CS (Main) Exam, 2020 URC-B-MDCS fafera-fagm / MEDICAL SCIENCE ‘yea-ua II / Paper II Fratttea are: atta ae often 3% : 250 Time Allowed : Three Hours Maximum Marks : 250 sreaaua & fern faire sgaet rv sre a aree 33 a et Paeeheaftver estes sigaer Peerage Te: pend rrr wea & at ah eo # frrartra & cen feet atte stttaht chit HF Bee 1 aherth ai et er wet see 23 # | swe Hoar 1 a5 siftard & a2 a artes ne 8 oH oH ¥ aire & 1 webs were oar eres A ETB | Fa a er rea 3 Rea aBe ome waen-a9 & oth va area a sehr wera (FLA..) gfe years Ale Ba 1 sige area ed ‘seh area fra 1a Fa IE ies ET Bich | reat roe etn, at Fae &, a5 orga rar AT TRE 1 ral arth sharers or, af Pea a Ref er ore eth) eae ae, 1 ger vt te or sien Fra 7 aera 2 1 sonia rye #8) are | a Bi, ab xe & sae HT HE TEN TR aE A SFT: BP / eee TH TA IST NT Ye AS in EY BIT HAT TE | Question Paper Specific Instructions Please read each of the following instructions carefully before attempting questions : There are EIGHT questions divided in TWO SECTIONS and printed both in HINDI and in ENGLISH. Candidate has to attempt FIVE questions in all. Questions no. 1 and 5 are compulsory and out of the remaining, any THREE are to be attempted choosing at least ONE question from each section. The number of marks carried by a question / part is indicated against it. Answers must be written in the medium authorized in the Admission Certificate which must be stated clearly on the cover of this Question-cum-Answer (QCA) Booklet in the space provided. No marks will be given for answers written in a medium other than the authorized one. Word limit in questions, wherever specified, should be adhered to. Illustrate your answers with suitable sketches and diagrams, wherever considered necessary. Coloured pencils may be used for the purpose. Attempts of questions shall be counted in sequential order. Unless struck off, attempt of a question shall be counted even if attempted partly. Any page or portion of the page left blank in the Question-cum-Answer Booklet must be clearly struck off. URC-EB-MDCS aWEA SECTION A SRA D.10 ais & agen, Refiearee & aa vet % Bats F avis ifr | frrafter area ¥ gra a ara fia oasftenh (Serie) cari @r frag wen wees ciarwT aor Uap Ufa a aos Aare | As per ICD-10 classification, describe briefly the types of schizophrenia. Enumerate the various catatonic symptoms observed in schizophrenia and describe each in one line. 5+5=10 fafa series teeter rent at Farge | WH 50kg aa4 a ey, fea ehinheer A’, ae cet at A dia rear @ afta @ 1 sa en svar fear arn arte, fee Ae | Enumerate the various primary haemostatic disorders. Discuss the treatment of severe haemarthrosis of right knee in a 50 kg male suffering with Haemophilia A. 54+5=10 Be 18 We aT sree free awT 7 keg, venfte, ana, ganfs ae ae Fistefioer & sfagqa & arr wren or @ | smé.aeaené. MNCD Shetwter & agere ga ater & wees 3 fore eer He Sh ? An 18-month-old child weighing 7 kg has presented with history of diarrhoea, vomiting, rapid breathing and dehydration. How will you manage the child as per IMNCI protocol ? 10 G 12m & fry at ate, song eae cen sagt eaea & arr eT STAT 21 ee fig & cet & aro fare aan ae saree fe sad wie % feu RTT HET eT | A 12-month-old child has presented with cough, respiratory distress and noisy respiration. Enumerate their causes and the management, 10 URC-B-MDCS s© we 7-afa sen & aren et sah Sed Faceq cer wet we Gea fart fad 2) sa een A at at we A A aideee saga ae aT fem BoTT al @ ween A ada alt a a fiqe ara 8 2 eas Shas fates fig 8 wend @, 58 Free | Gi) Fa Bore @ Galera fart a frnge | Parents of a 7-year-old girl noticed milky white macules on her upper eyelids and hands. Her mother had been recently diagnosed as a case of autoimmune thyroiditis. (i) What is the diagnosis for her skin lesions ? Enlist the differential diagnosis of this clinical entity. (ii) Enumerate the disorders associated with this condition. (ii) How would you classify this disorder ? 44343=10 Q2 (a) Gi) “Sama aren” art Fag? Gi) Fae aren HA aA arch ataweart Ft ae werfafe (Getta) Srh, sash water vega Fifsre | (ii) WH 94 Beare a FaaTa Fras ay 1600 Wz sik St 7 fer we TAT fad afafaftrefirenc &, sae veer & fore get eT eT ? (iv) Wi aitad carer St far-fes feafeat t save at 2, re frac | wet vRad corer 8 fer oer 8, seh ania A ter sega fife | (What are the causes of “neonatal jaundice” ? (i) Outline the algorithm for its work-up. (iii) How will you manage a 34 weeks newborn at 7 days of life weighing 1600 gm with hyperbilirubinemia ? (iv) Enumerate the indications of exchange transfusion and outline the procedure. 5474444520 URC-B-MDCS 3() @)aipepa Rae & fafa aro ere? Gi) ore Reaav & sree area sitpope Fear gen React ofpopa Fim & ate dle Ba fee ara 2 2 (ai) Foes fear ar afta en 8 2 Reef Grapes Reet ae #28 shah @ ues @ wad @ fas MA wn wien & fe ae Ft afar ar fae Son vg aaa @ 2s esi aw FaeT | (What are the various causes of pleural effusion ? (ii) How can we differentiate between transudative and exudative pleural effusion based on ‘Light's criteria’ ? (iii) What is parapneumonic effusion ? Enlist factors which indicate towards inserting a chest tube to manage a case of parapneumonic effusion. 64445215 (©) & 30-adfa goa & gedit oft aiehtal a ete wat & fran dtaies weft ‘gfora 2 cen fir oe Ca-eaa Bem & | Ded Bee GPa 2 | @ wa fer & faite dream ease F wets & fetes fer fraree | Gi) 3H fer & we, wear ce seus damn areft eure FH SER & FAT fanes t wed &, daa af acre | Gi) Fa ret Ren a wafer ee are feta on egies are ssa #7 A 30-year-old male presented with well-demarcated erythematous plaques with silvery white scales on the knees and elbows. Grattage test was positive. (i) Enlist the differential diagnosis for various clinical forms of this disorder. (i) State briefly the treatment options for this disorder, for mild, moderate and severe presentation. (iii) What are the various disease modifying factors for this skin disorder ? 44744=15 URC-B-MDCS 4Q3. (a) (b) (©) we 4g A fing dha ag & RT Aig H oer SA oA aRarht B ong mE eI ata ea sah met 1 cre 2, faterd & cen fear & cam FI cftanttas sfirger S3 Ve ae Te eT & Fe Arey A are a aTEATTeT H SAT Z| walters aonfaa fret ae? ii) ag Prear srert-sremt arg af faaa-faea dereierell & aver wae Sten B 2 (ii) ga fran & Aahte fas en é, sBfea Hf | Gv) ya fen & yea tem, fetta ad qdta ofe A aan a-fafecdt ‘aftrat en 2, sah feta Afire | ‘A 4-month-old infant presented with severe itching disturbing her sleep. On examination she had redness, papules and excoriations on the cheeks. Family history revealed asthma in mother since childhood. (What is the most likely diagnosis ? ii) What is the clinical presentation in different age groups ? State its diagnostic criteria. (iv) Discuss first, second and third line of management and the non-medical measures for this condition. 24+4+4+10=20 @) waa Sarre wat & er Frey, wen ae serge fe sew er Roa org we wee tit 2 | Gi) 6 Beare a fry St ara eT Canfas equa BH Bra vega eta @, TAHT yates ary a He? (ii) Qasia ares freer aya 10 kg @ afk fra aa FT SHI STeT Ea 2, Sam Tae aT HA HT? (i) Enumerate the causes of cyanotic congenital heart disease and the ages of their presentation. (i) How will you manage a 6 weeks infant presenting with cyanosis and congestive heart failure ? Gii) How will you manage a 2-year-old child weighing 10 kg in a cyanotic spell ? 54545215 @) TeRRReB camo] aera: Fret are ae fers frre den wees sheft aie ar srifcia ere Fife | Go frm agqate-s dam & sya 4 area Al afr Ft fear ifsre, | ( Enumerate the commonly encountered serological patterns of Hepatitis-B infection along with the interpretation of each. (i) Discuss the role of Tenofovir in the treatment of chronic Hepatitis-B infection. 1045=15 sQ4 (a) (b) © we 2o-aMia gee a wm arent ge Fy geht aft cin we are er eae qdent ga a sare fen stare gE I @ Fa aa & fee arcane ea 8 aan wen afta dom ott en safe am? Gi) Wate date aq ont asta fee STAR, Fae | Hapa Ft Faen Aftat € an wets Soh & gape F wears BAS yea ot sreeen # anfrita ¥q an satan # 2 Gi) Gis A aye 4 Arenas safteatrat saan #2 dv) Tet fer-Rést & agen tis Gai as siau-teft car sine fee ort & wn fer 2 A 22-year-old male is bitten by a stray dog on his right leg. The bite was an unprovoked bite. (i) What are the immediate dos and don'ts for such a wound ? (i) As per the national guidelines on rabies prophylaxis, what are the categories of dog bite in humans and what are the recommended post-exposure prophylaxis in each ? (iii) What are the clinical manifestations of rabies in humans ? (iv) What are the intramuscular and intradermal regimens of anti-rabies vaccine as per national guidelines ? 3+346+8=20 we aatgg after A sored okt zadt we agent, de, awfiet, defi, aeerta, wraet Hae are Patent facet a ang & | @) Fa fren a Sha a valet grep aeifira a awa F 2 Gi) 36 Rar & trererfirs ohad aaa a #2 Gi) 4 fran & senfepfa sia-attors aac | ‘An elderly female developed itchy, firm, shiny, violet, polygonal, flat topped papules on her wrists and ankles. (@ What could be the associated environmental factors for this disorder ? (ii) What are its clinical variants ? (iii) State its histopathology findings. 6454415 @ sata an og} ae A yg} aes aro fae | Gi) seit Fa are Satta afar ar dan A dara @q aueee Gat at Prange sit sah ara-ereft aang | Gil) DPT &% & fae eazen sftger werd ait siafhte (argh) a wat 8? (Enumerate the common causes of under-5 mortality. (i) Enumerate the vaccines preventing CNS infections in children and their schedule. (ii) What are the adverse events and contraindications of DPT vaccine ? 54545515 URC-B-MDCS éQ5. (a) (b) (o) @ (e) WEB SECTION B frasiterectn Ft treaties fatremsi, tae Staegare TM Te ST Has H aos fife | Describe in brief the clinical features, diagnostic work-up and management of a case of pheochromocytoma. 34344=10 anit apa Pash an 2a-fapftorn, drereftrs fensit cer wees aT Fete Fanta fifa | Describe in brief the etiopathogenesis, clinical features and management of a case of amoebic liver abscess. 34+34+4=10 Um a5-aiia sfsentea afger at ferret at aa @ ant ware et wer @ ok ara Asa Tait sea @ 1 @ Fa wore & are falar | G) ahs vee A an Malate Sh, seh eater weqe Fife | A 35-year-old unmarried female presents with heavy menstrual bleeding since two years with severe anaemia. (@ Write the causes for this condition. (ii) Outline the management protocol of this patient. 5+5=10 fear dea Ft geet # a wea (wea) & senza aH & ? ada # feather Ser Ft afew ae seta at Fara & 7 ame agar fasten da A aii 8 at wh ofe & HS er are S ? fester Seq @ sre anfarail era sera Sera St Bad z 7 What are the advantages of vaginal births over caesarean section ? What are the current caesarean section rates globally and in India ? What, according to you, is the reason behind rising caesarean section rates ? (iv) What are the implications of caesarean sections on future pregnancies ? 3424243210 Gi) fare rg & fare ser aH Hr ay FIT-aaT He LETT? Gi) shia are & sagen, Fer ara gq at a Fa ar a aT frat san @, oferta fifi 1 Gi) Bree } oR Far} aes wes 8 aH aH aT firgait wt Ae ate 1 fre wear atiena feat Sra 8 2 (i) What is the significance of birth weight for an infant ? (ii) Under the international standards, what is the definition of low birth weight ? Gii) From the perspective of causation, how are low birth weight babies broadly grouped ? 34+3+4=10 URC-B-MDCS 3Qe. (a) (b) (©) @) saris Sasi (sigrerht) seater (Por) = sfonfia Aisa 1 Gi) cravat feacife araaicren ar frat aa fe rat 8 2 Gil) 27-adia after fret srattres yaa orafte (wigs) ar sige @, sat sramfas feat avatcran & vaes At ater sega Aire | @ Define Premature Ovarian Insufficiency (POD. Gi) How do you diagnose POI? (iii) Outline management for a 27-year-old woman with history of primary infertility presenting with POI. 345+12=20 (Mesa aor a & fafereasita wae & fea tide a fafa 1 Gi) Teh aor tq fee or ara fafa aeivant at free | Gi) Yes am Tetra & Troe FH dae Pde HA | (i) Write briefly about the medical management of peptic ulcer disease. (i) Enumerate various surgeries for duodenal ulcer. Gii) Discuss in brief about the sequelae of peptic ulcer surgery. 5+545=15 @ Saree ast & ae aay wel ade & after octet ar sar ond dem ¥ cara 2 1 Gi) Tere wren Peta aris & sieria, after organ & facies Bg war Urdife sears oT ta 2 Gil) efter orgetftar at feted Bt gan 8 gah fare Pra-fea wala A gfe Oh sree @, oferta stare 1 () Name the States in India which continue to be heavily infected with lymphatic filariasis. (ii) Under the National Filaria Control Programme, what is the strategy being adopted to achieve the elimination of lymphatic filariasis ? (iii) Define the criteria which must be met to state that elimination of lymphatic filariasis has been achieved. 3+6+6=15 URC-B-MDCS eQi. (a) am s5-atia gor at ae H starts sifrera aA x Sgared # aren sree 1 Fa crag 2, St aera Ao aT et @ wah aS aa Tree ears SA? Gi) en Bs (geese Sits Se) ht ahead fefae | siae-nefsor Reva amt & fore sraatctta ster & weit at ae arelenaT eich @ 2 Git) fer ae? an aan ae 8 ce see aT Hea Bla BP sea eT BA ‘fren sit arfee 2 ‘A 35-year-old male is brought to casualty after suffering from blunt trauma chest. He is having significant hemothorax. (i) What will be the clinical picture of this patient ? (i) Write boundaries of triangle of safety. What is the rationale of underwater seal in intercostal drainage ? (iii) What is ‘Flail chest’ and what is its significance ? How will you manage it ? 6+6+8=20 o) @ gta after care fiers erga eK fea sae a set ge ASAT steit A qf ea A Ser weer @, sats F ferflac | Gi) afte anton zareea fret 3 sienla wenfer a wyE arietal al eaters, Pitre raver ces wraftres careca Sar a fre a aT TATA BI (@ State in brief how the National Rural Health Mission aims to fulfil the goals of Janani Suraksha Yojana at the community level. (ii) List the key areas of action proposed under the National Rural Health Mission which aim to make primary healthcare comprehensive and universal. 748215 © @ Water mites fed & tanita sein wae g, FE fare | G) BRS wide Ga aa aH seed gS sews sewer oH BI 82 qadea wide Med A geen A see se era TTT 4, Gato H ange | Gi) “GRARA wiRaeR” st ofonftr Aire | ss ard wer At frrenfae wre? Gv) Pee & SaGat mites” & am wage | a aftraar wart a as gam fare se a wie Peer srr aafee 2 3@ Enumerate non-contraceptive usage of oral contraceptive pills. (ii) What are long-acting reversible contraceptives ? Mention briefly their advantages over oral contraceptives. (ii) Define “Emergency contraception”, What is their mechanism of action ? (iv) Enumerate any two “Emergency contraceptives”. How should they be prescribed for their maximum effectiveness ? 3444345215 Qs. (a) (i) aa 3 wary f sree are fee wan aaa Fee ra ora cred @ cer ga del | SRE arse dia eae 4, 38 oneifsa Hie | Gi) aren Ae FH Ys werefat (Ge) | Re By sea A a sien eit orftrs gtr @ | aay fi fate By ser OAR ARE RAR PTT gona Bt aH B | (i) State in brief how dietary factors may influence the cardio-vascular health in adults highlighting the specific cause-effect relationship. Gi) Explain why vegans are more at risk to develop Vitamin Byy deficiency. State the ill-effects of Vitamin By» deficiency on human health. 10+10=20 ) & so-adia afgen 7 mre % srarda & aa Sgared Fuga 2 | za fara a eae 8 vam Ht aS coe BUT a | da af ved saan tef-ordeser gon an gen ue ad wea ae fa cutee as fester dea Hear gH 8 | @ sae feat or yates Ba fren er afte cen ae qeaiem ae ara arcane frend ara ehh 2 Gi) Fem aioe ora at aq ga TH A wer ste ae ahh, se exten sega fare | A 30-year-old Ppl; woman presents to casualty with 7 month amenorrhoea and gives history of off and on bleeding per vaginum since 2 days. She has had one myomectomy three years back and has undergone one lower segment caesarean section one year back. (How will you evaluate her and what are your concerns ? (ii) Outline the management protocol to optimize her outcome. 748215 URC-B-MDCS 10(© && 45.adia gee aw 7g H welts ara 8 fared ya wa at wer? at ara GS zo ch a war’ | ata ae a om wen fH a TAT | @ Fsaie Rav wre? Gi) TEATRO a ge Gs aati sore wer Gata FH avhs ifs | Gi) FA Boe & wae Al eta eqa Ae | A 45-year-old male is having pain and pus discharging wound near anus. On examination, he is found to be having fistula-in-ano. (What is ‘Goodsall rule’ ? (i) Briefly describe Park’s classification system of fistula-in-ano. (iii) Outline the management of this condition. 54545215