Download UPSC CMS Paper II 2020 Question Paper with Answer Key

Combined Medical Services Examination-2020
Paper-II

1.
Indications for fasciotomy in compartment syndrome include all EXCEPT:

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(a) Distal sensory disturbance
(b) Compartment pressure > 30 mm Hg
(c) Pain on passive movement of affected muscles
(d) Palpable distal pulses

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2.
Which one of the following statements is NOT correct regarding Necrotising Soft Tissue
infections?

(a) Crepitus, skin blistering and focal skin gangrene are typical presenting features

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(b) They are monomicrobial in nature
(c) Treatment consists of wide local excision and appropriate antibiotics
(d) Tissue biopsy is required for culture and diagnosis
3.
Which type of surgery is laparoscopic cholecystectomy classified as?

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(a) Clean
(b) Clean contaminated
(c) Contaminated
(d) Dirty

--- Content provided by FirstRanker.com ---

4.
A 22-year female has presented with a history of malaise, cough, alternating constipation and
diarrhoea with intermittent abdominal pain for last 6 months. She also complains of
abdominal distension for last 2 days. On examination her abdomen has a doughy feel along
with an ill defined mass over the right lower quadrant. She is most likely suffering from:

--- Content provided by FirstRanker.com ---

(a) Appendicular lump
(b) Ileocaecal tuberculosis
(c) Carcinoma caecum
(d) Ovarian mass

--- Content provided by FirstRanker.com ---

5.
Consider the following statements regarding needle stick injuries:

1. Injured part should be washed under running water
2. Dominant index finger is the commonest site for needle stick injury

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3. All needle stick injuries should be reported
4. Hepatitis/HIV testing should be done after needle stick injury

Which of the statements given above are correct?

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

--- Content provided by FirstRanker.com ---

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Combined Medical Services Examination-2020
Paper-II

1.

--- Content provided by FirstRanker.com ---

Indications for fasciotomy in compartment syndrome include all EXCEPT:

(a) Distal sensory disturbance
(b) Compartment pressure > 30 mm Hg
(c) Pain on passive movement of affected muscles

--- Content provided by FirstRanker.com ---

(d) Palpable distal pulses
2.
Which one of the following statements is NOT correct regarding Necrotising Soft Tissue
infections?

--- Content provided by FirstRanker.com ---

(a) Crepitus, skin blistering and focal skin gangrene are typical presenting features
(b) They are monomicrobial in nature
(c) Treatment consists of wide local excision and appropriate antibiotics
(d) Tissue biopsy is required for culture and diagnosis
3.

--- Content provided by FirstRanker.com ---

Which type of surgery is laparoscopic cholecystectomy classified as?

(a) Clean
(b) Clean contaminated
(c) Contaminated

--- Content provided by FirstRanker.com ---

(d) Dirty
4.
A 22-year female has presented with a history of malaise, cough, alternating constipation and
diarrhoea with intermittent abdominal pain for last 6 months. She also complains of
abdominal distension for last 2 days. On examination her abdomen has a doughy feel along

--- Content provided by FirstRanker.com ---

with an ill defined mass over the right lower quadrant. She is most likely suffering from:

(a) Appendicular lump
(b) Ileocaecal tuberculosis
(c) Carcinoma caecum

--- Content provided by FirstRanker.com ---

(d) Ovarian mass
5.
Consider the following statements regarding needle stick injuries:

1. Injured part should be washed under running water

--- Content provided by FirstRanker.com ---

2. Dominant index finger is the commonest site for needle stick injury
3. All needle stick injuries should be reported
4. Hepatitis/HIV testing should be done after needle stick injury

Which of the statements given above are correct?

--- Content provided by FirstRanker.com ---

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

--- Content provided by FirstRanker.com ---

6.

--- Content provided by FirstRanker.com ---

Consider the following statements regarding claudication:

1. It is a marker for silent coronary disease
2. Structured exercise program ( 2 hours per week for 3 months) leads to
improvement in symptoms

--- Content provided by FirstRanker.com ---

3. Diabetes mellitus increases the risk and severity of claudication
4. Beta blockers may exacerbate claudication

Which of the above statements are correct?

--- Content provided by FirstRanker.com ---

(a) 1 and 2 only
(b) 1, 3 and 4 only
(c) 2, 3 and 4 only
(d) 1, 2, 3 and 4
7.

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A 50-year old lady underwent uneventful bariatric surgery for morbid obesity. On the third
post operative day, she develops breathless and pulmonary embolism is suspected. The next
investigation to confirm the diagnosis will be:

(a) Echocardiography

--- Content provided by FirstRanker.com ---

(b) Duplex venography
(c) CT pulmonary angiography
(d) MR angiography
8.
Medical management of thyrotoxic crisis includes all of the following EXCEPT:

--- Content provided by FirstRanker.com ---

(a) IV fluids
(b) IV propanolol
(c) IV hydrocortisone
(d) IV antibiotics

--- Content provided by FirstRanker.com ---

9.
A patient operated for a parotid gland tumour developed symptoms of sweating and
erytherma (flushing) over the region of surgical excision while eating. The probable
diagnosis is:

--- Content provided by FirstRanker.com ---

(a) Parotid gland fistula
(b) Sialadenitis
(c) Chronic wound infection
(d) Frey?s syndrome
10.

--- Content provided by FirstRanker.com ---

First line hormone therapy for post-menopausal woman with metastatic carcinoma breast is:

(a) Tamoxifen
(b) Ovarian suppression by surgery
(c) Antiprogestins

--- Content provided by FirstRanker.com ---

(d) Anastrazole
FirstRanker.com - FirstRanker's Choice
Combined Medical Services Examination-2020
Paper-II

--- Content provided by FirstRanker.com ---

1.
Indications for fasciotomy in compartment syndrome include all EXCEPT:

(a) Distal sensory disturbance
(b) Compartment pressure > 30 mm Hg

--- Content provided by FirstRanker.com ---

(c) Pain on passive movement of affected muscles
(d) Palpable distal pulses
2.
Which one of the following statements is NOT correct regarding Necrotising Soft Tissue
infections?

--- Content provided by FirstRanker.com ---

(a) Crepitus, skin blistering and focal skin gangrene are typical presenting features
(b) They are monomicrobial in nature
(c) Treatment consists of wide local excision and appropriate antibiotics
(d) Tissue biopsy is required for culture and diagnosis

--- Content provided by FirstRanker.com ---

3.
Which type of surgery is laparoscopic cholecystectomy classified as?

(a) Clean
(b) Clean contaminated

--- Content provided by FirstRanker.com ---

(c) Contaminated
(d) Dirty
4.
A 22-year female has presented with a history of malaise, cough, alternating constipation and
diarrhoea with intermittent abdominal pain for last 6 months. She also complains of

--- Content provided by FirstRanker.com ---

abdominal distension for last 2 days. On examination her abdomen has a doughy feel along
with an ill defined mass over the right lower quadrant. She is most likely suffering from:

(a) Appendicular lump
(b) Ileocaecal tuberculosis

--- Content provided by FirstRanker.com ---

(c) Carcinoma caecum
(d) Ovarian mass
5.
Consider the following statements regarding needle stick injuries:

--- Content provided by FirstRanker.com ---

1. Injured part should be washed under running water
2. Dominant index finger is the commonest site for needle stick injury
3. All needle stick injuries should be reported
4. Hepatitis/HIV testing should be done after needle stick injury

--- Content provided by FirstRanker.com ---

Which of the statements given above are correct?

(a) 1, 2 and 4
(b) 1, 2 and 3
(c) 1, 3 and 4

--- Content provided by FirstRanker.com ---

(d) 2, 3 and 4

--- Content provided by FirstRanker.com ---

6.
Consider the following statements regarding claudication:

1. It is a marker for silent coronary disease
2. Structured exercise program ( 2 hours per week for 3 months) leads to

--- Content provided by FirstRanker.com ---

improvement in symptoms
3. Diabetes mellitus increases the risk and severity of claudication
4. Beta blockers may exacerbate claudication

Which of the above statements are correct?

--- Content provided by FirstRanker.com ---

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

--- Content provided by FirstRanker.com ---

7.
A 50-year old lady underwent uneventful bariatric surgery for morbid obesity. On the third
post operative day, she develops breathless and pulmonary embolism is suspected. The next
investigation to confirm the diagnosis will be:

--- Content provided by FirstRanker.com ---

(a) Echocardiography
(b) Duplex venography
(c) CT pulmonary angiography
(d) MR angiography
8.

--- Content provided by FirstRanker.com ---

Medical management of thyrotoxic crisis includes all of the following EXCEPT:

(a) IV fluids
(b) IV propanolol
(c) IV hydrocortisone

--- Content provided by FirstRanker.com ---

(d) IV antibiotics
9.
A patient operated for a parotid gland tumour developed symptoms of sweating and
erytherma (flushing) over the region of surgical excision while eating. The probable
diagnosis is:

--- Content provided by FirstRanker.com ---

(a) Parotid gland fistula
(b) Sialadenitis
(c) Chronic wound infection
(d) Frey?s syndrome

--- Content provided by FirstRanker.com ---

10.
First line hormone therapy for post-menopausal woman with metastatic carcinoma breast is:

(a) Tamoxifen
(b) Ovarian suppression by surgery

--- Content provided by FirstRanker.com ---

(c) Antiprogestins
(d) Anastrazole

--- Content provided by FirstRanker.com ---

11.
All of the following are major subtypes of breast cancer based on Gene array analysis
EXCEPT:

(a) Luminal A and Luminal B

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(b) Triple negative
(c) Her-2 receptor positive
(d) Oestrogen receptor positive
12.
All of the following are sequelae of peptic ulcer surgery EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Bilious vomiting
(b) Dumping syndrome
(c) Diarrhoea
(d) Increased appetite

--- Content provided by FirstRanker.com ---

13.
The Child-Turcotte-Pugh (CTP) score for quantifying the severity of chronic liver disease
includes all variables EXCEPT:

(a) Serum bilirubin

--- Content provided by FirstRanker.com ---

(b) Serum albumin
(c) Serum creatinine
(d) INR (International Normalised Ratio)
14.
?Chain of Lakes? appearance due to sacculation with intervening short strictures of pancreatic

--- Content provided by FirstRanker.com ---

duct is seen on:

(a) ERCP
(b) CECT abdomen
(c) Plain X-ray abdomen

--- Content provided by FirstRanker.com ---

(d) Ultrasonography
15.
Which one of the following statements is NOT correct regarding Pyogenic Liver Abscess?

(a) Anorexia, fever, malaise and right upper quadrant abdominal discomfort are the

--- Content provided by FirstRanker.com ---

most common presenting features
(b) It is more common in elderly, diabetics and immunocompromised patients
(c) Treatment is with oral antibiotics alone
(d) Streptococcus milleri and escherichia coli are the most common causative
organisms

--- Content provided by FirstRanker.com ---

16.
?Swiss cheese defects? are seen during laparoscopic repair of:

(a) Ventral hernia
(b) Inguinal hernia

--- Content provided by FirstRanker.com ---

(c) Obturator hernia
(d) Femoral hernia
FirstRanker.com - FirstRanker's Choice
Combined Medical Services Examination-2020
Paper-II

--- Content provided by FirstRanker.com ---

1.
Indications for fasciotomy in compartment syndrome include all EXCEPT:

(a) Distal sensory disturbance

--- Content provided by FirstRanker.com ---

(b) Compartment pressure > 30 mm Hg
(c) Pain on passive movement of affected muscles
(d) Palpable distal pulses
2.
Which one of the following statements is NOT correct regarding Necrotising Soft Tissue

--- Content provided by FirstRanker.com ---

infections?

(a) Crepitus, skin blistering and focal skin gangrene are typical presenting features
(b) They are monomicrobial in nature
(c) Treatment consists of wide local excision and appropriate antibiotics

--- Content provided by FirstRanker.com ---

(d) Tissue biopsy is required for culture and diagnosis
3.
Which type of surgery is laparoscopic cholecystectomy classified as?

(a) Clean

--- Content provided by FirstRanker.com ---

(b) Clean contaminated
(c) Contaminated
(d) Dirty
4.
A 22-year female has presented with a history of malaise, cough, alternating constipation and

--- Content provided by FirstRanker.com ---

diarrhoea with intermittent abdominal pain for last 6 months. She also complains of
abdominal distension for last 2 days. On examination her abdomen has a doughy feel along
with an ill defined mass over the right lower quadrant. She is most likely suffering from:

(a) Appendicular lump

--- Content provided by FirstRanker.com ---

(b) Ileocaecal tuberculosis
(c) Carcinoma caecum
(d) Ovarian mass
5.
Consider the following statements regarding needle stick injuries:

--- Content provided by FirstRanker.com ---

1. Injured part should be washed under running water
2. Dominant index finger is the commonest site for needle stick injury
3. All needle stick injuries should be reported
4. Hepatitis/HIV testing should be done after needle stick injury

--- Content provided by FirstRanker.com ---

Which of the statements given above are correct?

(a) 1, 2 and 4
(b) 1, 2 and 3

--- Content provided by FirstRanker.com ---

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

--- Content provided by FirstRanker.com ---

6.
Consider the following statements regarding claudication:

1. It is a marker for silent coronary disease

--- Content provided by FirstRanker.com ---

2. Structured exercise program ( 2 hours per week for 3 months) leads to
improvement in symptoms
3. Diabetes mellitus increases the risk and severity of claudication
4. Beta blockers may exacerbate claudication

--- Content provided by FirstRanker.com ---

Which of the above statements are correct?

(a) 1 and 2 only
(b) 1, 3 and 4 only
(c) 2, 3 and 4 only

--- Content provided by FirstRanker.com ---

(d) 1, 2, 3 and 4
7.
A 50-year old lady underwent uneventful bariatric surgery for morbid obesity. On the third
post operative day, she develops breathless and pulmonary embolism is suspected. The next
investigation to confirm the diagnosis will be:

--- Content provided by FirstRanker.com ---

(a) Echocardiography
(b) Duplex venography
(c) CT pulmonary angiography
(d) MR angiography

--- Content provided by FirstRanker.com ---

8.
Medical management of thyrotoxic crisis includes all of the following EXCEPT:

(a) IV fluids
(b) IV propanolol

--- Content provided by FirstRanker.com ---

(c) IV hydrocortisone
(d) IV antibiotics
9.
A patient operated for a parotid gland tumour developed symptoms of sweating and
erytherma (flushing) over the region of surgical excision while eating. The probable

--- Content provided by FirstRanker.com ---

diagnosis is:

(a) Parotid gland fistula
(b) Sialadenitis
(c) Chronic wound infection

--- Content provided by FirstRanker.com ---

(d) Frey?s syndrome
10.
First line hormone therapy for post-menopausal woman with metastatic carcinoma breast is:

(a) Tamoxifen

--- Content provided by FirstRanker.com ---

(b) Ovarian suppression by surgery
(c) Antiprogestins
(d) Anastrazole

--- Content provided by FirstRanker.com ---

11.
All of the following are major subtypes of breast cancer based on Gene array analysis
EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Luminal A and Luminal B
(b) Triple negative
(c) Her-2 receptor positive
(d) Oestrogen receptor positive
12.

--- Content provided by FirstRanker.com ---

All of the following are sequelae of peptic ulcer surgery EXCEPT:

(a) Bilious vomiting
(b) Dumping syndrome
(c) Diarrhoea

--- Content provided by FirstRanker.com ---

(d) Increased appetite
13.
The Child-Turcotte-Pugh (CTP) score for quantifying the severity of chronic liver disease
includes all variables EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Serum bilirubin
(b) Serum albumin
(c) Serum creatinine
(d) INR (International Normalised Ratio)
14.

--- Content provided by FirstRanker.com ---

?Chain of Lakes? appearance due to sacculation with intervening short strictures of pancreatic
duct is seen on:

(a) ERCP
(b) CECT abdomen

--- Content provided by FirstRanker.com ---

(c) Plain X-ray abdomen
(d) Ultrasonography
15.
Which one of the following statements is NOT correct regarding Pyogenic Liver Abscess?

--- Content provided by FirstRanker.com ---

(a) Anorexia, fever, malaise and right upper quadrant abdominal discomfort are the
most common presenting features
(b) It is more common in elderly, diabetics and immunocompromised patients
(c) Treatment is with oral antibiotics alone
(d) Streptococcus milleri and escherichia coli are the most common causative

--- Content provided by FirstRanker.com ---

organisms
16.
?Swiss cheese defects? are seen during laparoscopic repair of:

(a) Ventral hernia

--- Content provided by FirstRanker.com ---

(b) Inguinal hernia
(c) Obturator hernia
(d) Femoral hernia

--- Content provided by FirstRanker.com ---

17.
Which of the following are correct regarding splenic artery aneurysm?

1. Main arterial trunk is the common site

--- Content provided by FirstRanker.com ---

2. Palpable thrill can be felt
3. It is symptomless unless it ruptures

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

(a) 1 and 2 only
(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3
18.

--- Content provided by FirstRanker.com ---

Valentino?s syndrome is:

(a) Pain on per-vaginal examination in pelvic abscess
(b) Pain over left shoulder in left hypochondriac collection
(c) Pain over left groin in perirenal collection

--- Content provided by FirstRanker.com ---

(d) Pain in right iliac fossa in perforated peptic ulcer
19.
Spontaneous bacterial peritonitis occurs due to:

(a) duodenal stump blowout

--- Content provided by FirstRanker.com ---

(b) peptic ulcer perforation
(c) acute bacterial infection of ascites
(d) infection via fallopian tubes
20.
Structure not forming boundaries of the ?Triangle of doom? seen during laparoscopic

--- Content provided by FirstRanker.com ---

inguinal hernia surgery dissection is:

(a) Vas deferens
(b) Inferior epigastric artery
(c) Spermatic cord vessels

--- Content provided by FirstRanker.com ---

(d) Peritoneum
21.
The term mid-line shift is associated with:

(a) Head injury

--- Content provided by FirstRanker.com ---

(b) Chest injury
(c) Abdominal injury
(d) Limb injury
22.
Which one of the following cranial nerves does NOT supply to the external ear?

--- Content provided by FirstRanker.com ---

(a) Cranial nerve V
(b) Cranial nerve VI
FirstRanker.com - FirstRanker's Choice
Combined Medical Services Examination-2020

--- Content provided by FirstRanker.com ---

Paper-II

1.
Indications for fasciotomy in compartment syndrome include all EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Distal sensory disturbance
(b) Compartment pressure > 30 mm Hg
(c) Pain on passive movement of affected muscles
(d) Palpable distal pulses
2.

--- Content provided by FirstRanker.com ---

Which one of the following statements is NOT correct regarding Necrotising Soft Tissue
infections?

(a) Crepitus, skin blistering and focal skin gangrene are typical presenting features
(b) They are monomicrobial in nature

--- Content provided by FirstRanker.com ---

(c) Treatment consists of wide local excision and appropriate antibiotics
(d) Tissue biopsy is required for culture and diagnosis
3.
Which type of surgery is laparoscopic cholecystectomy classified as?

--- Content provided by FirstRanker.com ---

(a) Clean
(b) Clean contaminated
(c) Contaminated
(d) Dirty
4.

--- Content provided by FirstRanker.com ---

A 22-year female has presented with a history of malaise, cough, alternating constipation and
diarrhoea with intermittent abdominal pain for last 6 months. She also complains of
abdominal distension for last 2 days. On examination her abdomen has a doughy feel along
with an ill defined mass over the right lower quadrant. She is most likely suffering from:

--- Content provided by FirstRanker.com ---

(a) Appendicular lump
(b) Ileocaecal tuberculosis
(c) Carcinoma caecum
(d) Ovarian mass
5.

--- Content provided by FirstRanker.com ---

Consider the following statements regarding needle stick injuries:

1. Injured part should be washed under running water
2. Dominant index finger is the commonest site for needle stick injury
3. All needle stick injuries should be reported

--- Content provided by FirstRanker.com ---

4. Hepatitis/HIV testing should be done after needle stick injury

Which of the statements given above are correct?

(a) 1, 2 and 4

--- Content provided by FirstRanker.com ---

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

--- Content provided by FirstRanker.com ---

6.
Consider the following statements regarding claudication:

--- Content provided by FirstRanker.com ---

1. It is a marker for silent coronary disease
2. Structured exercise program ( 2 hours per week for 3 months) leads to
improvement in symptoms
3. Diabetes mellitus increases the risk and severity of claudication
4. Beta blockers may exacerbate claudication

--- Content provided by FirstRanker.com ---

Which of the above statements are correct?

(a) 1 and 2 only
(b) 1, 3 and 4 only

--- Content provided by FirstRanker.com ---

(c) 2, 3 and 4 only
(d) 1, 2, 3 and 4
7.
A 50-year old lady underwent uneventful bariatric surgery for morbid obesity. On the third
post operative day, she develops breathless and pulmonary embolism is suspected. The next

--- Content provided by FirstRanker.com ---

investigation to confirm the diagnosis will be:

(a) Echocardiography
(b) Duplex venography
(c) CT pulmonary angiography

--- Content provided by FirstRanker.com ---

(d) MR angiography
8.
Medical management of thyrotoxic crisis includes all of the following EXCEPT:

(a) IV fluids

--- Content provided by FirstRanker.com ---

(b) IV propanolol
(c) IV hydrocortisone
(d) IV antibiotics
9.
A patient operated for a parotid gland tumour developed symptoms of sweating and

--- Content provided by FirstRanker.com ---

erytherma (flushing) over the region of surgical excision while eating. The probable
diagnosis is:

(a) Parotid gland fistula
(b) Sialadenitis

--- Content provided by FirstRanker.com ---

(c) Chronic wound infection
(d) Frey?s syndrome
10.
First line hormone therapy for post-menopausal woman with metastatic carcinoma breast is:

--- Content provided by FirstRanker.com ---

(a) Tamoxifen
(b) Ovarian suppression by surgery
(c) Antiprogestins
(d) Anastrazole

--- Content provided by FirstRanker.com ---

11.
All of the following are major subtypes of breast cancer based on Gene array analysis
EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Luminal A and Luminal B
(b) Triple negative
(c) Her-2 receptor positive
(d) Oestrogen receptor positive

--- Content provided by FirstRanker.com ---

12.
All of the following are sequelae of peptic ulcer surgery EXCEPT:

(a) Bilious vomiting
(b) Dumping syndrome

--- Content provided by FirstRanker.com ---

(c) Diarrhoea
(d) Increased appetite
13.
The Child-Turcotte-Pugh (CTP) score for quantifying the severity of chronic liver disease
includes all variables EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Serum bilirubin
(b) Serum albumin
(c) Serum creatinine
(d) INR (International Normalised Ratio)

--- Content provided by FirstRanker.com ---

14.
?Chain of Lakes? appearance due to sacculation with intervening short strictures of pancreatic
duct is seen on:

(a) ERCP

--- Content provided by FirstRanker.com ---

(b) CECT abdomen
(c) Plain X-ray abdomen
(d) Ultrasonography
15.
Which one of the following statements is NOT correct regarding Pyogenic Liver Abscess?

--- Content provided by FirstRanker.com ---

(a) Anorexia, fever, malaise and right upper quadrant abdominal discomfort are the
most common presenting features
(b) It is more common in elderly, diabetics and immunocompromised patients
(c) Treatment is with oral antibiotics alone

--- Content provided by FirstRanker.com ---

(d) Streptococcus milleri and escherichia coli are the most common causative
organisms
16.
?Swiss cheese defects? are seen during laparoscopic repair of:

--- Content provided by FirstRanker.com ---

(a) Ventral hernia
(b) Inguinal hernia
(c) Obturator hernia
(d) Femoral hernia

--- Content provided by FirstRanker.com ---

17.
Which of the following are correct regarding splenic artery aneurysm?

--- Content provided by FirstRanker.com ---

1. Main arterial trunk is the common site
2. Palpable thrill can be felt
3. It is symptomless unless it ruptures

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

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

--- Content provided by FirstRanker.com ---

18.
Valentino?s syndrome is:

(a) Pain on per-vaginal examination in pelvic abscess
(b) Pain over left shoulder in left hypochondriac collection

--- Content provided by FirstRanker.com ---

(c) Pain over left groin in perirenal collection
(d) Pain in right iliac fossa in perforated peptic ulcer
19.
Spontaneous bacterial peritonitis occurs due to:

--- Content provided by FirstRanker.com ---

(a) duodenal stump blowout
(b) peptic ulcer perforation
(c) acute bacterial infection of ascites
(d) infection via fallopian tubes
20.

--- Content provided by FirstRanker.com ---

Structure not forming boundaries of the ?Triangle of doom? seen during laparoscopic
inguinal hernia surgery dissection is:

(a) Vas deferens
(b) Inferior epigastric artery

--- Content provided by FirstRanker.com ---

(c) Spermatic cord vessels
(d) Peritoneum
21.
The term mid-line shift is associated with:

--- Content provided by FirstRanker.com ---

(a) Head injury
(b) Chest injury
(c) Abdominal injury
(d) Limb injury
22.

--- Content provided by FirstRanker.com ---

Which one of the following cranial nerves does NOT supply to the external ear?

(a) Cranial nerve V
(b) Cranial nerve VI
(c) Cranial nerve VII

--- Content provided by FirstRanker.com ---

(d) Cranial nerve IX

23.
Left Internal Mammary Artery (LIMA) has become the conduit of choice for Left Anterior
Descending (LAD) artery during coronary artery bypass grafting because:

--- Content provided by FirstRanker.com ---

(a) Long term patency rates are more than 98%
(b) It is close to LAD
(c) Atherosclerosis is never seen in this vessel
(d) It is very easy to harvest

--- Content provided by FirstRanker.com ---

24.
A 50-year old male with significant smoking history presented in the surgical emergency
with sudden severe breathlessness. Chest X-ray shows right sided Pneumothorax. The
appropriate management requires:

--- Content provided by FirstRanker.com ---

(a) Aspiration of air with 16-18 G cannula
(b) Right chest drain of size 8-14 Fr
(c) Oxygen by face mask
(d) Mechanical ventilation
25.

--- Content provided by FirstRanker.com ---

Which one of the following statements regarding Felon is NOT correct?

(a) There is infection of the finger tip between specialised fibrous septa
(b) It is a painless condition
(c) Incision and drainage is the treatment of choice

--- Content provided by FirstRanker.com ---

(d) It is common in diabetics
26.
The most common site for osteosarcoma is:

(a) Proximal femur

--- Content provided by FirstRanker.com ---

(b) Distal femur
(c) Proximal humerus
(d) Distal humerus
27.
Rapid Sequence Induction is indicated in:

--- Content provided by FirstRanker.com ---

(a) Emergency surgery for intestinal obstruction
(b) Elective open hernia surgery
(c) Cardiopulmonary bypass surgery
(d) Elective laparoscopic surgery

--- Content provided by FirstRanker.com ---

28.
Which one of the following statements about Compartment Syndrome is NOT correct?

(a) It is commonest in a closed fracture

--- Content provided by FirstRanker.com ---

(b) Pain is on active movement but not on passive movement of muscles
(c) Fasciotomy is the treatment of choice
(d) Volkmann?s Ischaemic contractive is a late complication

FirstRanker.com - FirstRanker's Choice

--- Content provided by FirstRanker.com ---

Combined Medical Services Examination-2020
Paper-II

1.
Indications for fasciotomy in compartment syndrome include all EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Distal sensory disturbance
(b) Compartment pressure > 30 mm Hg
(c) Pain on passive movement of affected muscles
(d) Palpable distal pulses

--- Content provided by FirstRanker.com ---

2.
Which one of the following statements is NOT correct regarding Necrotising Soft Tissue
infections?

(a) Crepitus, skin blistering and focal skin gangrene are typical presenting features

--- Content provided by FirstRanker.com ---

(b) They are monomicrobial in nature
(c) Treatment consists of wide local excision and appropriate antibiotics
(d) Tissue biopsy is required for culture and diagnosis
3.
Which type of surgery is laparoscopic cholecystectomy classified as?

--- Content provided by FirstRanker.com ---

(a) Clean
(b) Clean contaminated
(c) Contaminated
(d) Dirty

--- Content provided by FirstRanker.com ---

4.
A 22-year female has presented with a history of malaise, cough, alternating constipation and
diarrhoea with intermittent abdominal pain for last 6 months. She also complains of
abdominal distension for last 2 days. On examination her abdomen has a doughy feel along
with an ill defined mass over the right lower quadrant. She is most likely suffering from:

--- Content provided by FirstRanker.com ---

(a) Appendicular lump
(b) Ileocaecal tuberculosis
(c) Carcinoma caecum
(d) Ovarian mass

--- Content provided by FirstRanker.com ---

5.
Consider the following statements regarding needle stick injuries:

1. Injured part should be washed under running water
2. Dominant index finger is the commonest site for needle stick injury

--- Content provided by FirstRanker.com ---

3. All needle stick injuries should be reported
4. Hepatitis/HIV testing should be done after needle stick injury

Which of the statements given above are correct?

--- Content provided by FirstRanker.com ---

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

--- Content provided by FirstRanker.com ---

6.
Consider the following statements regarding claudication:

--- Content provided by FirstRanker.com ---

1. It is a marker for silent coronary disease
2. Structured exercise program ( 2 hours per week for 3 months) leads to
improvement in symptoms
3. Diabetes mellitus increases the risk and severity of claudication

--- Content provided by FirstRanker.com ---

4. Beta blockers may exacerbate claudication

Which of the above statements are correct?

(a) 1 and 2 only

--- Content provided by FirstRanker.com ---

(b) 1, 3 and 4 only
(c) 2, 3 and 4 only
(d) 1, 2, 3 and 4
7.
A 50-year old lady underwent uneventful bariatric surgery for morbid obesity. On the third

--- Content provided by FirstRanker.com ---

post operative day, she develops breathless and pulmonary embolism is suspected. The next
investigation to confirm the diagnosis will be:

(a) Echocardiography
(b) Duplex venography

--- Content provided by FirstRanker.com ---

(c) CT pulmonary angiography
(d) MR angiography
8.
Medical management of thyrotoxic crisis includes all of the following EXCEPT:

--- Content provided by FirstRanker.com ---

(a) IV fluids
(b) IV propanolol
(c) IV hydrocortisone
(d) IV antibiotics
9.

--- Content provided by FirstRanker.com ---

A patient operated for a parotid gland tumour developed symptoms of sweating and
erytherma (flushing) over the region of surgical excision while eating. The probable
diagnosis is:

(a) Parotid gland fistula

--- Content provided by FirstRanker.com ---

(b) Sialadenitis
(c) Chronic wound infection
(d) Frey?s syndrome
10.
First line hormone therapy for post-menopausal woman with metastatic carcinoma breast is:

--- Content provided by FirstRanker.com ---

(a) Tamoxifen
(b) Ovarian suppression by surgery
(c) Antiprogestins
(d) Anastrazole

--- Content provided by FirstRanker.com ---

11.
All of the following are major subtypes of breast cancer based on Gene array analysis

--- Content provided by FirstRanker.com ---

EXCEPT:

(a) Luminal A and Luminal B
(b) Triple negative
(c) Her-2 receptor positive

--- Content provided by FirstRanker.com ---

(d) Oestrogen receptor positive
12.
All of the following are sequelae of peptic ulcer surgery EXCEPT:

(a) Bilious vomiting

--- Content provided by FirstRanker.com ---

(b) Dumping syndrome
(c) Diarrhoea
(d) Increased appetite
13.
The Child-Turcotte-Pugh (CTP) score for quantifying the severity of chronic liver disease

--- Content provided by FirstRanker.com ---

includes all variables EXCEPT:

(a) Serum bilirubin
(b) Serum albumin
(c) Serum creatinine

--- Content provided by FirstRanker.com ---

(d) INR (International Normalised Ratio)
14.
?Chain of Lakes? appearance due to sacculation with intervening short strictures of pancreatic
duct is seen on:

--- Content provided by FirstRanker.com ---

(a) ERCP
(b) CECT abdomen
(c) Plain X-ray abdomen
(d) Ultrasonography
15.

--- Content provided by FirstRanker.com ---

Which one of the following statements is NOT correct regarding Pyogenic Liver Abscess?

(a) Anorexia, fever, malaise and right upper quadrant abdominal discomfort are the
most common presenting features
(b) It is more common in elderly, diabetics and immunocompromised patients

--- Content provided by FirstRanker.com ---

(c) Treatment is with oral antibiotics alone
(d) Streptococcus milleri and escherichia coli are the most common causative
organisms
16.
?Swiss cheese defects? are seen during laparoscopic repair of:

--- Content provided by FirstRanker.com ---

(a) Ventral hernia
(b) Inguinal hernia
(c) Obturator hernia
(d) Femoral hernia

--- Content provided by FirstRanker.com ---

17.
Which of the following are correct regarding splenic artery aneurysm?

--- Content provided by FirstRanker.com ---

1. Main arterial trunk is the common site
2. Palpable thrill can be felt
3. It is symptomless unless it ruptures

--- Content provided by FirstRanker.com ---

Select the correct answer using the code given below:

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

--- Content provided by FirstRanker.com ---

(d) 1, 2 and 3
18.
Valentino?s syndrome is:

(a) Pain on per-vaginal examination in pelvic abscess

--- Content provided by FirstRanker.com ---

(b) Pain over left shoulder in left hypochondriac collection
(c) Pain over left groin in perirenal collection
(d) Pain in right iliac fossa in perforated peptic ulcer
19.
Spontaneous bacterial peritonitis occurs due to:

--- Content provided by FirstRanker.com ---

(a) duodenal stump blowout
(b) peptic ulcer perforation
(c) acute bacterial infection of ascites
(d) infection via fallopian tubes

--- Content provided by FirstRanker.com ---

20.
Structure not forming boundaries of the ?Triangle of doom? seen during laparoscopic
inguinal hernia surgery dissection is:

(a) Vas deferens

--- Content provided by FirstRanker.com ---

(b) Inferior epigastric artery
(c) Spermatic cord vessels
(d) Peritoneum
21.
The term mid-line shift is associated with:

--- Content provided by FirstRanker.com ---

(a) Head injury
(b) Chest injury
(c) Abdominal injury
(d) Limb injury

--- Content provided by FirstRanker.com ---

22.
Which one of the following cranial nerves does NOT supply to the external ear?

(a) Cranial nerve V
(b) Cranial nerve VI

--- Content provided by FirstRanker.com ---

(c) Cranial nerve VII
(d) Cranial nerve IX

23.
Left Internal Mammary Artery (LIMA) has become the conduit of choice for Left Anterior

--- Content provided by FirstRanker.com ---

Descending (LAD) artery during coronary artery bypass grafting because:

(a) Long term patency rates are more than 98%
(b) It is close to LAD
(c) Atherosclerosis is never seen in this vessel

--- Content provided by FirstRanker.com ---

(d) It is very easy to harvest
24.
A 50-year old male with significant smoking history presented in the surgical emergency
with sudden severe breathlessness. Chest X-ray shows right sided Pneumothorax. The
appropriate management requires:

--- Content provided by FirstRanker.com ---

(a) Aspiration of air with 16-18 G cannula
(b) Right chest drain of size 8-14 Fr
(c) Oxygen by face mask
(d) Mechanical ventilation

--- Content provided by FirstRanker.com ---

25.
Which one of the following statements regarding Felon is NOT correct?

(a) There is infection of the finger tip between specialised fibrous septa
(b) It is a painless condition

--- Content provided by FirstRanker.com ---

(c) Incision and drainage is the treatment of choice
(d) It is common in diabetics
26.
The most common site for osteosarcoma is:

--- Content provided by FirstRanker.com ---

(a) Proximal femur
(b) Distal femur
(c) Proximal humerus
(d) Distal humerus
27.

--- Content provided by FirstRanker.com ---

Rapid Sequence Induction is indicated in:

(a) Emergency surgery for intestinal obstruction
(b) Elective open hernia surgery
(c) Cardiopulmonary bypass surgery

--- Content provided by FirstRanker.com ---

(d) Elective laparoscopic surgery

28.
Which one of the following statements about Compartment Syndrome is NOT correct?

--- Content provided by FirstRanker.com ---

(a) It is commonest in a closed fracture
(b) Pain is on active movement but not on passive movement of muscles
(c) Fasciotomy is the treatment of choice
(d) Volkmann?s Ischaemic contractive is a late complication

--- Content provided by FirstRanker.com ---

29.
Which one of the following is NOT the strength of ultrasound as a diagnostic modality?

--- Content provided by FirstRanker.com ---

(a) No radiation
(b) Short learning curve
(c) Inexpensive
(d) Allows dynamic studies to be done

--- Content provided by FirstRanker.com ---

30.
Which of the following statements regarding lymphoedema following breast cancer treatment
are correct?

1. Incidence has decreased due to rarely combined therapy of axillary LN dissection and

--- Content provided by FirstRanker.com ---

radiotherapy
2. Precipitating cause like LN metastasis is a major determinant
3. The condition is often painful
4. Oedematous limb is susceptible to bacterial infection

--- Content provided by FirstRanker.com ---

Select the correct answer using the code given below:

(a) 1, 2 and 3
(b) 2, 3 and 4
(c) 1, 3 and 4

--- Content provided by FirstRanker.com ---

(d) 1, 2 and 4
31.
Which one of the following is NOT a risk factor for development of venous thrombosis in
surgical patients?

--- Content provided by FirstRanker.com ---

(a) Age > 60 years
(b) Pregnancy
(c) Obesity (BMI > 30 kg/m
2
)

--- Content provided by FirstRanker.com ---

(d) Diabetes ( HbA1c > 7.5%)
32.
Which one of the following is NOT a complication of massive blood transfusion?

(a) Coagulopathy

--- Content provided by FirstRanker.com ---

(b) Hypocalcaemia
(c) Hyperthermia
(d) Hyperkalemia
33.
Stage III ?Pressure sore? is full thickness skin loss extending:

--- Content provided by FirstRanker.com ---

(a) into subcutaneous tissue but not through fascia
(b) through subcutaneous tissue into fascia
(c) through subcutaneous tissue into fascia and muscles
(d) through subcutaneous tissue into fascia, muscles and bone

--- Content provided by FirstRanker.com ---

FirstRanker.com - FirstRanker's Choice
Combined Medical Services Examination-2020
Paper-II

--- Content provided by FirstRanker.com ---

1.
Indications for fasciotomy in compartment syndrome include all EXCEPT:

(a) Distal sensory disturbance

--- Content provided by FirstRanker.com ---

(b) Compartment pressure > 30 mm Hg
(c) Pain on passive movement of affected muscles
(d) Palpable distal pulses
2.
Which one of the following statements is NOT correct regarding Necrotising Soft Tissue

--- Content provided by FirstRanker.com ---

infections?

(a) Crepitus, skin blistering and focal skin gangrene are typical presenting features
(b) They are monomicrobial in nature
(c) Treatment consists of wide local excision and appropriate antibiotics

--- Content provided by FirstRanker.com ---

(d) Tissue biopsy is required for culture and diagnosis
3.
Which type of surgery is laparoscopic cholecystectomy classified as?

(a) Clean

--- Content provided by FirstRanker.com ---

(b) Clean contaminated
(c) Contaminated
(d) Dirty
4.
A 22-year female has presented with a history of malaise, cough, alternating constipation and

--- Content provided by FirstRanker.com ---

diarrhoea with intermittent abdominal pain for last 6 months. She also complains of
abdominal distension for last 2 days. On examination her abdomen has a doughy feel along
with an ill defined mass over the right lower quadrant. She is most likely suffering from:

(a) Appendicular lump

--- Content provided by FirstRanker.com ---

(b) Ileocaecal tuberculosis
(c) Carcinoma caecum
(d) Ovarian mass
5.
Consider the following statements regarding needle stick injuries:

--- Content provided by FirstRanker.com ---

1. Injured part should be washed under running water
2. Dominant index finger is the commonest site for needle stick injury
3. All needle stick injuries should be reported
4. Hepatitis/HIV testing should be done after needle stick injury

--- Content provided by FirstRanker.com ---

Which of the statements given above are correct?

(a) 1, 2 and 4
(b) 1, 2 and 3

--- Content provided by FirstRanker.com ---

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

--- Content provided by FirstRanker.com ---

6.
Consider the following statements regarding claudication:

1. It is a marker for silent coronary disease

--- Content provided by FirstRanker.com ---

2. Structured exercise program ( 2 hours per week for 3 months) leads to
improvement in symptoms
3. Diabetes mellitus increases the risk and severity of claudication
4. Beta blockers may exacerbate claudication

--- Content provided by FirstRanker.com ---

Which of the above statements are correct?

(a) 1 and 2 only
(b) 1, 3 and 4 only
(c) 2, 3 and 4 only

--- Content provided by FirstRanker.com ---

(d) 1, 2, 3 and 4
7.
A 50-year old lady underwent uneventful bariatric surgery for morbid obesity. On the third
post operative day, she develops breathless and pulmonary embolism is suspected. The next
investigation to confirm the diagnosis will be:

--- Content provided by FirstRanker.com ---

(a) Echocardiography
(b) Duplex venography
(c) CT pulmonary angiography
(d) MR angiography

--- Content provided by FirstRanker.com ---

8.
Medical management of thyrotoxic crisis includes all of the following EXCEPT:

(a) IV fluids
(b) IV propanolol

--- Content provided by FirstRanker.com ---

(c) IV hydrocortisone
(d) IV antibiotics
9.
A patient operated for a parotid gland tumour developed symptoms of sweating and
erytherma (flushing) over the region of surgical excision while eating. The probable

--- Content provided by FirstRanker.com ---

diagnosis is:

(a) Parotid gland fistula
(b) Sialadenitis
(c) Chronic wound infection

--- Content provided by FirstRanker.com ---

(d) Frey?s syndrome
10.
First line hormone therapy for post-menopausal woman with metastatic carcinoma breast is:

(a) Tamoxifen

--- Content provided by FirstRanker.com ---

(b) Ovarian suppression by surgery
(c) Antiprogestins
(d) Anastrazole

--- Content provided by FirstRanker.com ---

11.
All of the following are major subtypes of breast cancer based on Gene array analysis
EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Luminal A and Luminal B
(b) Triple negative
(c) Her-2 receptor positive
(d) Oestrogen receptor positive
12.

--- Content provided by FirstRanker.com ---

All of the following are sequelae of peptic ulcer surgery EXCEPT:

(a) Bilious vomiting
(b) Dumping syndrome
(c) Diarrhoea

--- Content provided by FirstRanker.com ---

(d) Increased appetite
13.
The Child-Turcotte-Pugh (CTP) score for quantifying the severity of chronic liver disease
includes all variables EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Serum bilirubin
(b) Serum albumin
(c) Serum creatinine
(d) INR (International Normalised Ratio)
14.

--- Content provided by FirstRanker.com ---

?Chain of Lakes? appearance due to sacculation with intervening short strictures of pancreatic
duct is seen on:

(a) ERCP
(b) CECT abdomen

--- Content provided by FirstRanker.com ---

(c) Plain X-ray abdomen
(d) Ultrasonography
15.
Which one of the following statements is NOT correct regarding Pyogenic Liver Abscess?

--- Content provided by FirstRanker.com ---

(a) Anorexia, fever, malaise and right upper quadrant abdominal discomfort are the
most common presenting features
(b) It is more common in elderly, diabetics and immunocompromised patients
(c) Treatment is with oral antibiotics alone
(d) Streptococcus milleri and escherichia coli are the most common causative

--- Content provided by FirstRanker.com ---

organisms
16.
?Swiss cheese defects? are seen during laparoscopic repair of:

(a) Ventral hernia

--- Content provided by FirstRanker.com ---

(b) Inguinal hernia
(c) Obturator hernia
(d) Femoral hernia

--- Content provided by FirstRanker.com ---

17.
Which of the following are correct regarding splenic artery aneurysm?

1. Main arterial trunk is the common site

--- Content provided by FirstRanker.com ---

2. Palpable thrill can be felt
3. It is symptomless unless it ruptures

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

(a) 1 and 2 only
(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3
18.

--- Content provided by FirstRanker.com ---

Valentino?s syndrome is:

(a) Pain on per-vaginal examination in pelvic abscess
(b) Pain over left shoulder in left hypochondriac collection
(c) Pain over left groin in perirenal collection

--- Content provided by FirstRanker.com ---

(d) Pain in right iliac fossa in perforated peptic ulcer
19.
Spontaneous bacterial peritonitis occurs due to:

(a) duodenal stump blowout

--- Content provided by FirstRanker.com ---

(b) peptic ulcer perforation
(c) acute bacterial infection of ascites
(d) infection via fallopian tubes
20.
Structure not forming boundaries of the ?Triangle of doom? seen during laparoscopic

--- Content provided by FirstRanker.com ---

inguinal hernia surgery dissection is:

(a) Vas deferens
(b) Inferior epigastric artery
(c) Spermatic cord vessels

--- Content provided by FirstRanker.com ---

(d) Peritoneum
21.
The term mid-line shift is associated with:

(a) Head injury

--- Content provided by FirstRanker.com ---

(b) Chest injury
(c) Abdominal injury
(d) Limb injury
22.
Which one of the following cranial nerves does NOT supply to the external ear?

--- Content provided by FirstRanker.com ---

(a) Cranial nerve V
(b) Cranial nerve VI
(c) Cranial nerve VII
(d) Cranial nerve IX

--- Content provided by FirstRanker.com ---

23.
Left Internal Mammary Artery (LIMA) has become the conduit of choice for Left Anterior
Descending (LAD) artery during coronary artery bypass grafting because:

--- Content provided by FirstRanker.com ---

(a) Long term patency rates are more than 98%
(b) It is close to LAD
(c) Atherosclerosis is never seen in this vessel
(d) It is very easy to harvest
24.

--- Content provided by FirstRanker.com ---

A 50-year old male with significant smoking history presented in the surgical emergency
with sudden severe breathlessness. Chest X-ray shows right sided Pneumothorax. The
appropriate management requires:

(a) Aspiration of air with 16-18 G cannula

--- Content provided by FirstRanker.com ---

(b) Right chest drain of size 8-14 Fr
(c) Oxygen by face mask
(d) Mechanical ventilation
25.
Which one of the following statements regarding Felon is NOT correct?

--- Content provided by FirstRanker.com ---

(a) There is infection of the finger tip between specialised fibrous septa
(b) It is a painless condition
(c) Incision and drainage is the treatment of choice
(d) It is common in diabetics

--- Content provided by FirstRanker.com ---

26.
The most common site for osteosarcoma is:

(a) Proximal femur
(b) Distal femur

--- Content provided by FirstRanker.com ---

(c) Proximal humerus
(d) Distal humerus
27.
Rapid Sequence Induction is indicated in:

--- Content provided by FirstRanker.com ---

(a) Emergency surgery for intestinal obstruction
(b) Elective open hernia surgery
(c) Cardiopulmonary bypass surgery
(d) Elective laparoscopic surgery

--- Content provided by FirstRanker.com ---

28.
Which one of the following statements about Compartment Syndrome is NOT correct?

(a) It is commonest in a closed fracture
(b) Pain is on active movement but not on passive movement of muscles

--- Content provided by FirstRanker.com ---

(c) Fasciotomy is the treatment of choice
(d) Volkmann?s Ischaemic contractive is a late complication

--- Content provided by FirstRanker.com ---

29.
Which one of the following is NOT the strength of ultrasound as a diagnostic modality?

(a) No radiation

--- Content provided by FirstRanker.com ---

(b) Short learning curve
(c) Inexpensive
(d) Allows dynamic studies to be done
30.
Which of the following statements regarding lymphoedema following breast cancer treatment

--- Content provided by FirstRanker.com ---

are correct?

1. Incidence has decreased due to rarely combined therapy of axillary LN dissection and
radiotherapy
2. Precipitating cause like LN metastasis is a major determinant

--- Content provided by FirstRanker.com ---

3. The condition is often painful
4. Oedematous limb is susceptible to bacterial infection

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

(a) 1, 2 and 3
(b) 2, 3 and 4
(c) 1, 3 and 4
(d) 1, 2 and 4
31.

--- Content provided by FirstRanker.com ---

Which one of the following is NOT a risk factor for development of venous thrombosis in
surgical patients?

(a) Age > 60 years
(b) Pregnancy

--- Content provided by FirstRanker.com ---

(c) Obesity (BMI > 30 kg/m
2
)
(d) Diabetes ( HbA1c > 7.5%)
32.

--- Content provided by FirstRanker.com ---

Which one of the following is NOT a complication of massive blood transfusion?

(a) Coagulopathy
(b) Hypocalcaemia
(c) Hyperthermia

--- Content provided by FirstRanker.com ---

(d) Hyperkalemia
33.
Stage III ?Pressure sore? is full thickness skin loss extending:

(a) into subcutaneous tissue but not through fascia

--- Content provided by FirstRanker.com ---

(b) through subcutaneous tissue into fascia
(c) through subcutaneous tissue into fascia and muscles
(d) through subcutaneous tissue into fascia, muscles and bone

--- Content provided by FirstRanker.com ---

34.
During subclavian vein puncture in a surgical ward suddenly a patient developed severe
breathlessness. On auscultation breath sound was absent and the ipsilateral chest was
tympanitic on percussion. The probable diagnosis is:

--- Content provided by FirstRanker.com ---

(a) Iatrogenic pneumothorax
(b) Introgenic hemothorax
(c) Spontaneous pneumothorax
(d) Tension pneumothorax

--- Content provided by FirstRanker.com ---

35.
Kohler?s disease is avascular necrosis of :

(a) Lunate
(b) Capitellum of humerus

--- Content provided by FirstRanker.com ---

(c) First metatarsal head
(d) Navicular
36.
Which one of the following is NOT true of Pyoderma gangrenosum?

--- Content provided by FirstRanker.com ---

(a) It is characterized by cutaneous ulceration with purple undermined edges
(b) It is often secondary to heightened immunological reactivity from another disease
process
(c) Cultures often show Gram positive Staphylococci
(d) Lesions generally respond to steroids

--- Content provided by FirstRanker.com ---

37.
Which of the following is NOT a tissue repair surgery for inguinal hernia repair?

(a) Bassini?s repair
(b) Shouldice repair

--- Content provided by FirstRanker.com ---

(c) Stoppa?s repair
(d) Desarda repair
38.
Which one of the following type of meshes is recommended for intraperitoneal use in
abdominal wall hernia?

--- Content provided by FirstRanker.com ---

(a) Light weight, porous meshes
(b) Heavy weight, porous meshes
(c) Absorbable meshes
(d) Tissue separating meshes
39.

--- Content provided by FirstRanker.com ---

Which one of the following is NOT correct regarding MEN-1 syndrome?

(a) It involves parathyroid glands
(b) It involves pancreas
(c) It involves pituitary gland

--- Content provided by FirstRanker.com ---

(d) It involves pineal gland

FirstRanker.com - FirstRanker's Choice
Combined Medical Services Examination-2020
Paper-II

--- Content provided by FirstRanker.com ---

1.
Indications for fasciotomy in compartment syndrome include all EXCEPT:

(a) Distal sensory disturbance

--- Content provided by FirstRanker.com ---

(b) Compartment pressure > 30 mm Hg
(c) Pain on passive movement of affected muscles
(d) Palpable distal pulses
2.
Which one of the following statements is NOT correct regarding Necrotising Soft Tissue

--- Content provided by FirstRanker.com ---

infections?

(a) Crepitus, skin blistering and focal skin gangrene are typical presenting features
(b) They are monomicrobial in nature
(c) Treatment consists of wide local excision and appropriate antibiotics

--- Content provided by FirstRanker.com ---

(d) Tissue biopsy is required for culture and diagnosis
3.
Which type of surgery is laparoscopic cholecystectomy classified as?

(a) Clean

--- Content provided by FirstRanker.com ---

(b) Clean contaminated
(c) Contaminated
(d) Dirty
4.
A 22-year female has presented with a history of malaise, cough, alternating constipation and

--- Content provided by FirstRanker.com ---

diarrhoea with intermittent abdominal pain for last 6 months. She also complains of
abdominal distension for last 2 days. On examination her abdomen has a doughy feel along
with an ill defined mass over the right lower quadrant. She is most likely suffering from:

(a) Appendicular lump

--- Content provided by FirstRanker.com ---

(b) Ileocaecal tuberculosis
(c) Carcinoma caecum
(d) Ovarian mass
5.
Consider the following statements regarding needle stick injuries:

--- Content provided by FirstRanker.com ---

1. Injured part should be washed under running water
2. Dominant index finger is the commonest site for needle stick injury
3. All needle stick injuries should be reported
4. Hepatitis/HIV testing should be done after needle stick injury

--- Content provided by FirstRanker.com ---

Which of the statements given above are correct?

(a) 1, 2 and 4
(b) 1, 2 and 3

--- Content provided by FirstRanker.com ---

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

--- Content provided by FirstRanker.com ---

6.
Consider the following statements regarding claudication:

1. It is a marker for silent coronary disease

--- Content provided by FirstRanker.com ---

2. Structured exercise program ( 2 hours per week for 3 months) leads to
improvement in symptoms
3. Diabetes mellitus increases the risk and severity of claudication
4. Beta blockers may exacerbate claudication

--- Content provided by FirstRanker.com ---

Which of the above statements are correct?

(a) 1 and 2 only
(b) 1, 3 and 4 only
(c) 2, 3 and 4 only

--- Content provided by FirstRanker.com ---

(d) 1, 2, 3 and 4
7.
A 50-year old lady underwent uneventful bariatric surgery for morbid obesity. On the third
post operative day, she develops breathless and pulmonary embolism is suspected. The next
investigation to confirm the diagnosis will be:

--- Content provided by FirstRanker.com ---

(a) Echocardiography
(b) Duplex venography
(c) CT pulmonary angiography
(d) MR angiography

--- Content provided by FirstRanker.com ---

8.
Medical management of thyrotoxic crisis includes all of the following EXCEPT:

(a) IV fluids
(b) IV propanolol

--- Content provided by FirstRanker.com ---

(c) IV hydrocortisone
(d) IV antibiotics
9.
A patient operated for a parotid gland tumour developed symptoms of sweating and
erytherma (flushing) over the region of surgical excision while eating. The probable

--- Content provided by FirstRanker.com ---

diagnosis is:

(a) Parotid gland fistula
(b) Sialadenitis
(c) Chronic wound infection

--- Content provided by FirstRanker.com ---

(d) Frey?s syndrome
10.
First line hormone therapy for post-menopausal woman with metastatic carcinoma breast is:

(a) Tamoxifen

--- Content provided by FirstRanker.com ---

(b) Ovarian suppression by surgery
(c) Antiprogestins
(d) Anastrazole

--- Content provided by FirstRanker.com ---

11.
All of the following are major subtypes of breast cancer based on Gene array analysis
EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Luminal A and Luminal B
(b) Triple negative
(c) Her-2 receptor positive
(d) Oestrogen receptor positive
12.

--- Content provided by FirstRanker.com ---

All of the following are sequelae of peptic ulcer surgery EXCEPT:

(a) Bilious vomiting
(b) Dumping syndrome
(c) Diarrhoea

--- Content provided by FirstRanker.com ---

(d) Increased appetite
13.
The Child-Turcotte-Pugh (CTP) score for quantifying the severity of chronic liver disease
includes all variables EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Serum bilirubin
(b) Serum albumin
(c) Serum creatinine
(d) INR (International Normalised Ratio)
14.

--- Content provided by FirstRanker.com ---

?Chain of Lakes? appearance due to sacculation with intervening short strictures of pancreatic
duct is seen on:

(a) ERCP
(b) CECT abdomen

--- Content provided by FirstRanker.com ---

(c) Plain X-ray abdomen
(d) Ultrasonography
15.
Which one of the following statements is NOT correct regarding Pyogenic Liver Abscess?

--- Content provided by FirstRanker.com ---

(a) Anorexia, fever, malaise and right upper quadrant abdominal discomfort are the
most common presenting features
(b) It is more common in elderly, diabetics and immunocompromised patients
(c) Treatment is with oral antibiotics alone
(d) Streptococcus milleri and escherichia coli are the most common causative

--- Content provided by FirstRanker.com ---

organisms
16.
?Swiss cheese defects? are seen during laparoscopic repair of:

(a) Ventral hernia

--- Content provided by FirstRanker.com ---

(b) Inguinal hernia
(c) Obturator hernia
(d) Femoral hernia

--- Content provided by FirstRanker.com ---

17.
Which of the following are correct regarding splenic artery aneurysm?

1. Main arterial trunk is the common site

--- Content provided by FirstRanker.com ---

2. Palpable thrill can be felt
3. It is symptomless unless it ruptures

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

(a) 1 and 2 only
(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3
18.

--- Content provided by FirstRanker.com ---

Valentino?s syndrome is:

(a) Pain on per-vaginal examination in pelvic abscess
(b) Pain over left shoulder in left hypochondriac collection
(c) Pain over left groin in perirenal collection

--- Content provided by FirstRanker.com ---

(d) Pain in right iliac fossa in perforated peptic ulcer
19.
Spontaneous bacterial peritonitis occurs due to:

(a) duodenal stump blowout

--- Content provided by FirstRanker.com ---

(b) peptic ulcer perforation
(c) acute bacterial infection of ascites
(d) infection via fallopian tubes
20.
Structure not forming boundaries of the ?Triangle of doom? seen during laparoscopic

--- Content provided by FirstRanker.com ---

inguinal hernia surgery dissection is:

(a) Vas deferens
(b) Inferior epigastric artery
(c) Spermatic cord vessels

--- Content provided by FirstRanker.com ---

(d) Peritoneum
21.
The term mid-line shift is associated with:

(a) Head injury

--- Content provided by FirstRanker.com ---

(b) Chest injury
(c) Abdominal injury
(d) Limb injury
22.
Which one of the following cranial nerves does NOT supply to the external ear?

--- Content provided by FirstRanker.com ---

(a) Cranial nerve V
(b) Cranial nerve VI
(c) Cranial nerve VII
(d) Cranial nerve IX

--- Content provided by FirstRanker.com ---

23.
Left Internal Mammary Artery (LIMA) has become the conduit of choice for Left Anterior
Descending (LAD) artery during coronary artery bypass grafting because:

--- Content provided by FirstRanker.com ---

(a) Long term patency rates are more than 98%
(b) It is close to LAD
(c) Atherosclerosis is never seen in this vessel
(d) It is very easy to harvest
24.

--- Content provided by FirstRanker.com ---

A 50-year old male with significant smoking history presented in the surgical emergency
with sudden severe breathlessness. Chest X-ray shows right sided Pneumothorax. The
appropriate management requires:

(a) Aspiration of air with 16-18 G cannula

--- Content provided by FirstRanker.com ---

(b) Right chest drain of size 8-14 Fr
(c) Oxygen by face mask
(d) Mechanical ventilation
25.
Which one of the following statements regarding Felon is NOT correct?

--- Content provided by FirstRanker.com ---

(a) There is infection of the finger tip between specialised fibrous septa
(b) It is a painless condition
(c) Incision and drainage is the treatment of choice
(d) It is common in diabetics

--- Content provided by FirstRanker.com ---

26.
The most common site for osteosarcoma is:

(a) Proximal femur
(b) Distal femur

--- Content provided by FirstRanker.com ---

(c) Proximal humerus
(d) Distal humerus
27.
Rapid Sequence Induction is indicated in:

--- Content provided by FirstRanker.com ---

(a) Emergency surgery for intestinal obstruction
(b) Elective open hernia surgery
(c) Cardiopulmonary bypass surgery
(d) Elective laparoscopic surgery

--- Content provided by FirstRanker.com ---

28.
Which one of the following statements about Compartment Syndrome is NOT correct?

(a) It is commonest in a closed fracture
(b) Pain is on active movement but not on passive movement of muscles

--- Content provided by FirstRanker.com ---

(c) Fasciotomy is the treatment of choice
(d) Volkmann?s Ischaemic contractive is a late complication

--- Content provided by FirstRanker.com ---

29.
Which one of the following is NOT the strength of ultrasound as a diagnostic modality?

(a) No radiation

--- Content provided by FirstRanker.com ---

(b) Short learning curve
(c) Inexpensive
(d) Allows dynamic studies to be done
30.
Which of the following statements regarding lymphoedema following breast cancer treatment

--- Content provided by FirstRanker.com ---

are correct?

1. Incidence has decreased due to rarely combined therapy of axillary LN dissection and
radiotherapy
2. Precipitating cause like LN metastasis is a major determinant

--- Content provided by FirstRanker.com ---

3. The condition is often painful
4. Oedematous limb is susceptible to bacterial infection

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

(a) 1, 2 and 3
(b) 2, 3 and 4
(c) 1, 3 and 4
(d) 1, 2 and 4
31.

--- Content provided by FirstRanker.com ---

Which one of the following is NOT a risk factor for development of venous thrombosis in
surgical patients?

(a) Age > 60 years
(b) Pregnancy

--- Content provided by FirstRanker.com ---

(c) Obesity (BMI > 30 kg/m
2
)
(d) Diabetes ( HbA1c > 7.5%)
32.

--- Content provided by FirstRanker.com ---

Which one of the following is NOT a complication of massive blood transfusion?

(a) Coagulopathy
(b) Hypocalcaemia
(c) Hyperthermia

--- Content provided by FirstRanker.com ---

(d) Hyperkalemia
33.
Stage III ?Pressure sore? is full thickness skin loss extending:

(a) into subcutaneous tissue but not through fascia

--- Content provided by FirstRanker.com ---

(b) through subcutaneous tissue into fascia
(c) through subcutaneous tissue into fascia and muscles
(d) through subcutaneous tissue into fascia, muscles and bone

--- Content provided by FirstRanker.com ---

34.
During subclavian vein puncture in a surgical ward suddenly a patient developed severe
breathlessness. On auscultation breath sound was absent and the ipsilateral chest was
tympanitic on percussion. The probable diagnosis is:

--- Content provided by FirstRanker.com ---

(a) Iatrogenic pneumothorax
(b) Introgenic hemothorax
(c) Spontaneous pneumothorax
(d) Tension pneumothorax

--- Content provided by FirstRanker.com ---

35.
Kohler?s disease is avascular necrosis of :

(a) Lunate
(b) Capitellum of humerus

--- Content provided by FirstRanker.com ---

(c) First metatarsal head
(d) Navicular
36.
Which one of the following is NOT true of Pyoderma gangrenosum?

--- Content provided by FirstRanker.com ---

(a) It is characterized by cutaneous ulceration with purple undermined edges
(b) It is often secondary to heightened immunological reactivity from another disease
process
(c) Cultures often show Gram positive Staphylococci
(d) Lesions generally respond to steroids

--- Content provided by FirstRanker.com ---

37.
Which of the following is NOT a tissue repair surgery for inguinal hernia repair?

(a) Bassini?s repair
(b) Shouldice repair

--- Content provided by FirstRanker.com ---

(c) Stoppa?s repair
(d) Desarda repair
38.
Which one of the following type of meshes is recommended for intraperitoneal use in
abdominal wall hernia?

--- Content provided by FirstRanker.com ---

(a) Light weight, porous meshes
(b) Heavy weight, porous meshes
(c) Absorbable meshes
(d) Tissue separating meshes
39.

--- Content provided by FirstRanker.com ---

Which one of the following is NOT correct regarding MEN-1 syndrome?

(a) It involves parathyroid glands
(b) It involves pancreas
(c) It involves pituitary gland

--- Content provided by FirstRanker.com ---

(d) It involves pineal gland

40.
Which one of the following is NOT an electronic information site in surgery?

--- Content provided by FirstRanker.com ---

(a) Pubmed
(b) Embase
(c) Cochrane library
(d) National medical library
41.

--- Content provided by FirstRanker.com ---

Which one of the following statements regarding pre-conceptional counseling is NOT
correct?

(a) It is needed only in selected complicated pregnancies
(b) It helps in early detection of risk factors

--- Content provided by FirstRanker.com ---

(c) It helps in reducing maternal morbidity and mortality
(d) It is a part of preventive medicine
42.
Consider the following statements regarding Non Stress Test (NST):

--- Content provided by FirstRanker.com ---

1. Reactive NST indicates a healthy fetus
2. NST is an observed association of fetal breathing with fetal movements
3. NST has a low false negative rate (< 1%) but high false positive rate (>50%)
4. Testing should be started at 20 weeks

--- Content provided by FirstRanker.com ---

Which of the statement(s) given above is/are correct?

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

--- Content provided by FirstRanker.com ---

(d) 1 and 4
43.
Which one of the following is a protective factor for endometrial hyperplasia?

(a) Diabetes

--- Content provided by FirstRanker.com ---

(b) Tamoxifen therapy
(c) Multiparity
(d) Delayed menopause
44.
A woman who is not breast feeding her newborn child is advised to use a contraceptive

--- Content provided by FirstRanker.com ---

method by:

(a) 3
rd
postpartum week

--- Content provided by FirstRanker.com ---

(b) 6
th
postpartum week
(c) 3
rd

--- Content provided by FirstRanker.com ---

postpartum month
(d) 6
th
postpartum month

--- Content provided by FirstRanker.com ---

FirstRanker.com - FirstRanker's Choice

--- Content provided by FirstRanker.com ---

Combined Medical Services Examination-2020
Paper-II

1.
Indications for fasciotomy in compartment syndrome include all EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Distal sensory disturbance
(b) Compartment pressure > 30 mm Hg
(c) Pain on passive movement of affected muscles
(d) Palpable distal pulses

--- Content provided by FirstRanker.com ---

2.
Which one of the following statements is NOT correct regarding Necrotising Soft Tissue
infections?

(a) Crepitus, skin blistering and focal skin gangrene are typical presenting features

--- Content provided by FirstRanker.com ---

(b) They are monomicrobial in nature
(c) Treatment consists of wide local excision and appropriate antibiotics
(d) Tissue biopsy is required for culture and diagnosis
3.
Which type of surgery is laparoscopic cholecystectomy classified as?

--- Content provided by FirstRanker.com ---

(a) Clean
(b) Clean contaminated
(c) Contaminated
(d) Dirty

--- Content provided by FirstRanker.com ---

4.
A 22-year female has presented with a history of malaise, cough, alternating constipation and
diarrhoea with intermittent abdominal pain for last 6 months. She also complains of
abdominal distension for last 2 days. On examination her abdomen has a doughy feel along
with an ill defined mass over the right lower quadrant. She is most likely suffering from:

--- Content provided by FirstRanker.com ---

(a) Appendicular lump
(b) Ileocaecal tuberculosis
(c) Carcinoma caecum
(d) Ovarian mass

--- Content provided by FirstRanker.com ---

5.
Consider the following statements regarding needle stick injuries:

1. Injured part should be washed under running water
2. Dominant index finger is the commonest site for needle stick injury

--- Content provided by FirstRanker.com ---

3. All needle stick injuries should be reported
4. Hepatitis/HIV testing should be done after needle stick injury

Which of the statements given above are correct?

--- Content provided by FirstRanker.com ---

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

--- Content provided by FirstRanker.com ---

6.
Consider the following statements regarding claudication:

--- Content provided by FirstRanker.com ---

1. It is a marker for silent coronary disease
2. Structured exercise program ( 2 hours per week for 3 months) leads to
improvement in symptoms
3. Diabetes mellitus increases the risk and severity of claudication

--- Content provided by FirstRanker.com ---

4. Beta blockers may exacerbate claudication

Which of the above statements are correct?

(a) 1 and 2 only

--- Content provided by FirstRanker.com ---

(b) 1, 3 and 4 only
(c) 2, 3 and 4 only
(d) 1, 2, 3 and 4
7.
A 50-year old lady underwent uneventful bariatric surgery for morbid obesity. On the third

--- Content provided by FirstRanker.com ---

post operative day, she develops breathless and pulmonary embolism is suspected. The next
investigation to confirm the diagnosis will be:

(a) Echocardiography
(b) Duplex venography

--- Content provided by FirstRanker.com ---

(c) CT pulmonary angiography
(d) MR angiography
8.
Medical management of thyrotoxic crisis includes all of the following EXCEPT:

--- Content provided by FirstRanker.com ---

(a) IV fluids
(b) IV propanolol
(c) IV hydrocortisone
(d) IV antibiotics
9.

--- Content provided by FirstRanker.com ---

A patient operated for a parotid gland tumour developed symptoms of sweating and
erytherma (flushing) over the region of surgical excision while eating. The probable
diagnosis is:

(a) Parotid gland fistula

--- Content provided by FirstRanker.com ---

(b) Sialadenitis
(c) Chronic wound infection
(d) Frey?s syndrome
10.
First line hormone therapy for post-menopausal woman with metastatic carcinoma breast is:

--- Content provided by FirstRanker.com ---

(a) Tamoxifen
(b) Ovarian suppression by surgery
(c) Antiprogestins
(d) Anastrazole

--- Content provided by FirstRanker.com ---

11.
All of the following are major subtypes of breast cancer based on Gene array analysis

--- Content provided by FirstRanker.com ---

EXCEPT:

(a) Luminal A and Luminal B
(b) Triple negative
(c) Her-2 receptor positive

--- Content provided by FirstRanker.com ---

(d) Oestrogen receptor positive
12.
All of the following are sequelae of peptic ulcer surgery EXCEPT:

(a) Bilious vomiting

--- Content provided by FirstRanker.com ---

(b) Dumping syndrome
(c) Diarrhoea
(d) Increased appetite
13.
The Child-Turcotte-Pugh (CTP) score for quantifying the severity of chronic liver disease

--- Content provided by FirstRanker.com ---

includes all variables EXCEPT:

(a) Serum bilirubin
(b) Serum albumin
(c) Serum creatinine

--- Content provided by FirstRanker.com ---

(d) INR (International Normalised Ratio)
14.
?Chain of Lakes? appearance due to sacculation with intervening short strictures of pancreatic
duct is seen on:

--- Content provided by FirstRanker.com ---

(a) ERCP
(b) CECT abdomen
(c) Plain X-ray abdomen
(d) Ultrasonography
15.

--- Content provided by FirstRanker.com ---

Which one of the following statements is NOT correct regarding Pyogenic Liver Abscess?

(a) Anorexia, fever, malaise and right upper quadrant abdominal discomfort are the
most common presenting features
(b) It is more common in elderly, diabetics and immunocompromised patients

--- Content provided by FirstRanker.com ---

(c) Treatment is with oral antibiotics alone
(d) Streptococcus milleri and escherichia coli are the most common causative
organisms
16.
?Swiss cheese defects? are seen during laparoscopic repair of:

--- Content provided by FirstRanker.com ---

(a) Ventral hernia
(b) Inguinal hernia
(c) Obturator hernia
(d) Femoral hernia

--- Content provided by FirstRanker.com ---

17.
Which of the following are correct regarding splenic artery aneurysm?

--- Content provided by FirstRanker.com ---

1. Main arterial trunk is the common site
2. Palpable thrill can be felt
3. It is symptomless unless it ruptures

--- Content provided by FirstRanker.com ---

Select the correct answer using the code given below:

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

--- Content provided by FirstRanker.com ---

(d) 1, 2 and 3
18.
Valentino?s syndrome is:

(a) Pain on per-vaginal examination in pelvic abscess

--- Content provided by FirstRanker.com ---

(b) Pain over left shoulder in left hypochondriac collection
(c) Pain over left groin in perirenal collection
(d) Pain in right iliac fossa in perforated peptic ulcer
19.
Spontaneous bacterial peritonitis occurs due to:

--- Content provided by FirstRanker.com ---

(a) duodenal stump blowout
(b) peptic ulcer perforation
(c) acute bacterial infection of ascites
(d) infection via fallopian tubes

--- Content provided by FirstRanker.com ---

20.
Structure not forming boundaries of the ?Triangle of doom? seen during laparoscopic
inguinal hernia surgery dissection is:

(a) Vas deferens

--- Content provided by FirstRanker.com ---

(b) Inferior epigastric artery
(c) Spermatic cord vessels
(d) Peritoneum
21.
The term mid-line shift is associated with:

--- Content provided by FirstRanker.com ---

(a) Head injury
(b) Chest injury
(c) Abdominal injury
(d) Limb injury

--- Content provided by FirstRanker.com ---

22.
Which one of the following cranial nerves does NOT supply to the external ear?

(a) Cranial nerve V
(b) Cranial nerve VI

--- Content provided by FirstRanker.com ---

(c) Cranial nerve VII
(d) Cranial nerve IX

23.
Left Internal Mammary Artery (LIMA) has become the conduit of choice for Left Anterior

--- Content provided by FirstRanker.com ---

Descending (LAD) artery during coronary artery bypass grafting because:

(a) Long term patency rates are more than 98%
(b) It is close to LAD
(c) Atherosclerosis is never seen in this vessel

--- Content provided by FirstRanker.com ---

(d) It is very easy to harvest
24.
A 50-year old male with significant smoking history presented in the surgical emergency
with sudden severe breathlessness. Chest X-ray shows right sided Pneumothorax. The
appropriate management requires:

--- Content provided by FirstRanker.com ---

(a) Aspiration of air with 16-18 G cannula
(b) Right chest drain of size 8-14 Fr
(c) Oxygen by face mask
(d) Mechanical ventilation

--- Content provided by FirstRanker.com ---

25.
Which one of the following statements regarding Felon is NOT correct?

(a) There is infection of the finger tip between specialised fibrous septa
(b) It is a painless condition

--- Content provided by FirstRanker.com ---

(c) Incision and drainage is the treatment of choice
(d) It is common in diabetics
26.
The most common site for osteosarcoma is:

--- Content provided by FirstRanker.com ---

(a) Proximal femur
(b) Distal femur
(c) Proximal humerus
(d) Distal humerus
27.

--- Content provided by FirstRanker.com ---

Rapid Sequence Induction is indicated in:

(a) Emergency surgery for intestinal obstruction
(b) Elective open hernia surgery
(c) Cardiopulmonary bypass surgery

--- Content provided by FirstRanker.com ---

(d) Elective laparoscopic surgery

28.
Which one of the following statements about Compartment Syndrome is NOT correct?

--- Content provided by FirstRanker.com ---

(a) It is commonest in a closed fracture
(b) Pain is on active movement but not on passive movement of muscles
(c) Fasciotomy is the treatment of choice
(d) Volkmann?s Ischaemic contractive is a late complication

--- Content provided by FirstRanker.com ---

29.
Which one of the following is NOT the strength of ultrasound as a diagnostic modality?

--- Content provided by FirstRanker.com ---

(a) No radiation
(b) Short learning curve
(c) Inexpensive
(d) Allows dynamic studies to be done

--- Content provided by FirstRanker.com ---

30.
Which of the following statements regarding lymphoedema following breast cancer treatment
are correct?

1. Incidence has decreased due to rarely combined therapy of axillary LN dissection and

--- Content provided by FirstRanker.com ---

radiotherapy
2. Precipitating cause like LN metastasis is a major determinant
3. The condition is often painful
4. Oedematous limb is susceptible to bacterial infection

--- Content provided by FirstRanker.com ---

Select the correct answer using the code given below:

(a) 1, 2 and 3
(b) 2, 3 and 4
(c) 1, 3 and 4

--- Content provided by FirstRanker.com ---

(d) 1, 2 and 4
31.
Which one of the following is NOT a risk factor for development of venous thrombosis in
surgical patients?

--- Content provided by FirstRanker.com ---

(a) Age > 60 years
(b) Pregnancy
(c) Obesity (BMI > 30 kg/m
2
)

--- Content provided by FirstRanker.com ---

(d) Diabetes ( HbA1c > 7.5%)
32.
Which one of the following is NOT a complication of massive blood transfusion?

(a) Coagulopathy

--- Content provided by FirstRanker.com ---

(b) Hypocalcaemia
(c) Hyperthermia
(d) Hyperkalemia
33.
Stage III ?Pressure sore? is full thickness skin loss extending:

--- Content provided by FirstRanker.com ---

(a) into subcutaneous tissue but not through fascia
(b) through subcutaneous tissue into fascia
(c) through subcutaneous tissue into fascia and muscles
(d) through subcutaneous tissue into fascia, muscles and bone

--- Content provided by FirstRanker.com ---

34.
During subclavian vein puncture in a surgical ward suddenly a patient developed severe

--- Content provided by FirstRanker.com ---

breathlessness. On auscultation breath sound was absent and the ipsilateral chest was
tympanitic on percussion. The probable diagnosis is:

(a) Iatrogenic pneumothorax
(b) Introgenic hemothorax

--- Content provided by FirstRanker.com ---

(c) Spontaneous pneumothorax
(d) Tension pneumothorax
35.
Kohler?s disease is avascular necrosis of :

--- Content provided by FirstRanker.com ---

(a) Lunate
(b) Capitellum of humerus
(c) First metatarsal head
(d) Navicular
36.

--- Content provided by FirstRanker.com ---

Which one of the following is NOT true of Pyoderma gangrenosum?

(a) It is characterized by cutaneous ulceration with purple undermined edges
(b) It is often secondary to heightened immunological reactivity from another disease
process

--- Content provided by FirstRanker.com ---

(c) Cultures often show Gram positive Staphylococci
(d) Lesions generally respond to steroids
37.
Which of the following is NOT a tissue repair surgery for inguinal hernia repair?

--- Content provided by FirstRanker.com ---

(a) Bassini?s repair
(b) Shouldice repair
(c) Stoppa?s repair
(d) Desarda repair
38.

--- Content provided by FirstRanker.com ---

Which one of the following type of meshes is recommended for intraperitoneal use in
abdominal wall hernia?
(a) Light weight, porous meshes
(b) Heavy weight, porous meshes
(c) Absorbable meshes

--- Content provided by FirstRanker.com ---

(d) Tissue separating meshes
39.
Which one of the following is NOT correct regarding MEN-1 syndrome?

(a) It involves parathyroid glands

--- Content provided by FirstRanker.com ---

(b) It involves pancreas
(c) It involves pituitary gland
(d) It involves pineal gland

40.

--- Content provided by FirstRanker.com ---

Which one of the following is NOT an electronic information site in surgery?

(a) Pubmed
(b) Embase
(c) Cochrane library

--- Content provided by FirstRanker.com ---

(d) National medical library
41.
Which one of the following statements regarding pre-conceptional counseling is NOT
correct?

--- Content provided by FirstRanker.com ---

(a) It is needed only in selected complicated pregnancies
(b) It helps in early detection of risk factors
(c) It helps in reducing maternal morbidity and mortality
(d) It is a part of preventive medicine
42.

--- Content provided by FirstRanker.com ---

Consider the following statements regarding Non Stress Test (NST):

1. Reactive NST indicates a healthy fetus
2. NST is an observed association of fetal breathing with fetal movements
3. NST has a low false negative rate (< 1%) but high false positive rate (>50%)

--- Content provided by FirstRanker.com ---

4. Testing should be started at 20 weeks

Which of the statement(s) given above is/are correct?

(a) 1 and 3

--- Content provided by FirstRanker.com ---

(b) 2 only
(c) 3 only
(d) 1 and 4
43.
Which one of the following is a protective factor for endometrial hyperplasia?

--- Content provided by FirstRanker.com ---

(a) Diabetes
(b) Tamoxifen therapy
(c) Multiparity
(d) Delayed menopause

--- Content provided by FirstRanker.com ---

44.
A woman who is not breast feeding her newborn child is advised to use a contraceptive
method by:

(a) 3

--- Content provided by FirstRanker.com ---

rd
postpartum week
(b) 6
th
postpartum week

--- Content provided by FirstRanker.com ---

(c) 3
rd
postpartum month
(d) 6
th

--- Content provided by FirstRanker.com ---

postpartum month

--- Content provided by FirstRanker.com ---

45.
Pearl index for contraceptive effectiveness is calculated in terms of which of the following?

1. Pregnancy rate

--- Content provided by FirstRanker.com ---

2. Abortion rate
3. Hundred woman years
4. Thousand woman years

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

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

--- Content provided by FirstRanker.com ---

46.
Indications for removal of IUDs are all EXCEPT:

(a) Perforation of uterus
(b) Cyclical menstrual bleeding

--- Content provided by FirstRanker.com ---

(c) Flaring up of salpingitis
(d) Pregnancy with IUD
47.
Contraindications for insertion of IUDs are all EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Suspected pregnancy
(b) Trophoblastic disease
(c) Severe dysmenorrhea
(d) During cesarean section
48.

--- Content provided by FirstRanker.com ---

Which one of the following is NOT a contraindication for use of Mini pill?

(a) Pregnancy
(b) Breast feeding
(c) Thromboembolic disease

--- Content provided by FirstRanker.com ---

(d) History of breast cancer
49.
Which one of the following is the most commonly used surgical method/technique of female
sterilization as recommended by Government of India?

--- Content provided by FirstRanker.com ---

(a) Uchida technique
(b) Irving method
(c) Pomeroy?s method
(d) Madlener technique

--- Content provided by FirstRanker.com ---

--- Content provided by FirstRanker.com ---

FirstRanker.com - FirstRanker's Choice
Combined Medical Services Examination-2020
Paper-II

--- Content provided by FirstRanker.com ---

1.
Indications for fasciotomy in compartment syndrome include all EXCEPT:

(a) Distal sensory disturbance
(b) Compartment pressure > 30 mm Hg

--- Content provided by FirstRanker.com ---

(c) Pain on passive movement of affected muscles
(d) Palpable distal pulses
2.
Which one of the following statements is NOT correct regarding Necrotising Soft Tissue
infections?

--- Content provided by FirstRanker.com ---

(a) Crepitus, skin blistering and focal skin gangrene are typical presenting features
(b) They are monomicrobial in nature
(c) Treatment consists of wide local excision and appropriate antibiotics
(d) Tissue biopsy is required for culture and diagnosis

--- Content provided by FirstRanker.com ---

3.
Which type of surgery is laparoscopic cholecystectomy classified as?

(a) Clean
(b) Clean contaminated

--- Content provided by FirstRanker.com ---

(c) Contaminated
(d) Dirty
4.
A 22-year female has presented with a history of malaise, cough, alternating constipation and
diarrhoea with intermittent abdominal pain for last 6 months. She also complains of

--- Content provided by FirstRanker.com ---

abdominal distension for last 2 days. On examination her abdomen has a doughy feel along
with an ill defined mass over the right lower quadrant. She is most likely suffering from:

(a) Appendicular lump
(b) Ileocaecal tuberculosis

--- Content provided by FirstRanker.com ---

(c) Carcinoma caecum
(d) Ovarian mass
5.
Consider the following statements regarding needle stick injuries:

--- Content provided by FirstRanker.com ---

1. Injured part should be washed under running water
2. Dominant index finger is the commonest site for needle stick injury
3. All needle stick injuries should be reported
4. Hepatitis/HIV testing should be done after needle stick injury

--- Content provided by FirstRanker.com ---

Which of the statements given above are correct?

(a) 1, 2 and 4
(b) 1, 2 and 3
(c) 1, 3 and 4

--- Content provided by FirstRanker.com ---

(d) 2, 3 and 4

--- Content provided by FirstRanker.com ---

6.
Consider the following statements regarding claudication:

1. It is a marker for silent coronary disease
2. Structured exercise program ( 2 hours per week for 3 months) leads to

--- Content provided by FirstRanker.com ---

improvement in symptoms
3. Diabetes mellitus increases the risk and severity of claudication
4. Beta blockers may exacerbate claudication

Which of the above statements are correct?

--- Content provided by FirstRanker.com ---

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

--- Content provided by FirstRanker.com ---

7.
A 50-year old lady underwent uneventful bariatric surgery for morbid obesity. On the third
post operative day, she develops breathless and pulmonary embolism is suspected. The next
investigation to confirm the diagnosis will be:

--- Content provided by FirstRanker.com ---

(a) Echocardiography
(b) Duplex venography
(c) CT pulmonary angiography
(d) MR angiography
8.

--- Content provided by FirstRanker.com ---

Medical management of thyrotoxic crisis includes all of the following EXCEPT:

(a) IV fluids
(b) IV propanolol
(c) IV hydrocortisone

--- Content provided by FirstRanker.com ---

(d) IV antibiotics
9.
A patient operated for a parotid gland tumour developed symptoms of sweating and
erytherma (flushing) over the region of surgical excision while eating. The probable
diagnosis is:

--- Content provided by FirstRanker.com ---

(a) Parotid gland fistula
(b) Sialadenitis
(c) Chronic wound infection
(d) Frey?s syndrome

--- Content provided by FirstRanker.com ---

10.
First line hormone therapy for post-menopausal woman with metastatic carcinoma breast is:

(a) Tamoxifen
(b) Ovarian suppression by surgery

--- Content provided by FirstRanker.com ---

(c) Antiprogestins
(d) Anastrazole

--- Content provided by FirstRanker.com ---

11.
All of the following are major subtypes of breast cancer based on Gene array analysis
EXCEPT:

(a) Luminal A and Luminal B

--- Content provided by FirstRanker.com ---

(b) Triple negative
(c) Her-2 receptor positive
(d) Oestrogen receptor positive
12.
All of the following are sequelae of peptic ulcer surgery EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Bilious vomiting
(b) Dumping syndrome
(c) Diarrhoea
(d) Increased appetite

--- Content provided by FirstRanker.com ---

13.
The Child-Turcotte-Pugh (CTP) score for quantifying the severity of chronic liver disease
includes all variables EXCEPT:

(a) Serum bilirubin

--- Content provided by FirstRanker.com ---

(b) Serum albumin
(c) Serum creatinine
(d) INR (International Normalised Ratio)
14.
?Chain of Lakes? appearance due to sacculation with intervening short strictures of pancreatic

--- Content provided by FirstRanker.com ---

duct is seen on:

(a) ERCP
(b) CECT abdomen
(c) Plain X-ray abdomen

--- Content provided by FirstRanker.com ---

(d) Ultrasonography
15.
Which one of the following statements is NOT correct regarding Pyogenic Liver Abscess?

(a) Anorexia, fever, malaise and right upper quadrant abdominal discomfort are the

--- Content provided by FirstRanker.com ---

most common presenting features
(b) It is more common in elderly, diabetics and immunocompromised patients
(c) Treatment is with oral antibiotics alone
(d) Streptococcus milleri and escherichia coli are the most common causative
organisms

--- Content provided by FirstRanker.com ---

16.
?Swiss cheese defects? are seen during laparoscopic repair of:

(a) Ventral hernia
(b) Inguinal hernia

--- Content provided by FirstRanker.com ---

(c) Obturator hernia
(d) Femoral hernia

--- Content provided by FirstRanker.com ---

17.
Which of the following are correct regarding splenic artery aneurysm?

1. Main arterial trunk is the common site
2. Palpable thrill can be felt

--- Content provided by FirstRanker.com ---

3. It is symptomless unless it ruptures

Select the correct answer using the code given below:

(a) 1 and 2 only

--- Content provided by FirstRanker.com ---

(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3
18.
Valentino?s syndrome is:

--- Content provided by FirstRanker.com ---

(a) Pain on per-vaginal examination in pelvic abscess
(b) Pain over left shoulder in left hypochondriac collection
(c) Pain over left groin in perirenal collection
(d) Pain in right iliac fossa in perforated peptic ulcer

--- Content provided by FirstRanker.com ---

19.
Spontaneous bacterial peritonitis occurs due to:

(a) duodenal stump blowout
(b) peptic ulcer perforation

--- Content provided by FirstRanker.com ---

(c) acute bacterial infection of ascites
(d) infection via fallopian tubes
20.
Structure not forming boundaries of the ?Triangle of doom? seen during laparoscopic
inguinal hernia surgery dissection is:

--- Content provided by FirstRanker.com ---

(a) Vas deferens
(b) Inferior epigastric artery
(c) Spermatic cord vessels
(d) Peritoneum

--- Content provided by FirstRanker.com ---

21.
The term mid-line shift is associated with:

(a) Head injury
(b) Chest injury

--- Content provided by FirstRanker.com ---

(c) Abdominal injury
(d) Limb injury
22.
Which one of the following cranial nerves does NOT supply to the external ear?

--- Content provided by FirstRanker.com ---

(a) Cranial nerve V
(b) Cranial nerve VI
(c) Cranial nerve VII
(d) Cranial nerve IX

--- Content provided by FirstRanker.com ---

23.
Left Internal Mammary Artery (LIMA) has become the conduit of choice for Left Anterior
Descending (LAD) artery during coronary artery bypass grafting because:

(a) Long term patency rates are more than 98%

--- Content provided by FirstRanker.com ---

(b) It is close to LAD
(c) Atherosclerosis is never seen in this vessel
(d) It is very easy to harvest
24.
A 50-year old male with significant smoking history presented in the surgical emergency

--- Content provided by FirstRanker.com ---

with sudden severe breathlessness. Chest X-ray shows right sided Pneumothorax. The
appropriate management requires:

(a) Aspiration of air with 16-18 G cannula
(b) Right chest drain of size 8-14 Fr

--- Content provided by FirstRanker.com ---

(c) Oxygen by face mask
(d) Mechanical ventilation
25.
Which one of the following statements regarding Felon is NOT correct?

--- Content provided by FirstRanker.com ---

(a) There is infection of the finger tip between specialised fibrous septa
(b) It is a painless condition
(c) Incision and drainage is the treatment of choice
(d) It is common in diabetics
26.

--- Content provided by FirstRanker.com ---

The most common site for osteosarcoma is:

(a) Proximal femur
(b) Distal femur
(c) Proximal humerus

--- Content provided by FirstRanker.com ---

(d) Distal humerus
27.
Rapid Sequence Induction is indicated in:

(a) Emergency surgery for intestinal obstruction

--- Content provided by FirstRanker.com ---

(b) Elective open hernia surgery
(c) Cardiopulmonary bypass surgery
(d) Elective laparoscopic surgery

28.

--- Content provided by FirstRanker.com ---

Which one of the following statements about Compartment Syndrome is NOT correct?

(a) It is commonest in a closed fracture
(b) Pain is on active movement but not on passive movement of muscles
(c) Fasciotomy is the treatment of choice

--- Content provided by FirstRanker.com ---

(d) Volkmann?s Ischaemic contractive is a late complication

--- Content provided by FirstRanker.com ---

29.
Which one of the following is NOT the strength of ultrasound as a diagnostic modality?

(a) No radiation
(b) Short learning curve

--- Content provided by FirstRanker.com ---

(c) Inexpensive
(d) Allows dynamic studies to be done
30.
Which of the following statements regarding lymphoedema following breast cancer treatment
are correct?

--- Content provided by FirstRanker.com ---

1. Incidence has decreased due to rarely combined therapy of axillary LN dissection and
radiotherapy
2. Precipitating cause like LN metastasis is a major determinant
3. The condition is often painful

--- Content provided by FirstRanker.com ---

4. Oedematous limb is susceptible to bacterial infection

Select the correct answer using the code given below:

(a) 1, 2 and 3

--- Content provided by FirstRanker.com ---

(b) 2, 3 and 4
(c) 1, 3 and 4
(d) 1, 2 and 4
31.
Which one of the following is NOT a risk factor for development of venous thrombosis in

--- Content provided by FirstRanker.com ---

surgical patients?

(a) Age > 60 years
(b) Pregnancy
(c) Obesity (BMI > 30 kg/m

--- Content provided by FirstRanker.com ---

2
)
(d) Diabetes ( HbA1c > 7.5%)
32.
Which one of the following is NOT a complication of massive blood transfusion?

--- Content provided by FirstRanker.com ---

(a) Coagulopathy
(b) Hypocalcaemia
(c) Hyperthermia
(d) Hyperkalemia

--- Content provided by FirstRanker.com ---

33.
Stage III ?Pressure sore? is full thickness skin loss extending:

(a) into subcutaneous tissue but not through fascia
(b) through subcutaneous tissue into fascia

--- Content provided by FirstRanker.com ---

(c) through subcutaneous tissue into fascia and muscles
(d) through subcutaneous tissue into fascia, muscles and bone

--- Content provided by FirstRanker.com ---

34.
During subclavian vein puncture in a surgical ward suddenly a patient developed severe
breathlessness. On auscultation breath sound was absent and the ipsilateral chest was
tympanitic on percussion. The probable diagnosis is:

--- Content provided by FirstRanker.com ---

(a) Iatrogenic pneumothorax
(b) Introgenic hemothorax
(c) Spontaneous pneumothorax
(d) Tension pneumothorax
35.

--- Content provided by FirstRanker.com ---

Kohler?s disease is avascular necrosis of :

(a) Lunate
(b) Capitellum of humerus
(c) First metatarsal head

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(d) Navicular
36.
Which one of the following is NOT true of Pyoderma gangrenosum?

(a) It is characterized by cutaneous ulceration with purple undermined edges

--- Content provided by FirstRanker.com ---

(b) It is often secondary to heightened immunological reactivity from another disease
process
(c) Cultures often show Gram positive Staphylococci
(d) Lesions generally respond to steroids
37.

--- Content provided by FirstRanker.com ---

Which of the following is NOT a tissue repair surgery for inguinal hernia repair?

(a) Bassini?s repair
(b) Shouldice repair
(c) Stoppa?s repair

--- Content provided by FirstRanker.com ---

(d) Desarda repair
38.
Which one of the following type of meshes is recommended for intraperitoneal use in
abdominal wall hernia?
(a) Light weight, porous meshes

--- Content provided by FirstRanker.com ---

(b) Heavy weight, porous meshes
(c) Absorbable meshes
(d) Tissue separating meshes
39.
Which one of the following is NOT correct regarding MEN-1 syndrome?

--- Content provided by FirstRanker.com ---

(a) It involves parathyroid glands
(b) It involves pancreas
(c) It involves pituitary gland
(d) It involves pineal gland

--- Content provided by FirstRanker.com ---

40.
Which one of the following is NOT an electronic information site in surgery?

(a) Pubmed

--- Content provided by FirstRanker.com ---

(b) Embase
(c) Cochrane library
(d) National medical library
41.
Which one of the following statements regarding pre-conceptional counseling is NOT

--- Content provided by FirstRanker.com ---

correct?

(a) It is needed only in selected complicated pregnancies
(b) It helps in early detection of risk factors
(c) It helps in reducing maternal morbidity and mortality

--- Content provided by FirstRanker.com ---

(d) It is a part of preventive medicine
42.
Consider the following statements regarding Non Stress Test (NST):

1. Reactive NST indicates a healthy fetus

--- Content provided by FirstRanker.com ---

2. NST is an observed association of fetal breathing with fetal movements
3. NST has a low false negative rate (< 1%) but high false positive rate (>50%)
4. Testing should be started at 20 weeks

Which of the statement(s) given above is/are correct?

--- Content provided by FirstRanker.com ---

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

--- Content provided by FirstRanker.com ---

43.
Which one of the following is a protective factor for endometrial hyperplasia?

(a) Diabetes
(b) Tamoxifen therapy

--- Content provided by FirstRanker.com ---

(c) Multiparity
(d) Delayed menopause
44.
A woman who is not breast feeding her newborn child is advised to use a contraceptive
method by:

--- Content provided by FirstRanker.com ---

(a) 3
rd
postpartum week
(b) 6

--- Content provided by FirstRanker.com ---

th
postpartum week
(c) 3
rd
postpartum month

--- Content provided by FirstRanker.com ---

(d) 6
th
postpartum month

--- Content provided by FirstRanker.com ---

45.
Pearl index for contraceptive effectiveness is calculated in terms of which of the following?

--- Content provided by FirstRanker.com ---

1. Pregnancy rate
2. Abortion rate
3. Hundred woman years
4. Thousand woman years

--- Content provided by FirstRanker.com ---

Select the correct answer using the code given below:

(a) 1 only
(b) 2 and 3

--- Content provided by FirstRanker.com ---

(c) 1, 2 and 4
(d) 1 and 3
46.
Indications for removal of IUDs are all EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Perforation of uterus
(b) Cyclical menstrual bleeding
(c) Flaring up of salpingitis
(d) Pregnancy with IUD
47.

--- Content provided by FirstRanker.com ---

Contraindications for insertion of IUDs are all EXCEPT:

(a) Suspected pregnancy
(b) Trophoblastic disease
(c) Severe dysmenorrhea

--- Content provided by FirstRanker.com ---

(d) During cesarean section
48.
Which one of the following is NOT a contraindication for use of Mini pill?

(a) Pregnancy

--- Content provided by FirstRanker.com ---

(b) Breast feeding
(c) Thromboembolic disease
(d) History of breast cancer
49.
Which one of the following is the most commonly used surgical method/technique of female

--- Content provided by FirstRanker.com ---

sterilization as recommended by Government of India?

(a) Uchida technique
(b) Irving method
(c) Pomeroy?s method

--- Content provided by FirstRanker.com ---

(d) Madlener technique

--- Content provided by FirstRanker.com ---

50.
Which of the following is/are required for a registered medical practitioner to qualify for

--- Content provided by FirstRanker.com ---

performing Medical Termination of Pregnancy (MTP), as per revised rules of MTP Act?

1. Certified for assisting at least 15 MTP in an authorized centre
2. Diploma or degree in Obstetrics and Gynaecology
3. House surgeon training for 3 months in Obstetrics and Gynaecology

--- Content provided by FirstRanker.com ---

4. Certified training for 6 months in laparoscopic surgeries

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

--- Content provided by FirstRanker.com ---

(c) 1, 2 and 3
(d) 1, 2 and 4
51.
Which one of the following is NOT a support of uterus, preventing its descent?

--- Content provided by FirstRanker.com ---

(a) Endopelvic fascia
(b) Mackenrodt?s ligament
(c) Inguinal ligament
(d) Pubocervical ligament
52.

--- Content provided by FirstRanker.com ---

As per ICMR guidelines, which one of the following statements is true regarding effects of
COVID-19 on fetus according to current evidence?

(a) There is increased risk of early pregnancy loss
(b) COVID-19 virus is not teratogenic

--- Content provided by FirstRanker.com ---

(c) COVID-19 virus infection is an indication of MTP
(d) There is increased risk of fetal growth restriction
53.
As per ICMR guidelines, which one of the following statements is true regarding COVID-19
infection in pregnancy?

--- Content provided by FirstRanker.com ---

(a) Covid-19 pneumonia in pregnancy is more severe with poor recovery
(b) Pregnant women with heart disease are at higher risk
(c) Vaginal secretions always test positive for COVID-19 in pregnancy
(d) COVID-19 virus is secreted in breast milk

--- Content provided by FirstRanker.com ---

54.
Which one of the following is NOT a method of management of Deep Transverse Arrest with
the living fetus?

(a) Caesarean section

--- Content provided by FirstRanker.com ---

(b) Delivery by ventouse
(c) Delivery by application of forceps to the unrotated head
(d) Manual rotation and application of forceps

--- Content provided by FirstRanker.com ---

FirstRanker.com - FirstRanker's Choice
Combined Medical Services Examination-2020

--- Content provided by FirstRanker.com ---

Paper-II

1.
Indications for fasciotomy in compartment syndrome include all EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Distal sensory disturbance
(b) Compartment pressure > 30 mm Hg
(c) Pain on passive movement of affected muscles
(d) Palpable distal pulses
2.

--- Content provided by FirstRanker.com ---

Which one of the following statements is NOT correct regarding Necrotising Soft Tissue
infections?

(a) Crepitus, skin blistering and focal skin gangrene are typical presenting features
(b) They are monomicrobial in nature

--- Content provided by FirstRanker.com ---

(c) Treatment consists of wide local excision and appropriate antibiotics
(d) Tissue biopsy is required for culture and diagnosis
3.
Which type of surgery is laparoscopic cholecystectomy classified as?

--- Content provided by FirstRanker.com ---

(a) Clean
(b) Clean contaminated
(c) Contaminated
(d) Dirty
4.

--- Content provided by FirstRanker.com ---

A 22-year female has presented with a history of malaise, cough, alternating constipation and
diarrhoea with intermittent abdominal pain for last 6 months. She also complains of
abdominal distension for last 2 days. On examination her abdomen has a doughy feel along
with an ill defined mass over the right lower quadrant. She is most likely suffering from:

--- Content provided by FirstRanker.com ---

(a) Appendicular lump
(b) Ileocaecal tuberculosis
(c) Carcinoma caecum
(d) Ovarian mass
5.

--- Content provided by FirstRanker.com ---

Consider the following statements regarding needle stick injuries:

1. Injured part should be washed under running water
2. Dominant index finger is the commonest site for needle stick injury
3. All needle stick injuries should be reported

--- Content provided by FirstRanker.com ---

4. Hepatitis/HIV testing should be done after needle stick injury

Which of the statements given above are correct?

(a) 1, 2 and 4

--- Content provided by FirstRanker.com ---

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

--- Content provided by FirstRanker.com ---

6.
Consider the following statements regarding claudication:

--- Content provided by FirstRanker.com ---

1. It is a marker for silent coronary disease
2. Structured exercise program ( 2 hours per week for 3 months) leads to
improvement in symptoms
3. Diabetes mellitus increases the risk and severity of claudication
4. Beta blockers may exacerbate claudication

--- Content provided by FirstRanker.com ---

Which of the above statements are correct?

(a) 1 and 2 only
(b) 1, 3 and 4 only

--- Content provided by FirstRanker.com ---

(c) 2, 3 and 4 only
(d) 1, 2, 3 and 4
7.
A 50-year old lady underwent uneventful bariatric surgery for morbid obesity. On the third
post operative day, she develops breathless and pulmonary embolism is suspected. The next

--- Content provided by FirstRanker.com ---

investigation to confirm the diagnosis will be:

(a) Echocardiography
(b) Duplex venography
(c) CT pulmonary angiography

--- Content provided by FirstRanker.com ---

(d) MR angiography
8.
Medical management of thyrotoxic crisis includes all of the following EXCEPT:

(a) IV fluids

--- Content provided by FirstRanker.com ---

(b) IV propanolol
(c) IV hydrocortisone
(d) IV antibiotics
9.
A patient operated for a parotid gland tumour developed symptoms of sweating and

--- Content provided by FirstRanker.com ---

erytherma (flushing) over the region of surgical excision while eating. The probable
diagnosis is:

(a) Parotid gland fistula
(b) Sialadenitis

--- Content provided by FirstRanker.com ---

(c) Chronic wound infection
(d) Frey?s syndrome
10.
First line hormone therapy for post-menopausal woman with metastatic carcinoma breast is:

--- Content provided by FirstRanker.com ---

(a) Tamoxifen
(b) Ovarian suppression by surgery
(c) Antiprogestins
(d) Anastrazole

--- Content provided by FirstRanker.com ---

11.
All of the following are major subtypes of breast cancer based on Gene array analysis
EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Luminal A and Luminal B
(b) Triple negative
(c) Her-2 receptor positive
(d) Oestrogen receptor positive

--- Content provided by FirstRanker.com ---

12.
All of the following are sequelae of peptic ulcer surgery EXCEPT:

(a) Bilious vomiting
(b) Dumping syndrome

--- Content provided by FirstRanker.com ---

(c) Diarrhoea
(d) Increased appetite
13.
The Child-Turcotte-Pugh (CTP) score for quantifying the severity of chronic liver disease
includes all variables EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Serum bilirubin
(b) Serum albumin
(c) Serum creatinine
(d) INR (International Normalised Ratio)

--- Content provided by FirstRanker.com ---

14.
?Chain of Lakes? appearance due to sacculation with intervening short strictures of pancreatic
duct is seen on:

(a) ERCP

--- Content provided by FirstRanker.com ---

(b) CECT abdomen
(c) Plain X-ray abdomen
(d) Ultrasonography
15.
Which one of the following statements is NOT correct regarding Pyogenic Liver Abscess?

--- Content provided by FirstRanker.com ---

(a) Anorexia, fever, malaise and right upper quadrant abdominal discomfort are the
most common presenting features
(b) It is more common in elderly, diabetics and immunocompromised patients
(c) Treatment is with oral antibiotics alone

--- Content provided by FirstRanker.com ---

(d) Streptococcus milleri and escherichia coli are the most common causative
organisms
16.
?Swiss cheese defects? are seen during laparoscopic repair of:

--- Content provided by FirstRanker.com ---

(a) Ventral hernia
(b) Inguinal hernia
(c) Obturator hernia
(d) Femoral hernia

--- Content provided by FirstRanker.com ---

17.
Which of the following are correct regarding splenic artery aneurysm?

--- Content provided by FirstRanker.com ---

1. Main arterial trunk is the common site
2. Palpable thrill can be felt
3. It is symptomless unless it ruptures

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

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

--- Content provided by FirstRanker.com ---

18.
Valentino?s syndrome is:

(a) Pain on per-vaginal examination in pelvic abscess
(b) Pain over left shoulder in left hypochondriac collection

--- Content provided by FirstRanker.com ---

(c) Pain over left groin in perirenal collection
(d) Pain in right iliac fossa in perforated peptic ulcer
19.
Spontaneous bacterial peritonitis occurs due to:

--- Content provided by FirstRanker.com ---

(a) duodenal stump blowout
(b) peptic ulcer perforation
(c) acute bacterial infection of ascites
(d) infection via fallopian tubes
20.

--- Content provided by FirstRanker.com ---

Structure not forming boundaries of the ?Triangle of doom? seen during laparoscopic
inguinal hernia surgery dissection is:

(a) Vas deferens
(b) Inferior epigastric artery

--- Content provided by FirstRanker.com ---

(c) Spermatic cord vessels
(d) Peritoneum
21.
The term mid-line shift is associated with:

--- Content provided by FirstRanker.com ---

(a) Head injury
(b) Chest injury
(c) Abdominal injury
(d) Limb injury
22.

--- Content provided by FirstRanker.com ---

Which one of the following cranial nerves does NOT supply to the external ear?

(a) Cranial nerve V
(b) Cranial nerve VI
(c) Cranial nerve VII

--- Content provided by FirstRanker.com ---

(d) Cranial nerve IX

23.
Left Internal Mammary Artery (LIMA) has become the conduit of choice for Left Anterior
Descending (LAD) artery during coronary artery bypass grafting because:

--- Content provided by FirstRanker.com ---

(a) Long term patency rates are more than 98%
(b) It is close to LAD
(c) Atherosclerosis is never seen in this vessel
(d) It is very easy to harvest

--- Content provided by FirstRanker.com ---

24.
A 50-year old male with significant smoking history presented in the surgical emergency
with sudden severe breathlessness. Chest X-ray shows right sided Pneumothorax. The
appropriate management requires:

--- Content provided by FirstRanker.com ---

(a) Aspiration of air with 16-18 G cannula
(b) Right chest drain of size 8-14 Fr
(c) Oxygen by face mask
(d) Mechanical ventilation
25.

--- Content provided by FirstRanker.com ---

Which one of the following statements regarding Felon is NOT correct?

(a) There is infection of the finger tip between specialised fibrous septa
(b) It is a painless condition
(c) Incision and drainage is the treatment of choice

--- Content provided by FirstRanker.com ---

(d) It is common in diabetics
26.
The most common site for osteosarcoma is:

(a) Proximal femur

--- Content provided by FirstRanker.com ---

(b) Distal femur
(c) Proximal humerus
(d) Distal humerus
27.
Rapid Sequence Induction is indicated in:

--- Content provided by FirstRanker.com ---

(a) Emergency surgery for intestinal obstruction
(b) Elective open hernia surgery
(c) Cardiopulmonary bypass surgery
(d) Elective laparoscopic surgery

--- Content provided by FirstRanker.com ---

28.
Which one of the following statements about Compartment Syndrome is NOT correct?

(a) It is commonest in a closed fracture

--- Content provided by FirstRanker.com ---

(b) Pain is on active movement but not on passive movement of muscles
(c) Fasciotomy is the treatment of choice
(d) Volkmann?s Ischaemic contractive is a late complication

--- Content provided by FirstRanker.com ---

29.
Which one of the following is NOT the strength of ultrasound as a diagnostic modality?

--- Content provided by FirstRanker.com ---

(a) No radiation
(b) Short learning curve
(c) Inexpensive
(d) Allows dynamic studies to be done
30.

--- Content provided by FirstRanker.com ---

Which of the following statements regarding lymphoedema following breast cancer treatment
are correct?

1. Incidence has decreased due to rarely combined therapy of axillary LN dissection and
radiotherapy

--- Content provided by FirstRanker.com ---

2. Precipitating cause like LN metastasis is a major determinant
3. The condition is often painful
4. Oedematous limb is susceptible to bacterial infection

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

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

--- Content provided by FirstRanker.com ---

31.
Which one of the following is NOT a risk factor for development of venous thrombosis in
surgical patients?

(a) Age > 60 years

--- Content provided by FirstRanker.com ---

(b) Pregnancy
(c) Obesity (BMI > 30 kg/m
2
)
(d) Diabetes ( HbA1c > 7.5%)

--- Content provided by FirstRanker.com ---

32.
Which one of the following is NOT a complication of massive blood transfusion?

(a) Coagulopathy
(b) Hypocalcaemia

--- Content provided by FirstRanker.com ---

(c) Hyperthermia
(d) Hyperkalemia
33.
Stage III ?Pressure sore? is full thickness skin loss extending:

--- Content provided by FirstRanker.com ---

(a) into subcutaneous tissue but not through fascia
(b) through subcutaneous tissue into fascia
(c) through subcutaneous tissue into fascia and muscles
(d) through subcutaneous tissue into fascia, muscles and bone

--- Content provided by FirstRanker.com ---

34.
During subclavian vein puncture in a surgical ward suddenly a patient developed severe
breathlessness. On auscultation breath sound was absent and the ipsilateral chest was

--- Content provided by FirstRanker.com ---

tympanitic on percussion. The probable diagnosis is:

(a) Iatrogenic pneumothorax
(b) Introgenic hemothorax
(c) Spontaneous pneumothorax

--- Content provided by FirstRanker.com ---

(d) Tension pneumothorax
35.
Kohler?s disease is avascular necrosis of :

(a) Lunate

--- Content provided by FirstRanker.com ---

(b) Capitellum of humerus
(c) First metatarsal head
(d) Navicular
36.
Which one of the following is NOT true of Pyoderma gangrenosum?

--- Content provided by FirstRanker.com ---

(a) It is characterized by cutaneous ulceration with purple undermined edges
(b) It is often secondary to heightened immunological reactivity from another disease
process
(c) Cultures often show Gram positive Staphylococci

--- Content provided by FirstRanker.com ---

(d) Lesions generally respond to steroids
37.
Which of the following is NOT a tissue repair surgery for inguinal hernia repair?

(a) Bassini?s repair

--- Content provided by FirstRanker.com ---

(b) Shouldice repair
(c) Stoppa?s repair
(d) Desarda repair
38.
Which one of the following type of meshes is recommended for intraperitoneal use in

--- Content provided by FirstRanker.com ---

abdominal wall hernia?
(a) Light weight, porous meshes
(b) Heavy weight, porous meshes
(c) Absorbable meshes
(d) Tissue separating meshes

--- Content provided by FirstRanker.com ---

39.
Which one of the following is NOT correct regarding MEN-1 syndrome?

(a) It involves parathyroid glands
(b) It involves pancreas

--- Content provided by FirstRanker.com ---

(c) It involves pituitary gland
(d) It involves pineal gland

40.
Which one of the following is NOT an electronic information site in surgery?

--- Content provided by FirstRanker.com ---

(a) Pubmed
(b) Embase
(c) Cochrane library
(d) National medical library

--- Content provided by FirstRanker.com ---

41.
Which one of the following statements regarding pre-conceptional counseling is NOT
correct?

(a) It is needed only in selected complicated pregnancies

--- Content provided by FirstRanker.com ---

(b) It helps in early detection of risk factors
(c) It helps in reducing maternal morbidity and mortality
(d) It is a part of preventive medicine
42.
Consider the following statements regarding Non Stress Test (NST):

--- Content provided by FirstRanker.com ---

1. Reactive NST indicates a healthy fetus
2. NST is an observed association of fetal breathing with fetal movements
3. NST has a low false negative rate (< 1%) but high false positive rate (>50%)
4. Testing should be started at 20 weeks

--- Content provided by FirstRanker.com ---

Which of the statement(s) given above is/are correct?

(a) 1 and 3
(b) 2 only

--- Content provided by FirstRanker.com ---

(c) 3 only
(d) 1 and 4
43.
Which one of the following is a protective factor for endometrial hyperplasia?

--- Content provided by FirstRanker.com ---

(a) Diabetes
(b) Tamoxifen therapy
(c) Multiparity
(d) Delayed menopause
44.

--- Content provided by FirstRanker.com ---

A woman who is not breast feeding her newborn child is advised to use a contraceptive
method by:

(a) 3
rd

--- Content provided by FirstRanker.com ---

postpartum week
(b) 6
th
postpartum week
(c) 3

--- Content provided by FirstRanker.com ---

rd
postpartum month
(d) 6
th
postpartum month

--- Content provided by FirstRanker.com ---

--- Content provided by FirstRanker.com ---

45.
Pearl index for contraceptive effectiveness is calculated in terms of which of the following?

1. Pregnancy rate
2. Abortion rate

--- Content provided by FirstRanker.com ---

3. Hundred woman years
4. Thousand woman years

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

(a) 1 only
(b) 2 and 3
(c) 1, 2 and 4
(d) 1 and 3
46.

--- Content provided by FirstRanker.com ---

Indications for removal of IUDs are all EXCEPT:

(a) Perforation of uterus
(b) Cyclical menstrual bleeding
(c) Flaring up of salpingitis

--- Content provided by FirstRanker.com ---

(d) Pregnancy with IUD
47.
Contraindications for insertion of IUDs are all EXCEPT:

(a) Suspected pregnancy

--- Content provided by FirstRanker.com ---

(b) Trophoblastic disease
(c) Severe dysmenorrhea
(d) During cesarean section
48.
Which one of the following is NOT a contraindication for use of Mini pill?

--- Content provided by FirstRanker.com ---

(a) Pregnancy
(b) Breast feeding
(c) Thromboembolic disease
(d) History of breast cancer

--- Content provided by FirstRanker.com ---

49.
Which one of the following is the most commonly used surgical method/technique of female
sterilization as recommended by Government of India?

(a) Uchida technique

--- Content provided by FirstRanker.com ---

(b) Irving method
(c) Pomeroy?s method
(d) Madlener technique

--- Content provided by FirstRanker.com ---

--- Content provided by FirstRanker.com ---

50.
Which of the following is/are required for a registered medical practitioner to qualify for
performing Medical Termination of Pregnancy (MTP), as per revised rules of MTP Act?

1. Certified for assisting at least 15 MTP in an authorized centre

--- Content provided by FirstRanker.com ---

2. Diploma or degree in Obstetrics and Gynaecology
3. House surgeon training for 3 months in Obstetrics and Gynaecology
4. Certified training for 6 months in laparoscopic surgeries

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

(a) 1 only
(b) 2 only
(c) 1, 2 and 3
(d) 1, 2 and 4
51.

--- Content provided by FirstRanker.com ---

Which one of the following is NOT a support of uterus, preventing its descent?

(a) Endopelvic fascia
(b) Mackenrodt?s ligament
(c) Inguinal ligament

--- Content provided by FirstRanker.com ---

(d) Pubocervical ligament
52.
As per ICMR guidelines, which one of the following statements is true regarding effects of
COVID-19 on fetus according to current evidence?

--- Content provided by FirstRanker.com ---

(a) There is increased risk of early pregnancy loss
(b) COVID-19 virus is not teratogenic
(c) COVID-19 virus infection is an indication of MTP
(d) There is increased risk of fetal growth restriction
53.

--- Content provided by FirstRanker.com ---

As per ICMR guidelines, which one of the following statements is true regarding COVID-19
infection in pregnancy?

(a) Covid-19 pneumonia in pregnancy is more severe with poor recovery
(b) Pregnant women with heart disease are at higher risk

--- Content provided by FirstRanker.com ---

(c) Vaginal secretions always test positive for COVID-19 in pregnancy
(d) COVID-19 virus is secreted in breast milk
54.
Which one of the following is NOT a method of management of Deep Transverse Arrest with
the living fetus?

--- Content provided by FirstRanker.com ---

(a) Caesarean section
(b) Delivery by ventouse
(c) Delivery by application of forceps to the unrotated head
(d) Manual rotation and application of forceps

--- Content provided by FirstRanker.com ---

--- Content provided by FirstRanker.com ---

55.
Successful version of breech presentation is likely in case all of the following EXCEPT:

(a) Breech with extended legs
(b) Complete breech with sacroanterior position

--- Content provided by FirstRanker.com ---

(c) Non engaged breech
(d) Adequate amniotic fluid
56.
Implantation of a fertilised ovum occurs on which day following fertilisation?

--- Content provided by FirstRanker.com ---

(a) Day 6
(b) Day 10
(c) Day 14
(d) Day 20
57.

--- Content provided by FirstRanker.com ---

During total abdominal hysterectomy the ureter is likely to undergo injury or ligation during
the following steps EXCEPT:

(a) During division and ligation of the round ligaments
(b) During division and ligation of infundibulopelvic ligaments

--- Content provided by FirstRanker.com ---

(c) During division and ligation of mackenrodt?s and uterosacral ligaments
(d) At the vaginal angles while incising the vagina to remove the cervix with the
uterus
58.
The net effect of antenatal care has been the following EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Reduction in maternal mortality
(b) Reduction in perinatal mortality
(c) Reduction in the incidence of institutional delivery
(d) Reduction in maternal morbidity

--- Content provided by FirstRanker.com ---

59.
Which one of the following is NOT a component of active phase in the partograph?

(a) Acceleration phase
(b) Phase of maximum slope

--- Content provided by FirstRanker.com ---

(c) Phase of deceleration
(d) Phase of expulsion
60.
From medicolegal point of view which one of the following is NOT a sign of previous child
birth?

--- Content provided by FirstRanker.com ---

(a) Perineum is lax and there is evidence of scarring
(b) Introitus is gaping and there is presence of carunculae myrtiformis
(c) Abdomen is lax and loose with striae and linea alba
(d) Conical cervix with round external os

--- Content provided by FirstRanker.com ---

--- Content provided by FirstRanker.com ---

FirstRanker.com - FirstRanker's Choice
Combined Medical Services Examination-2020
Paper-II

1.

--- Content provided by FirstRanker.com ---

Indications for fasciotomy in compartment syndrome include all EXCEPT:

(a) Distal sensory disturbance
(b) Compartment pressure > 30 mm Hg
(c) Pain on passive movement of affected muscles

--- Content provided by FirstRanker.com ---

(d) Palpable distal pulses
2.
Which one of the following statements is NOT correct regarding Necrotising Soft Tissue
infections?

--- Content provided by FirstRanker.com ---

(a) Crepitus, skin blistering and focal skin gangrene are typical presenting features
(b) They are monomicrobial in nature
(c) Treatment consists of wide local excision and appropriate antibiotics
(d) Tissue biopsy is required for culture and diagnosis
3.

--- Content provided by FirstRanker.com ---

Which type of surgery is laparoscopic cholecystectomy classified as?

(a) Clean
(b) Clean contaminated
(c) Contaminated

--- Content provided by FirstRanker.com ---

(d) Dirty
4.
A 22-year female has presented with a history of malaise, cough, alternating constipation and
diarrhoea with intermittent abdominal pain for last 6 months. She also complains of
abdominal distension for last 2 days. On examination her abdomen has a doughy feel along

--- Content provided by FirstRanker.com ---

with an ill defined mass over the right lower quadrant. She is most likely suffering from:

(a) Appendicular lump
(b) Ileocaecal tuberculosis
(c) Carcinoma caecum

--- Content provided by FirstRanker.com ---

(d) Ovarian mass
5.
Consider the following statements regarding needle stick injuries:

1. Injured part should be washed under running water

--- Content provided by FirstRanker.com ---

2. Dominant index finger is the commonest site for needle stick injury
3. All needle stick injuries should be reported
4. Hepatitis/HIV testing should be done after needle stick injury

Which of the statements given above are correct?

--- Content provided by FirstRanker.com ---

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

--- Content provided by FirstRanker.com ---

6.

--- Content provided by FirstRanker.com ---

Consider the following statements regarding claudication:

1. It is a marker for silent coronary disease
2. Structured exercise program ( 2 hours per week for 3 months) leads to
improvement in symptoms

--- Content provided by FirstRanker.com ---

3. Diabetes mellitus increases the risk and severity of claudication
4. Beta blockers may exacerbate claudication

Which of the above statements are correct?

--- Content provided by FirstRanker.com ---

(a) 1 and 2 only
(b) 1, 3 and 4 only
(c) 2, 3 and 4 only
(d) 1, 2, 3 and 4
7.

--- Content provided by FirstRanker.com ---

A 50-year old lady underwent uneventful bariatric surgery for morbid obesity. On the third
post operative day, she develops breathless and pulmonary embolism is suspected. The next
investigation to confirm the diagnosis will be:

(a) Echocardiography

--- Content provided by FirstRanker.com ---

(b) Duplex venography
(c) CT pulmonary angiography
(d) MR angiography
8.
Medical management of thyrotoxic crisis includes all of the following EXCEPT:

--- Content provided by FirstRanker.com ---

(a) IV fluids
(b) IV propanolol
(c) IV hydrocortisone
(d) IV antibiotics

--- Content provided by FirstRanker.com ---

9.
A patient operated for a parotid gland tumour developed symptoms of sweating and
erytherma (flushing) over the region of surgical excision while eating. The probable
diagnosis is:

--- Content provided by FirstRanker.com ---

(a) Parotid gland fistula
(b) Sialadenitis
(c) Chronic wound infection
(d) Frey?s syndrome
10.

--- Content provided by FirstRanker.com ---

First line hormone therapy for post-menopausal woman with metastatic carcinoma breast is:

(a) Tamoxifen
(b) Ovarian suppression by surgery
(c) Antiprogestins

--- Content provided by FirstRanker.com ---

(d) Anastrazole



11.

--- Content provided by FirstRanker.com ---

All of the following are major subtypes of breast cancer based on Gene array analysis
EXCEPT:

(a) Luminal A and Luminal B
(b) Triple negative

--- Content provided by FirstRanker.com ---

(c) Her-2 receptor positive
(d) Oestrogen receptor positive
12.
All of the following are sequelae of peptic ulcer surgery EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Bilious vomiting
(b) Dumping syndrome
(c) Diarrhoea
(d) Increased appetite
13.

--- Content provided by FirstRanker.com ---

The Child-Turcotte-Pugh (CTP) score for quantifying the severity of chronic liver disease
includes all variables EXCEPT:

(a) Serum bilirubin
(b) Serum albumin

--- Content provided by FirstRanker.com ---

(c) Serum creatinine
(d) INR (International Normalised Ratio)
14.
?Chain of Lakes? appearance due to sacculation with intervening short strictures of pancreatic
duct is seen on:

--- Content provided by FirstRanker.com ---

(a) ERCP
(b) CECT abdomen
(c) Plain X-ray abdomen
(d) Ultrasonography

--- Content provided by FirstRanker.com ---

15.
Which one of the following statements is NOT correct regarding Pyogenic Liver Abscess?

(a) Anorexia, fever, malaise and right upper quadrant abdominal discomfort are the
most common presenting features

--- Content provided by FirstRanker.com ---

(b) It is more common in elderly, diabetics and immunocompromised patients
(c) Treatment is with oral antibiotics alone
(d) Streptococcus milleri and escherichia coli are the most common causative
organisms
16.

--- Content provided by FirstRanker.com ---

?Swiss cheese defects? are seen during laparoscopic repair of:

(a) Ventral hernia
(b) Inguinal hernia
(c) Obturator hernia

--- Content provided by FirstRanker.com ---

(d) Femoral hernia



17.

--- Content provided by FirstRanker.com ---

Which of the following are correct regarding splenic artery aneurysm?

1. Main arterial trunk is the common site
2. Palpable thrill can be felt
3. It is symptomless unless it ruptures

--- Content provided by FirstRanker.com ---

Select the correct answer using the code given below:

(a) 1 and 2 only
(b) 2 and 3 only

--- Content provided by FirstRanker.com ---

(c) 1 and 3 only
(d) 1, 2 and 3
18.
Valentino?s syndrome is:

--- Content provided by FirstRanker.com ---

(a) Pain on per-vaginal examination in pelvic abscess
(b) Pain over left shoulder in left hypochondriac collection
(c) Pain over left groin in perirenal collection
(d) Pain in right iliac fossa in perforated peptic ulcer
19.

--- Content provided by FirstRanker.com ---

Spontaneous bacterial peritonitis occurs due to:

(a) duodenal stump blowout
(b) peptic ulcer perforation
(c) acute bacterial infection of ascites

--- Content provided by FirstRanker.com ---

(d) infection via fallopian tubes
20.
Structure not forming boundaries of the ?Triangle of doom? seen during laparoscopic
inguinal hernia surgery dissection is:

--- Content provided by FirstRanker.com ---

(a) Vas deferens
(b) Inferior epigastric artery
(c) Spermatic cord vessels
(d) Peritoneum
21.

--- Content provided by FirstRanker.com ---

The term mid-line shift is associated with:

(a) Head injury
(b) Chest injury
(c) Abdominal injury

--- Content provided by FirstRanker.com ---

(d) Limb injury
22.
Which one of the following cranial nerves does NOT supply to the external ear?

(a) Cranial nerve V

--- Content provided by FirstRanker.com ---

(b) Cranial nerve VI
(c) Cranial nerve VII
(d) Cranial nerve IX

23.

--- Content provided by FirstRanker.com ---

Left Internal Mammary Artery (LIMA) has become the conduit of choice for Left Anterior
Descending (LAD) artery during coronary artery bypass grafting because:

(a) Long term patency rates are more than 98%
(b) It is close to LAD

--- Content provided by FirstRanker.com ---

(c) Atherosclerosis is never seen in this vessel
(d) It is very easy to harvest
24.
A 50-year old male with significant smoking history presented in the surgical emergency
with sudden severe breathlessness. Chest X-ray shows right sided Pneumothorax. The

--- Content provided by FirstRanker.com ---

appropriate management requires:

(a) Aspiration of air with 16-18 G cannula
(b) Right chest drain of size 8-14 Fr
(c) Oxygen by face mask

--- Content provided by FirstRanker.com ---

(d) Mechanical ventilation
25.
Which one of the following statements regarding Felon is NOT correct?

(a) There is infection of the finger tip between specialised fibrous septa

--- Content provided by FirstRanker.com ---

(b) It is a painless condition
(c) Incision and drainage is the treatment of choice
(d) It is common in diabetics
26.
The most common site for osteosarcoma is:

--- Content provided by FirstRanker.com ---

(a) Proximal femur
(b) Distal femur
(c) Proximal humerus
(d) Distal humerus

--- Content provided by FirstRanker.com ---

27.
Rapid Sequence Induction is indicated in:

(a) Emergency surgery for intestinal obstruction
(b) Elective open hernia surgery

--- Content provided by FirstRanker.com ---

(c) Cardiopulmonary bypass surgery
(d) Elective laparoscopic surgery

28.
Which one of the following statements about Compartment Syndrome is NOT correct?

--- Content provided by FirstRanker.com ---

(a) It is commonest in a closed fracture
(b) Pain is on active movement but not on passive movement of muscles
(c) Fasciotomy is the treatment of choice
(d) Volkmann?s Ischaemic contractive is a late complication

--- Content provided by FirstRanker.com ---

29.

--- Content provided by FirstRanker.com ---

Which one of the following is NOT the strength of ultrasound as a diagnostic modality?

(a) No radiation
(b) Short learning curve
(c) Inexpensive

--- Content provided by FirstRanker.com ---

(d) Allows dynamic studies to be done
30.
Which of the following statements regarding lymphoedema following breast cancer treatment
are correct?

--- Content provided by FirstRanker.com ---

1. Incidence has decreased due to rarely combined therapy of axillary LN dissection and
radiotherapy
2. Precipitating cause like LN metastasis is a major determinant
3. The condition is often painful
4. Oedematous limb is susceptible to bacterial infection

--- Content provided by FirstRanker.com ---

Select the correct answer using the code given below:

(a) 1, 2 and 3
(b) 2, 3 and 4

--- Content provided by FirstRanker.com ---

(c) 1, 3 and 4
(d) 1, 2 and 4
31.
Which one of the following is NOT a risk factor for development of venous thrombosis in
surgical patients?

--- Content provided by FirstRanker.com ---

(a) Age > 60 years
(b) Pregnancy
(c) Obesity (BMI > 30 kg/m
2

--- Content provided by FirstRanker.com ---

)
(d) Diabetes ( HbA1c > 7.5%)
32.
Which one of the following is NOT a complication of massive blood transfusion?

--- Content provided by FirstRanker.com ---

(a) Coagulopathy
(b) Hypocalcaemia
(c) Hyperthermia
(d) Hyperkalemia
33.

--- Content provided by FirstRanker.com ---

Stage III ?Pressure sore? is full thickness skin loss extending:

(a) into subcutaneous tissue but not through fascia
(b) through subcutaneous tissue into fascia
(c) through subcutaneous tissue into fascia and muscles

--- Content provided by FirstRanker.com ---

(d) through subcutaneous tissue into fascia, muscles and bone



34.

--- Content provided by FirstRanker.com ---

During subclavian vein puncture in a surgical ward suddenly a patient developed severe
breathlessness. On auscultation breath sound was absent and the ipsilateral chest was
tympanitic on percussion. The probable diagnosis is:

(a) Iatrogenic pneumothorax

--- Content provided by FirstRanker.com ---

(b) Introgenic hemothorax
(c) Spontaneous pneumothorax
(d) Tension pneumothorax
35.
Kohler?s disease is avascular necrosis of :

--- Content provided by FirstRanker.com ---

(a) Lunate
(b) Capitellum of humerus
(c) First metatarsal head
(d) Navicular

--- Content provided by FirstRanker.com ---

36.
Which one of the following is NOT true of Pyoderma gangrenosum?

(a) It is characterized by cutaneous ulceration with purple undermined edges
(b) It is often secondary to heightened immunological reactivity from another disease

--- Content provided by FirstRanker.com ---

process
(c) Cultures often show Gram positive Staphylococci
(d) Lesions generally respond to steroids
37.
Which of the following is NOT a tissue repair surgery for inguinal hernia repair?

--- Content provided by FirstRanker.com ---

(a) Bassini?s repair
(b) Shouldice repair
(c) Stoppa?s repair
(d) Desarda repair

--- Content provided by FirstRanker.com ---

38.
Which one of the following type of meshes is recommended for intraperitoneal use in
abdominal wall hernia?
(a) Light weight, porous meshes
(b) Heavy weight, porous meshes

--- Content provided by FirstRanker.com ---

(c) Absorbable meshes
(d) Tissue separating meshes
39.
Which one of the following is NOT correct regarding MEN-1 syndrome?

--- Content provided by FirstRanker.com ---

(a) It involves parathyroid glands
(b) It involves pancreas
(c) It involves pituitary gland
(d) It involves pineal gland

--- Content provided by FirstRanker.com ---

40.
Which one of the following is NOT an electronic information site in surgery?

(a) Pubmed
(b) Embase

--- Content provided by FirstRanker.com ---

(c) Cochrane library
(d) National medical library
41.
Which one of the following statements regarding pre-conceptional counseling is NOT
correct?

--- Content provided by FirstRanker.com ---

(a) It is needed only in selected complicated pregnancies
(b) It helps in early detection of risk factors
(c) It helps in reducing maternal morbidity and mortality
(d) It is a part of preventive medicine

--- Content provided by FirstRanker.com ---

42.
Consider the following statements regarding Non Stress Test (NST):

1. Reactive NST indicates a healthy fetus
2. NST is an observed association of fetal breathing with fetal movements

--- Content provided by FirstRanker.com ---

3. NST has a low false negative rate (< 1%) but high false positive rate (>50%)
4. Testing should be started at 20 weeks

Which of the statement(s) given above is/are correct?

--- Content provided by FirstRanker.com ---

(a) 1 and 3
(b) 2 only
(c) 3 only
(d) 1 and 4
43.

--- Content provided by FirstRanker.com ---

Which one of the following is a protective factor for endometrial hyperplasia?

(a) Diabetes
(b) Tamoxifen therapy
(c) Multiparity

--- Content provided by FirstRanker.com ---

(d) Delayed menopause
44.
A woman who is not breast feeding her newborn child is advised to use a contraceptive
method by:

--- Content provided by FirstRanker.com ---

(a) 3
rd
postpartum week
(b) 6
th

--- Content provided by FirstRanker.com ---

postpartum week
(c) 3
rd
postpartum month
(d) 6

--- Content provided by FirstRanker.com ---

th
postpartum month

--- Content provided by FirstRanker.com ---

45.
Pearl index for contraceptive effectiveness is calculated in terms of which of the following?

--- Content provided by FirstRanker.com ---

1. Pregnancy rate
2. Abortion rate
3. Hundred woman years
4. Thousand woman years

--- Content provided by FirstRanker.com ---

Select the correct answer using the code given below:

(a) 1 only
(b) 2 and 3
(c) 1, 2 and 4

--- Content provided by FirstRanker.com ---

(d) 1 and 3
46.
Indications for removal of IUDs are all EXCEPT:

(a) Perforation of uterus

--- Content provided by FirstRanker.com ---

(b) Cyclical menstrual bleeding
(c) Flaring up of salpingitis
(d) Pregnancy with IUD
47.
Contraindications for insertion of IUDs are all EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Suspected pregnancy
(b) Trophoblastic disease
(c) Severe dysmenorrhea
(d) During cesarean section

--- Content provided by FirstRanker.com ---

48.
Which one of the following is NOT a contraindication for use of Mini pill?

(a) Pregnancy
(b) Breast feeding

--- Content provided by FirstRanker.com ---

(c) Thromboembolic disease
(d) History of breast cancer
49.
Which one of the following is the most commonly used surgical method/technique of female
sterilization as recommended by Government of India?

--- Content provided by FirstRanker.com ---

(a) Uchida technique
(b) Irving method
(c) Pomeroy?s method
(d) Madlener technique

--- Content provided by FirstRanker.com ---

--- Content provided by FirstRanker.com ---

50.
Which of the following is/are required for a registered medical practitioner to qualify for
performing Medical Termination of Pregnancy (MTP), as per revised rules of MTP Act?

--- Content provided by FirstRanker.com ---

1. Certified for assisting at least 15 MTP in an authorized centre
2. Diploma or degree in Obstetrics and Gynaecology
3. House surgeon training for 3 months in Obstetrics and Gynaecology
4. Certified training for 6 months in laparoscopic surgeries

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

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(d) 1, 2 and 4
51.
Which one of the following is NOT a support of uterus, preventing its descent?

(a) Endopelvic fascia

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(b) Mackenrodt?s ligament
(c) Inguinal ligament
(d) Pubocervical ligament
52.
As per ICMR guidelines, which one of the following statements is true regarding effects of

--- Content provided by FirstRanker.com ---

COVID-19 on fetus according to current evidence?

(a) There is increased risk of early pregnancy loss
(b) COVID-19 virus is not teratogenic
(c) COVID-19 virus infection is an indication of MTP

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(d) There is increased risk of fetal growth restriction
53.
As per ICMR guidelines, which one of the following statements is true regarding COVID-19
infection in pregnancy?

--- Content provided by FirstRanker.com ---

(a) Covid-19 pneumonia in pregnancy is more severe with poor recovery
(b) Pregnant women with heart disease are at higher risk
(c) Vaginal secretions always test positive for COVID-19 in pregnancy
(d) COVID-19 virus is secreted in breast milk
54.

--- Content provided by FirstRanker.com ---

Which one of the following is NOT a method of management of Deep Transverse Arrest with
the living fetus?

(a) Caesarean section
(b) Delivery by ventouse

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(c) Delivery by application of forceps to the unrotated head
(d) Manual rotation and application of forceps

--- Content provided by FirstRanker.com ---

55.
Successful version of breech presentation is likely in case all of the following EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Breech with extended legs
(b) Complete breech with sacroanterior position
(c) Non engaged breech
(d) Adequate amniotic fluid
56.

--- Content provided by FirstRanker.com ---

Implantation of a fertilised ovum occurs on which day following fertilisation?

(a) Day 6
(b) Day 10
(c) Day 14

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(d) Day 20
57.
During total abdominal hysterectomy the ureter is likely to undergo injury or ligation during
the following steps EXCEPT:

--- Content provided by FirstRanker.com ---

(a) During division and ligation of the round ligaments
(b) During division and ligation of infundibulopelvic ligaments
(c) During division and ligation of mackenrodt?s and uterosacral ligaments
(d) At the vaginal angles while incising the vagina to remove the cervix with the
uterus

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58.
The net effect of antenatal care has been the following EXCEPT:

(a) Reduction in maternal mortality
(b) Reduction in perinatal mortality

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(c) Reduction in the incidence of institutional delivery
(d) Reduction in maternal morbidity
59.
Which one of the following is NOT a component of active phase in the partograph?

--- Content provided by FirstRanker.com ---

(a) Acceleration phase
(b) Phase of maximum slope
(c) Phase of deceleration
(d) Phase of expulsion
60.

--- Content provided by FirstRanker.com ---

From medicolegal point of view which one of the following is NOT a sign of previous child
birth?

(a) Perineum is lax and there is evidence of scarring
(b) Introitus is gaping and there is presence of carunculae myrtiformis

--- Content provided by FirstRanker.com ---

(c) Abdomen is lax and loose with striae and linea alba
(d) Conical cervix with round external os

--- Content provided by FirstRanker.com ---

61.
The components of partograph are all EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Time
(b) Fetal heart rate
(c) Maternal respiratory rate
(d) Maternal urine analysis
62.

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Which of the following information are provided by partograph?

1. Colour of liquor
2. Uterine contractions with duration and frequency
3. Dilatation of cervix

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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
63.
Intraoperative recognition of ureter is by which of the following features?

--- Content provided by FirstRanker.com ---

1. Transparent tubular appearance
2. Pale glistening appearance
3. Longitudinal vessels on surface
4. Circumferential vessels on surface

--- Content provided by FirstRanker.com ---

Select the correct answer using the code given below:

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

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(d) 1 and 4
64.
Hysterosalpingography (HSG) is least helpful in detecting which of the following?

(a) Tubal patency

--- Content provided by FirstRanker.com ---

(b) Pelvic adhesions
(c) Asherman syndrome
(d) Congenital uterine anomaly

--- Content provided by FirstRanker.com ---

--- Content provided by FirstRanker.com ---

FirstRanker.com - FirstRanker's Choice
Combined Medical Services Examination-2020
Paper-II

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1.
Indications for fasciotomy in compartment syndrome include all EXCEPT:

(a) Distal sensory disturbance

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(b) Compartment pressure > 30 mm Hg
(c) Pain on passive movement of affected muscles
(d) Palpable distal pulses
2.
Which one of the following statements is NOT correct regarding Necrotising Soft Tissue

--- Content provided by FirstRanker.com ---

infections?

(a) Crepitus, skin blistering and focal skin gangrene are typical presenting features
(b) They are monomicrobial in nature
(c) Treatment consists of wide local excision and appropriate antibiotics

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(d) Tissue biopsy is required for culture and diagnosis
3.
Which type of surgery is laparoscopic cholecystectomy classified as?

(a) Clean

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(b) Clean contaminated
(c) Contaminated
(d) Dirty
4.
A 22-year female has presented with a history of malaise, cough, alternating constipation and

--- Content provided by FirstRanker.com ---

diarrhoea with intermittent abdominal pain for last 6 months. She also complains of
abdominal distension for last 2 days. On examination her abdomen has a doughy feel along
with an ill defined mass over the right lower quadrant. She is most likely suffering from:

(a) Appendicular lump

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(b) Ileocaecal tuberculosis
(c) Carcinoma caecum
(d) Ovarian mass
5.
Consider the following statements regarding needle stick injuries:

--- Content provided by FirstRanker.com ---

1. Injured part should be washed under running water
2. Dominant index finger is the commonest site for needle stick injury
3. All needle stick injuries should be reported
4. Hepatitis/HIV testing should be done after needle stick injury

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Which of the statements given above are correct?

(a) 1, 2 and 4
(b) 1, 2 and 3

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

--- Content provided by FirstRanker.com ---

6.
Consider the following statements regarding claudication:

1. It is a marker for silent coronary disease

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2. Structured exercise program ( 2 hours per week for 3 months) leads to
improvement in symptoms
3. Diabetes mellitus increases the risk and severity of claudication
4. Beta blockers may exacerbate claudication

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Which of the above statements are correct?

(a) 1 and 2 only
(b) 1, 3 and 4 only
(c) 2, 3 and 4 only

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(d) 1, 2, 3 and 4
7.
A 50-year old lady underwent uneventful bariatric surgery for morbid obesity. On the third
post operative day, she develops breathless and pulmonary embolism is suspected. The next
investigation to confirm the diagnosis will be:

--- Content provided by FirstRanker.com ---

(a) Echocardiography
(b) Duplex venography
(c) CT pulmonary angiography
(d) MR angiography

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8.
Medical management of thyrotoxic crisis includes all of the following EXCEPT:

(a) IV fluids
(b) IV propanolol

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(c) IV hydrocortisone
(d) IV antibiotics
9.
A patient operated for a parotid gland tumour developed symptoms of sweating and
erytherma (flushing) over the region of surgical excision while eating. The probable

--- Content provided by FirstRanker.com ---

diagnosis is:

(a) Parotid gland fistula
(b) Sialadenitis
(c) Chronic wound infection

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(d) Frey?s syndrome
10.
First line hormone therapy for post-menopausal woman with metastatic carcinoma breast is:

(a) Tamoxifen

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(b) Ovarian suppression by surgery
(c) Antiprogestins
(d) Anastrazole

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11.
All of the following are major subtypes of breast cancer based on Gene array analysis
EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Luminal A and Luminal B
(b) Triple negative
(c) Her-2 receptor positive
(d) Oestrogen receptor positive
12.

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All of the following are sequelae of peptic ulcer surgery EXCEPT:

(a) Bilious vomiting
(b) Dumping syndrome
(c) Diarrhoea

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(d) Increased appetite
13.
The Child-Turcotte-Pugh (CTP) score for quantifying the severity of chronic liver disease
includes all variables EXCEPT:

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(a) Serum bilirubin
(b) Serum albumin
(c) Serum creatinine
(d) INR (International Normalised Ratio)
14.

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?Chain of Lakes? appearance due to sacculation with intervening short strictures of pancreatic
duct is seen on:

(a) ERCP
(b) CECT abdomen

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(c) Plain X-ray abdomen
(d) Ultrasonography
15.
Which one of the following statements is NOT correct regarding Pyogenic Liver Abscess?

--- Content provided by FirstRanker.com ---

(a) Anorexia, fever, malaise and right upper quadrant abdominal discomfort are the
most common presenting features
(b) It is more common in elderly, diabetics and immunocompromised patients
(c) Treatment is with oral antibiotics alone
(d) Streptococcus milleri and escherichia coli are the most common causative

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organisms
16.
?Swiss cheese defects? are seen during laparoscopic repair of:

(a) Ventral hernia

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(b) Inguinal hernia
(c) Obturator hernia
(d) Femoral hernia

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17.
Which of the following are correct regarding splenic artery aneurysm?

1. Main arterial trunk is the common site

--- Content provided by FirstRanker.com ---

2. Palpable thrill can be felt
3. It is symptomless unless it ruptures

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

(a) 1 and 2 only
(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3
18.

--- Content provided by FirstRanker.com ---

Valentino?s syndrome is:

(a) Pain on per-vaginal examination in pelvic abscess
(b) Pain over left shoulder in left hypochondriac collection
(c) Pain over left groin in perirenal collection

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(d) Pain in right iliac fossa in perforated peptic ulcer
19.
Spontaneous bacterial peritonitis occurs due to:

(a) duodenal stump blowout

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(b) peptic ulcer perforation
(c) acute bacterial infection of ascites
(d) infection via fallopian tubes
20.
Structure not forming boundaries of the ?Triangle of doom? seen during laparoscopic

--- Content provided by FirstRanker.com ---

inguinal hernia surgery dissection is:

(a) Vas deferens
(b) Inferior epigastric artery
(c) Spermatic cord vessels

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(d) Peritoneum
21.
The term mid-line shift is associated with:

(a) Head injury

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(b) Chest injury
(c) Abdominal injury
(d) Limb injury
22.
Which one of the following cranial nerves does NOT supply to the external ear?

--- Content provided by FirstRanker.com ---

(a) Cranial nerve V
(b) Cranial nerve VI
(c) Cranial nerve VII
(d) Cranial nerve IX

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23.
Left Internal Mammary Artery (LIMA) has become the conduit of choice for Left Anterior
Descending (LAD) artery during coronary artery bypass grafting because:

--- Content provided by FirstRanker.com ---

(a) Long term patency rates are more than 98%
(b) It is close to LAD
(c) Atherosclerosis is never seen in this vessel
(d) It is very easy to harvest
24.

--- Content provided by FirstRanker.com ---

A 50-year old male with significant smoking history presented in the surgical emergency
with sudden severe breathlessness. Chest X-ray shows right sided Pneumothorax. The
appropriate management requires:

(a) Aspiration of air with 16-18 G cannula

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(b) Right chest drain of size 8-14 Fr
(c) Oxygen by face mask
(d) Mechanical ventilation
25.
Which one of the following statements regarding Felon is NOT correct?

--- Content provided by FirstRanker.com ---

(a) There is infection of the finger tip between specialised fibrous septa
(b) It is a painless condition
(c) Incision and drainage is the treatment of choice
(d) It is common in diabetics

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26.
The most common site for osteosarcoma is:

(a) Proximal femur
(b) Distal femur

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(c) Proximal humerus
(d) Distal humerus
27.
Rapid Sequence Induction is indicated in:

--- Content provided by FirstRanker.com ---

(a) Emergency surgery for intestinal obstruction
(b) Elective open hernia surgery
(c) Cardiopulmonary bypass surgery
(d) Elective laparoscopic surgery

--- Content provided by FirstRanker.com ---

28.
Which one of the following statements about Compartment Syndrome is NOT correct?

(a) It is commonest in a closed fracture
(b) Pain is on active movement but not on passive movement of muscles

--- Content provided by FirstRanker.com ---

(c) Fasciotomy is the treatment of choice
(d) Volkmann?s Ischaemic contractive is a late complication

--- Content provided by FirstRanker.com ---

29.
Which one of the following is NOT the strength of ultrasound as a diagnostic modality?

(a) No radiation

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(b) Short learning curve
(c) Inexpensive
(d) Allows dynamic studies to be done
30.
Which of the following statements regarding lymphoedema following breast cancer treatment

--- Content provided by FirstRanker.com ---

are correct?

1. Incidence has decreased due to rarely combined therapy of axillary LN dissection and
radiotherapy
2. Precipitating cause like LN metastasis is a major determinant

--- Content provided by FirstRanker.com ---

3. The condition is often painful
4. Oedematous limb is susceptible to bacterial infection

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

(a) 1, 2 and 3
(b) 2, 3 and 4
(c) 1, 3 and 4
(d) 1, 2 and 4
31.

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Which one of the following is NOT a risk factor for development of venous thrombosis in
surgical patients?

(a) Age > 60 years
(b) Pregnancy

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(c) Obesity (BMI > 30 kg/m
2
)
(d) Diabetes ( HbA1c > 7.5%)
32.

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Which one of the following is NOT a complication of massive blood transfusion?

(a) Coagulopathy
(b) Hypocalcaemia
(c) Hyperthermia

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(d) Hyperkalemia
33.
Stage III ?Pressure sore? is full thickness skin loss extending:

(a) into subcutaneous tissue but not through fascia

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(b) through subcutaneous tissue into fascia
(c) through subcutaneous tissue into fascia and muscles
(d) through subcutaneous tissue into fascia, muscles and bone

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34.
During subclavian vein puncture in a surgical ward suddenly a patient developed severe
breathlessness. On auscultation breath sound was absent and the ipsilateral chest was
tympanitic on percussion. The probable diagnosis is:

--- Content provided by FirstRanker.com ---

(a) Iatrogenic pneumothorax
(b) Introgenic hemothorax
(c) Spontaneous pneumothorax
(d) Tension pneumothorax

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35.
Kohler?s disease is avascular necrosis of :

(a) Lunate
(b) Capitellum of humerus

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(c) First metatarsal head
(d) Navicular
36.
Which one of the following is NOT true of Pyoderma gangrenosum?

--- Content provided by FirstRanker.com ---

(a) It is characterized by cutaneous ulceration with purple undermined edges
(b) It is often secondary to heightened immunological reactivity from another disease
process
(c) Cultures often show Gram positive Staphylococci
(d) Lesions generally respond to steroids

--- Content provided by FirstRanker.com ---

37.
Which of the following is NOT a tissue repair surgery for inguinal hernia repair?

(a) Bassini?s repair
(b) Shouldice repair

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(c) Stoppa?s repair
(d) Desarda repair
38.
Which one of the following type of meshes is recommended for intraperitoneal use in
abdominal wall hernia?

--- Content provided by FirstRanker.com ---

(a) Light weight, porous meshes
(b) Heavy weight, porous meshes
(c) Absorbable meshes
(d) Tissue separating meshes
39.

--- Content provided by FirstRanker.com ---

Which one of the following is NOT correct regarding MEN-1 syndrome?

(a) It involves parathyroid glands
(b) It involves pancreas
(c) It involves pituitary gland

--- Content provided by FirstRanker.com ---

(d) It involves pineal gland

40.
Which one of the following is NOT an electronic information site in surgery?

--- Content provided by FirstRanker.com ---

(a) Pubmed
(b) Embase
(c) Cochrane library
(d) National medical library
41.

--- Content provided by FirstRanker.com ---

Which one of the following statements regarding pre-conceptional counseling is NOT
correct?

(a) It is needed only in selected complicated pregnancies
(b) It helps in early detection of risk factors

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(c) It helps in reducing maternal morbidity and mortality
(d) It is a part of preventive medicine
42.
Consider the following statements regarding Non Stress Test (NST):

--- Content provided by FirstRanker.com ---

1. Reactive NST indicates a healthy fetus
2. NST is an observed association of fetal breathing with fetal movements
3. NST has a low false negative rate (< 1%) but high false positive rate (>50%)
4. Testing should be started at 20 weeks

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Which of the statement(s) given above is/are correct?

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

--- Content provided by FirstRanker.com ---

(d) 1 and 4
43.
Which one of the following is a protective factor for endometrial hyperplasia?

(a) Diabetes

--- Content provided by FirstRanker.com ---

(b) Tamoxifen therapy
(c) Multiparity
(d) Delayed menopause
44.
A woman who is not breast feeding her newborn child is advised to use a contraceptive

--- Content provided by FirstRanker.com ---

method by:

(a) 3
rd
postpartum week

--- Content provided by FirstRanker.com ---

(b) 6
th
postpartum week
(c) 3
rd

--- Content provided by FirstRanker.com ---

postpartum month
(d) 6
th
postpartum month

--- Content provided by FirstRanker.com ---

45.

--- Content provided by FirstRanker.com ---

Pearl index for contraceptive effectiveness is calculated in terms of which of the following?

1. Pregnancy rate
2. Abortion rate
3. Hundred woman years

--- Content provided by FirstRanker.com ---

4. Thousand woman years

Select the correct answer using the code given below:

(a) 1 only

--- Content provided by FirstRanker.com ---

(b) 2 and 3
(c) 1, 2 and 4
(d) 1 and 3
46.
Indications for removal of IUDs are all EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Perforation of uterus
(b) Cyclical menstrual bleeding
(c) Flaring up of salpingitis
(d) Pregnancy with IUD

--- Content provided by FirstRanker.com ---

47.
Contraindications for insertion of IUDs are all EXCEPT:

(a) Suspected pregnancy
(b) Trophoblastic disease

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(c) Severe dysmenorrhea
(d) During cesarean section
48.
Which one of the following is NOT a contraindication for use of Mini pill?

--- Content provided by FirstRanker.com ---

(a) Pregnancy
(b) Breast feeding
(c) Thromboembolic disease
(d) History of breast cancer
49.

--- Content provided by FirstRanker.com ---

Which one of the following is the most commonly used surgical method/technique of female
sterilization as recommended by Government of India?

(a) Uchida technique
(b) Irving method

--- Content provided by FirstRanker.com ---

(c) Pomeroy?s method
(d) Madlener technique

--- Content provided by FirstRanker.com ---

50.

--- Content provided by FirstRanker.com ---

Which of the following is/are required for a registered medical practitioner to qualify for
performing Medical Termination of Pregnancy (MTP), as per revised rules of MTP Act?

1. Certified for assisting at least 15 MTP in an authorized centre
2. Diploma or degree in Obstetrics and Gynaecology

--- Content provided by FirstRanker.com ---

3. House surgeon training for 3 months in Obstetrics and Gynaecology
4. Certified training for 6 months in laparoscopic surgeries

Select the correct answer using the code given below:
(a) 1 only

--- Content provided by FirstRanker.com ---

(b) 2 only
(c) 1, 2 and 3
(d) 1, 2 and 4
51.
Which one of the following is NOT a support of uterus, preventing its descent?

--- Content provided by FirstRanker.com ---

(a) Endopelvic fascia
(b) Mackenrodt?s ligament
(c) Inguinal ligament
(d) Pubocervical ligament

--- Content provided by FirstRanker.com ---

52.
As per ICMR guidelines, which one of the following statements is true regarding effects of
COVID-19 on fetus according to current evidence?

(a) There is increased risk of early pregnancy loss

--- Content provided by FirstRanker.com ---

(b) COVID-19 virus is not teratogenic
(c) COVID-19 virus infection is an indication of MTP
(d) There is increased risk of fetal growth restriction
53.
As per ICMR guidelines, which one of the following statements is true regarding COVID-19

--- Content provided by FirstRanker.com ---

infection in pregnancy?

(a) Covid-19 pneumonia in pregnancy is more severe with poor recovery
(b) Pregnant women with heart disease are at higher risk
(c) Vaginal secretions always test positive for COVID-19 in pregnancy

--- Content provided by FirstRanker.com ---

(d) COVID-19 virus is secreted in breast milk
54.
Which one of the following is NOT a method of management of Deep Transverse Arrest with
the living fetus?

--- Content provided by FirstRanker.com ---

(a) Caesarean section
(b) Delivery by ventouse
(c) Delivery by application of forceps to the unrotated head
(d) Manual rotation and application of forceps

--- Content provided by FirstRanker.com ---

55.

--- Content provided by FirstRanker.com ---

Successful version of breech presentation is likely in case all of the following EXCEPT:

(a) Breech with extended legs
(b) Complete breech with sacroanterior position
(c) Non engaged breech

--- Content provided by FirstRanker.com ---

(d) Adequate amniotic fluid
56.
Implantation of a fertilised ovum occurs on which day following fertilisation?

(a) Day 6

--- Content provided by FirstRanker.com ---

(b) Day 10
(c) Day 14
(d) Day 20
57.
During total abdominal hysterectomy the ureter is likely to undergo injury or ligation during

--- Content provided by FirstRanker.com ---

the following steps EXCEPT:

(a) During division and ligation of the round ligaments
(b) During division and ligation of infundibulopelvic ligaments
(c) During division and ligation of mackenrodt?s and uterosacral ligaments

--- Content provided by FirstRanker.com ---

(d) At the vaginal angles while incising the vagina to remove the cervix with the
uterus
58.
The net effect of antenatal care has been the following EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Reduction in maternal mortality
(b) Reduction in perinatal mortality
(c) Reduction in the incidence of institutional delivery
(d) Reduction in maternal morbidity
59.

--- Content provided by FirstRanker.com ---

Which one of the following is NOT a component of active phase in the partograph?

(a) Acceleration phase
(b) Phase of maximum slope
(c) Phase of deceleration

--- Content provided by FirstRanker.com ---

(d) Phase of expulsion
60.
From medicolegal point of view which one of the following is NOT a sign of previous child
birth?

--- Content provided by FirstRanker.com ---

(a) Perineum is lax and there is evidence of scarring
(b) Introitus is gaping and there is presence of carunculae myrtiformis
(c) Abdomen is lax and loose with striae and linea alba
(d) Conical cervix with round external os

--- Content provided by FirstRanker.com ---

61.

--- Content provided by FirstRanker.com ---

The components of partograph are all EXCEPT:

(a) Time
(b) Fetal heart rate
(c) Maternal respiratory rate

--- Content provided by FirstRanker.com ---

(d) Maternal urine analysis
62.
Which of the following information are provided by partograph?

1. Colour of liquor

--- Content provided by FirstRanker.com ---

2. Uterine contractions with duration and frequency
3. Dilatation of cervix

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

(a) 1 and 2 only
(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3
63.

--- Content provided by FirstRanker.com ---

Intraoperative recognition of ureter is by which of the following features?

1. Transparent tubular appearance
2. Pale glistening appearance
3. Longitudinal vessels on surface

--- Content provided by FirstRanker.com ---

4. Circumferential vessels on surface

Select the correct answer using the code given below:

(a) 1 and 3

--- Content provided by FirstRanker.com ---

(b) 2 and 4
(c) 2 and 3
(d) 1 and 4
64.
Hysterosalpingography (HSG) is least helpful in detecting which of the following?

--- Content provided by FirstRanker.com ---

(a) Tubal patency
(b) Pelvic adhesions
(c) Asherman syndrome
(d) Congenital uterine anomaly

--- Content provided by FirstRanker.com ---

--- Content provided by FirstRanker.com ---

65.

--- Content provided by FirstRanker.com ---

Which of the following are characteristics of Trichomonas vaginitis?

1. Presence of greenish frothy discharge
2. Vaginal pH > 4.5
3. Presence of clue cells in microscopic examination

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4. Strawberry spots on the vaginal mucosa

Select the correct answer using the code given below:

(a) 1, 2 and 3

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(b) 1, 2 and 4
(c) 2, 3 and 4
(d) 1, 3 and 4
66.
Tumor marker of epithelial ovarian carcinoma is:

--- Content provided by FirstRanker.com ---

(a) Ca.125
(b) Alpha feto protein
(c) Beta HCG
(d) LDH

--- Content provided by FirstRanker.com ---

67.
The most common site of cervical cancer is:

(a) Endocervix
(b) Ectocervix

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(c) Transformation zone
(d) Isthmus
68.
The placenta synthesizes all EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Oestriol
(b) Corticotrophin releasing hormone
(c) PAPP-A(Pregnancy Associated Plasma Protein A)
(d) Dehydroepiandrosterone
69.

--- Content provided by FirstRanker.com ---

Withdrawal bleeding following administration of progesterone in a case of secondary
amenorrhea indicates all EXCEPT:

(a) Absence of pregnancy
(b) Production endogenous estrogen

--- Content provided by FirstRanker.com ---

(c) Endometrium is responsive to estrogen
(d) Defect in pituitary gland
70.
Monilial vaginitis is commonly associated with all EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Prolonged antibiotic therapy
(b) Diabetes Mellitus
(c) Treatment of malaria with chloroquine
(d) Pregnancy
FirstRanker.com - FirstRanker's Choice

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Combined Medical Services Examination-2020
Paper-II

1.
Indications for fasciotomy in compartment syndrome include all EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Distal sensory disturbance
(b) Compartment pressure > 30 mm Hg
(c) Pain on passive movement of affected muscles
(d) Palpable distal pulses

--- Content provided by FirstRanker.com ---

2.
Which one of the following statements is NOT correct regarding Necrotising Soft Tissue
infections?

(a) Crepitus, skin blistering and focal skin gangrene are typical presenting features

--- Content provided by FirstRanker.com ---

(b) They are monomicrobial in nature
(c) Treatment consists of wide local excision and appropriate antibiotics
(d) Tissue biopsy is required for culture and diagnosis
3.
Which type of surgery is laparoscopic cholecystectomy classified as?

--- Content provided by FirstRanker.com ---

(a) Clean
(b) Clean contaminated
(c) Contaminated
(d) Dirty

--- Content provided by FirstRanker.com ---

4.
A 22-year female has presented with a history of malaise, cough, alternating constipation and
diarrhoea with intermittent abdominal pain for last 6 months. She also complains of
abdominal distension for last 2 days. On examination her abdomen has a doughy feel along
with an ill defined mass over the right lower quadrant. She is most likely suffering from:

--- Content provided by FirstRanker.com ---

(a) Appendicular lump
(b) Ileocaecal tuberculosis
(c) Carcinoma caecum
(d) Ovarian mass

--- Content provided by FirstRanker.com ---

5.
Consider the following statements regarding needle stick injuries:

1. Injured part should be washed under running water
2. Dominant index finger is the commonest site for needle stick injury

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3. All needle stick injuries should be reported
4. Hepatitis/HIV testing should be done after needle stick injury

Which of the statements given above are correct?

--- Content provided by FirstRanker.com ---

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

--- Content provided by FirstRanker.com ---

6.
Consider the following statements regarding claudication:

--- Content provided by FirstRanker.com ---

1. It is a marker for silent coronary disease
2. Structured exercise program ( 2 hours per week for 3 months) leads to
improvement in symptoms
3. Diabetes mellitus increases the risk and severity of claudication

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4. Beta blockers may exacerbate claudication

Which of the above statements are correct?

(a) 1 and 2 only

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(b) 1, 3 and 4 only
(c) 2, 3 and 4 only
(d) 1, 2, 3 and 4
7.
A 50-year old lady underwent uneventful bariatric surgery for morbid obesity. On the third

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post operative day, she develops breathless and pulmonary embolism is suspected. The next
investigation to confirm the diagnosis will be:

(a) Echocardiography
(b) Duplex venography

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(c) CT pulmonary angiography
(d) MR angiography
8.
Medical management of thyrotoxic crisis includes all of the following EXCEPT:

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(a) IV fluids
(b) IV propanolol
(c) IV hydrocortisone
(d) IV antibiotics
9.

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A patient operated for a parotid gland tumour developed symptoms of sweating and
erytherma (flushing) over the region of surgical excision while eating. The probable
diagnosis is:

(a) Parotid gland fistula

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(b) Sialadenitis
(c) Chronic wound infection
(d) Frey?s syndrome
10.
First line hormone therapy for post-menopausal woman with metastatic carcinoma breast is:

--- Content provided by FirstRanker.com ---

(a) Tamoxifen
(b) Ovarian suppression by surgery
(c) Antiprogestins
(d) Anastrazole

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11.
All of the following are major subtypes of breast cancer based on Gene array analysis

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EXCEPT:

(a) Luminal A and Luminal B
(b) Triple negative
(c) Her-2 receptor positive

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(d) Oestrogen receptor positive
12.
All of the following are sequelae of peptic ulcer surgery EXCEPT:

(a) Bilious vomiting

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(b) Dumping syndrome
(c) Diarrhoea
(d) Increased appetite
13.
The Child-Turcotte-Pugh (CTP) score for quantifying the severity of chronic liver disease

--- Content provided by FirstRanker.com ---

includes all variables EXCEPT:

(a) Serum bilirubin
(b) Serum albumin
(c) Serum creatinine

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(d) INR (International Normalised Ratio)
14.
?Chain of Lakes? appearance due to sacculation with intervening short strictures of pancreatic
duct is seen on:

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(a) ERCP
(b) CECT abdomen
(c) Plain X-ray abdomen
(d) Ultrasonography
15.

--- Content provided by FirstRanker.com ---

Which one of the following statements is NOT correct regarding Pyogenic Liver Abscess?

(a) Anorexia, fever, malaise and right upper quadrant abdominal discomfort are the
most common presenting features
(b) It is more common in elderly, diabetics and immunocompromised patients

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(c) Treatment is with oral antibiotics alone
(d) Streptococcus milleri and escherichia coli are the most common causative
organisms
16.
?Swiss cheese defects? are seen during laparoscopic repair of:

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(a) Ventral hernia
(b) Inguinal hernia
(c) Obturator hernia
(d) Femoral hernia

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17.
Which of the following are correct regarding splenic artery aneurysm?

--- Content provided by FirstRanker.com ---

1. Main arterial trunk is the common site
2. Palpable thrill can be felt
3. It is symptomless unless it ruptures

--- Content provided by FirstRanker.com ---

Select the correct answer using the code given below:

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

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(d) 1, 2 and 3
18.
Valentino?s syndrome is:

(a) Pain on per-vaginal examination in pelvic abscess

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(b) Pain over left shoulder in left hypochondriac collection
(c) Pain over left groin in perirenal collection
(d) Pain in right iliac fossa in perforated peptic ulcer
19.
Spontaneous bacterial peritonitis occurs due to:

--- Content provided by FirstRanker.com ---

(a) duodenal stump blowout
(b) peptic ulcer perforation
(c) acute bacterial infection of ascites
(d) infection via fallopian tubes

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20.
Structure not forming boundaries of the ?Triangle of doom? seen during laparoscopic
inguinal hernia surgery dissection is:

(a) Vas deferens

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(b) Inferior epigastric artery
(c) Spermatic cord vessels
(d) Peritoneum
21.
The term mid-line shift is associated with:

--- Content provided by FirstRanker.com ---

(a) Head injury
(b) Chest injury
(c) Abdominal injury
(d) Limb injury

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22.
Which one of the following cranial nerves does NOT supply to the external ear?

(a) Cranial nerve V
(b) Cranial nerve VI

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(c) Cranial nerve VII
(d) Cranial nerve IX

23.
Left Internal Mammary Artery (LIMA) has become the conduit of choice for Left Anterior

--- Content provided by FirstRanker.com ---

Descending (LAD) artery during coronary artery bypass grafting because:

(a) Long term patency rates are more than 98%
(b) It is close to LAD
(c) Atherosclerosis is never seen in this vessel

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(d) It is very easy to harvest
24.
A 50-year old male with significant smoking history presented in the surgical emergency
with sudden severe breathlessness. Chest X-ray shows right sided Pneumothorax. The
appropriate management requires:

--- Content provided by FirstRanker.com ---

(a) Aspiration of air with 16-18 G cannula
(b) Right chest drain of size 8-14 Fr
(c) Oxygen by face mask
(d) Mechanical ventilation

--- Content provided by FirstRanker.com ---

25.
Which one of the following statements regarding Felon is NOT correct?

(a) There is infection of the finger tip between specialised fibrous septa
(b) It is a painless condition

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(c) Incision and drainage is the treatment of choice
(d) It is common in diabetics
26.
The most common site for osteosarcoma is:

--- Content provided by FirstRanker.com ---

(a) Proximal femur
(b) Distal femur
(c) Proximal humerus
(d) Distal humerus
27.

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Rapid Sequence Induction is indicated in:

(a) Emergency surgery for intestinal obstruction
(b) Elective open hernia surgery
(c) Cardiopulmonary bypass surgery

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(d) Elective laparoscopic surgery

28.
Which one of the following statements about Compartment Syndrome is NOT correct?

--- Content provided by FirstRanker.com ---

(a) It is commonest in a closed fracture
(b) Pain is on active movement but not on passive movement of muscles
(c) Fasciotomy is the treatment of choice
(d) Volkmann?s Ischaemic contractive is a late complication

--- Content provided by FirstRanker.com ---

29.
Which one of the following is NOT the strength of ultrasound as a diagnostic modality?

--- Content provided by FirstRanker.com ---

(a) No radiation
(b) Short learning curve
(c) Inexpensive
(d) Allows dynamic studies to be done

--- Content provided by FirstRanker.com ---

30.
Which of the following statements regarding lymphoedema following breast cancer treatment
are correct?

1. Incidence has decreased due to rarely combined therapy of axillary LN dissection and

--- Content provided by FirstRanker.com ---

radiotherapy
2. Precipitating cause like LN metastasis is a major determinant
3. The condition is often painful
4. Oedematous limb is susceptible to bacterial infection

--- Content provided by FirstRanker.com ---

Select the correct answer using the code given below:

(a) 1, 2 and 3
(b) 2, 3 and 4
(c) 1, 3 and 4

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(d) 1, 2 and 4
31.
Which one of the following is NOT a risk factor for development of venous thrombosis in
surgical patients?

--- Content provided by FirstRanker.com ---

(a) Age > 60 years
(b) Pregnancy
(c) Obesity (BMI > 30 kg/m
2
)

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(d) Diabetes ( HbA1c > 7.5%)
32.
Which one of the following is NOT a complication of massive blood transfusion?

(a) Coagulopathy

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(b) Hypocalcaemia
(c) Hyperthermia
(d) Hyperkalemia
33.
Stage III ?Pressure sore? is full thickness skin loss extending:

--- Content provided by FirstRanker.com ---

(a) into subcutaneous tissue but not through fascia
(b) through subcutaneous tissue into fascia
(c) through subcutaneous tissue into fascia and muscles
(d) through subcutaneous tissue into fascia, muscles and bone

--- Content provided by FirstRanker.com ---

34.
During subclavian vein puncture in a surgical ward suddenly a patient developed severe

--- Content provided by FirstRanker.com ---

breathlessness. On auscultation breath sound was absent and the ipsilateral chest was
tympanitic on percussion. The probable diagnosis is:

(a) Iatrogenic pneumothorax
(b) Introgenic hemothorax

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(c) Spontaneous pneumothorax
(d) Tension pneumothorax
35.
Kohler?s disease is avascular necrosis of :

--- Content provided by FirstRanker.com ---

(a) Lunate
(b) Capitellum of humerus
(c) First metatarsal head
(d) Navicular
36.

--- Content provided by FirstRanker.com ---

Which one of the following is NOT true of Pyoderma gangrenosum?

(a) It is characterized by cutaneous ulceration with purple undermined edges
(b) It is often secondary to heightened immunological reactivity from another disease
process

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(c) Cultures often show Gram positive Staphylococci
(d) Lesions generally respond to steroids
37.
Which of the following is NOT a tissue repair surgery for inguinal hernia repair?

--- Content provided by FirstRanker.com ---

(a) Bassini?s repair
(b) Shouldice repair
(c) Stoppa?s repair
(d) Desarda repair
38.

--- Content provided by FirstRanker.com ---

Which one of the following type of meshes is recommended for intraperitoneal use in
abdominal wall hernia?
(a) Light weight, porous meshes
(b) Heavy weight, porous meshes
(c) Absorbable meshes

--- Content provided by FirstRanker.com ---

(d) Tissue separating meshes
39.
Which one of the following is NOT correct regarding MEN-1 syndrome?

(a) It involves parathyroid glands

--- Content provided by FirstRanker.com ---

(b) It involves pancreas
(c) It involves pituitary gland
(d) It involves pineal gland

40.

--- Content provided by FirstRanker.com ---

Which one of the following is NOT an electronic information site in surgery?

(a) Pubmed
(b) Embase
(c) Cochrane library

--- Content provided by FirstRanker.com ---

(d) National medical library
41.
Which one of the following statements regarding pre-conceptional counseling is NOT
correct?

--- Content provided by FirstRanker.com ---

(a) It is needed only in selected complicated pregnancies
(b) It helps in early detection of risk factors
(c) It helps in reducing maternal morbidity and mortality
(d) It is a part of preventive medicine
42.

--- Content provided by FirstRanker.com ---

Consider the following statements regarding Non Stress Test (NST):

1. Reactive NST indicates a healthy fetus
2. NST is an observed association of fetal breathing with fetal movements
3. NST has a low false negative rate (< 1%) but high false positive rate (>50%)

--- Content provided by FirstRanker.com ---

4. Testing should be started at 20 weeks

Which of the statement(s) given above is/are correct?

(a) 1 and 3

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(b) 2 only
(c) 3 only
(d) 1 and 4
43.
Which one of the following is a protective factor for endometrial hyperplasia?

--- Content provided by FirstRanker.com ---

(a) Diabetes
(b) Tamoxifen therapy
(c) Multiparity
(d) Delayed menopause

--- Content provided by FirstRanker.com ---

44.
A woman who is not breast feeding her newborn child is advised to use a contraceptive
method by:

(a) 3

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rd
postpartum week
(b) 6
th
postpartum week

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(c) 3
rd
postpartum month
(d) 6
th

--- Content provided by FirstRanker.com ---

postpartum month

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45.
Pearl index for contraceptive effectiveness is calculated in terms of which of the following?

1. Pregnancy rate

--- Content provided by FirstRanker.com ---

2. Abortion rate
3. Hundred woman years
4. Thousand woman years

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

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

--- Content provided by FirstRanker.com ---

46.
Indications for removal of IUDs are all EXCEPT:

(a) Perforation of uterus
(b) Cyclical menstrual bleeding

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(c) Flaring up of salpingitis
(d) Pregnancy with IUD
47.
Contraindications for insertion of IUDs are all EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Suspected pregnancy
(b) Trophoblastic disease
(c) Severe dysmenorrhea
(d) During cesarean section
48.

--- Content provided by FirstRanker.com ---

Which one of the following is NOT a contraindication for use of Mini pill?

(a) Pregnancy
(b) Breast feeding
(c) Thromboembolic disease

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(d) History of breast cancer
49.
Which one of the following is the most commonly used surgical method/technique of female
sterilization as recommended by Government of India?

--- Content provided by FirstRanker.com ---

(a) Uchida technique
(b) Irving method
(c) Pomeroy?s method
(d) Madlener technique

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--- Content provided by FirstRanker.com ---

50.
Which of the following is/are required for a registered medical practitioner to qualify for
performing Medical Termination of Pregnancy (MTP), as per revised rules of MTP Act?

--- Content provided by FirstRanker.com ---

1. Certified for assisting at least 15 MTP in an authorized centre
2. Diploma or degree in Obstetrics and Gynaecology
3. House surgeon training for 3 months in Obstetrics and Gynaecology
4. Certified training for 6 months in laparoscopic surgeries

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

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51.
Which one of the following is NOT a support of uterus, preventing its descent?

(a) Endopelvic fascia
(b) Mackenrodt?s ligament

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(c) Inguinal ligament
(d) Pubocervical ligament
52.
As per ICMR guidelines, which one of the following statements is true regarding effects of
COVID-19 on fetus according to current evidence?

--- Content provided by FirstRanker.com ---

(a) There is increased risk of early pregnancy loss
(b) COVID-19 virus is not teratogenic
(c) COVID-19 virus infection is an indication of MTP
(d) There is increased risk of fetal growth restriction

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53.
As per ICMR guidelines, which one of the following statements is true regarding COVID-19
infection in pregnancy?

(a) Covid-19 pneumonia in pregnancy is more severe with poor recovery

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(b) Pregnant women with heart disease are at higher risk
(c) Vaginal secretions always test positive for COVID-19 in pregnancy
(d) COVID-19 virus is secreted in breast milk
54.
Which one of the following is NOT a method of management of Deep Transverse Arrest with

--- Content provided by FirstRanker.com ---

the living fetus?

(a) Caesarean section
(b) Delivery by ventouse
(c) Delivery by application of forceps to the unrotated head

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(d) Manual rotation and application of forceps

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55.
Successful version of breech presentation is likely in case all of the following EXCEPT:

(a) Breech with extended legs

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(b) Complete breech with sacroanterior position
(c) Non engaged breech
(d) Adequate amniotic fluid
56.
Implantation of a fertilised ovum occurs on which day following fertilisation?

--- Content provided by FirstRanker.com ---

(a) Day 6
(b) Day 10
(c) Day 14
(d) Day 20

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57.
During total abdominal hysterectomy the ureter is likely to undergo injury or ligation during
the following steps EXCEPT:

(a) During division and ligation of the round ligaments

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(b) During division and ligation of infundibulopelvic ligaments
(c) During division and ligation of mackenrodt?s and uterosacral ligaments
(d) At the vaginal angles while incising the vagina to remove the cervix with the
uterus
58.

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The net effect of antenatal care has been the following EXCEPT:

(a) Reduction in maternal mortality
(b) Reduction in perinatal mortality
(c) Reduction in the incidence of institutional delivery

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(d) Reduction in maternal morbidity
59.
Which one of the following is NOT a component of active phase in the partograph?

(a) Acceleration phase

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(b) Phase of maximum slope
(c) Phase of deceleration
(d) Phase of expulsion
60.
From medicolegal point of view which one of the following is NOT a sign of previous child

--- Content provided by FirstRanker.com ---

birth?

(a) Perineum is lax and there is evidence of scarring
(b) Introitus is gaping and there is presence of carunculae myrtiformis
(c) Abdomen is lax and loose with striae and linea alba

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(d) Conical cervix with round external os

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61.
The components of partograph are all EXCEPT:

(a) Time

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(b) Fetal heart rate
(c) Maternal respiratory rate
(d) Maternal urine analysis
62.
Which of the following information are provided by partograph?

--- Content provided by FirstRanker.com ---

1. Colour of liquor
2. Uterine contractions with duration and frequency
3. Dilatation of cervix

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Select the correct answer using the code given below:

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

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(d) 1, 2 and 3
63.
Intraoperative recognition of ureter is by which of the following features?

1. Transparent tubular appearance

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2. Pale glistening appearance
3. Longitudinal vessels on surface
4. Circumferential vessels on surface

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

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

--- Content provided by FirstRanker.com ---

64.
Hysterosalpingography (HSG) is least helpful in detecting which of the following?

(a) Tubal patency
(b) Pelvic adhesions

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(c) Asherman syndrome
(d) Congenital uterine anomaly

--- Content provided by FirstRanker.com ---

--- Content provided by FirstRanker.com ---

65.
Which of the following are characteristics of Trichomonas vaginitis?

1. Presence of greenish frothy discharge

--- Content provided by FirstRanker.com ---

2. Vaginal pH > 4.5
3. Presence of clue cells in microscopic examination
4. Strawberry spots on the vaginal mucosa

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

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

--- Content provided by FirstRanker.com ---

66.
Tumor marker of epithelial ovarian carcinoma is:

(a) Ca.125
(b) Alpha feto protein

--- Content provided by FirstRanker.com ---

(c) Beta HCG
(d) LDH
67.
The most common site of cervical cancer is:

--- Content provided by FirstRanker.com ---

(a) Endocervix
(b) Ectocervix
(c) Transformation zone
(d) Isthmus
68.

--- Content provided by FirstRanker.com ---

The placenta synthesizes all EXCEPT:

(a) Oestriol
(b) Corticotrophin releasing hormone
(c) PAPP-A(Pregnancy Associated Plasma Protein A)

--- Content provided by FirstRanker.com ---

(d) Dehydroepiandrosterone
69.
Withdrawal bleeding following administration of progesterone in a case of secondary
amenorrhea indicates all EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Absence of pregnancy
(b) Production endogenous estrogen
(c) Endometrium is responsive to estrogen
(d) Defect in pituitary gland
70.

--- Content provided by FirstRanker.com ---

Monilial vaginitis is commonly associated with all EXCEPT:

(a) Prolonged antibiotic therapy
(b) Diabetes Mellitus
(c) Treatment of malaria with chloroquine

--- Content provided by FirstRanker.com ---

(d) Pregnancy
71.
Which one of the following is NOT a risk factor for the development of placenta previa?

(a) Maternal age

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(b) Smoking
(c) Previous caesarean section
(d) Maternal anaemia
72.
Common clinical presentations of moderate to severe abruption are all EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Uterine tenderness
(b) Fetal distress
(c) Unexplained pre term labour
(d) Prolonged labour

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73.
Common trisomies resulting in spontaneous abortion are all EXCEPT:

(a) Trisomy 21
(b) Trisomy 18

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(c) Trisomy 16
(d) Trisomy 1
74.
The initial prevention strategy for antiphospholipid syndrome will be:

--- Content provided by FirstRanker.com ---

1. Steroids
2. Heparin
3. Low dose aspirin
4. Progesterone support

--- Content provided by FirstRanker.com ---

Which of the above is/are correct?

(a) 2 and 3
(b) 3 and 4
(c) 3 only

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(d) 1 and 4
75.
Diagnostic criteria for PCOD are:

1. Oligo/amenorrohoea

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2. Hyperandrogenism
3. Polycystic ovaries on ultrasound

Which of the above are correct?

--- Content provided by FirstRanker.com ---

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

--- Content provided by FirstRanker.com ---

FirstRanker.com - FirstRanker's Choice
Combined Medical Services Examination-2020
Paper-II

--- Content provided by FirstRanker.com ---

1.
Indications for fasciotomy in compartment syndrome include all EXCEPT:

(a) Distal sensory disturbance
(b) Compartment pressure > 30 mm Hg

--- Content provided by FirstRanker.com ---

(c) Pain on passive movement of affected muscles
(d) Palpable distal pulses
2.
Which one of the following statements is NOT correct regarding Necrotising Soft Tissue
infections?

--- Content provided by FirstRanker.com ---

(a) Crepitus, skin blistering and focal skin gangrene are typical presenting features
(b) They are monomicrobial in nature
(c) Treatment consists of wide local excision and appropriate antibiotics
(d) Tissue biopsy is required for culture and diagnosis

--- Content provided by FirstRanker.com ---

3.
Which type of surgery is laparoscopic cholecystectomy classified as?

(a) Clean
(b) Clean contaminated

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(c) Contaminated
(d) Dirty
4.
A 22-year female has presented with a history of malaise, cough, alternating constipation and
diarrhoea with intermittent abdominal pain for last 6 months. She also complains of

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abdominal distension for last 2 days. On examination her abdomen has a doughy feel along
with an ill defined mass over the right lower quadrant. She is most likely suffering from:

(a) Appendicular lump
(b) Ileocaecal tuberculosis

--- Content provided by FirstRanker.com ---

(c) Carcinoma caecum
(d) Ovarian mass
5.
Consider the following statements regarding needle stick injuries:

--- Content provided by FirstRanker.com ---

1. Injured part should be washed under running water
2. Dominant index finger is the commonest site for needle stick injury
3. All needle stick injuries should be reported
4. Hepatitis/HIV testing should be done after needle stick injury

--- Content provided by FirstRanker.com ---

Which of the statements given above are correct?

(a) 1, 2 and 4
(b) 1, 2 and 3
(c) 1, 3 and 4

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(d) 2, 3 and 4

--- Content provided by FirstRanker.com ---

6.
Consider the following statements regarding claudication:

1. It is a marker for silent coronary disease
2. Structured exercise program ( 2 hours per week for 3 months) leads to

--- Content provided by FirstRanker.com ---

improvement in symptoms
3. Diabetes mellitus increases the risk and severity of claudication
4. Beta blockers may exacerbate claudication

Which of the above statements are correct?

--- Content provided by FirstRanker.com ---

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

--- Content provided by FirstRanker.com ---

7.
A 50-year old lady underwent uneventful bariatric surgery for morbid obesity. On the third
post operative day, she develops breathless and pulmonary embolism is suspected. The next
investigation to confirm the diagnosis will be:

--- Content provided by FirstRanker.com ---

(a) Echocardiography
(b) Duplex venography
(c) CT pulmonary angiography
(d) MR angiography
8.

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Medical management of thyrotoxic crisis includes all of the following EXCEPT:

(a) IV fluids
(b) IV propanolol
(c) IV hydrocortisone

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(d) IV antibiotics
9.
A patient operated for a parotid gland tumour developed symptoms of sweating and
erytherma (flushing) over the region of surgical excision while eating. The probable
diagnosis is:

--- Content provided by FirstRanker.com ---

(a) Parotid gland fistula
(b) Sialadenitis
(c) Chronic wound infection
(d) Frey?s syndrome

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10.
First line hormone therapy for post-menopausal woman with metastatic carcinoma breast is:

(a) Tamoxifen
(b) Ovarian suppression by surgery

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(c) Antiprogestins
(d) Anastrazole

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11.
All of the following are major subtypes of breast cancer based on Gene array analysis
EXCEPT:

(a) Luminal A and Luminal B

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(b) Triple negative
(c) Her-2 receptor positive
(d) Oestrogen receptor positive
12.
All of the following are sequelae of peptic ulcer surgery EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Bilious vomiting
(b) Dumping syndrome
(c) Diarrhoea
(d) Increased appetite

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13.
The Child-Turcotte-Pugh (CTP) score for quantifying the severity of chronic liver disease
includes all variables EXCEPT:

(a) Serum bilirubin

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(b) Serum albumin
(c) Serum creatinine
(d) INR (International Normalised Ratio)
14.
?Chain of Lakes? appearance due to sacculation with intervening short strictures of pancreatic

--- Content provided by FirstRanker.com ---

duct is seen on:

(a) ERCP
(b) CECT abdomen
(c) Plain X-ray abdomen

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(d) Ultrasonography
15.
Which one of the following statements is NOT correct regarding Pyogenic Liver Abscess?

(a) Anorexia, fever, malaise and right upper quadrant abdominal discomfort are the

--- Content provided by FirstRanker.com ---

most common presenting features
(b) It is more common in elderly, diabetics and immunocompromised patients
(c) Treatment is with oral antibiotics alone
(d) Streptococcus milleri and escherichia coli are the most common causative
organisms

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16.
?Swiss cheese defects? are seen during laparoscopic repair of:

(a) Ventral hernia
(b) Inguinal hernia

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(c) Obturator hernia
(d) Femoral hernia

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17.
Which of the following are correct regarding splenic artery aneurysm?

1. Main arterial trunk is the common site
2. Palpable thrill can be felt

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3. It is symptomless unless it ruptures

Select the correct answer using the code given below:

(a) 1 and 2 only

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(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3
18.
Valentino?s syndrome is:

--- Content provided by FirstRanker.com ---

(a) Pain on per-vaginal examination in pelvic abscess
(b) Pain over left shoulder in left hypochondriac collection
(c) Pain over left groin in perirenal collection
(d) Pain in right iliac fossa in perforated peptic ulcer

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19.
Spontaneous bacterial peritonitis occurs due to:

(a) duodenal stump blowout
(b) peptic ulcer perforation

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(c) acute bacterial infection of ascites
(d) infection via fallopian tubes
20.
Structure not forming boundaries of the ?Triangle of doom? seen during laparoscopic
inguinal hernia surgery dissection is:

--- Content provided by FirstRanker.com ---

(a) Vas deferens
(b) Inferior epigastric artery
(c) Spermatic cord vessels
(d) Peritoneum

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21.
The term mid-line shift is associated with:

(a) Head injury
(b) Chest injury

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(c) Abdominal injury
(d) Limb injury
22.
Which one of the following cranial nerves does NOT supply to the external ear?

--- Content provided by FirstRanker.com ---

(a) Cranial nerve V
(b) Cranial nerve VI
(c) Cranial nerve VII
(d) Cranial nerve IX

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23.
Left Internal Mammary Artery (LIMA) has become the conduit of choice for Left Anterior
Descending (LAD) artery during coronary artery bypass grafting because:

(a) Long term patency rates are more than 98%

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(b) It is close to LAD
(c) Atherosclerosis is never seen in this vessel
(d) It is very easy to harvest
24.
A 50-year old male with significant smoking history presented in the surgical emergency

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with sudden severe breathlessness. Chest X-ray shows right sided Pneumothorax. The
appropriate management requires:

(a) Aspiration of air with 16-18 G cannula
(b) Right chest drain of size 8-14 Fr

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(c) Oxygen by face mask
(d) Mechanical ventilation
25.
Which one of the following statements regarding Felon is NOT correct?

--- Content provided by FirstRanker.com ---

(a) There is infection of the finger tip between specialised fibrous septa
(b) It is a painless condition
(c) Incision and drainage is the treatment of choice
(d) It is common in diabetics
26.

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The most common site for osteosarcoma is:

(a) Proximal femur
(b) Distal femur
(c) Proximal humerus

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(d) Distal humerus
27.
Rapid Sequence Induction is indicated in:

(a) Emergency surgery for intestinal obstruction

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(b) Elective open hernia surgery
(c) Cardiopulmonary bypass surgery
(d) Elective laparoscopic surgery

28.

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Which one of the following statements about Compartment Syndrome is NOT correct?

(a) It is commonest in a closed fracture
(b) Pain is on active movement but not on passive movement of muscles
(c) Fasciotomy is the treatment of choice

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(d) Volkmann?s Ischaemic contractive is a late complication

--- Content provided by FirstRanker.com ---

29.
Which one of the following is NOT the strength of ultrasound as a diagnostic modality?

(a) No radiation
(b) Short learning curve

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(c) Inexpensive
(d) Allows dynamic studies to be done
30.
Which of the following statements regarding lymphoedema following breast cancer treatment
are correct?

--- Content provided by FirstRanker.com ---

1. Incidence has decreased due to rarely combined therapy of axillary LN dissection and
radiotherapy
2. Precipitating cause like LN metastasis is a major determinant
3. The condition is often painful

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4. Oedematous limb is susceptible to bacterial infection

Select the correct answer using the code given below:

(a) 1, 2 and 3

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(b) 2, 3 and 4
(c) 1, 3 and 4
(d) 1, 2 and 4
31.
Which one of the following is NOT a risk factor for development of venous thrombosis in

--- Content provided by FirstRanker.com ---

surgical patients?

(a) Age > 60 years
(b) Pregnancy
(c) Obesity (BMI > 30 kg/m

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2
)
(d) Diabetes ( HbA1c > 7.5%)
32.
Which one of the following is NOT a complication of massive blood transfusion?

--- Content provided by FirstRanker.com ---

(a) Coagulopathy
(b) Hypocalcaemia
(c) Hyperthermia
(d) Hyperkalemia

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33.
Stage III ?Pressure sore? is full thickness skin loss extending:

(a) into subcutaneous tissue but not through fascia
(b) through subcutaneous tissue into fascia

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(c) through subcutaneous tissue into fascia and muscles
(d) through subcutaneous tissue into fascia, muscles and bone

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34.
During subclavian vein puncture in a surgical ward suddenly a patient developed severe
breathlessness. On auscultation breath sound was absent and the ipsilateral chest was
tympanitic on percussion. The probable diagnosis is:

--- Content provided by FirstRanker.com ---

(a) Iatrogenic pneumothorax
(b) Introgenic hemothorax
(c) Spontaneous pneumothorax
(d) Tension pneumothorax
35.

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Kohler?s disease is avascular necrosis of :

(a) Lunate
(b) Capitellum of humerus
(c) First metatarsal head

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(d) Navicular
36.
Which one of the following is NOT true of Pyoderma gangrenosum?

(a) It is characterized by cutaneous ulceration with purple undermined edges

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(b) It is often secondary to heightened immunological reactivity from another disease
process
(c) Cultures often show Gram positive Staphylococci
(d) Lesions generally respond to steroids
37.

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Which of the following is NOT a tissue repair surgery for inguinal hernia repair?

(a) Bassini?s repair
(b) Shouldice repair
(c) Stoppa?s repair

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(d) Desarda repair
38.
Which one of the following type of meshes is recommended for intraperitoneal use in
abdominal wall hernia?
(a) Light weight, porous meshes

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(b) Heavy weight, porous meshes
(c) Absorbable meshes
(d) Tissue separating meshes
39.
Which one of the following is NOT correct regarding MEN-1 syndrome?

--- Content provided by FirstRanker.com ---

(a) It involves parathyroid glands
(b) It involves pancreas
(c) It involves pituitary gland
(d) It involves pineal gland

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40.
Which one of the following is NOT an electronic information site in surgery?

(a) Pubmed

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(b) Embase
(c) Cochrane library
(d) National medical library
41.
Which one of the following statements regarding pre-conceptional counseling is NOT

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correct?

(a) It is needed only in selected complicated pregnancies
(b) It helps in early detection of risk factors
(c) It helps in reducing maternal morbidity and mortality

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(d) It is a part of preventive medicine
42.
Consider the following statements regarding Non Stress Test (NST):

1. Reactive NST indicates a healthy fetus

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2. NST is an observed association of fetal breathing with fetal movements
3. NST has a low false negative rate (< 1%) but high false positive rate (>50%)
4. Testing should be started at 20 weeks

Which of the statement(s) given above is/are correct?

--- Content provided by FirstRanker.com ---

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

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43.
Which one of the following is a protective factor for endometrial hyperplasia?

(a) Diabetes
(b) Tamoxifen therapy

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(c) Multiparity
(d) Delayed menopause
44.
A woman who is not breast feeding her newborn child is advised to use a contraceptive
method by:

--- Content provided by FirstRanker.com ---

(a) 3
rd
postpartum week
(b) 6

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th
postpartum week
(c) 3
rd
postpartum month

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(d) 6
th
postpartum month

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45.
Pearl index for contraceptive effectiveness is calculated in terms of which of the following?

--- Content provided by FirstRanker.com ---

1. Pregnancy rate
2. Abortion rate
3. Hundred woman years
4. Thousand woman years

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Select the correct answer using the code given below:

(a) 1 only
(b) 2 and 3

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(c) 1, 2 and 4
(d) 1 and 3
46.
Indications for removal of IUDs are all EXCEPT:

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(a) Perforation of uterus
(b) Cyclical menstrual bleeding
(c) Flaring up of salpingitis
(d) Pregnancy with IUD
47.

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Contraindications for insertion of IUDs are all EXCEPT:

(a) Suspected pregnancy
(b) Trophoblastic disease
(c) Severe dysmenorrhea

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(d) During cesarean section
48.
Which one of the following is NOT a contraindication for use of Mini pill?

(a) Pregnancy

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(b) Breast feeding
(c) Thromboembolic disease
(d) History of breast cancer
49.
Which one of the following is the most commonly used surgical method/technique of female

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sterilization as recommended by Government of India?

(a) Uchida technique
(b) Irving method
(c) Pomeroy?s method

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(d) Madlener technique

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50.
Which of the following is/are required for a registered medical practitioner to qualify for

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performing Medical Termination of Pregnancy (MTP), as per revised rules of MTP Act?

1. Certified for assisting at least 15 MTP in an authorized centre
2. Diploma or degree in Obstetrics and Gynaecology
3. House surgeon training for 3 months in Obstetrics and Gynaecology

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4. Certified training for 6 months in laparoscopic surgeries

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

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(c) 1, 2 and 3
(d) 1, 2 and 4
51.
Which one of the following is NOT a support of uterus, preventing its descent?

--- Content provided by FirstRanker.com ---

(a) Endopelvic fascia
(b) Mackenrodt?s ligament
(c) Inguinal ligament
(d) Pubocervical ligament
52.

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As per ICMR guidelines, which one of the following statements is true regarding effects of
COVID-19 on fetus according to current evidence?

(a) There is increased risk of early pregnancy loss
(b) COVID-19 virus is not teratogenic

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(c) COVID-19 virus infection is an indication of MTP
(d) There is increased risk of fetal growth restriction
53.
As per ICMR guidelines, which one of the following statements is true regarding COVID-19
infection in pregnancy?

--- Content provided by FirstRanker.com ---

(a) Covid-19 pneumonia in pregnancy is more severe with poor recovery
(b) Pregnant women with heart disease are at higher risk
(c) Vaginal secretions always test positive for COVID-19 in pregnancy
(d) COVID-19 virus is secreted in breast milk

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54.
Which one of the following is NOT a method of management of Deep Transverse Arrest with
the living fetus?

(a) Caesarean section

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(b) Delivery by ventouse
(c) Delivery by application of forceps to the unrotated head
(d) Manual rotation and application of forceps

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55.
Successful version of breech presentation is likely in case all of the following EXCEPT:

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(a) Breech with extended legs
(b) Complete breech with sacroanterior position
(c) Non engaged breech
(d) Adequate amniotic fluid

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56.
Implantation of a fertilised ovum occurs on which day following fertilisation?

(a) Day 6
(b) Day 10

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(c) Day 14
(d) Day 20
57.
During total abdominal hysterectomy the ureter is likely to undergo injury or ligation during
the following steps EXCEPT:

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(a) During division and ligation of the round ligaments
(b) During division and ligation of infundibulopelvic ligaments
(c) During division and ligation of mackenrodt?s and uterosacral ligaments
(d) At the vaginal angles while incising the vagina to remove the cervix with the

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uterus
58.
The net effect of antenatal care has been the following EXCEPT:

(a) Reduction in maternal mortality

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(b) Reduction in perinatal mortality
(c) Reduction in the incidence of institutional delivery
(d) Reduction in maternal morbidity
59.
Which one of the following is NOT a component of active phase in the partograph?

--- Content provided by FirstRanker.com ---

(a) Acceleration phase
(b) Phase of maximum slope
(c) Phase of deceleration
(d) Phase of expulsion

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60.
From medicolegal point of view which one of the following is NOT a sign of previous child
birth?

(a) Perineum is lax and there is evidence of scarring

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(b) Introitus is gaping and there is presence of carunculae myrtiformis
(c) Abdomen is lax and loose with striae and linea alba
(d) Conical cervix with round external os

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61.
The components of partograph are all EXCEPT:

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(a) Time
(b) Fetal heart rate
(c) Maternal respiratory rate
(d) Maternal urine analysis

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62.
Which of the following information are provided by partograph?

1. Colour of liquor
2. Uterine contractions with duration and frequency

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3. Dilatation of cervix

Select the correct answer using the code given below:

(a) 1 and 2 only

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(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3
63.
Intraoperative recognition of ureter is by which of the following features?

--- Content provided by FirstRanker.com ---

1. Transparent tubular appearance
2. Pale glistening appearance
3. Longitudinal vessels on surface
4. Circumferential vessels on surface

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Select the correct answer using the code given below:

(a) 1 and 3
(b) 2 and 4

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(c) 2 and 3
(d) 1 and 4
64.
Hysterosalpingography (HSG) is least helpful in detecting which of the following?

--- Content provided by FirstRanker.com ---

(a) Tubal patency
(b) Pelvic adhesions
(c) Asherman syndrome
(d) Congenital uterine anomaly

--- Content provided by FirstRanker.com ---

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65.
Which of the following are characteristics of Trichomonas vaginitis?

--- Content provided by FirstRanker.com ---

1. Presence of greenish frothy discharge
2. Vaginal pH > 4.5
3. Presence of clue cells in microscopic examination
4. Strawberry spots on the vaginal mucosa

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Select the correct answer using the code given below:

(a) 1, 2 and 3
(b) 1, 2 and 4

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(c) 2, 3 and 4
(d) 1, 3 and 4
66.
Tumor marker of epithelial ovarian carcinoma is:

--- Content provided by FirstRanker.com ---

(a) Ca.125
(b) Alpha feto protein
(c) Beta HCG
(d) LDH
67.

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The most common site of cervical cancer is:

(a) Endocervix
(b) Ectocervix
(c) Transformation zone

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(d) Isthmus
68.
The placenta synthesizes all EXCEPT:

(a) Oestriol

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(b) Corticotrophin releasing hormone
(c) PAPP-A(Pregnancy Associated Plasma Protein A)
(d) Dehydroepiandrosterone
69.
Withdrawal bleeding following administration of progesterone in a case of secondary

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amenorrhea indicates all EXCEPT:

(a) Absence of pregnancy
(b) Production endogenous estrogen
(c) Endometrium is responsive to estrogen

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(d) Defect in pituitary gland
70.
Monilial vaginitis is commonly associated with all EXCEPT:

(a) Prolonged antibiotic therapy

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(b) Diabetes Mellitus
(c) Treatment of malaria with chloroquine
(d) Pregnancy
71.
Which one of the following is NOT a risk factor for the development of placenta previa?

--- Content provided by FirstRanker.com ---

(a) Maternal age
(b) Smoking
(c) Previous caesarean section
(d) Maternal anaemia

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72.
Common clinical presentations of moderate to severe abruption are all EXCEPT:

(a) Uterine tenderness
(b) Fetal distress

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(c) Unexplained pre term labour
(d) Prolonged labour
73.
Common trisomies resulting in spontaneous abortion are all EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Trisomy 21
(b) Trisomy 18
(c) Trisomy 16
(d) Trisomy 1
74.

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The initial prevention strategy for antiphospholipid syndrome will be:

1. Steroids
2. Heparin
3. Low dose aspirin

--- Content provided by FirstRanker.com ---

4. Progesterone support

Which of the above is/are correct?

(a) 2 and 3

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(b) 3 and 4
(c) 3 only
(d) 1 and 4
75.
Diagnostic criteria for PCOD are:

--- Content provided by FirstRanker.com ---

1. Oligo/amenorrohoea
2. Hyperandrogenism
3. Polycystic ovaries on ultrasound

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Which of the above are correct?

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

--- Content provided by FirstRanker.com ---

(d) 1, 2 and 3


76.
Which of the following symptoms can be associated with pelvic organ prolapse?

--- Content provided by FirstRanker.com ---

1. Difficulty in passing urine
2. Incomplete evacuation of urine
3. Urgency and frequency

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Select the correct answer using the code given below:

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

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(d) 1, 2 and 3
77.
A 30 year old lady, P
2
L

--- Content provided by FirstRanker.com ---

2
presents with painful unilateral swelling in vulva for 3 days. Which
of the following statements are true regarding the above case?

1. Bartholin?s abscess may be the likely diagnosis

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2. It is to be managed by marsupialisation
3. Gonococcus is the most common pathogenic organism

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

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(b) 3 only
(c) 1 and 2 only
(d) 1, 2 and 3
78.
Which one of the following is NOT a sign of separation of placenta?

--- Content provided by FirstRanker.com ---

(a) Uterus becomes globular, firm and ballotable
(b) The fundal height reduces further
(c) Slight bulging in the suprapubic region
(d) Apparent lengthenic of the cord with slight gush of vaginal bleeding

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79.
Consider the following regarding examination of a rape victim:

1. Emergency pill is provided
2. Internal examination must be performed

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3. HIV testing is done

Which of the above statements is/are correct?

(a) 1 and 3 only

--- Content provided by FirstRanker.com ---

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

--- Content provided by FirstRanker.com ---

FirstRanker.com - FirstRanker's Choice
Combined Medical Services Examination-2020
Paper-II

--- Content provided by FirstRanker.com ---

1.
Indications for fasciotomy in compartment syndrome include all EXCEPT:

(a) Distal sensory disturbance

--- Content provided by FirstRanker.com ---

(b) Compartment pressure > 30 mm Hg
(c) Pain on passive movement of affected muscles
(d) Palpable distal pulses
2.
Which one of the following statements is NOT correct regarding Necrotising Soft Tissue

--- Content provided by FirstRanker.com ---

infections?

(a) Crepitus, skin blistering and focal skin gangrene are typical presenting features
(b) They are monomicrobial in nature
(c) Treatment consists of wide local excision and appropriate antibiotics

--- Content provided by FirstRanker.com ---

(d) Tissue biopsy is required for culture and diagnosis
3.
Which type of surgery is laparoscopic cholecystectomy classified as?

(a) Clean

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(b) Clean contaminated
(c) Contaminated
(d) Dirty
4.
A 22-year female has presented with a history of malaise, cough, alternating constipation and

--- Content provided by FirstRanker.com ---

diarrhoea with intermittent abdominal pain for last 6 months. She also complains of
abdominal distension for last 2 days. On examination her abdomen has a doughy feel along
with an ill defined mass over the right lower quadrant. She is most likely suffering from:

(a) Appendicular lump

--- Content provided by FirstRanker.com ---

(b) Ileocaecal tuberculosis
(c) Carcinoma caecum
(d) Ovarian mass
5.
Consider the following statements regarding needle stick injuries:

--- Content provided by FirstRanker.com ---

1. Injured part should be washed under running water
2. Dominant index finger is the commonest site for needle stick injury
3. All needle stick injuries should be reported
4. Hepatitis/HIV testing should be done after needle stick injury

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Which of the statements given above are correct?

(a) 1, 2 and 4
(b) 1, 2 and 3

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

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6.
Consider the following statements regarding claudication:

1. It is a marker for silent coronary disease

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2. Structured exercise program ( 2 hours per week for 3 months) leads to
improvement in symptoms
3. Diabetes mellitus increases the risk and severity of claudication
4. Beta blockers may exacerbate claudication

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Which of the above statements are correct?

(a) 1 and 2 only
(b) 1, 3 and 4 only
(c) 2, 3 and 4 only

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(d) 1, 2, 3 and 4
7.
A 50-year old lady underwent uneventful bariatric surgery for morbid obesity. On the third
post operative day, she develops breathless and pulmonary embolism is suspected. The next
investigation to confirm the diagnosis will be:

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(a) Echocardiography
(b) Duplex venography
(c) CT pulmonary angiography
(d) MR angiography

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8.
Medical management of thyrotoxic crisis includes all of the following EXCEPT:

(a) IV fluids
(b) IV propanolol

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(c) IV hydrocortisone
(d) IV antibiotics
9.
A patient operated for a parotid gland tumour developed symptoms of sweating and
erytherma (flushing) over the region of surgical excision while eating. The probable

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diagnosis is:

(a) Parotid gland fistula
(b) Sialadenitis
(c) Chronic wound infection

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(d) Frey?s syndrome
10.
First line hormone therapy for post-menopausal woman with metastatic carcinoma breast is:

(a) Tamoxifen

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(b) Ovarian suppression by surgery
(c) Antiprogestins
(d) Anastrazole

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11.
All of the following are major subtypes of breast cancer based on Gene array analysis
EXCEPT:

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(a) Luminal A and Luminal B
(b) Triple negative
(c) Her-2 receptor positive
(d) Oestrogen receptor positive
12.

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All of the following are sequelae of peptic ulcer surgery EXCEPT:

(a) Bilious vomiting
(b) Dumping syndrome
(c) Diarrhoea

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(d) Increased appetite
13.
The Child-Turcotte-Pugh (CTP) score for quantifying the severity of chronic liver disease
includes all variables EXCEPT:

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(a) Serum bilirubin
(b) Serum albumin
(c) Serum creatinine
(d) INR (International Normalised Ratio)
14.

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?Chain of Lakes? appearance due to sacculation with intervening short strictures of pancreatic
duct is seen on:

(a) ERCP
(b) CECT abdomen

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(c) Plain X-ray abdomen
(d) Ultrasonography
15.
Which one of the following statements is NOT correct regarding Pyogenic Liver Abscess?

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(a) Anorexia, fever, malaise and right upper quadrant abdominal discomfort are the
most common presenting features
(b) It is more common in elderly, diabetics and immunocompromised patients
(c) Treatment is with oral antibiotics alone
(d) Streptococcus milleri and escherichia coli are the most common causative

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organisms
16.
?Swiss cheese defects? are seen during laparoscopic repair of:

(a) Ventral hernia

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(b) Inguinal hernia
(c) Obturator hernia
(d) Femoral hernia

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17.
Which of the following are correct regarding splenic artery aneurysm?

1. Main arterial trunk is the common site

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2. Palpable thrill can be felt
3. It is symptomless unless it ruptures

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

(a) 1 and 2 only
(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3
18.

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Valentino?s syndrome is:

(a) Pain on per-vaginal examination in pelvic abscess
(b) Pain over left shoulder in left hypochondriac collection
(c) Pain over left groin in perirenal collection

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(d) Pain in right iliac fossa in perforated peptic ulcer
19.
Spontaneous bacterial peritonitis occurs due to:

(a) duodenal stump blowout

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(b) peptic ulcer perforation
(c) acute bacterial infection of ascites
(d) infection via fallopian tubes
20.
Structure not forming boundaries of the ?Triangle of doom? seen during laparoscopic

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inguinal hernia surgery dissection is:

(a) Vas deferens
(b) Inferior epigastric artery
(c) Spermatic cord vessels

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(d) Peritoneum
21.
The term mid-line shift is associated with:

(a) Head injury

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(b) Chest injury
(c) Abdominal injury
(d) Limb injury
22.
Which one of the following cranial nerves does NOT supply to the external ear?

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(a) Cranial nerve V
(b) Cranial nerve VI
(c) Cranial nerve VII
(d) Cranial nerve IX

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23.
Left Internal Mammary Artery (LIMA) has become the conduit of choice for Left Anterior
Descending (LAD) artery during coronary artery bypass grafting because:

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(a) Long term patency rates are more than 98%
(b) It is close to LAD
(c) Atherosclerosis is never seen in this vessel
(d) It is very easy to harvest
24.

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A 50-year old male with significant smoking history presented in the surgical emergency
with sudden severe breathlessness. Chest X-ray shows right sided Pneumothorax. The
appropriate management requires:

(a) Aspiration of air with 16-18 G cannula

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(b) Right chest drain of size 8-14 Fr
(c) Oxygen by face mask
(d) Mechanical ventilation
25.
Which one of the following statements regarding Felon is NOT correct?

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(a) There is infection of the finger tip between specialised fibrous septa
(b) It is a painless condition
(c) Incision and drainage is the treatment of choice
(d) It is common in diabetics

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26.
The most common site for osteosarcoma is:

(a) Proximal femur
(b) Distal femur

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(c) Proximal humerus
(d) Distal humerus
27.
Rapid Sequence Induction is indicated in:

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(a) Emergency surgery for intestinal obstruction
(b) Elective open hernia surgery
(c) Cardiopulmonary bypass surgery
(d) Elective laparoscopic surgery

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28.
Which one of the following statements about Compartment Syndrome is NOT correct?

(a) It is commonest in a closed fracture
(b) Pain is on active movement but not on passive movement of muscles

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(c) Fasciotomy is the treatment of choice
(d) Volkmann?s Ischaemic contractive is a late complication

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29.
Which one of the following is NOT the strength of ultrasound as a diagnostic modality?

(a) No radiation

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(b) Short learning curve
(c) Inexpensive
(d) Allows dynamic studies to be done
30.
Which of the following statements regarding lymphoedema following breast cancer treatment

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are correct?

1. Incidence has decreased due to rarely combined therapy of axillary LN dissection and
radiotherapy
2. Precipitating cause like LN metastasis is a major determinant

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3. The condition is often painful
4. Oedematous limb is susceptible to bacterial infection

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

(a) 1, 2 and 3
(b) 2, 3 and 4
(c) 1, 3 and 4
(d) 1, 2 and 4
31.

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Which one of the following is NOT a risk factor for development of venous thrombosis in
surgical patients?

(a) Age > 60 years
(b) Pregnancy

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(c) Obesity (BMI > 30 kg/m
2
)
(d) Diabetes ( HbA1c > 7.5%)
32.

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Which one of the following is NOT a complication of massive blood transfusion?

(a) Coagulopathy
(b) Hypocalcaemia
(c) Hyperthermia

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(d) Hyperkalemia
33.
Stage III ?Pressure sore? is full thickness skin loss extending:

(a) into subcutaneous tissue but not through fascia

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(b) through subcutaneous tissue into fascia
(c) through subcutaneous tissue into fascia and muscles
(d) through subcutaneous tissue into fascia, muscles and bone

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34.
During subclavian vein puncture in a surgical ward suddenly a patient developed severe
breathlessness. On auscultation breath sound was absent and the ipsilateral chest was
tympanitic on percussion. The probable diagnosis is:

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(a) Iatrogenic pneumothorax
(b) Introgenic hemothorax
(c) Spontaneous pneumothorax
(d) Tension pneumothorax

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35.
Kohler?s disease is avascular necrosis of :

(a) Lunate
(b) Capitellum of humerus

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(c) First metatarsal head
(d) Navicular
36.
Which one of the following is NOT true of Pyoderma gangrenosum?

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(a) It is characterized by cutaneous ulceration with purple undermined edges
(b) It is often secondary to heightened immunological reactivity from another disease
process
(c) Cultures often show Gram positive Staphylococci
(d) Lesions generally respond to steroids

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37.
Which of the following is NOT a tissue repair surgery for inguinal hernia repair?

(a) Bassini?s repair
(b) Shouldice repair

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(c) Stoppa?s repair
(d) Desarda repair
38.
Which one of the following type of meshes is recommended for intraperitoneal use in
abdominal wall hernia?

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(a) Light weight, porous meshes
(b) Heavy weight, porous meshes
(c) Absorbable meshes
(d) Tissue separating meshes
39.

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Which one of the following is NOT correct regarding MEN-1 syndrome?

(a) It involves parathyroid glands
(b) It involves pancreas
(c) It involves pituitary gland

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(d) It involves pineal gland

40.
Which one of the following is NOT an electronic information site in surgery?

--- Content provided by FirstRanker.com ---

(a) Pubmed
(b) Embase
(c) Cochrane library
(d) National medical library
41.

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Which one of the following statements regarding pre-conceptional counseling is NOT
correct?

(a) It is needed only in selected complicated pregnancies
(b) It helps in early detection of risk factors

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(c) It helps in reducing maternal morbidity and mortality
(d) It is a part of preventive medicine
42.
Consider the following statements regarding Non Stress Test (NST):

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1. Reactive NST indicates a healthy fetus
2. NST is an observed association of fetal breathing with fetal movements
3. NST has a low false negative rate (< 1%) but high false positive rate (>50%)
4. Testing should be started at 20 weeks

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Which of the statement(s) given above is/are correct?

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

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(d) 1 and 4
43.
Which one of the following is a protective factor for endometrial hyperplasia?

(a) Diabetes

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(b) Tamoxifen therapy
(c) Multiparity
(d) Delayed menopause
44.
A woman who is not breast feeding her newborn child is advised to use a contraceptive

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method by:

(a) 3
rd
postpartum week

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(b) 6
th
postpartum week
(c) 3
rd

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postpartum month
(d) 6
th
postpartum month

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45.

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Pearl index for contraceptive effectiveness is calculated in terms of which of the following?

1. Pregnancy rate
2. Abortion rate
3. Hundred woman years

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4. Thousand woman years

Select the correct answer using the code given below:

(a) 1 only

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(b) 2 and 3
(c) 1, 2 and 4
(d) 1 and 3
46.
Indications for removal of IUDs are all EXCEPT:

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(a) Perforation of uterus
(b) Cyclical menstrual bleeding
(c) Flaring up of salpingitis
(d) Pregnancy with IUD

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47.
Contraindications for insertion of IUDs are all EXCEPT:

(a) Suspected pregnancy
(b) Trophoblastic disease

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(c) Severe dysmenorrhea
(d) During cesarean section
48.
Which one of the following is NOT a contraindication for use of Mini pill?

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(a) Pregnancy
(b) Breast feeding
(c) Thromboembolic disease
(d) History of breast cancer
49.

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Which one of the following is the most commonly used surgical method/technique of female
sterilization as recommended by Government of India?

(a) Uchida technique
(b) Irving method

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(c) Pomeroy?s method
(d) Madlener technique

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50.

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Which of the following is/are required for a registered medical practitioner to qualify for
performing Medical Termination of Pregnancy (MTP), as per revised rules of MTP Act?

1. Certified for assisting at least 15 MTP in an authorized centre
2. Diploma or degree in Obstetrics and Gynaecology

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3. House surgeon training for 3 months in Obstetrics and Gynaecology
4. Certified training for 6 months in laparoscopic surgeries

Select the correct answer using the code given below:
(a) 1 only

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(b) 2 only
(c) 1, 2 and 3
(d) 1, 2 and 4
51.
Which one of the following is NOT a support of uterus, preventing its descent?

--- Content provided by FirstRanker.com ---

(a) Endopelvic fascia
(b) Mackenrodt?s ligament
(c) Inguinal ligament
(d) Pubocervical ligament

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52.
As per ICMR guidelines, which one of the following statements is true regarding effects of
COVID-19 on fetus according to current evidence?

(a) There is increased risk of early pregnancy loss

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(b) COVID-19 virus is not teratogenic
(c) COVID-19 virus infection is an indication of MTP
(d) There is increased risk of fetal growth restriction
53.
As per ICMR guidelines, which one of the following statements is true regarding COVID-19

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infection in pregnancy?

(a) Covid-19 pneumonia in pregnancy is more severe with poor recovery
(b) Pregnant women with heart disease are at higher risk
(c) Vaginal secretions always test positive for COVID-19 in pregnancy

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(d) COVID-19 virus is secreted in breast milk
54.
Which one of the following is NOT a method of management of Deep Transverse Arrest with
the living fetus?

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(a) Caesarean section
(b) Delivery by ventouse
(c) Delivery by application of forceps to the unrotated head
(d) Manual rotation and application of forceps

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55.

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Successful version of breech presentation is likely in case all of the following EXCEPT:

(a) Breech with extended legs
(b) Complete breech with sacroanterior position
(c) Non engaged breech

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(d) Adequate amniotic fluid
56.
Implantation of a fertilised ovum occurs on which day following fertilisation?

(a) Day 6

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(b) Day 10
(c) Day 14
(d) Day 20
57.
During total abdominal hysterectomy the ureter is likely to undergo injury or ligation during

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the following steps EXCEPT:

(a) During division and ligation of the round ligaments
(b) During division and ligation of infundibulopelvic ligaments
(c) During division and ligation of mackenrodt?s and uterosacral ligaments

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(d) At the vaginal angles while incising the vagina to remove the cervix with the
uterus
58.
The net effect of antenatal care has been the following EXCEPT:

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(a) Reduction in maternal mortality
(b) Reduction in perinatal mortality
(c) Reduction in the incidence of institutional delivery
(d) Reduction in maternal morbidity
59.

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Which one of the following is NOT a component of active phase in the partograph?

(a) Acceleration phase
(b) Phase of maximum slope
(c) Phase of deceleration

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(d) Phase of expulsion
60.
From medicolegal point of view which one of the following is NOT a sign of previous child
birth?

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(a) Perineum is lax and there is evidence of scarring
(b) Introitus is gaping and there is presence of carunculae myrtiformis
(c) Abdomen is lax and loose with striae and linea alba
(d) Conical cervix with round external os

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61.

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The components of partograph are all EXCEPT:

(a) Time
(b) Fetal heart rate
(c) Maternal respiratory rate

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(d) Maternal urine analysis
62.
Which of the following information are provided by partograph?

1. Colour of liquor

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2. Uterine contractions with duration and frequency
3. Dilatation of cervix

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

(a) 1 and 2 only
(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3
63.

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Intraoperative recognition of ureter is by which of the following features?

1. Transparent tubular appearance
2. Pale glistening appearance
3. Longitudinal vessels on surface

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4. Circumferential vessels on surface

Select the correct answer using the code given below:

(a) 1 and 3

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(b) 2 and 4
(c) 2 and 3
(d) 1 and 4
64.
Hysterosalpingography (HSG) is least helpful in detecting which of the following?

--- Content provided by FirstRanker.com ---

(a) Tubal patency
(b) Pelvic adhesions
(c) Asherman syndrome
(d) Congenital uterine anomaly

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65.

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Which of the following are characteristics of Trichomonas vaginitis?

1. Presence of greenish frothy discharge
2. Vaginal pH > 4.5
3. Presence of clue cells in microscopic examination

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4. Strawberry spots on the vaginal mucosa

Select the correct answer using the code given below:

(a) 1, 2 and 3

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(b) 1, 2 and 4
(c) 2, 3 and 4
(d) 1, 3 and 4
66.
Tumor marker of epithelial ovarian carcinoma is:

--- Content provided by FirstRanker.com ---

(a) Ca.125
(b) Alpha feto protein
(c) Beta HCG
(d) LDH

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67.
The most common site of cervical cancer is:

(a) Endocervix
(b) Ectocervix

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(c) Transformation zone
(d) Isthmus
68.
The placenta synthesizes all EXCEPT:

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(a) Oestriol
(b) Corticotrophin releasing hormone
(c) PAPP-A(Pregnancy Associated Plasma Protein A)
(d) Dehydroepiandrosterone
69.

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Withdrawal bleeding following administration of progesterone in a case of secondary
amenorrhea indicates all EXCEPT:

(a) Absence of pregnancy
(b) Production endogenous estrogen

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(c) Endometrium is responsive to estrogen
(d) Defect in pituitary gland
70.
Monilial vaginitis is commonly associated with all EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Prolonged antibiotic therapy
(b) Diabetes Mellitus
(c) Treatment of malaria with chloroquine
(d) Pregnancy
71.

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Which one of the following is NOT a risk factor for the development of placenta previa?

(a) Maternal age
(b) Smoking
(c) Previous caesarean section

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(d) Maternal anaemia
72.
Common clinical presentations of moderate to severe abruption are all EXCEPT:

(a) Uterine tenderness

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(b) Fetal distress
(c) Unexplained pre term labour
(d) Prolonged labour
73.
Common trisomies resulting in spontaneous abortion are all EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Trisomy 21
(b) Trisomy 18
(c) Trisomy 16
(d) Trisomy 1

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74.
The initial prevention strategy for antiphospholipid syndrome will be:

1. Steroids
2. Heparin

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3. Low dose aspirin
4. Progesterone support

Which of the above is/are correct?

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(a) 2 and 3
(b) 3 and 4
(c) 3 only
(d) 1 and 4
75.

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Diagnostic criteria for PCOD are:

1. Oligo/amenorrohoea
2. Hyperandrogenism
3. Polycystic ovaries on ultrasound

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Which of the above are correct?

(a) 1 and 2 only
(b) 2 and 3 only

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


76.

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Which of the following symptoms can be associated with pelvic organ prolapse?

1. Difficulty in passing urine
2. Incomplete evacuation of urine
3. Urgency and frequency

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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.
A 30 year old lady, P
2

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L
2
presents with painful unilateral swelling in vulva for 3 days. Which
of the following statements are true regarding the above case?

--- Content provided by FirstRanker.com ---

1. Bartholin?s abscess may be the likely diagnosis
2. It is to be managed by marsupialisation
3. Gonococcus is the most common pathogenic organism

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

(a) 1 and 3 only
(b) 3 only
(c) 1 and 2 only
(d) 1, 2 and 3
78.

--- Content provided by FirstRanker.com ---

Which one of the following is NOT a sign of separation of placenta?

(a) Uterus becomes globular, firm and ballotable
(b) The fundal height reduces further
(c) Slight bulging in the suprapubic region

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(d) Apparent lengthenic of the cord with slight gush of vaginal bleeding
79.
Consider the following regarding examination of a rape victim:

1. Emergency pill is provided

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2. Internal examination must be performed
3. HIV testing is done

Which of the above statements is/are correct?

--- Content provided by FirstRanker.com ---

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

--- Content provided by FirstRanker.com ---

80.
Consider the following cardinal movements of mechanism of normal labor:

--- Content provided by FirstRanker.com ---

1. Engagement
2. Internal rotation
3. Flexion
4. Restitution
5. Crowning

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6. External rotation

What is the correct sequence of movements in labor in occipito-lateral position?

(a) 1, 2, 3, 4, 5 and 6

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(b) 1, 3, 2, 5, 4 and 6
(c) 2, 1, 3, 4, 5 and 6
(d) 3, 1, 2, 4, 6 and 5
81.
Which of the following represent the properties of an ideal disinfectant?

--- Content provided by FirstRanker.com ---

1. It is broad spectrum
2. It is fast acting
3. It is non-toxic

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

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82.
Which of the following measures can help reduce the risk of systemic hypertension?

1. Reduction in dietary intake of common salt
2. Controlling weight for age

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3. Increasing potassium rich foods in the diet

Select the correct answer using the code given below:

(a) 1 and 2 only

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

--- Content provided by FirstRanker.com ---

--- Content provided by FirstRanker.com ---

FirstRanker.com - FirstRanker's Choice
Combined Medical Services Examination-2020
Paper-II

--- Content provided by FirstRanker.com ---

1.
Indications for fasciotomy in compartment syndrome include all EXCEPT:

(a) Distal sensory disturbance
(b) Compartment pressure > 30 mm Hg

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(c) Pain on passive movement of affected muscles
(d) Palpable distal pulses
2.
Which one of the following statements is NOT correct regarding Necrotising Soft Tissue
infections?

--- Content provided by FirstRanker.com ---

(a) Crepitus, skin blistering and focal skin gangrene are typical presenting features
(b) They are monomicrobial in nature
(c) Treatment consists of wide local excision and appropriate antibiotics
(d) Tissue biopsy is required for culture and diagnosis

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3.
Which type of surgery is laparoscopic cholecystectomy classified as?

(a) Clean
(b) Clean contaminated

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(c) Contaminated
(d) Dirty
4.
A 22-year female has presented with a history of malaise, cough, alternating constipation and
diarrhoea with intermittent abdominal pain for last 6 months. She also complains of

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abdominal distension for last 2 days. On examination her abdomen has a doughy feel along
with an ill defined mass over the right lower quadrant. She is most likely suffering from:

(a) Appendicular lump
(b) Ileocaecal tuberculosis

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(c) Carcinoma caecum
(d) Ovarian mass
5.
Consider the following statements regarding needle stick injuries:

--- Content provided by FirstRanker.com ---

1. Injured part should be washed under running water
2. Dominant index finger is the commonest site for needle stick injury
3. All needle stick injuries should be reported
4. Hepatitis/HIV testing should be done after needle stick injury

--- Content provided by FirstRanker.com ---

Which of the statements given above are correct?

(a) 1, 2 and 4
(b) 1, 2 and 3
(c) 1, 3 and 4

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(d) 2, 3 and 4

--- Content provided by FirstRanker.com ---

6.
Consider the following statements regarding claudication:

1. It is a marker for silent coronary disease
2. Structured exercise program ( 2 hours per week for 3 months) leads to

--- Content provided by FirstRanker.com ---

improvement in symptoms
3. Diabetes mellitus increases the risk and severity of claudication
4. Beta blockers may exacerbate claudication

Which of the above statements are correct?

--- Content provided by FirstRanker.com ---

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

--- Content provided by FirstRanker.com ---

7.
A 50-year old lady underwent uneventful bariatric surgery for morbid obesity. On the third
post operative day, she develops breathless and pulmonary embolism is suspected. The next
investigation to confirm the diagnosis will be:

--- Content provided by FirstRanker.com ---

(a) Echocardiography
(b) Duplex venography
(c) CT pulmonary angiography
(d) MR angiography
8.

--- Content provided by FirstRanker.com ---

Medical management of thyrotoxic crisis includes all of the following EXCEPT:

(a) IV fluids
(b) IV propanolol
(c) IV hydrocortisone

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(d) IV antibiotics
9.
A patient operated for a parotid gland tumour developed symptoms of sweating and
erytherma (flushing) over the region of surgical excision while eating. The probable
diagnosis is:

--- Content provided by FirstRanker.com ---

(a) Parotid gland fistula
(b) Sialadenitis
(c) Chronic wound infection
(d) Frey?s syndrome

--- Content provided by FirstRanker.com ---

10.
First line hormone therapy for post-menopausal woman with metastatic carcinoma breast is:

(a) Tamoxifen
(b) Ovarian suppression by surgery

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(c) Antiprogestins
(d) Anastrazole

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11.
All of the following are major subtypes of breast cancer based on Gene array analysis
EXCEPT:

(a) Luminal A and Luminal B

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(b) Triple negative
(c) Her-2 receptor positive
(d) Oestrogen receptor positive
12.
All of the following are sequelae of peptic ulcer surgery EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Bilious vomiting
(b) Dumping syndrome
(c) Diarrhoea
(d) Increased appetite

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13.
The Child-Turcotte-Pugh (CTP) score for quantifying the severity of chronic liver disease
includes all variables EXCEPT:

(a) Serum bilirubin

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(b) Serum albumin
(c) Serum creatinine
(d) INR (International Normalised Ratio)
14.
?Chain of Lakes? appearance due to sacculation with intervening short strictures of pancreatic

--- Content provided by FirstRanker.com ---

duct is seen on:

(a) ERCP
(b) CECT abdomen
(c) Plain X-ray abdomen

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(d) Ultrasonography
15.
Which one of the following statements is NOT correct regarding Pyogenic Liver Abscess?

(a) Anorexia, fever, malaise and right upper quadrant abdominal discomfort are the

--- Content provided by FirstRanker.com ---

most common presenting features
(b) It is more common in elderly, diabetics and immunocompromised patients
(c) Treatment is with oral antibiotics alone
(d) Streptococcus milleri and escherichia coli are the most common causative
organisms

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16.
?Swiss cheese defects? are seen during laparoscopic repair of:

(a) Ventral hernia
(b) Inguinal hernia

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(c) Obturator hernia
(d) Femoral hernia

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17.
Which of the following are correct regarding splenic artery aneurysm?

1. Main arterial trunk is the common site
2. Palpable thrill can be felt

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3. It is symptomless unless it ruptures

Select the correct answer using the code given below:

(a) 1 and 2 only

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(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3
18.
Valentino?s syndrome is:

--- Content provided by FirstRanker.com ---

(a) Pain on per-vaginal examination in pelvic abscess
(b) Pain over left shoulder in left hypochondriac collection
(c) Pain over left groin in perirenal collection
(d) Pain in right iliac fossa in perforated peptic ulcer

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19.
Spontaneous bacterial peritonitis occurs due to:

(a) duodenal stump blowout
(b) peptic ulcer perforation

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(c) acute bacterial infection of ascites
(d) infection via fallopian tubes
20.
Structure not forming boundaries of the ?Triangle of doom? seen during laparoscopic
inguinal hernia surgery dissection is:

--- Content provided by FirstRanker.com ---

(a) Vas deferens
(b) Inferior epigastric artery
(c) Spermatic cord vessels
(d) Peritoneum

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21.
The term mid-line shift is associated with:

(a) Head injury
(b) Chest injury

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(c) Abdominal injury
(d) Limb injury
22.
Which one of the following cranial nerves does NOT supply to the external ear?

--- Content provided by FirstRanker.com ---

(a) Cranial nerve V
(b) Cranial nerve VI
(c) Cranial nerve VII
(d) Cranial nerve IX

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23.
Left Internal Mammary Artery (LIMA) has become the conduit of choice for Left Anterior
Descending (LAD) artery during coronary artery bypass grafting because:

(a) Long term patency rates are more than 98%

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(b) It is close to LAD
(c) Atherosclerosis is never seen in this vessel
(d) It is very easy to harvest
24.
A 50-year old male with significant smoking history presented in the surgical emergency

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with sudden severe breathlessness. Chest X-ray shows right sided Pneumothorax. The
appropriate management requires:

(a) Aspiration of air with 16-18 G cannula
(b) Right chest drain of size 8-14 Fr

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(c) Oxygen by face mask
(d) Mechanical ventilation
25.
Which one of the following statements regarding Felon is NOT correct?

--- Content provided by FirstRanker.com ---

(a) There is infection of the finger tip between specialised fibrous septa
(b) It is a painless condition
(c) Incision and drainage is the treatment of choice
(d) It is common in diabetics
26.

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The most common site for osteosarcoma is:

(a) Proximal femur
(b) Distal femur
(c) Proximal humerus

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(d) Distal humerus
27.
Rapid Sequence Induction is indicated in:

(a) Emergency surgery for intestinal obstruction

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(b) Elective open hernia surgery
(c) Cardiopulmonary bypass surgery
(d) Elective laparoscopic surgery

28.

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Which one of the following statements about Compartment Syndrome is NOT correct?

(a) It is commonest in a closed fracture
(b) Pain is on active movement but not on passive movement of muscles
(c) Fasciotomy is the treatment of choice

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(d) Volkmann?s Ischaemic contractive is a late complication

--- Content provided by FirstRanker.com ---

29.
Which one of the following is NOT the strength of ultrasound as a diagnostic modality?

(a) No radiation
(b) Short learning curve

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(c) Inexpensive
(d) Allows dynamic studies to be done
30.
Which of the following statements regarding lymphoedema following breast cancer treatment
are correct?

--- Content provided by FirstRanker.com ---

1. Incidence has decreased due to rarely combined therapy of axillary LN dissection and
radiotherapy
2. Precipitating cause like LN metastasis is a major determinant
3. The condition is often painful

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4. Oedematous limb is susceptible to bacterial infection

Select the correct answer using the code given below:

(a) 1, 2 and 3

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(b) 2, 3 and 4
(c) 1, 3 and 4
(d) 1, 2 and 4
31.
Which one of the following is NOT a risk factor for development of venous thrombosis in

--- Content provided by FirstRanker.com ---

surgical patients?

(a) Age > 60 years
(b) Pregnancy
(c) Obesity (BMI > 30 kg/m

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2
)
(d) Diabetes ( HbA1c > 7.5%)
32.
Which one of the following is NOT a complication of massive blood transfusion?

--- Content provided by FirstRanker.com ---

(a) Coagulopathy
(b) Hypocalcaemia
(c) Hyperthermia
(d) Hyperkalemia

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33.
Stage III ?Pressure sore? is full thickness skin loss extending:

(a) into subcutaneous tissue but not through fascia
(b) through subcutaneous tissue into fascia

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(c) through subcutaneous tissue into fascia and muscles
(d) through subcutaneous tissue into fascia, muscles and bone

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34.
During subclavian vein puncture in a surgical ward suddenly a patient developed severe
breathlessness. On auscultation breath sound was absent and the ipsilateral chest was
tympanitic on percussion. The probable diagnosis is:

--- Content provided by FirstRanker.com ---

(a) Iatrogenic pneumothorax
(b) Introgenic hemothorax
(c) Spontaneous pneumothorax
(d) Tension pneumothorax
35.

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Kohler?s disease is avascular necrosis of :

(a) Lunate
(b) Capitellum of humerus
(c) First metatarsal head

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(d) Navicular
36.
Which one of the following is NOT true of Pyoderma gangrenosum?

(a) It is characterized by cutaneous ulceration with purple undermined edges

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(b) It is often secondary to heightened immunological reactivity from another disease
process
(c) Cultures often show Gram positive Staphylococci
(d) Lesions generally respond to steroids
37.

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Which of the following is NOT a tissue repair surgery for inguinal hernia repair?

(a) Bassini?s repair
(b) Shouldice repair
(c) Stoppa?s repair

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(d) Desarda repair
38.
Which one of the following type of meshes is recommended for intraperitoneal use in
abdominal wall hernia?
(a) Light weight, porous meshes

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(b) Heavy weight, porous meshes
(c) Absorbable meshes
(d) Tissue separating meshes
39.
Which one of the following is NOT correct regarding MEN-1 syndrome?

--- Content provided by FirstRanker.com ---

(a) It involves parathyroid glands
(b) It involves pancreas
(c) It involves pituitary gland
(d) It involves pineal gland

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40.
Which one of the following is NOT an electronic information site in surgery?

(a) Pubmed

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(b) Embase
(c) Cochrane library
(d) National medical library
41.
Which one of the following statements regarding pre-conceptional counseling is NOT

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correct?

(a) It is needed only in selected complicated pregnancies
(b) It helps in early detection of risk factors
(c) It helps in reducing maternal morbidity and mortality

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(d) It is a part of preventive medicine
42.
Consider the following statements regarding Non Stress Test (NST):

1. Reactive NST indicates a healthy fetus

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2. NST is an observed association of fetal breathing with fetal movements
3. NST has a low false negative rate (< 1%) but high false positive rate (>50%)
4. Testing should be started at 20 weeks

Which of the statement(s) given above is/are correct?

--- Content provided by FirstRanker.com ---

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

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43.
Which one of the following is a protective factor for endometrial hyperplasia?

(a) Diabetes
(b) Tamoxifen therapy

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(c) Multiparity
(d) Delayed menopause
44.
A woman who is not breast feeding her newborn child is advised to use a contraceptive
method by:

--- Content provided by FirstRanker.com ---

(a) 3
rd
postpartum week
(b) 6

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th
postpartum week
(c) 3
rd
postpartum month

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(d) 6
th
postpartum month

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45.
Pearl index for contraceptive effectiveness is calculated in terms of which of the following?

--- Content provided by FirstRanker.com ---

1. Pregnancy rate
2. Abortion rate
3. Hundred woman years
4. Thousand woman years

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Select the correct answer using the code given below:

(a) 1 only
(b) 2 and 3

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(c) 1, 2 and 4
(d) 1 and 3
46.
Indications for removal of IUDs are all EXCEPT:

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(a) Perforation of uterus
(b) Cyclical menstrual bleeding
(c) Flaring up of salpingitis
(d) Pregnancy with IUD
47.

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Contraindications for insertion of IUDs are all EXCEPT:

(a) Suspected pregnancy
(b) Trophoblastic disease
(c) Severe dysmenorrhea

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(d) During cesarean section
48.
Which one of the following is NOT a contraindication for use of Mini pill?

(a) Pregnancy

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(b) Breast feeding
(c) Thromboembolic disease
(d) History of breast cancer
49.
Which one of the following is the most commonly used surgical method/technique of female

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sterilization as recommended by Government of India?

(a) Uchida technique
(b) Irving method
(c) Pomeroy?s method

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(d) Madlener technique

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50.
Which of the following is/are required for a registered medical practitioner to qualify for

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performing Medical Termination of Pregnancy (MTP), as per revised rules of MTP Act?

1. Certified for assisting at least 15 MTP in an authorized centre
2. Diploma or degree in Obstetrics and Gynaecology
3. House surgeon training for 3 months in Obstetrics and Gynaecology

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4. Certified training for 6 months in laparoscopic surgeries

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

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(c) 1, 2 and 3
(d) 1, 2 and 4
51.
Which one of the following is NOT a support of uterus, preventing its descent?

--- Content provided by FirstRanker.com ---

(a) Endopelvic fascia
(b) Mackenrodt?s ligament
(c) Inguinal ligament
(d) Pubocervical ligament
52.

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As per ICMR guidelines, which one of the following statements is true regarding effects of
COVID-19 on fetus according to current evidence?

(a) There is increased risk of early pregnancy loss
(b) COVID-19 virus is not teratogenic

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(c) COVID-19 virus infection is an indication of MTP
(d) There is increased risk of fetal growth restriction
53.
As per ICMR guidelines, which one of the following statements is true regarding COVID-19
infection in pregnancy?

--- Content provided by FirstRanker.com ---

(a) Covid-19 pneumonia in pregnancy is more severe with poor recovery
(b) Pregnant women with heart disease are at higher risk
(c) Vaginal secretions always test positive for COVID-19 in pregnancy
(d) COVID-19 virus is secreted in breast milk

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54.
Which one of the following is NOT a method of management of Deep Transverse Arrest with
the living fetus?

(a) Caesarean section

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(b) Delivery by ventouse
(c) Delivery by application of forceps to the unrotated head
(d) Manual rotation and application of forceps

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55.
Successful version of breech presentation is likely in case all of the following EXCEPT:

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(a) Breech with extended legs
(b) Complete breech with sacroanterior position
(c) Non engaged breech
(d) Adequate amniotic fluid

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56.
Implantation of a fertilised ovum occurs on which day following fertilisation?

(a) Day 6
(b) Day 10

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(c) Day 14
(d) Day 20
57.
During total abdominal hysterectomy the ureter is likely to undergo injury or ligation during
the following steps EXCEPT:

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(a) During division and ligation of the round ligaments
(b) During division and ligation of infundibulopelvic ligaments
(c) During division and ligation of mackenrodt?s and uterosacral ligaments
(d) At the vaginal angles while incising the vagina to remove the cervix with the

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uterus
58.
The net effect of antenatal care has been the following EXCEPT:

(a) Reduction in maternal mortality

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(b) Reduction in perinatal mortality
(c) Reduction in the incidence of institutional delivery
(d) Reduction in maternal morbidity
59.
Which one of the following is NOT a component of active phase in the partograph?

--- Content provided by FirstRanker.com ---

(a) Acceleration phase
(b) Phase of maximum slope
(c) Phase of deceleration
(d) Phase of expulsion

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60.
From medicolegal point of view which one of the following is NOT a sign of previous child
birth?

(a) Perineum is lax and there is evidence of scarring

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(b) Introitus is gaping and there is presence of carunculae myrtiformis
(c) Abdomen is lax and loose with striae and linea alba
(d) Conical cervix with round external os

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61.
The components of partograph are all EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Time
(b) Fetal heart rate
(c) Maternal respiratory rate
(d) Maternal urine analysis

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62.
Which of the following information are provided by partograph?

1. Colour of liquor
2. Uterine contractions with duration and frequency

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3. Dilatation of cervix

Select the correct answer using the code given below:

(a) 1 and 2 only

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(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3
63.
Intraoperative recognition of ureter is by which of the following features?

--- Content provided by FirstRanker.com ---

1. Transparent tubular appearance
2. Pale glistening appearance
3. Longitudinal vessels on surface
4. Circumferential vessels on surface

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Select the correct answer using the code given below:

(a) 1 and 3
(b) 2 and 4

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(c) 2 and 3
(d) 1 and 4
64.
Hysterosalpingography (HSG) is least helpful in detecting which of the following?

--- Content provided by FirstRanker.com ---

(a) Tubal patency
(b) Pelvic adhesions
(c) Asherman syndrome
(d) Congenital uterine anomaly

--- Content provided by FirstRanker.com ---

--- Content provided by FirstRanker.com ---

65.
Which of the following are characteristics of Trichomonas vaginitis?

--- Content provided by FirstRanker.com ---

1. Presence of greenish frothy discharge
2. Vaginal pH > 4.5
3. Presence of clue cells in microscopic examination
4. Strawberry spots on the vaginal mucosa

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Select the correct answer using the code given below:

(a) 1, 2 and 3
(b) 1, 2 and 4

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(c) 2, 3 and 4
(d) 1, 3 and 4
66.
Tumor marker of epithelial ovarian carcinoma is:

--- Content provided by FirstRanker.com ---

(a) Ca.125
(b) Alpha feto protein
(c) Beta HCG
(d) LDH
67.

--- Content provided by FirstRanker.com ---

The most common site of cervical cancer is:

(a) Endocervix
(b) Ectocervix
(c) Transformation zone

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(d) Isthmus
68.
The placenta synthesizes all EXCEPT:

(a) Oestriol

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(b) Corticotrophin releasing hormone
(c) PAPP-A(Pregnancy Associated Plasma Protein A)
(d) Dehydroepiandrosterone
69.
Withdrawal bleeding following administration of progesterone in a case of secondary

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amenorrhea indicates all EXCEPT:

(a) Absence of pregnancy
(b) Production endogenous estrogen
(c) Endometrium is responsive to estrogen

--- Content provided by FirstRanker.com ---

(d) Defect in pituitary gland
70.
Monilial vaginitis is commonly associated with all EXCEPT:

(a) Prolonged antibiotic therapy

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(b) Diabetes Mellitus
(c) Treatment of malaria with chloroquine
(d) Pregnancy
71.
Which one of the following is NOT a risk factor for the development of placenta previa?

--- Content provided by FirstRanker.com ---

(a) Maternal age
(b) Smoking
(c) Previous caesarean section
(d) Maternal anaemia

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72.
Common clinical presentations of moderate to severe abruption are all EXCEPT:

(a) Uterine tenderness
(b) Fetal distress

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(c) Unexplained pre term labour
(d) Prolonged labour
73.
Common trisomies resulting in spontaneous abortion are all EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Trisomy 21
(b) Trisomy 18
(c) Trisomy 16
(d) Trisomy 1
74.

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The initial prevention strategy for antiphospholipid syndrome will be:

1. Steroids
2. Heparin
3. Low dose aspirin

--- Content provided by FirstRanker.com ---

4. Progesterone support

Which of the above is/are correct?

(a) 2 and 3

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(b) 3 and 4
(c) 3 only
(d) 1 and 4
75.
Diagnostic criteria for PCOD are:

--- Content provided by FirstRanker.com ---

1. Oligo/amenorrohoea
2. Hyperandrogenism
3. Polycystic ovaries on ultrasound

--- Content provided by FirstRanker.com ---

Which of the above are correct?

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

--- Content provided by FirstRanker.com ---

(d) 1, 2 and 3


76.
Which of the following symptoms can be associated with pelvic organ prolapse?

--- Content provided by FirstRanker.com ---

1. Difficulty in passing urine
2. Incomplete evacuation of urine
3. Urgency and frequency

--- Content provided by FirstRanker.com ---

Select the correct answer using the code given below:

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

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(d) 1, 2 and 3
77.
A 30 year old lady, P
2
L

--- Content provided by FirstRanker.com ---

2
presents with painful unilateral swelling in vulva for 3 days. Which
of the following statements are true regarding the above case?

1. Bartholin?s abscess may be the likely diagnosis

--- Content provided by FirstRanker.com ---

2. It is to be managed by marsupialisation
3. Gonococcus is the most common pathogenic organism

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

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(b) 3 only
(c) 1 and 2 only
(d) 1, 2 and 3
78.
Which one of the following is NOT a sign of separation of placenta?

--- Content provided by FirstRanker.com ---

(a) Uterus becomes globular, firm and ballotable
(b) The fundal height reduces further
(c) Slight bulging in the suprapubic region
(d) Apparent lengthenic of the cord with slight gush of vaginal bleeding

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79.
Consider the following regarding examination of a rape victim:

1. Emergency pill is provided
2. Internal examination must be performed

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3. HIV testing is done

Which of the above statements is/are correct?

(a) 1 and 3 only

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

--- Content provided by FirstRanker.com ---

80.
Consider the following cardinal movements of mechanism of normal labor:
1. Engagement

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2. Internal rotation
3. Flexion
4. Restitution
5. Crowning
6. External rotation

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What is the correct sequence of movements in labor in occipito-lateral position?

(a) 1, 2, 3, 4, 5 and 6
(b) 1, 3, 2, 5, 4 and 6

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(c) 2, 1, 3, 4, 5 and 6
(d) 3, 1, 2, 4, 6 and 5
81.
Which of the following represent the properties of an ideal disinfectant?

--- Content provided by FirstRanker.com ---

1. It is broad spectrum
2. It is fast acting
3. It is non-toxic

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

(a) 1 and 2 only
(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3
82.

--- Content provided by FirstRanker.com ---

Which of the following measures can help reduce the risk of systemic hypertension?

1. Reduction in dietary intake of common salt
2. Controlling weight for age
3. Increasing potassium rich foods in the diet

--- Content provided by FirstRanker.com ---

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

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83.
Keeping biological determinants in perspective, consider the following statements:

1. Presence of a normal karyotype is the first requisite for human health
2. Genetic screening can play an important role in prevention of wide spectrum of

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diseases
3. If an individual is allowed to live in healthy relationship with the environment, the
person?s genetic potentialities can transform into phenotypic realities

Which of the above statements is/are correct?

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

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84.
NITI Aayog has the following roles EXCEPT:

(a) It provides critical directional and strategic input in the development process
(b) It provides relevant technical advice with focus on technology upgradation

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(c) It focuses on capacity building
(d) It focuses on the development of ?Referral Service Complex?
85.
Poor hand hygiene of a mess worker in a university college mess led to Hepatitis A cases in
the hostel inmates. What type of epidemic will this exposure present with?

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1. Propagated
2. Common source-continuous exposure
3. Common source-point exposure

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Select the correct answer using the code given below:

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

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(d) 2 only

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FirstRanker.com - FirstRanker's Choice
Combined Medical Services Examination-2020

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Paper-II

1.
Indications for fasciotomy in compartment syndrome include all EXCEPT:

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(a) Distal sensory disturbance
(b) Compartment pressure > 30 mm Hg
(c) Pain on passive movement of affected muscles
(d) Palpable distal pulses
2.

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Which one of the following statements is NOT correct regarding Necrotising Soft Tissue
infections?

(a) Crepitus, skin blistering and focal skin gangrene are typical presenting features
(b) They are monomicrobial in nature

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(c) Treatment consists of wide local excision and appropriate antibiotics
(d) Tissue biopsy is required for culture and diagnosis
3.
Which type of surgery is laparoscopic cholecystectomy classified as?

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(a) Clean
(b) Clean contaminated
(c) Contaminated
(d) Dirty
4.

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A 22-year female has presented with a history of malaise, cough, alternating constipation and
diarrhoea with intermittent abdominal pain for last 6 months. She also complains of
abdominal distension for last 2 days. On examination her abdomen has a doughy feel along
with an ill defined mass over the right lower quadrant. She is most likely suffering from:

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(a) Appendicular lump
(b) Ileocaecal tuberculosis
(c) Carcinoma caecum
(d) Ovarian mass
5.

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Consider the following statements regarding needle stick injuries:

1. Injured part should be washed under running water
2. Dominant index finger is the commonest site for needle stick injury
3. All needle stick injuries should be reported

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4. Hepatitis/HIV testing should be done after needle stick injury

Which of the statements given above are correct?

(a) 1, 2 and 4

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

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6.
Consider the following statements regarding claudication:

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1. It is a marker for silent coronary disease
2. Structured exercise program ( 2 hours per week for 3 months) leads to
improvement in symptoms
3. Diabetes mellitus increases the risk and severity of claudication
4. Beta blockers may exacerbate claudication

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Which of the above statements are correct?

(a) 1 and 2 only
(b) 1, 3 and 4 only

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(c) 2, 3 and 4 only
(d) 1, 2, 3 and 4
7.
A 50-year old lady underwent uneventful bariatric surgery for morbid obesity. On the third
post operative day, she develops breathless and pulmonary embolism is suspected. The next

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investigation to confirm the diagnosis will be:

(a) Echocardiography
(b) Duplex venography
(c) CT pulmonary angiography

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(d) MR angiography
8.
Medical management of thyrotoxic crisis includes all of the following EXCEPT:

(a) IV fluids

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(b) IV propanolol
(c) IV hydrocortisone
(d) IV antibiotics
9.
A patient operated for a parotid gland tumour developed symptoms of sweating and

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erytherma (flushing) over the region of surgical excision while eating. The probable
diagnosis is:

(a) Parotid gland fistula
(b) Sialadenitis

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(c) Chronic wound infection
(d) Frey?s syndrome
10.
First line hormone therapy for post-menopausal woman with metastatic carcinoma breast is:

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(a) Tamoxifen
(b) Ovarian suppression by surgery
(c) Antiprogestins
(d) Anastrazole

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11.
All of the following are major subtypes of breast cancer based on Gene array analysis
EXCEPT:

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(a) Luminal A and Luminal B
(b) Triple negative
(c) Her-2 receptor positive
(d) Oestrogen receptor positive

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12.
All of the following are sequelae of peptic ulcer surgery EXCEPT:

(a) Bilious vomiting
(b) Dumping syndrome

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(c) Diarrhoea
(d) Increased appetite
13.
The Child-Turcotte-Pugh (CTP) score for quantifying the severity of chronic liver disease
includes all variables EXCEPT:

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(a) Serum bilirubin
(b) Serum albumin
(c) Serum creatinine
(d) INR (International Normalised Ratio)

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14.
?Chain of Lakes? appearance due to sacculation with intervening short strictures of pancreatic
duct is seen on:

(a) ERCP

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(b) CECT abdomen
(c) Plain X-ray abdomen
(d) Ultrasonography
15.
Which one of the following statements is NOT correct regarding Pyogenic Liver Abscess?

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(a) Anorexia, fever, malaise and right upper quadrant abdominal discomfort are the
most common presenting features
(b) It is more common in elderly, diabetics and immunocompromised patients
(c) Treatment is with oral antibiotics alone

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(d) Streptococcus milleri and escherichia coli are the most common causative
organisms
16.
?Swiss cheese defects? are seen during laparoscopic repair of:

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(a) Ventral hernia
(b) Inguinal hernia
(c) Obturator hernia
(d) Femoral hernia

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17.
Which of the following are correct regarding splenic artery aneurysm?

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1. Main arterial trunk is the common site
2. Palpable thrill can be felt
3. It is symptomless unless it ruptures

Select the correct answer using the code given below:

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

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18.
Valentino?s syndrome is:

(a) Pain on per-vaginal examination in pelvic abscess
(b) Pain over left shoulder in left hypochondriac collection

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(c) Pain over left groin in perirenal collection
(d) Pain in right iliac fossa in perforated peptic ulcer
19.
Spontaneous bacterial peritonitis occurs due to:

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(a) duodenal stump blowout
(b) peptic ulcer perforation
(c) acute bacterial infection of ascites
(d) infection via fallopian tubes
20.

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Structure not forming boundaries of the ?Triangle of doom? seen during laparoscopic
inguinal hernia surgery dissection is:

(a) Vas deferens
(b) Inferior epigastric artery

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(c) Spermatic cord vessels
(d) Peritoneum
21.
The term mid-line shift is associated with:

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(a) Head injury
(b) Chest injury
(c) Abdominal injury
(d) Limb injury
22.

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Which one of the following cranial nerves does NOT supply to the external ear?

(a) Cranial nerve V
(b) Cranial nerve VI
(c) Cranial nerve VII

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(d) Cranial nerve IX

23.
Left Internal Mammary Artery (LIMA) has become the conduit of choice for Left Anterior
Descending (LAD) artery during coronary artery bypass grafting because:

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(a) Long term patency rates are more than 98%
(b) It is close to LAD
(c) Atherosclerosis is never seen in this vessel
(d) It is very easy to harvest

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24.
A 50-year old male with significant smoking history presented in the surgical emergency
with sudden severe breathlessness. Chest X-ray shows right sided Pneumothorax. The
appropriate management requires:

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(a) Aspiration of air with 16-18 G cannula
(b) Right chest drain of size 8-14 Fr
(c) Oxygen by face mask
(d) Mechanical ventilation
25.

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Which one of the following statements regarding Felon is NOT correct?

(a) There is infection of the finger tip between specialised fibrous septa
(b) It is a painless condition
(c) Incision and drainage is the treatment of choice

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(d) It is common in diabetics
26.
The most common site for osteosarcoma is:

(a) Proximal femur

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(b) Distal femur
(c) Proximal humerus
(d) Distal humerus
27.
Rapid Sequence Induction is indicated in:

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(a) Emergency surgery for intestinal obstruction
(b) Elective open hernia surgery
(c) Cardiopulmonary bypass surgery
(d) Elective laparoscopic surgery

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28.
Which one of the following statements about Compartment Syndrome is NOT correct?

(a) It is commonest in a closed fracture

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(b) Pain is on active movement but not on passive movement of muscles
(c) Fasciotomy is the treatment of choice
(d) Volkmann?s Ischaemic contractive is a late complication

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29.
Which one of the following is NOT the strength of ultrasound as a diagnostic modality?

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(a) No radiation
(b) Short learning curve
(c) Inexpensive
(d) Allows dynamic studies to be done
30.

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Which of the following statements regarding lymphoedema following breast cancer treatment
are correct?

1. Incidence has decreased due to rarely combined therapy of axillary LN dissection and
radiotherapy

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2. Precipitating cause like LN metastasis is a major determinant
3. The condition is often painful
4. Oedematous limb is susceptible to bacterial infection

Select the correct answer using the code given below:

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

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31.
Which one of the following is NOT a risk factor for development of venous thrombosis in
surgical patients?

(a) Age > 60 years

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(b) Pregnancy
(c) Obesity (BMI > 30 kg/m
2
)
(d) Diabetes ( HbA1c > 7.5%)

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32.
Which one of the following is NOT a complication of massive blood transfusion?

(a) Coagulopathy
(b) Hypocalcaemia

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(c) Hyperthermia
(d) Hyperkalemia
33.
Stage III ?Pressure sore? is full thickness skin loss extending:

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(a) into subcutaneous tissue but not through fascia
(b) through subcutaneous tissue into fascia
(c) through subcutaneous tissue into fascia and muscles
(d) through subcutaneous tissue into fascia, muscles and bone

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34.
During subclavian vein puncture in a surgical ward suddenly a patient developed severe
breathlessness. On auscultation breath sound was absent and the ipsilateral chest was

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tympanitic on percussion. The probable diagnosis is:

(a) Iatrogenic pneumothorax
(b) Introgenic hemothorax
(c) Spontaneous pneumothorax

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(d) Tension pneumothorax
35.
Kohler?s disease is avascular necrosis of :

(a) Lunate

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(b) Capitellum of humerus
(c) First metatarsal head
(d) Navicular
36.
Which one of the following is NOT true of Pyoderma gangrenosum?

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(a) It is characterized by cutaneous ulceration with purple undermined edges
(b) It is often secondary to heightened immunological reactivity from another disease
process
(c) Cultures often show Gram positive Staphylococci

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(d) Lesions generally respond to steroids
37.
Which of the following is NOT a tissue repair surgery for inguinal hernia repair?

(a) Bassini?s repair

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(b) Shouldice repair
(c) Stoppa?s repair
(d) Desarda repair
38.
Which one of the following type of meshes is recommended for intraperitoneal use in

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abdominal wall hernia?
(a) Light weight, porous meshes
(b) Heavy weight, porous meshes
(c) Absorbable meshes
(d) Tissue separating meshes

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39.
Which one of the following is NOT correct regarding MEN-1 syndrome?

(a) It involves parathyroid glands
(b) It involves pancreas

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(c) It involves pituitary gland
(d) It involves pineal gland

40.
Which one of the following is NOT an electronic information site in surgery?

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(a) Pubmed
(b) Embase
(c) Cochrane library
(d) National medical library

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41.
Which one of the following statements regarding pre-conceptional counseling is NOT
correct?

(a) It is needed only in selected complicated pregnancies

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(b) It helps in early detection of risk factors
(c) It helps in reducing maternal morbidity and mortality
(d) It is a part of preventive medicine
42.
Consider the following statements regarding Non Stress Test (NST):

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1. Reactive NST indicates a healthy fetus
2. NST is an observed association of fetal breathing with fetal movements
3. NST has a low false negative rate (< 1%) but high false positive rate (>50%)
4. Testing should be started at 20 weeks

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Which of the statement(s) given above is/are correct?

(a) 1 and 3
(b) 2 only

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(c) 3 only
(d) 1 and 4
43.
Which one of the following is a protective factor for endometrial hyperplasia?

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(a) Diabetes
(b) Tamoxifen therapy
(c) Multiparity
(d) Delayed menopause
44.

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A woman who is not breast feeding her newborn child is advised to use a contraceptive
method by:

(a) 3
rd

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postpartum week
(b) 6
th
postpartum week
(c) 3

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rd
postpartum month
(d) 6
th
postpartum month

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45.
Pearl index for contraceptive effectiveness is calculated in terms of which of the following?

1. Pregnancy rate
2. Abortion rate

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3. Hundred woman years
4. Thousand woman years

Select the correct answer using the code given below:

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(a) 1 only
(b) 2 and 3
(c) 1, 2 and 4
(d) 1 and 3
46.

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Indications for removal of IUDs are all EXCEPT:

(a) Perforation of uterus
(b) Cyclical menstrual bleeding
(c) Flaring up of salpingitis

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(d) Pregnancy with IUD
47.
Contraindications for insertion of IUDs are all EXCEPT:

(a) Suspected pregnancy

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(b) Trophoblastic disease
(c) Severe dysmenorrhea
(d) During cesarean section
48.
Which one of the following is NOT a contraindication for use of Mini pill?

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(a) Pregnancy
(b) Breast feeding
(c) Thromboembolic disease
(d) History of breast cancer

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49.
Which one of the following is the most commonly used surgical method/technique of female
sterilization as recommended by Government of India?

(a) Uchida technique

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(b) Irving method
(c) Pomeroy?s method
(d) Madlener technique

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50.
Which of the following is/are required for a registered medical practitioner to qualify for
performing Medical Termination of Pregnancy (MTP), as per revised rules of MTP Act?

1. Certified for assisting at least 15 MTP in an authorized centre

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2. Diploma or degree in Obstetrics and Gynaecology
3. House surgeon training for 3 months in Obstetrics and Gynaecology
4. Certified training for 6 months in laparoscopic surgeries

Select the correct answer using the code given below:

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(a) 1 only
(b) 2 only
(c) 1, 2 and 3
(d) 1, 2 and 4
51.

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Which one of the following is NOT a support of uterus, preventing its descent?

(a) Endopelvic fascia
(b) Mackenrodt?s ligament
(c) Inguinal ligament

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(d) Pubocervical ligament
52.
As per ICMR guidelines, which one of the following statements is true regarding effects of
COVID-19 on fetus according to current evidence?

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(a) There is increased risk of early pregnancy loss
(b) COVID-19 virus is not teratogenic
(c) COVID-19 virus infection is an indication of MTP
(d) There is increased risk of fetal growth restriction
53.

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As per ICMR guidelines, which one of the following statements is true regarding COVID-19
infection in pregnancy?

(a) Covid-19 pneumonia in pregnancy is more severe with poor recovery
(b) Pregnant women with heart disease are at higher risk

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(c) Vaginal secretions always test positive for COVID-19 in pregnancy
(d) COVID-19 virus is secreted in breast milk
54.
Which one of the following is NOT a method of management of Deep Transverse Arrest with
the living fetus?

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(a) Caesarean section
(b) Delivery by ventouse
(c) Delivery by application of forceps to the unrotated head
(d) Manual rotation and application of forceps

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55.
Successful version of breech presentation is likely in case all of the following EXCEPT:

(a) Breech with extended legs
(b) Complete breech with sacroanterior position

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(c) Non engaged breech
(d) Adequate amniotic fluid
56.
Implantation of a fertilised ovum occurs on which day following fertilisation?

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(a) Day 6
(b) Day 10
(c) Day 14
(d) Day 20
57.

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During total abdominal hysterectomy the ureter is likely to undergo injury or ligation during
the following steps EXCEPT:

(a) During division and ligation of the round ligaments
(b) During division and ligation of infundibulopelvic ligaments

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(c) During division and ligation of mackenrodt?s and uterosacral ligaments
(d) At the vaginal angles while incising the vagina to remove the cervix with the
uterus
58.
The net effect of antenatal care has been the following EXCEPT:

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(a) Reduction in maternal mortality
(b) Reduction in perinatal mortality
(c) Reduction in the incidence of institutional delivery
(d) Reduction in maternal morbidity

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59.
Which one of the following is NOT a component of active phase in the partograph?

(a) Acceleration phase
(b) Phase of maximum slope

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(c) Phase of deceleration
(d) Phase of expulsion
60.
From medicolegal point of view which one of the following is NOT a sign of previous child
birth?

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(a) Perineum is lax and there is evidence of scarring
(b) Introitus is gaping and there is presence of carunculae myrtiformis
(c) Abdomen is lax and loose with striae and linea alba
(d) Conical cervix with round external os

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61.
The components of partograph are all EXCEPT:

(a) Time
(b) Fetal heart rate

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(c) Maternal respiratory rate
(d) Maternal urine analysis
62.
Which of the following information are provided by partograph?

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1. Colour of liquor
2. Uterine contractions with duration and frequency
3. Dilatation of cervix

Select the correct answer using the code given below:

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

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63.
Intraoperative recognition of ureter is by which of the following features?

1. Transparent tubular appearance
2. Pale glistening appearance

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3. Longitudinal vessels on surface
4. Circumferential vessels on surface

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

(a) 1 and 3
(b) 2 and 4
(c) 2 and 3
(d) 1 and 4
64.

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Hysterosalpingography (HSG) is least helpful in detecting which of the following?

(a) Tubal patency
(b) Pelvic adhesions
(c) Asherman syndrome

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(d) Congenital uterine anomaly

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65.
Which of the following are characteristics of Trichomonas vaginitis?

1. Presence of greenish frothy discharge
2. Vaginal pH > 4.5

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3. Presence of clue cells in microscopic examination
4. Strawberry spots on the vaginal mucosa

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

(a) 1, 2 and 3
(b) 1, 2 and 4
(c) 2, 3 and 4
(d) 1, 3 and 4
66.

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Tumor marker of epithelial ovarian carcinoma is:

(a) Ca.125
(b) Alpha feto protein
(c) Beta HCG

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(d) LDH
67.
The most common site of cervical cancer is:

(a) Endocervix

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(b) Ectocervix
(c) Transformation zone
(d) Isthmus
68.
The placenta synthesizes all EXCEPT:

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(a) Oestriol
(b) Corticotrophin releasing hormone
(c) PAPP-A(Pregnancy Associated Plasma Protein A)
(d) Dehydroepiandrosterone

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69.
Withdrawal bleeding following administration of progesterone in a case of secondary
amenorrhea indicates all EXCEPT:

(a) Absence of pregnancy

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(b) Production endogenous estrogen
(c) Endometrium is responsive to estrogen
(d) Defect in pituitary gland
70.
Monilial vaginitis is commonly associated with all EXCEPT:

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(a) Prolonged antibiotic therapy
(b) Diabetes Mellitus
(c) Treatment of malaria with chloroquine
(d) Pregnancy

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71.
Which one of the following is NOT a risk factor for the development of placenta previa?

(a) Maternal age
(b) Smoking

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(c) Previous caesarean section
(d) Maternal anaemia
72.
Common clinical presentations of moderate to severe abruption are all EXCEPT:

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(a) Uterine tenderness
(b) Fetal distress
(c) Unexplained pre term labour
(d) Prolonged labour
73.

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Common trisomies resulting in spontaneous abortion are all EXCEPT:

(a) Trisomy 21
(b) Trisomy 18
(c) Trisomy 16

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(d) Trisomy 1
74.
The initial prevention strategy for antiphospholipid syndrome will be:

1. Steroids

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2. Heparin
3. Low dose aspirin
4. Progesterone support

Which of the above is/are correct?

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

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75.
Diagnostic criteria for PCOD are:

1. Oligo/amenorrohoea
2. Hyperandrogenism

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3. Polycystic ovaries on ultrasound

Which of the above are correct?

(a) 1 and 2 only

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

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76.
Which of the following symptoms can be associated with pelvic organ prolapse?

1. Difficulty in passing urine
2. Incomplete evacuation of urine

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3. Urgency and frequency

Select the correct answer using the code given below:

(a) 1 and 2 only

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(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3
77.
A 30 year old lady, P

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2
L
2
presents with painful unilateral swelling in vulva for 3 days. Which
of the following statements are true regarding the above case?

--- Content provided by FirstRanker.com ---

1. Bartholin?s abscess may be the likely diagnosis
2. It is to be managed by marsupialisation
3. Gonococcus is the most common pathogenic organism

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

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78.
Which one of the following is NOT a sign of separation of placenta?

(a) Uterus becomes globular, firm and ballotable
(b) The fundal height reduces further

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(c) Slight bulging in the suprapubic region
(d) Apparent lengthenic of the cord with slight gush of vaginal bleeding
79.
Consider the following regarding examination of a rape victim:

--- Content provided by FirstRanker.com ---

1. Emergency pill is provided
2. Internal examination must be performed
3. HIV testing is done

Which of the above statements is/are correct?

--- Content provided by FirstRanker.com ---

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

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80.

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Consider the following cardinal movements of mechanism of normal labor:
1. Engagement
2. Internal rotation
3. Flexion
4. Restitution

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5. Crowning
6. External rotation

What is the correct sequence of movements in labor in occipito-lateral position?

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(a) 1, 2, 3, 4, 5 and 6
(b) 1, 3, 2, 5, 4 and 6
(c) 2, 1, 3, 4, 5 and 6
(d) 3, 1, 2, 4, 6 and 5
81.

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Which of the following represent the properties of an ideal disinfectant?

1. It is broad spectrum
2. It is fast acting
3. It is non-toxic

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

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(d) 1, 2 and 3
82.
Which of the following measures can help reduce the risk of systemic hypertension?

1. Reduction in dietary intake of common salt

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2. Controlling weight for age
3. Increasing potassium rich foods in the diet

Select the correct answer using the code given below:

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

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83.
Keeping biological determinants in perspective, consider the following statements:

--- Content provided by FirstRanker.com ---

1. Presence of a normal karyotype is the first requisite for human health
2. Genetic screening can play an important role in prevention of wide spectrum of
diseases
3. If an individual is allowed to live in healthy relationship with the environment, the
person?s genetic potentialities can transform into phenotypic realities

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Which of the above statements is/are correct?

(a) 1 and 2 only
(b) 1 and 3 only

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(c) 1, 2 and 3
(d) 2 and 3 only
84.
NITI Aayog has the following roles EXCEPT:

--- Content provided by FirstRanker.com ---

(a) It provides critical directional and strategic input in the development process
(b) It provides relevant technical advice with focus on technology upgradation
(c) It focuses on capacity building
(d) It focuses on the development of ?Referral Service Complex?
85.

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Poor hand hygiene of a mess worker in a university college mess led to Hepatitis A cases in
the hostel inmates. What type of epidemic will this exposure present with?

1. Propagated
2. Common source-continuous exposure

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3. Common source-point exposure

Select the correct answer using the code given below:

(a) 1 and 2

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

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86.
What is the specificity of sputum microscopy in detection of Pulmonary Tuberculosis (PTB)
as per the information given below?

PTB Total

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Sputum microscopy Present Absent
Positive 270 20 290
Negative 30 180 210
Total 300 200 500

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(a) 10 %
(b) 36 %
(c) 90 %
(d) 94 %
87.

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In a cohort of 500 women attending antenatal clinic, 70 % had ultrasonography (USG). This
cohort was followed up at delivery. Of the women who had USG, 70 delivered low birth
weight (LBW) babies; whereas of the women, who did not undergo USG, 50 delivered LBW
babies. The incidence of LBW babies among women who had USG is:

--- Content provided by FirstRanker.com ---

(a) 10 %
(b) 15 %
(c) 20 %
(d) 25 %
88.

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Major source of vitamin K
1
is:

(a) Fresh dark green vegetables

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(b) Exposure of body to sunlight
(c) Citrus fruits
(d) Foods rich in polyunsaturated fatty acids
89.
Which one of the following is NOT a function of Epidemiology?

--- Content provided by FirstRanker.com ---

(a) To study historically the rise and fall of disease in the population
(b) Searching for the causes and risk factor
(c) Identifying syndromes
(d) Making clinical diagnosis

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90.
Which one of the following is NOT a contagious disease?

(a) Malaria
(b) Scabies

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(c) Trachoma
(d) Leprosy


FirstRanker.com - FirstRanker's Choice

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Combined Medical Services Examination-2020
Paper-II

1.
Indications for fasciotomy in compartment syndrome include all EXCEPT:

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(a) Distal sensory disturbance
(b) Compartment pressure > 30 mm Hg
(c) Pain on passive movement of affected muscles
(d) Palpable distal pulses

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2.
Which one of the following statements is NOT correct regarding Necrotising Soft Tissue
infections?

(a) Crepitus, skin blistering and focal skin gangrene are typical presenting features

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(b) They are monomicrobial in nature
(c) Treatment consists of wide local excision and appropriate antibiotics
(d) Tissue biopsy is required for culture and diagnosis
3.
Which type of surgery is laparoscopic cholecystectomy classified as?

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(a) Clean
(b) Clean contaminated
(c) Contaminated
(d) Dirty

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4.
A 22-year female has presented with a history of malaise, cough, alternating constipation and
diarrhoea with intermittent abdominal pain for last 6 months. She also complains of
abdominal distension for last 2 days. On examination her abdomen has a doughy feel along
with an ill defined mass over the right lower quadrant. She is most likely suffering from:

--- Content provided by FirstRanker.com ---

(a) Appendicular lump
(b) Ileocaecal tuberculosis
(c) Carcinoma caecum
(d) Ovarian mass

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5.
Consider the following statements regarding needle stick injuries:

1. Injured part should be washed under running water
2. Dominant index finger is the commonest site for needle stick injury

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3. All needle stick injuries should be reported
4. Hepatitis/HIV testing should be done after needle stick injury

Which of the statements given above are correct?

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

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6.
Consider the following statements regarding claudication:

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1. It is a marker for silent coronary disease
2. Structured exercise program ( 2 hours per week for 3 months) leads to
improvement in symptoms
3. Diabetes mellitus increases the risk and severity of claudication

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4. Beta blockers may exacerbate claudication

Which of the above statements are correct?

(a) 1 and 2 only

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(b) 1, 3 and 4 only
(c) 2, 3 and 4 only
(d) 1, 2, 3 and 4
7.
A 50-year old lady underwent uneventful bariatric surgery for morbid obesity. On the third

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post operative day, she develops breathless and pulmonary embolism is suspected. The next
investigation to confirm the diagnosis will be:

(a) Echocardiography
(b) Duplex venography

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(c) CT pulmonary angiography
(d) MR angiography
8.
Medical management of thyrotoxic crisis includes all of the following EXCEPT:

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(a) IV fluids
(b) IV propanolol
(c) IV hydrocortisone
(d) IV antibiotics
9.

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A patient operated for a parotid gland tumour developed symptoms of sweating and
erytherma (flushing) over the region of surgical excision while eating. The probable
diagnosis is:

(a) Parotid gland fistula

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(b) Sialadenitis
(c) Chronic wound infection
(d) Frey?s syndrome
10.
First line hormone therapy for post-menopausal woman with metastatic carcinoma breast is:

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(a) Tamoxifen
(b) Ovarian suppression by surgery
(c) Antiprogestins
(d) Anastrazole

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11.
All of the following are major subtypes of breast cancer based on Gene array analysis

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EXCEPT:

(a) Luminal A and Luminal B
(b) Triple negative
(c) Her-2 receptor positive

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(d) Oestrogen receptor positive
12.
All of the following are sequelae of peptic ulcer surgery EXCEPT:

(a) Bilious vomiting

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(b) Dumping syndrome
(c) Diarrhoea
(d) Increased appetite
13.
The Child-Turcotte-Pugh (CTP) score for quantifying the severity of chronic liver disease

--- Content provided by FirstRanker.com ---

includes all variables EXCEPT:

(a) Serum bilirubin
(b) Serum albumin
(c) Serum creatinine

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(d) INR (International Normalised Ratio)
14.
?Chain of Lakes? appearance due to sacculation with intervening short strictures of pancreatic
duct is seen on:

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(a) ERCP
(b) CECT abdomen
(c) Plain X-ray abdomen
(d) Ultrasonography
15.

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Which one of the following statements is NOT correct regarding Pyogenic Liver Abscess?

(a) Anorexia, fever, malaise and right upper quadrant abdominal discomfort are the
most common presenting features
(b) It is more common in elderly, diabetics and immunocompromised patients

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(c) Treatment is with oral antibiotics alone
(d) Streptococcus milleri and escherichia coli are the most common causative
organisms
16.
?Swiss cheese defects? are seen during laparoscopic repair of:

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(a) Ventral hernia
(b) Inguinal hernia
(c) Obturator hernia
(d) Femoral hernia

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17.
Which of the following are correct regarding splenic artery aneurysm?

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1. Main arterial trunk is the common site
2. Palpable thrill can be felt
3. It is symptomless unless it ruptures

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Select the correct answer using the code given below:

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

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(d) 1, 2 and 3
18.
Valentino?s syndrome is:

(a) Pain on per-vaginal examination in pelvic abscess

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(b) Pain over left shoulder in left hypochondriac collection
(c) Pain over left groin in perirenal collection
(d) Pain in right iliac fossa in perforated peptic ulcer
19.
Spontaneous bacterial peritonitis occurs due to:

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(a) duodenal stump blowout
(b) peptic ulcer perforation
(c) acute bacterial infection of ascites
(d) infection via fallopian tubes

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20.
Structure not forming boundaries of the ?Triangle of doom? seen during laparoscopic
inguinal hernia surgery dissection is:

(a) Vas deferens

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(b) Inferior epigastric artery
(c) Spermatic cord vessels
(d) Peritoneum
21.
The term mid-line shift is associated with:

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(a) Head injury
(b) Chest injury
(c) Abdominal injury
(d) Limb injury

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22.
Which one of the following cranial nerves does NOT supply to the external ear?

(a) Cranial nerve V
(b) Cranial nerve VI

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(c) Cranial nerve VII
(d) Cranial nerve IX

23.
Left Internal Mammary Artery (LIMA) has become the conduit of choice for Left Anterior

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Descending (LAD) artery during coronary artery bypass grafting because:

(a) Long term patency rates are more than 98%
(b) It is close to LAD
(c) Atherosclerosis is never seen in this vessel

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(d) It is very easy to harvest
24.
A 50-year old male with significant smoking history presented in the surgical emergency
with sudden severe breathlessness. Chest X-ray shows right sided Pneumothorax. The
appropriate management requires:

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(a) Aspiration of air with 16-18 G cannula
(b) Right chest drain of size 8-14 Fr
(c) Oxygen by face mask
(d) Mechanical ventilation

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25.
Which one of the following statements regarding Felon is NOT correct?

(a) There is infection of the finger tip between specialised fibrous septa
(b) It is a painless condition

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(c) Incision and drainage is the treatment of choice
(d) It is common in diabetics
26.
The most common site for osteosarcoma is:

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(a) Proximal femur
(b) Distal femur
(c) Proximal humerus
(d) Distal humerus
27.

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Rapid Sequence Induction is indicated in:

(a) Emergency surgery for intestinal obstruction
(b) Elective open hernia surgery
(c) Cardiopulmonary bypass surgery

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(d) Elective laparoscopic surgery

28.
Which one of the following statements about Compartment Syndrome is NOT correct?

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(a) It is commonest in a closed fracture
(b) Pain is on active movement but not on passive movement of muscles
(c) Fasciotomy is the treatment of choice
(d) Volkmann?s Ischaemic contractive is a late complication

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29.
Which one of the following is NOT the strength of ultrasound as a diagnostic modality?

--- Content provided by FirstRanker.com ---

(a) No radiation
(b) Short learning curve
(c) Inexpensive
(d) Allows dynamic studies to be done

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30.
Which of the following statements regarding lymphoedema following breast cancer treatment
are correct?

1. Incidence has decreased due to rarely combined therapy of axillary LN dissection and

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radiotherapy
2. Precipitating cause like LN metastasis is a major determinant
3. The condition is often painful
4. Oedematous limb is susceptible to bacterial infection

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Select the correct answer using the code given below:

(a) 1, 2 and 3
(b) 2, 3 and 4
(c) 1, 3 and 4

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(d) 1, 2 and 4
31.
Which one of the following is NOT a risk factor for development of venous thrombosis in
surgical patients?

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(a) Age > 60 years
(b) Pregnancy
(c) Obesity (BMI > 30 kg/m
2
)

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(d) Diabetes ( HbA1c > 7.5%)
32.
Which one of the following is NOT a complication of massive blood transfusion?

(a) Coagulopathy

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(b) Hypocalcaemia
(c) Hyperthermia
(d) Hyperkalemia
33.
Stage III ?Pressure sore? is full thickness skin loss extending:

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(a) into subcutaneous tissue but not through fascia
(b) through subcutaneous tissue into fascia
(c) through subcutaneous tissue into fascia and muscles
(d) through subcutaneous tissue into fascia, muscles and bone

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34.
During subclavian vein puncture in a surgical ward suddenly a patient developed severe

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breathlessness. On auscultation breath sound was absent and the ipsilateral chest was
tympanitic on percussion. The probable diagnosis is:

(a) Iatrogenic pneumothorax
(b) Introgenic hemothorax

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(c) Spontaneous pneumothorax
(d) Tension pneumothorax
35.
Kohler?s disease is avascular necrosis of :

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(a) Lunate
(b) Capitellum of humerus
(c) First metatarsal head
(d) Navicular
36.

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Which one of the following is NOT true of Pyoderma gangrenosum?

(a) It is characterized by cutaneous ulceration with purple undermined edges
(b) It is often secondary to heightened immunological reactivity from another disease
process

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(c) Cultures often show Gram positive Staphylococci
(d) Lesions generally respond to steroids
37.
Which of the following is NOT a tissue repair surgery for inguinal hernia repair?

--- Content provided by FirstRanker.com ---

(a) Bassini?s repair
(b) Shouldice repair
(c) Stoppa?s repair
(d) Desarda repair
38.

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Which one of the following type of meshes is recommended for intraperitoneal use in
abdominal wall hernia?
(a) Light weight, porous meshes
(b) Heavy weight, porous meshes
(c) Absorbable meshes

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(d) Tissue separating meshes
39.
Which one of the following is NOT correct regarding MEN-1 syndrome?

(a) It involves parathyroid glands

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(b) It involves pancreas
(c) It involves pituitary gland
(d) It involves pineal gland

40.

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Which one of the following is NOT an electronic information site in surgery?

(a) Pubmed
(b) Embase
(c) Cochrane library

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(d) National medical library
41.
Which one of the following statements regarding pre-conceptional counseling is NOT
correct?

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(a) It is needed only in selected complicated pregnancies
(b) It helps in early detection of risk factors
(c) It helps in reducing maternal morbidity and mortality
(d) It is a part of preventive medicine
42.

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Consider the following statements regarding Non Stress Test (NST):

1. Reactive NST indicates a healthy fetus
2. NST is an observed association of fetal breathing with fetal movements
3. NST has a low false negative rate (< 1%) but high false positive rate (>50%)

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4. Testing should be started at 20 weeks

Which of the statement(s) given above is/are correct?

(a) 1 and 3

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(b) 2 only
(c) 3 only
(d) 1 and 4
43.
Which one of the following is a protective factor for endometrial hyperplasia?

--- Content provided by FirstRanker.com ---

(a) Diabetes
(b) Tamoxifen therapy
(c) Multiparity
(d) Delayed menopause

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44.
A woman who is not breast feeding her newborn child is advised to use a contraceptive
method by:

(a) 3

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rd
postpartum week
(b) 6
th
postpartum week

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(c) 3
rd
postpartum month
(d) 6
th

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postpartum month

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45.
Pearl index for contraceptive effectiveness is calculated in terms of which of the following?

1. Pregnancy rate

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2. Abortion rate
3. Hundred woman years
4. Thousand woman years

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

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

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46.
Indications for removal of IUDs are all EXCEPT:

(a) Perforation of uterus
(b) Cyclical menstrual bleeding

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(c) Flaring up of salpingitis
(d) Pregnancy with IUD
47.
Contraindications for insertion of IUDs are all EXCEPT:

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(a) Suspected pregnancy
(b) Trophoblastic disease
(c) Severe dysmenorrhea
(d) During cesarean section
48.

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Which one of the following is NOT a contraindication for use of Mini pill?

(a) Pregnancy
(b) Breast feeding
(c) Thromboembolic disease

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(d) History of breast cancer
49.
Which one of the following is the most commonly used surgical method/technique of female
sterilization as recommended by Government of India?

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(a) Uchida technique
(b) Irving method
(c) Pomeroy?s method
(d) Madlener technique

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50.
Which of the following is/are required for a registered medical practitioner to qualify for
performing Medical Termination of Pregnancy (MTP), as per revised rules of MTP Act?

--- Content provided by FirstRanker.com ---

1. Certified for assisting at least 15 MTP in an authorized centre
2. Diploma or degree in Obstetrics and Gynaecology
3. House surgeon training for 3 months in Obstetrics and Gynaecology
4. Certified training for 6 months in laparoscopic surgeries

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

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51.
Which one of the following is NOT a support of uterus, preventing its descent?

(a) Endopelvic fascia
(b) Mackenrodt?s ligament

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(c) Inguinal ligament
(d) Pubocervical ligament
52.
As per ICMR guidelines, which one of the following statements is true regarding effects of
COVID-19 on fetus according to current evidence?

--- Content provided by FirstRanker.com ---

(a) There is increased risk of early pregnancy loss
(b) COVID-19 virus is not teratogenic
(c) COVID-19 virus infection is an indication of MTP
(d) There is increased risk of fetal growth restriction

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53.
As per ICMR guidelines, which one of the following statements is true regarding COVID-19
infection in pregnancy?

(a) Covid-19 pneumonia in pregnancy is more severe with poor recovery

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(b) Pregnant women with heart disease are at higher risk
(c) Vaginal secretions always test positive for COVID-19 in pregnancy
(d) COVID-19 virus is secreted in breast milk
54.
Which one of the following is NOT a method of management of Deep Transverse Arrest with

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the living fetus?

(a) Caesarean section
(b) Delivery by ventouse
(c) Delivery by application of forceps to the unrotated head

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(d) Manual rotation and application of forceps

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55.
Successful version of breech presentation is likely in case all of the following EXCEPT:

(a) Breech with extended legs

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(b) Complete breech with sacroanterior position
(c) Non engaged breech
(d) Adequate amniotic fluid
56.
Implantation of a fertilised ovum occurs on which day following fertilisation?

--- Content provided by FirstRanker.com ---

(a) Day 6
(b) Day 10
(c) Day 14
(d) Day 20

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57.
During total abdominal hysterectomy the ureter is likely to undergo injury or ligation during
the following steps EXCEPT:

(a) During division and ligation of the round ligaments

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(b) During division and ligation of infundibulopelvic ligaments
(c) During division and ligation of mackenrodt?s and uterosacral ligaments
(d) At the vaginal angles while incising the vagina to remove the cervix with the
uterus
58.

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The net effect of antenatal care has been the following EXCEPT:

(a) Reduction in maternal mortality
(b) Reduction in perinatal mortality
(c) Reduction in the incidence of institutional delivery

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(d) Reduction in maternal morbidity
59.
Which one of the following is NOT a component of active phase in the partograph?

(a) Acceleration phase

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(b) Phase of maximum slope
(c) Phase of deceleration
(d) Phase of expulsion
60.
From medicolegal point of view which one of the following is NOT a sign of previous child

--- Content provided by FirstRanker.com ---

birth?

(a) Perineum is lax and there is evidence of scarring
(b) Introitus is gaping and there is presence of carunculae myrtiformis
(c) Abdomen is lax and loose with striae and linea alba

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(d) Conical cervix with round external os

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61.
The components of partograph are all EXCEPT:

(a) Time

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(b) Fetal heart rate
(c) Maternal respiratory rate
(d) Maternal urine analysis
62.
Which of the following information are provided by partograph?

--- Content provided by FirstRanker.com ---

1. Colour of liquor
2. Uterine contractions with duration and frequency
3. Dilatation of cervix

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Select the correct answer using the code given below:

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

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(d) 1, 2 and 3
63.
Intraoperative recognition of ureter is by which of the following features?

1. Transparent tubular appearance

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2. Pale glistening appearance
3. Longitudinal vessels on surface
4. Circumferential vessels on surface

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

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

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64.
Hysterosalpingography (HSG) is least helpful in detecting which of the following?

(a) Tubal patency
(b) Pelvic adhesions

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(c) Asherman syndrome
(d) Congenital uterine anomaly

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65.
Which of the following are characteristics of Trichomonas vaginitis?

1. Presence of greenish frothy discharge

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2. Vaginal pH > 4.5
3. Presence of clue cells in microscopic examination
4. Strawberry spots on the vaginal mucosa

Select the correct answer using the code given below:

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

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66.
Tumor marker of epithelial ovarian carcinoma is:

(a) Ca.125
(b) Alpha feto protein

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(c) Beta HCG
(d) LDH
67.
The most common site of cervical cancer is:

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(a) Endocervix
(b) Ectocervix
(c) Transformation zone
(d) Isthmus
68.

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The placenta synthesizes all EXCEPT:

(a) Oestriol
(b) Corticotrophin releasing hormone
(c) PAPP-A(Pregnancy Associated Plasma Protein A)

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(d) Dehydroepiandrosterone
69.
Withdrawal bleeding following administration of progesterone in a case of secondary
amenorrhea indicates all EXCEPT:

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(a) Absence of pregnancy
(b) Production endogenous estrogen
(c) Endometrium is responsive to estrogen
(d) Defect in pituitary gland
70.

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Monilial vaginitis is commonly associated with all EXCEPT:

(a) Prolonged antibiotic therapy
(b) Diabetes Mellitus
(c) Treatment of malaria with chloroquine

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(d) Pregnancy
71.
Which one of the following is NOT a risk factor for the development of placenta previa?

(a) Maternal age

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(b) Smoking
(c) Previous caesarean section
(d) Maternal anaemia
72.
Common clinical presentations of moderate to severe abruption are all EXCEPT:

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(a) Uterine tenderness
(b) Fetal distress
(c) Unexplained pre term labour
(d) Prolonged labour

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73.
Common trisomies resulting in spontaneous abortion are all EXCEPT:

(a) Trisomy 21
(b) Trisomy 18

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(c) Trisomy 16
(d) Trisomy 1
74.
The initial prevention strategy for antiphospholipid syndrome will be:

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1. Steroids
2. Heparin
3. Low dose aspirin
4. Progesterone support

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Which of the above is/are correct?

(a) 2 and 3
(b) 3 and 4
(c) 3 only

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(d) 1 and 4
75.
Diagnostic criteria for PCOD are:

1. Oligo/amenorrohoea

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2. Hyperandrogenism
3. Polycystic ovaries on ultrasound

Which of the above are correct?

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

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76.
Which of the following symptoms can be associated with pelvic organ prolapse?

1. Difficulty in passing urine

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2. Incomplete evacuation of urine
3. Urgency and frequency

Select the correct answer using the code given below:

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

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A 30 year old lady, P
2
L
2
presents with painful unilateral swelling in vulva for 3 days. Which

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of the following statements are true regarding the above case?

1. Bartholin?s abscess may be the likely diagnosis
2. It is to be managed by marsupialisation
3. Gonococcus is the most common pathogenic organism

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

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(d) 1, 2 and 3
78.
Which one of the following is NOT a sign of separation of placenta?

(a) Uterus becomes globular, firm and ballotable

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(b) The fundal height reduces further
(c) Slight bulging in the suprapubic region
(d) Apparent lengthenic of the cord with slight gush of vaginal bleeding
79.
Consider the following regarding examination of a rape victim:

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1. Emergency pill is provided
2. Internal examination must be performed
3. HIV testing is done

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Which of the above statements is/are correct?

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

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(d) 3 only

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80.
Consider the following cardinal movements of mechanism of normal labor:
1. Engagement
2. Internal rotation
3. Flexion

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4. Restitution
5. Crowning
6. External rotation

What is the correct sequence of movements in labor in occipito-lateral position?

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(a) 1, 2, 3, 4, 5 and 6
(b) 1, 3, 2, 5, 4 and 6
(c) 2, 1, 3, 4, 5 and 6
(d) 3, 1, 2, 4, 6 and 5

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81.
Which of the following represent the properties of an ideal disinfectant?

1. It is broad spectrum
2. It is fast acting

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3. It is non-toxic

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
82.
Which of the following measures can help reduce the risk of systemic hypertension?

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1. Reduction in dietary intake of common salt
2. Controlling weight for age
3. Increasing potassium rich foods in the diet

Select the correct answer using the code given below:

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

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83.
Keeping biological determinants in perspective, consider the following statements:

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1. Presence of a normal karyotype is the first requisite for human health
2. Genetic screening can play an important role in prevention of wide spectrum of
diseases
3. If an individual is allowed to live in healthy relationship with the environment, the

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person?s genetic potentialities can transform into phenotypic realities

Which of the above statements is/are correct?

(a) 1 and 2 only

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(b) 1 and 3 only
(c) 1, 2 and 3
(d) 2 and 3 only
84.
NITI Aayog has the following roles EXCEPT:

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(a) It provides critical directional and strategic input in the development process
(b) It provides relevant technical advice with focus on technology upgradation
(c) It focuses on capacity building
(d) It focuses on the development of ?Referral Service Complex?

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85.
Poor hand hygiene of a mess worker in a university college mess led to Hepatitis A cases in
the hostel inmates. What type of epidemic will this exposure present with?

1. Propagated

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2. Common source-continuous exposure
3. Common source-point exposure

Select the correct answer using the code given below:

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

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86.
What is the specificity of sputum microscopy in detection of Pulmonary Tuberculosis (PTB)
as per the information given below?

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PTB Total
Sputum microscopy Present Absent
Positive 270 20 290
Negative 30 180 210
Total 300 200 500

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(a) 10 %
(b) 36 %
(c) 90 %
(d) 94 %

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87.
In a cohort of 500 women attending antenatal clinic, 70 % had ultrasonography (USG). This
cohort was followed up at delivery. Of the women who had USG, 70 delivered low birth
weight (LBW) babies; whereas of the women, who did not undergo USG, 50 delivered LBW
babies. The incidence of LBW babies among women who had USG is:

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(a) 10 %
(b) 15 %
(c) 20 %
(d) 25 %

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88.
Major source of vitamin K
1
is:

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(a) Fresh dark green vegetables
(b) Exposure of body to sunlight
(c) Citrus fruits
(d) Foods rich in polyunsaturated fatty acids
89.

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Which one of the following is NOT a function of Epidemiology?

(a) To study historically the rise and fall of disease in the population
(b) Searching for the causes and risk factor
(c) Identifying syndromes

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(d) Making clinical diagnosis
90.
Which one of the following is NOT a contagious disease?

(a) Malaria

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(b) Scabies
(c) Trachoma
(d) Leprosy

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91.
In primary immune response, how much more antigenic dose is required to induce IgG
antibodies as against the induction of IgM antibodies?

(a) 10 times more

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(b) 25 times more
(c) 50 times more
(d) 100 times more
92.
Pentavalent vaccine provides protection against which of the following diseases?

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(a) Diphtheria, Pertussis, Tuberculosis, Measles and Hepatitis B
(b) Diphtheria, Pertussis, Measles, Hepatitis B and Hib
(c) Diphtheria, Pertussis, Tetanus, Hepatitis B and Rubella
(d) Diphtheria, Pertussis, Tetanus, Hepatitis B and Hib

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93.
Consider the following data for a country:
Population in 0-14 years of age ? 391,558,367
Population between 15?64 years of age ? 856,076,200
Population above 65 years of age ? 71,943,390

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What shall be the dependency ratio of this country?

(a) 42.4 %
(b) 54.1 %
(c) 66.2 %

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(d) 78.6 %
94.
Which one of the following statements regarding Rabies Immunoglobulin is NOT true?

(a) It should be administered only once as soon as possible after the initiation of post

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exposure prophylaxis
(b) It should be administered all into or around the wound sites
(c) There is no scientific ground for performing a skin test prior to administering equine
immunoglobulin
(d) It can be administered till 15 days after the first dose of anti-rabies vaccine

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95.
All of the following are true about Bedaquiline (BDQ) EXCEPT:

(a) It specifically targets mycobacterial ATP synthase
(b) It is a bacteriostatic drug

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(c) It has extended half life
(d) It has high volume of tissue distribution
96.
Visual inspection based screening test with 5 % acetic acid is used for the screening of which
one of the following cancers?

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(a) Lung cancer
(b) Cervix cancer
(c) Oral cancer
(d) Breast cancer

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FirstRanker.com - FirstRanker's Choice
Combined Medical Services Examination-2020
Paper-II

1.

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Indications for fasciotomy in compartment syndrome include all EXCEPT:

(a) Distal sensory disturbance
(b) Compartment pressure > 30 mm Hg
(c) Pain on passive movement of affected muscles

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(d) Palpable distal pulses
2.
Which one of the following statements is NOT correct regarding Necrotising Soft Tissue
infections?

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(a) Crepitus, skin blistering and focal skin gangrene are typical presenting features
(b) They are monomicrobial in nature
(c) Treatment consists of wide local excision and appropriate antibiotics
(d) Tissue biopsy is required for culture and diagnosis
3.

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Which type of surgery is laparoscopic cholecystectomy classified as?

(a) Clean
(b) Clean contaminated
(c) Contaminated

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(d) Dirty
4.
A 22-year female has presented with a history of malaise, cough, alternating constipation and
diarrhoea with intermittent abdominal pain for last 6 months. She also complains of
abdominal distension for last 2 days. On examination her abdomen has a doughy feel along

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with an ill defined mass over the right lower quadrant. She is most likely suffering from:

(a) Appendicular lump
(b) Ileocaecal tuberculosis
(c) Carcinoma caecum

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(d) Ovarian mass
5.
Consider the following statements regarding needle stick injuries:

1. Injured part should be washed under running water

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2. Dominant index finger is the commonest site for needle stick injury
3. All needle stick injuries should be reported
4. Hepatitis/HIV testing should be done after needle stick injury

Which of the statements given above are correct?

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

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6.

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Consider the following statements regarding claudication:

1. It is a marker for silent coronary disease
2. Structured exercise program ( 2 hours per week for 3 months) leads to
improvement in symptoms

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3. Diabetes mellitus increases the risk and severity of claudication
4. Beta blockers may exacerbate claudication

Which of the above statements are correct?

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(a) 1 and 2 only
(b) 1, 3 and 4 only
(c) 2, 3 and 4 only
(d) 1, 2, 3 and 4
7.

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A 50-year old lady underwent uneventful bariatric surgery for morbid obesity. On the third
post operative day, she develops breathless and pulmonary embolism is suspected. The next
investigation to confirm the diagnosis will be:

(a) Echocardiography

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(b) Duplex venography
(c) CT pulmonary angiography
(d) MR angiography
8.
Medical management of thyrotoxic crisis includes all of the following EXCEPT:

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(a) IV fluids
(b) IV propanolol
(c) IV hydrocortisone
(d) IV antibiotics

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9.
A patient operated for a parotid gland tumour developed symptoms of sweating and
erytherma (flushing) over the region of surgical excision while eating. The probable
diagnosis is:

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(a) Parotid gland fistula
(b) Sialadenitis
(c) Chronic wound infection
(d) Frey?s syndrome
10.

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First line hormone therapy for post-menopausal woman with metastatic carcinoma breast is:

(a) Tamoxifen
(b) Ovarian suppression by surgery
(c) Antiprogestins

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(d) Anastrazole



11.

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All of the following are major subtypes of breast cancer based on Gene array analysis
EXCEPT:

(a) Luminal A and Luminal B
(b) Triple negative

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(c) Her-2 receptor positive
(d) Oestrogen receptor positive
12.
All of the following are sequelae of peptic ulcer surgery EXCEPT:

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(a) Bilious vomiting
(b) Dumping syndrome
(c) Diarrhoea
(d) Increased appetite
13.

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The Child-Turcotte-Pugh (CTP) score for quantifying the severity of chronic liver disease
includes all variables EXCEPT:

(a) Serum bilirubin
(b) Serum albumin

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(c) Serum creatinine
(d) INR (International Normalised Ratio)
14.
?Chain of Lakes? appearance due to sacculation with intervening short strictures of pancreatic
duct is seen on:

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(a) ERCP
(b) CECT abdomen
(c) Plain X-ray abdomen
(d) Ultrasonography

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15.
Which one of the following statements is NOT correct regarding Pyogenic Liver Abscess?

(a) Anorexia, fever, malaise and right upper quadrant abdominal discomfort are the
most common presenting features

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(b) It is more common in elderly, diabetics and immunocompromised patients
(c) Treatment is with oral antibiotics alone
(d) Streptococcus milleri and escherichia coli are the most common causative
organisms
16.

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?Swiss cheese defects? are seen during laparoscopic repair of:

(a) Ventral hernia
(b) Inguinal hernia
(c) Obturator hernia

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(d) Femoral hernia



17.

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Which of the following are correct regarding splenic artery aneurysm?

1. Main arterial trunk is the common site
2. Palpable thrill can be felt
3. It is symptomless unless it ruptures

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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
18.
Valentino?s syndrome is:

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(a) Pain on per-vaginal examination in pelvic abscess
(b) Pain over left shoulder in left hypochondriac collection
(c) Pain over left groin in perirenal collection
(d) Pain in right iliac fossa in perforated peptic ulcer
19.

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Spontaneous bacterial peritonitis occurs due to:

(a) duodenal stump blowout
(b) peptic ulcer perforation
(c) acute bacterial infection of ascites

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(d) infection via fallopian tubes
20.
Structure not forming boundaries of the ?Triangle of doom? seen during laparoscopic
inguinal hernia surgery dissection is:

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(a) Vas deferens
(b) Inferior epigastric artery
(c) Spermatic cord vessels
(d) Peritoneum
21.

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The term mid-line shift is associated with:

(a) Head injury
(b) Chest injury
(c) Abdominal injury

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(d) Limb injury
22.
Which one of the following cranial nerves does NOT supply to the external ear?

(a) Cranial nerve V

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(b) Cranial nerve VI
(c) Cranial nerve VII
(d) Cranial nerve IX

23.

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Left Internal Mammary Artery (LIMA) has become the conduit of choice for Left Anterior
Descending (LAD) artery during coronary artery bypass grafting because:

(a) Long term patency rates are more than 98%
(b) It is close to LAD

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(c) Atherosclerosis is never seen in this vessel
(d) It is very easy to harvest
24.
A 50-year old male with significant smoking history presented in the surgical emergency
with sudden severe breathlessness. Chest X-ray shows right sided Pneumothorax. The

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appropriate management requires:

(a) Aspiration of air with 16-18 G cannula
(b) Right chest drain of size 8-14 Fr
(c) Oxygen by face mask

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(d) Mechanical ventilation
25.
Which one of the following statements regarding Felon is NOT correct?

(a) There is infection of the finger tip between specialised fibrous septa

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(b) It is a painless condition
(c) Incision and drainage is the treatment of choice
(d) It is common in diabetics
26.
The most common site for osteosarcoma is:

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(a) Proximal femur
(b) Distal femur
(c) Proximal humerus
(d) Distal humerus

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27.
Rapid Sequence Induction is indicated in:

(a) Emergency surgery for intestinal obstruction
(b) Elective open hernia surgery

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(c) Cardiopulmonary bypass surgery
(d) Elective laparoscopic surgery

28.
Which one of the following statements about Compartment Syndrome is NOT correct?

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(a) It is commonest in a closed fracture
(b) Pain is on active movement but not on passive movement of muscles
(c) Fasciotomy is the treatment of choice
(d) Volkmann?s Ischaemic contractive is a late complication

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29.

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Which one of the following is NOT the strength of ultrasound as a diagnostic modality?

(a) No radiation
(b) Short learning curve
(c) Inexpensive

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(d) Allows dynamic studies to be done
30.
Which of the following statements regarding lymphoedema following breast cancer treatment
are correct?

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1. Incidence has decreased due to rarely combined therapy of axillary LN dissection and
radiotherapy
2. Precipitating cause like LN metastasis is a major determinant
3. The condition is often painful
4. Oedematous limb is susceptible to bacterial infection

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Select the correct answer using the code given below:

(a) 1, 2 and 3
(b) 2, 3 and 4

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(c) 1, 3 and 4
(d) 1, 2 and 4
31.
Which one of the following is NOT a risk factor for development of venous thrombosis in
surgical patients?

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(a) Age > 60 years
(b) Pregnancy
(c) Obesity (BMI > 30 kg/m
2

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)
(d) Diabetes ( HbA1c > 7.5%)
32.
Which one of the following is NOT a complication of massive blood transfusion?

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(a) Coagulopathy
(b) Hypocalcaemia
(c) Hyperthermia
(d) Hyperkalemia
33.

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Stage III ?Pressure sore? is full thickness skin loss extending:

(a) into subcutaneous tissue but not through fascia
(b) through subcutaneous tissue into fascia
(c) through subcutaneous tissue into fascia and muscles

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(d) through subcutaneous tissue into fascia, muscles and bone



34.

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During subclavian vein puncture in a surgical ward suddenly a patient developed severe
breathlessness. On auscultation breath sound was absent and the ipsilateral chest was
tympanitic on percussion. The probable diagnosis is:

(a) Iatrogenic pneumothorax

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(b) Introgenic hemothorax
(c) Spontaneous pneumothorax
(d) Tension pneumothorax
35.
Kohler?s disease is avascular necrosis of :

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(a) Lunate
(b) Capitellum of humerus
(c) First metatarsal head
(d) Navicular

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36.
Which one of the following is NOT true of Pyoderma gangrenosum?

(a) It is characterized by cutaneous ulceration with purple undermined edges
(b) It is often secondary to heightened immunological reactivity from another disease

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process
(c) Cultures often show Gram positive Staphylococci
(d) Lesions generally respond to steroids
37.
Which of the following is NOT a tissue repair surgery for inguinal hernia repair?

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(a) Bassini?s repair
(b) Shouldice repair
(c) Stoppa?s repair
(d) Desarda repair

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38.
Which one of the following type of meshes is recommended for intraperitoneal use in
abdominal wall hernia?
(a) Light weight, porous meshes
(b) Heavy weight, porous meshes

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(c) Absorbable meshes
(d) Tissue separating meshes
39.
Which one of the following is NOT correct regarding MEN-1 syndrome?

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(a) It involves parathyroid glands
(b) It involves pancreas
(c) It involves pituitary gland
(d) It involves pineal gland

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40.
Which one of the following is NOT an electronic information site in surgery?

(a) Pubmed
(b) Embase

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(c) Cochrane library
(d) National medical library
41.
Which one of the following statements regarding pre-conceptional counseling is NOT
correct?

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(a) It is needed only in selected complicated pregnancies
(b) It helps in early detection of risk factors
(c) It helps in reducing maternal morbidity and mortality
(d) It is a part of preventive medicine

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42.
Consider the following statements regarding Non Stress Test (NST):

1. Reactive NST indicates a healthy fetus
2. NST is an observed association of fetal breathing with fetal movements

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3. NST has a low false negative rate (< 1%) but high false positive rate (>50%)
4. Testing should be started at 20 weeks

Which of the statement(s) given above is/are correct?

--- Content provided by FirstRanker.com ---

(a) 1 and 3
(b) 2 only
(c) 3 only
(d) 1 and 4
43.

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Which one of the following is a protective factor for endometrial hyperplasia?

(a) Diabetes
(b) Tamoxifen therapy
(c) Multiparity

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(d) Delayed menopause
44.
A woman who is not breast feeding her newborn child is advised to use a contraceptive
method by:

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(a) 3
rd
postpartum week
(b) 6
th

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postpartum week
(c) 3
rd
postpartum month
(d) 6

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th
postpartum month

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45.
Pearl index for contraceptive effectiveness is calculated in terms of which of the following?

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1. Pregnancy rate
2. Abortion rate
3. Hundred woman years
4. Thousand woman years

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Select the correct answer using the code given below:

(a) 1 only
(b) 2 and 3
(c) 1, 2 and 4

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(d) 1 and 3
46.
Indications for removal of IUDs are all EXCEPT:

(a) Perforation of uterus

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(b) Cyclical menstrual bleeding
(c) Flaring up of salpingitis
(d) Pregnancy with IUD
47.
Contraindications for insertion of IUDs are all EXCEPT:

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(a) Suspected pregnancy
(b) Trophoblastic disease
(c) Severe dysmenorrhea
(d) During cesarean section

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48.
Which one of the following is NOT a contraindication for use of Mini pill?

(a) Pregnancy
(b) Breast feeding

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(c) Thromboembolic disease
(d) History of breast cancer
49.
Which one of the following is the most commonly used surgical method/technique of female
sterilization as recommended by Government of India?

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(a) Uchida technique
(b) Irving method
(c) Pomeroy?s method
(d) Madlener technique

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50.
Which of the following is/are required for a registered medical practitioner to qualify for
performing Medical Termination of Pregnancy (MTP), as per revised rules of MTP Act?

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1. Certified for assisting at least 15 MTP in an authorized centre
2. Diploma or degree in Obstetrics and Gynaecology
3. House surgeon training for 3 months in Obstetrics and Gynaecology
4. Certified training for 6 months in laparoscopic surgeries

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

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(d) 1, 2 and 4
51.
Which one of the following is NOT a support of uterus, preventing its descent?

(a) Endopelvic fascia

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(b) Mackenrodt?s ligament
(c) Inguinal ligament
(d) Pubocervical ligament
52.
As per ICMR guidelines, which one of the following statements is true regarding effects of

--- Content provided by FirstRanker.com ---

COVID-19 on fetus according to current evidence?

(a) There is increased risk of early pregnancy loss
(b) COVID-19 virus is not teratogenic
(c) COVID-19 virus infection is an indication of MTP

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(d) There is increased risk of fetal growth restriction
53.
As per ICMR guidelines, which one of the following statements is true regarding COVID-19
infection in pregnancy?

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(a) Covid-19 pneumonia in pregnancy is more severe with poor recovery
(b) Pregnant women with heart disease are at higher risk
(c) Vaginal secretions always test positive for COVID-19 in pregnancy
(d) COVID-19 virus is secreted in breast milk
54.

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Which one of the following is NOT a method of management of Deep Transverse Arrest with
the living fetus?

(a) Caesarean section
(b) Delivery by ventouse

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(c) Delivery by application of forceps to the unrotated head
(d) Manual rotation and application of forceps

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55.
Successful version of breech presentation is likely in case all of the following EXCEPT:

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(a) Breech with extended legs
(b) Complete breech with sacroanterior position
(c) Non engaged breech
(d) Adequate amniotic fluid
56.

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Implantation of a fertilised ovum occurs on which day following fertilisation?

(a) Day 6
(b) Day 10
(c) Day 14

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(d) Day 20
57.
During total abdominal hysterectomy the ureter is likely to undergo injury or ligation during
the following steps EXCEPT:

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(a) During division and ligation of the round ligaments
(b) During division and ligation of infundibulopelvic ligaments
(c) During division and ligation of mackenrodt?s and uterosacral ligaments
(d) At the vaginal angles while incising the vagina to remove the cervix with the
uterus

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58.
The net effect of antenatal care has been the following EXCEPT:

(a) Reduction in maternal mortality
(b) Reduction in perinatal mortality

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(c) Reduction in the incidence of institutional delivery
(d) Reduction in maternal morbidity
59.
Which one of the following is NOT a component of active phase in the partograph?

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(a) Acceleration phase
(b) Phase of maximum slope
(c) Phase of deceleration
(d) Phase of expulsion
60.

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From medicolegal point of view which one of the following is NOT a sign of previous child
birth?

(a) Perineum is lax and there is evidence of scarring
(b) Introitus is gaping and there is presence of carunculae myrtiformis

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(c) Abdomen is lax and loose with striae and linea alba
(d) Conical cervix with round external os

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61.
The components of partograph are all EXCEPT:

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(a) Time
(b) Fetal heart rate
(c) Maternal respiratory rate
(d) Maternal urine analysis
62.

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Which of the following information are provided by partograph?

1. Colour of liquor
2. Uterine contractions with duration and frequency
3. Dilatation of cervix

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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
63.
Intraoperative recognition of ureter is by which of the following features?

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1. Transparent tubular appearance
2. Pale glistening appearance
3. Longitudinal vessels on surface
4. Circumferential vessels on surface

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Select the correct answer using the code given below:

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

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(d) 1 and 4
64.
Hysterosalpingography (HSG) is least helpful in detecting which of the following?

(a) Tubal patency

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(b) Pelvic adhesions
(c) Asherman syndrome
(d) Congenital uterine anomaly

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65.
Which of the following are characteristics of Trichomonas vaginitis?

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1. Presence of greenish frothy discharge
2. Vaginal pH > 4.5
3. Presence of clue cells in microscopic examination
4. Strawberry spots on the vaginal mucosa

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Select the correct answer using the code given below:

(a) 1, 2 and 3
(b) 1, 2 and 4
(c) 2, 3 and 4

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(d) 1, 3 and 4
66.
Tumor marker of epithelial ovarian carcinoma is:

(a) Ca.125

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(b) Alpha feto protein
(c) Beta HCG
(d) LDH
67.
The most common site of cervical cancer is:

--- Content provided by FirstRanker.com ---

(a) Endocervix
(b) Ectocervix
(c) Transformation zone
(d) Isthmus

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68.
The placenta synthesizes all EXCEPT:

(a) Oestriol
(b) Corticotrophin releasing hormone

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(c) PAPP-A(Pregnancy Associated Plasma Protein A)
(d) Dehydroepiandrosterone
69.
Withdrawal bleeding following administration of progesterone in a case of secondary
amenorrhea indicates all EXCEPT:

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(a) Absence of pregnancy
(b) Production endogenous estrogen
(c) Endometrium is responsive to estrogen
(d) Defect in pituitary gland

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70.
Monilial vaginitis is commonly associated with all EXCEPT:

(a) Prolonged antibiotic therapy
(b) Diabetes Mellitus

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(c) Treatment of malaria with chloroquine
(d) Pregnancy
71.
Which one of the following is NOT a risk factor for the development of placenta previa?

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(a) Maternal age
(b) Smoking
(c) Previous caesarean section
(d) Maternal anaemia
72.

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Common clinical presentations of moderate to severe abruption are all EXCEPT:

(a) Uterine tenderness
(b) Fetal distress
(c) Unexplained pre term labour

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(d) Prolonged labour
73.
Common trisomies resulting in spontaneous abortion are all EXCEPT:

(a) Trisomy 21

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(b) Trisomy 18
(c) Trisomy 16
(d) Trisomy 1
74.
The initial prevention strategy for antiphospholipid syndrome will be:

--- Content provided by FirstRanker.com ---

1. Steroids
2. Heparin
3. Low dose aspirin
4. Progesterone support

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Which of the above is/are correct?

(a) 2 and 3
(b) 3 and 4

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(c) 3 only
(d) 1 and 4
75.
Diagnostic criteria for PCOD are:

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1. Oligo/amenorrohoea
2. Hyperandrogenism
3. Polycystic ovaries on ultrasound

Which of the above are correct?

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

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76.
Which of the following symptoms can be associated with pelvic organ prolapse?

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1. Difficulty in passing urine
2. Incomplete evacuation of urine
3. Urgency and frequency

Select the correct answer using the code given below:

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

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77.
A 30 year old lady, P
2
L
2

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presents with painful unilateral swelling in vulva for 3 days. Which
of the following statements are true regarding the above case?

1. Bartholin?s abscess may be the likely diagnosis
2. It is to be managed by marsupialisation

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3. Gonococcus is the most common pathogenic organism

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

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(c) 1 and 2 only
(d) 1, 2 and 3
78.
Which one of the following is NOT a sign of separation of placenta?

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(a) Uterus becomes globular, firm and ballotable
(b) The fundal height reduces further
(c) Slight bulging in the suprapubic region
(d) Apparent lengthenic of the cord with slight gush of vaginal bleeding
79.

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Consider the following regarding examination of a rape victim:

1. Emergency pill is provided
2. Internal examination must be performed
3. HIV testing is done

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Which of the above statements is/are correct?

(a) 1 and 3 only
(b) 2 only

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

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80.
Consider the following cardinal movements of mechanism of normal labor:
1. Engagement
2. Internal rotation

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3. Flexion
4. Restitution
5. Crowning
6. External rotation

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What is the correct sequence of movements in labor in occipito-lateral position?

(a) 1, 2, 3, 4, 5 and 6
(b) 1, 3, 2, 5, 4 and 6
(c) 2, 1, 3, 4, 5 and 6

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(d) 3, 1, 2, 4, 6 and 5
81.
Which of the following represent the properties of an ideal disinfectant?

1. It is broad spectrum

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2. It is fast acting
3. It is non-toxic

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

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(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3
82.
Which of the following measures can help reduce the risk of systemic hypertension?

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1. Reduction in dietary intake of common salt
2. Controlling weight for age
3. Increasing potassium rich foods in the diet

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Select the correct answer using the code given below:

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

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(d) 1, 2 and 3

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83.

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Keeping biological determinants in perspective, consider the following statements:

1. Presence of a normal karyotype is the first requisite for human health
2. Genetic screening can play an important role in prevention of wide spectrum of
diseases

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3. If an individual is allowed to live in healthy relationship with the environment, the
person?s genetic potentialities can transform into phenotypic realities

Which of the above statements is/are correct?

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(a) 1 and 2 only
(b) 1 and 3 only
(c) 1, 2 and 3
(d) 2 and 3 only
84.

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NITI Aayog has the following roles EXCEPT:

(a) It provides critical directional and strategic input in the development process
(b) It provides relevant technical advice with focus on technology upgradation
(c) It focuses on capacity building

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(d) It focuses on the development of ?Referral Service Complex?
85.
Poor hand hygiene of a mess worker in a university college mess led to Hepatitis A cases in
the hostel inmates. What type of epidemic will this exposure present with?

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1. Propagated
2. Common source-continuous exposure
3. Common source-point exposure

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

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

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86.
What is the specificity of sputum microscopy in detection of Pulmonary Tuberculosis (PTB)
as per the information given below?

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PTB Total
Sputum microscopy Present Absent
Positive 270 20 290
Negative 30 180 210

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Total 300 200 500

(a) 10 %
(b) 36 %
(c) 90 %

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(d) 94 %
87.
In a cohort of 500 women attending antenatal clinic, 70 % had ultrasonography (USG). This
cohort was followed up at delivery. Of the women who had USG, 70 delivered low birth
weight (LBW) babies; whereas of the women, who did not undergo USG, 50 delivered LBW

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babies. The incidence of LBW babies among women who had USG is:

(a) 10 %
(b) 15 %
(c) 20 %

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(d) 25 %
88.
Major source of vitamin K
1
is:

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(a) Fresh dark green vegetables
(b) Exposure of body to sunlight
(c) Citrus fruits
(d) Foods rich in polyunsaturated fatty acids

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89.
Which one of the following is NOT a function of Epidemiology?

(a) To study historically the rise and fall of disease in the population
(b) Searching for the causes and risk factor

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(c) Identifying syndromes
(d) Making clinical diagnosis
90.
Which one of the following is NOT a contagious disease?

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(a) Malaria
(b) Scabies
(c) Trachoma
(d) Leprosy

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91.
In primary immune response, how much more antigenic dose is required to induce IgG
antibodies as against the induction of IgM antibodies?

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(a) 10 times more
(b) 25 times more
(c) 50 times more
(d) 100 times more
92.

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Pentavalent vaccine provides protection against which of the following diseases?

(a) Diphtheria, Pertussis, Tuberculosis, Measles and Hepatitis B
(b) Diphtheria, Pertussis, Measles, Hepatitis B and Hib
(c) Diphtheria, Pertussis, Tetanus, Hepatitis B and Rubella

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(d) Diphtheria, Pertussis, Tetanus, Hepatitis B and Hib
93.
Consider the following data for a country:
Population in 0-14 years of age ? 391,558,367
Population between 15?64 years of age ? 856,076,200

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Population above 65 years of age ? 71,943,390
What shall be the dependency ratio of this country?

(a) 42.4 %
(b) 54.1 %

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(c) 66.2 %
(d) 78.6 %
94.
Which one of the following statements regarding Rabies Immunoglobulin is NOT true?

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(a) It should be administered only once as soon as possible after the initiation of post
exposure prophylaxis
(b) It should be administered all into or around the wound sites
(c) There is no scientific ground for performing a skin test prior to administering equine
immunoglobulin

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(d) It can be administered till 15 days after the first dose of anti-rabies vaccine
95.
All of the following are true about Bedaquiline (BDQ) EXCEPT:

(a) It specifically targets mycobacterial ATP synthase

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(b) It is a bacteriostatic drug
(c) It has extended half life
(d) It has high volume of tissue distribution
96.
Visual inspection based screening test with 5 % acetic acid is used for the screening of which

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one of the following cancers?

(a) Lung cancer
(b) Cervix cancer
(c) Oral cancer

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(d) Breast cancer
97.
Predictive accuracy of a screening test depends on the following EXCEPT:

(a) Disease prevalence

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(b) Disease incidence
(c) Sensitivity of screening test
(d) Specificity of screening test
98.
How much of Zinc supplement is recommended by WHO and UNICEF for infants less than 6

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months of age after an episode of acute diarrhoea?

(a) 20 mg per day for 10?14 days
(b) 10 mg per day for 10?14 days
(c) 5 mg per day for 7 days

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(d) 6 mg per day for 7 days
99.
Which one of the following statements regarding sequential administration of Inactivated
Polio Vaccine (IPV) and Oral Polio Vaccine (OPV) is NOT correct?

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(a) It will be cost effective in developing countries for Polio prevention
(b) The combined schedules of IPV and OPV appear to reduce or prevent Vaccine
Associated Paralytic Polio (VAPP)
(c) Intestinal mucosal immunity is lost due to IPV administration
(d) IPV and OPV together may optimize both the humoral and mucosal immunogenicity

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of Polio vaccine
100.
What is the recommended dose regimen of Vitamin A for the treatment of early stages of
Xerophthalmia?

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(a) Single massive dose of 2 lac International Units (IU)
(b) 2 lac IU on two successive days
(c) 2 doses of 1 lac IU in two successive days
(d) 2 doses of 1 lac IU at a gap of one week
101.

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Which is the most specific causative agent of Rabies?

(a) Lyssavirus serotype 1
(b) Lyssavirus serotype 2
(c) Lyssavirus serotype 3

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(d) Lyssavirus serotype 4
102.
Which one of the following is the antibiotic of choice for the prevention of Rheumatic heart
disease?

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(a) Benzathine Benzyl Penicillin
(b) Procaine Penicillin
(c) Doxycycline
(d) Ciprofloxacin

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FirstRanker.com - FirstRanker's Choice
Combined Medical Services Examination-2020
Paper-II

--- Content provided by FirstRanker.com ---

1.
Indications for fasciotomy in compartment syndrome include all EXCEPT:

(a) Distal sensory disturbance
(b) Compartment pressure > 30 mm Hg

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(c) Pain on passive movement of affected muscles
(d) Palpable distal pulses
2.
Which one of the following statements is NOT correct regarding Necrotising Soft Tissue
infections?

--- Content provided by FirstRanker.com ---

(a) Crepitus, skin blistering and focal skin gangrene are typical presenting features
(b) They are monomicrobial in nature
(c) Treatment consists of wide local excision and appropriate antibiotics
(d) Tissue biopsy is required for culture and diagnosis

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3.
Which type of surgery is laparoscopic cholecystectomy classified as?

(a) Clean
(b) Clean contaminated

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(c) Contaminated
(d) Dirty
4.
A 22-year female has presented with a history of malaise, cough, alternating constipation and
diarrhoea with intermittent abdominal pain for last 6 months. She also complains of

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abdominal distension for last 2 days. On examination her abdomen has a doughy feel along
with an ill defined mass over the right lower quadrant. She is most likely suffering from:

(a) Appendicular lump
(b) Ileocaecal tuberculosis

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(c) Carcinoma caecum
(d) Ovarian mass
5.
Consider the following statements regarding needle stick injuries:

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1. Injured part should be washed under running water
2. Dominant index finger is the commonest site for needle stick injury
3. All needle stick injuries should be reported
4. Hepatitis/HIV testing should be done after needle stick injury

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Which of the statements given above are correct?

(a) 1, 2 and 4
(b) 1, 2 and 3
(c) 1, 3 and 4

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(d) 2, 3 and 4

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6.
Consider the following statements regarding claudication:

1. It is a marker for silent coronary disease
2. Structured exercise program ( 2 hours per week for 3 months) leads to

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improvement in symptoms
3. Diabetes mellitus increases the risk and severity of claudication
4. Beta blockers may exacerbate claudication

Which of the above statements are correct?

--- Content provided by FirstRanker.com ---

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

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7.
A 50-year old lady underwent uneventful bariatric surgery for morbid obesity. On the third
post operative day, she develops breathless and pulmonary embolism is suspected. The next
investigation to confirm the diagnosis will be:

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(a) Echocardiography
(b) Duplex venography
(c) CT pulmonary angiography
(d) MR angiography
8.

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Medical management of thyrotoxic crisis includes all of the following EXCEPT:

(a) IV fluids
(b) IV propanolol
(c) IV hydrocortisone

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(d) IV antibiotics
9.
A patient operated for a parotid gland tumour developed symptoms of sweating and
erytherma (flushing) over the region of surgical excision while eating. The probable
diagnosis is:

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(a) Parotid gland fistula
(b) Sialadenitis
(c) Chronic wound infection
(d) Frey?s syndrome

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10.
First line hormone therapy for post-menopausal woman with metastatic carcinoma breast is:

(a) Tamoxifen
(b) Ovarian suppression by surgery

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(c) Antiprogestins
(d) Anastrazole

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11.
All of the following are major subtypes of breast cancer based on Gene array analysis
EXCEPT:

(a) Luminal A and Luminal B

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(b) Triple negative
(c) Her-2 receptor positive
(d) Oestrogen receptor positive
12.
All of the following are sequelae of peptic ulcer surgery EXCEPT:

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(a) Bilious vomiting
(b) Dumping syndrome
(c) Diarrhoea
(d) Increased appetite

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13.
The Child-Turcotte-Pugh (CTP) score for quantifying the severity of chronic liver disease
includes all variables EXCEPT:

(a) Serum bilirubin

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(b) Serum albumin
(c) Serum creatinine
(d) INR (International Normalised Ratio)
14.
?Chain of Lakes? appearance due to sacculation with intervening short strictures of pancreatic

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duct is seen on:

(a) ERCP
(b) CECT abdomen
(c) Plain X-ray abdomen

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(d) Ultrasonography
15.
Which one of the following statements is NOT correct regarding Pyogenic Liver Abscess?

(a) Anorexia, fever, malaise and right upper quadrant abdominal discomfort are the

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most common presenting features
(b) It is more common in elderly, diabetics and immunocompromised patients
(c) Treatment is with oral antibiotics alone
(d) Streptococcus milleri and escherichia coli are the most common causative
organisms

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16.
?Swiss cheese defects? are seen during laparoscopic repair of:

(a) Ventral hernia
(b) Inguinal hernia

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(c) Obturator hernia
(d) Femoral hernia

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17.
Which of the following are correct regarding splenic artery aneurysm?

1. Main arterial trunk is the common site
2. Palpable thrill can be felt

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3. It is symptomless unless it ruptures

Select the correct answer using the code given below:

(a) 1 and 2 only

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(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3
18.
Valentino?s syndrome is:

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(a) Pain on per-vaginal examination in pelvic abscess
(b) Pain over left shoulder in left hypochondriac collection
(c) Pain over left groin in perirenal collection
(d) Pain in right iliac fossa in perforated peptic ulcer

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19.
Spontaneous bacterial peritonitis occurs due to:

(a) duodenal stump blowout
(b) peptic ulcer perforation

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(c) acute bacterial infection of ascites
(d) infection via fallopian tubes
20.
Structure not forming boundaries of the ?Triangle of doom? seen during laparoscopic
inguinal hernia surgery dissection is:

--- Content provided by FirstRanker.com ---

(a) Vas deferens
(b) Inferior epigastric artery
(c) Spermatic cord vessels
(d) Peritoneum

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21.
The term mid-line shift is associated with:

(a) Head injury
(b) Chest injury

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(c) Abdominal injury
(d) Limb injury
22.
Which one of the following cranial nerves does NOT supply to the external ear?

--- Content provided by FirstRanker.com ---

(a) Cranial nerve V
(b) Cranial nerve VI
(c) Cranial nerve VII
(d) Cranial nerve IX

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23.
Left Internal Mammary Artery (LIMA) has become the conduit of choice for Left Anterior
Descending (LAD) artery during coronary artery bypass grafting because:

(a) Long term patency rates are more than 98%

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(b) It is close to LAD
(c) Atherosclerosis is never seen in this vessel
(d) It is very easy to harvest
24.
A 50-year old male with significant smoking history presented in the surgical emergency

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with sudden severe breathlessness. Chest X-ray shows right sided Pneumothorax. The
appropriate management requires:

(a) Aspiration of air with 16-18 G cannula
(b) Right chest drain of size 8-14 Fr

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(c) Oxygen by face mask
(d) Mechanical ventilation
25.
Which one of the following statements regarding Felon is NOT correct?

--- Content provided by FirstRanker.com ---

(a) There is infection of the finger tip between specialised fibrous septa
(b) It is a painless condition
(c) Incision and drainage is the treatment of choice
(d) It is common in diabetics
26.

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The most common site for osteosarcoma is:

(a) Proximal femur
(b) Distal femur
(c) Proximal humerus

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(d) Distal humerus
27.
Rapid Sequence Induction is indicated in:

(a) Emergency surgery for intestinal obstruction

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(b) Elective open hernia surgery
(c) Cardiopulmonary bypass surgery
(d) Elective laparoscopic surgery

28.

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Which one of the following statements about Compartment Syndrome is NOT correct?

(a) It is commonest in a closed fracture
(b) Pain is on active movement but not on passive movement of muscles
(c) Fasciotomy is the treatment of choice

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(d) Volkmann?s Ischaemic contractive is a late complication

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29.
Which one of the following is NOT the strength of ultrasound as a diagnostic modality?

(a) No radiation
(b) Short learning curve

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(c) Inexpensive
(d) Allows dynamic studies to be done
30.
Which of the following statements regarding lymphoedema following breast cancer treatment
are correct?

--- Content provided by FirstRanker.com ---

1. Incidence has decreased due to rarely combined therapy of axillary LN dissection and
radiotherapy
2. Precipitating cause like LN metastasis is a major determinant
3. The condition is often painful

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4. Oedematous limb is susceptible to bacterial infection

Select the correct answer using the code given below:

(a) 1, 2 and 3

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(b) 2, 3 and 4
(c) 1, 3 and 4
(d) 1, 2 and 4
31.
Which one of the following is NOT a risk factor for development of venous thrombosis in

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surgical patients?

(a) Age > 60 years
(b) Pregnancy
(c) Obesity (BMI > 30 kg/m

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2
)
(d) Diabetes ( HbA1c > 7.5%)
32.
Which one of the following is NOT a complication of massive blood transfusion?

--- Content provided by FirstRanker.com ---

(a) Coagulopathy
(b) Hypocalcaemia
(c) Hyperthermia
(d) Hyperkalemia

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33.
Stage III ?Pressure sore? is full thickness skin loss extending:

(a) into subcutaneous tissue but not through fascia
(b) through subcutaneous tissue into fascia

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(c) through subcutaneous tissue into fascia and muscles
(d) through subcutaneous tissue into fascia, muscles and bone

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34.
During subclavian vein puncture in a surgical ward suddenly a patient developed severe
breathlessness. On auscultation breath sound was absent and the ipsilateral chest was
tympanitic on percussion. The probable diagnosis is:

--- Content provided by FirstRanker.com ---

(a) Iatrogenic pneumothorax
(b) Introgenic hemothorax
(c) Spontaneous pneumothorax
(d) Tension pneumothorax
35.

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Kohler?s disease is avascular necrosis of :

(a) Lunate
(b) Capitellum of humerus
(c) First metatarsal head

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(d) Navicular
36.
Which one of the following is NOT true of Pyoderma gangrenosum?

(a) It is characterized by cutaneous ulceration with purple undermined edges

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(b) It is often secondary to heightened immunological reactivity from another disease
process
(c) Cultures often show Gram positive Staphylococci
(d) Lesions generally respond to steroids
37.

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Which of the following is NOT a tissue repair surgery for inguinal hernia repair?

(a) Bassini?s repair
(b) Shouldice repair
(c) Stoppa?s repair

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(d) Desarda repair
38.
Which one of the following type of meshes is recommended for intraperitoneal use in
abdominal wall hernia?
(a) Light weight, porous meshes

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(b) Heavy weight, porous meshes
(c) Absorbable meshes
(d) Tissue separating meshes
39.
Which one of the following is NOT correct regarding MEN-1 syndrome?

--- Content provided by FirstRanker.com ---

(a) It involves parathyroid glands
(b) It involves pancreas
(c) It involves pituitary gland
(d) It involves pineal gland

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40.
Which one of the following is NOT an electronic information site in surgery?

(a) Pubmed

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(b) Embase
(c) Cochrane library
(d) National medical library
41.
Which one of the following statements regarding pre-conceptional counseling is NOT

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correct?

(a) It is needed only in selected complicated pregnancies
(b) It helps in early detection of risk factors
(c) It helps in reducing maternal morbidity and mortality

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(d) It is a part of preventive medicine
42.
Consider the following statements regarding Non Stress Test (NST):

1. Reactive NST indicates a healthy fetus

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2. NST is an observed association of fetal breathing with fetal movements
3. NST has a low false negative rate (< 1%) but high false positive rate (>50%)
4. Testing should be started at 20 weeks

Which of the statement(s) given above is/are correct?

--- Content provided by FirstRanker.com ---

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

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43.
Which one of the following is a protective factor for endometrial hyperplasia?

(a) Diabetes
(b) Tamoxifen therapy

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(c) Multiparity
(d) Delayed menopause
44.
A woman who is not breast feeding her newborn child is advised to use a contraceptive
method by:

--- Content provided by FirstRanker.com ---

(a) 3
rd
postpartum week
(b) 6

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th
postpartum week
(c) 3
rd
postpartum month

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(d) 6
th
postpartum month

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45.
Pearl index for contraceptive effectiveness is calculated in terms of which of the following?

--- Content provided by FirstRanker.com ---

1. Pregnancy rate
2. Abortion rate
3. Hundred woman years
4. Thousand woman years

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Select the correct answer using the code given below:

(a) 1 only
(b) 2 and 3

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(c) 1, 2 and 4
(d) 1 and 3
46.
Indications for removal of IUDs are all EXCEPT:

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(a) Perforation of uterus
(b) Cyclical menstrual bleeding
(c) Flaring up of salpingitis
(d) Pregnancy with IUD
47.

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Contraindications for insertion of IUDs are all EXCEPT:

(a) Suspected pregnancy
(b) Trophoblastic disease
(c) Severe dysmenorrhea

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(d) During cesarean section
48.
Which one of the following is NOT a contraindication for use of Mini pill?

(a) Pregnancy

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(b) Breast feeding
(c) Thromboembolic disease
(d) History of breast cancer
49.
Which one of the following is the most commonly used surgical method/technique of female

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sterilization as recommended by Government of India?

(a) Uchida technique
(b) Irving method
(c) Pomeroy?s method

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(d) Madlener technique

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50.
Which of the following is/are required for a registered medical practitioner to qualify for

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performing Medical Termination of Pregnancy (MTP), as per revised rules of MTP Act?

1. Certified for assisting at least 15 MTP in an authorized centre
2. Diploma or degree in Obstetrics and Gynaecology
3. House surgeon training for 3 months in Obstetrics and Gynaecology

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4. Certified training for 6 months in laparoscopic surgeries

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

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(c) 1, 2 and 3
(d) 1, 2 and 4
51.
Which one of the following is NOT a support of uterus, preventing its descent?

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(a) Endopelvic fascia
(b) Mackenrodt?s ligament
(c) Inguinal ligament
(d) Pubocervical ligament
52.

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As per ICMR guidelines, which one of the following statements is true regarding effects of
COVID-19 on fetus according to current evidence?

(a) There is increased risk of early pregnancy loss
(b) COVID-19 virus is not teratogenic

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(c) COVID-19 virus infection is an indication of MTP
(d) There is increased risk of fetal growth restriction
53.
As per ICMR guidelines, which one of the following statements is true regarding COVID-19
infection in pregnancy?

--- Content provided by FirstRanker.com ---

(a) Covid-19 pneumonia in pregnancy is more severe with poor recovery
(b) Pregnant women with heart disease are at higher risk
(c) Vaginal secretions always test positive for COVID-19 in pregnancy
(d) COVID-19 virus is secreted in breast milk

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54.
Which one of the following is NOT a method of management of Deep Transverse Arrest with
the living fetus?

(a) Caesarean section

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(b) Delivery by ventouse
(c) Delivery by application of forceps to the unrotated head
(d) Manual rotation and application of forceps

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55.
Successful version of breech presentation is likely in case all of the following EXCEPT:

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(a) Breech with extended legs
(b) Complete breech with sacroanterior position
(c) Non engaged breech
(d) Adequate amniotic fluid

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56.
Implantation of a fertilised ovum occurs on which day following fertilisation?

(a) Day 6
(b) Day 10

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(c) Day 14
(d) Day 20
57.
During total abdominal hysterectomy the ureter is likely to undergo injury or ligation during
the following steps EXCEPT:

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(a) During division and ligation of the round ligaments
(b) During division and ligation of infundibulopelvic ligaments
(c) During division and ligation of mackenrodt?s and uterosacral ligaments
(d) At the vaginal angles while incising the vagina to remove the cervix with the

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uterus
58.
The net effect of antenatal care has been the following EXCEPT:

(a) Reduction in maternal mortality

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(b) Reduction in perinatal mortality
(c) Reduction in the incidence of institutional delivery
(d) Reduction in maternal morbidity
59.
Which one of the following is NOT a component of active phase in the partograph?

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(a) Acceleration phase
(b) Phase of maximum slope
(c) Phase of deceleration
(d) Phase of expulsion

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60.
From medicolegal point of view which one of the following is NOT a sign of previous child
birth?

(a) Perineum is lax and there is evidence of scarring

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(b) Introitus is gaping and there is presence of carunculae myrtiformis
(c) Abdomen is lax and loose with striae and linea alba
(d) Conical cervix with round external os

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61.
The components of partograph are all EXCEPT:

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(a) Time
(b) Fetal heart rate
(c) Maternal respiratory rate
(d) Maternal urine analysis

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62.
Which of the following information are provided by partograph?

1. Colour of liquor
2. Uterine contractions with duration and frequency

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3. Dilatation of cervix

Select the correct answer using the code given below:

(a) 1 and 2 only

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(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3
63.
Intraoperative recognition of ureter is by which of the following features?

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1. Transparent tubular appearance
2. Pale glistening appearance
3. Longitudinal vessels on surface
4. Circumferential vessels on surface

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Select the correct answer using the code given below:

(a) 1 and 3
(b) 2 and 4

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(c) 2 and 3
(d) 1 and 4
64.
Hysterosalpingography (HSG) is least helpful in detecting which of the following?

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(a) Tubal patency
(b) Pelvic adhesions
(c) Asherman syndrome
(d) Congenital uterine anomaly

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65.
Which of the following are characteristics of Trichomonas vaginitis?

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1. Presence of greenish frothy discharge
2. Vaginal pH > 4.5
3. Presence of clue cells in microscopic examination
4. Strawberry spots on the vaginal mucosa

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Select the correct answer using the code given below:

(a) 1, 2 and 3
(b) 1, 2 and 4

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(c) 2, 3 and 4
(d) 1, 3 and 4
66.
Tumor marker of epithelial ovarian carcinoma is:

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(a) Ca.125
(b) Alpha feto protein
(c) Beta HCG
(d) LDH
67.

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The most common site of cervical cancer is:

(a) Endocervix
(b) Ectocervix
(c) Transformation zone

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(d) Isthmus
68.
The placenta synthesizes all EXCEPT:

(a) Oestriol

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(b) Corticotrophin releasing hormone
(c) PAPP-A(Pregnancy Associated Plasma Protein A)
(d) Dehydroepiandrosterone
69.
Withdrawal bleeding following administration of progesterone in a case of secondary

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amenorrhea indicates all EXCEPT:

(a) Absence of pregnancy
(b) Production endogenous estrogen
(c) Endometrium is responsive to estrogen

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(d) Defect in pituitary gland
70.
Monilial vaginitis is commonly associated with all EXCEPT:

(a) Prolonged antibiotic therapy

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(b) Diabetes Mellitus
(c) Treatment of malaria with chloroquine
(d) Pregnancy
71.
Which one of the following is NOT a risk factor for the development of placenta previa?

--- Content provided by FirstRanker.com ---

(a) Maternal age
(b) Smoking
(c) Previous caesarean section
(d) Maternal anaemia

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72.
Common clinical presentations of moderate to severe abruption are all EXCEPT:

(a) Uterine tenderness
(b) Fetal distress

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(c) Unexplained pre term labour
(d) Prolonged labour
73.
Common trisomies resulting in spontaneous abortion are all EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Trisomy 21
(b) Trisomy 18
(c) Trisomy 16
(d) Trisomy 1
74.

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The initial prevention strategy for antiphospholipid syndrome will be:

1. Steroids
2. Heparin
3. Low dose aspirin

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4. Progesterone support

Which of the above is/are correct?

(a) 2 and 3

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(b) 3 and 4
(c) 3 only
(d) 1 and 4
75.
Diagnostic criteria for PCOD are:

--- Content provided by FirstRanker.com ---

1. Oligo/amenorrohoea
2. Hyperandrogenism
3. Polycystic ovaries on ultrasound

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Which of the above are correct?

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

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(d) 1, 2 and 3


76.
Which of the following symptoms can be associated with pelvic organ prolapse?

--- Content provided by FirstRanker.com ---

1. Difficulty in passing urine
2. Incomplete evacuation of urine
3. Urgency and frequency

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Select the correct answer using the code given below:

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

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(d) 1, 2 and 3
77.
A 30 year old lady, P
2
L

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2
presents with painful unilateral swelling in vulva for 3 days. Which
of the following statements are true regarding the above case?

1. Bartholin?s abscess may be the likely diagnosis

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2. It is to be managed by marsupialisation
3. Gonococcus is the most common pathogenic organism

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

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(b) 3 only
(c) 1 and 2 only
(d) 1, 2 and 3
78.
Which one of the following is NOT a sign of separation of placenta?

--- Content provided by FirstRanker.com ---

(a) Uterus becomes globular, firm and ballotable
(b) The fundal height reduces further
(c) Slight bulging in the suprapubic region
(d) Apparent lengthenic of the cord with slight gush of vaginal bleeding

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79.
Consider the following regarding examination of a rape victim:

1. Emergency pill is provided
2. Internal examination must be performed

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3. HIV testing is done

Which of the above statements is/are correct?

(a) 1 and 3 only

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

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80.
Consider the following cardinal movements of mechanism of normal labor:
1. Engagement

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2. Internal rotation
3. Flexion
4. Restitution
5. Crowning
6. External rotation

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What is the correct sequence of movements in labor in occipito-lateral position?

(a) 1, 2, 3, 4, 5 and 6
(b) 1, 3, 2, 5, 4 and 6

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(c) 2, 1, 3, 4, 5 and 6
(d) 3, 1, 2, 4, 6 and 5
81.
Which of the following represent the properties of an ideal disinfectant?

--- Content provided by FirstRanker.com ---

1. It is broad spectrum
2. It is fast acting
3. It is non-toxic

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

(a) 1 and 2 only
(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3
82.

--- Content provided by FirstRanker.com ---

Which of the following measures can help reduce the risk of systemic hypertension?

1. Reduction in dietary intake of common salt
2. Controlling weight for age
3. Increasing potassium rich foods in the diet

--- Content provided by FirstRanker.com ---

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

--- Content provided by FirstRanker.com ---

--- Content provided by FirstRanker.com ---

83.
Keeping biological determinants in perspective, consider the following statements:

1. Presence of a normal karyotype is the first requisite for human health
2. Genetic screening can play an important role in prevention of wide spectrum of

--- Content provided by FirstRanker.com ---

diseases
3. If an individual is allowed to live in healthy relationship with the environment, the
person?s genetic potentialities can transform into phenotypic realities

Which of the above statements is/are correct?

--- Content provided by FirstRanker.com ---

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

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84.
NITI Aayog has the following roles EXCEPT:

(a) It provides critical directional and strategic input in the development process
(b) It provides relevant technical advice with focus on technology upgradation

--- Content provided by FirstRanker.com ---

(c) It focuses on capacity building
(d) It focuses on the development of ?Referral Service Complex?
85.
Poor hand hygiene of a mess worker in a university college mess led to Hepatitis A cases in
the hostel inmates. What type of epidemic will this exposure present with?

--- Content provided by FirstRanker.com ---

1. Propagated
2. Common source-continuous exposure
3. Common source-point exposure

--- Content provided by FirstRanker.com ---

Select the correct answer using the code given below:

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

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(d) 2 only

--- Content provided by FirstRanker.com ---

--- Content provided by FirstRanker.com ---

86.
What is the specificity of sputum microscopy in detection of Pulmonary Tuberculosis (PTB)

--- Content provided by FirstRanker.com ---

as per the information given below?

PTB Total
Sputum microscopy Present Absent
Positive 270 20 290

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Negative 30 180 210
Total 300 200 500

(a) 10 %
(b) 36 %

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(c) 90 %
(d) 94 %
87.
In a cohort of 500 women attending antenatal clinic, 70 % had ultrasonography (USG). This
cohort was followed up at delivery. Of the women who had USG, 70 delivered low birth

--- Content provided by FirstRanker.com ---

weight (LBW) babies; whereas of the women, who did not undergo USG, 50 delivered LBW
babies. The incidence of LBW babies among women who had USG is:

(a) 10 %
(b) 15 %

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(c) 20 %
(d) 25 %
88.
Major source of vitamin K
1

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is:

(a) Fresh dark green vegetables
(b) Exposure of body to sunlight
(c) Citrus fruits

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(d) Foods rich in polyunsaturated fatty acids
89.
Which one of the following is NOT a function of Epidemiology?

(a) To study historically the rise and fall of disease in the population

--- Content provided by FirstRanker.com ---

(b) Searching for the causes and risk factor
(c) Identifying syndromes
(d) Making clinical diagnosis
90.
Which one of the following is NOT a contagious disease?

--- Content provided by FirstRanker.com ---

(a) Malaria
(b) Scabies
(c) Trachoma
(d) Leprosy

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91.
In primary immune response, how much more antigenic dose is required to induce IgG
antibodies as against the induction of IgM antibodies?

--- Content provided by FirstRanker.com ---

(a) 10 times more
(b) 25 times more
(c) 50 times more
(d) 100 times more

--- Content provided by FirstRanker.com ---

92.
Pentavalent vaccine provides protection against which of the following diseases?

(a) Diphtheria, Pertussis, Tuberculosis, Measles and Hepatitis B
(b) Diphtheria, Pertussis, Measles, Hepatitis B and Hib

--- Content provided by FirstRanker.com ---

(c) Diphtheria, Pertussis, Tetanus, Hepatitis B and Rubella
(d) Diphtheria, Pertussis, Tetanus, Hepatitis B and Hib
93.
Consider the following data for a country:
Population in 0-14 years of age ? 391,558,367

--- Content provided by FirstRanker.com ---

Population between 15?64 years of age ? 856,076,200
Population above 65 years of age ? 71,943,390
What shall be the dependency ratio of this country?

(a) 42.4 %

--- Content provided by FirstRanker.com ---

(b) 54.1 %
(c) 66.2 %
(d) 78.6 %
94.
Which one of the following statements regarding Rabies Immunoglobulin is NOT true?

--- Content provided by FirstRanker.com ---

(a) It should be administered only once as soon as possible after the initiation of post
exposure prophylaxis
(b) It should be administered all into or around the wound sites
(c) There is no scientific ground for performing a skin test prior to administering equine

--- Content provided by FirstRanker.com ---

immunoglobulin
(d) It can be administered till 15 days after the first dose of anti-rabies vaccine
95.
All of the following are true about Bedaquiline (BDQ) EXCEPT:

--- Content provided by FirstRanker.com ---

(a) It specifically targets mycobacterial ATP synthase
(b) It is a bacteriostatic drug
(c) It has extended half life
(d) It has high volume of tissue distribution
96.

--- Content provided by FirstRanker.com ---

Visual inspection based screening test with 5 % acetic acid is used for the screening of which
one of the following cancers?

(a) Lung cancer
(b) Cervix cancer

--- Content provided by FirstRanker.com ---

(c) Oral cancer
(d) Breast cancer
97.
Predictive accuracy of a screening test depends on the following EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Disease prevalence
(b) Disease incidence
(c) Sensitivity of screening test
(d) Specificity of screening test
98.

--- Content provided by FirstRanker.com ---

How much of Zinc supplement is recommended by WHO and UNICEF for infants less than 6
months of age after an episode of acute diarrhoea?

(a) 20 mg per day for 10?14 days
(b) 10 mg per day for 10?14 days

--- Content provided by FirstRanker.com ---

(c) 5 mg per day for 7 days
(d) 6 mg per day for 7 days
99.
Which one of the following statements regarding sequential administration of Inactivated
Polio Vaccine (IPV) and Oral Polio Vaccine (OPV) is NOT correct?

--- Content provided by FirstRanker.com ---

(a) It will be cost effective in developing countries for Polio prevention
(b) The combined schedules of IPV and OPV appear to reduce or prevent Vaccine
Associated Paralytic Polio (VAPP)
(c) Intestinal mucosal immunity is lost due to IPV administration

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(d) IPV and OPV together may optimize both the humoral and mucosal immunogenicity
of Polio vaccine
100.
What is the recommended dose regimen of Vitamin A for the treatment of early stages of
Xerophthalmia?

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(a) Single massive dose of 2 lac International Units (IU)
(b) 2 lac IU on two successive days
(c) 2 doses of 1 lac IU in two successive days
(d) 2 doses of 1 lac IU at a gap of one week

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101.
Which is the most specific causative agent of Rabies?

(a) Lyssavirus serotype 1
(b) Lyssavirus serotype 2

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(c) Lyssavirus serotype 3
(d) Lyssavirus serotype 4
102.
Which one of the following is the antibiotic of choice for the prevention of Rheumatic heart
disease?

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(a) Benzathine Benzyl Penicillin
(b) Procaine Penicillin
(c) Doxycycline
(d) Ciprofloxacin

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103.
All of the following are global targets for WHO Global Action Plan (2013?2020) for
Prevention and Control of NCDs, EXCEPT:

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(a) A 10 % relative reduction in risk of premature mortality from cardiovascular diseases,
cancer, diabetes and chronic respiratory diseases
(b) A 10 % relative reduction in prevalence of insufficient physical activity
(c) A 10 % relative reduction in mean population intake of salt/sodium

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(d) At least 10 % relative reduction in the harmful use of alcohol
104.
Under the Employees State Insurance (ESI) Scheme, extended sickness benefit is provided in
which of the following infectious diseases?

--- Content provided by FirstRanker.com ---

1. Tuberculosis
2. Leprosy
3. Chronic empyema

Select the correct answer using the code given below:

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

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105.
In the context of NCD prevention and control in India, the extent of relative reduction in
household use of solid fuels as a primary source of energy for cooking by 2025 is targeted at:

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(a) 30 %
(b) 40 %
(c) 50 %
(d) 60 %
106.

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Consider the following criteria which may indicate elimination of lymphatic filariasis in a
community:

1. When lymphatic filariasis ceases to be a public health problem in the community
2. When the number of microfilaria carriers declines to 1.5 % within the community

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3. When children born in the community after the initiation of elimination programme
are free from circulating antigenaemia

Which of the criteria stated above hold true?

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

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FirstRanker.com - FirstRanker's Choice
Combined Medical Services Examination-2020
Paper-II

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1.
Indications for fasciotomy in compartment syndrome include all EXCEPT:

(a) Distal sensory disturbance

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(b) Compartment pressure > 30 mm Hg
(c) Pain on passive movement of affected muscles
(d) Palpable distal pulses
2.
Which one of the following statements is NOT correct regarding Necrotising Soft Tissue

--- Content provided by FirstRanker.com ---

infections?

(a) Crepitus, skin blistering and focal skin gangrene are typical presenting features
(b) They are monomicrobial in nature
(c) Treatment consists of wide local excision and appropriate antibiotics

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(d) Tissue biopsy is required for culture and diagnosis
3.
Which type of surgery is laparoscopic cholecystectomy classified as?

(a) Clean

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(b) Clean contaminated
(c) Contaminated
(d) Dirty
4.
A 22-year female has presented with a history of malaise, cough, alternating constipation and

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diarrhoea with intermittent abdominal pain for last 6 months. She also complains of
abdominal distension for last 2 days. On examination her abdomen has a doughy feel along
with an ill defined mass over the right lower quadrant. She is most likely suffering from:

(a) Appendicular lump

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(b) Ileocaecal tuberculosis
(c) Carcinoma caecum
(d) Ovarian mass
5.
Consider the following statements regarding needle stick injuries:

--- Content provided by FirstRanker.com ---

1. Injured part should be washed under running water
2. Dominant index finger is the commonest site for needle stick injury
3. All needle stick injuries should be reported
4. Hepatitis/HIV testing should be done after needle stick injury

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Which of the statements given above are correct?

(a) 1, 2 and 4
(b) 1, 2 and 3

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

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6.
Consider the following statements regarding claudication:

1. It is a marker for silent coronary disease

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2. Structured exercise program ( 2 hours per week for 3 months) leads to
improvement in symptoms
3. Diabetes mellitus increases the risk and severity of claudication
4. Beta blockers may exacerbate claudication

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Which of the above statements are correct?

(a) 1 and 2 only
(b) 1, 3 and 4 only
(c) 2, 3 and 4 only

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(d) 1, 2, 3 and 4
7.
A 50-year old lady underwent uneventful bariatric surgery for morbid obesity. On the third
post operative day, she develops breathless and pulmonary embolism is suspected. The next
investigation to confirm the diagnosis will be:

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(a) Echocardiography
(b) Duplex venography
(c) CT pulmonary angiography
(d) MR angiography

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8.
Medical management of thyrotoxic crisis includes all of the following EXCEPT:

(a) IV fluids
(b) IV propanolol

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(c) IV hydrocortisone
(d) IV antibiotics
9.
A patient operated for a parotid gland tumour developed symptoms of sweating and
erytherma (flushing) over the region of surgical excision while eating. The probable

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diagnosis is:

(a) Parotid gland fistula
(b) Sialadenitis
(c) Chronic wound infection

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(d) Frey?s syndrome
10.
First line hormone therapy for post-menopausal woman with metastatic carcinoma breast is:

(a) Tamoxifen

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(b) Ovarian suppression by surgery
(c) Antiprogestins
(d) Anastrazole

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11.
All of the following are major subtypes of breast cancer based on Gene array analysis
EXCEPT:

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(a) Luminal A and Luminal B
(b) Triple negative
(c) Her-2 receptor positive
(d) Oestrogen receptor positive
12.

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All of the following are sequelae of peptic ulcer surgery EXCEPT:

(a) Bilious vomiting
(b) Dumping syndrome
(c) Diarrhoea

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(d) Increased appetite
13.
The Child-Turcotte-Pugh (CTP) score for quantifying the severity of chronic liver disease
includes all variables EXCEPT:

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(a) Serum bilirubin
(b) Serum albumin
(c) Serum creatinine
(d) INR (International Normalised Ratio)
14.

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?Chain of Lakes? appearance due to sacculation with intervening short strictures of pancreatic
duct is seen on:

(a) ERCP
(b) CECT abdomen

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(c) Plain X-ray abdomen
(d) Ultrasonography
15.
Which one of the following statements is NOT correct regarding Pyogenic Liver Abscess?

--- Content provided by FirstRanker.com ---

(a) Anorexia, fever, malaise and right upper quadrant abdominal discomfort are the
most common presenting features
(b) It is more common in elderly, diabetics and immunocompromised patients
(c) Treatment is with oral antibiotics alone
(d) Streptococcus milleri and escherichia coli are the most common causative

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organisms
16.
?Swiss cheese defects? are seen during laparoscopic repair of:

(a) Ventral hernia

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(b) Inguinal hernia
(c) Obturator hernia
(d) Femoral hernia

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17.
Which of the following are correct regarding splenic artery aneurysm?

1. Main arterial trunk is the common site

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2. Palpable thrill can be felt
3. It is symptomless unless it ruptures

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

(a) 1 and 2 only
(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3
18.

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Valentino?s syndrome is:

(a) Pain on per-vaginal examination in pelvic abscess
(b) Pain over left shoulder in left hypochondriac collection
(c) Pain over left groin in perirenal collection

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(d) Pain in right iliac fossa in perforated peptic ulcer
19.
Spontaneous bacterial peritonitis occurs due to:

(a) duodenal stump blowout

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(b) peptic ulcer perforation
(c) acute bacterial infection of ascites
(d) infection via fallopian tubes
20.
Structure not forming boundaries of the ?Triangle of doom? seen during laparoscopic

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inguinal hernia surgery dissection is:

(a) Vas deferens
(b) Inferior epigastric artery
(c) Spermatic cord vessels

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(d) Peritoneum
21.
The term mid-line shift is associated with:

(a) Head injury

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(b) Chest injury
(c) Abdominal injury
(d) Limb injury
22.
Which one of the following cranial nerves does NOT supply to the external ear?

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(a) Cranial nerve V
(b) Cranial nerve VI
(c) Cranial nerve VII
(d) Cranial nerve IX

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23.
Left Internal Mammary Artery (LIMA) has become the conduit of choice for Left Anterior
Descending (LAD) artery during coronary artery bypass grafting because:

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(a) Long term patency rates are more than 98%
(b) It is close to LAD
(c) Atherosclerosis is never seen in this vessel
(d) It is very easy to harvest
24.

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A 50-year old male with significant smoking history presented in the surgical emergency
with sudden severe breathlessness. Chest X-ray shows right sided Pneumothorax. The
appropriate management requires:

(a) Aspiration of air with 16-18 G cannula

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(b) Right chest drain of size 8-14 Fr
(c) Oxygen by face mask
(d) Mechanical ventilation
25.
Which one of the following statements regarding Felon is NOT correct?

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(a) There is infection of the finger tip between specialised fibrous septa
(b) It is a painless condition
(c) Incision and drainage is the treatment of choice
(d) It is common in diabetics

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26.
The most common site for osteosarcoma is:

(a) Proximal femur
(b) Distal femur

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(c) Proximal humerus
(d) Distal humerus
27.
Rapid Sequence Induction is indicated in:

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(a) Emergency surgery for intestinal obstruction
(b) Elective open hernia surgery
(c) Cardiopulmonary bypass surgery
(d) Elective laparoscopic surgery

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28.
Which one of the following statements about Compartment Syndrome is NOT correct?

(a) It is commonest in a closed fracture
(b) Pain is on active movement but not on passive movement of muscles

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(c) Fasciotomy is the treatment of choice
(d) Volkmann?s Ischaemic contractive is a late complication

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29.
Which one of the following is NOT the strength of ultrasound as a diagnostic modality?

(a) No radiation

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(b) Short learning curve
(c) Inexpensive
(d) Allows dynamic studies to be done
30.
Which of the following statements regarding lymphoedema following breast cancer treatment

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are correct?

1. Incidence has decreased due to rarely combined therapy of axillary LN dissection and
radiotherapy
2. Precipitating cause like LN metastasis is a major determinant

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3. The condition is often painful
4. Oedematous limb is susceptible to bacterial infection

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

(a) 1, 2 and 3
(b) 2, 3 and 4
(c) 1, 3 and 4
(d) 1, 2 and 4
31.

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Which one of the following is NOT a risk factor for development of venous thrombosis in
surgical patients?

(a) Age > 60 years
(b) Pregnancy

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(c) Obesity (BMI > 30 kg/m
2
)
(d) Diabetes ( HbA1c > 7.5%)
32.

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Which one of the following is NOT a complication of massive blood transfusion?

(a) Coagulopathy
(b) Hypocalcaemia
(c) Hyperthermia

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(d) Hyperkalemia
33.
Stage III ?Pressure sore? is full thickness skin loss extending:

(a) into subcutaneous tissue but not through fascia

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(b) through subcutaneous tissue into fascia
(c) through subcutaneous tissue into fascia and muscles
(d) through subcutaneous tissue into fascia, muscles and bone

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34.
During subclavian vein puncture in a surgical ward suddenly a patient developed severe
breathlessness. On auscultation breath sound was absent and the ipsilateral chest was
tympanitic on percussion. The probable diagnosis is:

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(a) Iatrogenic pneumothorax
(b) Introgenic hemothorax
(c) Spontaneous pneumothorax
(d) Tension pneumothorax

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35.
Kohler?s disease is avascular necrosis of :

(a) Lunate
(b) Capitellum of humerus

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(c) First metatarsal head
(d) Navicular
36.
Which one of the following is NOT true of Pyoderma gangrenosum?

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(a) It is characterized by cutaneous ulceration with purple undermined edges
(b) It is often secondary to heightened immunological reactivity from another disease
process
(c) Cultures often show Gram positive Staphylococci
(d) Lesions generally respond to steroids

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37.
Which of the following is NOT a tissue repair surgery for inguinal hernia repair?

(a) Bassini?s repair
(b) Shouldice repair

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(c) Stoppa?s repair
(d) Desarda repair
38.
Which one of the following type of meshes is recommended for intraperitoneal use in
abdominal wall hernia?

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(a) Light weight, porous meshes
(b) Heavy weight, porous meshes
(c) Absorbable meshes
(d) Tissue separating meshes
39.

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Which one of the following is NOT correct regarding MEN-1 syndrome?

(a) It involves parathyroid glands
(b) It involves pancreas
(c) It involves pituitary gland

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(d) It involves pineal gland

40.
Which one of the following is NOT an electronic information site in surgery?

--- Content provided by FirstRanker.com ---

(a) Pubmed
(b) Embase
(c) Cochrane library
(d) National medical library
41.

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Which one of the following statements regarding pre-conceptional counseling is NOT
correct?

(a) It is needed only in selected complicated pregnancies
(b) It helps in early detection of risk factors

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(c) It helps in reducing maternal morbidity and mortality
(d) It is a part of preventive medicine
42.
Consider the following statements regarding Non Stress Test (NST):

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1. Reactive NST indicates a healthy fetus
2. NST is an observed association of fetal breathing with fetal movements
3. NST has a low false negative rate (< 1%) but high false positive rate (>50%)
4. Testing should be started at 20 weeks

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Which of the statement(s) given above is/are correct?

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

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(d) 1 and 4
43.
Which one of the following is a protective factor for endometrial hyperplasia?

(a) Diabetes

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(b) Tamoxifen therapy
(c) Multiparity
(d) Delayed menopause
44.
A woman who is not breast feeding her newborn child is advised to use a contraceptive

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method by:

(a) 3
rd
postpartum week

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(b) 6
th
postpartum week
(c) 3
rd

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postpartum month
(d) 6
th
postpartum month

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45.

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Pearl index for contraceptive effectiveness is calculated in terms of which of the following?

1. Pregnancy rate
2. Abortion rate
3. Hundred woman years

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4. Thousand woman years

Select the correct answer using the code given below:

(a) 1 only

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(b) 2 and 3
(c) 1, 2 and 4
(d) 1 and 3
46.
Indications for removal of IUDs are all EXCEPT:

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(a) Perforation of uterus
(b) Cyclical menstrual bleeding
(c) Flaring up of salpingitis
(d) Pregnancy with IUD

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47.
Contraindications for insertion of IUDs are all EXCEPT:

(a) Suspected pregnancy
(b) Trophoblastic disease

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(c) Severe dysmenorrhea
(d) During cesarean section
48.
Which one of the following is NOT a contraindication for use of Mini pill?

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(a) Pregnancy
(b) Breast feeding
(c) Thromboembolic disease
(d) History of breast cancer
49.

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Which one of the following is the most commonly used surgical method/technique of female
sterilization as recommended by Government of India?

(a) Uchida technique
(b) Irving method

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(c) Pomeroy?s method
(d) Madlener technique

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50.

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Which of the following is/are required for a registered medical practitioner to qualify for
performing Medical Termination of Pregnancy (MTP), as per revised rules of MTP Act?

1. Certified for assisting at least 15 MTP in an authorized centre
2. Diploma or degree in Obstetrics and Gynaecology

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3. House surgeon training for 3 months in Obstetrics and Gynaecology
4. Certified training for 6 months in laparoscopic surgeries

Select the correct answer using the code given below:
(a) 1 only

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(b) 2 only
(c) 1, 2 and 3
(d) 1, 2 and 4
51.
Which one of the following is NOT a support of uterus, preventing its descent?

--- Content provided by FirstRanker.com ---

(a) Endopelvic fascia
(b) Mackenrodt?s ligament
(c) Inguinal ligament
(d) Pubocervical ligament

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52.
As per ICMR guidelines, which one of the following statements is true regarding effects of
COVID-19 on fetus according to current evidence?

(a) There is increased risk of early pregnancy loss

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(b) COVID-19 virus is not teratogenic
(c) COVID-19 virus infection is an indication of MTP
(d) There is increased risk of fetal growth restriction
53.
As per ICMR guidelines, which one of the following statements is true regarding COVID-19

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infection in pregnancy?

(a) Covid-19 pneumonia in pregnancy is more severe with poor recovery
(b) Pregnant women with heart disease are at higher risk
(c) Vaginal secretions always test positive for COVID-19 in pregnancy

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(d) COVID-19 virus is secreted in breast milk
54.
Which one of the following is NOT a method of management of Deep Transverse Arrest with
the living fetus?

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(a) Caesarean section
(b) Delivery by ventouse
(c) Delivery by application of forceps to the unrotated head
(d) Manual rotation and application of forceps

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55.

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Successful version of breech presentation is likely in case all of the following EXCEPT:

(a) Breech with extended legs
(b) Complete breech with sacroanterior position
(c) Non engaged breech

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(d) Adequate amniotic fluid
56.
Implantation of a fertilised ovum occurs on which day following fertilisation?

(a) Day 6

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(b) Day 10
(c) Day 14
(d) Day 20
57.
During total abdominal hysterectomy the ureter is likely to undergo injury or ligation during

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the following steps EXCEPT:

(a) During division and ligation of the round ligaments
(b) During division and ligation of infundibulopelvic ligaments
(c) During division and ligation of mackenrodt?s and uterosacral ligaments

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(d) At the vaginal angles while incising the vagina to remove the cervix with the
uterus
58.
The net effect of antenatal care has been the following EXCEPT:

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(a) Reduction in maternal mortality
(b) Reduction in perinatal mortality
(c) Reduction in the incidence of institutional delivery
(d) Reduction in maternal morbidity
59.

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Which one of the following is NOT a component of active phase in the partograph?

(a) Acceleration phase
(b) Phase of maximum slope
(c) Phase of deceleration

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(d) Phase of expulsion
60.
From medicolegal point of view which one of the following is NOT a sign of previous child
birth?

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(a) Perineum is lax and there is evidence of scarring
(b) Introitus is gaping and there is presence of carunculae myrtiformis
(c) Abdomen is lax and loose with striae and linea alba
(d) Conical cervix with round external os

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61.

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The components of partograph are all EXCEPT:

(a) Time
(b) Fetal heart rate
(c) Maternal respiratory rate

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(d) Maternal urine analysis
62.
Which of the following information are provided by partograph?

1. Colour of liquor

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2. Uterine contractions with duration and frequency
3. Dilatation of cervix

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

(a) 1 and 2 only
(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3
63.

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Intraoperative recognition of ureter is by which of the following features?

1. Transparent tubular appearance
2. Pale glistening appearance
3. Longitudinal vessels on surface

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4. Circumferential vessels on surface

Select the correct answer using the code given below:

(a) 1 and 3

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(b) 2 and 4
(c) 2 and 3
(d) 1 and 4
64.
Hysterosalpingography (HSG) is least helpful in detecting which of the following?

--- Content provided by FirstRanker.com ---

(a) Tubal patency
(b) Pelvic adhesions
(c) Asherman syndrome
(d) Congenital uterine anomaly

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65.

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Which of the following are characteristics of Trichomonas vaginitis?

1. Presence of greenish frothy discharge
2. Vaginal pH > 4.5
3. Presence of clue cells in microscopic examination

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4. Strawberry spots on the vaginal mucosa

Select the correct answer using the code given below:

(a) 1, 2 and 3

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(b) 1, 2 and 4
(c) 2, 3 and 4
(d) 1, 3 and 4
66.
Tumor marker of epithelial ovarian carcinoma is:

--- Content provided by FirstRanker.com ---

(a) Ca.125
(b) Alpha feto protein
(c) Beta HCG
(d) LDH

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67.
The most common site of cervical cancer is:

(a) Endocervix
(b) Ectocervix

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(c) Transformation zone
(d) Isthmus
68.
The placenta synthesizes all EXCEPT:

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(a) Oestriol
(b) Corticotrophin releasing hormone
(c) PAPP-A(Pregnancy Associated Plasma Protein A)
(d) Dehydroepiandrosterone
69.

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Withdrawal bleeding following administration of progesterone in a case of secondary
amenorrhea indicates all EXCEPT:

(a) Absence of pregnancy
(b) Production endogenous estrogen

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(c) Endometrium is responsive to estrogen
(d) Defect in pituitary gland
70.
Monilial vaginitis is commonly associated with all EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Prolonged antibiotic therapy
(b) Diabetes Mellitus
(c) Treatment of malaria with chloroquine
(d) Pregnancy
71.

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Which one of the following is NOT a risk factor for the development of placenta previa?

(a) Maternal age
(b) Smoking
(c) Previous caesarean section

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(d) Maternal anaemia
72.
Common clinical presentations of moderate to severe abruption are all EXCEPT:

(a) Uterine tenderness

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(b) Fetal distress
(c) Unexplained pre term labour
(d) Prolonged labour
73.
Common trisomies resulting in spontaneous abortion are all EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Trisomy 21
(b) Trisomy 18
(c) Trisomy 16
(d) Trisomy 1

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74.
The initial prevention strategy for antiphospholipid syndrome will be:

1. Steroids
2. Heparin

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3. Low dose aspirin
4. Progesterone support

Which of the above is/are correct?

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(a) 2 and 3
(b) 3 and 4
(c) 3 only
(d) 1 and 4
75.

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Diagnostic criteria for PCOD are:

1. Oligo/amenorrohoea
2. Hyperandrogenism
3. Polycystic ovaries on ultrasound

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Which of the above are correct?

(a) 1 and 2 only
(b) 2 and 3 only

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


76.

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Which of the following symptoms can be associated with pelvic organ prolapse?

1. Difficulty in passing urine
2. Incomplete evacuation of urine
3. Urgency and frequency

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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.
A 30 year old lady, P
2

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L
2
presents with painful unilateral swelling in vulva for 3 days. Which
of the following statements are true regarding the above case?

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1. Bartholin?s abscess may be the likely diagnosis
2. It is to be managed by marsupialisation
3. Gonococcus is the most common pathogenic organism

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

(a) 1 and 3 only
(b) 3 only
(c) 1 and 2 only
(d) 1, 2 and 3
78.

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Which one of the following is NOT a sign of separation of placenta?

(a) Uterus becomes globular, firm and ballotable
(b) The fundal height reduces further
(c) Slight bulging in the suprapubic region

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(d) Apparent lengthenic of the cord with slight gush of vaginal bleeding
79.
Consider the following regarding examination of a rape victim:

1. Emergency pill is provided

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2. Internal examination must be performed
3. HIV testing is done

Which of the above statements is/are correct?

--- Content provided by FirstRanker.com ---

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

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80.
Consider the following cardinal movements of mechanism of normal labor:

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1. Engagement
2. Internal rotation
3. Flexion
4. Restitution
5. Crowning

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6. External rotation

What is the correct sequence of movements in labor in occipito-lateral position?

(a) 1, 2, 3, 4, 5 and 6

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(b) 1, 3, 2, 5, 4 and 6
(c) 2, 1, 3, 4, 5 and 6
(d) 3, 1, 2, 4, 6 and 5
81.
Which of the following represent the properties of an ideal disinfectant?

--- Content provided by FirstRanker.com ---

1. It is broad spectrum
2. It is fast acting
3. It is non-toxic

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

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82.
Which of the following measures can help reduce the risk of systemic hypertension?

1. Reduction in dietary intake of common salt
2. Controlling weight for age

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3. Increasing potassium rich foods in the diet

Select the correct answer using the code given below:

(a) 1 and 2 only

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

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83.
Keeping biological determinants in perspective, consider the following statements:

1. Presence of a normal karyotype is the first requisite for human health

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2. Genetic screening can play an important role in prevention of wide spectrum of
diseases
3. If an individual is allowed to live in healthy relationship with the environment, the
person?s genetic potentialities can transform into phenotypic realities

--- Content provided by FirstRanker.com ---

Which of the above statements is/are correct?

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

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(d) 2 and 3 only
84.
NITI Aayog has the following roles EXCEPT:

(a) It provides critical directional and strategic input in the development process

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(b) It provides relevant technical advice with focus on technology upgradation
(c) It focuses on capacity building
(d) It focuses on the development of ?Referral Service Complex?
85.
Poor hand hygiene of a mess worker in a university college mess led to Hepatitis A cases in

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the hostel inmates. What type of epidemic will this exposure present with?

1. Propagated
2. Common source-continuous exposure
3. Common source-point exposure

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Select the correct answer using the code given below:

(a) 1 and 2
(b) 1 and 3

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(c) 1 only
(d) 2 only

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86.

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What is the specificity of sputum microscopy in detection of Pulmonary Tuberculosis (PTB)
as per the information given below?

PTB Total
Sputum microscopy Present Absent

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Positive 270 20 290
Negative 30 180 210
Total 300 200 500

(a) 10 %

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(b) 36 %
(c) 90 %
(d) 94 %
87.
In a cohort of 500 women attending antenatal clinic, 70 % had ultrasonography (USG). This

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cohort was followed up at delivery. Of the women who had USG, 70 delivered low birth
weight (LBW) babies; whereas of the women, who did not undergo USG, 50 delivered LBW
babies. The incidence of LBW babies among women who had USG is:

(a) 10 %

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(b) 15 %
(c) 20 %
(d) 25 %
88.
Major source of vitamin K

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1
is:

(a) Fresh dark green vegetables
(b) Exposure of body to sunlight

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(c) Citrus fruits
(d) Foods rich in polyunsaturated fatty acids
89.
Which one of the following is NOT a function of Epidemiology?

--- Content provided by FirstRanker.com ---

(a) To study historically the rise and fall of disease in the population
(b) Searching for the causes and risk factor
(c) Identifying syndromes
(d) Making clinical diagnosis
90.

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Which one of the following is NOT a contagious disease?

(a) Malaria
(b) Scabies
(c) Trachoma

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(d) Leprosy


91.
In primary immune response, how much more antigenic dose is required to induce IgG

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antibodies as against the induction of IgM antibodies?

(a) 10 times more
(b) 25 times more
(c) 50 times more

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(d) 100 times more
92.
Pentavalent vaccine provides protection against which of the following diseases?

(a) Diphtheria, Pertussis, Tuberculosis, Measles and Hepatitis B

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(b) Diphtheria, Pertussis, Measles, Hepatitis B and Hib
(c) Diphtheria, Pertussis, Tetanus, Hepatitis B and Rubella
(d) Diphtheria, Pertussis, Tetanus, Hepatitis B and Hib
93.
Consider the following data for a country:

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Population in 0-14 years of age ? 391,558,367
Population between 15?64 years of age ? 856,076,200
Population above 65 years of age ? 71,943,390
What shall be the dependency ratio of this country?

--- Content provided by FirstRanker.com ---

(a) 42.4 %
(b) 54.1 %
(c) 66.2 %
(d) 78.6 %
94.

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Which one of the following statements regarding Rabies Immunoglobulin is NOT true?

(a) It should be administered only once as soon as possible after the initiation of post
exposure prophylaxis
(b) It should be administered all into or around the wound sites

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(c) There is no scientific ground for performing a skin test prior to administering equine
immunoglobulin
(d) It can be administered till 15 days after the first dose of anti-rabies vaccine
95.
All of the following are true about Bedaquiline (BDQ) EXCEPT:

--- Content provided by FirstRanker.com ---

(a) It specifically targets mycobacterial ATP synthase
(b) It is a bacteriostatic drug
(c) It has extended half life
(d) It has high volume of tissue distribution

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96.
Visual inspection based screening test with 5 % acetic acid is used for the screening of which
one of the following cancers?

(a) Lung cancer

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(b) Cervix cancer
(c) Oral cancer
(d) Breast cancer
97.
Predictive accuracy of a screening test depends on the following EXCEPT:

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(a) Disease prevalence
(b) Disease incidence
(c) Sensitivity of screening test
(d) Specificity of screening test

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98.
How much of Zinc supplement is recommended by WHO and UNICEF for infants less than 6
months of age after an episode of acute diarrhoea?

(a) 20 mg per day for 10?14 days

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(b) 10 mg per day for 10?14 days
(c) 5 mg per day for 7 days
(d) 6 mg per day for 7 days
99.
Which one of the following statements regarding sequential administration of Inactivated

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Polio Vaccine (IPV) and Oral Polio Vaccine (OPV) is NOT correct?

(a) It will be cost effective in developing countries for Polio prevention
(b) The combined schedules of IPV and OPV appear to reduce or prevent Vaccine
Associated Paralytic Polio (VAPP)

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(c) Intestinal mucosal immunity is lost due to IPV administration
(d) IPV and OPV together may optimize both the humoral and mucosal immunogenicity
of Polio vaccine
100.
What is the recommended dose regimen of Vitamin A for the treatment of early stages of

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Xerophthalmia?

(a) Single massive dose of 2 lac International Units (IU)
(b) 2 lac IU on two successive days
(c) 2 doses of 1 lac IU in two successive days

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(d) 2 doses of 1 lac IU at a gap of one week
101.
Which is the most specific causative agent of Rabies?

(a) Lyssavirus serotype 1

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(b) Lyssavirus serotype 2
(c) Lyssavirus serotype 3
(d) Lyssavirus serotype 4
102.
Which one of the following is the antibiotic of choice for the prevention of Rheumatic heart

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disease?

(a) Benzathine Benzyl Penicillin
(b) Procaine Penicillin
(c) Doxycycline

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(d) Ciprofloxacin


103.
All of the following are global targets for WHO Global Action Plan (2013?2020) for

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Prevention and Control of NCDs, EXCEPT:

(a) A 10 % relative reduction in risk of premature mortality from cardiovascular diseases,
cancer, diabetes and chronic respiratory diseases
(b) A 10 % relative reduction in prevalence of insufficient physical activity

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(c) A 10 % relative reduction in mean population intake of salt/sodium
(d) At least 10 % relative reduction in the harmful use of alcohol
104.
Under the Employees State Insurance (ESI) Scheme, extended sickness benefit is provided in
which of the following infectious diseases?

--- Content provided by FirstRanker.com ---

1. Tuberculosis
2. Leprosy
3. Chronic empyema

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Select the correct answer using the code given below:

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

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(d) 1, 2 and 3

105.
In the context of NCD prevention and control in India, the extent of relative reduction in
household use of solid fuels as a primary source of energy for cooking by 2025 is targeted at:

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(a) 30 %
(b) 40 %
(c) 50 %
(d) 60 %

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106.
Consider the following criteria which may indicate elimination of lymphatic filariasis in a
community:

1. When lymphatic filariasis ceases to be a public health problem in the community

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2. When the number of microfilaria carriers declines to 1.5 % within the community
3. When children born in the community after the initiation of elimination programme
are free from circulating antigenaemia

Which of the criteria stated above hold true?

--- Content provided by FirstRanker.com ---

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

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107.
Hold over time of cold chain equipment depends on all of the following factors EXCEPT:

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(a) Ambient temperature
(b) Quantity of vaccines kept
(c) Types of vaccines kept
(d) Condition of icepack lining

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108.
Which of the following statements regarding Physical Quality of Life Index (PQLI) are
correct?

1. It consolidates infant mortality, life expectancy at age one, and literacy

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2. It does not measure economic growth but measures the result of economic policies
3. For each component, the performance of individual countries is placed on a scale of
0-100

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

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

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109.
Disability-adjusted life years (DALYs) include:

(a) Years of lost life (YLL)
(b) Years lost to disability (YLD)

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(c) Both YLL and YLD
(d) Neither YLL nor YLD
110.
Which of the following are health care delivery indicators?

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1. Population per trained birth attendant
2. Population per health/sub centre
3. Doctor-nurse ratio

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

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

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FirstRanker.com - FirstRanker's Choice
Combined Medical Services Examination-2020

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Paper-II

1.
Indications for fasciotomy in compartment syndrome include all EXCEPT:

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(a) Distal sensory disturbance
(b) Compartment pressure > 30 mm Hg
(c) Pain on passive movement of affected muscles
(d) Palpable distal pulses
2.

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Which one of the following statements is NOT correct regarding Necrotising Soft Tissue
infections?

(a) Crepitus, skin blistering and focal skin gangrene are typical presenting features
(b) They are monomicrobial in nature

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(c) Treatment consists of wide local excision and appropriate antibiotics
(d) Tissue biopsy is required for culture and diagnosis
3.
Which type of surgery is laparoscopic cholecystectomy classified as?

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(a) Clean
(b) Clean contaminated
(c) Contaminated
(d) Dirty
4.

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A 22-year female has presented with a history of malaise, cough, alternating constipation and
diarrhoea with intermittent abdominal pain for last 6 months. She also complains of
abdominal distension for last 2 days. On examination her abdomen has a doughy feel along
with an ill defined mass over the right lower quadrant. She is most likely suffering from:

--- Content provided by FirstRanker.com ---

(a) Appendicular lump
(b) Ileocaecal tuberculosis
(c) Carcinoma caecum
(d) Ovarian mass
5.

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Consider the following statements regarding needle stick injuries:

1. Injured part should be washed under running water
2. Dominant index finger is the commonest site for needle stick injury
3. All needle stick injuries should be reported

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4. Hepatitis/HIV testing should be done after needle stick injury

Which of the statements given above are correct?

(a) 1, 2 and 4

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

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6.
Consider the following statements regarding claudication:

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1. It is a marker for silent coronary disease
2. Structured exercise program ( 2 hours per week for 3 months) leads to
improvement in symptoms
3. Diabetes mellitus increases the risk and severity of claudication
4. Beta blockers may exacerbate claudication

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Which of the above statements are correct?

(a) 1 and 2 only
(b) 1, 3 and 4 only

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(c) 2, 3 and 4 only
(d) 1, 2, 3 and 4
7.
A 50-year old lady underwent uneventful bariatric surgery for morbid obesity. On the third
post operative day, she develops breathless and pulmonary embolism is suspected. The next

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investigation to confirm the diagnosis will be:

(a) Echocardiography
(b) Duplex venography
(c) CT pulmonary angiography

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(d) MR angiography
8.
Medical management of thyrotoxic crisis includes all of the following EXCEPT:

(a) IV fluids

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(b) IV propanolol
(c) IV hydrocortisone
(d) IV antibiotics
9.
A patient operated for a parotid gland tumour developed symptoms of sweating and

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erytherma (flushing) over the region of surgical excision while eating. The probable
diagnosis is:

(a) Parotid gland fistula
(b) Sialadenitis

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(c) Chronic wound infection
(d) Frey?s syndrome
10.
First line hormone therapy for post-menopausal woman with metastatic carcinoma breast is:

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(a) Tamoxifen
(b) Ovarian suppression by surgery
(c) Antiprogestins
(d) Anastrazole

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11.
All of the following are major subtypes of breast cancer based on Gene array analysis
EXCEPT:

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(a) Luminal A and Luminal B
(b) Triple negative
(c) Her-2 receptor positive
(d) Oestrogen receptor positive

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12.
All of the following are sequelae of peptic ulcer surgery EXCEPT:

(a) Bilious vomiting
(b) Dumping syndrome

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(c) Diarrhoea
(d) Increased appetite
13.
The Child-Turcotte-Pugh (CTP) score for quantifying the severity of chronic liver disease
includes all variables EXCEPT:

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(a) Serum bilirubin
(b) Serum albumin
(c) Serum creatinine
(d) INR (International Normalised Ratio)

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14.
?Chain of Lakes? appearance due to sacculation with intervening short strictures of pancreatic
duct is seen on:

(a) ERCP

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(b) CECT abdomen
(c) Plain X-ray abdomen
(d) Ultrasonography
15.
Which one of the following statements is NOT correct regarding Pyogenic Liver Abscess?

--- Content provided by FirstRanker.com ---

(a) Anorexia, fever, malaise and right upper quadrant abdominal discomfort are the
most common presenting features
(b) It is more common in elderly, diabetics and immunocompromised patients
(c) Treatment is with oral antibiotics alone

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(d) Streptococcus milleri and escherichia coli are the most common causative
organisms
16.
?Swiss cheese defects? are seen during laparoscopic repair of:

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(a) Ventral hernia
(b) Inguinal hernia
(c) Obturator hernia
(d) Femoral hernia

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17.
Which of the following are correct regarding splenic artery aneurysm?

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1. Main arterial trunk is the common site
2. Palpable thrill can be felt
3. It is symptomless unless it ruptures

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

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

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18.
Valentino?s syndrome is:

(a) Pain on per-vaginal examination in pelvic abscess
(b) Pain over left shoulder in left hypochondriac collection

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(c) Pain over left groin in perirenal collection
(d) Pain in right iliac fossa in perforated peptic ulcer
19.
Spontaneous bacterial peritonitis occurs due to:

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(a) duodenal stump blowout
(b) peptic ulcer perforation
(c) acute bacterial infection of ascites
(d) infection via fallopian tubes
20.

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Structure not forming boundaries of the ?Triangle of doom? seen during laparoscopic
inguinal hernia surgery dissection is:

(a) Vas deferens
(b) Inferior epigastric artery

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(c) Spermatic cord vessels
(d) Peritoneum
21.
The term mid-line shift is associated with:

--- Content provided by FirstRanker.com ---

(a) Head injury
(b) Chest injury
(c) Abdominal injury
(d) Limb injury
22.

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Which one of the following cranial nerves does NOT supply to the external ear?

(a) Cranial nerve V
(b) Cranial nerve VI
(c) Cranial nerve VII

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(d) Cranial nerve IX

23.
Left Internal Mammary Artery (LIMA) has become the conduit of choice for Left Anterior
Descending (LAD) artery during coronary artery bypass grafting because:

--- Content provided by FirstRanker.com ---

(a) Long term patency rates are more than 98%
(b) It is close to LAD
(c) Atherosclerosis is never seen in this vessel
(d) It is very easy to harvest

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24.
A 50-year old male with significant smoking history presented in the surgical emergency
with sudden severe breathlessness. Chest X-ray shows right sided Pneumothorax. The
appropriate management requires:

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(a) Aspiration of air with 16-18 G cannula
(b) Right chest drain of size 8-14 Fr
(c) Oxygen by face mask
(d) Mechanical ventilation
25.

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Which one of the following statements regarding Felon is NOT correct?

(a) There is infection of the finger tip between specialised fibrous septa
(b) It is a painless condition
(c) Incision and drainage is the treatment of choice

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(d) It is common in diabetics
26.
The most common site for osteosarcoma is:

(a) Proximal femur

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(b) Distal femur
(c) Proximal humerus
(d) Distal humerus
27.
Rapid Sequence Induction is indicated in:

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(a) Emergency surgery for intestinal obstruction
(b) Elective open hernia surgery
(c) Cardiopulmonary bypass surgery
(d) Elective laparoscopic surgery

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28.
Which one of the following statements about Compartment Syndrome is NOT correct?

(a) It is commonest in a closed fracture

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(b) Pain is on active movement but not on passive movement of muscles
(c) Fasciotomy is the treatment of choice
(d) Volkmann?s Ischaemic contractive is a late complication

--- Content provided by FirstRanker.com ---

29.
Which one of the following is NOT the strength of ultrasound as a diagnostic modality?

--- Content provided by FirstRanker.com ---

(a) No radiation
(b) Short learning curve
(c) Inexpensive
(d) Allows dynamic studies to be done
30.

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Which of the following statements regarding lymphoedema following breast cancer treatment
are correct?

1. Incidence has decreased due to rarely combined therapy of axillary LN dissection and
radiotherapy

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2. Precipitating cause like LN metastasis is a major determinant
3. The condition is often painful
4. Oedematous limb is susceptible to bacterial infection

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

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

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31.
Which one of the following is NOT a risk factor for development of venous thrombosis in
surgical patients?

(a) Age > 60 years

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(b) Pregnancy
(c) Obesity (BMI > 30 kg/m
2
)
(d) Diabetes ( HbA1c > 7.5%)

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32.
Which one of the following is NOT a complication of massive blood transfusion?

(a) Coagulopathy
(b) Hypocalcaemia

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(c) Hyperthermia
(d) Hyperkalemia
33.
Stage III ?Pressure sore? is full thickness skin loss extending:

--- Content provided by FirstRanker.com ---

(a) into subcutaneous tissue but not through fascia
(b) through subcutaneous tissue into fascia
(c) through subcutaneous tissue into fascia and muscles
(d) through subcutaneous tissue into fascia, muscles and bone

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34.
During subclavian vein puncture in a surgical ward suddenly a patient developed severe
breathlessness. On auscultation breath sound was absent and the ipsilateral chest was

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tympanitic on percussion. The probable diagnosis is:

(a) Iatrogenic pneumothorax
(b) Introgenic hemothorax
(c) Spontaneous pneumothorax

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(d) Tension pneumothorax
35.
Kohler?s disease is avascular necrosis of :

(a) Lunate

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(b) Capitellum of humerus
(c) First metatarsal head
(d) Navicular
36.
Which one of the following is NOT true of Pyoderma gangrenosum?

--- Content provided by FirstRanker.com ---

(a) It is characterized by cutaneous ulceration with purple undermined edges
(b) It is often secondary to heightened immunological reactivity from another disease
process
(c) Cultures often show Gram positive Staphylococci

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(d) Lesions generally respond to steroids
37.
Which of the following is NOT a tissue repair surgery for inguinal hernia repair?

(a) Bassini?s repair

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(b) Shouldice repair
(c) Stoppa?s repair
(d) Desarda repair
38.
Which one of the following type of meshes is recommended for intraperitoneal use in

--- Content provided by FirstRanker.com ---

abdominal wall hernia?
(a) Light weight, porous meshes
(b) Heavy weight, porous meshes
(c) Absorbable meshes
(d) Tissue separating meshes

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39.
Which one of the following is NOT correct regarding MEN-1 syndrome?

(a) It involves parathyroid glands
(b) It involves pancreas

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(c) It involves pituitary gland
(d) It involves pineal gland

40.
Which one of the following is NOT an electronic information site in surgery?

--- Content provided by FirstRanker.com ---

(a) Pubmed
(b) Embase
(c) Cochrane library
(d) National medical library

--- Content provided by FirstRanker.com ---

41.
Which one of the following statements regarding pre-conceptional counseling is NOT
correct?

(a) It is needed only in selected complicated pregnancies

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(b) It helps in early detection of risk factors
(c) It helps in reducing maternal morbidity and mortality
(d) It is a part of preventive medicine
42.
Consider the following statements regarding Non Stress Test (NST):

--- Content provided by FirstRanker.com ---

1. Reactive NST indicates a healthy fetus
2. NST is an observed association of fetal breathing with fetal movements
3. NST has a low false negative rate (< 1%) but high false positive rate (>50%)
4. Testing should be started at 20 weeks

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Which of the statement(s) given above is/are correct?

(a) 1 and 3
(b) 2 only

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(c) 3 only
(d) 1 and 4
43.
Which one of the following is a protective factor for endometrial hyperplasia?

--- Content provided by FirstRanker.com ---

(a) Diabetes
(b) Tamoxifen therapy
(c) Multiparity
(d) Delayed menopause
44.

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A woman who is not breast feeding her newborn child is advised to use a contraceptive
method by:

(a) 3
rd

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postpartum week
(b) 6
th
postpartum week
(c) 3

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rd
postpartum month
(d) 6
th
postpartum month

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45.
Pearl index for contraceptive effectiveness is calculated in terms of which of the following?

1. Pregnancy rate
2. Abortion rate

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3. Hundred woman years
4. Thousand woman years

Select the correct answer using the code given below:

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(a) 1 only
(b) 2 and 3
(c) 1, 2 and 4
(d) 1 and 3
46.

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Indications for removal of IUDs are all EXCEPT:

(a) Perforation of uterus
(b) Cyclical menstrual bleeding
(c) Flaring up of salpingitis

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(d) Pregnancy with IUD
47.
Contraindications for insertion of IUDs are all EXCEPT:

(a) Suspected pregnancy

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(b) Trophoblastic disease
(c) Severe dysmenorrhea
(d) During cesarean section
48.
Which one of the following is NOT a contraindication for use of Mini pill?

--- Content provided by FirstRanker.com ---

(a) Pregnancy
(b) Breast feeding
(c) Thromboembolic disease
(d) History of breast cancer

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49.
Which one of the following is the most commonly used surgical method/technique of female
sterilization as recommended by Government of India?

(a) Uchida technique

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(b) Irving method
(c) Pomeroy?s method
(d) Madlener technique

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50.
Which of the following is/are required for a registered medical practitioner to qualify for
performing Medical Termination of Pregnancy (MTP), as per revised rules of MTP Act?

1. Certified for assisting at least 15 MTP in an authorized centre

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2. Diploma or degree in Obstetrics and Gynaecology
3. House surgeon training for 3 months in Obstetrics and Gynaecology
4. Certified training for 6 months in laparoscopic surgeries

Select the correct answer using the code given below:

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(a) 1 only
(b) 2 only
(c) 1, 2 and 3
(d) 1, 2 and 4
51.

--- Content provided by FirstRanker.com ---

Which one of the following is NOT a support of uterus, preventing its descent?

(a) Endopelvic fascia
(b) Mackenrodt?s ligament
(c) Inguinal ligament

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(d) Pubocervical ligament
52.
As per ICMR guidelines, which one of the following statements is true regarding effects of
COVID-19 on fetus according to current evidence?

--- Content provided by FirstRanker.com ---

(a) There is increased risk of early pregnancy loss
(b) COVID-19 virus is not teratogenic
(c) COVID-19 virus infection is an indication of MTP
(d) There is increased risk of fetal growth restriction
53.

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As per ICMR guidelines, which one of the following statements is true regarding COVID-19
infection in pregnancy?

(a) Covid-19 pneumonia in pregnancy is more severe with poor recovery
(b) Pregnant women with heart disease are at higher risk

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(c) Vaginal secretions always test positive for COVID-19 in pregnancy
(d) COVID-19 virus is secreted in breast milk
54.
Which one of the following is NOT a method of management of Deep Transverse Arrest with
the living fetus?

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(a) Caesarean section
(b) Delivery by ventouse
(c) Delivery by application of forceps to the unrotated head
(d) Manual rotation and application of forceps

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55.
Successful version of breech presentation is likely in case all of the following EXCEPT:

(a) Breech with extended legs
(b) Complete breech with sacroanterior position

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(c) Non engaged breech
(d) Adequate amniotic fluid
56.
Implantation of a fertilised ovum occurs on which day following fertilisation?

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(a) Day 6
(b) Day 10
(c) Day 14
(d) Day 20
57.

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During total abdominal hysterectomy the ureter is likely to undergo injury or ligation during
the following steps EXCEPT:

(a) During division and ligation of the round ligaments
(b) During division and ligation of infundibulopelvic ligaments

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(c) During division and ligation of mackenrodt?s and uterosacral ligaments
(d) At the vaginal angles while incising the vagina to remove the cervix with the
uterus
58.
The net effect of antenatal care has been the following EXCEPT:

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(a) Reduction in maternal mortality
(b) Reduction in perinatal mortality
(c) Reduction in the incidence of institutional delivery
(d) Reduction in maternal morbidity

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59.
Which one of the following is NOT a component of active phase in the partograph?

(a) Acceleration phase
(b) Phase of maximum slope

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(c) Phase of deceleration
(d) Phase of expulsion
60.
From medicolegal point of view which one of the following is NOT a sign of previous child
birth?

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(a) Perineum is lax and there is evidence of scarring
(b) Introitus is gaping and there is presence of carunculae myrtiformis
(c) Abdomen is lax and loose with striae and linea alba
(d) Conical cervix with round external os

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61.
The components of partograph are all EXCEPT:

(a) Time
(b) Fetal heart rate

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(c) Maternal respiratory rate
(d) Maternal urine analysis
62.
Which of the following information are provided by partograph?

--- Content provided by FirstRanker.com ---

1. Colour of liquor
2. Uterine contractions with duration and frequency
3. Dilatation of cervix

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

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

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63.
Intraoperative recognition of ureter is by which of the following features?

1. Transparent tubular appearance
2. Pale glistening appearance

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3. Longitudinal vessels on surface
4. Circumferential vessels on surface

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

(a) 1 and 3
(b) 2 and 4
(c) 2 and 3
(d) 1 and 4
64.

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Hysterosalpingography (HSG) is least helpful in detecting which of the following?

(a) Tubal patency
(b) Pelvic adhesions
(c) Asherman syndrome

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(d) Congenital uterine anomaly

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65.
Which of the following are characteristics of Trichomonas vaginitis?

1. Presence of greenish frothy discharge
2. Vaginal pH > 4.5

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3. Presence of clue cells in microscopic examination
4. Strawberry spots on the vaginal mucosa

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

(a) 1, 2 and 3
(b) 1, 2 and 4
(c) 2, 3 and 4
(d) 1, 3 and 4
66.

--- Content provided by FirstRanker.com ---

Tumor marker of epithelial ovarian carcinoma is:

(a) Ca.125
(b) Alpha feto protein
(c) Beta HCG

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(d) LDH
67.
The most common site of cervical cancer is:

(a) Endocervix

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(b) Ectocervix
(c) Transformation zone
(d) Isthmus
68.
The placenta synthesizes all EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Oestriol
(b) Corticotrophin releasing hormone
(c) PAPP-A(Pregnancy Associated Plasma Protein A)
(d) Dehydroepiandrosterone

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69.
Withdrawal bleeding following administration of progesterone in a case of secondary
amenorrhea indicates all EXCEPT:

(a) Absence of pregnancy

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(b) Production endogenous estrogen
(c) Endometrium is responsive to estrogen
(d) Defect in pituitary gland
70.
Monilial vaginitis is commonly associated with all EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Prolonged antibiotic therapy
(b) Diabetes Mellitus
(c) Treatment of malaria with chloroquine
(d) Pregnancy

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71.
Which one of the following is NOT a risk factor for the development of placenta previa?

(a) Maternal age
(b) Smoking

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(c) Previous caesarean section
(d) Maternal anaemia
72.
Common clinical presentations of moderate to severe abruption are all EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Uterine tenderness
(b) Fetal distress
(c) Unexplained pre term labour
(d) Prolonged labour
73.

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Common trisomies resulting in spontaneous abortion are all EXCEPT:

(a) Trisomy 21
(b) Trisomy 18
(c) Trisomy 16

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(d) Trisomy 1
74.
The initial prevention strategy for antiphospholipid syndrome will be:

1. Steroids

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2. Heparin
3. Low dose aspirin
4. Progesterone support

Which of the above is/are correct?

--- Content provided by FirstRanker.com ---

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

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75.
Diagnostic criteria for PCOD are:

1. Oligo/amenorrohoea
2. Hyperandrogenism

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3. Polycystic ovaries on ultrasound

Which of the above are correct?

(a) 1 and 2 only

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

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76.
Which of the following symptoms can be associated with pelvic organ prolapse?

1. Difficulty in passing urine
2. Incomplete evacuation of urine

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3. Urgency and frequency

Select the correct answer using the code given below:

(a) 1 and 2 only

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(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3
77.
A 30 year old lady, P

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2
L
2
presents with painful unilateral swelling in vulva for 3 days. Which
of the following statements are true regarding the above case?

--- Content provided by FirstRanker.com ---

1. Bartholin?s abscess may be the likely diagnosis
2. It is to be managed by marsupialisation
3. Gonococcus is the most common pathogenic organism

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

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78.
Which one of the following is NOT a sign of separation of placenta?

(a) Uterus becomes globular, firm and ballotable
(b) The fundal height reduces further

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(c) Slight bulging in the suprapubic region
(d) Apparent lengthenic of the cord with slight gush of vaginal bleeding
79.
Consider the following regarding examination of a rape victim:

--- Content provided by FirstRanker.com ---

1. Emergency pill is provided
2. Internal examination must be performed
3. HIV testing is done

Which of the above statements is/are correct?

--- Content provided by FirstRanker.com ---

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

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80.

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Consider the following cardinal movements of mechanism of normal labor:
1. Engagement
2. Internal rotation
3. Flexion
4. Restitution

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5. Crowning
6. External rotation

What is the correct sequence of movements in labor in occipito-lateral position?

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(a) 1, 2, 3, 4, 5 and 6
(b) 1, 3, 2, 5, 4 and 6
(c) 2, 1, 3, 4, 5 and 6
(d) 3, 1, 2, 4, 6 and 5
81.

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Which of the following represent the properties of an ideal disinfectant?

1. It is broad spectrum
2. It is fast acting
3. It is non-toxic

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

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(d) 1, 2 and 3
82.
Which of the following measures can help reduce the risk of systemic hypertension?

1. Reduction in dietary intake of common salt

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2. Controlling weight for age
3. Increasing potassium rich foods in the diet

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

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

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83.
Keeping biological determinants in perspective, consider the following statements:

--- Content provided by FirstRanker.com ---

1. Presence of a normal karyotype is the first requisite for human health
2. Genetic screening can play an important role in prevention of wide spectrum of
diseases
3. If an individual is allowed to live in healthy relationship with the environment, the
person?s genetic potentialities can transform into phenotypic realities

--- Content provided by FirstRanker.com ---

Which of the above statements is/are correct?

(a) 1 and 2 only
(b) 1 and 3 only

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(c) 1, 2 and 3
(d) 2 and 3 only
84.
NITI Aayog has the following roles EXCEPT:

--- Content provided by FirstRanker.com ---

(a) It provides critical directional and strategic input in the development process
(b) It provides relevant technical advice with focus on technology upgradation
(c) It focuses on capacity building
(d) It focuses on the development of ?Referral Service Complex?
85.

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Poor hand hygiene of a mess worker in a university college mess led to Hepatitis A cases in
the hostel inmates. What type of epidemic will this exposure present with?

1. Propagated
2. Common source-continuous exposure

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3. Common source-point exposure

Select the correct answer using the code given below:

(a) 1 and 2

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

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86.
What is the specificity of sputum microscopy in detection of Pulmonary Tuberculosis (PTB)
as per the information given below?

PTB Total

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Sputum microscopy Present Absent
Positive 270 20 290
Negative 30 180 210
Total 300 200 500

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(a) 10 %
(b) 36 %
(c) 90 %
(d) 94 %
87.

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In a cohort of 500 women attending antenatal clinic, 70 % had ultrasonography (USG). This
cohort was followed up at delivery. Of the women who had USG, 70 delivered low birth
weight (LBW) babies; whereas of the women, who did not undergo USG, 50 delivered LBW
babies. The incidence of LBW babies among women who had USG is:

--- Content provided by FirstRanker.com ---

(a) 10 %
(b) 15 %
(c) 20 %
(d) 25 %
88.

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Major source of vitamin K
1
is:

(a) Fresh dark green vegetables

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(b) Exposure of body to sunlight
(c) Citrus fruits
(d) Foods rich in polyunsaturated fatty acids
89.
Which one of the following is NOT a function of Epidemiology?

--- Content provided by FirstRanker.com ---

(a) To study historically the rise and fall of disease in the population
(b) Searching for the causes and risk factor
(c) Identifying syndromes
(d) Making clinical diagnosis

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90.
Which one of the following is NOT a contagious disease?

(a) Malaria
(b) Scabies

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(c) Trachoma
(d) Leprosy


91.

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In primary immune response, how much more antigenic dose is required to induce IgG
antibodies as against the induction of IgM antibodies?

(a) 10 times more
(b) 25 times more

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(c) 50 times more
(d) 100 times more
92.
Pentavalent vaccine provides protection against which of the following diseases?

--- Content provided by FirstRanker.com ---

(a) Diphtheria, Pertussis, Tuberculosis, Measles and Hepatitis B
(b) Diphtheria, Pertussis, Measles, Hepatitis B and Hib
(c) Diphtheria, Pertussis, Tetanus, Hepatitis B and Rubella
(d) Diphtheria, Pertussis, Tetanus, Hepatitis B and Hib
93.

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Consider the following data for a country:
Population in 0-14 years of age ? 391,558,367
Population between 15?64 years of age ? 856,076,200
Population above 65 years of age ? 71,943,390
What shall be the dependency ratio of this country?

--- Content provided by FirstRanker.com ---

(a) 42.4 %
(b) 54.1 %
(c) 66.2 %
(d) 78.6 %

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94.
Which one of the following statements regarding Rabies Immunoglobulin is NOT true?

(a) It should be administered only once as soon as possible after the initiation of post
exposure prophylaxis

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(b) It should be administered all into or around the wound sites
(c) There is no scientific ground for performing a skin test prior to administering equine
immunoglobulin
(d) It can be administered till 15 days after the first dose of anti-rabies vaccine
95.

--- Content provided by FirstRanker.com ---

All of the following are true about Bedaquiline (BDQ) EXCEPT:

(a) It specifically targets mycobacterial ATP synthase
(b) It is a bacteriostatic drug
(c) It has extended half life

--- Content provided by FirstRanker.com ---

(d) It has high volume of tissue distribution
96.
Visual inspection based screening test with 5 % acetic acid is used for the screening of which
one of the following cancers?

--- Content provided by FirstRanker.com ---

(a) Lung cancer
(b) Cervix cancer
(c) Oral cancer
(d) Breast cancer
97.

--- Content provided by FirstRanker.com ---

Predictive accuracy of a screening test depends on the following EXCEPT:

(a) Disease prevalence
(b) Disease incidence
(c) Sensitivity of screening test

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(d) Specificity of screening test
98.
How much of Zinc supplement is recommended by WHO and UNICEF for infants less than 6
months of age after an episode of acute diarrhoea?

--- Content provided by FirstRanker.com ---

(a) 20 mg per day for 10?14 days
(b) 10 mg per day for 10?14 days
(c) 5 mg per day for 7 days
(d) 6 mg per day for 7 days
99.

--- Content provided by FirstRanker.com ---

Which one of the following statements regarding sequential administration of Inactivated
Polio Vaccine (IPV) and Oral Polio Vaccine (OPV) is NOT correct?

(a) It will be cost effective in developing countries for Polio prevention
(b) The combined schedules of IPV and OPV appear to reduce or prevent Vaccine

--- Content provided by FirstRanker.com ---

Associated Paralytic Polio (VAPP)
(c) Intestinal mucosal immunity is lost due to IPV administration
(d) IPV and OPV together may optimize both the humoral and mucosal immunogenicity
of Polio vaccine
100.

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What is the recommended dose regimen of Vitamin A for the treatment of early stages of
Xerophthalmia?

(a) Single massive dose of 2 lac International Units (IU)
(b) 2 lac IU on two successive days

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(c) 2 doses of 1 lac IU in two successive days
(d) 2 doses of 1 lac IU at a gap of one week
101.
Which is the most specific causative agent of Rabies?

--- Content provided by FirstRanker.com ---

(a) Lyssavirus serotype 1
(b) Lyssavirus serotype 2
(c) Lyssavirus serotype 3
(d) Lyssavirus serotype 4
102.

--- Content provided by FirstRanker.com ---

Which one of the following is the antibiotic of choice for the prevention of Rheumatic heart
disease?

(a) Benzathine Benzyl Penicillin
(b) Procaine Penicillin

--- Content provided by FirstRanker.com ---

(c) Doxycycline
(d) Ciprofloxacin


103.

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All of the following are global targets for WHO Global Action Plan (2013?2020) for
Prevention and Control of NCDs, EXCEPT:

(a) A 10 % relative reduction in risk of premature mortality from cardiovascular diseases,
cancer, diabetes and chronic respiratory diseases

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(b) A 10 % relative reduction in prevalence of insufficient physical activity
(c) A 10 % relative reduction in mean population intake of salt/sodium
(d) At least 10 % relative reduction in the harmful use of alcohol
104.
Under the Employees State Insurance (ESI) Scheme, extended sickness benefit is provided in

--- Content provided by FirstRanker.com ---

which of the following infectious diseases?

1. Tuberculosis
2. Leprosy
3. Chronic empyema

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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

105.
In the context of NCD prevention and control in India, the extent of relative reduction in

--- Content provided by FirstRanker.com ---

household use of solid fuels as a primary source of energy for cooking by 2025 is targeted at:

(a) 30 %
(b) 40 %
(c) 50 %

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(d) 60 %
106.
Consider the following criteria which may indicate elimination of lymphatic filariasis in a
community:

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1. When lymphatic filariasis ceases to be a public health problem in the community
2. When the number of microfilaria carriers declines to 1.5 % within the community
3. When children born in the community after the initiation of elimination programme
are free from circulating antigenaemia

--- Content provided by FirstRanker.com ---

Which of the criteria stated above hold true?

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

--- Content provided by FirstRanker.com ---

(d) 1, 2 and 3



107.

--- Content provided by FirstRanker.com ---

Hold over time of cold chain equipment depends on all of the following factors EXCEPT:

(a) Ambient temperature
(b) Quantity of vaccines kept
(c) Types of vaccines kept

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(d) Condition of icepack lining
108.
Which of the following statements regarding Physical Quality of Life Index (PQLI) are
correct?

--- Content provided by FirstRanker.com ---

1. It consolidates infant mortality, life expectancy at age one, and literacy
2. It does not measure economic growth but measures the result of economic policies
3. For each component, the performance of individual countries is placed on a scale of
0-100

--- Content provided by FirstRanker.com ---

Select the correct answer using the code given below:

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

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(d) 1, 2 and 3
109.
Disability-adjusted life years (DALYs) include:

(a) Years of lost life (YLL)

--- Content provided by FirstRanker.com ---

(b) Years lost to disability (YLD)
(c) Both YLL and YLD
(d) Neither YLL nor YLD
110.
Which of the following are health care delivery indicators?

--- Content provided by FirstRanker.com ---

1. Population per trained birth attendant
2. Population per health/sub centre
3. Doctor-nurse ratio

--- Content provided by FirstRanker.com ---

Select the correct answer using the code given below:

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

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(d) 1, 2 and 3

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111.

--- Content provided by FirstRanker.com ---

Which of the following key action areas are incorporated in the Ottawa Charter?

1. Building healthy public policy
2. Strengthening community action for health
3. Reorienting health services

--- Content provided by FirstRanker.com ---

Select the correct answer using the code given below:

(a) 1 and 2 only
(b) 2 and 3 only

--- Content provided by FirstRanker.com ---

(c) 1 and 3 only
(d) 1, 2 and 3
112.
Under Chapter XXI of the 10
th

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revision of the International Statistical Classification of
Diseases and Related Health Problems (ICD-10), lifestyle-related problems fall under which
of the following code range?

(a) U 50.0 ? U 50.5

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(b) U 10.0 ? U 10.5
(c) Z 72.0 ? Z 72.5
(d) Z 10.0 ? Z 10.5
113.
Which of the following diseases are spread by airborne transmission?

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1. Influenza
2. Chicken pox
3. Q-fever
4. Psittacosis

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Select the correct answer using the code given below:

(a) 1 and 3 only
(b) 1 and 4 only

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(c) 3 and 4 only
(d) 1, 2, 3 and 4
114.
DASH diet plan is advocated in the control of which one of the following diseases?

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(a) Cancer
(b) Chronic Obstructive Pulmonary Disease
(c) Hypertension
(d) Rheumatic heart disease
115.

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Endemic ascitis occurs due to:

(a) Naturally occurring toxin
(b) Bacterial toxin
(c) Fungal toxin

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(d) Viral toxin
FirstRanker.com - FirstRanker's Choice
Combined Medical Services Examination-2020
Paper-II

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1.
Indications for fasciotomy in compartment syndrome include all EXCEPT:

(a) Distal sensory disturbance
(b) Compartment pressure > 30 mm Hg

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(c) Pain on passive movement of affected muscles
(d) Palpable distal pulses
2.
Which one of the following statements is NOT correct regarding Necrotising Soft Tissue
infections?

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(a) Crepitus, skin blistering and focal skin gangrene are typical presenting features
(b) They are monomicrobial in nature
(c) Treatment consists of wide local excision and appropriate antibiotics
(d) Tissue biopsy is required for culture and diagnosis

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3.
Which type of surgery is laparoscopic cholecystectomy classified as?

(a) Clean
(b) Clean contaminated

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(c) Contaminated
(d) Dirty
4.
A 22-year female has presented with a history of malaise, cough, alternating constipation and
diarrhoea with intermittent abdominal pain for last 6 months. She also complains of

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abdominal distension for last 2 days. On examination her abdomen has a doughy feel along
with an ill defined mass over the right lower quadrant. She is most likely suffering from:

(a) Appendicular lump
(b) Ileocaecal tuberculosis

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(c) Carcinoma caecum
(d) Ovarian mass
5.
Consider the following statements regarding needle stick injuries:

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1. Injured part should be washed under running water
2. Dominant index finger is the commonest site for needle stick injury
3. All needle stick injuries should be reported
4. Hepatitis/HIV testing should be done after needle stick injury

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Which of the statements given above are correct?

(a) 1, 2 and 4
(b) 1, 2 and 3
(c) 1, 3 and 4

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(d) 2, 3 and 4

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6.
Consider the following statements regarding claudication:

1. It is a marker for silent coronary disease
2. Structured exercise program ( 2 hours per week for 3 months) leads to

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improvement in symptoms
3. Diabetes mellitus increases the risk and severity of claudication
4. Beta blockers may exacerbate claudication

Which of the above statements are correct?

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

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7.
A 50-year old lady underwent uneventful bariatric surgery for morbid obesity. On the third
post operative day, she develops breathless and pulmonary embolism is suspected. The next
investigation to confirm the diagnosis will be:

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(a) Echocardiography
(b) Duplex venography
(c) CT pulmonary angiography
(d) MR angiography
8.

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Medical management of thyrotoxic crisis includes all of the following EXCEPT:

(a) IV fluids
(b) IV propanolol
(c) IV hydrocortisone

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(d) IV antibiotics
9.
A patient operated for a parotid gland tumour developed symptoms of sweating and
erytherma (flushing) over the region of surgical excision while eating. The probable
diagnosis is:

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(a) Parotid gland fistula
(b) Sialadenitis
(c) Chronic wound infection
(d) Frey?s syndrome

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10.
First line hormone therapy for post-menopausal woman with metastatic carcinoma breast is:

(a) Tamoxifen
(b) Ovarian suppression by surgery

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(c) Antiprogestins
(d) Anastrazole

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11.
All of the following are major subtypes of breast cancer based on Gene array analysis
EXCEPT:

(a) Luminal A and Luminal B

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(b) Triple negative
(c) Her-2 receptor positive
(d) Oestrogen receptor positive
12.
All of the following are sequelae of peptic ulcer surgery EXCEPT:

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(a) Bilious vomiting
(b) Dumping syndrome
(c) Diarrhoea
(d) Increased appetite

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13.
The Child-Turcotte-Pugh (CTP) score for quantifying the severity of chronic liver disease
includes all variables EXCEPT:

(a) Serum bilirubin

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(b) Serum albumin
(c) Serum creatinine
(d) INR (International Normalised Ratio)
14.
?Chain of Lakes? appearance due to sacculation with intervening short strictures of pancreatic

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duct is seen on:

(a) ERCP
(b) CECT abdomen
(c) Plain X-ray abdomen

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(d) Ultrasonography
15.
Which one of the following statements is NOT correct regarding Pyogenic Liver Abscess?

(a) Anorexia, fever, malaise and right upper quadrant abdominal discomfort are the

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most common presenting features
(b) It is more common in elderly, diabetics and immunocompromised patients
(c) Treatment is with oral antibiotics alone
(d) Streptococcus milleri and escherichia coli are the most common causative
organisms

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16.
?Swiss cheese defects? are seen during laparoscopic repair of:

(a) Ventral hernia
(b) Inguinal hernia

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(c) Obturator hernia
(d) Femoral hernia

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17.
Which of the following are correct regarding splenic artery aneurysm?

1. Main arterial trunk is the common site
2. Palpable thrill can be felt

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3. It is symptomless unless it ruptures

Select the correct answer using the code given below:

(a) 1 and 2 only

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(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3
18.
Valentino?s syndrome is:

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(a) Pain on per-vaginal examination in pelvic abscess
(b) Pain over left shoulder in left hypochondriac collection
(c) Pain over left groin in perirenal collection
(d) Pain in right iliac fossa in perforated peptic ulcer

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19.
Spontaneous bacterial peritonitis occurs due to:

(a) duodenal stump blowout
(b) peptic ulcer perforation

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(c) acute bacterial infection of ascites
(d) infection via fallopian tubes
20.
Structure not forming boundaries of the ?Triangle of doom? seen during laparoscopic
inguinal hernia surgery dissection is:

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(a) Vas deferens
(b) Inferior epigastric artery
(c) Spermatic cord vessels
(d) Peritoneum

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21.
The term mid-line shift is associated with:

(a) Head injury
(b) Chest injury

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(c) Abdominal injury
(d) Limb injury
22.
Which one of the following cranial nerves does NOT supply to the external ear?

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(a) Cranial nerve V
(b) Cranial nerve VI
(c) Cranial nerve VII
(d) Cranial nerve IX

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23.
Left Internal Mammary Artery (LIMA) has become the conduit of choice for Left Anterior
Descending (LAD) artery during coronary artery bypass grafting because:

(a) Long term patency rates are more than 98%

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(b) It is close to LAD
(c) Atherosclerosis is never seen in this vessel
(d) It is very easy to harvest
24.
A 50-year old male with significant smoking history presented in the surgical emergency

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with sudden severe breathlessness. Chest X-ray shows right sided Pneumothorax. The
appropriate management requires:

(a) Aspiration of air with 16-18 G cannula
(b) Right chest drain of size 8-14 Fr

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(c) Oxygen by face mask
(d) Mechanical ventilation
25.
Which one of the following statements regarding Felon is NOT correct?

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(a) There is infection of the finger tip between specialised fibrous septa
(b) It is a painless condition
(c) Incision and drainage is the treatment of choice
(d) It is common in diabetics
26.

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The most common site for osteosarcoma is:

(a) Proximal femur
(b) Distal femur
(c) Proximal humerus

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(d) Distal humerus
27.
Rapid Sequence Induction is indicated in:

(a) Emergency surgery for intestinal obstruction

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(b) Elective open hernia surgery
(c) Cardiopulmonary bypass surgery
(d) Elective laparoscopic surgery

28.

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Which one of the following statements about Compartment Syndrome is NOT correct?

(a) It is commonest in a closed fracture
(b) Pain is on active movement but not on passive movement of muscles
(c) Fasciotomy is the treatment of choice

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(d) Volkmann?s Ischaemic contractive is a late complication

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29.
Which one of the following is NOT the strength of ultrasound as a diagnostic modality?

(a) No radiation
(b) Short learning curve

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(c) Inexpensive
(d) Allows dynamic studies to be done
30.
Which of the following statements regarding lymphoedema following breast cancer treatment
are correct?

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1. Incidence has decreased due to rarely combined therapy of axillary LN dissection and
radiotherapy
2. Precipitating cause like LN metastasis is a major determinant
3. The condition is often painful

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4. Oedematous limb is susceptible to bacterial infection

Select the correct answer using the code given below:

(a) 1, 2 and 3

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(b) 2, 3 and 4
(c) 1, 3 and 4
(d) 1, 2 and 4
31.
Which one of the following is NOT a risk factor for development of venous thrombosis in

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surgical patients?

(a) Age > 60 years
(b) Pregnancy
(c) Obesity (BMI > 30 kg/m

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2
)
(d) Diabetes ( HbA1c > 7.5%)
32.
Which one of the following is NOT a complication of massive blood transfusion?

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(a) Coagulopathy
(b) Hypocalcaemia
(c) Hyperthermia
(d) Hyperkalemia

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33.
Stage III ?Pressure sore? is full thickness skin loss extending:

(a) into subcutaneous tissue but not through fascia
(b) through subcutaneous tissue into fascia

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(c) through subcutaneous tissue into fascia and muscles
(d) through subcutaneous tissue into fascia, muscles and bone

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34.
During subclavian vein puncture in a surgical ward suddenly a patient developed severe
breathlessness. On auscultation breath sound was absent and the ipsilateral chest was
tympanitic on percussion. The probable diagnosis is:

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(a) Iatrogenic pneumothorax
(b) Introgenic hemothorax
(c) Spontaneous pneumothorax
(d) Tension pneumothorax
35.

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Kohler?s disease is avascular necrosis of :

(a) Lunate
(b) Capitellum of humerus
(c) First metatarsal head

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(d) Navicular
36.
Which one of the following is NOT true of Pyoderma gangrenosum?

(a) It is characterized by cutaneous ulceration with purple undermined edges

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(b) It is often secondary to heightened immunological reactivity from another disease
process
(c) Cultures often show Gram positive Staphylococci
(d) Lesions generally respond to steroids
37.

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Which of the following is NOT a tissue repair surgery for inguinal hernia repair?

(a) Bassini?s repair
(b) Shouldice repair
(c) Stoppa?s repair

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(d) Desarda repair
38.
Which one of the following type of meshes is recommended for intraperitoneal use in
abdominal wall hernia?
(a) Light weight, porous meshes

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(b) Heavy weight, porous meshes
(c) Absorbable meshes
(d) Tissue separating meshes
39.
Which one of the following is NOT correct regarding MEN-1 syndrome?

--- Content provided by FirstRanker.com ---

(a) It involves parathyroid glands
(b) It involves pancreas
(c) It involves pituitary gland
(d) It involves pineal gland

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40.
Which one of the following is NOT an electronic information site in surgery?

(a) Pubmed

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(b) Embase
(c) Cochrane library
(d) National medical library
41.
Which one of the following statements regarding pre-conceptional counseling is NOT

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correct?

(a) It is needed only in selected complicated pregnancies
(b) It helps in early detection of risk factors
(c) It helps in reducing maternal morbidity and mortality

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(d) It is a part of preventive medicine
42.
Consider the following statements regarding Non Stress Test (NST):

1. Reactive NST indicates a healthy fetus

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2. NST is an observed association of fetal breathing with fetal movements
3. NST has a low false negative rate (< 1%) but high false positive rate (>50%)
4. Testing should be started at 20 weeks

Which of the statement(s) given above is/are correct?

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

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43.
Which one of the following is a protective factor for endometrial hyperplasia?

(a) Diabetes
(b) Tamoxifen therapy

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(c) Multiparity
(d) Delayed menopause
44.
A woman who is not breast feeding her newborn child is advised to use a contraceptive
method by:

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(a) 3
rd
postpartum week
(b) 6

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th
postpartum week
(c) 3
rd
postpartum month

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(d) 6
th
postpartum month

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45.
Pearl index for contraceptive effectiveness is calculated in terms of which of the following?

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1. Pregnancy rate
2. Abortion rate
3. Hundred woman years
4. Thousand woman years

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Select the correct answer using the code given below:

(a) 1 only
(b) 2 and 3

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(c) 1, 2 and 4
(d) 1 and 3
46.
Indications for removal of IUDs are all EXCEPT:

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(a) Perforation of uterus
(b) Cyclical menstrual bleeding
(c) Flaring up of salpingitis
(d) Pregnancy with IUD
47.

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Contraindications for insertion of IUDs are all EXCEPT:

(a) Suspected pregnancy
(b) Trophoblastic disease
(c) Severe dysmenorrhea

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(d) During cesarean section
48.
Which one of the following is NOT a contraindication for use of Mini pill?

(a) Pregnancy

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(b) Breast feeding
(c) Thromboembolic disease
(d) History of breast cancer
49.
Which one of the following is the most commonly used surgical method/technique of female

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sterilization as recommended by Government of India?

(a) Uchida technique
(b) Irving method
(c) Pomeroy?s method

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(d) Madlener technique

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50.
Which of the following is/are required for a registered medical practitioner to qualify for

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performing Medical Termination of Pregnancy (MTP), as per revised rules of MTP Act?

1. Certified for assisting at least 15 MTP in an authorized centre
2. Diploma or degree in Obstetrics and Gynaecology
3. House surgeon training for 3 months in Obstetrics and Gynaecology

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4. Certified training for 6 months in laparoscopic surgeries

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

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(c) 1, 2 and 3
(d) 1, 2 and 4
51.
Which one of the following is NOT a support of uterus, preventing its descent?

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(a) Endopelvic fascia
(b) Mackenrodt?s ligament
(c) Inguinal ligament
(d) Pubocervical ligament
52.

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As per ICMR guidelines, which one of the following statements is true regarding effects of
COVID-19 on fetus according to current evidence?

(a) There is increased risk of early pregnancy loss
(b) COVID-19 virus is not teratogenic

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(c) COVID-19 virus infection is an indication of MTP
(d) There is increased risk of fetal growth restriction
53.
As per ICMR guidelines, which one of the following statements is true regarding COVID-19
infection in pregnancy?

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(a) Covid-19 pneumonia in pregnancy is more severe with poor recovery
(b) Pregnant women with heart disease are at higher risk
(c) Vaginal secretions always test positive for COVID-19 in pregnancy
(d) COVID-19 virus is secreted in breast milk

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54.
Which one of the following is NOT a method of management of Deep Transverse Arrest with
the living fetus?

(a) Caesarean section

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(b) Delivery by ventouse
(c) Delivery by application of forceps to the unrotated head
(d) Manual rotation and application of forceps

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55.
Successful version of breech presentation is likely in case all of the following EXCEPT:

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(a) Breech with extended legs
(b) Complete breech with sacroanterior position
(c) Non engaged breech
(d) Adequate amniotic fluid

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56.
Implantation of a fertilised ovum occurs on which day following fertilisation?

(a) Day 6
(b) Day 10

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(c) Day 14
(d) Day 20
57.
During total abdominal hysterectomy the ureter is likely to undergo injury or ligation during
the following steps EXCEPT:

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(a) During division and ligation of the round ligaments
(b) During division and ligation of infundibulopelvic ligaments
(c) During division and ligation of mackenrodt?s and uterosacral ligaments
(d) At the vaginal angles while incising the vagina to remove the cervix with the

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uterus
58.
The net effect of antenatal care has been the following EXCEPT:

(a) Reduction in maternal mortality

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(b) Reduction in perinatal mortality
(c) Reduction in the incidence of institutional delivery
(d) Reduction in maternal morbidity
59.
Which one of the following is NOT a component of active phase in the partograph?

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(a) Acceleration phase
(b) Phase of maximum slope
(c) Phase of deceleration
(d) Phase of expulsion

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60.
From medicolegal point of view which one of the following is NOT a sign of previous child
birth?

(a) Perineum is lax and there is evidence of scarring

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(b) Introitus is gaping and there is presence of carunculae myrtiformis
(c) Abdomen is lax and loose with striae and linea alba
(d) Conical cervix with round external os

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61.
The components of partograph are all EXCEPT:

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(a) Time
(b) Fetal heart rate
(c) Maternal respiratory rate
(d) Maternal urine analysis

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62.
Which of the following information are provided by partograph?

1. Colour of liquor
2. Uterine contractions with duration and frequency

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3. Dilatation of cervix

Select the correct answer using the code given below:

(a) 1 and 2 only

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(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3
63.
Intraoperative recognition of ureter is by which of the following features?

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1. Transparent tubular appearance
2. Pale glistening appearance
3. Longitudinal vessels on surface
4. Circumferential vessels on surface

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Select the correct answer using the code given below:

(a) 1 and 3
(b) 2 and 4

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(c) 2 and 3
(d) 1 and 4
64.
Hysterosalpingography (HSG) is least helpful in detecting which of the following?

--- Content provided by FirstRanker.com ---

(a) Tubal patency
(b) Pelvic adhesions
(c) Asherman syndrome
(d) Congenital uterine anomaly

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65.
Which of the following are characteristics of Trichomonas vaginitis?

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1. Presence of greenish frothy discharge
2. Vaginal pH > 4.5
3. Presence of clue cells in microscopic examination
4. Strawberry spots on the vaginal mucosa

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Select the correct answer using the code given below:

(a) 1, 2 and 3
(b) 1, 2 and 4

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(c) 2, 3 and 4
(d) 1, 3 and 4
66.
Tumor marker of epithelial ovarian carcinoma is:

--- Content provided by FirstRanker.com ---

(a) Ca.125
(b) Alpha feto protein
(c) Beta HCG
(d) LDH
67.

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The most common site of cervical cancer is:

(a) Endocervix
(b) Ectocervix
(c) Transformation zone

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(d) Isthmus
68.
The placenta synthesizes all EXCEPT:

(a) Oestriol

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(b) Corticotrophin releasing hormone
(c) PAPP-A(Pregnancy Associated Plasma Protein A)
(d) Dehydroepiandrosterone
69.
Withdrawal bleeding following administration of progesterone in a case of secondary

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amenorrhea indicates all EXCEPT:

(a) Absence of pregnancy
(b) Production endogenous estrogen
(c) Endometrium is responsive to estrogen

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(d) Defect in pituitary gland
70.
Monilial vaginitis is commonly associated with all EXCEPT:

(a) Prolonged antibiotic therapy

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(b) Diabetes Mellitus
(c) Treatment of malaria with chloroquine
(d) Pregnancy
71.
Which one of the following is NOT a risk factor for the development of placenta previa?

--- Content provided by FirstRanker.com ---

(a) Maternal age
(b) Smoking
(c) Previous caesarean section
(d) Maternal anaemia

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72.
Common clinical presentations of moderate to severe abruption are all EXCEPT:

(a) Uterine tenderness
(b) Fetal distress

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(c) Unexplained pre term labour
(d) Prolonged labour
73.
Common trisomies resulting in spontaneous abortion are all EXCEPT:

--- Content provided by FirstRanker.com ---

(a) Trisomy 21
(b) Trisomy 18
(c) Trisomy 16
(d) Trisomy 1
74.

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The initial prevention strategy for antiphospholipid syndrome will be:

1. Steroids
2. Heparin
3. Low dose aspirin

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4. Progesterone support

Which of the above is/are correct?

(a) 2 and 3

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(b) 3 and 4
(c) 3 only
(d) 1 and 4
75.
Diagnostic criteria for PCOD are:

--- Content provided by FirstRanker.com ---

1. Oligo/amenorrohoea
2. Hyperandrogenism
3. Polycystic ovaries on ultrasound

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Which of the above are correct?

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

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(d) 1, 2 and 3


76.
Which of the following symptoms can be associated with pelvic organ prolapse?

--- Content provided by FirstRanker.com ---

1. Difficulty in passing urine
2. Incomplete evacuation of urine
3. Urgency and frequency

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Select the correct answer using the code given below:

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

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(d) 1, 2 and 3
77.
A 30 year old lady, P
2
L

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2
presents with painful unilateral swelling in vulva for 3 days. Which
of the following statements are true regarding the above case?

1. Bartholin?s abscess may be the likely diagnosis

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2. It is to be managed by marsupialisation
3. Gonococcus is the most common pathogenic organism

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

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(b) 3 only
(c) 1 and 2 only
(d) 1, 2 and 3
78.
Which one of the following is NOT a sign of separation of placenta?

--- Content provided by FirstRanker.com ---

(a) Uterus becomes globular, firm and ballotable
(b) The fundal height reduces further
(c) Slight bulging in the suprapubic region
(d) Apparent lengthenic of the cord with slight gush of vaginal bleeding

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79.
Consider the following regarding examination of a rape victim:

1. Emergency pill is provided
2. Internal examination must be performed

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3. HIV testing is done

Which of the above statements is/are correct?

(a) 1 and 3 only

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

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80.
Consider the following cardinal movements of mechanism of normal labor:
1. Engagement

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2. Internal rotation
3. Flexion
4. Restitution
5. Crowning
6. External rotation

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What is the correct sequence of movements in labor in occipito-lateral position?

(a) 1, 2, 3, 4, 5 and 6
(b) 1, 3, 2, 5, 4 and 6

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(c) 2, 1, 3, 4, 5 and 6
(d) 3, 1, 2, 4, 6 and 5
81.
Which of the following represent the properties of an ideal disinfectant?

--- Content provided by FirstRanker.com ---

1. It is broad spectrum
2. It is fast acting
3. It is non-toxic

Select the correct answer using the code given below:

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(a) 1 and 2 only
(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3
82.

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Which of the following measures can help reduce the risk of systemic hypertension?

1. Reduction in dietary intake of common salt
2. Controlling weight for age
3. Increasing potassium rich foods in the diet

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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

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83.
Keeping biological determinants in perspective, consider the following statements:

1. Presence of a normal karyotype is the first requisite for human health
2. Genetic screening can play an important role in prevention of wide spectrum of

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diseases
3. If an individual is allowed to live in healthy relationship with the environment, the
person?s genetic potentialities can transform into phenotypic realities

Which of the above statements is/are correct?

--- Content provided by FirstRanker.com ---

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

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84.
NITI Aayog has the following roles EXCEPT:

(a) It provides critical directional and strategic input in the development process
(b) It provides relevant technical advice with focus on technology upgradation

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(c) It focuses on capacity building
(d) It focuses on the development of ?Referral Service Complex?
85.
Poor hand hygiene of a mess worker in a university college mess led to Hepatitis A cases in
the hostel inmates. What type of epidemic will this exposure present with?

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1. Propagated
2. Common source-continuous exposure
3. Common source-point exposure

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Select the correct answer using the code given below:

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

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(d) 2 only

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86.
What is the specificity of sputum microscopy in detection of Pulmonary Tuberculosis (PTB)

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as per the information given below?

PTB Total
Sputum microscopy Present Absent
Positive 270 20 290

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Negative 30 180 210
Total 300 200 500

(a) 10 %
(b) 36 %

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(c) 90 %
(d) 94 %
87.
In a cohort of 500 women attending antenatal clinic, 70 % had ultrasonography (USG). This
cohort was followed up at delivery. Of the women who had USG, 70 delivered low birth

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weight (LBW) babies; whereas of the women, who did not undergo USG, 50 delivered LBW
babies. The incidence of LBW babies among women who had USG is:

(a) 10 %
(b) 15 %

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(c) 20 %
(d) 25 %
88.
Major source of vitamin K
1

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is:

(a) Fresh dark green vegetables
(b) Exposure of body to sunlight
(c) Citrus fruits

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(d) Foods rich in polyunsaturated fatty acids
89.
Which one of the following is NOT a function of Epidemiology?

(a) To study historically the rise and fall of disease in the population

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(b) Searching for the causes and risk factor
(c) Identifying syndromes
(d) Making clinical diagnosis
90.
Which one of the following is NOT a contagious disease?

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(a) Malaria
(b) Scabies
(c) Trachoma
(d) Leprosy

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91.
In primary immune response, how much more antigenic dose is required to induce IgG
antibodies as against the induction of IgM antibodies?

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(a) 10 times more
(b) 25 times more
(c) 50 times more
(d) 100 times more

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92.
Pentavalent vaccine provides protection against which of the following diseases?

(a) Diphtheria, Pertussis, Tuberculosis, Measles and Hepatitis B
(b) Diphtheria, Pertussis, Measles, Hepatitis B and Hib

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(c) Diphtheria, Pertussis, Tetanus, Hepatitis B and Rubella
(d) Diphtheria, Pertussis, Tetanus, Hepatitis B and Hib
93.
Consider the following data for a country:
Population in 0-14 years of age ? 391,558,367

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Population between 15?64 years of age ? 856,076,200
Population above 65 years of age ? 71,943,390
What shall be the dependency ratio of this country?

(a) 42.4 %

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(b) 54.1 %
(c) 66.2 %
(d) 78.6 %
94.
Which one of the following statements regarding Rabies Immunoglobulin is NOT true?

--- Content provided by FirstRanker.com ---

(a) It should be administered only once as soon as possible after the initiation of post
exposure prophylaxis
(b) It should be administered all into or around the wound sites
(c) There is no scientific ground for performing a skin test prior to administering equine

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immunoglobulin
(d) It can be administered till 15 days after the first dose of anti-rabies vaccine
95.
All of the following are true about Bedaquiline (BDQ) EXCEPT:

--- Content provided by FirstRanker.com ---

(a) It specifically targets mycobacterial ATP synthase
(b) It is a bacteriostatic drug
(c) It has extended half life
(d) It has high volume of tissue distribution
96.

--- Content provided by FirstRanker.com ---

Visual inspection based screening test with 5 % acetic acid is used for the screening of which
one of the following cancers?

(a) Lung cancer
(b) Cervix cancer

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(c) Oral cancer
(d) Breast cancer
97.
Predictive accuracy of a screening test depends on the following EXCEPT:

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(a) Disease prevalence
(b) Disease incidence
(c) Sensitivity of screening test
(d) Specificity of screening test
98.

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How much of Zinc supplement is recommended by WHO and UNICEF for infants less than 6
months of age after an episode of acute diarrhoea?

(a) 20 mg per day for 10?14 days
(b) 10 mg per day for 10?14 days

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(c) 5 mg per day for 7 days
(d) 6 mg per day for 7 days
99.
Which one of the following statements regarding sequential administration of Inactivated
Polio Vaccine (IPV) and Oral Polio Vaccine (OPV) is NOT correct?

--- Content provided by FirstRanker.com ---

(a) It will be cost effective in developing countries for Polio prevention
(b) The combined schedules of IPV and OPV appear to reduce or prevent Vaccine
Associated Paralytic Polio (VAPP)
(c) Intestinal mucosal immunity is lost due to IPV administration

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(d) IPV and OPV together may optimize both the humoral and mucosal immunogenicity
of Polio vaccine
100.
What is the recommended dose regimen of Vitamin A for the treatment of early stages of
Xerophthalmia?

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(a) Single massive dose of 2 lac International Units (IU)
(b) 2 lac IU on two successive days
(c) 2 doses of 1 lac IU in two successive days
(d) 2 doses of 1 lac IU at a gap of one week

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101.
Which is the most specific causative agent of Rabies?

(a) Lyssavirus serotype 1
(b) Lyssavirus serotype 2

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(c) Lyssavirus serotype 3
(d) Lyssavirus serotype 4
102.
Which one of the following is the antibiotic of choice for the prevention of Rheumatic heart
disease?

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(a) Benzathine Benzyl Penicillin
(b) Procaine Penicillin
(c) Doxycycline
(d) Ciprofloxacin

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103.
All of the following are global targets for WHO Global Action Plan (2013?2020) for
Prevention and Control of NCDs, EXCEPT:

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(a) A 10 % relative reduction in risk of premature mortality from cardiovascular diseases,
cancer, diabetes and chronic respiratory diseases
(b) A 10 % relative reduction in prevalence of insufficient physical activity
(c) A 10 % relative reduction in mean population intake of salt/sodium

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(d) At least 10 % relative reduction in the harmful use of alcohol
104.
Under the Employees State Insurance (ESI) Scheme, extended sickness benefit is provided in
which of the following infectious diseases?

--- Content provided by FirstRanker.com ---

1. Tuberculosis
2. Leprosy
3. Chronic empyema

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

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

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105.
In the context of NCD prevention and control in India, the extent of relative reduction in
household use of solid fuels as a primary source of energy for cooking by 2025 is targeted at:

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(a) 30 %
(b) 40 %
(c) 50 %
(d) 60 %
106.

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Consider the following criteria which may indicate elimination of lymphatic filariasis in a
community:

1. When lymphatic filariasis ceases to be a public health problem in the community
2. When the number of microfilaria carriers declines to 1.5 % within the community

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3. When children born in the community after the initiation of elimination programme
are free from circulating antigenaemia

Which of the criteria stated above hold true?

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

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107.
Hold over time of cold chain equipment depends on all of the following factors EXCEPT:

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(a) Ambient temperature
(b) Quantity of vaccines kept
(c) Types of vaccines kept
(d) Condition of icepack lining
108.

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Which of the following statements regarding Physical Quality of Life Index (PQLI) are
correct?

1. It consolidates infant mortality, life expectancy at age one, and literacy
2. It does not measure economic growth but measures the result of economic policies

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3. For each component, the performance of individual countries is placed on a scale of
0-100

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

(a) 1 and 2 only
(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3
109.

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Disability-adjusted life years (DALYs) include:

(a) Years of lost life (YLL)
(b) Years lost to disability (YLD)
(c) Both YLL and YLD

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(d) Neither YLL nor YLD
110.
Which of the following are health care delivery indicators?

1. Population per trained birth attendant

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2. Population per health/sub centre
3. Doctor-nurse ratio

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

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

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111.
Which of the following key action areas are incorporated in the Ottawa Charter?

--- Content provided by FirstRanker.com ---

1. Building healthy public policy
2. Strengthening community action for health
3. Reorienting health services

Select the correct answer using the code given below:

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

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112.
Under Chapter XXI of the 10
th
revision of the International Statistical Classification of
Diseases and Related Health Problems (ICD-10), lifestyle-related problems fall under which

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of the following code range?

(a) U 50.0 ? U 50.5
(b) U 10.0 ? U 10.5
(c) Z 72.0 ? Z 72.5

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(d) Z 10.0 ? Z 10.5
113.
Which of the following diseases are spread by airborne transmission?

1. Influenza

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2. Chicken pox
3. Q-fever
4. Psittacosis

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

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

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114.
DASH diet plan is advocated in the control of which one of the following diseases?

(a) Cancer
(b) Chronic Obstructive Pulmonary Disease

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(c) Hypertension
(d) Rheumatic heart disease
115.
Endemic ascitis occurs due to:

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(a) Naturally occurring toxin
(b) Bacterial toxin
(c) Fungal toxin
(d) Viral toxin
116.

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The presence of which of the following bacteria in drinking water is an important
confirmatory evidence of recent faecal pollution of water?

(a) E. coli
(b) Streptococci

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(c) Clostridium
(d) Klebsiella
117.
With regard to the Goals, Milestones and Targets for the Global Technical Strategy for
Malaria (2016-2030), consider the following statements:

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1. Compared to 2015, the target is to reduce the malaria mortality rates globally by at
least 90% by year 2030
2. Compared to 2015, the target is to reduce malaria case incidence by 90% by year
2030

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3. Eliminate malaria from at least 35 countries, where malaria was transmitted in
2015, by year 2030

Which of the above statements hold true?

--- Content provided by FirstRanker.com ---

(a) 1 and 2 only
(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3
118.

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Which one of the following IUDs is associated with a low pregnancy rate (0.2 per 100), less
number of ectopic pregnancies and lower menstrual blood loss?

(a) Cu T-380A
(b) ML-Cu 375

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(c) Progestasert
(d) LNG-20(Mirena)
119.
The incidence of diarrhoea is highest among infants in the age group of 6?11 months due to
all of the following reasons EXCEPT:

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(a) Declining level of maternal antibodies
(b) Introduction of foods which may be contaminated
(c) Eruption of teeth
(d) Direct contact with human or animal faeces

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FirstRanker.com - FirstRanker's Choice

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Combined Medical Services Examination-2020
Paper-II

1.
Indications for fasciotomy in compartment syndrome include all EXCEPT:

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(a) Distal sensory disturbance
(b) Compartment pressure > 30 mm Hg
(c) Pain on passive movement of affected muscles
(d) Palpable distal pulses

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2.
Which one of the following statements is NOT correct regarding Necrotising Soft Tissue
infections?

(a) Crepitus, skin blistering and focal skin gangrene are typical presenting features

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(b) They are monomicrobial in nature
(c) Treatment consists of wide local excision and appropriate antibiotics
(d) Tissue biopsy is required for culture and diagnosis
3.
Which type of surgery is laparoscopic cholecystectomy classified as?

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(a) Clean
(b) Clean contaminated
(c) Contaminated
(d) Dirty

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4.
A 22-year female has presented with a history of malaise, cough, alternating constipation and
diarrhoea with intermittent abdominal pain for last 6 months. She also complains of
abdominal distension for last 2 days. On examination her abdomen has a doughy feel along
with an ill defined mass over the right lower quadrant. She is most likely suffering from:

--- Content provided by FirstRanker.com ---

(a) Appendicular lump
(b) Ileocaecal tuberculosis
(c) Carcinoma caecum
(d) Ovarian mass

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5.
Consider the following statements regarding needle stick injuries:

1. Injured part should be washed under running water
2. Dominant index finger is the commonest site for needle stick injury

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3. All needle stick injuries should be reported
4. Hepatitis/HIV testing should be done after needle stick injury

Which of the statements given above are correct?

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

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6.
Consider the following statements regarding claudication:

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1. It is a marker for silent coronary disease
2. Structured exercise program ( 2 hours per week for 3 months) leads to
improvement in symptoms
3. Diabetes mellitus increases the risk and severity of claudication

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4. Beta blockers may exacerbate claudication

Which of the above statements are correct?

(a) 1 and 2 only

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(b) 1, 3 and 4 only
(c) 2, 3 and 4 only
(d) 1, 2, 3 and 4
7.
A 50-year old lady underwent uneventful bariatric surgery for morbid obesity. On the third

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post operative day, she develops breathless and pulmonary embolism is suspected. The next
investigation to confirm the diagnosis will be:

(a) Echocardiography
(b) Duplex venography

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(c) CT pulmonary angiography
(d) MR angiography
8.
Medical management of thyrotoxic crisis includes all of the following EXCEPT:

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(a) IV fluids
(b) IV propanolol
(c) IV hydrocortisone
(d) IV antibiotics
9.

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A patient operated for a parotid gland tumour developed symptoms of sweating and
erytherma (flushing) over the region of surgical excision while eating. The probable
diagnosis is:

(a) Parotid gland fistula

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(b) Sialadenitis
(c) Chronic wound infection
(d) Frey?s syndrome
10.
First line hormone therapy for post-menopausal woman with metastatic carcinoma breast is:

--- Content provided by FirstRanker.com ---

(a) Tamoxifen
(b) Ovarian suppression by surgery
(c) Antiprogestins
(d) Anastrazole

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11.
All of the following are major subtypes of breast cancer based on Gene array analysis

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EXCEPT:

(a) Luminal A and Luminal B
(b) Triple negative
(c) Her-2 receptor positive

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(d) Oestrogen receptor positive
12.
All of the following are sequelae of peptic ulcer surgery EXCEPT:

(a) Bilious vomiting

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(b) Dumping syndrome
(c) Diarrhoea
(d) Increased appetite
13.
The Child-Turcotte-Pugh (CTP) score for quantifying the severity of chronic liver disease

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includes all variables EXCEPT:

(a) Serum bilirubin
(b) Serum albumin
(c) Serum creatinine

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(d) INR (International Normalised Ratio)
14.
?Chain of Lakes? appearance due to sacculation with intervening short strictures of pancreatic
duct is seen on:

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(a) ERCP
(b) CECT abdomen
(c) Plain X-ray abdomen
(d) Ultrasonography
15.

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Which one of the following statements is NOT correct regarding Pyogenic Liver Abscess?

(a) Anorexia, fever, malaise and right upper quadrant abdominal discomfort are the
most common presenting features
(b) It is more common in elderly, diabetics and immunocompromised patients

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(c) Treatment is with oral antibiotics alone
(d) Streptococcus milleri and escherichia coli are the most common causative
organisms
16.
?Swiss cheese defects? are seen during laparoscopic repair of:

--- Content provided by FirstRanker.com ---

(a) Ventral hernia
(b) Inguinal hernia
(c) Obturator hernia
(d) Femoral hernia

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17.
Which of the following are correct regarding splenic artery aneurysm?

--- Content provided by FirstRanker.com ---

1. Main arterial trunk is the common site
2. Palpable thrill can be felt
3. It is symptomless unless it ruptures

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Select the correct answer using the code given below:

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

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(d) 1, 2 and 3
18.
Valentino?s syndrome is:

(a) Pain on per-vaginal examination in pelvic abscess

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(b) Pain over left shoulder in left hypochondriac collection
(c) Pain over left groin in perirenal collection
(d) Pain in right iliac fossa in perforated peptic ulcer
19.
Spontaneous bacterial peritonitis occurs due to:

--- Content provided by FirstRanker.com ---

(a) duodenal stump blowout
(b) peptic ulcer perforation
(c) acute bacterial infection of ascites
(d) infection via fallopian tubes

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20.
Structure not forming boundaries of the ?Triangle of doom? seen during laparoscopic
inguinal hernia surgery dissection is:

(a) Vas deferens

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(b) Inferior epigastric artery
(c) Spermatic cord vessels
(d) Peritoneum
21.
The term mid-line shift is associated with:

--- Content provided by FirstRanker.com ---

(a) Head injury
(b) Chest injury
(c) Abdominal injury
(d) Limb injury

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22.
Which one of the following cranial nerves does NOT supply to the external ear?

(a) Cranial nerve V
(b) Cranial nerve VI

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(c) Cranial nerve VII
(d) Cranial nerve IX

23.
Left Internal Mammary Artery (LIMA) has become the conduit of choice for Left Anterior

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Descending (LAD) artery during coronary artery bypass grafting because:

(a) Long term patency rates are more than 98%
(b) It is close to LAD
(c) Atherosclerosis is never seen in this vessel

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(d) It is very easy to harvest
24.
A 50-year old male with significant smoking history presented in the surgical emergency
with sudden severe breathlessness. Chest X-ray shows right sided Pneumothorax. The
appropriate management requires:

--- Content provided by FirstRanker.com ---

(a) Aspiration of air with 16-18 G cannula
(b) Right chest drain of size 8-14 Fr
(c) Oxygen by face mask
(d) Mechanical ventilation

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25.
Which one of the following statements regarding Felon is NOT correct?

(a) There is infection of the finger tip between specialised fibrous septa
(b) It is a painless condition

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(c) Incision and drainage is the treatment of choice
(d) It is common in diabetics
26.
The most common site for osteosarcoma is:

--- Content provided by FirstRanker.com ---

(a) Proximal femur
(b) Distal femur
(c) Proximal humerus
(d) Distal humerus
27.

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Rapid Sequence Induction is indicated in:

(a) Emergency surgery for intestinal obstruction
(b) Elective open hernia surgery
(c) Cardiopulmonary bypass surgery

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(d) Elective laparoscopic surgery

28.
Which one of the following statements about Compartment Syndrome is NOT correct?

--- Content provided by FirstRanker.com ---

(a) It is commonest in a closed fracture
(b) Pain is on active movement but not on passive movement of muscles
(c) Fasciotomy is the treatment of choice
(d) Volkmann?s Ischaemic contractive is a late complication

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29.
Which one of the following is NOT the strength of ultrasound as a diagnostic modality?

--- Content provided by FirstRanker.com ---

(a) No radiation
(b) Short learning curve
(c) Inexpensive
(d) Allows dynamic studies to be done

--- Content provided by FirstRanker.com ---

30.
Which of the following statements regarding lymphoedema following breast cancer treatment
are correct?

1. Incidence has decreased due to rarely combined therapy of axillary LN dissection and

--- Content provided by FirstRanker.com ---

radiotherapy
2. Precipitating cause like LN metastasis is a major determinant
3. The condition is often painful
4. Oedematous limb is susceptible to bacterial infection

--- Content provided by FirstRanker.com ---

Select the correct answer using the code given below:

(a) 1, 2 and 3
(b) 2, 3 and 4
(c) 1, 3 and 4

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(d) 1, 2 and 4
31.
Which one of the following is NOT a risk factor for development of venous thrombosis in
surgical patients?

--- Content provided by FirstRanker.com ---

(a) Age > 60 years
(b) Pregnancy
(c) Obesity (BMI > 30 kg/m
2
)

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(d) Diabetes ( HbA1c > 7.5%)
32.
Which one of the following is NOT a complication of massive blood transfusion?

(a) Coagulopathy

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(b) Hypocalcaemia
(c) Hyperthermia
(d) Hyperkalemia
33.
Stage III ?Pressure sore? is full thickness skin loss extending:

--- Content provided by FirstRanker.com ---

(a) into subcutaneous tissue but not through fascia
(b) through subcutaneous tissue into fascia
(c) through subcutaneous tissue into fascia and muscles
(d) through subcutaneous tissue into fascia, muscles and bone

--- Content provided by FirstRanker.com ---

34.
During subclavian vein puncture in a surgical ward suddenly a patient developed severe

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breathlessness. On auscultation breath sound was absent and the ipsilateral chest was
tympanitic on percussion. The probable diagnosis is:

(a) Iatrogenic pneumothorax
(b) Introgenic hemothorax

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(c) Spontaneous pneumothorax
(d) Tension pneumothorax
35.
Kohler?s disease is avascular necrosis of :

--- Content provided by FirstRanker.com ---

(a) Lunate
(b) Capitellum of humerus
(c) First metatarsal head
(d) Navicular
36.

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Which one of the following is NOT true of Pyoderma gangrenosum?

(a) It is characterized by cutaneous ulceration with purple undermined edges
(b) It is often secondary to heightened immunological reactivity from another disease
process

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(c) Cultures often show Gram positive Staphylococci
(d) Lesions generally respond to steroids
37.
Which of the following is NOT a tissue repair surgery for inguinal hernia repair?

--- Content provided by FirstRanker.com ---

(a) Bassini?s repair
(b) Shouldice repair
(c) Stoppa?s repair
(d) Desarda repair
38.

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Which one of the following type of meshes is recommended for intraperitoneal use in
abdominal wall hernia?
(a) Light weight, porous meshes
(b) Heavy weight, porous meshes
(c) Absorbable meshes

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(d) Tissue separating meshes
39.
Which one of the following is NOT correct regarding MEN-1 syndrome?

(a) It involves parathyroid glands

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(b) It involves pancreas
(c) It involves pituitary gland
(d) It involves pineal gland

40.

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Which one of the following is NOT an electronic information site in surgery?

(a) Pubmed
(b) Embase
(c) Cochrane library

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(d) National medical library
41.
Which one of the following statements regarding pre-conceptional counseling is NOT
correct?

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(a) It is needed only in selected complicated pregnancies
(b) It helps in early detection of risk factors
(c) It helps in reducing maternal morbidity and mortality
(d) It is a part of preventive medicine
42.

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Consider the following statements regarding Non Stress Test (NST):

1. Reactive NST indicates a healthy fetus
2. NST is an observed association of fetal breathing with fetal movements
3. NST has a low false negative rate (< 1%) but high false positive rate (>50%)

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4. Testing should be started at 20 weeks

Which of the statement(s) given above is/are correct?

(a) 1 and 3

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(b) 2 only
(c) 3 only
(d) 1 and 4
43.
Which one of the following is a protective factor for endometrial hyperplasia?

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(a) Diabetes
(b) Tamoxifen therapy
(c) Multiparity
(d) Delayed menopause

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44.
A woman who is not breast feeding her newborn child is advised to use a contraceptive
method by:

(a) 3

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rd
postpartum week
(b) 6
th
postpartum week

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(c) 3
rd
postpartum month
(d) 6
th

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postpartum month

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45.
Pearl index for contraceptive effectiveness is calculated in terms of which of the following?

1. Pregnancy rate

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2. Abortion rate
3. Hundred woman years
4. Thousand woman years

Select the correct answer using the code given below:

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

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46.
Indications for removal of IUDs are all EXCEPT:

(a) Perforation of uterus
(b) Cyclical menstrual bleeding

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(c) Flaring up of salpingitis
(d) Pregnancy with IUD
47.
Contraindications for insertion of IUDs are all EXCEPT:

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(a) Suspected pregnancy
(b) Trophoblastic disease
(c) Severe dysmenorrhea
(d) During cesarean section
48.

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Which one of the following is NOT a contraindication for use of Mini pill?

(a) Pregnancy
(b) Breast feeding
(c) Thromboembolic disease

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(d) History of breast cancer
49.
Which one of the following is the most commonly used surgical method/technique of female
sterilization as recommended by Government of India?

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(a) Uchida technique
(b) Irving method
(c) Pomeroy?s method
(d) Madlener technique

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50.
Which of the following is/are required for a registered medical practitioner to qualify for
performing Medical Termination of Pregnancy (MTP), as per revised rules of MTP Act?

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1. Certified for assisting at least 15 MTP in an authorized centre
2. Diploma or degree in Obstetrics and Gynaecology
3. House surgeon training for 3 months in Obstetrics and Gynaecology
4. Certified training for 6 months in laparoscopic surgeries

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

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51.
Which one of the following is NOT a support of uterus, preventing its descent?

(a) Endopelvic fascia
(b) Mackenrodt?s ligament

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(c) Inguinal ligament
(d) Pubocervical ligament
52.
As per ICMR guidelines, which one of the following statements is true regarding effects of
COVID-19 on fetus according to current evidence?

--- Content provided by FirstRanker.com ---

(a) There is increased risk of early pregnancy loss
(b) COVID-19 virus is not teratogenic
(c) COVID-19 virus infection is an indication of MTP
(d) There is increased risk of fetal growth restriction

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53.
As per ICMR guidelines, which one of the following statements is true regarding COVID-19
infection in pregnancy?

(a) Covid-19 pneumonia in pregnancy is more severe with poor recovery

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(b) Pregnant women with heart disease are at higher risk
(c) Vaginal secretions always test positive for COVID-19 in pregnancy
(d) COVID-19 virus is secreted in breast milk
54.
Which one of the following is NOT a method of management of Deep Transverse Arrest with

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the living fetus?

(a) Caesarean section
(b) Delivery by ventouse
(c) Delivery by application of forceps to the unrotated head

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(d) Manual rotation and application of forceps

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55.
Successful version of breech presentation is likely in case all of the following EXCEPT:

(a) Breech with extended legs

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(b) Complete breech with sacroanterior position
(c) Non engaged breech
(d) Adequate amniotic fluid
56.
Implantation of a fertilised ovum occurs on which day following fertilisation?

--- Content provided by FirstRanker.com ---

(a) Day 6
(b) Day 10
(c) Day 14
(d) Day 20

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57.
During total abdominal hysterectomy the ureter is likely to undergo injury or ligation during
the following steps EXCEPT:

(a) During division and ligation of the round ligaments

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(b) During division and ligation of infundibulopelvic ligaments
(c) During division and ligation of mackenrodt?s and uterosacral ligaments
(d) At the vaginal angles while incising the vagina to remove the cervix with the
uterus
58.

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The net effect of antenatal care has been the following EXCEPT:

(a) Reduction in maternal mortality
(b) Reduction in perinatal mortality
(c) Reduction in the incidence of institutional delivery

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(d) Reduction in maternal morbidity
59.
Which one of the following is NOT a component of active phase in the partograph?

(a) Acceleration phase

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(b) Phase of maximum slope
(c) Phase of deceleration
(d) Phase of expulsion
60.
From medicolegal point of view which one of the following is NOT a sign of previous child

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birth?

(a) Perineum is lax and there is evidence of scarring
(b) Introitus is gaping and there is presence of carunculae myrtiformis
(c) Abdomen is lax and loose with striae and linea alba

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(d) Conical cervix with round external os

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61.
The components of partograph are all EXCEPT:

(a) Time

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(b) Fetal heart rate
(c) Maternal respiratory rate
(d) Maternal urine analysis
62.
Which of the following information are provided by partograph?

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1. Colour of liquor
2. Uterine contractions with duration and frequency
3. Dilatation of cervix

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Select the correct answer using the code given below:

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

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(d) 1, 2 and 3
63.
Intraoperative recognition of ureter is by which of the following features?

1. Transparent tubular appearance

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2. Pale glistening appearance
3. Longitudinal vessels on surface
4. Circumferential vessels on surface

Select the correct answer using the code given below:

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

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64.
Hysterosalpingography (HSG) is least helpful in detecting which of the following?

(a) Tubal patency
(b) Pelvic adhesions

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(c) Asherman syndrome
(d) Congenital uterine anomaly

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65.
Which of the following are characteristics of Trichomonas vaginitis?

1. Presence of greenish frothy discharge

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2. Vaginal pH > 4.5
3. Presence of clue cells in microscopic examination
4. Strawberry spots on the vaginal mucosa

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

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

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66.
Tumor marker of epithelial ovarian carcinoma is:

(a) Ca.125
(b) Alpha feto protein

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(c) Beta HCG
(d) LDH
67.
The most common site of cervical cancer is:

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(a) Endocervix
(b) Ectocervix
(c) Transformation zone
(d) Isthmus
68.

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The placenta synthesizes all EXCEPT:

(a) Oestriol
(b) Corticotrophin releasing hormone
(c) PAPP-A(Pregnancy Associated Plasma Protein A)

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(d) Dehydroepiandrosterone
69.
Withdrawal bleeding following administration of progesterone in a case of secondary
amenorrhea indicates all EXCEPT:

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(a) Absence of pregnancy
(b) Production endogenous estrogen
(c) Endometrium is responsive to estrogen
(d) Defect in pituitary gland
70.

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Monilial vaginitis is commonly associated with all EXCEPT:

(a) Prolonged antibiotic therapy
(b) Diabetes Mellitus
(c) Treatment of malaria with chloroquine

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(d) Pregnancy
71.
Which one of the following is NOT a risk factor for the development of placenta previa?

(a) Maternal age

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(b) Smoking
(c) Previous caesarean section
(d) Maternal anaemia
72.
Common clinical presentations of moderate to severe abruption are all EXCEPT:

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(a) Uterine tenderness
(b) Fetal distress
(c) Unexplained pre term labour
(d) Prolonged labour

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73.
Common trisomies resulting in spontaneous abortion are all EXCEPT:

(a) Trisomy 21
(b) Trisomy 18

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(c) Trisomy 16
(d) Trisomy 1
74.
The initial prevention strategy for antiphospholipid syndrome will be:

--- Content provided by FirstRanker.com ---

1. Steroids
2. Heparin
3. Low dose aspirin
4. Progesterone support

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Which of the above is/are correct?

(a) 2 and 3
(b) 3 and 4
(c) 3 only

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(d) 1 and 4
75.
Diagnostic criteria for PCOD are:

1. Oligo/amenorrohoea

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2. Hyperandrogenism
3. Polycystic ovaries on ultrasound

Which of the above are correct?

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

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76.
Which of the following symptoms can be associated with pelvic organ prolapse?

1. Difficulty in passing urine

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2. Incomplete evacuation of urine
3. Urgency and frequency

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

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

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A 30 year old lady, P
2
L
2
presents with painful unilateral swelling in vulva for 3 days. Which

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of the following statements are true regarding the above case?

1. Bartholin?s abscess may be the likely diagnosis
2. It is to be managed by marsupialisation
3. Gonococcus is the most common pathogenic organism

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

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(d) 1, 2 and 3
78.
Which one of the following is NOT a sign of separation of placenta?

(a) Uterus becomes globular, firm and ballotable

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(b) The fundal height reduces further
(c) Slight bulging in the suprapubic region
(d) Apparent lengthenic of the cord with slight gush of vaginal bleeding
79.
Consider the following regarding examination of a rape victim:

--- Content provided by FirstRanker.com ---

1. Emergency pill is provided
2. Internal examination must be performed
3. HIV testing is done

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Which of the above statements is/are correct?

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

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(d) 3 only

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80.
Consider the following cardinal movements of mechanism of normal labor:
1. Engagement
2. Internal rotation
3. Flexion

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4. Restitution
5. Crowning
6. External rotation

What is the correct sequence of movements in labor in occipito-lateral position?

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(a) 1, 2, 3, 4, 5 and 6
(b) 1, 3, 2, 5, 4 and 6
(c) 2, 1, 3, 4, 5 and 6
(d) 3, 1, 2, 4, 6 and 5

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81.
Which of the following represent the properties of an ideal disinfectant?

1. It is broad spectrum
2. It is fast acting

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3. It is non-toxic

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
82.
Which of the following measures can help reduce the risk of systemic hypertension?

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1. Reduction in dietary intake of common salt
2. Controlling weight for age
3. Increasing potassium rich foods in the diet

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

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

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83.
Keeping biological determinants in perspective, consider the following statements:

--- Content provided by FirstRanker.com ---

1. Presence of a normal karyotype is the first requisite for human health
2. Genetic screening can play an important role in prevention of wide spectrum of
diseases
3. If an individual is allowed to live in healthy relationship with the environment, the

--- Content provided by FirstRanker.com ---

person?s genetic potentialities can transform into phenotypic realities

Which of the above statements is/are correct?

(a) 1 and 2 only

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(b) 1 and 3 only
(c) 1, 2 and 3
(d) 2 and 3 only
84.
NITI Aayog has the following roles EXCEPT:

--- Content provided by FirstRanker.com ---

(a) It provides critical directional and strategic input in the development process
(b) It provides relevant technical advice with focus on technology upgradation
(c) It focuses on capacity building
(d) It focuses on the development of ?Referral Service Complex?

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85.
Poor hand hygiene of a mess worker in a university college mess led to Hepatitis A cases in
the hostel inmates. What type of epidemic will this exposure present with?

1. Propagated

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2. Common source-continuous exposure
3. Common source-point exposure

Select the correct answer using the code given below:

--- Content provided by FirstRanker.com ---

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

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--- Content provided by FirstRanker.com ---

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86.
What is the specificity of sputum microscopy in detection of Pulmonary Tuberculosis (PTB)
as per the information given below?

--- Content provided by FirstRanker.com ---

PTB Total
Sputum microscopy Present Absent
Positive 270 20 290
Negative 30 180 210
Total 300 200 500

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(a) 10 %
(b) 36 %
(c) 90 %
(d) 94 %

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87.
In a cohort of 500 women attending antenatal clinic, 70 % had ultrasonography (USG). This
cohort was followed up at delivery. Of the women who had USG, 70 delivered low birth
weight (LBW) babies; whereas of the women, who did not undergo USG, 50 delivered LBW
babies. The incidence of LBW babies among women who had USG is:

--- Content provided by FirstRanker.com ---

(a) 10 %
(b) 15 %
(c) 20 %
(d) 25 %

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88.
Major source of vitamin K
1
is:

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(a) Fresh dark green vegetables
(b) Exposure of body to sunlight
(c) Citrus fruits
(d) Foods rich in polyunsaturated fatty acids
89.

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Which one of the following is NOT a function of Epidemiology?

(a) To study historically the rise and fall of disease in the population
(b) Searching for the causes and risk factor
(c) Identifying syndromes

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(d) Making clinical diagnosis
90.
Which one of the following is NOT a contagious disease?

(a) Malaria

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(b) Scabies
(c) Trachoma
(d) Leprosy

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91.
In primary immune response, how much more antigenic dose is required to induce IgG
antibodies as against the induction of IgM antibodies?

(a) 10 times more

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(b) 25 times more
(c) 50 times more
(d) 100 times more
92.
Pentavalent vaccine provides protection against which of the following diseases?

--- Content provided by FirstRanker.com ---

(a) Diphtheria, Pertussis, Tuberculosis, Measles and Hepatitis B
(b) Diphtheria, Pertussis, Measles, Hepatitis B and Hib
(c) Diphtheria, Pertussis, Tetanus, Hepatitis B and Rubella
(d) Diphtheria, Pertussis, Tetanus, Hepatitis B and Hib

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93.
Consider the following data for a country:
Population in 0-14 years of age ? 391,558,367
Population between 15?64 years of age ? 856,076,200
Population above 65 years of age ? 71,943,390

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What shall be the dependency ratio of this country?

(a) 42.4 %
(b) 54.1 %
(c) 66.2 %

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(d) 78.6 %
94.
Which one of the following statements regarding Rabies Immunoglobulin is NOT true?

(a) It should be administered only once as soon as possible after the initiation of post

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exposure prophylaxis
(b) It should be administered all into or around the wound sites
(c) There is no scientific ground for performing a skin test prior to administering equine
immunoglobulin
(d) It can be administered till 15 days after the first dose of anti-rabies vaccine

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95.
All of the following are true about Bedaquiline (BDQ) EXCEPT:

(a) It specifically targets mycobacterial ATP synthase
(b) It is a bacteriostatic drug

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(c) It has extended half life
(d) It has high volume of tissue distribution
96.
Visual inspection based screening test with 5 % acetic acid is used for the screening of which
one of the following cancers?

--- Content provided by FirstRanker.com ---

(a) Lung cancer
(b) Cervix cancer
(c) Oral cancer
(d) Breast cancer

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97.
Predictive accuracy of a screening test depends on the following EXCEPT:

(a) Disease prevalence
(b) Disease incidence

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(c) Sensitivity of screening test
(d) Specificity of screening test
98.
How much of Zinc supplement is recommended by WHO and UNICEF for infants less than 6
months of age after an episode of acute diarrhoea?

--- Content provided by FirstRanker.com ---

(a) 20 mg per day for 10?14 days
(b) 10 mg per day for 10?14 days
(c) 5 mg per day for 7 days
(d) 6 mg per day for 7 days

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99.
Which one of the following statements regarding sequential administration of Inactivated
Polio Vaccine (IPV) and Oral Polio Vaccine (OPV) is NOT correct?

(a) It will be cost effective in developing countries for Polio prevention

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(b) The combined schedules of IPV and OPV appear to reduce or prevent Vaccine
Associated Paralytic Polio (VAPP)
(c) Intestinal mucosal immunity is lost due to IPV administration
(d) IPV and OPV together may optimize both the humoral and mucosal immunogenicity
of Polio vaccine

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100.
What is the recommended dose regimen of Vitamin A for the treatment of early stages of
Xerophthalmia?

(a) Single massive dose of 2 lac International Units (IU)

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(b) 2 lac IU on two successive days
(c) 2 doses of 1 lac IU in two successive days
(d) 2 doses of 1 lac IU at a gap of one week
101.
Which is the most specific causative agent of Rabies?

--- Content provided by FirstRanker.com ---

(a) Lyssavirus serotype 1
(b) Lyssavirus serotype 2
(c) Lyssavirus serotype 3
(d) Lyssavirus serotype 4

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102.
Which one of the following is the antibiotic of choice for the prevention of Rheumatic heart
disease?

(a) Benzathine Benzyl Penicillin

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(b) Procaine Penicillin
(c) Doxycycline
(d) Ciprofloxacin

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103.
All of the following are global targets for WHO Global Action Plan (2013?2020) for
Prevention and Control of NCDs, EXCEPT:

(a) A 10 % relative reduction in risk of premature mortality from cardiovascular diseases,

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cancer, diabetes and chronic respiratory diseases
(b) A 10 % relative reduction in prevalence of insufficient physical activity
(c) A 10 % relative reduction in mean population intake of salt/sodium
(d) At least 10 % relative reduction in the harmful use of alcohol
104.

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Under the Employees State Insurance (ESI) Scheme, extended sickness benefit is provided in
which of the following infectious diseases?

1. Tuberculosis
2. Leprosy

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3. Chronic empyema

Select the correct answer using the code given below:

(a) 1 and 2 only

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

105.

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In the context of NCD prevention and control in India, the extent of relative reduction in
household use of solid fuels as a primary source of energy for cooking by 2025 is targeted at:

(a) 30 %
(b) 40 %

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(c) 50 %
(d) 60 %
106.
Consider the following criteria which may indicate elimination of lymphatic filariasis in a
community:

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1. When lymphatic filariasis ceases to be a public health problem in the community
2. When the number of microfilaria carriers declines to 1.5 % within the community
3. When children born in the community after the initiation of elimination programme
are free from circulating antigenaemia

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Which of the criteria stated above hold true?

(a) 1 and 2 only
(b) 2 and 3 only

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

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107.
Hold over time of cold chain equipment depends on all of the following factors EXCEPT:

(a) Ambient temperature
(b) Quantity of vaccines kept

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(c) Types of vaccines kept
(d) Condition of icepack lining
108.
Which of the following statements regarding Physical Quality of Life Index (PQLI) are
correct?

--- Content provided by FirstRanker.com ---

1. It consolidates infant mortality, life expectancy at age one, and literacy
2. It does not measure economic growth but measures the result of economic policies
3. For each component, the performance of individual countries is placed on a scale of
0-100

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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
109.
Disability-adjusted life years (DALYs) include:

--- Content provided by FirstRanker.com ---

(a) Years of lost life (YLL)
(b) Years lost to disability (YLD)
(c) Both YLL and YLD
(d) Neither YLL nor YLD
110.

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Which of the following are health care delivery indicators?

1. Population per trained birth attendant
2. Population per health/sub centre
3. Doctor-nurse ratio

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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

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111.
Which of the following key action areas are incorporated in the Ottawa Charter?

1. Building healthy public policy
2. Strengthening community action for health

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3. Reorienting health services

Select the correct answer using the code given below:

(a) 1 and 2 only

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(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3
112.
Under Chapter XXI of the 10

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th
revision of the International Statistical Classification of
Diseases and Related Health Problems (ICD-10), lifestyle-related problems fall under which
of the following code range?

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(a) U 50.0 ? U 50.5
(b) U 10.0 ? U 10.5
(c) Z 72.0 ? Z 72.5
(d) Z 10.0 ? Z 10.5
113.

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Which of the following diseases are spread by airborne transmission?

1. Influenza
2. Chicken pox
3. Q-fever

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4. Psittacosis

Select the correct answer using the code given below:

(a) 1 and 3 only

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(b) 1 and 4 only
(c) 3 and 4 only
(d) 1, 2, 3 and 4
114.
DASH diet plan is advocated in the control of which one of the following diseases?

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(a) Cancer
(b) Chronic Obstructive Pulmonary Disease
(c) Hypertension
(d) Rheumatic heart disease

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115.
Endemic ascitis occurs due to:

(a) Naturally occurring toxin
(b) Bacterial toxin

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(c) Fungal toxin
(d) Viral toxin
116.
The presence of which of the following bacteria in drinking water is an important
confirmatory evidence of recent faecal pollution of water?

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(a) E. coli
(b) Streptococci
(c) Clostridium
(d) Klebsiella

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117.
With regard to the Goals, Milestones and Targets for the Global Technical Strategy for
Malaria (2016-2030), consider the following statements:

1. Compared to 2015, the target is to reduce the malaria mortality rates globally by at

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least 90% by year 2030
2. Compared to 2015, the target is to reduce malaria case incidence by 90% by year
2030
3. Eliminate malaria from at least 35 countries, where malaria was transmitted in
2015, by year 2030

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Which of the above statements hold true?

(a) 1 and 2 only
(b) 2 and 3 only

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(c) 1 and 3 only
(d) 1, 2 and 3
118.
Which one of the following IUDs is associated with a low pregnancy rate (0.2 per 100), less
number of ectopic pregnancies and lower menstrual blood loss?

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(a) Cu T-380A
(b) ML-Cu 375
(c) Progestasert
(d) LNG-20(Mirena)

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119.
The incidence of diarrhoea is highest among infants in the age group of 6?11 months due to
all of the following reasons EXCEPT:

(a) Declining level of maternal antibodies

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(b) Introduction of foods which may be contaminated
(c) Eruption of teeth
(d) Direct contact with human or animal faeces

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120.
In the context of ?Anti-Malaria Month Campaign?, consider the following statements:

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1. It is observed every year in the month of June
2. It is planned during the Monsoon season
3. It aims to enhance the level of community awareness and participation

Select the correct answer using the code given below:

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

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