Anatomy
1 questionsWhat stage of embryonic development is shown in the following image?
FMGE 2025 - Anatomy FMGE Practice Questions and MCQs
Question 231: What stage of embryonic development is shown in the following image?
- A. Gastrula
- B. Morula
- C. Blastocyst (Correct Answer)
- D. Ova
Explanation: ***Blastocyst*** - The image shows a structure with a distinct fluid-filled cavity (the **blastocoel**, labeled X), an inner cell mass (**embryoblast**), and an outer cell layer (**trophoblast**), which are the defining features of a blastocyst. - This stage occurs around day 5 post-fertilization and is responsible for implantation into the **endometrium** of the uterine wall, which is depicted superior to the blastocyst in the illustration. *Morula* - A morula is a solid, compacted ball of 16-32 cells (**blastomeres**) that precedes the blastocyst stage; it does not have the large internal cavity shown in the image. - The morula forms around day 3-4 after fertilization, and it is the entry of fluid into the morula that transforms it into a blastocyst. *Ova* - An ovum (plural: ova) is a single, unfertilized female gamete (egg cell). - The image shows a multicellular embryo that is the result of fertilization and several rounds of cell division, not a single cell. *Gastrula* - Gastrulation is the process that follows the blastocyst stage, where the embryo organizes into three primary germ layers: **ectoderm**, **mesoderm**, and **endoderm**. - The structure shown is a pre-implantation embryo and has not yet undergone gastrulation, which is characterized by the formation of the **primitive streak**.
Community Medicine
3 questionsA total of 60 patients were diagnosed with COVID-19. Out of which, 12 deaths were reported. Calculate the Case Fatality Rate?
In a normal distribution, the mean value is 82, the SD is 1.5. Calculate the range of two standard deviations?
Which vaccine is contraindicated in pregnancy?
FMGE 2025 - Community Medicine FMGE Practice Questions and MCQs
Question 231: A total of 60 patients were diagnosed with COVID-19. Out of which, 12 deaths were reported. Calculate the Case Fatality Rate?
- A. 40%
- B. 10%
- C. 30%
- D. 20% (Correct Answer)
Explanation: ***20%*** - The **Case Fatality Rate (CFR)** is calculated by dividing the number of deaths from a specific disease by the total number of confirmed cases of that disease, multiplied by **100** to get the percentage. - Based on the data: (12 deaths / 60 cases) * 100 = **0.20** * 100 = **20%**. *30%* - This result is incorrect; it would correspond to **18 deaths** out of 60 cases, not the reported 12 deaths. - A calculation error yielding **30%** does not align with the standard formula for CFR using the given figures. *40%* - This percentage represents a CFR where **24 deaths** were reported among 60 cases, which is double the actual number of fatalities. - Such a high error suggests a significant misapplication of the **CFR formula**. *10%* - This value is incorrect; **10%** CFR would be obtained if only **6 deaths** occurred (6/60 * 100). - This result significantly underestimates the **Case Fatality Rate** as it is half of the calculated actual rate.
Question 232: In a normal distribution, the mean value is 82, the SD is 1.5. Calculate the range of two standard deviations?
- A. 60-68
- B. 79-85 (Correct Answer)
- C. 40-49
- D. 50-57
Explanation: ***79-85***- For a **normal distribution**, the range covering two standard deviations (2 SD) is calculated using the formula: **Mean $\pm$ (2 $\times$ SD)**. The $2\sigma$ interval encompasses approximately **95.45%** of the data points.- Calculation: Lower limit $= 82 - (2 \times 1.5) = 82 - 3 = 79$. Upper limit $= 82 + (2 \times 1.5) = 85$. The correct range is **79-85**. *60-68*- This range is highly incorrect as it is centered far below the **mean of 82** and the width (8 units) is too wide for a total of 3 units (2 SD) dispersion. - The lower limit of 60 is over 14 standard deviations away from the mean, indicating it is an outlier range not relevant to the $2\sigma$ calculation. *50-57*- This range is excessively far from the **mean of 82** and its width (7 units) does not correspond to the required 3 units of dispersion needed for $\pm 2$ SD. - Ranges like this would include virtually none of the observations expected in a population with a mean of 82 and a small **standard deviation** of 1.5. *40-49*- This interval is centered around 44.5, which is highly divergent from the actual **mean of 82**, and therefore cannot represent the population's $\pm 2$ SD range. - In a normal distribution, the data is symmetric around the mean; any calculated range must therefore include the mean near its center, which this option fails to do.
Question 233: Which vaccine is contraindicated in pregnancy?
- A. TDaP
- B. Rabies
- C. Influenza
- D. Varicella (Correct Answer)
Explanation: ***Varicella (Correct Answer)*** - This is a **live attenuated vaccine** that is **contraindicated in pregnancy** due to the theoretical risk of causing congenital infection, such as **fetal varicella syndrome** - Vaccination should be postponed until the **postpartum period** - If an unprotected pregnant woman is exposed, **Varicella-Zoster Immune Globulin (VZIG)** may be indicated *Influenza (Incorrect)* - The **inactivated influenza vaccine** (injectable form) is **recommended and safe** for all pregnant women, regardless of the trimester - Vaccination protects both the mother and the newborn by reducing the risk of severe **influenza-related morbidity** in the mother - Provides passive antibody transfer to protect the infant during the first 6 months of life *Rabies (Incorrect)* - This is an **inactivated (non-live) vaccine** that is **safe to administer during pregnancy** if post-exposure prophylaxis (**PEP**) is indicated - The necessity of protection against a life-threatening disease like **rabies** outweighs the minimal risks associated with the inactivated vaccine - No contraindication in pregnancy when indicated *TDaP (Incorrect)* - TDaP (**Tetanus, Diphtheria, and acellular Pertussis**) is a **recommended non-live vaccine** given during *every* pregnancy - Ideally administered between **27-36 weeks of gestation** to ensure maximum maternal antibody transfer to the fetus - Provides passive immunity to the newborn against **pertussis** (whooping cough), protecting vulnerable infants
Pediatrics
2 questionsA girl presents with microcephaly and a high-pitched cry. Which of the following is the most likely chromosomal abnormality?
A child presents with recurrent Staphylococcus infections. Laboratory examination shows very low levels of immunoglobulins (G, A, M, E), and a low quantity of B cells. There is a normal reaction to environmental antigens on the skin. What is the most likely diagnosis?
FMGE 2025 - Pediatrics FMGE Practice Questions and MCQs
Question 231: A girl presents with microcephaly and a high-pitched cry. Which of the following is the most likely chromosomal abnormality?
- A. Mosaicism
- B. Trisomy
- C. Isochromosome
- D. Deletion (Correct Answer)
Explanation: ***Deletion***- The combination of **microcephaly** and a peculiar **high-pitched cry** (often described as 'cat-like') is the hallmark clinical presentation of **Cri-du-chat syndrome**.- Cri-du-chat syndrome is caused by a **deletion** of the distal part of the short arm of chromosome 5 (5p-).*Isochromosome*- An **isochromosome** is a structural chromosomal abnormality where an arm is duplicated, resulting in two copies of one arm and none of the other (e.g., often seen in X chromosome abnormalities like **Turner syndrome**).- This type of structural error does not typically result in the specific features of Cri-du-chat syndrome, which require the loss of specific genes on **chromosome 5 short arm**.*Trisomy*- **Trisomy** is the presence of an extra copy of a chromosome (47 total chromosomes, e.g., **Down syndrome - Trisomy 21**).- Syndromes resulting from autosomal trisomies (like Patau or Edwards) present with different constellations of congenital and developmental abnormalities, lacking the pathognomonic **cat-like cry**.*Mosaicism*- **Mosaicism** describes the presence of two or more populations of cells with different genotypes in one individual, often mitigating the severity of major aneuploidies.- While it can occur with some deletions, **mosaicism** is not the primary mechanism or classification for the specific **Cri-du-chat syndrome** which is defined by the **5p deletion**.
Question 232: A child presents with recurrent Staphylococcus infections. Laboratory examination shows very low levels of immunoglobulins (G, A, M, E), and a low quantity of B cells. There is a normal reaction to environmental antigens on the skin. What is the most likely diagnosis?
- A. Common variable immunodeficiency
- B. Hyper IgM syndrome
- C. DiGeorge syndrome
- D. Bruton's agammaglobulinemia (Correct Answer)
Explanation: ***Bruton's agammaglobulinemia***- This X-linked disease is caused by a defect in the **Bruton tyrosine kinase (BTK)** gene, which is essential for B-cell maturation.- The deficiency results in a severe block in B-cell development, leading to **near absence of mature B cells** and consequently, extremely **low levels of all immunoglobulin isotypes** (IgG, A, M, E).*DiGeorge syndrome*- Primary feature is **T-cell deficiency** due to failure of the 3rd and 4th pharyngeal pouches, leading to **thymic hypoplasia**; this would typically impair the skin test response. - Although B cell numbers can sometimes be affected, the hallmark is severe T-cell deficiency, and Ig levels are often normal or near-normal, unlike the pan-hypogammaglobulinemia seen here.*Hyper IgM syndrome*- This condition is characterized by a failure in **isotype switching** (often due to defects in **CD40L**), resulting in normal or high levels of **IgM** but very low levels of IgG, IgA, and IgE.- B cells are present in normal counts, distinguishing it from this patient who has very few B cells and very low IgM.*Common variable immunodeficiency*- CVID typically presents later, in adolescence or adulthood, and causes **hypogammaglobulinemia** (low IgG and usually low IgA/IgM).- While B-cell function is impaired, patients usually have **normal B-cell counts**, contrasting with the severe reduction in B cells seen in this child.
Physiology
1 questionsHormone responsible for milk ejection reflex in the image shown?
FMGE 2025 - Physiology FMGE Practice Questions and MCQs
Question 231: Hormone responsible for milk ejection reflex in the image shown?
- A. GH
- B. TSH
- C. Oxytocin (Correct Answer)
- D. FSH
Explanation: ***Oxytocin*** - The image shows a baby breastfeeding, which involves the **suckling reflex**. This reflex triggers the release of oxytocin from the posterior pituitary gland. - Oxytocin is crucial for the **milk ejection reflex** (or let-down reflex), as it causes the contraction of myoepithelial cells surrounding the alveoli in the mammary glands, expelling milk. *TSH* - Thyroid-Stimulating Hormone (TSH) is released from the anterior pituitary and its primary role is to stimulate the **thyroid gland** to produce thyroid hormones. - It is involved in regulating the body's **metabolism** and is not directly responsible for lactation. *GH* - Growth Hormone (GH) is secreted by the anterior pituitary and is essential for overall **somatic growth**, particularly of bones and muscles. - While it contributes to mammary gland development, it does not mediate the immediate process of milk ejection during breastfeeding. *FSH* - Follicle-Stimulating Hormone (FSH) is an anterior pituitary hormone that plays a key role in the reproductive cycle. - It stimulates the growth of **ovarian follicles** in females and **spermatogenesis** in males, and is not involved in lactation.
Radiology
3 questionsBased on the provided MRI images of the knee (A and B), which show a well-defined fluid collection anterior to the patella, what is the most likely diagnosis?
Which of the following conditions is associated with Holman-Miller sign in the CT image given below?
A patient with CSOM presented to the OPD with seizures. On examination, homonymous hemianopia was present. Identify the condition based on the CT scan given below.
FMGE 2025 - Radiology FMGE Practice Questions and MCQs
Question 231: Based on the provided MRI images of the knee (A and B), which show a well-defined fluid collection anterior to the patella, what is the most likely diagnosis?
- A. Rheumatoid arthritis
- B. Housemaid's knee (Correct Answer)
- C. Gout
- D. Subdermal abscess
Explanation: ***Housemaid's knee*** - The MRI shows fluid accumulation specifically in the **prepatellar bursa**, which is located anterior to the patella. This finding is the hallmark of prepatellar bursitis. - This condition is colloquially termed **"Housemaid's knee"** as it commonly results from chronic irritation and inflammation of the bursa due to repetitive kneeling. *Subdermal abscess* - A **subdermal abscess** would appear as a collection of pus in the subcutaneous tissue, often with irregular borders and significant surrounding **inflammatory changes (cellulitis)**, which are not the primary findings here. - The fluid collection is well-defined and confined to the anatomical location of the **prepatellar bursa**, not a disorganized subcutaneous collection. *Gout* - Gout typically presents as an acute **intra-articular** inflammation with a large joint effusion. Chronic gout can show characteristic **"rat-bite" erosions** on imaging, which are not visible here. - While gout can cause bursitis, the diagnosis is confirmed by identifying **negatively birefringent urate crystals** in aspirated fluid, and the imaging is less specific than for simple bursitis. *Rheumatoid arthritis* - Rheumatoid arthritis is a systemic disease causing **synovitis** and **pannus formation**, leading to joint destruction and bone erosions, none of which are seen in the image. - While bursitis can be associated with rheumatoid arthritis, it is typically part of a widespread **polyarthritis**, not an isolated finding as shown.
Question 232: Which of the following conditions is associated with Holman-Miller sign in the CT image given below?
- A. Nasal polyp
- B. Rhinosporidiosis
- C. Maxillary sinusitis
- D. Juvenile nasopharyngeal angiofibroma (Correct Answer)
Explanation: ***Juvenile nasopharyngeal angiofibroma***- Holman-Miller sign refers to the classic imaging finding of **anterior bowing** of the posterior wall of the **maxillary sinus** due to the aggressive expansion of this benign tumor originating in the **sphenopalatine foramen**.- This highly **vascular** tumor typically affects **adolescent males** and presents with unilateral, recurrent, and severe epistaxis and nasal obstruction.*Maxillary sinusitis*- CT findings usually include non-specific features like **mucoperiosteal thickening**, air-fluid levels, or complete opacification, without significant displacement of the bony walls.- It is an inflammatory condition, caused by infection or allergy, which does not produce the bone displacement characteristic of aggressive local tumor growth like **JNA**.*Nasal polyp*- Nasal polyps arise from the nasal and sinus mucosa (often the **ethmoids**) and cause pressure-induced **bone erosion** or remodeling, but not the specific **anterior bowing** of the posterior maxillary wall.- They are typically associated with conditions such as **allergic rhinitis** or aspirin-exacerbated respiratory disease.*Rhinosporidiosis*- This condition is characterized by proliferative, **friable, strawberry-like masses** within the nasal cavity, caused by the organism *Rhinosporidium seeberi*.- Imaging usually shows only soft tissue masses within the nasal cavity or nasopharynx without the extensive **bony displacement** needed to produce Holman-Miller sign.
Question 233: A patient with CSOM presented to the OPD with seizures. On examination, homonymous hemianopia was present. Identify the condition based on the CT scan given below.
- A. Meningitis
- B. Cerebellar abscess
- C. Extradural abscess
- D. Temporal abscess (Correct Answer)
Explanation: ***Temporal abscess*** - The patient's history of **CSOM** (Chronic Suppurative Otitis Media) is a classic risk factor for an **otogenic brain abscess**, with the temporal lobe being the most common site due to its proximity to the middle ear and mastoid. - The clinical signs of **seizures** and **homonymous hemianopia** (from involvement of optic radiations), combined with the characteristic **ring-enhancing lesion** on the CT scan, are pathognomonic for a temporal lobe abscess. *Cerebellar abscess* - A cerebellar abscess would present with signs of **cerebellar dysfunction**, such as **ataxia**, **nystagmus**, and **dysmetria**, which are absent in this patient's presentation. - While also a potential complication of otitis media, the focal neurological deficit of **homonymous hemianopia** localizes the lesion to the cerebrum, not the cerebellum. *Extradural abscess* - An extradural abscess is located between the dura mater and the skull and appears as a **lens-shaped (biconvex)** collection on CT, which is morphologically distinct from the **intraparenchymal, ring-enhancing lesion** shown. - Such an abscess is less likely to cause focal signs like hemianopia unless there is significant mass effect on the underlying brain parenchyma. *Meningitis* - Meningitis involves diffuse inflammation of the meninges and does not typically form a **focal, ring-enhancing mass** on a CT scan; findings are often normal or show diffuse meningeal enhancement. - The presence of a specific focal neurological deficit like **homonymous hemianopia** strongly points towards a localized lesion like an abscess rather than diffuse meningitis.