FMGE 2025 Previous Year Questions Practice Questions

Q: A 45-year-old woman presented with tingling sensation of lateral 3 digits with loss of sensation of base of thumb on the dorsal aspect of the hand. Which is the nerve involved?

Radial nerve. ***Radial nerve*** - The **superficial branch of the radial nerve** provides sensory innervation to the dorsal aspect of the hand, including the dorsal surface of the thumb, index, middle, and the radial half of the ring finger up to the nail beds [1]. - The patient's symptoms of sensory loss at the **dorsal base of the thumb** (anatomical snuffbox) and tingling in the lateral digits are classic signs of superficial radial nerve involvement [1]. *Ulnar nerve* - The **ulnar nerve** provides sensation to the medial one and a half digits (the little finger and the medial half of the ring finger) on both the palmar and dorsal sides [1]. - Involvement of the ulnar nerve would not cause sensory changes in the lateral three digits or the thumb. *Median nerve* - The **median nerve** supplies sensation to the palmar aspect of the lateral three and a half digits and the nail beds on the dorsal side [1]. - It does not supply the dorsal aspect of the hand or the base of the thumb, which is a key localizing feature in this case. Common entrapment leads to **carpal tunnel syndrome** [2]. *AIN* - The **Anterior Interosseous Nerve (AIN)** is a purely **motor** branch of the median nerve [2]. - An injury to the AIN would result in motor weakness, specifically an inability to flex the thumb and index finger to make an 'OK' sign, but would not cause any sensory loss [2]. [Practice more FMGE 2025 questions on OnCourse]

Q: Patient with HIV presenting with bouts of cough and fever. Which medium is appropriate for diagnosis?

Lowenstein-Jensen (LJ) medium. ***Lowenstein-Jensen (LJ) medium*** - This egg-based culture medium is the standard solid medium used globally for the isolation of **Mycobacterium tuberculosis**. - Given the patient's history of **HIV** and symptoms of cough and fever, **Pulmonary Tuberculosis (TB)** is the differential diagnosis most likely requiring this specialized medium. *Tinsdale media* - Tinsdale medium is specifically used for the primary isolation and identification of **Corynebacterium diphtheriae**. - The characteristic presentation of **diphtheria** (pseudomembrane, severe pharyngitis) differs significantly from the suspected chronic respiratory symptoms of TB. *MacConkey agar* - This is a selective and differential medium designed to isolate and differentiate **Gram-negative enteric bacilli** (e.g., *E. coli*, *Salmonella*). - It is completely inadequate for the isolation of the slow-growing, **acid-fast bacilli** characteristic of mycobacteria. *Loeffler serum slope (LSS)* - Loeffler serum slope is an enrichment medium primarily used to promote the growth and demonstration of characteristic morphology in **Corynebacterium diphtheriae**. - While sometimes used for initial inoculum, it is not the definitive medium required for the isolation of **Mycobacterium tuberculosis** due to its composition and intended purpose. [Practice more FMGE 2025 questions on OnCourse]

Q: A firefighter was admitted with fever, cough, culture shown in the image reveals gram-negative, oxidase-positive bacilli. Colonies transilluminating while passing under UV light. Choose the correct agent.

Pseudomonas aeruginosa. ***Pseudomonas aeruginosa*** - This organism is a **gram-negative**, **oxidase-positive** bacillus, matching the description. The image shows growth with a characteristic green pigment (**pyocyanin** and **pyoverdin**). - The key identifier is the production of **pyoverdin**, a fluorescent siderophore, which causes the colonies to transilluminate under UV light. *Klebsiella* - *Klebsiella* is **oxidase-negative**, which rules it out based on the biochemical test results provided. - It typically produces large, **mucoid colonies** due to its prominent capsule and is a lactose fermenter, features not described here. *Staphylococcus aureus* - *Staphylococcus aureus* is a **gram-positive coccus**, not a gram-negative bacillus, making it incorrect based on the initial microscopy. - It is also **oxidase-negative** and characteristically forms opaque, often golden-yellow colonies, not greenish fluorescent ones. *Serratia* - *Serratia* is a gram-negative bacillus but is **oxidase-negative**, which is inconsistent with the findings. - Certain species like *Serratia marcescens* are known for producing a red pigment called **prodigiosin**, especially at room temperature, not a green fluorescent pigment. [Practice more FMGE 2025 questions on OnCourse]

Q: A firefighter with fever and cough has a culture showing gram-negative, oxidase-positive bacilli with fluorescent colonies under UV light. Which of the following organisms is most likely causing the infection?

Pseudomonas aeruginosa. ***Pseudomonas aeruginosa***- This organism is a non-lactose fermenting, **Gram-negative bacillus** that is definitively **oxidase-positive**.- It characteristically produces the siderophore **pyoverdine**, which is fluorescent under UV light, confirming the most likely etiology.*Klebsiella*- *Klebsiella* species are **oxidase-negative** (**distinguishing factor**) and typically highly encapsulated, often causing consolidation in pneumonia.- They are also strong **lactose fermenters** and do not produce fluorescent pigments.*Staphylococcus aureus*- *S. aureus* is a **Gram-positive coccus** (stains purple) arranged in clusters, not a Gram-negative bacillus (stains pink).- It is non-motile, shows no fluorescence, and is identified by being coagulase and catalase positive.*Serratia*- *Serratia marcescens* is generally **oxidase-negative** (unlike the clinical finding) and belongs to the Enterobacteriaceae family.- Under room temperature, *Serratia* often produces a characteristic **red pigment** (**prodigiosin**), not a fluorescent pigment. [Practice more FMGE 2025 questions on OnCourse]

Q: A 9-month-old child was admitted to ICU with a history of recurrent sinusitis and otitis media by Staphylococcus aureus. Blood test shows decreased serum IgA, IgG, IgM, IgE, and plasma B cells. What is the diagnosis?

Bruton syndrome. ***Bruton syndrome***- This diagnosis (X-linked agammaglobulinemia or XLA) is defined by the failure of **B cell maturation** due to a mutation in the **BTK gene**, leading to near-total absence of mature B cells and plasma cells.- The clinical presentation is recurrent infections, often *S. aureus* and encapsulated bacteria, correlated with the drastic reduction of all serum **immunoglobulin levels** (IgA, IgG, IgM, IgE).*Ataxia telangiectasia*- This is an **autosomal recessive** T-cell/B-cell defect associated with defects in **DNA repair** (ATM gene), causing progressive cerebellar ataxia and oculocutaneous telangiectasias.- While associated with immunodeficiency, it typically presents with low **IgA** and **IgE**, not the complete absence of plasma B cells seen here.*Chronic granulomatous disease*- This is a phagocytic disorder due to a defect in the **NADPH oxidase** complex, preventing neutrophils from generating a respiratory burst necessary to kill catalase-positive organisms (like *S. aureus*).- Although the child has *S. aureus* infection, **serum Ig and B cell levels** remain normal, which contradicts the profound pan-hypogammaglobulinemia seen in this scenario.*DiGeorge syndrome*- Caused by defective development of the 3rd and 4th pharyngeal pouches, resulting in **T-cell deficiency** (thymic hypoplasia), **hypocalcemia**, and cardiac defects.- The primary immunodeficiency affects T cells, leading to susceptibility to **viral and fungal infections**; B cell numbers are usually normal, even though antibody production might be secondarily impaired. [Practice more FMGE 2025 questions on OnCourse]

Question 1

A 45-year-old woman presented with tingling sensation of lateral 3 digits with loss of sensation of base of thumb on the dorsal aspect of the hand. Which is the nerve involved?

Accepted Answer

Radial nerve

Answer

Median nerve

Answer

AIN

Answer

Ulnar nerve

Question 2

Patient with HIV presenting with bouts of cough and fever. Which medium is appropriate for diagnosis?

Accepted Answer

Lowenstein-Jensen (LJ) medium

Answer

MacConkey agar

Answer

Loeffler serum slope (LSS)

Answer

Tinsdale media

Question 3

A firefighter was admitted with fever, cough, culture shown in the image reveals gram-negative, oxidase-positive bacilli. Colonies transilluminating while passing under UV light. Choose the correct agent.

Accepted Answer

Pseudomonas aeruginosa

Answer

Staphylococcus aureus

Answer

Serratia

Answer

Klebsiella

Question 4

A firefighter with fever and cough has a culture showing gram-negative, oxidase-positive bacilli with fluorescent colonies under UV light. Which of the following organisms is most likely causing the infection?

Accepted Answer

Pseudomonas aeruginosa

Answer

Staphylococcus aureus

Answer

Serratia

Answer

Klebsiella

Question 5

A 9-month-old child was admitted to ICU with a history of recurrent sinusitis and otitis media by Staphylococcus aureus. Blood test shows decreased serum IgA, IgG, IgM, IgE, and plasma B cells. What is the diagnosis?

Accepted Answer

Bruton syndrome

Answer

Chronic granulomatous disease

Answer

DiGeorge syndrome

Answer

Ataxia telangiectasia

Question 6

Chronic malnutrition is best measured by?

Accepted Answer

Height for age

Answer

Weight for height

Answer

Body mass index

Answer

Weight for age

Question 7

Which anti-epileptic drug is commonly associated with gum hypertrophy and dizziness as side effects?

Accepted Answer

Phenytoin

Answer

Carbamazepine

Answer

Topiramate

Answer

Levetiracetam

Question 8

Which segment of the nephron has the lowest osmolality under the influence of antidiuretic hormone (ADH)?

Accepted Answer

Early distal tubule

Answer

Descending limb of the loop of Henle

Answer

Collecting duct

Answer

Late distal tubule

Question 9

Which of the following is the afferent limb of the corneal reflex?

Accepted Answer

Trigeminal nerve

Answer

Facial nerve

Answer

Trochlear nerve

Answer

Optic nerve

Question 10

Which of the following changes occurs during muscle contraction while exercising, as shown in the image?

Accepted Answer

I length decrease

Answer

M length increase

Answer

M length increase and I decrease

Answer

A length decrease

FMGE 2025

Anatomy

Microbiology

Pediatrics

Pharmacology

Physiology