338 - UPSC CMS 2010 Mcqs with answers - part 1

1q: A young college student having regular heart rate of 172 beats per minute attends OPD for uneasy sensation in chest. Carotid sinus pressure brings down the heart rate to 72 per minute. What is the most likely diagnosis ?
a. Ventricular tachycardia
b. Atrial fibrillation
c. Sinus arrythmia
d. PSVT

answer d. PSVT.

2q: A 66 year old lady presents to the emergency with 2 episodes of vomiting. Her ECG shows elevation of ST segment in inferior leads. Her BP is 80 mm systolic. The best way to start correcting her BP is ?
a. Immediate thrombolysis
b. Rescue PTCA
c. Normal saline infusion
d. Dopamine infusion

answer c. Normal saline infusion.

3q: A 15 year old boy is brought to the emergency room by the class teacher from the chemistry laboratory. The boy is an atopic individual with pulse rate of 116/minute regular, unable to speak in sentences and ABG shows severe hypoxemia. What is the probable diagnosis ?
a. Acute bacterial pneumonia
b. Acute severe asthma
c. Acute pleurisy
d. Tension pneumothorax

answer b. Acute severe asthma.

4q: A 45 year old man presented with regurgitated food particles eaten several days earlier. He has foul smelling breath and occasional dysphagia for solid food. What is the probable diagnosis ?
a. GOO
b. Zenker's diverticulum
c. Scleroderma
d. Diabetic gastroparesis

answer b. Zenker's diverticulum.

5q: Which one of the following bacteria almost never causes cavities in the lungs ?
a. Staphylococcus aureus
b. Pseudomonas aeruginosa
c. Actinomyces
d. Haemophilus influenzae

answer d. H.inflenza.

6q: A 24 year old woman with the history of ulcerative colitis presented with progressive jaundice associated with pruritis and intermittent right upper quadrant abdominal pain. What would be the most likely ERCP finding ?
a. Normal finding
b. Diffuse strictures of common bile duct
c. Malignant strictures of CBD
d. Stones

answer b. Diffuse strictures of CBD.

7q: Early recurrent falls in elderly with opthalmoplegia suggests the possibility of ?
a. Huntington's chorea
b. Parkinson's disease
c. Shy-Drager syndrome
d. Progressive Supra nuclear palsy

answer d. Progressive supranuclear palsy.

8q: Consider the following :
Recognised causes of Proximal Type II (RTA) include :
1. Amyloidosis
2. Heavy metal poisoning
3. Renal transplant rejection
4. Hyperparathyroidism

Select the correct answer using the code given below :
a. 1,3,4
b. 1 and 2 only
c. 1,2 and 3
d. 2,3 and 4

answer c. 1,2,3.

Causes of Proximal RTA :


Familial disorders
* Cystinosis
* Galactosemia
* Glycogen storage disease (type I)
* Hereditary fructose intolerance
* Lowe syndrome
* Tyrosinemia
* Wilson's disease

Acquired disorders
* Amyloidosis
* Multiple myeloma
* Paroxysmal nocturnal hemoglobinuria
* Kidney transplant rejection
* Toxins, such as HAART, ifosfamide, lead, and cadmium (heavy metals)

9q: Criteria for hospital admission of an adult with community acquired pneumonia includes all except ?
a. Respiratory rate greater than 28/min
b. TLC greater than 11,000/cu.mm
c. New onset confusion or impaired level of consciousness
d. Hypoxemia PaO2 less than 60 mm Hg

answer b. TLC greater than 11,000/cu.mm

*Go to this page to read more about PSI score and CURB-65 score.

10q: Consuming which of the following food products is most associated with E.Coli type 0157 infection ?
a. Eggs
b. Poultry
c. Beef
d. Soft cheese

answer c. Beef.

*Escherichia coli O157:H7 is an enterohemorrhagic strain of the bacterium Escherichia coli and a cause of foodborne illness. Infection often leads to hemorrhagic diarrhea, and occasionally to kidney failure, especially in young children and elderly. Most illness has been associated with eating undercooked, contaminated ground beef, drinking unpasteurized milk, swimming in or drinking contaminated water, and eating contaminated vegetables.

218 - UPSC 2007 medical entrance mcqs with answers part 28

136. Intrauterine foetal growth retardation may be associated with the following except


(a) maternal drug addiction
(b) maternal smoking
(c) foetal viral infection
(d) regular maternal aspirin intake

answer d . regular maternal aspirin intake

Exact lines taken from chapter 14 of Williams obstetrics 22nd edition : read along :
Because aspirin is a potent prostaglandin inhibitor, there is a theoretical concern that fetal exposure could lead to premature closure of the ductus arteriosus. Despite this, and with the massive number of exposures, premature closure has not been reported. DiSessa and colleagues (1994) performed echocardiography from 15 to 40 weeks in 63 fetuses exposed to 60 mg of aspirin given daily to prevent preeclampsia. They consistently found normal ductus flow velocity and cardiac output. Acetaminophen also has not been associated with an increased risk of anomalies (Pastore and colleagues, 1999; Thulstrup and associates, 1999).


137. Face to pubes delivery is possible with which cephalic presentation?


(a) Mento-anterior
(b) Mento-posterior
(c) Occipito sacral
(d) Brow presentation

answer will post soon

138. With reference to meningococcal meningitis, which one of the following statements is not correct?


(a) Fatality in untreated cases is 60 percent
(b) Disease spreads mainly by droplet infection
(c) Treatment of cases has no significant effect on epidemiological pattern of disease
(d) Mass chemoprophylaxis causes immediate drop in the incidence rate of cases

answer will post soon

139. With reference to the epidemiology of Severe Acute Respiratory Syndrome (SARS), which one of the following statements is not correct?


(a) Patient is most infectious during the first five days of illness
(b) No evidence of mother to child transmission is observed
(c) Children are rarely affected
(d). No evidence of child to child

answer will post soon

140. Consider the following diseases:


1. Trench fever
2. Q fever
3. Weil's disease
4. Brill-Zinsser disease


Which of the above is / are caused by rickettsial infection?


(a) 1 only
(b) 2 and 3 only
(c) 1, 2 and 4 only
(d) 1, 2, 3 and 4

answer c . 1,2 and 4 . weil’s disease is caused by leptospira .

217 - UPSC 2007 medical entrance mcqs with answers part 27

131q. What is the average number of fleas of each species per rodent called?


(a) General Flea Index
(b) Specific Flea Index
(c) Incidence of Flea Species
(d) Flea Infestation Rate

answer b . specific flea index

132. Which one of the following is not a viral haemorrhagic fever?


(a) Yellow fever
(b) Rocky Mountain spotted fever
(c) Kyasanur Forest disease
(d) Dengue fever

answer b . rocky mountain spotted fever . it is caused by rickettsia rickettsi, a bacteria .

133. What is the method of sampling in which the units are picked up at regular intervals from the universe?


(a) Simple random sampling
(b) Systematic random sampling
(c) Stratified random sampling
(d) Snow- ball sampling

answer will post soon

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


List-I List-II


(State) (Retinol as vitamin)


A. Pregnancy 1. 600 mcg
B. Lactation 2. 950 mcg
C. Infant 3. 350 mcg
D. Children (1-6 years ) 4. 400 mcg 


Code:
(a) A B C D
1 3 2 4


b) A B C D
4 2 3 1


(c) A B C D
4 3 2 1


d) A B C D
1 2 3 4

answer d . A1 B2 C3 D4

The values given in the question are not the exact values but in the question , (d) is the best answer to pick . The exact values about the dietary requirements of all vitamins in all kinds of individuals are given in a beautiful table in chapter 70 – table 70.1 of Harrison’s internal medicine 17th edition . please go through that table for more information .


135. Which one of the following will be affected by inter-observer variation ?


a) Sensitivity
b) Predictive value of the positive test
c) Specificity
(d) Reliability

answer will post soon

216 - UPSC 2007 medical entrance mcqs with answers part 26

126. Guidelines for handling of Biomedical Waste (Management and Handling) Rule, 1998 are laid down by


a. Ministry of Social-Welfare
b. Directorate of Medical Education and Research 
c. Ministry of Health and Family Welfare
d. Ministry of Environment and Forests

answer d . ministry of environment and forests

127. Which one of the following is not a target disease under 'Vision 2020 : The Right to Sight'?


(a) Refractive error
(b) Trachoma
(c) Corneal blindness
(d) Diabetic retinopathy

answer c . corneal blindness

The target area diseases for VISION 2020 are :


1. cataract
2. trachoma
3. onchoceriasis
4. childhood blindness
5. refractive error
6. low vision
7. glaucoma
8. diabetic retinopathy
9. age related macular degeneration


For complete information on VISION 2020 visit this web page .


128. What is Berkesonian bias?


(a) Mis-classification bias
(b) Recall bias
(c) Selection bias
(d) Non-response bias

answer c . selection bias

BERKESONIAN BIAS :
Potential problem in hospital-based studies when comparing the frequency of two conditions that require or lead to hospitalization (e.g. tuberculosis and lung cancer), due to the fact that persons with both conditions are more likely to be hospitalized than those with only one.


129. The WHO definition for blindness is the inability of counting fingers in daylight at a minimum distance of


(a) 3 feet
(b) 6 feet
(c) 3 metres
(d) 6 metres

answer c . 3 meters

130. Which one of the following is the category 1 of biomedical waste in India?


(a) Human anatomical waste
(b) Microbiological and biotechnological waste
(c) Discarded medicines and cytotoxic drugs
(d) Animal waste

answer a . human anatomical waste

CATEGORIES OF BMW


Category No. 1 Human Anatomical Waste
Category No. 2 Animal Waste
Category No. 3 Microbiology & Biotechnology Waste
Category No. 4 Waste sharps
Category No. 5 Discarded Medicines and Cytotoxic drugs
Category No. 6 Soiled Waste
Category No. 7 Solid Waste
Category No. 8 Liquid Waste
Category No. 9 Incineration Ash
Category No. 10 Chemical Waste


TREATMENT OF BMW


Category No.1 Incineration /deep burial


Category No.2 Incineration /deep burial


Category No.3 Autoclaving/microwaving/incineration


Category No.4 Disinfection(chemical treatment)/autoclaving/ microwavingandmutilation/shredding


Category No.5 Incineration/destruction/ and drugs disposal in secured landfills


Category No. 6 Incineration/autoclaving/microwaving


Category No.7 Disinfection by chemical treatment/autoclaving/ microwaving and mutilation/ shredding


Category No.8 Disinfection by chemical treatment ; discharge into drains


Category No.9 Disposal in municipal land fill


Category No.10 Chemical treatment and discharge into drains for liquids and secured landfill for solids.

215 - UPSC 2007 medical entrance mcqs with answers part 25

The following five (5) items consist of two statements, one labelled as the 'Assertion (A)' and the other as 'Reason (R)'. You are to examine these statements carefully and select the correct answers to these items using the code given below:
Code:
(a) Both A and R are individually true and R is the correct explanation of A
(b) Both A and R are individually true but R is not the correct explanation of A
(c) A is true but R is false
(d) A is false but R is true


121. Assertion (A) :
When ABO and Rh incompatibilities coexist, the baby is likely to have more severe haemolytic disease.
Reason (R)
Both ABO and Rh antibodies cause haemolysis of foetal red blood cells.

answer A . both A and R are correct and R is the correct explanation of A

122. Assertion (A) :
In category III contact with a cat or dog, both antirabies immunoglobulin and vaccine are given immediately.
Reason (R) :
It takes at least 30 days to achieve a maximum level of immunity after vaccination.

answer will post soon

123. Assertion (A) :
As long as baby is less than six months old, a woman can rely on exclusive breast-feeding alone for contraception unless she menstruates.
Reason (R) :
Exclusive breast-feeding alone is the only safe method of contraception during six months after delivery.

answer c . A is true but R is false

124. Assertion (A) :
One of the pathological conditions of acquired coagulopathy is abruptio placentae.
Reason (R) :
In abruptio placentae, thromboplastin is liberated from the retroplacental clot and damaged decidua.

answer a . both A and R are true and R is the correct explanation of A

125. Assertion (A) :
Hypocalcemia is more common among babies fed with cow's milk.
Reason (R) :
Cow's milk contains less concentration of calcium than that of human milk.

answer c . A is true but R is false

Have a look at this page , which beautifully compares both breast milk and cow’s milk and their respective constituents with the values given in tables comparing each other . 

214 - UPSC 2007 medical entrance mcqs with answers part 24

116. Regarding Ludwig angina consider the following statements :

1 It is characterized by cellulitis usually of odontogenic origin.
2 It involves the submandibular sublingual and submental spaces.

which of the statements given above is are correct ?


A. 1 only
B. 2 only
C. Both 1 and 2
D. Neither 1 nor 2

answer will post soon

117. in a Sutured surgical wound , the process of epithelialization is completed within .

A. 24 Hours
B. 48 hours
C. 72 hours
D. 96 hours

answer A . 24 hours

It took a lot of time for me to find this answer . but finally found it in The washington manual of surgery . check out this page from the Washington manual of surgery by google books to view the answer yourself .


118. with reference to duodenal ulcers consider the following statement :

1 They occur most often in the second part of duodenum
2 infection with H pylori and NSAID induced injury account for maturity of duodenal ulcers
3. malignant duodenal users are extremely rare .
4. Eradication of H Pylori has greatly reduced the recurrence rates in duodenal ulcers .

A. 1, 2 and 3 only
B. 2,3 and 4 only
C. 1 and 4 only
D. 1,2,3 , and 4

answer b . 2,3 and 4 only

DUs occur most often in the first portion of duodenum (greater than 95%), with roughly 90% located within 3 cm of the pylorus. H. pylori and NSAID-induced injury account for the majority of DUs. Malignant DUs are extremely rare. The greatest impact of understanding the role of H. pylori in peptic disease has been the ability to prevent recurrence. Documented eradication of H. pylori in patients with PUD is associated with a dramatic decrease in ulcer recurrence to less than 10–20% as compared to 59% in GU patients and 67% in DU patients when the organism is not eliminated.


119. A Patient present with hemoptysis copious sputum and tram lines ( abnormal air bronchogram ) pattern on the chest X –ray what is the most likely diagnosis ?


A. Lung abscess
B. Pulmonary embolism with infraction
C. Bronchiectasis
D. carcinoma of lung

answer c . bronchiectasis

120. peripheral eosinophilia is not a characteristic feature of

a. Hypersensitivity
b. Allergic aspergillosis 
c. Tropical eosinophilia
d. Loeffler Syndrome

answer a . hypersensitivity

In chapter 249 of Harrison's internal medicine 17th edition, while discussing the diagnosis of hypersensitivity pneumoinitis, the author clearly mentions that eosinophilia is not a feature of hypersensitivity pneumonitis . In the same chapter read all the causes of eosinophilia which the author mentions in a table . 

213 - UPSC 2007 medical entrance mcqs with answers part 23

111. carcinoma of lip is characterized by the following except that

A. 90% of The lip cancers occur on the lower lip
B. the most common site of origin is the vermilion border
C. 2 CM X 2 2 CM Cell carcinomas can be treated by V shaped excision and primary closure
D. Since lymph nodded mutates are common of ten a radical dissection of neck is mandatory .

answer will post soon

112. A 40 year old man presented with a flat 1 cm x 1 cm scaly , itchy back mole on the front of the thigh . examinations did not reveal any
inguinal lymphadenopathy . the best course of managements would be

A. FNAC of the lesion
B. Incision biopsy
C. Excisional biopsy
D. wide excision with inguinal lumphadenctomy

answer will post soon

113. Tumors of anterior mediastinum include all of the following except

A. Thymoma
B. Lymphoma
C. Germ cell tumor
D. Schwanoma

answer d . schwannoma

Anterior mediastinal compartment, also known as anterosuperior compartment, is anterior to the pericardium. Masses in this area are more likely to be malignant than those in the other compartments.Most common masses found here include thymomas, germ cell tumors, lymphomas, thyroid tissue, and parathyroid lesions.

114. Extensive surgical debridement decompression of amputation may be indicated in the following clinical setting except .

A. Progressive synergistic gangrene
B. Acute Thrombophlebitis
C. acute hemolytic streptococcal cellulite
D. Acute thabdonuplysis

answer will post soon

115. Which one of the following bacteria is classified as facultative anaerobe ?

A. Pseudomonas
B. Bactericides
C. Escherichia
D. Clostridium

answer c . escherichia

click here to view a detailed information about all the facultative anaerobic organsims .

212 - UPSC 2007 medical entrance mcqs with answers part 22

106q: The post exposure prophylaxis against rabies is given in a course of five doses of human diploid cell derived rabies vaccine these doses are given on

A. Days 0,1, 4, 10, and 30
B. Days 0, 3,7, 14 , and 30
C. Days 0,7, 14, ,21 and 28
D. Days 0, 4, 14, ,24 and 30

answer b . 0,3,7,14,30

107 Haemolysis in G 6 PD ( glucose 6- phosphate dehydrogenase ) deficiencies may be induced by the following except

A. Primaquine
B. Phenacetin
C. Pronenecid
D. Penicillin

answer d . pencillin

Here is a list of all the drugs causing hemolysis in Glucose 6 phosphate dehydrogenase ( G6PD ) deficiency categorised into 3 groups based on their risk of causing hemolysis . first is the group which definitely cause hemolysis in G6PD deficiency , second is the group which have probable risk and the third is the group has doubtful risk .  go to that page here . 

108q: In India , what is the most common cause of unilateral lymph edema of lower limb?

A . Lymphedema
B Carcinoma of penis with metastasis nodes
C Filariasis
D tubercular lymphadenopathy

answer will post soon

109q: Etiopathpgenesis of diabetic foot include the following except .

A. Myelopathy

B. Osteoarthropathy

C. microangiopathy

D. Infection

answer will post soon

110 . Protein metabolism after trauma is characterized by the following except

A. Increased liver gluconegenesis
B. inhibition of skeletal muscle break down by interleukin I and tumor necroses factor
C. Increased urinary nitrogen loss
D. Hepatic synthesis of acute phase reactants

answer will post soon

211 - UPSC 2007 medical entrance mcqs with answers part 21

101. Which of the following is a potent stimulus for the production of erythro-poietin ?

A. Alpha interferon
B. Interkeukin-3
C. Hypoxia
D Hypercarbia

answer will post soon

102. Among the following one is not a good dietary source of iron ?

A . Liver
B. Jaggery
C. Fish
D. Milk

answer will post soon

103. A man who had under gone total mastectomy remains well for five year then he develops anemia. What is the most likely cause of this anemia?

A. protein deficiency
B. Zinc deficiency
C. Folic acid deficiency
D. Vitamin B 12 deficiency

answer will post soon

104q: Loeffler s syndrome is characterized by

A. Transient migratory pulmonary infiltration
B. Fibrosis in the pulmonary apices
C. Fibrosis in the base of one or both lungs
D. Miliary mottling

answer will post soon

105q: The level of which on of the flowing hormones is likely to increase after hypothalamic ablation ?

A. Growth hormone
B. Prolactin
C. FSH
D. ACTH

answer b . prolactin

210 - UPSC 2007 medical entrance mcqs with answers part 20

96. Which one of the following is not autosomal recessive?

(a) Adult polycystic kidney disease
(b) Cystic fibrosis of pancreas
(c) Homocystinuria
(d) Mucopolysaccharidosis

answer will post soon

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

List-I List-II

(Poison) (Antidote)

A. Benzodiazepine 1. D-Penicillamine
B. Copper sulphate 2. Flumazenil
C. Opiates 3. N-acetyl cysteine
D. Paracetamol 4. Naloxone

Code:
a. A B C D
2 4 1 3

b. A B C D
2 1 4 3

c. A B C D
3 4 1 2

d. A B C D
3 1 4 2

answer a . A2 B4 C1 D3 antidote of opiods is naloxone antidote of benzodiazepines is flumazenil antidote of copper sulphate is D-pencillamine antidote of paracetamol is N-acetyl cysteine

98q: Estimation of plasma cholinesterase levels may be helpful in the management of which one of the following poisonings ?

a. Datura
b. Barbiturate
c. Organophosphours
d. opium

answer will post soon

99. Antinuclear antibodies are present in what presence of cases of SLE ?

a. 50 %
b. 70%
c. 80%
d. More than 90%

answer will post soon

100. a 40 year old male patient is hospitalized with huge splenomegaly marked sternal tenderness and a total leucocyte count of 85000 per cubic millimeter and metamyelocytes which one of the following drugs is best indicated for his disease ?

a. Cyclophospyamide
b. Chlorambucil
c. Melphalan
d. Hydroxyurea

answer will post soon

209 - UPSC 2007 medical entrance mcqs with answers part 19

91. In a patient suspected to be suffering from vesicoureteric reflux, which one of the following radiological investigations may confirm the diagnosis?

(a) Intravenous urography
(b) Micturating cystourethrography
(c) Pelvic ultrasound
(d) Antegrade pyelography

answer will post soon

92. During the treatment of chronic myeloid leukemia, cytogenetic remission is least likely to occur with which one of the following modalities of treatment?

(a) Hydroxyurea
(b) Imatinib mesylate
(c) Interferon-alpha
(d) Bone marrow transplantation.

answer will post soon

93. Pancytopenia may occur in the following except

(a) Megaloblastic anaemia
(b) Severe iron-deficiency anaemia
(c) Hypoplastic anaemia
(d) Paroxysmal nocturnal haemoglo binuria

answer will post soon

94. A patient of rheumatic heart disease with mitral stenosis and atrial fibrillation is on oral warfarin. On one OPD visit, his INR is found to be 6. What is the action to be taken?

(a) Stop warfarin, and review
(b) Stop warfarin, and administer protamine sulphate
(c) Stop warfarin, and administer fresh frozen plasma
(d) Stop warfarin, and administer intramuscular vitamin K

answer will post soon

95. Which antipsychotic drug may cause severe agranulocytosis?

(a) Clozapine (b) Olanzapine
(c) Pimozide (d) Risperidone

answer will post soon

208 - UPSC 2007 medical entrance mcqs with answers part 18

86. What is the most common opportunistic infection in AIDS?

(a) Tuberculosis
(b) Cryptococcosis
(c) Pneumocystitis carinii
(d) Histoplasmosis

answer c . pneumocystis carinii

87. In chronic Hepatitis B infection, which one of the following markers is indicative of active viral replication and the corresponding risk of disease transmission?

(a) HBe antigen
(b) HBs antigen
(c) Anti-HBe
(d) Anti-HBs

answer a . HBe antigen

88. Match list-I with list-II and select the correct answer using the code given below the lists:

List-I List-II

(Type of hyperlipidemia) (Features)

A. Hyperchylomicronaemia) 1. Palmer plane xanthoma
B. Hyperbetalipoproteinemia - 2. Subcutaneous extensor tendon xanthoma
C. Typer III hyperlipoproteinemia 3. Eruptive xanthoma over buttocks
D. Familial LPL Deficiency mg% 4. Tryglyceride level above

Code:
a. A B C D
3 1 2 4

b. A B C D
3 2 1 4

c. A B C D
4 1 2 3

d. A B C D
4 2 1 3

answer will post soon

89. Tetany may be a feature of the following except

(a) Hyperventilation
(b) Hypokalaemic alkalosis
(c) Hypoinagnesaemia
(d) Hyponatraemia

answer will post soon

90. With reference to non-ketotic; hyperglycemic, hyperosmolar coma, consider the following statements:

1. It is common in second and third decade of life:
2. It is typically seen in Type I diabetes mellitus.
3. Blood sugar is usually above 500 mg/dl.

Which of the statements given above is/are correct?

(a) 1 and 2 only
(b) 3 only
(c) 2 and 3 only
(d) 1, 2 and 3

answer will post soon

207 - UPSC 2007 medical entrance mcqs with answers part 17

81. Regarding rheumatic heart disease, consider the following statements:

1. Rheumatic carditis is a pancarditis.
2. Carey-Coombs murmur is a delayed systolic munnur heard during the course of acute rheumatic fever.
3. Mitral regurgitation is the most common manifestation of acute rheumatic carditis.

Which of the statements given above is/are correct?

(a) 1 only
(b) 1 and 2
(c) 2 and 3
(d) 1 and 3

answer will post soon

82. Which one of the following does not cause pulsus paradoxus ?

(a) Severe aortic regurgitation
(b) Cardiac tamponade
(c) Constrictive pericarditis
(d) Acute severe bronchial asthma

answer a . severe aortic regurgitation causes of pulsus paradoxus are : 1. hypovolemic shock 2. acute obstructive airway disease 3. chronic obstructive airway disease ( asthma ) 4. pulmonary embolus 5. cardiac tamponade 6. constrictive pericarditis

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

List-I List- II

(Heart sound) (Disease)

A. Loud S1 1.Valvular pulmonary stenosis
B. Loud S2 2.Atrial septal defect
C. Soft S2 3.Mitral stenosis
D. Wide and fixed S2 4. Pulmonary arterial Hypertension

Code:

a. A B C D
3 4 1 2

b. A B C D
3 1 4 2

c. A B C D
2 4 1 3

d. A B C D
2 1 4 3

answer a . A3 B4 C1 D2 loud S1 is seen in mitral stenosis and tricuspid stenosis loud S2 is seen in pulmonary arterial hypertension ( it is loud P2 actually ) soft S2 is seen in valvular pulmonary stenosis wide and fixed S2 is seen in atrial septal defect

84. Ghon's complex is not characterised by

(a) Hilar lymph nodes
(b) Pleural effusion
(c) Prominent draining lymphatics
(d) Subpleural focus

answer b . pleural effusion

85. Which one of the following is the drug of choice in the case of ventricular tachycardia in myocardial infarction?

(a) Xylocard
(b) Digitalis
(c) Quinidine
(d) Disopyramide

answer will post soon

206 - UPSC 2007 medical entrance mcqs with answers part 16

76. With reference to the treatment of chronic Hepatitis B infection, consider the following drugs:

1. Lamivudine
2. Alpha interferon
3. Ribavirin
4. Acyclovir

Which of the above drugs are useful in the treatment of chronic Hepatitis B infection?

(a) 1 and 2 only
(b) 1 and 3 only
(c) 2 and 3 only
(d) 1, 2, 3 and 4

answer a . 1 and 2 only

77. Cavitating pulmonary lesions can be seen in the following except

(a) Sarcoidoses
(b) Tuberculosis
(c) Carcinoma of lung
(d) Histoplasmosis

answer will post soon

78. Which one of the following is not likely to be associated with pulmonary fibrosis?

(a) Coal miners lung
(b) Primary sclerosing cholangitis
(c) Primary biliary cirrhosis
(d) Ankylosing spondylitis

answer will post soon

79. The following agents may be used as prophylaxis in high altitude pulmonary edema except

(a) ACE inhibitor
(b) Acetazolamide
(c) Nifedipine
(d) Digoxin

answer will post soon

80. With reference to right ventricular myocardial infarction, consider the following statements:

1. It may occur along with inferior wall myocardial infarction.
2. The ECG shows ST segment elevation in right precordial leads.
3. Prognosis in right ventricular infarction is better than the left ventricular myocardial infarction.
4. The treatment may include intra¬ venous fluid challenge.

Which of the statements given above are correct?

(a) 1, 2 and 3 only
(b) 2, 3 and 4 only
(c) 1 and 4 only
(d) 1, 2, 3 and 4

answer will post soon

205 - UPSC 2007 medical entrance mcqs with answers part 15

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

List-I List-II

(Finding in urine examination) ( Disease)

A. red cell casts 1. Nephrotic syndrome
B. Microscopic hematuria 2. Chronic renal failure
C. Proteinuria 3. Polycystic kidney
D. Broad cell casts 4. Glomerulonephritis

Code:
a. A B C D
4 3 1 2

b. A B C D
4 1 3 2

c. A B C D
2 3 1 4

d. A B C D
2 1 3 4

answer a . A4 B3 C1 D2 red cell casts are seen in glomerulonephritis microscopic hematuria is seen in polycystic kidney proteinuria is seen in nephrotic syndrome broad cell casts are seen in chronic renal failure

72. A young male with acid peptic disease receives three units of blood for upper gastrointestinal bleeding. Two months later he presents with .fever, malaise and tender hepatomegaly. His serum bilirubin is normal and the liver enzymes are elevated - ALT 800 IU/L and AST 600 IU/L.

Which of the following are the likely infections in this case?

1. Hepatitis A
2. Hepatitis B
3. Hepatitis C
4. Hepatitis E
5. Cytomegalo virus

Select the correct answer using the code given below:

(a) 1, 2 and 3
(b) 2, 3 and 4
(c) 2, 3 and 5
(d) 1 and 4

answer will post soon

73. Celiac sprue causes syndrome due to

(a) Coliform infection of small bowel
(b) Lactase deficiency
(c) Hypersensitivity to dietary gluten
(d) Ischaemia of celiac artery

answer c . hypersensitivity to dietary gluten

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

List I List- II

(Type of anaemia) (Cause)

A. Macrocytic anaemia 1. Iron deficiency
B. Microcytic anaemia 2. Hypothyroidism
C. Haemolytic anaemia 3. Vitamin B12 deficiency
D. Megaloblastic anaemia 4. Alpha methyl dopa

Code:
a. A B C D
3 1 4 2

b. A B C D
3 4 1 2

c. A B C D
2 1 4 3

d. A B C D
2 4 1 3

answer c . A2 B1 C4 D3 macrocytic anemia is caused by hypothyroidism microcytic anemia is caused by iron deficiency anemia megaloblastic anemia is caused by B12 deficiency hemolytic anemia is caused by alpha methyl dopa

75. Gastric erosions are likely to be associated with the following conditions except

(a) Pernicious anaemia
(b) Cor pulmonale
(c) Polycythemia rubra vera
(d) Hepatic cirrhosis

answer will post soon

204 - UPSC 2007 medical entrance mcqs with answers part 14

66. The clinical manifestation of cauda equina lesion include the following except

(a) Urinary retention
(b) Radicular pain
(c) Dermatomal sensory loss
(d) Extensor plantar reflexes

answer will post soon

67. Following blood transfusion, non-cardiogenic pulmonary oedema may sometimes occur because of

(a) RBC incompatibility
(b) Antigen-antibody mechanism involving human leucocyte antigen
(c) Platelet surface antigen reaction
(d) Antibody to IgA in donor plasma

answer will post soon

68. What is the most frequent tooth to be impacted?

(a) Lower third molar
(b) Upper third molar
(c) Lower canine
(d) Upper premolar

answer will post soon

69. Fogarty's catheter is used, for

(a) Drainage of urinary bladder
(b) Parenteral hyperalimentation
(c) Removal of embolus from blood vessels
(d) Ureteric catheterization

answer c . removal of embolus from blood vessels

70. Consider the following conditions:

1. Central diabetes insipidus
2. Uncontrolled diabetes mellitus
3. Mannitol infusion
4. Post-obstructive diuresis

Which of the above result in solute diuresis?

(a) 1 and 2 only
(b) I, 2 and 3
(c) 2, 3 and 4
(d) 1, 3 and 4

answer will post soon

202 - UPSC 2007 medical entrance mcqs with answers part 12

56. In a patient with ischaemic stroke, intravenous recombinant tissue plasminogen activator has mainly been found to be useful during the initial

(a) 3 hours
(b) 6 hours
(c) 12 hours
(d) 24 hours

answer a. 3 hours

Read these exact lines from Harrison's internal medicine 17th edition .  

The National Institute of Neurological Disorders and Stroke (NINDS) recombinant tPA (rtPA) Stroke Study showed a clear benefit for IV rtPA in selected patients with acute stroke . The NINDS study used IV rtPA (0.9 mg/kg to a 90-mg max; 10% as a bolus, then the remainder over 60 min) vs. placebo in patients with ischemic stroke within 3 h of onset. Half of the patients were treated within 90 min. Symptomatic intracerebral hemorrhage occurred in 6.4% of patients on rtPA and 0.6% on placebo. There was a nonsignificant 4% reduction in mortality in patients on rtPA (21% on placebo and 17% on rtPA); there was a significant 12% absolute increase in the number of patients with only minimal disability (32% on placebo and 44% on rtPA.) Thus, despite an increased incidence of symptomatic intracerebral hemorrhage, treatment with IV rtPA within 3 h of the onset of ischemic stroke improved clinical outcome. 

57. Consider the following:

1. Malnutrition
2. Lithostatin (pancreatic stone protein) deficiency
3. Cassava tuber
4: Oxidant stress (heightened cytochrome P-450 activity)

Which of the above produce tropical calcific pancreatitis (fibrocalculous pancreatic diabetes) ?

(a) 1, 2 and 3 only
(b) 2, 3 and 4 only
(c) I and 4 only
(d) 1, 2, 3 and 4

answer d. 1,2,3 and 4

58. The prognosis in reduced or unreduced fractures involving epiphyseal plate is very poor if the fracture line

(a) runs along the epiphyseal plate
(b) extends into epiphysis
(c) crushes the epiphyseal plate
d) crosses the epiphyseal plate

answer c . crushes the epiphyseal plate

59. A green stick fracture

(a) occurs mainly in the elderly
(b) is a fatigue fracture
(c) is a spiral fracture of long bone
(d) is a fracture where part of cortex is intact and part is crumpled

answer d. is a fracture where part of cortex is intact and part is crumpled

60. With reference to varicocele, which one of the following is not true of it ?

(a) Varicosity of cremasteric veins
(b) Left side is affected usually
(c) Feels like a bag of worms
(d) May lead to infertility

answer a. varicosity of cremasteric veins . it is actually due to dilation of pampiniform plexus of veins

201 - UPSC 2007 medical entrance mcqs with answers part 11

51. Chronic renal failure with inappropriately high haemoglobin levels may be seen with:

a. Hypertensive nephropathy
b. Ischemic nephropathy
c. Diabetic nephropathy
d. Polycystic renal disease

answer will post soon

52. Regarding rheumatoid arthritis, which one of the following statements is correct?

a. NSAIDs are helpful in controlling the disease process
b. Corticosteroids, on long term basis, are to be given in all cases
c. DMARDs should be given early and preferably in combinations
d. Every patient of rheumatoid arthritis has a positive rheumatoid factor

answer will post soon

53. Consider the following sites of lesion in brain:

1. Lateral geniculate body
2. Optic radiation
3. Optic tract
4. Optic chiasma

Which of the above can result in homonymous hemianopia?

(a) 1, 2 and 4
(b) 2, 3 and 4
(c) 1 and 4 only
(d) 1, 2 and 3 .

answer d . 1 , 2 and 3

54. What is the typical feature of nerve entrapment in the carpal tunnel syndrome?

(a) Symptoms diminish by wrist flexion
(b) Pain worsens at night
(c) Erythema present in the cutaneous distribution of median nerve
(d) Motor symptoms precede sensory symptoms

answer a . symptoms diminish by wrist flexion .

Have a look at this flow chart about carpal tunnel syndrome .

55. Which one of the following is not a feature of Guillain Barre syndrome?

(a) Albumino-cytological dissociation
(b) Transient bladder disturbances
(c) Areflexia
(d) Babinski plantar response

answer d . babinski plantar response . deep tendon reflexes are attenuated or absent in guillain barre syndrome

200 - UPSC 2007 medical entrance mcqs with answers part 10

Directions:
The following 3 (three) items consist of two statements, one labelled as the' Assertion (A)' and the other as 'Reason (R)'. You are to examine these two statements carefully and select the correct answer using the code given below.
(a) Both A and R are individually true and R is the correct explanation of A .
(b) Both A and R are individually true but R is not the correct explanation of A
(c) A is true but R is false
(d) A is false but R is true

46. Assertion (A) : If Perthes test is positive, surgery is
absolutely contraindicated in varicose vein
of leg.
Reason (R) : Perthes test confirms perforator
incompetence.

answer c . A is true but R is false

47. Assertion (A) : Raloxifene is a drug used in the
treatment of breast carcinoma.
Reason (R) : It is preferred over tamoxifen since it
has less incidence of thromboembolism.

answer c . A is true but R is false

48. Assertion (A) : Femoral hernia is more likely to become
strangulated than inguinal hernia.
Reason (R) : Femoral hernia is more common in
females and gets neglected more often.

answer B . both A and R are true but R is not the correct explanation for A

49. Of the various modalities used in the treatment of life-threatening effects of hyperkalemia, which one of the following has the most rapid onset of action?

(a) Hemodialysis
(b) Sodium bicarbonate infusion
(c) Insulin and glucose infusion
(d) Intravenous calcium gluconate

answer will post soon

50. A patient presents with acute gastroenteritis in a dehydrated state. Which of the following conditions is highly suggestive of pre-renal renal failure?

(a) Urinary sodium greater than 40 m mol;
Urine osmolality  greater than 500 m osm/L
(b) Urinary sodium greater than 40 m mol;
Urine osmolality less than 500 m osm/L
(c) Urinary sodium less than 40 m mol 
Urine osmolality greater than 500 m osm/L
(d) Urinary sodium less than 40 m osm/L 
Urine osmolality less than 500 m osm/L

answer will post soon