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Combined Medical Services Examination-2020 Paper-I
Combined Medical Services Examination-2020 Paper-I
Paper-I
1.
A chronic alcoholic develops a paroxysm of palpitations after alcohol binge. Which of the
following Arrhythmia is most likely?
(a) Ventricular fibrillation
(b) Ventricular premature complex
(c) Atrial flutter
(d) Atrial fibrillation
2.
An elderly-man with history of Diabetes mellitus and Coronary Artery Disease comes for
follow-up, with complaints of muscle pains. Which one of the following drugs could be the
most likely cause?
(a) Aspirin
(b) Glimepiride
(c) Enalapril
(d) Atorvastatin
3.
A 40-year old lady comes to outdoor clinic with complaints of sudden onset chest pain. The
chest X-ray shows bilateral Pneumothorax. Examination reveals abnormalities of body
habitus-including long arms, legs and finger (arachnodactyly), scoliosis, high arched palate,
joint hypermobility, and a pansystolic murmur at cardiac apex. Which one of the following
diseases is most likely?
(a) Takayasu’s arteritis
(b) Raynaud’s syndrome
(c) Marfan’s syndrome
(d) Rheumatic heart disease-Mitral regurgitation
4.
All of the following are indications for treadmill testing/exercise-testing EXCEPT:
(a) To confirm the diagnosis of angina
(b) To evaluate stable angina
(c) To assess outcome after coronary revascularization
(d) To evaluate the treatment efficacy of antianginal drugs
5.
Kussmaul’s sign is present in all of the following conditions, EXCEPT:
6.
Which one of the following is NOT a common cause of atrial fibrillation?
(a) DC Cardioversion
(b) Injection Lignocaine
(c) Injection Amiodarone
(d) Injection Adenosine
9.
Which one of the following drugs is a Direct Renin Inhibitor?
(a) Benedipine
(b) Azilsartan
(c) Aliskiren
(d) Lisinopril
10.
All of the following are causes of systolic hypertension with wide pulse pressure EXCEPT:
(a) Albuterol
(b) Anti-leukotrienes
(c) Aminophylline
(d) Magnesium sulfate
19.
Consider the following statements with regard to respiratory examination:
28.
The most common cause of acute hepatitis outbreaks in India is:
(a) Hepatitis E
(b) Hepatitis C
(c) Hepatitis B
(d) Hepatitis A
29.
Spontaneous oesophageal perforation after a bout of forceful vomiting or retching is
characteristically seen in which one of the following conditions?
35.
White cell casts in urine examination are strongly suggestive of:
(a) Nephritis
(b) Pyelonephritis
(c) Renal stone disease
(d) Papillitis
36.
A 13-year old boy presents with hematuria, oliguria, edema and hypertension. He has history
of sore throat two weeks prior to presentation. Laboratory investigations are remarkable for
low C3 and increased titres of ASO and antiDNase. Which one of the following statements is
NOT correct about management for this condition?
41.
Vertical gaze palsy with convergence retraction nystagmus is seen in:
(a) Weber syndrome
(b) Millard Gubler syndrome
(c) Claude syndrome
(d) Parinaud syndrome
42.
A patient on looking forward was found to have his right eye deviated downwards and
outwards with pupil dilated. He is suffering from:
(a) Left 3rd nerve palsy
(b) Left 6th nerve palsy
(c) Right 4th nerve palsy
(d) Right 3rd nerve palsy
43.
All of the following are features of Cauda Equina syndrome EXCEPT:
47.
A 35 year old man presents with history of low grade fever and headache for last five weeks.
Clinical examination is remarkable for signs of meningismus. He undergoes lumbar puncture
(LP) and a day later reports worsening of headache. Which one of the following features is
NOT consistent with diagnosis of “Post-LP” headache?
53.
Fever with splenomegaly and lymphadenopathy can be seen in
(a) Infectious mononucleosis
(b) Chronic leukaemia
(c) Both infectious mononucleosis and chronic leukaemia
(d) Neither infectious mononucleosis nor chronic leukaemia
54.
Every individual carries four alpha gene alleles. Deletion of three alleles leads to
development of:
(a) Haemoglobin X disease
(b) Haemoglobin H disease
(c) Haemoglobin F disease
(d) Hydrops fetalis
55.
Which one of the following is NOT true regarding Chronic Myeloid Leukaemia (CML)?
(a) It is a clonal malignancy of haematopoetic stem
(b) Risk of developing CML is increased in monozygotic turns
(c) CML is defined by presence of BCR-ABL 1 fusion gene
(d) 10 year survival with TKI therapy is 85%
56.
Diagnostic criteria of multiple myeloma includes which of the following?
59.
Which one of the following is NOT the criterion for the diagnosis of Diabetes mellitus?
(a) Symptoms of diabetes and random plasma sugar concentration ≥ 200 mg/dL
(b) HbA1c ≥ 6.5 %
(c) 2-hours plasma glucose ≥ 200 mg/dL during an oral glucose tolerance test
(d) Fasting plasma glucose ≥ 110 mg/dL
60.
A young lady presents in outdoor clinic with complaints of menstrual irregularity, weight
gain, hair loss, tiredness and weakness. What will be the investigation of choice?
(a) FSH & LH level
(b) Estrogen level
(c) Free T3 and free T4 level
(d) Free T4 and TSH level
61.
Consider the following statements about erectile dysfunction in diabetic males:
1. It affects 60 % of males
2. Its common cause is an underlying neuro-vascular pathology
3. It may be aggravated by beta-adrenergic agonist drugs
4. Endocrine disorders like hyperprolactinemia may cause it
1. Primary Hyperparathyroidism
2. Pituitary tumours
3. Medullary carcinoma of thyroid
4. Pheochromocytoma
(a) 1, 2 and 4
(b) 1, 2 and 3
(c) 1, 3 and 4
(d) 2, 3 and 4
66.
Consider the following statements with regard to Graves’ ophthalmopathy :
1. Older age
2. A high gas transfer factor for carbon monoxide (TLCO)
3. Proteinuria
4. Diffuse skin disease
88.
Which of the following statements regarding pegloticase are correct?
1. It is enzyme conjugate
2. It is useful in chronic Gout management
3. The main adverse effects are infusion reactions and development of antibodies
95.
Which one of the following is NOT an appropriate criterion for diagnosis of Systemic
Inflammatory Response Syndrome (SIRS)?
(a) Respiratory rate > 20/mm
(b) Heart rate > 90/min
(c) Total leucocyte count > 16 ൈ 109 per Litre
(d) Temperature > 38 0C
96.
All of the following predispose to Acute Respiratory Distress Syndrome EXCEPT:
(a) Acute Pancreatitis
(b) Toxic gas inhalation
(c) Aspiration of gastric contents
(d) Severe Bronchial asthma
97.
An 8 year old child has consumed a few tablets of a drug that were being taken by his mother
on a regular basis. Following this the child develops gastric necrosis, acidosis, shock and
hepatic necrosis. Which is the most likely drug?
(a) Multivitamins
(b) Calcium carbonate
(c) Folic acid
(d) Iron
98.
A newborn weighing 1.5 kg at birth presents at 6 hours of age with lethargy, weak and high
pitched cry and difficulty in feeding. What is the next step in management?
99.
In a child with acute organophosphorus poisoning, which one of the following drugs will act
as anti-sialogogue and peripheral parasympatholytic agent?
(a) Carbamates
(b) Atropine
(c) Benzodiazepine
(d) Pralidoxime
100.
A 6-year old child needs to undergo a central Catheter placement for total parental nutrition.
The procedure is likely to evoke pain and anxiety. Which of the following is the most
appropriate drug for sedation and analgesia in this child?
(a) Atropine
(b) Lidocaine
(c) Adenosine
(d) Nalaxone
102.
Which one of the following drugs is used in cardiopulmonary resuscitation for pulseless
ventricular fibrillation?
(a) Atropine
(b) Adenosine
(c) Lidocaine
(d) Amiodarone
103.
Which one of the following is a sign of good attachment during breastfeeding?
(a) The baby’s nose is at the level of the nipple
(b) The baby’s chin touches the breast
(c) Most of the nipple is in the mouth and the lower areola is visible
(d) The baby’s lower lip is inverted
104.
Which one of the following signs is NOT included as an indicator of a vigorous baby
immediately after delivery of an infant born through meconium strained liquor?
(a) Pink colour
(b) Strong respiratory efforts
(c) Good muscle tone
(d) Active movements of the baby
105.
All are true for a Cephalohematoma in a newborn EXCEPT:
(a) It is located over the parietal bones in the subcutaneous plane
(b) It may be associated with hyperbilirubinemia
(c) It increases in size in the first 12–24 hours
(d) It can take 3–6 weeks to resolve
106.
Which of the following sick neonates can be started on “Minimal Enteral Feeding”, if
hemodynamically stable?
(a) Septic neonate with sclerema
(b) Neonate with necrotizing enterocolitis (NEC)
(c) Neonate on mechanical ventilation
(d) Symptomatic hypoglycaemia
107.
Which one of the following drugs is contraindicated in a mother who is breastfeeding her
infant?
(a) Bromocriptine
(b) Chlorpromazine
(c) Acyclovir
(d) Morphine
108.
A term neonate presents with tachypnea on day 1 after birth. The chest X-ray reveals
hyperexpanded lung fields, prominent vascular markings, and prominent interlobar fissure.
Which of the following is the most probable diagnosis?
(a) Congenital lobar emphysema
(b) Diaphragmatic hernia
(c) Transient tachypnea of the newborn
(d) Tracheoesophageal fistula
109.
A pre-school boy can go upstairs on alternate feet and has also started copying a circle. How
many blocks should he be able to build a tower with, without toppling over?
(a) 5
(b) 7
(c) 9
(d) More than 10
110.
Which one of the following drugs is the antidote for benzodiazepine poisoning?
(a) Flumazenil
(b) Atropine
(c) Naloxone
(d) Pralidoxime aldoxime methiodide
111.
A 3-year old child develops severe respiratory distress after inhalation of fumes arising from
burning plastic. The child is started on supportive ventilation. Which one of the following
antidotes needs to be given?
(a) Hydroxycobalamin
(b) Amylnitrate
(c) Sodium nitrite
(d) N-acetyl cysteine
112.
A child has an incurving of the little finger. What is this condition known as?
(a) Camptodactyly
(b) Brachydactyly
(c) Partial cutaneous syndactyly
(d) Clinodactyly
113.
A 4-week old infant presents with repeated episodes of non-bilious vomiting since 7 days.
The infant seems active and hungry after the vomiting. Examination reveals an olive-shaped
mass in the epigartrium. Which metabolic abnormality is expected in this infant?
(a) Hyperchloremia
(b) Metabolic alkalosis
(c) Hyperkalemia
(d) Hyponatramia
114.
Which one of the following is the correct dose and route of administration of hepatitis B
vaccine in children?