IAS Mains Previous Years Paper : Medical Sciences (2007)

PAPER - I
SECTION A
1. Attempt any three of the following questions :
(a) Describe pelvic diaphragm, write in brief about its applied anatomy. (20)
(b) Draw a schematic labelled diagram of a transverse section of thorax passing through the sternal angle. Also enumerate branches of thoracic aorta. (20)
(c) What are the hormones which regulate growth and development of human body during adolescence ? How development is regulated by them ? (20)
(d) Describe the mechanism of mineralization of bone. Enumerate the clinical features of deficiency of the factor responsible for mineralization. (20)

2. (a) Give an outline of anatomy of facial nerve mentioning its clinical significance. (20)
(b) Describe in short the normal and anomalous development of urinary bladder. (20)
(c) Describe neuronal pathways and reflexes which maintain balance and posture of human body. (20)

3. (a) Describe the normal development and differentiation of haemotopoitic cells. (20)
(b) What are the properties and functions of pulmonary surfactants. Discuss the pulmonary function tests. (20)
(c) Describe the endocrine functions of hypothalamus. Enumerate the clinical features of Acromegaly. (20)

4. (a) Discuss the physiology of normal sleep. (20)
(b) Describe the control and regulation of normal homeostasis. (20)
(c) What is Henderson-Hasselbach equation ? How is the acid base balance maintained in the body ? (20)

SECTION B
5. Attempt any three of the following questions :
(a) Discuss the type and mechanism of Ischemic cell injury. (20)
(b) Discuss the pathophysiology and laboratory diagnosis of Cholera. How does classical vibrio cholerae differ from Eltor vibrio? (20)
(c) Describe the mechanism of action of Retro-viral drugs in different stages of HIV replication. What are their toxicities? (20)
(d) Describe the role of DMA Profiling in Forensic medicine. (20)

6. (a) Discuss the colorectal carcinogenesis. (20)
(b) Give the morphological changes and complications in myocardial infarction. (20)
(c) What is hydatid disease? Describe the etiopathogenesis, pathological lesions and laboratory diagnosis of echinococcus. (20)

7. (a) What are newer quinolones? Describe their mechanism of action and development of resistance to them. What are the advantages of newer quinolones over the older quinolones ? (20)

(b) What drugs are used in resistant staphylococcal infection? Discuss the mode of action and toxicity of cefpirome. (20)
(c) Enumerate anti platelets drugs. Describe their mechanism of action and their toxicity. (20)

8. (a) Describe the features of contact wound by a rifled firearm. How will you differentiate entry and exit wound in a distant fire. (20)
(b) Classify the organophosphorous compounds. Describe the signs, symptoms and management of acute organophosphorus poisoning. (20)
(c) Describe how will you differentiate between homicidal and suicidal injuries. (20)

PAPER - II
SECTION A
(General Medicine, Paediatrics and Dermatology)
1. Answer any three of the following : (3 x 20 = 60)
(a) Describe the symptoms and sign of actue MI. How will you investigate the case and what positive finding will you get in reports ? Describe the treatment in brief.

(b) Describe in brief all the different types of developmental milestones in the first year of life.

(c) What do you understand with the term nephrotic syndrome ? Classify the various nephrotic syndromes according to etiology. How will you manage a case of minimal lesion type of nephrotic syndrome - first attack ?

(d) Write briefly on :
(i) Scabies
(ii) Ichthyosis

2. (a) A 35 years old patient comes with chest pain on left side. There is also history of high-grade fever for the last 3 days. Write your differential diagnosis. How will you manage a case of acute pneumonitis ? (10 + 10 = 20)

(b) A10 years old child comes with history of continuous high-grade fever for last 10 days, and spleen tip is palpable. (5 +10 + 5 = 20 )
(i) What is differential diagnosis ?
(ii) How will you approach the case ?
(iii) What is the treatment of enteric fever ?

(c) A patient aged 50 years is brought in unconscious state from street by the police. There was a card in his pocket mentioning that he was diabetic. How will you approach the case ? Describe in detail. (20)

3. (a) A 2 years old child is brought to you with history of still unable to walk. There is history of some delayed milestones. On examination anterior fontanelle was open and wrists were widened,
(i) Write what all history you would like to know.
(ii) What positive examination findings, will you try to find, to make a diagnosis ?
(iii) What is your differential diagnosis ?
(iv) What drugs are used in the treatment-of rickets and hypothyroidism ? Also mention their doses. (5 + 5 + 5 + 5=20)

(b) A newborn comes with deep jaundice at the age of 48 hours. What history would you like to take ? What all investigations will you advise ? How will you treat the case if serum bilirubin (indirect) levels comes 18 mg/dl ? (5 + 5 + 10 = 20)

(c) Mention all causes of exanthematous fever. How will you manage a case of measles ? What are the complications of measles ? How can you prevent this disease ? (5 + 5 + 5 + 5 = 20)

4. (a) What do you understand with the terms miliary tuberculosis and disseminated tuberculosis ? What are the complications of the miliary tuberculosis ? How will you diagnose and manage the case of a TBM ? (8 + 8 + 14 = 30)

(b) What are the complications of an untreated acute glomerulonephritis (AGN) in a 10 years old girl ? How will you manage each complication ? (10 + 20 = 30)

SECTION B
(General Surgery, Obstetrics and Gynaecology including Family Planning and Preventive and Social Medicine)
5. Answer any three of the following : (20 x 3 = 60)
(a) Write on the following :
(i) Breast Conservation Therapy
(ii) Subphrenic Abscess

(b) What are the indications of tracheostomy ? Describe the steps of emergency tracheostomy and its post-operative management.
(c) What are the risks associated with termination of pregnancy?
(d) Describe briefly the prevention of nutritional blindness in a community.

6. (a) What are the causes and clinical features of acute intestinal obstruction? How will you assess and prepare such a patient for operative management? (20)

(b) What are the clinical features and plan of assessment of a patient of benign prostatic hypertrophy? Discuss its medical management and indications for surgery. (20)

(c) A 14 years old boy presents with a painful swelling on the left side of the neck with fever for

2 weeks. Discuss the differential diagnosis and investigative workup. Outline the management of tuberculous lymphadenitis.  (20)

7. (a) Describe the functions of the placenta including some description of their clinical relevance. (30)
(b) Describe the management of a 14 years old girl with menorrhagia. (30)

8. (a) Describe briefly the 'post-exposure prophylaxis' of human rabies. (30)
(b) What is an epidemic ? Describe the various steps in the investigation of an epidemic. (5 + 25 = 30)