Anatomy
1 questionsPartial claw hand is caused by lesion involving the:
FMGE 2013 - Anatomy FMGE Practice Questions and MCQs
Question 1: Partial claw hand is caused by lesion involving the:
- A. Anterior interosseous nerve
- B. Radial nerve
- C. Median nerve
- D. Ulnar nerve (Correct Answer)
Explanation: ***Ulnar nerve*** - A lesion of the **ulnar nerve** causes a **partial claw hand** (also called "ulnar claw") because the **medial two lumbricals** (which flex the MCP joints and extend the IP joints of the 4th and 5th digits) and the **interossei** are paralyzed [1]. - This leads to hyperextension at the **metacarpophalangeal (MCP) joints** and flexion at the **interphalangeal (IP) joints** of the **4th and 5th fingers only** (hence "partial") [1]. - The lateral two fingers (index and middle) are spared because their lumbricals are supplied by the median nerve [1]. *Anterior interosseous nerve* - Injury to the **anterior interosseous nerve** primarily affects the **flexor pollicis longus**, **flexor digitorum profundus** (index and middle fingers), and **pronator quadratus**. - This results in the inability to make an "OK" sign (pinch sign) and does not typically cause a claw hand deformity. *Radial nerve* - A **radial nerve** lesion leads to **wrist drop** and the inability to extend the wrist and fingers. - This deformity is distinct from a claw hand, which involves hyperextension at the MCP joints and flexion at the IP joints. *Median nerve* - A **median nerve** lesion results in a "hand of benediction" or "ape hand" deformity, affecting the **thenar muscles** and the **lateral two lumbricals** [1]. - This involves paralysis of the thumb's opposition and the inability to flex the index and middle fingers, not the characteristic clawing of the 4th and 5th digits.
Forensic Medicine
1 questionsLynching is a type of:
FMGE 2013 - Forensic Medicine FMGE Practice Questions and MCQs
Question 1: Lynching is a type of:
- A. Suicidal hanging
- B. Judicial hanging
- C. Accidental hanging
- D. Homicidal hanging (Correct Answer)
Explanation: ***Homicidal hanging*** - **Lynching** is a form of **extrajudicial punishment** carried out by groups, most commonly involving **hanging** as a method of execution. - This act is driven by **prejudice** or group hatred, aligning with the definition of **homicidal intent** rather than self-inflicted harm or accident. *Suicidal hanging* - **Suicidal hanging** is an individual act where a person intentionally ends their own life by suspension. - It lacks the element of **group violence** and **premeditated murder** by others characteristic of lynching. *Judicial hanging* - **Judicial hanging** is a legal method of execution carried out by the state following due process and a court order. - Lynching, in contrast, is an **illegal** act outside the bounds of the legal system, violating established laws. *Accidental hanging* - **Accidental hanging** occurs when a person inadvertently suspends themselves, often during play or an unfortunate incident. - This type of hanging lacks any **malicious intent**, which is a defining characteristic of lynching.
Microbiology
1 questionsSymptoms of food poisoning seen within 6 h are commonly due to:
FMGE 2013 - Microbiology FMGE Practice Questions and MCQs
Question 1: Symptoms of food poisoning seen within 6 h are commonly due to:
- A. Shigella
- B. Bacillus cereus
- C. Staphylococcus aureus (Correct Answer)
- D. Salmonella
Explanation: ***Staphylococcus aureus*** - Food poisoning due to *Staphylococcus aureus* is caused by preformed **enterotoxins** in the food, leading to rapid onset of symptoms, typically within 1-6 hours. - Common symptoms include **nausea**, **vomiting**, **abdominal cramps**, and **diarrhea**, often appearing abruptly and resolving within 24-48 hours. *Shigella* - *Shigella* infections typically cause symptoms after an **incubation period of 1-7 days**, which is much longer than the 6-hour window. - It is characterized by **dysentery** (bloody and mucoid stools), fever, and severe abdominal cramps, resulting from direct invasion of the intestinal mucosa. *Bacillus cereus* - *Bacillus cereus* can cause two types of food poisoning: diarrheal (onset 6-15 hours) and emetic (onset 0.5-6 hours). While the emetic form can occur within 6 hours, it is more specifically associated with contaminated **rice products** and prominent vomiting. - The emetic type is due to a **preformed toxin (cereulide)**, but *S. aureus* is a more common and general cause of rapid-onset food poisoning across various food types. *Salmonella* - Food poisoning from *Salmonella* typically has an **incubation period of 6 hours to 6 days**, usually 12-72 hours. - Symptoms include **fever**, diarrhea (which can be bloody), abdominal pain, nausea, and vomiting, and are due to bacterial invasion rather than preformed toxin.
Pharmacology
3 questionsAll of the following diuretics increase K+ excretion EXCEPT:
All are features of organophosphorus poisoning, except:
Antidote for benzodiazepine poisoning: FMGE 10, 13; NEET 14
FMGE 2013 - Pharmacology FMGE Practice Questions and MCQs
Question 1: All of the following diuretics increase K+ excretion EXCEPT:
- A. Acetazolamide
- B. Triamterene (Correct Answer)
- C. Thiazide
- D. Furosemide
Explanation: ***Triamterene*** - **Triamterene** is a **potassium-sparing diuretic** that blocks epithelial sodium channels (ENaC) in the collecting duct, thereby reducing sodium reabsorption and potassium secretion. - Unlike most other diuretics, it causes **decreased K+ excretion** and can lead to hyperkalemia. *Acetazolamide* - **Acetazolamide** is a **carbonic anhydrase inhibitor** that acts in the proximal tubule, inhibiting bicarbonate reabsorption. - This leads to increased delivery of sodium and bicarbonate to the collecting duct, which enhances **potassium secretion** and increases K+ excretion. *Thiazide* - **Thiazide diuretics** (e.g., hydrochlorothiazide) act by inhibiting the Na+/Cl- cotransporter in the **distal convoluted tubule**. - This increases the delivery of sodium to the collecting duct, which stimulates the exchange of sodium for **potassium**, leading to increased K+ excretion and hypokalemia. *Furosemide* - **Furosemide** is a **loop diuretic** that inhibits the Na+/K+/2Cl- cotransporter in the **thick ascending limb of the loop of Henle**. - This prevents the reabsorption of these ions, leading to increased delivery of sodium to the collecting duct, which promotes **potassium secretion** and increased K+ excretion.
Question 2: All are features of organophosphorus poisoning, except:
- A. Lacrimation
- B. Bradycardia
- C. Sweating
- D. Mydriasis (Correct Answer)
Explanation: ***Mydriasis*** - Organophosphorus poisoning leads to excessive **acetylcholine** activity, causing **miosis** (pinpoint pupils), not mydriasis. - Mydriasis would indicate **anticholinergic** effects, which are opposite to the symptoms of organophosphorus poisoning. *Lacrimation* - Excess **acetylcholine** stimulates **muscarinic receptors** in lacrimal glands, leading to excessive tear production. - This is a classic "SLUDGE" symptom (Salivation, Lacrimation, Urination, Defecation, Gastric upset, Emesis). *Bradycardia* - Increased **acetylcholine** activity at cardiac muscarinic receptors (M2 receptors) slows the heart rate, causing **bradycardia**. - This is a common and potentially dangerous cardiovascular effect of organophosphorus poisoning. *Sweating* - **Acetylcholine** acts on muscarinic receptors in secretory glands, including sweat glands, causing profuse **sweating**. - This is another characteristic cholinergic symptom due to widespread autonomic overstimulation.
Question 3: Antidote for benzodiazepine poisoning: FMGE 10, 13; NEET 14
- A. Flumazenil (Correct Answer)
- B. Naloxone
- C. Atropine
- D. N-acetyl-cysteine
Explanation: ***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.
Surgery
2 questionsA patient presented with bleeding from thigh and broken 5th rib on right side. What should be done first:
Curling ulcer is seen in:
FMGE 2013 - Surgery FMGE Practice Questions and MCQs
Question 1: A patient presented with bleeding from thigh and broken 5th rib on right side. What should be done first:
- A. Strapping of chest
- B. Control bleeding (Correct Answer)
- C. Internal fixation of rib
- D. Wait & watch
Explanation: ***Control bleeding*** - In trauma cases, **hemorrhage control** is the immediate priority to prevent exsanguination and hypovolemic shock, which can be rapidly fatal. - The **ABCDE approach** in trauma management (Airway, Breathing, Circulation, Disability, Exposure) dictates that controlling life-threatening bleeding falls under "Circulation" and often takes precedence over other injuries once the airway is secured. *Strapping of chest* - While a fractured rib can cause pain and impair breathing, **chest strapping** is generally not recommended as it restricts chest wall movement, potentially leading to **atelectasis** and **pneumonia**. - Furthermore, it does not address the immediate life threat of uncontrolled bleeding from the thigh. *Internal fixation of rib* - **Internal fixation** of a broken rib is an advanced and elective surgical procedure, typically performed significantly later for specific indications such as flail chest or non-union. - It is not an emergent intervention and would be performed only after the patient is stable and all life-threatening conditions, including active bleeding, have been addressed. *Wait & watch* - A "wait and watch" approach is inappropriate for a patient with active bleeding and a fractured rib, as it delays critical interventions and can lead to **deterioration** of the patient's condition. - Immediate assessment and intervention are required to manage both the bleeding and the potential respiratory compromise from the rib fracture.
Question 2: Curling ulcer is seen in:
- A. Corticosteroids
- B. Burn (Correct Answer)
- C. TPN
- D. Head injury
Explanation: ***Burn*** - **Curling's ulcer** is a type of acute peptic ulcer that can develop in the **duodenum** in patients suffering from severe burns. - It is believed to be caused by **ischemia** due to reduced plasma volume and systemic vasoconstriction following the burn injury, leading to decreased blood flow to the gastrointestinal tract. *Corticosteroids* - Corticosteroid use can increase the risk of **peptic ulcer disease** by impairing mucosal defense and inhibiting prostaglandin synthesis. - However, the ulcers associated with corticosteroids are not specifically termed Curling's ulcers; this term is reserved for ulcers caused by severe burns. *TPN* - Total Parenteral Nutrition (TPN) itself does not directly cause specific ulcers like Curling's ulcers. - Complications of TPN can include issues like **cholestasis** or **catheter-related infections**, but not acute stress ulcers. *Head injury* - Acute gastric ulcers that can develop after a severe head injury or other central nervous system trauma are known as **Cushing's ulcers**. - These ulcers are thought to be caused by **increased vagal stimulation** and excessive gastric acid secretion.