UPSC Medical Sciences Optional 2025 Question Paper and Analysis

PAPER I (Anatomy/Biochemistry/Physiology)

SECTION A

QUESTION 1

1.a. Describe the formation, course and branches of ulnar nerve. Which muscles do each of the branches supply? Why is ulnar nerve called musician’s nerve? (10)

1.b. Name the nerves and their branches that supply the sole of the foot stating the specific area of their distribution. Explain in brief what is Morton’s metatarsalgia? (10)

1.c. Classify jaundice according to its etiology. Make a tabular representation of the blood, urinary and stool findings observed in different types of jaundice? (10)

1.d. Describe the process of generation and conduction of nerve impulses in humans. Add a note on saltatory condition. (7+3=10)

1.e. With the help of a suitable diagram, explain the innervation and functions of muscle spindle (10)

QUESTION 2

2.a. Using a well labelled diagram, trace the taste pathway from circumvallate papillae of tongue to the cerebral cortex. (15)

2.b.i. Enumerate any five tests for the assessment of renal tubular functions. Explain the underlying principle and their interpretation. (10)

2.b.ii. Explain the role of biotin in intermediary metabolism with suitable examples. Add a note on the mechanism of action of any biotin-antagonist with its application in medicine? (10)

2.c.i. Define cardiac output and describe regulation of cardiac output in normal adults. Add a note on cardiac index and cardiac reserve (7+3=10)

2.c.ii. Define systemic vascular resistance and list its determinants. Explain briefly role of its determinants. (3+2=5)

QUESTION 3

3.a. A 36-year old cyclist suffered pelvic injury while riding into a pothole on the road. Following this incident, he has severe pelvic pain and is unable to pass urine. His retrograde urethrogram shows contrast limited to superficial perineal pouch.

1. What is the most likely structure and its site of involvement, which is responsible for his inability to pass urine?
2. What are the parts of the principal structure involved?
3. (III) With help of a labelled diagram, illustrate the difference in the contents of superficial perineal pouch in males and females. (5+5+10=20)

3.b.i. Describe Selenium under the headings of ‘its dietary sources’, ‘its biochemical roles’ and ‘its deficiency diseases’ with their clinical manifestations. (10)

3.b.ii. Restriction Fragment Length Polymorphism has a number of applications in clinical medicine. Briefly state any three. (5)

3.c.i. With the help of suitable examples explain the second messenger mechanisms that mediate the downstream actions of hormones inside the cell (10)

3.c.ii. Give a brief account of synthesis, storage, secretion and functions of the posterior pituitary hormones. (5)

QUESTION 4

4.a.i. A 55 year old lady visits surgery OPD with a three months old history of a painless hard swelling in her left breast. On examination, it is found that the swelling is firm, immovable and is located in upper inner quadrant, along with retraction of nipple. She is advised to undergo pre-operative sentinel lymph node biopsy and surgery. Explain the anatomical basis of pre-operative sentinel node biopsy in this case? (5)

4.a.ii. A 45-year-old man presents at orthopaedic OPD with swollen and painful right knee. He gives a history of fall while playing cricket two weeks ago. On examination, his right knee has tenderness, swelling, decreased range of mobility and anterior joint instability. His MRI scan reveals damage to one of the major knee joint stabilizers.

1. Name all the ligaments and write their specific roles in stabilization of the knee joint.
2. Name the most likely structure involved in the given case and write two points to support your viewpoint. (10)

4.b.i. Explain the principle of radioimmunoassay (RIA) and outline its role in the diagnosis of thyroid disorders. Add a note on the advantages and disadvantages of this technique. (10)

4.b.ii. Enumerate hematopoietic vitamins. Explain the biochemical basis of the deficiency manifestations of any ‘two’ of them which lead to anemia. (10)

4.c.i. Briefly describe the development of cell-mediated immunity. List the cell types involved, along with their actions (5)

4.c.ii. Briefly describe the process of phagocytosis (5)

4.c.iii. Give an account of the formation and function of thrombocytes (5)

SECTION B (Pathology/Forensic Medicine/Pharmacology/Microbiology)

QUESTION 5

5.a.i. Enumerate the topical anti fungal drugs along with their indication and side effects. (5)

5.a.ii. Name antihelminthic drugs used in treatment of neurocysticercosis and also mention their side effects (5)

5.b.i. Enumerate the cells of lymphoreticular system. Schematically represent the process of B-cell maturation. (5)

5.b.ii. Make a schematic flowchart of pathogenesis of salmonella causing enteric fever. Mention two important categories of drug resistance in Salmonella type. (5)

5.c. What are the risk factors for lung carcinoma? Describe the morphological features of three major histological types of lung carcinoma? (4+6=10)

5.d. Describe the classification of cervical intraepithelial neoplasia/squamous intraepithelial lesion. Write a note on the role of Human Papilloma virus in the pathogenesis of cervical carcinoma. (5+5=10)

5.e. Classify poisons base don the chief symptoms. Describe the legal duties of a medical practitioner in a case of suspected poisoning. (10)

QUESTION 6

6.a.i. Describe the approach to laboratory diagnosis of chronic myeloid leukemia-chronic phase. (10)

6.a.ii. Describe the gross and light microscopic changes evolved over two weeks duration in myocardial infarction. Add a note on the role of serum cardiac biomarkers in the diagnosis of myocardial infarction. (5+5=10)

6.b.i. Explain why beta blockers should not be given to diabetes patients who are in oral hypoglycemic agents. (5)

6.b.ii. Explain why folic acid is given with methotrexate? (5)

6.c.i. A 12 year old child developed fever with multiple crops of vesicular rash starting from the face spreading towards the trunk.

1. Mention the mode of transmission and spread of the probable viral agent. Prepare a flowchart of the course of the infection in humans. Mention three tests for laboratory diagnosis of the agent.
2. Discuss the post-exposure preventive strategies (5+5=10)

6.c.ii. Enumerate the malarial parasites prevalent in India. Of them, which species is notoriously associated with life-threatening complications? What are the different characteristic peripheral blood smear findings in different species of parasites that cause malaria? (10)

QUESTION 7

7.a.i. Define Drowning. Enumerate the different modes of death in a case of drowning.  List the postmortem findings in a case of wet drowning. (10)

7.a.ii. Describe Diatom test and enumerate its limitations (5)

7.b.i. Enumerate four major primary glomerulonephritides presenting with nephrotic syndrome. Describe pathogenesis, light microscopic, immunofluroscence microscopy and electron microscopic findings of post-infectious glomerulonephritis. (2+8=10)

7.b.ii. Describe steps of wound healing by first intention. Enumerate factors that influence tissue repair. (10)

7.c.i. Describe the role of nitrates, their route of administration and their side effects while being used in the management of angina pectoris? (5)

7.c.ii. Describe in brief the mechanism of action and therapeutic uses of Exenatide. (5)

7.c.iii. Enumerate the advantages of artemisia-based combination therapies in the treatment of malaria (5)

QUESTION 8

8.a.i. Describe the challenges of circulating vaccine-Derived Poliovirus (VDPV). Add a note on the environmental surveillance and preventive strategies for effective maintenance of Polio elimination. (10)

8.a.ii. Describe mode of infection and clinical manifestations of cryptococcosis. Discuss the role of Rapid diagnostic test in comparison to conventional techniques for identifying the infection. (10)

8.b.i. Define Injury, Hurt and Grievous hurt. Add a note on the medicolwegal aspects of contusion (10)

8.b.ii. Describe the various tests prescribed for blood and seminal stains obtained during the examination of a victim of rape and their role in the investigations (10)

8.c.i. Enumerate the drugs used in the management of hypertensive crisis. Also describe the route of administration and their side effects. (5)

8.c.ii. Name the drugs, doses and duration of treatment after post-exposure prophylaxis of HIV. (5)

PAPER II

SECTION A (General Medicine/Dermatology and Paediatrics)

QUESTION 1

1.a. briefly describe the role of lifestyle interventions in prevention of coronary artery disease (10)

1.b. Discuss the role of various imaging modalities in the diagnostic evaluation of pyelonephritis (10)

1.c. Write the criteria for diagnosing pneumonia in children according to the ‘Acute respiratory Infection (ARI) Control Program (WHO). Write the treatment strategies of different types of pneumonia according to the ARI control program (6+4=10)

1.d. How will you treat hypothermia in a 3-year-old child with severe acute malnutrition (SAM)? How will you prevent hypothermia in an SAM child? (5+5=10)

1.e. A joint family comprising senior citizens, antenatal women and one-month-odl infant is suffering from scabies.

1. Name the organism that causes scabies in humans? (2)
2. What factors are involved in the transmission of scabies in a family? (3)
3. (iii) How do you plan to treat scabies in this family? (5)

Question 2

2.a. A 23 year old woman with Type I Diabetes Mellitus presents with nausea, vomiting and altered sensorium. On examination, she is tachypneic and hypotensive. Her random blood sugar is 460mg/dL, and routine examination of urine is positive (++) for ketone. Outline the stepwise approach to the diagnosis and management of this patient. (20)

2.b.i. Define acute diarrhea in children. List its causes. How would you assess for dehydration in such a child.? (2+3+5)

2.b.ii. Write the nutritional management of acute diarrhea and the steps to be taken for prevention of acute diarrhea. (5+5=10)

2.c.i. Define eczema? (3)

2.c.ii. How do you classify eczema? (3)

2.c.iii. Enumerate the difference between allergic contact dermatitis and irritant contact dermatitis? (4)

QUESTION 3

3.a.i. Elaborate indications for initiating antiviral therapy in a patient with chronic hepatitis B. (10)

3.a.ii. Write the first-line antivirus treatment regimen for the management of chronic hepatitis B along with the recommended monitoring strategy during therapy? (15)

3.b. Write the risk factors for respiratory distress syndrome (RDS) in newborn. What is the differential diagnosis of RDS? How will you manage respiratory distress syndrome in newborn? (5+5+5=15)

3.c. A 28 year old female with a long history of psoriasis develops symmetrical, flexural and grouped pustules with high grade fever and severe constitutional symptoms in the third trimester.

1. What is your diagnosis? (3)
2. How do you manage the condition? (4)
3. (iii) What are the complications? (3)

QUESTION 4

4.a.i. How do you differentiate between acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) based on peripheral smear and bone marrow findings? (10)

4.a.ii.Describe the current standard of care for acute lymphoblastic leukemia (ALL) in adults and children (15)

4.b. Enumerate the various types of vaccines available in National immunization schedule (NIS) in children. Define adverse events following Immunization. State the adverse events of any three vaccines. ((6+3+6=15)

4.c. Discuss the diagnostic approach to and curative management of renovascular hypertension? (10)

SECTION B (General Surgery/OBG/PSM)

QUESTION 5

5.a.i. Enumerate the advantages as well as the limitations of laparoscopic surgery (5)

5.a.ii. Describe the different techniques of creating pneumoperitoneum during laparoscopic surgery (5)

5.b. Describe the etiology, clinical features and management of anal fissure? (10)

5.c.i. Define maternal mortality rate (MMR) and enumerate the causes of maternal mortality in India? (5)

5.c.ii. What are the steps to be taken to reduce maternal mortality in India? (5)

5.d. Discuss the clinical features, diagnosis and treatment of pelvic endometriosis? (10)

5.e. Explain the significance of the Kilkari initiative with reference to National Rural Health Mission. What is it aimed at and how is it being implemented? (10)

QUESTION 6

6.a.i. Classify hypertensive disorders in pregnancy? (5)

6.a.ii. Enumerate the types and complications of eclampsia? (5)

6.a.iii. Discuss the management of anterpatrum eclampsia in a 25-year-old primigravida with 32 weeks of pregnancy? (10)

6.b.i. Describe the clinical features and management of ulcerative colitis (10)

6.b.ii. Enlist the differences between ulcerative colitis and Crohn’s disease (5)

6.c. What are the major objectives of Home Based Newborn care? State the responsibilities that that ASHA is entrusted with to make the program a success? (5+10=15)

QUESTION 7

7.a.i. Describe the clinical features and diagnostic workup of a suspected case of peritonitis? (10)

7.a.ii. Enumerate the principles of management of peritonitis? (5)

7.a.iii. Enlist the important complications of peritonitis. (5)

7.b. Anaemia Mukt Bharat Programme employs a multi pronged approach. What are the interventions it focuses on to achieve its goals? What are the specific measures being undertaken under this program? Which are specific population groups that this program targets? (5+5+5-15)

7.c.i. Define infertility. How will you investigate the tubal factors of female infertility? (10)

7.c.ii. enumerate the assisted reproductive (ART) procedures? (5)

QUESTION 8

8.a. Under the National Framework for Malaria Elimination in India, What are the targets set for the years 2027 and 2030 respectively? What are the key interventions recommended for states and UTs which require intensified control and fall under category 3? Which are the parameters employed for maintaining epidemiological surveillance over malaria? (5+10+5=20)

8.b.i. Describe the WHO medical eligibility criteria for contraceptive use for women with medical conditions? (5)

8.b.ii. Discuss the complications of intrauterine contraceptive device (IUCD) (5)

8.b.iii. How will you manage a case of misplaced copper-T (cu-T) (5)

8.c. Describe the embryogenesis, clinical features and principles of management of cleft palate? (5+5+5)