(Download) UPSC Combined Medical Services Exam (Paper -2) - 2019 Gynecology and Obstetrics, Preventive and Social Medicine

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(Download) UPSC Combined Medical Services Exam (Paper -2) - 2019

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

Paper -2 :

1.What is the correct order of the normal phases of wound healing?
(a) Proliferative phase → Haemostatic phase → Inflammatory phase → Remodelling phase
(b) Haemostatic phase → Inflammatory phase → Proliferative phase → Remodelling phase
(c) Destructive phase → Proliferative phase → Remodelling phase → Inflammatory phase
(d) Remodelling phase → Proliferative phase → Destructive phase → Inflammatory phase

2.All of the following are risk factors for an increased risk of wound infection EXCEPT:
(a) Obesity
(b) Hypertension
(c) Jaundice
(d) Cancer

3.Systemic Inflammatory Response Syndrome (SIRS) is characterized by all of the following EXCEPT:
(a) Hyperthermia (>38˚C)
(b) Platelet count (<1,00,000/mm3)
(c) Tachypnoea (>20/min)
(d) Hypothermia (<36˚C)

4.Gentleman of 56 years underwent laparoscopic left hemicolectomy for diagnosed left colonic carcinoma. Histopathology revealed the tumour to be invading submucosa and muscularis propria. Among the 16 regional lymph nodes harvested, 2 were positive for malignant deposits. His staging as per AJCC will be:
(a) T1, N1, M0
(b) T2, N1, M0
(c) T1, N0, M0
(d) T2, N1, M1

5.All of the following are hormonal agents used in treatment of cancer EXCEPT:
(a) Anastrazole
(b) Irinotecan
(c) Cabergoline
(d) Leuprolide 

6.Which of the following statements regarding lymphoedema are correct?
1. Patients experience constant dull ache and even severe pain sometimes
2. Manual lymphatic drainage has a role
3. Primary lymphoedema is caused by congenital lymphatic dysplasia
4. Nonne Milroy’s disease is a type of primary lymphoedema
Select the correct answer using the code given below:
(a) 3 and 4 only
(b) 1 and 2 only
(c) 1, 2 and 3 only
(d) 1, 2, 3 and 4

7.Indications for carotid endarterectomy in symptomatic patients are all of the following EXCEPT:
(a) Hemianopia
(b) Monocular blindness
(c) Dysphasia
(d) Persistent hypertension

8.A policeman of 45 years presented with Lipodermatosclerosis over lower medial aspect of left
leg, along with a healed venous ulcer. As per the CEAP (Clinical-etiology-anatomypathophysiology) classification his clinical classification will be:
(a) C4a
(b) C4b
(c) C5
(d) C6

9.What is true about the management of a corrosive injury of oesophagus?
(a) Early skilled endoscopy is must
(b) Immediate surgery with oesophagectomy is advisable
(c) Broad spectrum antibiotics should be started as soon as possible
(d) Immediate NG tube insertion and gastric lavage should be preformed
 
10.Which of   the statements regarding Salivary gland neoplasms are correct?
1. 80–90% of parotid tumors are malignant
2. 90 % of sublingual gland tumors are malignant
3. 60–70 % of submandibular gland tumors are benign
4. Parotid gland is most common site for salivary gland tumors
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

11.A few  days following viral fever, a 50 year old female presented with pain in neck, fever,
malaise and firm enlargement of both the lobes of thyroid. On investigation thyroid antibodies
were normal & serum T4 was high normal. Probable diagnosis is:
(a) Autoimmune thyroiditis
(b) Lymphoma of thyroid
(c) Granulomatous thyroiditis
(d) Riedel’s thyroiditis

12.No increased relative risk of invasive breast carcinoma based on histopathological examination of benign breast tissue is for all of the following EXCEPT:
(a) Hyperplasia
(b) Periductal mastitis
(c) Squamous metaplasia
(d) Solitary papilloma of lactiferous sinus

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13.Which of the following statements regarding Paget’s disease of nipple are correct?
1. It represents benign pathology of nipple areola complex
2. It is eczema like condition of nipple and areola
3. Erosion of nipple is seen
4. Nipple biopsy is required for definitive diagnosis
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) 2 and 4 only
 
14.A gentleman of 36 years presented with a long history of upper abdominal pain which was periodic and often occurred early morning. For last 3 months, he is having projectile vomiting, which is non bilious, unpleasant in nature with undigested food materials. On examination he appears unwell, dehydrated and seemed to have lost weight. Probably he is suffering from: 
(a) Gastric outlet obstruction
(b) Carcinoma stomach
(c) Gastro-oesophageal reflux with oesophagitis
(d) Superior mesenteric artery syndrome

15.A 40 year old female patient presents with colicky abdominal pain associated with episodes of
mild diarrhoea for last 6 months accompanied with intermittent fever and weight loss. There are
multiple discharging sinuses on perineal examination. The most likely clinical diagnosis in this
patient is:
(a) Amoebic colitis
(b) Crohn disease
(c) Ulcerative colitis
(d) Ileocaecal Tuberculosis

16.A gentleman of  48 years was being worked up for hepatocellular function. He had no history or signs of encephalopathy. His serum bilirubin was 5 mg%, serum albumin was 3.9 gm%, International normalized ratio was 1.6. On ultrasound no free fluid was detected inside abdomen. As per Child-Turcotte-Pugh (CTP) classification, he was in:
(a) CTP–A
(b) CTP–B
(c) CTP–C
(d) CTP–D

17.Which of the statements regarding Calot’s triangle are correct?
1. Common hepatic duct forms the medial boundary of the Calot’s triangle
2. Inferior surface of the right lobe of the liver forms the superior boundary of Calot’s triangle
3. Right hepatic artery is usually found as a content of the Calot’s triangle
4. Cystic duct and medial border of gall bladder forms the lateral border of Calot’s triangle
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
 
18.Consider the following statements regarding Opportunistic post-splenectomy infections (OPSI):
1. Haemophilus influenzae, Neisseria meningitidis and Streptococcus pneumonae are the most common causative agents
2. Risk is greatest in the patients who have undergone splenectomy for trauma
3. Risk is greatest within the first 2–3 years following splenectomy
4. Prophylactic vaccination should be done 2 weeks prior to elective splenectomy
Which of the statements given above are correct?
(a) 1, 2 and 3
(b) 2, 3 and 4
(c) 1, 3 and 4
(d) 1, 2 and 4

19.A 48 year old male with the history of chronic duodenal ulcer presented in surgical emergency with the complaints of sudden severe pain in the abdomen. At presentation: Pulse = 120/m, BP = 90/60 mm of Hg Abdomen: Tenderness (+), Rigidity (+), Guarding (+) Respiratory Rate: 20/m X-ray: Gas under right dome of diaphragm The probable diagnosis is:
(a) Acute appendicitis
(b) Acute Pancreatitis
(c) Acute Myocardial infraction
(d) Perforation Peritonitis

20.A young sports person presented in surgical emergency with the complaints of severe pain in the groin area, extending into the scrotum and upper thigh. The pain is debilitating and he is not able to exercise. On examination there is tenderness in the region of Inguinal canal and pubic tubercle. He is probably suffering from: 
(a) Varicocele
(b) Inguinal hernia
(c) Sportsman hernia
(d) Femoral hernia

21.Ventral hernia includes all EXCEPT:
(a) Epigastric hernia
(b) Para-umbilical hernia
(c) Lumbar hernia
(d) Inguinal hernia
 
22.Diaphragmatic injury is suspected in a 50 year gentleman with history of blunt abdominal trauma, having a normal chest X-ray. He is best managed by:
(a) Diagnostic peritoneal lavage and proceed
(b) Upper GI contrast study
(c) CECT abdomen
(d) Diagnostic laparoscopy

23.A 20 years old man      had history of pain in the right side of abdomen. His X-ray abdomen AP view shows radio-opaque shadow, which on lateral film falls behind the vertebral column. The probable diagnosis is:
(a) Gall stone disease
(b) Renal Calculus
(c) Calcified mesenteric lymph node
(d) Phlebolith

24.Urinary bladder can be injured in all of the following operations EXCEPT:
(a) Inguinal hernia repair
(b) Hysterectomy
(c) Surgery for rectum
(d) Inguinal lymph node dissection

25.In diffuse axonal injury all are true EXCEPT:
(a) Form of primary brain injury
(b) Seen in high energy
(c) Patient is comatose
(d) CT scan shows pathognomonic finding

26.A 70 years old man on anticoagulants due to some heart disease suffered a minor head injury.One month later he has severe headache with slowly developing neurological signs. The probable diagnosis is:
(a) Extradural haematoma
(b) Acute subdural haematoma
(c) Chronic subdural haematoma
(d) Subarachnoid haemorrhage
 
27.Regarding “Quinsy” all of the following are correct EXCEPT:
(a) It is an abscess in the peritonsillar region
(b) Severe trismus is caused by spasm induced by pterygoid muscles
(c) Pus may be seen pointing underneath the thin mucosa in all cases and is diagnostic
(d) In early stage, intravenous broad spectrum antibiotics may resolve it

28.The most common organism causing Acute Otitis media in children is:
(a) Streptococcus pneumoniae
(b) Staphylococcus epidermidis
(c) Escherichia coli
(d) Klebsiella pneumoniae

29.A 50 year old male presented with pain along the left arm and ptosis. His chest X-ray showed soft tissue opacity at the apex of the left lung along with the erosion of the adjacent rib. The probable diagnosis is:
(a) Pancoast lung
(b) Bronchial carcinoma
(c) Lung abscess
(d) Adenocarcinoma of lung

30.Which of the following is NOT true about Dupuytren’s Contracture?
(a) Autosomal dominant
(b) Occurs in elderly men
(c) Not familial
(d) Associated with alcoholism, smoking and hypothyroidism

31.Which of the following statements regarding the  flat foot are true?
1. All children below 3 year have flat foot
2. 15% adult have flat foot
3. Painless flexible foot need no treatment
4. Rigid flat foot is a result of tarsal coalition
Select the correct answer using the code given below:
(a) 3 and 4 only
(b) 1 and 2 only
(c) 1, 2 and 3 only
(d) 1, 2, 3 and 4 

32.All of the following are causes of acute red eye EXCEPT:
(a) Conjunctivitis
(b) Keratitis
(c) Acute macular oedema
(d) Acute glaucoma

33.All are true about Vernal conjunctivitis EXCEPT:
(a) Type of allergic conjunctivitis
(b) Itchy eyes with other allergic problems
(c) Cobblestone appearance
(d) Most signs are in lower lid

34.Preoperative Samsoon and Young  modified, Mallampati test is used for assessing:
(a) Preoperative nutrition status of patient
(b) Patient’s overall fitness for surgery
(c) Difficulty in intubation
(d) Blood requirement during surgery

35.In Split thickness graft, which part of  the skin is/are included?
(a) Epidermis only
(b) Epidermis and dermis
(c) Epidermis and part of dermis
(d) Epidermis, dermis and part of sub cutaneous tissue

36.A young boy riding a motorcycle, met  with a road traffic accident. On examination he had maxillofacial trauma with paraesthesia of the lower lip. Most likely underlying he has a:
(a) Fracture involving infraorbital foramen
(b) Fracture involving floor of orbit
(c) Fracture of the mandibular body
(d) Fracture of temporal bone
 
37.A 20 year old patient underwent open hernia surgery four days back. He is running fever for the last one day and on local examination the operated site was wet with pus and surrounding redness and edema. The appropriate management would be:
(a) Change of antibiotics
(b) Daily dressing
(c) Opening sutures and cleaning of wound
(d) Sending pus for C/S

38.Good surgical practice and surgical ethics include all EXCEPT:
(a) Respect autonomy
(b) Informed consent
(c) Confidentiality
(d) Experiment

39.Refeeding syndrome seen after enteral or parenteral nutrition is characterized by all EXCEPT:
(a) Hypophosphatemia
(b) Hypocalcemia
(c) Hypomagnesemia
(d) Hyponatremia

40.The capillary refill time is prolonged in all types of shock EXCEPT:
(a) Hypovolaemic shock
(b) Cardiogenic shock
(c) Septic shock
(d) Obstructive shock

41.Which of the following is NOT the hormonal basis for hyperemesis gravidarum?
(a) Excess of Chorionic Gonadotropin
(b) Excess of Human Placental Lactogen
(c) Excess of Progesterone
(d) High serum levels of Estrogen
 
42.Consider the following statements regarding  pregnancy with Rh isoimmunization:
1. Indirect coombs test is performed in mother
2. Methergin is withheld at delivery of anterior shoulder
3. Middle cerebral artery peak systolic velocity is an accurate method to predict fetal anemia
Which of the statements given above are correct?
(a) 1 and 2 only
(b) 1, 2 and 3
(c) 2 and 3 only
(d) 1 and 3 only

43.In fetus with Spina bifida, which of the following sign/signs may be seen on ultrasound?
(a) Lemon sign
(b) Banana sign
(c) Defect seen in vertebral bodies or tissue overlying it
(d) All of these

44.In pregnancy with Down syndrome consider the following biomarkers:
1. β HCG is raised
2. α FP is raised
3. Inhibin is decreased
Which of the above statements is/are correct?
(a) 1, 2 and 3
(b) 1 only
(c) 2 and 3 only
(d) 1 and 2 only

45.A 25 year old G2P1L1, Rh –ve woman presented at 30 weeks gestation to the antenatal clinic, the indirect Coomb’s test (ICT) was found to be positive. What would be the next line of management?
(a) Anti D to be given
(b) ICT titers to be closely monitored at weekly intervals
(c) Amniocentesis for estimation of bilirubin by Liley’s chart is to be done
(d) Baby is to be delivered as soon as possible
 
46.Given below are the Obstetric maneuvers and their indications. Which one of the following is correctly matched?
(a) McRobert’s maneuver – After coming head of breech
(b) Lovset’s maneuver – Delivery of foot in breech
(c) Pinard’s maneuver – Delivery of extended arm
(d) Ritgen’s maneuver – Controlled delivery of fetal head

47.The Maternal serum α-fetoprotein level is elevated in all EXCEPT:
(a) Down syndrome
(b) Neural tube defect
(c) Intra uterine death
(d) Omphalocele

48.Which one of the following statements regarding Bartholin’s glands is NOT true?
(a) They are situated in superficial perineal pouch
(b) Duct opens at the junction between anterior one third and posterior two third between hymen and labium minus
(c) Gonococci is the most common causing Bartholin’s abscess
(d) The duct is lined by columnar epithelium

49.An 18 year old unmarried girl comes with complaints of heavy, prolonged bleeding during menses. Which among the following investigations is NOT usually advised?
(a) Urine pregnancy test
(b) Ultrasound uterus and adnexa
(c) Coagulation profile
(d) Dilatation and curettage

50.Which one of the following is true about Basal body temperature?
1. Biphasic pattern
2. Increase in the level of progesterone and norepinephrine
3. Temperature falls by 0.5˚C after ovulation
4. It can predict ovulation precisely
Select the correct answer using the code given below:
(a) 1 and 3
(b) 1 and 2
(c) 1 and 4
(d) 2 and 3 

51.Consider the following statements regarding infertility:
1. Endometrial biopsy provides information regarding ovulatory factor
2. Both tubal and peritoneal factors can be assessed at laparoscopy
3. Unexplained infertility may be due to luteal phase defect
Which of the statements given above is/are correct?
(a) 1 and 2 only
(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3

52.Which one of the following about  primary dysmenorrhea is NOT true?
(a) Confined to adolescent
(b) Always confined to ovulatory cycles
(c) Pain increases following pregnancy and delivery
(d) Pain is related to uterine hypoxia

53.Consider the following statements regarding diameters of a normal female pelvis:
1. AP diameter is the shortest diameter at brim
2. Oblique diameter is the largest diameter of inlet
3. Diagonal conjugate cannot be directly measured
Which of the statements given above is/are correct?
(a) 1 and 2 only
(b) 1, 2 and 3
(c) 1 only
(d) 2 only

54.Which of the following is NOT  a characteristic clinical feature of Bacterial Vaginosis?
(a) Vaginal pH ≥ 5
(b) Thick curdy discharge
(c) Amine odour in 10 % KOH test
(d) Clue cells
 
55.Which of the following are the vaccines for prevention of cervical cancer?
1. Cervarix
2. Gardasil
3. T-dap
4. Influenza
Select the correct answer using the code given below:
(a) 1 and 3
(b) 2 and 3
(c) 1 and 2
(d) 2 and 4

56.Consider the following statements regarding Carcinoma Cervix:
1. Clinical staging is done
2. Treatment if provided in stage I leads to survival rate of 80–90 %
3. Surgery is preferred in young women with stage III disease
4. HPV virus is considered to be the causative agent
Which of the statements given above are correct?
(a) 1 and 2 only
(b) 1, 2 and 4 only
(c) 3 and 4 only
(d) 1, 2, 3 and 4

57.Which one of the following is  NOT a mandatory procedure for FIGO staging of Carcinoma cervix?
(a) Pelvic examination
(b) Biopsy
(c) Ultrasound abdomen
(d) Endocervical curettage

58.Consider the following statements regarding Uterine Leiomyoma:
1. Prevalence is highest between 35 and 45 years
2. More common in nulliparous women
3. Display reversible shrinkage after treatment with GnRH
4. Requires to be treated only if symptomatic
Which of the statements given above are correct?
(a) 2 and 3 only
(b) 1 and 4 only
(c) 1, 2 and 3 only
(d) 1, 2, 3 and 4 

59.A 58 year old woman with suspected ovarian cancer was operated for surgical staging. On laparotomy and subsequent histopathological examination of the specimen it was found that both ovaries were involved, capsule was ruptured, ascites was present containing malignant cells. Uterus and tubes were normal and there were no peritoneal implants. The FIGO stage for this patient would be:
(a) Stage I
(b) Stage II
(c) Stage III
(d) Stage IV

60.Which one of the following is the serum marker in epithelial ovarian cancer?
(a) CA–125
(b) CEA
(c) AFP
(d) HCG

61.Which of the following is NOT an ideally suited condition for use of ring pessary in case of uterine prolapse?
(a) Late pregnancy
(b) Puerperium
(c) Patient unfit for surgery
(d) Patient’s unwillingness for surgery

62.Labour is called normal if it fulfills following criteria EXCEPT:
(a) Vaginal breech delivery
(b) Vaginal delivery with episiotomy
(c) Vertex presentation
(d) Spontaneous onset at term

63.Which one of the following methods is NOT used for cervical cancer screening?
(a) Pap smear
(b) VIA
(c) VILI
(d) Cervical biopsy 

64.Consider the following regarding the use of  Magnesium Sulphate:
1. Used as tocolytic
2. As neuroprotective agent
3. Used in management of postpartum eclampsia
Which of the statements given above are correct?
(a) 1 and 2 only
(b) 1, 2 and 3
(c) 1 and 3 only
(d) 2 and 3 only

65.Which one of the following is NOT a common cause of recurrent abortions?
(a) Maternal diabetes
(b) TORCH group of infections
(c) Antiphospholipid syndrome
(d) Chromosomal abnormality

66.Contraindications to Uterine Cerclage for  Incompetent os are all EXCEPT:
(a) Previous history suggestive of abortion due to incompetent os
(b) Ruptured membrane
(c) Bulging membrane
(d) History of vaginal bleeding

67.The most common cause of early spontaneous abortion is:
(a) Chromosomal abnormality
(b) Infection
(c) Endocrine disorder
(d) Teratogens

68.Cause of Fetal growth restriction may be:
1. Chromosomal abnormality
2. Congenital abnormality
3. Abnormal cord insertion
Which of the statements given above is/are correct?
(a) 1 and 2 only
(b) 2 and 3 only
(c) 1, 2 and 3
(d) 1 and 3 only 

69.Which one of the following regarding fetal growth restriction is NOT true?
(a) Daily fetal movement count is advised
(b) Biophysical profile is done
(c) Delivery always at 34 weeks
(d) Umbilical artery Doppler studies are done

70.Which one of the following statements regarding contraception is NOT true?
(a) Vaginal ring is a barrier method
(b) Implanon is a hormonal contraceptive
(c) Copper T can be used as post coital contraception
(d) Copper T can be inserted just after delivery

71.A 26 year old P2L2 has just had delivery. What are the contraceptive choices she has at present?
1. Post placental insertion of IUCD
2. Post partum ligation
3. Oral contraceptive pill
4. Lap ligation
Select the correct answer using the code given below:
(a) 1 and 2 only
(b) 1, 2 and 4
(c) 2 only
(d) 1 and 3

72.A 22 year old woman comes with complaints of pain and discomfort in vaginal region. On examination there is unilateral tender swelling in the posterior half of labium minus, overlying skin is red and edematous. What is the most probable diagnosis?
(a) Utero vaginal prolapse
(b) Inversion of uterus
(c) Bartholin’s abscess
(d) Trichomoniasis
 
73.A 29 year old woman is noted to have three consecutive first trimester spontaneous abortion. Examination reveals fibroid uterus. Which of the following types of uterine fibroids would most likely lead to recurrent abortions?
(a) Submucosal
(b) Intramural
(c) Subserosal
(d) Cervical

74.A 25 year old infertile woman is noted to have blocked fallopian tube on Hysterosalpingography. Which of the following is the best next step for this woman?
(a) Clomiphene citrate therapy
(b) Gonadotropin therapy
(c) Laparoscopy
(d) Intrauterine insemination

75.The contraceptive choice for a 38 year old woman with chronic hypertension and history of dysmenorrhea and menorrhagia (malignancy ruled out) is:
(a) Copper intrauterine device
(b) Levonorgestrel intrauterine device
(c) Combined oral contraceptive pills
(d) Sterilization

76.Which one of the following drugs does NOT interfere with efficacy of oral contraceptive pills and increase the failure rates?
(a) Ranitidine
(b) Rifampicin
(c) Ampicillin
(d) Barbiturates

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77.Which one of the following antihypertensive drugs is NOT safe during pregnancy?
(a) Labetalol
(b) ACE-inhibitors
(c) Alpha-methyl dopa
(d) Nifedipine 

78.Tubectomy is commonly performed at which site of fallopian tube?
(a) Ampulla
(b) Infundibulum
(c) Isthmus
(d) Cornua

79.A 60 year old woman presents with postmenopausal   bleeding. On endometrial curettage she is diagnosed as endometrial carcinoma. Which one of the following is a risk factor for endometrial cancer?
(a) Multiparity
(b) Oral contraceptive use
(c) Smoking
(d) Diabetes mellitus

80.A 29 year old woman presents in emergency ward with amenorrhea of 6 weeks and pain. Urine pregnancy test shows positive. Examination shows diffuse significant lower abdomen tenderness. The pelvic examination is difficult to accomplish due to guarding. Her Beta-hCG level is 4000 mIU/ml. Transvaginal ultrasound shows no pregnancy in the uterus and no adnexal mass but moderate fluid in abdomen. Which of the following is the next best step? 
(a) Repeat Beta-hCG level in 48 hours
(b) Institution of methotrexate
(c) Emergency laparotomy
(d) Wait and watch

81.Global hunger index combines three equally weighted indicators EX CEPT:
(a) Undernourishment
(b) Child underweight
(c) Child mortality
(d) Child morbidity
 
82.Physical Quality of life consolidates which of the following indicators?
1. Infant Mortality Rate
2. Life expectancy at birth
3. Literacy
4. Per capita income
5. Mean years of schooling
6. Life expectancy at age one
Select the correct answer using the code given below:
(a) 1, 2 and 3
(b) 1, 4 and 5
(c) 2, 3 and 6
(d) 1, 3 and 6

83. The sequence of events leading to disability and handicap is:
(a) Disease → Disabilty→Impairment→Handicap
(b) Disease → Impairment→Disability→Handicap
(c) Disease → Handicap→Impairment→Disability
(d) Disease → Disabilty→Handicap→Impairment

84.Which one of the following is NOT done as screening test in pregnancy?
(a) Syphilis-VDRL
(b) Serum cholesterol
(c) Diabetes
(d) Neural tube defects

85.Which one of the following statements is NOT true for taking a decision on screening for disease?
(a) Disease prevalence should be high
(b) Disease is lethal
(c) Proportion of false negatives is high
(d) Sensitivity and specificity are high
 
86.In a case-control study, 300 women aged 20-45 years suffering from breast cancer were compared with age-matched 300 women without breast cancer. It was observed that 120 women among cases and 60 women among controls were obese. The odds ratio of developing breast cancer among obese women is:
(a) 9/5
(b) 11/5
(c) 8/3
(d) 11/3

87.Standardized Mortality ratio is best explained by which one of the following statements?
(a) New spells of disease in a given period of time per 1000 population
(b) Number of deaths in a given period of time per 1000 population
(c) Percentage of total number of deaths that occur in a population to the number of deaths that are expected to occur
(d) Percentage of deaths in women as compared to deaths in men

88.In a family of six (2 parents and 4 children), the youngest child catches measles infection. The parents are immune to the infection. On 3rd and 5th day of the infection of the first child, the two other children also suffer from measles. The secondary attack rate (SAR) of measles is: 
(a) 33.3 %
(b) 40 %
(c) 50 %
(d) 66.6 %

89.What is the relative risk of developing pulmonary embolism in users of oral contraceptives as per the information given below? Women using OCs Pulmonary embolism Total

Women using OCs	Pulmonary embolism		Total
	Yes	No
Yes	120	80	200
No	10	70	80
Total	130	150	280

(a) 0.48
(b) 4.80
(c) 2.40
(d) 0.24 

90.Which one of the following epidemiologic methods can be used to identify risk factors and estimate the degree of risk?
(a) Cohort study and Randomized control trial
(b) Case control and Cross-sectional studies
(c) Case control and Cohort studies
(d) Cohort study and Ecological studies

91.Which one of the following tests should be applied to compare mean haemoglobin level of two groups of antenatal mothers?
(a) Chi-square test
(b) Paired t-test
(c) Unpaired t-Test
(d) Analysis of variance

92.In a population of 5000, there are 19 % eligible couples. To achieve a couple protection rate (CPR) of 60 %, how many of these should be covered for family planning services?
(a) 530
(b) 550
(c) 570
(d) 590

93.The drug of choice for chemoprophylaxis to health care personnel and close contacts of suspected or confirmed case of pandemic influenza A (H1N1) is:
(a) Zanamavir
(b) Oseltamivir
(c) Ribavirin
(d) Amantadine

94.Which one of the following is the recommended site for immunization with hepatitis B vaccine in young children for ensuring reliable absorption?
(a) Gluteal region
(b) Anterolateral aspect of thigh
(c) Deltoid region
(d) Anterior aspect of thigh 

95.Vaccine associated Paralytic Poliomyelitis is mostly observed due to which of the following isolate type strain?
(a) Type–1 only
(b) Type–3
(c) Type–2 only
(d) Both Type-1 and 2

96.The specific goals for 2025 under the integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhea (GAPPD) are all of the following EXCEPT:
(a) Reduce mortality from pneumonia in children less than 5 years of age to fewer than 3 per 1000 live births
(b) Reduce mortality from diarrhea in children less than 5 years of age to fewer than 1 per 1000 live births
(c) Reduce the incidence of severe pneumonia by 90 % in children less than 5 years of age compared to 2010 levels
(d) Reduce incidence of severe diarrhea by 75 % in children less than 5 years of age compared to 2010 levels

97.Association between hardness of drinking water and death rate from cardiovascular diseases is:
(a) Direct
(b) Inverse
(c) No association
(d) Association is obtained in presence of confounders

98.Which one of the following statements regarding Magnesium is NOT true?
(a) It is constituent of bones
(b) It is essential for normal metabolism of calcium and potassium
(c) Human adult body contains about 50 g of Magnesium
(d) Daily requirement of magnesium is estimated to be about 340 mg/day for adults
 
99.Which one of the following oil/fat contains   high mono-unsaturated fatty acid and moderate linoleic acid?
(a) Groundnut oil
(b) Palm kernel oil
(c) Safflower oil
(d) Flax seed oil

100.Which one of the following trace elements if deficient in the diet can lead to low birth weight,preterm delivery, spontaneous abortion or even congenital malformation like anencephaly?
(a) Copper
(b) Cobalt
(c) Selenium
(d) Zinc

101.An adult weighs 73 kgs and has a height of 1.75 meters. For the purpose of classification of overweight and obesity as per WHO recommendation, this person will be classified as:
(a) Underweight
(b) Normal
(c) Preobese
(d) Overweight

102.Which one of the following statements regarding WHO Global Action Plan for the prevention and control of NCDs (2013–2020) is NOT correct?
(a) At least 10 percent relative reduction in the harmful use of alcohol as appropriate within national context
(b) A 20 percent relative reduction in prevalence of insufficient physical activity
(c) A 10 percent relative reduction in mean population intake of salt/sodium
(d) Halt the rise of diabetes and obesity

103.All are components of Jai Vigyan Mission Mode project on community control of RF/RHD in India EXCEPT:
(a) To study the epidemiology of streptococcal sore throats
(b) To establish registries for RF and RHD
(c) Antibiotic treatment of streptococcal sore throats
(d) Vaccine development for streptococcal infection 

104.What type of indicator is Sustainable Development Goal target 3.4, which calls for a one third reduction in premature mortality from Non Communicable Diseases (NCD’s) by year 2030?
1. Impact
2. Coverage/risk factor
3. Risk factor/determinants
Select the correct answer using the code given below:
(a) 1 only
(b) 2 and 3
(c) 1 and 3
(d) 3 only

105.Which one of the following occupational diseases is the most common cause of permanent disability and mortality?
(a) Silicosis
(b) Anthracosis
(c) Byssinosis
(d) Asbestosis

106.Which one of the following conditions is  NOT inborn error of metabolism?
(a) Tay-Sach’s disease
(b) Maple syrup urine disease
(c) Neural tube defects
(d) Down’s syndrome

107.Amniocentesis is called for in all of the following circumstances EXCEPT:
(a) A mother aged 35 years or more
(b) Mother who had a child with Down’s syndrome or other chromosomal anomalies
(c) Parents who are known to have chromosomal translocation
(d) A father aged 50 year or more

108.As per WHO recommendations which one of the following mumps vaccine strains should NOT be used in National Immunization Programme?
(a) Teryl Lynn
(b) Rubini
(c) L-Zagreb
(d) RIT 4385
 
109.All of the following are mass approaches towards education of general public EXCEPT:
(a) Internet
(b) Roleplaying
(c) Direct mailing
(d) Posters, Bill boards and signs

110.Which one of the following Ministries controls the Integrated Child Protection Scheme (ICPS)?
(a) Ministry of Health and Family Welfare
(b) Ministry of Women and Child Development
(c) Ministry of AYUSH
(d) Ministry of Human Resource Development

111.Which of the following is a contraindication  for BCG vaccination in a newborn?
(a) Low birth weight
(b) History of Tuberculosis in mother
(c) Prematurity
(d) HIV infection-symptomatic

112.Rashtriya Bal Swasthya Karyakram (RBSK)  attempts to identify all of the following deficiencies in children in the age group 0–18 years EXCEPT:
(a) Severe acute malnutrition
(b) Zinc deficiency
(c) Vitamin A deficiency
(d) Vitamin D deficiency

113.Children of severe acute malnutrition discharged from Nutritional Rehabilitation Centres (NRCs) should be observed in the community by an Anganwari Worker (AWW) as per which one of the following schedules?
(a) Once a week for first month and then twice weekly
(b) Twice weekly in first month and then once a week
(c) Once a week for first month and then once fortnightly
(d) Twice weekly in first month and then once fortnightly
 
114.The facilities provided to pregnant women under the Janani Shishu Suraksha Karyakram are all EXCEPT:
(a) All pregnant women delivery in public health institution to have absolutely free and no expense delivery including cesarean section
(b) Free diet up to 3 days during normal delivery
(c) Free diagnosis and free blood whenever required
(d) Complications during ANC, PNC are not covered

115.All of the following drugs are effective for treatment of human reservoir for hookworm infection in single dose EXCEPT:
(a) Piperazine
(b) Albendazole
(c) Levamisole
(d) Pyrantel

116.A woman delivers a healthy baby with weight 2.2 kg at the time  of birth. What measures are to be taken?
1. The baby should be exclusively breast fed for first six months
2. The vaccination with OPU and BCG should be delayed till the baby is 2.5 kg of weight
3. Baby should be kept with mother and kangaroo care to be given
Select the correct answer using the code given below:
(a) 1, 2 and 3
(b) 1 and 2 only
(c) 1 and 3 only
(d) 2 and 3 only

117.LNG-20 (Mirena) is a third generation intra uterine device. What are the advantages of its use?
1. Low uterine pregnancy rates
2. Prevents anemia
3. Long effective life of 10 years
4. No effect on incidence of ectopic pregnancy
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
 
118.Open vial policy applies to which one of the following vaccines?
(a) BCG
(b) Measles
(c) Hep B
(d) JE

119.A village ‘X’ has a population of 5000 with a birth rate  of 25 per thousand. In any given month,how many pregnancies should be registered with the ANM of this village?
(a) 66
(b) 67
(c) 68
(d) 69

120.In India, for providing HIV treatment services Link  ART Centres are situated at:
(a) Select medical colleges
(b) Medical colleges and district level hospitals
(c) Sub-district level hospitals and Community Health Centres
(d) Primary Health Centres 

 

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