FMGE 2019 Practice Questions

Q: Testicular artery is a branch of -

Abdominal aorta. ***Abdominal aorta*** - The **testicular arteries**, also known as **gonadal arteries**, originate directly from the anterior aspect of the **abdominal aorta**. - They typically arise just inferior to the **renal arteries** at the level of the second lumbar vertebra (L2) and descend to supply the testes. *Common iliac artery* - The common iliac artery is a terminal branch of the **abdominal aorta**, but it gives rise to the internal and external iliac arteries, not directly the testicular artery. [2] - It bifurcates at the level of the sacroiliac joint. [3] *External iliac artery* - The external iliac artery primarily supplies the **lower limb** and gives off the inferior epigastric and deep circumflex iliac arteries. [1] - It does not directly provide branches to the testes. *Internal iliac artery* - The internal iliac artery primarily supplies the **pelvic organs**, gluteal region, and perineum. - While it has numerous branches, none of them are the main gonadal arteries; it contributes to the blood supply of the reproductive organs through other smaller branches. [3]

Q: Trigone of bladder is derived from?

Distal part of Mesonephric duct. Distal part of Mesonephric duct - The **trigone of the bladder** develops from the **caudal (distal) ends of the mesonephric ducts**, which are absorbed into the posterior wall of the forming bladder. - The mesonephric duct origin contributes to the **smooth muscle** of the trigone, giving it distinct structural characteristics compared to the rest of the bladder wall. - The trigone appears as a smooth triangular area bounded by the two ureteric orifices and the internal urethral orifice [1]. *Ventral part of Urogenital sinus* - The **ventral part of the urogenital sinus** primarily forms the **fundus and body of the urinary bladder**, but not the trigone. - This region undergoes differentiation to form the majority of the bladder's wall and provides the epithelial lining for the entire bladder including the trigone. *Distal part of Paramesonephric duct* - The **paramesonephric ducts (Müllerian ducts)** are primarily involved in the development of the female reproductive tract, forming the **fallopian tubes, uterus, and upper vagina**. - They do not contribute to the formation of the urinary bladder or its trigone. *Ventral part of Mesonephric duct* - While the mesonephric ducts are crucial, it is specifically the **distal (caudal) ends** that are incorporated into the bladder to form the trigone, not merely the general ventral part. - The more proximal parts of the mesonephric ducts in males develop into structures like the **epididymis, v\as deferens, seminal vesicles, and ejaculatory ducts**.

Q: In the shown lateral view, the structure marked with arrowhead is?

Trachea. ***Trachea*** - This is a lateral view of the thorax, and the **trachea** is the most anterior conduit in the superior mediastinum, visible as an **air-filled structure** anterior to the esophagus. - The arrowhead points to a vertical air column in the anterior aspect, consistent with the expected anatomical location and appearance of the **trachea**. *Pulmonary artery* - The **pulmonary artery** lies anterior to the main bronchi and usually branches before this level, and it is a vascular structure, not an air-filled lumen. - It would appear as a soft tissue density, not a radiolucent (dark) air-filled structure on an X-ray. *Left atrium* - The **left atrium** is located posteriorly to the ascending aorta and pulmonary artery, and it is a cardiac chamber, not an air-filled tubular structure. - It is also a soft tissue density and would not be visible as a distinct air-filled lumen on a lateral chest X-ray in this position. *Esophagus* - The **esophagus** is located posterior to the trachea, running behind it in the mediastinum. - While it is a tubular structure, it is usually not air-filled unless there is swallowed air or a pathology (e.g., hiatus hernia), and it would be located *behind* the structure indicated by the arrowhead.

Q: The contraceptive which is contraindicated in DVT is?

OCP. ***OCP*** - **Oral contraceptive pills (OCPs)**, especially those containing estrogen, increase the risk of **venous thromboembolism (VTE)**, including deep vein thrombosis (DVT). - Estrogen promotes a **hypercoagulable state** by increasing clotting factors and decreasing natural anticoagulants. *Barrier method* - **Barrier methods** like condoms or diaphragms are non-hormonal and act physically to prevent sperm from reaching the egg. - They have **no systemic effects** on coagulation and are safe for individuals with DVT. *Non hormonal IUCD* - **Non-hormonal intrauterine contraceptive devices (IUCDs)**, such as copper IUCDs, prevent conception primarily by causing a local inflammatory reaction in the uterus. - They do not release hormones and therefore **do not affect coagulation** or increase DVT risk. *Billing's method* - The **Billing's ovulation method** (cervical mucus method) is a natural family planning technique based on observing changes in cervical mucus. - It involves no medications or devices and thus has **no impact on DVT risk**.

Q: For severe acute malnutrition in children (6-59 months), MAC will be less than

11.5 cm. ***11.5 cm*** - A **Mid-Upper Arm circumference (MUAC) below 11.5 cm** is a key diagnostic criterion for **severe acute malnutrition (SAM)** in children aged 6-59 months. - This measurement is a simple and effective screening tool in resource-limited settings to identify children at high risk of mortality due to malnutrition [1]. *13.5 cm* - A MUAC of 13.5 cm or greater is generally considered **nutritionally healthy** for children in this age group, indicating adequate muscle and fat reserves. - This measurement would typically rule out severe acute malnutrition and often even moderate malnutrition. *12.5 cm* - A MUAC between 11.5 cm and 12.5 cm is typically indicative of **moderate acute malnutrition (MAM)**, not severe acute malnutrition. - While concerning, it suggests a less critical nutritional status compared to a MUAC below 11.5 cm. *14.5 cm* - A MUAC of 14.5 cm or greater is well within the healthy range for children aged 6-59 months, indicating **good nutritional status**. - This measurement would suggest no signs of acute malnutrition.

Q: Which of the following drug causes postural hypotension commonly?

Alpha blocker. ***Alpha blocker*** - **Alpha-1 adrenergic blockers** cause common postural hypotension by blocking **alpha-1 receptors** on vascular smooth muscle, leading to vasodilation and reduced peripheral vascular resistance. - This vasodilation, especially in the upright position, can cause blood to pool in the lower extremities, decreasing venous return to the heart and thus lowering blood pressure. *Angiotensin receptor blockers* - These drugs block the effects of **angiotensin II**, leading to vasodilation and decreased aldosterone secretion, typically causing a more gradual and less pronounced drop in blood pressure. - While they can cause hypotension, **postural hypotension** is less common and usually less severe compared to alpha blockers due to their different mechanism of action and less abrupt vasodilation. *Beta blocker* - **Beta-blockers** primarily reduce heart rate and myocardial contractility, thereby decreasing cardiac output, which can contribute to generalized hypotension. - They do not directly cause significant **vasodilation** in the same manner as alpha-blockers, making postural hypotension less common unless there are other contributing factors. *ACE inhibitor* - **ACE inhibitors** prevent the conversion of angiotensin I to **angiotensin II**, leading to vasodilation and reduced aldosterone. - They can cause hypotension, especially with the first dose or in volume-depleted patients, but **postural hypotension** is typically less frequent and severe than with alpha-blockers.

Q: Which of the following is not a formal thought disorder?

Delusion. ***Delusion*** - A **delusion** is a **fixed, false belief** that is firmly held despite clear evidence to the contrary and is not consistent with the person's cultural or religious background. It is a **disorder of thought content**, not thought form or process. - While delusions are a hallmark symptom of many psychotic disorders, they represent what a person thinks, rather than how they think. *Neologism* - **Neologism** refers to the **creation of new, nonsensical words or phrases** that are intelligible only to the person coining them. - This is a formal thought disorder because it reflects a break in the conventional structure and coherence of language. *Derailment* - **Derailment**, also known as **loose associations**, is a thought disorder where the person's thoughts shift from one topic to another in a way that is loosely connected or completely unrelated. - This represents a disruption in the logical flow and organization of ideas, making it a formal thought disorder. *Tangentiality* - **Tangentiality** is a thought disorder where the person **strays from the main topic** and never returns to the original point or answers the question asked. - It reflects an inability to maintain focused thought and is a formal thought disorder related to the process of thinking.

Q: Comment on the diagnosis of the CT chest image shown below.

Aortic dissection. ***Aortic dissection*** - The image shows a **flap-like linear structure** within the aortic lumen, which represents an **intimal flap** separating the true and false lumens, characteristic of an aortic dissection. - This condition involves a tear in the **aortic intima**, allowing blood to flow between the layers of the aortic wall, a serious and life-threatening event. *Aortic aneurysm* - An aortic aneurysm would present as a **focal dilation** of the aorta, exceeding its normal diameter, without evidence of an intimal flap or separate lumens. - While it can be a precursor to dissection, an aneurysm itself does not show the distinct internal flap seen in dissection. *Pulmonary embolism* - Pulmonary embolism involves a **filling defect** within the pulmonary arteries, typically caused by a blood clot, and would be located in the pulmonary vasculature, not the aorta. - The image clearly depicts an issue with the aorta, not the pulmonary arteries. *Cardiac myxoma* - A cardiac myxoma is a **benign tumor** typically found in the atria of the heart, most commonly the left atrium. - It would appear as an intracardiac mass and not as an intimal flap within the aortic lumen.

Q: In which location is a transplanted kidney typically placed?

Iliac fossa. ***Iliac fossa*** - The **iliac fossa** is the standard site for kidney transplantation due to its accessibility and the proximity of suitable blood vessels (iliac artery and vein) for anastomosis. [1] - Placing the kidney here allows for easier access for potential biopsies and monitoring. *Retroperitoneal space* - The patient's native kidneys are located in the **retroperitoneal space**, but a transplanted kidney is typically placed in a more accessible anterior location. - Transplanting a kidney into the retroperitoneal space would be a more complex and invasive procedure due to the depth and surrounding structures. *Hypogastric region* - While the iliac fossa is part of the broader hypogastric region, the term **hypogastric region** is less specific for the precise anatomical location of kidney transplantation. - The iliac fossa specifically refers to the concave surface of the ilium, which provides a suitable bed for the donated kidney. *Kidney fossa* - **Kidney fossa** is not a formally recognized anatomical term for a specific site of kidney transplantation. - The term "fossa" describes a depression or hollow, but in the context of transplantation, the iliac fossa is the correct anatomical landmark used.

Question 1

Testicular artery is a branch of -

Accepted Answer

Abdominal aorta

Answer

Common iliac artery

Answer

External iliac artery

Answer

Internal iliac artery

Question 2

Trigone of bladder is derived from?

Accepted Answer

Distal part of Mesonephric duct

Answer

Ventral part of Urogenital sinus

Answer

Distal part of Paramesonephric duct

Answer

Ventral part of Mesonephric duct

Question 3

In the shown lateral view, the structure marked with arrowhead is?

Accepted Answer

Trachea

Answer

Pulmonary artery

Answer

Left atrium

Answer

Esophagus

Question 4

The contraceptive which is contraindicated in DVT is?

Accepted Answer

OCP

Answer

Barrier method

Answer

Non hormonal IUCD

Answer

Billing's method

Question 5

For severe acute malnutrition in children (6-59 months), MAC will be less than

Accepted Answer

11.5 cm

Answer

13.5 cm

Answer

12.5 cm

Answer

14.5 cm

Question 6

Which of the following drug causes postural hypotension commonly?

Accepted Answer

Alpha blocker

Answer

Angiotensin receptor blockers

Answer

Beta blocker

Answer

ACE inhibitor

Question 7

Which of the following is not a formal thought disorder?

Accepted Answer

Delusion

Answer

Neologism

Answer

Derailment

Answer

Tangentiality

Question 8

Comment on the diagnosis of the CT chest image shown below.

Accepted Answer

Aortic dissection

Answer

Aortic aneurysm

Answer

Pulmonary embolism

Answer

Cardiac myxoma

Question 9

In which location is a transplanted kidney typically placed?

Accepted Answer

Iliac fossa

Answer

Retroperitoneal space

Answer

Hypogastric region

Answer

Kidney fossa

Question 10

A 27-year-old woman presents with 26 weeks of gestation with a thyroid lesion which is found to be papillary carcinoma of thyroid. Which is the best treatment for this patient?

Accepted Answer

Observation

Answer

Hemi-thyroidectomy

Answer

Total thyroidectomy

Answer

Thyroid ablation using radioactive Iodine

FMGE 2019

Anatomy

Obstetrics and Gynecology

Pediatrics

Pharmacology

Psychiatry

Radiology

Surgery