Download UPSC CMS 2018 Paper I Question Paper

COMBINED MEDICAL SERVICES EXAM ? 22.07.2018
Medical Sciences Paper I
1. Most common valve involved in Carcinoid syndrome is:
(a) Mitral valve
(b) Tricuspid valve

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(c) Aortic valve
(d) Pulmonary valve
2. A 70 year old man reports to the emergency with acute chest pain. ECG shows
inferior wall Myocardial Infarction (MI). He has recently been discharged 7 days back
following thrombolysis with streptokinase for Acute Anterior wall MI. What will be

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the appropriate management?
(a) Aspirin, Sublingual nitroglycerin, Clopidogrel, Primary PCI
(b) Aspirin, Sublingual nitroglycerin, Clopidogrel, Streptokinase
(c) Aspirin, Sublingual nitroglycerin, Clopidogrel, Heparin
(d) Aspirin, Sublingual nitroglycerin, Clopidogrel, Beta blockers

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3. The presence of a fusion beat on an Electrocardiogram is diagnostic of:
(a) Atrial Fibrillation
(b) Ventricular Tachycardia
(c) Supraventricular Tachycardia
(d) Sinus Bradycardia

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4. A 64 year old man presents with chest pain of 24 hours duration. His ECG reveals ST
elevation, Anterior Wall Myocardial Infarction. The preferred treatment modality for
him is:
(a) Primary percutaneous coronary intervention
(b) Thrombolysis with Alteplase

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(c) Thrombolysis with Streptokinase
(d) Nitroglycerin infusion , Aspirin and Beta blockers
5. The preferred anti hypertensive drug for a 74 year old male with benign prostatic
hypertrophy is:
(a) Amlodepine

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(b) Hydrochlorothiazide
(c) Prazosin
(d) Atenolol

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6. The treatment of choice for a 32 year old male patient of severe mitral stenosis
(Rheumatic) with thickened and calcified valves on echocardiography is:

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(a) Balloon valvuloplasty
(b) Mitral valve replacement
(c) Medical management only
(d) Mitral valvotomy
7. Which one of the following is an example of Type-IV respiratory failure?

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(a) Bronchial asthma
(b) Pulmonary embolism
(c) COPD
(d) Shock
8. All of the following are seen in Polyarteritis Nodosa EXCEPT:

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(a) Glomerulonephritis
(b) Peripheral Neuropathy
(c) Bowel Infarction
(d) Pericarditis
9. All of the following are the pointers to organic cause of psychiatric disease EXCEPT:

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(a) Late age of onset of psychiatric illness
(b) No previous history of psychiatric illness
(c) Family history of psychiatric illness
(d) No apparent psychological precipitant
10. All of the following are Long Acting Beta Agonists (LABA) EXCEPT:

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(a) Levo salbutamol
(b) Salmeterol
(c) Formoterol
(d) Indacaterol
11. Deficiency of which immune function results in tubercular infections?

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(a) Defective phagocytic function
(b) Defect in T cell function
(c) Defect in B cell function
(d) Defect in antibody productivity

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12. The most common agent responsible for community acquired pneumonia is:

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(a) Streptococcus pneumoniae
(b) Mycoplasma pneumoniae
(c) Staphylococcus aureus
(d) Legionella haemophilia
13. A 26 year old woman presents with fever, arthralgia and erythema nodosum. Her

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chest X-ray reveals bilateral hilar lymphadenopathy. Her mantoux test is negative.
The most likely diagnosis is:
(a) Tuberculosis
(b) Allergic bronchopulmonary aspergillosis
(c) Sarcoidosis

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(d) Pulmonary thromboembolism
14. Which of the following are the characteristics of Exudative pleural effusion?
1. Pleural fluid protein/serum protein > 0.5
2. Pleural fluid protein/serum protein < 0.5
3. Pleural fluid LDH/serum LDH > 0.6

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4. Pleural fluid LDH/serum LDH < 0.6
Select the correct answer using the code given below:
(a) 1 and 3
(b) 1 and 4
(c) 2 and 3

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(d) 2 and 4
15. All of the following are seen in Whipple's disease EXCEPT:
(a) Weight loss
(b) Migratory arthropathy
(c) Dementia

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(d) Hemolytic anemia

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16. A middle aged patient with chronic liver disease presents with pain abdomen and
distension. He also has diarrhoea and fever since one day. On examination, he is
hemodynamically stable with fever of 100 oF. There is jaundice, pallor, pedal edema

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and ascites. A diagnostic paracentesis is done. Ascitic fluid protein is 0.8 gm%, sugar
100 mg%, total count 500/mm3 of which 85% are polymorphonuclear leaukocytes and
15% lymphocytes. Most likely diagnosis is:
(a) Spontaneous bacterial peritonitis
(b) Secondary bacterial peritonitis

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(c) Perforation peritonitis
(d) T B peritonitis
17. Herald patch followed by rash is characteristic of:
(a)
Psoriasis

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(b)
Lichen planus
(c)
Pityriasis rosea
(d)

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Dermatophytosis
18. A young male comes to the OPD with history of jaundice since many years. He has
noted that the jaundice may fluctuate but is often aggravated when he is fasting. There
is no history of hospitalisation, no drug use, alcoholism or blood transfusion. Family
history is not significant. Clinical examination is unremarkable except for mild scleral

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icterus. What is the likely diagnosis?
(a) Dubin Johnson syndrome
(b) Crigler Najjar syndrome type-I
(c) Gilbert's syndrome
(d) Rotor syndrome

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19.
All of the following are causes of anemia in a case of chronic kidney disease EXCEPT:
(a) Decreased red blood cell survival
(b) Hemoglobinopathy
(c) Erythropoietin deficiency

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(d) Gastrointestinal blood loss
20.
Characteristic feature of upper motor neuron lesion includes:
(a) Fasciculations
(b) Hyporeflexia

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(c) Clonus
(d) Muscle wasting

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21.
Which one of the following arteries is involved in causation of lateral medullary syndrome?
(a) Anterior superior cerebellar artery

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(b) Anterior inferior cerebellar artery
(c) Posterior superior cerebellar artery
(d) Posterior inferior cerebellar artery
22.
A right handed 70 year old man has a brain scan which reveals a lesion that has damaged his

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left angular and supramarginal gyrus. On examination, one would expect the following
EXCEPT:
(a) Difficulty with left to right discrimination
(b) Inappropriate affect
(c) Finger agnosia

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(d) Inability to write
23.
Total iron binding capacity of more than 360 ?g/dl is seen in anemia due to:
(a) Chronic inflammation
(b) Hemoglobinopathies

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(c) Sideroblastic anemia
(d) Iron deficiency anaemia
24.
Escape behaviour with paroxysmal occurrence is seen in:
(a)

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Phobic disorder
(b)
Anxiety disorder
(c)
Obsessive compulsive disorder

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(d)
Panic disorder
25.
Which of the following conditions are associated with prolonged prothrombin time?
1. Factor VIII deficiency

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2. Factor VII deficiency
3. Heparin anticoagulation
4. Warfarin anticoagulation
Select the correct answer using the code given below:
(a) 1 and 4

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(b) 1 and 3
(c) 2 and 3
(d) 2 and 4

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26.

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Syndrome X includes:
(a) Hyperlipidemia, Obesity, Type-2 DM
(b) Obesity, CAD, COPD
(c) Hyperlipidemia, Hyperuricemia with CAD
(d) Hyponatremia, Hyperlipidemia with type-2 DM

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27.
Growth hormone secretion is inhibited by:
(a) Arginine
(b) Glucose
(c) Clonidine

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(d) L-Dopa
28.
Which one of the following drugs causes hypercalcemia?
(a) Phenytoin
(b) Heparin

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(c) Lithium
(d) Furosemide
29
All of the following insulins are longer acting EXCEPT:
(a) Glargine

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(b) Degludec
(c) Glulisine
(d) Detemir
30.
The presence of vitiligo on examination suggests an associated:

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(a) Autoimmune disease
(b) Degenerative disease
(c) Infection
(d) Malignancy
31.

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A mildy elevated TSH ( 5-20 mU/L) along with a normal T3 and normal T4 levels is
suggestive of :
(a) Primary hypothyroidism
(b) Subclinical hypothyroidism
(c) Artefact

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(d) Thyroid hormone resistance

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32.
Which one of the following suggests patient to be prediabetic?
(a) HbA1c 5.6%, FPG 126 mg/dL
(b) HbA1c 6%, FPG 130 mg/dL

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(c) HbA1c 6.2%, FPG 105 mg/dL
(d) HbA1c 6.6%, FPG 115 mg/dL
33.
Cutaneous manifestations of tuberculosis includes:
(a) Erythema nodosum and lupus vulgaris

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(b) Erythema marginatum and lupus vulgaris
(c) Phyctenular conjunctivitis and erythema multiforme
(d) Pyoderma gangrenosum and Dactylitis
34.
Treatment of scrub typhus is:

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(a) Ciprofloxacin
(b) Clindamycin
(c) Penicillin
(d) Azithromycin
35.

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Which one of the following is NOT correct regarding Clostridum tetani?
(a) Anaerobic
(b) Non motile
(c) Gram positive
(d) Spore bearing

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36.
All of the following are extrapulmonary manifestations of mycoplasma infection EXCEPT:
(a) Arthritis
(b) Guillain Barre syndrome
(c) Stevens Johnson syndrome

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(d) Dementia
37.
A `slapped cheek rash' is characteristic of infection with:
(a) Rubella
(b) Parvovirus B19

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(c) Human herpesvirus 6
(d) Measles

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38.
A 34 week pregnant nurse comes in contact with a patient with chickenpox at her workplace.
She has never had chickenpox in the past and is unvaccinated. The best option for her is:

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(a) Varicella zoster immunoglobulin to be given within 7 days
(b) Vaccinate for chicken pox
(c) Start oral acyclovir
(d) Wait and watch
39.

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Which one of the following has the maximum diagnostic sensitivity for Leishmaniasis?
(a) Splenic aspirate
(b) Bone marrow aspirate
(c) Ascitic fliud aspirate
(d) Lymph node aspirate

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40.
Which one of the following statements regarding cryptosporidiosis is NOT correct?
(a) Infection is acquired by feco-oral route
(b) It is usually a mild self limiting illness in immunocompetent patient
(c) In HIV infected persons it is a serious opportunistic infection

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(d) Treatment is with metronidazole
41.
All of the following are live attenuated vaccines EXCEPT:
(a) MMR(Measles, Mumps, Rubella) vaccine
(b) Rabies vaccine

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(c) Oral polio vaccine
(d) BCG vaccine
42.
All of the following are soil transmitted nematodes EXCEPT:
(a) Ancyclostoma duodenale

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(b) Strongyloides stercoralis
(c) Necator americanus
(d) Ascaris lumbricoides

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43.
A veterinary doctor is bitten by a stray dog, which is classified as a category 3 bite. He has

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completed his pre-exposure prophylactic vaccination with human diploid cell Rabies
vaccine with three doses administered on day 0, 7, 28 about 1 year back. Appropriate
treatment would include which of the following?
1. Wound care
2. Antibiotics

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3. Booster dose of Anti Rabies vaccine
4. Rabies immune globulin at wound site
Select the correct answer using the code given below:
(a) 1 only
(b) 1 and 2 only

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(c) 1, 2 and 3
(d) 2, 3 and 4
44.
Loffler's syndrome is caused due to infection by:
(a) Strongyloidiasis

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(b) Filariasis
(c) Cysticercosis
(d) Ascaris
45.
Which of the following is/are the common infectious syndrome(s) associated with klebsiella

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pneumoniae?
1. Pneumonia
2. Intra-abdominal infections
3. Hepatitis
Select the correct answer using the code given below:

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(a) 1 only
(b) 1 and 2 only
(c) 1, 2 and 3
(d) 2 only

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46.

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Differential diagnosis of dysenteric syndrome includes which of the following?
1. Salmonella infection
2. Campylobacter infection
3. Shigella infection
4. Clostridium infection

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Select the correct answer using the code given below:
(a) 1, 2 and 4 only
(b) 2, 3 and 4 only
(c) 1 and 3 only
(d) 1, 2, 3 and 4

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47.
Antifungal agent of choice for the treatment of mucormycosis is:
(a) Voriconazole
(b) Intraconazole
(c) Amphotericin-B

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(d) Fluconazole
48.
What drug therapy would be appropriate for management of UTI in a pregnant patient?
(a) Trimethoprim-sulfamethoxazole
(b) Ciprofloxacin

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(c) Ampicillin
(d) All of these
49.
Which one of the following conditions is NOT associated with lymphocytosis?
(a) Infectious mononucleosis

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(b) Viral fevers
(c) Rickettsial fevers
(d) Leptospirosis
50.
Which of the following is NOT a diagnostic criterion of Kwashiorkor?

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(a) Serum albumin < 2.8 g/dl
(b) Triceps skinfold thickness < 3 mm
(c) Easy hair pluckability
(d) Edema

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51.

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Which one of the following drugs does NOT have any action against Salmonella typhi?
(a) Erythromycin
(b) Amoxicillin
(c) Co-trimoxazole
(d) Doxycycline

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52.
All of the following drugs are used for the treatment of influenza EXCEPT:
(a) Zanamivir
(b) Rimantadine
(c) Oseltamivir

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(d) Tenofovir
53.
Diagnostic accuracy has been enhanced by the ability to detect specific DNA sequences in all
of the following infectious micro-organisms EXCEPT:
(a) Cytomegalovirus(CMV)

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(b) Human Immunodeficiency virus (HIV)
(c) Mycobacterium tuberculosis
(d) Staphylococcus aureus
54.
Hip Flexor Spasm is characteristic of:

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(a) Osteomyelitis femur
(b) Septic arthritis hip joint
(c) Psoas abscess
(d) Deep vein thrombosis
55.

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Gastroenteritis associated with eating raw eggs is usually attributed to:
(a) E.coli
(b) Noro virus
(c) Salmonella species
(d) Clostriduim botulinum

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56.
Which one of the following diseases is NOT caused by protozoa?
(a) Trypanosomiasis
(b) Leishmaniasis
(c) Amoebiasis

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(d) Schistosomiasis

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57
An adult with fever and right sided chest pain is found to have a moderate right sided pleural
effusion. Chest X-Ray (PA view) also shows a moderate pleural effusion. A diagnostic
thoracocentesis reveals straw coloured exudates with 50 mg% of sugar and lymphocytic

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pleocytosis. ADA levels are borderline. What investigation would be most likely to confirm a
diagnosis of tuberculosis?
(a) Needle Biopsy of the Pleura
(b) Pleural Fluid Xpert MTB/RIF assay
(c) Pleural Fluid AFB smear

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(d) Pleural Fluid AFB-culture
58.
Consider the following statements with regard to acute anterior poliomyelitis:
1. It is caused by a virus belonging to picornavirus family
2. Muscle pain and cramps may be associated with diffuse transient fasciculations at the

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onset
3. Tonsillectomy reduces the risk of bulbar poliomyelitis
4. Cerebrospinal fluid may show mild pleocytosis with increase polymorphonuclear
cells in early course of disease
Which of the above statements are correct?

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(a) 1, 2 and 3
(b) 2, 3 and 4
(c) 1, 2 and 4
(d) 1, 3 and 4
59.

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Which one of the following is NOT seen in case of Marasmus?
(a) Reduced triceps skinfold thickness
(b) Normal serum albumin
(c) Easy hair pluckability
(d) Decreased mid arm circumference

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60.
Perception of an object in absence of stimulus is:
(a) Illusions
(b) Delusions
(c) Hallucination

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(d) Psychosis
61.
All of the following drugs can be used for the treatment for cessation of smoking EXCEPT:
(a) Nicotine gum
(b) Clonazepam

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(c) Bapropion
(d) Varenicline

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62.
All of the following features are present in Organophosphorus poisoning EXCEPT:

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(a) Bronchorrhea
(b) Hypertonia
(c) Confusion
(d) Fasciculations
63.

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Small sized pupils are seen in poisoning with all EXCEPT:
(a) Organophosphorous compounds
(b) Opioids
(c) Clonidine
(d) Cocaine

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64.
A 24 year old male presents with consumption of an unknown substance. His respiratory rate
is 22/minute, pulse rate is 110/minute, BP is 150/94 mmHg and he has 2 episodes of seizures.
There are tremors and hallucinations. The substance ingested most likely is:
(a) Amphetamines

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(b) Diazepam
(c) Oxycodone
(d) Ethanol
65.
The toxic effects of aluminium phosphide is due to the release of:

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(a) Phosgene
(b) Chlorine
(c) Inorganic phosphates
(d) Phosphine
66.

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An 18 year old boy was brought to the emergency department after being bitten by a saw-
scaled viper. The monitoring which is most crucial in this patient is:
(a) Single breath count
(b) Neck flop
(c) Whole blood clotting time

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(d) Creatine phosphokinase
67.
Bite of cobra is likely to result in:
(a) Flaccid paralysis
(b) Coagulopathy

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(c) Myolysis
(d) Cardiotoxicity

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68.
Hematuria is a prominent symptom with infection due to:
(a) Strongyloides stercoralis

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(b) Schistosoma hematobium
(c) Toxocara spp.
(d) Gnathostomiasis
69.
Bite of the Tsetse Fly transmits:

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(a) Leishmaniasis
(b) Chaga's disease
(c) Dengue fever
(d) African Trypanosomiasis
70.

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A 60 year old man with pneumonia is unconscious and has a PaO2 of 50 mm Hg. The
preferred modality of treatment for him is:
(a) Oxygen through nasal cannula
(b) Non invasive ventilation
(c) Invasive mechanical ventilation

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(d) No respiratory support is indicated
71.
Oliguria is defined as a reduction in urine output
(a) Less than 1 ml/kg/hour
(b) Less than 0.5 ml/kg/hour

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(c) Less than 200 ml in 24 hours
(d) Any decrease over previous urine output
72.
All of the following are signs of Brain death EXCEPT:
(a) Pupils fixed and unresponsive to light

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(b) Corneal reflexes absent
(c) Bilateral planter response ? Mute or Absent
(d) No gag reflex
73.
A 35 year old man with history of alcoholism presents with ophthalmoplegia, ataxia and

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global confusion. The treatment of choice for this patient is:
(a) I.V. Glucose
(b) I.V. Thiamine
(c) I.V. Mannitol
(d) I.V. Immunoglobulin

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74.
Most common form of paroxysmal supraventricular Tachycardia is:
(a) Junctional Ectopic Tachycardia
(b) AV Nodal Reentry Tachycardia (ANVRT)
(c) Accessory Pathways

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(d) Accelerated junctional rhythm
75.
The primary therapeutic intervention in symptomatic Sino atrial node dysfunction is:
(a) I.V. Atropine
(b) I.V. Isoprenaline

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(c) Permanent pacemaker
(d) I.V. Theophylline
76.
Which of the following are the Indications for lung transplantation?
1.

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Emphysema
2.
Primary pulmonary hypertension
3.
Obliterative bronchiolitis

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Select the correct answer using the code given below:
(a)
1 and 2 only
(b)
2 and 3 only

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(c)
1 and 3 only
(d)
1, 2 and 3
77.

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Which one of the following is used to distinguish narrowing of large airway from small
airway?
(a) Peak expiratory flow rate is measured
(b) Flow/ volume loops are recorded
(c) Forced expiratory volume in one second is measured

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(d) Flow/time loops are recorded
78.
The most common cause of chronic relapsing diarrhoea is:
(a) Inflammatory bowel disease
(b) Coeliac disease

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(c) Microscopic colitis
(d) Irritable bowel syndrome
79.
The most common cause of severe acute lower gastrointestinal bleeding is:
(a) Angiodysplasia of colon

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(b) Diverticular disease
(c) Ischaemia of bowel
(d) Inlammatory bowel disease

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80.

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Risk scoring system used to stratify the patients of acute upper gastrointestinal bleeding to
predict the need for intervention to treat bleeding is:
(a) Modified Blatchford score
(b) Modified Child Pugh score
(c) Balthazar score

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(d) Meld score
81.
Corkscrew hairs are seen due to deficiency of:
(a) Vitamin A
(b) Vitamin E

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(c) Vitamin K
(d) Vitamin C
82.
Which of the following are the indications of Renal biopsy?
1. Chronic Kidney disease with normal sized kidney

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2. Nephrotic syndrome in adults
3. Nephrotic syndrome in children with atypical features
Select the correct answer using the code given below:
(a) 1 and 2 only
(b) 2 and 3 only

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(c) 1 and 3 only
(d) 1, 2 and 3
83.
Which of the following are common risk factors for contrast Induced Nephrotoxicity?
1. Use of high osmolality, ionic contrast media

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2. Diabetes Mellitus
3. Myeloma
Select the correct answer using the code given below:
(a) 1 and 2 only
(b) 2 and 3 only

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(c) 1 and 3 only
(d) 1, 2 and 3
84.
Presence of Dysmorphic Erythrocytes in urine analysis is suggestive of:
(a) Pyelonephritis

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(b) Nephritis
(c) Renal stone disease
(d) Renal tract infection

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85.
Syndrome of Inappropriate ADH secretion (SIADH) is usually associated with:

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(a) Small cell lung cancer
(b) Squamous cell lung cancer
(c) Large cell lung cancer
(d) Adenocarcinoma lung cancer
86.

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A silent, resonant Hemithorax on examination is suggestive of:
(a) Large Pleural effusion
(b) Pneumothorax
(c) Bronchial asthma
(d) Consolidation

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87.
Gower's sign is positive in:
(a) Peroneal muscle atrophy
(b) Duchenne's dystrophy
(c) Friedreich ataxia

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(d) Cerebellar disease
88.
All of the following are the indications of renal replacement therapy EXCEPT:
(a) Metabolic Acidosis (pH < 7.25)
(b) Hypercalcemia

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(c) Hyperkalemia ( K+ > 6 mmol/L)
(d) Fluid overload
89.
All of the bacterial diseases are exotoxin-mediated EXCEPT:
(a) Botulism

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(b) Diphtheria
(c) Typhoid
(d) Tetanus
90.
The following substances can cause dilated pupils EXCEPT:

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(a) Tricyclic Antidepressants
(b) Cocaine
(c) Clonidine
(d) Amphetamines
91.

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Which one of the following drugs can cause Pulmonary Eosinophilia?
(a) Nitrofurantoin
(b) Valproate
(c) Enalapril
(d) Amoxycillin

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92.
CA 19-9 is a tumour marker used for the diagnosis of:
(a) Lung cancer
(b) Prostate cancer
(c) Ovarian cancer

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(d) Pancreatic cancer

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93.
Tinea versicolor is caused by:
(a) Candida albicans
(b) Trichophyton

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(c) Streptococci
(d) Malassezia furfur
94.
Osborn wave in ECG is characteristic of:
(a)

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Hypothyroidism
(b)
Hypovolemia
(c)
Hypothermia

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(d)
Hypocalcemia
95.
Disease modifying agent of choice for the peripheral manifestations of ankylosing spondylitis
is:

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(a)
Methotrexate
(b)
Hydroxychloroquine
(c)

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Sulfasalazine
(d)
Leflunomide
96.
Drug of choice for treating hypertensive emergency in a case of Aortic dissection is:

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(a)
Phentolamine
(b)
Prazosin
(c)

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Nitroprusside
(d)
Amlodipine
97.
A 5 year old boy is brought to the Emergency Room following a crushing injury. The ECG

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reveals peaked T waves, prolonged PR interval and widened QRS complexes. Which of the
following treatments should be administered immediately?
(a) Sodium bicarbonate infusion
(b) Intravenous bolus procainamide
(c) Insulin infusion

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(d) Intravenous magnesium sulphate
98.
A child with Acute Lymphoblastic Leukemia is started on chemotherapy. After 2 days he
develops vomiting, decreased urine output abdominal pain and tetanic spasms. The ECG
reveals QTC prolongation. Which one of the following therapies will be detrimental to his

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management?
(a) Normal maintenance intravenous fluid
(b) Oral phosphate binders
(c) Intravenous rasburicase
(d) None of these

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99.
Which of the following treatment modalities is NOT recommended for worsening respiratory
distress in a child suspected to be suffering from acute croup?
(a) Sedation
(b) Intravenous antibiotics

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(c) Nebulised racemic epinephrine
(d) Intramuscular dexamethasone
100.
Which of the following developmental skills will you expect a child to have acquired by 9
months?

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(a) Cruising around the furniture
(b) Mature pincer grasp
(c) Waves `bye-bye'
(d) Refers to mother as `ma-ma'
101.

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Which of the following is physiological in a term neonate?
(a) Hypotonia
(b) Erythema toxicum
(c) Jaundice at 20 hours of life
(d) Direct serum bilirubin level = 3.0 mg/dL

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102.
A preterm neonate undergoes the initial steps of resuscitation. The clinician observes that the
baby is breathing, has a heart rate of 80/minute and the baby is pink. What will be the next
immediate step in management?
(a) Administering intravenous epinephrine

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(b) Chest compressions
(c) Positive pressure ventilation
(d) Supplemental oxygen
103.
A child is able to copy a triangle, names 4 colours, dresses and undresses easily and is able to

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skip. What is the likely age of this child?
(a) 30 months
(b) 36 months
(c) 48 months
(d) 60 months

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104.
Which of the following will be considered to be a `RED FLAG' in child development?
(a) No vocalization by 4 months
(b) Unable to sit without support by 10 months
(c) Unable to walk independently by 15 months

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(d) Unable to speak a single word with meaning by 15 months

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105.
Gastric lavage is contraindicated in which of the following?
1. Corrosive poisoning
2. Organophosphorus poisoning

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3. Iron intoxication
4. Turpentine oil ingestion
Select the correct answer using the codes given below:
(a) 1 and 2
(b) 2 and 3

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(c) 3 and 4
(d) 4 and 1
106.
A 10-year old girl is brought to the emergency following a road traffic accident. The child is
comatose with GCS score of 4. She is hypertensive, has bradycardia and extensor posturing.

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CT imaging reveals comminuted skull fractures and intraparenchymal hemorrhage. The
initial management should include all of the following measures EXCEPT:
(a) Head of bed elevation
(b) Mechanical ventilation
(c) Intravenous dexamethasone

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(d) Hypertonic saline administration
107.
A 3-year old boy is brought with complaints of staying aloof. He also has delayed speech.
Rest of the developmental milestones were attained normally. The most likely diagnosis is:
(a) Selective mutism

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(b) Attention deficit hyperactivity disorder
(c) Autism
(d) Phonological disorder
108.
Which of the following statements regarding HPV (Human Papilloma Virus) vaccine is NOT

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true?
(a) It can be safely administered in pregnancy
(b) The recommended age for initiation of vaccination is 10?12 years
(c) Catch up vaccination may be permitted up to 26 years of age, provided the woman is
not sexually active

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(d) The vaccine is administered intramuscularly in deltoid region
109.
A 6-year old boy comes to the immunization clinic having received all vaccines as per
schedule till 18 months of age. Which vaccine should be administered now?
(a) DTPw booster

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(b) TdaP booster
(c) DT booster
(d) TT booster

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110.
"Time-out" strategy is used for management of children having:

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(a) Tics
(b) Temper tantrums
(c) Stuttering
(d) Breath holding spells
111

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All of the following are included in the `Mission Indradhanush' EXCEPT:
(a) Japanese Encephalitis vaccine
(b) Measles vaccine
(c) Hepatitis A vaccine
(d) Haemophilus influenza type B vaccine

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112.
Which of the following is the best mode of management of a newborn born to a mother with
Hepatitis B infection?
(a) Hepatitis B Immunoglobulin (HBIG) and Hepatitis B vaccine at birth
(b) 1 and monotherapy with Infection

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(c) 1 and monotherapy with Lamivudine
(d) 1 and monotherapy with Adefovir
113.
At what age should a lateral neck radiograph be done for a child with Downs syndrome to
rule out atlanto-occipital subluxation?

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(a) At birth
(b) At 1 year
(c) At 2 years
(d) At 3 years
114.

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Which X ray will be used to evaluate the bone age (skeletal age)of a term newborn at birth?
(a) Wrist
(b) Shoulder
(c) Knee
(d) Elbow

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115.
Which of the following permanent tooth eruption event has close correlation with menarche?
(a) First premolar
(b) First molar
(c) Second premolar

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(d) Second molar

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116.
Which one of the following is NOT a component of the `4 Ds' that are the focus of the
Rashtriya Bal Suraksha Karyakram'(RBSK)?
(a) Deficit

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(b) Disease
(c) Deficiency
(d) Developmental delay
117.
In which one of the following age groups is the highest rate of drowning observed,

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worldwide?
(a) Less than 1 year
(b) 1?4 years
(c) 4?10 years
(d) 10?15 years

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118.
Which of the following is the recommended initial intravenous therapy in a 2-year old child
with Severe Acute Malnutrition with Severe Dehydration and Shock?
(a) Ringer Lactate(R) at the rate of 30 mL/kg over first 30 minutes
(b) Half-normal saline (N/2) in 5% dextrose at the rate of 15 mL/kg over first 60

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minutes
(c) Normal saline(NS) at the rate of 20 mL/kg over the first 30 minutes
(d) N/5 saline with 5% dextrose at the rate of 30 mL/kg over first 60 minutes
119.
A female carrier for hemophilia A gene gets married to a genetically normal male. What are

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the chances of her delivering a male offspring with hemophilia?
(a) 0%
(b) 25%
(c) 50%
(d) 100%

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120.
What is the definition of `Cold stress' in a newborn as measured by the axillary temperature?
(a) 35.0 ? 35.5 ?C
(b) 35.0 ? 36.0 ?C
(c) 35.5 ? 36.5 ?C

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(d) 36.0 ? 36.4 ?C

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