(Download) UPSC Combined Medical Services Exam (Paper -1) - 2016

General Medicine and Pediatrics

1. A 40-year old male is admitted with acute inferior wall myocardial infarction. Half an hour later his B.P. is 80/50 mm Hg and heart rate is 40/minute with sinus rhythm. The most appropriate step in the management of this patient would be:

(a) Administration of normal saline 300 ml over 15 minutes
(b) Immediate insertion of temporary pacemaker
(c) Intravenous administration of atropine sulfate
(d) Intravenous administration of iso-prenaline 50μg/minute

2. The characteristic feature of tricuspid insufficiency in the jugular venous pulse is:

(a) Prominent ‘a’ wave
(b) Exaggerated ‘x’ and ‘y’ descents
(c) Cannon waves
(d) Obliteration of the ‘x’ descent and prominent ‘CV’ wave

3. Match List I with List II and select the correct answer using the code given below the lists:

List I (Clinical Features) List II (Diagnosis)
A. Osler’s node: 1. Patent ductus arteriosus with reversal of shunt
B. Differential cyanosis: 2. Aortic stenosis with aortic regurgitation
C. Bisferiens pulse: 3. Pulmonary hypertension
D. Graham Steell murmur: 4. Subacute bacterial endocarditis

Code:

A B C D
(a) 4 1 2 3
(b) 4 1 3 2
(c) 1 4 2 3
(d) 1 4 3 2

4. Acute aortic regurgitation occurs in:

(a) Infective endocarditis
(b) Ankylosing spondylitis
(c) Marfan’s syndrome
(d) Rheumatoid arthritis

5. The following are early complications of acute myocardial infarction except:

(a) Papillary muscle dysfunction
(b) Ventricular septal defect
(c) Ventricular free wall rupture
(d) Dressler’s syndrome

6. For which one of the following serum proteins, the levels of protein do not decrease in nephrotic syndrome?

(a) Albumin
(b) Transferrin
(c) Fibrinogen
(d) Ceruloplasmin

7. Following are the causes of high anion-gap acidosis except:

(a) Renal tubular acidosis
(b) Acute renal failure
(c) Chronic renal failure
(d) Diabetic ketoacidosis

8. A patient of cirrhosis develops oliguria and worsening azotemia. Urinary sediment is normal. Urinary sodium concentration is 5 mEq/L. The most likely cause could be:

(a) Interstitial nephritis
(b) Acute tubular necrosis
(c) Acute glomerulonephritis
(d) Hepato-renal syndrome

9. Which one of the following infections is related to subacute sclerosing panencephalitis (SSPE)?

(a) HIV
(b) Measles virus
(c) Japanese B encephalitis virus
(d) JC virus

10. Consider the following:

1. Failure to swing the arms while walking
2. Nystagmus
3. Cogwheel rigidity
4. Festinant gait

Typical features of Parkinsonism include which of the above?

(a) 2, 3 and 4
(b) 1, 2 and 4
(c) 1 and 3 only
(d) 1, 3 and 4

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