Saturday, December 14, 2013

UPSC MAINS OPTIONAL QUESTION PAPER: MEDICAL SCIENCE 2013

Medical Science Paper I: Section A

Q- 1(a) Describe the shoulder joint under the following heads.  [2.5*4 =10]
  1. Type
  2. Movements
  3. Muscles
  4. Applied anatomy
Q-1 (b) Describe the thyroid gland under the following heads. [10]
  1. Lobes
  2. Relations
  3. Surgical anatomy
Q-1 (c) Define synapse, enumerate the steps of synaptic transmission. What is  the significance of synaptic delay ?  [10]
Q-1 (d) What is the mechanism of accommodation in eye ? Why near point recedes in old age ? [5 + 5 = 10]
Q-1 (e) Avidin, an egg protein has great affinity for a vitamin. Discuss the biochemical role of that vitamin. [10]
Q-2 (a) Describe the morphological relations of Kidney. Add a note on relations of right Kidney. [5 + 5 = 10]
Q-2 (b) Describe the steps in development of uterus. Name any four congenital malformations of uterus. [6 + 4 = 10]
Q-2 (c) Define a dermatome. Illustrate by means of labelled diagram(s) dermatomes of lower limb. [10]
Q-2 (d) Name the functions of placenta. List any four malformations of placenta. [10]
Q-2 (e) Describe the structures forming the floor of fourth ventricle of brain. [10]
Q-3 (a) Enumerate the factors required for normal erythropoiesis. Why polycythemia occurs at high altitude ? [10 +5=15]
Q-3 (b) Describe the role of baroreceptors in regulation of normal B.P . Why is it effective only in short term regulation of Blood Pressure ( B.P) ? [10 + 5=15]
Q-3 (c) Describe the physiological basis of signs and symptoms of insulin deficiency. Explain the saying, starvation in the midst of plenty. [ 15 + 5= 20]
Q-4 (a) Name the folate antagonists used in treatment of bacterial infections and malignancy. Discuss their mechanism of actions also. [20]
Q-4 (b) Which mineral irreversibly inhibits glycolysis ? Discuss clinical manifestations due to its deficiency and toxicity. [20]
Q-4 (c) Write in brief- [5 + 5 = 10]
  1. Reverse transcriptase- P.C.R.
  2. Significance of S. enzymes in liver diseases

Medical Science Paper 1: Section B

Q-5 (a) Discuss differentiating features of primary and metastatic malignancies. [10]
Q-5 (b) Briefly describe various cells of immune system. Discuss classification system to differentiate lymphocytes. [10]
Q-5 (c) Explain why ?
  1. Aspirin should not be administered around full- term pregnancy period
[2.5]
  1. Thiazide diuretics alone are first line drugs for treating mild (stage-1) Hypertension and also potentiate other antihypertensive drug’s effect when used in combination with them to treat stage II & III hypertension.[2.5]
  2. Low molecular weight heparin(LMWH) are preferred over conventional heparin for anticoagulant indication. [2.5]
  3. Metformin is a first line orally effective drug for treating Type-II diabetes mellitus. [2.5]
Q-5 (d) Describe different types of injuries sustained by a victim of gang rape. How will you proceed to examine and opine in such a situation? [10]
Q-5 (e) Discuss role of mediators in different reactions of inflammation.[10]
Q-6 (a) Discuss pathogenesis of oral cancer. Briefly describe the malignant lesions that are likely to affect oral cavity. [15]
Q-6 (b) Describe aetiopathogenesis of alcoholic cirrhosis. Describe the gross and microscopic appearance. [15]
Q-6 (c)
  1. Discuss pathogenicity and laboratory diagnosis of Amoebiasis. [10]
  2. Discuss pathogenicity and laboratory diagnosis of Herpes simplex virus [10]
Q-7 (a) Discuss morphology, pathogenicity and laboratory diagnosis of Candidiasis. [15]
Q-7 (b)
  1. Discuss the pharmacological strategies available for post myocardial infarction. [7.5]
  2. Discuss the first line antimycobacterial drugs with special reference to their mechanism of action, side effects and development of resistance. [7.5]
Q-7 (c) What are the possible contributing factors in pathogenesis of carcinoma breast? Describe briefly histopathology of different types of breast carcinoma. [20]
Q-8 (a) Enumerate the drugs of abuse among young population of India. Describe the long term effects of drug abuse on health and personality of drug abuser. [20]
Q-8 (b) What are various tests to detect semen? Describe the confirmatory tests for semen stains. [15]
Q-8 (c) Enumerate the injuries caused by sharp weapon. Describe how you will correlate the weapon of offence with injuries. [15]

Medical Science Paper II: Section A

Q-1 (a) A 45 year old lady after the death of his husband 2 months back, is feeling lonely and remains aloof. [3+7=10]
  1. Enumerate the likely conditions.
  2. How will you diagnose and manage a major depressive disorder ?
Q-1 (b) What is the principle of ultrasound? In which medical conditions, it is almost diagnostic?[3+7=10]
Q-1 (c) A 2 year old boy was brought to you with cough and fever for 3 days. On examination the respiratory rate was 46 per minute along with lower chest indrawing.
  1. Classify the illness of this child as per IMNCI
  2. Outline the treatment of this child.
  3. Enumerate the general danger signs you will ask or look for in this child to assess the severity of illness. [2+4+4=10]
Q-1 (d) An 8 month old child, weighing 8 kg, is brought with loose motions 6 per day, mixed with blood, for last 2 days. There is no history of vomiting.
  1. Enumerate the 4 most important signs you will look/feel for to assess the severity of dehydration.
  2. Assessment of dehydration reveals SOME dehydration. Write the initial prescription for appropriate management of this child.[4+6=10]
Q-1 (e) How will you differentiate between irritant and contact dermatitis? Write the salient differentiating points of both. [10]
Q-2 (a) An 18 year old boy was brought to the casualty in stuporose condition with history of high grade fever since last 3 days.
  1. Enumerate the causes
  2. Describe the management of cerebral malaria. [10+15]
Q-2 (b) An 18 month old girl is diagnosed with Severe Acute Malnutrition (SAM). Outline the 4 diagnostic criteria for this condition. Write the 10 steps for appropriate management of severe malnutrition as per WHO guidelines. [5+10]
Q-2 (c)
  1. Enumerate the cutaneous, mucosal, follicular and nail manifestations of Lichen Planus.
  2. Describe the histopathological features of lichen planus and their relevance to clinical presentation. [6+4]
Q-3 (a) An elderly woman is bed ridden for 4 weeks because of a fractured hip. She is brought to the casualty with sudden onset of breathlessness.
  1. Enumerate the possible causes of breathlessness in this case.
  2. Describe the management of acute pulmonary embolism.  [5+20]
Q-3 (b) A 3 year child was brought to you with history of cyanotic spells and exertional dyspnea. The symptoms were relieved on assuming a knee chest position. The child had central cyanosis and clubbing. There were no features suggestive of congestive heart failure. Heart size was normal.
  1. What is the most probable diagnosis ?
  2. What is the major pathophysiological abnormality ?
  3. Describe the pathophysiology and management of cyanotic spells in this condition. [2+3+10=15]
Q-3 (c)
  1. What are the various etiological factors for causation of vitiligo?
  2. Enumerate various disorders associated with vitiligo?  [6+4=10]
Q-4 (a) A 50 year old male, chronic heavy alcoholic for 20 years, was administered aspirin for headache. Following which he developed sudden massive hematemesis.
  1. Enumerate the causes of hematemesis in this case.
  2. How will you manage this patient ? [10+15]
Q-4 (b)
  1. Draw a flow diagram of pathophysiology of Respiratory Distress Syndrome in new born.
  2. Outline the measures to prevent RDS in pregnant woman at 30 weeks of gestation, with threatened preterm labour.
  3. Enumerate the clinical factors predisposing to billirubin toxicity in new born infants. [ 5 + 5 + 5 =15]
Q-4 (c) A child in 2nd class of public school had an itchy skin lesion. Within next 1 month, this lesion spread to 10 other students in the same class. Examination revealed multiple excoriated papulovesicular itchy lesions in finger webs and flexural aspects of wrists.
  1. What is the most likely diagnosis ?
  2. Outline the prophylactic measures to be undertaken to prevent the spread to other children.
  3. Outline the management of individual children in this class. [2+4+4]

Medical Science Paper 2: Section B

Q-5 (a) What are the advantages and limitations of minimally invasive surgery? Briefly enumerate the principles of laparoscopic cholecystectomy and the complications which can occur during the procedure.[4+6]
Q-5 (b) What are the mode of infection, clinical presentation and complications of amoebic liver abscess? Briefly outline the management of patients with amoebic liver abscess including surgical intervention. [2+5+3]
Q-5 (c) Define menopause. What are the signs and symptoms of menopause ? How will you treat a case of hot flushes in a postmenopausal  woman ? [2+5+3]
Q-5 (d) What are the commonly used methods of first trimester termination of pregnancy ? Enumerate the immediate and remote complications of Medical Termination of Pregnancy. [5+5]
Q-5 (e) Write a paragraph on relative and attributable risks related to disease. How do they differ in the case of heart diseases ?[6+4]
Q-6 (a) How will you calculate the expected date of delivery ? what are the methods recently used for induction of labour ? What are the indications for terminations of induction of labour ?     [ 4+8+8]
Q-6 (b) What are the shortfalls in the health care delivery systems at secondary and tertiary care level ?[7+8]
Q-6 (c) what are the boundaries and parts of oral cavity? Enumerate various factors predisposing to oral cancers. Briefly enumerate the assessment and treatment of a patient with ulceroproliferative growth involving anterior 2/3 of the tongue. [4+3+8]
Q-7 (a) what are various types and causes of nipple discharge in a female? How would you examine, investigate and treat a patient with large 6 cm breast tumour with mobile axillary lymph nodes in the axilla ? [4+16]
Q-7 (b) What methods can be used for permanent sterilization of a 32 year old female having 2 children? How is laparoscopic sterilization superior to tubectomy ? [10+5]
Q-7 (c) Discuss the role of Information, Education and Communication systems (IEC) in the management of sexually transmitted diseases (STDs).[5+5+5]
Q-8 (a) What do you understand by Expanded Programme of Immunisation(EPI) ? Describe its components. [10+10]
Q-8 (b) What is the difference in clinical presentation of right and left sided colonic cancers? Enumerate various factors predisposing to colonic cancers and briefly outline the management of a patient with caecal carcinoma.      [4+4+7]
Q-8 (c) Define accidental haemorrhage. How would you manage a woman at 34 weeks of pregnancy, who comes to casualty with history of painful bout of bleeding ? Mention the foetal and maternal complications associated with accidental haemorrhage. [3+6+6]
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