FMGE 2018 Practice Questions

Q: Cell that can form all cell types in the body is called?

Totipotent. ***Totipotent*** - **Totipotent** cells have the ability to differentiate into **all cell types** of the organism, including the **extraembryonic tissues** (like the placenta). - The **zygote** immediately after fertilization is the most well-known example of a totipotent cell, as it can form an entire organism. *Lineage stem cells* - **Lineage stem cells** (or **multipotent** stem cells) are restricted to differentiating into cells within a specific **cell lineage** or germ layer. - For example, **hematopoietic stem cells** can form all types of blood cells but no other tissue types. *Multipotent* - **Multipotent** stem cells can differentiate into a limited number of cell types within a specific tissue or organ, but not all cell types of the body. - Examples include **mesenchymal stem cells** which can form bone, cartilage, and fat cells, or **neural stem cells** which can form neurons and glia. *Pluripotent* - **Pluripotent** cells can differentiate into **all cell types** of the three germ layers (ectoderm, mesoderm, and endoderm) that make up the embryo, but not the extraembryonic tissues. - **Embryonic stem cells** are a prime example of pluripotent cells, as they can form any cell type in the body but cannot form a complete organism on their own.

Q: Western blot is done for:

Protein. ***Protein*** - **Western blot** is a laboratory technique used to detect specific **proteins** in a sample of tissue homogenate or extract. - It involves separating proteins by **electrophoresis**, transferring them to a membrane, and then detecting them using **antibodies**. *RNA* - **Northern blot** is the technique specifically designed for the detection and analysis of **RNA** molecules. - It involves separating RNA fragments by **electrophoresis**, transferring them to a membrane, and querying with a labeled probe. *Lipid* - There is no direct "lipid blot" technique analogous to Western, Northern, or Southern blots. - **Lipids** are typically analyzed using techniques such as mass spectrometry, thin-layer chromatography, or gas chromatography. *DNA* - **Southern blot** is the molecular biology method used for the detection of specific **DNA** sequences in DNA samples. - It involves fragmenting DNA, separating by **electrophoresis**, and then hybridizing with a labeled DNA probe.

Q: Oliguria is defined as:-

Less than 400 ml of urine excreted in a day. ***Less than 400 ml of urine excreted in a day*** - Oliguria is clinically defined as **urine production** of less than **400-500 mL per 24 hours** in adults. - This reduction in urine output is often a critical sign of acute kidney injury or other underlying medical conditions impacting **renal function**. *More than 900 ml of urine excreted in a day* - This volume is within the normal range of **daily urine output** for an adult, which is typically between **800 mL and 2000 mL**. - It does not represent oliguria, which indicates a significantly **decreased urine production**. *Absence of urine production* - The complete absence of urine production is known as **anuria**, which is a more severe condition than oliguria. - Anuria is typically defined as less than **50 mL of urine per 24 hours**. *600 ml to 700 ml of urine excreted in a day* - While this volume is below the typical average, it does not meet the strict clinical definition of oliguria, which is typically set at **less than 400-500 mL/day**. - This range might be considered **borderline decreased** but is not severe enough to be classified as oliguric by most standards.

Q: All are true about Allergic Bronchopulmonary Aspergillosis (ABPA) except?

Distal bronchiectasis. ***Distal bronchiectasis*** - This statement is incorrect as ABPA typically causes **central bronchiectasis**, affecting the proximal airways. - The inflammatory response to *Aspergillus* in ABPA mainly targets larger airways, leading to their dilation. *Serum precipitins to Aspergillus* - The presence of **serum precipitins** (IgG antibodies) against *Aspergillus* antigens is a major diagnostic criterion for ABPA. - This indicates a significant immune response to the fungus, which is characteristic of the disease. *Increased IgE Levels* - **Elevated serum total IgE levels** are a hallmark of ABPA, reflecting the allergic hypersensitivity reaction [1]. - This is a key diagnostic criterion, with levels often exceeding 1000 IU/mL. *Seen in asthmatics* - ABPA is predominantly seen in patients with **asthma** (and less commonly, cystic fibrosis), as an exacerbation or complication [1]. - The fungus *Aspergillus* colonizes the airways, triggering an allergic inflammatory response in susceptible individuals.

Q: All the following are feature of polycystic disease of kidneys except:-

Erythrocytosis. Polycystic kidney disease (PKD) is an autosomal dominant condition where multiple cysts enlarge slowly, compressing and damaging surrounding kidney tissue [1]. ***Erythrocytosis*** - **Polycystic kidney disease (PKD)** typically leads to **anemia** due to reduced erythropoietin production by the damaged kidneys [2]. - **Erythrocytosis** (an abnormally high red blood cell count) is not a common feature of PKD; it is more often associated with conditions like **renal cell carcinoma** or certain chronic hypoxic states. *Renal failure* - **Progressive cyst growth** in PKD eventually destroys functional kidney tissue, leading to a decline in renal function and often culminating in **end-stage renal disease**, which occurs in about 50% of PKD1 patients [1]. - **Renal failure** is a common and serious complication of PKD, necessitating dialysis or kidney transplantation. *Hematuria* - **Cysts in PKD** can rupture into the collecting system, leading to **gross hematuria** (visible blood in urine) or microscopic hematuria [1]. - Trauma to the flank or infection within a cyst can trigger an episode of **hematuria** [1]. *Hypertension* - **Hypertension** is a very common early manifestation of PKD, often preceding any significant decline in glomerular filtration rate. - It results from activation of the **renin-angiotensin-aldosterone system (RAAS)** due to renal ischemia caused by cyst enlargement [1].

Q: Optic disc changes of retinitis pigmentosa:

Consecutive optic atrophy. **Consecutive optic atrophy** - In **retinitis pigmentosa**, the progressive degeneration of photoreceptors and retinal pigment epithelium leads to secondary or **consecutive optic atrophy**. - This atrophy is characterized by a **pale, waxy optic disc** due to loss of retinal ganglion cell axons and glia. *Hyperemia of disc* - **Hyperemia of the optic disc** indicates **inflammation** or **swelling** of the optic nerve head, such as in optic neuritis or papilledema. - This is not a typical feature of retinitis pigmentosa, which involves retinal degeneration, not acute inflammation of the optic nerve. *No significant change* - As **retinitis pigmentosa** progresses, significant changes occur in the retina and optic nerve, including **pigmentary deposits**, **vascular attenuation**, and **optic disc pallor**. - Therefore, stating no significant change would be incorrect as the disease significantly alters the fundus appearance. *Blurring of disc margins* - **Blurring of the optic disc margins** is a hallmark sign of **papilledema** (swelling due to increased intracranial pressure) or an acutely inflamed optic nerve head. - This is distinct from the **optic atrophy** seen in retinitis pigmentosa, which typically involves clear but pale disc margins.

Q: Which of the following is true about Anaplasia?

Loss of differentiation. ***Loss of differentiation*** - **Anaplasia** is defined as the loss of structural and functional differentiation in cells, indicating a reversal to a more primitive state [1]. - It is a hallmark feature of **malignancy** and is associated with increased proliferative capacity and aggressiveness of tumors [1]. *Benign and fully reversible* - **Anaplasia** is a characteristic of **malignant tumors** and is generally not reversible without treatment [1]. - Benign cellular changes are typically reversible and maintain their differentiation features [1]. *Loss of cohesion between cells* - While loss of cohesion can occur in some aggressive tumors, it is more specifically related to changes in cell adhesion molecules and is not the primary definition of **anaplasia**. - **Anaplasia** refers to the loss of differentiation, not solely the physical separation of cells [1]. *Change of epithelium type* - This description refers to **metaplasia**, which is the reversible change of one differentiated cell type to another differentiated cell type [1]. - **Anaplasia** involves a loss of differentiation, not merely a change to a different, still differentiated, cell type [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Neoplasia, pp. 276-280.

Q: Dose of vitamin A for an 18 month old baby, with keratomalacia, weighing 10 kg is?

2,00,000 IU. **2,00,000 IU** - For children 12 months of age and older with **keratomalacia** due to vitamin A deficiency, the recommended dose is **200,000 IU** orally, given immediately. - This dose should be repeated the next day and again after four weeks to replenish stores and prevent recurrence. *1,00,000 IU* - This dose is typically recommended for infants **aged 6 to 11 months** with **clinical vitamin A deficiency**, including keratomalacia. - It is insufficient for an 18-month-old child with active keratomalacia. *50,000 IU* - This dose is usually given to infants **under 6 months** of age with clinical signs of **vitamin A deficiency**. - It is too low for an 18-month-old baby with keratomalacia. *5,00,000 IU* - This dose is excessively high and potentially toxic for an 18-month-old child. - Vitamin A toxicity can lead to adverse effects, including **increased intracranial pressure** and liver damage.

Q: In the management of diabetes mellitus, lactic acidosis is caused by which of the following?

Metformin. ***Metformin*** - Metformin can cause **lactic acidosis**, especially in patients with **renal impairment**, as it inhibits hepatic gluconeogenesis and lactate clearance [1]. - The risk is increased in conditions leading to **tissue hypoperfusion** or **hypoxemia**, where lactate production is elevated. *Pioglitazone* - **Pioglitazone** is a thiazolidinedione that improves insulin sensitivity but is not associated with lactic acidosis [1]. - Its main risks include **fluid retention**, **heart failure**, and increased risk of **bladder cancer**. *Glipizide* - **Glipizide** is a sulfonylurea that stimulates insulin secretion from beta cells but does not cause lactic acidosis [2]. - The primary adverse effect is **hypoglycemia** [2]. *Tolbutamide* - **Tolbutamide** is an older generation sulfonylurea, similar to glipizide, and also acts by stimulating insulin release [2]. - Its main risk is **hypoglycemia**, and it is not associated with lactic acidosis [2].

Q: What is the best stimulus for release of vasopressin?

Hyperosmolality of extracellular fluid. ***Hyperosmolality of extracellular fluid*** - **Hyperosmolality** is sensed by **osmoreceptors** in the hypothalamus, which then stimulate the release of vasopressin (ADH). - This response is crucial for **water conservation** to dilute the extracellular fluid and restore normal osmolality. *Hypotension* - While hypotension does stimulate vasopressin release, its effect is less potent than that of hyperosmolality in terms of triggering release. - Baroreceptors sense a decrease in blood pressure, leading to an increase in **ADH** to help maintain blood volume and pressure. *Hypertension* - **Hypertension** would typically inhibit vasopressin release, as the body would attempt to excrete more water to lower blood volume and pressure. - Increased blood pressure signals stretch receptors, leading to a decrease in **ADH** secretion. *Decreased plasma volume* - A decrease in **plasma volume** (hypovolemia) also stimulates ADH release, but this is often accompanied by changes in osmolality. - The primary stimulus for ADH is usually the resulting **increase in plasma osmolality** due to water loss, or significant drops in blood pressure detected by baroreceptors.

Question 1

Cell that can form all cell types in the body is called?

Accepted Answer

Totipotent

Answer

Lineage stem cells

Answer

Multipotent

Answer

Pluripotent

Question 2

Western blot is done for:

Accepted Answer

Protein

Answer

RNA

Answer

Lipid

Answer

DNA

Question 3

Oliguria is defined as:-

Accepted Answer

Less than 400 ml of urine excreted in a day

Answer

More than 900 ml of urine excreted in a day

Answer

Absence of urine production

Answer

600 ml to 700 ml of urine excreted in a day

Question 4

All are true about Allergic Bronchopulmonary Aspergillosis (ABPA) except?

Accepted Answer

Distal bronchiectasis

Answer

Serum precipitins to Aspergillus

Answer

Increased IgE Levels

Answer

Seen in asthmatics

Question 5

All the following are feature of polycystic disease of kidneys except:-

Accepted Answer

Erythrocytosis

Answer

Renal failure

Answer

Hematuria

Answer

Hypertension

Question 6

Optic disc changes of retinitis pigmentosa:

Accepted Answer

Consecutive optic atrophy

Answer

Hyperemia of disc

Answer

No significant change

Answer

Blurring of disc margins

Question 7

Which of the following is true about Anaplasia?

Accepted Answer

Loss of differentiation

Answer

Benign and fully reversible

Answer

Loss of cohesion between cells

Answer

Change of epithelium type

Question 8

Dose of vitamin A for an 18 month old baby, with keratomalacia, weighing 10 kg is?

Accepted Answer

2,00,000 IU

Answer

1,00,000 IU

Answer

50,000 IU

Answer

5,00,000 IU

Question 9

In the management of diabetes mellitus, lactic acidosis is caused by which of the following?

Accepted Answer

Metformin

Answer

Pioglitazone

Answer

Glipizide

Answer

Tolbutamide

Question 10

What is the best stimulus for release of vasopressin?

Accepted Answer

Hyperosmolality of extracellular fluid

Answer

Hypotension

Answer

Hypertension

Answer

Decreased plasma volume

FMGE 2018

Anatomy

Biochemistry

Internal Medicine

Ophthalmology

Pathology

Pediatrics

Pharmacology

Physiology