UPSC-CMS 2021 Practice Questions

Q: After male sterilization, additional contraceptive protection is

needed for 2 to 3 months. ***needed for 2 to 3 months*** - After **vasectomy**, residual **sperm** distal to the ligation site can remain in the ejaculatory ducts and vas deferens. - It takes approximately **20 ejaculations** or **2 to 3 months** for these sperm to be cleared from the reproductive tract, requiring additional contraception until **azoospermia** is confirmed. *not needed* - This option is incorrect because the male reproductive tract is not immediately sterile after a vasectomy due to the presence of **pre-existing sperm**. - Without additional contraception, there is a risk of **unintended pregnancy** until sterility is confirmed by follow-up testing. *needed for 1 to 2 months* - While closer, a duration of **1 to 2 months** may not be sufficient for all residual sperm to be cleared from the system. - The standard recommendation often extends to **3 months** or a specific number of ejaculations to ensure complete sterility. *needed for 1 month* - This duration is generally too short to ensure the complete clearance of **viable sperm** from the ejaculatory ducts after a vasectomy. - Relying on this period alone would carry a higher risk of **contraceptive failure**.

Q: The life expectancy at birth for a country A is 64 years. The minimum and maximum values of life expectancy are 20 years and 86 years respectively. As part of Human Development Index (HDI), what is the Life Expectancy Index for the country A ?

0.667. **0.667** - The Life Expectancy Index (LEI) is a component of the Human Development Index (HDI). - Formula: **LEI = (Actual Life Expectancy - Minimum Life Expectancy) / (Maximum Life Expectancy - Minimum Life Expectancy)** - Calculation: (64 - 20) / (86 - 20) = 44 / 66 = **0.667** - The index ranges from 0 to 1, where higher values indicate better life expectancy relative to the reference range. *0.512* - This value would result from calculation errors, such as using incorrect minimum or maximum values. - For example, if a different denominator was used or if the actual life expectancy was miscalculated. *0.970* - This value is too high and suggests a calculation error. - An index of 0.970 would indicate the country's life expectancy is 84 years (very close to the maximum of 86 years). *0.744* - This value does not correspond to the given parameters. - Could result from arithmetic errors or using different reference values for minimum/maximum life expectancy. - Using the correct formula with given values yields 0.667, not 0.744.

Q: Which of the following indicators stand consolidated in Physical Quality of Life Index (PQLI)? 1. Infant mortality 2. Life expectancy at age one 3. Per capita income 4. Literacy

1, 2 and 4. ***1, 2 and 4*** - The **Physical Quality of Life Index (PQLI)** is a composite index that measures the quality of life based on three specific indicators: infant mortality, life expectancy at age one, and literacy. - These indicators were chosen to reflect basic human needs and achievements independent of economic production. *1, 2 and 3* - This option incorrectly includes **per capita income** as an indicator. The PQLI was developed as an alternative to economic measures like GDP or per capita income. - **Per capita income** is an economic indicator, whereas PQLI focuses on social indicators of well-being. *2, 3 and 4* - This option incorrectly includes **per capita income** and excludes **infant mortality**, which is a core component of the PQLI reflecting the health status of a population. - The PQLI specifically aims to capture non-economic aspects of development. *1, 3 and 4* - This option incorrectly includes **per capita income** and excludes **life expectancy at age one**, which is a critical health indicator in the PQLI. - PQLI specifically includes **life expectancy at age one** instead of other age groups to reflect achievements in reducing early childhood mortality and improving health.

Q: Consider the following staff: 1. Medical Officer 2. Pharmacist 3. Anaesthetist 4. Health Educator Of them, who are routinely posted to a PHC ?

1, 2 and 4. ***1, 2 and 4*** - According to **IPHS (Indian Public Health Standards)** for PHC staffing, a **Medical Officer** is the essential physician providing primary medical care, and a **Pharmacist** is mandatory for dispensing medications and managing the drug store. - While a designated "Health Educator" post may not be uniformly established at all PHCs, **health education activities** are a core PHC function, often performed by staff nurses, ANMs, or health workers as part of their routine duties under the supervision of the Medical Officer. - In the context of this question and official guidelines, these three roles represent the personnel involved in **medical care, pharmaceutical services, and health education functions** at PHC level. *2, 3 and 4* - An **Anaesthetist** is NOT routinely posted at PHC level as PHCs do not perform surgical procedures requiring anaesthesia. - Anaesthetists are stationed at **CHCs (Community Health Centres)** with operation theatre facilities or higher-level hospitals. - This option incorrectly includes anaesthetist while omitting the essential Medical Officer. *1, 2 and 3* - While **Medical Officer** and **Pharmacist** are definitely routine PHC staff, an **Anaesthetist** is not posted at PHC level. - PHCs provide basic primary healthcare services, not surgical interventions requiring anaesthesia services. - Anaesthetists are found at CHC level and above. *1, 3 and 4* - This option incorrectly includes an **Anaesthetist** who is not a PHC-level staff member. - Additionally, it omits the **Pharmacist**, who is a mandatory and essential staff member at every PHC for medication dispensing and drug store management. - Without a pharmacist, the PHC cannot function effectively in providing essential medicines.

Q: Which one of the following management techniques helps in standardising the methods of performing jobs ?

Systems Analysis. ***Systems Analysis*** - **Systems analysis** is a management technique that systematically examines processes, workflows, and organizational systems to identify inefficiencies and standardize operations. - It helps in **standardizing methods of performing jobs** by breaking down complex tasks into components, analyzing each step, and establishing uniform procedures and protocols. - In public health administration, systems analysis is used to create **standard operating procedures (SOPs)** and ensure consistency in service delivery. - This is the **best answer** among the given options for standardizing job methods. *Work Sampling* - **Work sampling** is a work measurement technique that uses random observations to determine the proportion of time workers spend on various activities. - Its primary purpose is **data collection and time measurement**, not the standardization of how tasks should be performed. - It helps identify *what* workers do, but not *how* to standardize the methods. *Personnel Management* - **Personnel management** deals with human resource functions including recruitment, training, performance appraisal, and employee welfare. - While training may involve teaching standardized methods, personnel management itself is **not a technique for standardizing job methods**. - It focuses on managing people, not on analyzing and standardizing work processes. *Decision Making* - **Decision making** is a cognitive and managerial process of choosing between alternatives to achieve organizational goals. - It is a **general management function**, not a specific technique for analyzing and standardizing how jobs are performed. - While decisions may lead to standardization, decision making itself is not the technique that accomplishes it.

Q: STDs are transmitted by

Direct contact. ***Direct contact*** - **Sexually Transmitted Diseases (STDs)** are primarily spread through direct physical contact, most commonly during **sexual activity** (vaginal, anal, or oral sex). - This mode of transmission allows for the exchange of infected bodily fluids or skin-to-skin contact, leading to the spread of pathogens like bacteria, viruses, or parasites. *Contact with soil* - Diseases transmitted through contact with soil, such as **tetanus** or **hookworm infections**, typically involve pathogens that reside in the soil. - This is not a primary mode of transmission for common STDs. *Droplet infection* - **Droplet infection** involves the transmission of pathogens through respiratory droplets expelled during coughing, sneezing, or talking, like in **influenza** or **tuberculosis**. - STDs are generally not aerosolized and do not spread through this route. *Vector borne* - **Vector-borne diseases** are transmitted by an intermediate organism, often an insect (e.g., **mosquitoes** for malaria, **ticks** for Lyme disease). - STDs do not rely on vectors for transmission between human hosts.

Q: In which one of the following study designs, the unit of study involves populations rather than individuals ?

Ecological studies. ***Correct: Ecological studies*** - **Ecological studies** analyze health-related data at a population level, such as countries or communities, rather than individual patients. - They are used to observe correlations between exposure and outcome among different groups or over time. - The unit of analysis is the **population or group**, not individuals. *Incorrect: Cross-sectional studies* - **Cross-sectional studies** examine individuals at a single point in time to determine the prevalence of a disease or exposure. - While they can describe populations, the unit of observation and analysis remains the **individual**. *Incorrect: Cohort studies* - **Cohort studies** follow groups of individuals (cohorts) over time to investigate the incidence of an outcome and its association with specific exposures. - The primary unit of study is the **individual**, who is tracked for disease development. *Incorrect: Case-control studies* - **Case-control studies** compare individuals with a disease (cases) to individuals without the disease (controls) to identify past exposures. - This design focuses on **individual-level data** to determine risk factors.

Q: What is the Standardized Mortality Ratio (SMR) for the hazardous industry workers (as compared to national population)?

120. ***120*** - To calculate the Standardized Mortality Ratio (SMR), we first need to calculate the **expected deaths** for the hazardous industry workers based on the national death rates. - The formula for expected deaths in each age group is: (National death rate / 1000) × Number of hazardous industry workers - For age group 25-34: Expected deaths = (2.0 / 1000) × 3000 = **6** - For age group 35-44: Expected deaths = (3.5 / 1000) × 2000 = **7** - For age group 45-54: Expected deaths = (6.0 / 1000) × 2000 = **12** - **Total expected deaths** = 6 + 7 + 12 = **25** - **Total observed deaths** = 8 + 9 + 13 = **30** - **SMR formula**: (Total Observed Deaths / Total Expected Deaths) × 100 - **SMR = (30 / 25) × 100 = 1.2 × 100 = 120** - This indicates that the hazardous industry workers have a **20% higher mortality rate** compared to the national population after age-standardization. *100* - An SMR of 100 would indicate that the observed mortality equals the expected mortality (no difference from the national average). - However, the observed deaths (30) exceed the expected deaths (25), so the SMR must be greater than 100. - This option represents the null value where there is no excess mortality. *110* - This option underestimates the actual SMR calculated from the data. - An SMR of 110 would suggest only a 10% excess mortality, which does not match the observed-to-expected ratio of 30:25. - The calculation clearly shows a ratio of 1.2, not 1.1. *130* - This option overestimates the SMR. - An SMR of 130 would require observed deaths to be 1.3 times the expected deaths (32.5 deaths expected for 30 observed). - The actual ratio is 30/25 = 1.2, making this value too high.

Q: Which one of the following best explains the relationship among Prevalence (P), Incidence (I) and Duration (D) of a disease given the assumption that the population is stable ?

P = I x D. **Fundamental Epidemiological Relationship:** In a stable population with endemic disease, the relationship between prevalence, incidence, and duration is expressed as: **Prevalence = Incidence × Average Duration (P = I × D)** ***P = I × D*** - This is the **correct formula** that describes the relationship under conditions of a **stable population** and **endemic disease**. - Prevalence is directly proportional to both the incidence rate and the average duration of the disease. - This formula reflects that the number of existing cases (prevalence) equals the rate at which new cases occur (incidence) multiplied by how long people have the disease (duration). - Example: If incidence = 10 cases/1000/year and average duration = 5 years, then prevalence = 50 cases/1000. *I = P × D* - This formula incorrectly suggests that incidence increases with both prevalence and duration. - This would mean that longer disease duration causes higher incidence, which is illogical. - Correctly rearranged, this would be I = P/D (incidence equals prevalence divided by duration). *D = P × I* - This formula incorrectly states that duration is the product of prevalence and incidence. - This would mean higher incidence causes longer duration, which is epidemiologically incorrect. - Correctly rearranged, this would be D = P/I (duration equals prevalence divided by incidence). *I = P + D* - This formula implies a simple additive relationship, which is **epidemiologically invalid**. - Prevalence, incidence, and duration are related **multiplicatively**, not additively, in a steady state. - This equation has no basis in epidemiological theory.

Q: Which of the following are absolute contraindications of Combined Oral Contraceptive (COCs)? 1. Arterial or venous thrombosis history 2. Severe hypertension 3. Gestational trophoblastic neoplasia 4. Diabetes with vascular complications

1, 2 and 4. ***1, 2 and 4*** - A history of **arterial or venous thrombosis** (e.g., deep vein thrombosis, pulmonary embolism, stroke, myocardial infarction) is an absolute contraindication due to the increased risk of clotting associated with estrogen in COCs. - **Severe hypertension** (systolic ≥160 mmHg or diastolic ≥100 mmHg) is a contraindication because COCs can exacerbate blood pressure control and increase the risk of cardiovascular events. - **Diabetes with vascular complications** (e.g., nephropathy, retinopathy, neuropathy, macrovascular disease) indicates advanced microvascular or macrovascular disease, making COCs unsafe due to increased cardiovascular risk. *1, 3 and 4* - While a history of **arterial or venous thrombosis** and **diabetes with vascular complications** are absolute contraindications, **gestational trophoblastic neoplasia** itself is generally not an absolute contraindication to COCs once the disease is in remission or resolved. - The primary concern with gestational trophoblastic neoplasia is avoiding pregnancy during the monitoring period, for which COCs can be used, although other methods may be preferred. *2, 3 and 4* - **Severe hypertension** and **diabetes with vascular complications** are absolute contraindications, but **gestational trophoblastic neoplasia** is not. - The use of COCs in gestational trophoblastic neoplasia is generally considered acceptable after successful treatment and during the follow-up period to prevent pregnancy. *1, 2 and 3* - **Arterial or venous thrombosis history** and **severe hypertension** are absolute contraindications. - However, **gestational trophoblastic neoplasia** is not an absolute contraindication for COCs once the patient has been successfully treated and is being monitored.

Question 1

After male sterilization, additional contraceptive protection is

Accepted Answer

needed for 2 to 3 months

Answer

not needed

Answer

needed for 1 to 2 months

Answer

needed for 1 month

Question 2

The life expectancy at birth for a country A is 64 years. The minimum and maximum values of life expectancy are 20 years and 86 years respectively. As part of Human Development Index (HDI), what is the Life Expectancy Index for the country A ?

Accepted Answer

0.667

Answer

0.512

Answer

0.970

Answer

0.744

Question 3

Which of the following indicators stand consolidated in Physical Quality of Life Index (PQLI)?

1. Infant mortality
2. Life expectancy at age one
3. Per capita income
4. Literacy

Accepted Answer

1, 2 and 4

Answer

1, 2 and 3

Answer

2, 3 and 4

Answer

1, 3 and 4

Question 4

Consider the following staff:

1. Medical Officer
2. Pharmacist
3. Anaesthetist
4. Health Educator Of them, who are routinely posted to a PHC ?

Accepted Answer

1, 2 and 4

Answer

2, 3 and 4

Answer

1, 2 and 3

Answer

1, 3 and 4

Question 5

Which one of the following management techniques helps in standardising the methods of performing jobs ?

Accepted Answer

Systems Analysis

Answer

Work Sampling

Answer

Personnel Management

Answer

Decision Making

Question 6

STDs are transmitted by

Accepted Answer

Direct contact

Answer

Contact with soil

Answer

Droplet infection

Answer

Vector borne

Question 7

In which one of the following study designs, the unit of study involves populations rather than individuals ?

Accepted Answer

Ecological studies

Answer

Cross-sectional studies

Answer

Cohort studies

Answer

Case-control studies

Question 8

What is the Standardized Mortality Ratio (SMR) for the hazardous industry workers (as compared to national population)?

Accepted Answer

120

Answer

110

Answer

100

Answer

130

Question 9

Which one of the following best explains the relationship among Prevalence (P), Incidence (I) and Duration (D) of a disease given the assumption that the population is stable ?

Accepted Answer

P = I x D

Answer

I = P x D

Answer

D = P x I

Answer

I = P + D

Question 10

Which of the following are absolute contraindications of Combined Oral Contraceptive (COCs)?

1. Arterial or venous thrombosis history
2. Severe hypertension
3. Gestational trophoblastic neoplasia
4. Diabetes with vascular complications

Accepted Answer

1, 2 and 4

Answer

1, 3 and 4

Answer

2, 3 and 4

Answer

1, 2 and 3

UPSC-CMS 2021

Community Medicine

Obstetrics and Gynecology