UPSC Paper -1 Booklet D 2013

1.      Cconsider the following statements regarding leprosy:
1.  Lepra reactions are not a feature of tuberculoid leprosy.
2. Erythema nodosum leprosum often occurs following institution of  chemotherpy
3. Elevated circulating level of tumour nectosis factor (TNF) is detected in patients with ENL
4.Lucio phenomenon occurs in untreated patients with tuberculoid leprosy
Which of the statement given above are correct?
a)      1,2 and 3
b)      2,3 and 4
c)      1,2 and 4
d)      1,3 and 4
2.      Match List I with List II and select the correct answer using the code given below  the lists :
List I                        List II
(organism)                (Vector)
A.Borrelia                1. Aedes aegypati
Burgdorfei               2. Culex moxquito
B Dengue                 3. Pediculus homonis            Carporis
C Japanese               4.lxodes tick
D Rickettsia
Code :
                 A         B          C          D
(a)             1          4          2          3
(b)             2          3          4          1
(c)             4          1          2          3
(d)             3          1          2          4
3.      As regards schizophrenia,which one of the following statements is not correct ?
(a)    Occurs in 0.-0.8 per cent of general Population.
(b)   Increasing parental age enhances the risk in the chilod
(c)    If both parents are affected,the risk in their offspring is above 90 per cent
(d)   The illness may resemble severe and persistent neurosis
4.      Consider the  following statements regarding organo-phosphorus poisoning:
1.      There is inhibition of cholinesterase function.
2.      In chronic exposure ,there may be peripheral neuropathy
3.      In acute poisoning there may be muscular weakness.
4.      In intermediate syndrome, sensory functions may be affected
Which of the statement given above are correct?
(a)    1,2and 3
(b)   2,3and 4
(c)    1,2and 4
(d)   1,3and 4
5.      Which one of the following is a specific antidote  for opiate overdose?
(a)    Fomepizole
(b)   Flumazenil
(c)    Naloxone
(d)   Physostigmine
6.      Which one of the following statements concerning catheter associated urinary tract infection is correct?
(a)    Most catheter associated infections are symptomatic
(b)   Routine antimicrobial prophylaxis is indicated
(c)    Microscopic bacteria correlates with significant colony count (>105/ml) in symptomatic cases
(d)   Skin organisms such as staphylo-coccus and streptococcus are the most common aeteological orga-nisms
7.      Which one of the following is not a feature of Type-I renal  tubular acidosis?
(a)    Lower tubule re-absorption of calcium
(b)   Defectivebicarbonate abscription in distal tubule
(c)    Low serum potassium level
(d)   Increased anion gap.
8.      Which one of the following is not a feature of Adult Polycystic Kidney Disease?
(a)    Hypertension
(b)   Intermittent renal colic
(c)    Massive Proteinuria
(d)   Macroscopic haematuria
9.      Pin point pupil may be found in all of the following except
(a)    Organophosphorus poisoning
(b)   Morphine haemorrhage
(c)    Pontine haemorrhage
(d)   Paracetamol poisoning
10.  Pulmonary complication of rheumatoid arthritis include the following except
(a)    Pulmonary nodules
(b)   Mesothelioma
(c)    Fibrosing alveolitis
(d)   Pleural effusion
11.  In a right-handed person, which of the following sings is not a characteristic feature of occlusion in the right middle cerebral artery?
(a)     Left hemiplegia with left UMN VII craninal nerve palsy
(b)   Left  hemiplegia with aphasia
(c)    Left hemiplegia with right anosognosia
(d)   Left hemiplegia with left hemi anaesthesia
12.  Metoclopramide suppresses which of the following neurotransmitters in vomiting?
(a)    Dopamine
(b)   Serotonin 5-HT4
(c)    Histamine
(d)   Acetylcholine
13.  The amyloid protein in primary systemic  amylodoisis belongs to which of the following classes of fibril proteins?
(a)    AA protein
(b)   AL protein
(c)    Aβ protein precursor
(d)   Β2 microglobulin protein
14.  Match list I with II and select the correct answer using the code given below Lists:
List I               List II
(Globin           (Tyeps of
chains)                        haemoglobin)
(A)  α2 β2                       1. Hb A2
(B)  α2 y2                 2.Hb A
(C)  α2 §2                      3.Hb F
(D)  β2 β2                      4.Hb H
       Code :
                        A         B          C          D
            (a)        4          3          1          2
            (B)       4          1          3          2
            (C)       2          1          3          4
            (D)       2          3          1          4
15.  Which one of the following is not a common feature of cystic fibrosis?
(a)    Exocrine pancreatic insufficiency
(b)   Azoospermia
(c)    Distal gastrointestinal obstruction
(d)   Polyneuropathy

16.  A 60- year old male suffering  from auditory hallucination says that people staying upstairs were talking about him and conspiring against him. He field a police complaint against them but the allegations were proved to be wrong-The most likely diagnosis is
(a)    Depression
(b)   Dementia
(c)    Delusional disorder
(d)   Schizophrenia
17.  Each of the following is true about the idiopathic primary pulmonary hyper-tension except
(a)    It is usually associated with coronary artery disease
(b)   It is more common in females
(c)    It is usually asymptomatic to begain with
(d)   It is characterized by autosomal dominant inheritance
18.  Which one of the following is not correct about Wilson’s disease ?
(a)    It is an autosomal recessive disorder
(b)   Serum ceruloplasmin is low
(c)    There is hepatolenticular degeneration
(d)   Serum copper concentration is high
19.  Which one of the following is not anaetiology of transudative pleural effusion?
(a)    Mesothelioma
(b)   Cognestive heart failure
(c)    Cirrhosis
(d)   Nephrotic syndrome
20.  With reference to secondary tumours of the lung, which one of the following is not correct ?
(a)  Diagnosis is made from radio- logical examination
(b)  Endobronchial depositsare com-mon
(c)  These are usually multiple and            bilateral
(d)  Quite often there are no respiratory     symptoms
21.  A patient is being investigated for chronic diarrhea.Small PAS positive foamy macrophages.Thediagnosis is probably
(a)    Chronic amoebiasis
(b)   Chronic hiardiasis
(c)    Whipple’s disease
(d)      Intestinal sarcoidosis
22.Consider the following modalities of     treatment:
1. Ballon dilatation
2. heller’s operation
3. Local injection of botulinum toxin
Which of the above is/are the treatment modalities for achalasia cradia ?
(a)    1 only
(b)   1 and 2 only
(c)    2and  3 only
(d)   1 , 2 and 3
23.Consider susceptibility to the following    pulmonary pathogens:
1.  Tuberculosis
2.  P.aeruginosa
3. S.auraus
4. Nocardia sp.
 Which of the above is/are associated with lonh term glucocorticoid therapy ?
(a) 3 only
(b)1 and 4
(c) 2 and 3
(d)2,3 and 4
24. Match List I with List II and select the correct answer using the code given below he Lists:
    List I                       List II
(clinicalcordition)       (Clinical manifestation)
a.    Lepra reaction        1.Koebner;s phenomenon
b.   Herpes zoster         2.Erythema nodosum
c.    Psoriasis                 3.Nikolosky;s sign
d.   Pemphygus                        4.Chickenpox virus
      A        B          C          D
(a) 1         4          3          2
(b) 2         1          4          3
(c) 3         4          1          2
(d) 2         4          1          3
25. In moderate severity obstructive lung disease,the expacted abnormalities include the following except
(a) ↑Residual capacity
(b) ↓ Vital capacity
(c) ↓ FRC/TLC ratio
(d) FEV1/ FVC <, 70%
26. Rasmussen’s aneurysm is a
(a) dilated vessel in a tubercular lung cavity
(b) dilation of the root of aorta in valvular     stenosis
(c) dilated arota  in syphilitic affection
(d) dilated renal vessel in hypertensive renal              disease
27. The following are important diagnostic skin manifestations of acute rheumatic fever :
1. Erythema marginatum
2. Subcutaneous nodules
3.Oster’s nodes
4. Butterfly rash
Select the correct answer using the code given below:
(a) 1,2 and 4
(b) 1 and 2 only
(c)  2, 3 and 4
(d)1 and 3
 28. Aortic regurgitation is characterized by
1. Wide pulse pressure
2. Angina Pectoris,
3. Early diastolic murmur
4.Loud 1st heart sound
Select the correct answer using the code given below:
(a)    1,2 and 3
(b)   2,3 and 4
(c)    1,2and 4
(d)   1,3and 4
29. Match List I with List II and select the correct answer using the code given below the Lists:
      List I                      List II
    (disease)                     (Association)
A..Dermato-myositis    1.Heliotrope rash
B. Epidemic dropsy     2.Hyoer-natraemia
C. Arsenic poisoning   3.Hyper-pigmentation
D.Diabetes insipidus    4.Dihydro sanguirine

            A         B          C          D
(a)        1          4          3          2
(b)        1          3          4          2
(c)        2          4          3          1
(d)        2          3          4          1

30. Each of the following antibiotic can be given orally except
(a) Azithromycin
(b) Amikacin
(c) Cefdinir
(d) Linezolid0

31. Consider the following statements regarding              Austin Flint murmur:
1. It is heard in severe aortic regurgitation
2. It is produced at the anterior mitral leaflet by                        the regurgitant blood during diastole
3. It is an evidence of associated mitral stenosis
4. It is heard in aneurismal dilatation of the                   ascending aorta
Which of the statements given above are correct ?
(a)    1, 2 and 3
(b)    2,3 and 4
(c)     1, 3 and 4
(d)    1 and 2 only
32. Two or more oligoclonal bands in                                       cerebrospinal fluid are most often
      positive in :
(a)    Acute bacterinal meningitis
(b)   Multiple sclerosis
(c)     Subarachnoid haemorrhage
(d)   Polyneuropathy
33.A 30-year old male presented with fever,                            dry cough and weight loss of 6 months-
duration. The chest X-ray shows military pattern. The differential diagnosis includes all the following except?
(a) tuberculosis
(b) Wegener’s granulomatosis
(c) fungal infection
(d) sarcoidosis
34. Consider the following statement regarding a healthy adult :
1. Mean left atrial pressure is 12-20 mm Hg
2.Left ventricular end diastolic volume is                    between 70-100 ml/m2
3.Pulmonary vascular resistance is 20-120
   Dynes sec cm-2
4.Left ventricular ejection fraction at rest is                 0.55  to  0.80
 Which of the statement given above are correct ?
(a) 1 ,2 and 3
(b) 2, 3 and 4
(c) 1, 3 and 4
(d) 1, 2 and 4
35.In acute hypoxaemic respiratory failure,Which of the following statement is correct regarding arterial blood gas analysis ?
(a) PaO2 is decreased and PaCO2 is either                      normal or klow
  (b) PaO2 is decreased and PaCO2  is high
(c) Both PaO2 and PaCO2 levels are markedly                             reduced
(d) PaO2 is normal and PaCO2 is high
36. Match List I with List II and select the correct answer using the code given below the Lists :
   List I                                     ListII
(clinical condition)               (Association)
A.     Hypothyroidism   1.Prolonged P R
B.     Rheumatic cordies 2. Pin Point Pupils
C.     Subarachnoid       3.Subhyaloid
Haemorrhage            haemorrhage
D.     Morphine                         4.Hung-up
Poisoning                 reflex
            A         B          C          D
(A)       4          3          1          2
(B)       2          4          3          1
(C)       1          2          3          4
(D)       4          1          3          2
37. Each of the following is a sign of                             impaired ventricular function except
(a)   raised JVP
(b)   narrow pulse pressure
(c)   end-inspiratory lung crepitations
(d)   tapping apical impulse
38.Consider the following statements regarding coarctation of aorta :
1. It may be associated with Tuner syndrome
2. It most commonly occurs near the insertion                        of the ligamentum arteriosum
3. It is twice as common in females than                     males
4. It may be associated with bicuspid aortic                 valve
Which of the statements given above are correct ?

(a)    1, 2 and 3
(b)    2,3 and 4
(c)     1, 3 and 4
(d)    1 and 2 only
39. Which one of the following ECG findings is most likely to be seen at the time of cardiac arrest?
(a) Ventricular fibrillation
(b) Ventricular tachycardia
(c)  Atrial fibrillation
(d) Paroxysmal atrail tachycardia

40. The most reliable indicator of recent Hepatitis-B infection in a convalescing patient is
(a) IgM Anti  HBc
(b) IgM Anti  HBe
(c) HBs Ag
(d) IgG Anti HBs

41. A 2- year old child presents with generalized muscle hypotonia and weakness. Distal muscles are affected more than  the proximal muscle groups. Facial muscles are  spared..Deep  tendon reflexes are diminished. Electromyography reveals fibrillation pattern. The most likely site of  involvement is
(a) anterior horn cell
(b) peripheral nerve
(c) neuromuscular junction
(d) muscle

42. Confirmation of the diagnosis of Hirschsprung disease is by
(a)  barium enema
(b)  sigmoidosopy
(c)  rectal biopsy
(d)  family history
43. Subacute sclerosing panencephalitis is associated with which of the following viral infections?
(a) Mumps
(b) Measles
(c) Rubella
(d) Poliomyelitis
44. Match List I with List II and select the correct answer using the code given below the Lists :
   List I                                     List II
(Disease)                                  (Clinical                                                                       feature)
A) Acute pyogenic       1.Normal CSF
B) Tubercular              2.Blevated protis                                                             with no cell
C) Gullian–Barre         3.Elevated protin and                                                   cells (mainly                                            polymorphs)
D) Neurocysti-             4.Elevated proteins
      Cercosis                    and cells (mainly                                                          polymorphs)
Code :
                        A         B          C          D
            (a)        4          2          1          3
            (B)       4          3          2          1
            (C)       3          4          2          1
            (D)       3          4          1          4

45. Pseudotumour  cerebri is characterized by                            all of the following except
(a)  increase in intracranial tension
(b)  blurred vision and diplopia
(c)  focal neurological signs
(d)  self-limiting condition

46. Vitamin K-dependant clotting factors                        include all the following except
(a)   Factor  II
(b)   Factor  VIII
(c)   Factor   IX
(d)   Factor   X

47.Amother brings her 2- year old boy wuth short history of pallor .Examination reveals pallor, petechiac  and splenomegaly. Which of the following is the most likely diagnosis ?
(a)   Thalassaemia
(b)   Acute leukaemia
(c)   Hodgkin’s lymphoma
(d)   Idiopathic thrombocytopenic purpura

48. Match List I with List II and select the correct answer using the code given below the Lists :
   List I                                     List II
(Disease)                                  (Clinical                                                                       feature)
A)Acute lymphoblastic                      1. Recurrent
    Leukaemia                           keen joint                                                                     swelling
B) Juvenile rheumatoid                      2. Lymphadeno
     Arthritis                              pathy with                                                                    petechiae
C) Thalassaemia                   3. Sewlling of                                                                 small joints                                          of hands
D)Haemophilia                                4. Hepatospleno                                                               –megaly with                                        severe pallor
                        A         B          C          D
            (a)        4          1          2          3
            (B)       2          4          1          3
            (C)       2          3          4          1
            (D)       4          2          3          1

49.         Which of the following cells in  pheral blood smear are r.eces increased in all haemolytic anaemias ?
(a)              Sickle cells
(b)            Target cells
(c)              Burr cells
(d)   Reticulocyte cells
50.         Which of the following is not a naturally. occurring anticoagulant in the body ?
(a)              Protein C
(b)             Protein S
(c)              Antithrombin III
(d)             Von Willebrand Factor
51.         What is the earliest gestational age at which iodine trapping occurs in foetal thyroid ?
(a)              4-6 weeks
(b)             8-10 weeks
(c)                12-14 weeks
(d)               16-18 weeks
52.         Which of the following inborn errors of  metabolism can give rise to thrombo-embolic manifestation in a child "
(a)              Phenylketonuria
(b)             Homocystinuria/
(c)              Galactosaemia
(d)             Gaucher's disease

53.          In an infant born to a HIV-infected mother, at what age of child the ELISA test can reliably diagnose HIV infec­tion ?
(a) 3 months (b\/ 9 months
(c)                12 months
(d)               18 months
54.         The most likely diagnosis in a 2-day old neonate with indirect hyperbilirubine­mia, positive direct Coombs' test and spherocytes on peripheral blood smear is
(a)               Cephalhematoma
(b)              ABO incompatibility
(c)              Hereditary spherocytosis
(d)             G-6-P-D deficiency
55.         The triad of 'diarrhoea, dementia and dermatitis' is characteristically seen in the deficiency of vitamin
(a) Riboflavin
(b) Niacin
(c) Thiamine
(d) Pyridoxine
56.         Hyperkalaemia can occur in all the following except
(a)               Cushing's syndrome
(b)             Crush injuries
(c)              Renal failure
(d)             Intravascular haemolysis

57. An asymptoamic 3-year old girl is brought to        the emergency department after 2 hours of     accidental kerosene ingestion. The appropriate management is
      (a)  gastric lavage
      (b)  inducing emesis
      (c)  chest X-ray and observation
      (d)  charcoal haemoperfusion
58. A 28-year old woman suffering from sickle          cell anaemia marries a 31-year old with no      abnormality. What are the respective         probilities to have (i) sickle cell disease and    (ii) sickle cell trait in their offspring? 
      (a)  0% and 100%
      (b)  25% and 50%
      (c)  50% and 25%
      (d)  25% and 25%
59. What is the naturally occurring from of     vitamin D in the human skin?
      (a)  Calciferol
      (b)  7 hydrocholesterol

      (c)  25 hydroxy cholecalciferol
      (d)  1, 25 dihydroxy cholecalciferol
60. Warthin-Finkelday giant cells in lymphoid            tissue are characteristic of which f the             following infection?
      (a)  Mumps
      (b)  Measles
      (c)  Congenital cytomegalovirus infection
      (d)  HIV infection 

61. Some antibiotics act as ionophores, which             means that they
      (a) interfere directly with bacterial cell                  wall synthesis
      (b) increase cell membrane permeability               to specific ions
      (c)  inhibit both transcription and                           translation
      (d)  inhibit electrophoretic separation of                ions
62. Polymerase Chain Reaction technique is   used for
      (a)  DNA amplification
      (b)  DNA sequencing
      (c)  screening gene libraries
      (d)  synthesis of polymerases
63. In the hills, the soil erosion takes place      due to rapid flow of rain water. It can be         most effectively controlled by 
      (a) building dykes
      (b)  channelizing the water
      (c)  jhum cultivation
      (d)  terrace cultivation
64. The chemical substance “Taxol” is sa----  to have curative value for maligna tumours. ?It is obtaind from the
      (a) shoots of Taxodium sp.
      (b)  roots and fruits of Taxodium sp.
      (c) bark from stem of Taxus sp.
      (d)  roots of Taxus sp.

65. Greenhouse gases are called as such because they
      (a)  are used in warning plant  growth                   chambers
      (b) help in maintaining atmospheric O2                 and CO2 balance
      (c) are produced by green photo-                          synthesizing plants and are trapped
      (d) prevent the escape of heat waves                    reradiated from the Earth’s surface     
66. Bacillus thuringiensis is used to control    
      (a)  bacterial pathogens
      (b)  fungal pathogens
      (c)  insect pests
      (d)  nematodes
67. Which group of algae can provide             nitrogenous nutrients to paddy cultivation       under natural field condition?
      (a)  Blue-green algae
      (b)  Brown algae
      (c)  Green algae
      (d)  Red algae
68. Tissue culture technique can be used for               1. developing virus-free plants
          2. multiplication of elite genotypes of                  useful trees
          3. production of secondary metabolites                            of plants
      Select the correct answer using the code    given below:
(a)    1 only
(b)  2 and 3 only
(c)  1 and 3 only
(d)  1, 2 and 3
69. Which one of the following is an   appropriate description of mangrove               plants?
      (a)  Large wood-yielding trees of the                        tropical forests
      (b)  plants in marshy areas with breathing                           roots
      (c)  Succulent plants that can thrive in                    arid/desert areas
      (d)  Vast grassland areas interspersed with                         deciduous trees and and thorny                       bushes
70. Consider the following:
      1. Ethylene dibromide
      2. Potassium meta-bisulphate
      3. Sodium benzoate
      Which of the above is/are used as food     preservatives?
(a)    1 and 2 only
      (b)  3 only
      (c)  2 and 3 only
      (d)  1, 2 and 3
71. Rayon fibre is made from
      (a)  cellulose
      (b)  isoprene
      (c)  polyethylene
      (d)  polyvinyl chloride

72. Which of the following parts/spectra of solar        radiation is/are mostly absorbed by the            leaves of green plants?
      (a)  Infrared
      (b)  Red and blue
      (c)  Violet, indigo and orange
      (d)  Ultraviolet, green and orange
73. Other than nitrogen and oxygen, which one          of the following is the most abundant gas in    the       Earth’s atmosphere?
      (a) Argon
      (b)  Carbon dioxide
      (c)  Hydrogen
      (d)  Methane
74. Among the following regions of India,      which one receives the highest annual             average monsoon rainfall from June to    September?
      (a) Gangetic West Bengal
      (b)  Eastern Uttar Pradesh
      (c)  Western Uttar Pradesh
      (d)  Punjab
75. In which one of the following types of forest        is teak a dominant tree species?
      (a)  Tropical rain forest
      (b)  Tropical deciduous forest
      (c)  Tropical thorn and scrub forest
      (d)  Temperate forest with grasslands
76. Consider the following statement
      (1)  Carbon dioxide is released from the                interior of the Earth during volcanic                eruption.
      (2) Carbon dioxide corrodes the mental                             surface.
      Which of the statements given above  is/are          correct?
(a)    1 only
      (b)  2 only
      (c)  Both 1 and 2
      (d)  Neither 1 nor 2
77. With reference to the ‘Protected Areas in India, consider the following statements:
      1.   In a Wildlife Sanctuary, limited biotic             interference is permitted.
      2.   A Biosphere Reserve is declared         conserve a       few specific species flora and             fauna.
      Which of the statements given above is/are           correct?
(a)    1 only
(b)  2 and 3 only
(c) 1 and 3 only
(d)  1, 2 and 3       
Ans: 1 and 2 is correct….. 3 is not in the option???   
78. Which one of the following pollutants       causes surface deterioration of leather             goods?
      (a)  Hydrogen sulphide
      (b)  Nitrogen dioxide
      (c)  Ozone
      (d)  Sulpure dioxide
79. The Finance Commission derives its          authority from the
      (a)  Constitution of India
      (b)  Parliament of India
      (c)  President of India
      (d)  Supreme Court of India
80. Which of the following regions has the     lowest atmosphere humidity?
      (a)  Equatorial
      (b)  Monsoon
      (c)  Prairies
      (d)  Polar
81. Cartagenia Protocol on Biosafety deals with
      (a)  establishing or promoting in situ                      conservation facilities for rare and                  endangered
      (b)  maintaining the worldwide network                of gene blanks for all the known flora                   and fauna
      (c)  monitoring and regulating the                          development of living modified                                  organism
      (d)  ensuring safe handling, safe use and               safe trans-boundary movement of                   livingmodified organism
82. Which one of the following is a secondary            pollution?
      (a)  Benzene
      (b)  Nitrogen oxide
      (c)  Ozone
      (d)  sulpure dioxide
83. A transition zone or region separating two biomes is known as
      (a)  ecocline
      (b)  ecological niche
      (c)  ecotone
      (d)  ecotype
84. Eutrophication of water bodies is mainly   caused by
      (a)  carbonates and oxides
      (b)  hydrocarbon and metals
      (c)  carbonates and sulphates
      (d)  phosphates and nitrates
85. Consider the following:
      1.   Coal pits
      2.   Sewers
      3.   Volcanic eruptions
      Which of the above is/are the source/sources        of H2S in the environment?
(a)    1 and 2 only

(b)   2 only

(c)    1 and 3 only

(d)   1, 2 and 3
86. Which of the following is/are the   source/sources of methane, a green house       gas?
      1.   Cattle
      2.   Rice fields
      3.   Wetlands
      Select the correct answer using the code    given below:
(a)    1 only

(b)   2 and 3 only

(c)    1 and 3 only

(d)   1,2 and 3
87. As per the Constitutional provisions, if a   Panchayat is dissolved, elections are to be       held within
      (a)  1 month
      (b)  3 months
      (c)  6 months
      (d)  1 year
88. The release of which one of the following            into ponds and well helps in controlling the     mosquitoes?
(a)  Crab
(b)  Dogfish
(c)  Gambusia fish
(d)  Snail         
89. Consider the following statements:
1.   Infant mortality rate takes into account      the death of infants within a month after         birth.
2.   Infant mortality rate is the number of        infant deaths in a particular year per 100         live births during that year.     
      Select the correct answer using the code    given below:
(a)    1 only

(b)   2 only

(c)    Both 1 and 2

(d)   Neither 1 nor 2

90. In India, sovereignty resides in the
      (a)  Constitutional on India
      (b)  People on India
      (c)  President of India
      (d)  Parliament of India
91. Endemic cardiomyopathy in children is     linked to the deficiency of      
      (a)  Zinc
      (b)  cobalt
      (c)  selenium
      (d)  chromium
92. Beta-blocker therapy after acute    myocardial infarction is contraindicated          in  which of the following conditions?
      1.   Heart failure
      2.   Orthostatic hypotension
      3.   Peptic ulcer disease
      4.   Bronchial asthma
      Select the correct answer using the code    given below:
(a)    1 and 2 only

(b)   1, 2 and 4

(c)    1 and 4 only

(d)   2, 3 and 4

93. The following congenital heart diseases are           associated with cyanosis except
      (a)  complete transposition of the heart                  artries
      (b)  single ventricle with or without                                    pulmonic stenosis       
      (c)  hypoplastic left heart
      (d)  atrial septal defect with mitral                          stenosis

94. A 34-year old non-diabetic, normotensive             patient presents with acute severe        retrosternal pain. The ECG shows ST         elevation (≥ mm) in anterior chest leads.         Blood for CPK-MB, Tropin-T and AST           are       normal. A repeat ECG after 24 hours        is          normal. What is the likely diagnosis?
(a)    Acute pericarditis

(b)   Prinzmental’s angina

(c)    Acute anterior myocardial infarction

(d)   Acute non-myocardial infarction

95. Which one of the following is      characteristic os Openeing Sanp (on cardiac    auscultaion) ?
      (a)  Low pitched,early diastolic
      (b)  High pitched, early daiastolic
      (c)  High pitched, late diastolic
      (d)  Low pitched, late diastolic
96. Sudden onset of cough followed by          increased dyspnea is typical of
      (a)  Pneumothorax
      (b)  Lobar pneumonia
      (c)  Collapse of lung
      (d)  Acute pleurisy
97. Multi-drug resistance tuberculosis implies             resistance to at least
      (a)  any two antitubercular drugs
      (b)  Isoniazid and Ethambutol
      (c)  Rifampicin and Ethambutol
      (d)  Isoniazid and Rifampicin                                            
98. A patient of pulmonary tuberculosis is on             antitubercular therapy. He develops drug-       induced hepatitis. Which of the following            drugs is not responsible?
      (a)  Rifampicin
      (b)  Ethambutol
      (c)  Pyrazinamide
      (d)  Isoniazid
99. Which of the following is the best             determinant of adequacy of alveolar   ventilation?
      (a)  Arteraial pO2 level
      (b)  Arterail pCO2 level
      (c)  Minute ventilation
      (d)  Presence of cyanosis
100. Which of the following is a DNA virus?
      (a)  Hepatitis A virus
      (b)  Hepatitis B virus
      (c)  Hepatitis C virus
      (d)  Hepatitis E virus         

101. Drug of choice for the treatment of Taenia          solium and taenia saginatainfestation is
      (a)  Metronidazole
      (b)  Albemdazole
      (c)  Niclosamoide
      (d)  Diloxanide furoate

102. Very high serum transaminases               (ALT/AST  > 100 IU/L) except
      (a)  Viral hepatitis
      (b)  Ischaemin liver injury
      (c)  Toxin-induced liver injury
      (d)  Alcoholic liver disease
103. Necrotizing papillitis is a feature in all of              the following conditions except
      (a) Sickle cell disease
      (b)  Tuberculosis pyelonephritis
      (c)  Diabetes mellitus
      (d)  Analgesic nephropathy          
104. The characteristics abnormality found in               the urinaylisis of a case of acute                     glomerulonephritis is
      1.   Granular casts
      2.   Res cell casts
      3.   Hyaline casts
      4.   WBC casts
Select the correct answer using the code given below:
(a)    1, 2 and 3

(b)   1 and 4
      (c)  2 and 3 only   
      (d)  2 only

105. Most common mutation in Alport’s                     syndrome is in COL4A5 gene, which is           transmitted as
      (a)  autosomal dominat
      (b)  autosomal recessive
      (c)  X-linked
      (d)  variable, autosomal dominant or                                 autosomal recessive
106. Broad casts in urinary sediments is          specific  for    
      (a)  acute renal failure
      (b)  rapidly progressive renal failure
      (c)  chronic  renal failure
      (d)  asymptomatic urinary abnormality
107. Amaurosis fugax refers to transient                       ischaemic attack involving the region of        (a) retina         
      (b)  internal capsule           
      (c)  brain stem
      (d)  cerebral cortex
108. Sub-acute combined degeneration of spinal          cord results from the deficiency of which of  the following vitamins?
      (a)  B6
      (b)  B12
      (c)  B1
      (d)  B3

109. The following systemic disease are                      typicallyassociatedwith            polyneuropathy  except
      (a)  Diabetes mellitus
      (b)  Hyperthyroidism
      (c)  Uraemia
      (d)  Carcinoma bladder
110. A young boy with history of left ear         discharge develops fever, headache, vomiting and focal seizure of right             upper limb. The appropriate line of                  management is
      (a)  urgent CT head and antibiotics
      (b)  urgent EEG and antibiotics
      (c)  urgent Otoscopy anmd antibiotics
      (d)  urgent CBC (complete blood counts)               and antibiotics
111. Which of the following blood disorders    is  not associated with a large spleen?
      (a)  Beta thalassaemia
      (b) Chronic myeloid leukaemia
      (c)  Hair y cell leukaemia
      (d)  Sickle cell anaemia
112. Megaloblastic anaemia may be caused                   by the following  drugs except         
      (a)  Phenytoin       
      (b)  Methotrexate
      (c)  Pyrimethamine
      (d)  Amoxycillin-Clavulinic acid                              (amoxyclav)

113. Disseminated intravascular coagulation               (DIC) is characterized by the                           following except
      (a)  Widespread bleeding/thrombosis
      (b)  prolongatuion of prothrombin                                     time/partial thromboplastin                              time
      (c)  high levels of fibrin degradation
      (d)  high  platelet count
114. Match List I with List II and select the                  below the List:           
            List I                List II
      (Disease)                (Appropriate    Microbe)         
A.     Epidemic         1. Coxiella
Typhus                          burnetti

B.     Murine typhus 2. R. rickettsii

C.     Q fever            3. R. typhi

D.     Rocky mountain 4. Prowazekii
Spotted fever
                        A         B          C          D
            (a)        3          2          4          1         
            (b)        3          4          2          1         
            (c)        4          3          1          2         
            (d)        1          4          2          3

115. Which one of the following statements    list   not correct
        (a)            Fastidious fast-growing, gram- positive bacteria whose growth requires          an        atmosphere of L-cysteine
        (b)            Known to cause severe systemic                       infectios-most often bacterial                    endocarditis, ehich can develop on                                  either native or prosthetic valves
(c)    Normally reside in the oral cavity and                         has been associated with local infections         in the mouth

(d)   The cure rates for HACEK prothetic-valve endocarditis appears to be high

  116.   A-50 year male quartz quarry worker   presents with progressive dyspnoea on           exertion. Which of the following is the              likely pnueumoconiosis?      
      (a)  Asbestosis
      (b)  Byssinosis
      (c)  Silicosis
      (d)  Beryliosis
117.     Splenectomised patients have an               increased susceptibility to which one                     of the following infections?
      (a)  Entamoeba histolytica
      (b)  Giardia lamblia
      (c)  Streptococcus pneumonia
      (d)  Aspergillous niger
118.     Match List I with List II and select                   the       below the List:

                   List I                         List II
            (Class of drugs)           (Anti                            retroviral                         agents)         
A.     Nucleoside                  1. Stavudin
Analogue Reverse       
B.     Nucleotide                   2. Nevirapine  
Analogue Reverse
C.     Non-Nucleotide                       3. Lopanavir
Reverse Transcriptase
D.     Protease Inhibitor         4. Tenofovir
            A         B          C          D

(a)        1          3          2          4         

(b)        1          4          2          3         

(c)        2          3          1          4         

            (d)        2          4          1          3

120.     A 8-year old child present with itching            on the scalp with loss of hair. A          characteristics ‘black dot’ appearance is   seen. Which of the following is the most         likely cause?   
            (a) Alopecia areata
            (b) Pediculosis capitis
            (c) Tinea capitis
            (d) Traumatic alopecia


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