UPSC-CMS 2018 Practice Questions

Q: Which one of the following conditions can be screened during neonatal screening by biochemical tests?

Congenital hypothyroidism. ***Congenital hypothyroidism*** - **Neonatal screening** for congenital hypothyroidism is a standard practice, using biochemical tests to measure **thyroid-stimulating hormone (TSH)** and **thyroxine (T4)** levels in dried blood spots. - Early detection and treatment prevent severe **intellectual disability** and developmental delays caused by thyroid hormone deficiency. *Congenital dislocation of hip* - This condition is primarily screened through **physical examination** (e.g., Ortolani and Barlow maneuvers) and imaging (e.g., ultrasound), not biochemical tests. - It involves a structural abnormality of the hip joint, not a metabolic or biochemical disorder. *Congenital rubella* - Diagnosis of congenital rubella involves detecting **rubella-specific IgM antibodies** or viral RNA, which are immunological/virological tests, not typical biochemical screening. - This is an infectious disease, not an inborn error of metabolism screened biochemically. *Chromosomal abnormalities* - Conditions like Down syndrome (Trisomy 21) are detected through **karyotyping** or **genetic tests**, which examine the number and structure of chromosomes. - While some biochemical markers are used in prenatal screening for chromosomal abnormalities (e.g., quad screen), direct neonatal screening for chromosomal abnormalities is not performed via general biochemical tests.

Q: By which one of the following studies can relative risk be best calculated?

Cohort study. ***Cohort study*** - A cohort study directly follows groups of individuals (cohorts) over time to observe the **incidence of disease** in exposed versus unexposed groups. - This design allows for the direct calculation of **absolute risks** in each group, from which the **relative risk** can be easily derived. *Correlation study* - A correlation study examines the **relationship between variables** in a population, often using aggregated data, but does not follow individuals over time to assess incidence. - It can identify associations between exposures and outcomes but cannot calculate relative risk directly because it does not provide individual risk data. *Case-control study* - A case-control study compares individuals with a disease (cases) to individuals without the disease (controls) and looks back in time to determine past exposures. - While it can estimate the **odds ratio**, which approximates relative risk when the disease is rare, it cannot directly calculate relative risk because it does not provide the incidence of the disease in exposed versus unexposed populations. *Randomised control trial* - A randomized controlled trial (RCT) is an experimental study where participants are randomly assigned to an intervention or control group to assess the efficacy of an intervention. - While RCTs can calculate relative risk, they are primarily designed to establish **causality** and intervention effectiveness, not to investigate risk factors in naturally occurring populations in the same way a cohort study does for epidemiological insight.

Q: Orthotolidine (OT) test is done for determining residual free chlorine quantitatively and qualitatively. What is the colour of the solution after adding OT which indicates presence of free chlorine?

Yellow. ***Yellow*** - The **Orthotolidine (OT) test** historically was used to detect and quantify residual **free chlorine** in water. - When Orthotolidine reagent is added to water containing free chlorine, it produces a **yellow color**, with the intensity of the yellow directly proportional to the amount of free chlorine present. - **Important Note:** The OT test has been **discontinued and is no longer recommended** due to orthotolidine being a **suspected carcinogen**. It has been replaced by safer methods like the **DPD (N,N-diethyl-p-phenylenediamine) test**, which also detects free chlorine but uses a safer reagent. *Blue* - A blue color is not associated with the Orthotolidine test for free chlorine. - Other water quality tests or reagents might yield a blue color for different parameters. *Green* - A green color does not indicate the presence of free chlorine in the Orthotolidine test. - It may suggest interference from other substances or mixed reactions. *Red* - A red color is not the characteristic indicator for free chlorine in the Orthotolidine test. - Red or pink colors are associated with the **DPD method** (the current standard test), which produces a pink/red color in the presence of free chlorine.

Q: Consider the following in respect of Navjyot Shishu Suraksha Karyakram (NSSK): 1. It is a programme aimed to train health personnel in basic newborn care and resuscitation 2. It addresses care at birth issues (i.e. prevention of hypothermia, prevention of infection, early initiation of breastfeeding and basic newborn resuscitation) 3. The objective is to have a trained health person in basic newborn care and resuscitation at every delivery point Which of the statements given above are correct?

1, 2 and 3. ***1, 2 and 3*** - The **Navjyot Shishu Suraksha Karyakram (NSSK)** focuses on training healthcare personnel in **basic newborn care and resuscitation** to reduce neonatal mortality. - It addresses critical **care at birth issues**, including preventing **hypothermia**, preventing **infections**, promoting **early breastfeeding initiation**, and providing **basic newborn resuscitation**. The overarching objective is to ensure that a trained health person is available at **every delivery point** to provide essential newborn care. *1 and 2 only* - This option incorrectly excludes the third statement regarding the objective of having a trained health person at every delivery point. - The target of ensuring trained personnel at every birth is a core component and objective of the NSSK. *2 and 3 only* - This option incorrectly excludes the first statement, which details the primary function of training health personnel. - The NSSK is fundamentally a training program designed to equip healthcare providers with the necessary skills. *1 and 3 only* - This option incorrectly excludes the second statement, which outlines the specific care at birth issues addressed by the program. - The identified issues such as preventing hypothermia, infection, and promoting breastfeeding are central to the effectiveness of the NSSK.

Q: The most important indicator for assessment of impact in Salt Iodization Programme is:

Testing median urinary iodine excretion. ***Testing median urinary iodine excretion*** - **Urinary iodine excretion** is the most reliable biochemical indicator of recent **iodine intake** and is considered the best measure for assessing the iodine status of a population. - The **median urinary iodine concentration** is used to categorize a population's iodine nutrition status as deficient, adequate, or in excess, providing a direct measure of programme impact. *Testing iodine content of salt at consumer level* - While important for monitoring **salt iodization efforts**, this only reflects the availability of iodized salt, not necessarily the actual **iodine intake** or nutritional status of the consumers. - Salt content can degrade over time due to improper storage, heat, and humidity, leading to discrepancies between the salt's iodine content and the iodine actually consumed. *Testing iodine content of salt at production level* - This is crucial for **quality control** and ensuring compliance with iodization standards at the source. - However, it does not account for potential **iodine loss** during transport, storage, and household use, nor does it directly reflect the population's actual iodine status. *Testing serum iodine levels* - **Serum iodine levels** are primarily regulated by the thyroid gland and are not a sensitive indicator of a population's *recent iodine intake* or overall iodine nutrition status. - These levels are often maintained within a narrow range even with varying intake, making them less useful for monitoring large-scale intervention programmes like **salt iodization**.

Q: Caisson’s disease is usually seen in which group of workers?

Construction workers under sea level. ***Construction workers under sea level*** - **Caisson's disease**, also known as **decompression sickness** or **the bends**, occurs when individuals experience a rapid decrease in surrounding pressure. - Workers such as **divers, underwater construction workers, and tunnel builders** often work in high-pressure environments and are at risk if they ascend too quickly. *Workers in manufacture of gas* - While gas manufacturing can involve exposure to various chemicals and potential respiratory hazards, it does not typically involve the significant changes in **ambient pressure** that cause Caisson's disease. - This profession is not associated with the **rapid decompression** necessary for nitrogen bubbles to form in tissues. *Workers in radiation units* - Workers in radiation units are at risk of conditions related to **ionizing radiation exposure**, such as cancer or radiation sickness. - Their work environment does not involve changes in **pressure** that lead to Caisson's disease. *Cotton field agricultural workers* - Agricultural workers in cotton fields may suffer from respiratory conditions like **byssinosis** ("brown lung") due to cotton dust exposure. - Their work environment does not involve **hyperbaric conditions** or rapid decompression, which are prerequisites for Caisson's disease.

Q: These toxic effects like abdominal colic, obstinate constipation, loss of appetite, anaemia, stippling of red cells and blue line on gums are due to exposure to:

Lead. ***Lead*** - The constellation of symptoms including **abdominal colic**, **obstinate constipation**, **loss of appetite**, **anemia**, **stippling of red cells**, and a **blue line on the gums (Burton's line)** are classic manifestations of **chronic lead poisoning**. - Lead interferes with multiple organ systems, notably the **gastrointestinal**, **hematologic**, and **nervous systems**, causing these specific toxic effects. *Carbon monoxide* - **Carbon monoxide poisoning** primarily affects oxygen transport, leading to symptoms like headache, dizziness, nausea, and in severe cases, coma and death. - It does not cause abdominal colic, obstinate constipation, stippling of red cells, or a blue line on the gums. *Radiation* - **Radiation exposure** can lead to acute radiation syndrome with symptoms like nausea, vomiting, fatigue, hair loss, and damage to rapidly dividing cells, or long-term effects like cancer. - The symptoms described in the question are not characteristic of radiation sickness or exposure. *Asbestos* - **Asbestos exposure** is primarily associated with respiratory illnesses such as **asbestosis**, **mesothelioma**, and **lung cancer**, which develop many years after exposure. - It does not cause acute abdominal symptoms, anemia with red cell stippling, or a blue line on the gums.

Q: Which of the following is NOT a mass approach in health communication?

Role play. ***Role play*** - **Role play** is an **interpersonal** or **group communication** technique where individuals act out scenarios to practice skills or understand different perspectives. - It is not a **mass media approach** as it involves direct, interactive participation with a limited number of people. *Posters* - **Posters** are visual aids designed to convey information to a large, undifferentiated audience in public spaces. - They are a classic example of **mass communication** due to their wide reach and static display. *Health exhibition* - A **health exhibition** is a public event designed to educate a large number of people about health topics through various displays, stalls, and interactive presentations. - Such exhibitions utilize a range of media to reach a broad audience, making them a **mass approach**. *Folk methods* - **Folk methods** in health communication include traditional storytelling, skits, and songs performed by local artists or groups in public settings. - These methods are used to disseminate health messages to a community or large gathering, leveraging cultural resonance for **mass appeal**.

Q: Which of the following are non-modifiable risk factors for hypertension? 1. Age 2. Sex 3. Genetic factors Select the correct answer using the code given below:

1, 2 and 3. ***1, 2 and 3*** - **Age** is a significant non-modifiable risk factor for hypertension; blood pressure tends to increase with advancing age due to arterial stiffness and other physiological changes. - While lifestyle and environmental factors play a role, **genetic predisposition** (hereditary factors) is a well-established non-modifiable risk factor that influences an individual's susceptibility to hypertension. - **Sex** is also considered a non-modifiable risk factor, as hormonal differences and physiological variations between biological sexes influence the prevalence and progression of hypertension across different life stages. *1 only* - This option is incomplete as it excludes other well-recognized non-modifiable risk factors like **sex** and **genetic factors**. - While **age** is a crucial non-modifiable risk factor, focusing solely on it would overlook a comprehensive understanding of inherent risks. *1 and 2 only* - This option incorrectly omits **genetic factors**, which are fundamental non-modifiable determinants of hypertension risk. - Although **age** and **sex** are valid non-modifiable factors, the absence of **genetic predisposition** makes this option incomplete. *2 and 3 only* - This option incorrectly excludes **age**, which is one of the most prominent non-modifiable risk factors for hypertension, as blood pressure generally rises with age. - Omitting **age** from the list of non-modifiable factors provides an incomplete understanding of inherent hypertension risks.

Q: What is the correct daily dose of Iron and Folic acid to be prescribed to a child aged 12 years?

60 mg elemental Iron and 300 mcg folic acid. ***60 mg elemental Iron and 300 mcg folic acid*** - This is the **standard daily prophylactic dose** recommended for children aged 10-19 years (adolescents) in India as per **WIFS (Weekly Iron and Folic Acid Supplementation) program** when given daily. - Aligns with **ICMR and National Iron+ Initiative** guidelines for daily supplementation in adolescents. - This dose provides adequate iron for growth requirements and prevention of **nutritional anemia** in this age group. *20 mg elemental Iron and 100 mcg folic acid* - This dose is **too low** for a 12-year-old child and does not meet the iron requirements for adolescents. - This might be appropriate for younger children (6-59 months) but is **inadequate for adolescent growth and development**. - Would not effectively prevent iron deficiency anemia in this age group. *100 mg elemental Iron and 500 mcg folic acid* - This is the dose recommended for **weekly prophylactic supplementation** under the WIFS program, not for daily use. - When used daily, this dose may be used for **treatment of established iron deficiency anemia** rather than routine prophylaxis. - Daily use at this dose may cause **gastrointestinal side effects** like nausea and constipation. *30 mg elemental Iron and 250 mcg folic acid* - This dose is **intermediate but not standard** as per Indian guidelines for this age group. - Does not align with recommended protocols for adolescent supplementation. - Provides suboptimal iron for the growth spurt and increased requirements in 12-year-olds.

Question 1

Which one of the following conditions can be screened during neonatal screening by biochemical tests?

Accepted Answer

Congenital hypothyroidism

Answer

Congenital dislocation of hip

Answer

Congenital rubella

Answer

Chromosomal abnormalities

Question 2

By which one of the following studies can relative risk be best calculated?

Accepted Answer

Cohort study

Answer

Correlation study

Answer

Case-control study

Answer

Randomised control trial

Question 3

Orthotolidine (OT) test is done for determining residual free chlorine quantitatively and qualitatively. What is the colour of the solution after adding OT which indicates presence of free chlorine?

Accepted Answer

Yellow

Answer

Blue

Answer

Green

Answer

Red

Question 4

Consider the following in respect of Navjyot Shishu Suraksha Karyakram (NSSK):

1. It is a programme aimed to train health personnel in basic newborn care and resuscitation
2. It addresses care at birth issues (i.e. prevention of hypothermia, prevention of infection, early initiation of breastfeeding and basic newborn resuscitation)
3. The objective is to have a trained health person in basic newborn care and resuscitation at every delivery point

Which of the statements given above are correct?

Accepted Answer

1, 2 and 3

Answer

1 and 2 only

Answer

2 and 3 only

Answer

1 and 3 only

Question 5

The most important indicator for assessment of impact in Salt Iodization Programme is:

Accepted Answer

Testing median urinary iodine excretion

Answer

Testing Iodine content of salt at consumer level

Answer

Testing iodine content of salt at production level

Answer

Testing serum iodine levels

Question 6

Caisson’s disease is usually seen in which group of workers?

Accepted Answer

Construction workers under sea level

Answer

Workers in manufacture of gas

Answer

Workers in radiation units

Answer

Cotton field agricultural workers

Question 7

These toxic effects like abdominal colic, obstinate constipation, loss of appetite, anaemia, stippling of red cells and blue line on gums are due to exposure to:

Accepted Answer

Lead

Answer

Carbon monoxide

Answer

Radiation

Answer

Asbestos

Question 8

Which of the following is NOT a mass approach in health communication?

Accepted Answer

Role play

Answer

Posters

Answer

Health exhibition

Answer

Folk methods

Question 9

Which of the following are non-modifiable risk factors for hypertension?

1. Age
2. Sex
3. Genetic factors

Select the correct answer using the code given below:

Accepted Answer

1, 2 and 3

Answer

1 only

Answer

1 and 2 only

Answer

2 and 3 only

Question 10

What is the correct daily dose of Iron and Folic acid to be prescribed to a child aged 12 years?

Accepted Answer

60 mg elemental Iron and 300 mcg folic acid

Answer

30 mg elemental Iron and 250 mcg folic acid

Answer

20 mg elemental Iron and 100 mcg folic acid

Answer

100 mg elemental Iron and 500 mcg folic acid

UPSC-CMS 2018

Biochemistry

Community Medicine

Pharmacology