Anatomy
1 questionsHighest point of iliac crest is seen at?
FMGE 2019 - Anatomy FMGE Practice Questions and MCQs
Question 51: Highest point of iliac crest is seen at?
- A. L3
- B. L4 (Correct Answer)
- C. S2
- D. S1
Explanation: ***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.
Biochemistry
2 questionsZinc is cofactor of which enzyme?
All are cofactors for Dehydrogenase except:
FMGE 2019 - Biochemistry FMGE Practice Questions and MCQs
Question 51: Zinc is cofactor of which enzyme?
- A. Carboxylase
- B. Carbonic anhydrase (Correct Answer)
- C. Kinase
- D. Lysyl oxidase
Explanation: ***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.
Question 52: All are cofactors for Dehydrogenase except:
- A. SAM (Correct Answer)
- B. NADP
- C. NAD
- D. FAD
Explanation: ***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.
Community Medicine
1 questionsNITI Aayog stands for:
FMGE 2019 - Community Medicine FMGE Practice Questions and MCQs
Question 51: NITI Aayog stands for:
- A. Newer Initiative transforming India
- B. Nutritional institute for transforming India
- C. Nutrition Intake to India
- D. National Institution for Transforming India (Correct Answer)
Explanation: ***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.
Internal Medicine
1 questionsA patient is having a continuous tremor and he has tendency to fall. Lesion is most commonly seen in?
FMGE 2019 - Internal Medicine FMGE Practice Questions and MCQs
Question 51: A patient is having a continuous tremor and he has tendency to fall. Lesion is most commonly seen in?
- A. Putamen
- B. Substantia Nigra (Correct Answer)
- C. Globus pallidus
- D. Caudate nucleus
Explanation: ***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.
Microbiology
1 questionsMolluscum contagiosum is caused by a:
FMGE 2019 - Microbiology FMGE Practice Questions and MCQs
Question 51: Molluscum contagiosum is caused by a:
- A. Flavi virus
- B. Adenovirus
- C. Rubivirus
- D. Pox virus (Correct Answer)
Explanation: ***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.
Obstetrics and Gynecology
2 questionsAngle of cut in episiotomy is?
A multigravida woman in labor room, after delivery and placenta removal, uncontrolled bleeding was seen. What is the most common cause of PPH in this woman?
FMGE 2019 - Obstetrics and Gynecology FMGE Practice Questions and MCQs
Question 51: Angle of cut in episiotomy is?
- A. 45 degrees at the midline
- B. 30 degrees at the midline
- C. 60 degrees at the midline (Correct Answer)
- D. 15 degrees at the midline
Explanation: ***60 degrees at the midline*** - A **mediolateral episiotomy** is recommended at a **60-degree angle** from the midline, directed towards the ischial tuberosity. - This angle is based on **RCOG guidelines** and standard obstetric practice, providing optimal protection against **third- and fourth-degree perineal tears**. - The 60-degree angle effectively directs the incision away from the **anal sphincter** and **rectum**, while maintaining adequate surgical access. *45 degrees at the midline* - While sometimes used, this angle is **less protective** than 60 degrees against anal sphincter injuries. - Studies show that angles less than 60 degrees have a **higher risk** of extension into the anal sphincter complex compared to the recommended 60-degree angle. *30 degrees at the midline* - This angle is **too shallow** and provides insufficient protection against tearing towards the anal sphincter. - The risk of uncontrolled extension into the **anal sphincter complex** is significantly increased with such a small angle. *15 degrees at the midline* - This angle is **far too shallow** and would provide minimal expansion of the vaginal outlet. - It offers virtually no protection from extension into the **anal sphincter** and would likely result in an uncontrolled tear, making it an impractical choice for episiotomy.
Question 52: A multigravida woman in labor room, after delivery and placenta removal, uncontrolled bleeding was seen. What is the most common cause of PPH in this woman?
- A. Clotting factor deficiency
- B. Atony (Correct Answer)
- C. Traumatic PPH
- D. Retained tissues
Explanation: ***Atonic*** - **Uterine atony** is the most common cause of **postpartum hemorrhage (PPH)**, accounting for approximately 70-80% of cases. The uterus fails to contract adequately after placental delivery, leading to continuous bleeding from the placental bed. - Risk factors for uterine atony include multiparity, prolonged labor, rapid labor, polyhydramnios, and multiple gestations, which can lead to overdistension and fatigue of the uterine muscle. *Clotting factor deficiency* - While **coagulopathies** (clotting factor deficiencies) can cause PPH, they are a less common primary cause than uterine atony. - This cause would be suspected if there is a history of bleeding disorders, liver disease, or if PPH persists despite a well-contracted uterus. *Traumatic PPH* - **Traumatic PPH** results from lacerations of the cervix, vagina, or perineum, or from uterine rupture. These are less common than uterine atony. - This cause is typically suspected when the uterus feels firm but bleeding continues, or when visible trauma is present. *Retained tissues* - **Retained placental tissue** can prevent the uterus from contracting effectively, leading to PPH. However, it is less common than atony. - This cause is usually identified by the presence of placental fragments or membranes in the uterine cavity upon examination.
Ophthalmology
1 questionsKeratometer is used to assess:
FMGE 2019 - Ophthalmology FMGE Practice Questions and MCQs
Question 51: Keratometer is used to assess:
- A. Curvature of lens
- B. Curvature of cornea (Correct Answer)
- C. Thickness of cornea
- D. Diameter of cornea
Explanation: ***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.
Surgery
1 questionsA patient with varicose veins came to the hospital; an intern was on duty. Which test should he perform to assess the competency of deep veins?
FMGE 2019 - Surgery FMGE Practice Questions and MCQs
Question 51: A patient with varicose veins came to the hospital; an intern was on duty. Which test should he perform to assess the competency of deep veins?
- A. Ober test
- B. Thomas test
- C. Perthes test (Correct Answer)
- D. Brodie Trendelenburg test
Explanation: ***Perthes test*** - The Perthes test assesses the **patency and competency of the deep venous system** in the leg by observing changes in superficial varicosities during muscle activity. - If the varicosities diminish or disappear with ambulation and a tourniquet applied to compress superficial veins, it indicates that the **deep veins are competent** and can handle venous return. *Ober test* - The Ober test is used to assess the **tightness of the iliotibial band**, not venous competency. - It involves abducting and extending the hip while the patient lies on their side. *Thomas test* - The Thomas test evaluates for **hip flexion contracture**, especially of the iliopsoas muscle. - It is performed by having the patient lie supine and flexing one hip fully while observing the contralateral leg. *Brodie Trendelenburg test* - The Brodie Trendelenburg test is primarily used to assess the **competency of the valves of the saphenofemoral junction and perforating veins** to distinguish between superficial and deep venous insufficiency. - It involves elevating the leg, applying a tourniquet, and then observing refilling patterns of varicose veins upon standing.