QP-CMSE-24-PAPER-II-SURGERY-GYAE-OBST-PREVENT-SOCIAL-MEDCN-150724

Combined Medical Services Examination, 2024 DO NOT OPEN THIS TEST BOOKLET UNTIL YOU ARE TOLD TO DO SO 7.8.0. : KCSP-B-SGOP Test Booklet Series TEST BOOKLET ما 6 ଆ © = ০১ 1780-11 5೦೧ ಗ ৮টি ४ = ( Surgery, Gynaecology & Obstetrics, ৰম Preventive & Social Medicine ) Time Allowed : Two Hours Maximum Marks : 250 INSTRUCTIONS 1. IMMEDIATELY AFTER THE COMMENCEMENT OF THE EXAMINATION, YOU SHOULD CHECK THAT THIS TEST BOOKLET DOES NOT HAVE ANY UNPRINTED OR TORN OR MISSING PAGES OR ITEMS, ETC. IF SO, GET IT REPLACED BY A COMPLETE TEST BOOKLET. 2. Please note that it is the candidate’s responsibility to encode and fill in the Roll Number and Test Booklet Series A, B, C or D carefully and without any omission or discrepancy at the appropriate places in the OMR Answer Sheet. Any omission/discrepancy will render the Answer Sheet liable for rejection. 3. You have to enter your Roll Number on the Test Booklet in the Box provided alongside. DO NOT write anything else on the Test Booklet. 4. This Test Booklet contains 120 items (questions). Each item comprises four responses (answers). You will select the response which you want to mark on the Answer Sheet. In case you feel that there is more than one correct response, mark the response which you consider the best. In any case, choose ONLY ONE response for each item. 5. You have to mark all your responses ONLY on the separate Answer Sheet provided. See directions in the Answer Sheet. 6. All items carry equal marks. 7. Before you proceed to mark in the Answer Sheet the response to various items in the Test Booklet, you have to fill in some particulars in the Answer Sheet as per instructions sent to you with your Admission Certificate. 8. After you have completed filling in all your responses on the Answer Sheet and the examination has concluded, you should hand over to the Invigilator only the Answer Sheet. You are permitted to take away with you the Test Booklet. 9. Sheets for rough work are appended in the Test Booklet at the end. 10. Penalty for wrong answers : THERE WILL BE PENALTY FOR WRONG ANSWERS MARKED BY A CANDIDATE IN THE OBJECTIVE TYPE QUESTION PAPERS. (i) There are four alternatives for the answer to every question. For each question for which a wrong answer has been given by the candidate, one-third of the marks assigned to that question will be deducted as penalty. (ii) If a candidate gives more than one answer, it will be treated as a wrong answer even if one of the given answers happens to be correct and there will be same penalty as above to that question. (iii) If a question is left blank, i.e., no answer is given by the candidate, there will be no penalty for that question. DO NOT OPEN THIS TEST BOOKLET UNTIL YOU ARE TOLD TO DO SO 1. Which of the following are risk factors for wound infection? 1. 2; 3. 4. Malnutrition Poor perfusion Antibodies Foreign body material Select the correct answer using the code given below. (a) (b) (୬ (0) 1, 2 and 3 1, 2 and 4 1, 3 and 4 2, 3 and 4 2. Which types of cancer are associated with exposure to ionizing radiation? 7 2. 3. 4. Leukaemia Lung cancer ૩. Which of the following are correct regarding Li-Fraumeni syndrome? 15 It has autosomal dominant inheritance and is associated with P53 gene. It has autosomal recessive inheritance and is associated with P53 gene. It is associated with an increased risk of sarcomas and leukaemia. It is associated with an increased risk of brain tumours and osteo- sarcomas. Select the answer using the code given below. (a) (b) ‏رط‎ ‎(0) 2, ತಿ and 4 1, 3 and 4 1 and 4 only 1 and 3 only 4. A 48-year-old smoker presents to the OPD with complaints of cramping pain in both the calves on walking to about 100-150 metres. The pain is relieved on taking rest for about 2-3 minutes and Breast cancer Lymphoma Select the correct answer using the code given below. (a) (b) (6) (6) 1, 2 and 3 1, 2 and 4 1, 3 and 4 2, 3 and 4 KCSP-B-SGOP/77A 2 the patient is able to walk for some more distance again before the pain appears. This presentation is suggestive of (a) muscular fatigue (b) osteoarthritis of the knee (c) intermittent claudication (0) neurogenic claudication 5. A midline neck swelling just below the hyoid bone and managed by Sistrunk’s operation leads to postoperative need for thyroxine replacement. The most likely diagnosis is (a) lateral aberrant thyroid (0) thyroglossal cyst (c) solitary thyroid nodule (0) thyroglossal cyst with only functioning thyroid tissue 6. A 40-year-old smoker presents with soreness of tongue since last 2 months. On examination, it is found that the oral hygiene is poor and there is a white plaque over the lateral border of the tongue. What is the next step in the management of this patient? (a) Oral vitamin C supplementation (b) Oral antifungal treatment (c) Edge biopsy of the lesion (व) Local topical cauterization 7. Consider the following causes of visual loss : 1. Obstruction of the central retinal artery 2. Vitreous and retinal haemorrhage 3. Cataract 4. Retinal detachment Which of the above causes are associated with acute visual loss in a patient? (a) 1, 2 2043 (0) 1, 3 and 4 © 1, 2 ಹಾರೆ 4 (0 2, 3 and 4 KCSP-B-SGOP/77A 8. A 60-year-old lady presents with a recent onset increase in a long standing swelling on the front of the neck. The swelling, which was small, had been present since last 30 years, but has now increased to more than twice the size in the last 2 months. On examination, the swelling is firm to hard in consistency and moves with deglutition. What is the most likely cause of this clinical presentation? (a) Cystic degeneration (b) Haemorrhage (c) Malignant transformation (d) Myxomatous transformation 9. Which of the following chromosomal abnormalities are associated with brain tumours? 1. Neurofibromatosis type 1 2. Neurofibromatosis type 2 ૩. Peutz-Jeghers syndrome 4 Hereditary nonpolyposis colorectal cancer Select the correct answer using the code given below. (a) 1, 2 and3 ‎and 4‏ 2 ,1 رم ‎(જ 1, 3 and 4‏ ‎and 4‏ 3 ,2 0( ‎10. Which one of the following is correct ‎regarding “witch’s milk”? (a) It is seen in full-term infants. (b) It is seen only in preterm infants. ‎(c) It is caused by stimulation of foetal breast by progesterone. ‎(d) It is caused by stimulation of foetal breast by calcitonin. ‎(೫.7.೦. 11. Which of the following statements are 13. Which of the following are 10081 correct regarding Barrett’s oesophagus? complications of acute pancreatitis? 1. It is a metaplastic change. 1. Pseudocyst 2. Itisarisk factor for development of 2. Pleural effusion adenocarcinoma. 3. 11૯૫5 3. Ingestion of NSAIDs 15 the 4. Acute fluid collection aetiological factor for its Select the correct answer using the code development. given below. 4. Endoscopic mucosal resection is an 8 (a) 1, 2 and 3 effective treatment. (b) 2, 3 and 4 (c) 1, 2 and 4 (0 1, 3 and4 Select the answer using the code given below. (a) 1, 2 and 3 14. Which of the following are risk factors for છિ) 2, 3 and 4 the development of pancreatic cancer? (જ 1, 2 and 4 1. Cigarette smoking (व) 1,3 and 4 2. Diabetes mellitus 3. Caucasian ethnicity 12. Which among the following are 4. Male gender complications of liver trauma? Select the correct answer using the code 1. Liver abscess given below. 2. Biliary fistula (a) 1, 2 and 3 3. Portal thrombosis (b) 2, 3 and 4 4. Liver failure (જ 1, 2 and 4 (0 1, 3 and 4 Select the correct answer using the code pret બા, 15. Which of the following are metabolic causes of splenic enlargement? (a) Rickets and Still’s disease (a) 1, 2 and 3 604 (b) Amyloid and Gaucher’s disease ര 1,3 and 4 (c) Porphyria and Felty’s syndrome (व) 2,3 and 4 (d) Myelofibrosis and Weil’s disease KCSP-B-SGOP/77A 4 16. Which one of the following statements is correct about mesenteric cysts? (a) It occurs most commonly in children less than 18 years of age. (b) It is more common in males as compared to females. (c) It presents most commonly as a painless abdominal swelling. (व) Percutaneous’ aspiration with injection of sclerosant is the preferred treatment option. 17. Which of the following are features of umbilical hernia in adults? 1. Patients are commonly overweight with a thinned and attenuated midline raphe. 2. Most patients complain of pain due to tissue tension. 3. Men are affected more commonly than women. 4. Hernia repair can be done by the technique described by Mayo. Select the correct answer using the code given below. (a) 1, 2 and 3 ‏رم‎ 1, 2 and 4 © 1, 3 થત 4 (0) 2, 3 and 4 18. What is the most common cause of perforation of the oesophagus? (a) Barotrauma (0) Mediastinitis (c) Iatrogenic infection (0) Malignancy KCSP-B-SGOP/77A 19. Which of the following are stages of damage control surgery? 1. Patient’s selection 2. Control of haemorrhage 3. Resuscitation in ICU 4. Preventive surgery Select the correct answer using the code given below. (a) 1, 2 and 3 (b) 1, 2 and 4 (c) 1, 3 and 4 (0) 2, 3 and 4 20. Which of the following statements are correct regarding renal cell carcinoma? 1. It arises from the epithelium of the proximal convoluted tubule. 2. It has a female preponderance. 3. Major subtypes are clear cell, papillary and chromophobe. 4. Surgery is the mainstay of treatment for organ-confined disease. Select the answer using the code given below. (a) 1, 2 and 3 (0) 1, 2 and 4 ര 1, 3 and 4 (0) 2, 3 and 4 (2.1.0. 21. Which of the following are features of 23. Consider the following clinical features : autosomal dominant polycystic kidney 1. Raised ICP disease? 2. Seizures 1. Cyst may also occur 10 liver, 3. Focal deficit pancreas and arachnoid 4. Headache membrane. Which of the above clinical features are 2. Most commonly manifests between related to most brain tumours? 20-30 years of age. (a) 1, 2, 3 and 4 3. Clinical manifestations are renal (0) 1 and 2 only and extrarenal. (c) 1, 2 and 3 only 4. Men tend to progress to renal (0) 2, 3 and 4 only failure more rapidly than women. 4 24. The most common type of brain tumours associated with neurofibromatosis Select the correct answer using the code type 1 brain tumour syndrome is given below. (a) astrocytoma (b) acoustic neuroma () 1, 2 ands (c) meningioma (व) medulloblastoma (b) 1, 2 and 4 (9 1, 3 and 4 25. Which of the following are correct for herniation via foramen of Morgagni? (d) 2,3 and 4 1. It occurs posteriorly in chest. 2. Transverse colon is the commonest content. 22. Extracorporal Shock Wave 1107001057 3. Defect is between sternal and (ESWL) is most commonly used for the costal attachments. treatment of 4. It is a type of congenital hernia. (૦) gallbladder stones Select the answer using the code given క్‌ below. (b) urinary tract stones (a) 1, 2 and 3 (b) 1, 2 and 4 (જ 1, 3 and 4 (व) abdominal stony-hard tumour (व) 2, 3 and 4 (c) salivary gland stones KCSP-B-SGOP/77A 6 26. A 40-year-old lady complains of progressive deformities of her hands and fingers associated with stiffness which is present in both the hands and improves as the day progresses. On examination, there is symmetrical involvement of hands and fingers of both the upper limbs with flexion and ulnar deviation at the metacarpophalangeal joints. What is the most likely diagnosis in this lady? (a) Osteoarthritis (b) Ankylosing spondylitis (c) Rheumatoid arthritis (0) Tenosynovitis 27. A 52-year-old female complains of increasing pain in the right shoulder. She is also finding it increasingly difficult to do overhead abduction of the affected joint. She had been diagnosed as a diabetic 20 years back and is on treatment since then. What is the most likely cause of her clinical condition? (a) Rotator cuff tear (b) Frozen shoulder (c) Bacterial arthritis (व) Osteoarthritis KCSP-B-SGOP/77A 28. A 20-year-old girl presents to the OPD with complaints of ೩ progressively increasing swelling on the dorsum of the left wrist. The swelling is cystic and nontender on examination and becomes more prominent on plantar flexion of the wrist. The swelling is 2 cm × 1 cm in size. What is the likely diagnosis in this case? (a) Ganglion cyst (b) Sebaceous cyst (c) Dermoid cyst (97 Epidermoid cyst 29. Upper motor neuron lesions are characterized by which of the following? 1. Increased tone spasticity 2. Hyperreflexia 3. Absent plantar response 4. Motor weakness Select the correct answer using the code given below. (a) 1, 2 and3 മു 1, 2 and 4 ര 1, 3 and 4 (0) 2, 3 and 4 ૩૦. A 56-year-old female has been diagnosed with gallstones and is undergoing a preanaesthesia checkup. She has been a diabetic since last 15 years, but sugar levels are within the limits. Which category of physical status does she fit into? (a) ASA 4 (b) ASA 3 (c) ASA 2 (0) ASA1 [ ?.1.0. 31. A 30-year-old road traffic accident victim is being taken up for emergency laparotomy for haemoperitoneum and suspected multiorgan trauma. Which one of the following will be an indication for performing damage control surgery? (a) Blood pressure < 100 mm Hg (b) Acidosis with pH < 7:32 (c) Hypothermia < 36 °C (व) Coagulopathy 32. Consider the following : 1. Pain relief 2. Prevention of infection 3. Anaesthesia 4. Restoration of anatomy Which of the features given above are benefits of fracture treatment? (a) 1,3 and 4 (b) 1, 2 and 3 (c) 1, 2 and 4 (0) 2,3 and 4 33. A 30-year-old motorbike rider is brought to the emergency with history of a road traffic accident and altered consciousness. On secondary survey, the doctor notices presence of a bruise over the left mastoid process. The finding indicates (a) fracture of mastoid process (b) injury to the external auditory meatus (c) fracture of the skull base (৫) soft tissue injury to the neck KCSP-B-SGOP/77A 34. Hangman’s fracture is (a) traumatic spondylolisthesis of atlas vertebra (ಲ) (b) traumatic spondylolisthesis of axis vertebra (Co) (જ traumatic spondylolisthesis ‏۶ہ‎ ‎thoracic vertebra (7) (0) traumatic spondylolisthesis of lumbar vertebra (1) 35. Which of the following are correct in respect of Systemic Inflammatory Response Syndrome (SIRS)? 1. It is caused by the release of lipopolysaccharide endotoxin from dying E. coli bacteria. 2. It 15 8877೮ as bacteraemia. 3. It results in Multiple Organ Dysfunction Syndrome (MODS). 4. White cell counts of more than 12x 109 /litre are present. Select the answer using the code given below. (a) 75 (b) 1, 2 and 4 (c) 1, 3 and 4 (0) 2, 3 and 4 36. A surgeon is about to start a laparoscopic procedure on a patient. The floor nurse asks the surgeon about the identity of the patient, site of the procedure to be performed and any anticipated critical events during the surgery. These questions are a part of the (a) universal precautions checklist (b) nurses safety checklist (c) MCI patient safety checklist (व) WHO surgical safety checklist 37. Which of the following are correct for managing hypertrophic scars? 1. Silicone gel sheeting 2. Intralesional steroid injections 3. Vitamin A gel applications 4. Laser treatment Select the answer using the code given below. (a) 1,2 and 3 (b) 1, 2 and 4 (© 1, 3 and 4 (0) 2,3 and 4 38. Which of the following are approximate daily requirements of the common electrolytes in an adult? 1. Sodium 50-90 mM/day 2. Calcium 1 mM/day 3. Potassium 50 mM/day 4 Magnesium 1 mM/day KCSP-B-SGOP/77A Select the correct answer using the code given below. (a) 1, 2 and 3 (b) 1, 2 and 4 (c) 1, 3 and 4 (0 2, 3 and 4 39. Distributive shock is described by which of the following patterns of cardio- vascular responses? 1. Vasodilation 2. Reduced peripheral vascular resistance 3. Inadequate ‘afterload’ 4. Low cardiac output Select the correct answer using the code given below. (a) 1, 2 and 4 (b) 1, 3 and 4 ( 2, 3 and 4 (0 1, 2 and 3 40. The best measure of organ perfusion and the best monitor of adequacy of shock therapy is (a) central venous pressure (b) pulmonary wedge pressure (c) urine output (व्‌) restoring blood pressure/pulse vital parameters [ P.T.O. 41. Which one of the following statements is correct regarding foetal physiology? (a) Haematopoiesis is demonstrated first in the yolk sac by 14th day. (b) Meconium appears at 16 weeks. (c) Breathing movements are identified at 26 weeks. (व) Foetal pancreas secretes insulin as early as 20 weeks. 42. Which of the following are advantages of state of haemodilution during pregnancy? 1. Optimum gaseous exchange between maternal and foetal circulation due to decreased blood viscosity 2. Protection against adverse effect of supine and erect posture 3. Protection against adverse effect of blood loss during delivery Select the correct answer using the code given below. (a) 1 and 2 only (b) 2 and 3 only (c) 1 and 3 only (व) 1, 2 and 3 43. Consider the following statements regarding oligohydramnios : 1. It is defined on . (806 _ when maximum vertical pocket of liquor is less than 5 cm. 2. It is defined on USG when AFI is less than 5 cm. KCSP-B-SGOP/77A 10 Which of the statements given above is/are correct? (a) (৮) (c) 1 only 2 only Both 1 and 2 (क) Neither 1 nor 2 44. Which of the following are correct about endocrine changes in normal pregnancy? 1. Increase in levels of maternal serum iodine 2. ' 1006296. ൬ serum. levels... ‘of Corticotropin-Releasing Hormone (CRH) 3. Increase in serum 1618 of aldosterone 4. Increase in serum levels of ACTH Select the answer using the code given below. (a) 1, 2 and 3 (b) 1, 2 and 4 (c) 1, 3 and 4 (व) 2, 3 and 4 45. Which of the following features are correct regarding onset of true labour? 1. Regular uterine contractions 2. Progressive cervical dilation and effacement 3. Presence of show 4. Labour and delivery are synonymous Select the answer using the code given below. (a): 1, 2 and3 (b) 1, 2 and 4 જિ 1, 3 and 4 (व) 2, 3 and 4 46. According to the WHO Intrapartum Care 49. A 30-year-old female ‏ور‎ had a forceps Guidelines, 2018, the active phase of labour starts from what dilation of cervix? (0 3cm (b) 4 cm (© Scm (व) 6cm 47. The diameter of engagement of foetal skull in marked deflexion is (a) occipitofrontal diameter (©) suboccipitofrontal diameter (© mentovertical diameter delivery 2 days back. There was injury to head of baby resulting in collection of blood 10 soft tissue between pericranium and flat bone of skull, limited by suture line. What is the probable diagnosis? (a) Caput succedaneum (b) Intraventricular haemorrhage (c) Cephalohaematoma (व) Subgaleal haemorrhage (व) suboccipitobregmatic diameter 50. Which of the following are correct 48. Onset of labour is initiated by which of the following? 1. Uterine distension 2. Increased CRH and ACTH from foetal hypothalamic-pituitary- adrenal axis 3. Increased level of progesterone immediately before labour 4. Increased synthesis of myometrial receptors for oxytocin due to effect of oestrogen Select the correct answer using the code given below. (a) 1,2 and 3 (b) 1, 2 and 4 (c) 1, 3 and 4 (0) 2, 3 and 4 KCSP-B-SGOP/77A 11 regarding pathological findings of placenta accreta? 1. Absence of decidua basalis 2. Absence of Nitabuch’s fibrinoid layer 3. Loss of normal hypoechoic retroplacental myometrial zone in ultrasonography Select the answer using the code given below. (a). 1 and 2 only (b) 2 and 3 only (c) 1 and 3 only (@ 1,2and3 (2.1.0. 51. Which of the following statements are correct regarding peripartum cardiomyopathy? 1. It is usually seen in multiparous women. 2. Echocardiography shows ejection fraction less than 45%. 3. ACE inhibitors are contraindicated. 4. History of prior heart disease is mostly present. Select the answer using the code given below. (a) 1 and 2 only (b) 1, 2 and 3 (c) 3 and 4 only (0) 1, 3 and 4 52. Mrs. A, who is 9 months pregnant, presents to the labour room with complaints of severe pain in abdomen and vaginal bleeding for 30 minutes. She is 2nd gravida (producing second child) and delivered her first child 2 years back by caesarean delivery. On examination, she has scar tenderness, vaginal bleeding and haematuria. On CTG, she has an abnormal FHR tracing. What is her likely clinical diagnosis? (a) Urinary tract infection (b) Scar rupture/dehiscence during labour (c) Labour pain (0) Rupture of urinary bladder KCSP-B-SGOP/77A 12 53. A 28-year-old female 021.1 with history of previous caesarean presents to the gynaecology emergency in labour. On examination, she is hypotensive, foetal heart sounds are absent and foetal parts are easily palpable. What is her diagnosis? (a) Oligohydramnios (0) Abruptio placentae (c) Uterine rupture (d) Hydatidiform mole 54. A 24-year-old primigravida comes to ANC clinic at 8 months amenorrhoea. Her BP is found to be 160/100 mm Hg. Lab findings reveal thrombocytopenia, increased SGOT/SGPT and LDH. What is her diagnosis? (a) Obstetric cholestasis (b) Hepatitis B (c) HELLP syndrome (व्‌) Eclampsia 55. A patient, who is 2 months pregnant, reports to a hospital with complaints of increased vaginal bleeding and pain in lower abdomen. Internal examination reveals dilated internal os of cervix and products of conception are felt through it. What is her likely clinical diagnosis? (a) Threatened abortion (b) Inevitable abortion (c) Septic abortion (0) Incomplete abortion 56. Which one of the following is a common pathology associated with ureteric injury while performing . surgical procedure of abdominal hysterectomy? (a) Pelvic endometriosis (0) Adenomyosis (જ Hydrosalpinx (a) Ovarian teratoma 57. Which of the following are correct regarding pathology of stress urinary incontinence? 1. Hypermobility of urethra 2. Ascend of bladder neck and proximal urethra above pelvic diaphragm 3. Lowered urethral pressure 4. Increased detrusor activity Select the answer using the code given below. (a) 1 and 2 ७) 1 and 3 (© 2 and 4 (0 3 and 4 58. Which of the _ following operative procedures is/are conformity for the diagnosis of bicornuate uterus? (a) Dilation with curettages (b) Hysteroscopy (જ Hysteroscopy and laparoscopy (d) Hysterectomy KCSP-B-SGOP/77A 13 59. Which of the following are correct regarding pelvic cellular tissue? ) 2. It supports the pelvic organs. It forms protective sheath for blood vessels and terminal part of ureter. It prevents infection to be spread out of pelvis. Marked hypertrophy of pelvic cellular tissue occurs in pregnancy. Select the answer using the code given below. (a) (৮) (© (0) 1, 2 and 3 1, 2 and 4 1, 3 and 4 2, 3 and 4 60. Which of the following are correct regarding androgen insensitivity syndrome? 1. Inherited as X-linked recessive disorder Karyotype is 46 XXY It is 8150 called testicular feminization Confirmation of diagnosis by gonadal biopsy Select the answer using the code given below. (a) (b) (୬ (0) 1, 2 and 3 1, 2 and 4 1, 3 and 4 2, 3 and 4 (೫.7.೦. 61. Which of the following are useful investigations for diagnosis of unre- sponsive endometrium as a cause of primary amenorrhoea? 1. Karyotype 2. Progesterone challenge test 3. Hormonal studies 4. Hysterosalpingography Select the correct answer using the code given below. (a) 1, 2 and 3 (b) 1, 2 and 4 (c) 1,3 and 4 (व) 2, 3 800 4 + & 16-year-old girl with primary amenorrhoea presents to the gynaecology OPD for evaluation. She has normal secondary sexual characters. Her karyotype is 46,XX and ultrasound reveals normal ovaries and tubes but absent uterus. What is her clinical diagnosis? (a) Androgen insensitivity syndrome (b) Turner syndrome (© Mayer-Rokitansky-Kister-Hauser syndrome (0) Primary ovarian failure KCSP-B-SGOP/77A 63. A 25-year-old female comes to the gynaecology OPD for evaluation of secondary amenorrhoea. She gives history of previous dilatation and curettage, and her FSH levels are 8 IU/L. The probable cause of amenorrhoea is (a) Sheehan syndrome (b) Asherman syndrome (c) premature ovarian failure (0) incomplete abortion 64. Which of the following criteria are required to be fulfilled for hospitali- zation in a case of pelvic inflammatory disease? 1. Coexisting pregnancy 2. Mild fever and pain responding well to antibiotics 3. Suspected tubo-ovarian abscess 4. Coexistent HIV infection Select the correct answer using the code given below. (a) 1, 3 and 4 (b) 1, 2 and 3 (c) 1, 2 and 4 (व) 2, 3 and 4 65. ^ young female presented with complaints of lower abdominal pain, vaginal discharge, history of IUD use for last 3-4 years. On examination, the patient had fever, adnexal/cervical motion tenderness and increased ESR and C-reactive protein. What is the probable clinical diagnosis? (a) Ectopic pregnancy (b) Acute appendicitis (c) Diverticulitis (0 Acute PID 66. Which of the following are risk factors for 68. Which one of the following is correct Pelvic Inflammatory Disease (PID)? regarding choriocarcinoma? (a) Vaginal bleeding is the commonest presenting symptom 1. Use of contraceptive pills ਨ ਪਤ (b) About 20-30% of patients with 3. Genetic predisposition molar pregnancies develop chorio- carcinoma 4. Sexually active teenagers ५ छ 4 i (c) Primary site of involvement is Select the correct answer using the code fallopian tube given below. (0) Highly resistant tumour 19 chemotherapy (a) 1, 2 and 3 69. Which of the following are favourable (b) 2, 3 and 4 factors in prognosis of ovarian malignancy? (8 1, 3 and 4 4 1. Older age group 0۸۰۰۸۶۶۷۶٤ 2. Well-differentiated tumour 3. Smaller tumour volume 67. Which of the following are symptoms of 4. Absence of ascites ध 10519 Select the correct answer using the code 1. Postmenopausal bleeding given below. 2. Infertility (a) 1, 2 and 3 (b) 1, 2 and 4 (જ 1, 3 and 4 3. Chronic pelvic pain 4. Oligomenorrhoea (0) 2, 3 and 4 Select the correct answer using the code given below. 70. Which one of the following drugs is most effective in the treatment of gestational (a) 1, 2 and 3 trophoblastic neoplasia? ப அத்து (a) Cisplatin ১ 2 an (b) Methotrexate (c) 1,3 and 4 (c) Gemcitabine (व) 2, 3 and 4 (व्‌) None of the above KCSP-B-SGOP/77A 15 [2.00 71. A 48-year-old female underwent total 74. Which of the following are indications of hysterectomy with bilateral salpingo- cold knife conization? ৰ oophorectomy. The surgical specimen revealed solid ovarian tumour and histology revealed thecoma-fibroma. 1. Inconsistent finding colposcopy, cytology and directed biopsy Which one of the following is the most 2. Persistent CIN-1 lesion in women appropriate statement regarding this willing for future fertility condition? 3. Carcinoma in situ (a) 20% of such tumours are bilateral. 4. Unsatisfactory colposcopic finding છિ, Endometrial ‘hyperplasia is often entire margin of lesion is not visible associated. Select the correct answer using the code given below. (c) It is always associated with gross ascites. (व) It is derived from germ cells ia) 1, ടര്‍ $ 72. In POPQ classification for uterovaginal (b) 1, 2 and 4 prolapse, the only measurement done after reducing the prolapse is ‏لو‎ કાડ (८) genital hiatus (0 2, 3 and 4 (b) point C (c) point D 75. Which of the following are factors for poor ୩ “total vaginal length outcome following tuboplasty? 1. Dense pelvic adhesions 73. Which of the following are essential steps 2. Length of reconstructed tube less of Fothergill’s operation? 2 than 8 cm 1. Laparoscopic or vaginal ligation = స 3. Bilateral hydrosalpinx 2. Amputation of cervix 4. Reversal after 5 years of 3. Plication of Mackenrodt’s ligaments ர்‌ sterilization procedure in front of cervix 4. Ant colporrhaphy Select the correct answer using the code Select the correct answer using the code given below. given below. (a) 1, 2 and 3 (a) 1, 2 and 3 டு) 1, 2 and 4 0.7 ര 1, 3 and 4 ര 1, 3 జాడ 4 ‏رم‎ 2, 3 and 4 | (0) 2, 3 and 4 KCSP-B-SGOP/77A 16 76. Ulipristal acetate (progesterone receptor 79. Which of the following conditions are modulator) should not be prescribed as indications of removal of intrauterine emergency contraceptive in women with device? (a) glaucoma 1. Persistent irregular uterine (b) liver dysfunction bleeding (c) kidney failure 2. Perforation of uterus କଦ ଏ 3. Pyelonephritis 77. Injectable medroxyprogesterone IP ଏଚ Pregnancy: with: ୮୮ 1 150 mg/mL contraceptive injection is available in Family Health Programme Select the correct answer using the code of the Government of India under the given below. name (च) Saheli (a) 1, 2 and 3 (b) Sayana Press 7+ (b) 1, 2 and 4 (d) Sahiba (c) 1, 3 and 4 (0 2, 3 and 4 78. Which of the following are major complications of oral pills? 1. Cholestasis jaundice 80. A 25-year-old newly married female on Chloasma and acne liver enzyme inducers is requesting contraceptive advice in family planning clinic. Which of the following would Breast cancer be the most reliable method of contraception for her? 2 3. Venous thromboembolism 4 Select the correct answer using the code given below. ৰন ലല ன்‌ (a) Combined oral contraceptive ற (a) 1, 2 and 3 (b) Male condom (b) 1, 2 and 4 @ 1, 3 and 4 (c) Diaphragm (0) 2, 3 and 4 (व्‌) Depo-Provera injection KCSP-B-SGOP/77A 17 1350. 81. As per the Open Vial Policy, partially 83. The following table shows three broad used multidose vials of which of the components under which the objectives following vaccines can be used over of the National Health Policy, 2017 more than one immunization session? can be grouped, along with an example 1. 566. of goal/objective under that component : 2. DPT vaccine 3. Hepatitis B vaccine Pair Broad Goal/ Objective No. components examples 4. Measles vaccine 1 | Health status Increase life expec- Select the correct answer using the code and programme | tancy at birth from given below. impact 67:5 to 70 years by 2025 (a) 1 and 2 only 2 |Health systems | More than 90% of performance the newborn are (b) 2 and 3 only fully immunized by one year of age by જિ 1, 2 and 3 2025 (0 1,3 and 4 3 | Health systems | Increase State strengthening sector health spending to more than 8% of their 82. The statement, “Health is a dynamic budget by 2020 equilibrium between man and environment and disease a maladjust- ment of the human organism 10 How many of the pairs given above are environment” explains which one of the correctly matched? following concepts of health? (a) Bi ती (a) None of the pairs മ) Biomedic: (b) Ecological (b) Only one of the pairs (c) Psychosocial (c) Only two of the pairs (d) Holistic (d) All of the three pairs KCSP-B-SGOP/77A 18 84. 85. In the following table, the end results of planning are qualified by brief Consider the methods/techniques : 1. System analysis 2. Organizational design 3. Personnel management 4 Information systems Which of the above methods/ techniques are based on behavioural sciences? (a) 1, 2 and 3 (b) 1, 2 and 4 (જં 1, 3 and 4 (0) 2, 3 and 4 following management characteristics : Pair| End results Brief characteristics No. | of planning 1 | Goal Always constrained by time 2 | Objective Precise—either achieved or not achieved 3 | Target Permits the concept of degree of achievement How many of the pairs given above are correctly matched? (a) None of the pairs (b) Only one of the pairs (c) Only two of the pairs (व्‌) All of the pairs KCSP-B-SGOP/77A 19 86. Consider the following steps of a planning cycle : 2 2. Bt 4. Which among the following Assigning priorities among the problems Evaluation Selecting best programme Operating the programme is the correct sequence of steps? (a) (b) (০) (0) 3 -> 4 -> 1 ->2 1 -> 2 -» 3 -» 4 1 -> 3 ¬»4 -»2 2 -> 3 -> 4 -> 1 87. Which of the following statements are correct for incidence rate? 1 It is useful for taking action to control a disease. Rising incidence rates may indicate ineffectiveness of the current control programmes. Fluctuation in incidence rate may indicate a change in aetiology of disease. Select the answer using the code given below. (a) (b) (© (0) 1 and 2 only 2 and 3 only 1 and 3 only 1, 2 and 3 (೫.7.೦. 89. Consider 1006 88. Consider the following definition : “A high level of infection beginning early in life and affecting most of the child population, leading to a _ state of equilibrium such that the adult population shows evidence of the disease much less commonly than the children.” Which one of the following terms best fits this definition? (a) Holoendemic (b) Hyperendemic (c) Hypoendemic (97 Pandemic following statements regarding dengue virus : 1. It has four distinct serotypes. 2. Infection with any one serotype confers lifelong immunity for that virus serotype. 3. Secondary infection with dengue serotype 2 leads to severe form of dengue. KCSP-B-SGOP/77A 20 90. Consider ` 116 Which of the statements given above are correct? (a) 1 and 2 only (b) 2 and 3 only (c) 1 and 3 only (0 1, 2 and 3 following statements regarding dengue : 1. The mosquito becomes infective after an extrinsic incubation period of 8-10 days. 2. Once it becomes infective, the mosquito remains infective for life. 3. The genital tract of the mosquito does not get infected. Which of the statements given above are correct? (a) 1 and 2 only (b) 2 and 3 only (c) 1 and 3 only (0) 1, 2 and 3 ‎A researcher has obtained the country-‏ سے ‎level data on the average Body Mass‏ ‎Index (BMI) and the average sugar‏ ‎intake for 100 countries. Which among‏ ‎the following will be best suited to‏ ‎present the relationship between BMI‏ ‎and sugar intake in the 100 countries?‏ ‎(a) Bar chart (b) Pie diagram (c) Frequency polygon ‎(d) Scatter diagram ‎92. Frontline health workers are employed to record the births and deaths in countries which have made ` slow progress in the development of a comprehensive vital registration system. This approach is known as ‎(a) registration of vital events (b) lay reporting (c) sample registration system ‎(व्‌) census ‎93. While calculating the ‘total dependency ratio’, which one of the following is used in the denominator? ‎(a) Midyear population (b) Population 0 to 65 years (c) Population 15 to 64 years ‎(d) Population 14 to 70 years ‎KCSP-B-SGOP/77A ‎21 ‎94. As per the United Nations definition of ‎a vital events registration system, ‘vital events’ include which of the following? ‎1. Foetal deaths ‎2. School admissions 3. Legal separations 4 ‎College graduations ‎Select the correct answer using the code given below. ‎(a) 1 and 2 (b) 1 and 3 (8 2 and 3 ‎(8) 2 and 4 ‎95. Consider the following statements about ‎Kyasanur Forest Disease (KFD) : 1. It is transmitted by ticks. ‎2. It was originally called ‘pig disease’ because of the association with dead pigs. ‎3. It was first recognized in Karnataka State. ‎How many of the statements given above are correct? ‎(a) None of the statements ‎(b) Only one of the statements ‎(c) Only two of the statements ‎(d) All the three statements ‎(2.7.౦. 96. In countries with low levels of measles transmission, what should be the appropriate age for starting immuni- zation with measles-containing vaccine (MCV)? (a) 6 months (b) 9 months (c) 12 months (व्‌) 15-18 months 97. Monkeypox, a viral zoonotic disease, is caused by (a) a single-stranded RNA virus (b) a double-stranded RNA virus (c) a single-stranded DNA virus (व) a double-stranded DNA virus 98. Raju, a 6-year-old boy, was returning home from school. At the gate, he was scratched by a dog and there was some bleeding from the wound. Which option should be followed for the 2096 exposure prophylaxis? (a) Wash the wound and administer a shot of tetanus toxoid (b) Wash the wound and vaccinate with ARV only (c) Wash the wound, vaccinate with ARV and administer immuno- globulin (d) Wash and apply antiseptic to the wound KCSP-B-SGOP/77A 22 99. The method of combined disposal of refuse and night soil is known as (a) dumping (b) controlled tipping (c) incineration (व्‌) composting 100. Consider the following statements about working of septic tanks : 1. They are recommended for large communities, rather than small communities. 2. There should be no air space between the level of liquid in the tank and the undersurface of the cover. 3. Liquid effluent from the outlet pipe is free from all pathogens. How many of the statements given above are correct? (a) None of the statements (b) Only one of the statements (c) Only two of the statements (0) All the three statements 101. Of the following amino acids, which is categorized as a nonessential amino acid? (a) Leucine (b) Threonine (c) Tryptophan (च) Proline 102. Consider the following milks : 1. Buffalo milk 2. Cow milk ૩. Goat milk 4. Human milk What is the correct order (from highest to lowest) with regard to fat content per 100 gm in the milk? (0 1 -> 3 -> 4 -> 2 (0) 4 -> 2 -> 3 -> 1 (0) 2 -> 1 -> 4 -> 3 (0 1 -> 3 -> 2 ->4 103. Which of the following are unsaturated fatty acids? 1. Lauric acid 2. Linoleic acid 3. Oleic acid 4. Palmitic acid Select the correct answer using the code given below. (a) 1 and 2 (0) 1 and 4 ര 2 and 3 (0 3 and 4 KCSP-B-SGOP/77A 23 104. In India, the most widely prevalent stage of iron deficiency is (a) (৮) (6) (0) decreased iron stores without any other detectable abnormalities fall in percentage saturation of transferrin overt iron deficiency with impaired haemoglobin synthesis decrease in the concentration of circulating haemoglobin 105. Consider the following statements : Statement I : Waist circumference and waist to hip ratio are 0075 powerful predictors of subsequent risk of type 2 diabetes than Body Mass Index (BMI). Statement II : Central obesity is an important determinant of insulin resistance, the undergoing abnormality in most cases of type 2 diabetes. Which one of the following is correct in respect of the above statements? (a) (b) ০) (0) Both Statement I and Statement II are correct and Statement II is the correct explanation of Statement I Both Statement I and Statement II are correct but Statement II is not the correct explanation of Statement I Statement 1 is ೦೦೫೯೯೮೦೬ but Statement II is incorrect Statement I is incorrect but Statement II is correct (2.7.0. 106. Consider the following statement : 109. Consider the following pairs of genetic diseases that show Mendelian inheritance. Each of the following pairs represents a genetic disease and it has been matched with a type of inheritance : “The people should seek to preserve their traditional eating patterns and life- styles associated with low levels of Coronary Heart Disease (CHD).” 1 | Cystic fibrosis Autosomal recessive Which level of prevention is implied in this statement? চু Huntington’s chorea Autosomal dominant (a) Primordial 3 | Marfan’s syndrome | Recessive sex-linked (b) High risk (c) Primary (d) Secondary 107. Raju is 30 years of age. He has been working in the ceramic and pottery industry for the last 10 years. Which one of the following conditions should he be screened for? (a) Silicosis (0) Anthracosis (0) 37551/0815 (d) Asbestosis 108. An industrial worker was brought to a medical facility due to health problems. On his workup including laboratory tests, a finding of basophilic stippling of Red Blood Cells (RBC) was observed. Which among the following is he/she likely to be having? (a) Asbestosis (0) Farmer’s lung (c) Lead poisoning (व) Brucellosis KCSP-B-SGOP/77A 24 How many of the pairs given above are correctly matched? (a) None of the pairs (b) Only one of the pairs (c) Only two of the pairs (व) All the three pairs 110. Consider the following statements : Statement I : Signs of thalassemia major usually develop after 6 months of age. Statement II : This is the time when haemoglobin synthesis switches from haemo- globin F to haemoglobin A. Which one of the following is correct in respect of the above statements? (a) Both Statement I and Statement II are correct and Statement II is the correct explanation of Statement I (b) Both Statement I and Statement II are correct but Statement II is not the correct explanation of Statement I (જ Statement I 15 correct’ but Statement II is incorrect (व्‌) Statement 1 15 incorrect but Statement II is correct 111. Which of the following publications Which one of the following best is/are brought out by the World Health represents the correct sequence of Organization? phases in a normal nuclear family? 1 GD. Alert (૭ 1 -> 2 -> 3 ->4 (0) 4 -> 3 -> 1 -> 2 2. Morbidity and Mortality Weekly Report છિ 13435352 3. Weekly Epidemiological Record (व) 4 -> 1 -> 2 -> 3 Select the correct answer using the code given below. 113. Which among the following are characteristics of health education, rather than propaganda? (a) 2 only 1. Knowledge actively acquired, rather [છિ 1 end 2 than instilled 2. Appeals to emotion, rather than ie has reason ૩. Behaviour centred, rather than (૭ 308 information centred only 4. Arouses and stimulates primitive desires, rather than disciplines them 112. As per the basic model of a nuclear family life cycle, consider the following Select the correct answer using the code phases : given below. 1. Contraction (a) 1 and 2 2. Dissolution (b) 1 and 3 3. Extension (0 2 and 3 4. Formation (0 3 and 4 KCSP-B-SGOP/77A 25 2.9. 114. Consider the following statements regarding LNG-20 (Mirena) : 1. It is a T-shaped IUD filled with natural hormone progesterone. 2. It is associated with a low preg- nancy rate (2 per 1000 women). 3. 1115 associated with a large number of ectopic pregnancies. 4. It is associated with lower menstrual blood loss as compared to copper IUDs. Which of the statements given above is/are correct? (a) 2 only (b) 2 and 4 only (c) 1, 3 ఇండ 4 (0) 2, 3 and 4 115. The most common cause of maternal mortality in India is (a) obstetric haemorrhage (b) obstructed labour (c) unsafe abortion (0) toxaemia of pregnancy KCSP-B-SGOP/77A 26 116. In the ‘National Malaria Control Programme, Indoor Residual Spray (IRS) is the primary method of vector control in rural setting. Which one of the following is the ‘insecticide of choice’? (a) (৮) (6) (0) DDT Malathion Synthetic pyrethroid Temephos 117. Consider the following statements with regard to selection of Accredited Social Health Activist (ASHA) under NRHM : 1. ASHA must be a woman preferably in the age group of 18 to 25 years. ASHA must have had formal education up to at least class ten. ASHA must be a resident of the village. ASHA may be a married, widowed or divorced woman. Which of the statements given above are correct with regard to process of selection of ASHA? (a) (b) (c) (0) 1 and 2 only 2 and 3 only 3 and 4 only 1, 2, 3 and 4 118. Consider the following statements How many of the pairs given above are regarding the Central Drugs Standard correctly matched? Control Organization (CDSCO) in India : ± (a) None of the pairs 1. 7116 CDSCO is headed by the Drugs Controller General (India) at the (b) Only one pair Centre. (c) Only two pairs 2. The CDSCO is a part of the Directorate of Director General of (4 All the three pairs Health Services. 3. The CDSCO is under the Ministry of Chemicals ఇండ Fertilizers, 120. The table below shows the results of Government of India. ELISA test for HIV infection : 4. The CDSCO has a network of ae True infection status several port offices for monitoring the import and export of drugs. Infected Noninfected Which of the statements given above are | Positive | 4900 950 correct? ೫0000 ૭૦/૪૯ | 100 | 00 94050 ભૂ રા ಇಗ Total 5000 95000 ഭു 1 and 3 ര 1, 2 and 4 Consider the following statements : (व) 2 and 4 only 1. The sensitivity is 98%. 2. The specificity is 99%. 119. The National AIDS Control Organization provides prepacked colour-coded STI/RTI kits as a free supply to its designated STI/RTI clinics. Consider the following pairs : Which of the statements given above is/are correct? (a) 1 only Pair No. | Colour codes | STI/RTI conditions 1 [Red Urethral discharge छ) 2 only 2 Green Vaginitis (c) Both 1 and 2 3 Whit Inguinal bubo 5 ಹತ್ರಾ (0 Neither 1 nor 2 KCSP-B-SGOP/77A 27 10. ୦. KCSP-B-SGOP/77A SPACE FOR ROUGH WORK 28 SPACE FOR ROUGH WORK KCSP-B-SGOP/77A 29 1௦ SPACE FOR ROUGH WORK KCSP-B-SGOP/77A 30 KCSP-B-SGOP/77A SPACE FOR ROUGH WORK * # ਕੀ 31 SB24—73536