FMGE 2018 Practice Questions

Q: Secondary ossification centre appears before birth at

Lower end of femur. Lower end of femur - The distal femur is one of the very few secondary ossification centers that appears before birth, specifically during the 9th month of gestation. - Its presence is an important indicator of fetal maturity and can be seen on prenatal imaging. Upper end of femur - The proximal femoral epiphysis typically develops its secondary ossification center after birth, usually between 3-6 months of age. - This timing is considerably later than the distal femur. Lower end of tibia - The secondary ossification center for the distal tibia appears after birth, generally around 1-2 years of age. - This is a common timeline for many secondary ossification centers. Lower end of fibula - The secondary ossification center for the distal fibula also appears after birth, typically between 6 months and 1 year of age. - This timing is later than the distal femur but earlier than the distal tibia.

Q: Western blot is done for:

Protein. ***Protein*** - **Western blot** is a laboratory technique used to detect specific **proteins** in a sample of tissue homogenate or extract. - It involves separating proteins by **electrophoresis**, transferring them to a membrane, and then detecting them using **antibodies**. *RNA* - **Northern blot** is the technique specifically designed for the detection and analysis of **RNA** molecules. - It involves separating RNA fragments by **electrophoresis**, transferring them to a membrane, and querying with a labeled probe. *Lipid* - There is no direct "lipid blot" technique analogous to Western, Northern, or Southern blots. - **Lipids** are typically analyzed using techniques such as mass spectrometry, thin-layer chromatography, or gas chromatography. *DNA* - **Southern blot** is the molecular biology method used for the detection of specific **DNA** sequences in DNA samples. - It involves fragmenting DNA, separating by **electrophoresis**, and then hybridizing with a labeled DNA probe.

Q: Oliguria is defined as:-

Less than 400 ml of urine excreted in a day. ***Less than 400 ml of urine excreted in a day*** - Oliguria is clinically defined as **urine production** of less than **400-500 mL per 24 hours** in adults. - This reduction in urine output is often a critical sign of acute kidney injury or other underlying medical conditions impacting **renal function**. *More than 900 ml of urine excreted in a day* - This volume is within the normal range of **daily urine output** for an adult, which is typically between **800 mL and 2000 mL**. - It does not represent oliguria, which indicates a significantly **decreased urine production**. *Absence of urine production* - The complete absence of urine production is known as **anuria**, which is a more severe condition than oliguria. - Anuria is typically defined as less than **50 mL of urine per 24 hours**. *600 ml to 700 ml of urine excreted in a day* - While this volume is below the typical average, it does not meet the strict clinical definition of oliguria, which is typically set at **less than 400-500 mL/day**. - This range might be considered **borderline decreased** but is not severe enough to be classified as oliguric by most standards.

Q: All are true about Allergic Bronchopulmonary Aspergillosis (ABPA) except?

Distal bronchiectasis. ***Distal bronchiectasis*** - This statement is incorrect as ABPA typically causes **central bronchiectasis**, affecting the proximal airways. - The inflammatory response to *Aspergillus* in ABPA mainly targets larger airways, leading to their dilation. *Serum precipitins to Aspergillus* - The presence of **serum precipitins** (IgG antibodies) against *Aspergillus* antigens is a major diagnostic criterion for ABPA. - This indicates a significant immune response to the fungus, which is characteristic of the disease. *Increased IgE Levels* - **Elevated serum total IgE levels** are a hallmark of ABPA, reflecting the allergic hypersensitivity reaction [1]. - This is a key diagnostic criterion, with levels often exceeding 1000 IU/mL. *Seen in asthmatics* - ABPA is predominantly seen in patients with **asthma** (and less commonly, cystic fibrosis), as an exacerbation or complication [1]. - The fungus *Aspergillus* colonizes the airways, triggering an allergic inflammatory response in susceptible individuals.

Q: Most common cause of bacterial meningitis in post-neonatal period:

Streptococcus pneumoniae. ***Streptococcus pneumoniae*** - *S. pneumoniae* is the most common cause of **bacterial meningitis** in the post-neonatal period (1 month to 1 year of age), particularly in regions with high vaccination rates against Hib. - Its polysaccharide capsule and ability to evade the immune system contribute to its virulence in causing **central nervous system infections**. - Accounts for approximately 40-50% of bacterial meningitis cases in this age group. *Mycobacterium tuberculosis* - While it can cause **tuberculous meningitis**, this is a less common form of meningitis, typically with a more **insidious onset** and often associated with immunosuppression or endemic areas. - Represents a chronic form of meningitis rather than acute bacterial meningitis. *Staphylococcus aureus* - *S. aureus* meningitis typically occurs in specific contexts such as **post-neurosurgery**, following head trauma, or in patients with indwelling catheters or bacteremia. - It is not the most frequent pathogen in community-acquired meningitis in infants. *Klebsiella* - **Klebsiella pneumoniae** can cause meningitis, especially in **neonates** (first 28 days of life), immunocompromised individuals, or patients with healthcare-associated infections. - However, it is not the most common cause of meningitis in the post-neonatal period.

Q: Dose of vitamin A for an 18 month old baby, with keratomalacia, weighing 10 kg is?

2,00,000 IU. **2,00,000 IU** - For children 12 months of age and older with **keratomalacia** due to vitamin A deficiency, the recommended dose is **200,000 IU** orally, given immediately. - This dose should be repeated the next day and again after four weeks to replenish stores and prevent recurrence. *1,00,000 IU* - This dose is typically recommended for infants **aged 6 to 11 months** with **clinical vitamin A deficiency**, including keratomalacia. - It is insufficient for an 18-month-old child with active keratomalacia. *50,000 IU* - This dose is usually given to infants **under 6 months** of age with clinical signs of **vitamin A deficiency**. - It is too low for an 18-month-old baby with keratomalacia. *5,00,000 IU* - This dose is excessively high and potentially toxic for an 18-month-old child. - Vitamin A toxicity can lead to adverse effects, including **increased intracranial pressure** and liver damage.

Q: For a child 3-5 months of age with H1N1, treatment Oseltamivir dose is

20 mg BD X 5 days. ***20 mg BD X 5 days*** - For infants aged **3-5 months** with H1N1 influenza, the recommended dose of **Oseltamivir** is **20 mg twice daily** (BD) for **5 days**. This dosage is based on weight-based recommendations to ensure appropriate antiviral activity. - This treatment regimen is crucial for reducing the severity and duration of influenza symptoms in this vulnerable age group and should be initiated as early as possible. *12 mg BD X 5 days* - This dosage is typically recommended for younger infants, specifically those aged **less than 1 month up to 2 months** (up to 3 kg body weight). - It is **underdosing** for a child in the 3-5 months age range, which could lead to suboptimal antiviral effect. *25 mg BD X 5 days* - This dosage is generally used for children weighing **between 15 kg and 23 kg**, which is significantly higher than the average weight for an infant aged 3-5 months. - Administering this dose to a 3-5 month old would constitute an **overdose**, potentially leading to increased side effects such as nausea, vomiting, or other adverse reactions. *20 mg OD X 5 days* - While 20 mg is the correct single dose, giving it **once daily (OD)** is incorrect for treating H1N1 influenza in infants. - Oseltamivir requires a **twice-daily (BD)** regimen to maintain therapeutic drug levels and effectively inhibit viral replication over the 24-hour period.

Q: Cell that can form all cell types in the body is called?

Totipotent. ***Totipotent*** - **Totipotent** cells have the ability to differentiate into **all cell types** of the organism, including the **extraembryonic tissues** (like the placenta). - The **zygote** immediately after fertilization is the most well-known example of a totipotent cell, as it can form an entire organism. *Lineage stem cells* - **Lineage stem cells** (or **multipotent** stem cells) are restricted to differentiating into cells within a specific **cell lineage** or germ layer. - For example, **hematopoietic stem cells** can form all types of blood cells but no other tissue types. *Multipotent* - **Multipotent** stem cells can differentiate into a limited number of cell types within a specific tissue or organ, but not all cell types of the body. - Examples include **mesenchymal stem cells** which can form bone, cartilage, and fat cells, or **neural stem cells** which can form neurons and glia. *Pluripotent* - **Pluripotent** cells can differentiate into **all cell types** of the three germ layers (ectoderm, mesoderm, and endoderm) that make up the embryo, but not the extraembryonic tissues. - **Embryonic stem cells** are a prime example of pluripotent cells, as they can form any cell type in the body but cannot form a complete organism on their own.

Q: Best way to localize extra-adrenal pheochromocytoma:

Nuclear medicine scan (MIBG scan). ***Nuclear medicine scan (MIBG scan)*** - **Iodine-131-metaiodobenzylguanidine (MIBG) scan** is the imaging modality of choice for localizing extra-adrenal pheochromocytomas due to its high specificity for **neuroendocrine tumors** like pheochromocytomas and paragangliomas. - MIBG is structurally similar to **norepinephrine** and is actively taken up by adrenergic neurons, allowing visualization of hypersecreting chromaffin cells wherever they are located in the body. *X-ray* - **X-rays** provide limited soft tissue detail and are generally not useful for localizing pheochromocytomas, especially extra-adrenal ones. - They may show calcifications in some tumors but lack the sensitivity and specificity needed for definitive localization. *Clinical examination* - A **clinical examination** can identify signs and symptoms suggestive of pheochromocytoma (e.g., hypertension, palpitations, sweating) but cannot localize the tumor itself. - Localization requires **imaging studies** due to the variable and often deep-seated location of these tumors. *VMA excretion* - **Vanillylmandelic acid (VMA) excretion** is a biochemical test used to diagnose pheochromocytoma by measuring catecholamine metabolites in urine. - While it confirms the presence of a catecholamine-secreting tumor, it provides **no information about the tumor's location**.

Q: Marjolin's ulcer is:-

Squamous cell carcinoma from scar. ***Squamous cell carcinoma from scar*** - A Marjolin's ulcer is a rare but aggressive form of squamous cell carcinoma (SCC) that arises in areas of previously traumatized, chronically inflamed, or scarred skin. - Common sites include burn scars, chronic osteomyelitis tracts, pressure ulcers, and venous ulcers. - Typically has a long latency period (average 30-35 years after initial injury). - Characterized by higher rates of local recurrence and metastasis compared to conventional SCC. *Adenoma of scar* - An adenoma is a benign tumor of glandular origin and is not typically associated with scar tissue or malignant transformation in this context. - The malignancy arising in a scar is usually carcinoma, not adenoma. *Amoebic ulcer* - An amoebic ulcer is caused by the parasite *Entamoeba histolytica* and typically affects the colon, presenting as dysentery. - It is not a type of malignant transformation within a pre-existing scar. *Tubercular ulcer* - A tubercular ulcer is a manifestation of tuberculosis, often affecting the skin or mucous membranes and caused by *Mycobacterium tuberculosis*. - This is an infectious process and not a malignant transformation of scar tissue.

Question 1

Secondary ossification centre appears before birth at

Accepted Answer

Lower end of femur

Answer

Upper end of femur

Answer

Lower end of tibia

Answer

Lower end of fibula

Question 2

Western blot is done for:

Accepted Answer

Protein

Answer

RNA

Answer

Lipid

Answer

DNA

Question 3

Oliguria is defined as:-

Accepted Answer

Less than 400 ml of urine excreted in a day

Answer

More than 900 ml of urine excreted in a day

Answer

Absence of urine production

Answer

600 ml to 700 ml of urine excreted in a day

Question 4

All are true about Allergic Bronchopulmonary Aspergillosis (ABPA) except?

Accepted Answer

Distal bronchiectasis

Answer

Serum precipitins to Aspergillus

Answer

Increased IgE Levels

Answer

Seen in asthmatics

Question 5

Most common cause of bacterial meningitis in post-neonatal period:

Accepted Answer

Streptococcus pneumoniae

Answer

Mycobacterium tuberculosis

Answer

Staphylococcus aureus

Answer

Klebsiella

Question 6

Dose of vitamin A for an 18 month old baby, with keratomalacia, weighing 10 kg is?

Accepted Answer

2,00,000 IU

Answer

1,00,000 IU

Answer

50,000 IU

Answer

5,00,000 IU

Question 7

For a child 3-5 months of age with H1N1, treatment Oseltamivir dose is

Accepted Answer

20 mg BD X 5 days

Answer

12 mg BD X 5 days

Answer

25 mg BD X 5 days

Answer

20 mg OD X 5 days

Question 8

Cell that can form all cell types in the body is called?

Accepted Answer

Totipotent

Answer

Lineage stem cells

Answer

Multipotent

Answer

Pluripotent

Question 9

Best way to localize extra-adrenal pheochromocytoma:

Accepted Answer

Nuclear medicine scan (MIBG scan)

Answer

X-ray

Answer

Clinical examination

Answer

VMA excretion

Question 10

Marjolin's ulcer is:-

Accepted Answer

Squamous cell carcinoma from scar

Answer

Adenoma of scar

Answer

Amoebic ulcer

Answer

Tubercular ulcer

FMGE 2018

Anatomy

Biochemistry

Internal Medicine

Pediatrics

Pharmacology

Physiology

Radiology

Surgery