BPSC 69th CCE Prelims General Studies · Question 8 of 144

Correct — C, Only 3 and 4. The item is built out of one clean swap and two straight definitions, and the whole of it can be settled from the Greek roots. Pair 3 is right: dyspnoea is dys- (difficult, disordered) plus pnoia (breathing), and it denotes the subjective sensation of breathlessness or air hunger. It is a symptom rather than a disease, and it can arise from the lung (asthma, COPD, pneumonia, pleural effusion), from the heart (left-ventricular failure), from the blood (severe anaemia) or from anxiety. Its relatives share the ending: apnoea is a complete pause in breathing, tachypnoea abnormally rapid breathing, bradypnoea abnormally slow, and orthopnoea breathlessness that appears only on lying flat. Pair 4 is also right: anosmia is an- (without) plus osme (smell), the partial or complete loss of the sense of smell. A reduced sense of smell is hyposmia, a distorted one parosmia, a phantom one phantosmia, and the equivalent loss of taste is ageusia. Anosmia moved from an obscure ENT term to a household word in 2020, when sudden loss of smell turned out to be one of the more specific early markers of COVID-19. Pairs 1 and 2 have simply been exchanged with one another. Anorexia is an- plus orexis (appetite) — literally the absence of appetite — and anorexia nervosa is an eating disorder, defined by restriction of food intake to a significantly low body weight together with an intense fear of gaining weight and a disturbed perception of one's own body. Insomnia is the sleep disorder: in- (not) plus somnus (sleep), a persistent difficulty in falling asleep, staying asleep or getting back to sleep despite an adequate opportunity, with impairment the following day; the chronic form is defined as occurring at least three nights a week for at least three months. Restore each term to its own category and only pairs 3 and 4 stand as printed, which is option (c).

• (a)Only 1 and 2 — The exact inversion of the truth — it accepts the two swapped pairs and rejects the two accurate ones. This is what a candidate picks who registers that anorexia and insomnia are both real, serious and frequently discussed disorders, but never checks which category each belongs to, and who then assumes that the unfamiliar-looking Greek words at 3 and 4 must be the planted errors. In fact 3 and 4 are the only pairs printed correctly.
• (b)Only 2 and 3 — Half right and half wrong: dyspnoea really is shortness of breath, but insomnia is a sleep disorder and not an eating disorder, so pair 2 fails. This is the classic outcome of checking the list from the top, catching the anorexia error at pair 1, and then not applying the same scrutiny to pair 2 — where the very same swap has been made in the opposite direction.
• (d)All of the above — Cannot stand, because accepting it means accepting that anorexia and insomnia have exchanged their standard meanings — that a loss of appetite is a disorder of sleep and a loss of sleep is a disorder of eating. An 'all of the above' option is the standard reward for recognising every term in the list without verifying a single mapping, and this item is designed around exactly that reflex.

Clinical vocabulary in English is assembled from a small stock of Greek and Latin word parts, and a candidate who learns the parts can decode terms never seen before instead of memorising them one by one. The prefixes a- or an- mean absence (anaemia, apnoea, ageusia, anuria); dys- means difficult or disordered (dyspnoea, dysphagia, dysentery); hypo- and hyper- mean below and above normal; brady- and tachy- mean slow and fast. The endings carry the organ or function: -pnoea breathing, -phagia swallowing, -osmia smell, -geusia taste, -uria urine, -algia pain, -aemia blood, -itis inflammation. The two Latin-rooted words in this question follow the same logic — insomnia from somnus, sleep, and anorexia from the Greek orexis, appetite. Note also the distinction between a symptom and a disorder. Anorexia in strict usage is a symptom, the loss of appetite, which accompanies infections, cancers and many drugs; anorexia nervosa is the named psychiatric eating disorder. Dyspnoea likewise is a symptom, never a diagnosis in itself.

The reliable method on a four-pair matching item is not to hunt for the one you can confirm but to test every pair in turn, because BPSC's favourite device is to exchange two adjacent entries so that both members of the swap look plausible in isolation. Here the swap is between pairs 1 and 2: read them together and you can see that anorexia has been handed insomnia's category and insomnia has been handed anorexia's. That single observation kills (a), which takes both halves of the swap; kills (b), which takes one half of it; and kills (d), which takes everything. Only (c) is left. Reaching it positively is easier still, because pairs 3 and 4 are simply translations — dys + pnoia is 'difficult breathing' and an + osme is 'without smell' — so a candidate who knows the roots can verify them without knowing any clinical medicine at all. The reason so many candidates get this wrong is that they read pairs 1 and 2 in the language of everyday news, where anorexia is discussed as a slimming illness and insomnia as sleeplessness, and never notice that the paper has printed them the wrong way round.

• Anorexia is an- (without) plus orexis (appetite). Anorexia nervosa is an eating disorder marked by restricted intake to a significantly low body weight, intense fear of weight gain and a distorted body image; it carries among the highest mortality of any psychiatric illness.
• Insomnia is a sleep disorder — difficulty initiating or maintaining sleep despite adequate opportunity, with next-day impairment. Chronic insomnia is defined as at least three nights a week for at least three months; other sleep disorders include obstructive sleep apnoea, narcolepsy and restless legs syndrome.
• The -pnoea family: dyspnoea is difficult or laboured breathing, apnoea a temporary cessation of breathing, tachypnoea an abnormally fast rate and bradypnoea an abnormally slow one, against a normal adult resting rate of about 12 to 20 breaths a minute; orthopnoea is breathlessness that appears on lying flat.
• The smell-and-taste family: anosmia is total or partial loss of smell, hyposmia a reduced sense, parosmia a distorted one and phantosmia a phantom odour; loss of taste is ageusia. Sudden anosmia and ageusia were added to COVID-19 case definitions in 2020.
• The transferable kit for prelims: a-/an- absence (anaemia, anuria, ageusia), dys- difficulty (dysphagia is difficulty in swallowing, not in breathing), -osmia smell, -geusia taste, -pnoea breathing, -algia pain, -uria urine.

• Pairs 1 and 2 are swapped with each other rather than merely loose — a candidate who recognises all four words as genuine disorders and stops there is steered straight to 'All of the above'
• Confusing anorexia the symptom (loss of appetite) with anorexia nervosa the psychiatric eating disorder; the pairing with 'sleep disorder' fails on either reading
• Single-letter confusions: dyspnoea (difficult breathing) against dysphagia (difficult swallowing), and anosmia (loss of smell) against ageusia (loss of taste)

BPSC prefers a four-pair matching block in which two adjacent entries have been quietly exchanged, so every word in the list is familiar and only the mapping is false; the codes then always include an 'All of the above' to collect the candidate who recognises the vocabulary but verifies nothing. UPSC builds the same trap from three pairs instead of four and usually mis-assigns only one of them, as in 2014's 'Vitamin E : Night blindness', where the vitamin is real, the disease is real and just the pairing is wrong.

• practice — not a real PYQ

  Which one of the following pairs is correctly matched?

  • (a)Dysphagia : Difficulty in breathing
  • (b)Ageusia : Loss of the sense of smell
  • (c)Apnoea : Temporary cessation of breathing
  • (d)Hyposmia : Excessive daytime sleepiness

  Answer(c) Apnoea : Temporary cessation of breathing — from a- (without) and pnoia (breath). Dysphagia is difficulty in swallowing, ageusia is loss of taste, and hyposmia is a reduced sense of smell.

• practice — not a real PYQ

  Sudden loss of the sense of smell, recognised as an early symptom of COVID-19, is medically termed:

  • (a)Ageusia
  • (b)Aphasia
  • (c)Anaesthesia
  • (d)Anosmia

  Answer(d) Anosmia — an- (without) plus osme (smell). Ageusia is loss of taste, aphasia is loss of language, and anaesthesia is loss of sensation generally.