Anatomy
1 questionsProtrusion of mandible is due to which of the following muscles?
FMGE 2019 - Anatomy FMGE Practice Questions and MCQs
Question 141: Protrusion of mandible is due to which of the following muscles?
- A. Medial pterygoid
- B. Masseter
- C. Lateral pterygoid (Correct Answer)
- D. Temporalis
Explanation: ***Lateral pterygoid*** - The **lateral pterygoid muscle** is the primary muscle responsible for **protrusion of the mandible**. - Its bilateral contraction pulls the condyle of the mandible and the articular disc anteriorly, causing the lower jaw to move forward. *Medial pterygoid* - The **medial pterygoid muscle** primarily functions in **elevation** and **side-to-side movements** of the mandible. - While it assists in some mandibular movements, its main role is not protrusion. *Masseter* - The **masseter muscle** is a strong muscle involved in **elevating the mandible** and is crucial for **closing the jaw** (biting and chewing). - It does not contribute significantly to the forward movement or protrusion of the mandible. *Temporalis* - The **temporalis muscle** is a major muscle of mastication, responsible for **elevating the mandible** and **retracting** it. - Its fibers, particularly the posterior ones, pull the mandible backward, directly opposing protrusion.
Anesthesiology
1 questionsWhich of the following inhalational anaesthetic agent can cause hepatitis on repeated use?
FMGE 2019 - Anesthesiology FMGE Practice Questions and MCQs
Question 141: Which of the following inhalational anaesthetic agent can cause hepatitis on repeated use?
- A. Sevoflurane
- B. Halothane (Correct Answer)
- C. Ether
- D. Isoflurane
Explanation: ***Halothane*** - Halothane is known to cause **halothane hepatitis** (also known as halothane-induced liver injury), a rare but severe form of liver damage, particularly on **repeated exposure**. - This is due to the **metabolism of halothane** in the liver, which can produce reactive intermediates that lead to immune-mediated liver cell necrosis. *Sevoflurane* - Sevoflurane is generally considered to have a **low incidence of liver toxicity** and is preferred in patients with pre-existing liver disease. - While it can be metabolized to fluoride ions, the clinical significance of this in terms of liver damage is considered to be minimal compared to halothane. *Ether* - **Diethlyl ether** is an older anesthetic agent that is no longer commonly used due to its flammability and slower induction/recovery times. - While it can cause some hepatic dysfunction, it is not primarily associated with the severe, immune-mediated hepatitis seen with halothane. *Isoflurane* - Isoflurane is an ether-based anesthetic with a much **lower metabolism** rate than halothane. - This reduced metabolism contributes to its **lower potential for liver toxicity** compared to halothane, making it a safer option for patients with liver concerns.
Biochemistry
1 questionsType IV complex of ETC is inhibited by
FMGE 2019 - Biochemistry FMGE Practice Questions and MCQs
Question 141: Type IV complex of ETC is inhibited by
- A. Antimycin
- B. Oligomycin
- C. CO2
- D. Cyanide (Correct Answer)
Explanation: ***Cyanide*** - **Cyanide** is a potent inhibitor of **cytochrome c oxidase (Complex IV)** in the electron transport chain, binding to its ferric iron center and preventing the reduction of oxygen to water. - This inhibition effectively blocks electron flow, leading to a rapid cessation of ATP production and cellular respiration. *Antimycin* - **Antimycin A** specifically inhibits **Complex III (cytochrome bc1 complex)** of the electron transport chain. - It binds to the Qn site of Complex III, preventing the transfer of electrons from reduced ubiquinone to cytochrome c. *Oligomycin* - **Oligomycin** is an inhibitor of **ATP synthase (Complex V)**, not Complex IV. - It blocks the flow of protons through the Fo subunit of ATP synthase, thereby inhibiting ATP synthesis, but it does not directly affect electron transport itself. *CO2* - **CO2** is a waste product of cellular respiration and is not an inhibitor of any complex within the electron transport chain. - While high levels of CO2 can affect pH and cellular function, it does not directly interfere with the catalytic activity of ETC complexes.
Community Medicine
3 questionsSustainable Development Goals are designed by:
N95 mask is used for:
In Africa, vaccination was given in an endemic outbreak area for a specific disease but due to shortage of vaccines, mass chemoprophylaxis treatment was given to people who were not diseased. Which type of prevention is this?
FMGE 2019 - Community Medicine FMGE Practice Questions and MCQs
Question 141: Sustainable Development Goals are designed by:
- A. WHO
- B. UNICEF
- C. United Nations (Correct Answer)
- D. Government of India
Explanation: ***United Nations*** - The **Sustainable Development Goals (SDGs)** were developed and adopted by all United Nations Member States in 2015 as a universal call to action to end poverty, protect the planet, and ensure that all people enjoy peace and prosperity by 2030. - They build upon the success of the Millennium Development Goals (MDGs) and address global challenges, including those related to poverty, inequality, climate change, environmental degradation, peace, and justice. *WHO* - The **World Health Organization (WHO)** is a specialized agency of the United Nations responsible for international public health. - While WHO plays a crucial role in implementing health-related SDGs (specifically SDG 3 - Good Health and Well-being), it did not design the entire framework of all 17 SDGs. *UNICEF* - **UNICEF (United Nations Children's Fund)** is a United Nations agency dedicated to providing humanitarian and developmental aid to children worldwide. - UNICEF contributes significantly to achieving several SDGs, particularly those focused on children's well-being, education, and health, but it was not the sole designer of the SDGs. *Government of India* - The **Government of India** is a sovereign government responsible for governing India. - While India is a member state of the United Nations and is committed to achieving the SDGs within its national context, it did not design the global framework of the Sustainable Development Goals.
Question 142: N95 mask is used for:
- A. respiratory droplets
- B. Dust
- C. aerosol (Correct Answer)
- D. in general
Explanation: ***aerosol*** - **N95 masks** are specifically designed to filter out at least 95% of **airborne particles** (aerosols) 0.3 microns or larger. - This level of filtration is crucial for protecting against diseases transmitted via **aerosolized droplets**, such as tuberculosis or COVID-19. *respiratory droplets* - While an N95 mask can filter respiratory droplets, it is primarily designed for smaller **aerosol particles** that can remain suspended in the air. - **Surgical masks** are generally adequate for blocking larger respiratory droplets, preventing splash and splatter. *Dust* - While an N95 mask can filter dust, it is an **overkill** for most common dust exposures. - A simple **dust mask** or even a surgical mask can provide adequate protection against larger dust particles. *in general* - This option is too broad; N95 masks are specifically used when there's a risk of exposure to **aerosolized infectious agents** or **fine particulate matter**. - Their use is typically reserved for settings where **aerosol-generating procedures** are performed or when caring for patients with **airborne diseases**.
Question 143: In Africa, vaccination was given in an endemic outbreak area for a specific disease but due to shortage of vaccines, mass chemoprophylaxis treatment was given to people who were not diseased. Which type of prevention is this?
- A. Rehabilitation
- B. Health promotion
- C. Specific protection (Correct Answer)
- D. Early diagnosis and treatment
Explanation: ***Specific protection*** - **Vaccination** directly prevents disease, fitting into the criteria of specific protection. - **Mass chemoprophylaxis** aims to prevent disease in healthy individuals in an endemic area, which is also a form of specific protection. *Rehabilitation* - This involves measures to restore function and well-being after a disease has occurred and caused disability. - It does not involve preventing the initial onset of disease, as described in the scenario. *Health promotion* - Health promotion includes broad interventions like education, lifestyle changes, and environmental modifications to improve overall health and prevent disease indirectly. - It is not as targeted as vaccination or chemoprophylaxis against a specific disease. *Early diagnosis and treatment* - This level of prevention focuses on identifying and treating a disease in its early stages to prevent its progression and complications. - The scenario describes preventing disease in healthy individuals, not treating existing cases.
Forensic Medicine
1 questionsWhich of the following can be considered as grounds of divorce under matrimonial law?
FMGE 2019 - Forensic Medicine FMGE Practice Questions and MCQs
Question 141: Which of the following can be considered as grounds of divorce under matrimonial law?
- A. Sterility
- B. Frigidity
- C. Impotence developing after the marriage (Correct Answer)
- D. Temporary Mental illness
Explanation: ***Impotence developing after the marriage*** - **Impotence** (inability to consummate the marriage) can constitute a ground for **nullity** if it existed **at the time of marriage** and was not disclosed. - However, **impotence developing after marriage** may be considered under certain legal frameworks as inability to fulfill marital obligations, though its status varies by jurisdiction. - In the context of medical jurisprudence, **sexual incapacity** affecting the continuation of marriage is recognized as a potential ground in matrimonial disputes. - This is the **most appropriate answer** among the given options as it relates to inability to fulfill a fundamental aspect of marriage. *Sterility* - **Sterility** (inability to conceive children) is generally **not considered a ground for divorce** under most matrimonial laws. - It does not prevent consummation of marriage or fulfillment of other marital duties. - While it may cause personal distress, legal systems distinguish between inability to conceive and inability to engage in sexual relations. *Frigidity* - **Frigidity** (lack of sexual desire or responsiveness) is typically **not a sufficient ground for divorce** on its own. - If the spouse is physically capable of consummating the marriage, lack of desire alone does not constitute legal grounds. - It may overlap with other marital issues but has weaker legal standing compared to actual physical incapacity. *Temporary Mental illness* - **Temporary mental illness** is generally **not a ground for divorce** because it implies a recoverable condition. - For mental disorder to constitute grounds for divorce under Indian matrimonial law (Hindu Marriage Act Section 13), it must be: - **Incurable** or of such nature that cohabitation becomes unreasonable - **Continuous or intermittent** mental disorder of sufficient severity - A **temporary** condition that can be cured does not meet these criteria.
Pathology
1 questionsWhich of the following has Autosomal Recessive inheritance?
FMGE 2019 - Pathology FMGE Practice Questions and MCQs
Question 141: Which of the following has Autosomal Recessive inheritance?
- A. Osteogenesis imperfecta
- B. Hereditary spherocytosis
- C. von Willebrand Disease Type 1
- D. Sickle cell anaemia (Correct Answer)
Explanation: **Sickle cell anaemia** - This condition is inherited in an **autosomal recessive** pattern [2], meaning an individual must inherit two copies of the defective gene (one from each parent) to manifest the disease [3]. - It is caused by a mutation in the **beta-globin gene** [1], leading to abnormal hemoglobin production and characteristic sickle-shaped red blood cells [1]. *Osteogenesis imperfecta* - This disorder is predominantly inherited in an **autosomal dominant** pattern, meaning only one copy of the mutated gene is sufficient to cause the condition. - It is characterized by **brittle bones** due to defects in type I collagen synthesis. *Hereditary spherocytosis* - The most common and severe forms of hereditary spherocytosis are inherited as an **autosomal dominant** trait, though rarer autosomal recessive forms exist. - It involves defects in red blood cell membrane proteins, leading to **spherocytes** and hemolytic anemia. *von Willebrand Disease Type 1* - This is the most common type of von Willebrand disease and is inherited in an **autosomal dominant** pattern. - It is characterized by a **partial quantitative deficiency** of von Willebrand factor. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 598-599. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. (Basic Pathology) introduces the student to key general principles of pathology, both as a medical science and as a clinical activity with a vital role in patient care. Part 2 (Disease Mechanisms) provides fundamental knowledge about the cellular and molecular processes involved in diseases, providing the rationale for their treatment. Part 3 (Systematic Pathology) deals in detail with specific diseases, with emphasis on the clinically important aspects., pp. 53-54. [3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Genetic Disorders, pp. 150-151.
Physiology
1 questionsWhich of the following has prolonged inspiratory spasms that resemble breath holding?
FMGE 2019 - Physiology FMGE Practice Questions and MCQs
Question 141: Which of the following has prolonged inspiratory spasms that resemble breath holding?
- A. Kussmaul breathing
- B. Biot breathing
- C. Apneustic breathing (Correct Answer)
- D. Cheyne-Stokes breathing
Explanation: ***Apneustic breathing*** - This pattern is characterized by **prolonged inspiratory pauses**, resembling breath-holding, followed by a short, insufficient expiratory phase. - It is caused by damage to the **pons** in the brainstem, often due to stroke or trauma, which disrupts the normal rhythm of breathing. *Kussmaul breathing* - Characterized by **deep**, **rapid**, and labored breathing, typically seen in metabolic acidosis like **diabetic ketoacidosis**. - It is a compensatory mechanism to increase CO2 elimination and raise blood pH. *Biot's breathing* - Involves irregular breathing with **periods of apnea** interspersed with shallow breaths. - This pattern is associated with damage to the **medulla oblongata** or severe intracranial pressure. *Cheyne-Stokes breathing* - Characterized by a **crescendo-decrescendo pattern** of respiration, where breathing gradually increases in depth and rate, then decreases, followed by a period of **apnea**. - It is often observed in **heart failure**, stroke, or severe neurological conditions, indicating brainstem or cerebral dysfunction.
Surgery
1 questionsA 40-year-old patient presents with a femur fracture, pulmonary infiltration, and respiratory distress. What is the most likely diagnosis?
FMGE 2019 - Surgery FMGE Practice Questions and MCQs
Question 141: A 40-year-old patient presents with a femur fracture, pulmonary infiltration, and respiratory distress. What is the most likely diagnosis?
- A. Obstruction
- B. Pulmonary embolism
- C. Fat embolism (Correct Answer)
- D. Air embolism
Explanation: ***Fat embolism*** - A **femur fracture** significantly increases the risk of **fat embolism**, where fat globules from the bone marrow enter the bloodstream and lodge in the pulmonary capillaries. - The classic triad of **fat embolism syndrome** includes respiratory distress, neurological symptoms, and a petechial rash, but respiratory symptoms (pulmonary infiltration and distress) are usually the first to appear. *Obstruction* - While an obstruction could cause respiratory distress, it typically wouldn't be associated with diffuse **pulmonary infiltrates** following a long bone fracture. - **Airway obstruction** would present with stridor or wheezing, and is usually localized rather than systemic. *Pulmonary embolism* - A **pulmonary embolism** (PE) can cause respiratory distress and infiltrates, but given the context of a recent femur fracture, fat embolism is a more specific and likely diagnosis. - PE is usually due to a **venous thromboembolism** and can be suspected in immobilized patients, but the question points more strongly to fat release. *Air embolism* - **Air embolism** usually results from iatrogenic causes (e.g., central line insertion, surgery) or trauma to large veins, allowing a significant amount of air into the circulation. - While it can cause respiratory distress, it doesn't typically cause the diffuse **pulmonary infiltrates** described, which are characteristic of fat embolism.