Medical Science 2025 Paper II 50 marks Describe

Q8

(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 (b) (i) Describe the WHO medical eligibility criteria for contraceptive use for women with medical conditions. (ii) Discuss the complications of intrauterine contraceptive device (IUCD). (iii) How will you manage a case of misplaced copper-T (Cu-T)? 5+5+5=15 (c) Describe the embryogenesis, clinical features and principles of management of cleft palate. 5+5+5=15

हिंदी में प्रश्न पढ़ें

(a) भारत की मलेरिया उन्मूलन राष्ट्रीय रूपरेखा के अंतर्गत वर्ष 2027 तथा वर्ष 2030 के लिए क्रमशः क्या-क्या लक्ष्य निर्धारित किए गए हैं? ऐसे राज्य तथा केंद्रशासित प्रदेश (UTs) जिनमें तीव्र नियंत्रण की आवश्यकता है तथा जो श्रेणी 3 के अंतर्गत आते हैं, उनके लिए कौन-कौन से प्रमुख हस्तक्षेप अनुशंसित हैं? मलेरिया के ऊपर जानपदिक रोगविज्ञान की दृष्टि से निगरानी रखने के लिए कौन-कौन से पैरामीटर उपयोग में लाए जाते हैं? 5+10+5=20 (b) (i) चिकित्सा रुग्णताओं से प्रभावित महिलाओं के गर्भनिरोधक प्रयोग हेतु विश्व स्वास्थ्य संगठन द्वारा जारी चिकित्सा उपयुक्तता मानकों का वर्णन कीजिए। (ii) अंतर्गर्भाशयी गर्भनिरोधक युक्ति (आइ० यू० सी० डी०) से संबंध जटिलताओं की व्याख्या कीजिए। (iii) अनुपयुक्त स्थान पर पहुंची कॉपर-T (Cu-T) के मामले का प्रबंधन कैसे किया जाता है? 5+5+5=15 (c) खंड तालु के भ्रूणजनन, रोगलाक्षणिक विशेषताओं तथा प्रबंधन के सिद्धांतों का वर्णन कीजिए। 5+5+5=15

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Directive word: Describe

This question asks you to describe. 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 'describe' demands comprehensive, structured exposition of facts, mechanisms and procedures across all sub-parts. Allocate approximately 40% of time/words to part (a) given its 20 marks, 30% to part (b) with three sub-sections, and 30% to part (c). Structure as: brief introduction acknowledging India's malaria elimination timeline; systematic coverage of (a) targets, Category 3 interventions and surveillance parameters; (b) WHO MEC categories, IUCD complications with clinical correlates, and stepwise Cu-T management algorithm; (c) embryological basis with diagram, clinical features by cleft type, and multidisciplinary management principles; conclude with integrated public health perspective on reproductive and child health in India.

Key points expected

  • Part (a): 2027 target (zero indigenous malaria in Category 1 states/UTs) and 2030 target (malaria-free India); Category 3 interventions include intensified IRS, LLIN distribution, ACT-AL/ACT-SP based treatment, radical cure with primaquine, and strengthened surveillance
  • Part (a): Surveillance parameters include API, SPR, Pf proportion, therapeutic efficacy studies, insecticide resistance monitoring, and case-based reporting through IHIP
  • Part (b)(i): WHO MEC categories 1-4 with examples (category 1: no restriction like COPD; category 4: unacceptable risk like breast cancer with Cu-IUCD; category 3: theoretical concerns like migraine with aura)
  • Part (b)(ii): IUCD complications—immediate (pain, syncope, perforation), early (expulsion, PID, bleeding), late (pregnancy with device, embedment, actinomycosis)
  • Part (b)(iii): Misplaced Cu-T management—confirm location by ultrasound/X-ray, remove if extrauterine or partially expelled, hysteroscopic removal if embedded, laparoscopic retrieval if perforated
  • Part (c): Embryogenesis—failure of palatal shelves to fuse at 8-12 weeks due to genetic (IRF6, MSX1), environmental (smoking, folate deficiency), or mechanical factors; clinical features by Veau classification; principles of feeding, speech therapy, orthodontic preparation, and staged surgical repair (palatoplasty at 9-18 months)

Evaluation rubric

DimensionWeightMax marksExcellentAveragePoor
Concept correctness20%10Precise recall of NFME 2016-2030 targets with correct years; accurate WHO MEC category definitions with specific condition examples; correct embryological timeline for palatogenesis (weeks 6-12); no factual errors in drug regimens or surgical timingBroadly correct targets but confused years or categories; generic MEC description without category numbers; vague embryology 'first trimester'; minor errors in primaquine dosing or palatoplasty timingIncorrect targets (e.g., 2025, 2035); conflates MEC with other guidelines; fundamental errors in embryology (e.g., neural crest only, no mention of shelf elevation); dangerous errors like recommending copper-T continuation in ectopic pregnancy
Clinical correlation20%10Links Category 3 states to high-burden NE/tribal areas; correlates IUCD complications with clinical presentations (e.g., missing strings + pain suggests perforation); connects cleft palate to feeding difficulties, otitis media, and speech outcomes; uses Indian epidemiological dataMentions high-burden states without specificity; lists complications without clinical correlation; acknowledges speech problems in cleft palate without mechanism; limited Indian contextNo clinical application; purely theoretical lists; fails to connect misplaced Cu-T to diagnostic urgency; ignores functional sequelae of cleft palate
Diagram / pathway15%7.5Clear labeled diagram of palatal embryogenesis (shelves, nasal septum, tongue position) or Veau classification; flowchart for Cu-T management (location → imaging → removal method); surveillance flow diagram for malaria; neat, exam-appropriate presentationRough sketch without labels or incorrect anatomy; textual description of algorithm without visual; diagram mentioned but not executedNo diagrams despite clear pictorial demands; irrelevant diagrams; messy uninterpretable sketches
Differential / staging20%10Veau classification of cleft palate (I-IV) with precise anatomical boundaries; differentiates misplaced Cu-T types (expulsion, embedment, perforation, ectopic) with distinct management; distinguishes Category 1-3 states by API criteria; WHO MEC category differentiation with clinical examplesMentions Veau classification without details; conflates embedment with perforation; knows three categories exist without API thresholds; generic MEC descriptionNo classification system used; treats all clefts as identical; fails to differentiate Cu-T complications; no mention of state categorization criteria
Management / public-health angle25%12.5Comprehensive Category 3 intervention package (IRS, LLIN, ACT, primaquine radical cure, surveillance strengthening); stepwise Cu-T management algorithm with hysteroscopy/laparoscopy indications; multidisciplinary cleft team approach (plastic surgery, audiology, speech therapy, orthodontics, genetics); integration with RMNCH+A and NVBDCP programs; mention of Smile Train or similar initiatives in IndiaLists interventions without prioritization; basic removal for Cu-T without imaging algorithm; surgical repair mentioned without staging or team approach; limited public health integrationVague 'treatment' without specifics; no mention of radical cure for malaria; dangerous management suggestions (e.g., leave embedded Cu-T); no recognition of multidisciplinary needs in cleft care

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