UPSC-CMS 2023 - Community Medicine Practice Questions

Q: Which of the following will qualify as a Class III exposure to Rabies?

Bites by wild animals. ***Bites by wild animals*** - All bites and scratches by **wild carnivores (dogs, jackals, wolves, foxes)** or **bats** are **ALWAYS considered Category III exposures** regardless of the wound severity or location. - This is because wild animals cannot be observed for 10 days, and the risk of rabies is extremely high. - This classification mandates immediate post-exposure prophylaxis (PEP) with both **rabies immunoglobulin (RIG)** and **vaccine**. - This is the **most definitive** Category III exposure among the options. *Bites on legs by a dog* - According to WHO guidelines, **any transdermal bite or scratch** (breaking the skin) is technically a **Category III exposure**. - However, the classification can be modified if the biting dog is a **healthy domestic dog** that can be kept under **observation for 10 days**. - If the dog remains healthy during observation, PEP can be discontinued. - The question stem asks which "will qualify" - implying certainty. Wild animal bites are **always** Category III, while domestic dog bites may have conditional management based on observation. *Drinking unboiled milk of a suspect animal* - Rabies virus is transmitted through **saliva** via bites, scratches, or mucous membrane contamination. - The virus is **inactivated by gastric acid** and cannot be transmitted through the gastrointestinal route. - Ingesting milk from a suspect animal poses **no risk** of rabies transmission. - This is **not a rabies exposure** and does not require PEP. *Licks on intact skin by a dog* - Licks on **intact skin** are classified as **Category I exposure**. - Rabies virus **cannot penetrate healthy, unbroken skin**. - Category I exposures do **not warrant** any rabies post-exposure prophylaxis.

Q: Consider the following : 1. Magnesium Sulphate 2. Calcium bicarbonate 3. Calcium Sulphate 4. Magnesium bicarbonate Hardness of water relates to the presence of which of the above?

1, 2, 3 and 4. **Correct Answer: 1, 2, 3 and 4** **Hardness of water** is caused by the presence of dissolved multivalent metallic cations, primarily **calcium (Ca²⁺)** and **magnesium (Mg²⁺)** ions. These ions combine with various anions to form compounds that cause water hardness: - **Magnesium sulfate (MgSO₄)** - Causes **permanent hardness** (cannot be removed by boiling) - **Calcium bicarbonate (Ca(HCO₃)₂)** - Causes **temporary hardness** (can be removed by boiling) - **Calcium sulfate (CaSO₄)** - Causes **permanent hardness** - **Magnesium bicarbonate (Mg(HCO₃)₂)** - Causes **temporary hardness** **Therefore, all four compounds (1, 2, 3, and 4) contribute to water hardness.** *Why other options are incorrect:* *1, 2 and 3 only* - Incorrectly excludes **magnesium bicarbonate**, which is a significant contributor to temporary hardness *2, 3 and 4 only* - Incorrectly excludes **magnesium sulfate**, which contributes to permanent hardness *1 and 4 only* - Incorrectly omits **calcium bicarbonate** and **calcium sulfate**, which are major contributors to both temporary and permanent hardness

Q: In which of the following diseases is post-exposure immunisation prescribed?

Rabies. ***Rabies*** - **Rabies post-exposure prophylaxis (PEP)** is critical with documented or suspected exposure, given its near 100% fatality rate once symptoms appear. - PEP consists of both **rabies vaccine** and **rabies immunoglobulin** administered as soon as possible after exposure. *Poliomyelitis* - Poliovirus vaccination is a **pre-exposure intervention** aimed at preventing infection in the first place through herd immunity. - There is no specific post-exposure immunization strategy for polio once exposure has occurred. *Yellow fever* - The yellow fever vaccine is a highly effective **pre-exposure preventive measure** for individuals traveling to or living in endemic areas. - While it provides long-lasting immunity, it is not used as a post-exposure treatment. *Cholera* - Cholera vaccines are primarily used for **pre-exposure prevention**, especially for travelers or populations in endemic areas. - Post-exposure management of cholera focuses on **rehydration therapy** and antibiotics, not immunization.

Q: NACO (National AIDS Control Organization) in India works towards which of the following causes? 1. Screening high-risk cases of HIV 2. Facilitating adoption of orphans 3. Public education towards safe sex 4. Providing antiretroviral therapy. Select the correct answer using the code given below:

1, 3 and 4. **1, 3 and 4** - **NACO** (National AIDS Control Organization) is the primary body in India responsible for formulating policy and implementing programs for **HIV/AIDS prevention and control**. - Its core functions include **screening high-risk cases** for HIV, conducting **public education campaigns** on safe sex practices to prevent transmission, and ensuring access to **antiretroviral therapy (ART)** for those infected. *2, 3 and 4* - While NACO focuses on preventing and managing HIV/AIDS, **facilitating the adoption of orphans** (Option 2) is not a direct or primary function of NACO. - NACO's mandate centers on health-related interventions, not social welfare programs like adoption. *1, 2 and 4* - This option incorrectly includes "facilitating adoption of orphans" (Option 2) as a function of NACO. - Public education (Option 3) is a crucial component of NACO's strategy that is omitted in this selection. *1, 2 and 3* - This option incorrectly includes "facilitating adoption of orphans" (Option 2) and omits "providing antiretroviral therapy" (Option 4). - Providing **ART** is a fundamental and critical service directly managed and supported by NACO.

Q: Which one of the following is defined as "the average number of children a woman would have if she were to pass through her reproductive years, bearing children at the same rates as the women now in each age group" ?

Total Fertility Rate (TFR). **Total Fertility Rate (TFR)** - The **Total Fertility Rate (TFR)** is a measure of the average number of children a woman is expected to have over her lifetime, assuming current age-specific fertility rates. - It is a synthetic measure that reflects the reproductive patterns of a given population at a specific time. *Net Reproduction Rate (NRR)* - The **Net Reproduction Rate (NRR)** is similar to the Gross Reproduction Rate but also accounts for **mortality rates** among females before completing their reproductive years. - It measures the number of daughters a newborn girl can expect to have during her lifetime, considering current age-specific fertility and mortality rates. *General Fertility Rate (GFR)* - The **General Fertility Rate (GFR)** calculates the number of live births per 1,000 women of reproductive age (typically 15-49 years). - It is a broader measure than age-specific rates but does not project the total number of children a woman might have. *Age-Specific Fertility Rate (ASFR)* - An **Age-Specific Fertility Rate (ASFR)** measures the number of live births to women in a particular age group per 1,000 women in that same age group. - While it provides data for specific age cohorts, it does not combine these to give a lifetime average as described in the definition.

Q: Which among the following is correct about yellow fever vaccination requirement for international travellers ? 1. Term of validity of the certificate is changed from 10 years to the duration of the life of the vaccinated person. 2. Lifetime validity of the certificate applies automatically to all existing and new certificates. 3. Validity of the certificate begins 4 days after vaccination. 4. In India, booster dose of yellow fever vaccine is required for those whose certificate is prior to the year 2016. Select the correct answer using the code given below :

1 and 2. ***1 and 2*** - The **term of validity** of the International Certificate of Vaccination or Prophylaxis (ICVP) for yellow fever changed from 10 years to **lifetime duration** on **July 11, 2016** (WHO IHR amendment). - This **lifetime validity** applies automatically to all existing and new ICVPs, regardless of when they were issued. - Both statements accurately reflect current WHO International Health Regulations. *2 and 4* - While statement 2 is correct, statement 4 is incorrect; **India does not require a booster dose** for yellow fever even if the certificate is prior to 2016. - The lifetime validity supersedes all previous recommendations, and India follows WHO guidelines. *2 and 3* - While statement 2 is correct, statement 3 is incorrect; the **validity of the certificate begins 10 days after vaccination**, not 4 days. - This 10-day period allows for the development of adequate immune response to the yellow fever vaccine. *1 and 3* - While statement 1 is correct regarding the change to lifetime validity, statement 3 is incorrect; the **certificate's validity begins 10 days after vaccination**, not 4 days. - The 10-day waiting period is a standard requirement under WHO IHR.

Q: Which one among the following types of ventilation, best fits the following description - "A system of ventilation in which fresh air is blown into the room by centrifugal fans so as to create a positive pressure, and displace the vitiated air" ?

Plenum ventilation. ***Plenum ventilation*** - **Plenum ventilation** involves blowing fresh air into a space using fans, creating a **positive pressure** that displaces stale air. - This method is effective for maintaining good air quality and preventing the infiltration of unconditioned air from outside. *Exhaust ventilation* - **Exhaust ventilation** involves drawing air out of a space, creating a negative pressure, which allows fresh air to enter naturally. - This method is often used to remove contaminated air from specific areas, like kitchens or bathrooms, rather than supplying fresh air to an entire room. *Balanced ventilation* - **Balanced ventilation** systems aim to supply and exhaust equal amounts of air, maintaining neutral pressure within the space. - While it uses fans for both supply and exhaust, it doesn't primarily aim to create a positive pressure and displace air as described. *Natural ventilation* - **Natural ventilation** relies on natural forces like wind pressure and thermal buoyancy to move air through a building. - It does not involve mechanical fans to blow air, nor does it typically create a controlled positive pressure to displace vitiated air.

Q: The 'Nalgonda Technique' developed by the National Environmental Engineering Research Institute (NEERI) was developed primarily for the removal of which one of the following from water ?

Fluoride. ***Fluoride*** - The **Nalgonda Technique** is a defluoridation method primarily used to remove excess **fluoride** from drinking water. - This technique utilizes the principles of chemical precipitation, adsorption, and ion exchange, using **alum** (aluminum sulfate), **lime**, and **bleaching powder** as coagulants. - Developed by NEERI to address endemic **fluorosis** in areas with high fluoride content in groundwater, particularly in regions like Nalgonda district in Telangana. *Chlorine* - Chlorine is commonly used as a **disinfectant** in water treatment to kill bacteria and viruses, not as a target for removal by the Nalgonda Technique. - Excess chlorine can be removed via activated carbon filtration or aeration, methods distinct from the Nalgonda process. *Iron* - Iron removal from water typically involves **aeration**, oxidation (e.g., with chlorine or potassium permanganate), followed by filtration. - While alum (a component of the Nalgonda Technique) can aid in iron precipitation, the Nalgonda Technique's primary design is not for iron removal. *Asbestos* - Asbestos fibers are typically removed from water using **filtration methods** like membrane filtration or granular media filtration. - The Nalgonda Technique is a chemical precipitation process not specifically designed or effective for the removal of fibrous materials like asbestos.

Q: The expected outcome of Government of India's initiative 'SUMAN' is :

Zero preventable maternal and newborn deaths. ***Zero preventable maternal and newborn deaths*** - The **SUMAN (Surakshit Matritva Aashwasan)** initiative aims to provide assured, dignified, and quality healthcare at no cost to every woman and newborn visiting a public health facility. - The ultimate goal of this comprehensive program is to eradicate all **preventable maternal and newborn deaths**, ensuring healthy outcomes for both mother and child. *Limit preventable maternal and newborn deaths to between 1 - 2%* - This percentage represents a reduction target, but not the ultimate aspirational goal of the SUMAN initiative. - The initiative's design emphasizes achieving a state where no preventable deaths occur, rather than settling for a small percentage. *Limit preventable maternal and newborn deaths to between 2 - 5%* - This range of preventable deaths is too high to be considered the desired outcome of such a comprehensive maternal and child health program. - The SUMAN initiative strives for maximum safety and care, making even 2% to 5% an unacceptable target for preventable deaths. *Limit preventable maternal and newborn deaths to between 0.5 - 1%* - While a very low percentage, this still implies that some preventable deaths would be acceptable, which contradicts the core principle of the SUMAN initiative. - The program's foundational premise is that all preventable deaths should be eliminated through quality care and intervention.

Question 1

A 15-month-old child presents with fever and cough since the last two days, the respiratory rate is 55/min and there is no drawing of the chest. According to the National Programme for Acute Respiratory Infections, the line of management should be

Accepted Answer

Administration of antibiotic at home along with treatment for fever, advising the mother to return for reassessment after two days

Answer

Immediate referral of the child to hospital for urgent admission

Answer

Administration of treatment for fever at home, advising the mother to return after two days for assessment of the need for an antibiotic

Answer

Referral of the child to hospital for admission, after administration of first dose of antibiotic

Question 2

Which of the following will qualify as a Class III exposure to Rabies?

Accepted Answer

Bites by wild animals

Answer

Bites on legs by a dog

Answer

Drinking unboiled milk of a suspect animal

Answer

Licks on intact skin by a dog

Question 3

Consider the following :

1. Magnesium Sulphate
2. Calcium bicarbonate
3. Calcium Sulphate
4. Magnesium bicarbonate

Hardness of water relates to the presence of which of the above?

Accepted Answer

1, 2, 3 and 4

Answer

1, 2 and 3 only

Answer

2, 3 and 4 only

Answer

1 and 4 only

Question 4

In which of the following diseases is post-exposure immunisation prescribed?

Accepted Answer

Rabies

Answer

Poliomyelitis

Answer

Yellow fever

Answer

Cholera

Question 5

NACO (National AIDS Control Organization) in India works towards which of the following causes?

1. Screening high-risk cases of HIV
2. Facilitating adoption of orphans
3. Public education towards safe sex
4. Providing antiretroviral therapy.

Select the correct answer using the code given below:

Accepted Answer

1, 3 and 4

Answer

2, 3 and 4

Answer

1, 2 and 4

Answer

1, 2 and 3

Question 6

Which one of the following is defined as "the average number of children a woman would have if she were to pass through her reproductive years, bearing children at the same rates as the women now in each age group" ?

Accepted Answer

Total Fertility Rate (TFR)

Answer

Net Reproduction Rate (NRR)

Answer

General Fertility Rate (GFR)

Answer

Age-Specific Fertility Rate (ASFR)

Question 7

Which among the following is correct about yellow fever vaccination requirement for international travellers ?

1. Term of validity of the certificate is changed from 10 years to the duration of the life of the vaccinated person.
2. Lifetime validity of the certificate applies automatically to all existing and new certificates.
3. Validity of the certificate begins 4 days after vaccination.
4. In India, booster dose of yellow fever vaccine is required for those whose certificate is prior to the year 2016.

Select the correct answer using the code given below :

Accepted Answer

1 and 2

Answer

2 and 4

Answer

2 and 3

Answer

1 and 3

Question 8

Which one among the following types of ventilation, best fits the following description - "A system of ventilation in which fresh air is blown into the room by centrifugal fans so as to create a positive pressure, and displace the vitiated air" ?

Accepted Answer

Plenum ventilation

Answer

Exhaust ventilation

Answer

Balanced ventilation

Answer

Natural ventilation

Question 9

The 'Nalgonda Technique' developed by the National Environmental Engineering Research Institute (NEERI) was developed primarily for the removal of which one of the following from water ?

Accepted Answer

Fluoride

Answer

Chlorine

Answer

Iron

Answer

Asbestos

Question 10

The expected outcome of Government of India's initiative 'SUMAN' is :

Accepted Answer

Zero preventable maternal and newborn deaths

Answer

Limit preventable maternal and newborn deaths to between 1 - 2%

Answer

Limit preventable maternal and newborn deaths to between 2 - 5%

Answer

Limit preventable maternal and newborn deaths to between 0.5 - 1%

UPSC-CMS 2023 — Community Medicine