Acrodermatitis enteropathica is an autosomal recessive metabolic disorder which affects the absorption of which one of the following micronutrients?
UPSC-CMS 2025 - Biochemistry UPSC-CMS Practice Questions and MCQs
Question 91: Acrodermatitis enteropathica is an autosomal recessive metabolic disorder which affects the absorption of which one of the following micronutrients?
A. Zinc (Correct Answer)
B. Selenium
C. Iron
D. Iodine
Explanation: ***Correct: Zinc***
- **Acrodermatitis enteropathica** is an autosomal recessive disorder caused by a defect in the absorption of **zinc** from the intestines (due to mutations in the *SLC39A4* gene encoding the ZIP4 zinc transporter).
- This leads to the characteristic clinical triad: periorificial and acral **dermatitis**, **alopecia**, and **diarrhea**.
- Treatment involves lifelong zinc supplementation.
*Incorrect: Selenium*
- **Selenium** deficiency can lead to **Keshan disease** (cardiomyopathy) and **Kashin-Beck disease** (osteoarthropathy), which are distinct from acrodermatitis enteropathica.
- Symptoms related to selenium deficiency do not typically include the prominent dermatological and gastrointestinal features seen in acrodermatitis enteropathica.
*Incorrect: Iron*
- **Iron** deficiency primarily causes **anemia** and symptoms like fatigue, pallor, and pica.
- While iron is a crucial micronutrient, its malabsorption does not result in the specific skin, hair, and gastrointestinal manifestations of acrodermatitis enteropathica.
*Incorrect: Iodine*
- **Iodine** deficiency is strongly associated with **goiter** and various thyroid dysfunctions, including **hypothyroidism** and **cretinism**.
- These conditions are entirely different from the syndrome of acrodermatitis enteropathica, which is characterized by zinc malabsorption.
Dermatology
2 questions
Q91
Koebner phenomenon is seen in which one of the following conditions?
Q92
Consider the following regarding the human hair growth cycle :
I. Anagen is a phase of active hair growth
II. Telogen is a transitional phase
III. Catagen is a resting phase
Which of the statements given above is/are correct?
UPSC-CMS 2025 - Dermatology UPSC-CMS Practice Questions and MCQs
Question 91: Koebner phenomenon is seen in which one of the following conditions?
A. Behçet's disease
B. Leprosy
C. Acne Vulgaris
D. Psoriasis (Correct Answer)
Explanation: ***Psoriasis***
- The **Koebner phenomenon**, or isomorphic response, is characteristic of psoriasis, where new psoriatic lesions appear on areas of **traumatized skin**.
- This response is triggered by various forms of skin injury, such as scratches, surgical incisions, or sunburn.
*Behçet's disease*
- Behçet's disease is associated with **pathergy**, which is a hyper-reactivity to skin injury presenting as a sterile pustule or papule at the site of trauma, but it is distinct from the Koebner phenomenon.
- While both involve skin reactivity to trauma, pathergy in Behçet's disease is typically a pustular response, whereas Koebner phenomenon in psoriasis results in typical psoriatic lesions.
*Leprosy*
- Leprosy is an infectious disease causing **skin lesions** and nerve damage, but it does not typically exhibit the Koebner phenomenon.
- The skin manifestations in leprosy are primarily due to the infection with *Mycobacterium leprae* rather than an isomorphic response to trauma.
*Acne Vulgaris*
- Acne vulgaris is a common inflammatory skin condition involving hair follicles and sebaceous glands, characterized by **comedones, papules, pustules, and cysts**.
- It is not associated with the Koebner phenomenon; new lesions arise from follicular blockage and inflammation, not from skin trauma in the same manner as psoriasis.
Question 92: Consider the following regarding the human hair growth cycle :
I. Anagen is a phase of active hair growth
II. Telogen is a transitional phase
III. Catagen is a resting phase
Which of the statements given above is/are correct?
A. III only
B. I, II and III
C. I only (Correct Answer)
D. I and II only
Explanation: ***I only***
- Statement I is **correct**: **Anagen is the active growth phase** of the hair cycle where hair follicle cells in the matrix rapidly divide and differentiate
- The hair shaft actively grows during this phase, which typically lasts **2-7 years** and determines the maximum length of hair
- **Only statement I is accurate**, making this the correct answer
*III only*
- This option is incorrect because statement III claims **Catagen is a resting phase**, which is medically inaccurate
- **Catagen is actually the transitional/regression phase** (lasting 2-3 weeks) where hair growth stops and the follicle shrinks
- The **resting phase is Telogen**, not Catagen
*I, II and III*
- This option is incorrect because **both statements II and III contain errors**
- Statement II incorrectly identifies **Telogen as a transitional phase** when it is actually the **resting phase** (2-4 months)
- Statement III incorrectly identifies **Catagen as a resting phase** when it is actually the **transitional phase**
- Only statement I is correct
*I and II only*
- This option is incorrect because **statement II is inaccurate**
- Statement II claims **Telogen is a transitional phase**, but Telogen is actually the **resting phase** where the hair remains in the follicle before shedding
- The **transitional phase is Catagen**, not Telogen
- Only statement I is correct, not both I and II
Internal Medicine
3 questions
Q91
Consider the following statements regarding oculocutaneous albinism :
I. The disease results from genetic abnormalities leading to destruction of melanocytes
II. Type 1 albinism is due to a defect in the tyrosinase gene
III. Patients may present with poor vision, rotator nystagmus and alternating strabismus
IV. Patients are at an increased risk of sunburn or developing skin cancer
Which of the statements given above are correct?
Q92
A 42 year old man presented with recurrent oral ulcers since one year, episodes of redness of eye and genital ulcers. Which one of the following tests is of diagnostic value?
Q93
Which of the following statements are correct regarding hypernatremia in children?
I. Diabetes insipidus due to a deficiency of antidiuretic hormone (ADH) may cause hypernatremia
II. Addison disease may be associated with hypernatremia
III. Use of boiled skimmed milk can lead to hypernatremia
IV. Use of lactulose can lead to hypernatremia
Select the answer using the code given below :
UPSC-CMS 2025 - Internal Medicine UPSC-CMS Practice Questions and MCQs
Question 91: Consider the following statements regarding oculocutaneous albinism :
I. The disease results from genetic abnormalities leading to destruction of melanocytes
II. Type 1 albinism is due to a defect in the tyrosinase gene
III. Patients may present with poor vision, rotator nystagmus and alternating strabismus
IV. Patients are at an increased risk of sunburn or developing skin cancer
Which of the statements given above are correct?
A. I, II and IV
B. II, III and IV (Correct Answer)
C. I, III and IV
D. I, II and III
Explanation: ***II, III and IV***
- **Type 1 oculocutaneous albinism (OCA1)** is caused by mutations in the **tyrosinase gene (TYR)**, which encodes the enzyme tyrosinase essential for melanin synthesis [1].
- Patients commonly exhibit **poor vision**, **rotatory nystagmus**, and **alternating strabismus** due to abnormal foveal development and misrouting of optic nerve fibers [1].
- Due to the **lack of melanin**, which protects against UV radiation, these patients are at a significantly increased risk of **sunburn** and developing **skin cancers** like basal cell carcinoma and squamous cell carcinoma [1].
*I, II and IV*
- The first statement is incorrect; albinism is characterized by a **defect in melanin production**, not the destruction of melanocytes. Melanocytes are present but are unable to produce or distribute melanin effectively [1].
- Statements II and IV are correct, but the inclusion of the incorrect statement I makes this option incorrect overall.
*I, III and IV*
- The first statement is incorrect because oculocutaneous albinism is due to **impaired melanin synthesis**, not the destruction of melanocytes. Melanocytes are typically present [1].
- Statements III and IV are correct, but the inaccuracy of statement I makes this choice incorrect.
*I, II and III*
- Statement I is factually incorrect; albinism stems from a **defect in melanin production or transport**, not the destruction of melanocytes [1].
- Statements II and III are correct, but the inclusion of the incorrect statement I renders this option invalid.
Question 92: A 42 year old man presented with recurrent oral ulcers since one year, episodes of redness of eye and genital ulcers. Which one of the following tests is of diagnostic value?
A. Drug-sensitivity test
B. Pathergy test (Correct Answer)
C. Patch test
D. Mantoux test
Explanation: ***Pathergy test***
- The constellation of **recurrent oral and genital ulcers** along with **ocular inflammation (redness of eye)** is highly suggestive of **Behçet's disease**.
- The **pathergy test** assesses for a hyper-reactivity of the skin to needle prick, which is characteristic of Behçet's disease and thus of diagnostic value.
*Drug-sensitivity test*
- This test is primarily used to identify allergic reactions or sensitivities to specific medications.
- It would not be indicated for diagnosing a systemic inflammatory condition like Behçet's disease.
*Patch test*
- A **patch test** is used to identify substances that cause allergic contact dermatitis by applying potential allergens to the skin.
- It is not relevant for the diagnosis of Behçet's disease, which involves inflammatory rather than allergic reactions.
*Mantoux test*
- The **Mantoux test** (tuberculin skin test) is used to screen for **tuberculosis infection** [1].
- This patient's symptoms are not consistent with tuberculosis, and the Mantoux test has no role in diagnosing Behçet's disease [2].
Question 93: Which of the following statements are correct regarding hypernatremia in children?
I. Diabetes insipidus due to a deficiency of antidiuretic hormone (ADH) may cause hypernatremia
II. Addison disease may be associated with hypernatremia
III. Use of boiled skimmed milk can lead to hypernatremia
IV. Use of lactulose can lead to hypernatremia
Select the answer using the code given below :
A. II, III and IV
B. I, III and IV (Correct Answer)
C. I, II and IV
D. I, II and III
Explanation: ***I, III and IV***
- **Diabetes insipidus**, whether central (deficient ADH) or nephrogenic (renal unresponsiveness to ADH), leads to excessive free water loss, causing **hypernatremia** if fluid intake does not compensate [1].
- **Boiled skimmed milk** for infants can have a high solute load (especially sodium and protein) and inadequate free water, overwhelming immature renal capacity and leading to **dehydration** and **hypernatremia**.
- **Lactulose** is an osmotic laxative that draws water into the colon, which can lead to **dehydration** and potentially **hypernatremia** if significant fluid losses occur, especially in vulnerable populations like infants or the elderly.
*II, III and IV*
- **Addison's disease** (adrenocortical insufficiency) typically causes **hyponatremia** due to mineralocorticoid deficiency leading to renal sodium wasting and potassium retention, not hypernatremia [2].
- **Boiled skimmed milk** for infants can have a high solute load and inadequate free water, overwhelming immature renal capacity and leading to dehydration and hypernatremia.
- **Lactulose** is an osmotic laxative that draws water into the colon, which can lead to dehydration and potentially hypernatremia if significant fluid losses occur.
*I, II and IV*
- **Diabetes insipidus**, due to a deficiency of ADH, causes uncompensated free water loss and thus **hypernatremia**.
- **Addison's disease** usually causes **hyponatremia** due to impaired sodium reabsorption in the renal tubules, not hypernatremia [2].
- **Lactulose** can cause significant osmotic diarrhea, leading to free water loss and subsequent **hypernatremia** if not adequately replaced.
*I, II and III*
- **Diabetes insipidus** involves a lack of ADH, leading to unchecked water excretion and subsequent **hypernatremia** [1].
- **Addison's disease** leads to adrenal insufficiency, causing **hyponatremia** and hyperkalemia due to aldosterone deficiency [2].
- Feeding infants **boiled skimmed milk**, which is high in solute content and low in free water, can lead to increased renal solute load and excessive water loss, resulting in **hypernatremia**.
Pediatrics
1 questions
Q91
Which of the following statements are correct regarding the management of gastrointestinal bleeding in children?
I. Somatostatin or octreotide infusion should be given for at least 7 days after stoppage of initial bleeding to prevent rebleeding
II. Endoscopic Sclerotherapy (EST) involves endoscopic injection of N -butyl-2-cyanoacrylate or iso-butyl-2-cyanoacrylate
III. EST has upto 90 % efficacy in controlling acute bleeding
IV. Following an episode of acute variceal bleeding, all patients should receive secondary prophylaxis to prevent rebleeding
Select the answer using the code given below :
UPSC-CMS 2025 - Pediatrics UPSC-CMS Practice Questions and MCQs
Question 91: Which of the following statements are correct regarding the management of gastrointestinal bleeding in children?
I. Somatostatin or octreotide infusion should be given for at least 7 days after stoppage of initial bleeding to prevent rebleeding
II. Endoscopic Sclerotherapy (EST) involves endoscopic injection of N -butyl-2-cyanoacrylate or iso-butyl-2-cyanoacrylate
III. EST has upto 90 % efficacy in controlling acute bleeding
IV. Following an episode of acute variceal bleeding, all patients should receive secondary prophylaxis to prevent rebleeding
Select the answer using the code given below :
A. III and IV (Correct Answer)
B. I and III
C. II and IV
D. I and II
Explanation: ***III and IV***
**Statement I is INCORRECT:** Somatostatin or octreotide infusions are typically administered for **3-5 days** (not 7 days) after initial bleeding has stopped to prevent rebleeding. Prolonged use beyond this period is not generally recommended due to potential side effects and lack of additional benefit.
**Statement II is INCORRECT:** Endoscopic Sclerotherapy (EST) for esophageal varices involves injection of sclerosants such as **ethanolamine oleate, sodium tetradecyl sulfate**, or polidocanol. The tissue adhesives **N-butyl-2-cyanoacrylate** or **iso-butyl-2-cyanoacrylate** are used in **endoscopic variceal obturation (EVO)** for **gastric varices**, not in standard sclerotherapy for esophageal varices.
**Statement III is CORRECT:** Endoscopic Sclerotherapy (EST) demonstrates **up to 90% efficacy** in controlling acute variceal bleeding, making it a highly effective intervention for managing acute hemorrhage.
**Statement IV is CORRECT:** Following an episode of acute variceal bleeding, **all patients should receive secondary prophylaxis** (typically combination of non-selective beta-blockers and endoscopic band ligation) to prevent rebleeding, which is associated with significant morbidity and mortality.
*I and III* - Incorrect because Statement I is wrong about the duration of vasoactive drug therapy.
*II and IV* - Incorrect because Statement II confuses sclerotherapy agents with tissue adhesives used for gastric varices.
*I and II* - Incorrect because both statements I and II contain inaccuracies regarding duration of therapy and sclerosing agents respectively.
Pharmacology
3 questions
Q91
Consider the following statements with regard to the treatment of vitamin A deficiency :
I. Repeated high doses of retinol can cause liver damage and teratogenicity
II. Acute overdose of vitamin A may lead to increased intracranial pressure and skin desquamation
III. Regular vitamin A supplementation is also recommended for pregnant women even in countries where vitamin A deficiency is not endemic
IV. Excessive intake of carotene may cause harmless orange pigmentation of the skin
Which of the statements given above are correct?
Q92
Which one of the following oral drugs may be used as adjunctive therapy in the management of super-refractory status epilepticus?
Q93
Which of the following statements are correct regarding the use of benzodiazepines in the initial management of status epilepticus?
I. Upto two doses may be used 5 minutes apart, if seizures are not controlled
II. For Lorazepam, only a single dose should be used, even if seizures are not controlled
III. Dose of midazolam at this stage is 1-15 mcg / kg / min infusion
IV. Dose of both lorazepam and midazolam is 0.1 mg / kg
Select the answer using the code given below :
UPSC-CMS 2025 - Pharmacology UPSC-CMS Practice Questions and MCQs
Question 91: Consider the following statements with regard to the treatment of vitamin A deficiency :
I. Repeated high doses of retinol can cause liver damage and teratogenicity
II. Acute overdose of vitamin A may lead to increased intracranial pressure and skin desquamation
III. Regular vitamin A supplementation is also recommended for pregnant women even in countries where vitamin A deficiency is not endemic
IV. Excessive intake of carotene may cause harmless orange pigmentation of the skin
Which of the statements given above are correct?
A. II, III and IV
B. I, II and IV (Correct Answer)
C. I, II and III
D. I, III and IV
Explanation: **I, II and IV**
- Statement I is correct: Repeated high doses of **retinol** (preformed vitamin A) can accumulate in the liver, leading to **hepatotoxicity** and potential **teratogenic effects** on a developing fetus.
- Statement II is correct: **Acute vitamin A overdose** can manifest as symptoms such as **increased intracranial pressure** (pseudotumor cerebri) and **skin desquamation** (peeling skin).
- Statement IV is correct: Excessive intake of **carotene** (a vitamin A precursor from plants) can cause **carotenemia**, characterized by a harmless **orange pigmentation** of the skin, but it does not lead to vitamin A toxicity due to regulated conversion.
*II, III and IV*
- This option incorrectly includes statement III, which is false because regular vitamin A supplementation is generally **not recommended for pregnant women in non-endemic areas** due to the risk of teratogenicity.
- The other statements (II and IV) are correct, as acute overdose of vitamin A can cause increased intracranial pressure and skin desquamation, and excessive carotene intake can lead to harmless orange skin pigmentation.
*I, II and III*
- This option incorrectly includes statement III, which is false as routine vitamin A supplementation is **contraindicated for pregnant women in non-endemic areas** due to the risk of birth defects.
- Statements I and II are correct, as high retinol doses can cause liver damage and teratogenicity, and acute vitamin A overdose can lead to increased intracranial pressure and skin desquamation.
*I, III and IV*
- This option incorrectly includes statement III, which is false because **pregnant women in non-endemic areas should avoid regular vitamin A supplementation** to prevent toxicity and teratogenic effects.
- Statements I and IV are correct; high retinol doses can cause liver damage and teratogenicity, and excessive carotene intake can result in harmless orange skin pigmentation.
Question 92: Which one of the following oral drugs may be used as adjunctive therapy in the management of super-refractory status epilepticus?
A. Clobazam
B. Clonazepam
C. Topiramate (Correct Answer)
D. Lamotrigine
Explanation: ***Topiramate***
- **Topiramate** is an antiepileptic drug with multiple mechanisms of action, including potentiation of **GABAergic** activity, blockade of **voltage-gated sodium channels**, and antagonism of **AMPA/kainate glutamate receptors**.
- Its broad-spectrum action and ability to be administered orally make it a suitable **adjunctive therapy** in complex cases like **super-refractory status epilepticus (SRSE)**, where patients have failed other conventional treatments.
*Clobazam*
- **Clobazam** is a **benzodiazepine** primarily used as an **anxiolytic** and antiepileptic drug, particularly for Lennox-Gastaut syndrome.
- While supportive in status epilepticus, its primary role is in acute seizure termination rather than as a long-term adjunctive therapy for **super-refractory status epilepticus** post-acute phase.
*Clonazepam*
- **Clonazepam** is another **benzodiazepine** with potent **antiepileptic** properties.
- It is effective in terminating acute seizures but is not typically used as a primary oral adjunctive agent for **super-refractory status epilepticus** due to its sedative side effects and potential for tolerance.
*Lamotrigine*
- **Lamotrigine** is an **antiepileptic drug** that primarily works by inhibiting **voltage-sensitive sodium channels**, thereby stabilizing neuronal membranes and modulating the release of excitatory neurotransmitters.
- While effective for various seizure types, including focal and generalized seizures, it is not a first-line or common choice as an **adjunctive oral therapy** in **super-refractory status epilepticus**, which often requires drugs with faster onset or broader mechanisms beyond sodium channel blockade.
Question 93: Which of the following statements are correct regarding the use of benzodiazepines in the initial management of status epilepticus?
I. Upto two doses may be used 5 minutes apart, if seizures are not controlled
II. For Lorazepam, only a single dose should be used, even if seizures are not controlled
III. Dose of midazolam at this stage is 1-15 mcg / kg / min infusion
IV. Dose of both lorazepam and midazolam is 0.1 mg / kg
Select the answer using the code given below :
A. II and IV
B. I and IV (Correct Answer)
C. I and III
D. II and III
Explanation: ***I and IV***
- According to current guidelines, **up to two doses** of a benzodiazepine may be administered 5 minutes apart if the **seizures are not controlled** after the initial dose.
- The recommended dose for both **lorazepam and midazolam** in the initial management of status epilepticus is **0.1 mg/kg**.
*II and IV*
- This option is incorrect because statement II is false, as **multiple doses of lorazepam** can be administered if seizures are not controlled.
- While statement IV is correct regarding the dosage of lorazepam and midazolam.
*I and III*
- This option is incorrect because statement III is false, as **1-15 mcg/kg/min infusion** is the dose for **continuous infusion** of midazolam in refractory status epilepticus, not the initial bolus dose.
- Statement I is correct but paired with an incorrect statement.
*II and III*
- This option is incorrect because both statements II and III are false regarding the initial management of status epilepticus.
- As previously stated, **multiple doses of lorazepam** can be used, and the given midazolam dose is for **continuous infusion**, not the initial bolus.