FMGE 2017

Q: Cords of Billroth in spleen are found in

Red pulp. ***Correct: Red pulp*** - The **cords of Billroth** (or splenic cords) are a distinctive histological feature of the **red pulp** of the spleen. - These cords consist of a meshwork of reticular cells and reticular fibers, packed with macrophages, lymphocytes, plasma cells, and abundant red blood cells. *Incorrect: White pulp* - The **white pulp** is primarily involved in immune functions, containing lymphoid follicles rich in lymphocytes. - It is organized around central arterioles and does not contain the cords of Billroth. *Incorrect: Trabecular zone* - The **trabecular zone** consists of connective tissue septa that extend inward from the splenic capsule, carrying blood vessels and nerves. - It provides structural support to the spleen but is not where the cords of Billroth are located. *Incorrect: Mantle zone* - The **mantle zone** is a region within the **white pulp**, surrounding the germinal centers of lymphoid follicles. - It is composed mainly of naive B lymphocytes and is distinct from the cords of Billroth. [Practice more FMGE 2017 questions on OnCourse]

Q: NOT a content of carpal tunnel:-

Ulnar nerve. ***Ulnar nerve*** - The **ulnar nerve** passes superficial to the **flexor retinaculum**, meaning it is not a direct content of the carpal tunnel [1]. - Instead, it travels through a separate space known as **Guyon's canal**, alongside the ulnar artery [1]. *Median nerve* - The **median nerve** is a primary content of the carpal tunnel and is susceptible to compression within this space, leading to carpal tunnel syndrome [1]. - It provides sensory innervation to the lateral palm and digits, and motor innervation to certain thenar muscles [1]. *Flexor digitorum profundus* - The tendons of the **flexor digitorum profundus** muscles (four of them) pass through the carpal tunnel to insert onto the distal phalanges. - These tendons are responsible for **flexion of the distal interphalangeal (DIP) joints** of the medial four fingers. *Flexor digitorum superficialis* - The tendons of the **flexor digitorum superficialis** muscles (four of them) also pass through the carpal tunnel. - They are responsible for **flexion of the proximal interphalangeal (PIP) joints** of the medial four fingers. [Practice more FMGE 2017 questions on OnCourse]

Q: Heberden's arthropathy affects:

Distal interphalangeal joint. ***Distal interphalangeal joint*** - **Heberden's nodes** are pathognomonic bony enlargements that occur on the **distal interphalangeal (DIP) joints** of the fingers [1]. - They are a classic sign of **osteoarthritis**, resulting from cartilage degeneration and new bone formation [1]. *Lumbar spine involvement* - While osteoarthritis can affect the **lumbar spine**, it presents as **back pain** and stiffness, not as nodules on the fingers [1]. - **Heberden's nodes** are specifically associated with peripheral joint involvement, not axial skeleton [1]. *Sacroiliac joint involvement* - **Sacroiliac joint involvement** is characteristic of **spondyloarthropathies** like ankylosing spondylitis, causing inflammatory back pain [1]. - It does not present with bony nodes on the fingers, which are typical of osteoarthritic changes [1]. *Knee joint involvement* - **Knee joint involvement** is common in osteoarthritis, causing pain, swelling, and reduced range of motion [1]. - However, **Heberden's nodes** are distinct from knee symptoms and refer specifically to changes in the DIP joints [1]. [Practice more FMGE 2017 questions on OnCourse]

Q: Meningococcal meningitis is seen with which of the following complement deficiency?

C5. ***C5*** - Deficiencies in terminal complement components (C5-C9) lead to impaired formation of the **membrane attack complex (MAC)**, which is crucial for lysing Neisseria species [1]. - This significantly increases susceptibility to recurrent infections, particularly by **encapsulated bacteria** like *Neisseria meningitidis*, causing diseases such as meningococcal meningitis [2]. *C4* - C4 deficiency is primarily associated with **lupus-like syndromes** and **vasculitis**, due to impaired clearance of immune complexes. - While it can lead to some increased risk of infection, it is not specifically linked to a marked predisposition to meningococcal disease. *C1q* - C1q deficiency also leads to impaired **immune complex clearance** and is strongly associated with **systemic lupus erythematosus (SLE)**. - Like C4 deficiency, it does not typically present with recurrent meningococcal infections as the primary manifestation. *C2* - C2 deficiency is the **most common complement deficiency** and is associated with **lupus-like syndromes** and increased susceptibility to **pyogenic bacterial infections**. - Though it can lead to some increased infection risk, C2 deficiency is not as strongly or specifically linked to recurrent meningococcal meningitis as deficiencies in the terminal complement pathway [2]. [Practice more FMGE 2017 questions on OnCourse]

Q: Which of the following is not associated with pulmonary arterial hypertension?

Left ventricular hypertrophy. ***Left ventricular hypertrophy*** - **Left ventricular hypertrophy** is typically caused by conditions that increase the workload on the left ventricle, such as **systemic hypertension** or **aortic stenosis** [1]. - Pulmonary arterial hypertension directly affects the **pulmonary vasculature**, leading to increased pressure in the pulmonary circuit and ultimately right heart strain, not left ventricular hypertrophy. *Cor pulmonale* - **Cor pulmonale** is defined as **right ventricular enlargement** secondary to lung disease or pulmonary vascular disease. - Pulmonary arterial hypertension increases the afterload on the right ventricle, causing it to dilate and hypertrophy, eventually leading to **right heart failure** (cor pulmonale) [2]. *Mitral Stenosis* - **Mitral stenosis** causes an obstruction to blood flow from the left atrium to the left ventricle, leading to increased pressure in the left atrium and pulmonary veins. - This elevated pressure can be transmitted backward into the pulmonary arteries, leading to **pulmonary arterial hypertension** [3]. *Interstitial lung disease* - **Interstitial lung disease** (ILD) can lead to destruction and remodeling of the pulmonary capillaries, increasing pulmonary vascular resistance [2]. - This increased resistance causes the pulmonary arterial pressure to rise, resulting in **pulmonary arterial hypertension**. [Practice more FMGE 2017 questions on OnCourse]

78 Previous Year Questions with Answers & Explanations

Questions

Subjects

All (78)Anatomy (10)Biochemistry (4)Community Medicine (2)Dental (1)Dermatology (1)Internal Medicine (14)Microbiology (2)Obstetrics and Gynecology (3)Ophthalmology (2)Orthopaedics (2)Pathology (5)Pediatrics (2)Pharmacology (16)Physiology (5)Psychiatry (6)Radiology (1)Surgery (2)

Anatomy

2 questions

Cords of Billroth in spleen are found in

NOT a content of carpal tunnel:-

FMGE 2017 - Anatomy FMGE Practice Questions and MCQs

Question 1: Cords of Billroth in spleen are found in

A. White pulp
B. Red pulp (Correct Answer)
C. Trabecular zone
D. Mantle zone

Explanation: ***Correct: Red pulp*** - The **cords of Billroth** (or splenic cords) are a distinctive histological feature of the **red pulp** of the spleen. - These cords consist of a meshwork of reticular cells and reticular fibers, packed with macrophages, lymphocytes, plasma cells, and abundant red blood cells. *Incorrect: White pulp* - The **white pulp** is primarily involved in immune functions, containing lymphoid follicles rich in lymphocytes. - It is organized around central arterioles and does not contain the cords of Billroth. *Incorrect: Trabecular zone* - The **trabecular zone** consists of connective tissue septa that extend inward from the splenic capsule, carrying blood vessels and nerves. - It provides structural support to the spleen but is not where the cords of Billroth are located. *Incorrect: Mantle zone* - The **mantle zone** is a region within the **white pulp**, surrounding the germinal centers of lymphoid follicles. - It is composed mainly of naive B lymphocytes and is distinct from the cords of Billroth.

Question 2: NOT a content of carpal tunnel:-

A. Median nerve
B. Flexor digitorum profundus
C. Flexor digitorum superficialis
D. Ulnar nerve (Correct Answer)

Explanation: ***Ulnar nerve*** - The **ulnar nerve** passes superficial to the **flexor retinaculum**, meaning it is not a direct content of the carpal tunnel [1]. - Instead, it travels through a separate space known as **Guyon's canal**, alongside the ulnar artery [1]. *Median nerve* - The **median nerve** is a primary content of the carpal tunnel and is susceptible to compression within this space, leading to carpal tunnel syndrome [1]. - It provides sensory innervation to the lateral palm and digits, and motor innervation to certain thenar muscles [1]. *Flexor digitorum profundus* - The tendons of the **flexor digitorum profundus** muscles (four of them) pass through the carpal tunnel to insert onto the distal phalanges. - These tendons are responsible for **flexion of the distal interphalangeal (DIP) joints** of the medial four fingers. *Flexor digitorum superficialis* - The tendons of the **flexor digitorum superficialis** muscles (four of them) also pass through the carpal tunnel. - They are responsible for **flexion of the proximal interphalangeal (PIP) joints** of the medial four fingers.

Internal Medicine

4 questions

Heberden's arthropathy affects:

Meningococcal meningitis is seen with which of the following complement deficiency?

Which of the following is not associated with pulmonary arterial hypertension?

Which of these is least effective as first-line treatment for dangerous hyperkalemia?

FMGE 2017 - Internal Medicine FMGE Practice Questions and MCQs

Question 1: Heberden's arthropathy affects:

A. Distal interphalangeal joint (Correct Answer)
B. Lumbar spine involvement
C. Sacroiliac joint involvement
D. Knee joint involvement

Explanation: ***Distal interphalangeal joint*** - **Heberden's nodes** are pathognomonic bony enlargements that occur on the **distal interphalangeal (DIP) joints** of the fingers [1]. - They are a classic sign of **osteoarthritis**, resulting from cartilage degeneration and new bone formation [1]. *Lumbar spine involvement* - While osteoarthritis can affect the **lumbar spine**, it presents as **back pain** and stiffness, not as nodules on the fingers [1]. - **Heberden's nodes** are specifically associated with peripheral joint involvement, not axial skeleton [1]. *Sacroiliac joint involvement* - **Sacroiliac joint involvement** is characteristic of **spondyloarthropathies** like ankylosing spondylitis, causing inflammatory back pain [1]. - It does not present with bony nodes on the fingers, which are typical of osteoarthritic changes [1]. *Knee joint involvement* - **Knee joint involvement** is common in osteoarthritis, causing pain, swelling, and reduced range of motion [1]. - However, **Heberden's nodes** are distinct from knee symptoms and refer specifically to changes in the DIP joints [1].

Question 2: Meningococcal meningitis is seen with which of the following complement deficiency?

A. C4
B. C1q
C. C5 (Correct Answer)
D. C2

Explanation: ***C5*** - Deficiencies in terminal complement components (C5-C9) lead to impaired formation of the **membrane attack complex (MAC)**, which is crucial for lysing Neisseria species [1]. - This significantly increases susceptibility to recurrent infections, particularly by **encapsulated bacteria** like *Neisseria meningitidis*, causing diseases such as meningococcal meningitis [2]. *C4* - C4 deficiency is primarily associated with **lupus-like syndromes** and **vasculitis**, due to impaired clearance of immune complexes. - While it can lead to some increased risk of infection, it is not specifically linked to a marked predisposition to meningococcal disease. *C1q* - C1q deficiency also leads to impaired **immune complex clearance** and is strongly associated with **systemic lupus erythematosus (SLE)**. - Like C4 deficiency, it does not typically present with recurrent meningococcal infections as the primary manifestation. *C2* - C2 deficiency is the **most common complement deficiency** and is associated with **lupus-like syndromes** and increased susceptibility to **pyogenic bacterial infections**. - Though it can lead to some increased infection risk, C2 deficiency is not as strongly or specifically linked to recurrent meningococcal meningitis as deficiencies in the terminal complement pathway [2].

Question 3: Which of the following is not associated with pulmonary arterial hypertension?

A. Cor - pulmonale
B. Left ventricular hypertrophy (Correct Answer)
C. Mitral Stenosis
D. Interstitial lung disease

Explanation: ***Left ventricular hypertrophy*** - **Left ventricular hypertrophy** is typically caused by conditions that increase the workload on the left ventricle, such as **systemic hypertension** or **aortic stenosis** [1]. - Pulmonary arterial hypertension directly affects the **pulmonary vasculature**, leading to increased pressure in the pulmonary circuit and ultimately right heart strain, not left ventricular hypertrophy. *Cor pulmonale* - **Cor pulmonale** is defined as **right ventricular enlargement** secondary to lung disease or pulmonary vascular disease. - Pulmonary arterial hypertension increases the afterload on the right ventricle, causing it to dilate and hypertrophy, eventually leading to **right heart failure** (cor pulmonale) [2]. *Mitral Stenosis* - **Mitral stenosis** causes an obstruction to blood flow from the left atrium to the left ventricle, leading to increased pressure in the left atrium and pulmonary veins. - This elevated pressure can be transmitted backward into the pulmonary arteries, leading to **pulmonary arterial hypertension** [3]. *Interstitial lung disease* - **Interstitial lung disease** (ILD) can lead to destruction and remodeling of the pulmonary capillaries, increasing pulmonary vascular resistance [2]. - This increased resistance causes the pulmonary arterial pressure to rise, resulting in **pulmonary arterial hypertension**.

Question 4: Which of these is least effective as first-line treatment for dangerous hyperkalemia?

A. Calcium chloride injection
B. Beta-2 agonist (Salbutamol)
C. Intravenous sodium bicarbonate (Correct Answer)
D. Dialysis (Hemodialysis)

Explanation: ***Intravenous sodium bicarbonate*** - While it can drive potassium into cells, its effect is often **delayed and unreliable** in acute, dangerous hyperkalemia, especially without concurrent acidosis. - Its efficacy is most pronounced when hyperkalemia is associated with **metabolic acidosis**, which is not always the primary driving factor of dangerous hyperkalemia. *Calcium chloride injection* - This is a **first-line treatment** for dangerous hyperkalemia, as it **stabilizes the cardiac membrane** by antagonizing the direct effects of potassium on myocardial excitability [1]. - It does not lower serum potassium levels but **protects the heart** from life-threatening arrhythmias, buying time for other therapies to reduce potassium [1]. *Beta-2 agonist (Salbutamol)* - **Beta-2 agonists** like salbutamol are effective in shifting potassium **intracellularly**, thereby lowering serum potassium levels. - This effect is mediated by stimulating the **Na+/K+-ATPase pump** on cell membranes. *Dialysis (Hemodialysis)* - **Hemodialysis** is the **most effective and rapid** method for removing excess potassium from the body, especially in cases of severe or refractory hyperkalemia. - It provides definitive treatment by directly **filtering potassium** from the blood, and is often considered when other measures fail or in patients with kidney failure.

Orthopaedics

1 questions

Lauge - Hansen classification belongs to:-

Psychiatry

1 questions

A 6 year old child who does not interact with other children of his age group and prefers playing alone with repetitive behaviors, is likely to be suffering from:

Surgery

2 questions

Which of the following is the best management for radiation induced occlusive disease of carotid artery?

A 50 kg patient has 40 % burn of the body surface area. Calculate the ringer lactate solution to be given for first 8 hours of fluid:

FMGE 2017 - Surgery FMGE Practice Questions and MCQs

Question 1: Which of the following is the best management for radiation induced occlusive disease of carotid artery?

A. Carotid endarterectomy
B. Low dose aspirin
C. Carotid bypass procedure
D. Carotid angioplasty and stenting (Correct Answer)

Explanation: ***Carotid angioplasty and stenting*** - **Radiation-induced carotid artery disease** often involves the distal part of the carotid artery, making it less amenable to surgical endarterectomy. - **Angioplasty and stenting** offer a less invasive approach with good technical success in these challenging cases, especially given the increased fragility and fibrosis of radiated tissues. *Carotid endarterectomy* - **Carotid endarterectomy** in previously radiated fields is associated with a significantly higher risk of complications, including **cranial nerve injury**, **wound infection**, and **carotid artery rupture**, due to tissue fibrosis and scarring. - The disease often extends beyond the easily accessible segment for endarterectomy in radiation-induced cases. *Low dose aspirin* - **Low-dose aspirin** is an important component of medical therapy for **atherosclerotic disease** and **stroke prevention**, but it is insufficient as a sole treatment for symptomatic or high-grade occlusive disease of the carotid artery. - It helps manage the underlying **atherosclerotic process** but does not directly address the severe stenosis or occlusion. *Carotid bypass procedure* - **Carotid bypass procedures** are complex surgical interventions usually reserved for cases of **carotid artery occlusion** or **recurrent stenosis** after previous interventions where endarterectomy or stenting is not feasible. - While an option, it is more invasive and technically demanding than angioplasty and stenting, particularly in already radiated tissues with compromised vascular integrity.

Question 2: A 50 kg patient has 40 % burn of the body surface area. Calculate the ringer lactate solution to be given for first 8 hours of fluid:

A. 8 Litres
B. 2 Litres
C. 4 Litres (Correct Answer)
D. 1 Litre

Explanation: ***4 Litres*** - The **Parkland formula** for fluid resuscitation in burn patients is **4 mL x body weight (kg) x % total body surface area (TBSA) burned**. - For this patient: 4 mL x 50 kg x 40% = 8000 mL or **8 Litres** of Ringer's Lactate in the first 24 hours. Half of this volume ([8 Litres / 2] = **4 Litres**) is given in the first 8 hours. *8 Litres* - This amount represents the **total fluid requirement** for the entire first 24 hours, not just the first 8 hours. - Only **half of the total calculated fluid** is administered in the initial 8-hour period. *2 Litres* - This volume is generally **too low** for a patient with 40% TBSA burns, which is considered a significant burn. - Insufficient fluid resuscitation can lead to **burn shock** and organ hypoperfusion. *1 Litre* - This amount is **grossly inadequate** for a patient with 40% TBSA burns. - Administering such a small volume would likely result in **severe hypovolemic shock** and clinical deterioration.

About FMGE 2017 Questions

This page contains 78 questions from the FMGE 2017 paper, organised across 17 subjects for focused practice. Every question comes with the correct answer and a detailed explanation to help you understand the underlying concept. Subject-wise organisation lets you target specific areas and identify which topics carried the most weight in this particular year.

Practising year-wise papers is essential for understanding how the FMGE exam evolves — you can spot trending topics, gauge difficulty shifts, and benchmark your readiness against a real paper. To take your preparation further, download the Oncourse app for AI-driven performance insights, spaced repetition of questions you got wrong, and a personalised study plan built around your FMGE goals.