FMGE 2019 Practice Questions

Q: Highest point of iliac crest is seen at?

L4. ***L4*** - The **highest point of the iliac crest** typically corresponds to the level of the **L4 vertebral body**. - This anatomical landmark is crucial for procedures like **lumbar punctures** and determining the location for **epidural anesthesia**. *L3* - The L3 vertebral level is generally located slightly **above the highest point of the iliac crest**. - While close, it is not the most consistent anatomical correlation for the highest point. *S2* - The **S2 vertebral level** is significantly **below the iliac crests**, marking the approximate midpoint of the sacroiliac joint. - This level is used as a landmark for the **dermatome of the posterior thigh**. *S1* - The **S1 vertebral level** is also located **below the iliac crests**, forming the most superior segment of the sacrum. - It is used as a landmark for the **dermatome of the lateral foot and posterior leg**, and corresponds to the ankle jerk reflex.

Q: Zinc is cofactor of which enzyme?

Carbonic anhydrase. ***Carbonic anhydrase*** - **Zinc** is an essential cofactor for **carbonic anhydrase**, crucial for its enzymatic activity in catalyzing the reversible hydration of carbon dioxide. - This enzyme plays a vital role in processes like **pH regulation**, **carbon dioxide transport**, and **bicarbonate production** in various tissues. *Carboxylase* - Carboxylases typically require **biotin** as a cofactor for their activity, which involves the addition of a carboxyl group to a substrate. - Examples include **pyruvate carboxylase** and **acetyl-CoA carboxylase**, which are fundamental in metabolic pathways. *Kinase* - Kinases are enzymes that catalyze the transfer of a **phosphate group** from a high-energy donor molecule (like ATP) to a substrate. - Their activity often depends on cofactors like **magnesium (Mg2+)** or **manganese (Mn2+)**, not zinc. *Lysyl oxidase* - **Lysyl oxidase** is an enzyme that requires **copper** as a cofactor for its activity. - It plays a critical role in the **cross-linking of collagen and elastin**, essential for the integrity of connective tissues.

Q: All are cofactors for Dehydrogenase except:

SAM. ***SAM*** - **S-adenosylmethionine (SAM)** is a cofactor involved in **methyl group transfer reactions**, carried out by enzymes known as methyltransferases. - Dehydrogenase enzymes catalyze **redox reactions**, typically involving the transfer of hydride ions, and thus do not utilize SAM as a cofactor. *NADP* - **Nicotinamide adenine dinucleotide phosphate (NADP)** is a crucial coenzyme for many **dehydrogenase reactions**, particularly in **anabolic pathways** like fatty acid synthesis and the pentose phosphate pathway. - It acts as an **electron carrier**, accepting or donating hydride ions. *NAD* - **Nicotinamide adenine dinucleotide (NAD)** is a highly common coenzyme for numerous **dehydrogenase enzymes**, especially in **catabolic pathways** such as glycolysis, the Krebs cycle, and oxidative phosphorylation. - It functions as an **electron acceptor** or donor in redox reactions. *FAD* - **Flavin adenine dinucleotide (FAD)** is a coenzyme derived from **riboflavin (Vitamin B2)** and is associated with various dehydrogenase enzymes, particularly those involved in **electron transport** and fatty acid oxidation. - FAD can accept two hydrogen atoms (one hydride and one proton) to become FADH₂.

Q: NITI Aayog stands for:

National Institution for Transforming India. ***National Institute for Transforming India*** - NITI Aayog is the abbreviation for **National Institution for Transforming India**, a policy think tank of the Indian government. - It replaced the **Planning Commission** in 2015, aiming to foster cooperative federalism and bottom-up planning. *Newer Initiative transforming India* - This option is **descriptive** of NITI Aayog's function but not its official full form. - While NITI Aayog is indeed a newer initiative for transformation, this is not the **accurate expansion** of the acronym. *Nutritional institute for transforming India* - This option incorrectly specifies "Nutritional institute," limiting the scope of NITI Aayog's work. - NITI Aayog's mandate is **broader** than just nutrition; it covers various socio-economic development aspects. *Nutrition Intake to India* - This option is syntactically awkward and **does not align** with the established full form of NITI Aayog. - It also drastically **misrepresents** the organization's overarching purpose and functions.

Q: A patient is having a continuous tremor and he has tendency to fall. Lesion is most commonly seen in?

Substantia Nigra. ***Substantia Nigra*** - A lesion in the **substantia nigra** leads to a deficiency of **dopamine**, which is characteristic of **Parkinson's disease** [1]. - Symptoms like **continuous tremor (resting tremor)**, **postural instability (tendency to fall)**, rigidity, and bradykinesia are hallmark features of Parkinson's disease, linked to substantia nigra degeneration [1], [2]. *Putamen* - While the putamen is part of the basal ganglia and involved in motor control, its primary lesion is not typically associated with the classic triad of **Parkinsonian symptoms** (tremor, rigidity, bradykinesia) [1]. - Lesions here might instead contribute to involuntary movements like **dystonia** or **chorea**, which are not described. *Globus pallidus* - The globus pallidus is involved in regulating voluntary movement, and lesions here can cause various movement disorders, including **dystonia**, **chorea**, or **hemiballismus** [2]. - However, isolated pallidal lesions are less commonly the primary cause of the specific combination of **resting tremor** and **falls** seen in Parkinson's. *Caudate nucleus* - The caudate nucleus plays a crucial role in cognitive and motor functions and is primarily affected in diseases like **Huntington's disease**, leading to **chorea** and cognitive decline [2]. - Lesions in the caudate nucleus do not typically present with a **continuous tremor** and **tendency to fall** as the predominant symptoms.

Q: Molluscum contagiosum is caused by a:

Pox virus. ***Pox virus*** - **Molluscum contagiosum** is a common **cutaneous viral infection** caused by the **Molluscum Contagiosum Virus (MCV)**. - MCV belongs to the **Poxviridae family**, which are known for causing characteristic skin lesions. *Flavi virus* - **Flaviviruses** are a genus of RNA viruses, which cause diseases like **Dengue fever**, **Yellow fever**, and **Zika virus infection**. - They typically cause **systemic illnesses** with fever and rash, rather than localized skin lesions like molluscum contagiosum. *Adenovirus* - **Adenoviruses** are DNA viruses primarily associated with **respiratory infections** (e.g., common cold, bronchitis) and **conjunctivitis**. - They are not known to cause the characteristic **umbilicated papules** seen in molluscum contagiosum. *Rubivirus* - **Rubivirus** is a genus that includes the **Rubella virus**, which causes **German measles** (Rubella). - Rubella is characterized by a **maculopapular rash** and **lymphadenopathy**, which is distinct from the **umbilicated papules** seen in molluscum contagiosum.

Q: Angle of cut in episiotomy is?

60 degrees at the midline. ***60 degrees at the midline*** - A **mediolateral episiotomy** is recommended at a **60-degree angle** from the midline, directed towards the ischial tuberosity. - This angle is based on **RCOG guidelines** and standard obstetric practice, providing optimal protection against **third- and fourth-degree perineal tears**. - The 60-degree angle effectively directs the incision away from the **anal sphincter** and **rectum**, while maintaining adequate surgical access. *45 degrees at the midline* - While sometimes used, this angle is **less protective** than 60 degrees against anal sphincter injuries. - Studies show that angles less than 60 degrees have a **higher risk** of extension into the anal sphincter complex compared to the recommended 60-degree angle. *30 degrees at the midline* - This angle is **too shallow** and provides insufficient protection against tearing towards the anal sphincter. - The risk of uncontrolled extension into the **anal sphincter complex** is significantly increased with such a small angle. *15 degrees at the midline* - This angle is **far too shallow** and would provide minimal expansion of the vaginal outlet. - It offers virtually no protection from extension into the **anal sphincter** and would likely result in an uncontrolled tear, making it an impractical choice for episiotomy.

Q: A multigravida woman in labor room, after delivery and placenta removal, uncontrolled bleeding was seen. What is the most common cause of PPH in this woman?

Atony. ***Atonic*** - **Uterine atony** is the most common cause of **postpartum hemorrhage (PPH)**, accounting for approximately 70-80% of cases. The uterus fails to contract adequately after placental delivery, leading to continuous bleeding from the placental bed. - Risk factors for uterine atony include multiparity, prolonged labor, rapid labor, polyhydramnios, and multiple gestations, which can lead to overdistension and fatigue of the uterine muscle. *Clotting factor deficiency* - While **coagulopathies** (clotting factor deficiencies) can cause PPH, they are a less common primary cause than uterine atony. - This cause would be suspected if there is a history of bleeding disorders, liver disease, or if PPH persists despite a well-contracted uterus. *Traumatic PPH* - **Traumatic PPH** results from lacerations of the cervix, vagina, or perineum, or from uterine rupture. These are less common than uterine atony. - This cause is typically suspected when the uterus feels firm but bleeding continues, or when visible trauma is present. *Retained tissues* - **Retained placental tissue** can prevent the uterus from contracting effectively, leading to PPH. However, it is less common than atony. - This cause is usually identified by the presence of placental fragments or membranes in the uterine cavity upon examination.

Q: Keratometer is used to assess:

Curvature of cornea. ***Curvature of cornea*** - A **keratometer** (or ophthalmometer) is specifically designed to measure the **radius of curvature** of the **anterior surface of the cornea**. - This measurement is crucial for fitting **contact lenses**, diagnosing **astigmatism**, and planning **refractive surgeries**. *Curvature of lens* - The curvature of the **crystalline lens** inside the eye is not directly measured by a keratometer. - Lens curvature changes with **accommodation** and is assessed more indirectly through an **autorefractor** or during cataract surgery planning with specific formulas. *Thickness of cornea* - The **thickness of the cornea** is measured using a **pachymeter**, not a keratometer. - **Pachymetry** is important for diagnosing conditions like **glaucoma** and evaluating suitability for **refractive surgery**. *Diameter of cornea* - The **diameter of the cornea** (from limbus to limbus) is typically measured using a **ruler or calipers**, not a keratometer. - This measurement is relevant for contact lens fitting and surgical planning.

Q: A patient with varicose veins came to the hospital; an intern was on duty. Which test should he perform to assess the competency of deep veins?

Perthes test. ***Perthes test*** - The Perthes test assesses the **patency and competency of the deep venous system** in the leg by observing changes in superficial varicosities during muscle activity. - If the varicosities diminish or disappear with ambulation and a tourniquet applied to compress superficial veins, it indicates that the **deep veins are competent** and can handle venous return. *Ober test* - The Ober test is used to assess the **tightness of the iliotibial band**, not venous competency. - It involves abducting and extending the hip while the patient lies on their side. *Thomas test* - The Thomas test evaluates for **hip flexion contracture**, especially of the iliopsoas muscle. - It is performed by having the patient lie supine and flexing one hip fully while observing the contralateral leg. *Brodie Trendelenburg test* - The Brodie Trendelenburg test is primarily used to assess the **competency of the valves of the saphenofemoral junction and perforating veins** to distinguish between superficial and deep venous insufficiency. - It involves elevating the leg, applying a tourniquet, and then observing refilling patterns of varicose veins upon standing.

Question 1

Highest point of iliac crest is seen at?

Accepted Answer

L4

Answer

L3

Answer

S2

Answer

S1

Question 2

Zinc is cofactor of which enzyme?

Accepted Answer

Carbonic anhydrase

Answer

Carboxylase

Answer

Kinase

Answer

Lysyl oxidase

Question 3

All are cofactors for Dehydrogenase except:

Accepted Answer

SAM

Answer

NADP

Answer

NAD

Answer

FAD

Question 4

NITI Aayog stands for:

Accepted Answer

National Institution for Transforming India

Answer

Newer Initiative transforming India

Answer

Nutritional institute for transforming India

Answer

Nutrition Intake to India

Question 5

A patient is having a continuous tremor and he has tendency to fall. Lesion is most commonly seen in?

Accepted Answer

Substantia Nigra

Answer

Putamen

Answer

Globus pallidus

Answer

Caudate nucleus

Question 6

Molluscum contagiosum is caused by a:

Accepted Answer

Pox virus

Answer

Flavi virus

Answer

Adenovirus

Answer

Rubivirus

Question 7

Angle of cut in episiotomy is?

Accepted Answer

60 degrees at the midline

Answer

45 degrees at the midline

Answer

30 degrees at the midline

Answer

15 degrees at the midline

Question 8

A multigravida woman in labor room, after delivery and placenta removal, uncontrolled bleeding was seen. What is the most common cause of PPH in this woman?

Accepted Answer

Atony

Answer

Clotting factor deficiency

Answer

Traumatic PPH

Answer

Retained tissues

Question 9

Keratometer is used to assess:

Accepted Answer

Curvature of cornea

Answer

Curvature of lens

Answer

Thickness of cornea

Answer

Diameter of cornea

Question 10

A patient with varicose veins came to the hospital; an intern was on duty. Which test should he perform to assess the competency of deep veins?

Accepted Answer

Perthes test

Answer

Ober test

Answer

Thomas test

Answer

Brodie Trendelenburg test

FMGE 2019

Anatomy

Biochemistry

Community Medicine

Internal Medicine

Microbiology

Obstetrics and Gynecology

Ophthalmology

Surgery