UPSC-CMS 2020 Practice Questions

Q: Under Chapter XXI of the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10), lifestyle-related problems fall under which of the following code range?

Z 72.0 – Z 72.5. ***Z 72.0 – Z 72.5*** - This **ICD-10 Chapter XXI** code range is specifically assigned to **problems related to lifestyle**, which includes issues such as unhealthy diet, lack of physical activity, and stress. - These codes are used to identify factors influencing health status and contact with health services, contributing to a holistic view of patient care. *U 50.0 – U 50.5* - The **"U" code series** (U00-U99) in ICD-10 is generally reserved for **codes for special purposes**, such as provisional assignment of new diseases of uncertain etiology or for research purposes. - This range does not categorize lifestyle-related problems; instead, it is designated for emerging or yet-to-be-classified conditions. *U 10.0 – U 10.5* - Similar to the previous option, this **"U" code range** is part of the category for **codes for special purposes** and is not used for classifying lifestyle factors. - These codes are typically used for emergency situations, specific research projects, or temporary classifications. *Z 10.0 – Z 10.5* - The **"Z" codes** (Z00-Z99) in ICD-10 are generally used for **factors influencing health status and contact with health services**, but the Z10-Z13 range is specifically for **routine general health examinations** of defined subpopulations. - This range does not classify general lifestyle-related problems but rather specific types of health screenings or check-ups.

Q: Which of the following diseases are spread by airborne transmission? 1. Influenza 2. Chicken pox 3. Q-fever 4. Psittacosis Select the correct answer using the code given below:

3 and 4 only. ***3 and 4 only*** - **Q-fever (Coxiella burnetii)** and **Psittacosis (Chlamydia psittaci)** are true **airborne diseases** that spread via droplet nuclei or dust particles <5 μm that remain suspended in air and can travel long distances. - **Q-fever** spreads through inhalation of contaminated aerosols from infected animal products (particularly during parturition in livestock). - **Psittacosis** spreads via inhalation of aerosolized dried bird droppings or respiratory secretions from infected birds. - **Airborne transmission** requires particles small enough to remain suspended in air for extended periods and travel beyond 1-2 meters. *1, 2, 3 and 4* - This option is incorrect because **Influenza** is classified as a **droplet-borne disease**, not airborne. - **Influenza** spreads primarily through large respiratory droplets (>5 μm) that travel <1 meter and settle quickly, requiring close contact for transmission. - **Chickenpox**, while highly contagious, has both airborne and direct contact routes, but the primary emphasis in this question context should be on strict airborne diseases (Q-fever and Psittacosis). - The distinction between droplet and airborne transmission is critical for infection control measures (surgical masks vs N95 respirators). *1 and 3 only* - This option is incorrect as **Influenza** is not an airborne disease but rather spreads via droplet transmission. - While **Q-fever** is correctly identified as airborne, including Influenza makes this combination incorrect. - **Psittacosis** is also airborne and should be included. *1 and 4 only* - This option is incorrect because **Influenza** does not meet the criteria for airborne transmission. - While **Psittacosis** is correctly identified, the inclusion of Influenza and exclusion of Q-fever makes this choice inaccurate. - Both Q-fever and Psittacosis are classic examples of airborne zoonotic infections.

Q: Endemic ascites occurs due to:

Naturally occurring toxin. ***Naturally occurring toxin*** - Endemic ascites, specifically **hepatic veno-occlusive disease (HVOD)** leading to ascites, is primarily caused by **pyrrolizidine alkaloids**. - These are **naturally occurring toxins** found in certain plants (e.g., *Crotalaria*, *Heliotropium*) that contaminate food supplies, particularly in endemic regions. *Fungal toxin* - While some fungal toxins (e.g., aflatoxins) are hepatotoxic, they are more commonly associated with **hepatocellular carcinoma** or acute liver failure rather than endemic ascites due to veno-occlusive disease. - HVOD is specifically linked to plant-derived toxins. *Bacterial toxin* - Bacterial toxins are generally not implicated in the pathogenesis of **endemic ascites** through the mechanism of **veno-occlusive disease**. - Bacterial infections can cause liver damage or sepsis, but not typically the specific form of ascites seen in endemic situations. *Viral toxin* - Viruses, such as hepatitis viruses, can cause chronic liver disease and ascites, but this is due to **viral replication and immune-mediated damage**, not a viral toxin in the traditional sense. - Endemic ascites due to toxins refers specifically to exogenous, non-biological toxins.

Q: The presence of which of the following bacteria in drinking water is an important confirmatory evidence of recent faecal pollution of water?

E. coli. ***E. coli*** - The presence of **Escherichia coli** (E. coli) in drinking water is a definitive indicator of **recent fecal contamination**. - **E. coli** is a bacterium that normally lives in the intestines of humans and animals and its presence suggests a direct pathway for fecal matter to enter the water supply. *Streptococci* - **Fecal streptococci** (now often referred to as enterococci) can indicate fecal contamination, but they are not as specific as E. coli for **recent human fecal pollution** because they can persist longer in the environment and are found in both human and animal feces. - While useful as an indicator, they are generally considered **less precise for recent human fecal contamination** compared to E. coli. *Klebsiella* - **Klebsiella** species are found in the gastrointestinal tract and can be present in water, but their primary habitat is not exclusively fecal, as they can also be found in soil and on plants. - Therefore, their presence in water is **not as reliable an indicator** of recent fecal pollution as E. coli. *Clostridium* - **Clostridium perfringens** is a spore-forming bacterium found in feces, but its spores are highly resistant and can survive in the environment for extended periods. - Its presence indicates **past or intermittent fecal contamination** rather than recent contamination, making it less suitable for confirming recent fecal pollution.

Q: With regard to the Goals, Milestones and Targets for the Global Technical Strategy for Malaria (2016-2030), consider the following statements: 1. Compared to 2015, the target is to reduce the malaria mortality rates globally by at least 90% by year 2030 2. Compared to 2015, the target is to reduce malaria case incidence by 90% by year 2030 3. Eliminate malaria from at least 35 countries, where malaria was transmitted in 2015, by year 2030 Which of the above statements hold true?

1, 2 and 3. ***1, 2 and 3*** - All three statements accurately reflect the **core targets** set by the Global Technical Strategy for Malaria (2016-2030). - These ambitious goals aim to achieve significant reductions in malaria burden and eventual eradication in many regions. *1 and 3 only* - This option is incorrect because it omits statement 2, which is a verified goal for **reducing malaria case incidence**. - All three statements are indeed part of the strategy's published objectives. *1 and 2 only* - This option is incorrect as it excludes statement 3 regarding the **elimination of malaria** from at least 35 countries. - The strategy encompasses all three stated objectives for global malaria control. *2 and 3 only* - This option is incorrect because it fails to include statement 1, which specifies the target for **reducing malaria mortality rates**. - The strategy explicitly addresses all three aspects: mortality, incidence, and country-level elimination.

Q: The incidence of diarrhoea is highest among infants in the age group of 6–11 months due to all of the following reasons EXCEPT:

Eruption of teeth. ***Eruption of teeth*** - While teething can cause discomfort and sometimes lead to mild, temporary changes in bowel movements, it is **not a direct cause of diarrhea** and does not significantly increase the incidence of diarrheal diseases in this age group. - The physiological process of tooth eruption itself doesn't introduce pathogens that cause diarrheal illness or significantly compromise immune defenses in a way that leads to increased diarrhea. *Introduction of foods which may be contaminated* - This is a significant factor as infants begin complementary feeding, introducing them to **foods prepared with unhygienic practices** or contaminated water. - Exposure to new pathogens through solid foods increases the risk of **gastrointestinal infections**. *Declining level of maternal antibodies* - Maternal antibodies provided through breast milk decline significantly around 6 months, reducing the infant's **passive immunity** and making them more susceptible to infections, including those causing diarrhea. - This immunological gap coincides with the period when infants are more exposed to environmental pathogens. *Direct contact with human or animal faeces* - As infants become more mobile and explore their environment by crawling and putting objects in their mouths, their risk of exposure to **fecal-oral pathogens** from contaminated surfaces or hands increases. - Poor hygiene practices in handling infant waste or animal contact can lead to increased transmission of diarrheal causing agents.

Q: In the context of "Anti-Malaria Month Campaign", consider the following statements: 1. It is observed every year in the month of June 2. It is planned during the Monsoon season 3. It aims to enhance the level of community awareness and participation Select the correct answer using the code given below:

1 and 3. ***1 and 3*** - The **Anti-Malaria Month Campaign** is observed annually in **June** to raise awareness and implement preventive measures ahead of peak malaria transmission during the monsoon season. - A primary objective is to **enhance community awareness and participation** in malaria control efforts through activities like vector control (larvicidal measures, source reduction), early case detection, and prompt treatment. - Statement 2 is incorrect because the campaign is **planned and launched in June**, which coincides with the **onset** of monsoon, but the planning phase occurs **before** the monsoon rains intensify. The phrase "planned during monsoon" incorrectly suggests the planning happens during the monsoon period, whereas planning occurs in the pre-monsoon period (April-May) for implementation starting in June. *1 and 2* - While statement 1 is correct (observed in June) and statement 3 would be correct (enhancing participation), statement 2 creates confusion about timing. - The campaign **planning occurs before the monsoon season** (April-May), and **implementation begins in June** as monsoon arrives. Saying it is "planned during monsoon" is technically inaccurate. *2 and 3* - Statement 2 is incorrect as explained above - the campaign planning precedes the monsoon season. - While statement 3 about enhancing community participation is correct, this combination is wrong due to statement 2. *3 only* - This misses statement 1, which is clearly correct - the Anti-Malaria Month Campaign has been traditionally observed in **June** every year as part of the National Vector Borne Disease Control Programme (NVBDCP). - Both statements 1 and 3 are correct, making this option incomplete.

Q: DASH diet plan is advocated in the control of which one of the following diseases?

Hypertension. ***Hypertension*** - The **DASH (Dietary Approaches to Stop Hypertension)** diet is specifically designed to **lower blood pressure**, making it the primary dietary intervention for hypertension [1]. - It emphasizes foods rich in **potassium**, **calcium**, and **magnesium**, such as fruits, vegetables, and low-fat dairy, while limiting sodium, saturated fat, and cholesterol [1]. *Rheumatic heart disease* - **Rheumatic heart disease** is a consequence of untreated streptococcal infection and is not primarily managed through dietary interventions like the DASH diet. - Management focuses on **antibiotic treatment** and preventing recurrent infections, as well as addressing heart complications. *Cancer* - While a healthy diet contributes to overall cancer prevention and management, the **DASH diet** is not specifically tailored or broadly advocated as the primary dietary intervention for **cancer** control. - Dietary recommendations for cancer often vary based on the type of cancer and individual patient needs, sometimes focusing on specific antioxidants or anti-inflammatory foods. *Chronic Obstructive Pulmonary Disease* - **Chronic Obstructive Pulmonary Disease (COPD)** management primarily involves smoking cessation, bronchodilators, steroids, and oxygen therapy, with nutrition playing a supportive, rather than primary, role. - Nutritional support for COPD patients often focuses on maintaining adequate weight and energy intake, rather than a specific diet like DASH, which is aimed at blood pressure regulation.

Q: Which one of the following IUDs is associated with a low pregnancy rate (0.2 per 100), less number of ectopic pregnancies and lower menstrual blood loss?

LNG-20 (Mirena). ***LNG-20 (Mirena)*** - This **levonorgestrel-releasing IUD** (Mirena) has a very low pregnancy rate (0.2 per 100 women-years). - It significantly **reduces menstrual blood loss** and cramps and is associated with a lower risk of ectopic pregnancies compared to copper IUDs because it thins the endometrial lining, making implantation less likely. *Cu T-380A* - The **Cu T-380A copper IUD** has a slightly higher pregnancy rate (around 0.6-0.8 per 100 women-years) compared to Mirena. - It is known to **increase menstrual blood loss** and dysmenorrhea, which is contrary to the question's criteria. *ML-Cu 375* - The **Multiload Cu 375** is another type of copper IUD, with a pregnancy rate similar to or slightly higher than the TCu-380A. - Like other copper IUDs, it typically **increases menstrual flow** and may worsen menstrual pain. *Progestasert* - **Progestasert** was an early progesterone-releasing IUD that had a higher failure rate and a shorter lifespan (1 year) compared to newer LNG-IUDs. - While it aimed to reduce menstrual blood loss, its **overall efficacy and duration of action** were inferior to the LNG-20 system.

Question 1

Under Chapter XXI of the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10), lifestyle-related problems fall under which of the following code range?

Accepted Answer

Z 72.0 – Z 72.5

Answer

U 50.0 – U 50.5

Answer

U 10.0 – U 10.5

Answer

Z 10.0 – Z 10.5

Question 2

Which of the following diseases are spread by airborne transmission?

1. Influenza
2. Chicken pox
3. Q-fever
4. Psittacosis

Select the correct answer using the code given below:

Accepted Answer

3 and 4 only

Answer

1 and 3 only

Answer

1 and 4 only

Answer

1, 2, 3 and 4

Question 3

Endemic ascites occurs due to:

Accepted Answer

Naturally occurring toxin

Answer

Fungal toxin

Answer

Bacterial toxin

Answer

Viral toxin

Question 4

The presence of which of the following bacteria in drinking water is an important confirmatory evidence of recent faecal pollution of water?

Accepted Answer

E. coli

Answer

Streptococci

Answer

Klebsiella

Answer

Clostridium

Question 5

With regard to the Goals, Milestones and Targets for the Global Technical Strategy for Malaria (2016-2030), consider the following statements:

1. Compared to 2015, the target is to reduce the malaria mortality rates globally by at least 90% by year 2030
2. Compared to 2015, the target is to reduce malaria case incidence by 90% by year 2030
3. Eliminate malaria from at least 35 countries, where malaria was transmitted in 2015, by year 2030

Which of the above statements hold true?

Accepted Answer

1, 2 and 3

Answer

1 and 3 only

Answer

1 and 2 only

Answer

2 and 3 only

Question 6

The incidence of diarrhoea is highest among infants in the age group of 6–11 months due to all of the following reasons EXCEPT:

Accepted Answer

Eruption of teeth

Answer

Introduction of foods which may be contaminated

Answer

Declining level of maternal antibodies

Answer

Direct contact with human or animal faeces

Question 7

In the context of "Anti-Malaria Month Campaign", consider the following statements:

1. It is observed every year in the month of June

2. It is planned during the Monsoon season

3. It aims to enhance the level of community awareness and participation

Select the correct answer using the code given below:

Accepted Answer

1 and 3

Answer

1 and 2

Answer

2 and 3

Answer

3 only

Question 8

DASH diet plan is advocated in the control of which one of the following diseases?

Accepted Answer

Hypertension

Answer

Rheumatic heart disease

Answer

Cancer

Answer

Chronic Obstructive Pulmonary Disease

Question 9

Which one of the following IUDs is associated with a low pregnancy rate (0.2 per 100), less number of ectopic pregnancies and lower menstrual blood loss?

Accepted Answer

LNG-20 (Mirena)

Answer

Cu T-380A

Answer

ML-Cu 375

Answer

Progestasert

UPSC-CMS 2020

Community Medicine

Internal Medicine

Obstetrics and Gynecology