FMGE 2017 Practice Questions

Q: Colipase is found in?

Pancreatic juice. ***Pancreatic juice*** - **Colipase** is a co-enzyme secreted by the **pancreas** that is essential for the activity of pancreatic lipase. - It helps **pancreatic lipase** anchor to the surface of fat globules, preventing its inactivation by bile salts and facilitating fat digestion. *Saliva* - Saliva primarily contains **alpha-amylase** (ptyalin) for carbohydrate digestion and **lingual lipase** for initial fat digestion. - It does not contain colipase. *Bile* - **Bile** is produced by the liver and stored in the gallbladder, primarily aiding in fat emulsification. - It contains **bile salts**, cholesterol, bilirubin, and phospholipids but not digestive enzymes like colipase. *Succus entericus* - **Succus entericus**, or intestinal juice, is secreted by the small intestine and contains enzymes like **sucrase**, **maltase**, **lactase**, and peptidases. - It does not contain colipase, which is specifically a pancreatic enzyme.

Q: What is the incubation period of hepatitis B?

45 - 180 days. ***45 - 180 days*** - The typical incubation period for **Hepatitis B** infection ranges from **45 to 180 days** (approximately 6 weeks to 6 months). - This relatively long incubation period is characteristic of the **Hepadnaviridae family** to which HBV belongs. *1 - 30 days* - This period is generally too short for **Hepatitis B** and is more typical for certain **bacterial or viral respiratory illnesses**. - It does not align with the known epidemiology and viral replication cycle of **HBV**. *2 weeks - 6 months* - While **6 months** falls within the upper range, the lower limit of **2 weeks** (14 days) is generally too short for the typical incubation period of Hepatitis B. - The more precise range starts closer to **6 weeks (42 days)**. *15 - 45 days* - This range is too short for the common incubation period of **Hepatitis B**. - This period is more commonly associated with other viral infections, such as **Hepatitis A**.

Q: In a clinical laboratory, when is sample registration typically performed?

When samples are received at the laboratory. ***When samples are received at the laboratory*** - **Sample registration** is a critical step performed immediately upon a sample's arrival to ensure proper identification and tracking throughout its lifecycle in the laboratory. - This initial registration helps prevent **errors**, maintains **sample integrity**, and establishes a clear **audit trail**. *At the end of each working day* - Delaying registration until the end of the day introduces a significant risk of **misidentification**, **loss**, or **degradation** of samples. - Urgent or time-sensitive tests would be unduly **delayed**, potentially impacting patient care. *Once per week during batch processing* - Weekly batch processing for registration is entirely unsuitable for a clinical laboratory, where timely processing of individual samples is paramount. - This practice would lead to a massive backlog, compromise **sample stability**, and make it impossible to provide **prompt results** for patient diagnosis and treatment. *Only during quality control audits* - **Quality control audits** periodically review laboratory processes, including registration, but do not replace the need for real-time, continuous sample registration. - Relying solely on audits for registration would mean unregistered samples are processed, leading to **untraceable results** and potential patient harm.

Q: Tropical pulmonary eosinophilia is most characteristically seen due to which of the following infections?

Filaria. *Filaria* - **Tropical pulmonary eosinophilia (TPE)** is a hypersensitivity reaction to microfilariae from filarial nematodes like *Wuchereria bancrofti* and *Brugia malayi* [1]. - It is characterized by cough, dyspnea, wheezing, and marked **peripheral eosinophilia**, with interstitial infiltrates on chest X-ray [1]. *Roundworm* - **Ascaris lumbricoides** can cause **Loeffler's syndrome**, a transient pulmonary infiltration with eosinophilia during larval migration, but not chronic TPE [2]. - Symptoms are usually less severe and self-limiting compared to TPE [2]. *Trichinella* - **Trichinella spiralis** causes **trichinellosis**, presenting with muscle pain, fever, and periorbital edema, possibly with eosinophilia, but typically does not manifest as TPE. - Pulmonary involvement is rare and not the characteristic feature. *Ancylostoma* - **Hookworm (Ancylostoma duodenale, Necator americanus)** larvae can cause mild pulmonary symptoms and eosinophilia during migration through the lungs [3]. - However, they also do not typically lead to the severe and chronic pulmonary symptoms seen in TPE [3].

Q: Which of the following is true about carcinoid tumor?

Can occur throughout the gastrointestinal tract. ***Can occur throughout the gastrointestinal tract*** - Carcinoid tumors (neuroendocrine tumors) are most commonly found in the **gastrointestinal tract**, particularly in the small intestine, appendix, rectum, and stomach [2]. - They arise from **enterochromaffin cells** and can secrete various vasoactive substances. *Presentation is hypotension and diaphoresis* - The classic presentation of **carcinoid syndrome** includes episodes of **flushing**, **diarrhea**, and **bronchospasm**, often accompanied by **hypertension** rather than hypotension due to the release of serotonin and other vasoactive peptides [1]. - While diaphoresis can occur, **hypotension** is not a primary or characteristic feature. *Intestinal carcinoids are of high malignant potential* - The malignant potential of carcinoid tumors varies depending on their primary site and size but is generally considered to be of **low-to-moderate malignant potential**, particularly for appendiceal and rectal carcinoids [2]. - Liver metastases significantly increase morbidity and mortality, but many small intestinal carcinoids may grow slowly or remain localized for extended periods [1]. *Best diagnosed by elevated urinary vanillymandelic acid levels* - Elevated **urinary vanillymandellic acid (VMA)** levels are primarily used to diagnose **pheochromocytoma**, a tumor of the adrenal medulla that secretes catecholamines. - Carcinoid tumors are best diagnosed by measuring **urinary 5-hydroxyindoleacetic acid (5-HIAA)**, a breakdown product of serotonin.

Q: Which of the following aminoglycosides is most cochleotoxic:-

Gentamycin. ***Gentamycin*** - **Gentamycin** is known to be the most **cochleotoxic** aminoglycoside, causing irreversible damage to the hair cells in the cochlea [1]. - This toxicity can lead to **permanent hearing loss** and **tinnitus** due to its selective accumulation in inner ear fluids [2]. *Streptomycin* - While streptomycin can cause ototoxicity, its primary adverse effect is vestibulo-toxicity, affecting **balance** more than hearing [2]. - It mainly targets the hair cells of the semicircular canals and otolithic organs, leading to **vertigo** and ataxia [3]. *Amikacin* - Amikacin is also an ototoxic aminoglycoside but is generally considered **less cochleotoxic** than gentamycin. - Its ototoxic effects are comparable to gentamicin, but it is often reserved for infections resistant to other aminoglycosides. *Minocycline* - Minocycline is a **tetracycline antibiotic**, not an aminoglycoside, and is not associated with significant ototoxicity. - Its side effects typically include photosensitivity, gastrointestinal upset, and **vestibular dysfunction** (dizziness, vertigo) in some patients, distinct from cochlear damage.

Q: Zileuton is:-

5-Lipoxygenase inhibitor. ***5-Lipoxygenase inhibitor*** - **Zileuton** specifically inhibits **5-lipoxygenase**, an enzyme crucial for the synthesis of **leukotrienes**. - By blocking this enzyme, zileuton reduces the production of **pro-inflammatory leukotrienes**, which are involved in the pathophysiology of **asthma**. *Phospholipase inhibitor* - **Phospholipase A2 inhibitors** like **corticosteroids** act upstream by preventing the release of **arachidonic acid**, a precursor to both prostaglandins and leukotrienes. - Zileuton's action is more specific to the **leukotriene pathway**, occurring after arachidonic acid is already formed. *Cyclooxygenase inhibitor* - **Cyclooxygenase (COX) inhibitors** (like NSAIDs) block the synthesis of **prostaglandins** and **thromboxanes** from arachidonic acid. - Zileuton does not affect the COX pathway but rather targets the **lipoxygenase pathway**. *Leukotriene receptor antagonist* - **Leukotriene receptor antagonists** (e.g., Montelukast, Zafirlukast) block the binding of leukotrienes to their receptors, preventing their downstream effects. - While both target the **leukotriene pathway**, zileuton works by **inhibiting their production**, not their receptor binding.

Q: Which among the following is an iron chelator?

Desferrioxamine. ***Desferrioxamine*** - **Desferrioxamine** is a specific iron chelator used to treat **acute iron poisoning** and chronic iron overload, such as in patients with **thalassemia** requiring frequent transfusions. - It works by binding to free iron in the bloodstream and promoting its **excretion via urine**. *BAL* - **BAL (dimercaprol)** is primarily used as a chelating agent for **heavy metal poisoning**, particularly **arsenic, mercury, and lead** [1], [2]. - While it can chelate some metals, its affinity and primary use are not for iron. *EDTA* - **EDTA (ethylenediaminetetraacetic acid)** is a chelator often used for **lead poisoning** [1], [2] and hypercalcemia. - It has a high affinity for various divalent and trivalent metal ions [2], but it is not the primary or most specific iron chelator. *Penicillamine* - **Penicillamine** is a chelating agent primarily used for the treatment of **copper overload** in **Wilson's disease**. - It is also used in the treatment of severe **rheumatoid arthritis** and **cystinuria**, but not typically for iron chelation.

Q: In which of the following conditions is blood osmolality increased?

Diarrhea. ***Diarrhea*** - Diarrhea leads to a significant loss of **water and electrolytes** from the body, primarily from the extracellular fluid compartment. - This imbalance causes **hemoconcentration** and an increase in the concentration of solutes in the blood, thereby raising blood osmolality. *SIADH* - **Syndrome of Inappropriate Antidiuretic Hormone (SIADH)** is characterized by excessive secretion of ADH, leading to **dilutional hyponatremia**. - The excess water retention dilutes the blood, resulting in **decreased serum osmolality**. *Psychogenic polydipsia* - This condition involves excessive water intake due to psychological factors, which causes **dilution of body fluids**. - The increased water volume without a proportional increase in solutes leads to **decreased plasma osmolality**. *Cerebral toxoplasmosis* - **Cerebral toxoplasmosis** is an opportunistic infection of the brain, typically seen in immunocompromised individuals. - It primarily causes neurological symptoms and **does not directly impact blood osmolality** unless complicated by other factors like dehydration or SIADH (which is not a primary effect).

Question 1

Vitamin K leads to?

Accepted Answer

γ-carboxylation of glutamic acid residues in clotting factors II, VII, IX, and X

Answer

β-carboxylation of glutamic acid residues in clotting factors II, VII, IX, and X

Answer

α-carboxylation of aspartic acid residues in clotting factors II, VII, IX, and X

Answer

γ-carboxylation of aspartic acid residues in clotting factors II, VII, IX, and X

Question 2

Colipase is found in?

Accepted Answer

Pancreatic juice

Answer

Saliva

Answer

Bile

Answer

Succus entericus

Question 3

What is the incubation period of hepatitis B?

Accepted Answer

45 - 180 days

Answer

1 - 30 days

Answer

2 weeks - 6 months

Answer

15 - 45 days

Question 4

In a clinical laboratory, when is sample registration typically performed?

Accepted Answer

When samples are received at the laboratory

Answer

At the end of each working day

Answer

Once per week during batch processing

Answer

Only during quality control audits

Question 5

Tropical pulmonary eosinophilia is most characteristically seen due to which of the following infections?

Accepted Answer

Filaria

Answer

Roundworm

Answer

Trichinella

Answer

Ancylostoma

Question 6

Which of the following is true about carcinoid tumor?

Accepted Answer

Can occur throughout the gastrointestinal tract

Answer

Presentation is hypotension and diaphoresis

Answer

Intestinal carcinoids are of high malignant potential

Answer

Best diagnosed by elevated urinary vanillymandelic acid levels

Question 7

Which of the following aminoglycosides is most cochleotoxic:-

Accepted Answer

Gentamycin

Answer

Streptomycin

Answer

Amikacin

Answer

Minocycline

Question 8

Zileuton is:-

Accepted Answer

5-Lipoxygenase inhibitor

Answer

Phospholipase inhibitor

Answer

Leukotriene receptor antagonist

Answer

Cyclooxygenase inhibitor

Question 9

Which among the following is an iron chelator?

Accepted Answer

Desferrioxamine

Answer

BAL

Answer

EDTA

Answer

Penicillamine

Question 10

In which of the following conditions is blood osmolality increased?

Accepted Answer

Diarrhea

Answer

SIADH

Answer

Psychogenic polydipsia

Answer

Cerebral toxoplasmosis

FMGE 2017

Biochemistry

Community Medicine

Internal Medicine

Pharmacology

Physiology