UPSC-CMS 2010 Previous Year Questions Practice Questions

Q: Which one of the following biochemical abnormalities can be produced by repeated vomiting?

Metabolic alkalosis. ***Metabolic alkalosis*** - Repeated vomiting leads to the loss of **hydrochloric acid (HCl)** from the stomach, causing **hypochloremic metabolic alkalosis** with an increase in serum **bicarbonate (HCO3-)** and a rise in blood pH. - The loss of H+ and Cl- ions results in **compensatory hypokalemia** as the kidneys exchange K+ for H+ to maintain electroneutrality. - **Volume depletion** from vomiting triggers aldosterone secretion, which further promotes K+ loss and H+ excretion, perpetuating the alkalosis (contraction alkalosis). - This is one of the most common causes of metabolic alkalosis in clinical practice. *Metabolic acidosis* - This condition is characterized by a decrease in **serum pH** and **bicarbonate levels**, typically due to excess acid production or bicarbonate loss from diarrhea or renal tubular acidosis. - Vomiting does not directly cause metabolic acidosis; rather, it leads to the opposite effect by removing acidic gastric contents. *Ketosis* - **Ketosis** occurs when the body metabolizes fat for energy, producing **ketone bodies**, common in conditions like uncontrolled diabetes or prolonged starvation. - While severe, prolonged vomiting with reduced oral intake can indirectly lead to starvation ketosis, the primary and most characteristic biochemical abnormality of repeated vomiting is metabolic alkalosis, not ketosis. *Uraemia* - **Uraemia** is a syndrome caused by the accumulation of **nitrogenous waste products** (urea, creatinine) in the blood, primarily due to kidney failure. - Vomiting may be a *symptom* of uraemia, but it does not *cause* uraemia. Kidney function is the primary determinant of urea levels. [Practice more UPSC-CMS 2010 questions on OnCourse]

Q: A patient presents with claudication in both buttocks and has impotence. The clinical examination reveals bruit over lower abdomen. What is the clinical diagnosis?

Aortoiliac occlusion. Aortoiliac occlusion - The triad of **buttock claudication**, **impotence**, and **absent or diminished femoral pulses** (often associated with an abdominal bruit) is classic for **Leriche syndrome**, which is caused by aortoiliac occlusion [2], [3]. - This occlusion impairs blood flow to both lower extremities and the internal iliac arteries, affecting erectile function [1]. Bilateral iliofemoral occlusion - While this would cause bilateral lower limb symptoms, it typically would not explain the **impotence** as clearly as an aortoiliac occlusion which affects the internal iliac arteries that supply the penis [2], [3]. - An iliofemoral occlusion is distal to the aorta, and the symptom complex provided points to a more **proximal lesion**. Bilateral iliac artery occlusion - This would cause similar symptoms to aortoiliac occlusion including **buttock claudication** and **impotence** [2]. - However, the presence of a **bruit over the lower abdomen** often indicates a more proximal lesion involving the aorta, making aortoiliac occlusion a more comprehensive diagnosis for these findings. Bilateral femoropopliteal occlusion - This would primarily cause **calf and thigh claudication**, less commonly buttock claudication, as the occlusion is more distal [1]. - **Impotence** is not a typical symptom of isolated femoropopliteal occlusion, as the internal iliac arteries are usually unaffected. [Practice more UPSC-CMS 2010 questions on OnCourse]

Q: The normal ankle brachial pressure index (ABPI) is 1.0. A value of 0.8 suggests

some degree of arterial obstruction. ***some degree of arterial obstruction*** - An **ABPI of 0.8** indicates a reduction in blood flow to the lower extremities compared to the upper limbs [1]. - This value is generally considered to signify **mild to moderate peripheral artery disease (PAD)**, suggesting the presence of arterial narrowing or obstruction [1]. *impending gangrene* - **Impending gangrene** or critical limb ischemia is typically associated with a much lower ABPI, usually **below 0.4** or even 0.3 [1]. - At an ABPI of 0.8, severe tissue damage and gangrene are not imminent, although careful monitoring is still warranted. *presence of collaterals* - While **collateral arteries** can develop in response to chronic arterial obstruction, an ABPI of 0.8 primarily reflects the overall net blood flow, which is still reduced despite collaterals [1]. - The presence of collaterals can actually help to maintain tissue viability and prevent more severe symptoms, but they don't normalize the ABPI in the presence of significant disease [1]. *good flow* - A value of **1.0 to 1.4** is generally considered a normal ABPI, indicating good arterial flow. - An ABPI of **0.8 is significantly below normal** and suggests impaired rather than good blood flow [1]. [Practice more UPSC-CMS 2010 questions on OnCourse]

Q: Autoclaving is a method of sterilization. The process involves heating by steam at

15 lb pressure, 121 °C temperature for 15 minutes. ***15 lb pressure, 121 °C temperature for 15 minutes*** - This is the **standard recommended parameter** for routine sterilization in an autoclave, ensuring the destruction of most pathogenic and non-pathogenic microorganisms, including spores. - The combination of **steam at 121°C** (equivalent to 15 psi) for at least 15 minutes provides efficient heat transfer and penetration required for effective sterilization. *10 lb pressure, 100 °C temperature for 10 minutes* - This temperature (100 °C) is used for **boiling** or pasteurization, which is generally not sufficient for complete sterilization as it may not kill highly resistant spores. - The **lower pressure and temperature** would likely not achieve the required sterility assurance level. *20 lb pressure, 120 °C temperature for 20 minutes* - While higher pressure can achieve sterilization, this is **not the standard parameter** used for typical autoclave sterilization. - The standard combination of 15 lb at 121°C is more commonly recommended and taught in medical curricula. *25 lb pressure, 120 °C temperature for 25 minutes* - This combination of **higher pressure and longer duration** would likely achieve sterilization, but it exceeds the minimum standard parameters. - While effective, it is not the most **efficient or commonly recommended** setting and could potentially lead to material degradation for some items. [Practice more UPSC-CMS 2010 questions on OnCourse]

Q: Hypertrophic scar is characterized by the following, except

it outgrows the wound area. ***it outgrows the wound area*** - This statement is characteristic of a **keloid scar**, not a hypertrophic scar. Keloids are distinguished by their growth beyond the original wound margins [1]. - **Hypertrophic scars**, on the other hand, remain confined within the boundaries of the original injury, though they may be raised and erythematous [1]. *it involves the flexor surface* - While hypertrophic scars can occur on any body surface, they are commonly found on areas of **high tension**, such as the **flexor surfaces** of joints (e.g., knee, elbow) or the chest and shoulders. - This involvement is due to constant movement stretching the healing skin, which can stimulate excessive collagen production. *it is non-familial* - Hypertrophic scars are generally **not associated with a strong genetic predisposition** or familial inheritance patterns. - Their development is primarily linked to factors like wound tension, infection, and individual healing responses rather than inherited tendencies. *it is not related to the race* - The incidence of hypertrophic scars does **not show a significant racial predilection**, unlike keloid scars, which are more common in individuals with darker skin types. - Hypertrophic scars can affect individuals from all racial backgrounds. **References:** [1] Kumar v, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Inflammation and Repair, pp. 119-121. [Practice more UPSC-CMS 2010 questions on OnCourse]

Question 1

Which one of the following biochemical abnormalities can be produced by repeated vomiting?

Accepted Answer

Metabolic alkalosis

Answer

Metabolic acidosis

Answer

Ketosis

Answer

Uraemia

Question 2

A patient presents with claudication in both buttocks and has impotence. The clinical examination reveals bruit over lower abdomen. What is the clinical diagnosis?

Accepted Answer

Aortoiliac occlusion

Answer

Bilateral iliofemoral occlusion

Answer

Bilateral iliac artery occlusion

Answer

Bilateral femoropopliteal occlusion

Question 3

The normal ankle brachial pressure index (ABPI) is 1.0. A value of 0.8 suggests

Accepted Answer

some degree of arterial obstruction

Answer

impending gangrene

Answer

presence of collaterals

Answer

good flow

Question 4

Autoclaving is a method of sterilization. The process involves heating by steam at

Accepted Answer

15 lb pressure, 121 °C temperature for 15 minutes

Answer

10 lb pressure, 100 °C temperature for 10 minutes

Answer

20 lb pressure, 120 °C temperature for 20 minutes

Answer

25 lb pressure, 120 °C temperature for 25 minutes

Question 5

Hypertrophic scar is characterized by the following, except

Accepted Answer

it outgrows the wound area

Answer

it involves the flexor surface

Answer

it is non-familial

Answer

it is not related to the race

Question 6

Langhans' giant cells are characteristically seen in

Accepted Answer

peritoneal tuberculosis

Answer

typhoid Peyer's patch

Answer

tuberculoma

Answer

lymphoma

Question 7

Match List-I with List-II and select the correct answer using the code given below the Lists:

Accepted Answer

A→3  B→2  C→4  D→1

Answer

A→3  B→1  C→2  D→4

Answer

A→1  B→2  C→4  D→3

Answer

A→1  B→2  C→3  D→4

Question 8

In carcinoma breast, adjuvant radiotherapy is indicated after modified radical mastectomy in all of the following, except

Accepted Answer

ER, PR hormone receptor negative tumour

Answer

more than four positive axillary lymph nodes

Answer

positive margins

Answer

tumour size more than 5 cm

Question 9

The percutaneous PAIR therapy used in the treatment of uncomplicated hepatic hydatid cyst can be associated with the following complications, except

Accepted Answer

bradycardia

Answer

hypotension

Answer

vomiting

Answer

anaphylaxis

Question 10

Trendelenburg's operation is done for

Accepted Answer

primary varicose veins

Answer

deep vein thrombosis with varicose veins

Answer

varicocele

Answer

arteriovenous fistula

UPSC-CMS 2010

Biochemistry

Internal Medicine

Microbiology

Pathology

Surgery