UPSC 2014 mains Medical Science Optional Paper


Instructions for UPSC Medical Science Optional Paper

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  1. Each paper has duration of 3 hours and total 250 marks.
  2. Candidate has to attempt FIVE questions in all.
  3. Question
    Nos. 1 and 5 are compulsory and out of the remaining, THREE are to be
    attempted choosing at least ONE question from each Section.
  4. Illustrate your answers with suitable sketches and diagrams, whenever considered necessary. Colored pencils may be used for this purpose.
  5. 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 medium other than the authorized one.
  6. Word limit in questions, wherever specified, should be adhered to.
  7. Attempts
    of questions shall be counted in chronological 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 struck off.

Medical Science Paper 1: Section A

Q1.Answer all the following:

  1. Describe the zones and lobes of prostate gland. Add a note on applied anatomy of benign prostatic hypertrophy.
  2. Name
    the lateral descending tracts. List the effects of their lesion. What
    will happen to sensory loss in the lesion around central canal of spinal
  3. Describe the morphological characteristics of platelets and their functions. What will happen in their deficiency?
  4. Give a brief account of the mechanism of locking and unlocking of knee joint.
  5. Enumerate the various anti-oxidant vitamins and write about any one of them.

Q2. Answer the following :(20+15+15 marks)

  1. Write the various roles of calcium in the body. How blood calcium is level regulated?
  2. Explain the term Ovulation. Name the hormones necessary for ovulation. How is the knowledge of ovulation time helpful?
  3. Enumerate the branches of facial nerve and write a brief no on Bell’s palsy.

Q3. Answer the following: (20+15+15 marks)

  1. Define
    sleep. What are the different types of sleep? What are the differences
    in sleep of a newborn compared to that of an adult? What type of waves
    will be seen in electroencephalographic record in deep sleep?
  2. Describe the effects of damage to radial nerve at the level of deltoid tuberosity.
  3. What
    is obstructive jaundice? Enumerate the various biochemical tests which
    you would prescribe to the patient. Write their biochemical basis of
    changes you expect.

Q4. Answer the following :(20+15+15 marks)

  1. Describe the boundaries of inguinal canal. Add a note on the anatomy of different types of inguinal hernias.
  2. What are the functions of placenta? What do you mean by feto-placental unit?
  3. What are the advantages of breast-feeding? Why is there amenorrhoea during lactation?

Medical Science Paper 1: Section B

Q5.Answer all the following:

  1. Describe the pre-malignant lesions in oral mucosa.
  2. Discuss the role of Natural Killer (NK) cells and Antibody Dependent Cytotoxic Cells (ADCC).
  3. Write down the mechanism of action of Cyclophosphamide and its adverse effects.
  4. Describe the pathological changes and complications of Acute
  5. A
    dead body of a woman aged about 30 years was found in the river water.
    Describe how the autopsy surgeon will ascertain on post-mortem
    examination that the death was due to drowning.

Q6. Answer the following: (20+15+15 marks)

  1. Define
    and classify Diabetes mellitus. Discuss the pathophysiology of Type- 2
    diabetes. What are the complications of uncontrolled diabetes?
  2. Write
    the mechanism of analgesic effect of morphine. Mention the adverse
    reactions of morphine and the antidotal treatment in its poisoning.
  3. Discuss the etiology of bacillary dysentery and its laboratory diagnosis.

Q7. Answer the following: (20+15+15 marks)

  1. A
    25-year-old young male has been brought for medical examination to the
    hospital by the police with alleged history of committing rape on a
    12-year-old girl. How will the medical officer proceed to examine and
    what laboratory investigations shall be carried out and what type of
    material shall be preserved to establish whether he has committed the
    alleged crime or not?
  2. A young female has consumed carbolic acid
    accidentally. How will you establish the diagnosis and treat the
    patient? Describe the expected post-mortem findings in the event of
    death of such a patient.
  3. Write the general mechanism of action
    of antimicrobial drugs. Discuss the mechanism of action and adverse
    reactions of penicillins.

Q8. Answer the following: (20+15+15 marks)

  1. Discuss the pathogenicity of poliovirus infection. How is this virus isolated during surveillance programme?
  2. What are the characteristic features of a malignant tumour? Discuss the pathways of cancer spread.
  3. Discuss the mechanism of the following vasodilator drugs :
  1. Nifedipine
  2. Glyceryl trinitrate

Medical Science Paper B: Section A

Q1.Answer the following:

  1. A
    42-year-old lady from rural area has come with hugely distended
    abdomen, protuberant umbilicus and visible veins. She recently had
    bleeding per rectum. She has been running low-grade fever and cough for
    long. Give your differential diagnosis giving five important diagnostic
    features of each. Give a flowchart of your approach to this case.
  2. A
    40-year-old drug addict was found in a drowsy state on road. He was
    severely malnourished, cachectic and dehydrated. His blood pressure was
    70 mm of Hg. Name the diseases with their five distinctive features to
    which drug addicts are prone to. What is Pneumocystis carinii pneumonia?
    How would you investigate and treat?
  3. Enumerate the common
    causes of community-acquired pneumonia in under-five children. Discuss
    the criteria for diagnosis and classification of pneumonia in the
    community, without resorting to investigations.
  4. Enlist the
    diagnostic criteria for severe malnutrition according to WHO
    classification in under-five children. Discuss the home/community-based
    management of children with moderate malnutrition.
  5. Enumerate the points of differentiation between psoriatic and rheumatoid arthropathy.

Q2. Answer the following: (25+15+10 marks)

  1. A
    60-year-old chronic smoker, obese gentleman who had been suffering from
    diabetes for last five years, not on regular treatment, developed
    ‘Ghabarahat) and sudden breathless and perspiration. How would you work
    up this case? Draw a flowchart. Enumerate the line of treatment in case
    ECG indicates acute inferior wall myocardial infarction. Which lifestyle
    measures would you suggest to this person?
  2. How can you recognize heart failure in infants below 1 year of age? Enumerate the common causes of heart failure in infants.
  3. “Vitiligo is a multifactorial, polygenic disorder.” Give your justification to support the statement.

Q3. Answer the following: (25+15+10 marks)

  1. It
    is late September month of year. A 25-year-old young executive from
    tribal area has been brought to hospital with high fever, rashes all
    over the body and bleeding nose. Give your differential diagnosis. Name
    the investigations you will carry, out in this case to confirm your
    diagnosis. In case his platelets fall to 15000 per cu mm, how does it
    help you in diagnosis, prognosis and treatment? Describe the clinical
    features and treatment of dengue shock syndrome.
  2. Discuss the etiology and pathophysiology of kernicterus in newborns. How can you prevent kernicterus?
  3. A
    mason working at a building site has developed itchy, oozing lesions of
    hands and feet. What is the likely diagnosis? How will you identify the
    causative agent in him and manage the case?

Q4. Answer the following: (25+15+10 marks)

  1. A
    32-year-old lady with 12-week amenorrhoea has been brought to casualty
    with high fever. She is noted to have deep jaundice. List your
    differential diagnosis giving five essential features of each entity.
    Discuss your plan of investigations.  What would be your plan of
    treatment in case it turns out to be hepatitis B and urine output in 24
    hours drops to mere 200 ml?
  2. Describe the characteristics of
    Haemophilus influenzae b (Hib) vaccine. Enumerate the diseases which can
    be prevented by this vaccine. Describe the primary schedule of
    vaccination with Hib vaccine in an 8-month–old child.
  3. What is
    Stevens – Johnson syndrome (SJS)? Enumerate the common etiological
    factors and pathological events leading to its clinical manifestations.

Medical Science Paper 2: Section B

Q5. Answer the following:

  1. Describe briefly the clinical presentation, diagnosis and management of a patient with coarctation of aorta.
  2. Briefly enumerate and discuss the various therapeutic esopha-goduodenoscopic procedures.
  3. What
    are the signs and symptoms of first trimester of pregnancy? How would
    you confirm the diagnosis of first trimester of pregnancy?
  4. Enumerate the various tests of ovulation in a 20-year-old woman. What is the advantage of knowing the exact time of ovulation?
  5. Write about the Revised National Drug Policy for treatment of malaria.

Q6. Answer the following: (15+20+15 marks)

  1. What
    are the various causes of upper gastromtestanel (GI) bleed? Briefly
    discuss how you will assess and manage a patient with massive upper
    gastrointestinal bleed.
  2. What is abnormal lie? Enumerate the
    various causes of transverse lie multiparous woman. How will you manage
    the case of transverse lie at term with a live foetus?
  3. What are the principles of hospital waste management? Describe various treatment and disposal technologies for biomedical waste.

Q7. Answer the following: (20+15+15 marks)

  1. Describe the clinical features, investigations and management of patients with ulcerative colitis.
  2. Enumerate
    few commonly used intrauterine devices. What areindications,
    contraindications and complications of intrauterine device?
  3. Enumerate the Millennium Development Goals related to health Describe the challenges for MDG.

Q8. Answer the following: (15+15+20 marks)

  1. Describe
    the differential diagnosis in a 60-year-old male with painless,
    progressive jaundice of 2 months and palpable gallbladder. Briefly
    discuss how you will assess, investigate and manage a patient with a
    mass in pancreatic head.
  2. Define anteparturn haemorrhage. How
    would you manage a patient at 34 weeks of pregnancy who comes to
    casualty with a history of painless bout of bleeding? Mention the foetal
    and maternal complications associated with this condition.
  3. Describe the steps in designing, conducting and analyzing a cohort study for diabetes mellitus.
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