FMGE 2010 Practice Questions

Q: Wernicke-Korsakoff's syndrome is due to the deficiency of:

Thiamine. ***Correct: Thiamine*** - **Wernicke-Korsakoff syndrome** is a severe neurological disorder caused by a profound deficiency of **thiamine (vitamin B1)**, most commonly seen in chronic alcoholics - **Thiamine** is crucial for **glucose metabolism** in the brain, and its deficiency leads to impaired neuronal function and brain damage - **Wernicke encephalopathy** presents acutely with confusion, ataxia, and ophthalmoplegia - **Korsakoff psychosis** represents the chronic phase with profound memory impairment and confabulation *Incorrect: Pyridoxine* - Deficiency of **pyridoxine (vitamin B6)** can cause peripheral neuropathy, seizures, and sideroblastic anemia, but is not the cause of Wernicke-Korsakoff syndrome - **Isoniazid** treatment is a common cause of pyridoxine deficiency *Incorrect: Riboflavin* - **Riboflavin (vitamin B2)** deficiency leads to cheilosis, angular stomatitis, glossitis, and seborrheic dermatitis, but is not associated with Wernicke-Korsakoff syndrome - It plays a vital role as a coenzyme (FAD, FMN) in various **redox reactions** *Incorrect: Vitamin B12* - Deficiency of **vitamin B12 (cobalamin)** causes megaloblastic anemia and subacute combined degeneration of the spinal cord, with distinct neurological symptoms different from Wernicke-Korsakoff syndrome - **Intrinsic factor** is necessary for its absorption in the terminal ileum

Q: Fluoride, used in the collection of blood samples, inhibits which enzyme?

Enolase. ***Enolase*** - Fluoride acts as a potent inhibitor of **enolase** by forming a complex with magnesium and phosphate at the enzyme's active site. - By inhibiting the conversion of **2-phosphoglycerate** to **phosphoenolpyruvate**, fluoride effectively halts **glycolysis**, preserving blood glucose levels for laboratory measurement. *Glucokinase* - This enzyme catalyzes the phosphorylation of glucose in the **liver** and **pancreas** and is not inhibited by fluoride ions. - Its activity is regulated by **insulin** and the glucokinase regulatory protein (GKRP), rather than external anticoagulants used in blood vials. *Glucose-6-phosphatase* - This enzyme is responsible for modernizing blood sugar by converting **glucose-6-phosphate** into free glucose during **gluconeogenesis** and glycogenolysis. - It is primarily located in the **endoplasmic reticulum** of liver and kidney cells and is not the target of glycolytic inhibitors in blood tubes. *Hexokinase* - Hexokinase is the first regulatory enzyme of glycolysis that traps glucose in cells as **glucose-6-phosphate**. - Although it is a key glycolytic enzyme, fluoride specifically targets the downstream step catalyzed by **enolase** to achieve effective glucose preservation.

Q: Cobra poison is:

Neurotoxic. ***Neurotoxic*** - Cobra venom contains **alpha-neurotoxins** that block **nicotinic acetylcholine receptors** at neuromuscular junctions, causing flaccid paralysis. - The primary cause of death is **respiratory failure** due to paralysis of respiratory muscles, making neurotoxicity the dominant mechanism. *Vasculotoxic* - Vasculotoxic effects are characteristic of **viper venoms**, causing bleeding, swelling, and tissue necrosis. - Cobra venom's primary action targets the **nervous system**, not blood vessels. *Myotoxic* - Myotoxic venoms directly damage **muscle tissue**, leading to rhabdomyolysis and muscle pain. - While minor muscle effects may occur, **neurotoxicity** remains the predominant and life-threatening mechanism in cobra envenomation. *Cardiotoxic* - Some cobra venoms contain **cardiotoxins**, but these are secondary to the primary neurotoxic effects. - The main cause of cardiovascular collapse is **respiratory paralysis**, not direct cardiac toxicity.

Q: A dead body is found to have marks like branching of a tree on the front of the chest. The most likely cause of death could be due to:

Lightning injury. ***Lightning injury*** - The branching, tree-like marks described are known as **Lichtenberg figures**, which are characteristic cutaneous patterns caused by the passage of high-voltage electrical current, such as during a **lightning strike**. - These transient patterns are believed to be due to dilation of capillaries or arborizing superficial burns, sometimes referred to as ferning. *Road traffic accident* - Injuries from a **road traffic accident** typically include blunt force trauma, lacerations, fractures, and internal organ damage, but they do not produce branching, tree-like skin marks. - The pattern of injury is usually widespread and indicative of impact, shearing, or crushing forces, which is distinct from the described branching marks. *Injuries due to bomb blast* - **Bomb blast injuries** are usually categorized as primary (blast wave), secondary (projectiles), tertiary (body displacement), and quaternary (miscellaneous, e.g., burns, toxic inhalation). They would not typically produce the specific Lichtenberg figures. - While burns can occur, they are usually thermal or chemical burns, not the characteristic superficial dendritic branching marks seen with lightning. *Firearm* - **Firearm injuries** result from projectiles (bullets), leading to entrance wounds, exit wounds (if applicable), and internal organ damage along the bullet's path. - The markings associated with firearms do not include branching, tree-like patterns on the skin; instead, they might show tattooing, stippling, or muzzle imprint with close-range shots.

Q: Punishment for rape is given under which section of IPC: TN 09; FMGE 10; AI 10; Kerala 11

Sec. 376. ***Sec. 376*** - **Section 376** of the Indian Penal Code (IPC) specifically deals with the **punishment for rape**. - This section outlines the various forms of punishment, including imprisonment for varying terms and fines, depending on the specifics of the crime. *Sec. 320* - **Section 320** of the IPC defines **grievous hurt**, outlining the types of injuries considered severe. - It does not pertain to the crime or punishment of rape. *Sec. 351* - **Section 351** of the IPC defines **assault**, which involves making a gesture or preparation with the intention or knowledge that it will cause apprehension of criminal force. - This section is unrelated to the offense of rape. *Sec. 375* - **Section 375** of the IPC defines what constitutes **rape**, detailing the circumstances under which sexual intercourse is considered an act of rape. - While it defines the act, it is **Section 376** that prescribes the punishment for it.

Q: Antidote for benzodiazepine poisoning: FMGE 10, 13; NEET 14

Flumazenil. ***Flumazenil*** - **Flumazenil** is a competitive **benzodiazepine receptor antagonist** that can reverse the sedative and other central nervous system effects of benzodiazepines. - It works by blocking benzodiazepines from binding to their receptor sites on the **GABA-A receptor complex**. *Naloxone* - **Naloxone** is a competitive **opioid receptor antagonist** used to reverse opioid overdose. - It has no effect on **benzodiazepine toxicity** as it targets different receptor systems. *Atropine* - **Atropine** is an **anticholinergic drug** used to reverse the effects of **cholinergic poisoning** (e.g., from organophosphates, carbamates) or symptomatic bradycardia. - It works on muscarinic acetylcholine receptors and is not involved in benzodiazepine metabolism or action. *N-acetyl-cysteine* - **N-acetyl-cysteine (NAC)** is primarily used as an antidote for **acetaminophen (paracetamol) poisoning**, where it replenishes glutathione. - It is also used in some cases of mucolysis but has no role in reversing benzodiazepine toxicity.

Q: Secondary hemorrhage is seen:

7-14 days after surgery. ***7-14 days after surgery*** - **Secondary hemorrhage** is typically caused by **infection** leading to erosion of blood vessels, which takes several days to develop. - This type of bleeding is characterized by onset more than 24 hours after surgery, commonly occurring between **7 to 14 days post-operatively**. *6 h after surgery* - Hemorrhage occurring within the first 24 hours (or particularly within the first few hours) is usually classified as **primary hemorrhage**. - **Primary hemorrhage** is often due to inadequate hemostasis during the initial surgical procedure. *24 h after surgery* - Bleeding at 24 hours post-surgery still falls under the definition of **primary or reactionary hemorrhage**. - **Reactionary hemorrhage** occurs within the first 24 hours due to dislodgement of clots or changes in blood pressure. *During anesthesia* - Hemorrhage during anesthesia is by definition **primary hemorrhage**, occurring contemporaneously with the surgical procedure. - This is directly related to surgical technique or patient factors during the operation itself.

Question 1

Wernicke-Korsakoff's syndrome is due to the deficiency of:

Accepted Answer

Thiamine

Answer

Pyridoxine

Answer

Riboflavin

Answer

Vitamin B12

Question 2

Fluoride, used in the collection of blood samples, inhibits which enzyme?

Accepted Answer

Enolase

Answer

Glucokinase

Answer

Glucose-6-phosphatase

Answer

Hexokinase

Question 3

Cobra poison is:

Accepted Answer

Neurotoxic

Answer

Vasculotoxic

Answer

Myotoxic

Answer

Cardiotoxic

Question 4

A dead body is found to have marks like branching of a tree on the front of the chest. The most likely cause of death could be due to:

Accepted Answer

Lightning injury

Answer

Road traffic accident

Answer

Injuries due to bomb blast

Answer

Firearm

Question 5

Punishment for rape is given under which section of IPC: TN 09; FMGE 10; AI 10; Kerala 11

Accepted Answer

Sec. 376

Answer

Sec. 320

Answer

Sec. 351

Answer

Sec. 375

Question 6

Antidote for benzodiazepine poisoning: FMGE 10, 13; NEET 14

Accepted Answer

Flumazenil

Answer

Naloxone

Answer

Atropine

Answer

N-acetyl-cysteine

Question 7

Secondary hemorrhage is seen:

Accepted Answer

7-14 days after surgery

Answer

6 h after surgery

Answer

24 h after surgery

Answer

During anesthesia

FMGE 2010

Biochemistry

Forensic Medicine

Pharmacology

Surgery