UPSC CMSE General Medicine Syllabus

General Medicine syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for General Medicine in UPSC CMSE, not a summary of it.

1. 1

   Cardiology

   6 topics

   • Congenital Heart Disease
   • Rheumatic Heart Disease
   • Ischemic Heart Disease
   • Cardiomyopathies
   • Arrhythmias
   • Heart Failure
2. 2

   Respiratory System

   6 topics

   • Chronic Obstructive Pulmonary Disease
   • Asthma
   • Pneumonia
   • Tuberculosis
   • Lung Cancer
   • Pleural Diseases
3. 3

   Gastroenterology

   6 topics

   • Peptic Ulcer Disease
   • Inflammatory Bowel Disease
   • Hepatitis
   • Cirrhosis
   • Pancreatitis
   • Gastrointestinal Bleeding

General Medicine flashcards for UPSC CMSE

20 of 54 cards from the General Medicine deck — real questions with worked answers.

1. What is the most common congenital heart disease (acyanotic) and what murmur does it produce?

   Ventricular septal defect (VSD); produces a harsh pansystolic (holosystolic) murmur at the left lower sternal border.

2. Name the four anatomical components of Tetralogy of Fallot.

   (1) Ventricular septal defect, (2) Pulmonary stenosis (RV outflow obstruction), (3) Overriding aorta, (4) Right ventricular hypertrophy.

3. What is Eisenmenger syndrome?

   Reversal of a left-to-right shunt to right-to-left due to progressive pulmonary hypertension, leading to cyanosis; it makes the underlying defect inoperable.

4. Which congenital lesion classically causes radio-femoral delay and rib notching on chest X-ray?

   Coarctation of the aorta (rib notching from dilated collateral intercostal arteries).

5. What organism causes rheumatic fever and through what mechanism?

   Group A beta-hemolytic Streptococcus (Streptococcus pyogenes) via molecular mimicry triggering a type II hypersensitivity autoimmune reaction after pharyngitis.

6. State the major Jones criteria for diagnosing acute rheumatic fever.

   Carditis, polyarthritis (migratory), Sydenham chorea, erythema marginatum, and subcutaneous nodules (mnemonic JONES: Joints, O=carditis, Nodules, Erythema marginatum, Sydenham chorea).

7. Which valve is most commonly affected by chronic rheumatic heart disease, and what lesion results?

   The mitral valve; chronic RHD most commonly causes mitral stenosis.

8. What is the recommended secondary prophylaxis for rheumatic fever?

   Benzathine penicillin G intramuscularly every 3-4 weeks (or oral penicillin) to prevent recurrent streptococcal infection.

9. What is the most common cause of ischemic heart disease?

   Atherosclerosis of the coronary arteries causing reduced myocardial blood supply.

10. Differentiate stable angina, unstable angina, and myocardial infarction.

    Stable angina: pain on exertion, relieved by rest, no troponin rise. Unstable angina: pain at rest, no troponin rise. MI: troponin elevation indicating myocyte necrosis (NSTEMI without ST elevation, STEMI with ST elevation).

11. Which cardiac biomarker is most specific for myocardial infarction and when does it rise?

    Cardiac troponin (T or I); rises within 3-6 hours, peaks at 12-24 hours, and remains elevated for 7-14 days.

12. What ECG change indicates a transmural (full-thickness) myocardial infarction?

    ST-segment elevation (STEMI), often followed by Q-wave formation.

13. List the initial drug management (MONA-B) for acute coronary syndrome.

    Morphine, Oxygen (if hypoxic), Nitrates, Aspirin, and Beta-blockers; plus a second antiplatelet (e.g., clopidogrel) and statin.

14. What is the definition of dilated cardiomyopathy and its main consequence?

    Dilation of the ventricles with impaired systolic (contractile) function, leading to systolic heart failure; ejection fraction is reduced.

15. What is the inheritance and classic complication of hypertrophic cardiomyopathy?

    Autosomal dominant (sarcomere protein gene mutations); a leading cause of sudden cardiac death in young athletes due to outflow obstruction and arrhythmias.

16. How does restrictive cardiomyopathy impair cardiac function?

    Stiff, non-compliant ventricular walls impair diastolic filling (diastolic dysfunction) while systolic function is often preserved; causes include amyloidosis and hemochromatosis.

17. What ECG findings characterize atrial fibrillation?

    Absence of distinct P waves, an irregularly irregular R-R interval, and a fibrillatory baseline.

18. What is the CHA2DS2-VASc score used for?

    To estimate stroke risk in atrial fibrillation and guide the decision to start anticoagulation (Congestive HF, Hypertension, Age >=75 [2pts], Diabetes, Stroke/TIA [2pts], Vascular disease, Age 65-74, Sex category female).

19. Define ventricular fibrillation and its required treatment.

    Chaotic, disorganized ventricular electrical activity with no effective cardiac output; a cardiac arrest rhythm requiring immediate defibrillation (unsynchronized shock) and CPR.

20. What distinguishes first-, second-, and third-degree AV block on ECG?

    First-degree: prolonged PR >0.20s, all beats conducted. Second-degree: Mobitz I (Wenckebach) progressive PR lengthening then dropped beat; Mobitz II intermittent dropped beats with constant PR. Third-degree (complete): AV dissociation, P waves and QRS independent.

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