FMGE 2024

Q: A surgical procedure is performed on the great saphenous vein, around 2.5 cm anterior to the medial malleolus. Which of the following structures is most likely to be injured?

Saphenous nerve. ***Saphenous nerve***- The **saphenous nerve**, a terminal cutaneous branch of the femoral nerve, accompanies the **great saphenous vein (GSV)** throughout the length of the leg on the medial side.- It crosses the ankle just anterior to the medial malleolus, lying immediately adjacent to the GSV, making it highly susceptible to injury during surgical procedures like GSV cannulation, harvesting, or varicose vein surgery in this region.*Sural nerve*- The **sural nerve** is located laterally, typically accompanying the **small saphenous vein (SSV)**, and runs behind the **lateral malleolus**.- Therefore, it is anatomically distant from the surgical site located anterior to the medial malleolus.*Deep peroneal nerve*- The **deep peroneal nerve** is located deep within the **anterior compartment** of the leg and supplies the muscles of the anterior compartment.- Although its terminal branches cross the dorsum of the foot, it is not directly associated with the superficial GSV or the medial malleolus in a manner that would predispose it to injury during this specific superficial procedure.*Tibial nerve*- The **tibial nerve** passes through the **tarsal tunnel**, located deep and posterior (behind) the **medial malleolus**.- This nerve supplies the posterior compartment muscles and is deep to the fascia, making it unlikely to be injured during a superficial procedure performed 2.5 cm *anterior* to the medial malleolus. [Practice more FMGE 2024 questions on OnCourse]

Q: In the given image, the physician is trying to palpate which of the following arteries?

Posterior tibial artery. ***Posterior tibial artery***- The standard location for palpation of the **posterior tibial artery** pulse is just posterior and slightly inferior to the **medial malleolus**, ensuring evaluation of the posterior circulation of the foot.- Palpating this pulse, along with the **dorsalis pedis artery** pulse, is essential for determining adequate distal perfusion and diagnosing conditions like **Peripheral Arterial Disease (PAD)**.*Anterior tibial artery*- The **anterior tibial artery** is located deep within the anterior compartment of the leg.- It is typically not palpated in the leg; rather, its continuation, the **dorsalis pedis artery**, is palpated on the dorsum of the foot.*Dorsalis pedis artery*- Palpation of the **dorsalis pedis artery** (DPA) occurs on the dorsum of the foot, lateral to the tendon of the **extensor hallucis longus**.- This pulse assesses the blood flow supplied by the anterior circulation, differentiating it from the site behind the medial malleolus.*Lateral plantar artery*- The **lateral plantar artery** is situated deep within the sole of the foot, alongside the lateral plantar nerve.- Its deep location makes it generally inaccessible and impractical for routine clinical pulse assessment. [Practice more FMGE 2024 questions on OnCourse]

Q: Which of the following structures develop from the 6th pharyngeal arch artery on the left side?

Ductus arteriosus. ***Ductus arteriosus*** - The **ductus arteriosus** develops from the persistence of the distal portion of the **left 6th pharyngeal arch artery**. [2] - This structure is critical in fetal circulation, allowing blood to bypass the non-functional fetal lungs by shunting flow from the left pulmonary artery to the descending aorta. [1], [3] *Arch of Aorta* - The **arch of the aorta** mainly develops from the **aortic sac** and the distal part of the **left 4th pharyngeal arch artery**. - The 6th arch contributes only to the pulmonary system and the ductus shunt, not the primary aortic arch. *Carotid arteries* - Both the **common carotid arteries** and the **internal carotid arteries** are major derivatives of the **3rd pharyngeal arch arteries**. - The 3rd arch artery structure is completely separate from the 6th arch involvement in lung circulation development. *Subclavian artery* - The **left subclavian artery** arises largely from the **7th cervical intersegmental artery**, which is not part of the aortic arch system itself. - The **right subclavian artery** develops from the right 4th pharyngeal arch artery, the 7th intersegmental artery, and the right dorsal aorta. [Practice more FMGE 2024 questions on OnCourse]

Q: Which of the following is the type of joint between epiphysis and diaphysis of a long bone?

Synchondrosis. ***Synchondrosis***- A **synchondrosis** is a cartilaginous joint in which the bone parts are united by **hyaline cartilage**. - The classic example is the **epiphyseal plate** (growth plate) found between the epiphysis and diaphysis of a growing long bone, which permits bone lengthening. [1] *Symphysis*- A **symphysis** is a type of cartilaginous joint where articulating surfaces are covered by hyaline cartilage but separated by a broad plate of **fibrocartilage**.- Examples include the **pubic symphysis** and the joints between vertebral bodies (intervertebral discs). *Synostosis*- A **synostosis** is an immobile bony joint formed when two bones grow together and completely fuse, typically resulting from the ossification of a fibrous or cartilaginous joint.- After skeletal maturity, the synchondrosis of the epiphyseal plate ultimately forms a **synostosis** (the epiphyseal line/scar). [1] *Syndesmosis*- A **syndesmosis** is a type of fibrous joint where articulating bones are joined by a sheet of fibrous tissue, specifically a **ligament** or an **interosseous membrane**.- Key examples include the distal **tibiofibular joint** and the joints between the shafts of the radius and ulna. [Practice more FMGE 2024 questions on OnCourse]

Q: Which of the following nerves supplies the muscle that is involved in the moment given below?

A. Spinal accessory nerve. ***A. Spinal accessory nerve*** - This nerve provides motor innervation to the **Trapezius muscle**, which is responsible for elevation (shrugging) and retraction/rotation of the scapula, allowing the movement described. - It also innervates the **Sternocleidomastoid muscle**, which is crucial for turning the head to the opposite side and neck flexion. *B. Long thoracic nerve* - The long thoracic nerve supplies the **Serratus anterior** muscle, which protracts the scapula and stabilizes it against the chest wall. - Damage to this nerve results in **winged scapula**, particularly noticeable when pushing against a wall. *C. Axillary nerve* - The **Axillary nerve** primarily supplies the **Deltoid** (responsible for shoulder abduction after the initial 15 degrees) and the **Teres minor** muscles. - Impairment typically involves difficulty initiating or maintaining shoulder abduction and loss of sensation over the **regimental badge area**. *D. Radial nerve* - The radial nerve is the nerve of the posterior compartment of the arm, supplying all the **extensor muscles** of the upper limb. - It is vital for elbow extension via the **Triceps** and extension of the wrist and fingers, not the primary nerve for scapular movement. [Practice more FMGE 2024 questions on OnCourse]

109 Previous Year Questions with Answers & Explanations

109

Questions

Subjects

All (109)Anatomy (11)Anesthesiology (4)Biochemistry (6)Community Medicine (15)Dermatology (4)ENT (3)Forensic Medicine (4)Internal Medicine (9)Microbiology (1)Obstetrics and Gynecology (7)Ophthalmology (4)Orthopaedics (3)Pathology (4)Pediatrics (10)Pharmacology (6)Physiology (4)Psychiatry (3)Radiology (6)Surgery (5)

Anatomy

5 questions

A surgical procedure is performed on the great saphenous vein, around 2.5 cm anterior to the medial malleolus. Which of the following structures is most likely to be injured?

In the given image, the physician is trying to palpate which of the following arteries?

Which of the following structures develop from the 6th pharyngeal arch artery on the left side?

Which of the following is the type of joint between epiphysis and diaphysis of a long bone?

Which of the following nerves supplies the muscle that is involved in the moment given below?

FMGE 2024 - Anatomy FMGE Practice Questions and MCQs

Question 1: A surgical procedure is performed on the great saphenous vein, around 2.5 cm anterior to the medial malleolus. Which of the following structures is most likely to be injured?

A. Tibial nerve
B. Deep peroneal nerve
C. Sural nerve
D. Saphenous nerve (Correct Answer)

Explanation: ***Saphenous nerve***- The **saphenous nerve**, a terminal cutaneous branch of the femoral nerve, accompanies the **great saphenous vein (GSV)** throughout the length of the leg on the medial side.- It crosses the ankle just anterior to the medial malleolus, lying immediately adjacent to the GSV, making it highly susceptible to injury during surgical procedures like GSV cannulation, harvesting, or varicose vein surgery in this region.*Sural nerve*- The **sural nerve** is located laterally, typically accompanying the **small saphenous vein (SSV)**, and runs behind the **lateral malleolus**.- Therefore, it is anatomically distant from the surgical site located anterior to the medial malleolus.*Deep peroneal nerve*- The **deep peroneal nerve** is located deep within the **anterior compartment** of the leg and supplies the muscles of the anterior compartment.- Although its terminal branches cross the dorsum of the foot, it is not directly associated with the superficial GSV or the medial malleolus in a manner that would predispose it to injury during this specific superficial procedure.*Tibial nerve*- The **tibial nerve** passes through the **tarsal tunnel**, located deep and posterior (behind) the **medial malleolus**.- This nerve supplies the posterior compartment muscles and is deep to the fascia, making it unlikely to be injured during a superficial procedure performed 2.5 cm *anterior* to the medial malleolus.

Question 2: In the given image, the physician is trying to palpate which of the following arteries?

A. Anterior tibial artery
B. Posterior tibial artery (Correct Answer)
C. Lateral plantar artery
D. Dorsalis pedis artery

Explanation: ***Posterior tibial artery***- The standard location for palpation of the **posterior tibial artery** pulse is just posterior and slightly inferior to the **medial malleolus**, ensuring evaluation of the posterior circulation of the foot.- Palpating this pulse, along with the **dorsalis pedis artery** pulse, is essential for determining adequate distal perfusion and diagnosing conditions like **Peripheral Arterial Disease (PAD)**.*Anterior tibial artery*- The **anterior tibial artery** is located deep within the anterior compartment of the leg.- It is typically not palpated in the leg; rather, its continuation, the **dorsalis pedis artery**, is palpated on the dorsum of the foot.*Dorsalis pedis artery*- Palpation of the **dorsalis pedis artery** (DPA) occurs on the dorsum of the foot, lateral to the tendon of the **extensor hallucis longus**.- This pulse assesses the blood flow supplied by the anterior circulation, differentiating it from the site behind the medial malleolus.*Lateral plantar artery*- The **lateral plantar artery** is situated deep within the sole of the foot, alongside the lateral plantar nerve.- Its deep location makes it generally inaccessible and impractical for routine clinical pulse assessment.

Question 3: Which of the following structures develop from the 6th pharyngeal arch artery on the left side?

A. Arch of Aorta
B. Subclavian artery
C. Carotid arteries
D. Ductus arteriosus (Correct Answer)

Explanation: ***Ductus arteriosus*** - The **ductus arteriosus** develops from the persistence of the distal portion of the **left 6th pharyngeal arch artery**. [2] - This structure is critical in fetal circulation, allowing blood to bypass the non-functional fetal lungs by shunting flow from the left pulmonary artery to the descending aorta. [1], [3] *Arch of Aorta* - The **arch of the aorta** mainly develops from the **aortic sac** and the distal part of the **left 4th pharyngeal arch artery**. - The 6th arch contributes only to the pulmonary system and the ductus shunt, not the primary aortic arch. *Carotid arteries* - Both the **common carotid arteries** and the **internal carotid arteries** are major derivatives of the **3rd pharyngeal arch arteries**. - The 3rd arch artery structure is completely separate from the 6th arch involvement in lung circulation development. *Subclavian artery* - The **left subclavian artery** arises largely from the **7th cervical intersegmental artery**, which is not part of the aortic arch system itself. - The **right subclavian artery** develops from the right 4th pharyngeal arch artery, the 7th intersegmental artery, and the right dorsal aorta.

Question 4: Which of the following is the type of joint between epiphysis and diaphysis of a long bone?

A. Synchondrosis (Correct Answer)
B. Syndesmosis
C. Synostosis
D. Symphysis

Explanation: ***Synchondrosis***- A **synchondrosis** is a cartilaginous joint in which the bone parts are united by **hyaline cartilage**. - The classic example is the **epiphyseal plate** (growth plate) found between the epiphysis and diaphysis of a growing long bone, which permits bone lengthening. [1] *Symphysis*- A **symphysis** is a type of cartilaginous joint where articulating surfaces are covered by hyaline cartilage but separated by a broad plate of **fibrocartilage**.- Examples include the **pubic symphysis** and the joints between vertebral bodies (intervertebral discs). *Synostosis*- A **synostosis** is an immobile bony joint formed when two bones grow together and completely fuse, typically resulting from the ossification of a fibrous or cartilaginous joint.- After skeletal maturity, the synchondrosis of the epiphyseal plate ultimately forms a **synostosis** (the epiphyseal line/scar). [1] *Syndesmosis*- A **syndesmosis** is a type of fibrous joint where articulating bones are joined by a sheet of fibrous tissue, specifically a **ligament** or an **interosseous membrane**.- Key examples include the distal **tibiofibular joint** and the joints between the shafts of the radius and ulna.

Question 5: Which of the following nerves supplies the muscle that is involved in the moment given below?

A. A. Spinal accessory nerve (Correct Answer)
B. C. Axillary nerve
C. D. Radial nerve
D. B. Long thoracic nerve

Explanation: ***A. Spinal accessory nerve*** - This nerve provides motor innervation to the **Trapezius muscle**, which is responsible for elevation (shrugging) and retraction/rotation of the scapula, allowing the movement described. - It also innervates the **Sternocleidomastoid muscle**, which is crucial for turning the head to the opposite side and neck flexion. *B. Long thoracic nerve* - The long thoracic nerve supplies the **Serratus anterior** muscle, which protracts the scapula and stabilizes it against the chest wall. - Damage to this nerve results in **winged scapula**, particularly noticeable when pushing against a wall. *C. Axillary nerve* - The **Axillary nerve** primarily supplies the **Deltoid** (responsible for shoulder abduction after the initial 15 degrees) and the **Teres minor** muscles. - Impairment typically involves difficulty initiating or maintaining shoulder abduction and loss of sensation over the **regimental badge area**. *D. Radial nerve* - The radial nerve is the nerve of the posterior compartment of the arm, supplying all the **extensor muscles** of the upper limb. - It is vital for elbow extension via the **Triceps** and extension of the wrist and fingers, not the primary nerve for scapular movement.

Anesthesiology

2 questions

Which of the following is the use of the Mallampatti classification?

Which of the following is the most common drug used in day care surgery/TIVA?

FMGE 2024 - Anesthesiology FMGE Practice Questions and MCQs

Question 1: Which of the following is the use of the Mallampatti classification?

A. To evaluate the fitness of the patient
B. To evaluate the pros and cons of surgery
C. Endotracheal intubation (Correct Answer)
D. To evaluate the risk of surgery

Explanation: ***Correct Option C: Endotracheal intubation*** - The Mallampati classification assesses the visibility of the soft palate, uvula, and tonsillar pillars, which directly correlates with the ease of achieving a satisfactory view during **direct laryngoscopy** - It is a critical component of the **pre-anesthetic airway assessment** used alongside thyromental distance and mouth opening to predict difficult airway management and guide intubation strategy - Classes I-IV predict increasing difficulty in intubation, with Class III-IV indicating potentially difficult airways *Incorrect Option A: To evaluate the fitness of the patient* - Patient fitness evaluation involves holistic assessment of **cardiopulmonary reserve** and functional capacity, ensuring the patient can safely tolerate the physiological stress of surgery and anesthesia - Fitness relies on optimizing chronic medical conditions and functional capacity, not just anatomical classification of the airway opening *Incorrect Option B: To evaluate the pros and cons of surgery* - This evaluation is a clinical and ethical judgment based on the patient's **disease severity**, anticipated benefits, potential complications, and mortality associated with the procedure - The Mallampati score does not directly contribute to weighing the overall risk-benefit ratio of the surgical procedure itself *Incorrect Option D: To evaluate the risk of surgery* - Surgical risk is determined using tools like the **ASA physical status classification** (P1-P6), comorbidities, and type of surgery - While a predicted difficult airway (Mallampati class III or IV) increases the **anesthesia-related risk**, it does not comprehensively define the overall surgical risk profile

Question 2: Which of the following is the most common drug used in day care surgery/TIVA?

A. Sodium thiopentone
B. Ketamine
C. Propofol (Correct Answer)
D. Halothane

Explanation: ***Propofol***- **Propofol** is the anesthetic of choice for **TIVA** (Total Intravenous Anesthesia) and day care surgery due to its favorable pharmacokinetics, including rapid onset and smooth awakening.- Its **ultra-short duration of action** and rapid metabolic clearance ensure a quick, clear-headed recovery, which is essential for minimizing post-anesthesia care unit (PACU) time and facilitating early discharge.*Sodium thiopentone*- Although used for induction, **sodium thiopentone** has a longer context-sensitive half-time than propofol, resulting in **slower emergence** and potential for prolonged postoperative drowsiness.- Due to its slower recovery profile and higher risk of **residual sedation**, it is generally not preferred for short procedures in day care settings.*Halothane*- **Halothane** is a volatile **inhalational anesthetic** and, therefore, cannot be used for TIVA, which requires intravenous agents.- Modern volatile agents have largely replaced halothane due to the risk of severe side effects, notably cardiovascular depression and potentially fatal **halothane-induced hepatotoxicity**.*Ketamine*- **Ketamine** provides excellent analgesia and cardiovascular stability (sympathomimetic effects), but it frequently causes **psychomimetic side effects** (emergence delirium, hallucinations) during recovery, which are undesirable in day care.- Full Ketamine anesthesia often requires concurrent use with benzodiazepines (midazolam) to mitigate emergence phenomena, making it less suitable as a sole agent for smooth, rapid day care surgery recovery.

Biochemistry

2 questions

Zellweger syndrome is associated with which cellular organelle?

A 3-month-old baby presents with severe hepatomegaly, cataracts in both eyes, lethargy, and hypotonia. Based on these symptoms, which enzyme deficiency is most likely involved?

FMGE 2024 - Biochemistry FMGE Practice Questions and MCQs

Question 1: Zellweger syndrome is associated with which cellular organelle?

A. C. Lysosomes
B. D. Ribosomes
C. B. Mitochondria
D. A. Peroxisomes (Correct Answer)

Explanation: ***A. Peroxisomes*** - Zellweger syndrome is a severe disorder belonging to the group of **peroxisomal biogenesis disorders (PBDs)**, resulting from a failure to form functional peroxisomes due to mutations in *PEX* genes. - Functional peroxisomes are essential for the metabolism of substances like **very long-chain fatty acids (VLCFAs)** and plasmalogens; their absence leads to the accumulation of these toxic molecules. *B. Mitochondria* - **Mitochondria** are the powerhouse organelles responsible for cellular energy production via oxidative phosphorylation. - Mitochondrial disorders present with distinct features like lactic acidosis, myopathy, and neurodegeneration, which differ from the characteristic peroxisomal dysfunction seen in Zellweger syndrome. *C. Lysosomes* - **Lysosomes** are crucial for degrading cellular waste products and macromolecules; defects in these organelles cause **lysosomal storage diseases** (e.g., mucopolysaccharidoses). - Although some symptoms overlap, Zellweger syndrome is specifically defined by **peroxisomal dysfunction**, not primary lysosomal enzyme deficiency. *D. Ribosomes* - **Ribosomes** are responsible for synthesizing proteins via translation of mRNA. - Defects in ribosomes typically impair **global protein synthesis** or specific tissue development (ribosomopathies), which is distinct from the primary metabolic defects seen in Zellweger syndrome.

Question 2: A 3-month-old baby presents with severe hepatomegaly, cataracts in both eyes, lethargy, and hypotonia. Based on these symptoms, which enzyme deficiency is most likely involved?

A. Hepatic Glucose-6-Phosphatase
B. Galactose-1-Phosphate Uridyl Transferase (Correct Answer)
C. UDP-Galactose-4-Epimerase
D. Galactokinase

Explanation: ***Galactose-1-Phosphate Uridyl Transferase*** - **GALT** deficiency causes **Classic Galactosemia**, which is characterized by the accumulation of **galactose-1-phosphate**, leading to widespread organ damage. - The classic presentation in neonates includes **hepatomegaly**, **jaundice**, failure to thrive, hypoglycemia, **E. coli sepsis**, developmental delay, and pathognomonic **cataracts**. - This is the **most severe form** of galactosemia and matches all the clinical features in this case. *Galactokinase* - Deficiency of **Galactokinase (GALK)** leads to a milder form of galactosemia where **galactitol** accumulates, primarily causing **cataracts** in infancy. - Systemic symptoms like **hepatomegaly**, liver failure, and severe lethargy, as seen in this 3-month-old, are typically **absent** in GALK deficiency. *UDP-Galactose-4-Epimerase* - **GALE** deficiency is the rarest form of galactosemia with variable clinical severity. - While severe forms can present with symptoms similar to classic galactosemia, they are extremely rare and account for less than 5% of galactosemia cases. - The combination of severe hepatomegaly and cataracts at 3 months is most characteristic of **GALT deficiency**, not GALE deficiency. *Hepatic Glucose-6-Phosphatase* - Deficiency of this enzyme causes **Von Gierke disease** (GSD Type I), characterized by significant **hepatomegaly** and severe **fasting hypoglycemia**. - While it causes hepatomegaly and lethargy (from hypoglycemia), it is **not** associated with the development of **cataracts**, which differentiates it from galactosemia.

Ophthalmology

1 questions

Which of the following topical local anesthetics is commonly used in cataract surgery?

About FMGE 2024 Questions

This page contains 109 questions from the FMGE 2024 paper, organised across 19 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.