Anatomy
1 questionsInhaled foreign bodies are more likely to get lodged in the right main bronchus because
UPSC-CMS 2023 - Anatomy UPSC-CMS Practice Questions and MCQs
Question 21: Inhaled foreign bodies are more likely to get lodged in the right main bronchus because
- A. Right main bronchus is shorter, wider and nearly vertical (Correct Answer)
- B. Left main bronchus is wider and shorter
- C. Right main bronchus is shorter, narrower and lies horizontally in relation to trachea
- D. Left main bronchus is narrow and longer
Explanation: ***Right main bronchus is shorter, wider and nearly vertical*** - The **anatomical configuration** of the right main bronchus makes it a more direct continuation of the trachea. - Its **wider diameter** and **more vertical angle** allow foreign bodies to fall into it more easily due to gravity and airflow. *Left main bronchus is wider and shorter* - This statement is incorrect; the **left main bronchus** is actually **narrower and longer** than the right. - Its **more acute angle** stemming from the trachea also makes it less likely for foreign objects to lodge there directly. *Right main bronchus is shorter, narrower and lies horizontally in relation to trachea* - This statement is incorrect as the **right main bronchus** is indeed **shorter** but is **wider** and takes a **more vertical** course, not horizontal. - The description of being "narrower" and "horizontally" contradicts the anatomical characteristics that facilitate foreign body impaction. *Left main bronchus is narrow and longer* - This statement is anatomically correct for the left main bronchus; however, these characteristics make it **less likely** for foreign bodies to get lodged here. - The **narrower lumen** and **longer path**, combined with a more acute angle, make it a less direct route for inhaled objects.
Internal Medicine
1 questionsMatch List-I with List-II and select the correct answer using the code given below the Lists:
UPSC-CMS 2023 - Internal Medicine UPSC-CMS Practice Questions and MCQs
Question 21: Match List-I with List-II and select the correct answer using the code given below the Lists:
- A. A→4 B→3 C→1 D→2
- B. A→4 B→2 C→3 D→1
- C. A→3 B→4 C→1 D→2
- D. A→4 B→1 C→3 D→2 (Correct Answer)
Explanation: **A→4 B→1 C→3 D→2** - This option correctly matches each endocrine gland with its primary hormone: the **pineal gland** produces **melatonin**, the **testis** produces **testosterone**, the **adrenal gland** produces **cortisol**, and the **ovary** produces **estrogen**. - These pairings are fundamental to understanding the basic functions of the endocrine system. *A→4 B→3 C→1 D→2* - This option incorrectly matches the **testis** with **cortisol** (should be testosterone) and the **adrenal gland** with **melatonin** (should be cortisol). - Cortisol is a steroid hormone produced by the adrenal cortex, while melatonin from the pineal gland regulates sleep-wake cycles. *A→4 B→2 C→3 D→1* - This option incorrectly matches the **testis** with **estrogen** (should be testosterone) and the **ovary** with **melatonin** (should be estrogen). - Estrogen is the primary female sex hormone, while testosterone is the primary male sex hormone. *A→3 B→4 C→1 D→2* - This option incorrectly matches the **pineal gland** with **cortisol** (should be melatonin) and the **testis** with **estrogen** (should be testosterone). - The pineal gland is known for its role in circadian rhythms through melatonin production, not stress response hormones like cortisol.
Ophthalmology
2 questionsIn patients with systemic hypertension, the characteristic haemorrhage seen on ophthalmoscopy is
Spring catarrh is a type of conjunctivitis caused by
UPSC-CMS 2023 - Ophthalmology UPSC-CMS Practice Questions and MCQs
Question 21: In patients with systemic hypertension, the characteristic haemorrhage seen on ophthalmoscopy is
- A. Flame-shaped haemorrhage (Correct Answer)
- B. Wet sponge haemorrhage
- C. Suprachoroidal haemorrhage
- D. Dot haemorrhage
Explanation: ***Flame-shaped haemorrhage*** - **Flame-shaped hemorrhages** are superficial, linear hemorrhages occurring in the **nerve fiber layer** of the retina, characteristic of **hypertensive retinopathy**. - They result from the rupture of superficial capillaries due to **elevated intravascular pressure** in systemic hypertension. *Wet sponge haemorrhage* - This term is not a standard description for retinal hemorrhage types. - Retinal hemorrhages are typically categorized by their shape and depth, such as dot-and-blot, flame-shaped, or subretinal. *Suprachoroidal haemorrhage* - **Suprachoroidal hemorrhages** occur between the choroid and the sclera, often due to trauma or surgical complications. - They are much deeper than retinal hemorrhages and are typically not a direct, primary manifestation of chronic systemic hypertension on routine ophthalmoscopy. *Dot haemorrhage* - **Dot haemorrhages** are deep, punctate hemorrhages occurring in the **inner nuclear** or **outer plexiform layers** of the retina. - While they can be seen in various conditions including diabetic retinopathy, they are not the most characteristic type of hemorrhage seen specifically in systemic hypertension.
Question 22: Spring catarrh is a type of conjunctivitis caused by
- A. Virus infection
- B. Endogenous toxins
- C. Bacterial infection
- D. Exogenous allergen (Correct Answer)
Explanation: ***Exogenous allergen*** - **Spring catarrh**, also known as **vernal keratoconjunctivitis (VKC)**, is exclusively a type of allergic conjunctivitis. - It is triggered by exposure to **environmental allergens**, commonly identified as dust, pollen, or other airborne irritants, especially during warmer seasons. *Virus infection* - Viral conjunctivitis, such as that caused by **adenovirus**, often presents with watery discharge, redness, and may be associated with an upper respiratory tract infection. - Unlike spring catarrh, it is highly **contagious** and does not typically recur seasonally due to allergen exposure. *Endogenous toxins* - Ocular conditions caused by endogenous toxins are rare and usually associated with systemic diseases or metabolic disorders affecting body system, not typically a primary cause of conjunctivitis. - This category does not align with the clear allergic and seasonal presentation characteristic of spring catarrh. *Bacterial infection* - Bacterial conjunctivitis is characterized by purulent (pus-like) discharge, severe redness, and often involves one eye initially (though can spread to both). - It is treated with antibiotics and does not typically exhibit the seasonal recurrence or papillary hypertrophy on the tarsal conjunctiva seen in spring catarrh.
Orthopaedics
1 questionsThe following hallmarks characterise Diaphyseal aclasis except
UPSC-CMS 2023 - Orthopaedics UPSC-CMS Practice Questions and MCQs
Question 21: The following hallmarks characterise Diaphyseal aclasis except
- A. Pseudoarthrosis is common
- B. Chondrosarcoma may occur in less than 1% cases (Correct Answer)
- C. It is inherited as an autosomal dominant dysplasia
- D. Genu valgum can be found
Explanation: ***Chondrosarcoma may occur in less than 1% cases*** - This statement is incorrect as the risk of malignant transformation to **chondrosarcoma** in Diaphyseal aclasis (hereditary multiple exostoses) is commonly reported to be significantly higher, ranging from **5-25%**. - Therefore, stating it occurs in "less than 1% cases" is factually inaccurate, making this the correct answer as to what does *not* characterize the condition. *Pseudoarthrosis is common* - **Pseudoarthrosis** (false joint formation) can occur as a complication of **bony deformities** and the presence of osteochondromas, particularly in regions where they interfere with bone growth or cause fractures. - The abnormal growth of osteochondromas can predispose to fractures, which may heal poorly and result in pseudoarthrosis. *It is inherited as an autosomal dominant dysplasia* - Diaphyseal aclasis, also known as **hereditary multiple exostoses (HME)**, is indeed an **autosomal dominant** skeletal dysplasia. - It is caused by mutations in the **EXT1 or EXT2 genes**, which are involved in heparan sulfate proteoglycan synthesis, leading to abnormal bone growth. *Genu valgum can be found* - **Genu valgum** (knock-knees) is a common **skeletal deformity** observed in individuals with Diaphyseal aclasis. - The multiple osteochondromas can disturb the normal growth and alignment of long bones, frequently affecting the distal femur and proximal tibia leading to this angular deformity.
Surgery
5 questionsFollowing radical surgery for the carcinoma of breast, reconstruction of the breast can be performed by using the following procedures except
A Wolfe graft is a
The indications for surgery in patients with pulmonary tuberculosis include all of the following except
In a patient with stage T1 (tumor invading lamina propria) transitional cell carcinoma of the urinary bladder, the recommended treatment is
A localized nodule of squamous cell carcinoma in the vocal cord is best treated by
UPSC-CMS 2023 - Surgery UPSC-CMS Practice Questions and MCQs
Question 21: Following radical surgery for the carcinoma of breast, reconstruction of the breast can be performed by using the following procedures except
- A. Silicone implants
- B. Transversus abdominis muscle flap (TRAM flap)
- C. Latissimus dorsi flap (LD flap)
- D. Deltopectoral flap (Correct Answer)
Explanation: ***Deltopectoral flap*** - The **deltopectoral flap**, also known as the Bakamjian flap, is primarily used for **head and neck reconstruction**, particularly for defects in the pharynx, esophagus, or oral cavity. - It involves tissue from the shoulder and chest wall, but its design and vascular supply make it unsuitable for **breast reconstruction** after radical mastectomy, which requires significantly more volume and different tissue characteristics. *Silicone implants* - **Silicone implants** are a common method for breast reconstruction, offering a less invasive option than flap procedures. - They are placed either beneath the pectoral muscle or subcutaneously to restore breast volume and shape. *Transversus abdominis muscle flap (TRAM flap)* - The **TRAM flap** is a widely used and versatile autologous tissue reconstruction method, utilizing tissue from the lower abdomen to create a new breast mound. - It can be either pedicled (retaining its original blood supply) or free (requiring microvascular anastomosis), providing a natural-feeling and long-lasting reconstruction. *Latissimus dorsi flap (LD flap)* - The **latissimus dorsi (LD) flap** involves transferring muscle, fat, and skin from the back to the chest to reconstruct the breast. - It is particularly useful for smaller breasts or when combined with an implant, and it can provide good aesthetic results with reliable blood supply.
Question 22: A Wolfe graft is a
- A. Partial thickness skin graft
- B. Pinch skin graft
- C. Pedicle graft
- D. Large full thickness skin graft (Correct Answer)
Explanation: ***Large full thickness skin graft*** - A **Wolfe graft** is a type of **large full-thickness skin graft** that includes the epidermis and entire dermis. - Due to its full thickness, it provides better cosmetic results and less contracture compared to split-thickness grafts, but requires optimal **vascularization** at the recipient site. - The term "Wolfe graft" specifically refers to the **large size** of the full-thickness graft, distinguishing it from smaller grafts. *Partial thickness skin graft* - A **partial-thickness skin graft** (also known as a split-thickness skin graft) includes the epidermis and only a portion of the dermis. - While easier to harvest and more likely to **take** in less ideal recipient beds, they are known for more contraction and a less cosmetic appearance. *Pinch skin graft* - A **pinch graft** is a small, conical piece of skin, including the epidermis and dermis, taken by pinching the skin. - These grafts are generally less aesthetically pleasing, have limited applications, and are often used for small, non-cosmetic defects. *Pedicle graft* - A **pedicle graft** (or flap) is a section of tissue that remains attached to its original site at one or more points, maintaining its own **blood supply**. - Unlike a free graft, it is not completely detached from the donor site, allowing for transfer of more complex tissues like muscle or bone.
Question 23: The indications for surgery in patients with pulmonary tuberculosis include all of the following except
- A. Drug-resistant chronic tuberculous abscess
- B. Severe life-threatening haemoptysis
- C. AFB positive sputum with normal chest CT scan (Correct Answer)
- D. Aspergilloma within a tuberculous cavity with recurrent haemoptysis
Explanation: ***AFB positive sputum with normal chest CT scan*** - This scenario typically indicates **early or uncomplicated pulmonary tuberculosis** that is responsive to standard antitubercular drug therapy. - A normal chest CT scan suggests the absence of significant cavitations, extensive lung damage, or other structural abnormalities that would necessitate surgical intervention. *Drug-resistant chronic tuberculous abscess* - **Drug resistance** and the presence of a **chronic tuberculous abscess** make medical management difficult and often ineffective. - Surgical resection can remove the source of infection, facilitate cure, and prevent further dissemination of drug-resistant organisms. *Severe life-threatening haemoptysis* - **Severe or life-threatening haemoptysis** in TB patients often arises from eroded pulmonary vessels within cavitary lesions. - Surgical intervention (e.g., lobectomy, pneumonectomy) is critical to control bleeding and prevent fatal outcomes when conservative measures fail. *Aspergilloma within a tuberculous cavity with recurrent haemoptysis* - An **aspergilloma (fungal ball)** developing in a pre-existing tuberculous cavity can cause **recurrent haemoptysis** due to erosion of blood vessels by the fungus. - Surgical resection is often the definitive treatment to remove the aspergilloma and prevent further bleeding.
Question 24: In a patient with stage T1 (tumor invading lamina propria) transitional cell carcinoma of the urinary bladder, the recommended treatment is
- A. Radiation therapy
- B. Systemic chemotherapy
- C. Radical cystectomy
- D. Trans urethral resection of bladder tumour (TURBT) (Correct Answer)
Explanation: ***Trans urethral resection of bladder tumour (TURBT)*** - For **stage 1 (confined to mucosa and submucosa) transitional cell carcinoma** of the urinary bladder, TURBT is the primary and often curative treatment. - This procedure allows for both diagnostic staging and complete resection of visible tumors. *Radiation therapy* - **Radiation therapy** is generally reserved for more advanced stages or for patients who are not surgical candidates. - It is often used in combination with chemotherapy or as a palliative measure, not typically as monotherapy for early-stage disease. *Systemic chemotherapy* - **Systemic chemotherapy** is typically indicated for advanced, metastatic bladder cancer or as neoadjuvant/adjuvant therapy in muscle-invasive disease. - It is not the primary treatment for early-stage, non-muscle invasive bladder cancer. *Radical cystectomy* - **Radical cystectomy** is a major surgical procedure involving removal of the entire bladder and surrounding structures. - It is reserved for **muscle-invasive bladder cancer** or recurrent high-grade non-muscle invasive bladder cancer that has failed conservative treatments.
Question 25: A localized nodule of squamous cell carcinoma in the vocal cord is best treated by
- A. Cryosurgery
- B. Radiotherapy
- C. Laser therapy (Correct Answer)
- D. Surgical excision
Explanation: ***Laser therapy (Transoral Laser Microsurgery)*** - **CO2 laser excision** is an excellent first-line treatment for localized T1a squamous cell carcinoma of the vocal cord, offering **>90% cure rates**. - Advantages include: **precise tumor removal**, immediate pathological assessment with margin evaluation, **excellent voice preservation**, and shorter treatment duration compared to radiotherapy. - **Transoral laser microsurgery (TLM)** allows for cord-sparing procedures that maintain vocal function while achieving complete oncological resection. *Radiotherapy* - **Important Note:** **Radiotherapy is EQUALLY effective** as laser therapy for early T1 glottic cancer, with comparable **5-year local control rates (>90%)** and voice quality outcomes. - Both laser surgery and radiotherapy are **guideline-recommended first-line treatments** (NCCN, ESMO guidelines). - Choice between the two depends on tumor characteristics (anterior commissure involvement), patient preference, institutional expertise, and functional outcomes. - In examination contexts, laser therapy may be preferred as it provides histopathological confirmation and is often considered more definitive for "localized nodules." *Cryosurgery* - **Cryosurgery** is rarely used for vocal cord lesions due to **unpredictable tissue destruction**, potential for severe **vocal cord scarring**, and inability to obtain tissue for pathological margin assessment. - Not a standard treatment option for laryngeal cancer. *Surgical excision* - This term is ambiguous as **laser excision IS a form of surgical excision**. - If referring to **open surgical approaches** (laryngofissure, cordectomy via external approach), these are more invasive than transoral laser surgery and are reserved for larger tumors or salvage situations. - Traditional "cold steel" endoscopic excision is less precise than laser and can cause more trauma and scarring.