Anatomy
1 questionsWhich of the following is the safety muscle of tongue?
FMGE 2019 - Anatomy FMGE Practice Questions and MCQs
Question 131: Which of the following is the safety muscle of tongue?
- A. Genioglossus (Correct Answer)
- B. Hyoglossus
- C. Styloglossus
- D. Palatoglossus
Explanation: ***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.
Biochemistry
1 questionsWhich bases are present in human DNA?
FMGE 2019 - Biochemistry FMGE Practice Questions and MCQs
Question 131: Which bases are present in human DNA?
- A. Adenine-guanine-cytosine-thymine (Correct Answer)
- B. None of the above
- C. Adenine-guanine-cytosine-uracil
- D. Adenine-guanine-thiamine-uracil
Explanation: ***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.
Internal Medicine
3 questionsWhich of the following is a feature of Vit B12 deficiency anemia?
A patient after valve replacement will require follow up treatment with
Gynecomastia is seen in all except;
FMGE 2019 - Internal Medicine FMGE Practice Questions and MCQs
Question 131: Which of the following is a feature of Vit B12 deficiency anemia?
- A. Macro-ovalocytes
- B. All of the options (Correct Answer)
- C. Megaloblastic anemia
- D. Hypersegmented neutrophils
Explanation: **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.
Question 132: A patient after valve replacement will require follow up treatment with
- A. ACE inhibitors
- B. Beta blockers
- C. Thiazide
- D. Warfarin (Correct Answer)
Explanation: ***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.
Question 133: Gynecomastia is seen in all except;
- A. Kidney failure
- B. Liver failure
- C. Stilbestrol therapy for prostate cancer
- D. Teratoma of the testis
- E. Hormonal
- F. Leprosy (Correct Answer)
- . Idiopathic
- . Anorchism and After castration
- . Klinefelter's syndrome
Explanation: Leprosy - While leprosy can affect various endocrine glands, **gynecomastia is not a typical or direct manifestation** of the disease. - Its primary impact is on the peripheral nerves, skin, and upper respiratory tract, not directly on estrogen-androgen balance. *Kidney failure* - **Chronic kidney disease** often leads to **hormonal imbalances**, including increased prolactin and decreased testosterone, which can cause gynecomastia. - The altered metabolism and excretion of hormones contribute to this endocrine dysfunction. *Liver failure* - The liver is crucial for metabolizing **estrogens** and other hormones; **liver failure** leads to reduced estrogen breakdown and elevated circulating levels. - This **increased estrogen-to-androgen ratio** promotes breast tissue development in males. *Stilbestrol therapy for prostate cancer* - **Stilbestrol is a synthetic estrogen** often used as part of androgen deprivation therapy for prostate cancer. - Administering exogenous estrogen directly **stimulates breast tissue growth**, causing gynecomastia. *Teratoma of the testis* - Certain **testicular tumors**, including some teratomas, can produce **human chorionic gonadotropin (hCG)** [1]. - Elevated hCG can **stimulate Leydig cells to produce estrogen** and can also directly stimulate aromatase activity, leading to gynecomastia. *Hormonal* - This category generally refers to conditions where there is an **imbalance between estrogen and androgen levels**, favoring estrogenic effects. - **Any condition that increases estrogen or decreases testosterone** can lead to gynecomastia. *Idiopathic* - **Idiopathic gynecomastia** refers to cases where no identifiable underlying cause can be found despite thorough investigation. - It's a diagnosis of exclusion, signifying that the exact hormonal imbalance or mechanism remains unknown. *Anorchism and After castration* - Both anorchism (absence of testes) and castration (surgical removal of testes) result in a **severe deficiency of testosterone**. - Without sufficient androgen production, the **relative effect of even normal estrogen levels becomes dominant**, leading to gynecomastia. *Klinefelter's syndrome* - **Klinefelter's syndrome (47, XXY)** is a chromosomal disorder characterized by **testicular dysfunction**, leading to primary hypogonadism [2]. - This results in **low testosterone and relatively high estrogen levels** [3], a classic hormonal imbalance that causes gynecomastia.
Microbiology
1 questionsSARS is caused by novel variant of?
FMGE 2019 - Microbiology FMGE Practice Questions and MCQs
Question 131: SARS is caused by novel variant of?
- A. Coronavirus (Correct Answer)
- B. Toga virus
- C. Lyssa virus
- D. Pox virus
Explanation: ***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.
Obstetrics and Gynecology
2 questions32 years old lady with twin dichorionic diamniotic pregnancy, first baby breech presentation and second baby cephalic presentation. What is the management?
Risk of endometrial cancer is least in:
FMGE 2019 - Obstetrics and Gynecology FMGE Practice Questions and MCQs
Question 131: 32 years old lady with twin dichorionic diamniotic pregnancy, first baby breech presentation and second baby cephalic presentation. What is the management?
- A. Assisted breech
- B. C - Section (Correct Answer)
- C. Instrumental delivery
- D. Normal vaginal delivery
Explanation: ***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.
Question 132: Risk of endometrial cancer is least in:
- A. Late menopause
- B. A positive family history
- C. Obesity
- D. Multipara (Correct Answer)
Explanation: ***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.
Ophthalmology
1 questionsAppropriate treatment for mild congenital ptosis?
FMGE 2019 - Ophthalmology FMGE Practice Questions and MCQs
Question 131: Appropriate treatment for mild congenital ptosis?
- A. Frontalis sling procedure
- B. Antibiotics and hot compression
- C. LPS Resection (Correct Answer)
- D. Wedge resection of conjunctiva
Explanation: ***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.
Pediatrics
1 questionsKoplik spots are seen in?
FMGE 2019 - Pediatrics FMGE Practice Questions and MCQs
Question 131: Koplik spots are seen in?
- A. Rubella
- B. Mumps
- C. Varicella
- D. Measles (Correct Answer)
Explanation: ***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.