(Download) UPSC Combined Medical Services Exam (Paper -2) - 2017

Gynecology and Obstetrics, Preventive and Social Medicine

1. The external opening of branchial fistula is present in :
(a) Lower third of the neck
(b) Middle third of the neck
(c) Upper third of the neck
(d) Suprasternal notch

2. A eight year old male child complains of severe pain in right testes. The most probable diagnosis is
(a) Torsion of right testis
(b) Strangulated Inguinal hernia
(c) Acute epididym‐orchitis
(d) Undescended testis

3. Which one of the following statements is NOT correct regarding Gastroschisis?
(a) It is a ruptured exomphalos
(b) Gut has herniated through a defect to right of umbilicus
(c) Normally limited to midgut
(d) There is no covering membrane

4. Heineke‐Mikulicz operation is done for:
(a) Ureteric stricture
(b) Urethral stricture
(c) Pyloric stenosis
(d) Stricture common bile duct

5. A 32 year old female underwent laparoscopic cholecystectomy which was difficult. On her second post operative day, she develops jaundice. Her LFT parameters show serum bilirubin 6.8 mg/dL; direct bilirubin 5.6 and indirect bilirubin 1.2 mg/dL; and serum alkaline phosphatase 1226 IU/L. She is most likely suffering from obstructive jaundice due to:
(a) Bile duct injury
(b) Carcinoma gallbladder
(c) Hepatocellular carcinoma
(d) Carcinoma head of pancreas

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6. A 60 year old man presents with painless progressive jaundice for two months. He has a history of weight loss. On examination, his gallbladder is palpable which is smooth, non‐tender and globular. His serum bilirubin is 18.2 mg/dL. He is most likely suffering from:
(a) Carcinoma head of pancreas
(b) Carcinoma stomach
(c) Choledocholithiasis
(d) Klatskin tumour

7. A young 23 year old male riding his motorcycle meets with a road accident. He is tachypnoeic with HR 110/m and BP 112/74 mmHg. On examination, he has tenderness over left side of chest with decreased air entry. His trachea is pushed to opposite side. Abdominal examination is unremarkable. Most probably he is suffering from:
(a) Haemothorax
(b) Consolidation
(c) Subcutaneous emphysema
(d) Tracheal rupture

8. Mondor’s disease is
(a) Lymphangitis of mammary lymphatics
(b) Multiple breast cysts
(c) Eczema by nipple and areola
(d) Thrombophlebitis of superficial veins of breast

9. Which of the following is NOT true regarding ‘Renal Carbuncle’?
(a) It is an abscess in renal parenchyma
(b) It occurs in diabetic patient
(c) It is a type of renal tuberculosis
(d) It occurs in intravenous drug abusers

10. Anderson‐Hynes operation is performed for:
(a) Achalasia cardia
(b) Pyloric stenosis
(c) Pseudo‐pancreatic cyst
(d) Pelvi‐ureteric junction obstruction

11. Which of the following is NOT correct for ‘strawberry gall bladder’?
(a) It is a malignant condition of gall bladder
(b) It has sub mucous aggregation of cholesterol crystals
(c) It may be associated with cholesterol Stones
(d) Simple cholecystectomy is the treatment of choice

12. Treatment of choice for Recurrent Thyrotoxicosis after surgery is
(a) Further surgery
(b) Radio iodine followed by surgery
(c) Radio iodine
(d) Observe/follow –up

13. All the following are features of Polycystic disease of kidneys EXCEPT:
(a) Haematuria
(b) Hypertension
(c) Renal failure
(d) Erythrocytosis

14. Which one of the following is the most important selection criteria for obesity surgery ?
(a) BMI > 40
(b) BMI 30
(c) BMI 30 with co‐morbid disease
(d) BMI 35 without any co‐morbid disease

15. A 45 year old underwent abdominal rectal prolapse surgery. At present, he complains of sexual dysfunction which is probably due to the injury of:
(a) Pelvic autonomic nerves
(b) Inferior mesenteric artery
(c) Rectum
(d) Urinary bladder

16. In endoscopic retrograde cholangiopancreatography endoscope used is:
(a) End viewing
(b) Side viewing
(c) Rigid
(d) Front viewing

17. Oliguria is defined as:
(a) Absence of urine production
(b) More than 900 ml of urine excreted in a day
(c) 600 ml to 700 ml of urine excreted in a day
(d) Less than 300 ml of urine excreted in a day

18. A 40 year old man, with a history of a reducible left groin swelling of two years, comes with severe pain over left groin. The swelling is now non‐reducible and is very tender to touch. The most probable treatment plan for this patient would be:
(a) Continue conservative management
(b) Hot fomentation of groin area
(c) Oral antibiotics
(d) Prepare for emergency surgery

19. During laparoscopic inguinal hernia repair, in the ‘triangle of doom’, the following are true EXCEPT:
(a) Vas deferens on medial side
(b) Cord structures on lateral side
(c) Base by iliac vessels
(d) Dangerous area for dissection

20. All are rare type of lateral Hernia of abdominal wall, EXCEPT:
(a) Spigelian
(b) Obturator
(c) Superior lumbar
(d) Inferior lumbar

21. A 35 year old female had laparoscopic ventral hernia repair using polypropylene mesh in January 2015. In June 2015, she is again admitted with features of subacute intestinal obstruction and is managed conservatively. She continues to have recurrent colicky pain after that. Most probably she is suffering from:
(a) Recurrence of hernia
(b) New hernia
(c) Acute appendicitis
(d) Bowel adhesion to mesh

22. Which of the following is NOT correct for breast abscess?
(a) Drainage of abscess by a radial incision
(b) Antibiotic is given if pus is already present
(c) A counter‐incision is made in the dependant part
(d) Dressings are changed frequently

23. Important landmark in submandibular gland dissection is:
(a) Posterior border of mylohyoid muscle
(b) Posterior belly of digastrics muscle
(c) Anterior belly of digastrics muscle
(d) Facial artery

24. Which of the following is NOT a feature of Systemic Inflammatory Response Syndrome?
(a) Hyperthermia ( more than 380C)
(b) Hypothermia (less than 360C)
(c) Leucocytosis
(d) Bradycardia

25. A 35 year old man presents to Emergency with acute onset pain abdomen radiating to whole abdomen and abdominal distension for one day. On examination, he has tenderness and guarding all over abdomen with pulse rate of 100/m and BP 116/84 mmHg. Chest X‐ray erect position shows gas under bilateral domes of diaphragm. Probably he is suffering from:
(a) Acute pancreatitis
(b) Ruptured liver abscess
(c) Appendicular perforation
(d) Colonic perforation

26. A 70 year old man comes to Emergency with pain lower abdomen and not passing urine for eight hours. He has a past history of urgency, hesitancy and frequency of urine. On examination, he has a lump up to the umbilicus which is slightly tender. What is the next step of management?
(a) Get an urgent USG
(b) Per rectal examination
(c) Per urethral catheterise the patient
(d) Start antibiotics

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