Anatomy
1 questionsTibial and common peroneal nerves supply which of the following muscles?
FMGE 2018 - Anatomy FMGE Practice Questions and MCQs
Question 151: Tibial and common peroneal nerves supply which of the following muscles?
- A. Gracilis
- B. Adductor longus
- C. Biceps femoris (Correct Answer)
- D. Adductor magnus
Explanation: **Biceps femoris** - The **long head** of the biceps femoris is supplied by the **tibial nerve**. - The **short head** of the biceps femoris is supplied by the **common peroneal nerve**. *Gracilis* - The gracilis muscle is solely innervated by the **obturator nerve**. - It participates in **hip adduction** and **knee flexion**, but its innervation is distinct. *Adductor longus* - The adductor longus muscle is innervated exclusively by the **obturator nerve**. - Its primary function is **adduction of the thigh**. *Adductor magnus* - The adductor magnus has a dual innervation, but not by the tibial and common peroneal nerves. - Its **adductor part** is innervated by the **obturator nerve**, while its **hamstring part** is supplied by the **tibial nerve**.
Anesthesiology
1 questionsWhich of the following drugs is used for hypotensive anesthesia:
FMGE 2018 - Anesthesiology FMGE Practice Questions and MCQs
Question 151: Which of the following drugs is used for hypotensive anesthesia:
- A. Both Isoflurane and Nitroglycerin (Correct Answer)
- B. Isoflurane
- C. Nitroglycerin
- D. Dantrolene
Explanation: ***Both Isoflurane and Nitroglycerin*** - **Isoflurane** is a volatile anesthetic that can induce **hypotension** by decreasing systemic vascular resistance and myocardial contractility. - **Nitroglycerin** is a potent vasodilator that primarily acts on veins, but also on arteries, to reduce preload and afterload, thereby lowering blood pressure. *Isoflurane* - While **Isoflurane** can be used as part of a hypotensive anesthesia strategy, it is not the sole drug capable of achieving this effect. - Its hypotensive action is dose-dependent and results from **vasodilation** and direct **myocardial depression**. *Nitroglycerin* - **Nitroglycerin** is effective in inducing controlled **hypotension** due to its rapid onset and short duration of action as a vasodilator. - It is frequently used in anesthesia for its ability to reduce blood pressure, particularly in situations requiring a **dry surgical field**. *Dantrolene* - **Dantrolene** is a skeletal muscle relaxant primarily used to treat and prevent **malignant hyperthermia**. - It does not directly induce **hypotension** and is not indicated for hypotensive anesthesia.
Community Medicine
1 questionsRecommended daily dose of Iodine in a school-age child is:-
FMGE 2018 - Community Medicine FMGE Practice Questions and MCQs
Question 151: Recommended daily dose of Iodine in a school-age child is:-
- A. 120-200 ug
- B. 30-60 ug
- C. 500 ug
- D. 90-120 ug (Correct Answer)
Explanation: ***90-120 ug*** - The recommended daily intake of iodine for **school-age children (6-12 years)** is 90-120 micrograms (µg), which supports normal growth and thyroid function. - According to **WHO/UNICEF/ICCIDD recommendations**, children in this age group require 120 µg/day for optimal thyroid hormone synthesis. - Adequate iodine intake is crucial for the production of **thyroid hormones**, which regulate metabolism and brain development. *120-200 ug* - This range is higher than recommended for school-age children. - **Adolescents (≥12 years) and adults** require 150 µg/day, and **pregnant/lactating women** require 250 µg/day. *30-60 ug* - This range is **insufficient for children** and well below WHO recommendations. - Even **infants and young children (0-5 years)** require 90 µg/day, making this range inadequate for any pediatric age group. - Such low intake could lead to **iodine deficiency** and impaired thyroid function. *500 ug* - This amount is significantly higher than the recommended daily intake for children and could cause **iodine excess** or toxicity. - High doses of iodine can paradoxically inhibit thyroid function and lead to conditions like **iodine-induced hyperthyroidism** or hypothyroidism. - The **tolerable upper intake level** for children is much lower than this amount.
Internal Medicine
1 questionsWhich of the following is not a component of Jones criteria for diagnosing acute rheumatic fever?
FMGE 2018 - Internal Medicine FMGE Practice Questions and MCQs
Question 151: Which of the following is not a component of Jones criteria for diagnosing acute rheumatic fever?
- A. Erythema nodosum (Correct Answer)
- B. Sydenham chorea
- C. Pancarditis
- D. Migratory polyarthritis
Explanation: ***Erythema nodosum*** - **Erythema nodosum** is a delayed hypersensitivity reaction characterized by tender, red nodules, typically on the shins, but it is **not a major or minor criterion** in the Jones criteria for acute rheumatic fever. - While it can be associated with various inflammatory conditions, including streptococcal infections, its presence alone does not establish a diagnosis of **acute rheumatic fever (ARF)**. *Sydenham chorea* - **Sydenham chorea** is a major manifestation of ARF, characterized by involuntary, purposeless movements, and it is a key diagnostic criterion [1]. - It results from central nervous system involvement due to **autoimmune reaction** against basal ganglia. *Pancarditis* - **Pancarditis** (inflammation of all layers of the heart) is a major criterion for ARF, often leading to valvular damage, especially mitral stenosis [1]. - It can manifest as **pericarditis**, **myocarditis**, or **endocarditis** [1]. *Migratory polyarthritis* - **Migratory polyarthritis** is a major criterion for ARF, involving painful inflammation that moves from one joint to another. - It typically affects large joints such as the **knees, ankles, elbows, and wrists**.
Ophthalmology
3 questionsHerbert's pits are seen in:
Rosette cataract is seen after:
Cornea derives its nutrition chiefly from:
FMGE 2018 - Ophthalmology FMGE Practice Questions and MCQs
Question 151: Herbert's pits are seen in:
- A. Chlamydial conjunctivitis (Correct Answer)
- B. Gonococcal conjunctivitis
- C. Vernal conjunctivitis
- D. Atopic conjunctivitis
Explanation: ***Chlamydial conjunctivitis*** - **Herbert's pits** are pathognomonic for **trachoma**, a chronic form of chlamydial conjunctivitis caused by *Chlamydia trachomatis* serovars A-C. - They represent healed **follicles** on the superior tarsal conjunctiva, leading to characteristic stellate or linear scarring. *Gonococcal conjunctivitis* - This is an **acute, severe bacterial infection** that typically causes copious purulent discharge and significant edema. - It does not lead to the formation of Herbert's pits, which are sequelae of chronic follicular inflammation. *Vernal conjunctivitis* - A form of chronic allergic conjunctivitis, characterized by **"cobblestone papillae"** on the upper tarsal conjunctiva and **Horner-Trantas dots** at the limbus. - It is not associated with Herbert's pits; its pathophysiology involves mast cell degranulation and allergic inflammation. *Atopic conjunctivitis* - This is often seen in individuals with **atopic dermatitis, asthma, or allergic rhinitis**, presenting with itching, redness, tearing, and sometimes corneal complications. - It does not manifest with follicles or subsequent scarring like Herbert's pits, which are specific to trachoma.
Question 152: Rosette cataract is seen after:
- A. Infection
- B. Penetrating injury to eye
- C. Copper foreign body in eye
- D. Blunt trauma to eye (Correct Answer)
Explanation: ***Blunt trauma to eye*** - **Rosette cataract** is a classic finding following **blunt ocular trauma**, often due to the concussive force on the lens. - The characteristic **flower-petal or star-shaped opacity** forms in the anterior and/or posterior subcapsular regions of the lens. *Infection* - Ocular infections can lead to various complications like **uveitis** or **endophthalmitis**, but **rosette cataract** is not a typical direct sequela. - While inflammation can cause cataracts, they usually present as **inflammatory cataracts** rather than the specific rosette pattern. *Penetrating injury to eye* - **Penetrating injuries** to the eye often lead to **traumatic cataracts** due to direct lens capsule rupture. - These cataracts are typically focal and can progress rapidly, but the morphology is not usually described as a **rosette pattern** unless secondary to significant blunt force component. *Copper foreign body in eye* - A **copper foreign body** in the eye can cause **chalcosis oculi**, leading to a characteristic greenish-brown discoloration and a **sunflower cataract**. - This type of cataract has a distinct appearance from a **rosette cataract**, with a diffuse radial pattern rather than a focal star shape.
Question 153: Cornea derives its nutrition chiefly from:
- A. Aqueous humour (Correct Answer)
- B. Corneal vessels
- C. Perilimbal vessels
- D. Mucous layer
Explanation: ***Aqueous humour*** - The cornea is **avascular**, meaning it lacks its own blood vessels, and thus relies on the **aqueous humor** for metabolic support. - The aqueous humor, located in the anterior chamber, provides **glucose, amino acids, and oxygen** to the posterior surface of the cornea. *Corneal vessels* - The **cornea is avascular** under normal physiological conditions; the presence of corneal vessels (neovascularization) is typically a sign of pathology. - This avascularity is crucial for maintaining corneal transparency and optimal vision. *Perilimbal vessels* - Perilimbal vessels (at the limbus, the junction between cornea and sclera) primarily supply the **periphery of the cornea** and the limbal stem cell niche, not the entire cornea's main nutritional needs. - While they contribute some oxygen and nutrients, the **aqueous humor** is the predominant source for the central and posterior cornea. *Mucous layer* - The mucous layer, part of the tear film, primarily functions in **lubrication and adhesion** of the tear film to the corneal surface. - While it contains some dissolved oxygen from the atmosphere to supply the anterior cornea, its role in nutrient supply (glucose, amino acids) is **minimal** compared to the aqueous humor.
Orthopaedics
1 questionsBlount Disease is involvement of
FMGE 2018 - Orthopaedics FMGE Practice Questions and MCQs
Question 151: Blount Disease is involvement of
- A. Distal femur
- B. Distal tibia
- C. Proximal tibia (Correct Answer)
- D. Proximal femur
Explanation: ***Proximal tibia*** - Blount disease, also known as **tibia vara**, is a growth disorder affecting the **tibia** (shin bone) in children. - It specifically involves the **medial physis of the proximal tibia**, leading to abnormal growth in this area and resulting in a **bow-legged** deformity. *Distal femur* - Malformations or growth disturbances of the **distal femur** are typically associated with conditions like genu valgum (**knock-knees**) or other angular deformities originating higher up in the leg. - Blount disease's primary pathology does not originate from the distal femur. *Distal tibia* - Conditions affecting the **distal tibia** can lead to ankle deformities or foot problems. - Blount disease is distinctly a problem of the knee region, not the ankle. *Proximal femur* - Problems in the **proximal femur** are commonly associated with conditions like Legg-Calvé-Perthes disease or developmental dysplasia of the hip. - While these can also cause gait abnormalities, Blount disease's characteristic bowing deformity originates from the tibia.
Pediatrics
1 questionsA 6-year-old child is brought with high fever with rigors for 5 days with pain in right hypochondrium. On examination, the patient is anicteric and tenderness is noted in right upper quadrant. What is the best investigation for this case?
FMGE 2018 - Pediatrics FMGE Practice Questions and MCQs
Question 151: A 6-year-old child is brought with high fever with rigors for 5 days with pain in right hypochondrium. On examination, the patient is anicteric and tenderness is noted in right upper quadrant. What is the best investigation for this case?
- A. SGOT/LFT
- B. CECT
- C. Serology
- D. USG (Correct Answer)
Explanation: ***USG*** - A **ultrasound** is the preferred initial investigation, especially in children, for evaluating abdominal pain in the **right hypochondrium** with fever. - It can effectively identify common causes like **cholecystitis**, **hepatitis**, or **liver abscess**, which fit the clinical presentation. *SGOT/LFT* - **Liver function tests (LFTs)** like SGOT/AST and SGPT/ALT provide information about liver inflammation or damage but do not help localize the pathology. - They are useful for assessing liver function but are not the primary diagnostic tool to identify the cause of the pain or fever. *CECT* - **Contrast-enhanced computed tomography (CECT)** is a more advanced imaging technique, often used after initial screening or when ultrasound findings are inconclusive. - It involves radiation exposure and contrast risks, making it less suitable as a first-line investigation for a child with these symptoms. *Serology* - **Serological tests** detect antibodies or antigens related to specific infections (e.g., viral hepatitis) but do not provide immediate anatomical information. - While they can confirm an infectious cause, they cannot identify the source of the pain or rule out other non-infectious pathologies immediately.
Physiology
1 questionsWhich of the following hormones regulates blood levels of 1,25-OH-cholecalciferol positively?
FMGE 2018 - Physiology FMGE Practice Questions and MCQs
Question 151: Which of the following hormones regulates blood levels of 1,25-OH-cholecalciferol positively?
- A. Thyroxine
- B. Parathormone (Correct Answer)
- C. Calcitonin
- D. Insulin
Explanation: ***Parathormone*** - **Parathormone (PTH)** directly stimulates the **renal 1-alpha-hydroxylase** enzyme, which converts 25-hydroxycholecalciferol to its active form, **1,25-dihydroxycholecalciferol (calcitriol)**. - This activation is crucial for increasing **calcium absorption** from the gut and maintaining calcium homeostasis. *Thyroxine* - **Thyroxine** (thyroid hormone) primarily regulates **metabolism**, growth, and development. - It does not have a direct positive regulatory effect on the synthesis or blood levels of **1,25-OH-cholecalciferol**. *Calcitonin* - **Calcitonin** is a hormone that **lowers blood calcium levels** by inhibiting osteoclast activity and decreasing renal calcium reabsorption. - It does not positively regulate the production of **1,25-OH-cholecalciferol**; in fact, its actions are generally antagonistic to those influenced by active vitamin D. *Insulin* - **Insulin** is a key hormone in **glucose metabolism**, facilitating glucose uptake by cells and promoting glycogen synthesis. - It plays no direct role in the regulation or synthesis of **1,25-OH-cholecalciferol**.