UPSC-CMS 2016 Practice Questions

Q: With reference to dengue virus, consider the following statements: 1. In India, all the four serotypes are found. 2. The reservoir of infection is both man and mosquito. 3. Adults usually have a milder disease than children. 4. Dengue hemorrhagic fever is caused by infection with more than one dengue virus. Which of the statements given above is/are correct?

1, 2 and 4. ***1, 2 and 4*** - **All four serotypes** (DEN-1, DEN-2, DEN-3, and DEN-4) of the dengue virus are endemic in India, contributing to the recurrent outbreaks seen across the country. - Dengue is a **vector-borne disease**, meaning the virus cycles between humans (the primary reservoir) and mosquitoes (specifically *Aedes aegypti* and *Aedes albopictus*), making both essential for its transmission. - **Dengue hemorrhagic fever (DHF)**, or severe dengue, is often associated with a **second infection by a different serotype** of the dengue virus due to antibody-dependent enhancement (ADE). *2, 3 and 4* - The statement that adults usually have a milder disease than children is **incorrect**; children often present with milder, non-specific symptoms, while adults are more likely to develop typical dengue fever or severe forms. - The other statements regarding the presence of all four serotypes, the reservoir, and the cause of DHF are correct. *4 only* - While statement 4 (DHF caused by infection with more than one serotype) is correct, it overlooks the accuracy of statements 1 and 2. - Omitting statements 1 and 2 makes this option incomplete as both are established facts about dengue. *1 and 2 only* - This option correctly identifies that all four serotypes exist in India and that humans and mosquitoes serve as reservoirs. - However, it **incorrectly excludes statement 4** regarding the etiology of dengue hemorrhagic fever (DHF), which results from sequential infection with a different serotype.

Q: What is the window period for HIV infection?

6 – 24 weeks. ***6 – 24 weeks*** - The **window period** for HIV infection refers to the time after initial infection during which **antibodies have not yet developed** to a detectable level. - While it can vary depending on the testing method, the **6-24 week range** generally encompasses the period for traditional antibody tests to become positive. - This is the **conservative estimate** used for conventional HIV antibody testing, ensuring adequate time for seroconversion in most individuals. *3 – 6 weeks* - While many individuals will develop detectable antibodies within this timeframe, this range is **too narrow** to capture all cases of seroconversion. - Some individuals may take longer (up to 12 weeks or more) to develop detectable antibody levels, making this an **incomplete window period**. - The 6-24 week range provides a more **conservative and comprehensive** testing window. *3 – 15 days* - This timeframe is typically **too short** for the body to produce a detectable antibody response to HIV. - **Early HIV infection** during this period would likely be detected by more sensitive tests, such as **HIV RNA PCR**, which detect viral genetic material directly. - This represents the **eclipse period** rather than the full antibody window period. *6 – 8 months* - While some individuals may take longer to seroconvert, 6-8 months is generally considered **outside the typical window period** for most conventional HIV antibody tests. - Most people will develop detectable antibodies much earlier than this, usually within **3-12 weeks**. - This timeframe is excessively long and not reflective of standard testing protocols.

Q: Among the following foodstuffs, which one has the highest protein content per 100 gm?

Black gram. ***Black gram*** - **Black gram (Urad dal)** is a pulse known for its high protein content, typically around **24-25 grams per 100g**. - It is a staple in many cuisines and provides essential amino acids, making it a valuable protein source. *Ragi* - **Ragi (finger millet)** is a nutritious grain, but its protein content is relatively lower, around **7-8 grams per 100g**. - It is more notable for its high **calcium** and **fiber** content rather than protein. *Wheat* - **Wheat** contains a moderate amount of protein, usually around **12-14 grams per 100g**. - While it's a significant source of calories and carbohydrates, its protein content is less than that of black gram. *Egg* - A whole **egg** contains about **13 grams of protein per 100g**. - While eggs are an excellent source of high-quality protein, black gram typically surpasses this amount per 100g.

Q: Consider the following: 1. Skin 2. Water 3. Faeces 4. Urine Bleaching powder can be used for disinfection of which of the above?

2, 3 and 4. ***2, 3 and 4*** - **Bleaching powder** (calcium hypochlorite) is a strong oxidizing agent widely used for **disinfection** in public health. - It is highly effective for **water purification** (chlorination of drinking water and wells), **faeces disinfection** (in latrines and for controlling fecal-oral disease transmission), and **urine disinfection** (in urinals and public sanitation facilities). - These are the **standard applications** of bleaching powder in community medicine and environmental health. *1, 2 and 3* - While bleaching powder is effective for **water** and **faeces** disinfection, it is **NOT recommended for skin disinfection**. - Bleaching powder is a **strong irritant** that can cause chemical burns and skin damage. - **Skin antisepsis** requires gentler agents like alcohol, chlorhexidine, or povidone-iodine—not bleaching powder. *2 and 3 only* - This option correctly includes **water** and **faeces** disinfection. - However, it incorrectly omits **urine**, which is also routinely disinfected with bleaching powder in latrines, urinals, and sanitation systems for **odor control** and **pathogen elimination**. *1 and 2 only* - This option incorrectly includes **skin**, which should not be disinfected with bleaching powder due to its caustic nature. - It also omits both **faeces** and **urine**, which are major applications of bleaching powder in environmental health and sanitation.

Q: Smoking is associated with all the following diseases except:

Sarcoidosis. ***Sarcoidosis*** - **Smoking** has been found to have a protective or null effect on the development of **sarcoidosis**, and it is generally *not* considered a risk factor. - The etiology of sarcoidosis is unknown, but it is thought to involve a combination of genetic predisposition and environmental triggers, none of which strongly implicate smoking. *Emphysema* - **Smoking** is the leading cause of **emphysema**, a type of **COPD**, by causing chronic inflammation and destruction of alveolar walls. - Toxins and irritants in smoke activate inflammatory cells and enzymes, leading to the breakdown of elastic fibers in the lungs. *Cardiovascular disease* - **Smoking** is a major risk factor for various **cardiovascular diseases**, including **atherosclerosis**, **coronary artery disease**, and stroke. - It damages blood vessel walls, increases **blood pressure**, and promotes clot formation, significantly increasing the risk of cardiovascular events. *Lung cancer* - **Smoking** is the primary cause of the vast majority of **lung cancer** cases, with dose-dependent effects on risk [1]. - Carcinogens in tobacco smoke directly damage DNA in lung cells, leading to uncontrolled cell growth and tumor formation [1].

Q: A 35 year old nulliparous woman complains of menorrhagia and mass per abdomen. On examination, the positive findings are: she is anaemic, has a pelvic mass of 16-18 weeks size, firm in consistency which moves with the movement of cervix. What is the most likely clinical diagnosis?

Leiomyoma. ***Leiomyoma*** - A **leiomyoma**, or **fibroid**, is a common benign smooth muscle tumor of the uterus, often presenting as **menorrhagia** and a **pelvic mass**. - The mass being **firm, 16-18 weeks size**, and **moving with the cervix** is classic for a uterine fibroid, differentiating it from an adnexal or fixed uterine mass. *Adenomyosis* - Characterized by endometrial tissue within the myometrium, leading to a **globular, tender uterus**, often associated with **dysmenorrhea** and **menorrhagia**. - While it causes menorrhagia, the uterus is typically **tender** and **boggy**, not a firm, discrete mass freely mobile with the cervix. *Ovarian tumour* - An **ovarian tumor** would typically present as an **adnexal mass**, often separate from the uterus and not moving with the cervix. - While an ovarian tumor can cause a pelvic mass, it is less likely to be directly associated with the described menorrhagia or involve the cervix's movement. *Endometrial carcinoma* - Primarily causes **abnormal uterine bleeding**, especially in **postmenopausal women**, but usually does not present as a large, firm, mobile mass detectable on abdominal palpation. - While it can cause menorrhagia, a firm, discrete uterine mass that moves with the cervix is not a typical presentation of **endometrial carcinoma**.

Q: Abundant cornified cells in vaginal exfoliative cytology indicate:

Late proliferative phase. ***Late proliferative phase*** - During the **late proliferative phase**, estrogen levels are at their peak, leading to significant maturation and cornification of vaginal epithelial cells. - This phase is characterized by a high proportion of **superficial cells**, which are large, polygonal, and have small, pyknotic nuclei, reflecting extensive cornification. *Late secretory phase* - In the **late secretory phase**, progesterone levels are high, which causes an increase in **intermediate cells** and a decrease in superficial (cornified) cells. - The cytology would show a dominance of folded intermediate cells, often in clusters, and a **"navicular cell"** appearance, rather than abundant cornified cells. *Early secretory phase* - The **early secretory phase** is also dominated by progesterone's influence, leading to a shift from superficial to intermediate cells. - There would be a mixture of intermediate and some superficial cells, but not the abundance of **highly cornified cells** seen in the late proliferative phase. *Early proliferative phase* - The **early proliferative phase** follows menstruation and is characterized by rising estrogen, but not yet at its peak. - The cytology would typically show a mixture of **parabasal**, intermediate, and some superficial cells, reflecting the initial regeneration of the epithelium, with less cornification than the late proliferative phase.

Q: Polyhydramnios at term is diagnosed when AFI is more than:

25 cm. ***25 cm*** - **Polyhydramnios** is diagnosed when the **Amniotic Fluid Index (AFI)** at term is greater than or equal to **25 cm**. - This indicates an excessive amount of **amniotic fluid**, which can be associated with various maternal or fetal complications. *15 cm* - An AFI of 15 cm is within the **normal range** for amniotic fluid volume. - It does not meet the criteria for either **polyhydramnios** or **oligohydramnios**. *20 cm* - An AFI of 20 cm is considered to be in the **upper normal limit** or **borderline high**, but it does not definitively meet the diagnostic criteria for **polyhydramnios**. - Close monitoring would be indicated, but it's not severe polyhydramnios. *10 cm* - An AFI of 10 cm is also within the **normal range** for amniotic fluid volume. - It is neither indicative of too much nor too little amniotic fluid.

Q: Which of the following is not a potentially teratogenic infection if contracted in pregnancy?

Influenza virus. ***Influenza virus*** - While influenza can cause severe illness in pregnant women, it is **not generally considered teratogenic**, meaning it does not typically cause birth defects like the other listed infections. - The primary risks of influenza in pregnancy are severe maternal complications, **preterm birth**, and **low birth weight**, rather than congenital anomalies. *Chicken pox* - Maternal infection with **varicella-zoster virus (chickenpox)** during the first 20 weeks of pregnancy can lead to **Congenital Varicella Syndrome**, characterized by skin scarring, limb hypoplasia, microphthalmia, and neurological deficits. - Infection late in pregnancy can cause **neonatal varicella**, which can be severe and life-threatening for the newborn. *Rubella* - Maternal infection with **rubella (German measles)**, especially during the first trimester, is a well-known cause of **Congenital Rubella Syndrome (CRS)**. - CRS can result in severe birth defects, including **cataracts**, **heart defects** (e.g., patent ductus arteriosus, pulmonary artery stenosis), and **sensorineural hearing loss**. *Cytomegalovirus* - **Congenital cytomegalovirus (CMV)** infection is a leading cause of **non-hereditary sensorineural hearing loss** and neurodevelopmental disabilities. - While many infected infants are asymptomatic at birth, some develop **microcephaly**, periventricular calcifications, hepatosplenomegaly, and **chorioretinitis**.

Q: Consider the following statements: 1. Carbon dioxide is the safest gas for creating pneumoperitoneum in operative laparoscopy. 2. Laparoscopic sterilization is not recommended during the period of immediate postpartum. Which of the statements given above is/are correct?

Both 1 and 2. ***Both 1 and 2*** - **Carbon dioxide (CO2)** is the safest gas for creating pneumoperitoneum due to its **rapid absorption** and **excretion** by the body, minimizing the risk of gas embolism and tissue toxicity. - Laparoscopic sterilization is generally **not recommended during the immediate postpartum period** (first 6-8 weeks) due to the **enlarged uterus**, increased vascularity, and altered anatomy, which elevate the risk of complications such as hemorrhage and organ perforation. *1 only* - While carbon dioxide is indeed the safest gas for pneumoperitoneum, this option is incorrect because the second statement regarding postpartum sterilization is also accurate. - Selecting this option would imply that statement 2 is false, which is not the case. *Neither 1 nor 2* - This option is incorrect because both statements are clinically accurate and accepted practices in operative laparoscopy and postpartum care. - Both statements reflect standard surgical and obstetric guidelines. *2 only* - This option is incorrect because, in addition to the second statement being true, the first statement (regarding the safety of CO2 for pneumoperitoneum) is also correct. - Choosing this option would suggest that CO2 is not the safest gas, which contradicts established medical practice.

Question 1

With reference to dengue virus, consider the following statements:

1. In India, all the four serotypes are found.
2. The reservoir of infection is both man and mosquito.
3. Adults usually have a milder disease than children.
4. Dengue hemorrhagic fever is caused by infection with more than one dengue virus. Which of the statements given above is/are correct?

Accepted Answer

1, 2 and 4

Answer

2, 3 and 4

Answer

4 only

Answer

1 and 2 only

Question 2

What is the window period for HIV infection?

Accepted Answer

6 – 24 weeks

Answer

3 – 6 weeks

Answer

3 – 15 days

Answer

6 – 8 months

Question 3

Among the following foodstuffs, which one has the highest protein content per 100 gm?

Accepted Answer

Black gram

Answer

Ragi

Answer

Wheat

Answer

Egg

Question 4

Consider the following:

1. Skin

2. Water

3. Faeces

4. Urine
Bleaching powder can be used for disinfection of which of the above?

Accepted Answer

2, 3 and 4

Answer

1, 2 and 3

Answer

2 and 3 only

Answer

1 and 2 only

Question 5

Smoking is associated with all the following diseases except:

Accepted Answer

Sarcoidosis

Answer

Emphysema

Answer

Cardiovascular disease

Answer

Lung cancer

Question 6

A 35 year old nulliparous woman complains of menorrhagia and mass per abdomen. On examination, the positive findings are: she is anaemic, has a pelvic mass of 16-18 weeks size, firm in consistency which moves with the movement of cervix. What is the most likely clinical diagnosis?

Accepted Answer

Leiomyoma

Answer

Adenomyosis

Answer

Ovarian tumour

Answer

Endometrial carcinoma

Question 7

Abundant cornified cells in vaginal exfoliative cytology indicate:

Accepted Answer

Late proliferative phase

Answer

Late secretory phase

Answer

Early secretory phase

Answer

Early proliferative phase

Question 8

Polyhydramnios at term is diagnosed when AFI is more than:

Accepted Answer

25 cm

Answer

15 cm

Answer

20 cm

Answer

10 cm

Question 9

Which of the following is not a potentially teratogenic infection if contracted in pregnancy?

Accepted Answer

Influenza virus

Answer

Chicken pox

Answer

Rubella

Answer

Cytomegalovirus

Question 10

Consider the following statements:

1. Carbon dioxide is the safest gas for creating pneumoperitoneum in operative laparoscopy.
2. Laparoscopic sterilization is not recommended during the period of immediate postpartum. Which of the statements given above is/are correct?

Accepted Answer

Both 1 and 2

Answer

1 only

Answer

Neither 1 nor 2

Answer

2 only

UPSC-CMS 2016

Community Medicine

Internal Medicine

Obstetrics and Gynecology

Surgery