UPSC-CMS 2017 Practice Questions

Q: By applying the principles of ergonomics which of the following can be improved? 1. Designing of equipment and tools 2. Human efficiency 3. Layout of place of work 4. Reduction in industrial accidents Select the correct answer using the code given below:

1, 2, 3 and 4. ***1, 2, 3 and 4*** - **Ergonomics** is the science of designing and arranging workplaces, products, and systems so that they fit the people who use them, thereby improving **human efficiency**, safety, and comfort. - By optimizing the interaction between humans and their work environment, ergonomics directly impacts the **design of equipment and tools**, the **layout of the workplace**, and significantly contributes to the **reduction of industrial accidents**. *1, 3 and 4 only* - This option incorrectly excludes **human efficiency** as an outcome of applying ergonomic principles. - A primary goal of ergonomics is to enhance human performance and well-being, which directly translates to improved efficiency. *2, 3 and 4 only* - This option incorrectly excludes the **designing of equipment and tools** from the benefits of ergonomics. - Ergonomics is fundamentally applied in the design phase to ensure tools and equipment are user-friendly, safe, and effective. *1, 2 and 3 only* - This option incorrectly excludes the **reduction in industrial accidents** as a benefit of ergonomics. - By designing safer interfaces and work environments, ergonomics plays a crucial role in preventing workplace injuries and accidents.

Q: The risk of disease is measured by

Incidence Rate. ***Incidence Rate*** - **Incidence rate** measures the frequency of developing a new disease in a population over a specific period, thus directly reflecting the **risk** of disease occurrence. - It considers the number of **new cases** divided by the population at risk and provides insight into the dynamic process of becoming ill. *Prevalence Rate* - **Prevalence rate** measures the total number of existing cases of a disease in a population at a specific point in time or over a period. - It reflects the **burden** of disease but not the risk, as it includes both new and old cases. *Fatality Rate* - **Fatality rate** or **case fatality rate (CFR)** measures the proportion of individuals diagnosed with a disease who die from that disease. - It reflects the **severity** or prognosis of a disease, not the risk of acquiring it. *Attrition Rate* - **Attrition rate** refers to the rate of participants dropping out of a study or employees leaving an organization. - It is an indicator of **retention** or loss in a population, not the risk of disease.

Q: Which is/are the correct statements regarding the cut off points for the diagnosis of anaemia? 1. Haemoglobin for adult males is 13 g/dl 2. Haemoglobin for adult non-pregnant female is 12 g/dl 3. Haemoglobin for adult pregnant female is 11 g/dl 4. Haemoglobin for children six months to six years of age is 11 g/dl Select the correct answer using the code given below:

1, 2, 3 and 4. ***1, 2, 3 and 4*** - All four statements correctly represent the **World Health Organization (WHO) hemoglobin cut-off points** for diagnosing **anemia** across different population groups. - These standardized values are used globally for **screening, diagnosis, and public health surveillance** of anemia. - **Adult males: <13 g/dL**, **non-pregnant females: <12 g/dL**, **pregnant females: <11 g/dL**, and **children (6 months-6 years): <11 g/dL** are the accepted thresholds. *1 and 3 only* - This option incorrectly excludes statements 2 and 4, which are also valid WHO criteria. - Missing the cut-offs for non-pregnant women (12 g/dL) and young children (11 g/dL) would result in incomplete anemia assessment. *1 only* - This option is far too restrictive, acknowledging only the hemoglobin threshold for adult males. - It ignores the correct and distinct criteria for **women (pregnant and non-pregnant)** and **children**, which are essential for comprehensive anemia diagnosis. *2 and 4 only* - This option incorrectly omits statements 1 and 3, which are equally valid. - Excluding the hemoglobin cut-offs for adult males (13 g/dL) and pregnant women (11 g/dL) provides an incomplete picture of WHO anemia criteria.

Q: Health functionary at PHC level is:

Health Assistant (Female). ***Health Assistant (Female)*** - The **Health Assistant (Female)**, also known as the Block Extension Educator or Lady Health Visitor, supervises the work of multiple **Health Workers (Female)** and is primarily stationed at the **Primary Health Centre (PHC)** level in India. - Their role involves providing administrative and technical support, training, and supervision to grassroots health functionaries, making them a key health functionary at the PHC level. *Anganwadi Worker* - An **Anganwadi Worker** operates at the village level, typically managing an Anganwadi centre, which is primarily focused on children's health, nutrition, and early childhood education. - While they are important community health volunteers, they are not considered a primary health functionary at the PHC level, but rather work under the Integrated Child Development Services (ICDS) scheme. *Health Worker (Female)* - A **Health Worker (Female)**, also known as an Auxiliary Nurse Midwife (ANM), is a grassroots-level functionary, usually based at the **Sub-Centre (SC)**, which is below the PHC level. - They provide direct primary healthcare services to a defined population within a cluster of villages, and are supervised by the Health Assistant (Female) at the PHC. *ASHA* - An **ASHA (Accredited Social Health Activist)** is a community health volunteer who acts as a crucial link between the community and the public health system. - They operate at the village level, working primarily as a mobilizer, health educator, and facilitator for accessing health services, rather than a health functionary stationed at the PHC.

Q: Due to a measles outbreak in a community, a medical officer decided to immunize a child aged seven months with measles vaccine. When should the next measles vaccine be administered?

When the child completes nine months of age. ***When the child completes nine months of age*** - A measles vaccine given at **seven months during an outbreak** is considered a **zero-dose** or **early dose** and does NOT replace the routine immunization schedule. - According to the **Indian National Immunization Schedule**, the routine first dose of measles vaccine (MR vaccine) is given at **9 months of age**, regardless of whether an earlier outbreak dose was administered. - Vaccines given before 9 months have **reduced efficacy** due to interference from maternal antibodies, making the 9-month dose essential for adequate seroconversion. - After the 9-month dose, a second dose is given at **16-24 months** as per routine schedule. *When the child completes fifteen months of age* - While 15-18 months is appropriate timing for the **second dose** of measles vaccine in the routine schedule, it is not the immediate next dose after a 7-month outbreak vaccination. - The child still requires the **routine 9-month dose first**, followed by the second dose at 16-24 months. - Skipping the 9-month dose and going directly to 15 months would leave a prolonged gap without adequate protection. *Not required* - This is **incorrect** because early doses given before 9 months are considered zero-doses and do not provide reliable long-term immunity. - The routine schedule **must still be followed** to ensure proper immunization, starting with the 9-month dose. *After four weeks* - A four-week interval after the 7-month dose is **too short** and not recommended in immunization guidelines. - There is **no indication** for such an early repeat dose; the child should wait until the routine 9-month schedule for the next dose.

Q: Which of the following is/are the methods of assessment of nutritional status? 1. Clinical examination 2. Anthropometry 3. Biochemical evaluation 4. Orthotolidine test Select the correct answer using the code given below:

1, 2 and 3 only. ***1, 2 and 3 only*** - **Clinical examination** involves assessing physical signs of nutrient deficiencies or excesses. This includes inspecting for signs like **pallor** (iron deficiency), **cheilosis** (riboflavin deficiency), or **edema** (protein-energy malnutrition). - **Anthropometry** uses body measurements like **height, weight, body mass index (BMI), and skinfold thickness** to assess body composition and identify abnormalities such as **underweight, overweight, obesity, and stunting**. - **Biochemical evaluation** involves laboratory tests on blood or urine samples to measure nutrient levels (e.g., **serum albumin, ferritin, vitamin D**) or metabolic markers indicative of nutritional status. *1 only* - While **clinical examination** is a crucial component of nutritional assessment, it alone does not provide a comprehensive picture. - It may miss subclinical deficiencies or excesses that require further investigation through other methods. *1 and 3 only* - This option correctly identifies **clinical examination** and **biochemical evaluation** as assessment methods, but it incorrectly excludes **anthropometry**. - **Anthropometry** is fundamental for assessing growth, body composition, and identifying specific nutritional problems like **underweight, obesity, and stunting**. *1, 2, 3 and 4* - This option includes methods 1, 2, and 3, which are indeed correct methods for nutritional assessment. - However, the **Orthotolidine test** (method 4) is used to detect **blood in urine or feces**, specifically for investigating conditions like **gastrointestinal bleeding**, and is not a direct method for assessing general nutritional status.

Q: Retrospective cohort studies have the following features EXCEPT:

Generally more expensive than prospective studies. ***Generally more expensive than prospective studies*** - Retrospective cohort studies are typically **less expensive** than prospective studies because they utilize existing data, thus avoiding the costs associated with new data collection and long-term follow-up. - The primary expenses in retrospective studies often involve data retrieval and analysis, which are generally lower compared to the extensive resources needed for prospective data acquisition. *Investigator goes back in time to select study groups* - This is a hallmark feature of **retrospective cohort studies**, where researchers define study groups (exposed and unexposed) based on past exposures. - Data collection then proceeds by looking forward from the exposure to identify health outcomes that have already occurred. *Outcomes have occurred before the start of the study* - In a **retrospective cohort study**, both the exposure and the **outcomes of interest** have already taken place before the study officially begins. - Researchers identify existing records to link past exposures to these pre-existing outcomes. *Results are obtained more quickly* - Because all exposures and outcomes have already occurred and data is often readily available, **retrospective studies** can generate results much faster than prospective studies. - They do not require waiting for events to unfold in real-time, which significantly reduces the duration of the research process.

Q: What is the correct sequence of the following levels of prevention? 1. Specific protection 2. Early diagnosis and prompt treatment 3. Disability limitation and rehabilitation 4. Health promotion Select the correct sequence from the code given below:

4, 1, 2, 3. ***4, 1, 2, 3*** - The correct sequence of prevention levels starts with **health promotion** (primary prevention), followed by **specific protection** (also primary prevention, but more targeted). - It then moves to **early diagnosis and prompt treatment** (secondary prevention), and finally to **disability limitation and rehabilitation** (tertiary prevention). *3, 4, 1, 2* - This sequence incorrectly places **disability limitation and rehabilitation** (tertiary prevention) at the beginning, which occurs much later in the disease process. - It also scatters the primary prevention components (health promotion and specific protection) rather than grouping them appropriately at the start. *2, 3, 4, 1* - This sequence begins with **early diagnosis and prompt treatment** (secondary prevention), which is not the initial step in the comprehensive prevention model. - It also places **health promotion** and **specific protection** later than they should be, distorting the chronological progression of preventive actions. *1, 2, 3, 4* - This sequence begins with **specific protection**, which is a part of primary prevention but typically follows broader **health promotion** efforts. - It also places **health promotion** (4) as the last step, which is incorrect as it represents the fundamental and initial level of prevention.

Q: Which of the following items are among the uses of epidemiology?

All of these. ***All of these*** - Epidemiology encompasses various applications, and all three listed items are well-established uses of this discipline in public health practice. - Each of the following represents a distinct but complementary application of epidemiological principles. **To study historically the rise and fall of diseases:** - This is a fundamental application of epidemiology, as **epidemiological studies** track disease prevalence and incidence over time to understand their natural history and the impact of interventions. - Historical data helps in predicting future trends, understanding the **etiology** of diseases, and evaluating the effectiveness of public health measures. - This temporal perspective is essential for identifying emerging and re-emerging diseases. **To identify syndromes:** - Epidemiology plays a crucial role in defining and characterizing **syndromes** by observing patterns of symptoms, signs, and associated factors within a population. - This involves statistical analysis to link sets of clinical features to a common underlying condition or exposure. - Classic examples include identifying AIDS as a syndrome and recognizing new clinical entities through pattern recognition. **To arrive at community diagnosis:** - **Community diagnosis** involves assessing the health status of a community, identifying health problems, and determining their causes and risk factors using epidemiological methods. - This process is essential for planning and implementing effective public health interventions and allocating resources appropriately. - It forms the foundation for evidence-based public health planning and policy development.

Q: Tetanus spores can be effectively killed by

Gamma irradiation. ***Gamma irradiation*** - **Gamma irradiation** denatures proteins and damages nucleic acids, effectively destroying bacterial spores like those of *Clostridium tetani*. - This method is used for sterilizing heat-sensitive materials and achieving a high level of **microbial inactivation**. *Anti tetanus Serum* - **Anti-tetanus serum (ATS)** contains pre-formed antibodies that neutralize the circulating tetanus **toxin**, not the spores. - ATS is used for **passive immunization** and treatment of tetanus, but it does not kill the bacterial spores themselves. *Tetanus toxoid* - **Tetanus toxoid** is an inactivated bacterial toxin used to stimulate an immune response and provide **active immunization** against the toxin. - It does not directly kill tetanus spores; instead, it prevents the effects of the toxin produced by the spores. *Large doses of penicillin* - **Penicillin** is an antibiotic that can kill *Clostridium tetani* bacteria, but it is much less effective against the dormant and highly resistant **tetanus spores**. - While it can help eradicate active infection, spores often require more potent physical or chemical sterilization methods.

Question 1

By applying the principles of ergonomics which of the following can be improved?

1. Designing of equipment and tools
2. Human efficiency
3. Layout of place of work
4. Reduction in industrial accidents

Select the correct answer using the code given below:

Accepted Answer

1, 2, 3 and 4

Answer

1, 3 and 4 only

Answer

2, 3 and 4 only

Answer

1, 2 and 3 only

Question 2

The risk of disease is measured by

Accepted Answer

Incidence Rate

Answer

Prevalence Rate

Answer

Fatality Rate

Answer

Attrition Rate

Question 3

Which is/are the correct statements regarding the cut off points for the diagnosis of anaemia?

1. Haemoglobin for adult males is 13 g/dl

2. Haemoglobin for adult non-pregnant female is 12 g/dl

3. Haemoglobin for adult pregnant female is 11 g/dl

4. Haemoglobin for children six months to six years of age is 11 g/dl
Select the correct answer using the code given below:

Accepted Answer

1, 2, 3 and 4

Answer

1 and 3 only

Answer

1 only

Answer

2 and 4 only

Question 4

Health functionary at PHC level is:

Accepted Answer

Health Assistant (Female)

Answer

Anganwadi Worker

Answer

Health Worker (Female)

Answer

ASHA

Question 5

Due to a measles outbreak in a community, a medical officer decided to immunize a child aged seven months with measles vaccine. When should the next measles vaccine be administered?

Accepted Answer

When the child completes nine months of age

Answer

Not required

Answer

When the child completes fifteen months of age

Answer

After four weeks

Question 6

Which of the following is/are the methods of assessment of nutritional status?

1. Clinical examination
2. Anthropometry
3. Biochemical evaluation
4. Orthotolidine test

Select the correct answer using the code given below:

Accepted Answer

1, 2 and 3 only

Answer

1 only

Answer

1 and 3 only

Answer

1, 2, 3 and 4

Question 7

Retrospective cohort studies have the following features EXCEPT:

Accepted Answer

Generally more expensive than prospective studies

Answer

Investigator goes back in time to select study groups

Answer

Outcomes have occurred before the start of the study

Answer

Results are obtained more quickly

Question 8

What is the correct sequence of the following levels of prevention?

1. Specific protection
2. Early diagnosis and prompt treatment
3. Disability limitation and rehabilitation
4. Health promotion
Select the correct sequence from the code given below:

Accepted Answer

4, 1, 2, 3

Answer

3, 4, 1, 2

Answer

2, 3, 4, 1

Answer

1, 2, 3, 4

Question 9

Which of the following items are among the uses of epidemiology?

Accepted Answer

All of these

Answer

To study historically the rise and fall of the diseases

Answer

To identify syndromes

Answer

To arrive at community diagnosis

Question 10

Tetanus spores can be effectively killed by

Accepted Answer

Gamma irradiation

Answer

Anti tetanus Serum

Answer

Tetanus toxoid

Answer

Large doses of penicillin

UPSC-CMS 2017

Community Medicine

Microbiology