UPSC-CMS 2016 Practice Questions

Q: The two important values necessary for describing the variation in a series of observations are:

Mean and standard deviation. ***Mean and standard deviation*** - The **mean** provides a measure of the **central tendency**, representing the average value in the dataset. - The **standard deviation** quantifies the **dispersion** or spread of the data points around the mean, indicating the variability. *Median and standard deviation* - The **median** is a measure of **central tendency**, specifically the middle value, but it doesn't directly pair with standard deviation for describing overall variation in the most common statistical contexts. - While standard deviation describes spread, using the median for central tendency often leads to other measures of spread like **interquartile range (IQR)** for a more consistent representation of non-normally distributed data. *Mean and range* - The **mean** indicates the central point of the data, but the **range** (difference between maximum and minimum values) is a less robust measure of variation. - **Range** is highly susceptible to outliers and does not provide information about the distribution of data points within the entire set. *Median and range* - The **median** describes the **center** of the data, particularly useful for skewed distributions or data with outliers. - The **range** is a simple measure of spread, but it's very sensitive to extreme values and does not give a comprehensive picture of data variability.

Q: The time period from entry of an infective agent into a host until the host develops the capacity for maximal infectivity is called:

Generation time. ***Generation time*** - This is defined as the time interval between **entry of an infective agent into a host** until the host develops **maximal infectivity**. - It represents the period from infection to when an infected individual is most capable of transmitting the disease to others. - This term precisely matches the question's definition and is crucial for understanding disease transmission dynamics. *Incubation period* - The incubation period is the time from exposure to an infectious agent until the onset of **clinical symptoms** in the host. - It ends at symptom onset, not at maximal infectivity (which may occur before, during, or after symptom onset depending on the disease). - While infectivity may peak during or near the incubation period for some diseases, this term specifically refers to symptom development, not infectivity capacity. *Serial interval* - The serial interval is the time between the onset of symptoms in a **primary case** and the onset of symptoms in a **secondary case**. - This describes the time between successive cases in a transmission chain, not the development of infectivity in an individual host. *Period of communicability* - This is the **entire duration** during which an infected person can transmit the infectious agent to others. - It describes the total infectious period (from start to end of infectivity), not specifically the time until **maximal** infectivity is reached.

Q: Consider the following statements: Symposium is a method of health education characterised by 1. a series of speeches on a selected topic 2. presentation of different aspects of a topic by 3 or 4 experts. 3. a discussion among the symposium members 4. the chairperson making a comprehensive summary at the end of the session Which of these statements are correct?

1, 2 and 4. ***1, 2 and 4*** - A symposium is indeed characterized by a **series of speeches on a selected topic** (Statement 1) and the **presentation of different aspects of a topic by 3 or 4 experts** (Statement 2), providing a multifaceted view. - The chairperson typically plays a crucial role in concluding the session by **making a comprehensive summary** at the end (Statement 4), consolidating the diverse perspectives presented. *1, 3 and 4* - This option incorrectly includes "a discussion among the symposium members" (Statement 3) as a defining characteristic of a symposium. While discussion might occur after presentations, it's not the primary or required activity among the presenters themselves during the formal symposium structure. - A symposium primarily focuses on structured presentations from experts rather than an open discussion among them. *1, 2 and 3* - This option, like the first, incorrectly states that "a discussion among the symposium members" (Statement 3) is a core element of a symposium. - The format emphasizes individual expert presentations and a concluding summary over a direct discussion among the experts themselves. *2 and 3 only* - This option omits "a series of speeches on a selected topic" (Statement 1) and "the chairperson making a comprehensive summary at the end of the session" (Statement 4), both of which are fundamental characteristics of a symposium. - It also incorrectly includes Statement 3 ("discussion among symposium members"), which is not a defining feature of this format.

Q: Consider the following diseases: 1. Rift valley fever 2. Yellow Fever 3. Chikungunya fever 4. West Nile fever Which of the above diseases are transmitted by Aedes mosquito?

1, 2 and 3. ***1, 2 and 3*** - **Rift Valley fever**, **Yellow fever**, and **Chikungunya fever** are all primarily transmitted to humans through the bites of infected **Aedes mosquitoes**. - The **Aedes aegypti** and **Aedes albopictus** species are particularly significant vectors for these viral diseases. *1, 2 and 4* - This option incorrectly includes **West Nile fever** while omitting **Chikungunya fever**. - **West Nile fever** is primarily transmitted by **Culex mosquitoes**, not Aedes mosquitoes. *2, 3 and 4* - This option incorrectly includes **West Nile fever** as an Aedes mosquito-borne disease. - **Yellow fever** and **Chikungunya fever** are indeed transmitted by Aedes mosquitoes, but **West Nile fever** is not. *1, 3 and 4* - This option incorrectly includes **West Nile fever** in the list of Aedes-borne diseases. - While **Rift Valley fever** and **Chikungunya fever** are transmitted by Aedes mosquitoes, **West Nile fever** is primarily transmitted by Culex species.

Q: Consider the following statements: Poor prognostic indicators in advanced germ cell tumours show 1. primary sites in mediastinum 2. non-pulmonary metastasis 3. lactate dehydrogenase more than 10 times of normal value Which of the statements given above are correct?

1, 2 and 3. ***1, 2 and 3*** - **All three statements** represent poor prognostic indicators in advanced germ cell tumors, as defined by the **International Germ Cell Cancer Collaborative Group (IGCCCG)** classification. - A primary site in the **mediastinum**, the presence of **non-pulmonary visceral metastases**, and **LDH levels >10 times the upper limit of normal** are all independent factors associated with a worse prognosis. *1 and 2 only* - This option is incorrect because it excludes a critically important poor prognostic indicator: **markedly elevated lactate dehydrogenase (LDH)**. - While mediastinal primary and non-pulmonary metastases are poor prognostic factors, high LDH further defines the **poor risk group**. [1] *2 and 3 only* - This option is incorrect as it omits the significance of a **mediastinal primary site** as a poor prognostic factor in advanced germ cell tumors. - **Mediastinal germ cell tumors** are known to have a worse prognosis compared to testicular primaries, even in the absence of other poor risk factors. *1 and 3 only* - This option is incorrect because it fails to include **non-pulmonary metastases** as a distinct poor prognostic factor for advanced germ cell tumors. - The presence of metastases to sites like the **liver, brain, or bone** significantly worsens the prognosis compared to lung-only metastases.

Q: Which one of the following is the investigation of choice in a patient with haematemesis?

Flexible upper gastrointestinal endoscopy. ***Flexible upper gastrointestinal endoscopy*** - This is the **investigation of choice** for haematemesis as it allows for direct visualization of the upper gastrointestinal tract to identify the source of bleeding [1]. - It also enables **therapeutic intervention**, such as injection sclerotherapy, banding, or clip application, to stop the bleeding [1]. *Contrast enhanced CT scan* - A CT scan is generally **not the primary investigation** for acute haematemesis because it offers less diagnostic accuracy for mucosal lesions and cannot provide therapeutic intervention [1]. - While it can identify large bleeds or structural abnormalities, it is **less sensitive for smaller bleeds** or subtle mucosal abnormalities compared to endoscopy. *Barium meal for stomach and duodenum* - A barium meal is **contraindicated in acute gastrointestinal bleeding** as the barium can obscure endoscopic views and interfere with subsequent attempts at endoscopy or angiography [1]. - It provides **limited diagnostic information** about the active bleeding site and offers no therapeutic capabilities. *Selective left gastric angiography* - Angiography is typically reserved for cases of **severe, persistent bleeding** where endoscopy has failed to locate or control the bleed. - It is an **invasive procedure** with potential complications and is not indicated as the initial diagnostic investigation.

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*** - This option correctly matches **Stomach poison** with **Sodium fluoride** (4), **Organochlorine compound** with **Dieldrin** (3), **Organophosphorus compound** with **Temephos** (2), and **Carbamates** with **Propoxur** (1). - **Sodium fluoride** acts as a stomach poison requiring ingestion, **Dieldrin** is a persistent organochlorine insecticide, **Temephos** is an organophosphorus compound used for larval control, and **Propoxur** is a carbamate insecticide for household pest control. *A→4 B→3 C→1 D→2* - This option incorrectly matches **Organophosphorus compound** with **Propoxur** (1), which is actually a **carbamate**, not an organophosphorus compound. - It also incorrectly matches **Carbamates** with **Temephos** (2), which is actually an **organophosphorus** compound, not a carbamate. *A→3 B→4 C→2 D→1* - This option incorrectly matches **Stomach poison** with **Dieldrin** (3), which is an **organochlorine compound**, not a stomach poison. - It also incorrectly matches **Organochlorine compound** with **Sodium fluoride** (4), which functions as a **stomach poison**, not an organochlorine compound. *A→3 B→4 C→1 D→2* - This option creates multiple incorrect matches: **Stomach poison** with **Dieldrin** (3) instead of **Sodium fluoride**, and **Organochlorine compound** with **Sodium fluoride** (4) instead of **Dieldrin**. - It also incorrectly swaps the organophosphorus and carbamate matches, placing **Propoxur** with organophosphorus and **Temephos** with carbamates.

Q: Regarding haemorrhagic shock, which one of the following statements is correct?

Loss of 40% of circulating volume is life threatening. ***Loss of 40% of circulating volume is life threatening*** - A loss of **40% or more** of circulating blood volume corresponds to **Class IV haemorrhagic shock**, which is a severe, life-threatening condition requiring immediate and aggressive resuscitation. - At this stage, the body's compensatory mechanisms are overwhelmed, leading to profound systemic hypoperfusion, **organ dysfunction**, and a high risk of mortality. *Tachycardia presents in 100% of hypovolemic patients* - While **tachycardia** is a common compensatory mechanism in hypovolemia, it is not present in 100% of patients due to factors such as **beta-blocker use** or **pacemaker rhythm**. - In some early stages of blood loss, especially in young, healthy individuals, sufficient compensatory mechanisms may delay the onset of significant tachycardia. *Clinically manifested when > 10% of loss of total blood volume occurs* - Haemorrhagic shock is typically **clinically manifest** when there is a blood loss greater than **15%** (Class I shock), which represents approximately 750 mL in an average adult. - A loss of **less than 10%** often does not produce overt clinical signs as the body's compensatory mechanisms can effectively maintain vital signs within normal ranges. *In acute stage of shock, systemic vasodilation becomes evident* - In the acute stage of hemorrhagic shock, the body's primary compensatory mechanism is **systemic vasoconstriction**, not vasodilation, to maintain central blood pressure and perfuse vital organs. - **Vasodilation** can occur in the later, decompensated stages of shock, particularly in instances of **septic or neurogenic shock**, leading to a further drop in blood pressure.

Q: Which one of the following structures is not removed during a classical radical neck dissection?

Trapezius. ***Trapezius*** - The **trapezius muscle** is consistently spared (not removed) in a classical radical neck dissection, although it becomes non-functional due to sacrifice of its motor nerve supply. - While the muscle remains anatomically in place, removal of the **accessory nerve** leads to denervation of the trapezius, causing severe shoulder dysfunction including **shoulder drop** and inability to abduct the arm past 90 degrees. *Accessory nerve* - The **accessory nerve (cranial nerve XI)** is sacrificed in a classical radical neck dissection to ensure complete removal of lymphatic tissue and metastatic disease. - Its removal results in **denervation and paralysis of the trapezius muscle**, leading to shoulder weakness, shoulder drop, and limited shoulder abduction. - The accessory nerve also innervates the sternocleidomastoid, though this muscle is removed in the procedure. *Sternocleidomastoid* - The **sternocleidomastoid muscle** is removed in a classical radical neck dissection for oncological clearance, as lymph nodes closely associated with it can harbor metastatic disease. - Its removal contributes to cosmetic defect and can affect neck contour and mobility. *Internal jugular vein* - The **internal jugular vein** is resected during a classical radical neck dissection to achieve en bloc removal of lymphatic tissue in levels II, III, and IV, which often contain metastatic disease. - Its removal can lead to **venous congestion** in the head and neck initially, although collateral circulation through the external jugular and vertebral venous systems usually develops over time.

Q: Mousseau-Barbin Tube (M.B.Tube) is used for:

Advanced cancer oesophagus. ***Advanced cancer oesophagus*** - The **Mousseau-Barbin tube** is a type of **endoscopic stent** used for palliative management of **dysphagia** caused by advanced **oesophageal cancer**. - It provides a lumen through obstructed oesophageal segments, allowing patients to swallow food and liquids more easily. *Advanced cancer oropharynx* - While dysphagia can be a symptom of oropharyngeal cancer, the Mousseau-Barbin tube is specifically designed for placement within the **oesophagus**. - Management for advanced oropharyngeal cancer often involves other interventions like **radiotherapy**, **chemotherapy**, or **surgical resection**. *All of these* - This option is incorrect because the Mousseau-Barbin tube has a specific application for the **oesophagus**. - It is not routinely used for cancers of the oropharynx or stomach due to differences in anatomical location and disease progression. *Advanced cancer stomach* - Advanced stomach cancer, particularly in the distal stomach, would not typically benefit from an oesophageal stent. - Gastric outlet obstruction can occur, but specific **gastric stents** or **surgical bypasses** are used for this.

Question 1

The two important values necessary for describing the variation in a series of observations are:

Accepted Answer

Mean and standard deviation

Answer

Median and standard deviation

Answer

Mean and range

Answer

Median and range

Question 2

The time period from entry of an infective agent into a host until the host develops the capacity for maximal infectivity is called:

Accepted Answer

Generation time

Answer

Incubation period

Answer

Period of communicability

Answer

Serial interval

Question 3

Consider the following statements: Symposium is a method of health education characterised by

1. a series of speeches on a selected topic 
2. presentation of different aspects of a topic by 3 or 4 experts. 
3. a discussion among the symposium members 
4. the chairperson making a comprehensive summary at the end of the session Which of these statements are correct?

Accepted Answer

1, 2 and 4

Answer

1, 3 and 4

Answer

1, 2 and 3

Answer

2 and 3 only

Question 4

Consider the following diseases:

1. Rift valley fever

2. Yellow Fever

3. Chikungunya fever

4. West Nile fever

Which of the above diseases are transmitted by Aedes mosquito?

Accepted Answer

1, 2 and 3

Answer

1, 2 and 4

Answer

2, 3 and 4

Answer

1, 3 and 4

Question 5

Consider the following statements: Poor prognostic indicators in advanced germ cell tumours show

1. primary sites in mediastinum 
2. non-pulmonary metastasis 
3. lactate dehydrogenase more than 10 times of normal value Which of the statements given above are correct?

Accepted Answer

1, 2 and 3

Answer

1 and 2 only

Answer

2 and 3 only

Answer

1 and 3 only

Question 6

Which one of the following is the investigation of choice in a patient with haematemesis?

Accepted Answer

Flexible upper gastrointestinal endoscopy

Answer

Contrast enhanced CT scan

Answer

Barium meal for stomach and duodenum

Answer

Selective left gastric angiography

Question 7

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→4  B→3  C→1  D→2

Answer

A→3  B→4  C→2  D→1

Answer

A→3  B→4  C→1  D→2

Question 8

Regarding haemorrhagic shock, which one of the following statements is correct?

Accepted Answer

Loss of 40% of circulating volume is life threatening

Answer

Tachycardia presents in 100% of hypovolemic patients

Answer

Clinically manifested when > 10% of loss of total blood volume occurs

Answer

In acute stage of shock, systemic vasodilation becomes evident

Question 9

Which one of the following structures is not removed during a classical radical neck dissection?

Accepted Answer

Trapezius

Answer

Accessory nerve

Answer

Sternocleidomastoid

Answer

Internal jugular vein

Question 10

Mousseau-Barbin Tube (M.B.Tube) is used for:

Accepted Answer

Advanced cancer oesophagus

Answer

Advanced cancer oropharynx

Answer

All of these

Answer

Advanced cancer stomach

UPSC-CMS 2016

Community Medicine

Internal Medicine

Pharmacology

Physiology

Surgery