Community Medicine
1 questionsAt what altitude is kala azar unlikely to occur?
FMGE 2019 - Community Medicine FMGE Practice Questions and MCQs
Question 1: At what altitude is kala azar unlikely to occur?
- A. 400 meters
- B. 500 meters
- C. 600 meters (Correct Answer)
- D. 200 meters
Explanation: ***600 meters*** - Kala-azar, or **visceral leishmaniasis**, is primarily found in **low-lying areas** and is rarely reported at altitudes above 600 meters due to the specific ecological requirements of its **sand fly vector**. - The **Phlebotomus argentipes sand fly**, the main vector in the Indian subcontinent, prefers warm, humid climates and **lower altitudes**. *400 meters* - This altitude is within the **typical endemic range** for kala-azar, especially in regions like the Indian subcontinent. - The environmental conditions at 400 meters are generally conducive for the **survival and breeding** of the sand fly vector. *500 meters* - Similar to 400 meters, 500 meters is still considered within the **favorable altitude range** for kala-azar transmission. - The **sand fly vector** can thrive in the climate often found at this elevation. *200 meters* - This altitude represents a **highly endemic zone** for kala-azar, as it provides optimal conditions for the sand fly vector. - Lower altitudes are typically associated with increased **humidity and warmth**, favoring vector density and parasite transmission.
Forensic Medicine
1 questionsWhat type of poisoning is associated with the retention of lead bullets in the body?
FMGE 2019 - Forensic Medicine FMGE Practice Questions and MCQs
Question 1: What type of poisoning is associated with the retention of lead bullets in the body?
- A. Lead (Correct Answer)
- B. Phosphorus
- C. Nitro cellulose
- D. Iron
Explanation: ***Lead*** - **Lead bullets** are primarily composed of lead, and if retained in the body, lead can leach into the bloodstream causing **lead poisoning**. - This is a well-documented risk, especially when bullets are lodged in areas rich in bodily fluids or bone. *Phosphorus* - Phosphorus poisoning is typically associated with exposure to compounds like **white phosphorus**, often found in fireworks or industrial chemicals, not lead bullets. - Symptoms include severe gastrointestinal distress, multiorgan failure, and a characteristic **garlic-like odor**. *Nitro cellulose* - **Nitrocellulose** is a component of gun propellants (gunpowder), not the bullet itself. - Exposure would primarily be from inhalation of fumes during firing or accidental ingestion of powder, not retention of the bullet. *Iron* - **Iron poisoning** usually results from acute overdose of iron supplements, particularly in children. - While bullets contain trace amounts of iron, the primary toxic component of a retained bullet is **lead**, not iron.
Internal Medicine
2 questionsWhich of these conditions is classified as a nephritic syndrome?
A 20-year-old male presented with fatigue, weakness, and jaundice. What is the most likely diagnosis?
FMGE 2019 - Internal Medicine FMGE Practice Questions and MCQs
Question 1: Which of these conditions is classified as a nephritic syndrome?
- A. Minimal Change Disease
- B. Membranous Glomerulopathy
- C. Post Infectious Glomerulonephritis (Correct Answer)
- D. Focal Segmental Glomerulosclerosis
Explanation: ***Post infectious Glomerulonephritis*** - Characterized by **hematuria, hypertension, and edema**, typically following an infection, such as streptococcal pharyngitis [2]. - Immune-mediated response leads to **decreased GFR** and signs of nephritic syndrome [1][2]. *Focal segmental glomerulosclerosis* - Primarily causes **nephrotic syndrome**, characterized by proteinuria and edema rather than hematuria [2]. - Often associated with **secondary causes** like obesity or HIV, not typically post-infectious. *Membranous Glomerulopathy* - Results in significant **proteinuria** and is classified as a **nephrotic syndrome** rather than a nephritic one [2][3]. - It presents with **edema and hypoalbuminemia**, lacking the hallmark features of hematuria. *Minimal change disease* - Predominantly causes **nephrotic syndrome** with heavy proteinuria and little to no hematuria [2]. - Young children are commonly affected, and it responds well to **corticosteroid therapy** [1].
Question 2: A 20-year-old male presented with fatigue, weakness, and jaundice. What is the most likely diagnosis?
- A. Acute lymphoblastic leukemia
- B. Chronic myeloid leukemia
- C. Chronic lymphocytic leukemia
- D. Acute myeloid leukemia (Correct Answer)
Explanation: ***Acute myeloid leukemia*** - Presents with **fatigue** and **weakness** due to bone marrow infiltration and resultant cytopenias, typical in this age group [1]. - Often shows **myeloblasts** on peripheral blood smear, confirming the diagnosis [2]. *Chronic myeloid leukemia* - Usually occurs in **older adults** and characterized by **elevated white blood cell counts** with a predominance of mature neutrophils. - Symptoms like fatigue may arise, but there are distinct **Philadelphia chromosome** findings and typically a **longer symptom duration**. *Acute lymphoblastic leukemia* - More common in **younger children** and often associated with **lymphadenopathy** and **thrombocytopenia**, rather than fatigue alone. - Characteristically shows **lymphoblasts** in the blood, which are not mentioned in this patient's presentation. *Chronic lymphocytic leukemia* - Typically presents in adults over **50 years** and is characterized by **lymphocytosis** and often asymptomatic in early stages. - Fatigue may occur but lacks the acute presentation and findings seen in **acute leukemias**. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Blood And Bone Marrow Disease, pp. 607-608. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of White Blood Cells, Lymph Nodes, Spleen, and Thymus, pp. 621-622.
Microbiology
1 questionsA bacterium that can thrive at temperatures around 60-70 degrees Celsius is classified as
FMGE 2019 - Microbiology FMGE Practice Questions and MCQs
Question 1: A bacterium that can thrive at temperatures around 60-70 degrees Celsius is classified as
- A. Thermophilic (Correct Answer)
- B. Mesophilic
- C. Cryophilic
- D. Halophilic
Explanation: ***Thermophilic*** - **Thermophilic** bacteria are heat-loving organisms that thrive at high temperatures, typically in the range of **45°C to 80°C**, with optimal growth around 50-70°C - These organisms are commonly found in hot springs, compost heaps, and industrial processes - **Note**: Extreme thermophiles (hyperthermophiles) can grow at temperatures exceeding 80-100°C, found in hydrothermal vents and geothermal environments *Mesophilic* - **Mesophilic** bacteria grow best at moderate temperatures, typically between **20°C and 45°C** - This includes most human pathogens and bacteria found in normal body temperature environments - These organisms cannot survive the high temperatures characteristic of thermophiles *Cryophilic* - **Cryophilic** (or psychrophilic) bacteria are cold-loving organisms that thrive at low temperatures, typically **below 20°C** - These organisms are adapted to cold environments like polar regions, deep oceans, and refrigerated foods - They would be rapidly killed at thermophilic temperature ranges *Halophilic* - **Halophilic** bacteria require high concentrations of salt (NaCl) for growth - This classification is based on **salt tolerance**, not temperature preference - Halophiles can be mesophilic, thermophilic, or psychrophilic depending on their temperature requirements
Obstetrics and Gynecology
2 questionsA 32-year-old pregnant woman presents with mild bleeding and pain. On examination, the uterus is tender, and fetal heart sounds are absent. What is the most likely diagnosis?
What is the dose of mifepristone in medical abortion?
FMGE 2019 - Obstetrics and Gynecology FMGE Practice Questions and MCQs
Question 1: A 32-year-old pregnant woman presents with mild bleeding and pain. On examination, the uterus is tender, and fetal heart sounds are absent. What is the most likely diagnosis?
- A. Abruptio placenta (Correct Answer)
- B. Uterine rupture
- C. Ectopic pregnancy
- D. Placenta previa
Explanation: ***Abruptio placenta*** - This condition involves the **premature detachment of the placenta** from the uterine wall, leading to bleeding and severe abdominal pain due to uterine contractions and irritation. - The **tender uterus** is a characteristic finding, often described as a "woody hard" uterus in severe cases. - The absence of fetal heart sounds suggests **fetal demise**, which is a common and severe complication of placental abruption due to oxygen deprivation. *Uterine rupture* - **Uterine rupture** can present with abdominal pain, vaginal bleeding, and loss of fetal heart tones, making it an important differential. - However, it typically occurs during **active labor**, especially in women with previous cesarean sections or uterine surgery. - The presentation usually includes **sudden severe pain**, loss of uterine contractions, and the fetus may be palpable abdominally if completely extruded. *Ectopic pregnancy* - This occurs when the **fertilized egg implants outside the uterus**, most commonly in the fallopian tube. - Symptoms typically appear much earlier in pregnancy **(first trimester)** and the pain is usually localized, often presenting with a smaller, non-tender uterus. - Not consistent with the clinical picture of an obviously pregnant uterus. *Placenta previa* - **Placenta previa** is characterized by the placenta covering the cervical opening, leading to **painless vaginal bleeding**, often bright red. - The uterus is typically **soft and non-tender**, in contrast to the tender uterus described in the case. - This is the key differentiating feature from placental abruption.
Question 2: What is the dose of mifepristone in medical abortion?
- A. 400 mg
- B. 100 mg
- C. 200 mg (Correct Answer)
- D. 600 mg
Explanation: ***200 mg*** - The standard dose of **mifepristone** for **medical abortion** in various protocols, including those up to 10 weeks of gestation, is **200 mg orally**. - This dose effectively blocks **progesterone receptors**, leading to endometrial breakdown and sensitization of the uterus to prostaglandins. - **WHO-recommended dose** with optimal efficacy and safety profile. *400 mg* - **400 mg is not a standard or recommended dose** for medical abortion in any established protocol. - The evidence-based regimens use either **200 mg** (current standard) or 600 mg (older protocol), but not 400 mg. - No clinical advantage has been demonstrated for this intermediate dose. *100 mg* - A dose of **100 mg of mifepristone is considered suboptimal** and less effective for inducing medical abortion compared to the standard 200 mg dose. - It may not sufficiently block progesterone receptors, potentially leading to **incomplete abortion** or treatment failure. - Not recommended in any standard medical abortion protocol. *600 mg* - Although **600 mg was an older protocol** for medical abortion, it has largely been replaced by the **200 mg dose**. - Research has demonstrated that **200 mg is equally effective** while resulting in a better side effect profile and lower cost. - The dose reduction from 600 mg to 200 mg represents evidence-based protocol optimization.
Ophthalmology
1 questionsA person with a visual acuity of 6/60 in the right eye and 3/60 in the left eye would be categorized into which type of blindness?
FMGE 2019 - Ophthalmology FMGE Practice Questions and MCQs
Question 1: A person with a visual acuity of 6/60 in the right eye and 3/60 in the left eye would be categorized into which type of blindness?
- A. Moderate visual impairment (Correct Answer)
- B. Legal blindness
- C. Normal vision
- D. Low vision
Explanation: ***Moderate visual impairment*** - According to the **WHO International Classification of Diseases (ICD-11)**, moderate visual impairment is defined as visual acuity **< 6/18 to ≥ 6/60** in the better eye with best possible correction. - This patient's better eye (right eye) has a visual acuity of **6/60**, which falls at the **upper limit** of the moderate visual impairment category. - This is the standard classification used in Indian medical examinations and follows WHO guidelines. *Legal blindness* - **Legal blindness** is a **US administrative/legal term**, not a WHO classification category. It is defined as visual acuity **< 6/60 (or 20/200)** in the better eye, or visual field < 20 degrees. - Since this patient has exactly **6/60** (not less than 6/60), they do **not** meet the strict criteria for legal blindness. - This term is less commonly used in Indian medical literature, where WHO classifications are standard. *Low vision* - **Low vision** is a broad umbrella term that includes all categories of visual impairment from mild to severe, but it is not a specific classification category. - While this patient does have low vision, the more specific and appropriate classification is moderate visual impairment. *Normal vision* - **Normal vision** is defined as visual acuity of **6/6 to 6/12** in the better eye. - This patient's visual acuity of **6/60** represents significant visual impairment, far below the normal range.
Pathology
1 questionsWhich type of necrosis is seen in the brain?
FMGE 2019 - Pathology FMGE Practice Questions and MCQs
Question 1: Which type of necrosis is seen in the brain?
- A. Coagulative
- B. Liquefactive (Correct Answer)
- C. Fat
- D. Fibrinoid
Explanation: ***Liquefactive*** - Liquefactive necrosis is characterized by the transformation of tissue into a **liquid viscous mass**, commonly seen in the brain after **ischemic injury**. - Often associated with brain **infarcts** or **abscess formation**, where cell death results in the accumulation of **neutrophils and pus**. [1] *Fibrinoid* - Fibrinoid necrosis is typically associated with **immune-mediated vascular damage**, not commonly seen in the brain. - This type of necrosis occurs in conditions like **polyarteritis nodosa** or **lupus**, where **fibrin-like protein** deposits are found in vessel walls. *Coagulative* - Coagulative necrosis usually occurs in **myocardial infarction** and is characterized by the preservation of cell outlines due to **denaturation of proteins**. - It is not typical in brain tissue, which undergoes liquefactive necrosis in cases of cell death. *Fat* - Fat necrosis is primarily associated with **enzymatic destruction of adipose tissue**, often related to pancreatic damage or trauma. - It is not relevant to brain necrosis, which does not characteristically present with fat necrosis. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Central Nervous System, pp. 1268-1269.
Surgery
1 questionsWhich finding is assigned 2 points in the Alvarado scoring system for appendicitis assessment?
FMGE 2019 - Surgery FMGE Practice Questions and MCQs
Question 1: Which finding is assigned 2 points in the Alvarado scoring system for appendicitis assessment?
- A. Low-grade fever
- B. Leukocytosis (Correct Answer)
- C. Nausea and vomiting
- D. Rebound tenderness
Explanation: **Leukocytosis** - An elevated **white blood cell count** (typically greater than 10,000 cells/mm³) is a significant indicator of inflammation, assigned **2 points** in the Alvarado score. - This finding reflects the body's systemic response to the infection and inflammation associated with **appendicitis**. *Low-grade fever* - A low-grade fever (oral temperature of 37.3-38.0°C) is assigned **1 point** in the Alvarado score. - While indicative of inflammation, it is less specific and less weighted than leukocytosis. *Nausea and vomiting* - These gastrointestinal symptoms are common in appendicitis and are assigned **1 point** in the Alvarado score. - They are non-specific and can be present in many other abdominal conditions. *Rebound tenderness* - This clinical sign, indicating **peritoneal irritation**, is assigned **1 point** in the Alvarado score. - It is a physical exam finding, not a laboratory finding, and suggests localized inflammation.
About FMGE 2019 Questions
This page contains 272 questions from the FMGE 2019 paper, organised across 20 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.