FMGE 2019 Practice Questions

Q: Highest point of iliac crest is seen at?

L4. ***L4*** - The **highest point of the iliac crest** typically corresponds to the level of the **L4 vertebral body**. - This anatomical landmark is crucial for procedures like **lumbar punctures** and determining the location for **epidural anesthesia**. *L3* - The L3 vertebral level is generally located slightly **above the highest point of the iliac crest**. - While close, it is not the most consistent anatomical correlation for the highest point. *S2* - The **S2 vertebral level** is significantly **below the iliac crests**, marking the approximate midpoint of the sacroiliac joint. - This level is used as a landmark for the **dermatome of the posterior thigh**. *S1* - The **S1 vertebral level** is also located **below the iliac crests**, forming the most superior segment of the sacrum. - It is used as a landmark for the **dermatome of the lateral foot and posterior leg**, and corresponds to the ankle jerk reflex.

Q: Zinc is cofactor of which enzyme?

Carbonic anhydrase. ***Carbonic anhydrase*** - **Zinc** is an essential cofactor for **carbonic anhydrase**, crucial for its enzymatic activity in catalyzing the reversible hydration of carbon dioxide. - This enzyme plays a vital role in processes like **pH regulation**, **carbon dioxide transport**, and **bicarbonate production** in various tissues. *Carboxylase* - Carboxylases typically require **biotin** as a cofactor for their activity, which involves the addition of a carboxyl group to a substrate. - Examples include **pyruvate carboxylase** and **acetyl-CoA carboxylase**, which are fundamental in metabolic pathways. *Kinase* - Kinases are enzymes that catalyze the transfer of a **phosphate group** from a high-energy donor molecule (like ATP) to a substrate. - Their activity often depends on cofactors like **magnesium (Mg2+)** or **manganese (Mn2+)**, not zinc. *Lysyl oxidase* - **Lysyl oxidase** is an enzyme that requires **copper** as a cofactor for its activity. - It plays a critical role in the **cross-linking of collagen and elastin**, essential for the integrity of connective tissues.

Q: All are cofactors for Dehydrogenase except:

SAM. ***SAM*** - **S-adenosylmethionine (SAM)** is a cofactor involved in **methyl group transfer reactions**, carried out by enzymes known as methyltransferases. - Dehydrogenase enzymes catalyze **redox reactions**, typically involving the transfer of hydride ions, and thus do not utilize SAM as a cofactor. *NADP* - **Nicotinamide adenine dinucleotide phosphate (NADP)** is a crucial coenzyme for many **dehydrogenase reactions**, particularly in **anabolic pathways** like fatty acid synthesis and the pentose phosphate pathway. - It acts as an **electron carrier**, accepting or donating hydride ions. *NAD* - **Nicotinamide adenine dinucleotide (NAD)** is a highly common coenzyme for numerous **dehydrogenase enzymes**, especially in **catabolic pathways** such as glycolysis, the Krebs cycle, and oxidative phosphorylation. - It functions as an **electron acceptor** or donor in redox reactions. *FAD* - **Flavin adenine dinucleotide (FAD)** is a coenzyme derived from **riboflavin (Vitamin B2)** and is associated with various dehydrogenase enzymes, particularly those involved in **electron transport** and fatty acid oxidation. - FAD can accept two hydrogen atoms (one hydride and one proton) to become FADH₂.

Q: NITI Aayog stands for:

National Institution for Transforming India. ***National Institute for Transforming India*** - NITI Aayog is the abbreviation for **National Institution for Transforming India**, a policy think tank of the Indian government. - It replaced the **Planning Commission** in 2015, aiming to foster cooperative federalism and bottom-up planning. *Newer Initiative transforming India* - This option is **descriptive** of NITI Aayog's function but not its official full form. - While NITI Aayog is indeed a newer initiative for transformation, this is not the **accurate expansion** of the acronym. *Nutritional institute for transforming India* - This option incorrectly specifies "Nutritional institute," limiting the scope of NITI Aayog's work. - NITI Aayog's mandate is **broader** than just nutrition; it covers various socio-economic development aspects. *Nutrition Intake to India* - This option is syntactically awkward and **does not align** with the established full form of NITI Aayog. - It also drastically **misrepresents** the organization's overarching purpose and functions.

Q: A patient is having a continuous tremor and he has tendency to fall. Lesion is most commonly seen in?

Substantia Nigra. ***Substantia Nigra*** - A lesion in the **substantia nigra** leads to a deficiency of **dopamine**, which is characteristic of **Parkinson's disease** [1]. - Symptoms like **continuous tremor (resting tremor)**, **postural instability (tendency to fall)**, rigidity, and bradykinesia are hallmark features of Parkinson's disease, linked to substantia nigra degeneration [1], [2]. *Putamen* - While the putamen is part of the basal ganglia and involved in motor control, its primary lesion is not typically associated with the classic triad of **Parkinsonian symptoms** (tremor, rigidity, bradykinesia) [1]. - Lesions here might instead contribute to involuntary movements like **dystonia** or **chorea**, which are not described. *Globus pallidus* - The globus pallidus is involved in regulating voluntary movement, and lesions here can cause various movement disorders, including **dystonia**, **chorea**, or **hemiballismus** [2]. - However, isolated pallidal lesions are less commonly the primary cause of the specific combination of **resting tremor** and **falls** seen in Parkinson's. *Caudate nucleus* - The caudate nucleus plays a crucial role in cognitive and motor functions and is primarily affected in diseases like **Huntington's disease**, leading to **chorea** and cognitive decline [2]. - Lesions in the caudate nucleus do not typically present with a **continuous tremor** and **tendency to fall** as the predominant symptoms.

Q: Molluscum contagiosum is caused by a:

Pox virus. ***Pox virus*** - **Molluscum contagiosum** is a common **cutaneous viral infection** caused by the **Molluscum Contagiosum Virus (MCV)**. - MCV belongs to the **Poxviridae family**, which are known for causing characteristic skin lesions. *Flavi virus* - **Flaviviruses** are a genus of RNA viruses, which cause diseases like **Dengue fever**, **Yellow fever**, and **Zika virus infection**. - They typically cause **systemic illnesses** with fever and rash, rather than localized skin lesions like molluscum contagiosum. *Adenovirus* - **Adenoviruses** are DNA viruses primarily associated with **respiratory infections** (e.g., common cold, bronchitis) and **conjunctivitis**. - They are not known to cause the characteristic **umbilicated papules** seen in molluscum contagiosum. *Rubivirus* - **Rubivirus** is a genus that includes the **Rubella virus**, which causes **German measles** (Rubella). - Rubella is characterized by a **maculopapular rash** and **lymphadenopathy**, which is distinct from the **umbilicated papules** seen in molluscum contagiosum.

Q: Which of the following is an advantage of contact lenses over normal glasses?

Improved peripheral vision. ***Improved peripheral vision*** - Contact lenses sit directly on the cornea, moving with the eye and eliminating the **frame obstruction** and **edge distortions** associated with glasses. - This provides a wider and more natural **field of view**, enhancing peripheral vision. *Reduced prismatic effect* - While contact lenses do reduce the **magnification/minification** compared to glasses, the prismatic effect is a specific distortion most pronounced in **strong thick spectacle lenses** and can induce visual discomfort, which contact lenses inherently minimize. - This effect is due to the distance between the spectacle lens and the eye, which contact lenses eliminate. *Decreased risk of infection* - Wearing contact lenses inherently carries a **higher risk of eye infections** if proper hygiene and care are not meticulously followed. - Unlike glasses, contact lenses require regular cleaning, disinfection, and proper storage to prevent bacterial or fungal contamination. *UV protection (in specific lenses)* - While some contact lenses incorporate **UV-blocking agents**, this is not a universal feature of all contact lenses and is also available in many spectacle lenses. - UV protection from contact lenses primarily shields the cornea and iris but does not fully protect the surrounding ocular tissues like glasses (especially wrap-around styles) can.

Q: Keratometer is used to assess:

Curvature of cornea. ***Curvature of cornea*** - A **keratometer** (or ophthalmometer) is specifically designed to measure the **radius of curvature** of the **anterior surface of the cornea**. - This measurement is crucial for fitting **contact lenses**, diagnosing **astigmatism**, and planning **refractive surgeries**. *Curvature of lens* - The curvature of the **crystalline lens** inside the eye is not directly measured by a keratometer. - Lens curvature changes with **accommodation** and is assessed more indirectly through an **autorefractor** or during cataract surgery planning with specific formulas. *Thickness of cornea* - The **thickness of the cornea** is measured using a **pachymeter**, not a keratometer. - **Pachymetry** is important for diagnosing conditions like **glaucoma** and evaluating suitability for **refractive surgery**. *Diameter of cornea* - The **diameter of the cornea** (from limbus to limbus) is typically measured using a **ruler or calipers**, not a keratometer. - This measurement is relevant for contact lens fitting and surgical planning.

Q: Which of the following causes hypoxic hypoxia?

Pneumonia. ***Pneumonia*** - Pneumonia causes **hypoxic hypoxia** by impairing **gas exchange** in the lungs due to inflammation and fluid accumulation in the alveoli, leading to reduced oxygen uptake. - This results in a **low partial pressure of oxygen (PaO2)** in the arterial blood, even with normal oxygen-carrying capacity and tissue perfusion. *HCN poisoning* - **Hydrogen cyanide (HCN) poisoning** causes **histotoxic hypoxia**, where cells are unable to utilize oxygen despite adequate delivery, by inhibiting **cytochrome c oxidase** in the electron transport chain. - It does not directly reduce the amount of oxygen in the blood or its delivery to tissues. *CO poisoning* - **Carbon monoxide (CO) poisoning** causes **anemic hypoxia** by binding to hemoglobin with a much higher affinity than oxygen, forming **carboxyhemoglobin (COHb)**. - This reduces the **oxygen-carrying capacity** of the blood and shifts the oxygen-hemoglobin dissociation curve to the left, but it is not a direct problem with alveolar gas exchange or oxygen partial pressure. *Circulatory shock* - **Circulatory shock** causes **stagnant or ischemic hypoxia**, characterized by reduced blood flow and oxygen delivery to tissues due to systemic circulatory failure. - While it results in tissue oxygen deprivation, the primary issue is impaired perfusion rather than a defect in the initial oxygenation of blood in the lungs or the blood's capacity to carry oxygen.

Q: A patient who underwent gastrectomy develops sweating and diarrhea within 20 minutes after eating. What could be the cause?

Early dumping syndrome. ***Early dumping syndrome*** - Occurs **15-30 minutes after eating** in patients who have undergone **gastric surgery**, such as gastrectomy, due to rapid emptying of hyperosmolar chyme into the small intestine. - Symptoms include **sweating**, **diarrhea**, **nausea**, **cramping**, and **tachycardia** due to fluid shifts and hormonal responses. *Late dumping syndrome* - Typically occurs **1-3 hours after eating**, not within 20 minutes. - It is characterized by **hypoglycemia** due to an exaggerated insulin response to the rapid absorption of glucose, leading to symptoms like weakness, confusion, and tremor. *Hyperglycemia* - While a rapid influx of glucose can initially cause hyperglycemia, the symptoms described (sweating, diarrhea) are more indicative of the systemic effects of rapid gastric emptying rather than simple hyperglycemia itself. - Hyperglycemia post-meal is a normal physiological response, and the constellation of symptoms points to a post-surgical complication. *Hypoglycemia* - Hypoglycemia is characteristic of **late dumping syndrome**, occurring hours after a meal, not within 20 minutes. - The symptoms of early dumping syndrome are primarily driven by fluid shifts and neurovascular responses, not low blood glucose.

Question 1

Highest point of iliac crest is seen at?

Accepted Answer

L4

Answer

L3

Answer

S2

Answer

S1

Question 2

Zinc is cofactor of which enzyme?

Accepted Answer

Carbonic anhydrase

Answer

Carboxylase

Answer

Kinase

Answer

Lysyl oxidase

Question 3

All are cofactors for Dehydrogenase except:

Accepted Answer

SAM

Answer

NADP

Answer

NAD

Answer

FAD

Question 4

NITI Aayog stands for:

Accepted Answer

National Institution for Transforming India

Answer

Newer Initiative transforming India

Answer

Nutritional institute for transforming India

Answer

Nutrition Intake to India

Question 5

A patient is having a continuous tremor and he has tendency to fall. Lesion is most commonly seen in?

Accepted Answer

Substantia Nigra

Answer

Putamen

Answer

Globus pallidus

Answer

Caudate nucleus

Question 6

Molluscum contagiosum is caused by a:

Accepted Answer

Pox virus

Answer

Flavi virus

Answer

Adenovirus

Answer

Rubivirus

Question 7

Which of the following is an advantage of contact lenses over normal glasses?

Accepted Answer

Improved peripheral vision

Answer

Reduced prismatic effect

Answer

Decreased risk of infection

Answer

UV protection (in specific lenses)

Question 8

Keratometer is used to assess:

Accepted Answer

Curvature of cornea

Answer

Curvature of lens

Answer

Thickness of cornea

Answer

Diameter of cornea

Question 9

Which of the following causes hypoxic hypoxia?

Accepted Answer

Pneumonia

Answer

HCN poisoning

Answer

CO poisoning

Answer

Circulatory shock

Question 10

A patient who underwent gastrectomy develops sweating and diarrhea within 20 minutes after eating. What could be the cause?

Accepted Answer

Early dumping syndrome

Answer

Late dumping syndrome

Answer

Hyperglycemia

Answer

Hypoglycemia

FMGE 2019

Anatomy

Biochemistry

Community Medicine

Internal Medicine

Microbiology

Ophthalmology

Physiology

Surgery