FMGE 2019 Practice Questions

Q: Which of the following is the safety muscle of tongue?

Genioglossus. ***Genioglossus*** - The **genioglossus muscle** is considered the safety muscle of the tongue because its contraction pulls the tongue forward, preventing it from falling backward and **obstructing the airway**, especially during sleep or in an unconscious state. - Its forward action is crucial in maintaining a **patent airway** [1]. *Hyoglossus* - The **hyoglossus muscle** depresses and retracts the tongue. - Its primary action is not to prevent airway obstruction, but rather for **tongue movement** during speech and swallowing. *Styloglossus* - The **styloglossus muscle** retracts and elevates the tongue. - It helps in shaping the tongue for **swallowing and speech**, but does not have a primary role in airway patency. *Palatoglossus* - The **palatoglossus muscle** elevates the posterior part of the tongue and depresses the soft palate. - It is involved in initiating **swallowing** and separating the oral cavity from the pharynx, not in preventing airway collapse.

Q: Which bases are present in human DNA?

Adenine-guanine-cytosine-thymine. ***Adenine- guanine-cytosine-thymine*** - DNA (deoxyribonucleic acid) in humans, and most other organisms, is composed of four nitrogenous bases: **adenine (A), guanine (G), cytosine (C), and thymine (T)**. - These bases are paired specifically: **adenine with thymine (A-T)** and **guanine with cytosine (G-C)**, forming the rungs of the DNA double helix. *None of the above* - This option is incorrect because there is a definitive set of bases that make up human DNA, as described in the correct option. - The fundamental building blocks of human DNA are well-established and universally recognized in biology. *Adenine-guanine- cytosine-uracil* - This list of bases is characteristic of **RNA (ribonucleic acid)**, not DNA. - In RNA, **uracil (U)** replaces thymine (T), meaning RNA contains adenine (A), guanine (G), cytosine (C), and uracil (U). *Adenine-guanine-thiamine- uracil* - This option incorrectly includes **thiamine**, which is a **vitamin (B1)** and not a nitrogenous base found in nucleic acids. - It also incorrectly includes **uracil**, which is found in RNA, not DNA.

Q: A patient who recently got a denture fitted is found to have oral thrush that bleeds on scraping. What is the causative agent for this condition?

Candida. ***Candida*** - **Oral thrush** (candidiasis) is a common opportunistic fungal infection, especially in individuals with **dentures**, which create a warm, moist environment conducive to candidal growth. - The characteristic presentation includes **white patches** on the oral mucosa that, when scraped, reveal an **erythematous** (red) or **bleeding** surface. *Diphtheria* - Diphtheria causes a **pseudomembrane** in the throat that is tough, grayish, and hard to remove, but it's not typically associated with denture use or easy bleeding on scraping. - It is caused by the bacterium *Corynebacterium diphtheriae* and is accompanied by **severe systemic toxicity**, unlike the localized oral thrush. *Staph Aureus* - *Staphylococcus aureus* can cause various infections, but it is not typically associated with the characteristic **white, easily scrapable lesions** of oral thrush. - Oral *Staph aureus* infections might present as **impetigo** periorally or **abscesses**, neither of which fits the clinical description. *Strep Mutans* - *Streptococcus mutans* is primarily known for its role in **dental caries** (cavities) due to acid production from sugar fermentation. - It is not the causative agent for **oral thrush** or the described white, bleeding lesions on scraping.

Q: A young boy came to OPD with complaints of difficulty in breathing. On examination, bilateral polyps were found. On aspiration, bleeding was seen. What will be the initial management?

Topical corticosteroids. ***Topical corticosteroids*** - **Topical corticosteroids** are the **first-line medical management** for **nasal polyps**, helping to reduce inflammation and shrink polyp size. - They work by reducing local inflammation and edema, improving nasal airway patency and breathing. - **Important note**: The presence of **bleeding on aspiration** suggests a **vascular lesion** (such as juvenile nasopharyngeal angiofibroma in young males), which would require **imaging (CT/MRI) before any intervention** and **no biopsy** due to hemorrhage risk. However, if these are inflammatory polyps, topical steroids remain the initial medical management. *Antihistaminic* - **Antihistamines** are not first-line treatment for nasal polyps, as polyps are primarily an **eosinophilic inflammatory condition** rather than a simple IgE-mediated allergic reaction. - While antihistamines may help with associated allergic rhinitis symptoms, they do **not shrink polyps** or address the underlying inflammatory pathology. *Septoplasty* - **Septoplasty** is a surgical procedure to correct a **deviated nasal septum**, not for treating nasal polyps. - This would not address the bilateral polyps causing difficulty in breathing. *I and D* - **Incision and drainage (I&D)** is performed for abscesses or pus collections, which is not the presentation here. - Nasal polyps are benign inflammatory masses, not infectious collections requiring drainage.

Q: A patient after valve replacement will require follow up treatment with

Warfarin. ***Warfarin*** - Patients with **mechanical prosthetic heart valves** require lifelong anticoagulation with **warfarin** to prevent life-threatening thromboembolic complications [1]. - The target **international normalized ratio (INR)** typically ranges from 2.5 to 3.5, depending on the valve type and position. *ACE inhibitors* - **ACE inhibitors** are primarily used for managing **hypertension**, **heart failure**, and **renal protection**, not as routine post-valve replacement prophylaxis [2]. - While they may be used if these co-morbidities exist, they are not a universal requirement after valve surgery. *Beta blockers* - **Beta blockers** are often prescribed to control heart rate, manage **hypertension**, or reduce myocardial oxygen demand, but they are not the primary follow-up treatment for all valve replacement patients. - They do not address the critical need for **anticoagulation** in mechanical valve recipients. *Thiazide* - **Thiazide diuretics** are used to treat **hypertension** and **edema** by increasing salt and water excretion. - They do not play a direct role in preventing **thromboembolism** post-valve replacement and are not generally indicated unless chronic heart failure or hypertension is present.

Q: SARS is caused by novel variant of?

Coronavirus. ***Coronavirus*** - **Severe Acute Respiratory Syndrome (SARS)** is caused by a novel strain of **coronavirus**, specifically SARS-CoV. - Coronaviruses are a large family of viruses known to cause respiratory illnesses ranging from the common cold to more severe diseases. *Togavirus* - Togaviruses are a family of **RNA viruses** that include **Rubella virus** and **Alphaviruses** (e.g., Eastern equine encephalitis virus). - They are typically transmitted by **arthropod vectors** and do not cause SARS. *Lyssavirus* - Lyssaviruses belong to the family Rhabdoviridae and are the causative agents of **rabies**, a severe neurological disease. - They are transmitted through the bite of an infected animal and are not associated with SARS. *Poxvirus* - Poxviruses are a family of **DNA viruses** that include **Variola virus** (smallpox) and **Monkeypox virus**. - They are known for causing characteristic skin lesions and are not responsible for SARS.

Q: Appropriate treatment for mild congenital ptosis?

LPS Resection. ***LPS Resection*** - **LPS (levator palpebrae superioris) resection/advancement** is the most common surgical treatment for congenital ptosis, especially in mild to moderate cases. - This procedure strengthens the levator muscle, improving eyelid position and is appropriate when the **levator function is good** (typically greater than 4mm). *Frontalis sling procedure* - The **frontalis sling procedure** is generally reserved for severe congenital ptosis with poor levator function (<4mm) or in cases where the levator muscle is absent or highly dysfunctional. - It uses the frontalis muscle to lift the eyelid indirectly, which is less ideal for mild ptosis. *Antibiotics and hot compression* - **Antibiotics and hot compression** are treatments for infectious or inflammatory conditions of the eyelid, such as a **hordeolum** (stye) or **chalazion**. - They are not effective treatments for anatomical defects like congenital ptosis, which requires surgical intervention. *Wedge resection of conjunctiva* - **Wedge resection of the conjunctiva** might be used in some cases of conjunctival prolapse or for correction of specific conjunctival lesions or abnormalities. - It is not a standard or appropriate treatment for congenital ptosis.

Q: Which of the following is a feature of Vit B12 deficiency anemia?

All of the options. **All of the options** - **Vitamin B12 deficiency anemia** is a type of **megaloblastic anemia** characterized by impaired DNA synthesis, leading to large, immature red blood cells and neutrophils [1]. - The presence of **macro-ovalocytes** and **hypersegmented neutrophils** are classic hematological features seen on a peripheral blood smear [1]. *Macro-ovalocytes* - **Macro-ovalocytes** are abnormally large, oval-shaped red blood cells, which result from arrested maturation due to the deficiency. - While a hallmark of B12 deficiency, it is not the sole identifying feature, as other megaloblastic anemias can also present with them [2]. *Megaloblastic anemia* - **Megaloblastic anemia** is a broad category of anemia characterized by large, immature, and dysfunctional red blood cells, which is the primary classification for B12 deficiency [2]. - While accurate, it doesn't encompass the specific morphological findings seen in the blood smear of B12 deficiency, unlike the other options. *Hypersegmented neutrophils* - **Hypersegmented neutrophils** are neutrophils with five or more nuclear lobes, a characteristic sign of impaired DNA synthesis affecting granulopoiesis [1]. - This feature is highly specific to **megaloblastic anemias**, distinguishing them from other causes of macrocytosis.

Q: Koplik spots are seen in?

Measles. ***Measles*** - **Koplik spots** are pathognomonic rash that appears as small, white spots with a bluish-white center on an erythematous base on the **buccal mucosa** opposite the second molars. - They typically appear 2-3 days before the onset of the characteristic maculopapular rash, during the **prodromal phase** of measles (rubeola). *Rubella* - Rubella, or **German measles**, presents with a milder rash, **lymphadenopathy**, and mild fever. - It does not cause Koplik spots; instead, **Forchheimer spots** (petechiae on the soft palate) may be seen, but these are less specific. *Mumps* - Mumps is characterized primarily by **parotitis** (swelling of the salivary glands), fever, and headache. - It does not present with Koplik spots or any characteristic oral mucosal lesions. *Varicella* - Varicella, or **chickenpox**, is characterized by a **vesicular rash** that progresses from macules to papules to vesicles to crusts, appearing in crops. - It does not involve Koplik spots; the rash is typically generalized and pruritic.

Q: Which of the following is best assessed by FAST USG?

Pericardium. ***Pericardium*** - FAST USG is **most clinically significant** for detecting **pericardial effusions** and **cardiac tamponade** in trauma patients. - The **subxiphoid view** provides **excellent direct visualization** of the heart and pericardial space with minimal interference. - **Small volumes** of pericardial fluid (as little as 50-100 mL) are **clinically significant** and potentially life-threatening, requiring immediate intervention. - Cardiac tamponade is an **immediately reversible cause of shock** that demands urgent diagnosis and pericardiocentesis. - **Sensitivity >90%** for clinically significant pericardial effusions in the trauma setting. *Liver* - FAST assesses the **hepatorenal space (Morison's pouch)** for free fluid, not the liver parenchyma itself. - Requires **larger volumes of free fluid** (>200-500 mL) to be reliably detected in the peritoneal cavity. - Detailed assessment of actual liver injury requires **contrast-enhanced CT imaging**. *Spleen* - FAST evaluates the **splenorenal recess** for free fluid surrounding the spleen, not splenic parenchymal injury. - Detection depends on adequate volume of free fluid being present. - **CT scanning** is superior for defining splenic lacerations, hematomas, and grading injury severity. *Pleural cavity* - While Extended FAST (eFAST) can assess **pleural spaces** for effusion or pneumothorax, this is an **extension** of the standard 4-view FAST protocol. - Standard FAST focuses on the **four primary windows**: pericardial, perihepatic, perisplenic, and pelvic. - **Chest X-ray** and **CT** remain primary modalities for comprehensive thoracic assessment.

Question 1

Which of the following is the safety muscle of tongue?

Accepted Answer

Genioglossus

Answer

Hyoglossus

Answer

Styloglossus

Answer

Palatoglossus

Question 2

Which bases are present in human DNA?

Accepted Answer

Adenine-guanine-cytosine-thymine

Answer

None of the above

Answer

Adenine-guanine-cytosine-uracil

Answer

Adenine-guanine-thiamine-uracil

Question 3

A patient who recently got a denture fitted is found to have oral thrush that bleeds on scraping. What is the causative agent for this condition?

Accepted Answer

Candida

Answer

Diphtheria

Answer

Staph Aureus

Answer

Strep Mutans

Question 4

A young boy came to OPD with complaints of difficulty in breathing. On examination, bilateral polyps were found. On aspiration, bleeding was seen. What will be the initial management?

Accepted Answer

Topical corticosteroids

Answer

Septoplasty

Answer

I and D

Answer

Antihistaminic

Question 5

A patient after valve replacement will require follow up treatment with

Accepted Answer

Warfarin

Answer

ACE inhibitors

Answer

Beta blockers

Answer

Thiazide

Question 6

SARS is caused by novel variant of?

Accepted Answer

Coronavirus

Answer

Toga virus

Answer

Lyssa virus

Answer

Pox virus

Question 7

Appropriate treatment for mild congenital ptosis?

Accepted Answer

LPS Resection

Answer

Frontalis sling procedure

Answer

Antibiotics and hot compression

Answer

Wedge resection of conjunctiva

Question 8

Which of the following is a feature of Vit B12 deficiency anemia?

Accepted Answer

All of the options

Answer

Macro-ovalocytes

Answer

Megaloblastic anemia

Answer

Hypersegmented neutrophils

Question 9

Koplik spots are seen in?

Accepted Answer

Measles

Answer

Rubella

Answer

Mumps

Answer

Varicella

Question 10

Which of the following is best assessed by FAST USG?

Accepted Answer

Pericardium

Answer

Liver

Answer

Spleen

Answer

Pleural cavity

FMGE 2019

Anatomy

Biochemistry

Dental

ENT

Internal Medicine

Microbiology

Ophthalmology

Pathology

Pediatrics

Radiology