FMGE 2019 Practice Questions

Q: Protrusion of mandible is due to which of the following muscles?

Lateral pterygoid. ***Lateral pterygoid*** - The **lateral pterygoid muscle** is the primary muscle responsible for **protrusion of the mandible**. - Its bilateral contraction pulls the condyle of the mandible and the articular disc anteriorly, causing the lower jaw to move forward. *Medial pterygoid* - The **medial pterygoid muscle** primarily functions in **elevation** and **side-to-side movements** of the mandible. - While it assists in some mandibular movements, its main role is not protrusion. *Masseter* - The **masseter muscle** is a strong muscle involved in **elevating the mandible** and is crucial for **closing the jaw** (biting and chewing). - It does not contribute significantly to the forward movement or protrusion of the mandible. *Temporalis* - The **temporalis muscle** is a major muscle of mastication, responsible for **elevating the mandible** and **retracting** it. - Its fibers, particularly the posterior ones, pull the mandible backward, directly opposing protrusion.

Q: Which structure doesn't pass through the parotid gland?

Internal Carotid Artery. ***Internal Carotid Artery*** - The **internal carotid artery** does not pass through the parotid gland; it is located medial to the gland. - It ascends in the neck to supply the brain and does not traverse the glandular parenchyma. *Retromandibular vein* - The retromandibular vein is formed within the parotid gland by the union of the **superficial temporal vein** and the **maxillary vein**. - It then exits the gland and divides into anterior and posterior divisions. *Facial nerve* - The **facial nerve (cranial nerve VII)** enters the posterior aspect of the parotid gland and divides into its five terminal branches within the gland. - It supplies motor innervation to the **muscles of facial expression**. *External Carotid Artery and its branches* - The **external carotid artery** passes through the parotid gland, where it gives off several important branches. - The main branches within the gland are the **maxillary artery** and the **superficial temporal artery**.

Q: Type IV complex of ETC is inhibited by

Cyanide. ***Cyanide*** - **Cyanide** is a potent inhibitor of **cytochrome c oxidase (Complex IV)** in the electron transport chain, binding to its ferric iron center and preventing the reduction of oxygen to water. - This inhibition effectively blocks electron flow, leading to a rapid cessation of ATP production and cellular respiration. *Antimycin* - **Antimycin A** specifically inhibits **Complex III (cytochrome bc1 complex)** of the electron transport chain. - It binds to the Qn site of Complex III, preventing the transfer of electrons from reduced ubiquinone to cytochrome c. *Oligomycin* - **Oligomycin** is an inhibitor of **ATP synthase (Complex V)**, not Complex IV. - It blocks the flow of protons through the Fo subunit of ATP synthase, thereby inhibiting ATP synthesis, but it does not directly affect electron transport itself. *CO2* - **CO2** is a waste product of cellular respiration and is not an inhibitor of any complex within the electron transport chain. - While high levels of CO2 can affect pH and cellular function, it does not directly interfere with the catalytic activity of ETC complexes.

Q: In Africa, vaccination was given in an endemic outbreak area for a specific disease but due to shortage of vaccines, mass chemoprophylaxis treatment was given to people who were not diseased. Which type of prevention is this?

Specific protection. ***Specific protection*** - **Vaccination** directly prevents disease, fitting into the criteria of specific protection. - **Mass chemoprophylaxis** aims to prevent disease in healthy individuals in an endemic area, which is also a form of specific protection. *Rehabilitation* - This involves measures to restore function and well-being after a disease has occurred and caused disability. - It does not involve preventing the initial onset of disease, as described in the scenario. *Health promotion* - Health promotion includes broad interventions like education, lifestyle changes, and environmental modifications to improve overall health and prevent disease indirectly. - It is not as targeted as vaccination or chemoprophylaxis against a specific disease. *Early diagnosis and treatment* - This level of prevention focuses on identifying and treating a disease in its early stages to prevent its progression and complications. - The scenario describes preventing disease in healthy individuals, not treating existing cases.

Q: Patients are categorized on the basis of chances of survival in Disaster management:

Triage. ***Triage*** - **Triage** is the process of sorting and prioritizing patients based on the severity of their injuries and their chances of survival, especially in mass casualty incidents or disasters. - This system ensures that limited resources are allocated to maximize the number of survivors and provide the most effective care. *Tagging* - **Tagging** refers to the physical labeling of patients after they have been triaged, using color-coded tags (e.g., red for immediate, yellow for delayed, green for minor, black for expectant). - It is a result of the triage process, not the process of categorization itself. *Mitigation* - **Mitigation** involves measures taken to reduce the impact of a disaster or emergency, such as constructing earthquake-resistant buildings or developing flood control systems. - It focuses on preventing or lessening the severity of a disaster before it occurs, rather than categorizing patients. *Surge capacity* - **Surge capacity** is the ability of a healthcare system to expand its services and resources in response to an unexpected influx of patients, such as during a pandemic or mass casualty event. - It refers to the operational capability of the system, not the method of patient categorization.

Q: All the following are true about Meniere's disease except?

Destroying the cochlea is mandatory. ***Destroying the cochlea is mandatory*** - While various interventions, including **destructive procedures**, exist for Meniere's disease in severe cases refractory to medical therapy (e.g., labyrinthectomy, vestibular neurectomy), it is **not mandatory** for diagnosis or initial management. - Initial management typically involves **conservative medical treatment** to control symptoms, such as **diuretics**, low-salt diet, and symptomatic relief during attacks. *Low frequency hearing loss* - Meniere's disease typically presents with **fluctuating sensorineural hearing loss**, predominantly affecting **low frequencies** in the early stages. - This characteristic hearing loss is often associated with aural fullness and tinnitus. *Increase in endolymph* - The underlying pathology of Meniere's disease is believed to be **endolymphatic hydrops**, which is an **excessive accumulation of endolymph** in the inner ear. - This increased pressure within the endolymphatic system distorts the membranous labyrinth, leading to the classic symptoms. *Idiopathic* - Meniere's disease is generally considered **idiopathic**, meaning its specific cause is unknown. - While various theories exist regarding its etiology (e.g., viral infections, autoimmune disorders, vascular compromise), a definitive cause has not been identified.

Q: Which of the following is seen in mitral stenosis?

Diastolic murmur. ***Diastolic murmur*** - **Mitral stenosis** is characterized by a narrowing of the mitral valve, impeding blood flow from the left atrium to the left ventricle during **diastole**. - This turbulent flow during ventricular filling produces a characteristic **diastolic murmur**, often described as a low-pitched, rumbling sound [1], [3]. *None of the options* - This option is incorrect because **mitral stenosis** is indeed associated with a specific heart sound abnormality [1]. - The presence of a **diastolic murmur** is a hallmark physical finding in patients with mitral stenosis [1]. *Systolic murmur* - A **systolic murmur** is produced during ventricular contraction (systole), typically associated with **mitral regurgitation** or **aortic stenosis** [2]. - In **mitral stenosis**, the primary pathology is during diastole, making a systolic murmur less characteristic unless there's concomitant mitral regurgitation. *Loud S2* - A **loud S2** (second heart sound) can be heard in conditions like **pulmonary hypertension** or **systemic hypertension**. - While pulmonary hypertension can be a complication of severe **mitral stenosis** due to elevated left atrial pressure, a loud S2 is not the most direct or specific auscultatory finding for mitral stenosis itself; the distinct diastolic murmur is more characteristic [1].

Q: Smallest cestode among the following:

H. nana. ***H. nana*** - *Hymenolepis nana* (dwarf tapeworm) is the **smallest cestode** infecting humans, typically measuring only 15-40 mm in length. - Its small size and direct life cycle (often without an intermediate host) contribute to its ability to cause **autoinfection**. *Schistosoma* - *Schistosoma* species are **trematodes (flukes)**, not cestodes (tapeworms). - They are known for causing **schistosomiasis** and are distinct from tapeworms in morphology and life cycle. *T. saginata* - *Taenia saginata* (beef tapeworm) is one of the **largest human tapeworms**, often reaching lengths of 4-12 meters. - Its large size and characteristic **proglottids** (segments) are key identifying features. *T. Solium* - *Taenia solium* (pork tapeworm) is also a **large cestode**, measuring 2-7 meters in length. - It is clinically significant for causing **cysticercosis** if humans ingest its eggs.

Q: Find therapeutic index of drug from the information given below in the graph

16. ***16*** - The **therapeutic index (TI)** is calculated as **TD50/ED50**, which is the ratio of the **toxic dose in 50% of the population (TD50)** to the **effective dose in 50% of the population (ED50)**. - From the graph, the **ED50** (response curve) is **8 units**, and the **TD50** (toxicity curve) is **128 units**. Therefore, TI = 128 / 8 = **16**. *8* - This value represents the **effective dose in 50% of the population (ED50)**, not the therapeutic index. - **ED50** is the dose at which 50% of individuals exhibit the desired therapeutic effect. *1024* - This value is obtained by squaring 32 or cubing 8, which is not the correct way to calculate the **therapeutic index**. - There is no direct pharmacological calculation that would yield this number from the given ED50 and TD50 values. *128* - This value represents the **toxic dose in 50% of the population (TD50)**, not the therapeutic index. - **TD50** is the dose at which 50% of individuals experience a specified toxic effect.

Question 1

Protrusion of mandible is due to which of the following muscles?

Accepted Answer

Lateral pterygoid

Answer

Medial pterygoid

Answer

Masseter

Answer

Temporalis

Question 2

Which structure doesn't pass through the parotid gland?

Accepted Answer

Internal Carotid Artery

Answer

Retromandibular vein

Answer

Facial nerve

Answer

External Carotid Artery and its branches

Question 3

Type IV complex of ETC is inhibited by

Accepted Answer

Cyanide

Answer

Antimycin

Answer

Oligomycin

Answer

CO2

Question 4

In Africa, vaccination was given in an endemic outbreak area for a specific disease but due to shortage of vaccines, mass chemoprophylaxis treatment was given to people who were not diseased. Which type of prevention is this?

Accepted Answer

Specific protection

Answer

Rehabilitation

Answer

Health promotion

Answer

Early diagnosis and treatment

Question 5

Patients are categorized on the basis of chances of survival in Disaster management:

Accepted Answer

Triage

Answer

Tagging

Answer

Mitigation

Answer

Surge capacity

Question 6

All the following are true about Meniere's disease except?

Accepted Answer

Destroying the cochlea is mandatory

Answer

Low frequency hearing loss

Answer

Increase in endolymph

Answer

Idiopathic

Question 7

Which of the following can be considered as grounds of divorce under matrimonial law?

Accepted Answer

Impotence developing after the marriage

Answer

Sterility

Answer

Frigidity

Answer

Temporary Mental illness

Question 8

Which of the following is seen in mitral stenosis?

Accepted Answer

Diastolic murmur

Answer

None of the options

Answer

Systolic murmur

Answer

Loud S2

Question 9

Smallest cestode among the following:

Accepted Answer

H. nana

Answer

Schistosoma

Answer

T. saginata

Answer

T. solium

Question 10

Find therapeutic index of drug from the information given below in the graph

Accepted Answer

16

Answer

8

Answer

1024

Answer

128

FMGE 2019

Anatomy

Biochemistry

Community Medicine

ENT

Forensic Medicine

Internal Medicine

Microbiology

Pharmacology