PAPER : UPSC MODEL PAPER PATTERN 2008-09

 PAPER-II

SURGERY,Gynaecology AND OBSTETRICS,PREVENTIVE AND SOCIAL MEDICINE


1.A pt. Aged 35 yrs has cystosarcoma phylloides.What is the treatment of choice?
a.lumpectomy
b.simple mastectomy alone
c.simple mastectomy+axillary clearance
d.simple mastectomy+loco regional radiation


2.Common bile duct injuries are most commonly seen in :
a.radical gastrectomy
b.penetrating injuries of abdomen
c.ERCP & sphincterotomy
d.laproscopic cholecystectomy operation


3.Fibroblast in healing wound is derived from:
a.local mesenchyme
b.epithelium
c.endothelium
d.vascular fibrosis


4.Match list I & list II & select the correct answer using the code given below the lists
list-I list-II
(agent type) (product name)
A. debriding agent 1.opsite,tegaderm
B. polymeric film 2.porcine skin,amnion
C. hydrocolloids 3.Benoxyl benzoic acid
D. biological membranes 4.comfeel granuflex

CODES:
A B C D
a. 2 1 4 3
b. 3 4 1 2
c. 3 1 4 2
d. 2 4 1 3

5.Which one of the following factors is labelled as cytokines in the pathogenesis of SIRS(systemic inflammatory response syndrome)?
a.nitric oxide
b.complements
c.leukotriens
d.tumor necrosis factor


6.Radiotherapy is the treatment of choice for which one of the following tumors?
a.verrucous carcinoma
b.malignant melanoma
c.marjolin’s ulcer
d.rodent ulcer


7.Match list-I with list-II & select the correct answer using the code given below the lists:
list-I list-II
(pathogenesis) (cyst type)
A.persistent normal vestigial remnants 1.dermoid
B. hamartomas 2.meckel’s diverticulum
C.remnant of vitellointestinal tract 3.cystic hygroma
D.ectopia of various tissues 4.thyroglossal,branchial cyst

CODE:
A B C D
a. 1 2 3 4
b. 1 3 2 4
c. 4 2 3 1
d. 4 3 2 1


8.Which one of the following is the most common tumor to produce metastasis to cervical lymh nodes?
a.glottic carcinoma
b.nasopharyngeal carcinoma
c.carcinoma base of tounge
d.carcinoma lip

9.In primry hyperparathyroidism which one of the following is the most common finding?
a.solitary adenoma
b.double adenoma
c.hyperplasia of two or more glands
d.carcinoma


10.Crush syndrome is managed by which one of the following?
a.20% dextrose
b.hydrocortisone
c.maintaining high urine output
d.acidification of urine


11.Which one of the following is not a symptom of atherosclerosis occlusive disease at the bifurcation of aorta(Leriche syndrome)?
a.claudication of the buttock & thigh
b.claudication of the calf
c.sexual impotence
d.acidification localised to the feet


12.Cocket & Dodd’s operation is performed for which one of the following?
a.saphenofemoral flush ligation
b.subfascial ligation
c.deep vein thrombosis
d.diabetic foot


13.Which vital structures is preserved during radical neck dissection?
a.vagus nerve
b.submandibular gland
c.sternocleidomastoid
d.internal jugular vein


14.Which of the following receptors are missing from the surface of the intestines?
a.temprature
b.pressure
c.distension
d.touch


15.Mallory-Weiss tear occurs at :
a.gastro-esophageal junction
b.duodenal-jejunal flexure
c.ileo-caecal junction
d.colo-rectal junction


16.Consider the following statements regarding paget’s disease of the breast:
1.It is a malignant disease
b.diagnosis can be established by scrape cytology.
c.lymph nodes involvement is an associated clinical features
d.treatment of choice is simple mastectomy.
Which of the statements given above is/are correct?
a.1,2 & 4 only
b.1,2 & 3 only
c.3 & 4only
d.1,2,3 & 4

17.Which breast carcinoma is multi-centric & bilateral?
a.ductal
b.lobular
c.mucoid
d.colloid


18.What is the most common malignancy affecting spleen ?
a.angiosarcoma
b.hamartoma
c.secondaries
d.lymphoma


19.Which one of the following is the treatment of gall stone ileus?
a.cholecystectomy alone
b.removal of obstruction
c.cholesystectomy,closure of fistula & removal of stone by enterostomy
d.cholecystectomy with closure of fistula


20.Consider the following conditions:
1.choledochal cyst
2.choledocholithiasis
3.sclerosing cholangitis
d.mirizzi’s syndrome
Pain,fever & jaundice are associated with which one of the above conditions?
a.1,2& 3 only
b.1,2,3 & 4
c.1,3&4 only
d.2& 4 only


21.Which one of the following is management of pancreatic abscess?
a.needle aspiration
b.gastrocystostomy
c.external drainage
d.jejunocystostomy


22.Treatment of choice for desmoid tumor?
a.irradiation
b.wide excision
c.local excision
d.local excision following radiation

23.Match list-I with list-II & select the correct answer using the code given below the lists:
list-I list-II
(disease) (sign)
A. acute cholecystitis 1.kehr’s sign
B.acute pancreatitis 2.courvaisie’s sign
C. splenic rupture 3.cullen’s sign
d.pancreatic cancer 4.murphy’s sign
codes:
A B C D
a. 2 1 3 4
b. 4 3 1 2
c. 2 3 1 4
d. 4 1 3 2


24.When a ‘spontaneous perforation’ of esophagus occurs as a result of severe barotrauma while a person vomits aginst a closed glottis,what is the condition known as ?
a.Mallory-weiss syndrome
b.plummer vinson syndrome
c.kartergener syndrome
d.Boerhaave syndrome


25.Match list-I with list-II & select the correct answer using the code given below the lists:
List-I List-II
(radiological finding regarding esophagus) (disease)
A. smooth pencil shaped narrowing of 1.Diffuse spasm
lower segment
B.esophageal web 2.esophageal carcinoma

C.rat tail appear. 3.achalasia of esophagus

D.corkscrew esophagus 4.plummer-vinson syndrome

CODES:
A B C D
a. 1 2 3 4
b. 3 4 2 1
c. 3 2 4 1
d. 1 4 2 3


26.Which one of the following stomach cancers carries the best prognosis?
a.superficial spreading type
b.ulcerative type
c.liniticus plastica type
d.polypoidal type


27.Most common type of carcinoma of the rt colon?
a.stenosing
b.ulcerative
c.tubular
d.fyngating


28.High or low fistula in ano is termed according to its internal opening present with reference to :
a.anal canal
b.dentate line
c.anorectal ring
d.sacral promontary


29.The following are indications for perfoming thoracotomy after blunt injury of the chest except:
a.1000 ml drainage after placing an intercostal tube
b.continuous bleeding thr’ intercostal tube of more than 200 ml/hr for 3 or more hrs
c.cardiac tamponade
d.rib #


30.What is the first step taken in case of multiple injuries to face & neck?
a.blood transfusion
b.IV fluids
c.reconstruction
d.mainatainanace of airway


31.Which one of the following is not a wound closure technique?
a.partal thickness graft
b.complete graft
c.vascular graft
d.musculocutaneous graft


32.Ductous arteriosus closes in response to :
a.decrease in peripheral oxygen saturation
b.indomethacin therapy
c.PGE1
d.increase in pulmonary vascular resistance


33.Clinical features a/w coarctation of aortain older children are the following except:
a.upper body hypertension
b.prominent pulsation in the neck
c.fatiguaableness,tiredness in leg
d.absence of flow murmur over scapular region


34.What is the treatment of choice in severe flail chest?
a.IPPV
b.strapping
c.wiring
d.nasal oxygen


35.With reference to ESWL, consider the following statements:
a.It is the treatment of choice for stones larger than 2 cm
b.it is c/I in pregnancy
c.it is TOC for lower pole stones
d.it is a/w stein stress phenomenon
Which of the statements given above are correct?
a.1,2& 3 only
b.2 & 4only
c.3 & 4 only
d.1,2,3 & 4


36.Typical appearance of “spider leg” on excreatory urography is seen in :
a.hydronephrosis
b.polycystic kidney
c.medullary sponge kidney
d.renal cell carcinoma


37.What is the most common presentation of intracranial aneurysm?
a.coarctation of aorta
b.systemic hypertension
c.hypotension
d.intracranial haemorrhage


38.Pneumatosis intestinalis on a plain abdominal radiograph is seen in which of the following?
a.congenital atresia of bowel
b.meconium ileus
c.volvulus neonatorum
d.necrotising enterocolitis


39.With reference to fresh frozen plasma,which one the following statements is not correct?
a.it is used as volume expander
b.it is stored at –40 to –50 degree
c.it is a source of coagulation factors
d.it is given in a dose of 12-15 ml/kg body wt.


40.Vocal cord palsy in thyroid surgery is due to injury to:
a.superficial laryngeal nerve
b.recurrent laryngeal nerve
c.ansa cervacalis
d.vagus nerve


41.Cholestasis may lead to the following complications except:
a.intrauterine fetal death
b.meconium stained liquor
c.preterm labour
d.neonatal jaundice


42.In modern obstetrics,the internal podalic version is indicated in the presence of:
a.transverse lie with obstructed labour
b.2nd transverse twin
c.cord prolapse with live baby
d.extended breech presentation


43.Which one of the following statements regarding breast feeding is not correct?
a.breast feeding shud start within 1 hr after a normal delivery
b.colostrum shud be given to the baby
c.time schedule breast feeding is preferable to demand breast feeding
d.breast feeding alone shud be given for the first 6 months


44.Medical management of ectopic pregnancy can be done in the following except:
a.period of gestation 5 wks
b.beta-HCG level 6000 IU
c.absent fetal cardiac activity
d.gestational sac diameter 3 cm


45.Consider the following in a new born:
1.heart rate of 110
2.slow & irregular respiratory effort
3.flaccid muscle tone
4.no reflex irritability
5.blue colour
What is the apgar score in this case?
a.1
b.3
c.5
d.7

46.Non-immune hydrops fetalis is due to the following except:
a.alpha thalassemia major
b.functional abnormalities of heart
c.ABO incompatibility
d.toxoplasmosis


47.Consider the following statements regarding a cephal-haematoma:
1.present at birth
2.it can occur after a normal delivery
3.Commonest site is over the parietal bone
4.the bleeding is sub-periosteal
Which of the statements given above are correct in the context of cephal-haematoma?
a.1 & 4
b.1 & 2 only
c.1,2, & 3
d.2,3 & 4


48.In a newborn,what is the normal respiratory rate?
a.10-20 breath/min
b.30-40 breath/min
c.40-60 breath/min
d.60-80 breath/min


49.The following changes occur in idiopathic respiratory distess syndrome of the newborn except?
a.alveolar collpase
b.left to rt vascular shunting through the alveolar capillaries
c.increased pulmonary vascular resistance
d.dilatation of the ductus arteriosus


50.Which of the following is the earliest changes in the endometrium after ovulation?
a.secretion in the lumina of the endometrial glands
b.subnuclear vacuolation
c.corckscrew shaped glands
d.stromal cells become oedematous,enlarged & polyhedral in shape


51.Consider the following four events of development of fetus:
1.development of external genitalia
2.appearance of scalp hair
3.centres of ossification in bones
4.formation of eyelashes & eye-brows
What is the order in which they appear from lower to higher gestation?
a.1,3,2,4
b.1,3,4,2
c.3,1,4,2
d.3,1,2,4


52.In which of the following,chorionic villous sampling procedure can be adopted for diagnosis?
a.achondroplasia
b.neural tube defects
c.marfan’s syndrome
d.trisomy 18


53.From which of the following does clitoris develop:
a.congenital ridge
b.urogenital folds
c.genital tubercle
d.labioscrotal swelling


54.Which of the following physiological changes first to appear at the onset of puberty?
a.growth of breast & increase in ht
b.appearance of pubic & axillary hair
c.onset of menstruation
d.acne on the face


55.Which of the following is the definative treatment of adenomyosis?
a.LN 6-intrauterine device
b.GnRH analogues
c.danazol
d.hysterectomy


56.Which one of the following conditions of the endometrium is a/w a significantly increased risk of cancer?
a.adenomatous hyperplasia
b.hyperplasia with atypia
c.cystic glandular hyperplasia
d.proliferative phase


57.In an adult phenotypic female,absence of uterus suggest diagnosis of which one of the following?
a.Mayer rokitansky kuster hauser syndrome
b.congenital adrenal hyperplasia
c.true hermaphrodite
d.5-alpha-reductase deficiency


58.Which one of the following drugs are effective in DUB when the endometrial biopsy shows secretary pattern?
1.Medroxyprogesterone acetate
2.combined preparation of progesterone & estrogens
3.PG synthetase inhibitors
Select the correct answer using the codes given below:
a.1,2,3
b.1,2 only
c.2,3 only
d.1,3 only


59.Which one of the following genital infections is a/w preterm labour?
a.HPV
b.tricmonas vaginitis
c.monilial vaginitis
d.bacterial vaginosis


60.The following are long term complications of PCOS(polycystic ovarian syndrome) except:
a.type II DM
b.cardiovascular disease
c.endometrial cancer
d.ovarian cancer