FMGE 2019 Practice Questions

Q: Which of the following is the safety muscle of tongue?

Genioglossus. ***Genioglossus*** - The **genioglossus muscle** is considered the safety muscle of the tongue because its contraction pulls the tongue forward, preventing it from falling backward and **obstructing the airway**, especially during sleep or in an unconscious state. - Its forward action is crucial in maintaining a **patent airway** [1]. *Hyoglossus* - The **hyoglossus muscle** depresses and retracts the tongue. - Its primary action is not to prevent airway obstruction, but rather for **tongue movement** during speech and swallowing. *Styloglossus* - The **styloglossus muscle** retracts and elevates the tongue. - It helps in shaping the tongue for **swallowing and speech**, but does not have a primary role in airway patency. *Palatoglossus* - The **palatoglossus muscle** elevates the posterior part of the tongue and depresses the soft palate. - It is involved in initiating **swallowing** and separating the oral cavity from the pharynx, not in preventing airway collapse.

Q: Which bases are present in human DNA?

Adenine-guanine-cytosine-thymine. ***Adenine- guanine-cytosine-thymine*** - DNA (deoxyribonucleic acid) in humans, and most other organisms, is composed of four nitrogenous bases: **adenine (A), guanine (G), cytosine (C), and thymine (T)**. - These bases are paired specifically: **adenine with thymine (A-T)** and **guanine with cytosine (G-C)**, forming the rungs of the DNA double helix. *None of the above* - This option is incorrect because there is a definitive set of bases that make up human DNA, as described in the correct option. - The fundamental building blocks of human DNA are well-established and universally recognized in biology. *Adenine-guanine- cytosine-uracil* - This list of bases is characteristic of **RNA (ribonucleic acid)**, not DNA. - In RNA, **uracil (U)** replaces thymine (T), meaning RNA contains adenine (A), guanine (G), cytosine (C), and uracil (U). *Adenine-guanine-thiamine- uracil* - This option incorrectly includes **thiamine**, which is a **vitamin (B1)** and not a nitrogenous base found in nucleic acids. - It also incorrectly includes **uracil**, which is found in RNA, not DNA.

Q: A patient after valve replacement will require follow up treatment with

Warfarin. ***Warfarin*** - Patients with **mechanical prosthetic heart valves** require lifelong anticoagulation with **warfarin** to prevent life-threatening thromboembolic complications [1]. - The target **international normalized ratio (INR)** typically ranges from 2.5 to 3.5, depending on the valve type and position. *ACE inhibitors* - **ACE inhibitors** are primarily used for managing **hypertension**, **heart failure**, and **renal protection**, not as routine post-valve replacement prophylaxis [2]. - While they may be used if these co-morbidities exist, they are not a universal requirement after valve surgery. *Beta blockers* - **Beta blockers** are often prescribed to control heart rate, manage **hypertension**, or reduce myocardial oxygen demand, but they are not the primary follow-up treatment for all valve replacement patients. - They do not address the critical need for **anticoagulation** in mechanical valve recipients. *Thiazide* - **Thiazide diuretics** are used to treat **hypertension** and **edema** by increasing salt and water excretion. - They do not play a direct role in preventing **thromboembolism** post-valve replacement and are not generally indicated unless chronic heart failure or hypertension is present.

Q: SARS is caused by novel variant of?

Coronavirus. ***Coronavirus*** - **Severe Acute Respiratory Syndrome (SARS)** is caused by a novel strain of **coronavirus**, specifically SARS-CoV. - Coronaviruses are a large family of viruses known to cause respiratory illnesses ranging from the common cold to more severe diseases. *Togavirus* - Togaviruses are a family of **RNA viruses** that include **Rubella virus** and **Alphaviruses** (e.g., Eastern equine encephalitis virus). - They are typically transmitted by **arthropod vectors** and do not cause SARS. *Lyssavirus* - Lyssaviruses belong to the family Rhabdoviridae and are the causative agents of **rabies**, a severe neurological disease. - They are transmitted through the bite of an infected animal and are not associated with SARS. *Poxvirus* - Poxviruses are a family of **DNA viruses** that include **Variola virus** (smallpox) and **Monkeypox virus**. - They are known for causing characteristic skin lesions and are not responsible for SARS.

Q: 32 years old lady with twin dichorionic diamniotic pregnancy, first baby breech presentation and second baby cephalic presentation. What is the management?

C - Section. ***C-Section*** - When **twin A is in breech presentation** in a dichorionic diamniotic twin pregnancy, **elective Cesarean section** is the recommended mode of delivery according to ACOG and most international guidelines. - The primary concern is the **increased risk of complications with breech delivery** of the first twin, including **head entrapment**, **cord prolapse**, and **birth trauma**. - While twin B is cephalic (which would be favorable for vaginal delivery if it were the presenting twin), the non-cephalic presentation of twin A dictates the mode of delivery for both twins. *Assisted breech* - While breech extraction may be considered in select cases where **twin A is cephalic and twin B is breech**, attempting vaginal breech delivery when twin A presents as breech is generally not recommended. - The risks of breech delivery for the first twin include **difficulty delivering the aftercoming head**, **cord prolapse**, and **birth asphyxia**, which are unacceptable in an elective situation where cesarean section is readily available. *Instrumental delivery* - Instrumental delivery (forceps or vacuum) is used to assist delivery of a **cephalic presentation** in the second stage of labor. - It cannot be used for **breech presentation** of twin A, making it inappropriate as a primary management strategy in this scenario. *Normal vaginal delivery* - Vaginal delivery with **twin A in non-cephalic (breech) presentation** is contraindicated in most modern obstetric guidelines due to significantly increased perinatal morbidity and mortality. - Even though twin B is cephalic, the presentation of twin A determines the overall delivery approach in twin pregnancies.

Q: Risk of endometrial cancer is least in:

Multipara. ***Multipara*** - **Multiparity** (having multiple successful pregnancies) is associated with a reduced risk of **endometrial cancer**. Each pregnancy provides a period of reduced estrogen exposure and increased progesterone, which is protective against endometrial hyperplasia. - The protective effect is thought to be cumulative, with **higher parity** correlating with a lower risk. *Late menopause* - **Late menopause** prolongs the duration of lifetime exposure to endogenous unopposed estrogen, which significantly increases the risk of **endometrial cancer**. - Estrogen stimulates **endometrial proliferation**, and continued exposure without the counter-regulatory effects of progesterone (as seen in later menopause) can lead to atypical hyperplasia and malignancy. *A positive family history* - A **positive family history** of endometrial cancer suggests a genetic predisposition, which is a significant **risk factor**. - Conditions like **Lynch syndrome** (hereditary non-polyposis colorectal cancer or HNPCC) are strongly associated with an increased risk of endometrial cancer. *Obesity* - **Obesity** is a major risk factor for **endometrial cancer** due to increased peripheral conversion of androgens to estrogens in adipose tissue. - This leads to higher levels of **unopposed estrogen**, promoting endometrial proliferation and increasing cancer risk.

Q: Appropriate treatment for mild congenital ptosis?

LPS Resection. ***LPS Resection*** - **LPS (levator palpebrae superioris) resection/advancement** is the most common surgical treatment for congenital ptosis, especially in mild to moderate cases. - This procedure strengthens the levator muscle, improving eyelid position and is appropriate when the **levator function is good** (typically greater than 4mm). *Frontalis sling procedure* - The **frontalis sling procedure** is generally reserved for severe congenital ptosis with poor levator function (<4mm) or in cases where the levator muscle is absent or highly dysfunctional. - It uses the frontalis muscle to lift the eyelid indirectly, which is less ideal for mild ptosis. *Antibiotics and hot compression* - **Antibiotics and hot compression** are treatments for infectious or inflammatory conditions of the eyelid, such as a **hordeolum** (stye) or **chalazion**. - They are not effective treatments for anatomical defects like congenital ptosis, which requires surgical intervention. *Wedge resection of conjunctiva* - **Wedge resection of the conjunctiva** might be used in some cases of conjunctival prolapse or for correction of specific conjunctival lesions or abnormalities. - It is not a standard or appropriate treatment for congenital ptosis.

Q: Which of the following is a feature of Vit B12 deficiency anemia?

All of the options. **All of the options** - **Vitamin B12 deficiency anemia** is a type of **megaloblastic anemia** characterized by impaired DNA synthesis, leading to large, immature red blood cells and neutrophils [1]. - The presence of **macro-ovalocytes** and **hypersegmented neutrophils** are classic hematological features seen on a peripheral blood smear [1]. *Macro-ovalocytes* - **Macro-ovalocytes** are abnormally large, oval-shaped red blood cells, which result from arrested maturation due to the deficiency. - While a hallmark of B12 deficiency, it is not the sole identifying feature, as other megaloblastic anemias can also present with them [2]. *Megaloblastic anemia* - **Megaloblastic anemia** is a broad category of anemia characterized by large, immature, and dysfunctional red blood cells, which is the primary classification for B12 deficiency [2]. - While accurate, it doesn't encompass the specific morphological findings seen in the blood smear of B12 deficiency, unlike the other options. *Hypersegmented neutrophils* - **Hypersegmented neutrophils** are neutrophils with five or more nuclear lobes, a characteristic sign of impaired DNA synthesis affecting granulopoiesis [1]. - This feature is highly specific to **megaloblastic anemias**, distinguishing them from other causes of macrocytosis.

Q: Koplik spots are seen in?

Measles. ***Measles*** - **Koplik spots** are pathognomonic rash that appears as small, white spots with a bluish-white center on an erythematous base on the **buccal mucosa** opposite the second molars. - They typically appear 2-3 days before the onset of the characteristic maculopapular rash, during the **prodromal phase** of measles (rubeola). *Rubella* - Rubella, or **German measles**, presents with a milder rash, **lymphadenopathy**, and mild fever. - It does not cause Koplik spots; instead, **Forchheimer spots** (petechiae on the soft palate) may be seen, but these are less specific. *Mumps* - Mumps is characterized primarily by **parotitis** (swelling of the salivary glands), fever, and headache. - It does not present with Koplik spots or any characteristic oral mucosal lesions. *Varicella* - Varicella, or **chickenpox**, is characterized by a **vesicular rash** that progresses from macules to papules to vesicles to crusts, appearing in crops. - It does not involve Koplik spots; the rash is typically generalized and pruritic.

Question 1

Which of the following is the safety muscle of tongue?

Accepted Answer

Genioglossus

Answer

Hyoglossus

Answer

Styloglossus

Answer

Palatoglossus

Question 2

Which bases are present in human DNA?

Accepted Answer

Adenine-guanine-cytosine-thymine

Answer

None of the above

Answer

Adenine-guanine-cytosine-uracil

Answer

Adenine-guanine-thiamine-uracil

Question 3

A patient after valve replacement will require follow up treatment with

Accepted Answer

Warfarin

Answer

ACE inhibitors

Answer

Beta blockers

Answer

Thiazide

Question 4

Gynecomastia is seen in all except;

Accepted Answer

Leprosy

Answer

Kidney failure

Answer

Liver failure

Answer

Stilbestrol therapy for prostate cancer

Answer

Teratoma of the testis

Answer

Hormonal

Answer

Idiopathic

Answer

Anorchism and After castration

Answer

Klinefelter's syndrome

Question 5

SARS is caused by novel variant of?

Accepted Answer

Coronavirus

Answer

Toga virus

Answer

Lyssa virus

Answer

Pox virus

Question 6

32 years old lady with twin dichorionic diamniotic pregnancy, first baby breech presentation and second baby cephalic presentation. What is the management?

Accepted Answer

C - Section

Answer

Assisted breech

Answer

Instrumental delivery

Answer

Normal vaginal delivery

Question 7

Risk of endometrial cancer is least in:

Accepted Answer

Multipara

Answer

Late menopause

Answer

A positive family history

Answer

Obesity

Question 8

Appropriate treatment for mild congenital ptosis?

Accepted Answer

LPS Resection

Answer

Frontalis sling procedure

Answer

Antibiotics and hot compression

Answer

Wedge resection of conjunctiva

Question 9

Which of the following is a feature of Vit B12 deficiency anemia?

Accepted Answer

All of the options

Answer

Macro-ovalocytes

Answer

Megaloblastic anemia

Answer

Hypersegmented neutrophils

Question 10

Koplik spots are seen in?

Accepted Answer

Measles

Answer

Rubella

Answer

Mumps

Answer

Varicella

FMGE 2019

Anatomy

Biochemistry

Internal Medicine

Microbiology

Obstetrics and Gynecology

Ophthalmology

Pathology

Pediatrics