UPSC-CMS 2017 - Internal Medicine PYQs Practice Questions

Q: In endoscopic retrograde cholangiopancreatography endoscope used is:

Side viewing. ***Side viewing*** - **Side-viewing endoscopes** are specifically designed for ERCP, allowing the endoscopist to visualize the **ampulla of Vater** en face for precise cannulation [1]. - The side-viewing optic facilitates the passage of accessories like **catheters, guidewires**, and **sphincterotomes** into the bile and pancreatic ducts [1]. *End viewing* - **End-viewing endoscopes** (like standard gastroscopes or colonoscopes) have the camera directly at the tip, providing a straight-ahead view. - This design makes cannulation of the **ampulla of Vater** challenging, as it would be viewed tangentially, not directly. *Front viewing* - This term is synonymous with **end-viewing** and describes the typical orientation of standard gastrointestinal endoscopes. - While suitable for examining the lumen of organs, it lacks the specialized optics needed for the complex angulation and cannulation required in **ERCP**. *Rigid* - **Rigid endoscopes** are generally used for procedures where flexibility is not required, such as laparoscopy or cystoscopy [2]. - They are unsuitable for **ERCP**, which requires a highly flexible instrument to navigate the esophagus, stomach, duodenum, and access the **ampulla of Vater**. [Practice more Internal Medicine PYQs on OnCourse]

Q: Oliguria is defined as:

Less than 400 ml of urine excreted in a day. ***Less than 400 ml of urine excreted in a day*** - **Oliguria** is medically defined as a daily urine output that is **less than 400 ml** in adults. [1] - This level of urine production is often insufficient to effectively excrete metabolic waste products. [1] *600 ml to 700 ml of urine excreted in a day* - This range of urine output is generally considered within the **normal limits**, not oliguric. - Normal daily urine production for an adult typically ranges from **800 to 2000 ml**. *More than 900 ml of urine excreted in a day* - An output of **more than 900 ml** per day for an adult indicates normal urine production, well above the threshold for oliguria. - This level suggests adequate kidney function in terms of fluid excretion. *Absence of urine production* - The complete absence of urine production is known as **anuria**, which is a more severe condition than oliguria. [1] - Anuria is typically defined as **less than 50 ml of urine** per day. [1] [Practice more Internal Medicine PYQs on OnCourse]

Q: Which of the following is NOT a feature of Systemic Inflammatory Response Syndrome?

Bradycardia. ***Bradycardia*** - **Bradycardia** (a slow heart rate) is **not** a typical diagnostic criterion for **Systemic Inflammatory Response Syndrome (SIRS)**. - SIRS is usually associated with **tachycardia** (heart rate >90 beats/min) due to the body's increased metabolic demand and stress response [2]. *Hypothermia (less than 36°C)* - **Hypothermia** ( 38°C) is a common and primary diagnostic criterion for **SIRS**, reflecting the body's inflammatory response to infection or injury [2], [3]. - This elevated core temperature is part of the systemic response to pathogens or tissue damage. *Leucocytosis* - **Leucocytosis** (white blood cell count >12,000 cells/mm³) is a key diagnostic criterion for **SIRS**, indicating a robust innate immune response [1], [2]. - A WBC count 10% immature neutrophils ("bands") also fulfills this criterion. [Practice more Internal Medicine PYQs on OnCourse]

Question 1

In endoscopic retrograde cholangiopancreatography endoscope used is:

Accepted Answer

Side viewing

Answer

End viewing

Answer

Front viewing

Answer

Rigid

Question 2

Oliguria is defined as:

Accepted Answer

Less than 400 ml of urine excreted in a day

Answer

600 ml to 700 ml of urine excreted in a day

Answer

More than 900 ml of urine excreted in a day

Answer

Absence of urine production

Question 3

Which of the following is NOT a feature of Systemic Inflammatory Response Syndrome?

Accepted Answer

Bradycardia

Answer

Hypothermia (less than 36°C)

Answer

Hyperthermia (more than 38°C)

Answer

Leucocytosis

UPSC-CMS 2017 — Internal Medicine