Medical Science 2023 Paper II 50 marks Compulsory Outline

Q1

(a) (i) Enlist the clinical features of dengue fever. (ii) Outline the management of a patient with dengue haemorrhagic fever. (5+5=10 marks) (b) Write the symptoms of schizophrenia. (10 marks) (c) (i) What is the full form of IMNCI and what are its objectives? (ii) What are the components of integrated care provided under IMNCI? (4+6=10 marks) (d) State the immunization schedule under the National Immunization Programme for infants and children. (10 marks) (e) A 40-year-old male presented with multiple itchy, violaceous, flat-topped papules over skin for last one year. He also complained of burning sensation in mouth. (i) Diagnose this condition. (ii) What are the oral findings which can be associated with this condition? (iii) Outline its management. (2+3+5=10 marks)

हिंदी में प्रश्न पढ़ें

(क) (i) डेंगू ज्वर की रोगलाक्षणिक विशेषताओं की सूची प्रस्तुत कीजिए। (ii) डेंगू रक्तस्रावी ज्वर के रोगी के प्रबंधन की रूपरेखा प्रस्तुत कीजिए। (5+5=10) (ख) विखण्डित मनस्कता (सिज़ोफ्रेनिया) के लक्षण लिखिए। (10) (ग) (i) आई० एम० एन० सी० आई० का पूर्ण रूप क्या है तथा उसके क्या-क्या उद्देश्य हैं? (ii) आई० एम० एन० सी० आई० के अंतर्गत दी जाने वाली समाकलित देखभाल के क्या-क्या घटक हैं? (4+6=10) (घ) राष्ट्रीय प्रतिरक्षीकरण (टीकाकरण) कार्यक्रम के अंतर्गत शिशुओं और बच्चों के लिए निर्धारित प्रतिरक्षीकरण समय-सारणी का विवरण दीजिए। (10) (ङ) एक 40-वर्षीय पुरुष को विगत एक वर्ष से त्वचा पर बहुत कण्ठकारी, बैंगनी, चपटे पट वाली पिटिकाएँ हैं। साथ ही, उसे मुँह में जलन की संवेदना है। (i) इस रूपता में निदान (डायमोसिस) बताइए। (ii) इस रूपता में मुँह में क्या-क्या लक्षण हो सकते हैं? (iii) इस रोग के प्रबंधन की रूपरेखा प्रस्तुत कीजिए। (2+3+5=10)

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Directive word: Outline

This question asks you to outline. The directive word signals the depth of analysis expected, the structure of your answer, and the weight of evidence you must bring.

See our UPSC directive words guide for a full breakdown of how to respond to each command word.

How this answer will be evaluated

Approach

The directive 'outline' demands a structured, systematic presentation of facts across five distinct clinical topics without elaborate discussion. Begin with a brief introduction acknowledging the breadth of topics (infectious disease, psychiatry, child health, immunization, dermatology), then address each sub-question in sequence with clear headings, bullet points for clinical features and management steps, and a concise conclusion emphasizing integrated healthcare delivery in the Indian context.

Key points expected

  • Dengue: Distinguish DF (fever, myalgia, rash) from DHF (hemorrhagic manifestations, plasma leakage, shock) with WHO 2009 classification criteria
  • Schizophrenia: Cover positive symptoms (hallucinations, delusions, disorganized speech/behavior) and negative symptoms (alogia, avolition, affective flattening) per DSM-5/ICD-10
  • IMNCI: Full form (Integrated Management of Neonatal and Childhood Illnesses), objectives (reduce mortality, improve care quality), and 4 components (assess, classify, treat, counsel)
  • Immunization: Complete UIP schedule including BCG, OPV, Hep-B at birth; Pentavalent, OPV, Rotavirus, IPV, PCV at 6/10/14 weeks; MR/MMR, DPT booster doses; special focus on Mission Indradhanush
  • Lichen planus: Diagnosis from classic PPL (pruritic, polygonal, purple, planar papules), oral findings (Wickham striae, erosive lesions), and stepwise management (topical steroids, systemic agents for refractory cases)

Evaluation rubric

DimensionWeightMax marksExcellentAveragePoor
Concept correctness20%10Precise, accurate facts across all five topics: correct dengue classification (DF/DHF/DSS), accurate DSM-5/ICD-10 schizophrenia criteria, exact IMNCI terminology and objectives, complete UIP schedule with correct ages, and pathognomonic lichen planus features without factual errorsMostly correct information with minor inaccuracies (e.g., missing one vaccine in schedule, incomplete schizophrenia symptom list, vague IMNCI objectives) or confusion between DF and DHF criteriaSignificant factual errors (e.g., confusing DHF with DSS, listing mood symptoms as core schizophrenia features, incorrect IMNCI expansion, major gaps in immunization schedule, misdiagnosing lichen planus)
Clinical correlation20%10Strong clinical orientation: dengue warning signs (abdominal pain, persistent vomiting, mucosal bleeding) linked to plasma leakage; schizophrenia functional impairment emphasized; IMNCI linked to under-5 mortality in India; immunization coverage gaps noted; lichen planus oral involvement and Koebner phenomenon mentionedSome clinical context present but superficial (e.g., listing symptoms without severity stratification, mentioning IMNCI without mortality data, basic oral findings without clinical significance)Purely theoretical or bookish answer lacking clinical relevance; no mention of warning signs, functional outcomes, or Indian epidemiological context
Diagram / pathway15%7.5Includes at least 2 relevant diagrams: IMNCI algorithm flowchart, dengue clinical phases timeline, or lichen planus clinical photograph description; clear, labeled diagrams that enhance answer qualityOne diagram attempted (e.g., basic IMNCI triangle or immunization timeline) or described in text without actual sketch; diagrams lack labels or clarityNo diagrams despite high suitability (especially IMNCI algorithm); or diagrams completely irrelevant/unclear
Differential / staging20%10Explicit staging: dengue febrile/critical/convalescent phases with DHF grades I-IV; schizophrenia subtypes or course specifiers; IMNCI classification of illness severity (pink/yellow/green); lichen planus variants (hypertrophic, erosive, follicular) and differential diagnosis (lichenoid drug eruption, lichen sclerosus)Mentions some classification (e.g., DHF grades only, positive/negative symptoms without course specifiers, basic IMNCI color coding) but incomplete or poorly organizedNo staging or classification attempted; fails to distinguish dengue severity grades, schizophrenia symptom clusters, or lichen planus variants
Management / public-health angle25%12.5Comprehensive, prioritized management: dengue WHO guidelines (fluid resuscitation, no platelet transfusion prophylaxis); schizophrenia biopsychosocial approach with antipsychotics; IMNCI community-level implementation; Mission Indradhanush/U-WIN for immunization; lichen planus stepwise therapy (topical → intralesional → systemic); public health integration emphasizedStandard management listed without prioritization or evidence-based nuances; generic statements without specific drugs/doses; minimal public health linkageIncomplete or dangerous management (e.g., recommending platelet transfusion in stable dengue, missing antipsychotics in schizophrenia, no immunization catch-up strategy); no public health perspective

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