Medical Science UPSC PYQ 2018

A high maternal mortality rate continues to be a major public health challenge before the country. Keeping that in context, answer the following questions: (i) How is "Maternal Mortality Rate" (MMR) defined? State the major causes of maternal mortality in the country. (ii) The recent data indicates a major decline in MMR in the country. Briefly state, with due reasons, the various governmental initiatives which have led to this favourable decline in maternal mortality rate in India. (iii) The government has grouped the different states in the country in a specific manner to obtain a greater understanding of the ground situation and to map the changes following its initiatives. Briefly outline this strategy, and its benefits.

A 40-year-old male patient is presented with hematuria off and on for the last 4 months. (i) Enumerate the causes of hematuria. (ii) How will you investigate the patient to reach the diagnosis? (iii) Discuss the treatment of renal stones.

A 10-month-old infant having watery nasal discharge for the last 2 days developed rapid breathing, chest retraction and decreased feeding over the last one day. (i) What is the likely diagnosis in this patient? (ii) Enumerate the microbiological agents for this condition. (iii) Discuss the investigations and management of this condition.

(i) Enumerate the indications and complications of colonoscopy. (ii) Outline the principle of primary survey in trauma. (iii) Enumerate the advantages and disadvantages of "laparoscopic surgery".

Describe the pathogenesis of chronic myeloid leukemia (CML). Discuss clinico-pathological features of CML-chronic phase.

Role of PCR (Polymerase Chain Reaction) in the diagnosis and management of Mycobacterium tuberculosis.

Discuss precisely the mechanism of action, clinical uses and side effects of Spiranolactone.

A young woman presented to the emergency department with a history of pesticide intake. She has massive frothing from the mouth and nose. (i) Which is the pesticide she is likely to have consumed? (ii) State what would be the clinical features and management in this patient. (iii) Define the "Intermediate Syndrome" which may occur in this setting and its management.

What are extra pyramidal tracts? Describe their functions. How do they differ from pyramidal tracts?

(i) Describe the aetio-pathogenesis, clinical features and management of "Bipolar Disorder". (ii) Enumerate the side effects of commonly used anti-psychotic drugs.

Write short note on: Interferons and their uses.

Discuss precisely the mechanism of action, clinical uses and side effects of Metformin.

Define metastasis. What are the different pathways for the spread of cancer? Draw a flowchart describing the sequential steps involved in the hematogenous spread of a tumor.

Write down the Development of placenta, discuss the functions and anomalies of it.

Give an account of characteristics of a hormone. Describe the hormonal regulation of calcium level in the blood.

What is folate trap? What are the methods of assessment of vitamin B12 deficiency.

Explain regulation of megakaryocytopoiesis.

(i) Briefly state the basis which led to setting up of the programme "Mission Indradhanush". What are its targets and eventual goals? (ii) More recently, the government has launched "Intensified Mission Indradhanush". Discuss the thoughtline, specific focus, and operative strategy which govern its implementation.

(i) How does Classical scabies differ from "Crusted" scabies infection? (ii) How do you treat "Crusted" scabies infection in an institution?

(i) What are the current guidelines regarding the classification of hypertension? (ii) Enumerate the causes of secondary hypertension. (iii) Enumerate the various anti-hypertensive drugs based on their mechanism of action.

Define impaired glucose tolerance. Discuss the pathogenesis of Type I diabetes mellitus.

Give an account of monophylactic theory of haemopoiesis.

A 25-year-old young patient is presented to the emergency department with severe pain in abdomen for the last 3 hours. On clinical examination, the patient is oriented, but is dehydrated, having tachycardia with a blood pressure of 90/60 mm Hg. (i) Discuss the differential diagnosis of this patient. (ii) How will you investigate the case? (iii) Briefly outline the management of peptic ulcer perforation peritonitis.

Explain why: Aspirin should not be administered concurrently with warfarin.

Explain why: Imipenem, a beta lactam antibiotic is used in combination with cilastatin.

What is the regulatory mechanism of iron absorption at the level of intestine? What is the role of TIBC in iron metabolism? How does the body conserve iron?

(i) Discuss in brief the epidemiological factors which have led to the spread of dengue in different parts of the country. (ii) Discuss in brief the guidelines laid down by the Directorate of National Vector Borne Diseases Control Programme for the prevention and control of dengue.

A 45-year-old multiparous woman presents with a 2-year history of heavy, irregular periods and increasing tiredness. On clinical examination, she appears pale. The uterus is enlarged to 12 weeks in size. The cervix and adnexae are unremarkable. Describe, giving reasons, how you would manage the case.

(i) How does the pattern of rise in human chorionic gonadotropin (HCG) differ between a normal and abnormal pregnancy? (ii) How accurate are most home pregnancy tests? (iii) What are the most common causes of false positive and false negative pregnancy tests?

A 10-month-old infant with "Tetralogy of Fallot" is brought to the paediatric emergency ward with history of excessive crying and then becoming dyspneic, drowsy and bluish. (i) What is the likely diagnosis in this infant? Mention the basis for diagnosis. (ii) Describe the management of this condition.

Discuss the epidemiology, pathogenesis and laboratory diagnosis of a patient presenting with bacillary dysentery.

A 32-week preterm neonate born by a Caesarian section is found to have a respiratory rate of 70/minute, grunting and cyanosis within half an hour of birth. (i) What is the most likely diagnosis in this neonate? (ii) Describe the management of this condition. (iii) Write about its important complications.

Describe Hip Joint under the following headings: 1. Articular surface and Types 2. Ligaments 3. Relations 4. Blood supply and Nerve supply 5. Movement

A 40-year-old lady presents in the OPD with complaint of right breast lump for the last one year, progressively increasing in size. (i) How will you evaluate this patient? (ii) Briefly outline the treatment of "early breast cancer".

Describe the principle of Radio Immuno Assay (RIA). What are the main advantages and disadvantages of RIA technique?

A young male patient came to the medical emergency department with fever, headache and recurrent vomiting. He was also having some skin lesions on both lower limbs and abdomen. On clinical examination, he was drowsy and having neck rigidity. (i) What is his differential diagnosis? (ii) Discuss in brief the clinical manifestations, diagnosis and management of acute meningitis. (iii) What are the causes of recurrent meningitis?

Define nephrotic syndrome and enumerate its components. Discuss pathogenesis, histopathological, electron microscopic and immunofluorescence findings of membranous nephropathy.

List growth promoting hormones. Explain their contribution to growth after birth.

Discuss molecular subtypes of invasive breast carcinoma.

Role of iodine in synthesis and function of thyroid hormone. What is Graves Disease?

Discuss the Functional components, Nucleus, course and distribution of 4th cranial nerve. Add a note on its clinical significance.

Discuss the strategic plans laid down by NACO for diagnosis of individuals with AIDS indicative disease symptoms.

What are modes of contraction in a skeletal muscle? Give suitable examples. Explain length-tension relationship in skeletal muscle.

Discuss pathogenesis and laboratory diagnosis of Dengue haemorrhagic fever.

A 16-month-old child attending Paediatrics OPD with past history of diarrhoea and respiratory infections was found to have loss of subcutaneous fat and weight of 5.5 kilograms. (i) Which physical examination findings would help you to arrive at diagnosis in this child? (ii) Describe the two phases of treatment for this condition.

Describe the pathogenesis of granulomatous immune response in tuberculosis. Discuss gross and histomorphological features of central nervous system (CNS) tuberculosis.

Classify Arches of foot. Write in details about medial longitudinal Arch.

(i) How do combined oral contraceptives (COC) work? (ii) How long can a woman stay on COC? (iii) What effect do the COC have on the menstrual cycle? (iv) What is meant by "breakthrough bleeding"? What are its common causes?

A 70-year-old male, bed-ridden for the last 2 weeks following a fracture of the femoral neck, presented to the medical emergency department with sudden breathlessness and hypotension. (i) What is the likely diagnosis? (ii) How would you diagnose this patient? (iii) What would be the management for this patient?

(i) As per the National Family Health Survey-4, how grave is the situation in India with regard to Nutritional Anaemia. Give statistics substantiating your statement. (ii) Under the "National Iron+ Initiative", which are the specific groups being specially targeted? (iii) What specific interventions are being employed for different target groups under the National Iron+ Initiative? (iv) What are the mechanisms of service delivery being employed to implement the National Iron+ Initiative?

A middle-aged hypothyroid woman on irregular medication became drowsy two days ago following an episode of fever. (i) What could be the causes of drowsiness in this patient? (ii) How will you diagnose and manage the patient? (iii) State cardio-vascular manifestations in hypothyroidism.

Describe risk factors identified for breast carcinoma.

Write notes on issues you would raise in counselling a woman about to be delivered at 28 weeks gestation after placental abruption.

(i) Enumerate the causes of acute hepatitis. (ii) What are the natural history and clinical manifestations of chronic hepatitis-C infection? (iii) What are the direct acting antiviral agents for hepatitis-C infection?

Describe the Coronary Arteries. Add a note on cardiac dominance.

Describe the External, Internal features, parts of cerebellum. Add a note on the constitution of cerebellar peduncles.

Explain why: Patients chronically administered morphine remain constipated.

Describe the structure of tRNA in detail. What is the energetics of synthesis of one peptide bond? What are the inhibitors of protein synthesis?

Describe the aetio-pathogenesis, clinical features, investigations and management of varicose veins of lower limbs.

Write short note on: Monoclonal antibody and its application.

Discuss briefly the formula used for calculating the 'Total Body Surface Area' involved in burns in an adult and a child.

Explain the changes which takes place during luteal phase of menstrual cycle.

(i) Write a short note on the management of a case of aluminium phosphide poisoning. (ii) Enumerate 6 major Blood Groups. Give the Mendel's laws of inheritance of the blood groups and their role in disputed paternity testing.

What are different classes of drugs used in the treatment of hypertension? Discuss the mechanism of action, clinical uses and adverse effects of Sodium nitroprusside.

Define 'Head Injury'. What is the mechanism of 'Coup' and 'Contre Coup' brain damage.

(i) Describe various theories which have been proposed to explain the pathogenesis of vitiligo. (ii) How do you assess the severity of vitiligo? (iii) Describe the lines of treatment of various grades of the disease.

Discuss the adverse effects associated with the use of antimicrobial agents.

(i) Write the laboratory diagnosis and complication of Plasmodium falciparum infection. (ii) Enumerate species of Aspergillus, infections caused and laboratory diagnosis of aspergillosis.

What are the possible reasons for "unexplained" infertility?

A 13-month-old boy was brought by his mother with six episodes of loose stools and persistent vomiting to the emergency ward. He was found to be lethargic and his pulse rate was 160 per minute. (i) What are the danger signs you would ask for and look for in this child to assess the severity of his illness? (ii) If you find severe dehydration, how will you treat the child? (iii) If the child is fit to be discharged, yet has 2-3 episodes of loose stools, what advice would you give to the mother?

Define the term "cardiac reserve". Explain how is its control governed?

Define 'Rape' as per Criminal Law Amendment Act, 2013. An 11 yr old girl is brought to casualty with alleged history of rape 2 hours ago. Discuss the medico-legal examination in detail, including the samples that are to be collected.