FMGE 2023 Previous Year Questions Practice Questions

Q: Identify the histological image below.

Transitional epithelium. ***Transitional epithelium***- This is also known as **urothelium** and is specialized to line the urinary tract (ureters, bladder, proximal urethra) due to its unique structure.- It is characterized by large, bulbous surface cells called **dome cells** or **umbrella cells**, which protect subepithelial layers from urine. *Pseudostratified columnar epithelium*- This epithelium appears layered because the nuclei are at different levels, but all cells rest on the **basement membrane**.- It is commonly found lining the respiratory tract (**trachea** and bronchi) where it typically features **cilia** and goblet cells. *Non-keratinized squamous epithelium*- This tissue consists of multiple layers of cells (stratified) where the surface cells are flattened and **nucleated**.- Locations include the lining of the **vagina**, esophagus, and oral cavity, where protection from abrasion is needed. *Stratified squamous epithelium*- This general category includes both keratinized and non-keratinized types, but it lacks the characteristic **dome cells** of urothelium.- Its main function is providing robust protection from **mechanical stress**, and it does not exhibit the high degree of stretchability seen in the bladder lining. [Practice more FMGE 2023 questions on OnCourse]

Q: A patient presents cyst on the neck with anterior to the sternocleidomastoid at the junction of the upper and middle third of the muscle. This cyst is due to the persistence of which of the following embryological clefts?

2nd cleft. ***2nd cleft***- A cyst appearing anterior to the **sternocleidomastoid muscle (SCM)**, especially at the junction of the upper and middle third, is the classical presentation of a second branchial cleft cyst (BCC) [1].- Persistence of the **cervical sinus**, which is formed by the rapid growth of the second arch covering the 2nd, 3rd, and 4th clefts, results in the most common type of BCC (over 90%).*1st cleft*- First branchial cleft cysts are rare and typically manifest near the **external auditory canal**, the angle of the mandible, or within the parotid gland [1].- These defects are often associated with the structures of the first arch, such as the **facial nerve** or parotid gland parenchyma.*3rd cleft*- Cysts derived from the third cleft are uncommon and usually present lower in the neck, often close to or piercing the **thyrohyoid membrane**.- A third cleft fistula would course **posterior to the carotid arteries** and anterior to the vagus nerve before ending in the pyriform sinus.*4th cleft*- Remnants of the fourth cleft are extremely rare and typically involve a fistula that tracks inferiorly to the great vessels (e.g., the **aortic arch** on the left side).- Fourth arch defects are often associated with recurrent **thyroiditis** or infection originating from the pyriform sinus. [Practice more FMGE 2023 questions on OnCourse]

Q: A patient presented to the OPD with an abnormal gait. On examination, a right-sided hip drop was observed when the patient was asked to stand on the left foot. Which of the following muscles are paralyzed in this patient?

Left gluteus medius and gluteus minimus. ***Left gluteus medius and gluteus minimus*** - The Trendelenburg sign is positive when the pelvis drops on the side opposite the one being stood on (the unsupported side). - This indicates paralysis or weakness of the **hip abductors** on the **standing leg** (left side in this case), which are the gluteus medius and gluteus minimus, responsible for stabilizing the pelvis. - These muscles are innervated by the **superior gluteal nerve**. *Right gluteus maximus and gluteus medius* - Paralysis of muscles on the right side would typically manifest as a deficit when bearing weight on the **right leg** (causing the left hip to drop). - The **gluteus maximus** is mainly a powerful hip extensor (needed for climbing stairs, running, and rising from a seated position) and does not play the primary role in stabilizing the pelvis during single-leg stance. *Right gluteus medius and gluteus minimus* - If these muscles on the right side were paralyzed, the pelvis would drop on the **left side** when the patient attempts to stand on the right foot. - The finding of a right hip drop while standing on the left foot confirms the deficit is on the ipsilateral side of the standing limb (the **left side**). *Left gluteus maximus and gluteus medius* - While the **left gluteus medius** is correctly identified as being paralyzed, the inclusion of the gluteus maximus is inaccurate. - The **gluteus maximus** is innervated by the **inferior gluteal nerve** (not the superior gluteal nerve), and its paralysis causes difficulty with activities requiring hip extension, such as climbing stairs or rising from a chair (gluteus maximus lurch). - The Trendelenburg sign specifically tests the **superior gluteal nerve** and the hip abductors (gluteus medius and minimus), not the gluteus maximus. [Practice more FMGE 2023 questions on OnCourse]

Q: The framework of the external nose:

Upper 1/3rd bony and lower 2/3rd cartilaginous. ***Upper 1/3rd bony and lower 2/3rd cartilaginous*** - The superior portion (root and bridge) of the external nose is supported by the **nasal bones** and the **frontal process of the maxilla**, constituting the bony framework (approximately the upper third). - The inferior portion (apex and alae) is primarily supported by the **hyaline cartilages** (septal, lateral, and alar cartilages), which comprise the remaining two-thirds, ensuring flexibility. *Upper 1/2 is bony, and lower 1/2 is cartilaginous* - The anatomical ratio is not 1:1; the **cartilaginous component** provides the majority of the structure and length of the external nose, extending past the halfway point. - The **bony framework** includes the nasal bridge and is significantly shorter than the soft cartilaginous portion below it. *Upper 2/3rd is bony and the lower 1/3rd is cartilaginous* - This ratio is anatomically reversed and medically inaccurate, as it implies a dominant bony structure, which would make the nose **rigid**. - The **cartilaginous elements** are necessary for the mobility and shape of the nasal tip and alae, comprising the bulk (two-thirds) of the external framework. *None of the above* - Since the description "upper 1/3rd bony and lower 2/3rd cartilaginous" is anatomically accurate, this option is incorrect. - The correct anatomical framework is well-established in standard anatomy references and medical literature. [Practice more FMGE 2023 questions on OnCourse]

Q: In the given barium swallow image, which of the following shows the left atrium impression on the esophagus?

3. ***Correct: Option 3*** - This pointer correctly identifies the impression on the esophagus caused by the **left atrium**, which is the most posterior chamber of the heart. - An enlarged left atrium, often seen in conditions like **mitral stenosis**, can cause a prominent posterior indentation on the esophagus at this level. - The left atrium impression is typically seen at the level of T4-T6 vertebrae on barium swallow studies. *Incorrect: None of them* - This option is incorrect as the image clearly shows normal anatomical impressions on the esophagus, and pointer 3 correctly identifies the left atrial impression. - A barium swallow is a standard radiological procedure to visualize these impressions from adjacent cardiovascular structures. *Incorrect: Option 1* - This pointer indicates the impression of the **aortic arch**, which is the first and most superior indentation seen on a lateral or oblique view of a barium swallow. - The aortic arch crosses the esophagus on its left side at approximately T4 level, creating a distinct notch as it arches posteriorly. *Incorrect: Option 2* - This pointer shows the impression made by the **left main bronchus** as it crosses anterior to the esophagus. - This indentation is located inferior to the aortic arch impression at approximately T5 level and is typically less pronounced than the aortic or left atrial impressions. [Practice more FMGE 2023 questions on OnCourse]

Question 1

Identify the histological image below.

Accepted Answer

Transitional epithelium

Answer

Pseudostratified columnar epithelium

Answer

Non-keratinized squamous epithelium

Answer

Stratified squamous epithelium

Question 2

A patient presents cyst on the neck with anterior to the sternocleidomastoid at the junction of the upper and middle third of the muscle. This cyst is due to the persistence of which of the following embryological clefts?

Accepted Answer

2nd cleft

Answer

1st cleft

Answer

3rd cleft

Answer

4th cleft

Question 3

A patient presented to the OPD with an abnormal gait. On examination, a right-sided hip drop was observed when the patient was asked to stand on the left foot. Which of the following muscles are paralyzed in this patient?

Accepted Answer

Left gluteus medius and gluteus minimus

Answer

Right gluteus maximus and gluteus medius

Answer

Right gluteus medius and gluteus minimus

Answer

Left gluteus maximus and gluteus medius

Question 4

The framework of the external nose:

Accepted Answer

Upper 1/3rd bony and lower 2/3rd cartilaginous

Answer

Upper 1/2 is bony, and lower 1/2 is cartilaginous

Answer

Upper 2/3rd is bony and the lower 1/3rd is cartilaginous

Answer

None of the above

Question 5

In the given barium swallow image, which of the following shows the left atrium impression on the esophagus?

Accepted Answer

3

Answer

None of them

Answer

1

Answer

2

Question 6

A 55-year-old man is diagnosed with left testicular carcinoma. Which of the following lymph nodes is the first to be involved?

Accepted Answer

Para-aortic lymph nodes

Answer

Inguinal lymph nodes

Answer

Iliac lymph nodes

Answer

Pre-caval lymph nodes

Question 7

In the liver, the Apo-B gene is completely translated to ApoB-100; in the intestine, it is translated to ApoB-48. Which of the following mechanism explains this?

Accepted Answer

RNA editing

Answer

Gene splicing

Answer

Alternative polyadenylation

Answer

Gene rearrangements

Question 8

The culture media that is used to differentiate lactose fermenters and non-lactose fermenters is

Accepted Answer

Mac-Conkey agar

Answer

Bile salt agar

Answer

Thayer-Martin agar

Answer

Sabouraud Dextrose Agar

Question 9

The first heart sound coincides with which cardiac cycle phase?

Accepted Answer

Isovolumetric contraction

Answer

Rapid atrial filling

Answer

Aortic ejection

Answer

Isovolumetric relaxation

Question 10

Which among the following is true regarding creatinine clearance?

Accepted Answer

It is more than inulin clearance

Answer

Equal to inulin clearance

Answer

It is less than inulin clearance

Answer

Equal to renal plasma flow

FMGE 2023

Anatomy

Biochemistry

Microbiology

Physiology