Medical Science 2025 Paper II 50 marks Discuss

Q6

(a) (i) Classify hypertensive disorders in pregnancy. (ii) Enumerate the types and complications of eclampsia. (iii) Discuss the management of antepartum eclampsia in a 25-year-old primigravida with 32 weeks of pregnancy. 5+5+10=20 (b) (i) Describe the clinical features and management of ulcerative colitis. (ii) Enlist the differences between ulcerative colitis and Crohn's disease. 10+5=15 (c) What are the major objectives of 'Home-based Newborn Care'? State the responsibilities that 'ASHA' is entrusted with to make the programme a success. 5+10=15

हिंदी में प्रश्न पढ़ें

(a) (i) गर्भावस्था के अतिरक्तदाब विकारों को वर्गीकृत कीजिए। (ii) गर्भक्षेपक के प्रकार तथा जटिलताएँ गिनाइए। (iii) एक 25-वर्षीय प्रथमगर्भा, जो गर्भावस्था के 32वें सप्ताह में है, उसमें प्रसवपूर्व गर्भक्षेपक के प्रबंधन की व्याख्या कीजिए। 5+5+10=20 (b) (i) व्रणीय वृहदांत्रशोथ की रोगलाक्षणिक विशेषताओं तथा प्रबंधन का वर्णन कीजिए। (ii) व्रणीय वृहदांत्रशोथ तथा क्रोन रोग के बीच अंतर गिनाइए। 10+5=15 (c) 'गृह-आधारित नवजात देखभाल' के मुख्य उद्देश्य क्या हैं? इस कार्यक्रम को सफल बनाने के लिए 'आशा' कर्मियों को क्या-क्या दायित्व सौंपे गए हैं? 5+10=15

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Directive word: Discuss

This question asks you to discuss. 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 'discuss' demands a comprehensive, analytical treatment with balanced coverage across all five sub-parts. Allocate approximately 40% of time/words to part (a) given its 20 marks, 30% to part (b) for 15 marks, and 30% to part (c) for 15 marks. Structure as: brief introduction → systematic coverage of (a)(i)-(iii) with emphasis on management protocols → (b) with clinical features, management and clear comparative table → (c) with HBNC objectives and ASHA responsibilities → concluding synthesis on integrated maternal-neonatal care.

Key points expected

  • Part (a)(i): Classification per ISSHP/ACOG (Chronic hypertension, Gestational hypertension, Preeclampsia-eclampsia, Preeclampsia superimposed on chronic hypertension) with diagnostic criteria
  • Part (a)(ii): Types of eclampsia (antepartum, intrapartum, postpartum) and complications (maternal: CVA, DIC, renal failure, hepatic rupture; fetal: IUGR, abruption, stillbirth)
  • Part (a)(iii): Antepartum eclampsia management: ABCDE approach, MgSO4 regimen (Pritchard/Zuspan), control of severe hypertension (labetalol/hydralazine), delivery planning at 32 weeks with corticosteroids, monitoring for magnesium toxicity
  • Part (b)(i)-(ii): UC clinical features (bloody diarrhea, tenesmus, continuous involvement, crypt abscesses), management (5-ASA, steroids, immunomodulators, surgery indications); UC vs Crohn's table (skip lesions, transmural, granulomas, fistulas, rectal sparing)
  • Part (c): HBNC objectives (reduce NMR/IMR, early identification of danger signs, promote breastfeeding, thermal care); ASHA responsibilities (7 home visits, tracking LBW babies, referral for danger signs, counseling on exclusive breastfeeding, cord care, immunization)

Evaluation rubric

DimensionWeightMax marksExcellentAveragePoor
Concept correctness20%10Demonstrates precise knowledge of ISSHP 2013/ACOG classification for (a)(i); accurately states MgSO4 dosing protocols and toxicity signs for (a)(iii); correctly identifies UC histopathology (crypt abscesses, pseudopolyps) and ASHA's 7-visit schedule under HBNC; no factual errors across any sub-partBasic classification present but may miss preeclampsia superimposed category; MgSO4 mentioned without specific regimen; UC features listed but histology confused; ASHA responsibilities generic without visit specificsConfuses gestational with chronic hypertension criteria; omits MgSO4 as first-line anticonvulsant; fails to distinguish UC from Crohn's; ASHA role conflated with ANM or Anganwadi worker
Clinical correlation20%10For (a)(iii), contextualizes 32-week primigravida management with corticosteroid administration for fetal maturity before delivery; for (b), correlates UC severity with Truelove-Witts criteria and surgical urgency; for (c), links ASHA's early referral to reduction in neonatal mortality statistics (India's NMR trends)Mentions gestational age in (a)(iii) but omits steroid use; states UC is relapsing without severity stratification; describes ASHA visits without connecting to mortality outcomesNo clinical context for 32-week pregnancy (treats as term); UC management lacks severity-based approach; ASHA role described without community health worker context
Diagram / pathway20%10Includes flowchart for eclampsia management (ABCDE → MgSO4 → BP control → delivery decision); diagram of UC colonoscopic appearance (loss of vascular pattern, ulcerations, pseudopolyps); schematic of HBNC visit schedule; comparative table for UC vs Crohn's with ≥8 distinguishing featuresOne relevant diagram present (typically the UC vs Crohn's table) but eclampsia algorithm described in text only; HBNC timeline missing visual representationNo diagrams or tables; all comparisons and protocols in continuous prose; or diagrams drawn incorrectly (e.g., skip lesions labeled in UC)
Differential / staging20%10For (a): Distinguishes preeclampsia from chronic hypertension by proteinuria onset and timing; for (b): Explicitly contrasts UC with Crohn's, infectious colitis, and ischemic colitis; uses Montreal classification for UC (E1-E3, S0-S3); for eclampsia, stages seizure phases (prodromal, tonic, clonic, coma)Basic UC vs Crohn's comparison present but incomplete; hypertension classification without differentiating features; no disease staging mentionedFails to differentiate preeclampsia from gestational hypertension; no differential diagnosis for UC; confuses eclampsia stages with epilepsy classification
Management / public-health angle20%10For (a)(iii): Comprehensive antepartum eclampsia protocol including ICU monitoring, eclampsia box components, and delivery timing; for (b): Step-up/step-down UC management algorithm with biologics (infliximab) for refractory cases; for (c): HBNC integration with Janani Suraksha Yojana, ASHA's role in JSY conditional cash transfers, and linkage to NBSU/SCNU referralMgSO4 and delivery mentioned for eclampsia but no ICU/ monitoring details; UC management limited to 5-ASA and steroids; ASHA duties listed without program integrationEclampsia management omits MgSO4 or uses diazepam/phenytoin inappropriately; UC management lacks immunomodulators; HBNC confused with institutional delivery programs

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