UPSC-CMS 2023 Practice Questions

Q: The ratio between incidences among exposed and non-exposed persons is called

Relative risk. ***Correct: Relative risk*** - This is the ratio of the **incidence of disease** in an **exposed group** to the incidence of disease in an **unexposed group**. - It quantifies the likelihood of developing the disease in the exposed group relative to the unexposed group. - **Formula:** RR = (Incidence in exposed) / (Incidence in unexposed) *Incorrect: Positive predictive value* - This statistical measure indicates the probability that a person with a **positive test result** actually has the disease. - It is not a measure of incidence comparison between exposed and unexposed populations. *Incorrect: Attributable risk* - This measures the **absolute difference** in incidence rates between exposed and unexposed groups. - It quantifies the amount of disease incidence that can be directly attributed to the exposure, not a ratio. - **Formula:** AR = (Incidence in exposed) - (Incidence in unexposed) *Incorrect: Odds ratio* - This is a measure of association between an **exposure and an outcome**, representing the odds that an outcome will occur given a particular exposure, compared to the odds of the outcome occurring in the absence of that exposure. - It is commonly used in **case-control studies** and is a ratio of odds, not directly incidence rates.

Q: Match List-I with List-II and select the correct answer using the code given below the Lists:

A→4 B→3 C→2 D→1. ***A→4 B→3 C→2 D→1*** - A **symposium** (A) is characterized by a "discussion among the speakers" (4), where experts present different aspects of a topic, followed by interaction. - A **panel discussion** (B) involves a "series of speeches on a selected subject" (3) by panel members in front of an audience, often with interaction moderated by a chairperson. - A **workshop** (C) typically focuses on "arriving at a plan of action to solve the problem" (2) through practical, hands-on activities and collaborative problem-solving. - **Role-play** (D) is a technique where a "situation is dramatized" (1) by participants acting out roles to understand different perspectives or practice new skills. *A→1 B→3 C→2 D→4* - This option incorrectly matches "Symposium" with "Situation is dramatized" and "Role-play" with "Discussion among the speakers". - Role-play is about dramatizing a situation, while a symposium involves discussion among speakers. *A→1 B→2 C→3 D→4* - This option misaligns multiple matches, particularly with "Symposium" (A) and "Workshop" (C). - A workshop is about action plans, and a symposium is about discussions among speakers, not the other way around. *A→4 B→2 C→3 D→1* - This option incorrectly matches "Panel discussion" with "Arriving at a plan of action to solve the problem" and "Workshop" with "Series of speeches on a selected subject". - Workshops focus on action plans, and panel discussions involve a series of speeches.

Q: A new drug is to be evaluated for its therapeutic effect. The best study design will be.

Randomized controlled trial. ***Randomized controlled trial*** - This design is the **gold standard** for evaluating the effectiveness of a new therapeutic intervention. - **Randomization** minimizes confounding, and a control group allows for direct comparison of outcomes, isolating the **drug's effect**. *Natural experiment* - This design involves observing the effects of an intervention that occurs naturally, without researcher manipulation. - It lacks the **control** and **randomization** necessary to definitively attribute observed effects solely to the therapeutic agent. *Cross sectional survey* - This design assesses the prevalence of a condition or exposure at a single point in time. - It cannot establish **causality** or evaluate the therapeutic effect of an intervention over time. *Case control design* - This retrospective design compares individuals with a disease (cases) to those without (controls) to identify past exposures. - It is used to investigate **risk factors** for diseases, not to evaluate the therapeutic efficacy of a new drug.

Q: Consider the following criteria for a "screening test" : 1. Disease should have a latent period 2. Condition (disease) should be rare 3. Disease should be amenable to treatment Which of the above must be satisfied before including a screening test into any programme?

1 and 3. ***1 and 3*** - A successful screening program requires the disease to have a detectable **latent period** (criterion 1) during which early intervention can be beneficial. - Furthermore, the disease must be **amenable to treatment** (criterion 3); if there's no effective treatment, early detection offers no clinical advantage. *1 only* - While a **latent period** is essential for effective screening, it is not the sole criterion; the availability of treatment is equally critical. - Screening for a disease with a latent period but no effective treatment would lead to early diagnosis without improved outcomes, causing unnecessary anxiety. *2 only* - The **rarity of a condition** (criterion 2) is generally not a prerequisite for screening; in fact, screening is often more cost-effective for more prevalent diseases. - Screening rare diseases can lead to a low positive predictive value and higher rates of false positives, making it inefficient without substantial public health impact. *1 and 2* - Although a **latent period** is necessary, screening is generally more useful and cost-effective for diseases that are common enough to warrant population-level intervention, not necessarily rare diseases. - Screening primarily aims for early intervention and improved outcomes, which are not solely dependent on rarity, but on the disease's burden and treatability.

Q: "Risk ratio" is also known as:

Relative risk. ***Relative risk*** - **Risk ratio** is another term for **relative risk**, which is a measure of association between exposure to a factor and the risk of an outcome. - It compares the risk of an event in an **exposed group** to the risk of an event in an **unexposed group**. *Odds ratio* - The **odds ratio** is a measure of association that quantifies the relationship between an exposure and an outcome, often used in **case-control studies**. - It approximates the relative risk when the outcome is **rare** but is distinct in its calculation based on odds rather than risks. *Attributable risk* - **Attributable risk** (or risk difference) quantifies the **absolute difference in risk** between exposed and unexposed groups. - It represents the amount of disease incidence that can be directly attributed to the exposure. *Population attributable risk* - **Population attributable risk** is the proportion of a disease in the total population that is attributable to a specific exposure. - It considers both the **strength of the association** and the **prevalence of the exposure** in the population.

Q: Consider the following characteristics of biological agents : 1. Infectivity 2. Pathogenicity 3. Virulence 4. Communicability Among the above characteristics, which are used to measure the ability of biological agents to induce clinically apparent illness?

2 and 3. ***2 and 3*** - **Pathogenicity** is the ability of an infectious agent to cause disease (clinically apparent illness) in infected individuals, measured as the proportion of infected persons who develop clinical disease. - **Virulence** is the ability of an agent to produce severe disease, measured as the proportion of clinical cases that are severe or fatal. - **Both characteristics measure different aspects of the ability to induce clinically apparent illness**: pathogenicity measures whether clinical illness occurs, while virulence measures the severity of that clinical illness. - Together, they comprehensively describe an agent's capacity to produce clinically apparent disease. *2 only* - While pathogenicity does measure the ability to cause clinically apparent illness, this is incomplete. - Virulence is also a measure of the ability to induce clinically apparent illness, specifically measuring the severity spectrum of that illness. *3 only* - Virulence alone is insufficient as it only measures severity among those who are already clinically ill. - Pathogenicity is also needed to measure the ability to produce clinical illness in the first place. *1 and 2* - **Infectivity** measures the ability of an agent to enter, survive, and multiply in a host, which is a prerequisite for disease but does not measure clinical illness itself. - An agent can have high infectivity but low pathogenicity (causing mostly subclinical infections). - Only pathogenicity and virulence directly measure aspects of clinically apparent illness.

Q: "Mid-year population" is not the denominator of which mortality rate?

Proportional mortality rate. ***Proportional mortality rate*** - The **proportional mortality rate** uses the **total number of deaths from all causes** as its denominator, not the mid-year population. - It expresses the proportion of all deaths due to a specific cause, rather than a rate per population at risk. - Formula: PMR = (Deaths from specific cause / Total deaths) × 100 *Age specific death rate* - The **age-specific death rate** uses the **mid-year population of a specific age group** as its denominator to calculate the number of deaths within that group. - This allows for comparison of mortality across different age cohorts. *Crude death rate* - The **crude death rate** uses the **total mid-year population** of a given area as its denominator. - It represents the overall mortality experience of a population but does not account for age structure. *Weekly death rate* - Though not a standard epidemiological measure, if calculated, this would use the **mid-week or average population for that specific week** as its denominator. - This would measure mortality frequency over a shorter, defined period using a population base.

Q: The best indicator for the measurement of "completed family size"; that is the number of children a woman would have through her reproductive years is

Total fertility rate. ***Total fertility rate*** - The **Total Fertility Rate (TFR)** estimates the average number of children a woman would have over her lifetime if she were to experience the current age-specific fertility rates. - It is considered the best indicator of "completed family size" because it projects the total number of live births a woman is expected to have by the end of her reproductive life, assuming static fertility rates. *Net reproduction rate* - The **Net Reproduction Rate (NRR)** accounts for both fertility and mortality, indicating how many daughters each woman is expected to have who will survive to reproductive age. - While it measures population replacement, it doesn't directly represent the total number of children a woman *would have* through her reproductive years, as it only counts female offspring who survive to reproductive age. *General fertility rate* - The **General Fertility Rate (GFR)** measures the number of live births per 1,000 women aged 15-49 years in a given year. - It provides an overall measure of current fertility but does not project the total number of children a woman is expected to have over her lifetime, as it is a period measure. *Gross reproduction rate* - The **Gross Reproduction Rate (GRR)** is similar to TFR but only counts female births, representing the average number of daughters a woman would have if she survived through her entire reproductive life. - It does not account for mortality among female offspring, making TFR a more comprehensive measure of overall family size, and NRR a better measure of population replacement.

Question 1

The ratio between incidences among exposed and non-exposed persons is called

Accepted Answer

Relative risk

Answer

Positive predictive value

Answer

Attributable risk

Answer

Odds ratio

Question 2

Match List-I with List-II and select the correct answer using the code given below the Lists:

Accepted Answer

A→4  B→3  C→2  D→1

Answer

A→1  B→3  C→2  D→4

Answer

A→1  B→2  C→3  D→4

Answer

A→4  B→2  C→3  D→1

Question 3

A new drug is to be evaluated for its therapeutic effect. The best study design will be.

Accepted Answer

Randomized controlled trial

Answer

Natural experiment

Answer

Cross sectional survey

Answer

Case control design

Question 4

Consider the following criteria for a "screening test" :

1. Disease should have a latent period
2. Condition (disease) should be rare
3. Disease should be amenable to treatment Which of the above must be satisfied before including a screening test into any programme?

Accepted Answer

1 and 3

Answer

1 only

Answer

2 only

Answer

1 and 2

Question 5

"Risk ratio" is also known as:

Accepted Answer

Relative risk

Answer

Odds ratio

Answer

Attributable risk

Answer

Population attributable risk

Question 6

Consider the following characteristics of biological agents :

1. Infectivity
2. Pathogenicity
3. Virulence
4. Communicability

Among the above characteristics, which are used to measure the ability of biological agents to induce clinically apparent illness?

Accepted Answer

2 and 3

Answer

3 only

Answer

2 only

Answer

1 and 2

Question 7

"Mid-year population" is not the denominator of which mortality rate?

Accepted Answer

Proportional mortality rate

Answer

Age specific death rate

Answer

Crude death rate

Answer

Weekly death rate

Question 8

The best indicator for the measurement of "completed family size"; that is the number of children a woman would have through her reproductive years is

Accepted Answer

Total fertility rate

Answer

Net reproduction rate

Answer

General fertility rate

Answer

Gross reproduction rate

Question 9

Under the DOTS strategy of Revised National Tuberculosis Programme, the recommended line of management in Category I patients, if the sputum is positive after 2 months of Intensive Phase treatment with 4 drugs, is to

Accepted Answer

Continue the Intensive Phase of treatment with 4 drugs for 1 more month only, regardless of sputum positivity after that

Answer

Add one more drug, that is, to use 5 drugs until the sputum becomes negative

Answer

Continue the Intensive Phase of treatment with 4 drugs until the sputum becomes negative

Answer

Start the continuation phase with INH and Rifampicin

Question 10

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

UPSC-CMS 2023

Community Medicine