UPSC-CMS 2013
108 Previous Year Questions with Answers & Explanations
Anatomy
1 questionsThe commonest site for thyroglossal cyst is :
UPSC-CMS 2013 - Anatomy UPSC-CMS Practice Questions and MCQs
Question 1: The commonest site for thyroglossal cyst is :
- A. Submentum
- B. Subhyoid (Correct Answer)
- C. Suprahyoid
- D. Foramen caecum
Explanation: ***Subhyoid (Infrahyoid)*** - The **subhyoid (infrahyoid) region** is the most common location for thyroglossal cysts, accounting for **50-65% of cases**. - The thyroglossal duct passes through or is intimately related to the **body of the hyoid bone** during embryonic descent of the thyroid gland from the foramen cecum [1], [2]. - Cysts most frequently form **at or just below the level of the hyoid bone** in the midline neck. - These cysts characteristically **move upward with swallowing and tongue protrusion** due to their attachment to the hyoid bone. *Suprahyoid* - Suprahyoid cysts occur **above the hyoid bone** and account for approximately **20-25% of cases**. - While common, they are **less frequent than subhyoid cysts**. - These may present higher in the neck but still maintain the characteristic midline location. *Submentum* - The submental region is **anterior and superior to the hyoid bone** in the midline. - Thyroglossal cysts in this location are **uncommon** as the duct's path runs more posteriorly in relation to this space. - True submental cysts are rare and must be differentiated from dermoid cysts. *Foramen caecum* - This is the **embryological origin** of the thyroglossal duct at the base of the tongue [1], [2]. - Cysts at this location are called **lingual thyroglossal cysts** and are very rare (1-2% of cases) [1]. - They present as tongue base masses and can cause dysphagia or airway obstruction.
Community Medicine
1 questionsUniversal precautions to be followed by the surgical team include all of the following except :
UPSC-CMS 2013 - Community Medicine UPSC-CMS Practice Questions and MCQs
Question 1: Universal precautions to be followed by the surgical team include all of the following except :
- A. Wearing boots
- B. Wearing double gloves
- C. Donning water repellent gown
- D. Prophylactic antimicrobials (Correct Answer)
Explanation: **Prophylactic antimicrobials** - **Prophylactic antimicrobials** are given to prevent surgical site infections and are not considered a part of **universal precautions** themselves. - Universal precautions are primarily focused on preventing the transmission of bloodborne pathogens through physical barriers. *Wearing boots* - **Wearing boots** or shoe covers is an important component of **universal precautions** in the operating room to protect against splashes and contamination from blood and body fluids. - They also help maintain a sterile environment by preventing the introduction of contaminants from street shoes. *Wearing double gloves* - **Wearing double gloves** offers an extra layer of protection against sharps injuries and potential exposure to blood and body fluids, especially during procedures with a higher risk of puncture. - This practice reinforces the **barrier protection** aspect of universal precautions. *Donning water repellent gown* - A **water-repellent gown** acts as a crucial barrier to protect the surgical team's skin and clothing from contamination with blood, body fluids, and other potentially infectious materials. - This aligns with the principle of **universal precautions** to minimize exposure risks.
Forensic Medicine
1 questionsThe clinical signs of brain-stem death include all of the following except:
UPSC-CMS 2013 - Forensic Medicine UPSC-CMS Practice Questions and MCQs
Question 1: The clinical signs of brain-stem death include all of the following except:
- A. Absence of spontaneous respiration
- B. Profound hypotension (Correct Answer)
- C. Absent oculo-vestibular reflex
- D. Absence of pharyngeal reflex
Explanation: **Profound hypotension** - While patients with brainstem death can be hemodynamically unstable, **profound hypotension** itself is not a defining diagnostic criterion for brainstem death. It is often a consequence of brainstem injury, but not a direct sign indicating loss of brainstem function. - The criteria for brainstem death focus on the irreversible cessation of all brainstem reflexes and the capacity for spontaneous respiration, not peripheral circulatory status. *Absence of spontaneous respiration* - The **apnea test**, demonstrating no respiratory efforts despite adequate CO2 stimulation, is a critical component of brainstem death diagnosis, indicating irreversible loss of brainstem respiratory centers. - This sign confirms the total and irreversible cessation of the brainstem's ability to maintain vital functions. *Absent oculo-vestibular reflex* - The absence of the **oculo-vestibular reflex** (cold caloric test) indicates irreversible damage to the brainstem nuclei responsible for eye movements and vestibular function. - This is a key diagnostic criterion demonstrating the loss of specific brainstem reflexes. *Absence of pharyngeal reflex* - The absence of the **pharyngeal reflex** (gag reflex) signifies the loss of cranial nerve IX and X function, which are mediated by the brainstem. - This confirms the irreversible cessation of a vital protective reflex regulated by the brainstem.
Internal Medicine
2 questionsFactors important in the formation of gall stones include all of the following except :
The complications of ascaris lumbricoides infestation include all of the following except :
UPSC-CMS 2013 - Internal Medicine UPSC-CMS Practice Questions and MCQs
Question 1: Factors important in the formation of gall stones include all of the following except :
- A. Obesity
- B. The size of micelles
- C. Cholesterol saturation in bile
- D. Gall bladder motility (Correct Answer)
Explanation: ***Gall bladder motility*** - While factors like gallbladder **stasis** or **hypomotility** can *contribute* to gallstone formation by allowing bile to concentrate, normal gallbladder motility itself does not directly form stones. - Efficient gallbladder emptying helps prevent the supersaturation and precipitation of cholesterol and bilirubin that lead to stone formation [2]. *Obesity* - Obesity increases the **hepatic secretion of cholesterol**, leading to more cholesterol in the bile [1]. - This increased cholesterol can lead to **supersaturation** of bile, making it prone to forming cholesterol gallstones. *Cholesterol saturation in bile* - When bile contains more cholesterol than can be kept in solution by bile salts and phospholipids, it becomes **supersaturated** [3]. - This supersaturation is a primary driver for the **precipitation of cholesterol crystals**, which aggregate to form gallstones [1]. *The size of micelles* - Micelles are small aggregates of bile salts and phospholipids that solubilize cholesterol in bile [3]. - If the **micelle size is insufficient** or their number is reduced, they cannot adequately solubilize the cholesterol, leading to its precipitation and stone formation [3].
Question 2: The complications of ascaris lumbricoides infestation include all of the following except :
- A. lower gastro intestinal bleed
- B. cholangitis and obstructive jaundice
- C. peptic ulcer disease (Correct Answer)
- D. acute intestinal obstruction
Explanation: ***Peptic ulcer disease*** - **Peptic ulcer disease** is not a commonly recognized direct complication of *Ascaris lumbricoides* infestation. - While *Ascaris* can cause gastrointestinal symptoms, it does not typically lead to the formation of peptic ulcers. *Lower gastrointestinal bleed* - Heavy worm burdens can cause irritation and inflammation of the intestinal lining, potentially leading to **mucosal erosions** and **lower gastrointestinal bleeding**. - In rare cases, worms might erode into blood vessels, contributing to bleeding. *Cholangitis and obstructive jaundice* - Adult worms can migrate from the small intestine into the **biliary tree**, obstructing bile flow and causing **cholangitis** or **obstructive jaundice**. - They can also enter the pancreatic duct, leading to **pancreatitis**. *Acute intestinal obstruction* - A large bolus of adult worms can form a tangled mass (bolus) within the small intestine, leading to **complete or partial acute intestinal obstruction**. - This is a serious surgical emergency, especially in children with heavy worm loads.
Orthopaedics
1 questionsWhich one of the following fractures is most often complicated by fat embolism ?
UPSC-CMS 2013 - Orthopaedics UPSC-CMS Practice Questions and MCQs
Question 1: Which one of the following fractures is most often complicated by fat embolism ?
- A. Shaft of femur (Correct Answer)
- B. Shaft of tibia
- C. Supra condyler humerus
- D. Lumbar vertebrae
Explanation: ***Shaft of femur*** - **Long bone fractures**, especially those involving the **femur**, are classic causes of **fat embolism syndrome (FES)** due to the large amount of fatty marrow released into the circulation. - The **intraosseous pressure** increases at the fracture site, pushing fat globules into the bloodstream, which then travel to the lungs and other organs. *Shaft of tibia* - While the tibia is also a long bone and can cause fat emboli, it contains less marrow than the femur, making **tibial shaft fractures** less frequently associated with severe **fat embolism syndrome** compared to femoral fractures. - The **mechanical disruption** is generally less extensive than in a femoral fracture, reducing the volume of fatty material released. *Supra condyler humerus* - This fracture involves the **distal humerus**, which is a long bone, but its **marrow content is significantly less** than that of the femur. - While any long bone fracture can theoretically cause a **fat embolism**, the risk is much lower for **supracondylar humerus fractures** due to the smaller amount of fatty marrow. *Lumbar vertebrae* - Vertebral fractures, particularly those in the lumbar region, are primarily associated with the release of **bone marrow cells** and potentially spinal cord injury, but not typically with significant **fat embolism syndrome**. - The **marrow in vertebrae** is predominantly hematopoietic and much less fatty compared to the large medullary cavities of long bones like the femur.
Physiology
1 questionsNon-cardiac causes of raised central venous pressure include all of the following except:
UPSC-CMS 2013 - Physiology UPSC-CMS Practice Questions and MCQs
Question 1: Non-cardiac causes of raised central venous pressure include all of the following except:
- A. Hyper-volemia (Correct Answer)
- B. Abdominal compartment syndrome
- C. Positive pressure ventilation
- D. Tension pneumothorax
Explanation: **IMPORTANT NOTE:** This question as originally presented is medically problematic because **hypervolemia is actually a NON-CARDIAC cause** of elevated CVP. All four options listed are non-cardiac causes, making this question flawed. However, if this represents the original UPSC-CMS-2013 answer key, the intended distinction may have been between **systemic/volume-related causes** versus **mechanical/obstructive causes**. ***Hypervolemia (Marked as answer)*** - Hypervolemia (fluid overload) is technically a **non-cardiac, systemic cause** of elevated CVP, not a cardiac cause - It increases CVP by increasing **circulating blood volume** and venous return, without primary cardiac dysfunction - True **cardiac causes** would include right heart failure, tricuspid regurgitation, cardiac tamponade, or constrictive pericarditis - If this was the intended answer, the distinction may be: hypervolemia is a **systemic/volume cause** while the others are **mechanical/obstructive causes** *Abdominal compartment syndrome* - Increases **intra-abdominal pressure** which transmits to the thorax - Mechanically compresses the **inferior vena cava**, impeding venous return - This is clearly a **non-cardiac, mechanical cause** of elevated CVP *Positive pressure ventilation* - Increases **intrathoracic pressure** during mechanical ventilation - Directly opposes venous return to the right atrium - This is a **non-cardiac, mechanical cause** of elevated CVP *Tension pneumothorax* - Causes severe increase in **intrathoracic pressure** from trapped air - Compresses the **vena cavae** and impedes venous return - This is a **non-cardiac, mechanical/obstructive cause** of elevated CVP **Clinical Pearl:** When evaluating elevated CVP, distinguish between cardiac causes (right heart failure, tamponade), mechanical causes (tension pneumothorax, positive pressure ventilation), obstructive causes (SVC syndrome), and volume-related causes (hypervolemia).
Surgery
3 questionsA 25-year-old patient has 5 x 5 cm amoebic abscess in right lobe of liver. He is febrile and has pain in right hypochondrium. His primary management would include:
The surgical complications of typhoid fever include all of the following except :
Treatment of choice for acute femoral artery embolism is :
UPSC-CMS 2013 - Surgery UPSC-CMS Practice Questions and MCQs
Question 1: A 25-year-old patient has 5 x 5 cm amoebic abscess in right lobe of liver. He is febrile and has pain in right hypochondrium. His primary management would include:
- A. Laparotomy and drainage
- B. Administration of antibiotic and observation
- C. Ultra-sound guided aspiration
- D. Ultra-sound guided placement of pigtail catheter (Correct Answer)
Explanation: ***Ultra-sound guided placement of pigtail catheter*** - For an **amoebic liver abscess** of 5x5 cm with **significant symptoms** (fever and pain), **catheter drainage combined with anti-amoebic therapy** is indicated. - While medical therapy alone may suffice for smaller or less symptomatic abscesses, this patient's **symptomatic presentation** warrants drainage to provide rapid relief, prevent complications, and ensure resolution. - **Pigtail catheter placement** allows for continuous drainage and is the preferred minimally invasive approach for abscesses requiring intervention. - This approach is safer than open surgery and more effective than single aspiration for complete evacuation. *Laparotomy and drainage* - **Open surgical drainage** is reserved for complicated cases such as **ruptured abscesses**, peritonitis, or failure of percutaneous drainage. - For an uncomplicated 5x5 cm abscess, laparotomy is overly invasive and carries higher morbidity compared to image-guided percutaneous techniques. *Administration of antibiotic and observation* - **Anti-amoebic medications** (metronidazole) are essential for treating amoebic liver abscesses and must be given in all cases. - However, for a **5x5 cm abscess with fever and pain**, medical therapy alone may be insufficient for rapid symptom resolution. - The size (at the threshold of 5 cm) combined with symptomatic presentation justifies **drainage in addition to medical therapy** to prevent complications like rupture or secondary infection. - Observation alone without drainage in a symptomatic patient of this size risks delayed resolution and potential complications. *Ultra-sound guided aspiration* - **Single aspiration** may be considered for diagnostic purposes or in selected cases. - However, for a 5x5 cm abscess, **aspiration may require multiple procedures** for complete evacuation, and there's risk of inadequate drainage. - **Pigtail catheter drainage** is preferred over aspiration as it allows **continuous drainage**, reduces the need for repeat procedures, and has higher success rates for abscesses of this size.
Question 2: The surgical complications of typhoid fever include all of the following except :
- A. Acute pancreatitis (Correct Answer)
- B. Splenic abscess
- C. Acute cholecystitis
- D. Perforation peritonitis
Explanation: ***Acute pancreatitis*** - While typhoid fever can rarely involve the pancreas, **acute pancreatitis** is **not** considered a typical *surgical complication* of typhoid fever. - Pancreatic involvement, when it occurs, is generally mild and does not require surgical intervention. - This is the correct answer as it is NOT a recognized surgical complication. *Splenic abscess* - **Splenic abscess** is a rare but recognized complication of typhoid fever, resulting from hematogenous spread. - When present, it may require **percutaneous drainage** or **splenectomy** due to the risk of rupture. - Note: More common splenic manifestation is splenomegaly, not abscess. *Acute cholecystitis* - **Acute cholecystitis** is a well-recognized surgical complication of typhoid fever. - The gallbladder can serve as a chronic reservoir for **Salmonella Typhi**, leading to inflammation and stone formation. - This may require **cholecystectomy** in severe or recurrent cases. *Perforation peritonitis* - **Intestinal perforation**, particularly of the **terminal ileum**, is the **most common and serious** surgical complication of typhoid fever. - Occurs in approximately **1-3%** of cases, typically in the 2nd-3rd week of illness. - This leads to **peritonitis**, a life-threatening condition requiring **urgent laparotomy and surgical repair**.
Question 3: Treatment of choice for acute femoral artery embolism is :
- A. Immediate embolectomy (Correct Answer)
- B. Warfarin
- C. Embolectomy after rest for few days
- D. Heparin
Explanation: ***Immediate embolectomy*** - **Acute femoral artery embolism** is a medical emergency that requires prompt intervention to restore blood flow and prevent limb ischemia. - **Early surgical embolectomy** is the treatment of choice to physically remove the clot and immediately re-establish perfusion. *Warfarin* - **Warfarin** is an anticoagulant used for *long-term prevention* of future embolic events, but it is not effective for acute clot removal. - Its therapeutic effect is delayed, making it unsuitable for the immediate treatment of an acute embolism. *Embolectomy after rest for few days* - Delaying embolectomy for several days would lead to **irreversible tissue damage** and potential limb loss due to prolonged ischemia. - Time is critical in acute arterial occlusions, and immediate intervention is paramount. *Heparin* - **Heparin** is an anticoagulant used to *prevent further clot propagation* and reduce the risk of re-embolization. - While it can be initiated as an adjunct, it does not dissolve the existing embolus quickly enough to be the sole treatment for an acute limb-threatening obstruction.
About UPSC-CMS 2013 Questions
This page contains 108 questions from the UPSC-CMS 2013 paper, organised across 15 subjects for focused practice. Every question comes with the correct answer and a detailed explanation to help you understand the underlying concept. Subject-wise organisation lets you target specific areas and identify which topics carried the most weight in this particular year.
Practising year-wise papers is essential for understanding how the UPSC-CMS exam evolves — you can spot trending topics, gauge difficulty shifts, and benchmark your readiness against a real paper. To take your preparation further, download the Oncourse app for AI-driven performance insights, spaced repetition of questions you got wrong, and a personalised study plan built around your UPSC-CMS goals.