Community Medicine
2 questionsWhich of the following is a method for on-site disposal of domestic wastewater?
Disease usually not seen in a country but brought from abroad is:
FMGE 2018 - Community Medicine FMGE Practice Questions and MCQs
Question 111: Which of the following is a method for on-site disposal of domestic wastewater?
- A. Soakage pit (Correct Answer)
- B. Activated sludge process
- C. Oxidation pond
- D. All of the options
Explanation: ***Soakage pit*** - A **soakage pit**, also known as a **seepage pit** or **leach pit**, is an underground chamber that allows treated effluent from a septic tank to seep into the surrounding soil. - It is a common and effective on-site method for the **disposal of domestic wastewater**, particularly in rural or unsewered areas. *Activated sludge process* - The **activated sludge process** is a centralized biological wastewater treatment method used in municipal wastewater treatment plants, not typically for on-site domestic disposal. - It involves aerating wastewater in a tank with suspended microorganisms to consume organic pollutants. *Oxidation pond* - An **oxidation pond**, or **stabilization pond**, is a large, shallow basin where wastewater is treated through natural biological and physical processes. - While it treats wastewater, it is typically a **larger-scale** treatment method for communities or industries, rather than a standalone on-site disposal method for individual domestic units. *All of the options* - This option is incorrect because both the activated sludge process and oxidation ponds are generally larger-scale or centralized treatment methods, not practical for individual on-site domestic disposal. - Only the soakage pit is well-suited for **on-site domestic wastewater disposal**.
Question 112: Disease usually not seen in a country but brought from abroad is:
- A. Exotic (Correct Answer)
- B. Endemic
- C. Epidemic
- D. Zoonotic
Explanation: ***Exotic*** - An **exotic disease** refers to a disease that is not native or usually found in a particular country or region but is introduced from abroad. - This term highlights its **foreign origin** and rarity within the local population. *Endemic* - An **endemic disease** is one that is constantly present in a population or region with a relatively stable prevalence within that population. - It describes a disease that is **native** to a specific area, not typically brought from abroad. *Epidemic* - An **epidemic** signifies a sudden increase in the number of cases of a disease in a population over a particular period, substantially exceeding what is normally expected. - While it can be introduced from abroad, the definition focuses on the **rapid spread** rather than the origin itself. *Zoonotic* - A **zoonotic disease** is an infectious disease that has jumped from an animal to humans. - This term describes the **mode of transmission** from animals, not necessarily its geographic origin or whether it's new to a country.
Internal Medicine
4 questionsPheochromocytoma produces all except?
Which pattern of inheritance of disease is associated with consanguinity?
Commonest neurological tumour associated with NF-2:-
Continuous murmur is heard in?
FMGE 2018 - Internal Medicine FMGE Practice Questions and MCQs
Question 111: Pheochromocytoma produces all except?
- A. Secretin (Correct Answer)
- B. Vasoactive intestinal polypeptide
- C. Norepinephrine
- D. Calcitonin
Explanation: Secretin - **Secretin** is a hormone primarily produced by **S cells in the duodenum and jejunum** [3] in response to acidic chyme, stimulating pancreatic bicarbonate secretion. - Pheochromocytomas originate from **chromaffin cells** of the adrenal medulla and are known for producing catecholamines [2], not secretin. *Vasoactive intestinal polypeptide* - **Vasoactive intestinal polypeptide (VIP)** can be produced by some **neuroendocrine tumors** [1], including pheochromocytomas, though it's more commonly associated with VIPomas. - VIP acts as a **vasodilator** and can contribute to symptoms like flushing and diarrhea in rare cases of VIP-producing pheochromocytomas. *Calcitonin* - While calcitonin is primarily associated with **medullary thyroid carcinoma**, it can rarely be produced ectopically by **neuroendocrine tumors**, including some pheochromocytomas. - This ectopic production is part of the broader concept of **paraneoplastic syndromes** seen in various malignancies. *Norepinephrine* - **Norepinephrine** is a major catecholamine produced by pheochromocytomas, leading to classic symptoms such as **hypertension, palpitations, and sweating** [2]. - The tumor cells (chromaffin cells) are specialized to synthesize and release **catecholamines**, including norepinephrine and epinephrine [2].
Question 112: Which pattern of inheritance of disease is associated with consanguinity?
- A. Autosomal dominant
- B. X linked recessive
- C. Autosomal recessive (Correct Answer)
- D. X linked dominant
Explanation: ***Autosomal recessive*** - Consanguineous relationships increase the likelihood of offspring inheriting **two copies of a rare deleterious recessive allele**, one from each parent [1]. - This occurs because relatives share a greater proportion of their genes, making it more probable that both parents are **heterozygous carriers** for the same recessive disorder. *Autosomal dominant* - In autosomal dominant disorders, only **one copy of the altered gene** is needed to cause the disease, so expression is not typically influenced by consanguinity. - These conditions often manifest in every generation and are not more prevalent with increased shared genetic material. *X-linked recessive* - X-linked recessive disorders primarily affect males, as they only have one X chromosome, and are transmitted by carrier females. - While consanguinity can theoretically increase the carrier rate within a population, its direct impact on the inheritance pattern of an X-linked trait in a single family is less pronounced compared to autosomal recessive conditions. *X-linked dominant* - X-linked dominant disorders are expressed in heterozygous females and hemizygous males, with affected males often having more severe disease. - The inheritance pattern is not significantly influenced by consanguinity, as only one copy of the affected gene on the X chromosome is sufficient for disease manifestation.
Question 113: Commonest neurological tumour associated with NF-2:-
- A. Optic glioma
- B. Meningioma
- C. Spinal schwannoma
- D. Acoustic neuroma (Correct Answer)
Explanation: ***Acoustic neuroma*** - **Bilateral acoustic neuromas** (vestibular schwannomas) are the hallmark of **Neurofibromatosis type 2 (NF2)**, virtually diagnostic for the condition [1]. - These tumors arise from the **vestibulocochlear nerve (cranial nerve VIII)** and commonly cause hearing loss and balance problems [1]. *Optic glioma* - **Optic gliomas** are more characteristic of **Neurofibromatosis type 1 (NF1)**, not NF2. - While they can occur in NF2, they are not the most common or diagnostic feature. *Spinal schwannoma* - Spinal schwannomas can occur in NF2, but they are not the *most common* or *defining* neurological tumor associated with the condition. - The presence of multiple schwannomas, especially spinal, is a feature, but **bilateral acoustic neuromas** take precedence for diagnosis. *Meningioma* - Multiple **meningiomas** occur in a significant proportion of NF2 patients, making them common, but they are still secondary to **bilateral acoustic neuromas** in terms of diagnostic significance and prevalence as the *primary* neurological tumor. - These are tumors of the **meninges**, the protective layers surrounding the brain and spinal cord.
Question 114: Continuous murmur is heard in?
- A. Tetralogy of fallot
- B. Patent ductus arteriosus (Correct Answer)
- C. Ventricular septal defect
- D. Atrial septal defect
Explanation: ***Patent ductus arteriosus*** - A **continuous murmur** in PDA is often described as a **"machinery-like" murmur**, audible throughout systole and diastole [1]. - This murmur is caused by the continuous flow of blood from the higher-pressure aorta into the lower-pressure pulmonary artery [1]. *Tetralogy of Fallot* - The murmur associated with Tetralogy of Fallot is typically a **systolic ejection murmur** heard at the upper left sternal border [1]. - This murmur is due to pulmonary stenosis and is not continuous, as it is related to ventricular ejection [1]. *Ventricular septal defect* - A VSD typically presents with a **holosystolic murmur**, meaning it is heard throughout systole [1]. - The murmur in VSD is confined to systole and does not extend into diastole, distinguishing it from a continuous murmur [1]. *Atrial septal defect* - An ASD is typically associated with a **systolic ejection murmur** over the pulmonic area due to increased flow across the pulmonary valve [1]. - There may also be a **diastolic rumble** across the tricuspid valve, but neither of these is a continuous murmur [1].
Microbiology
1 questionsOtomycosis is most commonly caused by:
FMGE 2018 - Microbiology FMGE Practice Questions and MCQs
Question 111: Otomycosis is most commonly caused by:
- A. Mucor
- B. Actinomycetes
- C. Candida albicans
- D. Aspergillus fumigatus (Correct Answer)
Explanation: ***Aspergillus fumigatus*** - **Aspergillus species**, particularly *A. fumigatus* and *A. niger*, are the most frequent causes of **otomycosis**, accounting for 80-90% of cases. - They thrive in damp, warm environments, making the external auditory canal an ideal site for their growth, often presenting with a **black or grayish fungal debris**. *Mucor* - **Mucor** is a less common cause of otomycosis and is more often associated with **rhinocerebral mucormycosis** in immunocompromised individuals. - While it can cause opportunistic infections, its prevalence in otomycosis is significantly lower compared to Aspergillus. *Actinomycetes* - **Actinomycetes** are **filamentous bacteria**, not fungi, and are typically associated with **actinomycosis**, a chronic suppurative infection. - They are known to cause infections in the head and neck, but not typically otomycosis, which is a fungal infection of the ear. *Candida albicans* - **Candida albicans** is the second most common cause of otomycosis, but it is less prevalent than Aspergillus species. - Infections by Candida tend to be more common in individuals with a history of **antibiotic use** or in **immunocompromised patients**, and often present with a *creamy white discharge*.
Orthopaedics
1 questionsPatient had an injury to thumb causing thumb abduction. Which of the following can happen?
FMGE 2018 - Orthopaedics FMGE Practice Questions and MCQs
Question 111: Patient had an injury to thumb causing thumb abduction. Which of the following can happen?
- A. Kaplan lesion
- B. Game keepers thumb (Correct Answer)
- C. Mallet finger
- D. Bennett fracture
Explanation: ***Gamekeeper's thumb*** - A **Gamekeeper's thumb**, or **skier's thumb**, is an injury to the **ulnar collateral ligament (UCL)** of the thumb's metacarpophalangeal (MCP) joint. - This injury commonly occurs due to a **forceful abduction** and hyperextension of the thumb. *Kaplan lesion* - A **Kaplan lesion** refers to an avulsion fracture of the radial styloid process, usually associated with scaphoid fractures. - This lesion is typically related to wrist injuries, not primarily thumb abduction. *Bennett fracture* - A **Bennett fracture** is an intra-articular fracture at the base of the first metacarpal bone. - It usually results from an axial load applied to a partially flexed thumb, rather than pure abduction. *Mallet finger* - A **mallet finger** is an injury to the **extensor tendon** of the finger, causing the fingertip to remain in a flexed position. - This injury typically affects the distal interphalangeal (DIP) joint of any finger and is not directly related to thumb abduction.
Pharmacology
1 questionsThe drug that causes fall in elderly patients with postural hypotension is:-
FMGE 2018 - Pharmacology FMGE Practice Questions and MCQs
Question 111: The drug that causes fall in elderly patients with postural hypotension is:-
- A. Acarbose
- B. Prazosin (Correct Answer)
- C. Nor-adrenaline
- D. Metformin
Explanation: ***Prazosin*** - **Alpha-1 adrenergic blocker** used to treat hypertension and benign prostatic hyperplasia (BPH) - Commonly causes **orthostatic hypotension (postural hypotension)** as a side effect by blocking alpha-1 receptors on vascular smooth muscle, preventing compensatory vasoconstriction upon standing - Leads to **dizziness, lightheadedness, and falls**, especially in elderly patients who have reduced baroreceptor sensitivity - **First-dose phenomenon** is particularly notable, with marked hypotension after the initial dose *Acarbose* - Alpha-glucosidase inhibitor used to treat type 2 diabetes by reducing carbohydrate absorption in the intestine - Primary side effects are **gastrointestinal** (flatulence, diarrhea, abdominal discomfort) - Does not affect blood pressure or cause postural hypotension *Nor-adrenaline (Norepinephrine)* - **Vasopressor** and sympathomimetic agent that causes vasoconstriction through alpha-adrenergic receptor stimulation - **Increases blood pressure** and is used to treat severe hypotension in critical care settings - Would not cause falls due to postural hypotension; rather, it counteracts hypotension *Metformin* - **Biguanide** oral hypoglycemic agent for type 2 diabetes that primarily decreases hepatic glucose production and increases insulin sensitivity - Main side effects include gastrointestinal disturbances and rare lactic acidosis - Not associated with postural hypotension or increased risk of falls
Physiology
1 questionsIn which of the following conditions there is an increase in lung diffusion capacity?
FMGE 2018 - Physiology FMGE Practice Questions and MCQs
Question 111: In which of the following conditions there is an increase in lung diffusion capacity?
- A. Alveolar haemorrhage (Correct Answer)
- B. Pulmonary oedema
- C. Idiopathic pulmonary fibrosis
- D. Emphysema
Explanation: ***Alveolar haemorrhage*** - The presence of **red blood cells within the alveoli** provides an additional source of **hemoglobin**, which can bind to carbon monoxide (CO) and therefore **increase the measured CO diffusion capacity (DLCO)**. - This is often seen in conditions like **Goodpasture's syndrome** or **pulmonary capillaritis**. *Pulmonary oedema* - Characterized by an **accumulation of fluid in the interstitial and alveolar spaces**, which **increases the diffusion barrier** for gases. - This fluid buildup **impairs gas exchange**, leading to a **decrease in DLCO**. *Idiopathic pulmonary fibrosis* - This condition involves **thickening and scarring of the alveolar-capillary membrane**, which significantly **increases the diffusion distance** for gases. - The resultant **fibrosis and destruction of capillaries** lead to a **marked decrease in DLCO**. *Emphysema* - Emphysema causes **destruction of alveolar walls** and the **pulmonary capillary bed**, leading to a **reduction in the surface area available for gas exchange**. - This loss of functional alveolar-capillary units results in a **decreased DLCO**.