UPSC-CMS 2023

Q: The following statements regarding small bowel tuberculosis are correct except

The strictures are common in the ulcerative type. ***The strictures are common in the ulcerative type*** - While both ulcerative and hyperplastic types of small bowel tuberculosis can lead to complications, **strictures are more characteristic of the hyperplastic type**. - In the **hyperplastic form**, chronic inflammation, fibrosis, and granuloma formation cause wall thickening and luminal narrowing, resulting in strictures. *There are two types : ulcerative and hyperplastic* - This statement is correct. Small bowel tuberculosis is broadly classified into **ulcerative** and **hyperplastic** forms, with mixed types also occurring. - The type is often determined by the interplay between the virulence of the organism and the host's immune response. *In the ulcerative type, the bowel serosa is studded with tubercles* - This statement is correct. The **ulcerative type** is often associated with the **spread of infection to the serosa**, leading to the formation of visible **tubercles**. - This indicates more extensive disease and possible peritoneal involvement. *The ulcerative type occurs when the virulence of the organism is greater than the host defence* - This statement is correct. The **ulcerative form** is often observed when the **organism's virulence is high** and/or the host's **immune response is weak**, leading to destructive lesions. - This imbalance results in caseating necrosis and ulceration of the bowel wall. [Practice more UPSC-CMS 2023 questions on OnCourse]

Q: When a patient suffers from critical limb ischemia, the ankle-brachial pressure index (ABPI) is less than ...

0.3. ***0.3*** - A value of **less than 0.3** indicates **severe blood flow impairment**, consistent with critical limb ischemia, necessitating urgent intervention [1]. - This extremely low ABPI reflects a profound decrease in perfusion to the lower extremity [1]. *0.7* - An ABPI of **less than 0.7** typically suggests **moderate peripheral artery disease (PAD)**, which could cause claudication but is not usually indicative of critical limb ischemia [1]. - While concerning, it does not represent the severe, limb-threatening ischemia implied by the term "critical." *1.0* - An ABPI of around **1.0 (0.9-1.3)** is considered **normal**, indicating healthy blood flow without significant arterial obstruction. - This value would rule out any significant peripheral artery disease, including critical limb ischemia. *0.9* - An ABPI of **less than 0.9** generally suggests **peripheral artery disease (PAD)**, which can cause symptoms like intermittent claudication [1]. - However, it is not low enough to diagnose critical limb ischemia, which represents a more severe state of arterial insufficiency [1]. [Practice more UPSC-CMS 2023 questions on OnCourse]

Q: Which of the following most strongly suggests the diagnosis of primary hyper-parathyroidism ?

Serum calcium above 11 mg/dL. ***Serum calcium above 11 mg/dL*** - **Hypercalcemia** is the hallmark of primary hyperparathyroidism, as excessive parathyroid hormone (PTH) leads to increased calcium reabsorption from bones and kidneys [1, 3]. - A serum calcium level significantly above the normal range (typically 8.5-10.2 mg/dL) strongly suggests a parathyroid-related issue; specifically, levels exceeding 11.4 mg/dL (2.85 mmol/L) often warrant surgical consideration [1]. *Serum acid phosphatase above 120 IU/L* - **Elevated acid phosphatase** is more commonly associated with conditions like **prostatic carcinoma** with bone metastases or certain hematologic malignancies. - It is not a primary diagnostic marker for hyperparathyroidism. *Urinary calcium below 100 mg/day* - **Low urinary calcium** (hypocalciuria) is characteristic of **familial hypocalciuric hypercalcemia (FHH)**, a genetic condition that can mimic primary hyperparathyroidism [1]. - In primary hyperparathyroidism, **urinary calcium excretion is typically normal or high** due to the PTH-mediated increase in filtered calcium load. *Serum alkaline phosphatase above 120 IU/L* - **Elevated alkaline phosphatase** can indicate increased **bone turnover**, which can be seen in severe, prolonged primary hyperparathyroidism as an indicator of bone resorption [1, 2]. - However, it is a non-specific marker and can also be elevated in various liver diseases or other bone disorders; it is not as specific as hypercalcemia for diagnosing primary hyperparathyroidism [2]. [Practice more UPSC-CMS 2023 questions on OnCourse]

227 Previous Year Questions with Answers & Explanations

227

Questions

Subjects

All (227)Anatomy (8)Biochemistry (3)Community Medicine (52)Dermatology (1)Forensic Medicine (2)Internal Medicine (29)Microbiology (4)Obstetrics and Gynecology (66)Ophthalmology (2)Orthopaedics (1)Pathology (9)Pediatrics (6)Pharmacology (3)Physiology (10)Psychiatry (1)Radiology (6)Surgery (24)

Anatomy

1 questions

Match List-I with List-II and select the correct answer using the code given below the Lists: (Refer to the image below for the lists)

UPSC-CMS 2023 - Anatomy UPSC-CMS Practice Questions and MCQs

Question 1: Match List-I with List-II and select the correct answer using the code given below the Lists: (Refer to the image below for the lists)

A. A→4 B→3 C→1 D→2
B. A→3 B→2 C→4 D→1
C. A→4 B→3 C→2 D→1 (Correct Answer)
D. A→3 B→2 C→1 D→4

Explanation: ***A→4 B→3 C→2 D→1*** - **Atrial fibrillation** is characterized by **irregularly irregular rhythm** without distinct P waves, making the R-R interval highly variable. It is a supraventricular tachyarrhythmia, originating above the ventricles. - **Ventricular tachycardia** typically presents with a **wide QRS complex** (>0.12 s) and a **rapid, regular heart rate**, as it originates from the ventricles. - **Complete heart block** is characterized by complete dissociation between **P waves and QRS complexes**, meaning the atria and ventricles beat independently. This is reflected in an irregular P-P interval and a regular but slower R-R interval often due to an escape rhythm. - **Ventricular fibrillation** is an ECG emergency characterized by chaotic, **irregular electrical activity** and an absence of discernible P waves, QRS complexes, or T waves, leading to cardiac arrest. *A→4 B→3 C→1 D→2* - This option correctly matches A (Atrial fibrillation) with 4 (Irregular R-R interval without P waves) and B (Ventricular tachycardia) with 3 (Wide QRS complexes and regular rapid rate). However, it incorrectly matches C (Complete heart block) with 1 (Chaotic rhythm) and D (Ventricular fibrillation) with 2 (Dissociation of P and QRS waves). - **Complete heart block** involves **dissociation of P and QRS waves**, and **Ventricular fibrillation** is defined by a **chaotic rhythm**, not the other way around as suggested by C→1 and D→2. *A→3 B→2 C→4 D→1* - This option incorrectly matches A (Atrial fibrillation) with 3 (Wide QRS complexes and regular rapid rate), which describes ventricular tachycardia. - It also incorrectly matches C (Complete heart block) with 4 (Irregular R-R interval without P waves) and D (Ventricular fibrillation) with 1 (Chaotic rhythm), instead of the correct associations. *A→3 B→2 C→1 D→4* - This option incorrectly matches A (Atrial fibrillation) with 3 (Wide QRS complexes and regular rapid rate) which is characteristic of ventricular tachycardia. - It also incorrectly matches B (Ventricular tachycardia) with 2 (Dissociation of P and QRS waves), which is a characteristic of complete heart block, not ventricular tachycardia.

Internal Medicine

5 questions

The following statements regarding small bowel tuberculosis are correct except

Systemic Inflammatory Response Syndrome (SIRS) diagnostic criteria include the following except

When a patient suffers from critical limb ischemia, the ankle-brachial pressure index (ABPI) is less than ...

Which of the following most strongly suggests the diagnosis of primary hyper-parathyroidism ?

A young patient presented in the emergency with haematemesis and was found to have massive splenomegaly. The following conditions are associated with the above clinical presentation except

UPSC-CMS 2023 - Internal Medicine UPSC-CMS Practice Questions and MCQs

Question 1: The following statements regarding small bowel tuberculosis are correct except

A. There are two types : ulcerative and hyperplastic
B. In the ulcerative type, the bowel serosa is studded with tubercles
C. The ulcerative type occurs when the virulence of the organism is greater than the host defence
D. The strictures are common in the ulcerative type (Correct Answer)

Explanation: ***The strictures are common in the ulcerative type*** - While both ulcerative and hyperplastic types of small bowel tuberculosis can lead to complications, **strictures are more characteristic of the hyperplastic type**. - In the **hyperplastic form**, chronic inflammation, fibrosis, and granuloma formation cause wall thickening and luminal narrowing, resulting in strictures. *There are two types : ulcerative and hyperplastic* - This statement is correct. Small bowel tuberculosis is broadly classified into **ulcerative** and **hyperplastic** forms, with mixed types also occurring. - The type is often determined by the interplay between the virulence of the organism and the host's immune response. *In the ulcerative type, the bowel serosa is studded with tubercles* - This statement is correct. The **ulcerative type** is often associated with the **spread of infection to the serosa**, leading to the formation of visible **tubercles**. - This indicates more extensive disease and possible peritoneal involvement. *The ulcerative type occurs when the virulence of the organism is greater than the host defence* - This statement is correct. The **ulcerative form** is often observed when the **organism's virulence is high** and/or the host's **immune response is weak**, leading to destructive lesions. - This imbalance results in caseating necrosis and ulceration of the bowel wall.

Question 2: Systemic Inflammatory Response Syndrome (SIRS) diagnostic criteria include the following except

A. Temperature > 38°C or < 36°C
B. Tachycardia with a heart rate of more than 90/min.
C. White cell count < 4000/mm³ (Correct Answer)
D. Tachypnoea with a respiratory rate of > 20/min.

Explanation: ***White cell count < 4000/mm³*** - The correct SIRS criterion regarding white blood cell count is either > 12,000/mm³ or < 4,000/mm³ or the presence of > 10% **immature (band) forms**. [2] - This option correctly states a **WBC count below 4000/mm³**, which is indeed a criterion for SIRS. *Temperature > 38°C or < 36°C* - This is a correct criterion for SIRS, indicating a significant deviation from normal body temperature. [1] - Both **fever (hyperthermia)** and **hypothermia** are signs of systemic inflammation. *Tachycardia with a heart rate of more than 90/min.* - This is a correct criterion for SIRS, reflecting the increased metabolic demand and sympathetic activation during systemic inflammation. [2] - A persistent **heart rate above 90 bpm** is considered indicative of such stress. *Tachypnoea with a respiratory rate of > 20/min.* - This is a correct criterion for SIRS, showing the body's attempt to compensate for metabolic disturbances or increased oxygen demand. [2] - A **respiratory rate greater than 20 breaths per minute** or a PaCO2 less than 32 mmHg are both SIRS criteria.

Question 3: When a patient suffers from critical limb ischemia, the ankle-brachial pressure index (ABPI) is less than ...

A. 0.7
B. 1.0
C. 0.9
D. 0.3 (Correct Answer)

Explanation: ***0.3*** - A value of **less than 0.3** indicates **severe blood flow impairment**, consistent with critical limb ischemia, necessitating urgent intervention [1]. - This extremely low ABPI reflects a profound decrease in perfusion to the lower extremity [1]. *0.7* - An ABPI of **less than 0.7** typically suggests **moderate peripheral artery disease (PAD)**, which could cause claudication but is not usually indicative of critical limb ischemia [1]. - While concerning, it does not represent the severe, limb-threatening ischemia implied by the term "critical." *1.0* - An ABPI of around **1.0 (0.9-1.3)** is considered **normal**, indicating healthy blood flow without significant arterial obstruction. - This value would rule out any significant peripheral artery disease, including critical limb ischemia. *0.9* - An ABPI of **less than 0.9** generally suggests **peripheral artery disease (PAD)**, which can cause symptoms like intermittent claudication [1]. - However, it is not low enough to diagnose critical limb ischemia, which represents a more severe state of arterial insufficiency [1].

Question 4: Which of the following most strongly suggests the diagnosis of primary hyper-parathyroidism ?

A. Serum calcium above 11 mg/dL (Correct Answer)
B. Serum acid phosphatase above 120 IU/L
C. Urinary calcium below 100 mg/day
D. Serum alkaline phosphatase above 120 IU/L

Explanation: ***Serum calcium above 11 mg/dL*** - **Hypercalcemia** is the hallmark of primary hyperparathyroidism, as excessive parathyroid hormone (PTH) leads to increased calcium reabsorption from bones and kidneys [1, 3]. - A serum calcium level significantly above the normal range (typically 8.5-10.2 mg/dL) strongly suggests a parathyroid-related issue; specifically, levels exceeding 11.4 mg/dL (2.85 mmol/L) often warrant surgical consideration [1]. *Serum acid phosphatase above 120 IU/L* - **Elevated acid phosphatase** is more commonly associated with conditions like **prostatic carcinoma** with bone metastases or certain hematologic malignancies. - It is not a primary diagnostic marker for hyperparathyroidism. *Urinary calcium below 100 mg/day* - **Low urinary calcium** (hypocalciuria) is characteristic of **familial hypocalciuric hypercalcemia (FHH)**, a genetic condition that can mimic primary hyperparathyroidism [1]. - In primary hyperparathyroidism, **urinary calcium excretion is typically normal or high** due to the PTH-mediated increase in filtered calcium load. *Serum alkaline phosphatase above 120 IU/L* - **Elevated alkaline phosphatase** can indicate increased **bone turnover**, which can be seen in severe, prolonged primary hyperparathyroidism as an indicator of bone resorption [1, 2]. - However, it is a non-specific marker and can also be elevated in various liver diseases or other bone disorders; it is not as specific as hypercalcemia for diagnosing primary hyperparathyroidism [2].

Question 5: A young patient presented in the emergency with haematemesis and was found to have massive splenomegaly. The following conditions are associated with the above clinical presentation except

A. Kala-azar
B. Portal hypertension
C. Idiopathic thrombocytopenic purpura (Correct Answer)
D. Malaria

Explanation: ***Idiopathic thrombocytopenic purpura*** - While ITP can cause **bleeding** (including hematemesis) due to **thrombocytopenia**, it is generally **not associated with massive splenomegaly**. Splenomegaly, if present, is usually mild. - The primary defect in ITP is **immune-mediated platelet destruction**, not a cause of massive splenic enlargement, which typically results from conditions involving portal congestion, infiltrative diseases, or hemolytic processes. *Kala-azar* - **Kala-azar (visceral leishmaniasis)** is notoriously associated with **massive splenomegaly** and can cause **hematemesis** due to complications like **esophageal varices** or coagulopathy. - The parasite (Leishmania donovani) infiltrates the reticuloendothelial system, leading to profound splenomegaly. *Portal hypertension* - **Portal hypertension** is a direct cause of **massive splenomegaly** due to congestion and can lead to **hematemesis** from **ruptured esophageal varices**. - The increased pressure in the portal venous system causes blood to back up into the splenic vein, enlarging the spleen. *Malaria* - **Chronic malaria**, particularly from *Plasmodium falciparum* or *Plasmodium vivax*, can lead to significant, often **massive splenomegaly** (hyperreactive malarial splenomegaly). - While hematemesis is not a primary symptom, severe malaria can cause **coagulopathy** or contribute to **gastrointestinal bleeding** in complicated cases, though massive splenomegaly itself is a prominent feature.

Pathology

1 questions

The histological grade best correlates with the prognosis in which one of the following malignancies?

Radiology

1 questions

The sonographic finding of a cyst containing clear fluid is described as

Surgery

2 questions

Tidy wounds inflicted by sharp instruments and containing no devitalised tissues are expected to heal by

A patient has a 6-cm breast tumor with mobile, clinically positive, ipsilateral axillary lymph nodes and no evidence of distant metastasis. The stage of the breast cancer is

UPSC-CMS 2023 - Surgery UPSC-CMS Practice Questions and MCQs

Question 1: Tidy wounds inflicted by sharp instruments and containing no devitalised tissues are expected to heal by

A. Primary healing (Correct Answer)
B. Skin grafting
C. Secondary healing
D. Formation of contracture

Explanation: ***Primary healing*** - This mode of healing occurs in **clean, surgically incised, or sharply cut wounds** with minimal tissue loss and edges that can be approximated. - Features include minimal scarring and rapid re-epithelialization without granulation tissue formation. *Skin grafting* - This is a surgical procedure used to cover large wounds where **primary closure is not possible** or to repair areas with significant tissue loss. - It involves transplanting skin from one area of the body to another, not a natural healing process for tidy wounds. *Secondary healing* - This occurs in wounds with **significant tissue loss, infection, or edges that cannot be approximated**, requiring the formation of granulation tissue to fill the defect. - It results in a larger scar and takes longer to heal compared to primary healing. *Formation of contracture* - **Wound contracture** is a process that occurs during secondary healing, where myofibroblasts pull the wound edges together, leading to a reduction in wound size. - While it's a part of the healing process for certain wounds, it is not the primary mode of healing for tidy, sharp wounds and can lead to functional impairment if severe.

Question 2: A patient has a 6-cm breast tumor with mobile, clinically positive, ipsilateral axillary lymph nodes and no evidence of distant metastasis. The stage of the breast cancer is

A. Stage IIIb
B. Stage I
C. Stage IIb
D. Stage IIIa (Correct Answer)

Explanation: ***Stage IIIa*** - A **6-cm tumor (T3)** with **mobile, clinically positive ipsilateral axillary lymph nodes (N1)** and **no distant metastasis (M0)** classifies as **T3N1M0 = Stage IIIA** according to AJCC TNM staging. - Stage IIIA includes **T3N1M0** among other combinations, representing locally advanced breast cancer with significant tumor burden and regional nodal involvement. *Stage IIb* - Stage IIB is classified as **T2N1M0** (2-5 cm tumor with mobile axillary nodes) or **T3N0M0** (>5 cm tumor with no nodal involvement). - This patient has **T3N1M0**, which exceeds Stage IIB criteria due to the combination of large tumor size and positive lymph nodes. *Stage I* - Stage I involves **small tumors (T1, ≤2 cm)** with **no lymph node involvement (N0)** or only micrometastases. - The **6-cm tumor size** and **clinically evident axillary lymph node involvement** far exceed Stage I parameters. *Stage IIIb* - Stage IIIB requires **T4 disease** with chest wall invasion, skin involvement (ulceration, satellite nodules), or inflammatory breast cancer features. - This case shows **T3 disease** without signs of **locally advanced features** like chest wall fixation or skin changes.

About UPSC-CMS 2023 Questions

This page contains 227 questions from the UPSC-CMS 2023 paper, organised across 17 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.