UPSC-CMS 2025 Practice Questions

Q: Which of the following are congenital abnormalities of the gall bladder? I. The phrygian cap II. Floating gall bladder III. Absence of gall bladder IV. Spigelian gall bladder Select the correct answer using the code given below :

I, II and III. **I, II and III** - **Phrygian cap**, **floating gallbladder**, and **absence of gallbladder** are all recognized congenital anomalies of the gallbladder. [1] - These conditions arise from variations in gallbladder development during the **embryonic period**. *I, II and IV* - This option incorrectly includes **Spigelian gallbladder** (IV) as a congenital anomaly, while excluding **absence of gallbladder** (III). - The Spigelian lobe is a part of the liver, and **Spigelian hernia** is a distinct condition, not a congenital anomaly of the gallbladder itself. *II, III and IV* - This option incorrectly includes **Spigelian gallbladder** (IV) as a congenital anomaly and excludes the **Phrygian cap** (I), which is a common and benign congenital variation. - The Phrygian cap represents a folding of the gallbladder fundus and is universally recognized as congenital. *I, III and IV* - This option incorrectly includes **Spigelian gallbladder** (IV) as a congenital anomaly and excludes the **floating gallbladder** (II). - A floating gallbladder, due to a long mesentery, is a known congenital anatomical variation that can predispose to torsion. [1]

Q: Resection of which part of intestine does not significantly affect fluid and electrolyte balance?

Distal jejunum. ***Distal jejunum*** - The distal jejunum has significant **adaptive capacity** to take over the absorptive functions of other parts of the small intestine if they are resected. - Its resection typically has the **least impact** on fluid and electrolyte balance compared to other segments of the intestine, as critical absorption of most nutrients, water, and electrolytes occurs more proximally or distally. *Ileum* - The ileum is crucial for the absorption of **vitamin B12** and **bile salts**; its resection can lead to **malabsorption** and severe diarrhea. - Loss of bile salt absorption can result in **fat malabsorption** and lead to fluid and electrolyte disturbances. *Proximal jejunum* - The proximal jejunum is the primary site for the absorption of most **nutrients** (carbohydrates, proteins, fats), **water**, and **electrolytes**. - Its resection can lead to significant **malnutrition** and severe fluid and electrolyte imbalances due to widespread malabsorption. *Colon* - The colon is responsible for the final absorption of **water** and **electrolytes**, compacting stool for elimination. - Its resection can severely impair the body's ability to conserve water and electrolytes, leading to **dehydration** and electrolyte disturbances.

Q: Good measure of systemic perfusion on ABG is:

Lactate and / or the base deficit. ***Lactate and / or the base deficit*** - **Lactate** is a direct indicator of **anaerobic metabolism**, which occurs when tissue oxygen supply is insufficient to meet demand, reflecting poor systemic perfusion. - **Base deficit** (or base excess) quantifies the overall metabolic acid-base status and is sensitive to changes in unmeasured anions like lactate, making it a good marker of **tissue hypoperfusion** and metabolic acidosis. *Bicarbonate* - While bicarbonate reflects the body's primary **buffer system**, changes in bicarbonate can be influenced by both respiratory and metabolic processes and thus are not as specific a marker for systemic perfusion as lactate or base deficit. - A low bicarbonate often indicates **metabolic acidosis**, but it doesn't pinpoint the cause as precisely as lactate, which directly reflects anaerobic metabolism. *PCO2* - **PCO2** primarily reflects the **ventilatory status** and respiratory component of acid-base balance. - While extreme changes can indirectly affect perfusion (e.g., hypercapnia leading to vasodilation), it is not a direct or reliable measure of **systemic tissue perfusion**. *pH* - **pH** indicates the overall acid-base balance but is a **composite measure** influenced by both respiratory (PCO2) and metabolic (bicarbonate, lactate) factors. - It does not specifically isolate **perfusion deficits** as clearly as lactate or base deficit, which directly reflect metabolic responses to tissue hypoxia.

Q: Which of the following are functions of the gall bladder? I. Reservoir for bile II. Production of bile III. Secretion of mucus IV. Concentration of bile Select the correct answer using the code given below :

I, III and IV. ***I, III and IV (Correct)*** - The gallbladder **stores bile** produced by the liver, acting as a reservoir (I) until it's needed for digestion. - It **concentrates bile** 5-20 fold (IV) by absorbing water and electrolytes through its epithelium. - The gallbladder epithelium **secretes mucin** (III), which forms a protective mucous layer. - The gallbladder does **NOT produce bile** (II) - this is exclusively a function of hepatocytes in the liver. *II, III and IV (Incorrect)* - This option incorrectly includes bile production (II), which is **not a function of the gallbladder**. - The **liver produces bile**; the gallbladder only stores and concentrates it. - While III and IV are correct functions, the inclusion of II makes this option wrong. *I, II and III (Incorrect)* - This option incorrectly states that the gallbladder produces bile (II), which is a **hepatic function**. - Additionally, it omits bile concentration (IV), which is one of the **primary functions** of the gallbladder. - Only I and III are correct in this combination. *I, II and IV (Incorrect)* - This option incorrectly includes bile production (II) as a gallbladder function. - The gallbladder's actual roles are **storage (I), concentration (IV), and mucus secretion (III)** - not bile production.

Q: The commonest site of pressure sore is :

Heel. ***Heel*** - The **heel** is a common site for pressure sore development, especially in bedridden or immobile patients, due to sustained pressure on the bony prominence. - While less common as the *most* common site compared to the sacrum, it is still very frequently affected and can be equally severe. *Sacrum* - The **sacrum** is the *most common site* for pressure ulcers, particularly in individuals who are bed-bound or spend prolonged periods in a supine position. - This area experiences high pressure when lying on the back due to the body's weight pressing down on the bony prominence of the sacrum [1]. *Ischium* - The **ischial tuberosities** are common sites for pressure sores in individuals who are wheelchair-bound or spend extended periods in a seated position. - Pressure on this area is particularly high when sitting, making it vulnerable to tissue damage. *Occiput* - The **occiput** (back of the head) is a common site for pressure sores in infants, critically ill patients, or individuals who are supine for extended periods and unable to reposition their heads. - This is due to sustained pressure on the bony prominence of the skull against the mattress or support surface.

Q: Which of the following statements are correct regarding ABCDE of trauma care ? I. A stands for Airway with cervical spine protection II. B stands for Breathing and ventilation III. C stands for Control of massive external haemorrhage IV. D stands for Disability (Neurological status) Select the answer using the code given below :

I, II and IV. ***I, II and IV*** - All statements I, II, and IV accurately describe components of the **ABCDE approach in trauma care**. - **A** is for **Airway maintenance with cervical spine protection**, **B** for **Breathing and ventilation**, and **D** for **Disability (neurological status)**. - These are the core components as per **ATLS (Advanced Trauma Life Support) guidelines**. *I, II and III* - This option is incorrect because statement III is **incomplete and inaccurate**. - In the standard ATLS primary survey, **C stands for Circulation with hemorrhage control**, not just "Control of massive external haemorrhage." - While controlling hemorrhage is a critical part of 'C', the primary focus is on assessing and managing **circulation** (shock, perfusion, bleeding). - Note: ATLS 10th edition introduced ** for catastrophic hemorrhage** in tactical settings, but this is a separate step before A, not a replacement for C. *II, III and IV* - This option is incorrect as it omits statement I, which correctly describes **A as Airway with cervical spine protection**, the first and most critical step in trauma management. - Statement III also incorrectly describes what 'C' represents in the ABCDE approach. *I, III and IV* - This option is incorrect because it omits statement II, which correctly identifies **B as Breathing and ventilation**, an essential assessment following airway management. - Statement III is incomplete as it fails to mention that **C primarily stands for Circulation** (with hemorrhage control as one component).

Q: Which of the following statements are correct regarding Inguinal hernias in children? I. It is more common in premature boys. II. It should be repaired promptly. III. It is always indirect. IV. It may frequently be transilluminant. Select the answer using the code given below :

I, II and III. ***I, II and III*** - **Statement I is correct**: Inguinal hernias are significantly **more common in premature boys**, with an incidence of up to **30% in preterm infants** compared to 3-5% in term infants. Male predominance is marked (6-10:1 ratio). - **Statement II is correct**: Pediatric inguinal hernias should be **repaired promptly** (elective basis) due to the high risk of **incarceration and strangulation**, especially in infants under 1 year where the risk can be as high as 31%. - **Statement III is correct**: All inguinal hernias in children are **indirect hernias**, occurring through a **patent processus vaginalis**. Direct hernias are extremely rare in the pediatric population and represent adult pathology. - **Statement IV is incorrect**: Inguinal hernias are typically **NOT transilluminant** because they contain solid abdominal contents like bowel or omentum. **Transillumination** is a characteristic feature of **hydroceles** (fluid-filled), not hernias. *II and III* - While statements II and III are correct, this option is **incomplete** as it omits Statement I, which is also factually correct regarding the increased incidence in premature boys. *I, III and IV* - Statements I and III are correct, but **Statement IV is false**. Inguinal hernias do **not transilluminate** because they contain bowel or omentum, not fluid. Transillumination distinguishes hydroceles from hernias. *I, II and IV* - Statements I and II are correct, but **Statement IV is false** (hernias are not transilluminant), and Statement III is omitted despite being a fundamental characteristic of pediatric inguinal hernias (always indirect).

Question 1

Which of the following are congenital abnormalities of the gall bladder?
I. The phrygian cap
II. Floating gall bladder
III. Absence of gall bladder
IV. Spigelian gall bladder

Select the correct answer using the code given below :

Accepted Answer

I, II and III

Answer

I, II and IV

Answer

II, III and IV

Answer

I, III and IV

Question 2

Which one of following statements is correct regarding Budd-Chiari Syndrome (BCS)?

Accepted Answer

Abdominal discomfort and ascites are the main presenting features.

Answer

Venous drainage of the liver is occluded by IVC thrombus.

Answer

It principally affects young males.

Answer

Quadrate lobe (Segment 4) undergoes hypertrophy.

Question 3

Resection of which part of intestine does not significantly affect fluid and electrolyte balance?

Accepted Answer

Distal jejunum

Answer

Ileum

Answer

Proximal jejunum

Answer

Colon

Question 4

Good measure of systemic perfusion on ABG is:

Accepted Answer

Lactate and / or the base deficit

Answer

Bicarbonate

Answer

PCO2

Answer

pH

Question 5

Which of the following are functions of the gall bladder?
I. Reservoir for bile
II. Production of bile
III. Secretion of mucus
IV. Concentration of bile

Select the correct answer using the code given below :

Accepted Answer

I, III and IV

Answer

II, III and IV

Answer

I, II and III

Answer

I, II and IV

Question 6

The commonest site of pressure sore is :

Accepted Answer

Heel

Answer

Sacrum

Answer

Ischium

Answer

Occiput

Question 7

Which one of the following is correct regarding splenic artery aneurysm?

Accepted Answer

It is most commonly located in the middle third of the splenic artery.

Answer

It is generally multiple in number.

Answer

It is caused due to blunt trauma to the abdomen.

Answer

It is twice as common in men.

Question 8

Which of the following statements are correct regarding primary survey/management of traumatic head injury patient?
I. Ensure adequate oxygenation and circulation
II. Exclude hypoglycaemia
III. Check for mechanism of injury
IV. Check pupil size and response

Select the answer using the code given below :

Accepted Answer

I, II and IV

Answer

II, III and IV

Answer

I, III and IV

Answer

I, II and III

Question 9

Which of the following statements are correct regarding ABCDE of trauma care ?
I. A stands for Airway with cervical spine protection
II. B stands for Breathing and ventilation
III. C stands for Control of massive external haemorrhage
IV. D stands for Disability (Neurological status)
Select the answer using the code given below :

Accepted Answer

I, II and IV

Answer

I, II and III

Answer

II, III and IV

Answer

I, III and IV

Question 10

Which of the following statements are correct regarding Inguinal hernias in children?
I. It is more common in premature boys.
II. It should be repaired promptly.
III. It is always indirect.
IV. It may frequently be transilluminant.

Select the answer using the code given below :

Accepted Answer

I, II and III

Answer

II and III

Answer

I, III and IV

Answer

I, II and IV

UPSC-CMS 2025

Anatomy

Internal Medicine

Physiology

Surgery