Medical Science UPSC PYQ 2023

(a) A 65-year-old lady has progressively increasing dysphagia for last 6 months. She also has significant weight loss. How will you investigate her? (b) A 42-year-old male, known case of alcoholic liver disease with portal hypertension, is brought to casualty with severe haematemesis. Describe the management of this case. (c) (i) Name any five risk factors associated with pelvic organ prolapse. (ii) Enlist the management options for a 60-year-old postmenopausal lady with procedentia with cystocoele with enterocele with rectocoele. (d) Define chronic pelvic pain. What are the various causes of chronic pelvic pain in women? (e) The Janani-Shishu Suraksha Karyakram is a unique national initiative of the Government of India. State in brief the entitlements to pregnant women and neonates under this scheme. <!--qid:MAINS_2023_Medical_Science-II_Q5-->

(a) (i) Describe the morphological characteristics of Cryptococcus neoformans on microscopic examination. Discuss the pathogenesis of Cryptococcosis. (ii) Define meningococcaemia. Discuss laboratory diagnosis of acute meningococcal meningitis. Briefly write about the available meningococcal vaccines to prevent the disease. <!--qid:MAINS_2023_Medical_Science-I_Q8-->

(a) (i) Enumerate the causes for postpartum haemorrhage (PPH). (ii) Discuss the management of PPH. (b) (i) Enumerate the signs of lower limb arterial ischaemia. (ii) Briefly outline the diagnostic workup in a 62-year-old male with atherosclerotic lower limb peripheral arterial disease. (iii) State the management of this case. (c) The National Rural Health Mission is committed towards improving rural healthcare delivery system in the country. State the major initiatives that have been undertaken under this Mission to strengthen the healthcare infrastructure in rural areas. <!--qid:MAINS_2023_Medical_Science-II_Q6-->

(a) A 20-year-old male has presented to the medicine OPD. He has complaints of episodes of breathlessness associated with tightness of chest and wheezing since the childhood. These episodes occurred commonly during the change of season. (i) What is the most probable diagnosis? (ii) How will you confirm the diagnosis? (iii) Discuss in short the clinical features of the disease. (iv) Outline the stepwise approach to the management of the disease. (b) (i) What are the criteria for the identification of severe acute malnutrition (SAM) in children 6 months to 59 months of age? (ii) Enumerate the criteria for admission in the facility-based care for severe acute malnutrition. (iii) Write ten steps in the management of SAM. (c) Discuss in short the role of X-ray imaging in diagnosing a case of acute abdomen. <!--qid:MAINS_2023_Medical_Science-II_Q4-->

(a) (i) Describe the role of SRY (Sex-determining region on Y gene) transcription factors in testicular development. (ii) Describe Vitelline duct abnormalities. (b) (i) Describe the role of iodine in the synthesis of thyroid hormones. Discuss briefly about Hashimoto’s Thyroiditis and the biochemical investigations that will be done for its diagnosis. (ii) Explain briefly the biochemical role of Vitamin-K in the body. What is the biochemical basis of using Warfarin as an anticoagulant drug ? (c) (i) Describe the functions of vasopressin and the regulation of vasopressin secretion. (ii) Describe the physiological effects of glucagon. <!--qid:MAINS_2023_Medical_Science-I_Q4-->

(a) Classify the various types of poisons. Enumerate the features of Plumbism. Discuss the tests which will show/establish the onset of early stages of Pb poisoning. <!--qid:MAINS_2023_Medical_Science-I_Q7-->

SECTION A (a) A 35-year-old male smoker with complaints of difficulty in swallowing and ulcer on the tip of his tongue for the last one month, visits an ENT surgeon. Based on his clinical examination and histopathological investigation of the tongue lesion, he is diagnosed as a case of carcinoma of tongue with cervical lymphadenopathy. (i) Using a flow-chart, show the principal lymph node involved and its further distribution. (ii) Explain the role of tongue in swallowing. (b) Describe the following in the context of ‘Auditory pathway’ : (i) Its course from internal ear to auditory cortex (ii) Blood supply of the auditory cortex (c) Discuss the sources and Recommended Daily Allowance (RDA) of Folic Acid and the clinical manifestations of its deficiency in the body. Add a note on ‘Folate Trap’. (d) Describe the role of cerebellum in control of voluntary movement. Add a note on cerebellar dysfunction. (e) Describe the genesis of Rapid Eye Movement (REM) sleep. Why is REM sleep called paradoxical sleep ?2b:["$", <!--qid:MAINS_2023_Medical_Science-I_Q1-->

(a) (i) Enumerate any five risk factors for oral cancer. Describe its morphology. (ii) Enumerate five causes of membranous glomerulonephritis. Describe its morphology. <!--qid:MAINS_2023_Medical_Science-I_Q6-->

(a) A 56-year-old male visits a surgery OPD with complaints of difficulty in passage of urine especially on straining. Based on his clinical examination and ultrasound findings, he is diagnosed with Benign hypertrophy of Prostate. (i) What is the anatomical basis of his urinary problems? (ii) Describe the relations of Prostate gland. (iii) Describe the blood supply and lymphatic drainage of Prostate gland. (b) (i) Describe the biochemical role of copper in the body. Discuss briefly about Wilson disease and the biochemical investigations that will help in its diagnosis. (ii) Define Genetic code and explain the Wobble Hypothesis. Discuss briefly the post-translational modifications of proteins. (c) Explain the physiological changes that occur in a mother during pregnancy, under the following headings : (i) Genital organs (ii) Blood and its constituents (iii) Cardiovascular system <!--qid:MAINS_2023_Medical_Science-I_Q2-->

(a) Enumerate various classes of antihypertensive drugs. Briefly discuss the role of calcium channel blockers in the treatment of hypertension. <!--qid:MAINS_2023_Medical_Science-I_Q5-->

(a) A 30-year-old female has been brought to medical emergency with a history of low-grade fever, headache, anorexia and weight loss for the last one month. She has also developed diplopia and altered sensorium for the last two days. (i) What is the most likely diagnosis? (ii) Enumerate the investigations required to confirm the diagnosis. (iii) Differentiate between the CSF findings in pyogenic, tubercular and viral meningitis. (iv) Outline the treatment plan in this patient. (b) A 2-year-old boy was brought to the emergency with the complaints of sudden onset of respiratory distress with irritability. On examination, the child is disoriented and he has both peripheral and central cyanosis. He has deep sighing respiration with SpO₂ < 65% at room air. On oxygen therapy, his SpO₂ is increased to 80%. He has no organomegaly or neurological deficit. (i) Write the complete diagnosis of this boy. (ii) How will you manage this case in emergency? (iii) Classify the congenital cyanotic heart diseases. (c) A 48-year-old male presented with yellowish, greasy scales and redness over the scalp. (i) What is the most likely diagnosis? (ii) Mention the sites of involvement in this disease. (iii) Name the organism responsible for the pathogenesis of this disease. (iv) Outline its treatment.38:[ <!--qid:MAINS_2023_Medical_Science-II_Q2-->

(a) Discuss in short the aetiology, clinical features, investigations and management of chronic renal failure. (b) (i) Write the causes of unconjugated hyperbilirubinemia in a newborn. (ii) What is the mechanism of action of phototherapy in the treatment of hyperbilirubinemia? (iii) What are the potential complications of the phototherapy? (c) (i) Mention the nail findings in psoriasis. (ii) Discuss the topical and systemic therapies in psoriasis. <!--qid:MAINS_2023_Medical_Science-II_Q3-->

(a) (i) Describe the following regarding the knee joint : (I) All movements including locking and unlocking with muscles responsible for each (II) Role of cruciate ligaments in movement and stability (ii) Describe Carpal Tunnel Syndrome under the following headings : (I) Causes and structure(s) involved (II) Clinical features (b) (i) Explain the principle and steps of Polymerase Chain Reaction (PCR). Write its clinical applications. (ii) Discuss the serum biochemical markers of cholestasis. (c) (i) Describe the intrinsic regulation of cardiac output. (ii) Discuss the factors regulating erythropoiesis. <!--qid:MAINS_2023_Medical_Science-I_Q3-->

(a) (i) Enlist the clinical features of dengue fever. (ii) Outline the management of a patient with dengue haemorrhagic fever. (b) Write the symptoms of schizophrenia. (c) (i) What is the full form of IMNCI and what are its objectives? (ii) What are the components of integrated care provided under IMNCI? (d) State the immunization schedule under the National Immunization Programme for infants and children. (e) A 40-year-old male presented with multiple itchy, violaceous, flat-topped papules over skin for the last one year. He also complained of burning sensation in mouth. (i) Diagnose this condition. (ii) What are the oral findings which can be associated with this condition? (iii) Outline its management. <!--qid:MAINS_2023_Medical_Science-II_Q1-->