UPSC-CMS 2017 Previous Year Questions Practice Questions

Q: The external opening of branchial fistula is present in :

Lower third of the neck. ***Lower third of the neck*** - The external opening of a branchial fistula is typically found in the **lower third of the anterolateral neck**, anterior to the sternocleidomastoid muscle [1]. - This location corresponds to the embryological remnants of the second branchial cleft failing to close completely. *Middle third of the neck* - While other branchial anomalies might present in the middle third, the classic external opening of a **branchial fistula** is usually lower [1]. - Cysts (branchial cleft cysts) are more commonly found in the middle third [1]. *Upper third of the neck* - Anomalies in the upper third of the neck are less common for an external branchial fistula opening. - This region is more associated with anomalies of the first branchial cleft [1]. *Suprasternal notch* - The suprasternal notch is located at the base of the neck, and while cysts can occur in this area (e.g., cervicomediastinal thymic cysts), it is not the typical site for a **branchial fistula** opening. - This location is often associated with abnormalities of thyroid development or other midline defects. [Practice more UPSC-CMS 2017 questions on OnCourse]

Q: A 60 year old man presents with painless progressive jaundice for two months. He has a history of weight loss. On examination, his gallbladder is palpable which is smooth, non‐tender and globular. His serum bilirubin is 18.2 mg/dL. He is most likely suffering from:

Carcinoma head of pancreas. A 60 year old man presents with painless progressive jaundice for two months. He has a history of weight loss. On examination, his gallbladder is palpable which is smooth, non‐tender and globular. His serum bilirubin is 18.2 mg/dL. He is most likely suffering from: ***Carcinoma head of pancreas*** - The classic triad of **painless progressive jaundice**, **weight loss**, and a **palpable, non-tender gallbladder** (Courvoisier's sign) strongly indicates carcinoma of the head of the pancreas due to obstruction of the common bile duct [1]. - The high serum bilirubin value further supports a severe obstructive process, typical of a pancreatic head mass compressing the bile duct [1]. *Carcinoma stomach* - Carcinoma of the stomach typically presents with upper abdominal pain, dyspepsia, early satiety, and weight loss, but **jaundice is rare** unless there is extensive metastasis to the liver or porta hepatis. - It usually does not directly lead to **obstructive jaundice** with a palpable gallbladder, as the tumor's location is remote from the common bile duct. *Choledocholithiasis* - While choledocholithiasis can cause obstructive jaundice, it is often associated with **pain** (biliary colic) and fluctuating jaundice rather than the painless, progressive pattern described. - A gallbladder obstructed by a stone would typically be **tender** if inflamed, or decompressed if the obstruction is intermittent, rather than smooth and non-tender due to chronic distal obstruction. *Klatskin tumour* - A Klatskin tumor (hilar cholangiocarcinoma) causes obstructive jaundice, but it typically obstructs the bile ducts above the cystic duct insertion, meaning the **gallbladder would usually be decompressed and non-palpable** [2]. - These tumors often present with **jaundice and itching**, but the presence of a palpable gallbladder makes a pancreatic head mass more likely [2]. [Practice more UPSC-CMS 2017 questions on OnCourse]

Q: Which of the following is NOT true regarding ‘Renal Carbuncle’?

It is a type of renal tuberculosis. A **renal carbuncle** is essentially a **renal abscess** caused by bacterial infection, typically *Staphylococcus aureus* or *Escherichia coli*, not *Mycobacterium tuberculosis*. Renal tuberculosis manifests differently, often with **sterile pyuria** and granulomatous inflammation, and is not synonymous with a carbuncle. Patients with **diabetes mellitus** are at an increased risk of developing bacterial infections, including **renal carbuncles**, due to impaired immune function and glucose-rich urine. Poorly controlled diabetes is a significant **predisposing factor** for severe renal infections. **Intravenous drug users** are at higher risk of bloodstream infections, including **septic emboli** that can disseminate to the kidneys and form renal carbuncles. **Skin contaminants** and unsterile injection practices can introduce bacteria into the bloodstream that eventually localize in renal tissue. A **renal carbuncle** is defined as a focal collection of **pus** and necrotic tissue within the renal parenchyma, essentially a **renal abscess**. It results from the **hematogenous spread** of bacteria or, less commonly, from an ascending urinary tract infection [1]. [Practice more UPSC-CMS 2017 questions on OnCourse]

Q: An eight year old male child complains of severe pain in right testis. The most probable diagnosis is

Torsion of right testis. ***Torsion of right testis*** - **Testicular torsion** typically presents with sudden onset **severe unilateral testicular pain** in pre-pubertal boys, as described. - This condition is an emergency requiring prompt surgical intervention to preserve testicular viability, making it the most probable diagnosis for severe pain in a child's testis. *Acute epididymo-orchitis* - While causing testicular pain, **epididymo-orchitis** typically has a more gradual onset and is often associated with symptoms like **fever** and **dysuria**, which are not mentioned. - It usually occurs in older adolescents or adults and is less common in an 8-year-old without predisposing factors like a urinary tract infection. *Strangulated Inguinal hernia* - A **strangulated inguinal hernia** would present with an acutely painful, irreducible groin or scrotal swelling, often accompanied by signs of **bowel obstruction**. - While it can cause pain radiating to the testis, primary severe testicular pain without a palpable groin mass points away from this diagnosis. *Undescended testis* - An **undescended testis** (cryptorchidism) is a condition where the testis has not descended into the scrotum; it typically presents as an empty scrotum or a palpable mass in the inguinal canal. - It is usually **painless** unless undergoing torsion or developing malignancy, and severe acute pain as the primary symptom would be unusual for an uncomplicated undescended testis. [Practice more UPSC-CMS 2017 questions on OnCourse]

Q: Which one of the following statements is NOT correct regarding Gastroschisis?

It is a ruptured exomphalos. ***It is a ruptured exomphalos*** - This statement is incorrect because **gastroschisis** and **exomphalos (omphalocele)** are distinct congenital abdominal wall defects, and gastroschisis is not a ruptured form of exomphalos. - Gastroschisis involves a **full-thickness abdominal wall defect** with direct extrusion of bowel, while exomphalos involves herniation of abdominal contents into the base of the umbilical cord, covered by a membrane. *Gut has herniated through a defect to right of umbilicus* - Gastroschisis is typically characterized by a **paraumbilical defect**, almost always located to the **right of the umbilical cord**. - This anatomical location is a key differentiator from exomphalos, where the defect is at the central umbilical ring. *Normally limited to midgut* - The herniated contents in gastroschisis are predominantly the **small bowel (midgut)**, though other organs like the large bowel, stomach, or liver can occasionally be involved. - The limited involvement of other organs is a differentiating factor from an exomphalos, which can contain a wider array of abdominal viscera. *There is no covering membrane* - A defining feature of gastroschisis is the **absence of a peritoneal sac or covering membrane** over the herniated intestines. - This lack of protection exposes the bowel to amniotic fluid, leading to inflammation and a thickened, matted appearance of the bowel loops. [Practice more UPSC-CMS 2017 questions on OnCourse]

Question 1

The external opening of branchial fistula is present in :

Accepted Answer

Lower third of the neck

Answer

Middle third of the neck

Answer

Upper third of the neck

Answer

Suprasternal notch

Question 2

A 60 year old man presents with painless progressive jaundice for two months. He has a history of weight loss. On examination, his gallbladder is palpable which is smooth, non‐tender and globular. His serum bilirubin is 18.2 mg/dL. He is most likely suffering from:

Accepted Answer

Carcinoma head of pancreas

Answer

Carcinoma stomach

Answer

Choledocholithiasis

Answer

Klatskin tumour

Question 3

Which of the following is NOT true regarding ‘Renal Carbuncle’?

Accepted Answer

It is a type of renal tuberculosis

Answer

It occurs in diabetic patient

Answer

It occurs in intravenous drug abusers

Answer

It is an abscess in renal parenchyma

Question 4

An eight year old male child complains of severe pain in right testis. The most probable diagnosis is

Accepted Answer

Torsion of right testis

Answer

Acute epididymo-orchitis

Answer

Strangulated Inguinal hernia

Answer

Undescended testis

Question 5

Which one of the following statements is NOT correct regarding Gastroschisis?

Accepted Answer

It is a ruptured exomphalos

Answer

Gut has herniated through a defect to right of umbilicus

Answer

Normally limited to midgut

Answer

There is no covering membrane

Question 6

Heineke‐Mikulicz operation is done for:

Accepted Answer

Pyloric stenosis

Answer

Ureteric stricture

Answer

Urethral stricture

Answer

Stricture common bile duct

Question 7

A 32 year old female underwent laparoscopic cholecystectomy which was difficult. On her second post operative day, she develops jaundice. Her LFT parameters show serum bilirubin 6.8 mg/dL; direct bilirubin 5.6 and indirect bilirubin 1.2 mg/dL; and serum alkaline phosphatase 1226 IU/L. She is most likely suffering from obstructive jaundice due to:

Accepted Answer

Bile duct injury

Answer

Hepatocellular carcinoma

Answer

Carcinoma gallbladder

Answer

Carcinoma head of pancreas

Question 8

A 23-year-old male riding his motorcycle meets with a road accident. He is tachypnoeic with HR 110/min and BP 112/74 mmHg. On examination, he appears pale and has tenderness over the left side of chest with dullness to percussion. There is slight mediastinal shift to the opposite side. Abdominal examination is unremarkable. Most probably he is suffering from:

Accepted Answer

Haemothorax

Answer

Tension pneumothorax

Answer

Subcutaneous emphysema

Answer

Tracheal rupture

Question 9

Mondor’s disease is

Accepted Answer

Thrombophlebitis of superficial veins of breast

Answer

Multiple breast cysts

Answer

Eczema of nipple and areola

Answer

Lymphangitis of mammary lymphatics

Question 10

Anderson‐Hynes operation is performed for:

Accepted Answer

Pelvi-ureteric junction obstruction

Answer

Pseudo-pancreatic cyst

Answer

Achalasia cardia

Answer

Pyloric stenosis

UPSC-CMS 2017

Anatomy

Internal Medicine

Surgery

About UPSC-CMS 2017 Questions