UPSC-CMS 2017 Practice Questions

Q: The umbilical cord normally contains:

Two arteries and one vein. ***Two arteries and one vein*** - The umbilical cord typically contains **two umbilical arteries** [1] that carry deoxygenated blood and waste products from the fetus to the placenta. - It also contains **one umbilical vein** [2, 3] that carries oxygenated, nutrient-rich blood from the placenta to the fetus. - This is the **normal anatomical configuration** of the umbilical cord. *One artery and two veins* - This configuration is **incorrect** as there is only **one umbilical vein** [2] in the normal umbilical cord, not two. - The presence of a single artery (single umbilical artery - SUA) is a recognized anomaly associated with certain fetal abnormalities, but even in SUA, there is only one vein. *One artery and one vein* - This arrangement is **incorrect** as the normal umbilical cord contains **two arteries**, not one [1]. - Single umbilical artery (SUA) is the most common umbilical cord anomaly, occurring in about 1% of pregnancies, but this is still an abnormal finding. *Two arteries and two veins* - This statement is **incorrect** because the normal umbilical cord contains only **one umbilical vein**, not two. - The presence of two veins would be a rare anomaly and is not part of normal umbilical cord anatomy.

Q: Painless genital ulcer is found in which one of the following genital infections?

Granuloma inguinale. ***Granuloma inguinale*** - Presents as a **painless, slowly progressive ulcerative lesion** that bleeds easily. - Caused by *Klebsiella granulomatis*, it starts as a papule and then becomes a **beefy red, granulation tissue-like ulcer**. *Lymphogranuloma venerum* - Initially presents with a **small, painless papule or vesicle** that often goes unnoticed. - The most prominent clinical feature is **regional lymphadenopathy (buboes)**, which can be painful and suppurate. *Chancroid* - Characterized by **painful, deep, irregular ulcers** with ragged undermined borders. - These ulcers are typically **soft** and can be accompanied by painful inguinal lymphadenopathy. *Herpes simplex* - Causes **multiple, painful vesicular lesions** that quickly erode into ulcers. - These lesions often recur and are associated with **burning or itching sensations** before eruption.

Q: Which of the following cause/causes bacterial vaginosis? 1. Gardnerella 2. Mycoplasma hominis 3. Ureaplasma urealyticum Select the correct answer using the code given below:

1, 2 and 3. ***1, 2 and 3*** - Bacterial vaginosis is a polymicrobial syndrome resulting from an imbalance in the vaginal flora, often characterized by a decrease in **Lactobacilli** and an overgrowth of various anaerobic bacteria. - **Gardnerella vaginalis** is the most commonly associated bacterium, but **Mycoplasma hominis** and **Ureaplasma urealyticum** are also frequently isolated and contribute to the pathogenesis of the condition. *1 and 3 only* - This option incorrectly excludes **Mycoplasma hominis**, which is a recognized contributor to the polymicrobial nature of bacterial vaginosis. - While *Gardnerella* and *Ureaplasma* are significant, the disease involves multiple species. *2 and 3 only* - This option incorrectly excludes **Gardnerella vaginalis**, which is considered the hallmark organism and a primary diagnostic indicator for bacterial vaginosis. - Omitting *Gardnerella* would misrepresent the key infectious agents involved. *1 only* - This option incorrectly suggests that **Gardnerella vaginalis** is the sole causative agent, overlooking the polymicrobial nature of bacterial vaginosis. - The condition is characterized by a shift in the entire vaginal microenvironment, involving multiple types of bacteria.

Q: A 28 year old woman develops amenorrhoea after having dilatation and curettage. The most likely diagnosis is :

Asherman syndrome. ***Asherman syndrome*** - It is characterized by the formation of **intrauterine adhesions** or **synechiae** that occur due to trauma to the endometrial lining, most commonly following a **D&C procedure**. - These adhesions can lead to **amenorrhea**, hypomenorrhea, infertility, and recurrent pregnancy loss due to the obstruction of the uterine cavity. *Kallman syndrome* - This is a **congenital hypogonadotropic hypogonadism** characterized by a deficiency in GnRH production and an associated **anosmia** (loss of smell), neither of which are suggested by the clinical presentation. - Patients typically present with **primary amenorrhea** and delayed puberty, not secondary amenorrhea following a D&C. *Turner syndrome* - A **chromosomal disorder (45, XO)** leading to **gonadal dysgenesis** and ovarian failure. - It typically presents with **primary amenorrhea**, short stature, webbed neck, and other distinct physical features, which are not mentioned here. *Anorexia nervosa* - This is an **eating disorder** associated with severe caloric restriction and low body weight. - It can cause **hypothalamic amenorrhea** due to impaired GnRH pulsatility but is usually accompanied by significant weight loss and psychological symptoms, not typically heralded by a D&C.

Q: Fitz‐Hugh‐Curtis syndrome involving perihepatitis is present in the following:

Gonorrhoea. **Gonorrhoea** - **Fitz-Hugh-Curtis syndrome** is a complication of **pelvic inflammatory disease (PID)**, which is predominantly caused by sexually transmitted infections like *Neisseria gonorrhoeae* and *Chlamydia trachomatis*. - Perihepatitis, or inflammation of the liver capsule, occurs when bacteria from the pelvic infection spread to the liver surface. *Syphilis* - **Syphilis** primarily presents with chancres, rashes, and neurological or cardiovascular complications in later stages. - It does not typically cause **perihepatitis** as a direct complication of the infection itself. *Tuberculosis* - **Tuberculosis** is caused by *Mycobacterium tuberculosis* and usually affects the lungs, but can spread to other organs. - While it can cause peritonitis, it is not associated with **perihepatitis** in the context of **Fitz-Hugh-Curtis syndrome**. *Moniliasis* - **Moniliasis** (candidiasis) is a fungal infection caused by *Candida* species. - It is commonly associated with vaginal yeast infections or thrush but does not cause **Fitz-Hugh-Curtis syndrome** or perihepatitis.

Q: Where are antisperm antibodies usually present?

Cervix. ***Cervix*** - Antisperm antibodies are commonly found in the **cervical mucus**, where they can immobilize or agglutinate sperm, preventing their passage into the uterus. - The cervix acts as a key immunological barrier, and its secretions can contain antibodies that interfere with **sperm motility and viability**. *Vagina* - While some antibodies may be present, the **acidic environment** of the vagina is generally hostile to sperm, and it is not the primary site for antisperm antibody action in infertility. - The vagina's role is more about initial sperm reception rather than a concentrated immunological barrier against sperm movement. *Fallopian tube* - The fallopian tubes are primarily involved in **sperm capacitation**, fertilization, and early embryo transport. - Although immune cells exist, it is not the most common location for significant levels of antisperm antibodies to cause issues with sperm transport into the uterus. *Uterus* - The uterus is mainly a site for sperm transport to the fallopian tubes and implantation of the embryo. - While immune responses can occur, the **cervix** is the more critical location for antisperm antibody presence causing clinical infertility by blocking sperm entry.

Q: Modified Bishop’s score includes all EXCEPT:

Position of occiput. ***Position of occiput*** - The **position of the occiput** (fetal head position) is assessed during labor but is not a component of either the original or modified Bishop's score. - The Bishop's score universally evaluates **cervical ripeness** and does not incorporate fetal station or position. *Position of os* - The **position of the cervix (os)**, whether anterior, posterior, or mid-position, is a crucial component of the Bishop's score. - A more **anterior cervix** indicates a higher likelihood of successful induction. *Consistency of cervix* - **Cervical consistency** (firm, medium, soft) is a key factor in the Bishop's score, reflecting the degree of cervical ripening. - A **softer cervix** is more favorable for induction and spontaneous labor progression. *Cervical length and dilatation* - **Cervical effacement** (length) and **dilatation** are essential parameters in the Bishop's score, indicating the readiness of the cervix for labor. - A **shorter and more dilated cervix** correlates with a higher Bishop's score and increased success of labor induction.

Q: The engaging diameter of brow presentation is:

Mento‐vertical. ***Mento-vertical*** - In a **brow presentation**, the fetal head is incompletely extended, and the presenting part is the brow. - The **mento-vertical diameter** is the longest antero-posterior diameter of the fetal head, measuring approximately **13.5 cm**, and is the engaging diameter in a brow presentation. *Submento-bregmatic* - This diameter is measured from the junction of the neck and chin to the anterior fontanelle (bregma), reflecting the engaging diameter in a **face presentation** with full extension. - Its typical measurement is about **9.5 cm**, significantly shorter than the mento-vertical diameter. *Submento-vertical* - This diameter is not a standard engaging diameter used to describe typical fetal head presentations. - Standard obstetrical terminology focuses on submento-bregmatic for face and suboccipito-bregmatic for vertex presentations. *Suboccipito-bregmatic* - This is the engaging diameter for a **flexed vertex presentation** (occiput or crown of the head), which is the most common and favorable presentation. - It measures approximately **9.5 cm**, representing the optimal diameter for passage through the birth canal.

Q: Which of the following is/are the risk factors for acute pelvic inflammatory disease in women? 1. Intercourse during menstruation 2. Multiple sex partners Select the correct answer using the code given below:

Both 1 and 2. **Both 1 and 2** - **Intercourse during menstruation** increases the risk for acute PID, as the cervical mucus plug, which normally protects against ascending infection, is absent during menses. - **Multiple sex partners** significantly raises the risk of exposure to sexually transmitted infections (STIs), which are the primary cause of PID. *2 only* - While **multiple sex partners** is a major risk factor, denying intercourse during menstruation as a risk factor is incorrect. - The physiological changes during menstruation facilitate the ascent of bacteria, making coitus during this period a risk. *Neither 1 nor 2* - Both statements describe established risk factors for PID. - This option is incorrect because both **intercourse during menstruation** and **multiple sex partners** contribute to increased risk. *1 only* - While **intercourse during menstruation** is a risk factor, it is incorrect to exclude **multiple sex partners** as a significant risk factor for PID. - Having multiple partners dramatically increases the likelihood of acquiring **STIs**, the main cause of PID.

Q: Intramuscular injection of iron dextran is given by ‘Z’ technique to:

Reduce the staining. ***Reduce the staining*** - The **Z-track technique** creates a staggered path that prevents the dark iron solution from leaking back into the subcutaneous tissue, which can cause **permanent skin discoloration or staining**. - This method seals the medication deep in the muscle, preventing its reflux along the needle track. *Increase the iron absorption* - The Z-track technique is primarily about preventing **leakage and staining**, not enhancing the absorption rate of the iron. - Iron absorption is largely determined by factors like the patient's iron deficiency status and the form of iron administered, not the injection technique. *Alleviate the pain* - While proper injection technique can minimize discomfort, the Z-track method's primary purpose is not pain reduction but rather **preventing reflux** and associated staining. - Pain during injection is often related to the volume, viscosity, and acidity of the medication, as well as the injection site. *Decrease the incidence of infection* - Standard aseptic techniques, not the Z-track method itself, are crucial for **preventing infection** during intramuscular injections. - The Z-track technique does not inherently reduce the risk of infection beyond what is achieved with good sterile practice.

Question 1

The umbilical cord normally contains:

Accepted Answer

Two arteries and one vein

Answer

One artery and two veins

Answer

One artery and one vein

Answer

Two arteries and two veins

Question 2

Painless genital ulcer is found in which one of the following genital infections?

Accepted Answer

Granuloma inguinale

Answer

Lymphogranuloma venerum

Answer

Chancroid

Answer

Herpes simplex

Question 3

Which of the following cause/causes bacterial vaginosis?

1. Gardnerella
2. Mycoplasma hominis
3. Ureaplasma urealyticum

Select the correct answer using the code given below:

Accepted Answer

1, 2 and 3

Answer

1 and 3 only

Answer

2 and 3 only

Answer

1 only

Question 4

A 28 year old woman develops amenorrhoea after having dilatation and curettage. The most likely diagnosis is :

Accepted Answer

Asherman syndrome

Answer

Kallman syndrome

Answer

Turner syndrome

Answer

Anorexia nervosa

Question 5

Fitz‐Hugh‐Curtis syndrome involving perihepatitis is present in the following:

Accepted Answer

Gonorrhoea

Answer

Syphilis

Answer

Tuberculosis

Answer

Moniliasis

Question 6

Where are antisperm antibodies usually present?

Accepted Answer

Cervix

Answer

Vagina

Answer

Fallopian tube

Answer

Uterus

Question 7

Modified Bishop’s score includes all EXCEPT:

Accepted Answer

Position of occiput

Answer

Position of os

Answer

Consistency of cervix

Answer

Cervical length and dilatation

Question 8

The engaging diameter of brow presentation is:

Accepted Answer

Mento‐vertical

Answer

Submento‐bregmatic

Answer

Submento‐vertical

Answer

Suboccipito‐bregmatic

Question 9

Which of the following is/are the risk factors for acute pelvic inflammatory disease in women?

1. Intercourse during menstruation
2. Multiple sex partners

Select the correct answer using the code given below:

Accepted Answer

Both 1 and 2

Answer

2 only

Answer

Neither 1 nor 2

Answer

1 only

Question 10

Intramuscular injection of iron dextran is given by ‘Z’ technique to:

Accepted Answer

Reduce the staining

Answer

Increase the iron absorption

Answer

Alleviate the pain

Answer

Decrease the incidence of infection

UPSC-CMS 2017

Anatomy

Dermatology

Microbiology

Obstetrics and Gynecology

Pharmacology