The mother of a 14-month-old normally developing baby comes to you for feeding advice. Which of the following would be appropriate for her as per the IMNCI (Integrated Management of Neonatal and Childhood Illness) Program?
I. Breastfeed as often as the child wants
II. Keep the child in your lap and feed with your own hands
III. Offer food from the family pot
IV. Give 3 to 4 meals each day
Select the correct answer using the code given below :
UPSC-CMS 2025 - Community Medicine UPSC-CMS Practice Questions and MCQs
Question 111: The mother of a 14-month-old normally developing baby comes to you for feeding advice. Which of the following would be appropriate for her as per the IMNCI (Integrated Management of Neonatal and Childhood Illness) Program?
I. Breastfeed as often as the child wants
II. Keep the child in your lap and feed with your own hands
III. Offer food from the family pot
IV. Give 3 to 4 meals each day
Select the correct answer using the code given below :
A. II, III and IV
B. I, II and IV
C. I, II and III
D. I, III and IV (Correct Answer)
Explanation: ***I, III and IV***
- The IMNCI guidelines recommend continuing **breastfeeding on demand** up to two years of age or beyond, as it remains an important source of nutrients and immunity for the child.
- Feeding from the **family pot** ensures the child is exposed to a variety of foods and is integrated into family eating patterns, and 3-4 meals per day is appropriate for a 14-month-old, providing adequate energy and nutrients.
*II, III and IV*
- While feeding from the family pot and 3-4 meals per day are correct, the recommendation to keep the child in the lap and feed with one's own hands is not universally applicable or the sole recommended method; promoting responsive feeding involves observing and responding to the child's cues.
- The IMNCI guidelines emphasize **responsive feeding practices** where the caregiver observes and responds to the child's hunger and satiety cues rather than a specific physical feeding method.
*I, II and IV*
- Continuing breastfeeding and providing 3-4 meals per day are correct, but feeding with one's own hands in the lap is not a primary IMNCI guideline for feeding practices, which instead focuses on the quality of food and responsive feeding.
- **Offering food from the family pot** is a crucial IMNCI recommendation to ensure dietary diversity and integration into family meals, which is missing from this option.
*I, II and III*
- While continuing breastfeeding and feeding from the family pot are correct, the explicit instruction to "keep the child in your lap and feed with your own hands" is not a central or universally emphasized IMNCI guideline in the same way as responsive feeding and dietary diversity.
- The number of meals per day (3-4) is an important practical aspect of feeding a 14-month-old, which is excluded from this option, making it incomplete.
Forensic Medicine
1 questions
Q111
As per POCSO (Protection of Children from Sexual Offences) Act 2012, sexual assault is considered aggravated when
I. the abuse involves use of physical violence
II. the abused child is disabled
III. the abuse is committed by staff of an educational institution
IV. the abuse is committed by an immediate family member/first degree relative
Which of the above are correct?
UPSC-CMS 2025 - Forensic Medicine UPSC-CMS Practice Questions and MCQs
Question 111: As per POCSO (Protection of Children from Sexual Offences) Act 2012, sexual assault is considered aggravated when
I. the abuse involves use of physical violence
II. the abused child is disabled
III. the abuse is committed by staff of an educational institution
IV. the abuse is committed by an immediate family member/first degree relative
Which of the above are correct?
A. I and III
B. II and IV
C. II and III (Correct Answer)
D. I and IV
Explanation: **IMPORTANT NOTE:** According to POCSO Act 2012 Section 9, **ALL FOUR statements (I, II, III, and IV) are actually aggravating factors** for sexual assault. This question has a structural flaw as it lacks an "All of the above" option.
***II and III (Marked as answer, but incomplete)***
- **Disabled child (II)**: Section 9(a)(ii) explicitly includes when "the child is mentally ill or physically or mentally disabled" as an aggravating factor.
- **Educational institution staff (III)**: Section 9(n) includes when committed by "a member of the management or staff of an educational institution."
*However, statements I and IV are ALSO aggravating factors per POCSO Act 2012:*
**Statement I - Physical Violence:**
- Section 9(c) explicitly states aggravated sexual assault includes "when the child is subject to sexual assault by use of physical violence."
**Statement IV - Immediate Family Member/Relative:**
- Section 9(f) explicitly states aggravated sexual assault includes "when the sexual assault is committed by a person who is a relative of the child."
**Legal Reference:** POCSO Act 2012, Section 9 lists 16 circumstances that constitute aggravated sexual assault, including all four factors mentioned in this question.
*Note: This question requires review as the correct answer should be "All of the above" but this option is not available.*
Pathology
1 questions
Q111
Which of the following syndromes are caused due to genomic imprinting?
I. Rubinstein Taybi syndrome
II. Prader-Willi syndrome
III. Angelman syndrome
IV. Edward syndrome
Select the correct answer using the code given below :
UPSC-CMS 2025 - Pathology UPSC-CMS Practice Questions and MCQs
Question 111: Which of the following syndromes are caused due to genomic imprinting?
I. Rubinstein Taybi syndrome
II. Prader-Willi syndrome
III. Angelman syndrome
IV. Edward syndrome
Select the correct answer using the code given below :
A. II and IV
B. I and IV
C. I and III
D. II and III (Correct Answer)
Explanation: ***II and III (Correct Answer)***
- **Prader-Willi syndrome** and **Angelman syndrome** are classic examples of disorders caused by **genomic imprinting** defects on chromosome 15 [1].
- **Prader-Willi syndrome** results from the loss of paternal 15q11-q13 expression, while **Angelman syndrome** results from the loss of maternal 15q11-q13 expression [1].
- Both conditions demonstrate parent-of-origin effects, where the same chromosomal region causes different phenotypes depending on whether the mutation is inherited from the mother or father [1].
*II and IV (Incorrect)*
- While Prader-Willi syndrome is linked to genomic imprinting, **Edward syndrome** (Trisomy 18) is caused by a chromosomal abnormality (an extra copy of chromosome 18), not genomic imprinting.
- Edward syndrome presents with distinct clinical features like **micrognathia** and **rocker-bottom feet**, different from imprinting disorders.
*I and IV (Incorrect)*
- **Rubinstein-Taybi syndrome** is caused by mutations in the **CREBBP** gene or deletion of 16p13.3, which are not related to genomic imprinting.
- **Edward syndrome** is a chromosomal aneuploidy (Trisomy 18), not a disorder of genomic imprinting.
*I and III (Incorrect)*
- **Rubinstein-Taybi syndrome** is a genetic disorder caused by mutations in the CREBBP or EP300 genes, and it is not associated with genomic imprinting.
- Only **Angelman syndrome** among these two options is caused by genomic imprinting.
**References:**
[1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Genetic Disorders, pp. 181-182.
Pediatrics
4 questions
Q111
Which of the following are characteristic features of cerebral palsy?
I. Disorder of movement
II. Permanent nature
III. Progressive course
IV. Disorder of posture
Select the correct answer using the code given below :
Q112
Which of the following are tools commonly used in the evaluation of children with cerebral palsy for motor function and spasticity assessment?
I. Gross Motor Function Classification System
II. Medical Research Council System
III. Modified Connors Scale (Connors-II)
IV. Modified Ashworth Scale
Select the correct answer using the code given below:
Q113
Which of the following are causes of secondary immunodeficiency in children?
I. Diphenylhydantoin
II. Severe malnutrition
III. Post-varicella state
IV. Nephrotic syndrome
Select the correct answer using the code given below :
Q114
Which of the following statements are correct regarding vaccination routes for children?
I. Hepatitis B vaccine given in deltoid region has reduced efficacy
II. Two vaccines may be given in the same thigh, but separated by 1 inch
III. Separate sites are used when administering a vaccine and an immunoglobulin
IV. Two intramuscular vaccines should never be given on the same day
Select the answer using the code given below:
UPSC-CMS 2025 - Pediatrics UPSC-CMS Practice Questions and MCQs
Question 111: Which of the following are characteristic features of cerebral palsy?
I. Disorder of movement
II. Permanent nature
III. Progressive course
IV. Disorder of posture
Select the correct answer using the code given below :
A. I, II and III
B. I, III and IV
C. II, III and IV
D. I, II and IV (Correct Answer)
Explanation: ***Correct: I, II and IV***
- Cerebral palsy is defined as a group of **permanent disorders** that affect the development of **movement and posture**, causing activity limitations.
- It is attributed to **non-progressive disturbances** that occurred in the developing fetal or infant brain.
- Key characteristics: **Disorder of movement (I)** + **Permanent nature (II)** + **Disorder of posture (IV)** + Non-progressive course.
*Incorrect: I, II and III*
- While cerebral palsy is a **disorder of movement** and **permanent**, it is explicitly characterized by its **non-progressive** nature.
- The underlying brain lesion does not worsen over time, though clinical manifestations may change as the child develops.
- Statement III (Progressive course) is incorrect.
*Incorrect: I, III and IV*
- Cerebral palsy is fundamentally a **disorder of movement** and **posture**.
- However, a key distinguishing characteristic is its **non-progressive** nature; the brain injury itself does not advance or worsen.
- Statement III (Progressive course) contradicts the definition of cerebral palsy.
*Incorrect: II, III and IV*
- Cerebral palsy is **permanent** and affects **posture**, but it has a **non-progressive** course, not progressive.
- It is also fundamentally a **disorder of movement**, which is a primary manifestation.
- Statement III (Progressive course) is incorrect, making this combination wrong.
Question 112: Which of the following are tools commonly used in the evaluation of children with cerebral palsy for motor function and spasticity assessment?
I. Gross Motor Function Classification System
II. Medical Research Council System
III. Modified Connors Scale (Connors-II)
IV. Modified Ashworth Scale
Select the correct answer using the code given below:
A. III and IV
B. I and IV (Correct Answer)
C. I and II
D. II and III
Explanation: ***Correct: I and IV***
- The **Gross Motor Function Classification System (GMFCS)** is the gold standard tool to classify gross motor function in children with **cerebral palsy** based on self-initiated movement and functional limitations across five levels (I-V).
- The **Modified Ashworth Scale** is the most widely used clinical tool for assessing **spasticity** and muscle tone in cerebral palsy, grading resistance to passive movement on a 0-4 scale.
- These two tools directly address **motor function classification** and **spasticity assessment** as required in the question.
*Incorrect: III and IV*
- While the **Modified Ashworth Scale (IV)** is correctly identified for spasticity assessment, the **Modified Connors Scale (Connors-II)** is used exclusively for evaluating **Attention-Deficit/Hyperactivity Disorder (ADHD)**, not motor function or spasticity in cerebral palsy.
*Incorrect: I and II*
- The **GMFCS (I)** is correctly identified for motor function classification in cerebral palsy.
- However, the **Medical Research Council (MRC) System** is primarily used for **muscle strength grading** (0-5 scale) in conditions like peripheral neuropathy, stroke, or myopathy—not for motor function classification or spasticity assessment specific to cerebral palsy.
*Incorrect: II and III*
- Both tools are inappropriate for the stated purpose: the **MRC System** assesses muscle strength (not CP-specific motor function classification), and the **Modified Connors Scale** evaluates ADHD symptoms.
- Neither tool is standard for evaluating motor function or spasticity in cerebral palsy.
Question 113: Which of the following are causes of secondary immunodeficiency in children?
I. Diphenylhydantoin
II. Severe malnutrition
III. Post-varicella state
IV. Nephrotic syndrome
Select the correct answer using the code given below :
A. II, III and IV
B. I, III and IV
C. I, II and III
D. I, II and IV (Correct Answer)
Explanation: ***I, II and IV***
- **Diphenylhydantoin (phenytoin)**, an anticonvulsant, causes immunosuppression through multiple mechanisms including IgA deficiency, hypogammaglobulinemia, and impaired T-cell function, making it a well-documented cause of drug-induced secondary immunodeficiency.
- **Severe malnutrition** is one of the most common causes of secondary immunodeficiency worldwide, significantly impairing both cellular and humoral immunity by affecting T cells, B cells, and phagocytic function.
- **Nephrotic syndrome** causes loss of immunoglobulins (particularly IgG) in the urine due to increased glomerular permeability, directly resulting in hypogammaglobulinemia and increased susceptibility to encapsulated bacterial infections (especially *Streptococcus pneumoniae*).
*II, III and IV*
- While **severe malnutrition**, **post-varicella state**, and **nephrotic syndrome** are all causes of immunodeficiency, this option incorrectly excludes diphenylhydantoin.
- **Diphenylhydantoin** is a well-established cause of secondary immunodeficiency, not a minor or questionable cause.
*I, III and IV*
- This option incorrectly excludes **severe malnutrition**, which is one of the most important and prevalent causes of secondary immunodeficiency in children globally.
- Severe malnutrition affects multiple components of the immune system and is considered a primary cause in pediatric populations.
*I, II and III*
- While **diphenylhydantoin**, **severe malnutrition**, and **post-varicella state** can all affect immunity, this option incorrectly excludes **nephrotic syndrome**.
- The **post-varicella state** causes transient T-cell lymphopenia, but this is typically temporary and self-limited compared to the sustained immunoglobulin loss in nephrotic syndrome.
- **Nephrotic syndrome** represents a more consistent and clinically significant cause of secondary immunodeficiency with a clear mechanism (protein loss in urine).
Question 114: Which of the following statements are correct regarding vaccination routes for children?
I. Hepatitis B vaccine given in deltoid region has reduced efficacy
II. Two vaccines may be given in the same thigh, but separated by 1 inch
III. Separate sites are used when administering a vaccine and an immunoglobulin
IV. Two intramuscular vaccines should never be given on the same day
Select the answer using the code given below:
A. II and III (Correct Answer)
B. I and III
C. III only
D. II, III, and IV
Explanation: ***II and III***
- Hepatitis B vaccine can be given in the **deltoid region** for older children and adults with good efficacy; reduced efficacy primarily occurs if administered in the gluteal region due to high fat content, not the deltoid. Administering two vaccines in the same thigh, separated by 1 inch, is a recognized practice when multiple injections are needed and separate limbs are not feasible.
- Administering a vaccine and an immunoglobulin at **separate sites** is crucial to prevent the immunoglobulin from neutralizing the live attenuated vaccine, thereby reducing its efficacy.
*I and III*
- Statement I is incorrect because the **deltoid region** is an appropriate and effective site for Hepatitis B vaccine administration in older children and adults.
- Statement III is correct, as separating the sites for vaccine and immunoglobulin prevents **immune interference**.
*III only*
- While statement III is correct regarding the separation of vaccine and immunoglobulin administration, statement II is also correct, making this option incomplete.
- **Multiple injections** on the same limb with adequate spacing are acceptable under certain guidelines.
*II, III, and IV*
- Statement IV is incorrect; multiple **intramuscular vaccines** *can* be given on the same day if clinically indicated and the child is due for them, often in different limbs or at appropriately spaced sites on the same limb.
- Statements II and III are correct, but the inclusion of the incorrect statement IV makes this option invalid.
Pharmacology
1 questions
Q111
Which of the following medications may be used in a child diagnosed with Attention Deficit Hyperactivity Disorder?
I. Carbamazepine
II. Methylphenidate
III. Atomoxetine
IV. Clonazepam
Select the correct answer using the code given below :
UPSC-CMS 2025 - Pharmacology UPSC-CMS Practice Questions and MCQs
Question 111: Which of the following medications may be used in a child diagnosed with Attention Deficit Hyperactivity Disorder?
I. Carbamazepine
II. Methylphenidate
III. Atomoxetine
IV. Clonazepam
Select the correct answer using the code given below :
A. I and III
B. I and IV
C. II and III (Correct Answer)
D. II and IV
Explanation: ***II and III***
- **Methylphenidate** is a first-line **CNS stimulant** that increases dopamine and norepinephrine in the prefrontal cortex, improving attention and reducing hyperactivity/impulsivity
- **Atomoxetine** is a **selective norepinephrine reuptake inhibitor (SNRI)**, FDA-approved as a non-stimulant alternative for ADHD management
- Both medications are **evidence-based treatments** for ADHD in children with proven efficacy in controlled trials
*I and III*
- **Carbamazepine** is an anticonvulsant used for epilepsy and bipolar disorder, **not indicated for ADHD**
- While Atomoxetine is correct, pairing it with Carbamazepine makes this option incorrect
*I and IV*
- **Carbamazepine** has no role in ADHD management
- **Clonazepam** is a benzodiazepine used for anxiety and seizures, **contraindicated in ADHD** as it causes sedation and may worsen attention deficits
*II and IV*
- While Methylphenidate is a core ADHD medication, **Clonazepam is inappropriate** for ADHD treatment
- Benzodiazepines can impair cognitive function and exacerbate attention problems in ADHD patients
Psychiatry
1 questions
Q111
Specific genetic conditions account for a proportion of Autism Spectrum Disorder (ASD) cases. Which of the following are known to be associated with ASD ?
I. Tuberous sclerosis
II. Fragile X syndrome
III. Prader-Willi syndrome
IV. Patau syndrome
Select the correct answer using the code given below :
UPSC-CMS 2025 - Psychiatry UPSC-CMS Practice Questions and MCQs
Question 111: Specific genetic conditions account for a proportion of Autism Spectrum Disorder (ASD) cases. Which of the following are known to be associated with ASD ?
I. Tuberous sclerosis
II. Fragile X syndrome
III. Prader-Willi syndrome
IV. Patau syndrome
Select the correct answer using the code given below :
A. I and III
B. II and III
C. I and II (Correct Answer)
D. I and IV
Explanation: ***I and II***
- Both **Tuberous sclerosis** and **Fragile X syndrome** are well-established genetic conditions with a strong association with Autism Spectrum Disorder (ASD).
- Tuberous Sclerosis Complex (TSC) is a genetic disorder that causes **benign tumors** to grow in the brain and other organs, and approximately **40-50% of individuals with TSC also have ASD**. Fragile X syndrome is the **most common inherited cause of intellectual disability** and a leading known **single-gene cause of ASD**, with about **25-50% of affected males** meeting the diagnostic criteria for ASD.
*I and III*
- While Tuberous sclerosis is strongly associated with ASD, **Prader-Willi syndrome** has a less consistent and well-defined relationship with ASD despite some overlapping behavioral features.
- Prader-Willi syndrome is characterized by **hyperphagia (insatiable appetite)**, intellectual disability, and behavioral problems, but the autistic-like features may represent a behavioral phenocopy rather than true ASD.
*II and III*
- **Fragile X syndrome** is strongly associated with ASD, but **Prader-Willi syndrome** is not considered a primary or well-established genetic cause of ASD.
- While intellectual disability and behavioral difficulties can be present in both, their underlying genetic mechanisms and core features differ significantly regarding ASD classification.
*I and IV*
- **Tuberous sclerosis** is clearly linked to ASD, but **Patau syndrome (Trisomy 13)** is not associated with ASD.
- Patau syndrome is a severe chromosomal disorder characterized by **multiple congenital abnormalities** and **profound developmental delays**, often leading to early mortality. The severe nature of the condition and high infant mortality rate preclude typical ASD presentation.
Radiology
1 questions
Q111
A radiopaque density may be noticed in poisoning by which of the following agents?
UPSC-CMS 2025 - Radiology UPSC-CMS Practice Questions and MCQs
Question 111: A radiopaque density may be noticed in poisoning by which of the following agents?
A. Chloroquine
B. Phenazopyridine
C. Ethylene glycol
D. Chloral hydrate (Correct Answer)
Explanation: ***Chloral hydrate***
- Due to its halogenated structure, **chloral hydrate** can be radio-opaque on X-rays, making it one of the "CHIPES" substances.
- This property allows for radiological detection of its presence in the **gastrointestinal tract** following ingestion, particularly in large overdoses.
*Chloroquine*
- **Chloroquine** is not significantly radio-opaque and is generally not detectable on plain radiographs following overdose.
- Clinical diagnosis of chloroquine poisoning relies on symptoms such as **hypotension**, **cardiac arrhythmias**, and **hypokalemia**, not radiological findings.
*Phenazopyridine*
- **Phenazopyridine** is a urinary analgesic that does not possess properties that render it radiographically detectable.
- Its metabolism and excretion do not produce **radio-opaque metabolites** or complexes.
*Ethylene glycol*
- **Ethylene glycol** itself is not radio-opaque on plain X-rays, and its presence is typically diagnosed through laboratory tests like anion gap metabolic acidosis.
- While it can lead to the formation of **calcium oxalate crystals** in the kidneys, these are typically microscopic and not visible as general radiopacities in the GI tract.