CMS 2020 Paper I \u2013 Part 3 (Q61\u2013Q90)<\/title>\n<link href=\"https:\/\/fonts.googleapis.com\/css2?family=Playfair+Display:wght@600;700&family=Source+Serif+4:ital,wght@0,300;0,400;0,600;1,400&display=swap\" rel=\"stylesheet\">\n<style>\n\/* \u2500\u2500 Namespace: cms20p1c \u2500\u2500 *\/\n#cms20p1c *,#cms20p1c *::before,#cms20p1c *::after{box-sizing:border-box;margin:0;padding:0}\n\n#cms20p1c{\n --ter:#C0603A;\n --ter-light:#e8825f;\n --ter-pale:#fdf1ec;\n --teal:#2A7A6F;\n --teal-light:#3da394;\n --teal-pale:#eaf4f3;\n --ink:#1a1a1a;\n --ink-mid:#444;\n --ink-soft:#777;\n --line:#e0d8d4;\n --bg:#fdfaf8;\n --white:#ffffff;\n --correct:#1e6f46;\n --correct-bg:#eaf7ef;\n --correct-border:#43a047;\n --wrong:#b83232;\n --wrong-bg:#fdf0f0;\n --wrong-border:#e53935;\n --radius:10px;\n font-family:'Source Serif 4',Georgia,serif;\n font-size:16px;\n color:var(--ink);\n background:var(--bg);\n line-height:1.7;\n padding:0 0 48px;\n}\n\n\/* Sentinel *\/\n#cms20p1c .cq-sentinel{height:1px}\n\n\/* Fixed status bar *\/\n#cms20p1c .cq-statusbar{\n position:fixed;\n top:0;left:0;right:0;\n z-index:99999;\n background:var(--white);\n border-bottom:2px solid var(--line);\n border-left:4px solid var(--ter);\n box-shadow:0 2px 12px rgba(0,0,0,0.11);\n opacity:0;\n pointer-events:none;\n transform:translateY(-110%);\n transition:opacity 0.22s ease,transform 0.22s ease;\n}\n#cms20p1c .cq-statusbar.visible{\n opacity:1;\n pointer-events:auto;\n transform:translateY(0);\n}\n#cms20p1c .cq-sb-stats{\n display:flex;\n align-items:center;\n padding:0.38rem 0.7rem;\n font-size:0.73rem;\n color:var(--ink-soft);\n gap:0;\n}\n#cms20p1c .cq-sb-item{\n display:flex;\n align-items:center;\n gap:0.18rem;\n padding:0.1rem 0.5rem;\n border-right:1px solid var(--line);\n white-space:nowrap;\n line-height:1;\n}\n#cms20p1c .cq-sb-item:last-child{border-right:none}\n#cms20p1c .cq-sb-item strong{color:var(--ink);font-size:0.8rem;font-weight:700}\n#cms20p1c .cq-sb-sep{flex:1}\n#cms20p1c .cq-sb-progress{\n height:4px;background:var(--line);overflow:hidden;\n}\n#cms20p1c .cq-sb-fill{\n height:100%;\n background:linear-gradient(90deg,var(--ter),var(--teal));\n width:0%;\n transition:width 0.4s ease;\n}\n\n\/* Header *\/\n#cms20p1c .cq-header{\n background:var(--teal);\n color:var(--white);\n padding:28px 24px 22px;\n text-align:center;\n}\n#cms20p1c .cq-header h1{\n font-family:'Playfair Display',serif;\n font-size:1.45rem;\n font-weight:700;\n letter-spacing:0.01em;\n line-height:1.3;\n}\n#cms20p1c .cq-header p{\n font-size:0.85rem;\n opacity:0.85;\n margin-top:6px;\n font-style:italic;\n}\n#cms20p1c .cq-meta{\n display:flex;justify-content:center;gap:20px;margin-top:14px;flex-wrap:wrap;\n}\n#cms20p1c .cq-badge{\n background:rgba(255,255,255,0.15);\n border:1px solid rgba(255,255,255,0.3);\n border-radius:20px;\n padding:4px 14px;\n font-size:0.78rem;\n letter-spacing:0.03em;\n}\n\n\/* Body *\/\n#cms20p1c .cq-body{max-width:760px;margin:0 auto;padding:0 16px;}\n\n\/* Cards *\/\n#cms20p1c .cq-card{\n background:var(--white);\n border:1px solid var(--line);\n border-radius:var(--radius);\n margin:24px 0;\n overflow:hidden;\n transition:box-shadow 0.2s;\n}\n#cms20p1c .cq-card:hover{box-shadow:0 2px 12px rgba(192,96,58,0.1)}\n\n#cms20p1c .cq-qhead{\n background:var(--ter-pale);\n border-bottom:1px solid var(--line);\n padding:14px 18px;\n display:flex;gap:12px;align-items:flex-start;\n}\n#cms20p1c .cq-qnum{\n flex-shrink:0;\n width:26px;height:26px;\n border-radius:50%;\n background:var(--ter);\n color:#fff;\n font-size:0.72rem;font-weight:700;\n display:flex;align-items:center;justify-content:center;\n margin-top:2px;\n transition:background 0.2s;\n}\n#cms20p1c .cq-qnum.ans-c{background:var(--correct-border)}\n#cms20p1c .cq-qnum.ans-w{background:var(--wrong-border)}\n#cms20p1c .cq-qtext{font-size:0.93rem;color:var(--ink);line-height:1.65;}\n\n\/* Options *\/\n#cms20p1c .cq-options{padding:14px 18px;display:flex;flex-direction:column;gap:8px;}\n#cms20p1c .cq-opt{\n display:flex;align-items:flex-start;gap:10px;\n padding:10px 14px;\n border:1.5px solid var(--line);\n border-radius:8px;cursor:pointer;\n transition:border-color 0.15s,background 0.15s;\n background:var(--white);\n -webkit-tap-highlight-color:transparent;\n}\n#cms20p1c .cq-opt:hover:not(.cq-locked){\n border-color:var(--teal);background:var(--teal-pale);\n}\n#cms20p1c .cq-opt-letter{\n flex-shrink:0;width:20px;height:20px;\n border-radius:50%;border:1.5px solid var(--line);\n display:flex;align-items:center;justify-content:center;\n font-size:0.65rem;font-weight:700;color:var(--ink-soft);\n transition:all 0.15s;margin-top:1px;\n}\n#cms20p1c .cq-opt-text{font-size:0.89rem;color:var(--ink-mid);line-height:1.55;}\n#cms20p1c .cq-opt.cq-correct{border-color:var(--correct-border);background:var(--correct-bg);cursor:default;}\n#cms20p1c .cq-opt.cq-correct .cq-opt-letter{background:var(--correct-border);border-color:var(--correct-border);color:#fff;}\n#cms20p1c .cq-opt.cq-correct .cq-opt-text{color:var(--correct);font-weight:600}\n#cms20p1c .cq-opt.cq-wrong{border-color:var(--wrong-border);background:var(--wrong-bg);cursor:default;}\n#cms20p1c .cq-opt.cq-wrong .cq-opt-letter{background:var(--wrong-border);border-color:var(--wrong-border);color:#fff;}\n#cms20p1c .cq-opt.cq-wrong .cq-opt-text{color:var(--wrong)}\n#cms20p1c .cq-opt.cq-dimmed{opacity:0.42;cursor:default}\n#cms20p1c .cq-opt.cq-locked{cursor:default}\n\n\/* Explanation *\/\n#cms20p1c .cq-explanation{\n display:none;\n background:var(--teal-pale);\n border-top:1px solid #b2d8d3;\n padding:10px 18px 12px;\n font-size:0.82rem;color:#1a4f49;line-height:1.62;\n}\n#cms20p1c .cq-exp-label{\n font-size:0.7rem;font-weight:700;letter-spacing:0.08em;\n text-transform:uppercase;color:var(--teal);margin-bottom:4px;\n}\n\n\/* Submit \u2014 teal *\/\n#cms20p1c .cq-submit-wrap{text-align:center;padding:28px 16px 8px;}\n#cms20p1c .cq-btn{\n background:var(--teal);\n color:var(--white);border:none;border-radius:8px;\n padding:13px 36px;\n font-family:'Playfair Display',serif;\n font-size:1rem;font-weight:700;cursor:pointer;\n letter-spacing:0.02em;\n transition:background 0.2s,transform 0.1s;\n}\n#cms20p1c .cq-btn:hover{background:var(--teal-light)}\n#cms20p1c .cq-btn:active{transform:scale(0.98)}\n\n\/* Score panel *\/\n#cms20p1c .cq-score{\n display:none;background:var(--white);\n border:2px solid var(--teal);border-radius:var(--radius);\n margin:28px 0 0;padding:28px 24px;text-align:center;\n}\n#cms20p1c .cq-score-ring{\n width:110px;height:110px;border-radius:50%;\n background:conic-gradient(var(--teal) 0%,var(--line) 0%);\n display:flex;align-items:center;justify-content:center;\n margin:0 auto 20px;position:relative;\n}\n#cms20p1c .cq-score-ring::before{\n content:'';position:absolute;width:86px;height:86px;\n border-radius:50%;background:var(--white);\n}\n#cms20p1c .cq-ring-inner{\n position:relative;display:flex;flex-direction:column;\n align-items:center;line-height:1.2;\n}\n#cms20p1c .cq-ring-pct{\n font-family:'Playfair Display',serif;font-size:1.3rem;\n font-weight:700;color:var(--teal);\n}\n#cms20p1c .cq-ring-sub{\n font-size:0.6rem;color:var(--ink-soft);\n text-transform:uppercase;letter-spacing:0.05em;\n}\n#cms20p1c .cq-score h2{\n font-family:'Playfair Display',serif;font-size:1.2rem;\n color:var(--ink);margin-bottom:8px;\n}\n#cms20p1c .cq-net-line{font-size:1rem;color:var(--teal);font-weight:600;margin-bottom:6px;}\n#cms20p1c .cq-verdict{font-size:0.85rem;color:var(--ink-soft);margin-bottom:20px;}\n#cms20p1c .cq-score-bands{\n display:flex;justify-content:center;gap:10px;flex-wrap:wrap;font-size:0.8rem;\n}\n#cms20p1c .cq-band{padding:4px 12px;border-radius:16px;font-weight:600}\n#cms20p1c .cq-band-c{background:var(--correct-bg);color:var(--correct)}\n#cms20p1c .cq-band-w{background:var(--wrong-bg);color:var(--wrong)}\n#cms20p1c .cq-band-s{background:var(--teal-pale);color:var(--teal)}\n#cms20p1c .cq-retry-btn{\n margin-top:22px;background:transparent;\n border:2px solid var(--teal);color:var(--teal);\n border-radius:8px;padding:10px 28px;\n font-family:'Playfair Display',serif;font-size:0.95rem;font-weight:700;\n cursor:pointer;transition:background 0.2s,color 0.2s;\n}\n#cms20p1c .cq-retry-btn:hover{background:var(--teal);color:var(--white)}\n\n@media(max-width:480px){\n #cms20p1c .cq-header h1{font-size:1.15rem}\n #cms20p1c .cq-qtext{font-size:0.88rem}\n #cms20p1c .cq-opt-text{font-size:0.84rem}\n}\n<\/style>\n<\/head>\n<body>\n\n<div id=\"cms20p1c\">\n\n <div class=\"cq-sentinel\" id=\"cms20p1c-sentinel\"><\/div>\n\n \n <div class=\"cq-statusbar\" id=\"cms20p1c-statusbar\">\n <div class=\"cq-sb-stats\">\n <div class=\"cq-sb-item\">\u2705 <strong id=\"cms20p1c-sc\">0<\/strong><\/div>\n <div class=\"cq-sb-item\">\u274c <strong id=\"cms20p1c-sw\">0<\/strong><\/div>\n <div class=\"cq-sb-item\">\u23f3 <strong id=\"cms20p1c-sr\">30<\/strong> left<\/div>\n <div class=\"cq-sb-sep\"><\/div>\n <div class=\"cq-sb-item\">Net <strong id=\"cms20p1c-sn\">0<\/strong> \/ <strong id=\"cms20p1c-sm\">120<\/strong><\/div>\n <\/div>\n <div class=\"cq-sb-progress\"><div class=\"cq-sb-fill\" id=\"cms20p1c-fill\"><\/div><\/div>\n <\/div>\n\n <div class=\"cq-header\">\n <h1>Combined Medical Services Examination 2020<br>Paper I \u00b7 Part 3<\/h1>\n <p>Endocrinology \u00b7 Infectious Disease \u00b7 Rheumatology \u00b7 ENT<\/p>\n <div class=\"cq-meta\">\n <span class=\"cq-badge\">Questions 61 \u2013 90<\/span>\n <span class=\"cq-badge\">Options reshuffled<\/span>\n <\/div>\n <\/div>\n\n <div class=\"cq-body\">\n <div id=\"cms20p1c-questions\"><\/div>\n <div class=\"cq-submit-wrap\">\n <button class=\"cq-btn\" id=\"cms20p1c-submit\">Submit Answers<\/button>\n <\/div>\n <div class=\"cq-score\" id=\"cms20p1c-score\">\n <div class=\"cq-score-ring\" id=\"cms20p1c-ring\">\n <div class=\"cq-ring-inner\">\n <span class=\"cq-ring-pct\" id=\"cms20p1c-ring-pct\">0%<\/span>\n <span class=\"cq-ring-sub\">score<\/span>\n <\/div>\n <\/div>\n <h2>Your Result<\/h2>\n <div class=\"cq-net-line\" id=\"cms20p1c-net-line\"><\/div>\n <div class=\"cq-verdict\" id=\"cms20p1c-verdict\"><\/div>\n <div class=\"cq-score-bands\">\n <span class=\"cq-band cq-band-c\" id=\"cms20p1c-ct-c\"><\/span>\n <span class=\"cq-band cq-band-w\" id=\"cms20p1c-ct-w\"><\/span>\n <span class=\"cq-band cq-band-s\" id=\"cms20p1c-ct-s\"><\/span>\n <\/div>\n <button class=\"cq-retry-btn\" id=\"cms20p1c-retry\">\u21ba Retry Quiz<\/button>\n <\/div>\n <\/div>\n\n<\/div>\n\n<script>\n(function(){\n 'use strict';\n\n const NS = 'cms20p1c';\n const TOTAL = 30;\n const MAX = TOTAL * 4;\n\n const QUESTIONS = [\n {\n id:61,\n stem:'Consider the following statements about erectile dysfunction in diabetic males:\\n1. It affects 60% of males\\n2. Its common cause is an underlying neuro-vascular pathology\\n3. It may be aggravated by beta-adrenergic agonist drugs\\n4. Endocrine disorders like hyperprolactinemia may cause it\\nWhich of the statements given above are true?',\n correct:'2 and 4',\n options:['1 and 2','2 and 3','2 and 4','3 and 4'],\n exp:'Statement 2 (neurovascular pathology) and 4 (hyperprolactinaemia) are correct. Statement 1 is false \u2014 prevalence is closer to 35\u201355% in diabetics. Statement 3 is false \u2014 it is beta-blockers (not agonists) that aggravate erectile dysfunction.'\n },\n {\n id:62,\n stem:'All of the following can cause hyperprolactinaemia EXCEPT:',\n correct:'Hyperthyroidism',\n options:['Craniopharyngioma','Hyperthyroidism','Stress','Chronic renal failure'],\n exp:'Hypothyroidism (not hyperthyroidism) causes hyperprolactinaemia \u2014 elevated TRH stimulates prolactin release. Craniopharyngioma causes stalk compression (loss of dopamine inhibition), stress raises prolactin directly, and chronic renal failure impairs prolactin clearance.'\n },\n {\n id:63,\n stem:'All of the following can be seen in a case of thyrotoxicosis EXCEPT:',\n correct:'Deafness',\n options:['Atrial fibrillation','Periodic paralysis','Deafness','Osteoporosis'],\n exp:'Deafness is not a recognised feature of thyrotoxicosis. AF (~10\u201315% of hyperthyroid patients), thyrotoxic periodic paralysis (especially in Asian males), and accelerated bone resorption causing osteoporosis are all well-established manifestations.'\n },\n {\n id:64,\n stem:'Which one of the following hormones acts via the receptor tyrosine kinase?',\n correct:'IGF-1',\n options:['FSH','TSH','IGF-1','PTH'],\n exp:'IGF-1 (insulin-like growth factor) acts via a receptor tyrosine kinase \u2014 similar to insulin. FSH and TSH act via G-protein coupled receptors (Gs \u2192 cAMP). PTH acts via GPCR (Gs and Gq). Receptor tyrosine kinases are also used by insulin, GH (JAK-STAT via GPCR-like), EGF, and PDGF.'\n },\n {\n id:65,\n stem:'Consider the following disorders as constituent of Multiple Endocrine Neoplasia Type 2a (MEN 2a):\\n1. Primary Hyperparathyroidism\\n2. Pituitary tumours\\n3. Medullary carcinoma of thyroid\\n4. Phaeochromocytoma\\nWhich of the above are correct?',\n correct:'1, 3 and 4',\n options:['1, 2 and 4','1, 2 and 3','1, 3 and 4','2, 3 and 4'],\n exp:\"MEN 2a (Sipple's syndrome) = Medullary thyroid carcinoma + Phaeochromocytoma + Primary hyperparathyroidism. Pituitary tumours are a feature of MEN 1 (Wermer's syndrome) \u2014 not MEN 2a. All three are driven by RET proto-oncogene mutations.\"\n },\n {\n id:66,\n stem:\"Consider the following statements with regard to Graves' ophthalmopathy:\\n1. Proptosis is often asymmetric and can even appear to be unilateral\\n2. It is a clinical diagnosis\\n3. Worsening of symptoms upon glucocorticoid withdrawal is common\\n4. Radiation therapy is very effective in treatment\\nWhich of the above statements are correct?\",\n correct:'1, 2 and 3',\n options:['1 and 2 only','1, 2 and 3','2, 3 and 4','1 and 4 only'],\n exp:\"Graves' ophthalmopathy is a clinical diagnosis based on the NOSPECS\/CAS criteria. Proptosis is frequently asymmetric. Glucocorticoid rebound on withdrawal is well recognised. Radiation therapy has a modest role (useful for soft tissue involvement) but is not considered 'very effective' \u2014 statement 4 overstates its benefit.\"\n },\n {\n id:67,\n stem:'All of the following are common aetiologies of delirium EXCEPT:',\n correct:'Hypoparathyroidism',\n options:['Hyperthyroidism','Hypothyroidism','Hyperparathyroidism','Hypoparathyroidism'],\n exp:'Hypoparathyroidism causes hypocalcaemia \u2014 which manifests as neuromuscular excitability, tetany, and seizures rather than delirium per se. Hyperthyroidism (thyroid storm), myxoedema coma (hypothyroidism), and hypercalcaemia (hyperparathyroidism) are all well-recognised metabolic causes of delirium.'\n },\n {\n id:68,\n stem:'Key anthropometric measurements important for evaluating the degree of obesity are:',\n correct:'Weight, height and waist circumference',\n options:['Weight, height and waist circumference','Weight, height and hip circumference','Weight, height and mid-thigh circumference','Weight, height and chest circumference'],\n exp:'BMI (weight\/height\u00b2) quantifies overall adiposity; waist circumference reflects central\/visceral fat \u2014 the clinically more dangerous component. Together they form the standard anthropometric assessment for obesity. Waist:hip ratio adds further information but waist alone is the key second measure.'\n },\n {\n id:69,\n stem:'What is the minimum BMI recommended for considering adjuvant pharmacologic treatment in obesity with comorbidity?',\n correct:'27 kg\/m\u00b2',\n options:['23 kg\/m\u00b2','25 kg\/m\u00b2','27 kg\/m\u00b2','30 kg\/m\u00b2'],\n exp:'FDA\/clinical guidelines recommend pharmacotherapy at BMI \u226530 kg\/m\u00b2 without comorbidity, or \u226527 kg\/m\u00b2 with at least one weight-related comorbidity (hypertension, T2DM, dyslipidaemia). The 27 threshold acknowledges that metabolic risk justifies earlier pharmacological intervention.'\n },\n {\n id:70,\n stem:'A young medical student got pricked by a syringe needle used to draw blood from a patient whose HIV status is unknown. Which one of the following therapeutic interventions will be in the best interest of this student?',\n correct:'To give Dolutegravir + Tenofovir + Emtricitabine',\n options:['To start Dolutegravir immediately','To wash wound with soap and water and start Emtricitabine','To give Dolutegravir + Tenofovir + Emtricitabine','To give Dolutegravir + Tenofovir + Emtricitabine + HBV Immunoglobulin'],\n exp:'Current WHO\/NACO guidelines recommend a 3-drug PEP regimen: Dolutegravir + Tenofovir + Emtricitabine for 28 days, started as soon as possible after washing the wound. HBV immunoglobulin is only indicated if the source is HBsAg-positive and the healthcare worker is non-immune \u2014 not for unknown status without that context.'\n },\n {\n id:71,\n stem:'Cryptococcal infection is acquired through:',\n correct:'Inhalation route',\n options:['Inhalation route','Bite of Culex mosquito','Direct skin contact','Ingestion of spores'],\n exp:'Cryptococcus neoformans is acquired by inhalation of desiccated yeast or spores from soil contaminated with bird (pigeon) droppings. Primary infection is pulmonary; haematogenous spread leads to cryptococcal meningitis, especially in immunocompromised hosts.'\n },\n {\n id:72,\n stem:'Which one of the following is NOT appropriate treatment for Echinococcus granulosus and hydatid disease?',\n correct:'Diethylcarbamazine 2 mg\/kg thrice in a day for 12 days',\n options:['Albendazole 400 mg twice in a day for 3 months','Diethylcarbamazine 2 mg\/kg thrice in a day for 12 days','PAIR (percutaneous puncture, aspiration, injection of scolicide, reaspiration)','Praziquantel 20 mg\/kg twice daily for 14 days'],\n exp:'Diethylcarbamazine (DEC) is used for lymphatic filariasis \u2014 it has absolutely no role in hydatid disease. Albendazole, PAIR, and praziquantel (used adjunctively to prevent secondary seeding) are all accepted treatments for Echinococcus granulosus.'\n },\n {\n id:73,\n stem:'Which one of the following infections is NOT amenable to post-exposure prophylaxis with specific immunoglobulins?',\n correct:'HIV',\n options:['Hepatitis B','HIV','Tetanus','Rabies'],\n exp:'There is no specific immunoglobulin available for HIV post-exposure prophylaxis \u2014 HIV PEP uses antiretroviral drugs. Hepatitis B immune globulin (HBIG), tetanus immune globulin (TIG), and rabies immune globulin (RIG) are all established products for passive immunisation after exposure.'\n },\n {\n id:74,\n stem:'Echinocandins are a class of:',\n correct:'Antifungal agents',\n options:['Antiviral agents','Antiparasitic agents','Antitubercular agents','Antifungal agents'],\n exp:'Echinocandins (caspofungin, micafungin, anidulafungin) are lipopeptide antifungal agents that inhibit \u03b2-1,3-glucan synthase \u2014 disrupting fungal cell wall synthesis. They are active against Candida and Aspergillus species and have no antibacterial, antiviral, or antitubercular activity.'\n },\n {\n id:75,\n stem:'Recommended first-line drugs for initial treatment of tuberculosis include all EXCEPT:',\n correct:'Ethionamide',\n options:['Isoniazid','Rifampin','Ethambutol','Ethionamide'],\n exp:'The standard first-line anti-TB regimen (2HRZE\/4HR) comprises Isoniazid (H), Rifampicin (R), Pyrazinamide (Z), and Ethambutol (E). Ethionamide is a second-line drug used in drug-resistant TB \u2014 it is structurally related to INH but is not part of first-line therapy.'\n },\n {\n id:76,\n stem:'The most frequent adverse reaction of significance among people treated for drug-susceptible tuberculosis is:',\n correct:'Hepatitis',\n options:['Colitis','Hepatitis','Cystitis','Enteritis'],\n exp:'Drug-induced hepatotoxicity is the most clinically significant and frequent adverse effect of first-line ATT \u2014 caused primarily by Isoniazid, Rifampicin, and Pyrazinamide. Baseline and periodic LFT monitoring is essential. Peripheral neuropathy (INH) is common but less dangerous.'\n },\n {\n id:77,\n stem:'All adult patients in whom anti-tubercular treatment is being started should undergo baseline assessment of:',\n correct:'Liver function test',\n options:['Complete blood count','Liver function test','Lipid profile','Pulmonary function test'],\n exp:'Baseline LFT is mandatory before starting ATT because Isoniazid, Rifampicin, and Pyrazinamide are all potentially hepatotoxic. LFTs guide decisions on stopping or modifying treatment if hepatitis develops. No other listed investigation is a universally mandated baseline for ATT initiation.'\n },\n {\n id:78,\n stem:'A 30-year-old male presents with fever, headache, anorexia, nausea, vomiting and diarrhoea. On examination tongue is coated with abdominal tenderness, soft splenomegaly, relative bradycardia and rose spots rash. The most likely diagnosis is:',\n correct:'Enteric fever',\n options:['Malaria fever','Enteric fever','Leptospirosis','Dengue fever'],\n exp:\"Enteric fever (typhoid) classically presents in week 2 with: rose spots (salmon-coloured maculopapular rash on trunk), relative bradycardia (Faget's sign), splenomegaly, coated tongue, and abdominal tenderness. Caused by Salmonella typhi\/paratyphi; confirmed by blood culture (Widal test is supportive).\"\n },\n {\n id:79,\n stem:'The extrapulmonary sites most commonly involved in tuberculosis are all EXCEPT:',\n correct:'Skull TB',\n options:['Lymph node TB','Genitourinary TB','Skeletal TB','Skull TB'],\n exp:\"Extrapulmonary TB in order of frequency: lymph nodes (most common, ~35%), pleura, genitourinary, bone\/joint (Pott's spine being the classic skeletal site), and meninges. Skull TB is exceedingly rare and is not among the recognised common extrapulmonary sites.\"\n },\n {\n id:80,\n stem:'Which of the following is NOT a clinical feature of Botulism?',\n correct:'Impaired alertness',\n options:['Impaired alertness','Dysphagia','Diplopia','Ptosis'],\n exp:'Botulinum toxin blocks presynaptic acetylcholine release at the neuromuscular junction. Crucially, patients remain ALERT and afebrile \u2014 cognitive function and consciousness are unaffected (the toxin does not cross the blood-brain barrier). Dysphagia, diplopia, and ptosis are all classic descending paralytic features.'\n },\n {\n id:81,\n stem:'Post exposure prophylaxis (PEP) for HIV should contain:',\n correct:'3 antiretroviral drugs administered for 4 weeks',\n options:['2 antiretroviral drugs administered for 4 weeks','2 antiretroviral drugs administered for 6 weeks','3 antiretroviral drugs administered for 4 weeks','3 antiretroviral drugs administered for 6 weeks'],\n exp:'Current WHO and NACO guidelines recommend 3-drug PEP (preferred: Dolutegravir + Tenofovir + Emtricitabine) for 28 days (4 weeks). Earlier 2-drug regimens have been superseded. Duration beyond 4 weeks is not recommended.'\n },\n {\n id:82,\n stem:'Paralytic rabies is characterised by:',\n correct:'Flaccid muscle weakness',\n options:['Maculopapular rash','Flaccid muscle weakness','Spastic muscle weakness','Hyperexcitability and facial weakness'],\n exp:\"Paralytic (dumb) rabies accounts for ~30% of cases and presents with ascending flaccid paralysis resembling Guillain-Barr\u00e9 syndrome \u2014 without the characteristic hydrophobia and aerophobia of 'furious' rabies. It is often misdiagnosed and has a slower progression.\"\n },\n {\n id:83,\n stem:'All are true for Marasmus EXCEPT:',\n correct:'Protein wasting',\n options:['Reduced triceps skinfold','Reduced mid arm circumference','Protein wasting','Decreased body mass index'],\n exp:'Marasmus is caused by severe calorie (energy) deficiency \u2014 fat stores and muscle bulk are depleted, but serum proteins (albumin, etc.) are relatively preserved. This distinguishes it from Kwashiorkor, where protein deficiency is predominant and hypoalbuminaemia with oedema is the hallmark. \"Protein wasting\" in the sense of hypoalbuminaemia is therefore not a feature of pure marasmus.'\n },\n {\n id:84,\n stem:'A 20-year-old lady presents with high grade fever for five days and palpable purpura over extremities. She is confused with neck stiffness. Which of the following is the most likely diagnosis?',\n correct:'Acute meningococcaemia',\n options:['Disseminated intravascular coagulation','Acute meningococcaemia','Antiphospholipid antibody syndrome','Thrombotic thrombocytopenic purpura'],\n exp:'The triad of fever + non-blanching petechial\/purpuric rash + meningism in a young person is acute meningococcaemia (Neisseria meningitidis) until proven otherwise \u2014 a medical emergency. The rash reflects septic emboli and endothelial damage. Waterhouse-Friderichsen syndrome (bilateral adrenal haemorrhage) may supervene.'\n },\n {\n id:85,\n stem:'Fibroblast Growth Factor 23 (FGF-23) is increased in which one of the following conditions?',\n correct:'Renal Osteodystrophy',\n options:['Osteomalacia','Osteoporosis',\"Paget's disease\",'Renal Osteodystrophy'],\n exp:'FGF-23, a phosphatonin produced by osteocytes, is markedly elevated in CKD\/renal osteodystrophy \u2014 it rises early as the kidneys lose the ability to excrete phosphate, contributing to secondary hyperparathyroidism, vitamin D deficiency, and vascular calcification. FGF-23 is also elevated in tumour-induced osteomalacia (oncogenic osteomalacia).'\n },\n {\n id:86,\n stem:'Which of the following crystals are deposited in a case of pseudogout?',\n correct:'Calcium pyrophosphate dihydrate (CPPD)',\n options:['Monosodium urate','Calcium phosphate','Cholesterol crystals','Calcium pyrophosphate dihydrate (CPPD)'],\n exp:'Pseudogout (calcium pyrophosphate crystal deposition disease) is caused by CPPD crystals \u2014 positively birefringent, rhomboid-shaped on polarised light microscopy, depositing in articular cartilage (chondrocalcinosis on X-ray). Gout = monosodium urate (negatively birefringent, needle-shaped).'\n },\n {\n id:87,\n stem:'Which of the following features are associated with poor prognosis in Diffuse Cutaneous Systemic Sclerosis?\\n1. Older age\\n2. A high gas transfer factor for carbon monoxide (TLCO)\\n3. Proteinuria\\n4. Diffuse skin disease',\n correct:'1, 3 and 4',\n options:['1, 2 and 4','3 and 4 only','1, 3 and 4','1, 2 and 3'],\n exp:'Poor prognostic markers in dcSSc include: older age at onset, diffuse skin involvement, renal involvement (proteinuria), pulmonary hypertension, and LOW (not high) TLCO indicating reduced gas transfer. A high TLCO is actually a favourable finding. Statement 2 is therefore incorrect.'\n },\n {\n id:88,\n stem:'Which of the following statements regarding pegloticase are correct?\\n1. It is an enzyme conjugate\\n2. It is useful in chronic gout management\\n3. The main adverse effects are infusion reactions and development of antibodies',\n correct:'1, 2 and 3',\n options:['1 and 2 only','2 and 3 only','1 and 3 only','1, 2 and 3'],\n exp:'All three statements are correct. Pegloticase is PEGylated recombinant uricase (enzyme conjugate) \u2014 it converts urate to allantoin, a more soluble metabolite. It is indicated for refractory chronic tophaceous gout. Major adverse effects are infusion reactions and anti-pegloticase antibody formation, which reduces efficacy and increases infusion risk.'\n },\n {\n id:89,\n stem:'The most common cause of sensorineural hearing loss in adults is:',\n correct:'Presbycusis',\n options:['Otosclerosis','Meniere\\'s disease','Presbycusis','Meningitis'],\n exp:'Presbycusis (age-related sensorineural hearing loss) is by far the most common cause of SNHL in adults \u2014 affecting ~30% of those over 65. It results from progressive degeneration of cochlear hair cells and the stria vascularis. Otosclerosis causes conductive (not sensorineural) hearing loss.'\n },\n {\n id:90,\n stem:'A 50-year-old male presents with dizziness. Which one of the following clinical findings does NOT favour a central cause?',\n correct:'Inhibition by visual fixation',\n options:['Poor saccades','Gaze evoked nystagmus','Inhibition by visual fixation','Presence of diplopia, dysarthria'],\n exp:\"Inhibition of nystagmus by visual fixation is a feature of PERIPHERAL vestibular disorders \u2014 the visual system compensates for peripheral imbalance. In central lesions (brainstem\/cerebellum), nystagmus is NOT suppressed by fixation. Poor saccades, gaze-evoked nystagmus, and accompanying diplopia\/dysarthria all point to central pathology.\"\n }\n ];\n\n function shuffle(arr){\n const a=[...arr];\n for(let i=a.length-1;i>0;i--){\n const j=Math.floor(Math.random()*(i+1));\n [a[i],a[j]]=[a[j],a[i]];\n }\n return a;\n }\n\n function esc(s){\n return s.replace(\/&\/g,'&').replace(\/<\/g,'<').replace(\/>\/g,'>').replace(\/\"\/g,'"');\n }\n\n const LETTERS=['A','B','C','D'];\n let userAnswers={};\n let answered=0;\n let shuffledOpts={};\n\n function build(){\n const container=document.getElementById(NS+'-questions');\n container.innerHTML='';\n userAnswers={};\n answered=0;\n shuffledOpts={};\n document.getElementById(NS+'-score').style.display='none';\n updateStats();\n\n QUESTIONS.forEach(function(q){\n const opts=shuffle(q.options);\n shuffledOpts[q.id]=opts;\n\n const card=document.createElement('div');\n card.className='cq-card';\n\n card.innerHTML=\n '<div class=\"cq-qhead\">'+\n '<div class=\"cq-qnum\" id=\"'+NS+'-n'+q.id+'\">'+q.id+'<\/div>'+\n '<div class=\"cq-qtext\">'+q.stem.replace(\/\\n\/g,'<br>')+'<\/div>'+\n '<\/div>'+\n '<div class=\"cq-options\" id=\"'+NS+'-opts'+q.id+'\">'+\n opts.map(function(o,i){\n return '<div class=\"cq-opt\" id=\"'+NS+'-o'+q.id+'-'+i+'\" data-qid=\"'+q.id+'\" data-val=\"'+esc(o)+'\" role=\"button\" tabindex=\"0\">'+\n '<span class=\"cq-opt-letter\">'+LETTERS[i]+'<\/span>'+\n '<span class=\"cq-opt-text\">'+o+'<\/span>'+\n '<\/div>';\n }).join('')+\n '<\/div>'+\n '<div class=\"cq-explanation\" id=\"'+NS+'-exp'+q.id+'\">'+\n '<div class=\"cq-exp-label\">Explanation<\/div>'+\n q.exp+\n '<\/div>';\n\n container.appendChild(card);\n\n opts.forEach(function(_,i){\n document.getElementById(NS+'-o'+q.id+'-'+i)\n .addEventListener('click',function(){ pick(q.id,i); });\n });\n });\n }\n\n function pick(qid,oi){\n if(userAnswers[qid]!==undefined)return;\n const q=QUESTIONS.find(function(x){return x.id===qid;});\n const opts=shuffledOpts[qid];\n const chosen=opts[oi];\n const correct=chosen===q.correct;\n userAnswers[qid]=correct?'correct':'wrong';\n answered++;\n\n opts.forEach(function(o,i){\n const el=document.getElementById(NS+'-o'+qid+'-'+i);\n if(o===q.correct) { el.classList.add('cq-correct','cq-locked'); }\n else if(i===oi) { el.classList.add('cq-wrong','cq-locked'); }\n else { el.classList.add('cq-dimmed','cq-locked'); }\n });\n\n document.getElementById(NS+'-n'+qid).classList.add(correct?'ans-c':'ans-w');\n document.getElementById(NS+'-exp'+qid).style.display='block';\n updateStats();\n }\n\n function updateStats(){\n const c=Object.values(userAnswers).filter(function(v){return v==='correct';}).length;\n const w=Object.values(userAnswers).filter(function(v){return v==='wrong';}).length;\n const r=TOTAL-answered;\n const net=(c*4)-w;\n document.getElementById(NS+'-sc').textContent=c;\n document.getElementById(NS+'-sw').textContent=w;\n document.getElementById(NS+'-sr').textContent=r;\n document.getElementById(NS+'-sn').textContent=net>=0?'+'+net:net;\n document.getElementById(NS+'-sm').textContent=MAX;\n document.getElementById(NS+'-fill').style.width=(answered\/TOTAL*100)+'%';\n }\n\n function showScore(){\n const c=Object.values(userAnswers).filter(function(v){return v==='correct';}).length;\n const w=Object.values(userAnswers).filter(function(v){return v==='wrong';}).length;\n const s=TOTAL-answered;\n const net=(c*4)-w;\n const pct=Math.max(0,Math.round((net\/MAX)*100));\n const disp=Math.min(100,Math.max(0,pct));\n\n document.getElementById(NS+'-ring').style.background=\n 'conic-gradient(var(--teal) '+disp+'%,var(--line) 0%)';\n document.getElementById(NS+'-ring-pct').textContent=pct+'%';\n document.getElementById(NS+'-net-line').textContent='Net Score: '+net+' \/ '+MAX;\n\n let v='';\n if(pct>=80) v='Excellent \u2014 well above the qualifying threshold.';\n else if(pct>=60) v='Good attempt \u2014 consolidate the weaker areas.';\n else if(pct>=40) v='Fair \u2014 systematic revision of these topics is recommended.';\n else v='Needs significant revision across these topics.';\n document.getElementById(NS+'-verdict').textContent=v;\n\n document.getElementById(NS+'-ct-c').textContent='\u2705 '+c+' Correct';\n document.getElementById(NS+'-ct-w').textContent='\u274c '+w+' Wrong';\n document.getElementById(NS+'-ct-s').textContent='\u23ed '+s+' Skipped';\n\n const sc=document.getElementById(NS+'-score');\n sc.style.display='block';\n sc.scrollIntoView({behavior:'smooth',block:'center'});\n }\n\n document.getElementById(NS+'-submit').addEventListener('click',showScore);\n document.getElementById(NS+'-retry').addEventListener('click',function(){\n build();\n window.scrollTo({top:0,behavior:'smooth'});\n });\n\n new IntersectionObserver(\n function(entries){\n document.getElementById(NS+'-statusbar')\n .classList.toggle('visible',!entries[0].isIntersecting);\n },\n {threshold:0}\n ).observe(document.getElementById(NS+'-sentinel'));\n\n build();\n updateStats();\n\n})();\n<\/script>\n<\/body>\n<\/html>\n\n\n\n\n","protected":false},"excerpt":{"rendered":"<p>CMS 2020 Paper I \u2013 Part 3 (Q61\u2013Q90) \u2705 0 \u274c 0 \u23f3 30 left Net 0 \/ 120 Combined Medical Services Examination 2020Paper I \u00b7 Part 3 Endocrinology \u00b7 Infectious Disease \u00b7 Rheumatology \u00b7 ENT Questions 61 \u2013 90 Options reshuffled Submit Answers 0% score Your Result \u21ba Retry Quiz<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"","neve_meta_content_width":0,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","footnotes":""},"categories":[18],"tags":[],"class_list":["post-36515","post","type-post","status-publish","format-standard","hentry","category-cms"],"yoast_head":"\n<title>CMS 2020 P1 Part-3 - atsixty<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/atsixty.com\/index.php\/2026\/04\/07\/cms-2020-p1-part-3\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"CMS 2020 P1 Part-3 - atsixty\" \/>\n<meta property=\"og:description\" content=\"CMS 2020 Paper I \u2013 Part 3 (Q61\u2013Q90) \u2705 0 \u274c 0 \u23f3 30 left Net 0 \/ 120 Combined Medical Services Examination 2020Paper I \u00b7 Part 3 Endocrinology \u00b7 Infectious Disease \u00b7 Rheumatology \u00b7 ENT Questions 61 \u2013 90 Options reshuffled Submit Answers 0% score Your Result \u21ba Retry Quiz\" \/>\n<meta property=\"og:url\" content=\"https:\/\/atsixty.com\/index.php\/2026\/04\/07\/cms-2020-p1-part-3\/\" \/>\n<meta property=\"og:site_name\" content=\"atsixty\" \/>\n<meta property=\"article:published_time\" content=\"2026-04-07T15:25:25+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2026-04-08T03:03:45+00:00\" \/>\n<meta name=\"author\" content=\"Avi\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Avi\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/07\\\/cms-2020-p1-part-3\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/07\\\/cms-2020-p1-part-3\\\/\"},\"author\":{\"name\":\"Avi\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/#\\\/schema\\\/person\\\/cf65e7ac7d8226d95c0bdf1036f7951d\"},\"headline\":\"CMS 2020 P1 Part-3\",\"datePublished\":\"2026-04-07T15:25:25+00:00\",\"dateModified\":\"2026-04-08T03:03:45+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/07\\\/cms-2020-p1-part-3\\\/\"},\"wordCount\":48,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/#\\\/schema\\\/person\\\/cf65e7ac7d8226d95c0bdf1036f7951d\"},\"articleSection\":[\"CMS\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/07\\\/cms-2020-p1-part-3\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/07\\\/cms-2020-p1-part-3\\\/\",\"url\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/07\\\/cms-2020-p1-part-3\\\/\",\"name\":\"CMS 2020 P1 Part-3 - atsixty\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/#website\"},\"datePublished\":\"2026-04-07T15:25:25+00:00\",\"dateModified\":\"2026-04-08T03:03:45+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/07\\\/cms-2020-p1-part-3\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/07\\\/cms-2020-p1-part-3\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/07\\\/cms-2020-p1-part-3\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/atsixty.com\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"CMS 2020 P1 Part-3\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/#website\",\"url\":\"https:\\\/\\\/atsixty.com\\\/\",\"name\":\"At Sixty\",\"description\":\"The Option Taken\",\"publisher\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/#\\\/schema\\\/person\\\/cf65e7ac7d8226d95c0bdf1036f7951d\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/atsixty.com\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":[\"Person\",\"Organization\"],\"@id\":\"https:\\\/\\\/atsixty.com\\\/#\\\/schema\\\/person\\\/cf65e7ac7d8226d95c0bdf1036f7951d\",\"name\":\"Avi\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/wp-content\\\/uploads\\\/2025\\\/08\\\/logo-agency.png\",\"url\":\"https:\\\/\\\/atsixty.com\\\/wp-content\\\/uploads\\\/2025\\\/08\\\/logo-agency.png\",\"contentUrl\":\"https:\\\/\\\/atsixty.com\\\/wp-content\\\/uploads\\\/2025\\\/08\\\/logo-agency.png\",\"width\":200,\"height\":200,\"caption\":\"Avi\"},\"logo\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/wp-content\\\/uploads\\\/2025\\\/08\\\/logo-agency.png\"},\"sameAs\":[\"https:\\\/\\\/atsixty.com\"],\"url\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/author\\\/avinaux\\\/\"}]}<\/script>\n","yoast_head_json":{"title":"CMS 2020 P1 Part-3 - atsixty","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/atsixty.com\/index.php\/2026\/04\/07\/cms-2020-p1-part-3\/","og_locale":"en_US","og_type":"article","og_title":"CMS 2020 P1 Part-3 - atsixty","og_description":"CMS 2020 Paper I \u2013 Part 3 (Q61\u2013Q90) \u2705 0 \u274c 0 \u23f3 30 left Net 0 \/ 120 Combined Medical Services Examination 2020Paper I \u00b7 Part 3 Endocrinology \u00b7 Infectious Disease \u00b7 Rheumatology \u00b7 ENT Questions 61 \u2013 90 Options reshuffled Submit Answers 0% score Your Result \u21ba Retry Quiz","og_url":"https:\/\/atsixty.com\/index.php\/2026\/04\/07\/cms-2020-p1-part-3\/","og_site_name":"atsixty","article_published_time":"2026-04-07T15:25:25+00:00","article_modified_time":"2026-04-08T03:03:45+00:00","author":"Avi","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Avi","Est. reading time":"1 minute"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/07\/cms-2020-p1-part-3\/#article","isPartOf":{"@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/07\/cms-2020-p1-part-3\/"},"author":{"name":"Avi","@id":"https:\/\/atsixty.com\/#\/schema\/person\/cf65e7ac7d8226d95c0bdf1036f7951d"},"headline":"CMS 2020 P1 Part-3","datePublished":"2026-04-07T15:25:25+00:00","dateModified":"2026-04-08T03:03:45+00:00","mainEntityOfPage":{"@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/07\/cms-2020-p1-part-3\/"},"wordCount":48,"commentCount":0,"publisher":{"@id":"https:\/\/atsixty.com\/#\/schema\/person\/cf65e7ac7d8226d95c0bdf1036f7951d"},"articleSection":["CMS"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/atsixty.com\/index.php\/2026\/04\/07\/cms-2020-p1-part-3\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/07\/cms-2020-p1-part-3\/","url":"https:\/\/atsixty.com\/index.php\/2026\/04\/07\/cms-2020-p1-part-3\/","name":"CMS 2020 P1 Part-3 - atsixty","isPartOf":{"@id":"https:\/\/atsixty.com\/#website"},"datePublished":"2026-04-07T15:25:25+00:00","dateModified":"2026-04-08T03:03:45+00:00","breadcrumb":{"@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/07\/cms-2020-p1-part-3\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/atsixty.com\/index.php\/2026\/04\/07\/cms-2020-p1-part-3\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/07\/cms-2020-p1-part-3\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/atsixty.com\/"},{"@type":"ListItem","position":2,"name":"CMS 2020 P1 Part-3"}]},{"@type":"WebSite","@id":"https:\/\/atsixty.com\/#website","url":"https:\/\/atsixty.com\/","name":"At Sixty","description":"The Option Taken","publisher":{"@id":"https:\/\/atsixty.com\/#\/schema\/person\/cf65e7ac7d8226d95c0bdf1036f7951d"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/atsixty.com\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":["Person","Organization"],"@id":"https:\/\/atsixty.com\/#\/schema\/person\/cf65e7ac7d8226d95c0bdf1036f7951d","name":"Avi","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/atsixty.com\/wp-content\/uploads\/2025\/08\/logo-agency.png","url":"https:\/\/atsixty.com\/wp-content\/uploads\/2025\/08\/logo-agency.png","contentUrl":"https:\/\/atsixty.com\/wp-content\/uploads\/2025\/08\/logo-agency.png","width":200,"height":200,"caption":"Avi"},"logo":{"@id":"https:\/\/atsixty.com\/wp-content\/uploads\/2025\/08\/logo-agency.png"},"sameAs":["https:\/\/atsixty.com"],"url":"https:\/\/atsixty.com\/index.php\/author\/avinaux\/"}]}},"_links":{"self":[{"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/posts\/36515","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/comments?post=36515"}],"version-history":[{"count":5,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/posts\/36515\/revisions"}],"predecessor-version":[{"id":36533,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/posts\/36515\/revisions\/36533"}],"wp:attachment":[{"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/media?parent=36515"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/categories?post=36515"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/tags?post=36515"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}

{"id":36515,"date":"2026-04-07T20:55:25","date_gmt":"2026-04-07T15:25:25","guid":{"rendered":"https:\/\/atsixty.com\/?p=36515"},"modified":"2026-04-08T08:33:45","modified_gmt":"2026-04-08T03:03:45","slug":"cms-2020-p1-part-3","status":"publish","type":"post","link":"https:\/\/atsixty.com\/index.php\/2026\/04\/07\/cms-2020-p1-part-3\/","title":{"rendered":"CMS 2020 P1 Part-3"},"content":{"rendered":"\n\n\n\n\n\nCMS 2020 Paper I \u2013 Part 3 (Q61\u2013Q90)<\/title>\n<link href=\"https:\/\/fonts.googleapis.com\/css2?family=Playfair+Display:wght@600;700&family=Source+Serif+4:ital,wght@0,300;0,400;0,600;1,400&display=swap\" rel=\"stylesheet\">\n<style>\n\/* \u2500\u2500 Namespace: cms20p1c \u2500\u2500 *\/\n#cms20p1c *,#cms20p1c *::before,#cms20p1c *::after{box-sizing:border-box;margin:0;padding:0}\n\n#cms20p1c{\n --ter:#C0603A;\n --ter-light:#e8825f;\n --ter-pale:#fdf1ec;\n --teal:#2A7A6F;\n --teal-light:#3da394;\n --teal-pale:#eaf4f3;\n --ink:#1a1a1a;\n --ink-mid:#444;\n --ink-soft:#777;\n --line:#e0d8d4;\n --bg:#fdfaf8;\n --white:#ffffff;\n --correct:#1e6f46;\n --correct-bg:#eaf7ef;\n --correct-border:#43a047;\n --wrong:#b83232;\n --wrong-bg:#fdf0f0;\n --wrong-border:#e53935;\n --radius:10px;\n font-family:'Source Serif 4',Georgia,serif;\n font-size:16px;\n color:var(--ink);\n background:var(--bg);\n line-height:1.7;\n padding:0 0 48px;\n}\n\n\/* Sentinel *\/\n#cms20p1c .cq-sentinel{height:1px}\n\n\/* Fixed status bar *\/\n#cms20p1c .cq-statusbar{\n position:fixed;\n top:0;left:0;right:0;\n z-index:99999;\n background:var(--white);\n border-bottom:2px solid var(--line);\n border-left:4px solid var(--ter);\n box-shadow:0 2px 12px rgba(0,0,0,0.11);\n opacity:0;\n pointer-events:none;\n transform:translateY(-110%);\n transition:opacity 0.22s ease,transform 0.22s ease;\n}\n#cms20p1c .cq-statusbar.visible{\n opacity:1;\n pointer-events:auto;\n transform:translateY(0);\n}\n#cms20p1c .cq-sb-stats{\n display:flex;\n align-items:center;\n padding:0.38rem 0.7rem;\n font-size:0.73rem;\n color:var(--ink-soft);\n gap:0;\n}\n#cms20p1c .cq-sb-item{\n display:flex;\n align-items:center;\n gap:0.18rem;\n padding:0.1rem 0.5rem;\n border-right:1px solid var(--line);\n white-space:nowrap;\n line-height:1;\n}\n#cms20p1c .cq-sb-item:last-child{border-right:none}\n#cms20p1c .cq-sb-item strong{color:var(--ink);font-size:0.8rem;font-weight:700}\n#cms20p1c .cq-sb-sep{flex:1}\n#cms20p1c .cq-sb-progress{\n height:4px;background:var(--line);overflow:hidden;\n}\n#cms20p1c .cq-sb-fill{\n height:100%;\n background:linear-gradient(90deg,var(--ter),var(--teal));\n width:0%;\n transition:width 0.4s ease;\n}\n\n\/* Header *\/\n#cms20p1c .cq-header{\n background:var(--teal);\n color:var(--white);\n padding:28px 24px 22px;\n text-align:center;\n}\n#cms20p1c .cq-header h1{\n font-family:'Playfair Display',serif;\n font-size:1.45rem;\n font-weight:700;\n letter-spacing:0.01em;\n line-height:1.3;\n}\n#cms20p1c .cq-header p{\n font-size:0.85rem;\n opacity:0.85;\n margin-top:6px;\n font-style:italic;\n}\n#cms20p1c .cq-meta{\n display:flex;justify-content:center;gap:20px;margin-top:14px;flex-wrap:wrap;\n}\n#cms20p1c .cq-badge{\n background:rgba(255,255,255,0.15);\n border:1px solid rgba(255,255,255,0.3);\n border-radius:20px;\n padding:4px 14px;\n font-size:0.78rem;\n letter-spacing:0.03em;\n}\n\n\/* Body *\/\n#cms20p1c .cq-body{max-width:760px;margin:0 auto;padding:0 16px;}\n\n\/* Cards *\/\n#cms20p1c .cq-card{\n background:var(--white);\n border:1px solid var(--line);\n border-radius:var(--radius);\n margin:24px 0;\n overflow:hidden;\n transition:box-shadow 0.2s;\n}\n#cms20p1c .cq-card:hover{box-shadow:0 2px 12px rgba(192,96,58,0.1)}\n\n#cms20p1c .cq-qhead{\n background:var(--ter-pale);\n border-bottom:1px solid var(--line);\n padding:14px 18px;\n display:flex;gap:12px;align-items:flex-start;\n}\n#cms20p1c .cq-qnum{\n flex-shrink:0;\n width:26px;height:26px;\n border-radius:50%;\n background:var(--ter);\n color:#fff;\n font-size:0.72rem;font-weight:700;\n display:flex;align-items:center;justify-content:center;\n margin-top:2px;\n transition:background 0.2s;\n}\n#cms20p1c .cq-qnum.ans-c{background:var(--correct-border)}\n#cms20p1c .cq-qnum.ans-w{background:var(--wrong-border)}\n#cms20p1c .cq-qtext{font-size:0.93rem;color:var(--ink);line-height:1.65;}\n\n\/* Options *\/\n#cms20p1c .cq-options{padding:14px 18px;display:flex;flex-direction:column;gap:8px;}\n#cms20p1c .cq-opt{\n display:flex;align-items:flex-start;gap:10px;\n padding:10px 14px;\n border:1.5px solid var(--line);\n border-radius:8px;cursor:pointer;\n transition:border-color 0.15s,background 0.15s;\n background:var(--white);\n -webkit-tap-highlight-color:transparent;\n}\n#cms20p1c .cq-opt:hover:not(.cq-locked){\n border-color:var(--teal);background:var(--teal-pale);\n}\n#cms20p1c .cq-opt-letter{\n flex-shrink:0;width:20px;height:20px;\n border-radius:50%;border:1.5px solid var(--line);\n display:flex;align-items:center;justify-content:center;\n font-size:0.65rem;font-weight:700;color:var(--ink-soft);\n transition:all 0.15s;margin-top:1px;\n}\n#cms20p1c .cq-opt-text{font-size:0.89rem;color:var(--ink-mid);line-height:1.55;}\n#cms20p1c .cq-opt.cq-correct{border-color:var(--correct-border);background:var(--correct-bg);cursor:default;}\n#cms20p1c .cq-opt.cq-correct .cq-opt-letter{background:var(--correct-border);border-color:var(--correct-border);color:#fff;}\n#cms20p1c .cq-opt.cq-correct .cq-opt-text{color:var(--correct);font-weight:600}\n#cms20p1c .cq-opt.cq-wrong{border-color:var(--wrong-border);background:var(--wrong-bg);cursor:default;}\n#cms20p1c .cq-opt.cq-wrong .cq-opt-letter{background:var(--wrong-border);border-color:var(--wrong-border);color:#fff;}\n#cms20p1c .cq-opt.cq-wrong .cq-opt-text{color:var(--wrong)}\n#cms20p1c .cq-opt.cq-dimmed{opacity:0.42;cursor:default}\n#cms20p1c .cq-opt.cq-locked{cursor:default}\n\n\/* Explanation *\/\n#cms20p1c .cq-explanation{\n display:none;\n background:var(--teal-pale);\n border-top:1px solid #b2d8d3;\n padding:10px 18px 12px;\n font-size:0.82rem;color:#1a4f49;line-height:1.62;\n}\n#cms20p1c .cq-exp-label{\n font-size:0.7rem;font-weight:700;letter-spacing:0.08em;\n text-transform:uppercase;color:var(--teal);margin-bottom:4px;\n}\n\n\/* Submit \u2014 teal *\/\n#cms20p1c .cq-submit-wrap{text-align:center;padding:28px 16px 8px;}\n#cms20p1c .cq-btn{\n background:var(--teal);\n color:var(--white);border:none;border-radius:8px;\n padding:13px 36px;\n font-family:'Playfair Display',serif;\n font-size:1rem;font-weight:700;cursor:pointer;\n letter-spacing:0.02em;\n transition:background 0.2s,transform 0.1s;\n}\n#cms20p1c .cq-btn:hover{background:var(--teal-light)}\n#cms20p1c .cq-btn:active{transform:scale(0.98)}\n\n\/* Score panel *\/\n#cms20p1c .cq-score{\n display:none;background:var(--white);\n border:2px solid var(--teal);border-radius:var(--radius);\n margin:28px 0 0;padding:28px 24px;text-align:center;\n}\n#cms20p1c .cq-score-ring{\n width:110px;height:110px;border-radius:50%;\n background:conic-gradient(var(--teal) 0%,var(--line) 0%);\n display:flex;align-items:center;justify-content:center;\n margin:0 auto 20px;position:relative;\n}\n#cms20p1c .cq-score-ring::before{\n content:'';position:absolute;width:86px;height:86px;\n border-radius:50%;background:var(--white);\n}\n#cms20p1c .cq-ring-inner{\n position:relative;display:flex;flex-direction:column;\n align-items:center;line-height:1.2;\n}\n#cms20p1c .cq-ring-pct{\n font-family:'Playfair Display',serif;font-size:1.3rem;\n font-weight:700;color:var(--teal);\n}\n#cms20p1c .cq-ring-sub{\n font-size:0.6rem;color:var(--ink-soft);\n text-transform:uppercase;letter-spacing:0.05em;\n}\n#cms20p1c .cq-score h2{\n font-family:'Playfair Display',serif;font-size:1.2rem;\n color:var(--ink);margin-bottom:8px;\n}\n#cms20p1c .cq-net-line{font-size:1rem;color:var(--teal);font-weight:600;margin-bottom:6px;}\n#cms20p1c .cq-verdict{font-size:0.85rem;color:var(--ink-soft);margin-bottom:20px;}\n#cms20p1c .cq-score-bands{\n display:flex;justify-content:center;gap:10px;flex-wrap:wrap;font-size:0.8rem;\n}\n#cms20p1c .cq-band{padding:4px 12px;border-radius:16px;font-weight:600}\n#cms20p1c .cq-band-c{background:var(--correct-bg);color:var(--correct)}\n#cms20p1c .cq-band-w{background:var(--wrong-bg);color:var(--wrong)}\n#cms20p1c .cq-band-s{background:var(--teal-pale);color:var(--teal)}\n#cms20p1c .cq-retry-btn{\n margin-top:22px;background:transparent;\n border:2px solid var(--teal);color:var(--teal);\n border-radius:8px;padding:10px 28px;\n font-family:'Playfair Display',serif;font-size:0.95rem;font-weight:700;\n cursor:pointer;transition:background 0.2s,color 0.2s;\n}\n#cms20p1c .cq-retry-btn:hover{background:var(--teal);color:var(--white)}\n\n@media(max-width:480px){\n #cms20p1c .cq-header h1{font-size:1.15rem}\n #cms20p1c .cq-qtext{font-size:0.88rem}\n #cms20p1c .cq-opt-text{font-size:0.84rem}\n}\n<\/style>\n<\/head>\n<body>\n\n<div id=\"cms20p1c\">\n\n <div class=\"cq-sentinel\" id=\"cms20p1c-sentinel\"><\/div>\n\n \n <div class=\"cq-statusbar\" id=\"cms20p1c-statusbar\">\n <div class=\"cq-sb-stats\">\n <div class=\"cq-sb-item\">\u2705 <strong id=\"cms20p1c-sc\">0<\/strong><\/div>\n <div class=\"cq-sb-item\">\u274c <strong id=\"cms20p1c-sw\">0<\/strong><\/div>\n <div class=\"cq-sb-item\">\u23f3 <strong id=\"cms20p1c-sr\">30<\/strong> left<\/div>\n <div class=\"cq-sb-sep\"><\/div>\n <div class=\"cq-sb-item\">Net <strong id=\"cms20p1c-sn\">0<\/strong> \/ <strong id=\"cms20p1c-sm\">120<\/strong><\/div>\n <\/div>\n <div class=\"cq-sb-progress\"><div class=\"cq-sb-fill\" id=\"cms20p1c-fill\"><\/div><\/div>\n <\/div>\n\n <div class=\"cq-header\">\n <h1>Combined Medical Services Examination 2020<br>Paper I \u00b7 Part 3<\/h1>\n <p>Endocrinology \u00b7 Infectious Disease \u00b7 Rheumatology \u00b7 ENT<\/p>\n <div class=\"cq-meta\">\n <span class=\"cq-badge\">Questions 61 \u2013 90<\/span>\n <span class=\"cq-badge\">Options reshuffled<\/span>\n <\/div>\n <\/div>\n\n <div class=\"cq-body\">\n <div id=\"cms20p1c-questions\"><\/div>\n <div class=\"cq-submit-wrap\">\n <button class=\"cq-btn\" id=\"cms20p1c-submit\">Submit Answers<\/button>\n <\/div>\n <div class=\"cq-score\" id=\"cms20p1c-score\">\n <div class=\"cq-score-ring\" id=\"cms20p1c-ring\">\n <div class=\"cq-ring-inner\">\n <span class=\"cq-ring-pct\" id=\"cms20p1c-ring-pct\">0%<\/span>\n <span class=\"cq-ring-sub\">score<\/span>\n <\/div>\n <\/div>\n <h2>Your Result<\/h2>\n <div class=\"cq-net-line\" id=\"cms20p1c-net-line\"><\/div>\n <div class=\"cq-verdict\" id=\"cms20p1c-verdict\"><\/div>\n <div class=\"cq-score-bands\">\n <span class=\"cq-band cq-band-c\" id=\"cms20p1c-ct-c\"><\/span>\n <span class=\"cq-band cq-band-w\" id=\"cms20p1c-ct-w\"><\/span>\n <span class=\"cq-band cq-band-s\" id=\"cms20p1c-ct-s\"><\/span>\n <\/div>\n <button class=\"cq-retry-btn\" id=\"cms20p1c-retry\">\u21ba Retry Quiz<\/button>\n <\/div>\n <\/div>\n\n<\/div>\n\n<script>\n(function(){\n 'use strict';\n\n const NS = 'cms20p1c';\n const TOTAL = 30;\n const MAX = TOTAL * 4;\n\n const QUESTIONS = [\n {\n id:61,\n stem:'Consider the following statements about erectile dysfunction in diabetic males:\\n1. It affects 60% of males\\n2. Its common cause is an underlying neuro-vascular pathology\\n3. It may be aggravated by beta-adrenergic agonist drugs\\n4. Endocrine disorders like hyperprolactinemia may cause it\\nWhich of the statements given above are true?',\n correct:'2 and 4',\n options:['1 and 2','2 and 3','2 and 4','3 and 4'],\n exp:'Statement 2 (neurovascular pathology) and 4 (hyperprolactinaemia) are correct. Statement 1 is false \u2014 prevalence is closer to 35\u201355% in diabetics. Statement 3 is false \u2014 it is beta-blockers (not agonists) that aggravate erectile dysfunction.'\n },\n {\n id:62,\n stem:'All of the following can cause hyperprolactinaemia EXCEPT:',\n correct:'Hyperthyroidism',\n options:['Craniopharyngioma','Hyperthyroidism','Stress','Chronic renal failure'],\n exp:'Hypothyroidism (not hyperthyroidism) causes hyperprolactinaemia \u2014 elevated TRH stimulates prolactin release. Craniopharyngioma causes stalk compression (loss of dopamine inhibition), stress raises prolactin directly, and chronic renal failure impairs prolactin clearance.'\n },\n {\n id:63,\n stem:'All of the following can be seen in a case of thyrotoxicosis EXCEPT:',\n correct:'Deafness',\n options:['Atrial fibrillation','Periodic paralysis','Deafness','Osteoporosis'],\n exp:'Deafness is not a recognised feature of thyrotoxicosis. AF (~10\u201315% of hyperthyroid patients), thyrotoxic periodic paralysis (especially in Asian males), and accelerated bone resorption causing osteoporosis are all well-established manifestations.'\n },\n {\n id:64,\n stem:'Which one of the following hormones acts via the receptor tyrosine kinase?',\n correct:'IGF-1',\n options:['FSH','TSH','IGF-1','PTH'],\n exp:'IGF-1 (insulin-like growth factor) acts via a receptor tyrosine kinase \u2014 similar to insulin. FSH and TSH act via G-protein coupled receptors (Gs \u2192 cAMP). PTH acts via GPCR (Gs and Gq). Receptor tyrosine kinases are also used by insulin, GH (JAK-STAT via GPCR-like), EGF, and PDGF.'\n },\n {\n id:65,\n stem:'Consider the following disorders as constituent of Multiple Endocrine Neoplasia Type 2a (MEN 2a):\\n1. Primary Hyperparathyroidism\\n2. Pituitary tumours\\n3. Medullary carcinoma of thyroid\\n4. Phaeochromocytoma\\nWhich of the above are correct?',\n correct:'1, 3 and 4',\n options:['1, 2 and 4','1, 2 and 3','1, 3 and 4','2, 3 and 4'],\n exp:\"MEN 2a (Sipple's syndrome) = Medullary thyroid carcinoma + Phaeochromocytoma + Primary hyperparathyroidism. Pituitary tumours are a feature of MEN 1 (Wermer's syndrome) \u2014 not MEN 2a. All three are driven by RET proto-oncogene mutations.\"\n },\n {\n id:66,\n stem:\"Consider the following statements with regard to Graves' ophthalmopathy:\\n1. Proptosis is often asymmetric and can even appear to be unilateral\\n2. It is a clinical diagnosis\\n3. Worsening of symptoms upon glucocorticoid withdrawal is common\\n4. Radiation therapy is very effective in treatment\\nWhich of the above statements are correct?\",\n correct:'1, 2 and 3',\n options:['1 and 2 only','1, 2 and 3','2, 3 and 4','1 and 4 only'],\n exp:\"Graves' ophthalmopathy is a clinical diagnosis based on the NOSPECS\/CAS criteria. Proptosis is frequently asymmetric. Glucocorticoid rebound on withdrawal is well recognised. Radiation therapy has a modest role (useful for soft tissue involvement) but is not considered 'very effective' \u2014 statement 4 overstates its benefit.\"\n },\n {\n id:67,\n stem:'All of the following are common aetiologies of delirium EXCEPT:',\n correct:'Hypoparathyroidism',\n options:['Hyperthyroidism','Hypothyroidism','Hyperparathyroidism','Hypoparathyroidism'],\n exp:'Hypoparathyroidism causes hypocalcaemia \u2014 which manifests as neuromuscular excitability, tetany, and seizures rather than delirium per se. Hyperthyroidism (thyroid storm), myxoedema coma (hypothyroidism), and hypercalcaemia (hyperparathyroidism) are all well-recognised metabolic causes of delirium.'\n },\n {\n id:68,\n stem:'Key anthropometric measurements important for evaluating the degree of obesity are:',\n correct:'Weight, height and waist circumference',\n options:['Weight, height and waist circumference','Weight, height and hip circumference','Weight, height and mid-thigh circumference','Weight, height and chest circumference'],\n exp:'BMI (weight\/height\u00b2) quantifies overall adiposity; waist circumference reflects central\/visceral fat \u2014 the clinically more dangerous component. Together they form the standard anthropometric assessment for obesity. Waist:hip ratio adds further information but waist alone is the key second measure.'\n },\n {\n id:69,\n stem:'What is the minimum BMI recommended for considering adjuvant pharmacologic treatment in obesity with comorbidity?',\n correct:'27 kg\/m\u00b2',\n options:['23 kg\/m\u00b2','25 kg\/m\u00b2','27 kg\/m\u00b2','30 kg\/m\u00b2'],\n exp:'FDA\/clinical guidelines recommend pharmacotherapy at BMI \u226530 kg\/m\u00b2 without comorbidity, or \u226527 kg\/m\u00b2 with at least one weight-related comorbidity (hypertension, T2DM, dyslipidaemia). The 27 threshold acknowledges that metabolic risk justifies earlier pharmacological intervention.'\n },\n {\n id:70,\n stem:'A young medical student got pricked by a syringe needle used to draw blood from a patient whose HIV status is unknown. Which one of the following therapeutic interventions will be in the best interest of this student?',\n correct:'To give Dolutegravir + Tenofovir + Emtricitabine',\n options:['To start Dolutegravir immediately','To wash wound with soap and water and start Emtricitabine','To give Dolutegravir + Tenofovir + Emtricitabine','To give Dolutegravir + Tenofovir + Emtricitabine + HBV Immunoglobulin'],\n exp:'Current WHO\/NACO guidelines recommend a 3-drug PEP regimen: Dolutegravir + Tenofovir + Emtricitabine for 28 days, started as soon as possible after washing the wound. HBV immunoglobulin is only indicated if the source is HBsAg-positive and the healthcare worker is non-immune \u2014 not for unknown status without that context.'\n },\n {\n id:71,\n stem:'Cryptococcal infection is acquired through:',\n correct:'Inhalation route',\n options:['Inhalation route','Bite of Culex mosquito','Direct skin contact','Ingestion of spores'],\n exp:'Cryptococcus neoformans is acquired by inhalation of desiccated yeast or spores from soil contaminated with bird (pigeon) droppings. Primary infection is pulmonary; haematogenous spread leads to cryptococcal meningitis, especially in immunocompromised hosts.'\n },\n {\n id:72,\n stem:'Which one of the following is NOT appropriate treatment for Echinococcus granulosus and hydatid disease?',\n correct:'Diethylcarbamazine 2 mg\/kg thrice in a day for 12 days',\n options:['Albendazole 400 mg twice in a day for 3 months','Diethylcarbamazine 2 mg\/kg thrice in a day for 12 days','PAIR (percutaneous puncture, aspiration, injection of scolicide, reaspiration)','Praziquantel 20 mg\/kg twice daily for 14 days'],\n exp:'Diethylcarbamazine (DEC) is used for lymphatic filariasis \u2014 it has absolutely no role in hydatid disease. Albendazole, PAIR, and praziquantel (used adjunctively to prevent secondary seeding) are all accepted treatments for Echinococcus granulosus.'\n },\n {\n id:73,\n stem:'Which one of the following infections is NOT amenable to post-exposure prophylaxis with specific immunoglobulins?',\n correct:'HIV',\n options:['Hepatitis B','HIV','Tetanus','Rabies'],\n exp:'There is no specific immunoglobulin available for HIV post-exposure prophylaxis \u2014 HIV PEP uses antiretroviral drugs. Hepatitis B immune globulin (HBIG), tetanus immune globulin (TIG), and rabies immune globulin (RIG) are all established products for passive immunisation after exposure.'\n },\n {\n id:74,\n stem:'Echinocandins are a class of:',\n correct:'Antifungal agents',\n options:['Antiviral agents','Antiparasitic agents','Antitubercular agents','Antifungal agents'],\n exp:'Echinocandins (caspofungin, micafungin, anidulafungin) are lipopeptide antifungal agents that inhibit \u03b2-1,3-glucan synthase \u2014 disrupting fungal cell wall synthesis. They are active against Candida and Aspergillus species and have no antibacterial, antiviral, or antitubercular activity.'\n },\n {\n id:75,\n stem:'Recommended first-line drugs for initial treatment of tuberculosis include all EXCEPT:',\n correct:'Ethionamide',\n options:['Isoniazid','Rifampin','Ethambutol','Ethionamide'],\n exp:'The standard first-line anti-TB regimen (2HRZE\/4HR) comprises Isoniazid (H), Rifampicin (R), Pyrazinamide (Z), and Ethambutol (E). Ethionamide is a second-line drug used in drug-resistant TB \u2014 it is structurally related to INH but is not part of first-line therapy.'\n },\n {\n id:76,\n stem:'The most frequent adverse reaction of significance among people treated for drug-susceptible tuberculosis is:',\n correct:'Hepatitis',\n options:['Colitis','Hepatitis','Cystitis','Enteritis'],\n exp:'Drug-induced hepatotoxicity is the most clinically significant and frequent adverse effect of first-line ATT \u2014 caused primarily by Isoniazid, Rifampicin, and Pyrazinamide. Baseline and periodic LFT monitoring is essential. Peripheral neuropathy (INH) is common but less dangerous.'\n },\n {\n id:77,\n stem:'All adult patients in whom anti-tubercular treatment is being started should undergo baseline assessment of:',\n correct:'Liver function test',\n options:['Complete blood count','Liver function test','Lipid profile','Pulmonary function test'],\n exp:'Baseline LFT is mandatory before starting ATT because Isoniazid, Rifampicin, and Pyrazinamide are all potentially hepatotoxic. LFTs guide decisions on stopping or modifying treatment if hepatitis develops. No other listed investigation is a universally mandated baseline for ATT initiation.'\n },\n {\n id:78,\n stem:'A 30-year-old male presents with fever, headache, anorexia, nausea, vomiting and diarrhoea. On examination tongue is coated with abdominal tenderness, soft splenomegaly, relative bradycardia and rose spots rash. The most likely diagnosis is:',\n correct:'Enteric fever',\n options:['Malaria fever','Enteric fever','Leptospirosis','Dengue fever'],\n exp:\"Enteric fever (typhoid) classically presents in week 2 with: rose spots (salmon-coloured maculopapular rash on trunk), relative bradycardia (Faget's sign), splenomegaly, coated tongue, and abdominal tenderness. Caused by Salmonella typhi\/paratyphi; confirmed by blood culture (Widal test is supportive).\"\n },\n {\n id:79,\n stem:'The extrapulmonary sites most commonly involved in tuberculosis are all EXCEPT:',\n correct:'Skull TB',\n options:['Lymph node TB','Genitourinary TB','Skeletal TB','Skull TB'],\n exp:\"Extrapulmonary TB in order of frequency: lymph nodes (most common, ~35%), pleura, genitourinary, bone\/joint (Pott's spine being the classic skeletal site), and meninges. Skull TB is exceedingly rare and is not among the recognised common extrapulmonary sites.\"\n },\n {\n id:80,\n stem:'Which of the following is NOT a clinical feature of Botulism?',\n correct:'Impaired alertness',\n options:['Impaired alertness','Dysphagia','Diplopia','Ptosis'],\n exp:'Botulinum toxin blocks presynaptic acetylcholine release at the neuromuscular junction. Crucially, patients remain ALERT and afebrile \u2014 cognitive function and consciousness are unaffected (the toxin does not cross the blood-brain barrier). Dysphagia, diplopia, and ptosis are all classic descending paralytic features.'\n },\n {\n id:81,\n stem:'Post exposure prophylaxis (PEP) for HIV should contain:',\n correct:'3 antiretroviral drugs administered for 4 weeks',\n options:['2 antiretroviral drugs administered for 4 weeks','2 antiretroviral drugs administered for 6 weeks','3 antiretroviral drugs administered for 4 weeks','3 antiretroviral drugs administered for 6 weeks'],\n exp:'Current WHO and NACO guidelines recommend 3-drug PEP (preferred: Dolutegravir + Tenofovir + Emtricitabine) for 28 days (4 weeks). Earlier 2-drug regimens have been superseded. Duration beyond 4 weeks is not recommended.'\n },\n {\n id:82,\n stem:'Paralytic rabies is characterised by:',\n correct:'Flaccid muscle weakness',\n options:['Maculopapular rash','Flaccid muscle weakness','Spastic muscle weakness','Hyperexcitability and facial weakness'],\n exp:\"Paralytic (dumb) rabies accounts for ~30% of cases and presents with ascending flaccid paralysis resembling Guillain-Barr\u00e9 syndrome \u2014 without the characteristic hydrophobia and aerophobia of 'furious' rabies. It is often misdiagnosed and has a slower progression.\"\n },\n {\n id:83,\n stem:'All are true for Marasmus EXCEPT:',\n correct:'Protein wasting',\n options:['Reduced triceps skinfold','Reduced mid arm circumference','Protein wasting','Decreased body mass index'],\n exp:'Marasmus is caused by severe calorie (energy) deficiency \u2014 fat stores and muscle bulk are depleted, but serum proteins (albumin, etc.) are relatively preserved. This distinguishes it from Kwashiorkor, where protein deficiency is predominant and hypoalbuminaemia with oedema is the hallmark. \"Protein wasting\" in the sense of hypoalbuminaemia is therefore not a feature of pure marasmus.'\n },\n {\n id:84,\n stem:'A 20-year-old lady presents with high grade fever for five days and palpable purpura over extremities. She is confused with neck stiffness. Which of the following is the most likely diagnosis?',\n correct:'Acute meningococcaemia',\n options:['Disseminated intravascular coagulation','Acute meningococcaemia','Antiphospholipid antibody syndrome','Thrombotic thrombocytopenic purpura'],\n exp:'The triad of fever + non-blanching petechial\/purpuric rash + meningism in a young person is acute meningococcaemia (Neisseria meningitidis) until proven otherwise \u2014 a medical emergency. The rash reflects septic emboli and endothelial damage. Waterhouse-Friderichsen syndrome (bilateral adrenal haemorrhage) may supervene.'\n },\n {\n id:85,\n stem:'Fibroblast Growth Factor 23 (FGF-23) is increased in which one of the following conditions?',\n correct:'Renal Osteodystrophy',\n options:['Osteomalacia','Osteoporosis',\"Paget's disease\",'Renal Osteodystrophy'],\n exp:'FGF-23, a phosphatonin produced by osteocytes, is markedly elevated in CKD\/renal osteodystrophy \u2014 it rises early as the kidneys lose the ability to excrete phosphate, contributing to secondary hyperparathyroidism, vitamin D deficiency, and vascular calcification. FGF-23 is also elevated in tumour-induced osteomalacia (oncogenic osteomalacia).'\n },\n {\n id:86,\n stem:'Which of the following crystals are deposited in a case of pseudogout?',\n correct:'Calcium pyrophosphate dihydrate (CPPD)',\n options:['Monosodium urate','Calcium phosphate','Cholesterol crystals','Calcium pyrophosphate dihydrate (CPPD)'],\n exp:'Pseudogout (calcium pyrophosphate crystal deposition disease) is caused by CPPD crystals \u2014 positively birefringent, rhomboid-shaped on polarised light microscopy, depositing in articular cartilage (chondrocalcinosis on X-ray). Gout = monosodium urate (negatively birefringent, needle-shaped).'\n },\n {\n id:87,\n stem:'Which of the following features are associated with poor prognosis in Diffuse Cutaneous Systemic Sclerosis?\\n1. Older age\\n2. A high gas transfer factor for carbon monoxide (TLCO)\\n3. Proteinuria\\n4. Diffuse skin disease',\n correct:'1, 3 and 4',\n options:['1, 2 and 4','3 and 4 only','1, 3 and 4','1, 2 and 3'],\n exp:'Poor prognostic markers in dcSSc include: older age at onset, diffuse skin involvement, renal involvement (proteinuria), pulmonary hypertension, and LOW (not high) TLCO indicating reduced gas transfer. A high TLCO is actually a favourable finding. Statement 2 is therefore incorrect.'\n },\n {\n id:88,\n stem:'Which of the following statements regarding pegloticase are correct?\\n1. It is an enzyme conjugate\\n2. It is useful in chronic gout management\\n3. The main adverse effects are infusion reactions and development of antibodies',\n correct:'1, 2 and 3',\n options:['1 and 2 only','2 and 3 only','1 and 3 only','1, 2 and 3'],\n exp:'All three statements are correct. Pegloticase is PEGylated recombinant uricase (enzyme conjugate) \u2014 it converts urate to allantoin, a more soluble metabolite. It is indicated for refractory chronic tophaceous gout. Major adverse effects are infusion reactions and anti-pegloticase antibody formation, which reduces efficacy and increases infusion risk.'\n },\n {\n id:89,\n stem:'The most common cause of sensorineural hearing loss in adults is:',\n correct:'Presbycusis',\n options:['Otosclerosis','Meniere\\'s disease','Presbycusis','Meningitis'],\n exp:'Presbycusis (age-related sensorineural hearing loss) is by far the most common cause of SNHL in adults \u2014 affecting ~30% of those over 65. It results from progressive degeneration of cochlear hair cells and the stria vascularis. Otosclerosis causes conductive (not sensorineural) hearing loss.'\n },\n {\n id:90,\n stem:'A 50-year-old male presents with dizziness. Which one of the following clinical findings does NOT favour a central cause?',\n correct:'Inhibition by visual fixation',\n options:['Poor saccades','Gaze evoked nystagmus','Inhibition by visual fixation','Presence of diplopia, dysarthria'],\n exp:\"Inhibition of nystagmus by visual fixation is a feature of PERIPHERAL vestibular disorders \u2014 the visual system compensates for peripheral imbalance. In central lesions (brainstem\/cerebellum), nystagmus is NOT suppressed by fixation. Poor saccades, gaze-evoked nystagmus, and accompanying diplopia\/dysarthria all point to central pathology.\"\n }\n ];\n\n function shuffle(arr){\n const a=[...arr];\n for(let i=a.length-1;i>0;i--){\n const j=Math.floor(Math.random()*(i+1));\n [a[i],a[j]]=[a[j],a[i]];\n }\n return a;\n }\n\n function esc(s){\n return s.replace(\/&\/g,'&').replace(\/<\/g,'<').replace(\/>\/g,'>').replace(\/\"\/g,'"');\n }\n\n const LETTERS=['A','B','C','D'];\n let userAnswers={};\n let answered=0;\n let shuffledOpts={};\n\n function build(){\n const container=document.getElementById(NS+'-questions');\n container.innerHTML='';\n userAnswers={};\n answered=0;\n shuffledOpts={};\n document.getElementById(NS+'-score').style.display='none';\n updateStats();\n\n QUESTIONS.forEach(function(q){\n const opts=shuffle(q.options);\n shuffledOpts[q.id]=opts;\n\n const card=document.createElement('div');\n card.className='cq-card';\n\n card.innerHTML=\n '<div class=\"cq-qhead\">'+\n '<div class=\"cq-qnum\" id=\"'+NS+'-n'+q.id+'\">'+q.id+'<\/div>'+\n '<div class=\"cq-qtext\">'+q.stem.replace(\/\\n\/g,'<br>')+'<\/div>'+\n '<\/div>'+\n '<div class=\"cq-options\" id=\"'+NS+'-opts'+q.id+'\">'+\n opts.map(function(o,i){\n return '<div class=\"cq-opt\" id=\"'+NS+'-o'+q.id+'-'+i+'\" data-qid=\"'+q.id+'\" data-val=\"'+esc(o)+'\" role=\"button\" tabindex=\"0\">'+\n '<span class=\"cq-opt-letter\">'+LETTERS[i]+'<\/span>'+\n '<span class=\"cq-opt-text\">'+o+'<\/span>'+\n '<\/div>';\n }).join('')+\n '<\/div>'+\n '<div class=\"cq-explanation\" id=\"'+NS+'-exp'+q.id+'\">'+\n '<div class=\"cq-exp-label\">Explanation<\/div>'+\n q.exp+\n '<\/div>';\n\n container.appendChild(card);\n\n opts.forEach(function(_,i){\n document.getElementById(NS+'-o'+q.id+'-'+i)\n .addEventListener('click',function(){ pick(q.id,i); });\n });\n });\n }\n\n function pick(qid,oi){\n if(userAnswers[qid]!==undefined)return;\n const q=QUESTIONS.find(function(x){return x.id===qid;});\n const opts=shuffledOpts[qid];\n const chosen=opts[oi];\n const correct=chosen===q.correct;\n userAnswers[qid]=correct?'correct':'wrong';\n answered++;\n\n opts.forEach(function(o,i){\n const el=document.getElementById(NS+'-o'+qid+'-'+i);\n if(o===q.correct) { el.classList.add('cq-correct','cq-locked'); }\n else if(i===oi) { el.classList.add('cq-wrong','cq-locked'); }\n else { el.classList.add('cq-dimmed','cq-locked'); }\n });\n\n document.getElementById(NS+'-n'+qid).classList.add(correct?'ans-c':'ans-w');\n document.getElementById(NS+'-exp'+qid).style.display='block';\n updateStats();\n }\n\n function updateStats(){\n const c=Object.values(userAnswers).filter(function(v){return v==='correct';}).length;\n const w=Object.values(userAnswers).filter(function(v){return v==='wrong';}).length;\n const r=TOTAL-answered;\n const net=(c*4)-w;\n document.getElementById(NS+'-sc').textContent=c;\n document.getElementById(NS+'-sw').textContent=w;\n document.getElementById(NS+'-sr').textContent=r;\n document.getElementById(NS+'-sn').textContent=net>=0?'+'+net:net;\n document.getElementById(NS+'-sm').textContent=MAX;\n document.getElementById(NS+'-fill').style.width=(answered\/TOTAL*100)+'%';\n }\n\n function showScore(){\n const c=Object.values(userAnswers).filter(function(v){return v==='correct';}).length;\n const w=Object.values(userAnswers).filter(function(v){return v==='wrong';}).length;\n const s=TOTAL-answered;\n const net=(c*4)-w;\n const pct=Math.max(0,Math.round((net\/MAX)*100));\n const disp=Math.min(100,Math.max(0,pct));\n\n document.getElementById(NS+'-ring').style.background=\n 'conic-gradient(var(--teal) '+disp+'%,var(--line) 0%)';\n document.getElementById(NS+'-ring-pct').textContent=pct+'%';\n document.getElementById(NS+'-net-line').textContent='Net Score: '+net+' \/ '+MAX;\n\n let v='';\n if(pct>=80) v='Excellent \u2014 well above the qualifying threshold.';\n else if(pct>=60) v='Good attempt \u2014 consolidate the weaker areas.';\n else if(pct>=40) v='Fair \u2014 systematic revision of these topics is recommended.';\n else v='Needs significant revision across these topics.';\n document.getElementById(NS+'-verdict').textContent=v;\n\n document.getElementById(NS+'-ct-c').textContent='\u2705 '+c+' Correct';\n document.getElementById(NS+'-ct-w').textContent='\u274c '+w+' Wrong';\n document.getElementById(NS+'-ct-s').textContent='\u23ed '+s+' Skipped';\n\n const sc=document.getElementById(NS+'-score');\n sc.style.display='block';\n sc.scrollIntoView({behavior:'smooth',block:'center'});\n }\n\n document.getElementById(NS+'-submit').addEventListener('click',showScore);\n document.getElementById(NS+'-retry').addEventListener('click',function(){\n build();\n window.scrollTo({top:0,behavior:'smooth'});\n });\n\n new IntersectionObserver(\n function(entries){\n document.getElementById(NS+'-statusbar')\n .classList.toggle('visible',!entries[0].isIntersecting);\n },\n {threshold:0}\n ).observe(document.getElementById(NS+'-sentinel'));\n\n build();\n updateStats();\n\n})();\n<\/script>\n<\/body>\n<\/html>\n\n\n\n\n","protected":false},"excerpt":{"rendered":"<p>CMS 2020 Paper I \u2013 Part 3 (Q61\u2013Q90) \u2705 0 \u274c 0 \u23f3 30 left Net 0 \/ 120 Combined Medical Services Examination 2020Paper I \u00b7 Part 3 Endocrinology \u00b7 Infectious Disease \u00b7 Rheumatology \u00b7 ENT Questions 61 \u2013 90 Options reshuffled Submit Answers 0% score Your Result \u21ba Retry Quiz<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"","neve_meta_content_width":0,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","footnotes":""},"categories":[18],"tags":[],"class_list":["post-36515","post","type-post","status-publish","format-standard","hentry","category-cms"],"yoast_head":"\n<title>CMS 2020 P1 Part-3 - atsixty<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/atsixty.com\/index.php\/2026\/04\/07\/cms-2020-p1-part-3\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"CMS 2020 P1 Part-3 - atsixty\" \/>\n<meta property=\"og:description\" content=\"CMS 2020 Paper I \u2013 Part 3 (Q61\u2013Q90) \u2705 0 \u274c 0 \u23f3 30 left Net 0 \/ 120 Combined Medical Services Examination 2020Paper I \u00b7 Part 3 Endocrinology \u00b7 Infectious Disease \u00b7 Rheumatology \u00b7 ENT Questions 61 \u2013 90 Options reshuffled Submit Answers 0% score Your Result \u21ba Retry Quiz\" \/>\n<meta property=\"og:url\" content=\"https:\/\/atsixty.com\/index.php\/2026\/04\/07\/cms-2020-p1-part-3\/\" \/>\n<meta property=\"og:site_name\" content=\"atsixty\" \/>\n<meta property=\"article:published_time\" content=\"2026-04-07T15:25:25+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2026-04-08T03:03:45+00:00\" \/>\n<meta name=\"author\" content=\"Avi\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Avi\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/07\\\/cms-2020-p1-part-3\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/07\\\/cms-2020-p1-part-3\\\/\"},\"author\":{\"name\":\"Avi\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/#\\\/schema\\\/person\\\/cf65e7ac7d8226d95c0bdf1036f7951d\"},\"headline\":\"CMS 2020 P1 Part-3\",\"datePublished\":\"2026-04-07T15:25:25+00:00\",\"dateModified\":\"2026-04-08T03:03:45+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/07\\\/cms-2020-p1-part-3\\\/\"},\"wordCount\":48,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/#\\\/schema\\\/person\\\/cf65e7ac7d8226d95c0bdf1036f7951d\"},\"articleSection\":[\"CMS\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/07\\\/cms-2020-p1-part-3\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/07\\\/cms-2020-p1-part-3\\\/\",\"url\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/07\\\/cms-2020-p1-part-3\\\/\",\"name\":\"CMS 2020 P1 Part-3 - atsixty\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/#website\"},\"datePublished\":\"2026-04-07T15:25:25+00:00\",\"dateModified\":\"2026-04-08T03:03:45+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/07\\\/cms-2020-p1-part-3\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/07\\\/cms-2020-p1-part-3\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/2026\\\/04\\\/07\\\/cms-2020-p1-part-3\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/atsixty.com\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"CMS 2020 P1 Part-3\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/#website\",\"url\":\"https:\\\/\\\/atsixty.com\\\/\",\"name\":\"At Sixty\",\"description\":\"The Option Taken\",\"publisher\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/#\\\/schema\\\/person\\\/cf65e7ac7d8226d95c0bdf1036f7951d\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/atsixty.com\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":[\"Person\",\"Organization\"],\"@id\":\"https:\\\/\\\/atsixty.com\\\/#\\\/schema\\\/person\\\/cf65e7ac7d8226d95c0bdf1036f7951d\",\"name\":\"Avi\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/atsixty.com\\\/wp-content\\\/uploads\\\/2025\\\/08\\\/logo-agency.png\",\"url\":\"https:\\\/\\\/atsixty.com\\\/wp-content\\\/uploads\\\/2025\\\/08\\\/logo-agency.png\",\"contentUrl\":\"https:\\\/\\\/atsixty.com\\\/wp-content\\\/uploads\\\/2025\\\/08\\\/logo-agency.png\",\"width\":200,\"height\":200,\"caption\":\"Avi\"},\"logo\":{\"@id\":\"https:\\\/\\\/atsixty.com\\\/wp-content\\\/uploads\\\/2025\\\/08\\\/logo-agency.png\"},\"sameAs\":[\"https:\\\/\\\/atsixty.com\"],\"url\":\"https:\\\/\\\/atsixty.com\\\/index.php\\\/author\\\/avinaux\\\/\"}]}<\/script>\n","yoast_head_json":{"title":"CMS 2020 P1 Part-3 - atsixty","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/atsixty.com\/index.php\/2026\/04\/07\/cms-2020-p1-part-3\/","og_locale":"en_US","og_type":"article","og_title":"CMS 2020 P1 Part-3 - atsixty","og_description":"CMS 2020 Paper I \u2013 Part 3 (Q61\u2013Q90) \u2705 0 \u274c 0 \u23f3 30 left Net 0 \/ 120 Combined Medical Services Examination 2020Paper I \u00b7 Part 3 Endocrinology \u00b7 Infectious Disease \u00b7 Rheumatology \u00b7 ENT Questions 61 \u2013 90 Options reshuffled Submit Answers 0% score Your Result \u21ba Retry Quiz","og_url":"https:\/\/atsixty.com\/index.php\/2026\/04\/07\/cms-2020-p1-part-3\/","og_site_name":"atsixty","article_published_time":"2026-04-07T15:25:25+00:00","article_modified_time":"2026-04-08T03:03:45+00:00","author":"Avi","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Avi","Est. reading time":"1 minute"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/07\/cms-2020-p1-part-3\/#article","isPartOf":{"@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/07\/cms-2020-p1-part-3\/"},"author":{"name":"Avi","@id":"https:\/\/atsixty.com\/#\/schema\/person\/cf65e7ac7d8226d95c0bdf1036f7951d"},"headline":"CMS 2020 P1 Part-3","datePublished":"2026-04-07T15:25:25+00:00","dateModified":"2026-04-08T03:03:45+00:00","mainEntityOfPage":{"@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/07\/cms-2020-p1-part-3\/"},"wordCount":48,"commentCount":0,"publisher":{"@id":"https:\/\/atsixty.com\/#\/schema\/person\/cf65e7ac7d8226d95c0bdf1036f7951d"},"articleSection":["CMS"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/atsixty.com\/index.php\/2026\/04\/07\/cms-2020-p1-part-3\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/07\/cms-2020-p1-part-3\/","url":"https:\/\/atsixty.com\/index.php\/2026\/04\/07\/cms-2020-p1-part-3\/","name":"CMS 2020 P1 Part-3 - atsixty","isPartOf":{"@id":"https:\/\/atsixty.com\/#website"},"datePublished":"2026-04-07T15:25:25+00:00","dateModified":"2026-04-08T03:03:45+00:00","breadcrumb":{"@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/07\/cms-2020-p1-part-3\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/atsixty.com\/index.php\/2026\/04\/07\/cms-2020-p1-part-3\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/atsixty.com\/index.php\/2026\/04\/07\/cms-2020-p1-part-3\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/atsixty.com\/"},{"@type":"ListItem","position":2,"name":"CMS 2020 P1 Part-3"}]},{"@type":"WebSite","@id":"https:\/\/atsixty.com\/#website","url":"https:\/\/atsixty.com\/","name":"At Sixty","description":"The Option Taken","publisher":{"@id":"https:\/\/atsixty.com\/#\/schema\/person\/cf65e7ac7d8226d95c0bdf1036f7951d"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/atsixty.com\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":["Person","Organization"],"@id":"https:\/\/atsixty.com\/#\/schema\/person\/cf65e7ac7d8226d95c0bdf1036f7951d","name":"Avi","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/atsixty.com\/wp-content\/uploads\/2025\/08\/logo-agency.png","url":"https:\/\/atsixty.com\/wp-content\/uploads\/2025\/08\/logo-agency.png","contentUrl":"https:\/\/atsixty.com\/wp-content\/uploads\/2025\/08\/logo-agency.png","width":200,"height":200,"caption":"Avi"},"logo":{"@id":"https:\/\/atsixty.com\/wp-content\/uploads\/2025\/08\/logo-agency.png"},"sameAs":["https:\/\/atsixty.com"],"url":"https:\/\/atsixty.com\/index.php\/author\/avinaux\/"}]}},"_links":{"self":[{"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/posts\/36515","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/comments?post=36515"}],"version-history":[{"count":5,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/posts\/36515\/revisions"}],"predecessor-version":[{"id":36533,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/posts\/36515\/revisions\/36533"}],"wp:attachment":[{"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/media?parent=36515"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/categories?post=36515"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/atsixty.com\/index.php\/wp-json\/wp\/v2\/tags?post=36515"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}