FMGE 2018 Practice Questions

Q: Which of the following is a method for on-site disposal of domestic wastewater?

Soakage pit. ***Soakage pit*** - A **soakage pit**, also known as a **seepage pit** or **leach pit**, is an underground chamber that allows treated effluent from a septic tank to seep into the surrounding soil. - It is a common and effective on-site method for the **disposal of domestic wastewater**, particularly in rural or unsewered areas. *Activated sludge process* - The **activated sludge process** is a centralized biological wastewater treatment method used in municipal wastewater treatment plants, not typically for on-site domestic disposal. - It involves aerating wastewater in a tank with suspended microorganisms to consume organic pollutants. *Oxidation pond* - An **oxidation pond**, or **stabilization pond**, is a large, shallow basin where wastewater is treated through natural biological and physical processes. - While it treats wastewater, it is typically a **larger-scale** treatment method for communities or industries, rather than a standalone on-site disposal method for individual domestic units. *All of the options* - This option is incorrect because both the activated sludge process and oxidation ponds are generally larger-scale or centralized treatment methods, not practical for individual on-site domestic disposal. - Only the soakage pit is well-suited for **on-site domestic wastewater disposal**.

Q: Disease usually not seen in a country but brought from abroad is:

Exotic. ***Exotic*** - An **exotic disease** refers to a disease that is not native or usually found in a particular country or region but is introduced from abroad. - This term highlights its **foreign origin** and rarity within the local population. *Endemic* - An **endemic disease** is one that is constantly present in a population or region with a relatively stable prevalence within that population. - It describes a disease that is **native** to a specific area, not typically brought from abroad. *Epidemic* - An **epidemic** signifies a sudden increase in the number of cases of a disease in a population over a particular period, substantially exceeding what is normally expected. - While it can be introduced from abroad, the definition focuses on the **rapid spread** rather than the origin itself. *Zoonotic* - A **zoonotic disease** is an infectious disease that has jumped from an animal to humans. - This term describes the **mode of transmission** from animals, not necessarily its geographic origin or whether it's new to a country.

Q: Which pattern of inheritance of disease is associated with consanguinity?

Autosomal recessive. ***Autosomal recessive*** - Consanguineous relationships increase the likelihood of offspring inheriting **two copies of a rare deleterious recessive allele**, one from each parent [1]. - This occurs because relatives share a greater proportion of their genes, making it more probable that both parents are **heterozygous carriers** for the same recessive disorder. *Autosomal dominant* - In autosomal dominant disorders, only **one copy of the altered gene** is needed to cause the disease, so expression is not typically influenced by consanguinity. - These conditions often manifest in every generation and are not more prevalent with increased shared genetic material. *X-linked recessive* - X-linked recessive disorders primarily affect males, as they only have one X chromosome, and are transmitted by carrier females. - While consanguinity can theoretically increase the carrier rate within a population, its direct impact on the inheritance pattern of an X-linked trait in a single family is less pronounced compared to autosomal recessive conditions. *X-linked dominant* - X-linked dominant disorders are expressed in heterozygous females and hemizygous males, with affected males often having more severe disease. - The inheritance pattern is not significantly influenced by consanguinity, as only one copy of the affected gene on the X chromosome is sufficient for disease manifestation.

Q: Commonest neurological tumour associated with NF-2:-

Acoustic neuroma. ***Acoustic neuroma*** - **Bilateral acoustic neuromas** (vestibular schwannomas) are the hallmark of **Neurofibromatosis type 2 (NF2)**, virtually diagnostic for the condition [1]. - These tumors arise from the **vestibulocochlear nerve (cranial nerve VIII)** and commonly cause hearing loss and balance problems [1]. *Optic glioma* - **Optic gliomas** are more characteristic of **Neurofibromatosis type 1 (NF1)**, not NF2. - While they can occur in NF2, they are not the most common or diagnostic feature. *Spinal schwannoma* - Spinal schwannomas can occur in NF2, but they are not the *most common* or *defining* neurological tumor associated with the condition. - The presence of multiple schwannomas, especially spinal, is a feature, but **bilateral acoustic neuromas** take precedence for diagnosis. *Meningioma* - Multiple **meningiomas** occur in a significant proportion of NF2 patients, making them common, but they are still secondary to **bilateral acoustic neuromas** in terms of diagnostic significance and prevalence as the *primary* neurological tumor. - These are tumors of the **meninges**, the protective layers surrounding the brain and spinal cord.

Q: Continuous murmur is heard in?

Patent ductus arteriosus. ***Patent ductus arteriosus*** - A **continuous murmur** in PDA is often described as a **"machinery-like" murmur**, audible throughout systole and diastole [1]. - This murmur is caused by the continuous flow of blood from the higher-pressure aorta into the lower-pressure pulmonary artery [1]. *Tetralogy of Fallot* - The murmur associated with Tetralogy of Fallot is typically a **systolic ejection murmur** heard at the upper left sternal border [1]. - This murmur is due to pulmonary stenosis and is not continuous, as it is related to ventricular ejection [1]. *Ventricular septal defect* - A VSD typically presents with a **holosystolic murmur**, meaning it is heard throughout systole [1]. - The murmur in VSD is confined to systole and does not extend into diastole, distinguishing it from a continuous murmur [1]. *Atrial septal defect* - An ASD is typically associated with a **systolic ejection murmur** over the pulmonic area due to increased flow across the pulmonary valve [1]. - There may also be a **diastolic rumble** across the tricuspid valve, but neither of these is a continuous murmur [1].

Q: Otomycosis is most commonly caused by:

Aspergillus fumigatus. ***Aspergillus fumigatus*** - **Aspergillus species**, particularly *A. fumigatus* and *A. niger*, are the most frequent causes of **otomycosis**, accounting for 80-90% of cases. - They thrive in damp, warm environments, making the external auditory canal an ideal site for their growth, often presenting with a **black or grayish fungal debris**. *Mucor* - **Mucor** is a less common cause of otomycosis and is more often associated with **rhinocerebral mucormycosis** in immunocompromised individuals. - While it can cause opportunistic infections, its prevalence in otomycosis is significantly lower compared to Aspergillus. *Actinomycetes* - **Actinomycetes** are **filamentous bacteria**, not fungi, and are typically associated with **actinomycosis**, a chronic suppurative infection. - They are known to cause infections in the head and neck, but not typically otomycosis, which is a fungal infection of the ear. *Candida albicans* - **Candida albicans** is the second most common cause of otomycosis, but it is less prevalent than Aspergillus species. - Infections by Candida tend to be more common in individuals with a history of **antibiotic use** or in **immunocompromised patients**, and often present with a *creamy white discharge*.

Q: Patient had an injury to thumb causing thumb abduction. Which of the following can happen?

Game keepers thumb. ***Gamekeeper's thumb*** - A **Gamekeeper's thumb**, or **skier's thumb**, is an injury to the **ulnar collateral ligament (UCL)** of the thumb's metacarpophalangeal (MCP) joint. - This injury commonly occurs due to a **forceful abduction** and hyperextension of the thumb. *Kaplan lesion* - A **Kaplan lesion** refers to an avulsion fracture of the radial styloid process, usually associated with scaphoid fractures. - This lesion is typically related to wrist injuries, not primarily thumb abduction. *Bennett fracture* - A **Bennett fracture** is an intra-articular fracture at the base of the first metacarpal bone. - It usually results from an axial load applied to a partially flexed thumb, rather than pure abduction. *Mallet finger* - A **mallet finger** is an injury to the **extensor tendon** of the finger, causing the fingertip to remain in a flexed position. - This injury typically affects the distal interphalangeal (DIP) joint of any finger and is not directly related to thumb abduction.

Q: Pheochromocytoma produces all except?

Secretin. Secretin - **Secretin** is a hormone primarily produced by **S cells in the duodenum and jejunum** [3] in response to acidic chyme, stimulating pancreatic bicarbonate secretion. - Pheochromocytomas originate from **chromaffin cells** of the adrenal medulla and are known for producing catecholamines [2], not secretin. *Vasoactive intestinal polypeptide* - **Vasoactive intestinal polypeptide (VIP)** can be produced by some **neuroendocrine tumors** [1], including pheochromocytomas, though it's more commonly associated with VIPomas. - VIP acts as a **vasodilator** and can contribute to symptoms like flushing and diarrhea in rare cases of VIP-producing pheochromocytomas. *Calcitonin* - While calcitonin is primarily associated with **medullary thyroid carcinoma**, it can rarely be produced ectopically by **neuroendocrine tumors**, including some pheochromocytomas. - This ectopic production is part of the broader concept of **paraneoplastic syndromes** seen in various malignancies. *Norepinephrine* - **Norepinephrine** is a major catecholamine produced by pheochromocytomas, leading to classic symptoms such as **hypertension, palpitations, and sweating** [2]. - The tumor cells (chromaffin cells) are specialized to synthesize and release **catecholamines**, including norepinephrine and epinephrine [2].

Q: The drug that causes fall in elderly patients with postural hypotension is:-

Prazosin. ***Prazosin*** - **Alpha-1 adrenergic blocker** used to treat hypertension and benign prostatic hyperplasia (BPH) - Commonly causes **orthostatic hypotension (postural hypotension)** as a side effect by blocking alpha-1 receptors on vascular smooth muscle, preventing compensatory vasoconstriction upon standing - Leads to **dizziness, lightheadedness, and falls**, especially in elderly patients who have reduced baroreceptor sensitivity - **First-dose phenomenon** is particularly notable, with marked hypotension after the initial dose *Acarbose* - Alpha-glucosidase inhibitor used to treat type 2 diabetes by reducing carbohydrate absorption in the intestine - Primary side effects are **gastrointestinal** (flatulence, diarrhea, abdominal discomfort) - Does not affect blood pressure or cause postural hypotension *Nor-adrenaline (Norepinephrine)* - **Vasopressor** and sympathomimetic agent that causes vasoconstriction through alpha-adrenergic receptor stimulation - **Increases blood pressure** and is used to treat severe hypotension in critical care settings - Would not cause falls due to postural hypotension; rather, it counteracts hypotension *Metformin* - **Biguanide** oral hypoglycemic agent for type 2 diabetes that primarily decreases hepatic glucose production and increases insulin sensitivity - Main side effects include gastrointestinal disturbances and rare lactic acidosis - Not associated with postural hypotension or increased risk of falls

Q: In which of the following conditions there is an increase in lung diffusion capacity?

Alveolar haemorrhage. ***Alveolar haemorrhage*** - The presence of **red blood cells within the alveoli** provides an additional source of **hemoglobin**, which can bind to carbon monoxide (CO) and therefore **increase the measured CO diffusion capacity (DLCO)**. - This is often seen in conditions like **Goodpasture's syndrome** or **pulmonary capillaritis**. *Pulmonary oedema* - Characterized by an **accumulation of fluid in the interstitial and alveolar spaces**, which **increases the diffusion barrier** for gases. - This fluid buildup **impairs gas exchange**, leading to a **decrease in DLCO**. *Idiopathic pulmonary fibrosis* - This condition involves **thickening and scarring of the alveolar-capillary membrane**, which significantly **increases the diffusion distance** for gases. - The resultant **fibrosis and destruction of capillaries** lead to a **marked decrease in DLCO**. *Emphysema* - Emphysema causes **destruction of alveolar walls** and the **pulmonary capillary bed**, leading to a **reduction in the surface area available for gas exchange**. - This loss of functional alveolar-capillary units results in a **decreased DLCO**.

Question 1

Which of the following is a method for on-site disposal of domestic wastewater?

Accepted Answer

Soakage pit

Answer

Activated sludge process

Answer

Oxidation pond

Answer

All of the options

Question 2

Disease usually not seen in a country but brought from abroad is:

Accepted Answer

Exotic

Answer

Endemic

Answer

Epidemic

Answer

Zoonotic

Question 3

Which pattern of inheritance of disease is associated with consanguinity?

Accepted Answer

Autosomal recessive

Answer

Autosomal dominant

Answer

X linked recessive

Answer

X linked dominant

Question 4

Commonest neurological tumour associated with NF-2:-

Accepted Answer

Acoustic neuroma

Answer

Optic glioma

Answer

Meningioma

Answer

Spinal schwannoma

Question 5

Continuous murmur is heard in?

Accepted Answer

Patent ductus arteriosus

Answer

Tetralogy of fallot

Answer

Ventricular septal defect

Answer

Atrial septal defect

Question 6

Otomycosis is most commonly caused by:

Accepted Answer

Aspergillus fumigatus

Answer

Mucor

Answer

Actinomycetes

Answer

Candida albicans

Question 7

Patient had an injury to thumb causing thumb abduction. Which of the following can happen?

Accepted Answer

Game keepers thumb

Answer

Kaplan lesion

Answer

Mallet finger

Answer

Bennett fracture

Question 8

Pheochromocytoma produces all except?

Accepted Answer

Secretin

Answer

Vasoactive intestinal polypeptide

Answer

Norepinephrine

Answer

Calcitonin

Question 9

The drug that causes fall in elderly patients with postural hypotension is:-

Accepted Answer

Prazosin

Answer

Acarbose

Answer

Nor-adrenaline

Answer

Metformin

Question 10

In which of the following conditions there is an increase in lung diffusion capacity?

Accepted Answer

Alveolar haemorrhage

Answer

Pulmonary oedema

Answer

Idiopathic pulmonary fibrosis

Answer

Emphysema

FMGE 2018

Community Medicine

Internal Medicine

Microbiology

Orthopaedics

Pathology

Pharmacology

Physiology