UPSC-CMS 2017 Practice Questions

Q: The umbilical cord normally contains:

Two arteries and one vein. ***Two arteries and one vein*** - The umbilical cord typically contains **two umbilical arteries** [1] that carry deoxygenated blood and waste products from the fetus to the placenta. - It also contains **one umbilical vein** [2, 3] that carries oxygenated, nutrient-rich blood from the placenta to the fetus. - This is the **normal anatomical configuration** of the umbilical cord. *One artery and two veins* - This configuration is **incorrect** as there is only **one umbilical vein** [2] in the normal umbilical cord, not two. - The presence of a single artery (single umbilical artery - SUA) is a recognized anomaly associated with certain fetal abnormalities, but even in SUA, there is only one vein. *One artery and one vein* - This arrangement is **incorrect** as the normal umbilical cord contains **two arteries**, not one [1]. - Single umbilical artery (SUA) is the most common umbilical cord anomaly, occurring in about 1% of pregnancies, but this is still an abnormal finding. *Two arteries and two veins* - This statement is **incorrect** because the normal umbilical cord contains only **one umbilical vein**, not two. - The presence of two veins would be a rare anomaly and is not part of normal umbilical cord anatomy.

Q: Painless genital ulcer is found in which one of the following genital infections?

Granuloma inguinale. ***Granuloma inguinale*** - Presents as a **painless, slowly progressive ulcerative lesion** that bleeds easily. - Caused by *Klebsiella granulomatis*, it starts as a papule and then becomes a **beefy red, granulation tissue-like ulcer**. *Lymphogranuloma venerum* - Initially presents with a **small, painless papule or vesicle** that often goes unnoticed. - The most prominent clinical feature is **regional lymphadenopathy (buboes)**, which can be painful and suppurate. *Chancroid* - Characterized by **painful, deep, irregular ulcers** with ragged undermined borders. - These ulcers are typically **soft** and can be accompanied by painful inguinal lymphadenopathy. *Herpes simplex* - Causes **multiple, painful vesicular lesions** that quickly erode into ulcers. - These lesions often recur and are associated with **burning or itching sensations** before eruption.

Q: Fitz‐Hugh‐Curtis syndrome involving perihepatitis is present in the following:

Gonorrhoea. **Gonorrhoea** - **Fitz-Hugh-Curtis syndrome** is a complication of **pelvic inflammatory disease (PID)**, which is predominantly caused by sexually transmitted infections like *Neisseria gonorrhoeae* and *Chlamydia trachomatis*. - Perihepatitis, or inflammation of the liver capsule, occurs when bacteria from the pelvic infection spread to the liver surface. *Syphilis* - **Syphilis** primarily presents with chancres, rashes, and neurological or cardiovascular complications in later stages. - It does not typically cause **perihepatitis** as a direct complication of the infection itself. *Tuberculosis* - **Tuberculosis** is caused by *Mycobacterium tuberculosis* and usually affects the lungs, but can spread to other organs. - While it can cause peritonitis, it is not associated with **perihepatitis** in the context of **Fitz-Hugh-Curtis syndrome**. *Moniliasis* - **Moniliasis** (candidiasis) is a fungal infection caused by *Candida* species. - It is commonly associated with vaginal yeast infections or thrush but does not cause **Fitz-Hugh-Curtis syndrome** or perihepatitis.

Q: Which of the following cause/causes bacterial vaginosis? 1. Gardnerella 2. Mycoplasma hominis 3. Ureaplasma urealyticum Select the correct answer using the code given below:

1, 2 and 3. ***1, 2 and 3*** - Bacterial vaginosis is a polymicrobial syndrome resulting from an imbalance in the vaginal flora, often characterized by a decrease in **Lactobacilli** and an overgrowth of various anaerobic bacteria. - **Gardnerella vaginalis** is the most commonly associated bacterium, but **Mycoplasma hominis** and **Ureaplasma urealyticum** are also frequently isolated and contribute to the pathogenesis of the condition. *1 and 3 only* - This option incorrectly excludes **Mycoplasma hominis**, which is a recognized contributor to the polymicrobial nature of bacterial vaginosis. - While *Gardnerella* and *Ureaplasma* are significant, the disease involves multiple species. *2 and 3 only* - This option incorrectly excludes **Gardnerella vaginalis**, which is considered the hallmark organism and a primary diagnostic indicator for bacterial vaginosis. - Omitting *Gardnerella* would misrepresent the key infectious agents involved. *1 only* - This option incorrectly suggests that **Gardnerella vaginalis** is the sole causative agent, overlooking the polymicrobial nature of bacterial vaginosis. - The condition is characterized by a shift in the entire vaginal microenvironment, involving multiple types of bacteria.

Q: A 28 year old woman develops amenorrhoea after having dilatation and curettage. The most likely diagnosis is :

Asherman syndrome. ***Asherman syndrome*** - It is characterized by the formation of **intrauterine adhesions** or **synechiae** that occur due to trauma to the endometrial lining, most commonly following a **D&C procedure**. - These adhesions can lead to **amenorrhea**, hypomenorrhea, infertility, and recurrent pregnancy loss due to the obstruction of the uterine cavity. *Kallman syndrome* - This is a **congenital hypogonadotropic hypogonadism** characterized by a deficiency in GnRH production and an associated **anosmia** (loss of smell), neither of which are suggested by the clinical presentation. - Patients typically present with **primary amenorrhea** and delayed puberty, not secondary amenorrhea following a D&C. *Turner syndrome* - A **chromosomal disorder (45, XO)** leading to **gonadal dysgenesis** and ovarian failure. - It typically presents with **primary amenorrhea**, short stature, webbed neck, and other distinct physical features, which are not mentioned here. *Anorexia nervosa* - This is an **eating disorder** associated with severe caloric restriction and low body weight. - It can cause **hypothalamic amenorrhea** due to impaired GnRH pulsatility but is usually accompanied by significant weight loss and psychological symptoms, not typically heralded by a D&C.

Q: Modified Bishop’s score includes all EXCEPT:

Position of occiput. ***Position of occiput*** - The **position of the occiput** (fetal head position) is assessed during labor but is not a component of either the original or modified Bishop's score. - The Bishop's score universally evaluates **cervical ripeness** and does not incorporate fetal station or position. *Position of os* - The **position of the cervix (os)**, whether anterior, posterior, or mid-position, is a crucial component of the Bishop's score. - A more **anterior cervix** indicates a higher likelihood of successful induction. *Consistency of cervix* - **Cervical consistency** (firm, medium, soft) is a key factor in the Bishop's score, reflecting the degree of cervical ripening. - A **softer cervix** is more favorable for induction and spontaneous labor progression. *Cervical length and dilatation* - **Cervical effacement** (length) and **dilatation** are essential parameters in the Bishop's score, indicating the readiness of the cervix for labor. - A **shorter and more dilated cervix** correlates with a higher Bishop's score and increased success of labor induction.

Q: The engaging diameter of brow presentation is:

Mento‐vertical. ***Mento-vertical*** - In a **brow presentation**, the fetal head is incompletely extended, and the presenting part is the brow. - The **mento-vertical diameter** is the longest antero-posterior diameter of the fetal head, measuring approximately **13.5 cm**, and is the engaging diameter in a brow presentation. *Submento-bregmatic* - This diameter is measured from the junction of the neck and chin to the anterior fontanelle (bregma), reflecting the engaging diameter in a **face presentation** with full extension. - Its typical measurement is about **9.5 cm**, significantly shorter than the mento-vertical diameter. *Submento-vertical* - This diameter is not a standard engaging diameter used to describe typical fetal head presentations. - Standard obstetrical terminology focuses on submento-bregmatic for face and suboccipito-bregmatic for vertex presentations. *Suboccipito-bregmatic* - This is the engaging diameter for a **flexed vertex presentation** (occiput or crown of the head), which is the most common and favorable presentation. - It measures approximately **9.5 cm**, representing the optimal diameter for passage through the birth canal.

Q: Which of the following is/are the risk factors for acute pelvic inflammatory disease in women? 1. Intercourse during menstruation 2. Multiple sex partners Select the correct answer using the code given below:

Both 1 and 2. **Both 1 and 2** - **Intercourse during menstruation** increases the risk for acute PID, as the cervical mucus plug, which normally protects against ascending infection, is absent during menses. - **Multiple sex partners** significantly raises the risk of exposure to sexually transmitted infections (STIs), which are the primary cause of PID. *2 only* - While **multiple sex partners** is a major risk factor, denying intercourse during menstruation as a risk factor is incorrect. - The physiological changes during menstruation facilitate the ascent of bacteria, making coitus during this period a risk. *Neither 1 nor 2* - Both statements describe established risk factors for PID. - This option is incorrect because both **intercourse during menstruation** and **multiple sex partners** contribute to increased risk. *1 only* - While **intercourse during menstruation** is a risk factor, it is incorrect to exclude **multiple sex partners** as a significant risk factor for PID. - Having multiple partners dramatically increases the likelihood of acquiring **STIs**, the main cause of PID.

Q: Intramuscular injection of iron dextran is given by ‘Z’ technique to:

Reduce the staining. ***Reduce the staining*** - The **Z-track technique** creates a staggered path that prevents the dark iron solution from leaking back into the subcutaneous tissue, which can cause **permanent skin discoloration or staining**. - This method seals the medication deep in the muscle, preventing its reflux along the needle track. *Increase the iron absorption* - The Z-track technique is primarily about preventing **leakage and staining**, not enhancing the absorption rate of the iron. - Iron absorption is largely determined by factors like the patient's iron deficiency status and the form of iron administered, not the injection technique. *Alleviate the pain* - While proper injection technique can minimize discomfort, the Z-track method's primary purpose is not pain reduction but rather **preventing reflux** and associated staining. - Pain during injection is often related to the volume, viscosity, and acidity of the medication, as well as the injection site. *Decrease the incidence of infection* - Standard aseptic techniques, not the Z-track method itself, are crucial for **preventing infection** during intramuscular injections. - The Z-track technique does not inherently reduce the risk of infection beyond what is achieved with good sterile practice.

Q: Where are antisperm antibodies usually present?

Cervix. ***Cervix*** - Antisperm antibodies are commonly found in the **cervical mucus**, where they can immobilize or agglutinate sperm, preventing their passage into the uterus. - The cervix acts as a key immunological barrier, and its secretions can contain antibodies that interfere with **sperm motility and viability**. *Vagina* - While some antibodies may be present, the **acidic environment** of the vagina is generally hostile to sperm, and it is not the primary site for antisperm antibody action in infertility. - The vagina's role is more about initial sperm reception rather than a concentrated immunological barrier against sperm movement. *Fallopian tube* - The fallopian tubes are primarily involved in **sperm capacitation**, fertilization, and early embryo transport. - Although immune cells exist, it is not the most common location for significant levels of antisperm antibodies to cause issues with sperm transport into the uterus. *Uterus* - The uterus is mainly a site for sperm transport to the fallopian tubes and implantation of the embryo. - While immune responses can occur, the **cervix** is the more critical location for antisperm antibody presence causing clinical infertility by blocking sperm entry.

Question 1

The umbilical cord normally contains:

Accepted Answer

Two arteries and one vein

Answer

One artery and two veins

Answer

One artery and one vein

Answer

Two arteries and two veins

Question 2

Painless genital ulcer is found in which one of the following genital infections?

Accepted Answer

Granuloma inguinale

Answer

Lymphogranuloma venerum

Answer

Chancroid

Answer

Herpes simplex

Question 3

Fitz‐Hugh‐Curtis syndrome involving perihepatitis is present in the following:

Accepted Answer

Gonorrhoea

Answer

Syphilis

Answer

Tuberculosis

Answer

Moniliasis

Question 4

Which of the following cause/causes bacterial vaginosis?

1. Gardnerella
2. Mycoplasma hominis
3. Ureaplasma urealyticum

Select the correct answer using the code given below:

Accepted Answer

1, 2 and 3

Answer

1 and 3 only

Answer

2 and 3 only

Answer

1 only

Question 5

A 28 year old woman develops amenorrhoea after having dilatation and curettage. The most likely diagnosis is :

Accepted Answer

Asherman syndrome

Answer

Kallman syndrome

Answer

Turner syndrome

Answer

Anorexia nervosa

Question 6

Modified Bishop’s score includes all EXCEPT:

Accepted Answer

Position of occiput

Answer

Position of os

Answer

Consistency of cervix

Answer

Cervical length and dilatation

Question 7

The engaging diameter of brow presentation is:

Accepted Answer

Mento‐vertical

Answer

Submento‐bregmatic

Answer

Submento‐vertical

Answer

Suboccipito‐bregmatic

Question 8

Which of the following is/are the risk factors for acute pelvic inflammatory disease in women?

1. Intercourse during menstruation
2. Multiple sex partners

Select the correct answer using the code given below:

Accepted Answer

Both 1 and 2

Answer

2 only

Answer

Neither 1 nor 2

Answer

1 only

Question 9

Intramuscular injection of iron dextran is given by ‘Z’ technique to:

Accepted Answer

Reduce the staining

Answer

Increase the iron absorption

Answer

Alleviate the pain

Answer

Decrease the incidence of infection

Question 10

Where are antisperm antibodies usually present?

Accepted Answer

Cervix

Answer

Vagina

Answer

Fallopian tube

Answer

Uterus

UPSC-CMS 2017

Anatomy

Dermatology

Internal Medicine

Microbiology

Obstetrics and Gynecology

Pharmacology

Physiology