Which of the following are advantages of endotracheal intubation, in a child requiring pediatric advanced life support?
I. Inspiratory time can be controlled
II. Positive end-expiratory pressure can be provided
III. Peak expiratory pressure can be controlled
IV. Reduced risk of aspiration of gastric contents
Select the correct answer using the code given below :
UPSC-CMS 2025 - Anesthesiology UPSC-CMS Practice Questions and MCQs
Question 101: Which of the following are advantages of endotracheal intubation, in a child requiring pediatric advanced life support?
I. Inspiratory time can be controlled
II. Positive end-expiratory pressure can be provided
III. Peak expiratory pressure can be controlled
IV. Reduced risk of aspiration of gastric contents
Select the correct answer using the code given below :
A. II, III and IV
B. I, II and IV (Correct Answer)
C. I, III and IV
D. I, II and III
Explanation: ***I, II and IV***
- Endotracheal intubation allows for precise control of **inspiratory time**, optimizing ventilation for the child's respiratory mechanics.
- It enables the application of **positive end-expiratory pressure (PEEP)**, which helps maintain alveolar patency and improves oxygenation.
- An endotracheal tube provides a sealed airway, significantly **reducing the risk of aspiration** of gastric contents into the lungs.
*II, III and IV*
- While PEEP can be provided and aspiration risk is reduced, endotracheal intubation primarily controls **peak inspiratory pressure**, not peak expiratory pressure.
- **Peak expiratory pressure** is usually determined by the patient's lung mechanics and the ventilator's exhalation valve settings, not directly controlled by the tube.
*I, III and IV*
- Endotracheal intubation allows control of inspiratory time and reduces aspiration risk, but it does not directly control **peak expiratory pressure**.
- **Peak expiratory pressure** is largely a function of the patient's lung recoil and airway resistance during exhalation.
*I, II and III*
- Although inspiratory time can be controlled and PEEP can be provided, **peak expiratory pressure** is not a primary parameter controlled by endotracheal intubation.
- The main benefits revolve around controlled ventilation and airway protection, not active control over **peak expiratory pressure**.
Community Medicine
1 questions
Q101
Which of the following are included as a "Deficiency" under the Rashtriya Bal Swasthya Karyakram (RBSK) ?
I. Hypothyroidism
II. Vitamin A deficiency
III. Anemia
IV. Vitamin D deficiency
Select the correct answer using the code given below :
UPSC-CMS 2025 - Community Medicine UPSC-CMS Practice Questions and MCQs
Question 101: Which of the following are included as a "Deficiency" under the Rashtriya Bal Swasthya Karyakram (RBSK) ?
I. Hypothyroidism
II. Vitamin A deficiency
III. Anemia
IV. Vitamin D deficiency
Select the correct answer using the code given below :
A. I, III and IV
B. I, II and IV
C. II, III and IV (Correct Answer)
D. I, II and III
Explanation: ***II, III and IV***
- The **Rashtriya Bal Swasthya Karyakram (RBSK)** focuses on early identification and management of health conditions in children from birth to 18 years through the **"4Ds" framework**: Defects at birth, Deficiencies, Diseases, and Development delays.
- Under **"Deficiencies"**, RBSK specifically includes:
- **Vitamin A deficiency** - Causes night blindness and increased infection risk
- **Anemia** - Commonly due to iron, folate, or B12 deficiency
- **Vitamin D deficiency** - Leads to rickets and bone health issues
- **Severe Acute Malnutrition (SAM)**
- **Hypothyroidism** is classified under **"Diseases"** (along with diabetes, rheumatic heart disease, etc.), NOT deficiencies, making it incorrect for this question.
*I, III and IV*
- This option incorrectly includes **Hypothyroidism** as a deficiency, when it is actually classified under **"Diseases"** in the RBSK framework.
- While Anemia (III) and Vitamin D deficiency (IV) are correctly identified as deficiencies, the inclusion of Hypothyroidism makes this option incorrect.
*I, II and IV*
- This option incorrectly includes **Hypothyroidism**, which falls under **"Diseases"** rather than deficiencies.
- Although Vitamin A deficiency (II) and Vitamin D deficiency (IV) are correct deficiencies, the inclusion of Hypothyroidism disqualifies this option.
*I, II and III*
- This option incorrectly includes **Hypothyroidism** as a deficiency. RBSK categorizes endocrine disorders like hypothyroidism under **"Diseases"**.
- While Vitamin A deficiency (II) and Anemia (III) are correctly identified as deficiencies, the inclusion of Hypothyroidism makes this option inaccurate.
ENT
1 questions
Q101
In a child aged 3-12 years with an ear problem, which one of these situations merits urgent referral to hospital?
UPSC-CMS 2025 - ENT UPSC-CMS Practice Questions and MCQs
Question 101: In a child aged 3-12 years with an ear problem, which one of these situations merits urgent referral to hospital?
A. Pus seen draining from the ear, and discharge reported for more than or equal to 14 days
B. Pus seen draining from the ear, and discharge reported for less than 14 days
C. Tender swelling behind the ear (Correct Answer)
D. Pus seen draining from both ears, irrespective of duration
Explanation: ***Tender swelling behind the ear***
- A **tender swelling behind the ear**, particularly in a child with an ear problem, is a classic sign of **mastoiditis**, which is a serious complication requiring urgent medical attention due to the risk of intracranial spread.
- **Mastoiditis** often presents with fever, pain, and a prominent, pushed-out auricle.
*Pus seen draining from the ear, and discharge reported for more than or equal to 14 days*
- This suggests **chronic suppurative otitis media (CSOM)**, which typically requires a referral to ENT for assessment and management but is not usually an *urgent* referral unless there are signs of complications.
- While concerning, the chronicity itself doesn't immediately indicate an acute emergency in the absence of other symptoms like fever or severe pain.
*Pus seen draining from the ear, and discharge reported for less than 14 days*
- This indicates acute otitis media (AOM) with perforation, which is very common in children.
- It usually resolves with antibiotics and local care, and while a follow-up is important, it doesn't typically require urgent hospital referral.
*Pus seen draining from both ears, irrespective of duration*
- Bilateral ear discharge suggests bilateral acute or chronic otitis media, but does not inherently imply an acute emergency that requires urgent hospital referral.
- The key factor for urgency would be signs of complications, such as mastoiditis or intracranial involvement, rather than the bilaterality of discharge alone.
Internal Medicine
1 questions
Q101
Which of the following are causes of hypocalcemia in a child?
I. Hypomagnesemia
II. Hypophosphatemia
III. Metabolic acidosis
IV. Pseudohypoparathyroidism
Select the correct answer using the code given below :
UPSC-CMS 2025 - Internal Medicine UPSC-CMS Practice Questions and MCQs
Question 101: Which of the following are causes of hypocalcemia in a child?
I. Hypomagnesemia
II. Hypophosphatemia
III. Metabolic acidosis
IV. Pseudohypoparathyroidism
Select the correct answer using the code given below :
A. II and III
B. I and II
C. I and IV (Correct Answer)
D. III and IV
Explanation: ***I and IV***
- **Hypomagnesemia** impairs parathyroid hormone (PTH) secretion and causes target organ resistance to PTH, leading to hypocalcemia.
- **Pseudohypoparathyroidism** is a genetic disorder where target organs are resistant to PTH, resulting in hypocalcemia and hyperphosphatemia despite normal or elevated PTH levels [1].
*II and III*
- **Hypophosphatemia** is typically associated with **hypercalcemia** rather than hypocalcemia, as phosphate binds to calcium [3].
- **Metabolic acidosis** often causes an increase in **ionized calcium** (the physiologically active form) due to reduced protein binding, rather than overall hypocalcemia.
*I and II*
- While **hypomagnesemia** causes hypocalcemia, **hypophosphatemia** is generally associated with hypercalcemia, making this option incorrect [2].
- Hypophosphatemia reduces the formation of calcium-phosphate complexes, thus increasing free calcium levels.
*III and IV*
- **Pseudohypoparathyroidism** does cause hypocalcemia, but **metabolic acidosis** typically leads to higher ionized calcium levels, not hypocalcemia.
- The compensatory mechanisms for acidosis tend to mobilize calcium from bone, further counteracting hypocalcemia.
Pediatrics
4 questions
Q101
A child can make a tower of 3 blocks, runs, copies his mother while sweeping and has a vocabulary of 8-10 words. His developmental age is
Q102
A child can ride a tricycle, copies a circle, knows name and gender. The developmental age of this child is
Q103
A term baby with birth weight of 2.8 kg is born to a primigravida mother through vaginal delivery and cried immediately after birth. Which of the following statements are correct regarding his initial care after birth ?
I. The baby should be initiated on breastfeeding within one hour of birth
II. The baby should be kept in a separate area from the mother
III. The baby should be administered with 0.5 mg of vitamin K intramuscularly
IV. The baby should be thoroughly examined for congenital malformations from head to toe
Select the answer using the code given below :
Q104
For a sick child aged 4 years, which of the following are signs of "severe pneumonia or very severe disease", as per IMNCI (Integrated Management of Neonatal and Childhood Illness) Program?
I. Fast breathing (Greater than or equal to 40 breaths per minute)
II. Child vomits everything
III. Stridor in a calm child
IV. Chest indrawing:
Select the correct answer using the code given below :
UPSC-CMS 2025 - Pediatrics UPSC-CMS Practice Questions and MCQs
Question 101: A child can make a tower of 3 blocks, runs, copies his mother while sweeping and has a vocabulary of 8-10 words. His developmental age is
A. 18 months (Correct Answer)
B. 15 months
C. 24 months
D. 12 months
Explanation: ***18 months***
- At 18 months, children typically can **build a tower of 2-4 cubes**, run, and have a vocabulary of approximately **10 words**.
- They also begin to engage in **imitative play**, such as copying household tasks like sweeping.
*15 months*
- A 15-month-old can usually **build a tower of 2 blocks** and walk independently, but **running** is generally not yet mastered.
- Their vocabulary is typically smaller, around **4-6 words**, and imitative play is less complex.
*24 months*
- By 24 months, a child can build a tower of **5-7 cubes**, kick a ball, and their vocabulary expands significantly to **50-100 words** or more, including combining two words.
- They participate in more elaborate **pretend play** and understand two-step commands.
*12 months*
- A 12-month-old typically can **pull to stand**, take a few steps, and transfer objects between hands, but **running** is not expected.
- Their vocabulary is limited to **1-3 words** (like "mama" or "dada"), and their constructive play is minimal.
Question 102: A child can ride a tricycle, copies a circle, knows name and gender. The developmental age of this child is
A. 4 years
B. 5 years
C. 2 years
D. 3 years (Correct Answer)
Explanation: ***3 years***
- A child who can **ride a tricycle**, **copy a circle**, and knows their **name and gender** has achieved developmental milestones typically seen around **3 years of age**.
- **Riding a tricycle** demonstrates advanced gross motor skills, while **copying a circle** indicates fine motor skill development. **Knowing name and gender** points to cognitive and social-emotional understanding.
*4 years*
- By 4 years, a child can typically **hop on one foot**, **draw a square**, and **tell stories**.
- While they might refine skills acquired at 3, the listed milestones are primary for the 3-year mark.
*5 years*
- A 5-year-old usually can **skip**, **draw a triangle**, and **count 10 or more objects**.
- These milestones represent further advancements beyond those described in the question.
*2 years*
- At 2 years, a child typically starts to **kick a ball**, **draw a straight line**, and can say **two-to-four-word sentences**.
- The skills described (tricycle, circle) are generally too advanced for a 2-year-old.
Question 103: A term baby with birth weight of 2.8 kg is born to a primigravida mother through vaginal delivery and cried immediately after birth. Which of the following statements are correct regarding his initial care after birth ?
I. The baby should be initiated on breastfeeding within one hour of birth
II. The baby should be kept in a separate area from the mother
III. The baby should be administered with 0.5 mg of vitamin K intramuscularly
IV. The baby should be thoroughly examined for congenital malformations from head to toe
Select the answer using the code given below :
A. I and IV (Correct Answer)
B. II and III
C. I and II
D. I and III
Explanation: ***I and IV***
- **Early initiation of breastfeeding within one hour** is crucial for promoting bonding, establishing successful lactation, and providing the newborn with colostrum for immunity.
- A comprehensive **head-to-toe examination for congenital malformations** is a standard part of immediate newborn care to identify any anomalies requiring further evaluation or intervention.
*II and III*
- **Keeping the baby with the mother (rooming-in)** is recommended to promote bonding, facilitate unrestricted breastfeeding, and enable continuous monitoring by the mother.
- The standard dose of **vitamin K administered intramuscularly for a term baby is 1 mg**, not 0.5 mg, to prevent hemorrhagic disease of the newborn.
*I and II*
- While early breastfeeding (I) is correct, **keeping the baby in a separate area from the mother (II) is incorrect** as rooming-in is highly encouraged for newborn care.
- Separating the baby can hinder initial bonding and interfere with an early and successful breastfeeding experience.
*I and III*
- **Early initiation of breastfeeding within one hour (I) is correct**, but the **dose of vitamin K (III) is incorrect**, as 1 mg is the standard, not 0.5 mg.
- Incorrect medication dosages can have clinical implications, making this combination an unsuitable choice for correct initial care.
Question 104: For a sick child aged 4 years, which of the following are signs of "severe pneumonia or very severe disease", as per IMNCI (Integrated Management of Neonatal and Childhood Illness) Program?
I. Fast breathing (Greater than or equal to 40 breaths per minute)
II. Child vomits everything
III. Stridor in a calm child
IV. Chest indrawing:
Select the correct answer using the code given below :
A. I and II
B. II and III
C. III and IV (Correct Answer)
D. II and IV
Explanation: ***III and IV***
- **Stridor in a calm child** is a critical sign indicating severe upper airway obstruction, classified as "very severe disease" in IMNCI. This is a general danger sign requiring urgent referral.
- **Chest indrawing** (severe lower chest wall indrawing) signifies increased work of breathing and severe respiratory distress, categorizing it under "severe pneumonia" in IMNCI and requiring urgent referral.
- These two signs represent the most specific respiratory indicators of severe pneumonia or very severe disease.
*I and II*
- **Fast breathing** for a 4-year-old (age 12 months to 5 years) is correctly defined as ≥40 breaths per minute per IMNCI. However, fast breathing alone indicates **pneumonia** (not severe pneumonia), which can be managed as outpatient with oral antibiotics.
- **Child vomits everything** is indeed a general danger sign indicating "very severe disease" in IMNCI, but when combined with fast breathing (which indicates only simple pneumonia), this combination is less specific than III and IV.
*II and III*
- **Child vomits everything** is a general danger sign for "very severe disease" requiring urgent referral.
- **Stridor in a calm child** is also a sign of "very severe disease."
- While both are valid signs, this combination misses **chest indrawing**, which is the primary respiratory-specific sign of severe pneumonia and more directly answers the question about severe pneumonia classification.
*II and IV*
- **Child vomits everything** is a general danger sign for "very severe disease."
- **Chest indrawing** is the key sign of "severe pneumonia."
- While both are valid signs of severe pneumonia or very severe disease, the combination of **stridor and chest indrawing (III and IV)** represents the two most specific respiratory signs and is the preferred answer for this classification.
Pharmacology
2 questions
Q101
Which of the following statements are correct regarding management of hyperkalemia in a child?
I. Intravenous calcium (gluconate or chloride) is given to enhance cellular uptake of potassium
II. Beta adrenergic agonists (salbutamol or terbutaline) are used to stabilize myocardial cell membrane
III. Regular insulin and glucose given intravenously enhance cellular uptake of potassium
IV. Sodium polystyrene sulfonate enhances total body potassium elimination
Select the answer using the code given below :
Q102
Which of the following statements are correct about oral rotavirus vaccines?
I. The storage should be at 2-8°C
II. The vaccine should be used within 2 hours of reconstitution or opening
III. Past history of intussusception is a contraindication
IV. The vaccine can be given if the baby has ongoing diarrhoea
Select the answer using the code given below :
UPSC-CMS 2025 - Pharmacology UPSC-CMS Practice Questions and MCQs
Question 101: Which of the following statements are correct regarding management of hyperkalemia in a child?
I. Intravenous calcium (gluconate or chloride) is given to enhance cellular uptake of potassium
II. Beta adrenergic agonists (salbutamol or terbutaline) are used to stabilize myocardial cell membrane
III. Regular insulin and glucose given intravenously enhance cellular uptake of potassium
IV. Sodium polystyrene sulfonate enhances total body potassium elimination
Select the answer using the code given below :
A. I and II
B. III and IV (Correct Answer)
C. II and III
D. I and IV
Explanation: ***III and IV***
- Intravenous **regular insulin and glucose** work by promoting the intracellular shift of potassium, thereby lowering serum potassium levels. Insulin stimulates the Na+-K+ ATPase pump, moving potassium into cells, and glucose is given to prevent **hypoglycemia**.
- **Sodium polystyrene sulfonate (SPS)** is a cation exchange resin that binds potassium in the gastrointestinal tract and promotes its excretion in the stool, thus enhancing **total body potassium elimination**.
*I and II*
- Intravenous calcium (gluconate or chloride) is given to **stabilize the myocardial cell membrane**, reducing the risk of arrhythmias, not to enhance cellular uptake of potassium.
- Beta-adrenergic agonists like **salbutamol** or **terbutaline** promote the intracellular shift of potassium, similar to insulin, but they **do not stabilize the myocardial cell** membrane.
*II and III*
- Beta-adrenergic agonists **(salbutamol or terbutaline)** promote the cellular uptake of potassium, but they do not stabilize the myocardial cell membrane; that is the role of calcium.
- While regular insulin and glucose given intravenously do enhance cellular uptake of potassium, the statement regarding beta-adrenergic agonists is incorrect in its function to stabilize the myocardial cell membrane.
*I and IV*
- Intravenous calcium (gluconate or chloride) is administered to **protect the heart** from the effects of hyperkalemia by stabilizing the myocardial cell membrane, not to enhance cellular uptake of potassium.
- Although sodium polystyrene sulfonate (SPS) correctly enhances total body potassium elimination, the initial statement regarding calcium's mechanism of action is incorrect.
Question 102: Which of the following statements are correct about oral rotavirus vaccines?
I. The storage should be at 2-8°C
II. The vaccine should be used within 2 hours of reconstitution or opening
III. Past history of intussusception is a contraindication
IV. The vaccine can be given if the baby has ongoing diarrhoea
Select the answer using the code given below :
A. I and II
B. I and III (Correct Answer)
C. II and IV
D. III and IV
Explanation: ***I and III***
* **Oral rotavirus vaccines** require storage at **2-8°C** to maintain potency (cold chain maintenance is essential).
* A past history of **intussusception** is an **absolute contraindication** due to increased risk of recurrence.
*I and II*
* While statement I is correct, statement II is incorrect because oral rotavirus vaccines (Rotarix, RotaTeq) are **ready-to-use liquid formulations** that do **not require reconstitution**. Once the container is opened, the vaccine should be **administered immediately** during the same vaccination visit, not stored for 2 hours.
*II and IV*
* Statement II is incorrect as oral rotavirus vaccines are **ready-to-use** and should be **administered immediately** after opening, without any reconstitution.
* Statement IV is incorrect because the vaccine **should be postponed** if the baby has ongoing **moderate to severe diarrhoea** or vomiting, as this may affect vaccine absorption and effectiveness. Mild diarrhea is not a contraindication, but significant gastroenteritis warrants deferral.
*III and IV*
* While statement III is correct, statement IV is incorrect because ongoing **moderate to severe diarrhoea** is a reason to **postpone** administration of the rotavirus vaccine until the child recovers.