FMGE 2023 - Anatomy PYQs Practice Questions

Q: Identify the histological image below.

Transitional epithelium. ***Transitional epithelium***- This is also known as **urothelium** and is specialized to line the urinary tract (ureters, bladder, proximal urethra) due to its unique structure.- It is characterized by large, bulbous surface cells called **dome cells** or **umbrella cells**, which protect subepithelial layers from urine. *Pseudostratified columnar epithelium*- This epithelium appears layered because the nuclei are at different levels, but all cells rest on the **basement membrane**.- It is commonly found lining the respiratory tract (**trachea** and bronchi) where it typically features **cilia** and goblet cells. *Non-keratinized squamous epithelium*- This tissue consists of multiple layers of cells (stratified) where the surface cells are flattened and **nucleated**.- Locations include the lining of the **vagina**, esophagus, and oral cavity, where protection from abrasion is needed. *Stratified squamous epithelium*- This general category includes both keratinized and non-keratinized types, but it lacks the characteristic **dome cells** of urothelium.- Its main function is providing robust protection from **mechanical stress**, and it does not exhibit the high degree of stretchability seen in the bladder lining. [Practice more Anatomy PYQs on OnCourse]

Q: A patient presents cyst on the neck with anterior to the sternocleidomastoid at the junction of the upper and middle third of the muscle. This cyst is due to the persistence of which of the following embryological clefts?

2nd cleft. ***2nd cleft***- A cyst appearing anterior to the **sternocleidomastoid muscle (SCM)**, especially at the junction of the upper and middle third, is the classical presentation of a second branchial cleft cyst (BCC) [1].- Persistence of the **cervical sinus**, which is formed by the rapid growth of the second arch covering the 2nd, 3rd, and 4th clefts, results in the most common type of BCC (over 90%).*1st cleft*- First branchial cleft cysts are rare and typically manifest near the **external auditory canal**, the angle of the mandible, or within the parotid gland [1].- These defects are often associated with the structures of the first arch, such as the **facial nerve** or parotid gland parenchyma.*3rd cleft*- Cysts derived from the third cleft are uncommon and usually present lower in the neck, often close to or piercing the **thyrohyoid membrane**.- A third cleft fistula would course **posterior to the carotid arteries** and anterior to the vagus nerve before ending in the pyriform sinus.*4th cleft*- Remnants of the fourth cleft are extremely rare and typically involve a fistula that tracks inferiorly to the great vessels (e.g., the **aortic arch** on the left side).- Fourth arch defects are often associated with recurrent **thyroiditis** or infection originating from the pyriform sinus. [Practice more Anatomy PYQs on OnCourse]

Q: A patient presented to the OPD with an abnormal gait. On examination, a right-sided hip drop was observed when the patient was asked to stand on the left foot. Which of the following muscles are paralyzed in this patient?

Left gluteus medius and gluteus minimus. ***Left gluteus medius and gluteus minimus*** - The Trendelenburg sign is positive when the pelvis drops on the side opposite the one being stood on (the unsupported side). - This indicates paralysis or weakness of the **hip abductors** on the **standing leg** (left side in this case), which are the gluteus medius and gluteus minimus, responsible for stabilizing the pelvis. - These muscles are innervated by the **superior gluteal nerve**. *Right gluteus maximus and gluteus medius* - Paralysis of muscles on the right side would typically manifest as a deficit when bearing weight on the **right leg** (causing the left hip to drop). - The **gluteus maximus** is mainly a powerful hip extensor (needed for climbing stairs, running, and rising from a seated position) and does not play the primary role in stabilizing the pelvis during single-leg stance. *Right gluteus medius and gluteus minimus* - If these muscles on the right side were paralyzed, the pelvis would drop on the **left side** when the patient attempts to stand on the right foot. - The finding of a right hip drop while standing on the left foot confirms the deficit is on the ipsilateral side of the standing limb (the **left side**). *Left gluteus maximus and gluteus medius* - While the **left gluteus medius** is correctly identified as being paralyzed, the inclusion of the gluteus maximus is inaccurate. - The **gluteus maximus** is innervated by the **inferior gluteal nerve** (not the superior gluteal nerve), and its paralysis causes difficulty with activities requiring hip extension, such as climbing stairs or rising from a chair (gluteus maximus lurch). - The Trendelenburg sign specifically tests the **superior gluteal nerve** and the hip abductors (gluteus medius and minimus), not the gluteus maximus. [Practice more Anatomy PYQs on OnCourse]

Q: The framework of the external nose:

Upper 1/3rd bony and lower 2/3rd cartilaginous. ***Upper 1/3rd bony and lower 2/3rd cartilaginous*** - The superior portion (root and bridge) of the external nose is supported by the **nasal bones** and the **frontal process of the maxilla**, constituting the bony framework (approximately the upper third). - The inferior portion (apex and alae) is primarily supported by the **hyaline cartilages** (septal, lateral, and alar cartilages), which comprise the remaining two-thirds, ensuring flexibility. *Upper 1/2 is bony, and lower 1/2 is cartilaginous* - The anatomical ratio is not 1:1; the **cartilaginous component** provides the majority of the structure and length of the external nose, extending past the halfway point. - The **bony framework** includes the nasal bridge and is significantly shorter than the soft cartilaginous portion below it. *Upper 2/3rd is bony and the lower 1/3rd is cartilaginous* - This ratio is anatomically reversed and medically inaccurate, as it implies a dominant bony structure, which would make the nose **rigid**. - The **cartilaginous elements** are necessary for the mobility and shape of the nasal tip and alae, comprising the bulk (two-thirds) of the external framework. *None of the above* - Since the description "upper 1/3rd bony and lower 2/3rd cartilaginous" is anatomically accurate, this option is incorrect. - The correct anatomical framework is well-established in standard anatomy references and medical literature. [Practice more Anatomy PYQs on OnCourse]

Q: A 55-year-old man is diagnosed with left testicular carcinoma. Which of the following lymph nodes is the first to be involved?

Para-aortic lymph nodes. ***Para-aortic lymph nodes***- The testes originate in the retroperitoneum, and their lymphatic drainage follows the **gonadal vessels**, primarily draining to the **paraaortic** (L1/L2 level) nodes, irrespective of descent into the scrotum.- For the **left testis**, the primary landing site for metastatic cancer is the **para-aortic chain** due to its drainage pathway along the left gonadal vein into the left renal vein [1].*Inguinal lymph nodes*- These nodes drain the **scrotal skin**, coverings, and structures superficial to the **tunica vaginalis**, not the testis itself [1].- Involvement of inguinal nodes only occurs late in the disease if the tumor has invaded the scrotal wall, or post-scrotal trauma/surgery [1].*Iliac lymph nodes*- These nodes (internal and external) primarily drain the **pelvic structures** (e.g., bladder, prostate, lower limb).- They are considered second-echelon nodes for testicular cancer, typically involved only after spread to the primary retroperitoneal (para-aortic/paracaval) chains.*Pre-caval lymph nodes*- These nodes are the primary landing site for the **right testicular carcinoma** because the right testicular vein drains directly into the **Inferior Vena Cava (IVC)**.- For the left testis, the drainage is primarily routed to the **para-aortic** nodes, although some crossover to the pre-caval nodes may occur later. [Practice more Anatomy PYQs on OnCourse]

Question 1

Identify the histological image below.

Accepted Answer

Transitional epithelium

Answer

Pseudostratified columnar epithelium

Answer

Non-keratinized squamous epithelium

Answer

Stratified squamous epithelium

Question 2

A patient presents cyst on the neck with anterior to the sternocleidomastoid at the junction of the upper and middle third of the muscle. This cyst is due to the persistence of which of the following embryological clefts?

Accepted Answer

2nd cleft

Answer

1st cleft

Answer

3rd cleft

Answer

4th cleft

Question 3

A patient presented to the OPD with an abnormal gait. On examination, a right-sided hip drop was observed when the patient was asked to stand on the left foot. Which of the following muscles are paralyzed in this patient?

Accepted Answer

Left gluteus medius and gluteus minimus

Answer

Right gluteus maximus and gluteus medius

Answer

Right gluteus medius and gluteus minimus

Answer

Left gluteus maximus and gluteus medius

Question 4

The framework of the external nose:

Accepted Answer

Upper 1/3rd bony and lower 2/3rd cartilaginous

Answer

Upper 1/2 is bony, and lower 1/2 is cartilaginous

Answer

Upper 2/3rd is bony and the lower 1/3rd is cartilaginous

Answer

None of the above

Question 5

A 55-year-old man is diagnosed with left testicular carcinoma. Which of the following lymph nodes is the first to be involved?

Accepted Answer

Para-aortic lymph nodes

Answer

Inguinal lymph nodes

Answer

Iliac lymph nodes

Answer

Pre-caval lymph nodes

Question 6

Identify the sinus marked in the image.

Accepted Answer

Maxillary sinus

Answer

Pyriform sinus

Answer

Ethmoid sinus

Answer

Frontal sinus

Question 7

Which of the following is the right lateral rectus yoke muscle?

Accepted Answer

Left medial rectus

Answer

Right superior oblique

Answer

Right medial rectus

Answer

Left lateral rectus

Question 8

In relation to which wall of the orbit are the canaliculi that open into the lacrimal sac present?

Accepted Answer

Medial wall

Answer

Superior wall

Answer

Inferior wall

Answer

Lateral wall

Question 9

Which lymph node is most commonly involved in prostate cancer?

Accepted Answer

d.Internal iliac

Answer

a.Deep inguinal

Answer

b.Pelvic

Answer

c.Superficial inguinal

Question 10

Identify the segment marked in red in the image below.

Accepted Answer

a.V

Answer

c.VII

Answer

b.IVa

Answer

d.III

FMGE 2023 — Anatomy