UPSC-CMS 2012 Previous Year Questions Practice Questions

Q: Consider the following statements : HIV can be transmitted to a healthcare worker from a patient through : 1. A needle stick injury 2. Contact with the patient's blood 3. External examination of the patient 4. Inhalation Which of the statements given above is/are correct ?

1 and 2 only. ***1 and 2 only*** - **Needle stick injuries** pose a significant risk as they involve direct inoculation of infected blood into the healthcare worker's bloodstream. - **Contact with a patient's blood** can lead to transmission if there are cuts, abrasions, or mucous membrane exposures on the healthcare worker. *2 and 3 only* - **Contact with a patient's blood** is a known transmission route, but **external examination** alone, without blood contact or needle stick, typically carries no risk of HIV transmission. - HIV is not transmitted through casual contact or touch during an examination. *1 and 4* - **Needle stick injuries** are a recognized transmission route, but **inhalation** is not a mechanism for HIV transmission. - HIV is not an airborne virus and does not spread like respiratory illnesses. *1, 2 and 3* - While **needle stick injuries** and **contact with blood** are clear transmission pathways, **external examination** of a patient, in the absence of blood contact or needle stick injuries, does not transmit HIV. - HIV transmission requires specific fluid exchange (blood, semen, vaginal fluids, breast milk) entering the bloodstream or mucous membranes. [Practice more UPSC-CMS 2012 questions on OnCourse]

Q: The commonest cause of primary hyper-parathyroidism is

Parathyroid adenoma. ***Parathyroid adenoma*** - **Parathyroid adenomas** account for approximately **85% of all cases** of primary hyperparathyroidism. [1] - This condition involves a **benign tumor** of one or more parathyroid glands that secretes excessive parathyroid hormone (PTH), leading to hypercalcemia. [1] *Idiopathic parathyroid hyperplasia* - **Idiopathic parathyroid hyperplasia** is responsible for about **10-15% of cases** of primary hyperparathyroidism, making it less common than adenomas. - In hyperplasia, **all four parathyroid glands** are typically enlarged and overactive, unlike the localized growth in an adenoma. *Familial hyperparathyroidism* - **Familial hyperparathyroidism** is a rare cause, accounting for **less than 1% of cases**, and is often associated with genetic syndromes like **MEN1** or **MEN2A**. - It involves inherited genetic mutations that predispose individuals to parathyroid gland overactivity, which distinguishes it from sporadic causes. *Primary parathyroid carcinoma* - **Primary parathyroid carcinoma** is an **extremely rare malignancy**, accounting for **less than 1%** of all primary hyperparathyroidism cases. - While it causes severe hypercalcemia, its rarity means it is not the commonest cause. [Practice more UPSC-CMS 2012 questions on OnCourse]

Q: Which of the following statements is true about antibiotic therapy?

It has its greatest effect on multiplying organisms. ***It has its greatest effect on multiplying organisms*** - Most **antibiotics** target processes essential for bacterial growth and replication, such as cell wall synthesis, protein synthesis, or DNA replication. - Therefore, their efficacy is highest against **actively multiplying bacteria**, as these processes are most vulnerable during periods of rapid growth. *It enhances the intracellular killing of organisms by phagocytes* - Antibiotics primarily act directly on bacteria, either **killing them (bactericidal)** or inhibiting their growth (bacteriostatic), rather than directly augmenting host immune cell functions like intracellular killing by phagocytes. - While antibiotics reduce the bacterial load, which aids phagocytosis, they do not directly enhance the phagocyte's intrinsic killing mechanisms. *It facilitates killing of organisms by activation of complements* - The **complement system** is part of the innate immune response and is activated by antibodies or microbial surface components; antibiotics do not directly activate this system. - Antibiotic action is independent of complement activation, although a reduced bacterial load can indirectly influence the overall immune response. *It enhances the uptake of organisms by phagocytes* - Enhancing the uptake of organisms by phagocytes (opsonization) is primarily mediated by host immune components such as **antibodies** and **complement proteins**, which coat bacteria to facilitate recognition. - Antibiotics do not directly opsonize bacteria or enhance phagocytic uptake; their role is to inhibit or kill bacteria directly. [Practice more UPSC-CMS 2012 questions on OnCourse]

Q: The central venous pressure (CVP) is low in

Tension pneumothorax. ***Tension pneumothorax*** - A **tension pneumothorax** causes compression of the **superior and inferior vena cava** due to increased intrathoracic pressure and mediastinal shift. - This compression **impairs venous return** to the right atrium, leading to **decreased central venous pressure (CVP)**. - Despite elevated intrathoracic pressure, the net effect is **reduced venous return and low CVP**, along with hypotension and cardiac compromise. - This is a life-threatening emergency requiring immediate needle decompression. *Acute left ventricular failure* - In **acute left ventricular failure**, the left ventricle fails to pump blood effectively, causing backup into the pulmonary circulation. - However, the **right ventricle continues to pump** blood into the pulmonary circulation, leading to **increased right atrial pressure and elevated CVP**. - Patients typically present with **elevated CVP** along with pulmonary edema and dyspnea. *Massive pulmonary embolism* - A **massive pulmonary embolism** causes acute increase in **pulmonary vascular resistance** and right ventricular afterload. - The right ventricle becomes acutely strained and dilated, leading to **elevated right atrial pressure and increased CVP**. - Clinical features include hypotension, tachycardia, and jugular venous distension indicating high CVP. *Pericardial effusion* - A **pericardial effusion** causing **cardiac tamponade** compresses all cardiac chambers and restricts ventricular filling. - This leads to **equalization of diastolic pressures** in all chambers and **markedly elevated CVP**. - Classic Beck's triad includes hypotension, muffled heart sounds, and **jugular venous distension** (elevated CVP). [Practice more UPSC-CMS 2012 questions on OnCourse]

Question 1

Consider the following statements : HIV can be transmitted to a healthcare worker from a patient through :

1. A needle stick injury
2. Contact with the patient's blood
3. External examination of the patient
4. Inhalation
Which of the statements given above is/are correct ?

Accepted Answer

1 and 2 only

Answer

2 and 3 only

Answer

1 and 4

Answer

1, 2 and 3

Question 2

The commonest cause of primary hyper-parathyroidism is

Accepted Answer

Parathyroid adenoma

Answer

Idiopathic parathyroid hyperplasia

Answer

Familial hyperparathyroidism

Answer

Primary parathyroid carcinoma

Question 3

Which of the following statements is true about antibiotic therapy?

Accepted Answer

It has its greatest effect on multiplying organisms

Answer

It enhances the intracellular killing of organisms by phagocytes

Answer

It facilitates killing of organisms by activation of complements

Answer

It enhances the uptake of organisms by phagocytes

Question 4

The central venous pressure (CVP) is low in

Accepted Answer

Tension pneumothorax

Answer

Massive pulmonary embolism

Answer

Acute left ventricular failure

Answer

Pericardial effusion

Question 5

The term "debridement of the wound" refers to

Accepted Answer

Laying open all layers of the wound and excision of the devitalized tissue

Answer

Irrigation and cleaning of the wound

Answer

Closure of wound in layers

Answer

Clean excision of at least 1 mm of skin from the edge of the wound

Question 6

Which of the following statements is true regarding wound contracture ?

Accepted Answer

It is the function of specialised fibroblasts that contain actin myofilaments

Answer

Bacterial colonization of a wound slows the process of contraction

Answer

It may account for a 40% decrease in the size of a wound

Answer

It is a primary process affecting the closure of sutured wounds

Question 7

The scolicidal agents used in the surgery of a hydatid cyst include all of the following except

Accepted Answer

15% glutaraldehyde

Answer

Absolute alcohol

Answer

0.5% silver nitrate

Answer

20% (hypertonic) saline

Question 8

Which one of the following is an example of a chemodectoma ?

Accepted Answer

Carotid body tumour

Answer

Cock's peculiar tumour

Answer

Cystosarcoma phylloides

Answer

Keratoacanthoma

Question 9

In a 30-year-old male smoker, the commonest cause of dry gangrene of foot will be

Accepted Answer

Buerger's disease

Answer

Diabetes mellitus

Answer

Embolism

Answer

Atherosclerosis

Question 10

The following are the indications for carrying out a sympathectomy except

Accepted Answer

Venous ulcer of leg

Answer

Causalgia

Answer

Hyperhidrosis

Answer

Raynaud's disease

UPSC-CMS 2012

Community Medicine

Internal Medicine

Pharmacology

Physiology

Surgery