Last 5 Year PYQs in Medicine for FMGE

Q1. What is the probable diagnosis of a 45-year-old woman who complains of dryness in her mouth and eyes and has positive anti-Ro and anti-La antibodies? The image below shows a positive test result with a score of less than 5 mm in 5 minutes without anesthesia.​

1. Scleroderma
2. Dehydration
3. Lacrimal duct stones
4. Sjogren syndrome

Ans. 4) Sjogren Syndrome

• The above image is that of Schirmer’s test, and in the above case, the patient, a 45-year-old female patient, presents with dryness in the mouth and eyes. Schirmer’s was positive with a score of <5 mm in 5 minutes without anesthesia, indicating a tear deficiency The patient is also positive for anti-Ro and anti-La antibodies. The likely diagnosis in this case is Sjogren syndrome.

Also read: Last 5 Year PYQs in OBG for FMGE

Q2. What could be the probable diagnosis for a 54-year-old female patient who visits you with symptoms of finger swelling, heartburn, and occasional joint pain? During examination, her hands appear shiny, tight, and thickened with non-pitting edema. Additionally, she has interstitial lung disease and tests positive for ANA antibodies, topoisomerase I antibodies, and anti-RNA polymerase III antibodies.

1. Limited cutaneous systemic sclerosis
2. Diffuse cutaneous systemic sclerosis
3. Raynaud's phenomenon
4. Peutz-jeghers syndrome

Ans. 2) Diffuse cutaneous systemic sclerosis

• In the above case, along with the clinical presentation of swollen fingers, heartburn, and occasional joint pains, shiny and taut, thickened skin with non-pitting edema in the presence of ANA antibodies, topoisomerase I antibodies, and anti-RNA polymerase III antibodies. It is most suggestive of Diffuse cutaneous systemic sclerosis.

Q3. A 30-year-old female with a history of recurrent headaches presented for further evaluation. On further workup, hemoglobin and total WBC count were normal, while an elevated platelet count was seen. Bone marrow aspiration showed increased megakaryocytes and a JAK2 mutation. Which is the most likely diagnosis?

1. Polycythemia vera
2. Essential thrombocytosis
3. Primary myelofibrosis
4. Chronic myelogenous leukemia

Ans. 2) Essential thrombocytosis

• The most probable diagnosis is essential thrombocytosis.
• It is a clonal hematopoietic stem cell disorder causing uncontrolled proliferation of megakaryocytes, resulting in a raised level of circulating platelets that are often dysfunctional.
• The presence of JAK-2, CALR or rarely, MPL mutation and normal Hb and WBC level along with increased platelet count supports the diagnosis.

Q4. What is a macrovascular complication that develops in the advanced stages of diabetes?

1. Coronary artery disease
2. Foot ulcer
3. Nephropathy
4. Retinopathy

Ans. 1) Coronary artery disease

• Coronary artery disease is a macrovascular complication of diabetes, while others are all microvascular complications.
• It increases cardiovascular mortality due to atherosclerosis.​​

Also read: Last 5 Year PYQs in FMT for FMGE

Q5. A veterinary surgeon presents with complaints of fever, muscle pain, joint pain, fatigue, and weight loss for the past few weeks. On further inquiry, he says that his fever persists for weeks before it resolves, only to be followed by a relapse. You obtain his blood sample and inoculate it on the medium given below to isolate the suspected organism. Which of the following is the most likely organism?​

1. Burkholderia
2. Brucella
3. Mycobacterium
4. Coxiella

Ans. 2) Brucella

• The culture medium shown above is the image of Castenada biphasic medium. The most probable diagnosis is that of Brucellosis, which is caused by Brucella.

Q6. A 24-year-old female patient presented with malar rash, recurrent oral ulcers, and multiple joint pains. She has no relevant past history and does not take any medication. On further investigations, thrombocytopenia was seen, and the anti-Sm antibody was positive. Which of the following is the most likely diagnosis for this patient?

1. Scleroderma
2. Sjogren’s syndrome
3. Rheumatoid arthritis
4. Systemic lupus erythematosus

Ans. 4) Systemic lupus erythematosus

• Systemic lupus erythematosus is a connective tissue disorder characterized by malar rash, recurrent oral ulcers, and multiple joint pains. Thrombocytopenia and anti-Sm antibodies also support the diagnosis of systemic lupus erythematosus.

Q7. An elderly woman presented with symptoms of confusion, thirst, and abdominal pain. On examination, she had pallor and thoracic spine tenderness. Her lab investigations showed the following findings:. An x-ray of her skull is shown below. What is the most likely diagnosis?
Hb: 6.9 g/dL;
WBC: 4000/cm3 with normal differential count
Serum calcium 13 mg/dL
Creatinine 2.3mg/dL
Total protein: 9g/dL
Albumin 2.4g/dL
Urinalysis: positive for Bence-Jones proteins

1. Metastatic breast cancer
2. Multiple myeloma
3. Primary hyperparathyroidism
4. Milk alkali syndrome

Ans. 2) Multiple myeloma

• Multiple myeloma is a malignant plasma cell dyscrasia that is depicted by uncontrolled proliferation of cells or bone marrow. Here The skull x-ray reveals Raindrop configuration of Lytic lesions of the skull, which is a characteristic feature for multiple myeloma. And the complaint of thoracic tenderness is one of the most common and initial complaints of multiple myeloma. The other diagnostic modalities include hypercalcaemia, creatinine > 2 mg and Bence Jones protein, which is typical in Urine analysis.

Also read: Last 5 Year PYQs in Anatomy for FMGE

Q8. ​At which level is the lesion located if all extraocular muscles are paralyzed?

1. Frontal eye field
2. Cerebral surface
3. Midbrain and Pons
4. Spinal cord

Ans. 3) Midbrain and Pons

• When the midbrain and pons are affected, the cranial nerves 3,4,5,6,7 and 8 are lost due to their location. The oculomotor nerve loses its control and hence extraocular movements are lost, hence extra ocular muscles are paralyzed.

Q9. What is the diagnosis of a patient who presents with chronic small bowel diarrhea, with duodenal biopsy showing villous atrophy, and positive results for anti-endomysial antibodies and IgA TTG antibodies?

1. Short bowel syndrome
2. Whipple’s disease
3. Tropical sprue
4. Celiac sprue

Ans. 4) Celiac sprue

• In Celiac sprue, antibodies play a crucial role, with the most sensitive being the anti-TTG antibody and the anti-endomysial antibody being the most specific. Notably, symptoms are often remembered through the "Four D's":
  • Diarrhea triggered by gluten ingestion
  • Duodenum primarily affected, often leading to iron deficiency anemia
  • Dermatitis herpetiformis, a skin disorder linked to IgA, typically treated with Dapsone

Q10. What is the probable diagnosis for an overweight elderly man who arrived at the emergency department with intense chest pain lasting for two hours? He also experienced excessive sweating, pain in the left arm, nausea, and one instance of vomiting. During examination, his pulse rate was recorded as 58 beats per minute and his blood pressure was 90/60 mm of Hg. An electrocardiogram (ECG) was conducted and revealed the following results:. Additionally, the patient's cardiac biomarkers indicated increased troponin levels.​

1. Anterior wall
2. Inferior wall MI
3. Posterior wall MI
4. Pericarditis

Ans. 2: Inferior wall MI

• The diagnosis of an inferior wall myocardial infarction is made by elevated cardiac biomarkers (Trop I, CPK MB, LDH ), the ECG changes of myocardial ischemia, and the clinical symptoms (Levine sign) such as profuse sweating pain radiating to the left and nausea and vomiting. Here the ECG depicts evident ST elevation in leads II, III, and aVF.

Also read: Medicine Important Questions for NEET PG/FMGE

Q11. What does the image below represent in terms of murmurs?​

1. End diastolic
2. Pan systolic
3. Ejection systolic
4. Mid diastolic

Ans. 3) Ejection systolic

• An ejection systolic murmur occurs during the ejection phase of the cardiac cycle when blood is being pumped out of the heart. It is characterized by a continuous or crescendo-decrescendo sound that starts after the first heart sound (S1) and ends before the second heart sound (S2).
• The ejection systolic murmur is typically heard best over specific areas of the heart, such as the aortic or pulmonary valve areas, depending on the underlying cause of the murmur. It is caused by turbulent blood flow through a narrowed or abnormal valve or aorta during systole.

Q12. What is the probable diagnosis for a 55-year-old male patient who came to the hospital complaining of palpitations, and during examination, a diastolic murmur is detected in the left third intercostal space, along with the presence of a pistol shot sound over the femoral arteries?

1. Aortic regurgitation
2. Aortic stenosis
3. Tricuspid regurgitation
4. Mitral regurgitation

Ans. 1) Aortic regurgitation

• The above patient presents with the diastolic murmur and the pistol shot over femoral arteries, which is suggestive of aortic regurgitation. There is a backflow of blood from the aorta to the ventricle at the time of diastole.

Q13. A patient was asked to copy the face of a clock and his drawing is shown below. What is the correct term to be used here?​

1. Confabulation
2. Hemispatial neglect
3. Kinetic apraxia
4. Asterixis

Ans. 2) Hemispatial neglect

• Hemispatial neglect is the inability to report, respond, and orient to stimuli in one-half of the space despite having no motor or sensory deficits.
• Causes of spatial neglect include stroke, traumatic brain injury, brain tumors, and aneurysms. Rarely, neurodegenerative diseases can cause neglect symptoms.

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Q14. A person with dyspnea has a slight limitation in physical activity and doing ordinary activity causes symptoms but he is asymptomatic at rest. To which class does he belong, based on the New York Heart Association functional classification?

1. Class I
2. Class II
3. Class III
4. Class IV

Ans. 2) Class II

• As the patient has dyspnea on light physical activity, there is a slight limitation of physical activity. He is asymptomatic at rest. This is Class II in NYHA classification.

Q15. What is the most probable diagnosis for a 30-year-old female patient who reports symptoms of headache, vomiting, absence of menstruation, lactation without pregnancy, decreased sexual desire, acromegaly, and infertility, along with the presence of bitemporal hemianopia during a physical examination?

1. Corticotroph adenoma
2. Gonadotroph adenoma
3. Mammosomatotroph adenoma
4. Glioma

Ans. 3) Mammosomatotroph adenoma

• The above case is that of a mammosomatotroph adenoma of the pituitary, which causes an excess of prolactin and growth hormone secretion. Common symptoms include headache, vomiting, amenorrhea, galactorrhoea, loss of libido, acromegaly, and infertility.

Q16. What is the probable diagnosis for a girl who experiences prolonged menstrual bleeding and has normal platelet count, PT, and aPTT, but an increased bleeding time, which was determined to be due to a deficiency of GpIIb-IIIa after further analysis?

1. Bernard Soulier syndrome
2. Glanzmann thrombasthenia
3. Haemophilia A
4. Von Willebrand disease

Ans. 2) Glanzmann thrombasthenia

• The above case is that of Glanzmann thrombosthenia, which is an autosomal recessive platelet surface disorder of GPIIb/IIIa.
• It has normal platelet morphology, prolonged BT, absent or decreased clot retraction, and normal platelet aggregation in the presence of ristocetin.

Hope you found this blog helpful for your FMGE Medicine Preparation. For more informative and interesting posts like these, keep reading PrepLadder’s blogs. 

Also check the Previous Year Question Papers for FMG Exams.