(Download) UPSC Combined Medical Services Exam : Medical Sciences (Paper -2) - 2018 Gynecology and Obstetrics, Preventive and Social Medicine

(Download) UPSC Combined Medical Services Exam (Paper -2) - 2018

:: Gynecology and Obstetrics, Preventive and Social Medicine ::

1.What are the characteristics of ideal health indicators?
(a) They should be valid, reliable, sensitive, specific, feasible and relevant
(b) They should be mainly valid, reliable and sensitive but need not be specific
(c) They should be mainly valid, reliable and feasible but need not be sensitive
(d) They should be mainly valid, reliable and relevant but need not be feasible

  2.Which one of the following statements regarding predictive value of a positive test is true?
(a) It does not tell about diagnostic power of test
(b) The more prevalent the disease, the less accurate the test is
(c) It tells the probability that a patient with positive test has the disease in question
(d) It tells the probability that a patient with positive test does not have the disease in question

 3.The yield of a screening test CAN NOT be increased by which of the following?
(a) Including entire population
(b) Including high risk population
(c) Improved sensitivity
(d) Improved specificity

 4.Which one of the following statements regarding the growth chart is NOT true?
(a) It is used as a tool for growth monitoring and diagnosis
(b) It is used for planning and policy making
(c) It is used as tool for action against the Anganwadi worker
(d) It is used as tool for teaching and evaluation of effectiveness of programme

 5.Flattening of the growth curve in the growth chart signifies:
(a) Child is on a healthy path
(b) Child is severely malnourished
(c) Child is showing signs of growth failure
(d) Child does not need special care

 6.A well of contaminated water resulted in an outbreak of diarrhoea in a community. Which type of epidemic will this exposure present with?
1. Propagated epidemic
2. Common source – continuous exposure
3. Common source – point exposure
Select the correct answer using the codes given below:
(a) 1 and 2 only
(b) 3 only
(c) 1, 2 and 3
(d) 2 only

 7.Which one of the following experiments/ trials is NOT a part of non-randomized trial?
(a) Uncontrolled trial
(b) Risk factor trial
(c) Natural experiment
(d) Before and after comparison studies

 8.What is the relative risk of developing tuberculosis among tobacco users as per the information given below?

Tobacco user	Tuberculosis		Total
	Yes	No
Yes	40	80	120
No	10	70	80
Total	50	150	200

(a) 0.48
(b) 1.33
(c) 2.67
(d) 3.90

9.What is the attributable risk of tobacco for developing tuberculosis as per the information given below?

Tobacco users	Tuberculosis		Total
	Present	Absent
Yes	40	80	120
No	10	70	80
Total	50	150	200

(a) 50.5%
(b) 62.5%
(c) 70.6%
(d) 80.6% 

10. What is the sensitivity of EEG for detecting brain tumours as per the information given below?

	Brain tumour
EEG result	Absent	Present
Positive	54,000	36
Negative	3,06,000	4
	3,60,000	40

(a) 90%
(b) 85%
(c) 0.07%
(d) 99.99%

 11.Which sign is most important in deciding severe pneumonia in a child?
(a) Fast breathing
(b) Nasal flaring
(c) Chest indrawing
(d) Grunting

 12.Varicella-Zoster Immunoglobulin (VZIG) is NOT recommended for which of the exposed susceptible individuals?
(a) Newborn
(b) HIV/AIDS positive
(c) Healthy sibling
(d) Pregnant women

 13.Carriers of avirulent organism are called:
(a) Incubatory carriers
(b) Convalescent carriers
(c) Healthy carrier
(d) Pseudo carriers

 14.A cohort study was conducted among 200 men aged 20–30 years in Rampur village. Out of 200, 120 men were tobacco users and rest 80 didn’t take any form of tobacco. At the end of one year, 40 men among tobacco users and 10 men among non-tobacco users developed tuberculosis. The incidence of tuberculosis among tobacco users is:
(a) 12.5 per 100 men/ year
(b) 25.0 per 100 men / year
(c) 30.0 per 100 men/ year
(d) 33.3 per 100 men/ year 

 15.The data regarding two exposures A and B, associated with a disease X in a community is given below:

	Exposure A	Exposure B
Relative risk	5	10
Attributable risk	80 %	90 %
Population attributable risk	70 %	50 %

Which one of the following assertions and the reasons given is correct?
(a) Preference to control exposure B as it has a higher relative risk
(b) Preference to control exposure A, because it has a higher population attributable risk
(c) Preference to control exposure B, because it has a higher attributable risk
(d) Cannot decide, as the precedence of exposure in the community has not been mentioned

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6.Which of the following types of study designs will be most appropriate to find out the association between mobile phone radiation exposure and cancer?
(a) Cross-sectional
(b) Case-control
(c) Single-arm interventional
(d) Case-series

 17.The villages A and B have the following age compositions:

Age (years)	Mid-year   population (Village A)	Mid-year population (Village B)
0–4	8000	4000
5–9	4000	2000
10–19	5000	3000
20–39	7000	8000
40–59	6000	6000
60 and above	7000	10000

Which of the following is the best indicator for comparing the death rates of these two villages?
(a) Crude death rate
(b) Age standardized death rate
(c) Specific death rate
(d) Proportional mortality rate 

 18.Which of the following is/are suggested by rising incidence rates of any disease?
1. Need for a new disease control programme
2. Improvement in reporting practices
3. Change in the etiology of the disease
Select the correct answer using the codes given below:
(a) 1 and 3 only
(b) 1 only
(c) 1, 2 and 3
(d) 2 and 3 only

 19.What constitutes the denominator in ‘Total Dependency Ratio’?
(a) Population 15–45 years of age
(b) Mid year population
(c) Population 15–64 years of age
(d) Population less than 14 and more than 65 years of age

 20.A pregnant woman in 2nd trimester of pregnancy from North Eastern State has been diagnosed with uncomplicated P. falciparum. She should be treated with:
(a) Artemether and Lumefantrine
(b) Artesunate and Sulphadoxine
(c) Artesunate, Sulphadoxine and Pyrimethamine
(d) Chlorine and Primaquine

 21.By which one of the following studies can relative risk be best calculated?
(a) Cohort study
(b) Correlation study
(c) Case -control study
(d) Randomised control trial

 22.Orthotolidine (OT) test is done for determining residual free chlorine quantitatively and qualitatively. What is the colour of the solution after adding OT which indicates presence of free chlorine?
(a) Red
(b) Yellow
(c) Blue
(d) Green

23.Consider the following in respect of Navjat Shishu Suraksha Karyakram(NSSK): 
1 It is a programme aimed to train health personnel in basic newborn care and resuscitation
2 It addresses care at birth issue ( i.e prevention of hypothermia, prevention of infection,early initiation of breastfeeding and basic newborn resuscitation ) 
3 The objective is to have a trained health person in basic newborn care and resuscitation unit at every delivery point
Which of the statements given above are correct?
(a) 1 and 2 only
(b) 1 and 3 only
(c) 1, 2 and 3
(d) 2 and 3 only

24.The most important indicator for assessment of impact in Salt Iodization Programme is:
(a) Testing Iodine content of salt at consumer level
(b) Testing Iodine content of salt at production level
(c) Testing median urinary Iodine excretion
(d) Testing serum Iodine levels

 25.Caisson’s disease is usually seen in which group of workers?
(a) Cotton field agricultural workers
(b) Construction workers under sea level
(c) Workers in manufacture of gas
(d) Workers in radiation units

 26.These toxic effects like abdominal colic, obstinate constipation, loss of appetite, anaemia,stippling of red cells and blue line on gums are due to exposure to:
(a) Carbon monoxide
(b) Asbestos
(c) Lead
(d) Radiation

27.Which one of the following conditions can be screened during neonatal screening by biochemical tests?
(a) Congenital dislocation of hip
(b) Congenital hypothyroidism
(c) Chromosomal abnormalities
(d) Congenital rubella 

28.Which of the following is NOT a mass approach in health communication? 
(a) Folk methods
(b) Role play
(c) Posters
(d) Health exhibition

29.Which of the following are non –modifiable risk factors for hypertension? 
1. Age
2. Sex
3. Genetic factors
Select the correct answer using the code given below:
(a) 1 only
(b) 1 and 2 only
(c) 1, 2 and 3
(d) 2 and 3 only

30.What is the correct daily dose of Iron and Folic acid to be prescribed to a child aged 12 years?
(a) 20 mg elemental Iron and 100 mcg folic acid
(b) 30 mg elemental Iron and 250 mcg folic acid
(c) 60 mg elemental Iron and 300 mcg folic acid
(d) 100 mg elemental Iron and 500 mcg folic acid

31.When should breastfeeding be initiated to an infant born via a normal delivery? 
(a) Within half an hour
(b) Within one hour of birth
(c) Within 2–4 hours of birth
(d) After 4 hours of birth

32.As per biomedical waste management rule 2016 the metallic body implants should be discarded in which of the following?
(a) Yellow colored non-chlorinated plastic bag
(b) Red colored non-chlorinated plastic bag
(c) Card board box with blue colored marking
(d) Separate collection system 

33.Which of the following is NOT a quantitative method in the management of health services?
(a) Network analysis
(b) Management by objectives
(c) System analysis
(d) Planning programming budgeting system

34.India is in which stage of the demographic  cycle?
(a) High stationary
(b) Early expanding
(c) Late expanding
(d) Low stationary

35.Manual Vacuum Aspiration (MVA) that has been introduced in primary health centres helps in reducing which of the following indices?
(a) Infant mortality
(b) Neonatal mortality
(c) Preterm mortality
(d) Maternal mortality

36.The agreement (yes/no) between two observers is statistically measured by: 
(a) Specificity
(b) Sensitivity
(c) Correlation coefficient
(d) Kappa coefficient

37.How many post natal visits should be made by the ANM to the house of a low birth weight baby?
(a) 2
(b) 4
(c) 6
(d) 8

38.The difference between Type A and Type B sub centre as per Indian Public Health standards is in terms of:
(a) Labour room or delivery facility
(b) Staffing pattern
(c) Location
(d) Availability of drugs

39.Which of the following Screening methods for Disease is the least  useful?
(a) Mass screening
(b) High risk group screening
(c) Multiphasic screening
(d) Selective screening 

 40.Which one of the following is an indicator for evaluation of impact of family planning?
(a) Family size
(b) Number of postpartum services availed
(c) Change in behaviour of people
(d) Community needs assessment

 41.Consider the following hemodynamic changes occurring during pregnancy:
1. Increase in cardiac output
2. Increase in stroke volume
3. Increase in colloid oncotic pressure
4. Increase in pulse rate
Which of the statements given above are correct?
(a) 1, 3 and 4
(b) 1, 2 and 4
(c) 1, 2 and 3
(d) 2, 3 and 4

 42.Which of the following are the hypotheses for the onset of Labor?
1. Uterine distension
2. Activation of fetal hypothalamic-pituitary-adrenal axis
3. Increase in prostaglandins
4. Increase in serum calcium levels
Select the correct answer using the code given below:
(a) 1, 2 and 3
(b) 1, 2 and 4
(c) 1 and 3 only
(d) 2, 3 and 4

43.Which of following statements regarding Puerperal sepsis are correct?
1. Multiple per vaginal examinations increase the risk
2. The responsible microorganisms are group A and B beta-haemolytic Streptococcus
3. Retained bits of placenta and membrane predispose
4. Vaginal packing can decrease the risk
Select the correct answer using the code given below:
(a) 1, 2 and 3
(b) 2, 3 and 4
(c) 1, 3 and 4
(d) 1, 2 and 4

44.In case of Labour complicated with cord prolapse, which of the following statements are correct?
1. Reposition the patient in exaggerated Sims position
2. To replace the cord in the vagina
3. To replace the cord inside the uterus
4. Early amniotomy can prevent cord prolapse
Select the correct answer using the code given below:
(a) 1, 2, 3 and 4
(b) 1 and 2 only
(c) 1, 2 and 3 only
(d) 3 and 4 only

 45.The following are the contents of broad ligament EXCEPT:
(a) Fallopian tube
(b) Uterine and ovarian arteries with their branches
(c) Ovarian ligament
(d) Internal iIiac artery

 46.Which one of the following is true regarding normal menstrual physiology?
(a) Ovulation occurs after 48 hours of LH surge
(b) Oestradiol levels peak at 48 hours prior to ovulation
(c) Ovulation occurs after 12 hours of LH peak
(d) Threshold of LH surge generally persists for 48 hours

 47.Which one of the following is NOT a feature of Candida Vaginitis?
(a) Pruritus is out of proportion to discharge
(b) Discharge is thick and curdy
(c) Yeast-buds and pseudohyphae forms can be seen under the microscope
(d) Metronidazole is the treatment of choice

 48.Which of the following is NOT a high risk factor for developing endometrial carcinoma?
(a) Delayed menopause
(b) Hypertension
(c) Multiparity
(d) Obesity

 49.All of the following are the features of functional ovarian cyst EXCEPT:
(a) Usually < 7 cm in diameter
(b) Spontaneous regression occurs
(c) Unilocular
(d) Usually symptomatic

 50.Gestational trophoblastic disease is a spectrum comprising which of the following entities?
1. Complete Hydatidiform mole
2. Partial Hydatidiform mole
3. Invasive mole
4. Chorio carcinoma
Select the correct answer using the code given below:
(a) 1, 2 and 3 only
(b) 2, 3 and 4 only
(c) 1, 2, 3 and 4
(d) 1 and 4 only

51.Which of the following is NOT a component of Fothergill’s operation as a conservative surgery for uterovaginal prolapse?
(a) Amputation of cervix
(b) Plication of Mackenrodt’s ligaments
(c) Anterior colporrhaphy
(d) Cervicopexy

52.Which one of the following statements is NOT true regarding general physiological changes after delivery?
(a) Pulse may be raised on first day
(b) Temperature should not be above 99°F
(c) Blood volume returns to normal by second week
(d) Cardiac output remains unchanged after delivery

53.Consider following statements regarding Beta Thalassemia in pregnancy:
1. There is low MCH and MCV
2. Total Iron binding capacity may be elevated or normal
3. HbA2 more than 3.5% is seen in Haemoglobin Electrophoresis
Which of the statements given above is/are correct?
(a) 1 only
(b) 1 and 2 only
(c) 2 and 3 only
(d) 1, 2 and 3

54.A 20 year old Primigravida, comes at 35 weeks of gestation with complaints of swelling of feet. On examination her blood pressure is 170/110 mm Hg on 2 occasions; urine examination shows proteinuria. Which one of the following statements regarding her management is NOT true?
(a) Can be labelled as Preeclampsia
(b) Requires urgent admission
(c) Injection Dexamethasone is to be given for fetal lung maturity
(d) Both maternal and fetal monitoring are required

55.A 25 year old, G2P1L1 came with amenorrhoea of two and half months followed by bleeding PV and pain abdomen. On examination cervical OS is open with slight bleeding. The uterus is 10 weeks size with no tenderness in the fornices. The probable clinical diagnosis is:
(a) Ectopic pregnancy
(b) Incomplete abortion
(c) Missed abortion
(d) Inevitable abortion

56.Which one of the following statements regarding intrauterine growth restriction is NOT correct? 
(a) Defined according to biparietal diameter
(b) Doppler studies are indicated
(c) There is danger of fetal asphyxia during delivery
(d) Generally not seen in women with gestational diabetes

57.A 15 year old girl comes to the gynae casualty with a relative with complains of amenorrhoea 2 months. The urine pregnancy test is positive, ultrasound confirms 8 weeks pregnancy. The attendants are not willing to file a police case. What should the treating doctor do?
(a) Take consent for abortion and proceed
(b) Inform the police and make MLC
(c) Take parents consent for MTP
(d) None of these

58.Which of the following is an absolute contraindication for use of oral contraceptive pills?
(a) Epilepsy
(b) Smoking
(c) Focal Migraine
(d) Bronchial Asthma

59.The amount of Ethinyl Estradiol in third generation combined oral contraceptive pills is:
(a) 10–20 mcg
(b) 20–30 mcg
(c) 30–35 mcg
(d) 35–50 mcg 

60.Which one of the following clinical situations is NOT ideal to perform female sterilization procedure?
(a) Postmenstrual period
(b) 7 days postpartum
(c) Concurrent with MTP
(d) 3 months post abortion

61.Cardiac diseases in pregnancy which have major risk of maternal mortality are
1. Pulmonary hypertension
2. Aortic coarctation with valvular involvement
3. Atrial septal defect
4. Mitral stenosis
Select the correct answer using the code given below:
(a) 1 and 4
(b) 2 and 3
(c) 1 and 2
(d) 3 and 4

62.Pregnancy can be terminated at any gestation if the fetus is diagnosed to have:
(a) Duodenal atresia
(b) Bilateral talipes
(c) Anencephaly
(d) Hydrocephalus

63.Which one of the following is NOT a cause of recurrent spontaneous abortion?
(a) Chromosomal abnormality
(b) Antiphospholipid syndrome
(c) Rubella infection
(d) Inherited thrombophillia

64.The congenital abnormality which is invariably lethal is:
1. Anencephaly
2. Transposition of great vessel
3. Down Syndrome
Select the correct answer using the code given below:
(a) 1 only
(b) 1 and 3
(c) 1 and 2
(d) 2 and 3 

65.For vaginal breech delivery, ideal selection criteria would include:
1. Fetus not compromised
2. Adequate pelvis
3. Extended breech presentation
4. Estimated fetal weight < 3.5 kg
Select the correct answer using the code given below:
(a) 1, 2 and 3 only
(b) 1, 2, 3 and 4
(c) 1, 3 and 4 only
(d) 2 and 4 only

66.Consider the following presentations:
1. Brow presentation
2. Left mento anterior position
3. Occipito posterior position
4. Breech presentation
In which of the above Vaginal delivery is NOT possible?
(a) 1, 2 and 3
(b) 1 and 3 only
(c) 1 only
(d) 4 only

67.The blood supply of uterus is from: 
1. Uterine artery
2. Ovarian artery
3. Pudendal artery
4. Superior vesical artery
Select the correct answer using the code given below:
(a) 1 and 2
(b) 2 and 4
(c) 1 and 3
(d) 3 and 4

68.Which one of the following regarding amniotic fluid is true?
(a) The volume is highest at 28 weeks
(b) It reveals information about fetal lung maturity and wellbeing
(c) It is decreased in duodenal atresia in baby
(d) It is decreased in gestational diabetes 

69.Consider the following statements regarding changes in pregnancy:
1. Plasma volume increases up to 30–50%
2. Pregnancy is a hypercoagulable state
3. Hematocrit is decreased
4. Total plasma proteins increases
Which of the statements given above is/are correct?
(a) 1 only
(b) 1, 2, 3 and 4
(c) 1 and 2 only
(d) 3 and 4 only

70.Which one of the following statements regarding anatomy of fetal head is NOT true?
(a) Coronal suture separates frontal bones from parietal bones
(b) Lambdoid suture separates the two parietal bones
(c) Frontal suture separates the two frontal bones
(b) Bregma is a diamond shaped space at junction of coronal and sagittal sutures

71.A 30 year old lady, mother of 3 children presents with mass descending per vaginum. On examination it is found to have stage 3 prolapse, moderate cystocele, no posterior vaginal wall prolapse. The recommended surgery would be:
1. Cystocele repair
2. Rectocele repair
3. Manchester operation
4. Vaginal hysterectomy
Select the correct answer using the codes given below:
(a) 1 and 3 only
(b) 1, 2 and 3
(c) 3 only
(d) 1, 2 and 4

72.A 50 year old post menopausal woman comes with complaints of bleeding per vaginum.  
Which one of the following investigations is NOT required?
(a) Endometrial biopsy
(b) Diagnostic laproscopy
(c) Hysteroscopy
(d) Pap smear 

73.Which of the following statements regarding β-Human chorionic Gonadotropin are NOT correct? 
1. It is a glycoprotein hormone.
2. Serum levels increase in pregnancy, germ cells tumor and gestational trophoblastic disease
3. Its levels are same in single and multiple pregnancy
4. It has common and Alpha-sub unit with other hormones FSH, LH and TSH.
Select the correct answer using the codes given below:
(a) 1, 2 and 4
(b) 1, 2 and 3
(c) 2, 3 and 4
(d) 1, 3 and 4

 74.Which one of the following is NOT an emergency contraception method?
(a) Levenorgestrel
(b) Norplant
(c) Intra uterine contraceptive device
(d) High dose oral contraceptive pill

 75.All of the following statements are correct about vasectomy EXCEPT:
(a) No Scalpel Vasectomy (NSV) was first developed in China.
(b) It increases the incidence of testicular cancer
(c) It is less time consuming than tubectomy
(d) Addition contraception should be used for 3 months after vasectomy

 76.Which of the statement regarding anemia in pregnancy is NOT true?
(a) Iron deficiency anemia is most common in Tropics
(b) Faulty dietary habit is one of the factors responsible for anemia
(c) Mild anemia is most common
(d) If mother is severely anemic, the fetus is also severely anemic

 77.Which one of the following statements about male sterilization is NOT true?
(a) It is safer and less expensive
(b) Most men develop antisperm antibodies
(c) It has a low failure rate
(d) It is performed under general anaesthesia

 78.Which of the following is NOT a method of second Trimester abortion?
(a) Mifepristone and PGE1
(b) PGE2 analog
(c) Intra-amniotic KCl instillation
(d) Hysterotomy 

79.In the process of MTP (Medical Termination of Pregnancy) done by suction and evacuation,it was realized that perforation of uterus occurred with cannula. The next step should be:
(a) Laparotomy with exploration of bowel
(b) Manual vacuum aspiration
(c) Wait and watch
(d) Complete the evacuation with currette

80.Consider the following statements regarding MTP (Medical Termination of Pregnancy):
1. Suction and evacuation can be done up till 12 weeks.
2. Medical methods can be used up till 10 weeks
3. Manual vacuum aspiration (MVA) syringe can be used up to 6 weeks
Which of the statements given above is/are correct?
(a) 1 only
(b) 2 and 3
(c) 2 only
(d) 1 and 3

81.Cellulitis is: 
(a) A suppurative invasive infection of skin and subcutaneous tissues
(b) A nonsuppurative invasive infection of tissues
(c) Infection caused by Gram negative bacilli
(d) Infection caused by anaerobic Streptococci

82.Following are the factors for increased risk of wound infection EXCEPT:
(a) Malnutrition
(b) Good blood supply
(c) Metabolic diseases (diabetes, uraemia)
(d) Immunosuppression

83.A 25 year old lady underwent exploratory laparotomy for bowel injury which happened while she underwent medical termination of pregnancy 2 days back. 24 hours after exploratory laparotomy her pulse is 106/m, respiratory rate 26/m, total leucocyte count 14000/cumm with blood urea 84 mg% and serum creatinine 2.0 mg/dL. The lady is having:
(a) Wound infection
(b) Systematic inflammatory response syndrome
(c) Sepsis syndrome
(d) Multisystem organ failure (MSOF)

84.A 22 year old young man came with history of occasional bleeding per rectum. On colonoscopy, numerous sessile polyps were seen in descending and sigmoid colon. On family history his elder brother was operated for thyroid malignancy. The young man should be advised:
(a) Prophylactic panproctocolectomy
(b) Prophylactic anterior resection
(c) Surveillance colonoscopy every 6 months
(d) Colonoscopic removal of all polyps

85.A 47 year old post menopausal lady was on adjuvant hormonal treatment with Tamoxifen for 3 years for Carcinoma Breast. She came to Outpatient Department with history of passing blood clots per vagina. She is probably suffering from:
(a) Carcinoma Vulva
(b) Carcinoma Vagina
(c) Carcinoma Endometrium
(d) Uterine fibroid

86.Which of the following regarding blood supply of rectum is NOT true? 
(a) Superior rectal artery is a direct continuation of Inferior mesenteric artery
(b) Middle rectal artery arises from external iliac artery and passes through the lateral ligaments into rectum
(c) Inferior rectal artery arises from internal pudendal artery
(d) Inferior rectal artery traverses the Alcock’s canal into rectum

87.Gastric conduit after oesophageal resection is based upon: 
(a) Right Gastroepiploic artery
(b) Short gastric vessels and Vasa brevia
(c) Left gastric artery
(d) Right gastric artery

88.A 70 year old male having comorbidities present with benign appearing parotoid tumour. The best option is:
(a) Tumour enucleation
(b) Superficial Parotidectomy
(c) Aspiration biopsy confirmation
(d) Radio therapy

89.Fine Needle Aspiration Cytology (FNAC) is NOT conclusive in which one of the following thyroid swellings?
(a) Papillary carcinoma thyroid
(b) Follicular carcinoma thyroid
(c) Medullary carcinoma thyroid
(d) Thyroiditis

90.Patients with phlebographically confirmed deep vein thrombosis of the calf: 
(a) can expect asyptomatic recovery if treated promptly with anticoagulant
(b) may be effectively treated with low-dose heparin
(c) may be effectively treated with pneumatic compression stockings
(d) are at risk for significant pulmonary embolism

91.Herceptin (Trastuzumab) is an immunotherapeuctic agent used for: 
(a) Carcinoma prostrate
(b) Carcinoma breast
(c) Carcinoma rectum
(d) Ovarian malignancy

92.Mainstay of an accurate diagnosis of pancreatic injury following blunt abdominal trauma is:
(a) Computed Tomogram
(b) Diagnostic peritoneal lavage
(c) USG abdomen
(d) MRI abdomen

93.Pancreatic pseudocysts developing complications are best managed by:
(a) Conservative treatment
(b) Radiologically guided interventions
(c) External drainage
(d) Surgery

94.Which one of the following regarding absorbable meshes is NOT true?
(a) They are made of polygycolic acid fibre
(b) They are used in temporary abdominal wall closure
(c) They are used to buttress sutured repair
(d) They show very good results as collagen deposition is maximum 

95.Which one of the following is NOT a surgical modality for management of femoral hernia?
(a) Lotheissen’s (Inguinal) operation
(b) The high approach (Mc Evedy)
(c) The low approach (Lockwood)
(d) The canal ring narrowing operation (Lytle’s)

96.“Triangle of Doom” dissected and seen during Laparoscopic inguinal hernia repair is bounded by all EXCEPT:
(a) Vas deference
(b) Cord structures
(c) Peritoneal fold
(d) Inferior epigastric artery

97.Antro-chonal polyp always arises from: 
(a) Maxillary sinus
(b) Posterior ethmoidal cells
(c) Posterior end of the septum
(d) Nasopharynx

98.Paralytic ileus is a type of: 
(a) Dynamic obstruction
(b) Adynamic obstruction
(c) Inflammatory obstruction
(d) Drug induced obstruction

99.Indication of Coronary artery bypass grafting (CABG) is:
(a) More than 25% stenosis of critical left main stem
(b) More than 25% stenosis of proximal left anterior interventricular artery
(c) Triple vessel disease
(d) Deranged Stress Echocardiography report

100.Normal anatomical narrowing of ureter are present in all EXCEPT:
(a) Ureteropelvic junction
(b) Crossing the abdominal aorta
(c) Entering bladder wall
(d) Ureteric orifice 

101.Which one of the following is NOT correct regarding Adenocarcinoma of the kidney ?
(a) It is also called Grawitz tumour
(b) It always presents with haematuria
(c) It may be associated with Pyrexia of unknown origin
(d) Renal vein extention may embolize to lungs

102.Which one of the following regarding abdominal paediatric surgery is correct?
(a)Transverse abdominal incision is always used
(b) Incision can be closed with absorbable suture
(c) Bowel must be always anastomosed in double layer
(d) Skin over abdomen can never be closed with subcuticular sutures

103.Genetic disorder predisposing patients to  develop Berry aneurysm includes all EXCEPT:
(a) Adult polycystic kidney
(b) Fibromuscular dysplasia
(c) Neurofibromatosis Type II
(d) Marfan’s syndrome

104.Which one of the following regarding Nasal polyps is NOT true?
(a) Nasal polyps are very painful to touch
(b) Simple polyps are bilateral
(c) Bleeding polyp may indicate malignancy
(d) Meningocele must be excluded in children with polyps

105.Allen’s test is used in Cardiac surgery:
(a) To select finger prick for blood glucose estimation
(b) When radial artery harvest is planned
(c) For evaluation of AV fistula
(d) To check warmth of hands

106.In a lateral facial wound, if facial nerve injury is suspected, it should be:
(a) Left alone
(b) Skin and subcutaneous flaps to be raised to cover the cut ends
(c) Primary repair should be attempted
(d) Secondary repair using microscope gives best result

107.Radiologic views used for fracture Mandible (body and Ramus) are all EXCEPT:
(a) Orthopantomogram
(b) Lateral obliques
(c) Lower occlusal
(d) Submentovertex

108.Mallory-Weiss tear causing haematemesis is seen over:
(a) Oesophagus
(b) Gastroesophageal junction
(c) Anterior wall of stomach
(d) Fundus of stomach

109.Which one of the following factors is NOT involved in the pathogenesis of Systematic inflammatory response syndrome (SIRS)?
(a) Increased cytokine production
(b) Abnormal nitric oxide synthesis
(c) Free radical production
(d) Microvascular occlusion

110.Sleeve Gastrectomy done for Morbid obesity is a:
(a) Restrictive procedure
(b) Reversible procedure
(c) Mildly restrictive and mainly malabsorptive
(d) Malabsorptive procedure only

111.Pre-operative Nutrition Screening in a patient with morbid obesity planned for Gastric Bypass includes all EXCEPT:
(a) Serum Magnesium
(b) Serum Calcium
(c) Serum Vitamin B12
(d) Serum Insulin

112.In postoperative care the long term risks after Bariatric Surgery include all EXCEPT:
(a) Protein Calorie Malnutrition
(b) Deep Vein Thrombosis
(c) Vitamin and Micronutrient depletion syndromes
(d) Weight regain 

113.Hilton’s method of Incision and drainage of abscess has the advantage of:
(a) Complete drainage of pus
(b) Avoids injury to underlying vessels and nerves
(c) Provides irrigation
(d) Heals without scar

114.Indications of computed tomography after head injury include all EXCEPT:
(a) Glasgow Coma Scale < 13 at any point
(b) Open depressed fracture
(c) Mild head injury in a 50 year old man
(d) Amnesia > 30 minutes

115.Mondor’s disease is:
(a) Thrombophlebitis of superficial veins of the breast and anterior chest wall
(b) Other name for tuberculosis of breast
(c) Rare type of chronic intramammary abscess
(d) Named after the scientist who first coined the term “Actinomycosis of Breast”

116.Sengstaken-Blakemore tube is used to control bleeding in:
(a) Renal trauma
(b) Bleeding varices
(c) Splenic injury in portal hypertension
(d) Duodenal ulcer bleed

117.Which one of the following regarding Pancreatic effusion is correct?
(a) Free fluid collection in Pleural cavity
(b) Never associated with abdominal collection
(c) Pancreatic stenting is to be done
(d) Percutaneous drainage under image guidance is necessary

118.Which one of the following bone is affected in Keinbock’s disease?
(a) Lunate bone
(b) Capitellum of the humerus
(c) Metatarsal
(d) Navicular bone

119.Which one of the following regarding management of acute wounds is NOT true?
(a) The whole patient should be examined according to ATLS principles
(b) Wounds should be examined, taking into consideration site and structures damaged
(c) Bleeding wounds should be elevated and a pressure pad applied
(d) Clamps should be used to stop all bleeding vessels

120.Risk Scoring System which can be used post operatively is:
(a) ASA → American Society of Anaesthesiologist
(b) MET → Metabolic Equivalent Task
(c) RCRI → Revised Cardiac Risk Index
(d)POSSUM → Physiologic and operative severity Score for enUmeration of
Mortality and Morbidity 

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