FMGE 2021 Previous Year Questions Practice Questions

Q: The number of maternal deaths per 100,000 live births is called-

Maternal mortality ratio. ***Maternal mortality ratio*** - This is the standard epidemiological indicator defining the number of **maternal deaths per 100,000 live births**. - It measures the risk of death due to pregnancy in a population. *Maternal mortality rate* - This term is often used interchangeably with maternal mortality ratio, but technically, a **rate usually includes time in the denominator** (e.g., deaths per person-year). - While related to maternal mortality, it's not the precise term for deaths per live births. *Infant mortality rate* - This measures the number of **deaths of infants under one year of age per 1,000 live births**. - It does not specifically refer to deaths of mothers. *Perinatal mortality rate* - This calculates the number of **stillbirths and deaths in the first week of life per 1,000 total births** (live births plus stillbirths). - It focuses on deaths around the time of birth in the infant, not the mother. [Practice more FMGE 2021 questions on OnCourse]

Q: A patient presents with severe pain and swelling in his knee joint for 10 days. He also complains of pain and discomfort during urination. He says that he had diarrhea one month ago and he has been unwell since then. What is the most likely diagnosis?

Reactive arthritis. Reactive arthritis - This diagnosis is strongly supported by the triad of symptoms: **arthritis** (knee pain/swelling), **urethritis** (pain during urination), and a preceding **gastrointestinal infection** (diarrhea one month prior) [1]. - Reactive arthritis is an inflammatory arthritis triggered by an infection in another part of the body, often **gastrointestinal** or **genitourinary** [2]. *Psoriasis arthritis* - This condition is associated with **psoriasis**, a skin disease characterized by red, scaly patches, which is not mentioned in the patient's history. - While it can affect joints, it does not typically present with a preceding gastrointestinal infection or urethral symptoms. *Rheumatoid arthritis* - **Rheumatoid arthritis** typically presents with symmetric polyarticular joint involvement, often affecting smaller joints like those in the hands and feet, rather than a single large joint like the knee [3]. - It does not typically follow a gastrointestinal infection or involve urethral symptoms. *Enteropathic arthritis* - This type of arthritis is associated with **inflammatory bowel diseases** (IBD) like Crohn's disease or ulcerative colitis. - While diarrhea can be a symptom of IBD, the patient's presentation with acute urethritis points away from enteropathic arthritis as the primary diagnosis, which often involves axial skeleton or peripheral joints but typically not urethral inflammation. [Practice more FMGE 2021 questions on OnCourse]

Q: Following complete ileal and partial jejunal resection, the patient is most likely to have-

Vitamin B12 Deficiency. ***Vitamin B12 Deficiency*** - The **terminal ileum** is the primary site for **vitamin B12 absorption**, complexed with intrinsic factor [3]. Resection of this segment significantly impairs this process. - Patients with **ileal resection** are highly susceptible to developing **megaloblastic anemia** and neurological complications due to **vitamin B12 deficiency** [3]. *Constipation* - Complete ileal and partial jejunal resection is **more likely to cause diarrhea** rather than constipation, particularly due to malabsorption of bile salts and fats [2]. - **Bile salt malabsorption** in the colon often leads to secretory diarrhea [1]. *Gastric ulcer* - Gastric ulcers are typically associated with *Helicobacter pylori* infection or NSAID use, and are **not a direct consequence** of ileal and jejunal resection. - While short bowel syndrome can sometimes lead to increased gastric acid secretion, peptic ulcer formation is not the most likely or direct complication. *Folic acid deficiency* - **Folic acid** is primarily absorbed in the **jejunum**, and while partial jejunal resection occurred, complete ileal resection is less directly implicated in folate deficiency. - Other sections of the small intestine can often compensate for partial jejunal loss in folate absorption, making B12 deficiency a more immediate and severe concern after complete ileal resection. [Practice more FMGE 2021 questions on OnCourse]

Q: A 27-year-old woman presented with a malodorous discharge in the vagina which started a week earlier. On examination, Whiff's test is positive and the gram stain shows the presence of clue cells. This infection is commonly treated with which of the following?

Metronidazole. ***Metronidazole*** - This patient's symptoms (malodorous vaginal discharge, positive **Whiff test**, and presence of **clue cells** on Gram stain) are classic findings for **bacterial vaginosis (BV)**. - **Metronidazole** is the first-line and most effective antibiotic for treating bacterial vaginosis, as it targets the anaerobic bacteria overgrowing in the vagina. *Azithromycin* - **Azithromycin** is primarily used to treat infections like **chlamydia**, gonorrhea, or some respiratory tract infections. - It is **not effective** against the anaerobic bacteria responsible for bacterial vaginosis. *Nystatin pessary* - **Nystatin** is an **antifungal medication** specifically used to treat **vulvovaginal candidiasis (yeast infection)**. - The patient's presentation (malodorous discharge, positive Whiff test, clue cells) does not align with a yeast infection, making nystatin ineffective. *Tetracycline* - **Tetracycline** is a broad-spectrum antibiotic, but it is **not the preferred treatment** for bacterial vaginosis. - Its use is often associated with a higher risk of side effects and is typically reserved for other bacterial infections like **chlamydia**, acne, or Rocky Mountain spotted fever. [Practice more FMGE 2021 questions on OnCourse]

Q: Which is correct about ABO and Rh incompatibility leading to Erythroblastosis fetalis?

Cytotoxic. ***Cytotoxic*** - **Erythroblastosis fetalis** involves maternal antibodies (IgG) crossing the placenta and binding to fetal red blood cell antigens, leading to **complement-mediated lysis** of fetal red blood cells. - This is a classic example of a **Type II hypersensitivity reaction**, characterized by antibody-mediated cell destruction. *Cell mediated hypersensitivity* - This refers to **Type IV hypersensitivity reactions**, which involve T lymphocytes and macrophages, not antibodies. - Examples include **contact dermatitis** and **tuberculosis skin tests**. *Immune complex* - This describes **Type III hypersensitivity reactions**, where antigen-antibody complexes form and deposit in tissues, leading to inflammation. - Conditions like **serum sickness** and **lupus nephritis** are examples of immune complex diseases. *Antigen-antibody reaction* - While present, this option is too broad; all hypersensitivity reactions involve some form of antigen-antibody (or antigen-T cell) interaction. - It does not specifically describe the **mechanisms of tissue damage** or the **type of hypersensitivity** involved in erythroblastosis fetalis. [Practice more FMGE 2021 questions on OnCourse]

Question 1

The number of maternal deaths per 100,000 live births is called-

Accepted Answer

Maternal mortality ratio

Answer

Maternal mortality rate

Answer

Infant mortality rate

Answer

Perinatal mortality rate

Question 2

A patient presents with severe pain and swelling in his knee joint for 10 days. He also complains of pain and discomfort during urination. He says that he had diarrhea one month ago and he has been unwell since then. What is the most likely diagnosis?

Accepted Answer

Reactive arthritis

Answer

Psoriasis arthritis

Answer

Rheumatoid arthritis

Answer

Enteropathic arthritis

Question 3

Following complete ileal and partial jejunal resection, the patient is most likely to have-

Accepted Answer

Vitamin B12 Deficiency

Answer

Constipation

Answer

Gastric ulcer

Answer

Folic acid deficiency

Question 4

A 27-year-old woman presented with a malodorous discharge in the vagina which started a week earlier. On examination, Whiff's test is positive and the gram stain shows the presence of clue cells. This infection is commonly treated with which of the following?

Accepted Answer

Metronidazole

Answer

Azithromycin

Answer

Nystatin pessary

Answer

Tetracycline

Question 5

Which is correct about ABO and Rh incompatibility leading to Erythroblastosis fetalis?

Accepted Answer

Cytotoxic

Answer

Cell mediated hypersensitivity

Answer

Immune complex

Answer

Antigen-antibody reaction

Question 6

A patient was referred by a doctor to a radiologist for a CT scan and the doctor was given money for the referral. What is this unethical act called?

Accepted Answer

Fee splitting

Answer

Criminal negligence

Answer

Commission

Answer

Medical maloccurrence

Answer

Dichotomy

Question 7

Vitamin K supplementation is given to neonates to prevent _____ .

Accepted Answer

Hemorrhagic disease of the newborn

Answer

Scurvy

Answer

Keratomalacia

Answer

Breast milk jaundice

Answer

Rickets

Question 8

A patient from a North-Eastern state was diagnosed to have an infection with P. Falciparum malaria. What is the most appropriate treatment for this patient?

Accepted Answer

Artemether plus lumefantrine

Answer

Chloroquine

Answer

Mefloquine

Answer

Sulfadoxine plus pyrimethamine

Answer

Quinine plus doxycycline

Question 9

After 72 hours of Cessation of alcohol, which of the following withdrawal symptoms can be seen in alcoholic patients?

Accepted Answer

Delirium tremens

Answer

Seizures

Answer

Hallucinations

Answer

Tremors

Question 10

Which of the following statements is incorrect regarding vasectomy?

Accepted Answer

Sterility is achieved 3 weeks after the procedure

Answer

The procedure is done under local anesthesia

Answer

The vas deferens is the structure that is divided in the procedure

Answer

A no-scalpel technique is being widely used now

FMGE 2021

Community Medicine

Internal Medicine

OB/GYN

Patient Safety

Pediatrics

Pharmacology

Psychiatry

Surgery