Biochemistry
1 questionsWestern blot is used for:
FMGE 2009 - Biochemistry FMGE Practice Questions and MCQs
Question 1: Western blot is used for:
- A. RNA
- B. Maternal DNA
- C. DNA
- D. Proteins (Correct Answer)
Explanation: ***Proteins*** - **Western blot** (also known as protein immunoblot) is a widely used analytical technique in molecular biology and immunogenetics to **detect specific proteins** in a given sample. - It involves separating proteins by size using gel electrophoresis, transferring them to a membrane, and then detecting the protein of interest using specific **antibodies**. *RNA* - The technique used to detect RNA is called **Northern blot**, which involves separating RNA fragments by size and then detecting specific RNA sequences using nucleic acid probes. - While both Northern and Western blots involve electrophoresis and transfer to a membrane, the target molecule is different. *Maternal DNA* - Detection of specific DNA sequences, including maternal DNA or fetal DNA, is typically performed using techniques like **Southern blot** or, more commonly now, **PCR-based methods** and **next-generation sequencing**. - Maternal DNA itself is not the specific target of a Western blot; proteins derived from any source of DNA, maternal or otherwise, would be the target. *DNA* - The technique primarily used for the detection of specific DNA sequences is **Southern blot**, which involves separating DNA fragments by size and using labeled probes to identify target sequences. - Western blot is fundamentally designed for protein analysis, relying on antibody-antigen recognition rather than DNA hybridization.
Dental
1 questionsFiligree burn occur in:
FMGE 2009 - Dental FMGE Practice Questions and MCQs
Question 1: Filigree burn occur in:
- A. Lightning (Correct Answer)
- B. Vitriolage
- C. Electrocution
- D. High voltage electrical injury
Explanation: **Lightning** - **Filigree burns**, also known as **Lichtenberg figures**, are a pathognomonic sign of a **lightning strike**. - These fern-like or tree-like patterns are caused by the flow of high-voltage current along the skin. *High voltage electrical injury* - High voltage electrical injuries typically cause **deep, severe burns** at the points of contact and along the current's path through the body, but generally **do not produce filigree burns**. - The damage from high voltage is primarily due to thermal effects and can lead to extensive tissue necrosis and organ damage. *Vitriolage* - **Vitriolage** refers to injuries caused by **acid attacks**, which result in severe chemical burns. - These burns are characterized by **tissue destruction and discoloration** specific to the corrosive agent, and do not present as filigree patterns. *Electrocution* - **Electrocution** refers to death caused by electric shock. While it involves electric current, it typically results in **entrance and exit wounds**, and internal organ damage. - The term focuses on the fatal outcome and the direct path of the current through the body rather than specific superficial patterns like filigree burns, which are unique to lightning due to its massive, brief, and highly energetic discharge.
Forensic Medicine
2 questionsFracture of hyoid bone is indicative of:
In dry drowning:
FMGE 2009 - Forensic Medicine FMGE Practice Questions and MCQs
Question 1: Fracture of hyoid bone is indicative of:
- A. Manual strangulation (Correct Answer)
- B. Ligature strangulation
- C. Hanging
- D. Bansdola
Explanation: ***Manual strangulation*** - Fracture of the **hyoid bone** is **most indicative** of **manual strangulation** due to direct, localized anteroposterior compression of the neck by fingers and thumbs. - The **greater cornu of hyoid** is most commonly fractured when forceful thumb pressure is applied to the front of the neck during manual throttling. - Among all forms of neck compression, manual strangulation has the **highest incidence** of hyoid fracture (30-50% of cases), especially in victims over 40 years when the hyoid is calcified. - This is considered a **classical sign** in forensic pathology for manual strangulation. *Ligature strangulation* - Involves constriction of the neck by a **ligature** (e.g., rope, cord), which causes more **circumferential compression** rather than localized pressure. - Hyoid fracture occurs in only 10-15% of cases, as the force is distributed around the neck rather than concentrated on the hyoid. - **Ligature marks** are the more characteristic finding. *Hanging* - Involves suspension of the body by a ligature around the neck, typically with an **oblique ligature mark** going upward toward the point of suspension. - Hyoid fracture is relatively **rare in suicidal hanging** (10-20%), but can occur in **judicial hanging with drop** or in elderly individuals with calcified hyoid. - The mechanism is more cervical spine injury and vascular compression rather than direct hyoid trauma. *Bansdola* - **Bansdola** refers to a method involving twisting a stick through a ligature around the neck (garroting). - While it can cause neck injuries, the mechanism is more similar to ligature strangulation with circumferential compression. - **Hyoid fracture** is less characteristic compared to manual strangulation.
Question 2: In dry drowning:
- A. Water does not enter lungs because of laryngeal spasm (Correct Answer)
- B. Seen in alcoholics due to drowning in shallow pool
- C. Death occurs due to sudden immersion in cold water
- D. Death occurs in few days of submersion episode
Explanation: ***Water does not enter lungs because of laryngeal spasm*** - In **dry drowning**, water does not directly enter the lungs but instead causes **laryngospasm**, leading to **suffocation**. - This **reflexive closure of the larynx** prevents water from entering the trachea and bronchial tree during submersion. *Seen in alcoholics due to drowning in shallow pool* - While alcohol consumption can be a factor in drowning incidents, **dry drowning** specifically refers to the mechanism of death due to laryngospasm, not necessarily the circumstances or risk factors. - Drowning in a shallow pool is a circumstance of drowning; it does not define the physiological mechanism of dry drowning. *Death occurs due to sudden immersion in cold water* - Death due to sudden immersion in cold water often leads to **cardiac arrest** (cold shock response) or **hypothermia**, which are different mechanisms from the laryngospasm seen in dry drowning. - Although these can be contributing factors in some drowning deaths, they are not the primary cause of death in dry drowning. *Death occurs in few days of submersion episode* - Death occurring days after a submersion episode is typical of **secondary drowning** (also known as delayed drowning or "wet drowning" with subsequent complications), where inhaled water causes **acute respiratory distress syndrome (ARDS)** or other pulmonary issues. - In **dry drowning**, death occurs rapidly due to **asphyxia** from laryngospasm and not delayed respiratory complications.
Internal Medicine
1 questionsA girl presents with primary amenorrhea, grade V thelarche (mature breast), grade II pubarche (sparse growth of pubic hair) and no axillary hair. Likely diagnosis is:
FMGE 2009 - Internal Medicine FMGE Practice Questions and MCQs
Question 1: A girl presents with primary amenorrhea, grade V thelarche (mature breast), grade II pubarche (sparse growth of pubic hair) and no axillary hair. Likely diagnosis is:
- A. Turner syndrome
- B. Testicular feminization (Correct Answer)
- C. Gonadal dysgenesis
- D. Mullerian agenesis
Explanation: Androgen Insensitivity Syndrome (also known as testicular feminization) is characterized by a phenotype where primary amenorrhea occurs in a girl with mature (Grade V) breast development but sparse or absent pubic and axillary hair (Grade II pubarche). In this condition, androgens are produced but their receptors are non-functional, leading to normal breast development through the peripheral conversion of androgens to estrogens while inhibiting androgen-dependent hair growth [3]. *Turner syndrome* - Characterized by gonadal dysgenesis [1], leading to primary amenorrhea and absent or rudimentary breast development (grade I thelarche). Patients typically present with characteristic physical features such as short stature [1], webbed neck, and coarctation of the aorta, which are not mentioned here. *Gonadal dysgenesis* - This is a broader term for abnormal development of the gonads [2], often leading to primary amenorrhea and lack of secondary sexual characteristics [1]. Unlike the described case, individuals with gonadal dysgenesis would not have mature breast development. *Mullerian agenesis* - Presents with primary amenorrhea due to the absence or hypoplasia of the uterus and upper vagina, but normal ovarian function. Patients with Mullerian agenesis would typically have normal breast development and normal pubic and axillary hair growth, as their androgen receptors are functional.
Obstetrics and Gynecology
1 questionsRate of uterine involution per day following delivery:
FMGE 2009 - Obstetrics and Gynecology FMGE Practice Questions and MCQs
Question 1: Rate of uterine involution per day following delivery:
- A. 2.5 cm/day
- B. 1.25 cm/day
- C. 1 cm/day (Correct Answer)
- D. 2.25 cm/day
Explanation: ***1 cm/day*** - Following delivery, the uterus typically descends into the pelvis at a rate of **1 cm (or 1 finger breadth) per day**. - This process of **uterine involution** allows the fundus to return to its pre-pregnancy size and location within approximately **6 weeks**. *2.5 cm/day* - This rate of uterine involution is **too rapid** and not consistent with the normal physiological process. - A uterus undergoing such rapid changes might suggest an underlying complication, but it's not the typical rate. *1.25 cm/day* - While closer to the correct rate, **1.25 cm/day** is still slightly faster than the average expected rate of uterine involution. - The standard measurement used in clinical practice and textbooks is generally **1 cm/day**. *2.25 cm/day* - This rate is also **significantly faster** than the normal physiological process of uterine involution. - Such an accelerated rate would not be expected in a healthy postpartum woman.
Pathology
1 questionsConfirmatory diagnosis of rabies on postmortem:
FMGE 2009 - Pathology FMGE Practice Questions and MCQs
Question 1: Confirmatory diagnosis of rabies on postmortem:
- A. Negri bodies in saliva
- B. Anti-rabies antibodies in blood
- C. Negri bodies in brain (Correct Answer)
- D. Negri bodies in corneal scrapings
Explanation: ***Negri bodies in brain*** - The presence of **Negri bodies** (eosinophilic intracytoplasmic inclusions) found upon histological examination of brain tissue (specifically **Purkinje cells of the cerebellum** and **pyramidal cells of the hippocampus**) is the **pathognomonic microscopic finding** for rabies [1]. - This is considered the **gold standard for postmortem confirmation** because the rabies virus primarily targets and replicates in neuronal tissue, leading to these characteristic inclusions. *Negri bodies in saliva* - While rabies virus can be present in saliva, the presence of **Negri bodies** themselves in saliva is **not a diagnostic criterion**. - **Viral isolation** or **PCR** from saliva might detect the virus, but Negri bodies are cellular inclusions, not free virus particles. *Anti-rabies antibodies in blood* - The presence of **anti-rabies antibodies** in blood typically indicates **prior exposure or vaccination**, not necessarily an active, fatal infection as required for a postmortem diagnosis. - In unvaccinated individuals with clinical rabies, antibodies may only appear in the very late stages, if at all, due to the rapid progression of the disease and the virus's evasion of the immune system in the CNS. *Negri bodies in corneal scrapings* - While rabies virus antigens can sometimes be detected in **corneal impressions or scrapings** during life using **fluorescent antibody tests**, Negri bodies are not typically found or used for diagnosis in these samples [1]. - Corneal testing is primarily a **pre-mortem diagnostic aid** for antigen detection, not for visualizing Negri bodies. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Central Nervous System, pp. 1279-1280.
Pharmacology
1 questionsWhich of the following is NOT used for iron poisoning?
FMGE 2009 - Pharmacology FMGE Practice Questions and MCQs
Question 1: Which of the following is NOT used for iron poisoning?
- A. EDTA (Ethylenediaminetetraacetic acid)
- B. Desferrioxamine
- C. Gastric lavage
- D. Penicillamine (Correct Answer)
Explanation: ***Penicillamine*** - **Penicillamine** is a chelating agent indicated for **copper poisoning** (Wilson's disease), **lead poisoning**, and **rheumatoid arthritis**, but has **no role in iron poisoning**. - It works by chelating copper, lead, and other heavy metals, but does not effectively chelate iron. - This is the most clearly incorrect option as it is never indicated for iron toxicity. *EDTA (Ethylenediaminetetraacetic acid)* - **EDTA** is primarily used for **lead poisoning** and hypercalcemia. - While not routinely used for iron poisoning, it can form iron-EDTA complexes, which may paradoxically worsen toxicity. - **CaNa₂EDTA** is avoided in iron poisoning due to potential complications. *Desferrioxamine* - **Desferrioxamine (Deferoxamine)** is the **first-line antidote** for severe iron poisoning. - It is a highly specific iron-chelating agent that binds free iron in the bloodstream and promotes its renal excretion as ferrioxamine. - It reduces iron-mediated oxidative damage to organs (especially liver, heart, and GI tract). *Gastric lavage* - **Gastric lavage** can be used as a decontamination method in acute iron poisoning if performed early (within 1-2 hours of ingestion). - It helps remove unabsorbed iron tablets from the stomach, reducing further systemic absorption. - Whole bowel irrigation with polyethylene glycol is often preferred for iron tablet ingestion.
Psychiatry
1 questionsDrug of choice for obsessive-compulsive disorder is:
FMGE 2009 - Psychiatry FMGE Practice Questions and MCQs
Question 1: Drug of choice for obsessive-compulsive disorder is:
- A. Sertraline
- B. Fluoxetine (Correct Answer)
- C. Alprazolam
- D. Chlorpromazine
Explanation: ***Fluoxetine*** - **Selective serotonin reuptake inhibitors (SSRIs)** are the first-line pharmacological treatment for **obsessive-compulsive disorder (OCD)**. - **Fluoxetine** was traditionally considered a primary choice for OCD treatment and is FDA-approved for this indication. - It works by selectively inhibiting serotonin reuptake, increasing serotonergic neurotransmission, which is crucial in OCD pathophysiology. - Higher doses are typically required for OCD compared to depression (40-80 mg/day). *Sertraline* - **Sertraline** is also an **SSRI** and equally effective as fluoxetine for OCD treatment. - It is FDA-approved for OCD and considered a first-line option. - In current clinical practice, **all SSRIs (fluoxetine, sertraline, fluvoxamine, paroxetine) are considered equally appropriate first-line choices** with no single "drug of choice." - Selection depends on individual patient factors, side effect profile, and drug interactions. - **Note:** Both fluoxetine and sertraline are correct answers in modern practice; this question reflects historical exam teaching. *Alprazolam* - **Alprazolam** is a **benzodiazepine** used for short-term relief of anxiety and panic attacks. - It does not address the core pathophysiology of OCD (obsessions and compulsions). - Not recommended as monotherapy for OCD; may be used adjunctively for severe anxiety symptoms. *Chlorpromazine* - **Chlorpromazine** is a **first-generation antipsychotic** used primarily for schizophrenia and psychotic disorders. - Not indicated for OCD treatment as monotherapy. - Antipsychotics may be used as **augmentation** in treatment-resistant OCD but only as add-on to SSRIs.