earlier than TB (1962) and Anemia (1970).

Q: To understand the relationship between weight and height of a group of school children, the data can graphically be best depicted through

Scatter diagram. ***Scatter diagram*** - A **scatter diagram** (also called a scatter plot) is ideal for showing the relationship between **two continuous variables**, such as weight and height. - Each point on the graph represents an individual's paired values for weight and height, allowing visual identification of **patterns or correlations**. *Histogram* - A **histogram** is used to display the distribution of **a single continuous variable**, showing the frequency of data points within specific intervals or bins. - It would not effectively demonstrate the **relationship or correlation** between two variables simultaneously. *Bar diagram* - A **bar diagram** (or bar chart) is typically used for comparing **categorical data** or discrete values, showing frequencies or proportions for different categories. - It is not suitable for visualizing the relationship between **two continuous numerical variables** like weight and height. *Pictogram* - A **pictogram** uses images or symbols to represent data, often used for presenting simple statistics to a general audience. - It is generally used for **categorical data** or simple comparisons and lacks the precision needed to display the continuous relationship between weight and height.

Q: In a normal curve, the area of one standard deviation around the mean includes which of the following per cent of values in a distribution ?

68.3%. ***68.3%*** - In a **normal distribution**, approximately 68.3% of the data falls within **one standard deviation** (±1σ) of the mean. - This is a fundamental property of the **empirical rule** (68-95-99.7 rule) applied to normally distributed data. *95.4%* - This percentage represents the data within **two standard deviations** (±2σ) of the mean in a normal distribution. - It is often rounded to 95% for confidence intervals, but the precise value is 95.4%. *48.6%* - This value does not correspond to a standard interval around the mean in a **normal distribution**. - It might be a distracter derived from incorrectly calculating or misremembering the percentages of the empirical rule. *99.7%* - This percentage represents the data within **three standard deviations** (±3σ) of the mean in a normal distribution. - It indicates that almost all data points in a normal curve lie within this range.

Q: In which system, continuous enumeration of births and deaths by enumerator and an independent survey by investigator supervisor is done?

Sample Registration System. ***Sample Registration System*** - This system employs a **dual record approach** where a local enumerator continuously records vital events (births and deaths), and an independent investigator supervisor conducts periodic surveys. - The combination of continuous enumeration and independent surveys helps to improve the **accuracy and completeness** of vital statistics by cross-checking data. *Decadal census enumeration* - This involves a **complete enumeration** of the population, typically conducted every ten years, to gather demographic and social data. - While it collects population counts and some vital statistics, it is not designed for **continuous monitoring** or a dual-record system for births and deaths. *Model Registration System* - This system focuses on developing and testing **improved methods** for vital event registration in a localized or pilot area. - It is not a nationwide system for continuous enumeration and independent surveys, but rather a framework for **methodological development**. *National Family Health Survey* - This is a large-scale, multi-round survey that provides data on **family health, fertility, child mortality**, and other health indicators. - It uses **recall methods** and questionnaires to collect data from households and does not involve continuous enumeration of births and deaths by enumerators or independent supervisor verification.

Q: The following are all residual insecticides except

Pyrethrum. ***Pyrethrum*** - **Pyrethrum** is a **non-residual insecticide**, meaning its effects are short-lived, typically lasting hours to a few days. - It is derived from **chrysanthemum flowers** and is known for its rapid knockdown effect but lacks persistent activity against insects. *Gamma BHC* - **Gamma BHC (lindane)** is a **residual insecticide** known for its prolonged activity against a wide range of insects. - It is an **organochlorine insecticide** that persists in the environment and on surfaces for extended periods. *Malathion* - **Malathion** is a **residual insecticide** belonging to the **organophosphate class**. - It leaves an active residue on surfaces for several days to weeks, providing continuous insect control. *DDT* - **DDT** is a highly effective and long-lasting **residual insecticide** that was widely used for many years. - Its **persistence in the environment** is one of its defining characteristics, making it effective for sustained insect control, though it is now largely banned due to environmental concerns.

Question 1

Consider the following statements :

1. The deficiency of thiamine leads to the accumulation of pyruvic and lactic acids in the body.
2. Riboflavin deficiency impairs the optimal utilization of pyridoxine. Which of the statements given above is/are correct ?

Accepted Answer

Both 1 and 2

Answer

1 only

Answer

2 only

Answer

Neither 1 nor 2

Question 2

Other than cataract, which one among the following is the highest prevalent cause of blindness in the world ?

Accepted Answer

Glaucoma

Answer

Trachoma

Answer

Corneal opacity

Answer

Diabetic retinopathy

Question 3

In a programme, analysis of results in comparison to cost is known as

Accepted Answer

Cost benefit analysis

Answer

Cost effective analysis

Answer

Management by objectives

Answer

Cost utility study

Question 4

The degree to which a specific health care intervention achieves its objectives, when applied in a given population, is termed as its

Accepted Answer

Effectiveness

Answer

Sensitivity

Answer

Impact

Answer

Efficiency

Question 5

ICDS Scheme does not include

Accepted Answer

Primary school children

Answer

Pregnant women

Answer

Children in the age group of 0-6 years

Answer

Lactating women

Question 6

Which one of the following is the correct chronological sequence in which the national programs were launched in India for the given diseases ?

Accepted Answer

Malaria, Filaria, TB, Anemia

Answer

Malaria, Anemia, Filaria, TB

Answer

Anemia, Filaria, TB, Malaria

Answer

Anemia, TB, Malaria, Filaria

Question 7

To understand the relationship between weight and height of a group of school children, the data can graphically be best depicted through

Accepted Answer

Scatter diagram

Answer

Histogram

Answer

Bar diagram

Answer

Pictogram

Question 8

In a normal curve, the area of one standard deviation around the mean includes which of the following per cent of values in a distribution ?

Accepted Answer

68.3%

Answer

95.4%

Answer

48.6%

Answer

99.7%

Question 9

In which system, continuous enumeration of births and deaths by enumerator and an independent survey by investigator supervisor is done?

Accepted Answer

Sample Registration System

Answer

Decadal census enumeration

Answer

Model Registration System

Answer

National Family Health Survey

Question 10

The following are all residual insecticides except

Accepted Answer

Pyrethrum

Answer

Gamma BHC

Answer

Malathion

Answer

DDT

UPSC-CMS 2009

Biochemistry

Community Medicine