Prepare for the UPSC CMS Examination with official questions and detailed clinical solutions across General Medicine, Paediatrics, Surgery, Gynaecology & Obstetrics, and Preventive & Social Medicine.
Marking pattern: +2.00 positive, -0.66 negative (Official UPSC CMS Scheme).
A term neonate weighing 2 kg, delivered to a primigravida mother through vaginal route and through clear liquor, is found having gasping respiratory efforts after performing the initial steps in the delivery room. The next step in resuscitation is:
A newborn delivered at 37 weeks gestation and birth weight 2.7 kg, presents at 12 h of life with bilious vomiting. On examination, RR is 36/m, HR is 110/m, CRT is < 3s, and there is abdominal distention. Abdominal radiograph reveals multiple air-fluid levels with absent distal gas pattern. The most likely etiology is:
Consider the following statements regarding the management of tracheo-esophageal fistula in neonates:
1. The baby should be nursed in prone position.
2. The neonate should be kept nil per orally and started on intravenous fluids.
3. The neonate needs continuous oral suction using a slow suction device.
4. Surgery should be planned once the neonate attains 2.5 kg weight.
Which of the statements given above are correct?
An apparently well male neonate delivered by vaginal route in hospital is discharged on day 2 of life. He is brought to the outpatient department on day 4 of life as the mother complains of pink staining of his diapers. There is no bleeding from urethra or per rectum noticed during examination, and urine dipstick test for RBCs is negative. The baby is appearing playful and active. The most likely etiology of pink staining of diapers is:
A preterm neonate is brought to the emergency and the body temperature is noted to be 32°C. Which one of the following metabolic complications is unlikely?
A 3-year-old boy is brought to the outpatient department with complaints of developmental delay. He can feed himself a biscuit, can draw a line, can climb steps, and only says bisyllables. Which one of the following developmental screening tools is not suitable for him?
An 8-year-old girl is provided a few cubes and asked to create the structure in the image provided. If she can create the Structure A, but cannot make the Structure B, her developmental quotient (DQ) in the fine motor domain is:
A. 10-cube pyramid / steps (attained milestone)
B. Advanced complex block design
Select the correct answer using the options below:
A 2-year-old boy was brought to the emergency when his mother noticed that he had developed dusky appearance and lethargy over the past 6-8 hours. The child had been prescribed some medicine for vomiting by a local practitioner. Examination revealed normal sized pupils reacting to light, GCS 9, and shallow breathing with cyanosis. Arterial blood gas revealed a PaO₂ of 80 mmHg and SpO₂ of 60%. Which one of the following drugs may be implicated?
A 12-year-old boy is brought to the emergency in an unconscious state with a history of shallow breathing and increasing drowsiness noticed for two hours. He is noticed to have a dry mouth, cold extremities, is limp and has pin point pupils. The emergency physician suspects poisoning. Which one of the following antidotes should be administered?
A neonate is noted to have bilious vomiting at 6 hours of life with abdominal distention. An X-ray is ordered (see image). The most likely diagnosis is:
A 6-year-old boy is brought with complaints of involuntary, non-rhythmic, jerky movements of upper limbs and snorting sounds, noticed for the past 12 months. His MRI brain and EEG are normal. The child was mocked at by classmates in school and he stopped attending classes for the past 6 months. His ASLO titres and serum ceruloplasmin are non-contributory. The ideal therapy would be a trial of:
A 4-year-old unimmunized HIV-positive child on antiretroviral therapy for the last 2 years and weighing 15 kg is brought for vaccination. His records reveal a recent CD4 count of 750/mm³, with no evidence of any opportunistic infections in the past. Which of the following statements are applicable to this child?
1. Recombinant Hepatitis B vaccine can be safely administered.
2. MMR vaccine is always contraindicated.
3. BCG may be administered if chest radiograph is normal.
4. IPV is preferred over OPV.
Select the correct answer using the code given below:
As per the National Immunization Schedule, PCV (Pneumococcal Conjugate Vaccine) is offered at:
Which one of the following vaccines is an exception to the principle "At least 4 weeks interval is needed between two doses of the same vaccine to ensure adequate immune response"?
Administration of immunoglobulins interferes with the response to live vaccines, except:
A 14-year-old boy is reported by his neighbour to the police for repeated aggressive activities including beating up children in the neighbourhood. The boy's neighbour also noticed that he also snorts heroin sometimes. He will be categorized legally as suffering from:
As per the National Vector Borne Disease Control Programme, the first-line agent for treatment of Kala-azar (visceral leishmaniasis) is:
Which one of the following illnesses is not covered under the Rashtriya Bal Swasthya Karyakram?
A 2-year-old child is brought with complaints of not growing well. On examination, he weighs 8.1 kg, height 80 cm (WFL score between 0 and 2 SD), has a mid-arm circumference (MUAC) of 11.5 cm and both his palms are white. There is no edema of the feet. As per IMNCI, he will be classified as:
A 2-year-old previously unimmunized girl is brought with poor feeding and fever for 6 days. On day 4 of fever, her mother noticed a maculopapular reddish rash starting from the face and spreading over the neck, chest, arms and trunk over the next one day and she has developed extensive mouth ulcers. The child has a mid-arm circumference of 11 cm but no edema. As per IMNCI, she will be classified as: