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upsc.gov.in CMSE Combined Medical Services Examination Question Paper 2019 : Union Public Service Commission

Organisation : Union Public Service Commission
Exam : Combined Medical Services Examination – CMSE-2019
Document Type : Previous Year Question Papers
Year : 2019
Paper : Medical Sciences Paper – I & II
Website : https://upsc.gov.in/examinations/previous-question-papers

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UPSC CMSE Question Paper

Question Paper of Combined Medical Services Examination Paper for Medical Sciences Paper – I & II 2019 is now available in the official website of Union Public Service Commission.

Related : Union Public Commission Combined Medical Services Exam Previous Question Paper 2018 : www.pdfquestion.in/29371.html

CMSE-2019

Paper – I

1. Austin Flint Murmur occurs in:
(a) Severe Mitral Stenosis
(b) Severe Mitral Regurgitation
(c) Severe Aortic Regurgitation
(d) Severe Aortic Stenosis

2. Which amongst the following should be considered in a patient with acute chest pain and ST segment elevation in the precordial leads?
1. Acute myocardial infarction
2. Acute hyperkalemia
3. Pericarditis
4. Hypocalcemia
5. Oesophagitis
6. Pneumothorax
Select the correct answer using the code given below.
(a) 1, 2 and 3
(b) 1, 3 and 4
(c) 1, 4 and 5
(d) 2, 3 and 6

3. Which amongst the following is the most powerful independent risk factor for atherosclerosis?
(a) Age
(b) Hypertension
(c) Gender
(d) Physical Activity

4. In which of the following SA node dysfunction conditions, permanent pacing may NOT be required?
1. Beta blocker drugs
2. Narcotic drugs
3. Iatrogenic–Post RT/Surgery
4. Hypothyroidism
5. Sick sinus syndrome
6. Raised Intracranial tension
Select the correct answer using the code given below.
(a) 1, 2, 3 and 4
(b) 1, 2, 4 and 5
(c) 1, 2, 4 and 6
(d) 3, 5 and 6

5. Kartagener syndrome has the following features EXCEPT:
(a) Recurrent Sinusitis
(b) Transposition of Viscera
(c) Autosomal Dominant
(d) Bronchiectasis

Download Question Paper :
Paper – I :
https://www.pdfquestion.in/uploads/pdf2019/34103-CMSEP1.pdf
Paper – II :
https://www.pdfquestion.in/uploads/pdf2019/34103-CMSEP-2.pdf

6. Which of the following pulmonary function set is characteristic of COPD?
(a) FEV1 / FVC < 70% ; FEV1 ? ; FVC ? ; TLC ? DLCO Normal
(b) FEV1 / FVC < 70% ; FEV1 ? ; FVC ? ; TLC ? DLCO ?
(c) FEV1 / FVC < 70% ; FEV1 ? ; FVC ? ; TLC ? DLCO ?
(d) FEV1 / FVC < 70% ; FEV1 ? ; FVC ? ; TLC ? DLCO ?

7. Which of the following drugs causes dry cough as a side effect?
(a) Fluconazole
(b) Ramipril
(c) Cefixime
(d) Atenolol

8. For Acid Fast Bacilli (AFB) to be detected in sputum by the direct microscopy, the bacillary burden in sputum typically is:
(a) 500–1,000 organisms
(b) 5,000–10,000 organisms
(c) 10,000–20,000 organisms
(d) Any number of organisms

9. The pleural fluid is considered as empyema if following is present in it:
(a) Fluid glucose < 60 mg/dl
(b) Lactate Dehydrogenase (LDH) of more than 1000 U/L
(c) Fluid pH of less than 7.0
(d) All of these

10. Airway secretions contain all of the following antimicrobial peptides EXCEPT:
(a) Defensins
(b) Immunoglobulin A (IgA)
(c) Lysozyme
(d) Histidine

11. The respiratory motor neuron associated with origin of respiratory cycle is located in:
(a) Pons
(b) Posterior Medulla oblongata
(c) Ventral Medulla oblongata
(d) Mid brain

12. Consider the following statements regarding Weight Loss:
1. 4.5 kg over 6-12 months
2. 10 kg over 6-12 months
3. More than 5 % over 6-12 months
4. More than 10 % over 6-12 months
Which of the above constitute significant or clinically important weight loss?
(a) 1 and 3
(b) 1 and 4
(c) 2 and 3
(d) 2 and 4

13. Which of the following Ascitic Fluid analysis is most compatible with a diagnosis of Ascites secondary to portal hypertension?
(a) SAAG < 1.1 g/dl ; Ascitic Fluid Protein < 2.5 g/dl
(b) SAAG < 1.1 g/dl ; Ascitic Fluid Protein > 2.5 g /dl
(c) SAAG > 1.1 g/dl ; Ascitic Fluid Protein < 2.5 g /dl
(d) SAAG > 1.1 g/dl ; Ascitic Fluid Protein > 2.5 g /dl

14. All are the causes of Interstitial lung disease EXCEPT:
(a) Idiopathic Pulmonary Fibrosis
(b) Granulomatosis with Polyangiitis
(c) Sarcoidosis
(d) Bronchial Asthma

15. The rhythmic activity recorded on scalp by EEG in a normal awake adult lying quietly with eyes closed is:
(a) Less than 4Hz – Delta rhythm
(b) 4 to 7 Hz –Theta rhythm
(c) 8 to 13 Hz – Alpha rhythm
(d) More than 14 Hz –Beta rhythm

16. Transient Monocular blindness may be due to small platelet emboli that occludes:
(a) Posterior Cerebellar artery
(b) Posterior Cerebral artery
(c) Ophthalmic artery
(d) Vertebral artery

17. The phenomenon of sparing of macular vision is due to collateral circulation between:
(a) middle and posterior cerebral artery
(b) anterior and middle cerebral artery
(c) anterior and posterior cerebral artery
(d) anterior, middle and posterior cerebral artery

18. Characteristic features of Horner’s Syndrome are:
(a) partial ptosis, enophthalmos, constricted pupil, decreased sweating
(b) partial ptosis, exophthalmos, constricted pupil, decreased sweating
(c) partial ptosis, enophthalmos, dilated pupil, decreased sweating
(d) partial ptosis, enophthalmos, constricted pupil, increased sweating

19. All of the following statements are true EXCEPT:
(a) Dorsal column fibres synapse at the cuneate and gracile nuclei
(b) Pain and temperature sensations are carried by lateral spinothalamic tract
(c) Spinal cord ends at lower level of 5th lumbar vertebrae
(d) Dorsal spinocerebellar tract carries fibres from the same side of the body

20. The following conditions usually present with proximal muscle weakness, EXCEPT:
(a) Facio-scapulo-humeral dystrophy
(b) Myotonia dystrophica
(c) Duchene’s muscular dystrophy
(d) Becker muscular dystrophy

Paper – II

1. What is the correct order of the normal phases of wound healing?
(a) Proliferative phase ? Haemostatic phase ? Inflammatory phase ? Remodelling phase
(b) Haemostatic phase ? Inflammatory phase ? Proliferative phase ? Remodelling phase
(c) Destructive phase ? Proliferative phase ? Remodelling phase ? Inflammatory phase
(d) Remodelling phase ? Proliferative phase ? Destructive phase ? Inflammatory phase

2. All of the following are risk factors for an increased risk of wound infection EXCEPT:
(a) Obesity
(b) Hypertension
(c) Jaundice
(d) Cancer

3. Systemic Inflammatory Response Syndrome (SIRS) is characterized by all of the following
EXCEPT:
(a) Hyperthermia (>38°C)
(b) Platelet count (<1,00,000/mm3)
(c) Tachypnoea (>20/min)
(d) Hypothermia (<36°C)

4. Gentleman of 56 years underwent laparoscopic left hemicolectomy for diagnosed left colonic carcinoma. Histopathology revealed the tumour to be invading submucosa and muscularis propria. Among the 16 regional lymph nodes harvested, 2 were positive for malignant deposits. His staging as per AJCC will be:
(a) T1, N1, M0
(b) T2, N1, M0
(c) T1, N0, M0
(d) T2, N1, M1

5. All of the following are hormonal agents used in treatment of cancer EXCEPT:
(a) Anastrazole
(b) Irinotecan
(c) Cabergoline
(d) Leuprolide

6. Which of the following statements regarding lymphoedema are correct?
1. Patients experience constant dull ache and even severe pain sometimes
2. Manual lymphatic drainage has a role
3. Primary lymphoedema is caused by congenital lymphatic dysplasia
4. Nonne Milroy’s disease is a type of primary lymphoedema
Select the correct answer using the code given below:
(a) 3 and 4 only
(b) 1 and 2 only
(c) 1, 2 and 3 only
(d) 1, 2, 3 and 4

7. Indications for carotid endarterectomy in symptomatic patients are all of the following EXCEPT:
(a) Hemianopia
(b) Monocular blindness
(c) Dysphasia
(d) Persistent hypertension

8. A policeman of 45 years presented with Lipodermatosclerosis over lower medial aspect of left leg, along with a healed venous ulcer. As per the CEAP (Clinical-etiology-anatomypathophysiology) classification his clinical classification will be:
(a) C4a
(b) C4b
(c) C5
(d) C6

9. What is true about the management of a corrosive injury of oesophagus?
(a) Early skilled endoscopy is must
(b) Immediate surgery with oesophagectomy is advisable
(c) Broad spectrum antibiotics should be started as soon as possible
(d) Immediate NG tube insertion and gastric lavage should be preformed

10. Which of the statements regarding Salivary gland neoplasms are correct?
1. 80–90% of parotid tumors are malignant
2. 90 % of sublingual gland tumors are malignant
3. 60–70 % of submandibular gland tumors are benign
4. Parotid gland is most common site for salivary gland tumors
Select the correct answer using the code given below:
(a) 1, 2 and 3
(b) 2, 3 and 4
(c) 1, 3 and 4
(d) 1, 2 and 4

11. A few days following viral fever, a 50 year old female presented with pain in neck, fever, malaise and firm enlargement of both the lobes of thyroid. On investigation thyroid antibodies were normal & serum T4 was high normal. Probable diagnosis is:
(a) Autoimmune thyroiditis
(b) Lymphoma of thyroid
(c) Granulomatous thyroiditis
(d) Riedel’s thyroiditis

12. No increased relative risk of invasive breast carcinoma based on histopathological examination
of benign breast tissue is for all of the following EXCEPT:
(a) Hyperplasia
(b) Periductal mastitis
(c) Squamous metaplasia
(d) Solitary papilloma of lactiferous sinus

13. Which of the following statements regarding Paget’s disease of nipple are correct?
1. It represents benign pathology of nipple areola complex
2. It is eczema like condition of nipple and areola
3. Erosion of nipple is seen
4. Nipple biopsy is required for definitive diagnosis
Select the correct answer using the code given below:
(a) 1, 2 and 3
(b) 2, 3 and 4
(c) 1, 3 and 4
(d) 2 and 4 only

14. A gentleman of 36 years presented with a long history of upper abdominal pain which was periodic and often occurred early morning. For last 3 months, he is having projectile vomiting, which is non bilious, unpleasant in nature with undigested food materials. On examination he appears unwell, dehydrated and seemed to have lost weight. Probably he is suffering from:
(a) Gastric outlet obstruction
(b) Carcinoma stomach
(c) Gastro-oesophageal reflux with oesophagitis
(d) Superior mesenteric artery syndrome

15. A 40 year old female patient presents with colicky abdominal pain associated with episodes of mild diarrhoea for last 6 months accompanied with intermittent fever and weight loss. There are multiple discharging sinuses on perineal examination. The most likely clinical diagnosis in this patient is:
(a) Amoebic colitis
(b) Crohn disease
(c) Ulcerative colitis
(d) Ileocaecal Tuberculosis

16. A gentleman of 48 years was being worked up for hepatocellular function. He had no history or signs of encephalopathy. His serum bilirubin was 5 mg%, serum albumin was 3.9 gm%, International normalized ratio was 1.6. On ultrasound no free fluid was detected inside abdomen. As per Child-Turcotte-Pugh (CTP) classification, he was in:
(a) CTP–A
(b) CTP–B
(c) CTP–C
(d) CTP–D

17. Which of the statements regarding Calot’s triangle are correct?
1. Common hepatic duct forms the medial boundary of the Calot’s triangle
2. Inferior surface of the right lobe of the liver forms the superior boundary of Calot’s triangle
3. Right hepatic artery is usually found as a content of the Calot’s triangle
4. Cystic duct and medial border of gall bladder forms the lateral border of Calot’s triangle
Select the correct answer using the code given below:
(a) 1, 2 and 3
(b) 2, 3 and 4
(c) 1, 3 and 4
(d) 1, 2 and 4

18. Consider the following statements regarding Opportunistic post-splenectomy infections (OPSI):
1. Haemophilus influenzae, Neisseria meningitidis and Streptococcus pneumonae are the most common causative agents
2. Risk is greatest in the patients who have undergone splenectomy for trauma
3. Risk is greatest within the first 2–3 years following splenectomy
4. Prophylactic vaccination should be done 2 weeks prior to elective splenectomy
Which of the statements given above are correct?
(a) 1, 2 and 3
(b) 2, 3 and 4
(c) 1, 3 and 4
(d) 1, 2 and 4

19. A 48 year old male with the history of chronic duodenal ulcer presented in surgical emergency with the complaints of sudden severe pain in the abdomen.
At presentation :
Pulse = 120/m, BP = 90/60 mm of Hg
Abdomen: Tenderness (+), Rigidity (+), Guarding (+)
Respiratory Rate: 20/m
X-ray: Gas under right dome of diaphragm
The probable diagnosis is:
(a) Acute appendicitis
(b) Acute Pancreatitis
(c) Acute Myocardial infraction
(d) Perforation Peritonitis

20. A young sports person presented in surgical emergency with the complaints of severe pain in the groin area, extending into the scrotum and upper thigh. The pain is debilitating and he is not able to exercise. On examination there is tenderness in the region of Inguinal canal and pubic tubercle. He is probably suffering from:
(a) Varicocele
(b) Inguinal hernia
(c) Sportsman hernia
(d) Femoral hernia

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