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12-year data methodology·400 ranked topics·Weekly updates
Top 50 High-Yield Topics for UPSC CMS 2026
Ranked by 12 years of examiner behaviour — frequency, recency, distractor pipeline, and subject trend.
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Questions analyzed
2014–2025
Years covered
Apr 16
Last refresh
The 50 topics · ranked
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#1
Risk Factors for Wound Infection
General SurgeryAsked 4× · Last: 2024 · Avg gap: 2yYears: 2018, 2019, 2023, 2024Repeated 4x Distractor Pipeline Top PredictedThe most-repeated topic in 12 years of CMS. The classic trap: confusing host factors (diabetes, steroids, malnutrition) with operative factors (wound class, duration). Both count.
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#2
Management of Hyperkalemia
Emergency Medicine & Critical CareAsked 3× · Last: 2024 · Avg gap: 3yYears: 2018, 2021, 2024Repeated 3x Distractor Pipeline Top PredictedSequence matters: calcium gluconate first (membrane stabilisation), then insulin-dextrose (intracellular shift), then kayexalate or dialysis (removal). Distractors swap the order.
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#3
Diagnosis of Primary Hyperparathyroidism
EndocrinologyAsked 2× · Last: 2025 · Avg gap: 1yYears: 2024, 2025Repeated 2x Distractor Pipeline Top Predicted Back-to-BackAsked in back-to-back years (2024 AND 2025). Consecutive repeats convert to triple-repeats 17.6% of the time. Strongest single bet on this list.
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#4
Diagnosis of Ileocaecal Tuberculosis
Gastro-intestinalAsked 2× · Last: 2020 · Avg gap: 1yYears: 2019, 2020Repeated 2x Distractor Pipeline Top PredictedStrong option-conversion signal. Examiner banks on confusion with Crohn's — skip lesions, transmural vs submucosal, caseation presence are the discriminators.
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#5
Risk Factors for Pelvic Inflammatory Disease
Obstetrics and GynaecologyAsked 2× · Last: 2024 · Avg gap: 3yYears: 2021, 2024Repeated 2x Distractor Pipeline Top Predicted3-year gap, fits the examiner's cycle. IUCD (first 3 weeks), multiple partners, adolescent age, douching — the classic four.
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#6
Diagnosis of Rheumatoid Arthritis
RheumatologyAsked 3× · Last: 2024 · Avg gap: 4.5yYears: 2015, 2019, 2024Repeated 3x Distractor Pipeline Top PredictedCurrent criteria are 2010 ACR/EULAR. Distractors still push the outdated 1987 criteria. Anti-CCP > RF for specificity.
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#7
Treatment of Guillain-Barré Syndrome (IVIG)
NeurologyAsked 2× · Last: 2023 · Avg gap: 7yYears: 2016, 2023Repeated 2x Distractor Pipeline Top PredictedNeurology is rising (+2.3%). IVIG vs plasmapheresis — both work, equal efficacy. Steroids do NOT work in GBS.
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#8
Definition of Multidrug-Resistant Tuberculosis
Infectious DiseasesAsked 2× · Last: 2017 · Avg gap: 2yYears: 2015, 2017Repeated 2x Distractor Pipeline Top PredictedMDR = resistance to at least INH AND rifampicin. ID cycle is due for a spike in 2026 — this topic is a front-runner.
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#9
Complications of Massive Blood Transfusion
HematologyAsked 2× · Last: 2020 · Avg gap: 6yYears: 2014, 2020Repeated 2x Top Predicted6-year gap, statistically due. The classic trio: hypocalcemia (citrate), hypothermia, coagulopathy (dilutional). Add hyperkalemia for large volumes.
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#10
Diagnosis of Autism Spectrum Disorder
PediatricsAsked 3× · Last: 2022 · Avg gap: 2yYears: 2018, 2021, 2022Repeated 3x Due for Return (2022) Top Predicted4-year rule fits perfectly — last asked 2022. DSM-5 collapsed the Asperger's/PDD-NOS distinction. Social communication + restricted behaviours.
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#11
Contraceptive Choice in Chronic Hypertension
Obstetrics and GynaecologyAsked 2× · Last: 2019 · Avg gap: 2yYears: 2017, 2019Repeated 2x Distractor Pipeline Top PredictedAvoid estrogen (COCs). Safe options: POPs, DMPA, IUCDs (both Cu and LNG), barrier methods. Examiner tests the estrogen exclusion.
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#12
Developmental Milestones in Infants
PediatricsAsked 3× · Last: 2022 · Avg gap: 3.5yYears: 2015, 2021, 2022Repeated 3x Due for Return (2022) Top PredictedPerennial favourite. Last appeared 2022 — due. Social smile (6-8wks), sits without support (6mo), walks alone (12mo), two-word sentences (24mo).
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#13
Diagnosis of Bronchiectasis
Respiratory DiseasesAsked 2× · Last: 2023 · Avg gap: 6yYears: 2017, 2023Repeated 2x Distractor Pipeline Top PredictedHRCT is gold standard (tram-tracks, signet ring, bronchoarterial ratio >1). Distractor: bronchography (obsolete).
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#14
Koebner Phenomenon in Psoriasis
DermatologyAsked 2× · Last: 2025 · Avg gap: 9yYears: 2016, 2025Repeated 2x Distractor Pipeline Top PredictedLong gap then returned 2025. New lesions at sites of trauma. Also seen in lichen planus, vitiligo, warts.
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#15
Inheritance Pattern of Cystic Fibrosis
Gastro-intestinalAsked 2× · Last: 2025 · Avg gap: 4yYears: 2021, 2025Repeated 2x Distractor Pipeline Top PredictedAutosomal recessive, CFTR gene on chromosome 7 (ΔF508). Sweat chloride >60 mmol/L diagnostic.
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#16
Diagnosis of Infectious Mononucleosis
PediatricsAsked 2× · Last: 2019 · Avg gap: 3yYears: 2016, 2019Repeated 2x Top PredictedEBV infection. Heterophile antibody (monospot) test. Amoxicillin triggers rash — classic exam trap.
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#17
Cytomegalovirus Esophagitis in Organ Transplant
Infectious DiseasesAsked 2× · Last: 2019 · Avg gap: 4yYears: 2015, 2019Repeated 2x Top PredictedImmunocompromised pattern. Owl-eye inclusion bodies on biopsy. Ganciclovir first-line.
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#18
Management of Varicella Exposure in Pregnancy
Obstetrics and GynaecologyAsked 2× · Last: 2023 · Avg gap: 5yYears: 2018, 2023Repeated 2x Distractor Pipeline Top PredictedVZIG within 10 days of exposure for non-immune mothers. Acyclovir if chickenpox develops. Live vaccine contraindicated in pregnancy.
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#19
Diagnosis of Giardiasis
Gastro-intestinalAsked 2× · Last: 2025 · Avg gap: 2yYears: 2023, 2025Repeated 2x Top PredictedRecent recurrence (2023 and 2025). Stool O&P (3 samples), stool antigen (ELISA), string test for refractory. Metronidazole treatment.
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#20
Associated Conditions with Coeliac Disease
Gastro-intestinalAsked 2× · Last: 2021 · Avg gap: 2yYears: 2019, 2021Repeated 2x Due for Return (2021) Top PredictedLast 2021 — due on 5-year cycle. Dermatitis herpetiformis, T1DM, Down syndrome, IgA deficiency. Iron-deficiency anaemia a common presenting clue.
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#21
Early Infections Post-HSCT
HematologyAsked 2× · Last: 2019 · Avg gap: 4yYears: 2015, 2019Repeated 2x Top PredictedTimeline-based: bacterial (pre-engraftment <30d), fungal (Aspergillus, Candida), then viral (CMV 30-100d, EBV, HHV6).
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#22
Sickle Cell Disease - Pneumococcal Infection
HematologyAsked 2× · Last: 2023 · Avg gap: 7yYears: 2016, 2023Repeated 2x Distractor Pipeline Top PredictedFunctional asplenia from repeated splenic infarction. Penicillin prophylaxis from 2 months to 5 years. PCV13 + PPSV23 vaccination mandatory.
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#23
Classification of Portal Hypertension
Gastro-intestinalNew on the list · First appeared: 2025Years: 2025Distractor Pipeline Top PredictedNew entry, strong pipeline signal. Pre-hepatic (portal vein thrombosis), hepatic (cirrhosis most common), post-hepatic (Budd-Chiari).
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#24
Management of Idiopathic Thrombocytopenic Purpura
HematologyNew on the list · First appeared: 2025Years: 2025Distractor Pipeline Top PredictedFirst-line: corticosteroids. Emergency (bleeding): IVIG + platelets. Chronic/refractory: rituximab, TPO agonists, splenectomy last.
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#25
Endometrial Sampling Timing for Ovulation Diagnosis
Obstetrics and GynaecologyAsked 2× · Last: 2023 · Avg gap: 2yYears: 2021, 2023Repeated 2x Top PredictedLuteal phase — day 21-23 of a 28-day cycle. Secretory endometrium confirms ovulation. Progesterone >10 ng/mL equivalent.
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#26
Initial Management of Acute Pancreatitis
Gastro-intestinalNew on the list · First appeared: 2024Years: 2024Distractor Pipeline Top PredictedNPO, aggressive fluids (Ringer's Lactate 5-10 mL/kg/hr), pain control, anti-emetics. No antibiotics unless infected necrosis.
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#27
Local Complications of Acute Pancreatitis
Gastro-intestinalNew on the list · First appeared: 2024Years: 2024Distractor Pipeline Top PredictedPseudocyst (>4 weeks, fluid + encapsulated), walled-off necrosis, acute peripancreatic collection. Atlanta 2012 classification.
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#28
Barrett's Oesophagus
Gastro-intestinalNew on the list · First appeared: 2024Years: 2024Distractor Pipeline Top PredictedIntestinal metaplasia (goblet cells) replacing squamous epithelium. 30-125× adenocarcinoma risk. PPI + endoscopic surveillance every 3-5 years.
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#29
Failure Rates of Contraceptive Methods
PSMAsked 2× · Last: 2021 · Avg gap: 5yYears: 2016, 2021Repeated 2x Due for Return (2021) Top PredictedPearl index. Perfect vs typical use. IUCD <1%, COC 0.3/9%, condom 2/18%, rhythm 5/24%, sterilisation <0.5%.
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#30
Diagnosis of Celiac Disease - Gold Standard
Gastro-intestinalNew on the list · First appeared: 2024Years: 2024Distractor Pipeline Top PredictedDuodenal biopsy with villous atrophy + crypt hyperplasia (Marsh-Oberhuber classification). Anti-tTG IgA screen, but biopsy is gold standard.
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#31
Complications of Acute Pancreatitis
Gastro-intestinalNew on the list · First appeared: 2024Years: 2024Distractor Pipeline Top PredictedSystemic: ARDS, AKI, shock, DIC. Local: pseudocyst, necrosis, abscess, splenic vein thrombosis.
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#32
Initial Fluid Management in Acute Pancreatitis
Gastro-intestinalNew on the list · First appeared: 2024Years: 2024Distractor Pipeline Top PredictedRinger's Lactate > Normal Saline. 5-10 mL/kg/hr for first 12-24 hrs. Target: urine output >0.5 mL/kg/hr, HR <120, MAP 65-85.
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#33
Management of Acute Severe Asthma
Respiratory DiseasesAsked 2× · Last: 2020 · Avg gap: 5yYears: 2015, 2020Repeated 2x Top PredictedHigh-flow O2, nebulised salbutamol + ipratropium, IV/oral steroids, IV magnesium sulphate if refractory. Intubate if exhaustion or silent chest.
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#34
Acute Glomerulonephritis with Hypertensive Encephalopathy
PediatricsAsked 2× · Last: 2016 · Avg gap: 2yYears: 2014, 2016Repeated 2x Top PredictedPost-streptococcal. Labetalol or nicardipine IV for hypertensive emergency. Avoid over-rapid BP reduction — risk of ischemia.
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#35
Early Complications of Acute MI
CardiologyAsked 2× · Last: 2016 · Avg gap: 1yYears: 2015, 2016Repeated 2x Top PredictedArrhythmias #1 killer in first 24 hrs (VF). RV infarct with inferior MI → preload-sensitive. Mechanical: papillary muscle rupture, VSD, free wall.
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#36
Classification of Laparoscopic Cholecystectomy
General SurgeryAsked 2× · Last: 2020 · Avg gap: 6yYears: 2014, 2020Repeated 2x Top PredictedStrasberg classification of bile duct injuries (A through E). Most common: cystic duct leak (Type A). Major injuries (D, E) need HJ anastomosis.
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#37
Diagnosis of Iron Deficiency Anaemia
HematologyNew on the list · First appeared: 2024Years: 2024Distractor Pipeline Top PredictedMicrocytic hypochromic. Low ferritin (<30 ng/mL), low transferrin saturation (<20%), high TIBC. Ferritin is acute-phase reactant — may be falsely normal.
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#38
Management of Hypothyroidism
EndocrinologyNew on the list · First appeared: 2024Years: 2024Distractor Pipeline Top PredictedLevothyroxine 1.6 μg/kg/day. Monitor TSH every 6-8 weeks until stable, target 0.5-2.5 mIU/L. Start lower (25-50 μg) in elderly and cardiac patients.
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#39
Secondary Hyperaldosteronism - Renal Artery Stenosis
EndocrinologyNew on the list · First appeared: 2024Years: 2024Distractor Pipeline Top PredictedUnilateral RAS → reduced renal perfusion → RAAS activation → high aldosterone. Captopril test diagnostic. Treat with ACE-I (cautiously) or revascularisation.
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#40
Avoiding Propranolol in Diabetic Patients
EndocrinologyNew on the list · First appeared: 2024Years: 2024Distractor Pipeline Top PredictedNon-selective beta-blockers mask hypoglycaemia symptoms (tremor, tachycardia). Cardioselective (metoprolol, bisoprolol) preferred in diabetics.
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#41
Strengths of Ultrasound as a Diagnostic Modality
PSMAsked 2× · Last: 2020 · Avg gap: 6yYears: 2014, 2020Repeated 2x Top PredictedNo radiation, real-time, portable, cheap. Operator-dependent. Sensitivity/specificity vary by application. Doppler for vascular.
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#42
Diagnosis of Protein-Losing Enteropathy
Gastro-intestinalAsked 2× · Last: 2022 · Avg gap: 3yYears: 2019, 2022Repeated 2x Due for Return (2022) Top Predicted4-year rule — last 2022, due 2026. α1-antitrypsin clearance (stool measurement). Edema + hypoalbuminaemia without proteinuria or liver disease.
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#43
Diagnosis of Ectopic Pregnancy
Obstetrics and GynaecologyAsked 2× · Last: 2025 · Avg gap: 10yYears: 2015, 2025Repeated 2x Distractor Pipeline Top Predictedβ-hCG + TVUS. Discriminatory zone 1500-2000 mIU/mL. Empty uterus + β-hCG above zone = ectopic. Methotrexate if stable and criteria met.
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#44
Signs of Severe Pneumonia in Children (IMNCI)
PediatricsNew on the list · First appeared: 2025Years: 2025Distractor Pipeline Top PredictedChest indrawing, cyanosis, inability to drink, convulsions, lethargy, stridor at rest. Refer urgently. Pre-refer antibiotic (amoxicillin).
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#45
Nephronophthisis
Genito-UrinaryNew on the list · First appeared: 2025Years: 2025Distractor Pipeline Top PredictedAutosomal recessive. Medullary cysts, tubular atrophy. Progresses to renal failure in childhood/adolescence. Distinguish from ADPKD (AD, larger kidneys).
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#46
Radiological Mimicry of TB by Silicosis
Respiratory DiseasesNew on the list · First appeared: 2025Years: 2025Distractor Pipeline Top PredictedEggshell calcification of hilar nodes, upper lobe fibrosis, reticulonodular pattern. Increases actual TB risk 3-fold — silico-tuberculosis.
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#47
Diagnosis of MI by ECG
CardiologyNew on the list · First appeared: 2025Years: 2025Distractor Pipeline Top PredictedSTEMI: ST elevation >1 mm in 2 contiguous leads (>2 mm in V2-V3 for men). New LBBB. Reciprocal ST depression. Territory maps to coronary artery.
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#48
Mitral Regurgitation Murmur Location
CardiologyNew on the list · First appeared: 2025Years: 2025Distractor Pipeline Top PredictedApex, pansystolic, radiates to axilla. Best heard in left lateral decubitus, end-expiration, with bell. Differentiate from TR (tricuspid area, Carvallo's sign).
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#49
Management of Hyperkalaemia in Children
PediatricsNew on the list · First appeared: 2025Years: 2025Distractor Pipeline Top PredictedPaediatric-dosed: calcium gluconate 0.5 mL/kg IV, insulin 0.1 u/kg + dextrose 0.5 g/kg, salbutamol nebulisation, kayexalate 1 g/kg. Dialysis if refractory.
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#50
Breast Cancer Clinical Staging
General SurgeryNew on the list · First appeared: 2025Years: 2025Distractor Pipeline Top PredictedTNM 8th edition (AJCC). T by size (<2, 2-5, >5 cm), N by nodal involvement, M by distant mets. Stage 0 (DCIS) through Stage IV.
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