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(Download) UPSC IAS Mains Exam Paper - 2017 : Medical Science

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(Download) UPSC IAS Mains Exam Paper - 2017 : Medical Science

MEDICAL SCIENCE
(Paper: I)

Time Allowed : Three Hours

Maximum Marks : 250

Question Paper Specific Instructions

Please read each of the following instructions carefully before attempting questions :

There are EIGHT questions divided in TWO SECTIONS and printed both in HINDI and in ENGLISH.

Candidate has to attempt FIVE questions in all.

Questions no. 1 and 5 are compulsory and out of the remaining, any THREE are to be attempted choosing at least ONE question from each section.

The number of marks carried by a question/part is indicated against it.

Answers must be written in the medium authorized in the Admission Certificate which must be stated clearly on the cover of this Question-cum-Answer (QCA) Booklet in the space provided. No marks will be given for answers written in a medium other than the authorized one.

Word limit in questions, wherever specified, should be adhered to.

Illustrate your answers with suitable sketches and diagrams, wherever considered necessary. Coloured pencils may be used for the purpose.

Attempts of questions shall be counted in sequential order. Unless struck off, attempt of a question shall be counted even if attempted partly. Any page or portion of the page left blank in the Question-cum-answer Booklet must be clearly stuck off.

SECTION A

Q1. (a) Write in short about Embalming.
(b) Describe microscopically, the cellular components of lungs. Add a note on fetal distress syndrome.
(c) Describe the developmental component and nerve supply of the tongue.
(d) Describe the functions of spinocerebellum.
(e) Tabulate the findings of various biochemical tests in blood and urine of patients of pre-hepatic, hepatic and post-hepatic jaundice.

Q2. (a) Describe how iron is absorbed, transported and stored in our body. Give the different tests done to assess status of iron in the body.
(b) (i) Enumerate the sites for formation of erythrocytes in the embryo, foetus and adults.
(ii) Describe the characteristic changes in the cytoplasm and nucleus during erythropoiesis.

(c) (i) Describe in detail about hepatic spaces in relation to peritoneal reflection. Add a note on its applied importance.
(ii) Describe blood supply of brain stem and add a note on its applied importance.

Q3. (a) (i) Describe the functions of basal ganglia in voluntary actions.
(ii) Compare the functions of basal ganglia with primary cortex.

(b) Describe the gross anatomy, innervation and applied importance of the urinary bladder. Add a note on autonomous bladder.
(c) Discuss the principle of Polymerase Chain Reaction (PCR) technology and outline the steps involved. Write its clinical application.

Q4. (a) (i) Describe the shoulder joint under the following headings:

I. Movement
II. Blood Supply
III. Ligaments

(ii) Give the anatomic basis of black eye.

(b) (i) Show the sucking reflex through a diagram. Describe positive and negative feedback actions of estrogen.
(ii) Describe baroreceptor reflex mechanism in the regulation of blood Pressure.

(c) Justify the statement Vitamin D is a hormone'. Describe the synthesis, mechanism of action and physiological functions of vitamin D.

SECTION B

Q5. (a) Define neoplasm. List five differences between benign and malignant neoplasm.
(b) Explain the challenges in epidemiology and control measures in malaria. Discuss its laboratory diagnosis.
(c) Discuss acute paracetamol poisoning emphasizing on mechanism of toxicity and its treatment.
(d) Describe the gross and microscopic appearance of post-primary tuberculosis of lung.
(e) How will you assess that the injury is "Grievous Hurt' as per Section 320 of the Indian Penal Code ? Illustrate with examples.

Q6. (a) (i) Describe the gross and microscopic features of acute proliferative glomerulonephritis.
(ii) Describe in brief the etiopathogenesis of squamous cell carcinoma of cervix.

(b) Describe the mechanism of action of sulfonamides. Also describe which methods bacteria employ to develop resistance to it.
(c) (i) What are the factors responsible for invasive candida infection. Briefly describe the laboratory diagnosis of bloodstream candida infection.
(ii) Name opportunistic fungal (two) and parasitic (two) agents causing infections in an HIV patient. Describe the laboratory diagnosis of any one of them.

Q7. (a) A 16-year-old girl has been brought for medical examination to the hospital by the police with alleged history of rape. How will the medical officer proceed to examine her ? Describe the possible findings. What are the specimens preserved to establish the alleged crime?
(b) Discuss the clinical features, management and post-mortem findings in a case of cyanide poisoning.
(c) Explain the reasons for the following:

(i) Beta blockers should not be given with Verapamil.
(ii) Folinic Acid is administered along with Methotrexate.
(iii) Thiazides are useful in nephrogenic Diabetes insipidus.

Q8. (a) (i) Discuss the pathogenesis of enteric fever. What are the different mechanisms by which salmonella acquires antimicrobial Tesistance
(ii) Define immunological tolerance and discuss its role in autoimmunity, with one example.

(b) A 40-year-old chronic alcoholic male presents himself with ascites, splenomegaly, jaundice and hematomesis.

(i) What is the likely disease in the liver ?
(ii) What is the reason for hematemesis?
(iii) Describe the gross and microscopic features of the liver in this case.

(i) Griseofulvin
(ii) Sulfonylurea
(iii) Gentamicin

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MEDICAL SCIENCE
(Paper: II)

Time Allowed : Three Hours

Maximum Marks : 250

Question Paper Specific Instructions

Please read each of the following instructions carefully before attempting questions :

There are EIGHT questions divided in TWO SECTIONS and printed both in HINDI and in ENGLISH.

Candidate has to attempt FIVE questions in all.

Questions no. 1 and 5 are compulsory and out of the remaining, any THREE are to be attempted choosing at least ONE question from each section.

The number of marks carried by a question/part is indicated against it.

Word limit in questions, wherever specified, should be adhered to.

Illustrate your answers with suitable sketches and diagrams, wherever considered necessary. Coloured pencils may be used for the purpose.

SECTION A

Q1. (a) A young 23-year-old lady had attempted suicide thrice in last one year. What is the cause of her condition? How do you diagnose and manage Major Depressive Disorder?
(b) A 40-year-old man gives history of gradual loss of weight and altered bowel habits for last two years. What differential diagnosis would you consider? How will you manage Idiopathic Tropical Malabsorption Syndrome?
(c) What are the principles of Echocardiography? What is its diagnostic sigriilitarie
(d) A baby is delivered at 34 weeks of gestation; develops respiratory distress soon after birth:

(i) List the important causes of respiratory distress in this baby.
(ii) Mention the pathogenesis of Respiratory Distress Syndrome.
(iii) Outline the management of the baby.

(e) (i) Mention the important causes of mortality in children under 5 years of age.
(ii) Enlist the vaccines which can reduce the incidence of Acute Respiratory Infection in children.
(iii) Mention the measures to reduce mother to child transmission of HIV (Human Immunodeficiency Virus) infection.

Q2. (a) A 70-year-old man was found comatose on the road by a passerby. There were no external injurics. He was brought to the casualty. What are the common medical conditions in his case? How will you manage Diabetic Ketoacidosis?
(b) A 2-month-old infant presents with Central Cyanosis. He had two episodes of cyanotic spells.

(i) Enlist the differential diagnosis of Congenital Cyanotic Heart Diseases with reduced pulmonary blood flow.
(ii) Mention the complications of Congenital Cyanotic Heart Diseases.
(iii) Outline the management of a cyanotic spell.

(c) A 45-year-old gentleman, agriculturist by occupation, presents with recurrent itchy scaly lesions over face and limbs of one year duration. Examination revcalcd hyperpigmented scaly lesions over face, neck and upper and lower limbs. There were involvement of skin creases, eyelids, retroauricular areas and nasolabial folds. He gave history of photosensitivity.

(i) What is your likely diagnosis?
(ii) What tests will you perform to establish the cause of is condition? Describe in brief.
(iii) How will you treat this gentleman?

Q3. (a) A 30 year-old labD1JTET, 7th high fever bf three days duralitn, 35 tirp14ght ta emergency in hospital in semiconscious state.

(i) What are the likely causes for it?
(ii) How will you diagnose and manage Japanese Encephalitis?
(iii) What are the bad prognostic indicators for it?

(b) A 4 year old child presents with stunted growth and moderate pallor. The child had history of intermittent diarrhoea.

(i) Mention the differential diagnosis.
(ii) Mention the investigations required for diagnosis of celiac diseases.
(iii) Outline the management of celiac diseases in children.

(c) A 30-year-old female presents with itchy lesions over upper and lower limbs of one month duration. On examination, multiple discrete flat-topped skincoloured and violaceous papules were present around ankles, wrist and forearms.

(i) Which other areas will you examine to arrive at a clinical diagnosis?
(ii) What are the tests will you perform to confirm the diagnosis?
(iii) How will you treat this lady?

Q4. (a) A 20-year-old young man was brought to the casualty with severe headache. His blood pressure was 220/130 mm of Hg. On previous two occasions also his BP was recorded very high. What is the differential diagnosis? How will you investigate and manage him?
(b) A 3-year-old child presents with generalized oedema.

(i) Enlist the differential diagnosis.
(ii) Mention the investigations required for diagnosis of Idiopathic Nephrotic Syndrome.
(ii) Outline the treatment of Steroid-Resistant Nephrotic Syndrome.

(c) A 5-year-old malc child presents with generalized itchy excoriated papules over trunk, limbs and genitals of two weeks duration. There were few papulovesicles on palms and soles. His other sibling had similar skin problem.

(i) What is the likely diagnosis?
(ii) What is the cause for his condition?
(ii) Enumerate the various topical preparations available to treat this condition. Describe the method of application of one preparation.

SECTION-B

Q5. (a) A 40-year-old female fair in colour presented in casualty department with history of severe upper abdominal pain and vomiting after heavy fatty meal. On examination, tenderness is present in right hypochondrium.

(i) What is the diagnosis of the above-mentioned clinical condition, its etiopathogenesis and differential diagnosis?
(ii) Outline the management of chronic cholecystitis with cholelithiasis.

(b) A 75-year-old male presented with acute retention of urine with haematuria. On per rectal cxamination, hard nodular prostatic enlargement is present.

(i) Discuss the diagnosis and its investigation.
(ii) Outline the management of the above-mentioned condition.

(c) Enumerate commonly used methods of female sterilization. What are the advantages and disadvantages of each method?
(d) Define Assisted Reproductive Technology. Mention briefly the commonly used reproductive technologies. What are the indications and contraindications of each method?
(e) (i) What are trans-fatty acids?
(ii) Which foods are major source of trans-fatty acids?
(iii) What is the significance of trans-fatty acids from public health viewpoint?

Q6. (a) Deline Postpartumn Haemorrhage (PPH). What are the causes of PPH? How would you manage the case of PPH just after delivery? Discuss the preventive measures for control pf PPH.
(b) Discuss the causes of Benign Breast Disease, its investigation and management of bilateral fibroadenosis with mastalgia,
(c) (i) What are the primary objectives of Janani Suraksha Yojana?
(ii) What are the salient features of this scheme?
(iii) What is the Vande Mataram Scheme? How is it related to the Janani Suraksha Yojana?

Q7. (a) A 25-year-old male presented with history of off and on central abdominal distension with evening rising temperature and weight loss. On abdominal examination, firm, non-tender lump is present in right iliac fossa.

(i) Discuss the differential diagnosis of the above-mentioned case.
(ii) Mention the investigations and its findings.
(iii) Outline the management of ileocaecal tuberculosis.

(b) (i) Under the National Rural Health Mission (NRHM), what are the changes being carried out in the rural healthcare infrastructure in order to strengthen it?
(ii) Which of the existing programmes of Health and Family Welfare have been integrated into the National Rural Health Mission?

(c) Enumerate the common causes of menorrhagia in a 40-year-old woman. What are the different types of fibroid uterus? How would you manage the case of a 40-year-old woman suffering from menorrhagia due to fibroid uterus?

Q8. (a) "The End TB Strategy is a logical evolution and a paradigm shift from the past global TB strategies.

(i) What are its vision, goal, milestones and target indicators that are set to be achieved in specific future years?
(ii) What are the major hurdles which stand in its success? (112) What steps are required to overcome these hurdles?

(b) Define prolapse of uterus. Enumerate different degrees of prolapse of uterus. Enumerate the factors leading to prolapse of uterus. How would you manage the case of 3rd degree u terivagiral prolapse in a 38-year-old woman who has completed her family?
(c) A 35-year-old male sustains road traffic accident, On general examination, he 18 Griefited and pale, Pulse fate 12/ minute, GP 50/60 rTim pf Hz, TrairatcTy rate 32/minute. Chest contusion is present and right chest wall with decreased movement. On auscultation decreased breathing sound (Rt) with stony dullness (Rt) on percussion.

(i) Discuss the differential diagnosis.
(ii) How would you investigate?
(iii) Give the treatment of the above mentioned clinical scernario.