Community Medicine
2 questionsComponents of Kuppuswamy scale include:
Anthracosis is caused by:
FMGE 2019 - Community Medicine FMGE Practice Questions and MCQs
Question 111: Components of Kuppuswamy scale include:
- A. Income, Housing, Education
- B. Housing, Livestock, land
- C. Income, Livestock, Housing
- D. Income, Occupation, Education (Correct Answer)
Explanation: ***Income, Occupation, Education*** - The **Kuppuswamy scale** is a widely used tool in India for classifying the socioeconomic status of families. - It considers **income**, **occupation**, and **education** levels to assign a score. *Income, Housing, Education* - While income and education are components, **housing** is not a primary factor in the original Kuppuswamy scale. - Housing quality and type can be indicators of socioeconomic status, but they are not directly integrated into this specific scale. *Housing, Livestock, land* - None of these are direct components of the **Kuppuswamy scale** for socioeconomic classification. - These factors might be relevant for rural socioeconomic status but are not part of this specific urban-focused scale. *Income, Livestock, Housing* - While income is a component, **livestock** and **housing** are not included in the original Kuppuswamy scale. - This combination of factors would likely be more appropriate for assessing socioeconomic status in agricultural or rural settings.
Question 112: Anthracosis is caused by:
- A. Sugar cane waste
- B. Asbestos
- C. Silica
- D. Coal dust (Correct Answer)
Explanation: ***Coal dust*** - **Anthracosis** is a lung condition resulting from the accumulation of **coal dust** particles in the lungs. - It is a common finding in coal miners, hence the term **coal worker's pneumoconiosis**. *Sugar cane waste* - Inhalation of **sugar cane waste** can lead to **bagassosis**, a form of hypersensitivity pneumonitis. - Bagassosis is caused by an immunological reaction to organic dust, not inert particle build-up like anthracosis. *Asbestos* - Exposure to **asbestos** fibers causes **asbestosis**, a severe fibrotic lung disease. - Asbestosis is also linked to an increased risk of lung cancer and **mesothelioma**. *Silica* - Inhalation of **crystalline silica** dust results in **silicosis**, characterized by lung nodule formation and fibrosis. - Occupations involving mining, quarrying, and construction are at high risk for silicosis.
Internal Medicine
1 questionsFollowing statement are true about tremors except:
FMGE 2019 - Internal Medicine FMGE Practice Questions and MCQs
Question 111: Following statement are true about tremors except:
- A. Essential tremor is an uncommon movement disorder affecting 5%of population (Correct Answer)
- B. Normal individuals can have physiologic tremor that manifest as mild high frequency, postural or action tremors.
- C. PD is characterised by resting tremor
- D. Tremor consist of alternate contraction of agonist and antagonist muscle in oscillating rhythmic manner
Explanation: ***Essential tremor is an uncommon movement disorder affecting 5% of population*** - Essential tremor is, in fact, one of the most common movement disorders, affecting a significant portion of the population (often cited as 0.4% in the general population, with higher prevalence in older adults, ranging from 4-5%). - Therefore, stating it is "uncommon" contradicts its actual prevalence and epidemiological data. *Normal individuals can have physiologic tremor that manifest as mild high frequency, postural or action tremors.* - **Physiologic tremor** is a normal phenomenon present in healthy individuals, characterized by a low amplitude, high-frequency tremor. - It becomes more noticeable under conditions of **stress, fatigue, or stimulant use** and is typically seen as a **postural or action tremor**. *PD is characterised by resting tremor* - **Parkinson's disease (PD)** is classically associated with a **resting tremor**, meaning it occurs when the limb is at rest and supported, and often diminishes with voluntary movement [1], [2]. - This tremor usually presents as a **"pill-rolling"** movement of the fingers and thumb. *Tremor consist of alternate contraction of agonist and antagonist muscle in oscillating rhythmic manner* - Tremors are defined by their **oscillating, rhythmic, and involuntary movements** resulting from the alternating or synchronous contraction of **agonist and antagonist muscles** [1]. - This alternating muscle activity is what produces the characteristic shaking motion [2].
Microbiology
2 questionsThe causative agent for duodenal ulcer is:
Bacillus anthracis is:
FMGE 2019 - Microbiology FMGE Practice Questions and MCQs
Question 111: The causative agent for duodenal ulcer is:
- A. Lactobacilli
- B. E. coli
- C. H. Pylori (Correct Answer)
- D. Shigella
Explanation: ***H. pylori*** - ***H. pylori*** is a **Gram-negative spiral-shaped bacterium** that colonizes the stomach and duodenum, causing inflammation and increasing the risk of peptic ulcers, including duodenal ulcers. - It produces **urease**, which neutralizes stomach acid by converting urea to ammonia, protecting the bacteria and contributing to mucosal damage. *Lactobacilli* - **Lactobacilli** are **Gram-positive, rod-shaped bacteria** commonly found in the digestive tract and fermented foods. - They are generally considered **beneficial probiotics** and do not cause duodenal ulcers. *E. coli* - ***E. coli*** is a **Gram-negative, rod-shaped bacterium** typically found in the intestines of humans and animals. - While some strains can cause **gastrointestinal infections** (e.g., traveler's diarrhea), *E. coli* is not a known cause of duodenal ulcers. *Shigella* - **Shigella** is a **Gram-negative, rod-shaped bacterium** that causes **shigellosis**, an intestinal infection characterized by severe diarrhea (dysentery). - It primarily affects the **large intestine** and does not cause duodenal ulcers.
Question 112: Bacillus anthracis is:
- A. Gram negative cocci in cluster
- B. Gram positive rods with square ends (Correct Answer)
- C. Gram positive cocci in cluster
- D. Gram positive bacilli with spherical ends
Explanation: ***Gram positive rods with square ends*** - *Bacillus anthracis* is a **gram-positive bacterium**, meaning it retains the crystal violet stain due to its thick peptidoglycan layer. - Microscopically, it appears as **large, rod-shaped bacteria** (bacilli) with characteristic **square-cut ends**, often arranged in chains. *Gram negative cocci in cluster* - This describes organisms like **Neisseria gonorrhoeae** or **meningitidis**, which are spherical (cocci) and appear pink/red after Gram staining. - *Bacillus anthracis* is a **rod-shaped bacterium** that stains Gram-positive. *Gram positive cocci in cluster* - This morphology is characteristic of **Staphylococcus species**, which are spherical bacteria that stain purple and arrange in grape-like clusters. - *Bacillus anthracis* is a **rod-shaped bacterium**, not a coccus. *Gram positive bacilli with spherical ends* - While *Bacillus anthracis* is a **gram-positive bacillus**, its ends are distinctly **square-cut**, not spherical. - Bacteria with spherical or rounded ends would include some other *Bacillus* species or members of the **Clostridium** genus.
Obstetrics and Gynecology
1 questionsLady presents with infertility and diagnosed with bilateral cornual block on hysterosalpingography. What is the next step?
FMGE 2019 - Obstetrics and Gynecology FMGE Practice Questions and MCQs
Question 111: Lady presents with infertility and diagnosed with bilateral cornual block on hysterosalpingography. What is the next step?
- A. Tuboplasty
- B. Laparoscopy and hysteroscopy (Correct Answer)
- C. USG
- D. IVF
Explanation: ***Laparoscopy and hysteroscopy*** - A **laparoscopy** allows for direct visualization of the fallopian tubes to confirm the tubal obstruction and assess for other pelvic pathology like **endometriosis** or **adhesions**. - A **hysteroscopy** can be performed concurrently to inspect the uterine cavity and the tubal ostia for any intracavitary abnormalities or to attempt **canalization of the cornual block**. *Tuboplasty* - **Tuboplasty** is a corrective surgical procedure for tubal obstruction, but it is typically considered *after* a definitive diagnosis and assessment of the block's extent have been made via diagnostic procedures. - Its success rate varies depending on the location and nature of the block, and it is not the immediate next step for diagnosis. *USG* - **Transvaginal ultrasonography (USG)** is a useful tool for evaluating uterine and ovarian morphology but is generally *not definitive* for diagnosing tubal patency or specific locations of tubal blockage. - While it can identify some pathologies, it cannot visualize the fallopian tubes with sufficient clarity to determine cornual obstruction. *IVF* - **In vitro fertilization (IVF)** is an *assisted reproductive technology* used to bypass tubal factor infertility, but it is a treatment option, not a diagnostic step. - It would be considered *after* a full diagnostic workup has confirmed the tubal blockage and other fertility factors, and after counseling regarding prognosis and success rates.
Pathology
1 questionsWhich patient has the best prognosis in breast cancer?
FMGE 2019 - Pathology FMGE Practice Questions and MCQs
Question 111: Which patient has the best prognosis in breast cancer?
- A. Luminal B
- B. Luminal A (Correct Answer)
- C. Triple negative breast cancer
- D. HER2-positive breast cancer
Explanation: ***Luminal A*** - Luminal A breast cancer is characterized by **estrogen receptor (ER)-positive**, **progesterone receptor (PR)-positive**, and **HER2-negative** status, along with a **low Ki-67 index** [1]. - This subtype generally has the **best prognosis** among all breast cancer subtypes due to its hormone sensitivity and slower proliferation rate, making it highly responsive to endocrine therapy [1]. *Luminal B* - Luminal B breast cancer is typically **ER-positive**, **PR-negative or low**, and can be **HER2-positive or negative**, but notably has a **high Ki-67 index**, indicating rapid cell proliferation [1]. - Compared to Luminal A, it has a **worse prognosis** due to its more aggressive biological behavior, requiring more intensive treatment approaches. *HER2-positive breast cancer* - HER2-positive breast cancer is characterized by **overexpression or amplification of HER2 (human epidermal growth factor receptor 2)** [1]. - Although it was historically associated with poor prognosis, the introduction of **targeted HER2 therapy (trastuzumab, pertuzumab)** has significantly improved outcomes [2]. - However, it still has a **more aggressive course than Luminal A**, with higher proliferation rates and requires targeted therapy in addition to standard treatment. *Triple negative breast cancer* - Triple negative breast cancer is characterized by **ER-negative, PR-negative, and HER2-negative** status, lacking all three major hormone receptors [1]. - This subtype generally has the **worst prognosis** among breast cancer subtypes due to lack of targeted therapy options and more aggressive biological behavior with higher recurrence rates [2]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Breast, pp. 1059-1066. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. (Basic Pathology) introduces the student to key general principles of pathology, both as a medical science and as a clinical activity with a vital role in patient care. Part 2 (Disease Mechanisms) provides fundamental knowledge about the cellular and molecular processes involved in diseases, providing the rationale for their treatment. Part 3 (Systematic Pathology) deals in detail with specific diseases, with emphasis on the clinically important aspects., pp. 258-259.
Pharmacology
2 questionsWhich of the following is an oral direct thrombin inhibitor?
What is the dose of mifepristone in emergency contraception?
FMGE 2019 - Pharmacology FMGE Practice Questions and MCQs
Question 111: Which of the following is an oral direct thrombin inhibitor?
- A. Dabigatran (Correct Answer)
- B. Lepirudin
- C. Rivaroxaban
- D. Warfarin
Explanation: ***Dabigatran*** - **Dabigatran** is the correct answer because it is an **oral direct thrombin inhibitor (DTI)**, meaning it directly inhibits thrombin (factor IIa) to prevent clot formation. - It is one of the **novel oral anticoagulants (NOACs)**, used for conditions like atrial fibrillation and venous thromboembolism. *Lepirudin* - **Lepirudin** is a **direct thrombin inhibitor**, but it is administered **intravenously**, not orally. - It is typically used for **heparin-induced thrombocytopenia (HIT)** when heparin is contraindicated. *Rivaroxaban* - **Rivaroxaban** is an **oral anticoagulant**, but it is a **direct factor Xa inhibitor**, not a direct thrombin inhibitor. - This drug prevents the conversion of prothrombin to thrombin by inhibiting factor Xa. *Warfarin* - **Warfarin** is an **oral anticoagulant**, but it acts as a **vitamin K antagonist (VKA)**, inhibiting the synthesis of coagulation factors II, VII, IX, and X. - It does not directly inhibit thrombin, but rather reduces the production of thrombin precursors.
Question 112: What is the dose of mifepristone in emergency contraception?
- A. 25 mg
- B. 200 mcg
- C. 200 mg
- D. 10 mg (Correct Answer)
Explanation: ***10 mg*** - **10 mg is the WHO-recommended dose** of mifepristone for emergency contraception. - This single dose is **equally effective** as higher doses (25-50 mg) and works primarily by **delaying or inhibiting ovulation**. - It has been validated through **multiple international clinical trials** and is the standard regimen used globally. - When taken within **72-120 hours** of unprotected intercourse, it significantly reduces pregnancy risk. *25 mg* - While 25 mg of mifepristone has been studied for emergency contraception and shows efficacy, it is **not the standard recommended dose**. - The **10 mg dose is preferred** as it achieves similar efficacy with potentially fewer side effects and lower cost. - Some countries may use 25 mg, but **WHO guidelines recommend 10 mg** as the optimal dose. *200 mg* - A 200 mg dose of mifepristone is typically utilized for **medical abortion regimens**, often in combination with a prostaglandin analog (misoprostol). - This dosage achieves a different pharmacological effect, leading to **detachment of the embryo** and uterine contractions. - This is **far higher than needed** for emergency contraception purposes. *200 mcg* - **Mifepristone is not dosed in micrograms** (mcg) for emergency contraception or medical abortion; it is measured in milligrams (mg). - This unit and dosage are more commonly associated with other medications, such as **misoprostol** when used for obstetric indications. - 200 mcg would be 0.2 mg, which is **subtherapeutic** for any mifepristone indication.
Radiology
1 questionsA patient presented with complaints of dyspnoea. The shown X-ray is suggestive of:
FMGE 2019 - Radiology FMGE Practice Questions and MCQs
Question 111: A patient presented with complaints of dyspnoea. The shown X-ray is suggestive of:
- A. Pleural effusion (Correct Answer)
- B. Pneumothorax
- C. Hydropneumothorax
- D. Consolidation
Explanation: ***Pleural effusion*** - The X-ray shows a significant **right-sided pleural effusion** with blunting of the costophrenic angle and a meniscus sign characteristic of fluid accumulation in the pleural space. - Key radiological features include: **homogeneous opacity** in the lower zone, **obliteration of the costophrenic angle**, and the typical **concave upper border (meniscus sign)** of fluid layering. - The presence of dyspnea with these radiological findings is consistent with pleural effusion. **Note:** While the X-ray confirms pleural effusion, **differentiating between exudative and transudative effusion requires pleural fluid analysis** (Light's criteria), not imaging alone. *Pneumothorax* - A pneumothorax would appear as a **dark, air-filled space** with a visible **visceral pleural line** where the lung has collapsed away from the chest wall. - The image clearly shows **fluid opacity** (white/grey) in the right hemithorax, not air (black). *Hydropneumothorax* - This condition involves both **fluid and air** in the pleural space, typically presenting with a **straight horizontal air-fluid level** on an erect chest X-ray. - The X-ray here shows a **curved meniscus** rather than a straight air-fluid level, indicating pure fluid without air. *Consolidation* - Consolidation (as seen in pneumonia) appears as a **homogenous opacity within the lung parenchyma**, often with **air bronchograms**. - The image shows fluid in the **pleural space** (outside the lung), **displacing the lung medially**, rather than an opacity within the lung tissue itself.