FMGE 2011 Previous Year Questions Practice Questions

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

Enolase. ***Enolase*** - Fluoride is a potent inhibitor of **enolase**, an enzyme in the **glycolytic pathway**. - Inhibition of enolase prevents the conversion of **2-phosphoglycerate** to **phosphoenolpyruvate**, thereby halting glycolysis in collected blood samples. *Glucokinase* - Glucokinase is an enzyme primarily found in the **liver** and **pancreatic beta cells** that phosphorylates glucose. - Fluoride does not directly inhibit glucokinase; its primary site of action for preventing glycolysis in blood samples is enolase. *Glucose-6-phosphatase* - This enzyme is crucial for **glucose production** in the liver and kidneys, facilitating the dephosphorylation of **glucose-6-phosphate** to glucose. - Fluoride does not specifically target glucose-6-phosphatase as its mechanism for preventing glycolysis. *Hexokinase* - Hexokinase catalyzes the first step of glycolysis, phosphorylating **glucose to glucose-6-phosphate**. - While essential for glycolysis, hexokinase is not the primary target of fluoride's inhibitory action in blood collection, which specifically aims to stop the entire pathway further downstream at enolase. [Practice more FMGE 2011 questions on OnCourse]

Q: Fracture of hyoid bone is indicative of:

Manual strangulation. ***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. [Practice more FMGE 2011 questions on OnCourse]

Q: In dry drowning:

Water does not enter lungs because of laryngeal spasm. ***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. [Practice more FMGE 2011 questions on OnCourse]

Q: Gastric lavage is contraindicated in the following:

Kerosene poisoning. ***Kerosene poisoning*** - Gastric lavage is contraindicated in **hydrocarbon poisoning** like kerosene due to the high risk of **aspiration pneumonitis**. [1] - Aspiration of hydrocarbons can lead to severe **chemical pneumonitis**, acute respiratory distress syndrome (ARDS), and even death. *Barbiturate poisoning* - Gastric lavage can be useful in **barbiturate poisoning**, especially if presenting within 1-2 hours of ingestion, to remove unabsorbed drug. - It's part of the management strategy to reduce drug absorption and potentially speed up recovery. *Paracetamol poisoning* - **Gastric lavage** may be considered in paracetamol overdose, particularly if performed within 1-2 hours of ingestion, to remove unabsorbed drug. - However, **activated charcoal** is usually the preferred method for gastric decontamination in paracetamol overdose, followed by **N-acetylcysteine**. *Carbolic acid poisoning* - While typically considered a corrosive, gastric lavage might be cautiously used in **carbolic acid (phenol) poisoning** in specific circumstances, such as very early presentation or large ingestions, but it carries risks of esophageal injury. [2] - Dilution with milk or water is often preferred, but lavage should be avoided if there's evidence of significant caustic injury or perforation risk. [Practice more FMGE 2011 questions on OnCourse]

Q: Rate of uterine involution per day following delivery:

1 cm/day. ***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. [Practice more FMGE 2011 questions on OnCourse]

Question 1

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

Accepted Answer

Enolase

Answer

Glucokinase

Answer

Glucose-6-phosphatase

Answer

Hexokinase

Question 2

Fracture of hyoid bone is indicative of:

Accepted Answer

Manual strangulation

Answer

Ligature strangulation

Answer

Hanging

Answer

Bansdola

Question 3

In dry drowning:

Accepted Answer

Water does not enter lungs because of laryngeal spasm

Answer

Seen in alcoholics due to drowning in shallow pool

Answer

Death occurs due to sudden immersion in cold water

Answer

Death occurs in few days of submersion episode

Question 4

Gastric lavage is contraindicated in the following:

Accepted Answer

Kerosene poisoning

Answer

Barbiturate poisoning

Answer

Paracetamol poisoning

Answer

Carbolic acid poisoning

Question 5

Rate of uterine involution per day following delivery:

Accepted Answer

1 cm/day

Answer

2.5 cm/day

Answer

1.25 cm/day

Answer

2.25 cm/day

Question 6

Diffuse axonal injury is characterized by lesion at:

Accepted Answer

Junction of gray and white matter

Answer

Basal ganglia

Answer

Corpus callosum

Answer

White matter

Question 7

In males, first pubertal sign is:

Accepted Answer

Testicular enlargement

Answer

Pubic hair development

Answer

Hoarseness of voice

Answer

Penis enlargement

Question 8

All are true about atropine poisoning, except

Accepted Answer

Decreased temperature

Answer

Dysarthria

Answer

Dysphagia

Answer

Dilated pupils

Question 9

All are true about delirium tremens, except:

Accepted Answer

Normal sleep-wake cycle

Answer

Clouding of consciousness

Answer

Visual hallucinations

Answer

Coarse tremors

Question 10

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 2011

Biochemistry

Forensic Medicine

Internal Medicine

Obstetrics and Gynecology

Pathology

Pediatrics

Pharmacology

Psychiatry

Surgery

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