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UPSC CMS aspirant
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Dr. Ananya Sharma
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Most CMS aspirants piece together preparation from NEET PG sources that were never designed for this exam. PrepCMS is different. Every question, every mock test, and every analysis tool is built specifically for the UPSC CMS pattern.

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Covering Medicine, Surgery, PSM, OBG, and Pediatrics. Subject-wise and topic-wise practice with detailed explanations.

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Answer the question below to see how PrepCMS teaches. Each MCQ comes with a detailed explanation, comparison tables, and reasoning for every option - not just the correct answer.

Question 1 of 2
General Surgery CMS2025121 SRB's Manual of Surgery p.194
Vibration white finger refers to:
Pick an answer to test yourself
Cardiology CMS2025002 API General Medicine p.726
Consider the following statements for diagnosing ventricular aneurysm in a patient with recent myocardial infarction:
I.    Paradoxical impulse on chest wall
II.   Persistent ST elevation on ECG
III.  Unusual bulge from cardiac silhouette on X-ray
IV.   Presence of pulsus paradoxus
Which of the above are correct?
Pick an answer to test yourself
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From the desk of the founder

Why we built PrepCMS

Dr. Farhan Palathinkal, Co-founder of PrepCMS
Dr. Farhan Palathinkal
Co-founder, PrepCMS
Consultant, Critical Care Medicine
Apollo Adlux Hospital, Kerala

When we built PrepMCQ for Middle Eastern GPs — inspired by the struggles of my colleagues — I witnessed firsthand how focused, targeted preparation transforms outcomes. PrepMCQ continues to have a positive impact on many doctors pursuing their licensing goals.

I was then reached out to by many doctors asking for help with a platform that focuses on high-quality preparation for UPSC CMS.

Most aspirants today piece together preparation from NEET PG sources that were never designed for CMS. We built PrepCMS differently: every question, every mock test, every analysis tool is purpose-built for the UPSC CMSE pattern — because a Designated Officer deserves preparation designed for the role they are stepping into.

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CMS-specific MCQs Scattered across NEET PG sources 4,500+ dedicated CMS questions
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Your free trial includes Access to the platform, all notes and the full library of PYQ topics, plus limited access to the Cardiology Subject Exam. No payment needed to start.
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FAQ

Common questions about UPSC CMS preparation

How should I prepare for UPSC CMS 2026?
Start with previous year papers to understand the pattern. Then do subject-wise MCQ practice focusing on Medicine, Surgery, and PSM, which usually carry the strongest weight. Take at least 10 full-length mock tests before the exam. PrepCMS gives you all of this in one platform with PYQs from 2014-2025, 4,500+ subject-wise MCQs, and AI mock tests that simulate the real exam.
Is PrepCMS better than coaching for CMS?
PrepCMS is not a coaching institute. It is a practice and testing platform. It complements your coaching or self-study by giving you CMS-specific MCQs and mock tests that most coaching centres do not offer because they focus on NEET PG. Many students use PrepCMS alongside coaching for dedicated CMS practice.
Does PrepCMS have UPSC CMS previous year questions?
Yes. PrepCMS has the complete UPSC CMS PYQ bank from 2014 to 2025 with detailed explanations for every question. You can practice PYQs subject-wise or take them as full-length papers.
What subjects does UPSC CMS 2026 cover?
UPSC CMS covers 5 subjects: Medicine, Surgery, Preventive and Social Medicine, Obstetrics and Gynecology, and Pediatrics. The exam has 200 MCQs. PrepCMS covers all 5 subjects with topic-wise breakdowns.
How many vacancies are there in CMS 2026?
UPSC has announced 1,358 vacancies for Combined Medical Services 2026 across CHS, Railways, ESIC, and other central government health services. It is one of the highest vacancy counts in recent years.
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Explanation - General Surgery - CMS2025121
Vibration white finger refers to:

Vibration white finger refers to Raynaud's syndrome - episodic digital ischaemia from vasospasm triggered by prolonged exposure to vibrating tools (pneumatic drills, chain saws, boat machinery). This is secondary Raynaud's, also called hand-arm vibration syndrome (HAVS).

Raynaud's follows Coffman criteria: episodic, well-demarcated, reversible colour changes (white, then blue, then red) lasting 1-20 minutes, triggered by cold or vibration, bilateral and symmetrical for 2+ years. In HAVS attacks occur without cold, distinguishing it from primary Raynaud's disease (young females, normal pulses, heightened arteriolar sensitivity). Management: avoid vibration; calcium channel blockers relax smooth muscle.

A - Buerger's disease: Thromboangiitis obliterans of small/medium vessels in young male smokers. Progressive ischaemia leading to gangrene. No episodic blanching, no vibration link.

C - Acrocyanosis: Persistent cyanotic discoloration (not episodic white), benign, no treatment required. No triphasic colour change on rewarming.

D - Takayasu disease: Large-vessel vasculitis (aorta/branches) in young Asian females. Pulselessness, arm claudication. Not a digital vasospasm condition. Peripheral pulses intact in HAVS.

FeatureRaynaud's (VWF)Buerger'sAcrocyanosisTakayasu
Vessel sizeDigital arteriolesSmall/mediumDermal arteriolesAorta/branches
TriggerVibrating toolsTobaccoCold (persistent)Autoimmune
Colour changeWhite, blue, redIschaemic gangrenePersistent blueNone (proximal)
ReversibleYes, 1-20 minNo, progressivePartialNo
Explanation - Cardiology - CMS2025002
Diagnosing ventricular aneurysm in a patient with recent myocardial infarction
I - TRUE
Paradoxical precordial impulse. Dyskinetic anterior wall bulges outward during systole - palpable as inward movement at the apex.
II - TRUE
Persistent ST elevation in anterior leads (weeks to months post-MI) from ongoing injury current in scarred, dyskinetic tissue.
III - TRUE
Bulge along left heart border on PA CXR, visible above diaphragm in aneurysms larger than 5 cm.
IV - FALSE
Pulsus paradoxus (greater than 10 mmHg systolic drop on inspiration) signals pericardial constraint (tamponade), not ventricular aneurysm.

Ventricular aneurysms form after large transmural anterior MIs. The infarcted segment thins, stretches, and fibroses - creating a dyskinetic wall that bulges outward during systole while normal myocardium contracts inward. Occurs in roughly 10-20% of anterior MI cases without reperfusion.

A (I and II only) - omits the CXR bulge, a simple bedside confirmatory step on PA view before echo.

B (I and IV) - incorrectly pairs the paradoxical impulse with pulsus paradoxus. Fixed stroke volume in a stiff ventricle causes no respiratory BP variation.

D (II, III and IV) - drops the paradoxical impulse (most specific bedside sign) and includes pulsus paradoxus, which points to tamponade requiring urgent pericardiocentesis, not aneurysm management.

Echo confirms dyskinesia; MRI/angiography quantify size. Management: beta-blockers + ACEi for remodelling; anticoagulation for mural thrombus; ICD for arrhythmia risk; surgical resection if thrombus-laden or causing severe MR.

FeatureVentricular aneurysmCardiac tamponade
Precordial impulseParadoxical (inward systole)Normal or diminished
ST elevationPersistent anterior leadsElectrical alternans possible
CXRBulge - left heart borderEnlarged globular silhouette
Pulsus paradoxusAbsentPresent (>10 mmHg drop)
ManagementBeta-blocker, ACEi, ICD, surgeryUrgent pericardiocentesis