Biochemistry
1 questionsA disease with mitochondrial inheritance is inherited from which family member?
FMGE 2025 - Biochemistry FMGE Practice Questions and MCQs
Question 91: A disease with mitochondrial inheritance is inherited from which family member?
- A. Father
- B. Mother (Correct Answer)
- C. Both mother and father
- D. Grandmother (paternal)
Explanation: ***Mother*** - Mitochondrial inheritance is characterized by **maternal transmission** because almost all mitochondria in the zygote are derived from the **oocyte** (mother's egg cell). - Therefore, an affected mother will pass the disease to all of her children (sons and daughters), irrespective of sex. *Grandmother (paternal)* - The paternal grandmother passes her mitochondria to the **father**, but the father cannot transmit them to his offspring. - Inheritance is strictly maternal, meaning the genetic input from the paternal line (including the paternal grandmother) is **irrelevant** for mitochondrial DNA. *Father* - The **sperm contributes negligible mitochondrial DNA** to the fertilized egg; hence, fathers cannot pass on mitochondrial diseases to their children. - Paternal mitochondria are typically **ubiquitinated and degraded** following fertilization. *Both mother and father* - Inheritance from both parents is characteristic of **nuclear DNA** (Mendelian) disorders, such as autosomal dominant or recessive patterns. - Mitochondrial inheritance is distinctively **uniparental** and does not involve DNA contribution from both parents.
Community Medicine
4 questionsIn a class of 100 students, 80% students were immunised with measles, 12 were affected. What is the primary attack rate?
After how long is a patient advised to use alternative contraception following a vasectomy?
Which of the following is the population norm for an ASHA worker?
A total of 2000 patients were assessed for HIV. 200 were diagnosed positive. A new ELISA screening test was tested on the same group. It showed 260 as positive out of which only 130 had the disease. What is the specificity of the test?
FMGE 2025 - Community Medicine FMGE Practice Questions and MCQs
Question 91: In a class of 100 students, 80% students were immunised with measles, 12 were affected. What is the primary attack rate?
- A. 80%
- B. 70%
- C. 60% (Correct Answer)
- D. 50%
Explanation: ***60%*** - The **Primary Attack Rate** measures the number of new cases among the susceptible population during an outbreak; the susceptible population must first be determined by excluding the immunized students. - Calculation: The total susceptible population is 100 students - 80 immunized students = **20 susceptible contacts**. Primary Attack Rate = (12 affected / 20 susceptible) × 100 = **60%**. *80%* - This figure represents the percentage of students in the class who were **immunised** (80 out of 100), not the attack rate among the susceptible population. - Using 80 as the denominator would incorrectly calculate the rate among the protected group (12/80 = 15%). *70%* - This option is mathematically incorrect and does not result from the standard calculation of **Primary Attack Rate** using the given data (12 cases among 20 susceptible individuals). - It is likely derived from an incorrect calculation or failure to correctly identify the **susceptible population** for the denominator. *50%* - This value is incorrect, as the observed number of affected students (12) leads to a higher rate than 50% when calculated against the susceptible population (20). - A **Primary Attack Rate** of 50% would only account for 10 affected students (50% of 20 susceptible individuals).
Question 92: After how long is a patient advised to use alternative contraception following a vasectomy?
- A. 6 months
- B. 1 month
- C. 2 months
- D. 3 months (Correct Answer)
Explanation: ***Correct: 3 months*** - After vasectomy, **residual viable sperm remain in the distal vas deferens** and ejaculatory ducts - Alternative contraception is required for **at least 3 months** or **20 ejaculations** (whichever is later) - **Semen analysis should confirm azoospermia** before discontinuing alternative contraception - This is the standard recommendation per WHO and national family planning guidelines *Incorrect: 1 month* - Too short a duration; sperm clearance is usually incomplete at 1 month - Does not allow sufficient time for sperm elimination from the reproductive tract *Incorrect: 2 months* - Still shorter than the recommended 3-month period - May not ensure complete sperm clearance in all patients *Incorrect: 6 months* - Longer than necessary; while very safe, it exceeds standard guideline recommendations - Most men achieve azoospermia well before 6 months
Question 93: Which of the following is the population norm for an ASHA worker?
- A. 1000-1500
- B. 1000-2500 (Correct Answer)
- C. 2000-2500
- D. 700-1000
Explanation: ***Correct: 1000-2500*** The **official population norm** for ASHA worker deployment under the **National Health Mission (NHM)** is **1 ASHA per 1000-2500 population**. - The standard minimum coverage is **1000 population** in plain/non-tribal areas - In larger villages with population up to **2500**, a single ASHA may be deployed - Beyond 2500 population, **additional ASHA workers** are deployed - This range represents the official operational guideline for ASHA coverage *Incorrect: 1000-1500* - While this range includes the standard 1000 population norm, it **underestimates the upper limit** - The official NHM guideline allows a single ASHA to cover up to **2500 population** in large villages - This option artificially restricts the official range *Incorrect: 2000-2500* - This range **misses the lower limit** of the official norm, which starts at **1000 population** - A single ASHA worker should be deployed starting from 1000 population, not only at 2000+ - This would result in **under-deployment** of ASHA workers in smaller villages *Incorrect: 700-1000* - This range does not represent the standard population norm for ASHA deployment - While ASHA workers in **tribal/hilly/difficult terrain** may cover smaller habitations (minimum 100 population), **700-1000 is not an official range** specified in NHM guidelines - The standard norm begins at **1000 population** for plain areas
Question 94: A total of 2000 patients were assessed for HIV. 200 were diagnosed positive. A new ELISA screening test was tested on the same group. It showed 260 as positive out of which only 130 had the disease. What is the specificity of the test?
- A. 96% (Correct Answer)
- B. 68%
- C. 72%
- D. 80%
Explanation: ***96%*** - **Specificity** is the ability of a test to correctly identify those *without* the disease (True Negatives) among all disease-free individuals: Specificity = TN / (TN + FP) - Given data: Total patients = 2000; Actual HIV positive = 200; Actual HIV negative = 1800 - Test showed 260 positives, of which 130 were true positives (TP) - False Positives (FP) = 260 - 130 = 130 - True Negatives (TN) = Total negatives - FP = 1800 - 130 = 1670 - **Calculated Specificity = 1670/1800 × 100 = 92.78%** - Among the given options, **96% is the closest** to the calculated value of 92.78% *80%* - This value is too low and does not match the calculated specificity - This might represent a miscalculation or confusion with sensitivity *72%* - This is significantly lower than the actual specificity of 92.78% - This does not correspond to any standard epidemiological measure from the given data *68%* - This is the lowest option and far from the correct calculation - This may result from calculation errors such as using wrong denominators or confusing different test parameters
ENT
1 questionsA patient presents to the OPD with hearing loss. On examination: - Rinne test - Positive in the left ear and negative in the right ear - Weber's test - lateralization towards the left - Bone conduction test - Reduced in the right ear and similar in the left ear. Interpret the findings.
FMGE 2025 - ENT FMGE Practice Questions and MCQs
Question 91: A patient presents to the OPD with hearing loss. On examination: - Rinne test - Positive in the left ear and negative in the right ear - Weber's test - lateralization towards the left - Bone conduction test - Reduced in the right ear and similar in the left ear. Interpret the findings.
- A. Conductive hearing loss in left ear
- B. Conductive hearing loss in right ear
- C. Sensorineural hearing loss in right ear (Correct Answer)
- D. Sensorineural hearing loss in left ear
Explanation: ***Sensorineural hearing loss in right ear***- The **Weber test** lateralizes toward the **left ear**, which acts as the better ear. In cases of **unilateral sensorineural hearing loss (SNHL)**, sound lateralizes to the *unaffected* ear.- The **Bone Conduction (BC)** hearing is explicitly reported as **reduced in the right ear**, which is the definitive finding for damage to the **cochlea** or **auditory nerve** (SNHL).*Sensorineural hearing loss in left ear*- If SNHL was present in the left ear, the **Weber test** would lateralize to the *right ear* (the better ear), contradicting the finding of lateralization to the left.- The Rinne test is **positive** in the left ear (AC > BC), and BC is similar to normal, confirming that the left ear is functioning normally or has only mild SNHL.*Conductive hearing loss in left ear*- A **positive Rinne test** in the left ear (AC > BC) essentially rules out significant **conductive hearing loss (CHL)** in that ear, as CHL results in a negative Rinne test (BC > AC).- While Weber lateralization to the left is consistent with CHL in the left ear, the simultaneous positive Rinne test and normal BC assessment contradict this diagnosis.*Conductive hearing loss in right ear.*- Although the **Rinne test is negative** in the right ear (BC > AC), suggesting CHL, the **Weber test lateralizes to the left**; Weber lateralizes to the *affected* ear only in CHL.- Furthermore, **Bone Conduction is reduced** in the right ear, which is inconsistent with simple CHL, where BC is expected to be normal (or elevated due to masking).
Obstetrics and Gynecology
1 questionsWhich of the following drugs is not given for hypertension in pregnancy?
FMGE 2025 - Obstetrics and Gynecology FMGE Practice Questions and MCQs
Question 91: Which of the following drugs is not given for hypertension in pregnancy?
- A. Enalapril (Correct Answer)
- B. Nifedipine
- C. Methyldopa
- D. Labetalol
Explanation: ***Correct: Enalapril*** - **Enalapril** is an **Angiotensin-Converting Enzyme (ACE) inhibitor** which is strictly **contraindicated** throughout pregnancy, particularly during the second and third trimesters - The use of ACE inhibitors is associated with severe **fetal renal dysfunction**, resulting in **oligohydramnios**, **pulmonary hypoplasia**, and **fetal death** - ACE inhibitors are **NOT given** for hypertension in pregnancy due to these serious teratogenic effects *Incorrect: Methyldopa* - **Methyldopa**, a centrally acting **alpha-2 agonist**, is historically considered the first-line and safest drug for treating chronic hypertension during pregnancy - Its extensive use has demonstrated a favorable long-term safety profile for the development of the child - It operates by reducing **sympathetic outflow** from the central nervous system, thereby lowering peripheral vascular resistance *Incorrect: Labetalol* - **Labetalol** is a combined **alpha-1 and non-selective beta-blocker** and is a primary first-line choice for treating both chronic and **acute severe hypertension** in pregnant women - It is rapidly effective and safe, maintaining adequate **placental perfusion** - It exerts its antihypertensive effects by acting as a competitive antagonist at both adrenergic receptors *Incorrect: Nifedipine* - **Nifedipine** is a **dihydropyridine calcium channel blocker** frequently used for managing chronic hypertension and treating acute severe hypertension or **preeclampsia** in pregnancy - It is generally considered safe and effective - Its most common use is often an alternative first-line agent to Labetalol or for the management of hypertensive crises via its extended-release formulation
Pathology
1 questionsA male presents with a history of vestibular schwannoma and psammoma bodies in the brain. Which of the following is the most likely diagnosis?
FMGE 2025 - Pathology FMGE Practice Questions and MCQs
Question 91: A male presents with a history of vestibular schwannoma and psammoma bodies in the brain. Which of the following is the most likely diagnosis?
- A. Oligodendroglioma
- B. Pilocytic astrocytoma
- C. Meningioma (Correct Answer)
- D. GBM (Glioblastoma Multiforme)
Explanation: Correct: Meningioma - The presence of **psammoma bodies** (calcified, laminated, concentric whorls) is a classic histological feature highly characteristic of meningiomas, particularly the meningothelial and transitional subtypes [1], [2]. - The association with a vestibular schwannoma (especially if bilateral) strongly suggests **Neurofibromatosis Type 2 (NF2)**, where patients frequently develop multiple meningiomas alongside bilateral vestibular schwannomas [1]. - This combination of findings makes meningioma the most likely diagnosis. *Incorrect: GBM (Glioblastoma Multiforme)* - This is a highly aggressive, grade IV astrocytoma characterized histologically by pseudopalisading necrosis and microvascular proliferation [3]. - GBM typically occurs in older adults and is not characterized by psammoma bodies or a direct association with vestibular schwannomas observed in NF2 [3], [4]. *Incorrect: Pilocytic astrocytoma* - This is generally a low-grade (Grade I) tumor, prominent in children and young adults, often presenting in the cerebellum [4]. - Histological hallmarks include the presence of Rosenthal fibers (thick, eosinophilic corkscrew fibers) and bipolar cells, distinct from psammoma bodies. *Incorrect: Oligodendroglioma* - Histologically, these tumors are known for calcification and a characteristic 'fried-egg' appearance (round nuclei with clear perinuclear halos) and delicate branching capillaries. - While they can calcify, their characteristic histology does not include psammoma bodies, and they are not typically linked to NF2 or vestibular schwannomas. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Manifestations Of Central And Peripheral Nervous System Disease, pp. 727-728. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Central Nervous System, pp. 1316-1317. [3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Central Nervous System, p. 1310. [4] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Central Nervous System, pp. 1319-1320.
Pediatrics
2 questionsA child presents with telecanthus, hypertelorism, antimongoloid slant, and cardiac defects. What is the most likely chromosomal abnormality?
Which of the following represents the most severe form of neural tube defect where neural tissue is completely exposed without overlying skin, vertebral arches, or meninges?
FMGE 2025 - Pediatrics FMGE Practice Questions and MCQs
Question 91: A child presents with telecanthus, hypertelorism, antimongoloid slant, and cardiac defects. What is the most likely chromosomal abnormality?
- A. Microdeletion (Correct Answer)
- B. Inversion
- C. Translocation
- D. Trisomy
Explanation: ***Microdeletion***- The combination of craniofacial irregularities like **telecanthus** and **hypertelorism**, along with congenital **cardiac defects** (often conotruncal like **Tetralogy of Fallot**), is the classical presentation of the **22q11.2 deletion syndrome** (DiGeorge syndrome or VCFS).- A **microdeletion** is the loss of a small, contiguous segment of a chromosome, identifiable via **Fluorescence In Situ Hybridization (FISH)** or chromosomal microarray, which is the underlying cause of this syndrome.*Translocation*- **Translocations** (exchange of genetic material between non-homologous chromosomes) are typically associated with large structural rearrangements or specific syndromes like **familial Down syndrome**, not the specific phenotype described here.- These features are characteristic of a small, defined contiguous gene deletion syndrome, which is not the primary consequence of a standard **translocation**.*Inversion*- An **inversion** is the reversal of a segment within a chromosome; while pathogenic if breakpoints disrupt critical genes, it is not the primary chromosomal mechanism responsible for the **22q11.2 deletion syndrome**.- Most inversions are **balanced rearrangements** and often have no phenotypic consequence unless gene expression is significantly altered.*Trisomy*- **Trisomy** refers to an extra whole copy of a chromosome (e.g., Trisomy 13, 18, 21), and the resulting syndromes have unique and different facial features (e.g., **Trisomy 21** classically presents with upslanting palpebral fissures).- While trisomies cause significant cardiac defects, the specific constellation of **telecanthus** and **antimongoloid slant** helps differentiate this from common trisomy syndromes.
Question 92: Which of the following represents the most severe form of neural tube defect where neural tissue is completely exposed without overlying skin, vertebral arches, or meninges?
- A. Meningocele
- B. Spina bifida
- C. Open Neural tube defect (Correct Answer)
- D. Myelomeningocele
Explanation: ***Open Neural tube defect*** - The image displays a severe congenital anomaly where the neural tube has failed to close, leaving the neural tissue completely exposed. This specific presentation is consistent with **rachischisis**, the most severe form of spina bifida. - Characteristic features visible are the complete absence of overlying skin, vertebral arches, and meninges, exposing the flattened, malformed spinal cord (neural placode) along the entire spine. *Meningocele* - A **meningocele** is a less severe defect where a sac containing only meninges and cerebrospinal fluid protrudes through an opening in the spine; the spinal cord itself is not displaced. - This is incorrect as the image clearly shows exposed **neural tissue**, which is not a feature of a simple meningocele. *Spina bifida* - **Spina bifida** is a broad term for a range of defects involving incomplete closure of the spine. It includes mild forms like **spina bifida occulta** and severe forms like myelomeningocele, which are typically localized. - The defect in the image is far more extensive than a typical localized spina bifida, affecting a large portion or the entire spine, making it a severe type of open neural tube defect known as rachischisis. *Myelomeningocele* - In a **myelomeningocele**, both the meninges and the spinal cord protrude through the defect, typically forming a sac on the infant's back. - The image does not show a contained sac but rather a completely open, flattened neural plate, which is characteristic of **rachischisis**, a more severe condition than a typical myelomeningocele.