UPSC CMS 2025 Answer Key- Paper II

Accurate. Verified. Reliable.

Surgery

1. Which of the following are correct regarding late dumping?

It usually occurs during the second hour after meal.
It lasts for 30–40 minutes.
Minor symptoms are tremor, prostration, faintness.
It is relieved by lying down.

Options:
(a) I, II, and III
(b) I, II and IV
(c) I, III, and IV
(d) II, III, and IV

Answer: (a) I, II, and III

Rapid Revision

2. The commonly used muscle relaxant with quickest onset of action and spontaneous recovery is:

(a) Suxamethonium
(b) Vecuronium
(c) Atracurium
(d) Rocuronium

Answer: (a) Suxamethonium

3. The first imaging modality of choice for a 35-year-old lady, presenting to surgical emergency with complaints of colicky pain in right lower quadrant of abdomen and vomiting since last 2 days:

(a) Contrast abdomen
(b) Non-contrast CT abdomen
(c) Ultrasound abdomen
(d) Plain X-ray abdomen erect view

Answer: (c) Ultrasound abdomen

4. Which one of the following statements is not correct regarding Gastric outlet obstruction associated with long-standing peptic ulcer disease?

(a) Hypochloraemic alkalosis is the usual metabolic abnormality in such cases.
(b) Endoscopic biopsy is essential to exclude malignancy.
(c) Medical therapy has no role in the treatment of this condition.
(d) Operation is frequently required along with a drainage procedure.

Answer: (c) Medical therapy has no role in the treatment of this condition

5. Mallampati test is used for the assessment of:

(a) Tongue size
(b) Ability to protrude jaw
(c) Breath hold time
(d) Airway

Answer: (d) Airway

6. Which of the following are the risk factors for post-operative wound dehiscence?

Diabetes
Hypertension
Renal failure
Jaundice

Options:
(a) I, II, and III
(b) I and IV
(c) II, III, and IV
(d) I, III, and IV

Answer: (d) I, III, and IV

7. If faced with a surgical emergency in a child of 15 years for whom no consent is available for life-saving surgery and no time for seeking authority from someone, the next step should be:

(a) Conservative management till lawyer is available
(b) Search for relatives or neighbours
(c) Consent arrangement through Hospital Social Worker
(d) Go ahead with surgery without consent

Answer: (d) Go ahead with surgery without consent

8. A surgical department of a premier medical college conducted a study on rates of post-operative wound infection. The results of the study were negative for the proposed hypothesis. What should the department do with the results?

(a) Label them as worthless
(b) Redo the study with a new hypothesis
(c) Report the negative results
(d) Redesign the study and increase the sample size

Answer: (c) Report the negative results

Negative findings should still be published if the study was properly designed and executed.
There is a risk of publication bias if only positive results are published, leading to distortion of evidence-based practice.

There is no point in conducting a research or audit project and then leaving the results unreported. Even when results are negative, they are worth distributing; no project if properly conducted is worthless. Under-reporting of negative outcomes causes a systematic bias in the literature in favour of positive trials.

Ref: Bailey,E-28th, CHAPTER 13 Surgical audit and research

9. Which of the following information needs to be disclosed in order to establish valid consent for surgical treatment?

I. Condition and reasons why it warrants surgery
II. Type of surgery proposed
III. Unexpected hazards of proposed surgery
IV. The surgical experience and expertise of the operating surgeon

Select the 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

Answer: (a) I, II and III

10. Which of the following statements are correct regarding sutures in surgery?

I. Barbed sutures have the advantage of eliminating the need for knots.
II. Vertical mattress sutures help in eversion of wound edges.
III. Aberdeen knot is used for continuous suturing.
IV. Silk is preferred for subcuticular suturing.

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

Answer: (a) I, II and III

11. The most common site of urethral opening in case of hypospadias is:
(a) Just proximal to the glans
(b) On the penile shaft
(c) At the junction of penile shaft and scrotum
(d) On the perineum
Answer: (a) Just proximal to the glans

12. Which of the following about Minimal Access Surgery are correct?
I. Decreased intraoperative heat Ioss
II. Improved visualization
III. Increased chances of herniation
IV. Improved mobility

Select the 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
Answer: (b) I, II and IV

13. Which of the following are the symptoms commonly experienced by patients with lymphoedema?
I. Swelling
II. Burning sensation
III. Intolerance to cold
IV. Cramps

Select the correct answer using the code given below:
(a) I, II and III
(b) I, III and IV
(c) II, III and IV
(d) I, II and IV
Answer: (d) I, II and IV

14. Which of the following are the malignancies associated with lymphoedema?
I. Kaposi Sarcoma
II. Squamous cell carcinoma
III. Malignant melanoma
IV. Leukaemia

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
Answer: (a) I, II and III

15. Maximum safe dose for lignocaine (without adrenaline) as a local anaesthetic drug is:
(a) 3 mg/kg
(b) 5 mg/kg
(c) 7 mg/kg
(d) 10 mg/kg
Answer: (a) 3 mg/kg

3 mg/kg (7 mg/kg with adrenaline)

16. Which of the following are the techniques commonly used to close the raw area after excision of a pilonidal sinus in order to avoid a midline wound?
I. Limberg procedure
II. Y-V plasty
III. Z-plasty
IV. Karydakis procedure

Select the correct answer using the code given below:
(a) I, II and III
(b) I, III and IV
(c) II, III and IV
(d) I, II and IV
Answer: (b) I, III and IV

Rapid Revision

17. Which one of the following is considered the gold standard for the diagnosis of oesophageal motility disorders?
(a) Upper GI endoscopy
(b) Barium swallow
(c) High resolution manometry
(d) Contrast enhanced CT scan (CECT)
Answer: (c) High resolution manometry

From Test series

18. Which of the following are considered aetiological factors for Adenocarcinoma oesophagus?
I. Barrett’s oesophagus
II. Gastro-oesophageal reflux
III. Obesity
IV. Alcohol intake

Select the correct answer using the code given below:
(a) I, II and III
(b) I, III and IV
(c) II, III and IV
(d) I, II and IV
Answer: (a) I, II and III

Directly from Notes

19. A lady presents with history of a painless lump in the right breast since 1 month. On examination, the lump is hard, 3 × 4 cm in size in the upper outer quadrant and is not fixed to the skin or the underlying structures. The axilla reveals firm mobile lymph nodes (level I). Rest of systemic examination is normal. The clinical stage of this disease is:
(a) cT1N1Mx
(b) cT2N1Mx
(c) cT1N0Mx
(d) cT1N2Mx
Answer: (b) cT2N1Mx

From Rapid Revision

20. Consider the following statements regarding Plummer-Vinson syndrome:
I. Findings include cervical oesophageal web, iron deficiency anaemia and dysphagia.
II. It is a rare disease, mainly affecting middle-aged women.
III. There is predisposition to postcricoid, cervical oesophageal cancer.
IV. Treatment is usually surgical.

Which of the statements given above are correct?
(a) I, II and III
(b) I, III and IV
(c) II, III and IV
(d) I, II and IV
Answer: (a) I, II and III

From Rapid Revision

21. The commonest site of pressure sore is:
(a) Heel
(b) Sacrum
(c) Ischium
(d) Occiput
Answer: (c) Ischium

From Rapid Revision

22. Which of the following are functions of the gall bladder?
I. Reservoir for bile
II. Production of bile
III. Secretion of mucus
IV. Concentration of bile

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
Answer: (c) I, III and IV

23. Good measure of systemic perfusion by ABG is by measurement of:
(a) Bicarbonate
(b) pH
(c) Lactate and/or the base deficit
(d) PCO₂
Answer: (c) Lactate and/or the base deficit

From Main Notes

24. Which of the following are criteria for cancer screening?
I. Screening test should be sensitive and specific
II. Screening test should be acceptable to the screened population
III. The disease should be an uncommon one for screening to be effective
IV. Disease should be recognisable at an early stage

Select the correct answer using the code given below:
(a) I, II and III
(b) I, III and IV
(c) II, III and IV
(d) I, II and IV
Answer: (d) I, II and IV

25. Which one of the following statements is correct regarding Budd-Chiari Syndrome (BCS)?
(a) It principally affects young males.
(b) Venous drainage of the liver is occluded by IVC thrombus.
(c) Quadrate lobe (Segment IV) undergoes hypertrophy.
(d) Abdominal discomfort and ascites are the main presenting features.
Answer: (d) Abdominal discomfort and ascites are the main presenting features.

It principally affects young Females.
Venous drainage of the liver is occluded by hepatic venous thrombosis.
Segment I (the caudate lobe) undergoes hypertrophy.

26. Which of the following are congenital abnormalities of the gall bladder?
I. The phrygian cap
II. Floating gall bladder
III. Absence of gall bladder
IV. Spigelian gall bladder

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
Answer: (a) I, II and III

27. Which one of the following is correct regarding splenic artery aneurysm?
(a) It is twice as common in men.
(b) It is usually situated in the main arterial trunk.
(c) It is caused due to blunt trauma to the abdomen.
(d) It is generally multiple in number.
Answer: (b) It is usually situated in the main arterial trunk.

From Test Series

28. Which of the following statements are correct regarding primary survey/management of traumatic head injury patient?
I. Ensure adequate oxygenation and circulation
II. Exclude hypoglycaemia
III. Check for mechanism of injury
IV. Check pupil size and response

Select the answer using the code given below:
(a) I, II and III
(b) II, III and IV
(c) I, II and IV
(d) I, III and IV
Answer: (c) I, II and IV

29. Which of the following statements are correct regarding ABCDE of trauma care?
I. A stands for Airway with cervical spine protection
II. B stands for Breathing and ventilation
III. C stands for Control of massive external haemorrhage
IV. D stands for Disability (Neurological status)

Select the correct answer using the code given below:
(a) I and III
(b) I, II and IV
(c) I, III and IV
(d) II, III and IV
Answer: (b) I, II and IV

c – Control of massive external haemorrhage
A – Airway with cervical spine protection
B – Breathing and ventilation
C – Circulation and haemorrhage control
D – Disability (neurological status)
E – Exposure (full exposure of patient to identify all injuries)

30. Vibration white finger refers to:
(a) Buerger’s disease
(b) Raynaud’s syndrome
(c) Acrocyanosis
(d) Takayasu disease
Answer: (b) Raynaud’s syndrome

PYQ

31. Resection of which part of intestine does not significantly affect fluid and electrolyte balance?
(a) Ileum
(b) Proximal jejunum
(c) Distal jejunum
(d) Colon

Answer: (b) Proximal jejunum

32. A 45-year-old lady presents with complaints of fatigue, muscle weakness along with bilateral multiple renal calculi which were picked up on a routine ultrasound. Further workup revealed serum calcium levels of 11.4 mg%. What is the next best investigation required to arrive at a diagnosis?
(a) Neck ultrasound
(b) Sestamibi scan
(c) CECT head and neck
(d) MRI head and neck
Answer: (b) Sestamibi scan

33. Which of the following statements are correct regarding inguinal hernias in children?
I. It is more common in full-term
II. It should be repaired promptly.
III. It is always indirect.
IV. It may frequently be transilluminant.

Select the answer using the code given below:
(a) I, II and III
(b) I, III and IV
(c) II, III and IV
(d) I, II and IV
Answer: (c) II, III and IV

Inguinal hernia is more common in preterm, not full-term infants.

34. Which of the following are the aetiological factors associated with a communicating hydrocephalus?
I. Post haemorrhagic
II. Lesions within the ventricle
III. CSF infection
IV. Raised CSF protein

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
Answer: (c) I, III and IV

Lesions within the ventricle- obstructive Hydrocephalus

35. What is the most common type of tumour of Vermiform Appendix?
(a) Epithelial tumour
(b) Carcinoid tumour
(c) Germ cell tumour
(d) Papillary cell tumour
Answer: (b) Carcinoid tumour

36. A 60-year-old female presents with pain in her back of recent onset, which has become severe of late. During the course of investigations, she was found to have lytic lesions in the vertebrae and ribs. Which of the following organs should be carefully screened now for detecting the primary cause of these lesions?
(a) Small intestine
(b) Large intestine
(c) Renal
(d) Breast
Answer: (d) Breast

Breast cancer is the most common tumour that metastasises to the bones, especially the spine, ribs, and vertebrae. Haematogenous spread of breast carcinoma typically results in osteolytic lesions, particularly affecting the lumbar vertebrae, thoracic vertebrae, ribs, and skull.

37. The earliest specific cystoscopic appearance of Bilharzial cystitis is:
(a) Sandy patches
(b) Ulcers
(c) Tubercles
(d) Nodules
Answer: (a) Sandy patches

38. Which of the following statements are correct regarding a brain abscess?
I. Arises when the brain is exposed directly as a result of fracture or infection or air sinus
II. Presenting features include low-grade fever, confusion, seizures and focal deficits
III. MRI with contrast is the initial imaging modality of choice
IV. The aetiological agents include bacteria, fungi, protozoa and viruses

Select the 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
Answer: (b) I, II and IV

CT scan with contrast is the initial imaging modality of choice.

39. Which one of the following best describes craniosynostosis?
(a) It is delayed fusion of one or more cranial sutures preventing growth perpendicular to the suture
(b) It is the premature fusion of one or more cranial sutures, preventing growth perpendicular to the suture
(c) It is the premature fusion of one or more cranial sutures, facilitating growth perpendicular to the suture
(d) It is delayed fusion of one or more cranial sutures facilitating growth perpendicular to the suture
Answer: (b) It is the premature fusion of one or more cranial sutures, preventing growth perpendicular to the suture

40. Which of the following statements are correct regarding Cauda equina syndrome?
I. Its presenting symptoms are perineal numbness, painless urinary retention and fecal incontinence
II. Urgent investigation with MRI is required
III. It is present most commonly in the 45-60 year age group
IV. Confirmed cases require early surgical decompression

Select the 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
Answer: (b) I, II and IV

CES presents most commonly in the 20- to 45-year age group.

OBGYNE

41. Which of the following statements about hysterosalpingography, as an operative procedure, are correct?
I. Tubal patency assessment following tuboplasty operation
II. Diagnosis of uterine synechiae
III. Detection of IUD
IV. Diagnosis of subserosal fibroid
Select the answer using the code given:
(a) I, II and III
(b) I, II and IV
(c) I, III and IV
(d) II, III and IV

Answer: (a) I, II and III

HSG is not suitable for subserosal fibroid diagnosis, as these lie outside the endometrial cavity and do not distort the cavity, so they will not be visible on HSG.
Submucous fibroids may cause a filling defect on HSG, but subserosal types do not.

42. Which of the following are indications of endometrial sampling?
I. Endometrial tuberculosis
II. Endometrial polyp
III. Postmenopausal bleeding
IV. Abnormal uterine bleeding
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

Answer: (c) I, III and IV

Endometrial polyp- Hysterosalpingography (filling defect)

43. A 30-year-old P3L3 female presents in Gynaecology emergency with acute abdominal pain and vaginal bleeding of short duration (1 hour). She gives history of tubal ligation after birth of third child. On examination, right adnexal tenderness was found and os was closed. What is the probable diagnosis?

(a) Ectopic pregnancy
(b) Pelvic inflammatory disease
(c) Appendicitis
(d) Complete abortion

Answer: (a) Ectopic pregnancy

From Test series

44. Which of the following statements are correct regarding audit in Gynaecology?
I. It can replace the out of date clinical practice by better one
II. It is an efficient educational tool
III. It should be based on scientific data with facts and figures
IV. It is not labour-intensive
Select the answer using the code given below:
(a) I and IV
(b) I, II and III
(c) II only
(d) II, III and IV

Answer: (b) I, II and III

45. Which of the following are poor prognostic factors in endometrial adenocarcinoma?
I. Estrogen and progesterone receptor positivity
II. HER-2/neu gene expression
III. Histologic types papillary serous or clear cell carcinoma
IV. Aneuploid tumours
Select the correct answer using the code given below:
(a) I, II and III
(b) II and IV
(c) I, III and IV
(d) II, III and IV

Answer: (d) II, III and IV

Hormone receptor status (receptor positive tumors – better prognosis)

46. For which of the following conditions, surgery is indicated in a case of Fibroid Uterus?
I. Symptomatic and failed medical management
II. Size > 12 weeks
III. Pedunculated fibroid
Select the correct answer using the code given below:

(a) I, II and III
(b) I and II only
(c) II and III only
(d) I and III only

Answer: (a) I, II and III

47. Which of the following are criteria for opting Le Fort’s operation for surgical correction of pelvic organ prolapse?
I. Procidentia in old age
II. Unfit for long duration surgery
III. Associated uterine pathology
IV. Coital function no longer required
Select the correct answer using the code given below:
(a) I, III and IV
(b) I and II only
(c) II and IV
(d) I, II and IV

Answer: (d) I, II and IV

For Le Fort’s operation- There should not be any uterine or pelvic pathology.

48. Opening of Bartholin’s duct is in the:
(a) Vestibule outside the hymen at the junction of the anterior 2/3rd and posterior 1/3rd in the groove between the hymen and labium minus
(b) Groove between labia majora and labia minora
(c) Superficial perineal pouch at the junction of anterior 1/3rd and posterior 2/3rd
(d) Periurethral region in anterior part of labia minora

Answer: (a) Vestibule outside the hymen at the junction of the anterior 2/3rd and posterior 1/3rd in the groove between the hymen and labium minus

From Test series

Also in Revision Notes

49. Which of the following are Amsel’s diagnostic criteria?
I. Vaginal pH > 4.5
II. Positive Whiff test
III. Presence of Clue cells > 20%
IV. Positive bacterial vaginal culture
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 and III only

Answer: (a) I, II and III

Bacterial vaginal culture has no role in the diagnosis.

From Test series

50. Which of the following is measured without straining while examination under POP-Q?

(a) TVL
(b) Pb
(c) GH
(d) Point D

Answer: (a) TVL

51. Which of the following are neonatal complications of maternal diabetes during pregnancy?
I. Hyperbilirubinemia
II. Hypercalcemia
III. Cardiomyopathy
IV. Hypoglycemia
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

Answer: (c) I, III and IV

Hypocalcemia Not Hypercalcemia.

52. Which of the following are the predictive factors for Fetal Growth Restriction?
I. Low level of maternal first trimester Beta hCG
II. Abnormal uterine artery Doppler at 20–24 weeks of pregnancy
III. Fetal echogenic bowel on ultrasound
IV. Maternal medical disorder
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

Answer: (d) II, III and IV

A low level of 1st trimester PAPP-1 value Not Beta hCG.

53. Which of the following is the primary surveillance tool in the Growth Restricted Fetus?
(a) Uterine artery Doppler
(b) Umbilical venous pulsation
(c) Middle cerebral artery Doppler
(d) Umbilical artery Doppler

Answer: (d) Umbilical artery Doppler

From Test series

54. Glands of Cloquet are:
(a) Lymphatic drainage of vulva
(b) Lymphatic drainage of cervix
(c) Lymphatic drainage of uterus
(d) Lubricating glands of vagina

Answer: (a) Lymphatic drainage of vulva

Glands of Cloquet are actually lymph nodes, not true glands.
They are also known as the deep inguinal lymph nodes, especially the highest deep inguinal node, located in the femoral canal.
Glands of Cloquet are involved in the lymphatic drainage of the vulva.
Lymph from the vulva primarily drains to the superficial inguinal lymph nodes, but a part also reaches the deep inguinal nodes (Cloquet’s glands).

55. Causes of AUB are subdivided by the acronym PALM-COEIN. What are the characteristics of PALM causes?
I. Structural lesions
II. Diagnosed by ultrasound
III. Confirmed by histopathology
Select the correct answer using the code:
(a) I, II and III
(b) I and II only
(c) I and III only
(d) II and III only

Answer: (a) I, II and III

56. Daily suppressive therapy for HSV-1 & HSV-2 is:
(a) Valacyclovir 1 g once daily
(b) Acyclovir 400 mg once daily
(c) Acyclovir 400 mg thrice daily
(d) Valacyclovir 1 g twice daily

Answer: (a) Valacyclovir 1 g once daily

Initial therapy- Valacyclovir 1 g twice daily

Daily suppressive therapy- Valacyclovir 1 g once daily

57. Which one of the following is not a differential diagnosis of chronic inversion of uterus?
(a) Fibroid polyp
(b) Fungating cervical malignancy
(c) Cervical prolapse
(d) Gartner’s cyst

Answer: (d) Gartner’s cyst

58. A woman presents to Gynaecology OPD with complaints of malodorous vaginal discharge. On examination, the discharge was found to be grayish-white in colour and adherent to vaginal walls. Which one of the following is a bedside diagnostic criterion for the causative organism?
(a) Presence of RBCs in vaginal smear
(b) Vaginal pH < 4.5
(c) Positive 10% potassium hydroxide test
(d) Positive NAAT test

Answer: (c) Positive 10% potassium hydroxide test

Bacterial Vaginosis (BV): Positive whiff test (10% KOH test).

From Test series

59. Which of the following are the organisms involved in PID?
I. Neisseria gonorrhoeae
II. Chlamydia
III. Mycoplasma hominis
IV. Candida albicans
Select the correct answer:
(a) I, II and III
(b) II and IV
(c) I, III and IV
(d) I, II and IV

Answer: (a) I, II and III

From Main Notes

60. Which of the following are correct regarding puerperal blues?
I. Its incidence is around 50%
II. There is no specific metabolic or endocrine derangement
III. Treatment is reassurance and psychological support
Select the answer using the code:
(a) I, II and III
(b) I and II only
(c) II and III only
(d) I and III only

Answer: (a) I, II and III

61. Which one of the following is correct regarding postpartum psychosis?
(a) There is often no family history of psychosis
(b) Its onset is usually within 4 days of delivery
(c) Recurrence rate in subsequent pregnancy is 60-70%
(d) Electroconvulsive therapy is the first line and only treatment

Answer: (b) Its onset is usually within 4 days of delivery

62. Which of the following are correct in the treatment of cracked nipple?
I. Correct attachment (Latch on) will provide immediate relief from pain and rapid healing
II. If pain, mother should use breast pump and the infant is fed with the expressed milk
III. Miconazole lotion is applied over the nipple as well as in the baby’s mouth if there is oral thrush
Select the answer using the code:
(a) I and II only
(b) I and III only
(c) II and III only
(d) I, II and III

Answer: (d) I, II and III

63. What are the characteristics of dermoid cyst?
I. Germ cell ovarian tumour
II. Bilateral in 15–20% cases
III. Torsion is common
IV. Rupture is common
Select the correct answer using the code below:
(a) I, II and III
(b) I, III and IV
(c) II, III and IV
(d) I, II, III and IV

Answer: (a) I, II and III

Rupture is an uncommon complication. in dermoid cyst.

64. Which of the following factors are associated with cord prolapse during labour?
I. Malpresentations
II. Contracted pelvis
III. Stabilizing induction
IV. Prematurity
Select the correct answer using the code below:
(a) I, II, III and IV
(b) I, II and IV only
(c) I, II and III only
(d) III and IV only

Answer: (a) I, II, III and IV

65. Detection of magnesium toxicity in a patient receiving magnesium sulphate is noticed by which of the following?
I. Loss of tendon reflexes
II. Increased respiratory rate
III. Chest pain, heart block
IV. Cardiac arrest
Select the correct answer using the code:
(a) I, III and IV
(b) II and IV only
(c) I and III only
(d) III and IV only

Answer: (a) I, III and IV

Decreased respiratory rate (<12 per minute) Not increased.

66. Chadwick’s sign describes:
(a) The dusky hue of the vestibule and anterior vaginal wall visible at about 8th week of pregnancy
(b) Opening of cervix at 6th week of pregnancy
(c) The abdominal and vaginal fingers apposed below the body of the uterus during bimanual examination
(d) Regular and rhythmic uterine contraction which can be elicited during bimanual examination at 4–8 weeks of pregnancy

Answer: (a) The dusky hue of the vestibule and anterior vaginal wall visible at about 8th week of pregnancy

67. Matthews Duncan process has been described for:
(a) Marginal separation of placenta in normal labour
(b) Central separation of placenta in normal labour
(c) Controlled contraction in active management of third stage of labour
(d) Position of acute inversion of uterus following vaginal delivery

Answer: (a) Marginal separation of placenta in normal labour

68. A P1L1 lady after 4 hours of delivery is suffering from persistent, severe pain in the perineal region, rectal tenesmus, bearing down feeling and retention of urine. The probable diagnosis is:
(a) Cervical tear
(b) Vulval hematoma
(c) Supralevator hematoma
(d) Complete perineal tear

Answer: (c) Supralevator hematoma

69. According to WHO Intrapartum Guidelines 2018, which of the following are correct about birthing position?
I. For a woman without epidural analgesia, adoption of birthing position is individual woman’s choice
II. For a woman without epidural analgesia, upright birthing position may be adopted
III. For a woman with epidural analgesia, lithotomy and supine position only are recommended
Select the answer using the code given below:
(a) I and II only
(b) II and III only
(c) I and III only
(d) I, II and III

Answer: (a) I and II only

For women with or without epidural analgesia, encouraging the adoption of a birth position of the individual woman’s choice, including upright positions, is recommended.

Reference: https://iris.who.int/bitstream/handle/10665/272447/WHO-RHR-18.12-eng.pdf

70. According to WHO Intrapartum Care Guidelines 2018, which one of the following is correct about duration of first stage labour?
(a) Duration of latent phase of primigravida has not been established
(b) Duration of active stage of multigravida should not exceed 6 hours
(c) Duration of active stage of primigravida should not exceed 8 hours
(d) Duration of active stage of primigravida should not exceed 18 hours

Answer: (a) Duration of latent phase of primigravida has not been established

Standard duration of the latent first stage has not been established and can vary widely from one woman to another. However, the duration of active first stage (from 5 cm until full cervical dilatation) usually does not extend beyond 12 hours in first labours, and usually does not extend beyond 10 hours in subsequent labours.

Reference:

https://knowledgehub.health.gov.za/system/files/2024-04/revised%20_WHO%20Recommendations%20for%20a%20Positive%20Childbirth%20Experience%20_SA%20.pdf

71. Which of the following hematological findings are seen in pregnant women with thalassemia trait?
(a) Raised HbA2 and low MCV
(b) MCHC
(c) Low serum total iron binding capacity
(d) Low HbA2 and raised MCV

Answer: (a) Raised HbA2 and low MCV

MCHC- Normal

TIBC- Normal or elevated.

72. The best drug for maintenance therapy of Systemic Lupus Erythematosus (SLE) during pregnancy is:
(a) Hydroxychloroquine
(b) Sulfasalazine
(c) Tacrolimus
(d) Progestins

Answer: (a) Hydroxychloroquine

73. Which of the following maternal complications can be seen in hyperemesis gravidarum?
I. Wernicke’s encephalopathy
II. Hepatic failure
III. Hypoprothrombinemia
IV. Convulsions
Select the correct answer using the code given below:
(a) I, II, III and IV
(b) I, III and IV only
(c) II and IV only
(d) I and III only

Answer: (a) I, II, III and IV

74. Twin pregnancy should have ultrasound at 10–13 weeks to confirm which of the following?
I. Number of foetus
II. Viability of foetus
III. Chorionicity of twins
IV. Malformation in either foetus
Select the correct answer using the code given below:
(a) I, II, III and IV
(b) I, III and IV only
(c) I, II and IV only
(d) II and III only

Answer: (a) I, II, III and IV

75. Which of the following treatments are recommended for a pregnant woman suffering from sickle cell disease?
I. Folic acid 1 mg daily
II. Azathioprine
III. Blood transfusion if required
IV. Thromboprophylaxis with low molecular weight heparin
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

Answer: (c) I, III and IV

76. Which of the following are contraindications to External Cephalic Version (ECV) in breech?
I. Pregnancy less than 36 weeks
II. Multiple pregnancy
III. Previous cesarean delivery
IV. Rhesus isoimmunization
Select the correct answer using the code given below:
(a) I, III and IV
(b) II, III & IV
(c) I, II & IV
(d) I, II and III

Answer: (b) II, III & IV

77. The commonest ovarian tumour seen during pregnancy is:
(a) Benign cystic teratoma
(b) Mucinous cystadenoma
(c) Endometrioma
(d) Adenocarcinoma ovary

Answer: (a) Benign cystic teratoma

78. Which of the following statements are correct regarding shoulder dystocia?
I. It can be predicted during early labour.
II. Anencephaly is a risk factor.
III. Turtle neck sign is present.
IV. Episiotomy should always be given.
Select the 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

Answer: (d) II, III and IV

Shoulder dystocia neither could be predicted accurately nor could be prevented entirely.

79. A primigravida at 38 weeks pregnancy was put on oxytocin drip in view of slow labour at the rate of 30 mIU/min by the newly appointed registrar. She complains of confusion and starts throwing fits. What electrolyte imbalance is expected to have happened in this case?
(a) Hypernatremia
(b) Hyponatremia
(c) Hypokalemia
(d) Hypocalcemia

Answer: (b) Hyponatremia

The woman is receiving oxytocin infusion at 30 mIU/min, which is a high dose.
She develops confusion and seizures, which are classic signs of acute water intoxication.

At high doses, oxytocin exhibits ADH-like effect, causing:

Water retention
Dilutional hyponatremia

From Revision Notes

80. Which of the following factors favour posterior position of the vertex?
I. Anthropoid pelvis
II. Low inclination pelvis
III. Attachment of placenta on the anterior wall
IV. Primary brachycephaly
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

Answer: (c) I, III and IV

PSM- Easiest in CMS 2025

81. Which of the following indicators are considered for computing “Physical Quality of Life Index” (PQLI)?
I. Infant mortality
II. Life expectancy at age one
III. Literacy
IV. Per capita income
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

Answer- (a) I, II and III

From Test series

82. Which one of the following terms is an “all-or-none phenomenon” and is best described as termination of all transmission of infection by extermination of the infectious agent?
(a) Disease control
(b) Disease elimination
(c) Disease eradication
(d) Disease surveillance
Answer: (c) Disease eradication

83. “Objectives are set forth for different units and subunits, each of which prepares its own plan of action, usually on a short-term basis.” The definition best sums up which one among the following terms?
(a) Input-Output analysis
(b) Personnel management
(c) Management by objectives
(d) Work sampling
Answer: (c) Management by objectives

Ref: Park,E-27th,p-999

From Main Notes

84. The Panchayati Raj is a three-tier structure of rural local self-government in India with the three levels being village, block and district.
Consider the following bodies:
I. Gram Sabha
II. Gram Panchayat
III. Nyaya Panchayat
IV. Panchayat Samiti
Which of the above bodies are present at the village level?
(a) I and II only
(b) III and IV only
(c) I, II and III
(d) II, III and IV
Answer: (c) I, II and III

Ref: Park,E-27th,p-1007

85. Many patients with unexplained rash and fever were reported from a village close to the Primary Health Centre (PHC). What is the first step in initiating the investigation of such an epidemic?
(a) Rapid search for all cases
(b) Verification of diagnosis
(c) Confirm existence of epidemic
(d) Defining the population at risk

Answer: (b) Verification of diagnosis

86. John Snow’s discovery that cholera is a waterborne disease was the outcome of which type of study?
(a) Uncontrolled trial
(b) Natural experiment
(c) Risk factor trial
(d) Trial of aetiological agent
Answer: (b) Natural experiment

Ref: Park,E-27th,p-94

87. Given below is a table showing diagnosis of Myocardial infarction by ECG:

ECG results	Myocardial infarction Present	Myocardial infarction Absent
Positive	45	8000
Negative	5	32000
Total	50	40000

Consider the following statements:
I. Sensitivity is 90%.
II. Specificity is 80%.
Which of the statements given above is/are correct?
(a) I only
(b) II only
(c) Both I and II
(d) Neither I nor II
Answer: (c) Both I and II

88. Data obtained from hospital records is not a representative sample of the population. What are the reasons for this?
I. Mild cases and subclinical cases may be missed.
II. Population served by a hospital usually cannot be defined.
III. Cost of hospital care is not recorded.
IV. Admission policy for cases can vary from hospital to hospital.
Select the correct answer using the code given below:
(a) I and II only
(b) II and III only
(c) I, II and IV
(d) II, III and IV
Answer: (c) I, II and IV

Ref: Park,E-27th,p-969

89. Of the following ocular manifestations of Vitamin A deficiency, the first sign that can be clinically seen is:
(a) Bitot’s spots
(b) Nyctalopia
(c) Conjunctival Xerosis
(d) Corneal Xerosis
Answer: (c) Conjunctival Xerosis

Ref: Park,E-27th,p-730

90. The bony deformity of ‘pigeon chest’ in children occurs due to deficiency of:
(a) Vitamin A
(b) Vitamin D
(c) Vitamin E
(d) Vitamin K
Answer: (b) Vitamin D

91. Which one among the following essential amino acids is usually the “limiting” amino acid in most of the pulses?
(a) Lysine
(b) Methionine
(c) Threonine
(d) Valine
Answer: (b) Methionine

From Question bank

92. Which among the following are defence mechanisms adopted when an individual is faced with problems or failures?
I. Rationalization
II. Regression
III. Projection
IV. Replacement
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
Answer: (a) I, II and III

Ref: Park,E-27th,p-793

93. What are the reasons for choosing coliform organisms as indicators of faecal pollution of water rather than the waterborne pathogens directly?
I. They are present in great abundance in the human intestine and excreted in great numbers in faeces.
II. They have lower resistance to forces of natural purification.
III. They survive lesser than the pathogens.
IV. They are easily detected by culture methods.
Select the correct answer using the code given below:
(a) I and IV
(b) II and III
(c) I only
(d) IV only
Answer: (a) I and IV

They survive longer than the pathogens.
They have Greater resistance to forces of natural purification.

Ref: Park,E-27th,p-848

94. The Ministry of Health and Family Welfare has launched a programme to meet the challenge of high prevalence of anaemia amongst adolescent boys and girls.
Consider the following statements in relation to the key interventions being undertaken:
I. It entails supervised weekly administration of 100 mg elemental iron and 500 µg folic acid.
II. These weekly iron-folic acid supplements are administered by using a fixed day approach.
III. It entails supervised administration of Albendazole 400 mg every three months for control of helminth infestation.
Which of the statements given above is/are correct?
(a) I only
(b) II only
(c) I and III
(d) I and II
Answer: (d) I and II

Albendazole is given twice a year, not every three months.

Ref: Park,E-27th,p-533

95. The National Framework for Malaria Elimination in India (2016–2030) has defined certain milestones and targets. Among the following, which is the specific target that has to be met by the year 2027?
(a) All states and UTs must reduce API to less than 1 case per 1000 population at risk.
(b) All states and UTs must establish fully functional malaria surveillance to track, investigate and respond to each case.
(c) Entire country is to have no indigenous cases and no deaths due to malaria.
(d) Entire country has to initiate the process for certification of malaria elimination.
Answer: (c) Entire country is to have no indigenous cases and no deaths due to malaria.

By the year 2027- Indigenous transmission of malaria interrupted and the entire country to have no indigenous cases and no deaths due to malaria.
By the year 2030- The entire country to sustain status of zero indigenous cases and deaths due to malaria for 3 consecutive years; and India to initiate the processes for certification of malaria elimination status

Ref: Park,E-27th,p-475

96. Under the Pradhan Mantri Surakshit Matritva Abhiyan, the beneficiaries are being provided with a minimum package of antenatal care including certain investigations and drugs on a fixed day of every month. Which day of the month is specified for this purpose?
(a) 1st day of the month
(b) 7th day of the month
(c) 9th day of the month
(d) 15th day of the month
Answer: (c) 9th day of the month

From Test series

97. “Small for Date” (SFD) babies, also known as “small for gestational age” babies, weigh less than what percentile for the gestational age?
(a) 2nd percentile
(b) 5th percentile
(c) 10th percentile
(d) 20th percentile
Answer: (c) 10th percentile

98. In the most widespread calculation of Stillbirth Rate, the numerator is defined as foetal deaths weighing over ‘X’ gram at birth, during the year. Which one of the following is the correct value for ‘X’?
(a) 500
(b) 750
(c) 1000
(d) 1500
Answer: (c) 1000

From Test series

99. While performing triage in response to a disaster emergency, commonly an internationally accepted four-colour code system is used. Which one among the following four-colour categories represents the highest priority for emergency response?
(a) Black
(b) Green
(c) Red
(d) Yellow
Answer: (c) Red

100. Consider the following statements with regard to Ice-Lined Refrigerator (ILR) employed for storing vaccines at the sub-district level:
I. These types of refrigerators are top-opening.
II. Based on the temperature zone, the inside of ILRs can be divided into 3 parts.
III. The upper part of ILR is cooler compared to the lower part.
IV. Vaccines should never be kept directly on the floor of the ILR as they can get damaged.
Which of the statements given above are correct?
(a) I and II
(b) II and III
(c) III and IV
(d) I and IV
Answer: (d) I and IV

Based on the temperature zone, inside of the ILR can be divided into 2 parts, upper part and lower part. In most of the ILR models, the lower part is cooler compared to the upper part.

Ref: Park,E-27th,p-119

From Question bank

101. Which one of the following is the major contributor to the total energy intake, in terms of energy provided, in an average Indian diet?
(a) Fats
(b) Carbohydrates
(c) Proteins
(d) Vitamins
Answer: (b) Carbohydrates

From Question bank

102. Consider the following with regard to Amino Acids:
I. Essential Amino Acids are those that the body cannot synthesize and they must be obtained from dietary proteins.
II. Not just the Essential Amino Acids, Non-essential Amino Acids are also needed by the body for synthesis of tissue proteins.
III. Unless a protein contains all the Essential Amino Acids in amounts corresponding to human needs, a protein is said to be biologically incomplete.
IV. Animal proteins are rated superior to vegetable proteins.
Of the above statements, how many are correct?
(a) Only one
(b) Only two
(c) Only three
(d) All four
Answer: (d) All four

103. Which of the following strategies were encouraged by the UNICEF under its ‘GOBI Campaign’?
I. G for growth charts to better monitor child development
II. O for oral rehydration to treat all mild and moderate dehydration
III. B for better and continuous evaluation of children up to 5 years of age
IV. I for immunization against measles, diphtheria, polio, pertussis, tetanus and tuberculosis
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
Answer: (b) I, II and IV

104. What is the limit of daily exposure of noise that people can tolerate without substantial damage to their hearing?
(a) 65 dB
(b) 85 dB
(c) 105 dB
(d) 125 dB
Answer: (b) 85 dB

Ref: Park,E-27th,p-868

105. How much illumination is recommended by the Illuminating Engineering Society for the general office work?
(a) 100 lux
(b) 200 lux
(c) 400 lux
(d) 900 lux
Answer: (c) 400 lux

Ref: Park,E-27th,p-868

106. Dietary fibres have:
(a) anabolic effect
(b) catabolic effect
(c) no metabolic effect
(d) sometimes anabolic and sometimes catabolic effect, depending on the type
Answer: (c) no metabolic effect

107. Egg proteins are considered to be the best among food proteins because:
I. of their biological value
II. of their digestibility
III. they contain all the essential amino acids
IV. their calorie content is higher than in proteins of vegetable sources
Which of the statements given above is/are correct?
(a) I only
(b) I, II and III
(c) II, III and IV
(d) I, III and IV
Answer: (b) I, II and III

Ref: Park,E-27th,p-724,745

From Question bank

108. On a chest radiograph, which of the following occupational diseases is most likely to be mistaken as a case of tuberculosis of lungs?
(a) Anthracosis
(b) Silicosis
(c) Siderosis
(d) Byssinosis
Answer: (b) Silicosis

From Test series

109. With which variety of asbestos, Mesothelioma has been shown to have a strong association?
(a) Amosite
(b) Anthrophyllite
(c) Crocidolite
(d) Chrysolite
Answer: (c) Crocidolite

Ref: Park,E-27th,p-934

110. Under the Biomedical Waste Management Rules 2016, human anatomical waste is to be carried in which colour plastic bags?
(a) Yellow
(b) Red
(c) Blue
(d) Black
Answer: (a) Yellow

Rapid Revision

111. As an index of thermal comfort, the ‘Corrected Effective Temperature’ is considered to be an improvement over ‘Effective Temperature’. It deals with which of the following factors?
I. Air velocity
II. Humidity
III. Mean radiant heat
IV. Sweat rate
Select the correct answer using the code given below:
(a) I, III and IV
(b) II, III and IV
(c) I, II and III
(d) I and II only
Answer: (c) I, II and III

Air temperature, velocity, humidity and mean radiant heat.

Ref: Park,E-27th,p-859

112. In a child who has not received any dose of DPT and OPV immunization, up to what age can these vaccines be given under the Universal Immunization Programme?
(a) DPT up to 7 years of age and OPV up to 5 years of age
(b) DPT up to 8 years of age and OPV up to 6 years of age
(c) DPT up to 10 years of age and OPV up to 7 years of age
(d) DPT up to 12 years of age and OPV up to 10 years of age
Answer: (a) DPT up to 7 years of age and OPV up to 5 years of age

From Question bank

113.A traveller who has passed through a yellow fever endemic zone and does not possess a Certificate of Vaccination against yellow fever, enters a yellow fever ‘receptive’ area. For how long from the date of leaving the infected area must this traveller be placed on quarantine in a mosquito-proof ward?
(a) 6 days
(b) 7 days
(c) 8 days
(d) 10 days
Answer: (a) 6 days

Ref: Park,E-27th,p-329

From Must Know Topics

114. Under the Employees’ State Insurance Act 1948, if the sickness of an insured person is duly certified by an Insurance Medical Officer, periodical cash payment benefit is payable for a maximum period of how many days in any continuous period of 365 days, as Sickness Benefit?
(a) 30 days
(b) 61 days
(c) 91 days
(d) 121 days
Answer: (c) 91 days

Ref: Park,E-27th,p-944

From Rapid revision

115. Consider the following statements regarding Wernicke’s encephalopathy:
I. It is caused by niacin deficiency.
II. It is often seen in alcoholics.
III. Ophthalmoplegia, polyneuritis and ataxia are some of its characteristic features.
IV. It occurs occasionally in people who fast.
Which of the statements given above are correct?
(a) I, II and III
(b) II, III and IV
(c) I, III and IV
(d) I, II and IV
Answer: (b) II, III and IV

116. A housefly transmits any infectious agent by which of the following methods, most commonly?
(a) Propagative transmission
(b) Mechanical transmission
(c) Cyclo-propagative transmission
(d) Cyclo-developmental transmission
Answer: (b) Mechanical transmission

Ref: Park,E-27th,p-894

117. In the case of a 7-year-old school-going child, which would be the most appropriate indicator to measure the current nutritional status?
(a) Birth weight
(b) Mid upper arm circumference
(c) Head circumference
(d) Weight for height
Answer: (d) Weight for height

Ref: Park,E-27th,p-766

118. Consider the following statements with regard to Home Based Newborn Care (HBNC):
I. Early detection and special care of pre-term newborns is one of the major objectives of HBNC.
II. ANM is the main person involved in the delivery of HBNC.
III. Supporting the family for adoption of healthy practices helps achieve the key objectives of HBNC.
IV. The primary aim of HBNC is to improve newborn survival.
Which of the statements given above are correct?
(a) I and II only
(b) II and III only
(c) I, III and IV only
(d) I, II, III and IV

Answer: (c) I, III and IV only

Ref: Park,E-27th,p-527

119. Which of the following conditions are transmitted as a recessive, sex-linked trait?
I. Retinitis pigmentosa
II. Colour blindness
III. Cystic fibrosis
IV. Duchenne muscular dystrophy
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) I, III and IV
Answer: (b) I, II and IV

Cystic fibrosis – autosomal recessive disorder, not sex-linked

120. Under which name (brand) does the National AIDS Control Organisation provide the STI/RTI services?
(a) Antara Clinic
(b) Chhaya Clinic
(c) Sathi Clinic
(d) Suraksha Clinic
Answer: (d) Suraksha Clinic