FMGE 2017 Practice Questions

Q: Which of the following is TRUE about bronchopulmonary segments?

Pulmonary veins are intersegmental. Detailed knowledge of lung anatomy is essential for thoracic surgery. ***Pulmonary veins are intersegmental*** - The **pulmonary veins** run in the connective tissue septa **between** the bronchopulmonary segments, making them **intersegmental** [1]. - This anatomical arrangement allows surgeons to ligate the veins without affecting adjacent segments during a segmentectomy. *Spherical in shape* - Bronchopulmonary segments are typically **pyramid-shaped** or cone-shaped, with their apices directed towards the hilum [1]. - Their irregular, wedge-like structure allows them to fit together within the lung. *Artery is intersegmental* - The **bronchial arteries** and **pulmonary arteries** are **intrasegmental**, meaning they run **within** the bronchopulmonary segment alongside the bronchi. - Each segment has its own arterial supply, allowing for independent blood flow. *Non resectable* - Bronchopulmonary segments are considered **functionally and surgically independent units**, making them **resectable** [1]. - This allows for the removal of diseased segments while preserving healthy lung tissue, such as in cases of **lung cancer** or localized infection.

Q: Left anterior descending artery is a direct branch of

Left coronary artery. ***Left coronary artery*** - The left coronary artery (LCA) is a major coronary artery that arises from the **aorta** and quickly branches into two main arteries: the **left anterior descending (LAD) artery** [1] and the circumflex artery. - The LAD artery, also known as the **"widowmaker"**, supplies oxygenated blood to the **anterior wall of the left ventricle** and the interventricular septum, making it crucial for heart function. *Right coronary artery* - The **right coronary artery (RCA)** typically supplies the **right atrium**, most of the **right ventricle**, and the inferior wall of the left ventricle, which are distinct areas from the LAD's supply. - The RCA originates from the **right sinus of Valsalva** and travels in the atrioventricular groove, while the LAD originates from the left main coronary artery [1]. *Circumflex artery* - The circumflex artery is another main branch of the **left coronary artery**, typically supplying the **lateral and posterior walls of the left ventricle** and the left atrium. - While it branches from the same parent vessel as the LAD, it is a direct branch itself, not the origin of the LAD [1]. *Ascending aorta* - The ascending aorta is the initial part of the aorta that originates from the **left ventricle** and gives rise to the **coronary arteries** (both left and right coronary arteries). - It is the source from which the **left coronary artery** (and thus the LAD indirectly) originates, but it is not a direct branch itself.

Q: All of the following syndromes are seen with obesity except:

Carcinoid syndrome. ***Carcinoid syndrome*** - Carcinoid syndrome is caused by **neuroendocrine tumors** that secrete **serotonin** and other vasoactive substances, leading to symptoms like flushing, diarrhea, and bronchospasm [2]. **Obesity is not a primary feature** of this syndrome. - The symptoms are directly related to the **hormonal effects** of the secreted substances, not to metabolic alterations associated with obesity. *Laurence Moon - Biedl syndrome* - This is a **rare genetic disorder** characterized by **obesity**, retinitis pigmentosa, polydactyly, intellectual disability, and hypogonadism [1]. - Obesity is a **consistent and prominent feature** of this syndrome, often present from childhood. *Cohen syndrome* - Cohen syndrome is a rare genetic disorder characterized by **obesity** (especially truncal obesity), intellectual disability, microcephaly, characteristic facial features, and hypotonia. - While not as universally severe as in some other syndromes, **obesity is a common clinical feature** of Cohen syndrome. *Prader - Willi syndrome* - Prader-Willi syndrome is a genetic disorder caused by a deletion on chromosome 15, leading to **insatiable hunger (hyperphagia)** and chronic overeating, which results in **severe obesity** [1]. - **Obesity is a cardinal feature** of this syndrome, developing in early childhood due to hypothalamic dysfunction affecting appetite control.

Q: Which of the following is anaerobic non-acid fast bacilli:

Actinomyces. ***Actinomyces*** - *Actinomyces* species are **obligate anaerobes** to **facultative anaerobes** that appear as **Gram-positive, non-acid-fast, filamentous rods** (bacilli). - They are classically described as **anaerobic bacteria** and are the prototypical example of anaerobic non-acid-fast bacilli. - They cause chronic infections (actinomycosis) often involving abscess formation with sulfur granules and sinus tracts. *Mycobacterium tuberculosis* - *Mycobacterium tuberculosis* is an **obligate aerobe**, not anaerobic. - It is characterized by its **acid-fastness** due to high mycolic acid content in its cell wall. - Requires oxygen for growth and is the causative agent of tuberculosis. *Listeria* - *Listeria monocytogenes* is a **facultative anaerobe**, meaning it preferentially grows in **aerobic conditions** but can survive anaerobically. - While it is a non-acid-fast Gram-positive bacillus, it is **not classified as an anaerobic organism** in standard microbiology terminology. - *Actinomyces* is the classic answer for anaerobic non-acid-fast bacilli. *Nocardia* - *Nocardia* species are **strict aerobes**, not anaerobic. - They are **weakly acid-fast** filamentous bacteria, distinguishing them from the non-acid-fast *Actinomyces*. - Require oxygen for growth and are found in soil.

Q: Vertical transmission of resistance to ciprofloxacin occurs :-

Mutation. ***Mutation*** - Vertical transmission of resistance occurs when a bacterium with a **resistance gene**, such as one conferring resistance to **ciprofloxacin**, replicates and passes that gene to its progeny. - This typically happens through **spontaneous mutations** in the bacterial genome that alter the drug's target or uptake, and these mutations are then inherited by subsequent generations. *Transduction* - **Transduction** involves the transfer of genetic material, including resistance genes, via **bacteriophages** (viruses that infect bacteria). - This is a **horizontal gene transfer** mechanism, not a vertical one. *Conjugation* - **Conjugation** is the direct transfer of genetic material, often in the form of **plasmids**, from one bacterium to another through direct cell-to-cell contact. - This is a form of **horizontal gene transfer**, not vertical transmission. *Transformation* - **Transformation** is the uptake of **free DNA** from the environment by a bacterium, which can then integrate this DNA into its own genome. - This mechanism is also a type of **horizontal gene transfer**, not vertical transmission of resistance to daughter cells during replication.

Q: Most common uterine tumor is:-

Leiomyoma. ***Leiomyoma*** - **Leiomyomas**, also known as **fibroids**, are the most **common benign tumors of the uterus**. - They are composed of **smooth muscle cells** and can vary in size and location within the uterus. *Adenomyoma* - An **adenomyoma** is a benign uterine tumor characterized by the presence of **endometrial glands and stroma** within the myometrium. - While it is a uterine tumor, it is significantly **less common** than leiomyomas. *Endometrial cancer* - **Endometrial cancer** is a **malignant tumor** arising from the endometrium and is the most common gynecologic malignancy. - However, malignant tumors are generally **less common** than benign tumors like leiomyomas. *Leiomyosarcoma* - **Leiomyosarcoma** is a **rare and aggressive malignant tumor** of the smooth muscle tissue of the uterus. - It accounts for a very small percentage of uterine masses and is much less common than benign leiomyomas.

Q: Rolling of leucocytes on endothelial cells is mediated by which of the following proteins?

Selectins. **Selectins** - **Selectins** mediate the initial, weak and transient adhesion of **leukocytes** to the **endothelial cells** lining blood vessels [1]. - This interaction slows down the leukocytes, causing them to **roll** along the vascular endothelium as a prerequisite for **extravasation** [1]. *Integrins* - **Integrins** are responsible for the **firm adhesion** of leukocytes to endothelial cells, but not the rolling [1]. - They bind to **ICAM-1 (intercellular adhesion molecule-1)** on endothelial cells, leading to stable arrest of the leukocyte [1]. *PECAM-1* - **PECAM-1 (Platelet Endothelial Cell Adhesion Molecule-1)** plays a role in **diapedesis** or **transmigration**, the movement of leukocytes *through* the endothelial cell junctions [1]. - It facilitates the passage of the leukocyte by interacting with PECAM-1 on the endothelial cells, but does not mediate rolling [1]. *Transferrin* - **Transferrin** is an iron-binding protein found in blood plasma that regulates free **iron levels** in the body. - It is crucial for **iron transport** and metabolic processes but has no direct role in leukocyte adhesion or rolling on endothelial cells. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Inflammation and Repair, pp. 87-89.

Q: Empirical drug of choice for treatment of meningococcal meningitis is:-

Ceftriaxone. ***Ceftriaxone*** - As a **third-generation cephalosporin**, **Ceftriaxone** provides excellent coverage against common bacterial causes of meningitis, including *Neisseria meningitidis*. - It achieves high concentrations in the **cerebrospinal fluid (CSF)**, making it highly effective for CNS infections. *Cefotetan* - **Cefotetan** is a **second-generation cephalosporin** that has limited CSF penetration and less reliable coverage against common meningitis pathogens. - While it has activity against some gram-negative bacteria, it is not considered a first-line agent for empirical treatment of meningitis. *Cefoxitin* - **Cefoxitin** is also a **second-generation cephalosporin** with limited ability to cross the blood-brain barrier, making it unsuitable for treating meningitis. - Its spectrum of activity is more focused on anaerobic bacteria and some gram-negative organisms, not typically the main culprits in meningitis. *Gentamicin* - **Gentamicin** is an **aminoglycoside antibiotic** that has poor penetration into the CSF and is less effective as a monotherapy for meningitis. - It is often used in combination with other antibiotics, but not as an empirical monotherapy for suspected meningococcal meningitis.

Q: Which of the following ion plays a role in exocytosis?

Calcium. ***Calcium*** - **Calcium ions** are crucial for initiating the fusion of **secretory vesicles** with the plasma membrane during **exocytosis**. - An increase in intracellular calcium concentration, often due to an influx from outside the cell, triggers the release of neurotransmitters, hormones, and other substances. *Potassium* - **Potassium ions** are primarily involved in maintaining the **resting membrane potential** and repolarization during action potentials. - While essential for neuronal function, they do not directly trigger the **vesicle fusion** step of exocytosis. *Sodium* - **Sodium ions** are vital for depolarizing the membrane and initiating **action potentials**, as well as for certain co-transport mechanisms. - However, they do not directly bind to proteins involved in **exocytosis** to trigger the release mechanism. *Magnesium* - **Magnesium ions** serve as **cofactors** for many enzymes, including ATPases, and play a role in stabilizing nucleic acids and proteins. - While important for overall cellular function, magnesium does not directly initiate or regulate the **fusion events** of exocytosis.

Q: Prosopagnosia is:

Inability to recognize face. ***Inability to recognize face*** - **Prosopagnosia**, or **face blindness**, is a cognitive disorder characterized by an impaired ability to recognize familiar faces, including one's own. - This condition is often associated with damage to the **fusiform face area** in the brain, typically in the right hemisphere. *Inability to read* - The inability to read is known as **alexia** or **dyslexia**, which is distinct from the visual recognition deficit seen in prosopagnosia. - Alexia primarily involves difficulties with processing written language, not the visual recognition of faces. *Anosmia* - **Anosmia** refers to the complete or partial loss of the sense of smell and is a disorder affecting the olfactory system. - It is unrelated to visual processing or face recognition. *Inability to write* - The inability to write is termed **agraphia** or **dysgraphia**, a neurological condition that impairs writing ability. - This condition affects motor skills and language processing related to writing, not visual face recognition.

Question 1

Which of the following is TRUE about bronchopulmonary segments?

Accepted Answer

Pulmonary veins are intersegmental

Answer

Spherical in shape

Answer

Artery is intersegmental

Answer

Non resectable

Question 2

Left anterior descending artery is a direct branch of

Accepted Answer

Left coronary artery

Answer

Right coronary artery

Answer

Circumflex artery

Answer

Ascending aorta

Question 3

All of the following syndromes are seen with obesity except:

Accepted Answer

Carcinoid syndrome

Answer

Laurence Moon - Biedl syndrome

Answer

Cohen syndrome

Answer

Prader - Willi syndrome

Question 4

Which of the following is anaerobic non-acid fast bacilli:

Accepted Answer

Actinomyces

Answer

Mycobacterium tuberculosis

Answer

Listeria

Answer

Nocardia

Question 5

Vertical transmission of resistance to ciprofloxacin occurs :-

Accepted Answer

Mutation

Answer

Transduction

Answer

Conjugation

Answer

Transformation

Question 6

Most common uterine tumor is:-

Accepted Answer

Leiomyoma

Answer

Adenomyoma

Answer

Endometrial cancer

Answer

Leiomyosarcoma

Question 7

Rolling of leucocytes on endothelial cells is mediated by which of the following proteins?

Accepted Answer

Selectins

Answer

Integrins

Answer

Transferrin

Answer

PECAM-1

Question 8

Empirical drug of choice for treatment of meningococcal meningitis is:-

Accepted Answer

Ceftriaxone

Answer

Cefotetan

Answer

Cefoxitin

Answer

Gentamicin

Question 9

Which of the following ion plays a role in exocytosis?

Accepted Answer

Calcium

Answer

Potassium

Answer

Sodium

Answer

Magnesium

Question 10

Prosopagnosia is:

Accepted Answer

Inability to recognize face

Answer

Inability to read

Answer

Anosmia

Answer

Inability to write

FMGE 2017

Anatomy

Internal Medicine

Microbiology

Obstetrics and Gynecology

Pathology

Pharmacology

Physiology

Psychiatry