Dermatology
1 questionsWhich of the following are true about epidermal cyst? 1. It is lined by stratified squamous epithelium. 2. It is derived from hair follicle. 3. It contains keratin debris. 4. It is not fixed to the skin.
UPSC-CMS 2022 - Dermatology UPSC-CMS Practice Questions and MCQs
Question 31: Which of the following are true about epidermal cyst? 1. It is lined by stratified squamous epithelium. 2. It is derived from hair follicle. 3. It contains keratin debris. 4. It is not fixed to the skin.
- A. 1, 3 and 4
- B. 1, 2 and 4
- C. 2, 3 and 4
- D. 1, 2 and 3 (Correct Answer)
Explanation: ***1, 2 and 3*** - An **epidermal cyst** is indeed derived from the **infundibulum of a hair follicle**. - It is lined by **stratified squamous epithelium** and contains **keratin debris**, giving it a cheesy consistency. *1, 3 and 4* - While an epidermal cyst is lined by stratified squamous epithelium and contains keratin, it is often **fixed to the skin** due to its attachment to the follicular opening, making statement 4 incorrect. - The cyst's connection to the surface epithelium is a distinguishing feature, preventing it from being freely mobile. *1, 2 and 4* - Although statements 1 and 2 are true, statement 4, claiming it is not fixed to the skin, is generally **incorrect**. - Epidermal cysts typically have a punctum or small opening to the skin surface, indicating its attachment. *2, 3 and 4* - Statements 2 and 3 are correct, but statement 4, suggesting it is not fixed, is **false**. - The presence of a **central punctum**, which is common in epidermal cysts, signifies its epidermal origin and attachment to the skin.
Internal Medicine
4 questionsWhich of the following is included in Ranson scoring system to predict the severity of acute pancreatitis at the time of admission? A. WBC count > 15 x 10^3/L B. Blood glucose > 200 mg/dL C. LDH > 350 units/L D. AST > 250 units/L
Which organ is PRIMARILY involved in cystic fibrosis?
Which of the following are correct with regard to lung cancer? 1. Surgical resection has a limited role in curative treatment of lung cancer. 2. Pattern of disease and prognosis of oat cell carcinoma are different to other varieties in the lungs. 3. Small cell lung cancer is a type of Neuroendocrine Tumour (NET). 4. Squamous cancer appears as a cavitating tumour in the lungs.
Which of the following are correct about Felty's syndrome? 1. It is associated with rheumatoid arthritis. 2. It may present with leukopenia. 3. It may have splenomegaly. 4. Splenectomy always improves the blood picture.
UPSC-CMS 2022 - Internal Medicine UPSC-CMS Practice Questions and MCQs
Question 31: Which of the following is included in Ranson scoring system to predict the severity of acute pancreatitis at the time of admission? A. WBC count > 15 x 10^3/L B. Blood glucose > 200 mg/dL C. LDH > 350 units/L D. AST > 250 units/L
- A. LDH > 350 units/L
- B. Blood glucose > 200 mg/dL
- C. AST > 250 units/L
- D. WBC count > 15,000/mm³ (Correct Answer)
Explanation: ***WBC count > 15,000/mm³*** - A **high white blood cell count** upon admission is one of the initial criteria in the Ranson scoring system indicating more severe inflammation [1]. - This parameter helps to assess the systemic inflammatory response in acute pancreatitis. *LDH > 350 units/L* - The Ranson criteria specify an **LDH level greater than 350 units/L** as a predictor of severity for acute pancreatitis, but it is assessed **at 48 hours after admission**, not at admission. - This value reflects ongoing tissue damage and enzyme release. *Blood glucose > 200 mg/dL* - A blood glucose level > 200 mg/dL is a criterion for the Ranson score, but it is assessed **at 48 hours after admission**, not at the time of admission. - This can indicate significant pancreatic damage impacting insulin production. *AST > 250 units/L* - While an elevated AST level can be present in acute pancreatitis, the specific Ranson criterion for AST is **> 250 units/L**, and it is assessed **at 48 hours after admission**, not upon admission. - This elevation can suggest hepatobiliary involvement or severe pancreatic necrosis.
Question 32: Which organ is PRIMARILY involved in cystic fibrosis?
- A. Pancreas
- B. Kidney
- C. Liver
- D. Lungs (Correct Answer)
Explanation: Lungs - The lungs are **primarily affected** in cystic fibrosis due to the dysfunction of the **CFTR protein**, leading to the production of thick, sticky mucus [1]. - This thick mucus obstructs the airways, causing **recurrent infections**, inflammation, and progressive lung damage, which is the leading cause of morbidity and mortality [1], [2]. *Pancreas* - The pancreas is also significantly affected in cystic fibrosis, leading to **exocrine pancreatic insufficiency** and malabsorption. - However, while pancreatic issues are prominent, the **pulmonary complications** are typically the primary cause of severe illness and death [2]. *Kidney* - The kidneys are generally **not directly affected** by the primary pathology of cystic fibrosis. - Renal complications are usually secondary to treatments or long-term systemic effects of the disease. *Liver* - The liver can be affected in cystic fibrosis, leading to **focal biliary cirrhosis** and other hepatobiliary issues. - However, severe liver disease is less common than pulmonary or pancreatic manifestations and usually does not represent the primary organ involved in the acute or chronic progression of the disease.
Question 33: Which of the following are correct with regard to lung cancer? 1. Surgical resection has a limited role in curative treatment of lung cancer. 2. Pattern of disease and prognosis of oat cell carcinoma are different to other varieties in the lungs. 3. Small cell lung cancer is a type of Neuroendocrine Tumour (NET). 4. Squamous cancer appears as a cavitating tumour in the lungs.
- A. 1, 3 and 4
- B. 2, 3 and 4 (Correct Answer)
- C. 1, 2 and 3
- D. 1, 2 and 4
Explanation: ***2, 3 and 4*** - **Oat cell carcinoma** (small cell lung cancer) is known for its **aggressive behavior**, rapid growth, early metastasis, and distinct response to chemotherapy and radiation rather than surgery, making its pattern and prognosis different from **non-small cell lung cancer (NSCLC)** types [1]. - **Small cell lung cancer (SCLC)** originates from **neuroendocrine cells** in the lung, classifying it as a type of **Neuroendocrine Tumour (NET)**, which explains its unique biological and clinical characteristics [1]. - **Squamous cell carcinoma** is often centrally located and can undergo central necrosis, leading to **cavitation** which appears as a cavitating tumor on imaging [1]. *1, 3 and 4* - This option is incorrect because statement 1, which suggests surgical resection has a limited role in curative treatment, is generally **false for non-small cell lung cancer (NSCLC)**, where surgery is the primary curative modality in early stages [1]. - While statements 3 and 4 are correct, the inclusion of incorrect statement 1 makes this option invalid. *1, 2 and 3* - This option is incorrect as statement 1 claiming a limited role for surgical resection in curative treatment is generally **false for NSCLC**, where localized tumors are ideally treated with surgery [1]. - Statements 2 and 3 are correct, but the inaccuracy of statement 1 renders this option incorrect. *1, 2 and 4* - This option is incorrect because statement 1, which states that surgical resection has a limited role in curative treatment, is generally **incorrect for early-stage NSCLC** [1]. - Although statements 2 and 4 are accurate, the error in statement 1 makes this combination incorrect.
Question 34: Which of the following are correct about Felty's syndrome? 1. It is associated with rheumatoid arthritis. 2. It may present with leukopenia. 3. It may have splenomegaly. 4. Splenectomy always improves the blood picture.
- A. 1, 2 and 4
- B. 1, 2 and 3 (Correct Answer)
- C. 1, 3 and 4
- D. 2, 3 and 4
Explanation: ***1, 2 and 3*** - Felty's syndrome is a severe variant of **rheumatoid arthritis** characterized by the triad of **rheumatoid arthritis**, **splenomegaly**, and **neutropenia** (a type of leukopenia) [1]. - While splenectomy can be considered for persistent severe neutropenia, it does not **always improve the blood picture** and is reserved for cases unresponsive to other treatments. *1, 2 and 4* - This option correctly identifies the association with **rheumatoid arthritis** and **leukopenia** but incorrectly states that splenectomy **always improves the blood picture**. - Splenectomy is not a guarantee of improvement and is considered a last resort. *1, 3 and 4* - This option correctly identifies the association with **rheumatoid arthritis** and **splenomegaly** but incorrectly concludes that splenectomy **always improves the blood picture**, and misses the characteristic **leukopenia**. - Leukopenia, specifically neutropenia, is a defining feature of Felty's syndrome [1]. *2, 3 and 4* - This option incorrectly states that Felty's syndrome is always associated with leukopenia and splenomegaly, but the crucial missing element is its clear association with **rheumatoid arthritis**. - The primary underlying condition for Felty's syndrome is **long-standing, severe rheumatoid arthritis** [1].
Pathology
2 questionsThe commonest variety of peritoneal metastasis is
Which of the following are correct about glomus tumour? 1. It arises from Suquet-Hoyer canals. 2. Its usual site is nail bed. 3. It is usually a small purple nodule. 4. It is painless.
UPSC-CMS 2022 - Pathology UPSC-CMS Practice Questions and MCQs
Question 31: The commonest variety of peritoneal metastasis is
- A. plaques of varying sizes
- B. drop metastasis in pelvis
- C. diffuse adhesion
- D. discrete nodules (Correct Answer)
Explanation: ***discrete nodules*** - Peritoneal metastasis most commonly manifests as **discrete nodules** scattered across the peritoneal surfaces [1]. - These nodules vary in size and distribution, often arising from the implantation of malignant cells shed from a primary tumor. *plaques of varying sizes* - While plaques can occur, they are generally less common than discrete nodules as the primary manifestation of **peritoneal carcinomatosis**. - Plaques often represent confluent growth of numerous smaller nodules rather than the initial, more frequent presentation. *drop metastasis in pelvis* - **Drop metastases** to the pelvis are a common site for peritoneal dissemination due to gravity and fluid dynamics within the peritoneal cavity. - However, referring to it as simply "drop metastasis in pelvis" describes a location rather than the morphology, which is typically **nodular**. *diffuse adhesion* - **Diffuse adhesions** typically result from chronic inflammation or surgical procedures, connecting peritoneal surfaces. - While extensive tumor growth can lead to adhesions, the initial and most common pattern of metastasis is individual **tumor cell implantation** forming **discrete nodules**, not diffuse initial adherence. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. (Basic Pathology) introduces the student to key general principles of pathology, both as a medical science and as a clinical activity with a vital role in patient care. Part 2 (Disease Mechanisms) provides fundamental knowledge about the cellular and molecular processes involved in diseases, providing the rationale for their treatment. Part 3 (Systematic Pathology) deals in detail with specific diseases, with emphasis on the clinically important aspects., pp. 233-234.
Question 32: Which of the following are correct about glomus tumour? 1. It arises from Suquet-Hoyer canals. 2. Its usual site is nail bed. 3. It is usually a small purple nodule. 4. It is painless.
- A. 1, 2 and 4
- B. 2, 3 and 4
- C. 1, 3 and 4
- D. 1, 2 and 3 (Correct Answer)
Explanation: ***1, 2 and 3*** - Glomus tumors originate from the **Suquet-Hoyer canals**, specialized arteriovenous anastomoses involved in thermoregulation. - They are most frequently found in the **nail bed** (especially subungual region) as small, **purple** (reddish-blue) nodules and are typically very painful. - The classic triad includes severe pain, cold sensitivity, and point tenderness. *1, 2 and 4* - This option incorrectly states that glomus tumors are **painless**. In fact, they are characterized by severe pain due to their rich innervation. - While correct that they arise from Suquet-Hoyer canals and are found in the nail bed, the **painlessness** aspect is inaccurate. *2, 3 and 4* - This option incorrectly includes the statement that glomus tumors are **painless**, which contradicts a key distinguishing feature. - Although glomus tumors are typically found in the nail bed and appear as purple nodules, pain is a characteristic clinical feature, not absence of pain. *1, 3 and 4* - This option incorrectly states that glomus tumors are **painless** and omits the correct statement about the usual nail bed location. - While they do arise from Suquet-Hoyer canals and can be small purple nodules, their characteristic severe pain makes this option incorrect.
Surgery
3 questionsWhen the hernia extends between the layers of abdominal wall muscles and not directly through them, it is called
Which of the following are tension-free inguinal hernia repairs? 1. Stoppa's repair 2. Lichtenstein's repair 3. Laparoscopic TEP repair 4. Desarda's repair.
Anderson-Hynes plasty is a type of repair of
UPSC-CMS 2022 - Surgery UPSC-CMS Practice Questions and MCQs
Question 31: When the hernia extends between the layers of abdominal wall muscles and not directly through them, it is called
- A. Amyand's hernia
- B. Richter's hernia
- C. Littre's hernia
- D. Spigelian hernia (Correct Answer)
Explanation: ***Spigelian hernia*** - A **Spigelian hernia** occurs through a defect in the **Spigelian fascia**, extending between the transverse abdominis and internal oblique muscles. - It typically presents as a bulge between muscular layers, making it often **interparietal** and difficult to diagnose clinically due to its hidden nature. *Amyand's hernia* - This is a rare type of inguinal hernia that contains the **vermiform appendix** within the hernial sac. - It is notable for the potential complication of **appendicitis** within the hernia. *Richter's hernia* - A **Richter's hernia** involves only a portion of the circumference of the bowel wall becoming strangulated within the hernia orifice. - This can lead to **bowel necrosis** without complete obstruction, making diagnosis challenging. *Littre's hernia* - A **Littre's hernia** is characterized by the presence of a **Meckel's diverticulum** within the hernial sac. - It can occur in any hernia type (inguinal, femoral, umbilical) and carries a risk of diverticulitis or perforation.
Question 32: Which of the following are tension-free inguinal hernia repairs? 1. Stoppa's repair 2. Lichtenstein's repair 3. Laparoscopic TEP repair 4. Desarda's repair.
- A. 2, 3 and 4
- B. 1, 3 and 4
- C. 1, 2 and 4
- D. 1, 2 and 3 (Correct Answer)
Explanation: ***1, 2 and 3*** - **Stoppa's repair**, **Lichtenstein's repair**, and **Laparoscopic TEP repair** are all considered tension-free methods because they use mesh to reinforce the inguinal floor without putting tension on the surrounding tissues. - The use of mesh in these repairs distributes the tension across a wider area, minimizing pain and recurrence rates compared to traditional tension-based repairs. - **Desarda's repair** is excluded because it is a tissue-based (non-mesh) technique that uses the external oblique aponeurosis, and is NOT classified as a tension-free repair. *2, 3 and 4* - This option incorrectly excludes **Stoppa's repair**, which is a widely recognized tension-free technique using a large prosthetic mesh in the preperitoneal space. - **Desarda's repair** is incorrectly included as it is a tissue-based repair without mesh, not a tension-free technique. *1, 3 and 4* - This option incorrectly excludes **Lichtenstein's repair**, which is the most commonly performed tension-free open mesh repair for inguinal hernias. - It involves placing a prosthetic mesh over the defect without suturing muscle or fascia under tension. - **Desarda's repair** is incorrectly included as it does not use mesh and is not classified as tension-free. *1, 2 and 4* - This option incorrectly excludes **Laparoscopic TEP repair**, which is a minimally invasive tension-free approach utilizing mesh to reinforce the posterior wall of the inguinal canal in the preperitoneal space. - **Desarda's repair** is incorrectly included; while it aims to be physiological and mesh-free, it is a tissue-based technique and not a tension-free repair.
Question 33: Anderson-Hynes plasty is a type of repair of
- A. lower ureter
- B. ureteropelvic junction (Correct Answer)
- C. glans penis
- D. urinary bladder
Explanation: ***ureteropelvic junction*** - The **Anderson-Hynes pyeloplasty** is a widely used surgical procedure for the correction of a **ureteropelvic junction (UPJ) obstruction**. - It involves **excision of the stenotic or obstructed UPJ segment** and **reconstruction** to create a wide, funnel-shaped connection between the renal pelvis and the ureter. *lower ureter* - Repairs of the lower ureter, such as for distal ureteral strictures or reflux, typically involve procedures like ureteral re-implantation into the bladder or ureteroureterostomy, not the Anderson-Hynes plasty. - While these can address obstruction, the specific technique of Anderson-Hynes is designed for the UPJ. *glans penis* - The glans penis is part of the male external genitalia, and surgical repairs in this area, such as for hypospadias or strictures, are entirely unrelated to the ureter or kidney. - Surgical procedures for the glans penis would involve plastic and reconstructive techniques specific to the urethra and foreskin. *urinary bladder* - Repairs of the urinary bladder involve procedures for conditions like bladder diverticula, fistulae, or augmentation cystoplasty, which are distinct from managing obstructions in the upper urinary tract. - These procedures aim to restore bladder function and integrity, not to address blockages at the junction of the kidney and ureter.