UPSC-CMS 2019 Practice Questions

Q: Which one of the following conditions is NOT inborn error of metabolism?

Neural tube defects. ***Neural tube defects*** - Neural tube defects are **birth defects** that occur when the **neural tube** fails to close completely during early fetal development, typically affecting the brain, spinal cord, or both. - While they are congenital, they are not classified as **inborn errors of metabolism** because they primarily result from structural developmental anomalies rather than enzymatic pathway dysfunctions. *Phenylketonuria (PKU)* - PKU is an **autosomal recessive** inborn error of metabolism caused by a deficiency of the enzyme **phenylalanine hydroxylase**, leading to a buildup of phenylalanine. - This enzymatic defect impairs the body's ability to metabolize **phenylalanine**, making it a classic example of an inborn error of metabolism. *Maple syrup urine disease* - This is an **autosomal recessive** inborn error of metabolism characterized by a defect in the metabolism of **branched-chain amino acids** (leucine, isoleucine, and valine) due to a deficiency in the enzyme branched-chain alpha-keto acid dehydrogenase. - The accumulation of these amino acids and their keto-acids gives the urine a characteristic **maple syrup odor**. *Tay-Sachs disease* - Tay-Sachs disease is a fatal, **autosomal recessive** inborn error of metabolism caused by a deficiency of the enzyme **hexosaminidase A**. - This enzyme deficiency leads to the harmful accumulation of fatty acid derivatives called **gangliosides** in nerve cells in the brain, resulting in progressive neurological degeneration.

Q: All are components of Jai Vigyan Mission Mode project on community control of RF/RHD in India EXCEPT:

Vaccine development for streptococcal infection. ***Vaccine development for streptococcal infection*** - While **vaccine development** for Group A Streptococcus (GAS) is a long-term goal in controlling Rheumatic Fever (RF) and Rheumatic Heart Disease (RHD), it was **not an immediate component** of the Jai Vigyan Mission Mode project. - The mission focused on existing, actionable strategies for community control, rather than basic research and development of new interventions. *To study the epidemiology of streptococcal sore throats* - Understanding the **epidemiology of streptococcal sore throats** (the precursor to RF) is crucial for identifying high-risk populations and tailoring intervention strategies. - This component helps in mapping the incidence and prevalence of infections required to implement effective control strategies. *Antibiotic treatment of streptococcal sore throats* - **Prompt antibiotic treatment** of streptococcal sore throats is a cornerstone of primary prevention for RF, preventing the immune response that leads to the disease. - This is a direct, immediate intervention aimed at breaking the chain of infection and disease progression. *To establish registries for RF and RHD* - Establishing **registries for RF and RHD** is essential for monitoring disease burden, tracking outcomes, and evaluating the effectiveness of control programs. - Registries provide valuable data for public health planning and resource allocation.

Q: What type of indicator is Sustainable Development Goal target 3.4, which calls for a one third reduction in premature mortality from Non Communicable Diseases (NCDs) by year 2030? Consider the following statements: 1. Impact 2. Coverage/risk factor 3. Risk factor/determinants Which of the above statement(s) correctly identifies the type of indicator?

1 only. ***1 only*** - Sustainable Development Goal target 3.4, aiming for a one-third reduction in **premature mortality** from NCDs, is an **impact indicator**. - **Impact indicators** measure the overall effect of interventions on health outcomes, such as mortality rates. *2 and 3* - **Coverage/risk factor indicators** measure the proportion of the target population receiving an intervention or the prevalence of risk factors. - While reducing NCD mortality is related to controlling risk factors, the target itself directly measures a reduction in **death (an impact)**, not the risk factor prevalence or intervention coverage. *3 only* - **Risk factor/determinant indicators** specify factors that contribute to the disease or health outcome, like smoking rates or unhealthy diet. - The target of reducing **premature mortality** is a direct outcome of these risk factors, making it an impact indicator rather than a separate risk factor indicator. *1 and 3* - Although risk factors are determinants of NCD mortality, the **reduction in mortality** itself is a measure of the ultimate outcome or impact, not solely a risk factor. - The core of SDG 3.4 is the decrease in deaths, which unequivocally points to it being an **impact indicator**.

Q: Which one of the following occupational diseases is the most common cause of permanent disability and mortality?

Silicosis. ***Silicosis*** - **Silicosis** is the **most common serious occupational lung disease worldwide**, caused by inhaling **crystalline silica dust** from mining, quarrying, stone-cutting, and construction work. - It leads to **progressive massive fibrosis** with severe impairment of lung function, resulting in the **highest global burden of occupational disability and mortality** among pneumoconioses. - Particularly prevalent in **developing countries** including India, where exposure remains widespread in unregulated industries. - Increases risk of **tuberculosis, COPD, and lung cancer**, further contributing to mortality. *Byssinosis* - Caused by exposure to **cotton dust** in textile workers, leading to chest tightness and airway obstruction. - Generally **reversible in early stages** if exposure is eliminated. - Significantly **lower rates of permanent disability and mortality** compared to silicosis. *Anthracosis* - Also known as **coal worker's pneumoconiosis**, caused by inhaling coal dust. - Can progress to complicated pneumoconiosis, but is generally **less fibrogenic than silicosis**. - Lower global prevalence due to improved mining safety and decline of coal mining in many regions. *Asbestosis* - Caused by inhaling **asbestos fibers**, leading to diffuse pulmonary fibrosis. - While highly serious and associated with **mesothelioma and lung cancer**, its prevalence has **decreased significantly** due to asbestos bans in many countries. - Silicosis surpasses it in **overall global burden** due to continued widespread silica exposure.

Q: As per WHO recommendations which one of the following mumps vaccine strains should NOT be used in National Immunization Programme?

Rubini. ***Rubini*** - The **Rubini strain** of mumps vaccine is not recommended by the WHO for national immunization programs due to its **low immunogenicity** and **reduced efficacy**. - Studies have shown that the antibody response and protection offered by the Rubini strain are inferior compared to other widely used mumps vaccine strains. *Jeryl Lynn* - The **Jeryl Lynn strain** is a widely used and well-established mumps vaccine strain, with a good track record of efficacy and safety. - It is one of the strains commonly found in combined measles, mumps, and rubella **(MMR) vaccines** and is recommended by the WHO. *RIT 4385* - **RIT 4385** is another name for the **Jeryl Lynn strain** of mumps vaccine, referring to a specific manufacturing process or original isolate. - As such, it is a recommended and effective strain for national immunization programs. *L-Zagreb* - The **L-Zagreb strain** is a mumps vaccine strain that is also recommended by the WHO for inclusion in national immunization programs due to its demonstrated efficacy and safety profile. - It is used in various parts of the world as a component of MMR vaccines.

Q: All of the following are mass approaches towards education of general public EXCEPT:

Roleplaying. ***Roleplaying*** - **Roleplaying** is a participatory **small-group** or individual educational technique where participants act out scenarios, focusing on interpersonal communication and behavioral change. - It is not a **mass approach** because it requires active engagement and interaction from a limited number of participants. *Internet* - The **Internet** allows for the dissemination of health information to a vast, global audience through websites, social media, and digital campaigns. - Many individuals can access and consume this information simultaneously, making it a **mass communication channel**. *Posters, Bill boards and signs* - These are static visual aids designed to be placed in public spaces, reaching a large and diverse audience without direct interaction. - They rely on **exposure** to convey messages to the **general public** en masse. *Direct mailing* - **Direct mailing** involves sending educational materials to a large number of households or individuals through postal services. - Though personalized, it is still a **mass approach** because it targets a broad population segment rather than individual interventions.

Q: Which one of the following Ministries controls the Integrated Child Protection Scheme (ICPS)?

Ministry of Women and Child Development. ***Ministry of Women and Child Development*** - The **Integrated Child Protection Scheme (ICPS)** is a centrally sponsored scheme implemented by the Ministry of Women and Child Development. - This Ministry is responsible for designing and implementing policies and programs for the overall development and protection of women and children. *Ministry of Health and Family Welfare* - This ministry primarily focuses on **health services, disease prevention, and family planning** for the general population. - While it addresses child health, it is not the nodal ministry for the comprehensive protection and welfare of children as encompassed by ICPS. *Ministry of AYUSH* - The Ministry of AYUSH is responsible for the development and propagation of **Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homoeopathy** systems of medicine. - It does not have oversight of child protection schemes like ICPS. *Ministry of Human Resource Development* - This ministry (now Ministry of Education) is primarily concerned with **education, literacy, and vocational training**. - While it deals with children in an educational context, it does not directly control child protection schemes.

Q: Amniocentesis is called for in all of the following circumstances EXCEPT:

A father aged 50 year or more. ***A father aged 50 year or more*** - Advanced paternal age (typically 40 years or more) may be associated with a slightly increased risk of certain **autosomal dominant disorders** (e.g., achondroplasia, Marfan syndrome) and **schizophrenia** due to an accumulation of de novo mutations in sperm. - However, it is not a direct indication for **amniocentesis** for chromosomal abnormalities in the same way advanced maternal age or a history of chromosomal issues is. *Parents who are known to have chromosomal translocation* - If either parent carries a **balanced chromosomal translocation**, there is a significant risk that the pregnancy could result in an **unbalanced translocation** in the fetus, leading to developmental abnormalities or miscarriage. - **Amniocentesis** is indicated to determine whether the fetus has inherited an unbalanced translocation. *Mother who had a child with Down's syndrome or other chromosomal anomalies* - A prior pregnancy affected by **Down syndrome (Trisomy 21)** or another **chromosomal anomaly** significantly increases the risk of recurrence in subsequent pregnancies. - **Amniocentesis** allows for prenatal diagnosis to detect if the current fetus is affected. *A mother aged 35 years or more* - Advanced maternal age, generally defined as 35 years or older at the time of delivery, is associated with an increased risk of **aneuploidies**, such as **Down syndrome**. - **Amniocentesis** is offered to these mothers for prenatal chromosomal analysis.

Q: Which of the following is a contraindication for BCG vaccination in a newborn?

HIV infection-symptomatic. ***HIV infection-symptomatic*** - **Symptomatic HIV infection** in a newborn is a contraindication for BCG vaccination due to the risk of disseminated BCG disease in immunocompromised individuals. - Live attenuated vaccines like BCG can cause severe, life-threatening infections in individuals with compromised cellular immunity. *Prematurity* - **Prematurity** is generally not an absolute contraindication for BCG vaccination, although vaccination may be deferred until the infant is stable or reaches a certain weight. - The decision to vaccinate a premature infant often depends on the local epidemiology of tuberculosis and the infant's overall health status. *History of Tuberculosis in mother* - A maternal history of tuberculosis is **not a contraindication** for BCG vaccination in a newborn, especially if the newborn has been evaluated and is not actively infected. - Vaccinating infants in contact with TB cases can be an important part of preventing active disease. *Low birth weight* - **Low birth weight** is generally not an absolute contraindication for BCG vaccination, although it might lead to a delayed vaccination schedule. - The vaccine can be safely administered to healthy low birth weight infants, with careful consideration of their overall health.

Question 1

Which one of the following conditions is NOT inborn error of metabolism?

Accepted Answer

Neural tube defects

Answer

Phenylketonuria (PKU)

Answer

Maple syrup urine disease

Answer

Tay-Sachs disease

Question 2

Which one of the following statements regarding WHO Global Action Plan for the prevention and control of NCDs (2013–2020) is NOT correct?

Accepted Answer

A 10 percent relative reduction in mean population intake of salt/sodium

Answer

Halt the rise of diabetes and obesity

Answer

At least 10 percent relative reduction in the harmful use of alcohol as appropriate within national context

Answer

A 10 percent relative reduction in prevalence of insufficient physical activity

Question 3

All are components of Jai Vigyan Mission Mode project on community control of RF/RHD in India EXCEPT:

Accepted Answer

Vaccine development for streptococcal infection

Answer

To study the epidemiology of streptococcal sore throats

Answer

Antibiotic treatment of streptococcal sore throats

Answer

To establish registries for RF and RHD

Question 4

What type of indicator is Sustainable Development Goal target 3.4, which calls for a one third reduction in premature mortality from Non Communicable Diseases (NCDs) by year 2030?

Consider the following statements:
1. Impact
2. Coverage/risk factor  
3. Risk factor/determinants

Which of the above statement(s) correctly identifies the type of indicator?

Accepted Answer

1 only

Answer

2 and 3

Answer

3 only

Answer

1 and 3

Question 5

Which one of the following occupational diseases is the most common cause of permanent disability and mortality?

Accepted Answer

Silicosis

Answer

Byssinosis

Answer

Anthracosis

Answer

Asbestosis

Question 6

As per WHO recommendations which one of the following mumps vaccine strains should NOT be used in National Immunization Programme?

Accepted Answer

Rubini

Answer

Jeryl Lynn

Answer

RIT 4385

Answer

L-Zagreb

Question 7

All of the following are mass approaches towards education of general public EXCEPT:

Accepted Answer

Roleplaying

Answer

Internet

Answer

Posters, Bill boards and signs

Answer

Direct mailing

Question 8

Which one of the following Ministries controls the Integrated Child Protection Scheme (ICPS)?

Accepted Answer

Ministry of Women and Child Development

Answer

Ministry of Health and Family Welfare

Answer

Ministry of AYUSH

Answer

Ministry of Human Resource Development

Question 9

Amniocentesis is called for in all of the following circumstances EXCEPT:

Accepted Answer

A father aged 50 year or more

Answer

Parents who are known to have chromosomal translocation

Answer

Mother who had a child with Down's syndrome or other chromosomal anomalies

Answer

A mother aged 35 years or more

Question 10

Which of the following is a contraindication for BCG vaccination in a newborn?

Accepted Answer

HIV infection-symptomatic

Answer

Prematurity

Answer

History of Tuberculosis in mother

Answer

Low birth weight

UPSC-CMS 2019

Biochemistry

Community Medicine

Obstetrics and Gynecology

Pediatrics