QP-CMSE-26-SrgryGynaeObstPvntSclMdcnPaper-II-03082026

Combined Medical Services Examination, 2026 DO NOT OPEN THIS TEST BOOKLET UNTIL YOU ARE TOLD TO DO SO T.B.C. : NTDC-T-GSPO Test Booklet Series Serial No. 1105441 TEST BOOKLET Paper—II ( Surgery, Gynaecology & Obstetrics, Preventive & Social Medicine ) Time Allowed : Two Hours Maximum Marks : 250 * You have to enter your Roll Number on the Test Booklet in INSTRUCTIONS * 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. 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. the Box provided alongside. DO NOT write anything else on the Test Booklet. * 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. * You have to mark all your responses ONLY on the separate Answer Sheet provided. See directions in the Answer Sheet. „ All items carry equal marks. - 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. . 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. „ 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. (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 EE A 50-year-old destitute is brought to the emergency with a foul-smelling wound on his left foot. On examination, the wound is seen to have maggots with a lot of necrotic tissue. What is the class of this wound according to the CDC wound classification? (a) Class 1 (b) Class 2 (c) Class 3 (d) Class 4 2. Which one of the following is not a wound prone to the development of tetanus? (a) Compound fracture of tibia (b) Wound on forearm contaminated with soil (c) Donor site of a split-thickness skin graft (d) Dog bite over abdominal wall 3. All of the following are features of a major surgical site infection (SSI), except (0) significant amount of pus (b) delayed return home (c) excessive pain at the surgical site (d) patients being systemically ill NTDC-T-GSPO/83-A 4. An infant is brought to the clinic by the parents with the history of a swelling in the neck since birth. On examination, the swelling is found to be soft, partially compressible and brilliantly trans- illuminant. The most likely diagnosis is (a) sternomastoid tumour (b) branchial cyst (6) thyroglossal cyst (d) cystic hygroma 5. Which one of the following statements regarding inherited cancer syndromes is not correct? (a) Pituitary tumours are seen in MEN type 1. (b) Brain tumours. ஊக ୫୦୦୮ in Li-Fraumeni syndrome. (c) Breast cancer is seen in FAP syndrome. (d) Prostate cancer is seen in familial breast cancer syndrome. 6. Which of the following are the causes of secondary lymphoedema? 1. Trauma 2. Deep venous thrombosis 3. Fungal infection 4. Viral infection Select the correct answer using the code given below. (@) 11) 2 ఉండ 3 (b) 1, 2 and 4 (౧ 1, 3 and 4 (0 2, 3 and 4 217 The classical presentation of an acute 9. A patient is undergoing a surgery for embolic occlusion in a limb includes all removal of a benign tumour from of the following, except the parotid gland. Which one of the following structures should be (a) pain preserved during this surgery? (b) purple discoloration (a) Facial artery 15 அளகு (b) Auriculotemporal nerve (d) pulselessness (9) Zygomatic artery (घ) Facial nerve 8. The typical ulcer as shown in the following diagram is seen in 10. A 52-year-old carpenter presents with the history of a persistent non-healing ulcer on his lower alveolus. He is a smoker for last 30 years and also chews tobacco. What is the next most appropriate step in the management? (a) X-ray mandible (മ) syphilis (b) Edge biopsy of ulcer (b) squamous cell carcinoma (c) Local gum paint (c) tuberculosis (astringent + analgesic) (৫) basal cell carcinoma (৭) Systemic antibiotics NTDC-T-GSPO/83-A 3 [ P.T.O. 2 A 40-year-old female presents with symptoms of heat intolerance, excessive sweating and weight loss since 10-12 months. After clinical examination, the surgeon orders an investigation which is as shown in the image. The scan shown below is a/an 13. A 45-year-old lady presents with a hard lump in the left breast. On examination, the lump is found to be 4 ୦୮୮ × 6 ୦୮୮ in size, not fixed to the skin, but fixed to the underlying pectoralis major muscle. The T stage of this is (a) cT4a یہ )0( (જ ୯୮4୨ (५) cT2 (a) MRI scan (૪) non-contrast CT scan 14. Which one of the following statements ത്സ regarding choledochal cyst is not correct? (d) PET scan (a) Choledochal cysts are congenital dilatations of intra- and/or extra- ५ hepatic biliary system. 12. A 29-year-old lady presents with a history of discharge from the nipple of the left breast since 1 month duration. (b) Majority of patients are diagnosed Which one of the following is not warranted in the initial assessment of this patient? after 10 years of age. (c) It is associated with an increased (a) Clinical examination risk of developing cholangio- (৮) Histo/Cytopathology carcinoma. M ங்‌: 9 ‏چھ یت‎ (97 Radical excision of the cyst is the (व) Ultrasonography treatment of choice. NTDC-T-GSPO/83-A 4 15. Which one of the following is the most 17. Which one of the following statements common benign liver lesion? regarding peptic ulceration is not କ୍ଷ (a) Hepatic adenoma (a) Most peptic ulcers are caused by Helicobacter pylori or NSAIDs. (b) Hemangioma (b) Gastric ulcers are more common than duodenal ulcers. (c) Focal nodular hyperplasia (c) Gastric ulcers may be malignant. (0) Simple liver cyst (97 Gastric antisecretory agents and H. pylori eradication therapy are the mainstays of treatment. 16. The line diagram shows the cross- section of bowel intussusception. The 18. A trainee surgeon is performing his/her part marked with an asterisk is called first cholecystectomy. The area marked as with an asterisk in the diagram represents ಹಾ ಬ )* dag ‏کے‎ (a) apex (a) Rouviere’s area (0) intussusceptum (0) Bismuth’s triangle (0. 10635 (07 Calot’s triangle (व्‌) intussuscipiens (0) area of Lund NTDC-T-GSPO/83-A 5 1 ೫.1.0. Fe The manoeuvre (marked with an asterisk) shown in the following image is (a) Mattox (b) Kocher (£) Shoe-shine (व) Pringle 20. Which of the following are the common complications after splenectomy? 1. Pancreatic fistula 2. Thrombocytopenia 3. Opportunistic infection 4 Left basal atelectasis Select the correct 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 NTDC-T-GSPO/83-A 21. ^ 42-year-old lady underwent ৪ laparoscopic cholecystectomy, which was uneventful other than some spillage of bile and gallstones during dissection. Postoperatively the patient was fine but she started complaining of right shoulder. tip pain and developed high grade fever on the 3rd postoperative day. Her pulse was found to be 110/min and RR 20/min. The most likely diagnosis is (a) ascending cholangitis (b) liver abscess (c) right subdiaphragmatic abscess (0) DVT and pulmonary embolism 22. A 40-year-old male patient has undergone a surgical procedure for a swelling in his left groin. The image of the procedure is as shown. What procedure has been performed? (a) Shouldice repair (0) Lichtenstein’s repair (જ Bassini’s repair (0) Desarda’s repair 23. A patient of blunt trauma to the abdomen 25. The principle of adaptation shown in the is being explored in the emergency. following diagram is explained by Intraoperatively a non-expanding ৬০ is 5661 lifting the descending colon. What 15 the appropriate management of 10195 patient? © कन बी गा (a) Haematoma to be explored, nothing ५ च | ‏وق و جا‎ চি 1 (a) Moynihan’s aphorism (2) Goodsall’s rule (b) Haematoma to be explored, the colon to be resected (9 Monro-Kellie doctrine (4 Cushing’s law (c) Haematoma not to be explored, nothing to be done to the colon 26. Astrocytomas are associated with all of (व) Haematoma not to be explored, the the following syndromes, except colon to be resected (a) neurofibromatosis type 1 (0) neurofibromatosis type 2 (c) Cowden’s disease 24. The clinical condition shown in the image is (d) Li-Fraumeni syndrome 27. The procedure shown in the following images is (a) malrotated kidney : (a) elective tracheostomy (8) malascended kidney (b) emergency tracheostomy (c) doughnut kidney (c) emergency cricothyroidotomy (0) horseshoe kidney (d) percutaneous tracheostomy NTDC-T-GSPO/83-A 7 ۲۶۳0 re Consider the following statements 31. The maximum dose of Lidocaine (without regarding flail chest : adrenaline) for local anaesthesia is 1. Three or more ribs are fractured at (a) 2 mg/kg two or more places. 3 ೫೧8/3: 2. The chest wall shows paradoxical (୬ 85/18 motion. (c) 4 mg/kg 3. An X-ray chest AP view is the gold (d) 6 mg/kg standard for diagnosis. 4. Treatment involves oxygen support, ગાયા ઝલ 32. A young lady is brought to emergency department following stab injury to right chest. She is gasping for breath, with tachypnoea, distended neck veins and tracheal shift to left on examination. ( 1, 2 and 3 There is hyperresonance and absent (b) 1, 2 and 4 breath sounds on right hemithorax. The most probable diagnosis is Which of the statements given above are correct? (c) 1,3 and 4 ‎and 4 (a) right simple pneumothorax‏ 3 ,2 رم ‎an‏ 3 , ‎(b) right tension pneumothorax ‎29. All of the following are causes of (© cardiac tamponade secondary osteoarthritis of the hip, ‎except (0) right hydropneumothorax ‎(a) trauma ‎(b) diabetes 33. A 25-year-old motorcycle rider is brought to the emergency with history of motor vehicle accident. On primary survey, he (व) avascular necrosis is found to open eyes in response to pain, speaking inappropriate words and localizes pain. His Glasgow Coma Scale 30. All of the following are causes of acute score is red eye, except ‎(જ Perthes’ disease ‎(a) 3 ۷۸ 174 (6) keratitis (0) ஈட V3 Ms ‎© 83 V3 ‏ولا‎ ‎(¢) retinitis (0) ০৮150161105 ‎(d) uveitis (0) 82 V4 Ms ‎NTDC-T-GSPO/83-A 8 44 The type of fracture marked with arrow 36. Which one of the following imaging heads in the following figure is modalities imparts the highest dose of ionizing radiation to the patient? (a) Ultrasound (b) Chest X-ray (c) Screening mammography (व) CT head and neck 37. Which of the following parameters are assessed during preoperative airway assessment for a surgical patient? 1. Mouth opening 2. Ability to protrude the jaw 3. Thyromental distance 4. Cervicomental distance Select the correct answer using the code (a) Le Fort IV given below. (b) Le Fort 11 ര Le Fort ‏تا‎ જિ; સ ગા ¥ (0) Le Fort I છિ) 1, 3 and 4 (c) 2, 3 and 4 7 | 1 ৰঃ (0) 1, 2 and 4 35. Which of the following are the important parameters to be maintained in a patient with head trauma? 38. The type of suture technique shown in 1. MAP 70-80 mm Hg the following diagram is (mean arterial pressure) > Intracranial pressure < 20 mm Hg ६9 Cerebral perfusion pressure > 60 mm Hg 4. प > 140 mEq/L Select the correct answer using the code given below. (a) 1, 2 and 3 (૭) simple interrupted (b) 1, 2 and 4 (b) mattress (c) 1, 3 and 4 (c) Connell (व) 2, 3 and 4 (4 Donati NTDC-T-GSPO/83-A 9 ۲۶:3۰0: 39. Which of = following gastrointestinal secretions normally do not contain bicarbonate? 1. Stomach 2. Saliva 3. Duodenal 4. Tleal Select the correct answer using the code given below. (a) 1, 2 and3 (b) 1 and 3 only (c) 1,3 and 4 (d) 2 and 4 40. A 25-year-old motorcycle rider is brought to the emergency with history of motor vehicle accident. On examination, the patient is tachycardic (pulse 110/min) with a BP of 90 systolic. He has an open wound in the thigh with an estimated blood loss of 1000 mL. What is the severity of haemorrhagic shock this patient is suffering from? (a) Class 1 (b) Class 2 (c) Class 3 (0) Class 4 NTDC-T-GSPO/83-A 41. Which one of the following sets of 42. Consider 10 vaccines is contraindicated in pregnancy? (a) Pneumococcal, Hepatitis B, HPV (b) Rabies, Influenza, Hepatitis A (c) Varicella, Measles, Rubella (0 Diphtheria, Influenza, Pneumo- coccal the following statements regarding chorionic villus sampling (CVS) used for prenatal diagnosis : 1. It is done between 15 to 20 weeks of gestation. 2. Amniotic fluid studies give earlier diagnosis of prenatal genetic conditions than chorionic villus sampling. 3. Limb reduction deformity is low when CVS is performed after 9 completed weeks of gestation. 4. Inj. Anti-D 50 microgram should be administered following this procedure in ലാ Rh-negative mother. Which of the statements given above are correct? (a) 2 and 4 (b) 1, 2 and 3 (@ 1, 3 and 4 (च्‌) 3 and 4 only বিষ As per the WHO recommendations, all of the following may be given for active management of third stage of labour, except (a) Inj. Oxytocin (b) Inj. Methergine (c) Tab. Misoprostol (व्‌) Inj. Carboprost 44. Consider the following statements regarding the cause for onset of labour : Statement 1 : Alteration in estrogen-progesterone ratio results in prostaglandin synthesis and onset of labour. Statement 2 : Decreased fetal production of dehydroepiandrosterone sulfate (DHEA-S) and cortisol inhibits the conversion of fetal pregnenolone to progesterone. Which one of the following is correct with respect to the above statements? (a) Both Statements 1 and 2 are true and Statement 2 is the correct explanation of Statement 1 (b) Both Statements 1 and 2 are true but Statement 2 is not the correct explanation of Statement 1 (c) Statement 1 is 115 but Statement 2 is false (૦) Statement 1 15 181856 but Statement 2 is true NTDC-T-GSPO/83-A 11 45. Consider the following statements regarding the WHO Labour Care Guide for labour monitoring : 1. Active phase starts from 5cm of cervical dilatation. 2. There is fixed rate for dilatation for every hour of labour in active phase. 3. There are no alert or action lines on the partograph. 4. There is a separate section for intensive monitoring for second stage of labour as well. Which of the statements given above are correct? (a) 1, 2 and 4 (b) 1, 3 and 4 (c) 2,3 and 4 (0 1, 2 and 3 46. Which of the following are positive indicators for breech vaginal delivery? (a) Fetal weight less than 1:5 kg, flexed fetal head, frank breech (b) Frank breech, fetal weight more than 3:5 kg, gestational age more than 34 weeks (c) Frank breech, fetal weight 1:5 kg to 3-5 kg, gestational age more than 34 weeks (व) Flexed breech, fetal weight 1:5 kg to 3-5 kg, gestational age more than 34 weeks (2.1.౦. চু Which one of the following correctly defines puerperal pyrexia? (a) Rise in maternal oral temperature of 100-4 °F or more 24 hours apart within first 10 days of delivery (b) Rise in maternal oral temperature of 101:4 °F or more 24 hours apart within first 10 days of delivery (c) Rise in maternal oral temperature of 100:4 °F or more 24 hours apart within first 7 days of delivery (0) Rise in maternal oral temperature of 101-4 °F or more 24 hours apart within first 7 days of delivery 48. A mother presents on day 8 of normal vaginal delivery with painful left breast, fever with chills. On examination, her left breast is tender and red with raised local temperature. What should be the line of management? (a) Analgesics and antibiotics, plenty of fluids, breastfeeding continued from right breast (b) Hot fomentation, analgesics, restricted fluids, avoid breast- feeding from either breast (c) Antibiotics, incision and drainage, avoid breastfeeding from either breast (৫) Antibiotics, analgesics, restricted fluids, breastfeeding continued from right breast NTDC-T-GSPO/83-A 12 49. Consider the following abnormalities in a woman with preeclampsia : 1. Platelet count less than 1 lakh/ cumm 2. Serum creatinine > 1:1 mg/dL 3. Pulmonary edema 4. Proteinuria > 1 g per day Which of the above describe severe features of preeclampsia? (a) 1, 2 and 3 (b) 1, 2 and 4 (© 2, 3 and 4 (0) 1, 3 and4 50. Which one of the following parameters precisely defines grade 3 abruptio placentae? (a) Moderate vaginal bleeding (b) Maternal tachycardia (c) Low fibrinogen level (व्‌) Intrauterine fetal death 51. A primigravida comes to antenatal clinic for a routine antenatal visit. When should she be screened for diabetes in e (a) At 24 to 28 weeks of pregnancy and/or repeat at 30 to 32 weeks of pregnancy (b) Early in pregnancy and/or repeat at 24 to 28 weeks of pregnancy (c) Early in pregnancy and/or repeat at 30 to 32 weeks of pregnancy (0) At 9 to 11 weeks of pregnancy and/or repeat at 30 to 32 weeks of pregnancy 52. A primigravida comes to antenatal clinic at 6 weeks of pregnancy and mentions that she is a known case of epilepsy and 15 taking antiepileptic drug tablet Valproate since two years. What will be your next step regarding her medication? (a) Continue Valproate, increase the dose and explain her risk of teratogenicity (b) Stop Valproate and start her on Levetiracetam (c) Stop Valproate and start her on Phenytoin (0) Put her on polytherapy as one drug might not be effective 53. The next step to follow for a mother with Rh-negative pregnancy and antibody titre above critical level (husband Rh- positive) is (a) umbilical artery Doppler (8) cordocentesis (c) MCA PSV (व) amniocentesis NTDC-T-GSPO/83-A 13 54. Match List-I with 1451-11 and select the correct answer using the code given below the Lists : List-I 7456-77 (Description of condition (Type of in early pregnancy) abortion) A. Increased vaginal 1. Missed bleeding, aggravated abortion pelvic pain and dilated internal os 18. Brownish vaginal 2. Inevitable discharge and absent abortion fetal heart on ultra- sound at 11 weeks C. Decreased or absent 3. Threatened vaginal bleeding, abortion pelvic pain subsides and closed internal os D. Slight bleeding per 4. Complete vaginum, mild pelvic abortion pain and fetal heart present ୦୮ ultra- sound Code : (a) A B € D 2 4 1 8 (b) A B (৫ D 3 1 4 2 (0). A B ۳6 D 2 1 4 3 (0 A B @ D 3 4 ] 2 1.1.0. 55. 31 fetal growth restriction is 58. Match List-I with List-II and select the diagnosed before correct answer using the code given (a) 28 weeks of gestation below the Lists : (b) 30 weeks of gestation ۹ న : List-I 14541 (c) 32 weeks of gestation ்‌ ५ గ (Embryonic ۰ (Developed organ/ (୩) 34 weeks of gestation structure) structure in female) ‘ ৰ: A. Gubernaculum 1. Clitoris 56. Consider the following statements regarding vaginal epithelium in adult B. Genital tubercle 2. Uterus પ ક C. Mesonephric duct 3. Round ligament 1. From puberty till menopause, the ்‌ vaginal epithelium is devoid of any ౨. Paramesonephric 4. Urethra gland. duct 2. The basal epithelial layer contains Code : glycogen. 3. Intermediate and superficial cells (a) A B ८ D become continuous with those 2 1 4 3 covering vaginal portion of cervix. (b) A B 6 D 4. Unlike skin, it does not contain 2 4 1 3 hair follicle. (જ A B ০ D Which of the statements given above are 3 1 4 2 correct? (0) A B CD (a) 1, 3 and 4 3 4 1 2 (8) 1, 2 and 4 (0 2, 3 and 4 59. When does the secondary oocyte (0 1, 2 and 3 complete the second meiotic division? 57. Which one of the following statements is (a) Just before ovulation true regarding neurovascular anatomy (b) Just after ovulation of the uterus? 1151529 (a) The uterine artery arises from the রে had anterior division of the external (0) Just after fertilization iliac artery. (b) The uterine artery crosses the 60. The growth and _ differentiation of ureter 3:5 cm lateral to the internal primordial follicles is under the control os. of which hormone? (c) The venous channels of the uterus (a) LH drain into the internal iliac veins. ര (0) The somatic distribution of the 6059 uterine pain is the area of the (c) Growth hormone abdomen supplied by 75 and 16. (0) Progesterone NTDC-T-GSPO/83-A 14 न Consider the following statements with respect to endometrial cycle : 1. The basal zone is uninfluenced by any hormone. 2. Saw-toothed glandular epithelium is seen in secretory phase. 3. Stratum compactum contains mainly the glands and less stroma. 4. Pseudostratification is seen in proliferative phase of menstrual cycle. Which of the statements given above are correct? (a) 1, 3 and 4 (b) 1, 2 and 4 (જ 2, 3 and 4 (0) 1, 2 and3 62. Which one of the following statements explains self-priming of gonadotrophs? (a) Lower GnRH pulse frequencies favour FSH secretion and higher frequencies favour LH secretion. (b) Lower GnRH pulse frequencies favour LH secretion and higher frequencies favour FSH secretion. (c) Lower GnRH pulse frequencies favour LH as well as FSH secretion. (d) Higher GnRH pulse frequencies favour LH as well as FSH secretion. NTDC-T-GSPO/83-A 15 63. Consider the following diagnostic criteria for acute pelvic inflammatory disease (PID) : 1. Lower abdominal tenderness 2. Oral temperature >38 °C 3. Adnexal tenderness 4. Cervical motion tenderness Which of the above are included in the minimum criteria for diagnosis of PID? (a) (b) (6) (0) 1, 2 and 3 1, 2 and 4 1, 3 and 4 2, 3 and 4 64. Which one of the following statements is true regarding genital tuberculosis? (a) (৮) (© (0) The most common site of affection is ovary. Abdominal ostium is closed in tobacco pouch appearance. The most common mode of spread from primary to genital organs is haematogenous. Genital tuberculosis occurs in 1-29 of patients who had pulmonary tuberculosis in adolescence. 65. The drug of choice for treatment of chlamydial cervicitis is (a) (b) (0 (0) Metronidazole Ampicillin Azithromycin Secnidazole (೫.7.೦. ES Kit 6 used in syndromic management of 69. Which one of the following states the STI/RTI includes which one of the diagnostic criteria for postmolar following drug combinations? gestational trophoblastic neoplasia? (a) Cefixime, Metronidazole and (a) A rise of hCG levels of more than Doxycycline 10% for ௨3 values over 2 weeks’ time Cefixi i 6) గ ಷ್ಟ બાદા ‏ہے‎ (0) A rise of hCG levels of more than 5% for >4 values over 2 weeks’ time (c) Metronidazole, Doxycycline and (c) A rise of hCG levels of more than Fluconazole 15% for >3 values over 2 weeks’ time (0) Acyclovir, Doxycycline and Metronidazole (व्‌) A rise of hCG levels of more than 10% for >3 values over 4 weeks’ time 67. The most common site for vulvar carcinoma is 70. Consider the following regarding the ८ ક steps in Fothergill repair surgery for (0) labia minora uterine prolapse : (b) labia majora 1. Plication of Mackenrodt’s ligament in front of the cervix (c) clitoris 2. Shortening of uterosacral ligaments 7 3 ‏کو‎ mg ਮਿ 3. Plication of Mackenrodt’s ligament behind the cervix 4. Amputation of the cervix 68. Point A in radiotherapy in carcinoma cervix marks the site for which of the Which of the above steps form a part of following structures? steps in Fothergill repair surgery for uterine prolapse? (a) Obturator nodes (b) Inguinal nodes (a) 2 and 4 (c) Crossing of ureter by uterine artery ரகம்‌ வள்‌ (c) 1 and 2 (d) Crossing of ureter by descending cervical artery (0) 3 and 4 NTDC-T-GSPO/83-A 16 71. Consider the following surgical methods : 1. Haultain’s method 2. Gilliam’s operation 3. Spinelli’s operation 4. Cutting anterior cervical ring Which of the methods given above may be used for surgical management of EE uterine inversion? (a) 1, 2 and 3 (b) 2, 3 and 4 (જ 1, 3 and 4 (0) 1, 2 and 4 72. If 100 couples have used a method for a period of 2 years and have resulted in 10 pregnancies, what will be the effectiveness of the method used? (a) High (b) Moderate (c) Low (d) Cannot be commented 73. In postpartum period, the intrauterine device may be inserted in the woman (a) up to 72 hours of delivery (b) up to 48 hours of delivery (c) up to 36 hours of delivery (0) up to 24 hours of delivery NTDC-T-GSPO/83-A 17 74. Consider the following conditions in a woman of reproductive age group : 1. Diabetes with retinopathy 2. Age 36 years, non-smoker 3. Liver adenoma 4. History of stroke Which of the above are absolute contraindications for using combined oral contraceptive pills? (a) 1, 2 and 3 (b) 2, 3 and 4 (c) 1, 3 and 4 (0 1, 2 and 4 75. Which of the following statements regarding progesterone-only pills are correct? 1. They contain high-dose proges- terone as there is no estrogen component. 2. They do not have ‘on and off regimen. 3. They can be used with hepatic enzyme inducing drugs. 4. The failure rate is 03 to 2 per hundred women-years of use. Select the answer using the code given below. (a) 2 and 4 (b) 1 and 3 (c) 1 and 4 (৫) 2 and 3 (2.1.0. £ Which of the 76. After undergoing vasectomy, how many ejaculations and months are required for a man to become sterile? (a) 30 ejaculations and 2 months (b) 20 ejaculations and 2 months (c) 20 ejaculations and 3 months (d) 30 ejaculations and 3 months following regarding lactational method are correct? statements amenorrhea 1. It 18 - equally: ৬ effective 10 amenorrheic as well as menstruating woman if the woman is exclusively breastfeeding. 2. The risk of pregnancy’ in amenorrheic woman who 15 exclusively breastfeeding is less than 2% in the first 6 months. 3. It requires exclusive breastfeeding for 6 months. 4. The failure rate for exclusively breastfeeding and menstruating women is 15-20%. Select the answer using the code given below. (a) 2 and 4 (b) 2 and 3 (8 3 and 4 (व) 1 and 4 NTDC-T-GSPO/83-A 78. 79. Laparoscopic tubal sterilization can be done after (a) 48 hours of delivery (b) 7 days of delivery (c) 2 weeks of delivery (d) 6 weeks of delivery According to the Medical Termination of Pregnancy (Amendment) Act, 2021, MTP for pregnancy between 20 to 24 weeks needs opinion of (a) one registered medical practitioner (b) two registered medical practitioners (c) one registered medical practitioner and court order (0) two registered medical practitioners and court order 80. The combi-pack approved by the DGHS for medical method of MTP in the first trimester comprises of which one of the following combinations? (a) 200mg Mifepristone and 800% Misoprostol (b) 100mg Mifepristone and 400 பத Misoprostol (જી 400mg Mifepristone and 80018 Misoprostol (0) 200mg Mifepristone and 600 pg Misoprostol NTDC-T-GSPO/83-A 81. In the history of public health, as a part of modern medicine, the following four distinct phases can be demarcated : 1. ‘Health for All’ phase 2. Health promotional phase 3. Disease control phase 4. Social engineering phase Which one of the following 3 the correct sequence of the phases in chronological order (from the oldest to the newest)? (1) ` 1. ~> 3--> 2 -> 4 0) 2 -> 4 -> 1 -> 3 (0) 3 -> 2 -> 4 -> 1 (0 4 -> 1 -> 3 ->2 82. A person meets with an accident and 85 8. result of which, the person loses his/her right arm, because of which the person is not able to drive the car to reach his/her office, and has to hire a driver for the same. The given condition of the person is most appropriately classified as (a) impairment (b) disease (c) disability (0) handicap 83. As per ‘the 2030 Agenda for Sustainable Development’, the target ‘3-4’ refers to which one of the following? (a) By 2030, reduce the _ global maternal mortality ratio to less than 70 per 100000 live births (b) By 2020, halve the number of global deaths and injuries from road traffic accidents બિ ಈ ~ 2030; reduce 9) 0 premature mortality from non- communicable diseases through prevention and treatment, and promote mental health and well-being (च्‌) Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol 84. In a given set of conditions, a screening test has 90% sensitivity and 90% specificity for screening a particular disease. The prevalence of the disease at the given time in that population is 10%. Which one of the following statements regarding positive predictive value of the test is correct? (a) The positive predictive value is 90%. (b) The positive predictive value is 70%. (c) The positive predictive value is 60%. (0) The positive predictive value is 50%. ஸ்‌ In a historical study, the death rate among heavy smokers was 224 per 1 lakh person-years while among non-smokers was 10 per 1 lakh person-years. The death rate in the general population was 74 per 1 lakh person-years. Which one among the following best represents the attributable risk of smoking णि mortality in the given scenario? (2) 22:4% (b) 865% (੦) 95-5% 8) ௭0% 86. The changes that the malarial parasite undergoes in the mosquito represent which one of the following types of biological transmission? (a) Propagative (b) Developmental (c) Cyclopropagative (व) Cyclodevelopmental NTDC-T-GSPO/83-A 20 87. In a given population of 10000, there were 30 cases of diabetes already present on 01/01/2025 and in the year 2025, 400 more cases developed diabetes. But 10 cases of diabetes died in the year 2025, i.e., before 31/12/2025. Which one of the following statements is correct regarding the disease situation? (a) The incidence of diabetes in the population is 42/1000. (b) The point prevalence of diabetes on 31/12/2025 was 43/1000. (c) The period prevalence of diabetes in 2025 was 43/1000. (4% The prevalence of diabetes in 2025 was 44/1000. 88. The parameter which provides an estimate of the amount by which the disease under study can be reduced in a population, if the suspected factor is eliminated from that population, is called (a) relative risk (b) attributable risk (c) population attributable risk (97 risk difference =e Which of the _ following correctly represent ‘late expanding’, i.e., the third stage in the ‘demographic cycle’? (a) High birthrates and high death rates (b) Decline in death rates and decline in birthrates (c) Decline in death rates and rising birthrates (d) Low death rates and low birthrates 90. Which one of the following statements regarding sample registration system is not correct? (a) It is a dual record system. (b) It is a continuous enumeration by local enumerators and an independent survey every year by an investigator-supervisor. (c) It covers the entire country. (व्‌) It has facilitated more reliable estimates of births and deaths even at State level. NTDC-T-GSPO/83-A 21 91. Which one of the following fertility- related statistics most appropriately gives the approximate magnitude of ‘completed family size’? (a) Total Fertility Rate (TFR) (b) Total Marital Fertility Rate (TMFR) (c) Net Reproduction Rate (NRR) (d) Age-Specific Fertility Rate (ASFR) 92. A person had undergone the serology for suspected hepatitis B infection. His/Her serology shows the presence of HBs antigen and also IgG anti-HBc along with the presence of anti-HBe, while HBe antigen is negative. Which one of the following diagnoses is the correct interpretation of the serology results? (a) Active hepatitis B infection (b) Chronic hepatitis B infection with active viral replication (c) Chronic hepatitis B infection with low viral replication (व) Recovery/Vaccination from hepatitis B 93. Inoculation rate’, an important vector index for malaria survey, is correctly defined as (a) average number of anopheline bites per day per person (b) percentage of female anophelines with sporozoites in their salivary glands (જી man-biting rate multiplied by infective sporozoite rate (0) proportion of freshly fed female anophelines whose stomach contains human blood (೫.7.೦. চু A 2 receives a telephonic call from the mother of an 8-year-old boy, who informs that the boy has just been bitten by a monkey. The child was playing with his friends when a group of monkeys appeared nearby. Some of the children shouted and threw sticks and stones at the monkeys, who became angry and aggressive. One of the monkeys bit the lady’s son in the forearm and blood is visible over the wound. The nearest health facility is 3 kilometers away. Consider the following statements regarding how the doctor should respond : 1. Advise the mother to rush with the child to the health facility without waiting for anything. 2. Advise the mother to first thoroughly wash the wound with plenty of soap and running water for at least 15 minutes, and then seek treatment. 3. Advise the mother that the animal bite is category I and risk is very low, as the bite was provoked. 4. Advise the mother 10 seek treatment for the boy’s wound but the boy requires no treatment or prophylaxis for rabies as it is a monkey bite. Which of the statements given above is/are correct? (a) 1 only (b) 2 only (c) 1 and 3 (व). 2 and 4 NTDC-T-GSPO/83-A 22 95. Horrocks’ apparatus was used to find out the dose of bleaching powder required to disinfect the water in a well. The 3rd cup in the Horrocks’ apparatus showed the distinct blue colour. How much bleaching powder (good quality) will be required to disinfect the well, for every 455 liters of water?” (a) 3 grams (b) 12 grams (c) 9 grams (व्‌) 6 grams 96. To be effective, the size of the openings in the mosquito net should not exceed (a) 00475 inch in diameter (0) 0:00475 inch in diameter (८ 00475 centimeter in diameter (व) 0:00475 centimeter in diameter 97. As per the WHO expert group, the cutoff point of haemoglobin in venous blood ` for the diagnosis of anaemia in adult males is (a) 12 8/ वा. (0) 13 g/dL (0 11 g/dL (0 14 g/dL 98. A 12-year-old boy presented to a health centre in Telangana Ps with his parents, with complaints of recurrent diarrhea, and skin changes on areas of the body exposed to sunlight. There is a history of progressive disorientation and increasing irritability. The child and his family ate sorghum cereal, there was very little consumption of milk and no consumption of foods of animal origin like meat, though the family is not strictly vegetarian by food habit. Consider the following plans of action : 1. Absolute avoidance of milk in the child’s diet 2. Encouraging shift of cereal consumption from sorghum 10 maize 3. Encouraging consumption of meat in the child’s diet, if the family can afford ত 4. Supplementation with nicotinic acid or nicotinamide Which of the plans of action given above are correct? (a) 1 and 2 only (b) 3 and 4 only (c) 1, 2 and 3 (च) 2,3 and 4 NTDC-T-GSPO/83-A 99. As per the National Blindness and Visual Impairment Survey India (2015-2019), which one of the following is the most common cause of blindness in India? (a) Glaucoma (b) Diabetic retinopathy (c) Refractive error (untreated) (व्‌) Cataract (untreated) 100. Which one of the following most appropriately describes the ‘tracking’ phenomenon of blood pressure? (a) Continuous monitoring of blood pressure on any individual to keep a track of blood pressure for early diagnosis of hypertension (b) Persistence of rank order of blood pressure in individuals as they grow older (c) Keeping a track of the prevalence of hypertension in a community (0) Tracking of twins for change in blood pressure to see the effect of genetic makeup (2.1.0. 101. An ‏3ے‎ is weighing 80 kg and having a height of 16 meters. Under which category does the individual fall as per the WHO classification of BMI? (a) Normal (0) Pre-obese (c) Obese class I (d) Obese class II 102. A 42-year-old male industrial worker presented to a health centre with complaints of diminished working capacity, and debilitating respiratory complaints including chronic irritant cough, severe dyspnea on exertion and occasional pain in chest. He gave an occupational history of working in the same industry since the onset of adulthood till date. An X-ray of the chest showed ‘snowstorm’ appearance in the lung fields. High resolution radiographic imaging showed dense nodular fibrosis in the lungs. Which one of the following is the most likely diagnosis for this case? (a) Asbestosis (0) Bagassosis (0) Byssinosis (৫) Silicosis NTDC-T-GSPO/83-A 24 103. ‘Leukemia’, as an occupational cancer, is most commonly related to the exposure to which one of the following industrial chemicals? ( Mineral oil (૭) Auramine (© Beta-naphthylamine (0) Benzol 104. Which one of the following statements regarding sex chromosomes in the human body is correct? (a) Chromosome X is included in Group ୦ ୦୮ the autosomal chromosomes. (b) Chromosome Y is included in Group છે ୦୮ the autosomal chromosomes. (c) Chromosome X is included in Group G of the autosomal chromosomes. (0) Chromosome Y is included in Group F of the autosomal chromosomes. Fe Consider the following organizations of importance in the history of international health : 1. The Health Organization of the League of Nations 2. The Pan American Sanitary Bureau 3. The United Nations Relief and Rehabilitation Administration 4. The World Health Organization Which one of the following represents the correct chronological order (from the oldest to the newest) of the establishment of these organizations? (૭ 1 -> 2 -> 4 -> 3 (b 1 -> 3 -> 4 -> 2 (0 2 -> 4 -> 1 -> 3 (0 27135354 106. Which one among the following terms best fits the description “the entire gamut of preventive, therapeutic and rehabilitative services for the protection of society from antisocial, criminal or deviant conduct of man”? (a) Social delinquency (b) Social defence (c) Social pathology (৫) Social survey NTDC-T-GSPO/83-A 25 107. A 10-week-old infant was taken to a primary health centre by his/her mother for vaccination. The infant has taken all the doses as एला the recommended schedule of immunization at 6 weeks. The infant ௩7௨8 prescribed Pentavalent and Rotavirus vaccine. After 3 days of getting the vaccine, the mother reported to the PHC that the infant has suffered an episode of epilepsy. On enquiring, it was found that the infant had a history of two epileptic episodes in the week prior to immunization, 16., the 9th week. Considering the scenario, which one of the following statements is correct regarding this adverse event following immunization (AEFI)? (a) Itis vaccine product related AEFI. (b) It is immunization error related AEFI. (c) It is immunization stress related AEFI. (0) It is a coincidental event. 108. All of the following correctly represent the basic criteria for identifying ‘at risk’ infants, except (a) birth order 3 and above (b) twins (c) failure to gain weight during three successive months (व्‌) on artificial feeding [ P.T.O. Las Which of the following drugs have been used ৪৪ part of 7859 drug administration (MDA) for elimination of lymphatic filariasis in some or more districts of India? 1. Albendazole 2. Diethylcarbamazine 3. Ivermectin 4. Metronidazole Select the correct answer using the code given below. (a) 2 and 3 only (b) 1 and 4 only (c) 1, 2 and 3 (च) 1, 2 and 4 110. As per the National Framework for Malaria Elimination in India (2016-2030), which one of the following has to be achieved by the year 2027? (a) The entire country to have less than 1 case due to malaria per 1000 population at risk (b) The entire country to have less than 1 indigenous case of malaria per 1000 population at risk and less than 1 death due to malaria per 10000 population at risk (c) The entire country to have no indigenous case of malaria and less than 1 death due to malaria per 100000 population at risk (4 The entire country to have no indigenous case of malaria and no deaths due to malaria NTDC-T-GSPO/83-A 26 111. As per the Jal Jeevan Mission (JJM), the goal is to provide every rural household with a functional household tap connection that delivers at least how many liters of tap water per capita per day (1006)? (૭ 35 fey 55 () 75 (0 105 112. Which of the following vaccines are live vaccines? (a) BCG, Measles, Vaccine (IPV) (b) Measles, OPV, Yellow Fever (17D) Vaccine (c) BCG, IPV, Plague Vaccine (व) OPV, Hib Vaccine, HBV Injectable Polio Directions : Read the following case scenario and answer the two items that follow the case scenario. Your answers to these items should be based on the case scenario only. A 6-week-old infant has a history of fever for 2 days, and according to the mother, is not feeding well, taking 2-3 breastfeeds in a day. The infant has diarrhea for the last 2 days and has sunken eyes. The pus is draining from the umbilicus and the infant has a respiratory rate of 55 breaths per minute. 113. Which one of the following is correct regarding the classification of the infant as per the IMNCI guidelines? (a) Very severe disease (b) Local bacterial infection (c) No dehydration (व्‌) Severe dehydration =e What the most is/are treatment(s) for the infant? appropriate 1. Give 190 dose of intramuscular antibiotics. 2. Refer the child urgently to hospital and advise mother to continue breastfeeding. 3. Advise mother to give frequent sips of ORS on the way. 4. Teach mother to treat 10681 infection and send home with advice for a follow-up after 2 days. Select the correct answer using the code given below. (a) 1 and 2 only (b) 2 and 3 only (c) 1, 2 and 3 (0 4 Directions : Read the following case scenario and answer the five items that follow the case scenario. Your answers to these items should be based on the case scenario only. Mrs. M is a poor, migrant worker who has recently moved into a village along with her husband to work in the local brick kiln. They both will now be staying in this village for a while. The ASHA of that particular village visits her and comes to know that she has missed her last period. The last menstrual period (LMP) was on 6th January, while the ASHA visited her on 4th March of the same year. The lady has never delivered a child or had an abortion earlier. The ASHA talks to her and finds out that her age is 28 years, and measures that her height is 144 cm and weight is 52 kg. A blood test was performed and her haemoglobin was found to be 11-6 g/dL. NTDC-T-GSPO/83-A 27 115. Which one among the following test kits available under the National Health Programme can the ASHA use for the confirmation of pregnancy in this case? (a) Abha kit (b) (0) (0) Lakshya kit Nikshay kit Nischay kit 116. Once the confirmation of the pregnancy is done, consider the following statements regarding the registration of pregnancy : 1. It is to be done as soon as possible, and within 12 weeks. 2. It is to be done as soon as possible, once 12 weeks are complete. 3. It is the primary responsibility of the ASHA. 4. It is the primary responsibility of the ANM. Which of the statements given above are correct? (a) 1 and 3 (b) 2 and 4 (0 1 and 4 (0 2and3 [ P.T.O. 117. re that 8 pregnancy was confirmed, the ASHA informed Mrs. M that she should take iron and folic acid (IFA) supplementation for a minimum of X days during her pregnancy period, under the Government’s Anaemia Mukt Bharat Programme. Which one among the following best represents the X? (a) 60 (b) 100 (c) 180 (५) 240 118. From the data given in the case scenario, consider if the lady’s pregnancy would fall under a ‘high-risk’ pregnancy on account of 1. her age 2. her height and parity 3. her haemoglobin level Mrs. M’s pregnancy qualifies as a ‘high-risk’ pregnancy under which of the above parameters? (a) 1 (b) 2 4 3 (व्‌) None of the above NTDC-T-GSPO/83-A 119. Consider the following advices to be given by the ASHA to Mrs. M (assuming pregnancy 185 been _ confirmed) regarding personal hygiene measures : 1. Minimum 12 hours sleep at a stretch at night 2. Avoid resting immediately after mid-day meals 3. Avoid intake of extra fluids to avoid constipation 4. Avoid taking purgatives like castor oil to relieve constipation How many of the four advices listed above are correct? (a) One (b) Two (c) Three (च) Four 120. Although different triage systems have been used as a part of disaster response, the most common classification uses the following internationally accepted four-colour code system : 1. Black 2. Green 35 “Red 4. Yellow Which one among the following correctly represents the descending order (from the highest to the lowest) of priority for medical care and transportation to health centres? 2 جج 4 >- 3 >- 1 0( (6) 2 -> 4 -> 1 -> 3 (0 3 -> 4 -> 2 -> 1 (ಗ 3 -> 2 -> 4 -> 1 NTDC-T-GSPO/83-A | FOR ROUGH WORK ஆ FOR ROUGH WORK NTDC-T-GSPO/83-A 30 ബത്ത 1 र തത 1 FOR ROUGH WORK NTDC-T-GSPO/83-A 31 1೫:13:69, SPACE FOR ROUGH है; NTDC-T-GSPO/83-A 32 26BS—115968 ભા షం 5 ‏7یچ‎