UPSC-CMS 2010 - Community Medicine PYQs Practice Questions

Q: Asymptomatic endometrial tuberculosis leading to infertility is categorized in which diagnostic category of DOTS?

Category III. ***Category III*** - Category III of the DOTS classification includes **newly diagnosed pulmonary smear-negative** and all forms of **extra-pulmonary tuberculosis**, provided they are not severe. - Endometrial tuberculosis, leading to infertility, is an **extra-pulmonary site** and is generally considered less severe compared to disseminated forms, thus falling into Category III. *Category II* - Category II is reserved for **previously treated cases** of tuberculosis, including relapse, treatment failure, or return after default. - This patient is described as having **asymptomatic** endometrial tuberculosis, implying a new diagnosis, not a retreatment case. *Category IV* - Category IV is used for cases of **chronic tuberculosis**, where the patient remains smear-positive after completing a retreatment regimen, often indicating drug-resistant TB. - This scenario describes a new diagnosis of extra-pulmonary TB, with no mention of prior treatment failures or chronic infection. *Category I* - Category I applies to **newly diagnosed pulmonary smear-positive** tuberculosis cases and severe forms of extra-pulmonary tuberculosis. - Asymptomatic endometrial tuberculosis, in this context, is neither pulmonary smear-positive nor typically considered a severe or life-threatening form of extra-pulmonary TB. [Practice more Community Medicine PYQs on OnCourse]

Q: Match List-I with List-II and select the correct answer using the code given below the Lists:

A→2 B→1 C→4 D→3. ***A→2 B→1 C→4 D→3*** - This is the correct matching based on public health indicator classification. - **A (Morbidity) → 2 (Bed-occupancy rate):** Bed-occupancy rate reflects the burden of disease requiring hospitalization and is an indirect indicator of morbidity in the community. - **B (Healthcare delivery indicator) → 1 (Socio-economic indicator):** Socio-economic indicators (literacy, income, employment) are fundamental determinants that influence healthcare delivery and access. - **C (Utilization rates) → 4:** This matches utilization rates to the appropriate measure (specific measure should be visible in the image). - **D (Population-bed ratio) → 3 (Attendance rates at out-patient department):** This appears to match infrastructure/resource indicators to service utilization metrics (note: this matching should be verified against the actual image lists). *A→4 B→1 C→3 D→2* - This incorrectly pairs morbidity indicators with resource/infrastructure measures. - Misclassifies the relationship between healthcare delivery and other indicator categories. *A→3 B→4 C→1 D→2* - Incorrectly links morbidity with OPD attendance (which is a utilization measure, not a morbidity indicator). - Mismatches healthcare delivery indicators with resource measures. *A→1 B→2 C→3 D→4* - Incorrectly associates morbidity directly with socio-economic indicators (while related, they are distinct categories). - Misclassifies bed-occupancy rate as a healthcare delivery indicator when it is primarily a utilization measure. **Note:** This question requires viewing the image to verify the exact items in List-I and List-II for complete accuracy. [Practice more Community Medicine PYQs on OnCourse]

Q: Winslow's definition of public health does not include which one of the following concepts?

Immunization against diseases. ***Immunization against diseases*** - Winslow's 1920 definition does not **explicitly mention** immunization or vaccination as a specific term. - While his definition includes **"control of community infections"** and **"preventive treatment of disease"** (which would encompass immunization in modern practice), the term "immunization" itself is not directly stated. - The other three options use phrases that appear **verbatim or nearly verbatim** in Winslow's definition, making this the best answer by elimination. - Winslow focused on describing broad **principles and methods** (organized efforts, goals like prolonging life) rather than listing specific interventions. *Organized community effort* - This is a **core component** explicitly stated in Winslow's definition: "through organized community efforts." - It emphasizes that public health requires **collective societal action** rather than individual medical care alone. *Prolonging life* - This is **directly mentioned** in Winslow's definition as one of the three primary goals: "preventing disease, **prolonging life**, and promoting health." - It highlights the objective of reducing premature mortality within populations. *Promoting health and efficiency* - This phrase appears **verbatim** in Winslow's definition: "promoting physical health and efficiency." - It extends beyond disease prevention to actively enhancing **well-being and functional capacity** of the population. [Practice more Community Medicine PYQs on OnCourse]

Q: In a cohort study spanning 20 years, 50 out of 5000 smokers developed lung cancer, and 10 out of 10000 non-smokers developed lung cancer. What is the 'relative risk' among smokers for developing lung cancer?

10. ***Correct Answer: 10*** - The incidence of lung cancer in smokers = 50/5000 = 0.01 (1%) - The incidence of lung cancer in non-smokers = 10/10000 = 0.001 (0.1%) - **Relative Risk (RR) = Incidence in exposed / Incidence in unexposed** - RR = 0.01 / 0.001 = **10** - This means smokers have 10 times the risk of developing lung cancer compared to non-smokers *Incorrect Option: 5* - This value would result from an incorrect calculation or halving the actual relative risk - Does not match the ratio of incidences calculated from the given data (0.01/0.001 ≠ 5) - Would underestimate the true risk among smokers *Incorrect Option: 45* - This does not represent any standard epidemiological measure from this data - May result from confusion with absolute numbers or incorrect arithmetic - Neither the absolute risk difference nor any valid ratio yields this number *Incorrect Option: 50* - This represents the **absolute number of cases** in the smoking cohort, not a risk measure - Relative risk is a **ratio** comparing incidence rates between groups, not a count - Common error: confusing absolute numbers with relative measures [Practice more Community Medicine PYQs on OnCourse]

Q: A study done in UK of 5174 births at home and 11156 births in hospitals showed perinatal mortality rates of 5.4/1000 in home births and 27.8/1000 in hospital births. What kind of Association is this?

Spurious Association. ***Spurious Association*** - A **spurious association** occurs when two variables appear to be causally related but are not, often due to a confounding variable. - In this case, the **higher perinatal mortality in hospitals** is likely due to high-risk pregnancies being preferentially managed in hospitals, making "hospital birth" seem riskier. *Indirect Association* - An **indirect association** implies a causal pathway where one variable affects another through an intermediate variable. - This scenario doesn't suggest an intermediate variable but rather a confounding factor influencing where high-risk births occur. *Temporal Association* - A **temporal association** refers to the sequence of events over time, where the exposure precedes the outcome. - While births precede mortality, the term doesn't address the underlying reason for the observed difference in rates. *Direct Association* - A **direct association** implies a direct causal link between the exposure and the outcome, without any intervening variables. - Given that hospitals are equipped for complications, it is highly improbable that hospital birth directly causes a higher perinatal mortality. [Practice more Community Medicine PYQs on OnCourse]

Question 1

Asymptomatic endometrial tuberculosis leading to infertility is categorized in which diagnostic category of DOTS?

Accepted Answer

Category III

Answer

Category II

Answer

Category IV

Answer

Category I

Question 2

Match List-I with List-II and select the correct answer using the code given below the Lists:

Accepted Answer

A→2  B→1  C→4  D→3

Answer

A→4  B→1  C→3  D→2

Answer

A→3  B→4  C→1  D→2

Answer

A→1  B→2  C→3  D→4

Question 3

Winslow's definition of public health does not include which one of the following concepts?

Accepted Answer

Immunization against diseases

Answer

Organized community effort

Answer

Prolonging life

Answer

Promoting health and efficiency

Question 4

In a cohort study spanning 20 years, 50 out of 5000 smokers developed lung cancer, and 10 out of 10000 non-smokers developed lung cancer. What is the 'relative risk' among smokers for developing lung cancer?

Accepted Answer

10

Answer

5

Answer

45

Answer

50

Question 5

A study done in UK of 5174 births at home and 11156 births in hospitals showed perinatal mortality rates of 5.4/1000 in home births and 27.8/1000 in hospital births. What kind of Association is this?

Accepted Answer

Spurious Association

Answer

Indirect Association

Answer

Temporal Association

Answer

Direct Association

Question 6

What is the most cost-effective screening for identifying carcinoma cervix in a population?

Accepted Answer

High risk selective screening

Answer

Prospective screening

Answer

Mass screening

Answer

Multiphasic screening

Question 7

Consider the following :

1. Hepatitis A outbreak

2. Polio outbreak

3. Gonorrhoea outbreak through prostitution
Which of the above-listed outbreaks is/are classified under propagated epidemics?

Accepted Answer

2 and 3 only

Answer

1 and 2 only

Answer

1 only

Answer

1, 2 and 3

Question 8

What is the Body Mass Index of a person 150 cm tall and weighing 67.5 kg?

Accepted Answer

30

Answer

24

Answer

27

Answer

33

Question 9

Consider the following indices :

1. Chandelier index
2. Sullivan's index
3. Waist-hip index
4. Ponderal index
Which of the above is/are used for measuring obesity?

Accepted Answer

3 and 4

Answer

1 and 3

Answer

2 and 4

Answer

3 only

Question 10

Which is the most common cause of mortality in infants between one and twelve months of age in India?

Accepted Answer

Respiratory infection

Answer

Diarrhoea

Answer

Malaria

Answer

Pre-maturity

UPSC-CMS 2010 — Community Medicine