UPSC CMS 2025 Answer Key- Paper I
1. Which one of the following childhood epileptic disorders often needs long term treatment with anti epileptic drugs?
(a) Benign neonatal seizures
(b) Febrile seizures
(c) Benign rolandic epilepsy
(d) Juvenile myoclonic epilepsy
Correct answer: (d) Juvenile myoclonic epilepsy
2. Identify the clinical features associated with Parkinson’s disease: PYT
I. Reduced eye blinking
II. Drooling of saliva
III. Soft voice
IV. Macrographia
Select the correct answer:
(a) I, II, and III
(b) I, II, and IV
(c) I, III, and IV
(d) II, III, and IV
Correct answer: (a) I, II, and III
Small handwriting- micrographia (Slowness of movement)
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3. A 35 year female presents with easy fatigability. Investigations show that Hb is 6 g%; Red cell morphology is normocytic normochromic; and reticulocyte production index is 5.5. Which one of the following conditions favours this abnormality?
(a) Iron deficiency anemia
(b) Sideroblastic anemia
(c) Folate deficiency
(d) Hemolysis
Correct answer: (d) Hemolysis
4. A 46 year old lady on vegan diet for a decade presents with chief complaints of tingling and numbness in lower limbs for two months and a history of swaying while walking through narrow corridors. Which one of the following blood tests is advisable for diagnosis in this patient?
(a) Serum protein electrophoresis
(b) Anti-gliadin antibodies
(c) Vitamin 25(OH) D level
(d) Vitamin B12 levels
Correct answer: (d) Vitamin B12 levels
5. Which of the following conditions causes low-volume erythrocytosis?
(a) Polycythemia Rubra Vera
(b) Exogenous testosterone therapy
(c) Gaisbock’s syndrome
(d) High altitude
Correct answer: (c) Gaisbock’s syndrome
6. What is the first-line therapy in the chronic phase of chronic myeloid leukemia? PYQ 2009
(a) Rituximab
(b) Thalidomide
(c) Imatinib
(d) Chlorambucil
Correct answer: (c) Imatinib
7. Regarding management of idiopathic thrombocytopenic purpura, which statements are correct?
I. All patients with ITP and platelet count <100×10⁹/L should receive high-dose glucocorticoids
II. For patients with spontaneous bleeding, dexamethasone 40 mg daily for 4 days is indicated
III. Intravenous immunoglobulin can raise the platelet count
IV. Life-threatening bleeding should be treated with platelet transfusion
Select the correct answer:
(a) I, II and IV
(b) II, III and IV
(c) I, III and IV
(d) I, II and IV
Correct answer: (b) II, III and IV
Platelet count of more than 30 × 10 /L do not require treatment to raise the platelet count.
8. Which of the following drugs can cause secondary weight gain? PYQ 2021
I. Insulin
II. Propranolol
III. Orlistat
IV. Thyroxine
Select the correct answer using the code given below:
(a) I, II and IV
(b) I and III
(c) II, III and IV
(d) I and II only
Correct answer: (d) I and II only
9. Under which one of the following conditions, the HPA axis suppression is likely to result in crisis due to adrenal insufficiency following withdrawal of glucocorticoids?
(a) If glucocorticoids were given intravenously for five days
(b) If glucocorticoids were given orally for one week
(c) If glucocorticoids were prescribed repeatedly within the past year
(d) If the dose is less than 5 mg prednisolone per day
Correct answer: (c) If glucocorticoids were prescribed repeatedly within the past year
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10. What is the mode of inheritance of Wilson’s disease? PYQ 2008,2017,2013
(a) X-linked recessive
(b) Autosomal dominant
(c) Autosomal recessive
(d) It is an acquired disease
Correct answer: (c) Autosomal recessive
11. Which of the following can be used for management of severe hyperkalemia? PYQ: UPSC CMS 2021
I. Intravenous calcitonin
II. Intravenous sodium bicarbonate
III. Oral sodium polystyrene sulfonate
IV. Intravenous calcium gluconate
Select the correct answer:
(a) I, II and IV
(b) II, III and IV
(c) I and II only
(d) III and IV only
Correct answer: (b) II, III and IV
12. Which one of the following conditions can cause euvolemic hyponatremia?
(a) Adrenocortical failure
(b) Hypothyroidism
(c) Nephrotic syndrome
(d) Burns
Correct answer: (b) Hypothyroidism
13. Which of the following is correct regarding arginine vasopressin antagonist Tolvaptan?
(a) It is useful in hypovolemic hyponatremia
(b) It antagonizes the V1 receptor
(c) It should be used for at least 1 year
(d) It is an oral drug
Correct answer: (d) It is an oral drug
14. Which condition is caused by mutation in the NKCC2 gene, and presents with sodium wasting, hypokalemia, hypomagnesemia, and hypercalciuria?
(a) Alport syndrome
(b) Bartter syndrome
(c) Fanconi syndrome
(d) Gitelman syndrome
Correct answer: (b) Bartter syndrome
15. A 52-year-old male has uncontrolled diabetes. Which test helps in early detection of nephropathy? PYQ 2005
(a) Blood urea level
(b) Serum creatinine level
(c) Ultrasonography
(d) Urine albumin
Correct answer: (d) Urine albumin
16. Autosomal dominant mutation in which gene may cause focal segmental glomerulosclerosis with abnormal genitalia, Wilms tumor, and mental retardation? PYQ 2010
(a) WT1
(b) INF2
(c) LMX1B
(d) APOL1
Correct answer: (a) WT1
17. Kidney damage with Glomerular Filtration Rate (GFR) of 15–29 mL/min/1.73 m² corresponds to which stage of Chronic Kidney Disease? PYQ: UPSC CMS 2024
(a) Stage 2 (mild)
(b) Stage 3A (mild to moderate)
(c) Stage 4 (severe)
(d) Stage 5 (kidney failure)
Correct answer: (c) Stage 4 (severe)
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18. Which one of the following tubulo-interstitial kidney diseases is inherited in an autosomal recessive pattern?
(a) Medullary cystic kidney disease type 1
(b) Medullary cystic kidney disease type 2
(c) Nephronophthisis
(d) Juvenile hyperuricemic nephropathy
Correct answer: (c) Nephronophthisis
19. Which of the following findings in a patient suggest acute nephritis? PYT 2017
I. Hematuria
II. Oliguria
III. Reduced size of both kidneys
IV. Edema
Select the correct answer:
(a) I and III
(b) III and IV
(c) I and II only
(d) I, II and IV
Correct answer: (d) I, II and IV
20. A 35-year-old male presents with increased urine output. On evaluation, his urinary output is around 4 L/day and urinary osmolality is 200 mosmol/L. Which of the following are possible differential diagnoses? PYT 2007,2021
I. Psychogenic polydipsia
II. Solute diuresis
III. Central diabetes insipidus
IV. Nephrogenic diabetes insipidus
Select the correct answer:
(a) I, III and IV
(b) I and III only
(c) II and IV
(d) I and IV only
Correct answer: (a) I, III and IV
21. Contralateral homonymous upper quadrantanopia occurs due to a lesion in which anatomical location? PYQ 2024
(a) Frontal lobe
(b) Temporal lobe
(c) Parietal lobe
(d) Occipital lobe
Correct answer: (b) Temporal lobe
22. Which of the following are clinical features of migraine? PYT 2011,2012,2024
I. It is associated with dilatation of extracranial vessels
II. Common migraine is seen without aura
III. Aura is most often visual
Select the correct answer:
(a) I, II and III
(b) I and II only
(c) II and III only
(d) I and III only
Correct answer: (a) I, II and III
23. A 50-year-old man has brief episodes of lancinating unilateral facial pain in the buccal region, triggered by washing with cold water. What is the most likely diagnosis? PYT 2020
(a) Migraine
(b) Medication overuse headache
(c) Chronic paroxysmal hemicrania
(d) Trigeminal neuralgia
Correct answer: (d) Trigeminal neuralgia
24. Which of the following are seizure trigger factors? PYQ 2024
I. Sleep deprivation
II. Missed doses of antiepileptic drugs
III. Recreational drug misuse
IV. Physical exhaustion
Select the correct answer:
(a) II and III only
(b) I and IV only
(c) I, II and III only
(d) I, II, III and IV
Correct answer: (d) I, II, III and IV
Practice MCQ & PYQ 2024
25. What is the most likely diagnosis in a patient with periorbital swelling, fatigue, and macroglossia? PYT 2019
(a) Pancreatitis
(b) Myxedema
(c) Sarcoidosis
(d) Rheumatoid arthritis
Correct answer: (b) Myxedema
26. ‘Masson bodies’ due to immature collagen proliferation are characteristic of which condition?
(a) Lymphocytic interstitial pneumonia
(b) Cryptogenic organizing pneumonia
(c) Usual interstitial pneumonia
(d) Respiratory bronchiolitis
Correct answer: (b) Cryptogenic organizing pneumonia
27. Which statements are correct regarding respiratory function in old age?
I. There is increasing ventilation-perfusion mismatch
II. There is increased ventilatory response to hypoxia and hypercapnia
III. Decline in maximum oxygen uptake reduces cardiorespiratory reserve
IV. FEV1/FVC declines by 0.2–0.3% per year after age 40
Select the correct answer:
(a) I, II and III
(b) I, II and IV
(c) II, III and IV
(d) I, III and IV
Correct answer: (d) I, III and IV
Exact MCQ from our Practice Question bank
28. Which statement is correct regarding pulmonary involvement in rheumatoid disease?
(a) Rheumatoid nodules are usually asymptomatic and incidentally detected
(b) Nodules are often solitary and near hilum
(c) Pleural effusion is transudative & usually B/L
(d) Combination of pleural effusion and pneumoconiosis in these patients is known as Caplan syndrome
Correct answer: (a) Rheumatoid nodules are usually asymptomatic and incidentally detected
29. Which one of the following conditions is a complication of bacterial pharyngitis involving extension of infection into the internal jugular veins leading to thrombosis and metastatic dispersal of the organism?
(a) Cystic fibrosis
(b) Chronic pulmonary aspergillosis
(c) Lemierre syndrome
(d) Wegener’s granulomatosis
Correct answer: (c) Lemierre syndrome
30. A 42-year-old man with alcohol dependence has ascites and shifting dullness. What is the most appropriate drug to relieve abdominal distension?
(a) Octreotide
(b) Propranolol
(c) Lactulose
(d) Spironolactone
Correct answer: (d) Spironolactone
31. What is the investigation of choice for detecting gallbladder stones?
(a) Transabdominal ultrasound
(b) Erect X-ray abdomen
(c) Capsule endoscopy
(d) Computed tomography
Correct answer: (a) Transabdominal ultrasound
32. Which biologic agent used in inflammatory bowel disease inhibits Janus kinase enzyme?
(a) Infliximab
(b) Adalimumab
(c) Vedolizumab
(d) Tofacitinib
Correct answer: (d) Tofacitinib
33. Melanosis coli from chronic stimulant laxative use shows mucosal pigmentation due to which pigment?
(a) Melanin
(b) Haemosiderin
(c) Lipofuscin
(d) Hemoglobin
Correct answer: (c) Lipofuscin
34. Regarding Gilbert Syndrome, which statements are correct? PYT 2006,2022
I. Autosomal recessive trait for mutation in UDP-glucuronyl transferase
II. Elevation of unconjugated bilirubin
III. No stigmata of chronic liver disease other than jaundice
IV. Early liver biopsy is recommended in suspected Gilbert Syndrome
Select the correct answer:
(a) I and II only
(b) II and III only
(c) I, II and III
(d) III and IV
Correct answer: (c) I, II and III
35. What is the single most important treatment and prognostic factor in alcohol-related liver disease?
(a) N-acetyl cysteine
(b) Cessation of alcohol consumption
(c) Liver transplantation
(d) High-dose vitamin E
Correct answer: (b) Cessation of alcohol consumption
36. A chronic pancreatitis patient presents with abdominal skin pigmentation and history of hot water bottle use. What is the diagnosis?
(a) Erythema infectiosum
(b) Erythema marginatum
(c) Erythema nodosum
(d) Erythema ab igne
Correct answer: (d) Erythema ab igne
37. Which heart sounds are best heard with the bell of the stethoscope?
I. Opening snap
II. Systolic click
III. Third heart sound
IV. Mid-diastolic murmur
Select the correct answer:
(a) I and IV
(b) II and III only
(c) III and IV
(d) I, II and III
Correct answer: (c) III and IV
38. Which findings help diagnose a ventricular aneurysm in a recent myocardial infarction patient?
I. Paradoxical impulse on chest wall
II. Persistent ST elevation on ECG
III. Unusual bulge from cardiac silhouette on X-ray
IV. Presence of pulsus paradoxus
Correct option: (a) I, II and III
39. Which is true regarding subcutaneous nodules in rheumatic fever?
(a) They are present over flexor aspect of forearm
(b) They are painful tender nodules
(c) The usual size is 3–5 cm
(d) They typically appear more than 3 weeks after other manifestations
Correct answer: (d) They typically appear more than 3 weeks after other manifestations
40. Which is correct about Carey Coombs murmur?
(a) Soft systolic murmur due to mitral regurgitation
(b) Soft mid-diastolic murmur due to mitral valvulitis
(c) Harsh early diastolic murmur due to aortic regurgitation
(d) Blowing late systolic murmur due to aortic stenosis
Correct answer: (b) Soft mid-diastolic murmur due to mitral valvulitis
41. Which is correct regarding the Opening Snap (OS) in mitral stenosis? PYT 2021,2013
(a) OS is best heard with the bell of the stethoscope
(b) OS intensity increases with valve calcification
(c) OS moves closer to S2 as stenosis becomes more severe
(d) OS is best heard at the second left intercostal space
Correct answer: (c) OS moves closer to S2 as stenosis becomes more severe
42. Which intravenous adenosine response is correctly matched with the arrhythmia?
(a) Atrial fibrillation — Termination
(b) Atrioventricular nodal reentrant tachycardia — Termination and complete recovery
(c) Ventricular tachycardia — Termination
(d) Atrial flutter — Termination and complete recovery
Correct answer: (b) Atrioventricular nodal reentrant tachycardia — Termination and complete recovery
43. Consider the following steps for using a metered dose inhaler (MDI):
I. Incline the head backward to minimize oropharyngeal deposition
II. Remove the cap and shake the inhaler
III. Breathe out gently and place the mouthpiece into the mouth
IV. Hold the breath for 10 seconds
V. Simultaneously, begin a slow deep inspiration, depress the canister and continue to inhale
Which one of the following is the correct sequence of using MDI?
(a) III, II, I, V, IV
(b) II, I, IV, III, V
(c) II, III, I, V, IV
(d) III, I, II, IV, V
Correct answer: (c) II, III, I, V, IV
Exact MCQ asked from our Practice Question bank
44. Under the Stepwise Approach to Bronchial Asthma, what is the correct initial treatment at Step I for a patient diagnosed with asthma?
(a) Low dose inhaled corticosteroid only
(b) Low dose inhaled corticosteroid plus oral corticosteroid
(c) Low dose inhaled corticosteroid plus long-acting anti-muscarinic agents
(d) Low dose inhaled corticosteroid plus leukotriene antagonist
Correct answer: (a) Low dose inhaled corticosteroid only
45. A 62-year-old chronic smoker with COPD has FEV₁/FVC reduced and FEV₁ 70% of predicted. What is the severity of airflow obstruction as per GOLD criteria?
(a) Stage I – Mild
(b) Stage II – Moderate
(c) Stage III – Severe
(d) Stage IV – Very severe
Correct answer: (b) Stage II – Moderate
Rapid Revision & Practice Que bank
46. What is the inheritance pattern of cystic fibrosis? PYQ 2021
(a) Autosomal Dominant
(b) Autosomal Recessive
(c) X-linked Dominant
(d) X-linked Recessive
Correct answer: (b) Autosomal Recessive
47. Which of the following are contraindications for noninvasive positive-pressure ventilation in respiratory failure?
I. Craniofacial abnormalities
II. Significant burns
III. Respiratory failure with PaCO₂ of 60 mm Hg
IV. Cardiovascular instability
Select the correct answer:
(a) I, II and III
(b) I, II and IV
(c) I, III and IV
(d) II, III and IV
Correct answer: (b) I, II and IV
The initiation of noninvasive positive-pressure ventilation (NIPPV) in patients with respiratory failure, defined as Paco >45 mmHg, results in a significant reduction in mortality rate, need for intubation, complications of therapy, and hospital length of stay. Contraindications to NIPPV include cardiovascular instability, impaired mental status, inability to cooperate, copious secretions or the inability to clear secretions, craniofacial abnormalities or trauma precluding effective fitting of mask, extreme obesity, or significant burns.
Ref: Harrison, E-21th,p-2189
48. What term denotes extensive sclerosis of the chest wall restricting movement, seen in systemic sclerosis?
(a) Flail Chest
(b) Hidebound Chest
(c) Barrel Chest
(d) Pigeon Chest
Correct answer: (b) Hidebound Chest
49. What is correct for diagnosis of Giardiasis?
(a) Stool sample at 2–3 day intervals should be examined for cysts
(b) String test is used to find cysts of Giardia lamblia
(c) Jejunal biopsy can show larvae of Giardia lamblia
(d) Cystic form of Giardia lamblia survives in water up to 1 week only
Correct answer: (a) Stool sample at 2–3 day intervals should be examined for cysts
50. ‘Get up and go test’ in elderly evaluates:
(a) Gait and balance
(b) Cognition
(c) Driving ability
(d) Urinary incontinence
Correct answer: (a) Gait and balance
51. First-choice treatment in acute gout is:
(a) Oral Methotrexate
(b) Oral Colchicine
(c) Azathioprine
(d) Sulfasalazine
Correct answer: (b) Oral Colchicine
52. Best site for intercostal drain insertion in pneumothorax:
(a) Hesselbach’s triangle
(b) Petit’s triangle
(c) Triangle of safety
(d) Triangle of auscultation
Correct answer: (c) Triangle of safety
53. Antidote for Rivaroxaban and Apixaban in uncontrolled bleeding:
(a) Idarucizumab
(b) Andexanet Alfa
(c) Hydroxocobalamin
(d) Glucarpidase
Correct answer: (b) Andexanet Alfa
54. Common causes of mediastinal masses in superior and anterior mediastinum include:
I. Goitre
II. Thymic tumour
III. Neurogenic tumour
Select the correct answer:
(a) I and II only
(b) II and III only
(c) I and III only
(d) I, II and III
Correct answer: (a) I and II only
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55. Which one of the following is used to reverse the anticoagulant effects of Dabigatran?
(a) Glucarpidase
(b) Desferrioxamine
(c) Idarucizumab
(d) Protamine
Correct answer: (c) Idarucizumab
56. Which one of the following is a contraindication for wireless capsule endoscopy?
(a) Coeliac disease
(b) Small bowel stricture
(c) Occult gastrointestinal bleeding
(d) Small bowel Crohn’s disease
Correct answer: (b) Small bowel stricture
57. What is the causative organism of Erythrasma, a mild, localized superficial skin infection?
(a) Corynebacterium pseudotuberculosis
(b) Corynebacterium minutissimum
(c) Corynebacterium diphtheriae
(d) Corynebacterium mattuchotii
Correct answer: (b) Corynebacterium minutissimum
58. Which of the following is correctly matched regarding classification of portal hypertension by vascular obstruction site?
(a) Sinusoidal — Veno-occlusive
(b) Pre-hepatic — Portal vein thrombosis
(c) Intrahepatic presinusoidal — Cirrhosis
(d) Post-hepatic postsinusoidal — Schistosomiasis
Correct answer: (b) Pre-hepatic — Portal vein thrombosis
(a) Sinusoidal — Cirrhosis
(b) Pre-hepatic — Portal vein thrombosis
(c) Intrahepatic presinusoidal — Schistosomiasis
(d) Post-hepatic postsinusoidal — Budd Chiari
59. Which of the following is a secondary cause of headache?
(a) Migraine
(b) Tension-type headache
(c) Trigeminal autonomic cephalalgia
(d) Medication overuse headache
Correct answer: (d) Medication overuse headache
60. A 32-year-old man with recurrent jaundice and facial grimacing. What is a clinical clue to the diagnosis?
(a) Adenoma sebaceum in the mid-face
(b) Erythema nodosum on the skin
(c) Kayser-Fleischer rings in the cornea
(d) Osler’s nodes at the fingertips
Correct answer: (c) Kayser-Fleischer rings in the cornea
61. Which statements are typical for classic heat stroke? PYT 2020
I. Older patient
II. Normokalemia
III. Hyponatremia
IV. Marked lactic acidosis
Select the correct answer:
(a) I and III
(b) I and II
(c) III and IV
(d) II and IV
Correct answer: (a) I and III
62. Which of the following statements are correct regarding Weil’s disease?
I. It is caused by a virus named leptospira
II. Acute kidney injury can lead to oliguria
III. Microscopic agglutination test is the investigation of choice
IV. Ceftriaxone given parenterally is effective treatment
Select the correct answer:
(a) I, II and III
(b) II, III and IV
(c) I, II and IV
(d) III and IV
Correct answer: (b) II, III and IV
Leptospira- Bacteria; Not virus
63. Which of the following are components of the SOFA scoring system?
I. PaO₂/FiO₂ ratio
II. Mean arterial pressure
III. Glasgow coma scale
IV. Prothrombin time with INR
Select the correct answer:
(a) I, II and III
(b) II, III and IV
(c) I, III and IV
(d) I, II and IV
Correct answer: (a) I, II and III
64. What are the components for establishing the diagnosis of brain death? PYQ 2018
I. Absent brainstem reflexes
II. Apnoea in presence of elevated PCO₂
III. Hypothermia
IV. Irreversible and unresponsive coma
Select the correct answer:
(a) I, II and III
(b) I, II and IV
(c) III and IV
(d) II and IV only
Correct answer: (b) I, II and IV
65. The most common cause of non-traumatic subarachnoid hemorrhage is:
(a) A-V malformation
(b) Vascular aneurysm rupture
(c) Extension from primary intracerebral hemorrhage
(d) Idiopathic
Correct answer: (b) Vascular aneurysm rupture
66. Perioperative respiratory failure is an example of:
(a) Type I respiratory failure
(b) Type II respiratory failure
(c) Type III respiratory failure
(d) Type IV respiratory failure
Correct answer: (c) Type III respiratory failure
67. Murmur of mitral regurgitation is best heard at:
(a) Tricuspid area
(b) Aortic area
(c) Cardiac apex
(d) Pulmonary area
Correct answer: (c) Cardiac apex
68. A 25-year-old female presents with fever, agitation, and delirium; she is on carbimazole and missed recent doses. Which scoring system should be used to assess severity?
(a) DAS-28 score
(b) Burch-Wartofsky score
(c) Expanded Disability Status Scale
(d) Sequential Organ Failure Assessment (SOFA) Score
Correct answer: (b) Burch-Wartofsky score
69. Which area of the brain is most commonly affected in Wilson’s disease?
(a) Cerebellum
(b) Sub-cortex
(c) Thalamus
(d) Basal ganglia
Correct answer: (d) Basal ganglia
70. Which of the following are secondary iron overload conditions?
I. Transfusion-related iron load
II. Thalassemia
III. Hepatitis C associated liver disease
Select the correct answer:
(a) I, II and III
(b) I and II only
(c) II and III only
(d) I and III only
Correct answer: (a) I, II and III
71. Which of the following are features of Alzheimer’s disease?
I. It is a disorder of cerebral cortical function
II. Only short-term memory is affected
III. Patients deny anything is wrong
IV. Depression is commonly present
Select the correct answer:
(a) I, II and III
(b) II and IV
(c) I, III and IV
(d) II, III and IV
Correct answer: (c) I, III and IV
72. Glymphatics is the lymphatic structure of which system?
(a) Central Nervous System
(b) Respiratory System
(c) Renal System
(d) Gastrointestinal System
Correct answer: (a) Central Nervous System
73. Which of the following joints are commonly affected in osteoarthritis?
I. First metatarsophalangeal joint
II. Proximal interphalangeal joint
III. Ankle joint
IV. 5th and 6th cervical vertebrae
Select the correct answer:
(a) I and II only
(b) III and IV only
(c) I, II and IV only
(d) I, II, III and IV
Correct answer: (c) I, II and IV only
74. Which of the following are causes of reversible dementia?
I. Hypothyroidism
II. Vitamin B12 deficiency
III. Dementia with Lewy bodies
IV. Thiamine deficiency
Select the correct answer:
(a) I, II and III
(b) I, II and IV
(c) I, III and IV
(d) II, III and IV
Correct answer: (b) I, II and IV
75. Which of the following are clinical features of frontotemporal dementia?
I. Personality change
II. Language disturbance
III. Memory may be preserved in early stages
IV. Anticholinesterases are the drug of choice
Select the correct answer:
(a) I, II and III
(b) I, II and IV
(c) I, III and IV
(d) II, III and IV
Correct answer: (a) I, II and III
76. Which one of the following is the myelinating cell of the Central Nervous System?
(a) Astrocyte
(b) Microglia
(c) Schwann cell
(d) Oligodendrocyte
Correct answer: (d) Oligodendrocyte
77. Which one of the following correctly describes Mee’s lines seen in chronic arsenic poisoning?
(a) Transverse white lines on nails of fingers and toes
(b) Transverse red lines on the skin of palms and soles
(c) Transverse white lines on the skin of palms and soles
(d) Transverse red lines on the nails of fingers and toes
Correct answer: (a) Transverse white lines on nails of fingers and toes
78. Fomepizole is an antidote used to treat poisoning from which of the following substances?
I. Methanol
II. Digoxin
III. Cocaine
IV. Ethylene glycol
Select the correct answer using the code given below:
(a) I and II
(b) II and III
(c) III and IV
(d) I and IV
Correct answer: (d) I and IV
79. The 4A Test is a screening tool for detecting delirium. Which parameters are included?
I. Alertness
II. Apnoea
III. Abbreviated Mental Test (AMT4)
IV. Attention
Select the correct answer:
(a) I, II and III
(b) I and IV
(c) I, III and IV
(d) II, III and IV
Correct answer: (c) I, III and IV
80. Which combination of lab tests indicates heavy alcohol consumption with >60% sensitivity and specificity?
(a) GGT > 35 U/L and alkaline phosphatase > 45 U/L
(b) CDT > 20 U/L and serum uric acid < 7 mg/dL
(c) High normal MCV > 91 and CDT < 20 U/L
(d) GGT > 35 U/L and CDT > 20 U/L
Correct answer: (d) GGT > 35 U/L and CDT > 20 U/L
81. What is the antidote for belladonna poisoning?
(a) Physostigmine
(b) Amitriptyline
(c) Atropine
(d) Flumazenil
Correct answer: (a) Physostigmine
82. Which of the following prevents gastrointestinal absorption of thallium?
(a) Calcium carbonate
(b) Prussian blue
(c) Penicillamine
(d) Potassium permanganate
Correct answer: (b) Prussian blue
83. A 45-year-old farmer consumed pesticide and presents with frequent urination and salivation. What is the most likely toxidrome?
(a) Serotonergic
(b) Cholinergic
(c) Adrenergic
(d) Hypnotic
Correct answer: (b) Cholinergic
84. In salicylate poisoning, which parameters suggest the likely acid-base disturbance?
I. Arterial pH 7.25, anion gap 18 mmol/L
II. Arterial pH 7.25, anion gap 10 mmol/L
III. pCO₂ of 20 mm Hg
IV. pCO₂ of 48 mm Hg
Select the correct answer:
(a) I and III
(b) II and III
(c) I and IV
(d) II and IV
Correct answer: (a) I and III
85. Which vector transmits the filarial parasite Loa loa?
(a) Simulium
(b) Chrysops
(c) Cyclops
(d) Culicoides
Correct answer: (b) Chrysops
86. Which of the following is the most favorable prognostic parameter in Bell’s palsy?
(a) Incomplete paralysis in the first week
(b) Mild CSF lymphocytosis
(c) Denervation in EMG after 10 days
(d) Pain behind the ear
Correct answer: (a) Incomplete paralysis in the first week
87. Which group of drugs is ineffective against gram-positive bacteria?
(a) Monobactams
(b) Glycopeptides
(c) Fluoroquinolones
(d) First generation cephalosporins
Correct answer: (a) Monobactams
88. Which one of the following statements is correct regarding leprosy? PYT
(a) Type I leprosy reaction is also called erythema nodosum leprosum
(b) Type II leprosy reaction is an immune complex-mediated syndrome called Arthus phenomenon
(c) ‘Lion face’ appearance is seen in tuberculoid leprosy
(d) Nose is the last site of involvement in lepromatous leprosy
Correct answer: (d) Nose is the last site of involvement in lepromatous leprosy
89. A 56-year-old gardener has a purulent ulcerative nodule on his finger after a thorn prick. What is the most likely infection?
(a) Chromoblastomycosis
(b) Mycetoma
(c) Phaeohyphomycosis
(d) Sporotrichosis
Correct answer: (d) Sporotrichosis
90. A 36-year-old man has decreased appetite, sore mouth, diarrhea, and a red tongue with a pigmented scaly neck rash. Which food item in his diet is relevant?
(a) Rice
(b) Corn
(c) Milk
(d) Potato
Correct answer: (b) Corn
91. Acrodermatitis enteropathica is a metabolic disorder affecting absorption of:
(a) Iodine
(b) Zinc
(c) Iron
(d) Selenium
Correct answer: (b) Zinc
92. Which statements are correct regarding treatment of vitamin A deficiency?
I. Repeated high doses of retinol can cause liver damage and teratogenicity
II. Acute overdose may lead to raised intracranial pressure and skin desquamation
III. Regular vitamin A supplementation is recommended for pregnant women even in non-deficient countries
IV. Excessive carotene intake may cause harmless orange skin pigmentation
Select the correct answer:
(a) I, II and III
(b) I, II and IV
(c) II, III and IV
(d) I, III and IV
Correct answer: (b) I, II and IV
93. Koebner phenomenon is seen in:
(a) Psoriasis
(b) Acne vulgaris
(c) Behçet’s disease
(d) Leprosy
Correct answer: (a) Psoriasis
94. Regarding the human hair growth cycle, which statements are correct?
I. Anagen is the active growth phase
II. Telogen is the transitional phase
III. Catagen is the resting phase
(a) I only
(b) III only
(c) I and II only
(d) I, II and III
Correct answer: (a) I only
95. Which statements are correct about oculocutaneous albinism?
I. Caused by genetic abnormalities leading to melanocyte destruction
II. Type 1 albinism is due to tyrosinase gene defect
III. Patients may have poor vision, rotatory nystagmus, alternating strabismus
IV. Increased risk of sunburn and skin cancer
(a) I, II and III
(b) II and IV
(c) I, III and IV
(d) II, III and IV
Correct answer: (d) II, III and IV
Pediatrics: 8 questions from Cerebrum
96. A 42-year-old man has recurrent oral, genital ulcers and eye redness. Which test is diagnostically useful?
(a) Mantoux test
(b) Drug-sensitivity test
(c) Pathergy test
(d) Patch test
Correct answer: (c) Pathergy test
97. Which one of the following oral drugs may be used in the management of super-refractory status epilepticus?
(a) Clonazepam
(b) Clobazam
(c) Lamotrigine
(d) Topiramate
98. Which of the following statements are correct regarding the use of benzodiazepines in the initial management of status epilepticus?
I. Up to two doses may be used 5 minutes apart if seizures are not controlled
II. For Lorazepam, only a single dose should be used, even if seizures are not controlled
III. Dose of midazolam at this stage is 1–15 μg/kg/min infusion
IV. Dose of both lorazepam and midazolam is 0.1 mg/kg IV
(a) I and III
(b) I and IV
(c) II and III
(d) II and IV
99. Which of the following statements are correct regarding hypernatremia in children?
I. Diabetes insipidus due to a deficiency of antidiuretic hormone (ADH) may cause hypernatremia
II. Addison disease may be associated with hypernatremia
III. Use of boiled skimmed milk can lead to hypernatremia
IV. Use of lactulose can lead to hypernatremia
(a) I, III & IV
(b) II, III & IV
(c) I, II and III
(d) I, II and IV
100. Which of the following statements are correct regarding the management of gastrointestinal bleeding in children?
I. Somatostatin or octreotide infusion should be given for at least 7 days after stoppage of initial bleeding to prevent rebleeding
II. Endoscopic sclerotherapy (EST) involves endoscopic injection of N-butyl-2-cyanoacrylate or isobutyl-2-cyanoacrylate
III. EST has up to 90% efficacy in controlling acute bleeding
IV. Following an episode of acute variceal bleeding, all patients should receive secondary prophylaxis to prevent rebleeding
(a) I & II
(b) I & III
(c) III & IV
(d) II % IV
Somatostatin or octreotide infusion should be given for at least 24-48 hours after the bleeding has stopped and should not be discontinued abruptly.
EST involves endoscopic injection of 1-3 mL of sclerosant 1% ethoxysclerol. Gastric varices are managed with endoscopic injection of tissue adhesive glue, i.e. N-butyl-2-cyanoacrylate or isobutyl-2-cyanoacrylate.
101. Which of the following are advantages of endotracheal intubation in a child requiring pediatric advanced life support?
I. Inspiratory time can be controlled
II. Positive end-expiratory pressure can be provided
III. Peak expiratory pressure can be controlled
IV. Reduced risk of aspiration of gastric contents
(a) I, II and III
(b) I, II and IV
(c) I, III and IV
(d) II, III and IV
Answer: (b) I, II and IV
The advantages of endotracheal intubation are: (i) It ensures adequate ventilation; (ii) reduced risk of aspiration of gastric contents; (iii) inspiratory time and peak inspiratory pressure can be controlled; (iv) suction can be done to keep airway patent; and (v) positive end-expiratory pressure can be provided.
Ref: Ghai,E-10th,p-765
102. Which of the following are causes of hypocalcemia in a child ?
I. Hypomayrsemia
II. Hypophosphatemia
III. Metabolic acidosis
IV. Pseudohypoparathyroidism
Select the correct answer using the code given below :
(a) I and II
(b) II and III
(c) III and IV
(d) I and IV
Hyperphosphatemia (excess intake, CKD) & metabolic alkalosis are the causes of Hypocalcemia.
103. Which of the following are included as a “Deficiency” under the Rashtriya Bal Swasthya Karyakram (RBSK)?
I. Hypothyroidism
II. Vitamin A deficiency
III. Anemia
IV. Vitamin D deficiency
Select the correct answer using the code given below:
(a) I, II and III
(b) I, II and IV
(c) I, III and IV
(d) II, III and IV
Correct answer: (d) II, III and IV
104. Which of the following statements are correct regarding management of hyperkalemia in a child?
I. Intravenous calcium (gluconate or chloride) is given to enhance cellular uptake of potassium
II. Beta adrenergic agonists (salbutamol or terbutaline) are used to stabilize myocardial cell membrane
III. Regular insulin and glucose given intravenously enhance cellular uptake of potassium
IV. Sodium polystyrene sulfonate enhances total body potassium elimination
Select the answer using the code given below:
(a) I and II
(b) II and III
(c) I and IV
(d) III and IV
Correct answer: (d) III and IV
105. Which of the following statements are correct about oral rotavirus vaccines?
I. The storage should be at 2–8°C
II. The vaccine should be used within 2 hours of reconstitution or opening
III. Past history of intussusception is a contraindication
IV. The vaccine can be given if the baby has ongoing diarrhoea
Select the answer using the code given below:
(a) I and II
(b) III and IV
(c) I and III
(d) II and IV
Correct answer: (c) I and III
Postpone vaccination during ongoing diarrhea or moderate illness.
Use within 4 hours of reconstitution or opening.
The storage should be at 2–8°C except Rotasiil ( can be stored at < 25’C)
From Test Series
106. A child can make a tower of 3 blocks, runs, copies his mother while sweeping and has a vocabulary of 8–10 words. His developmental age is:
(a) 12 months
(b) 15 months
(c) 18 months
(d) 24 months
Correct answer: (c) 18 months
Rapid Revision
Also in Test series
107. A child can ride a tricycle, copies a circle, knows name and gender. The developmental age of this child is:
(a) 2 years
(b) 3 years
(c) 4 years
(d) 5 years
Correct answer: (b) 3 years
Rapid Revision
108. A term boy with birth weight of 3 kg is born to a primigravida mother through vaginal delivery and cried immediately after birth. Which of the following statements are correct regarding his initial care after birth?
I. The baby should be initiated on breastfeeding within one hour of birth
II. The baby should be kept in a separate area from the mother
III. The baby should be administered with 0.5 mg of vitamin K intramuscularly
IV. The baby should be thoroughly examined for congenital malformations from head to toe
Select the answer using the code given below:
(a) I and II
(b) I and III
(c) II and III
(d) I and IV
Correct answer: (d) I and IV
Give vitamin K1 to all the neonates (0.5 mg in < 1000 g and 1 mg in those > 1000 g). Vitamin K3 can cause hemolysis in G6PD-deficient neonates.
From Test series
109. For a sick child aged 4 years, which of the following are signs of “severe pneumonia or very severe disease”, as per IMNCI (Integrated Management of Neonatal and Childhood Illness) Program?
I. Fast breathing (≥ 40 breaths per minute)
II. Child vomits everything
III. Stridor in a calm child
IV. Chest indrawing
Select the correct answer using the code given below:
(a) I and II
(b) II and III
(c) III and IV
(d) II and IV
Correct answer: (b) II and III
PYQ
110. In a child aged 3½ years with an ear problem, which one of these situations merits urgent referral to hospital?
(a) Pus seen draining from the ear, and discharge reported for less than 14 days
(b) Pus seen draining from the ear, and discharge reported for ≥ 14 days
(c) Tender swelling behind the ear
(d) Pus seen draining from both ears, irrespective of duration
Correct answer: (c) Tender swelling behind the ear
Tender swelling behind the ear → strongly suggests mastoiditis, a serious complication of acute otitis media, requiring hospital admission.
111. Up to 10% of cases of Autism Spectrum Disorder (ASD) may be caused by genetic conditions. Which of the following are known to be associated with ASD?
I. Tuberous sclerosis
II. Fragile X syndrome
III. Prader-Willi syndrome
IV. Patau syndrome
Select the correct answer using the code given below:
(a) I and II
(b) I and III
(c) II and III
(d) I and IV
Correct answer: (a) I and II
PYQ: UPSC CMS 2023
112. Which of the following are characteristic features of cerebral palsy?
I. Disorder of movement
II. Permanent nature
III. Progressive course
IV. Disorder of posture
Select the correct answer using the code given below:
(a) I, II and III
(b) I, II and IV
(c) II, III and IV
(d) III and IV
Correct answer: (b) I, II and IV
Cerebral palsy refers to permanent, nonprogressive and occasionally evolving disorders of tone, movement or posture, caused by an insult to the developing brain.
113. Which of the following are the tools used for classification of spasticity in a child with cerebral palsy?
I. Gross Motor Function Classification System
II. Medical Research Council System
III. Modified Connors Scale (Connors-II)
IV. Modified Ashworth Scale
Select the correct answer using the code given below:
(a) I and II
(b) II and III
(c) III and IV
(d) I and IV
Correct answer: (d) I and IV
114. Which of the following medications may be used in a child diagnosed with Attention Deficit Hyperactivity Disorder?
I. Carbamazepine
II. Methylphenidate
III. Atomoxetine
IV. Clonazepam
Select the correct answer using the code given below:
(a) I and III
(b) II and III
(c) II and IV
(d) III and IV
Correct answer: (b) II and III
From Test series
115. Which of the following are causes of secondary immunodeficiency in children?
I. Diphenylhydantoin
II. Severe malnutrition
III. Post-varicella state
IV. Nephrotic syndrome
Select the correct answer using the code given below:
(a) I, II and III
(b) I, II and IV
(c) I, III and IV
(d) II, III and IV
Correct answer: (b) I, II and IV
116. Which of the following statements are correct regarding vaccination routes for children?
I. Hepatitis B vaccine given in deltoid region has reduced efficacy
II. Two vaccines may be given in the same thigh, but separated by 1 inch
III. Separate sites are used when administering a vaccine and an immunoglobulin
IV. Two intramuscular vaccines may be given on the same day but in separate limbs
Select the answer using the code given below:
(a) III only
(b) I and III
(c) II and III
(d) I and IV
Correct answer: (c) II and III
From Test series
117. A radiopaque density may be noticed in poisoning by which of the following agents?
(a) Phenazopyridine
(b) Ethylene glycol
(c) Chloroquine
(d) Chloral hydrate
Correct answer: (d) Chloral hydrate
Rapid Revision
118. Which of the following syndromes are caused due to genomic imprinting?
I. Rubinstein-Taybi syndrome
II. Prader-Willi syndrome
III. Angelman syndrome
IV. Edward syndrome
Select the correct answer using the code given below:
(a) I and III
(b) II and III
(c) II and IV
(d) I and IV
Correct answer: (b) II and III
119. As per POCSO (Protection of Children from Sexual Offences) Act 2012, aggravated sexual assault is considered when:
I. The abuse involves use of physical violence
II. The abused child is disabled
III. The abuse is committed by staff of an educational institution
IV. The abuse is committed by an immediate family member/first-degree relative
Which of the above are correct?
(a) I and IV
(b) I and III
(c) II and III
(d) II and IV
Correct answer: (c) II and III
120. The mother of a 14-month-old normally developing baby comes to you for feeding advice. Which of the following would be appropriate for her as per the IMNCI (Integrated Management of Neonatal and Childhood Illness) Program?
I. Breastfeed as often as the child wants
II. Keep the child in your lap and feed with your own hands
III. Offer food from the family pot
IV. Give 3 to 4 meals each day
Select the correct answer using the code given below:
(a) II, III and IV
(b) I, III and IV
(c) I, II and III
(d) I, II and IV
Correct answer: (b) I, III and IV
Keep the child in your lap and feed with your own hands- till 12 months
12 months to 2 years: Sit by the side of child and help him to finish the serving. Meals 5 times/day.