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Fmge like 300 questions

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Here are 300 FMGE-style MCQs covering all major subjects - mixed pattern, with 4 options and the correct answer marked.

FMGE Practice Questions - All Subjects Mixed (300 MCQs)

ANATOMY (Q1-Q30)

Q1. The nerve most commonly injured in anterior dislocation of shoulder joint is: A) Axillary nerve B) Radial nerve C) Musculocutaneous nerve D) Ulnar nerve Answer: A) Axillary nerve
Q2. Flexor digitorum profundus is supplied by: A) Ulnar nerve only B) Median nerve only C) Medial half by ulnar, lateral half by median nerve (anterior interosseous branch) D) Radial nerve Answer: C) Medial half by ulnar, lateral half by median nerve
Q3. The tricuspid valve is best auscultated at: A) 2nd right intercostal space B) 2nd left intercostal space C) 4th left intercostal space (lower left sternal border) D) Apex (5th ICS, MCL) Answer: C) 4th left intercostal space (lower left sternal border)
Q4. Scarpa's triangle boundaries - which is NOT a boundary? A) Inguinal ligament (superiorly) B) Adductor longus (medially) C) Sartorius (laterally) D) Gracilis (medially) Answer: D) Gracilis
Q5. The ureter is crossed anteriorly by the gonadal vessels at which level? A) L1 B) L2 C) L3 D) L4 Answer: B) L2
Q6. Which muscle is the prime mover of abduction of arm between 15-90 degrees? A) Trapezius B) Deltoid C) Supraspinatus D) Serratus anterior Answer: B) Deltoid
Q7. The bare area of the liver is bounded by: A) Coronary ligaments B) Falciform ligament C) Ligamentum teres D) Gastrohepatic ligament Answer: A) Coronary ligaments
Q8. Lateral rectus of eye is supplied by: A) CN III B) CN IV C) CN VI D) CN V Answer: C) CN VI (Abducens nerve)
Q9. The femoral ring is bounded posteriorly by: A) Inguinal ligament B) Lacunar ligament C) Pectineal ligament (Cooper's ligament) D) Femoral vein Answer: C) Pectineal ligament (Cooper's ligament)
Q10. Which of the following forms the posterior wall of the axilla? A) Subscapularis, teres major, latissimus dorsi B) Serratus anterior, subscapularis C) Pectoralis major, pectoralis minor D) Coracobrachialis, biceps Answer: A) Subscapularis, teres major, latissimus dorsi
Q11. Fossae of Rosenmuller is located in: A) Oropharynx B) Nasopharynx C) Hypopharynx D) Laryngopharynx Answer: B) Nasopharynx
Q12. Waldeyer's ring consists of all EXCEPT: A) Palatine tonsil B) Lingual tonsil C) Nasopharyngeal tonsil (adenoids) D) Submandibular lymph nodes Answer: D) Submandibular lymph nodes
Q13. The portal vein is formed by the union of: A) Superior mesenteric and inferior mesenteric veins B) Superior mesenteric and splenic veins C) Splenic and inferior mesenteric veins D) Splenic and left gastric veins Answer: B) Superior mesenteric and splenic veins
Q14. Obturator nerve originates from: A) L2, L3, L4 B) L1, L2, L3 C) L3, L4, L5 D) L4, L5, S1 Answer: A) L2, L3, L4
Q15. The McBurney's point is located at: A) Junction of lateral 1/3 and medial 2/3 of line joining ASIS to umbilicus B) Junction of lateral 2/3 and medial 1/3 of line joining ASIS to umbilicus C) Midpoint of inguinal ligament D) 2 cm above and medial to ASIS Answer: A) Junction of lateral 1/3 and medial 2/3
Q16. Meckel's diverticulum is a remnant of: A) Vitellointestinal duct B) Urachus C) Notochord D) Allantois Answer: A) Vitellointestinal duct
Q17. Which of the following is a derivative of the 1st pharyngeal arch? A) Styloid process B) Stapes C) Malleus and incus D) Hyoid (lesser cornu) Answer: C) Malleus and incus
Q18. The anterior fontanelle closes at: A) 6 months B) 12 months C) 18 months D) 24 months Answer: C) 18 months
Q19. Coronary sinus drains into: A) Right atrium B) Left atrium C) Right ventricle D) Left ventricle Answer: A) Right atrium
Q20. The muscle responsible for "scaphoid abdomen" when paralyzed: A) Rectus abdominis B) External oblique C) Transversus abdominis D) All muscles Answer: A) Rectus abdominis
Q21. Hasselbach's triangle is bounded by all EXCEPT: A) Inferior epigastric artery (laterally) B) Inguinal ligament (inferiorly) C) Rectus abdominis (medially) D) Cooper's ligament (superiorly) Answer: D) Cooper's ligament
Q22. The circle of Willis is formed by anastomosis of: A) Anterior communicating + posterior communicating arteries B) Middle cerebral + anterior cerebral arteries C) Both internal carotid and vertebrobasilar systems D) Only vertebrobasilar system Answer: C) Both internal carotid and vertebrobasilar systems
Q23. Which dermatome covers the umbilicus? A) T8 B) T10 C) T12 D) L1 Answer: B) T10
Q24. Sudomotor, vasomotor, and pilomotor fibers are: A) Somatic efferents B) Visceral afferents C) Postganglionic sympathetic fibers D) Preganglionic parasympathetic fibers Answer: C) Postganglionic sympathetic fibers
Q25. The commonest site of ectopic kidney: A) Thorax B) Pelvis C) Iliac fossa D) Lumbar region Answer: B) Pelvis
Q26. The gubernaculum in females persists as: A) Round ligament of uterus B) Broad ligament C) Cardinal ligament D) Ovarian ligament + round ligament Answer: D) Ovarian ligament + round ligament
Q27. Saphenous opening is a defect in: A) Fascia lata B) Fascia iliaca C) Cribiform fascia D) Deep fascia of thigh Answer: A) Fascia lata
Q28. Foramen of Winslow (epiploic foramen) - which vessel is in its anterior wall? A) Portal vein B) Hepatic artery C) Bile duct D) All three (portal triad) Answer: D) All three (portal triad) - free edge of lesser omentum
Q29. In carpal tunnel syndrome, which nerve is compressed? A) Ulnar nerve B) Radial nerve C) Median nerve D) Anterior interosseous nerve Answer: C) Median nerve
Q30. The muscle that inverts the foot: A) Tibialis posterior B) Peroneus longus C) Peroneus brevis D) Extensor digitorum longus Answer: A) Tibialis posterior

PHYSIOLOGY (Q31-Q60)

Q31. Normal intraocular pressure is: A) 5-10 mmHg B) 10-21 mmHg C) 22-30 mmHg D) 25-35 mmHg Answer: B) 10-21 mmHg
Q32. Resting membrane potential of a neuron is: A) -40 mV B) -55 mV C) -70 mV D) -90 mV Answer: C) -70 mV
Q33. The normal cardiac output at rest is: A) 2-3 L/min B) 4-6 L/min C) 7-8 L/min D) 10-12 L/min Answer: B) 4-6 L/min
Q34. Erythropoietin is mainly produced by: A) Liver B) Kidney (peritubular cells) C) Spleen D) Bone marrow Answer: B) Kidney (peritubular cells)
Q35. The first heart sound (S1) is caused by: A) Closure of aortic and pulmonary valves B) Closure of mitral and tricuspid valves C) Opening of mitral valve D) Rapid ventricular filling Answer: B) Closure of mitral and tricuspid valves
Q36. All of the following are features of Starling's law EXCEPT: A) Stroke volume increases with increased end-diastolic volume B) Heart rate is the primary determinant C) Myocardial contractility relates to fiber length D) Frank-Starling mechanism compensates for increased preload Answer: B) Heart rate is the primary determinant
Q37. Oxygen-hemoglobin dissociation curve shifts to the right in: A) Decreased temperature B) Decreased pCO2 C) Increased pH D) Increased 2,3-DPG Answer: D) Increased 2,3-DPG
Q38. Dead space in normal adult is approximately: A) 50 mL B) 150 mL C) 300 mL D) 500 mL Answer: B) 150 mL
Q39. Normal GFR is: A) 50 mL/min B) 80 mL/min C) 125 mL/min D) 180 mL/min Answer: C) 125 mL/min
Q40. The hormone that increases sodium reabsorption in the distal tubule and collecting duct: A) ADH B) ANP C) Aldosterone D) PTH Answer: C) Aldosterone
Q41. Surfactant is produced by: A) Type I pneumocytes B) Type II pneumocytes C) Clara cells D) Alveolar macrophages Answer: B) Type II pneumocytes
Q42. Cerebrospinal fluid (CSF) is produced primarily by: A) Arachnoid granulations B) Choroid plexus C) Ependymal cells D) Brain parenchyma Answer: B) Choroid plexus
Q43. The pacemaker of the heart is: A) AV node B) Bundle of His C) SA node D) Purkinje fibers Answer: C) SA node
Q44. Normal PR interval on ECG is: A) 0.04-0.08 seconds B) 0.12-0.20 seconds C) 0.25-0.40 seconds D) 0.40-0.60 seconds Answer: B) 0.12-0.20 seconds
Q45. The principal buffer in blood is: A) Phosphate buffer B) Plasma protein buffer C) Bicarbonate buffer D) Hemoglobin buffer Answer: C) Bicarbonate buffer (most important extracellular)
Q46. Hypocalcemia causes: A) Decreased neuromuscular excitability B) Increased neuromuscular excitability (tetany) C) Prolonged QT only D) Decreased reflexes Answer: B) Increased neuromuscular excitability (tetany)
Q47. Tidal volume in a normal adult at rest is: A) 150 mL B) 350 mL C) 500 mL D) 1200 mL Answer: C) 500 mL
Q48. The corpus luteum produces mainly: A) Estrogen only B) Progesterone and estrogen C) FSH D) LH Answer: B) Progesterone and estrogen
Q49. The hematocrit (PCV) for adult males: A) 30-35% B) 36-40% C) 40-50% D) 55-60% Answer: C) 40-50%
Q50. Glucose is actively reabsorbed in: A) Proximal convoluted tubule B) Loop of Henle C) Distal convoluted tubule D) Collecting duct Answer: A) Proximal convoluted tubule
Q51. The P wave on ECG represents: A) Ventricular depolarization B) Atrial depolarization C) Ventricular repolarization D) Atrial repolarization Answer: B) Atrial depolarization
Q52. Normal serum sodium level is: A) 120-130 mEq/L B) 135-145 mEq/L C) 150-160 mEq/L D) 100-115 mEq/L Answer: B) 135-145 mEq/L
Q53. Growth hormone acts primarily through: A) cAMP B) IGF-1 (somatomedin C) C) Direct receptor binding only D) Tyrosine kinase receptor Answer: B) IGF-1 (somatomedin C)
Q54. Vitamin B12 absorption requires: A) Pepsin B) Intrinsic factor C) Trypsin D) Bile salts Answer: B) Intrinsic factor
Q55. The baroreceptors are located in the: A) Aortic arch and carotid sinus B) Renal artery C) Mesenteric artery D) Pulmonary artery only Answer: A) Aortic arch and carotid sinus
Q56. The clotting factor NOT synthesized in the liver: A) Factor I (fibrinogen) B) Factor II (prothrombin) C) Factor III (tissue factor) D) Factor VIII von Willebrand portion Answer: D) Factor VIII (vWF is made by endothelium)
Q57. Spironolactone acts as: A) Loop diuretic B) Aldosterone antagonist C) Carbonic anhydrase inhibitor D) Osmotic diuretic Answer: B) Aldosterone antagonist
Q58. Normal arterial blood pH is: A) 7.25-7.35 B) 7.35-7.45 C) 7.45-7.55 D) 7.55-7.65 Answer: B) 7.35-7.45
Q59. The Hering-Breuer reflex involves: A) Chemoreceptors in aortic arch B) Stretch receptors in the lungs (prevents over-inflation) C) Baroreceptors in carotid sinus D) J-receptors Answer: B) Stretch receptors in the lungs
Q60. Vitamin K is required for activation of which clotting factors? A) II, VII, IX, X B) I, II, III, IV C) VIII, IX, X, XI D) V, VII, IX, X Answer: A) II, VII, IX, X (and Protein C and S)

BIOCHEMISTRY (Q61-Q90)

Q61. HbA1c reflects glycemic control over the past: A) 1 week B) 2-4 weeks C) 2-3 months D) 6 months Answer: C) 2-3 months
Q62. The rate-limiting enzyme in cholesterol synthesis: A) Squalene synthase B) HMG-CoA reductase C) HMG-CoA synthase D) Mevalonate kinase Answer: B) HMG-CoA reductase
Q63. Phenylketonuria (PKU) is due to deficiency of: A) Phenylalanine hydroxylase B) Tyrosinase C) Homogentisate oxidase D) Fumarylacetoacetase Answer: A) Phenylalanine hydroxylase
Q64. Vitamin C is required for: A) Carboxylation reactions B) Hydroxylation of proline in collagen synthesis C) Deamination of amino acids D) Beta-oxidation of fatty acids Answer: B) Hydroxylation of proline in collagen synthesis
Q65. The Km of an enzyme: A) Increases when substrate is added B) Is the substrate concentration at half-maximal velocity C) Increases with increasing enzyme concentration D) Is the maximum velocity Answer: B) Substrate concentration at half-maximal velocity
Q66. Which amino acid is the precursor for both serotonin and melatonin? A) Tyrosine B) Phenylalanine C) Tryptophan D) Histidine Answer: C) Tryptophan
Q67. Glycogen storage disease Type I (Von Gierke) is due to deficiency of: A) Lysosomal acid maltase B) Glucose-6-phosphatase C) Phosphorylase D) Branching enzyme Answer: B) Glucose-6-phosphatase
Q68. DNA replication occurs in which phase of cell cycle? A) G1 B) S phase C) G2 D) M phase Answer: B) S phase
Q69. Kwashiorkor is characterized by all EXCEPT: A) Pitting edema B) Normal weight for age C) Fatty liver D) Marasmus features Answer: D) Marasmus features (those are separate)
Q70. The enzyme deficient in Lesch-Nyhan syndrome: A) Adenosine deaminase B) HGPRT (hypoxanthine-guanine phosphoribosyl transferase) C) Xanthine oxidase D) Purine nucleoside phosphorylase Answer: B) HGPRT
Q71. Southern blotting detects: A) Protein B) RNA C) DNA D) Lipids Answer: C) DNA
Q72. Carbamoyl phosphate synthetase I is involved in: A) Pyrimidine synthesis B) Urea cycle (mitochondria) C) Gluconeogenesis D) Fatty acid synthesis Answer: B) Urea cycle (mitochondria)
Q73. Normal serum albumin level is: A) 1.5-2.5 g/dL B) 3.5-5.0 g/dL C) 5.5-7.0 g/dL D) 7.0-9.0 g/dL Answer: B) 3.5-5.0 g/dL
Q74. Orotic aciduria with megaloblastic anemia (no hyperammonemia) is due to deficiency of: A) OTC (ornithine transcarbamylase) B) UMP synthase C) Carbamoyl phosphate synthetase I D) Argininosuccinase Answer: B) UMP synthase
Q75. Beta-oxidation of fatty acids occurs in: A) Cytoplasm B) Smooth ER C) Mitochondria D) Peroxisomes (very long chain fatty acids) Answer: C) Mitochondria (also peroxisomes for VLCFA)
Q76. The enzyme that converts angiotensin I to angiotensin II: A) Renin B) ACE (angiotensin-converting enzyme) C) Angiotensinogen D) Chymase Answer: B) ACE
Q77. Catecholamines are derived from: A) Tryptophan B) Tyrosine C) Histidine D) Glycine Answer: B) Tyrosine
Q78. Cori's cycle involves glucose-lactate exchange between: A) Liver and kidney B) Muscle and liver C) Adipose and liver D) Brain and muscle Answer: B) Muscle and liver
Q79. Statin drugs inhibit which enzyme? A) Squalene epoxidase B) HMG-CoA reductase C) PCSK9 D) Lipoprotein lipase Answer: B) HMG-CoA reductase
Q80. The net gain of ATP from complete oxidation of one glucose molecule (aerobic): A) 2 B) 8 C) 30-32 D) 38-40 (older estimate) Answer: C) 30-32 (modern estimate)
Q81. Maple syrup urine disease involves accumulation of: A) Phenylalanine B) Branched-chain amino acids (Leu, Ile, Val) C) Homocysteine D) Methionine Answer: B) Branched-chain amino acids
Q82. Which vitamin acts as a coenzyme in transamination reactions? A) B1 (thiamine) B) B2 (riboflavin) C) B6 (pyridoxine) D) B12 (cobalamin) Answer: C) B6 (pyridoxine - as PLP)
Q83. Alkaptonuria is caused by deficiency of: A) Phenylalanine hydroxylase B) Homogentisate oxidase C) Tyrosinase D) FAH (fumarylacetoacetate hydrolase) Answer: B) Homogentisate oxidase
Q84. The major energy source for the brain under normal conditions: A) Fatty acids B) Ketone bodies C) Glucose D) Amino acids Answer: C) Glucose
Q85. Zinc-finger proteins are: A) Transcription factors that bind DNA B) Membrane receptors C) Enzymes D) Structural proteins Answer: A) Transcription factors that bind DNA
Q86. Which of the following is an essential fatty acid? A) Oleic acid B) Palmitic acid C) Linoleic acid D) Stearic acid Answer: C) Linoleic acid (omega-6)
Q87. Heme synthesis starts in: A) Cytoplasm B) Mitochondria C) Smooth ER D) Nucleus Answer: B) Mitochondria (ALA synthase reaction)
Q88. The most abundant immunoglobulin in serum: A) IgM B) IgA C) IgG D) IgE Answer: C) IgG
Q89. Non-essential amino acid synthesized from phenylalanine: A) Serine B) Tyrosine C) Alanine D) Glutamine Answer: B) Tyrosine
Q90. NADPH is produced by: A) Glycolysis B) TCA cycle C) HMP shunt (pentose phosphate pathway) D) Beta-oxidation Answer: C) HMP shunt (pentose phosphate pathway)

PATHOLOGY (Q91-Q120)

Q91. The most common cause of death in burn patients after 1 week: A) Hypovolemic shock B) Sepsis C) Respiratory failure D) Acute kidney injury Answer: B) Sepsis
Q92. Reed-Sternberg cells are seen in: A) Non-Hodgkin's lymphoma B) Hodgkin's lymphoma C) Multiple myeloma D) CLL Answer: B) Hodgkin's lymphoma
Q93. Caseating granuloma is characteristic of: A) Sarcoidosis B) Tuberculosis C) Crohn's disease D) Leprosy (tuberculoid) Answer: B) Tuberculosis
Q94. The tumor marker for hepatocellular carcinoma is: A) CEA B) PSA C) AFP (alpha-fetoprotein) D) CA 19-9 Answer: C) AFP
Q95. Philadelphia chromosome involves translocation: A) t(9;22) B) t(8;14) C) t(14;18) D) t(15;17) Answer: A) t(9;22) - BCR-ABL - CML
Q96. Amyloid in Alzheimer's disease is composed of: A) Tau protein B) Beta-amyloid (Aβ42) C) Prion protein D) Alpha-synuclein Answer: B) Beta-amyloid (Aβ42)
Q97. Virchow's triad for thrombosis includes all EXCEPT: A) Stasis of blood flow B) Endothelial injury C) Hypercoagulability D) Hypertension Answer: D) Hypertension
Q98. The most common type of lung cancer associated with smoking: A) Adenocarcinoma B) Squamous cell carcinoma C) Small cell carcinoma D) Large cell carcinoma Answer: B) Squamous cell carcinoma (centrally located, strongly associated with smoking)
Q99. Councilman bodies are seen in: A) Hepatitis B B) Yellow fever C) CMV infection D) EBV infection Answer: B) Yellow fever
Q100. Which clotting factor is deficient in Hemophilia A? A) Factor IX B) Factor VIII C) Factor XI D) Von Willebrand factor Answer: B) Factor VIII
Q101. Mallory-Weiss syndrome involves: A) Esophageal varices B) Longitudinal tear at gastroesophageal junction C) Barrett's esophagus D) Esophageal perforation Answer: B) Longitudinal tear at gastroesophageal junction
Q102. The most common primary bone tumor in adults: A) Ewing's sarcoma B) Osteosarcoma C) Chondrosarcoma D) Giant cell tumor Answer: C) Chondrosarcoma
Q103. Psammoma bodies are seen in all EXCEPT: A) Papillary carcinoma thyroid B) Meningioma C) Serous cystadenocarcinoma of ovary D) Follicular carcinoma thyroid Answer: D) Follicular carcinoma thyroid
Q104. The term "tumor emboli" refers to: A) Calcification in tumors B) Tumor cells in lymphatics/blood vessels C) Necrosis in tumors D) Invasion of adjacent structures Answer: B) Tumor cells in lymphatics/blood vessels
Q105. Glioblastoma multiforme is characterized by: A) Palisading necrosis and pseudopalisading B) Rosenthal fibers C) Antoni A and B patterns D) Homer-Wright rosettes Answer: A) Palisading necrosis and pseudopalisading
Q106. The most common glomerulonephritis in adults (worldwide): A) IgA nephropathy (Berger's disease) B) Membranous nephropathy C) FSGS D) Minimal change disease Answer: A) IgA nephropathy
Q107. Lewy bodies are seen in: A) Alzheimer's disease B) Parkinson's disease C) Huntington's disease D) Pick's disease Answer: B) Parkinson's disease
Q108. Type IV hypersensitivity (delayed) is mediated by: A) IgE B) IgG C) T lymphocytes (CD4+ T cells) D) Complement Answer: C) T lymphocytes
Q109. BCL-2 gene overexpression causes inhibition of: A) Cell proliferation B) Apoptosis C) DNA repair D) Cell cycle entry Answer: B) Apoptosis
Q110. The most common tumor of salivary glands: A) Mucoepidermoid carcinoma B) Pleomorphic adenoma (mixed tumor) C) Warthin's tumor D) Adenoid cystic carcinoma Answer: B) Pleomorphic adenoma
Q111. Fibrinous pericarditis classically causes which sound? A) S3 gallop B) Pericardial friction rub C) Opening snap D) Pansystolic murmur Answer: B) Pericardial friction rub
Q112. "Boot-shaped heart" on X-ray is seen in: A) VSD B) Tetralogy of Fallot C) ASD D) PDA Answer: B) Tetralogy of Fallot
Q113. The virus most associated with Burkitt's lymphoma: A) HPV B) EBV C) HTLV-1 D) HHV-8 Answer: B) EBV
Q114. Hyaline membrane disease (RDS of newborn) is due to deficiency of: A) Oxygen B) Surfactant C) Collagen D) Elastin Answer: B) Surfactant
Q115. Most common site of carcinoid tumor: A) Appendix B) Ileum C) Rectum D) Stomach Answer: A) Appendix
Q116. Pseudomembranous colitis is caused by: A) Salmonella B) Clostridium difficile C) Shigella D) E. coli O157:H7 Answer: B) Clostridium difficile
Q117. Which hepatitis virus is transmitted by fecal-oral route? A) Hepatitis B B) Hepatitis C C) Hepatitis A and E D) Hepatitis D Answer: C) Hepatitis A and E
Q118. Bence Jones proteins are seen in: A) Multiple myeloma B) Waldenstrom macroglobulinemia C) Both A and B D) IgA nephropathy Answer: A) Multiple myeloma
Q119. Mesothelioma is associated with: A) Silica dust B) Asbestos C) Coal dust D) Beryllium Answer: B) Asbestos
Q120. The most common thyroid cancer: A) Follicular carcinoma B) Papillary carcinoma C) Medullary carcinoma D) Anaplastic carcinoma Answer: B) Papillary carcinoma (>80% of thyroid malignancies)

PHARMACOLOGY (Q121-Q155)

Q121. Metformin mechanism of action: A) Stimulates insulin secretion B) Inhibits hepatic gluconeogenesis (activates AMPK) C) Alpha-glucosidase inhibitor D) SGLT-2 inhibitor Answer: B) Inhibits hepatic gluconeogenesis (activates AMPK)
Q122. Penicillin acts by: A) Inhibiting protein synthesis (30S) B) Inhibiting DNA gyrase C) Inhibiting cell wall synthesis (transpeptidase inhibition) D) Disrupting cell membrane Answer: C) Inhibiting cell wall synthesis
Q123. The antidote for organophosphate poisoning: A) Naloxone B) Atropine + Pralidoxime C) Flumazenil D) N-acetylcysteine Answer: B) Atropine + Pralidoxime
Q124. Warfarin's anticoagulant effect is reversed by: A) Protamine sulfate B) Vitamin K + Fresh frozen plasma C) Heparin D) Tranexamic acid Answer: B) Vitamin K + Fresh frozen plasma
Q125. The drug of choice for malaria in pregnancy: A) Primaquine B) Chloroquine C) Artemether D) Doxycycline Answer: B) Chloroquine (for chloroquine-sensitive P. vivax/P. falciparum)
Q126. Zero-order kinetics means: A) Rate of elimination is proportional to concentration B) Rate of elimination is constant regardless of concentration C) Drug is not metabolized D) Only one molecule eliminated at a time Answer: B) Rate of elimination is constant regardless of concentration
Q127. Gentamicin is nephrotoxic due to accumulation in: A) Proximal tubular cells B) Distal tubular cells C) Collecting duct D) Glomerular endothelium Answer: A) Proximal tubular cells
Q128. Which beta-blocker is cardioselective? A) Propranolol B) Carvedilol C) Metoprolol D) Labetalol Answer: C) Metoprolol (also atenolol, bisoprolol)
Q129. Morphine acts primarily on which receptor? A) Kappa B) Delta C) Mu (MOR) D) Sigma Answer: C) Mu receptor
Q130. The drug causing "gray baby syndrome": A) Tetracycline B) Chloramphenicol C) Sulfonamide D) Aminoglycosides Answer: B) Chloramphenicol
Q131. Aspirin irreversibly inhibits: A) COX-1 and COX-2 B) Lipoxygenase C) Phospholipase A2 D) Thrombin Answer: A) COX-1 and COX-2 (irreversibly)
Q132. Rifampicin is a potent: A) Cytochrome P450 inhibitor B) Cytochrome P450 inducer C) P-glycoprotein inhibitor D) UGT inhibitor Answer: B) CYP450 inducer
Q133. Ondansetron is a: A) D2 antagonist B) 5-HT3 antagonist C) H1 antagonist D) Muscarinic antagonist Answer: B) 5-HT3 antagonist
Q134. Heparin overdose is treated with: A) Vitamin K B) Protamine sulfate C) Tranexamic acid D) Fresh frozen plasma Answer: B) Protamine sulfate
Q135. The drug of choice for trichomoniasis: A) Albendazole B) Metronidazole C) Praziquantel D) Ivermectin Answer: B) Metronidazole
Q136. Cyclosporine acts by inhibiting: A) mTOR B) Calcineurin (blocks IL-2 transcription) C) Dihydrofolate reductase D) Purine synthesis Answer: B) Calcineurin
Q137. The mechanism of action of ACE inhibitors: A) Block angiotensin II receptor B) Prevent conversion of angiotensin I to angiotensin II C) Inhibit renin D) Block aldosterone Answer: B) Prevent conversion of angiotensin I to angiotensin II
Q138. Halothane hepatotoxicity is an example of: A) Type A (predictable) adverse drug reaction B) Type B (idiosyncratic) reaction C) Drug interaction D) Pharmacogenomic reaction Answer: B) Type B (idiosyncratic) reaction
Q139. The loading dose of a drug depends on: A) Clearance B) Volume of distribution (Vd) C) Half-life D) Bioavailability Answer: B) Volume of distribution (Vd)
Q140. Sildenafil (Viagra) acts by inhibiting: A) PDE-3 B) PDE-4 C) PDE-5 D) PDE-6 Answer: C) PDE-5 (increases cGMP, vasodilation)
Q141. Benzodiazepines act on which receptor? A) NMDA glutamate receptor B) GABA-A receptor (increase Cl- channel opening frequency) C) Glycine receptor D) Opioid receptor Answer: B) GABA-A receptor
Q142. Erythromycin is used as a prokinetic due to its action on: A) Dopamine receptors B) 5-HT4 receptors C) Motilin receptors D) Acetylcholine receptors Answer: C) Motilin receptors
Q143. Contraindication of metformin: A) Obesity B) Renal failure (eGFR <30) C) PCOS D) Non-alcoholic fatty liver disease Answer: B) Renal failure (risk of lactic acidosis)
Q144. The drug of choice for Pneumocystis pneumonia (PCP) prophylaxis in HIV: A) Dapsone B) Trimethoprim-sulfamethoxazole (Co-trimoxazole) C) Pentamidine D) Atovaquone Answer: B) TMP-SMX (Co-trimoxazole)
Q145. Tamoxifen is a: A) Pure estrogen antagonist B) Selective estrogen receptor modulator (SERM) C) Aromatase inhibitor D) GnRH agonist Answer: B) SERM
Q146. Drug of choice for Helicobacter pylori eradication (triple therapy): A) Clarithromycin + Amoxicillin + PPI B) Metronidazole + Tetracycline alone C) Ciprofloxacin + PPI D) Vancomycin + PPI Answer: A) Clarithromycin + Amoxicillin + PPI
Q147. Thiazide diuretics act at: A) Proximal tubule B) Thick ascending limb of loop of Henle C) Early distal convoluted tubule (Na-Cl cotransporter) D) Collecting duct Answer: C) Early distal convoluted tubule
Q148. Which drug causes pulmonary fibrosis as a side effect? A) Amiodarone B) Metformin C) Lisinopril D) Amlodipine Answer: A) Amiodarone
Q149. The antidote for acetaminophen (paracetamol) toxicity: A) Methylene blue B) N-acetylcysteine (NAC) C) Atropine D) Glucagon Answer: B) N-acetylcysteine (NAC)
Q150. Levodopa is combined with carbidopa to: A) Enhance CNS penetration B) Reduce peripheral conversion of L-DOPA to dopamine C) Prolong half-life D) Prevent dopamine metabolism in brain Answer: B) Reduce peripheral conversion of L-DOPA to dopamine
Q151. Clofazimine is used in treatment of: A) Tuberculosis B) Leprosy (multibacillary) C) Malaria D) Leishmaniasis Answer: B) Leprosy (multibacillary)
Q152. Succinylcholine is a: A) Competitive (non-depolarizing) NMJ blocker B) Depolarizing NMJ blocker C) Calcium channel blocker at NMJ D) Pre-synaptic blocker Answer: B) Depolarizing NMJ blocker
Q153. The first-line drug for absence (petit mal) seizures: A) Carbamazepine B) Phenytoin C) Ethosuximide D) Phenobarbital Answer: C) Ethosuximide
Q154. Ibuprofen's mechanism: A) Non-selective COX inhibition (reversible) B) Selective COX-2 inhibition C) Opioid receptor agonism D) 5-LOX inhibition Answer: A) Non-selective COX inhibition (reversible)
Q155. Clindamycin is particularly used for: A) Gram-negative anaerobes B) Gram-positive organisms + anaerobes (especially Bacteroides) C) Atypical organisms D) Mycobacteria Answer: B) Gram-positive organisms + anaerobes

MICROBIOLOGY (Q156-Q185)

Q156. The causative agent of plague is: A) Yersinia enterocolitica B) Yersinia pestis C) Francisella tularensis D) Brucella species Answer: B) Yersinia pestis
Q157. Which organism is NOT gram-positive? A) Staphylococcus aureus B) Streptococcus pyogenes C) Listeria monocytogenes D) Neisseria meningitidis Answer: D) Neisseria meningitidis (gram-negative diplococcus)
Q158. The "school of fish" arrangement is seen in: A) Corynebacterium diphtheriae B) Haemophilus ducreyi (chancroid) C) Clostridium perfringens D) Vibrio cholerae Answer: B) Haemophilus ducreyi
Q159. HIV destroys primarily which cells? A) CD8+ cytotoxic T cells B) B lymphocytes C) CD4+ T helper cells D) NK cells Answer: C) CD4+ T helper cells
Q160. The diagnostic test for syphilis (non-treponemal): A) FTA-ABS B) VDRL and RPR C) TPHA D) Dark-field microscopy Answer: B) VDRL and RPR
Q161. Koplik's spots are pathognomonic of: A) Rubella B) Measles (rubeola) C) Chickenpox D) Scarlet fever Answer: B) Measles (rubeola)
Q162. The most common cause of bacterial meningitis in adults: A) N. meningitidis B) Streptococcus pneumoniae C) Listeria monocytogenes D) H. influenzae Answer: B) Streptococcus pneumoniae
Q163. Which virus causes progressive multifocal leukoencephalopathy (PML)? A) CMV B) HSV C) JC virus D) EBV Answer: C) JC virus
Q164. Rose-thorn appearance on X-ray (splenic abscess/invasion) is seen in: A) Actinomycosis B) Mucormycosis (bread mold) C) Aspergillosis D) Candidiasis Answer: C) Aspergillosis (Aspergillus - angioinvasive, "halo sign")
Q165. The gene encoding MRSA resistance: A) mecA gene (encodes PBP2a) B) vanA gene C) blaTEM gene D) erm gene Answer: A) mecA gene
Q166. Weil-Felix test is used for diagnosis of: A) Typhoid fever B) Rickettsial infections C) Leptospirosis D) Brucellosis Answer: B) Rickettsial infections
Q167. The vector for Kala-azar (visceral leishmaniasis) is: A) Anopheles mosquito B) Sandfly (Phlebotomus) C) Aedes mosquito D) Culex mosquito Answer: B) Sandfly (Phlebotomus)
Q168. Negri bodies are seen in: A) Herpes encephalitis B) Rabies C) CMV encephalitis D) Polio Answer: B) Rabies
Q169. The commonest cause of neonatal meningitis: A) S. pneumoniae B) N. meningitidis C) Group B Streptococcus + E. coli D) Listeria Answer: C) Group B Streptococcus + E. coli
Q170. Which organism forms "sulfur granules" in tissue? A) Nocardia B) Actinomyces israelii C) Aspergillus D) Blastomyces Answer: B) Actinomyces israelii
Q171. The causative agent of gas gangrene: A) Clostridium tetani B) Clostridium perfringens C) Clostridium botulinum D) Clostridium difficile Answer: B) Clostridium perfringens
Q172. Tzanck smear is used to diagnose: A) Gonorrhea B) HSV/VZV infections C) Syphilis D) Chancroid Answer: B) HSV/VZV infections
Q173. The only bacterium that can form spores in living tissue: A) B. anthracis B) C. tetani C) B. cereus D) None - spores form under environmental stress Answer: A) Bacillus anthracis (anthrax)
Q174. "Thumb printing" on barium enema is seen in: A) Crohn's disease B) Ischemic colitis C) Ulcerative colitis D) Colorectal carcinoma Answer: B) Ischemic colitis
Q175. Which hepatitis virus is a DNA virus? A) Hepatitis A B) Hepatitis C C) Hepatitis B D) Hepatitis E Answer: C) Hepatitis B
Q176. The test for HIV diagnosis is: A) Western blot (confirmatory) + ELISA (screening) B) PCR alone C) CD4 count D) Viral culture Answer: A) ELISA (screening) confirmed by Western blot
Q177. Drug of choice for cryptococcal meningitis (induction phase): A) Fluconazole B) Amphotericin B + flucytosine C) Voriconazole D) Caspofungin Answer: B) Amphotericin B + flucytosine
Q178. Corynebacterium diphtheriae toxin acts by: A) ADP-ribosylation of EF-2 (inhibiting protein synthesis) B) Activating adenylate cyclase C) Blocking ACh release D) Blocking Na+ channels Answer: A) ADP-ribosylation of EF-2
Q179. Metachromatic granules (Babes-Ernst granules) are seen in: A) Bacillus anthracis B) Mycobacterium tuberculosis C) Corynebacterium diphtheriae D) Bordetella pertussis Answer: C) Corynebacterium diphtheriae
Q180. The "string of pearls" sign on X-ray is seen in: A) Amoebic liver abscess B) Intestinal obstruction C) Emphysema D) Miliary tuberculosis Answer: B) Intestinal obstruction (air-fluid levels)
Q181. Which Plasmodium species causes quartan (every 72h) fever? A) P. falciparum B) P. vivax C) P. malariae D) P. ovale Answer: C) P. malariae
Q182. The causative organism of whooping cough (pertussis): A) Bordetella pertussis B) Haemophilus influenzae C) Mycoplasma pneumoniae D) Chlamydia Answer: A) Bordetella pertussis
Q183. Schick test is used to assess immunity against: A) Tetanus B) Diphtheria C) Typhoid D) Smallpox Answer: B) Diphtheria
Q184. Which organism is responsible for "rose spots" in typhoid? A) Salmonella typhi (bacteremia) B) Rickettsial organisms C) Treponema pallidum D) Leptospira Answer: A) Salmonella typhi
Q185. Ebola virus transmission occurs via: A) Airborne droplets B) Direct contact with body fluids C) Fecal-oral route D) Vector-borne Answer: B) Direct contact with body fluids

MEDICINE (Q186-Q215)

Q186. The most common cause of myocardial infarction: A) Coronary artery spasm B) Atherosclerotic plaque rupture with thrombosis C) Embolism D) Coronary arteritis Answer: B) Atherosclerotic plaque rupture with thrombosis
Q187. GOLD staging of COPD is based on: A) FVC B) FEV1/FVC ratio C) FEV1 (% predicted) after bronchodilator D) Peak expiratory flow rate Answer: C) FEV1 (% predicted) after bronchodilator
Q188. HbA1c target for most diabetic patients: A) <5.0% B) <6.0% C) <7.0% D) <8.0% Answer: C) <7.0%
Q189. The drug of choice for acute gout attack: A) Allopurinol B) Probenecid C) Colchicine / NSAIDs D) Corticosteroids (IV) Answer: C) Colchicine / NSAIDs
Q190. In right heart failure, which vein is distended? A) Femoral vein B) Jugular vein (JVP elevated) C) Subclavian vein D) Brachial vein Answer: B) Jugular vein (raised JVP)
Q191. The hallmark of SLE: A) Anti-dsDNA and anti-Smith antibodies B) Anti-SSA (Ro) and SSB (La) C) Anti-Scl-70 D) RF (rheumatoid factor) Answer: A) Anti-dsDNA and anti-Smith antibodies
Q192. Charcot's triad consists of: A) Fever, jaundice, right upper quadrant pain (cholangitis) B) Nystagmus, ataxia, ophthalmoplegia (Wernicke's) C) Fever, rash, arthritis D) Headache, vomiting, papilledema Answer: A) Fever, jaundice, RUQ pain (cholangitis)
Q193. First-line treatment for essential hypertension in a young patient without comorbidities: A) ACE inhibitor or ARB B) Beta-blocker C) Any agent from 5 major classes D) Diuretic Answer: C) Any agent from 5 major classes (per JNC 8/current guidelines)
Q194. Hypothyroidism is characterized by: A) Weight loss, heat intolerance, tachycardia B) Weight gain, cold intolerance, bradycardia C) Exophthalmos, goiter D) Increased reflexes Answer: B) Weight gain, cold intolerance, bradycardia
Q195. Definitive diagnosis of multiple sclerosis: A) MRI brain + spinal cord B) McDonald criteria (clinical + MRI) C) Lumbar puncture (oligoclonal bands) D) Evoked potentials Answer: B) McDonald criteria (dissemination in time and space)
Q196. The most common cause of chronic kidney disease (CKD) worldwide: A) Hypertension B) Diabetes mellitus C) Glomerulonephritis D) Polycystic kidney disease Answer: B) Diabetes mellitus
Q197. Trousseau's sign is elicited by: A) Tapping over facial nerve B) Inflating blood pressure cuff above systolic pressure causing carpopedal spasm C) Dorsiflexion of foot D) Straight leg raise Answer: B) BP cuff above systolic pressure causing carpopedal spasm (hypocalcemia)
Q198. Addison's disease features include all EXCEPT: A) Hyperpigmentation B) Hyponatremia C) Hypertension D) Hyperkalemia Answer: C) Hypertension (hypotension is a feature of Addison's)
Q199. Treatment of choice for Helicobacter pylori-associated peptic ulcer: A) Omeprazole alone B) Triple therapy (PPI + clarithromycin + amoxicillin) C) Bismuth only D) Antacids Answer: B) Triple therapy
Q200. Kayser-Fleischer rings are pathognomonic of: A) Hemochromatosis B) Wilson's disease C) Primary biliary cirrhosis D) Sarcoidosis Answer: B) Wilson's disease (copper in Descemet's membrane)
Q201. Which finding is most specific for acute MI on ECG? A) T-wave inversion B) ST depression C) ST elevation (in STEMI) or new LBBB D) Q waves Answer: C) ST elevation (STEMI) or new LBBB
Q202. Hemoptysis + hematuria + glomerulonephritis suggests: A) Wegener's granulomatosis (GPA) B) Goodpasture syndrome C) SLE D) Churg-Strauss Answer: B) Goodpasture syndrome (anti-GBM antibodies)
Q203. Most common cause of community-acquired pneumonia: A) Mycoplasma pneumoniae B) Haemophilus influenzae C) Streptococcus pneumoniae D) Klebsiella Answer: C) Streptococcus pneumoniae
Q204. "Buffalo hump," "moon face," and "central obesity" are features of: A) Addison's disease B) Cushing's syndrome C) Acromegaly D) Hypothyroidism Answer: B) Cushing's syndrome
Q205. The initial treatment for anaphylaxis is: A) IV corticosteroids B) IV antihistamine C) IM epinephrine (adrenaline) 1:1000 D) Nebulized salbutamol Answer: C) IM epinephrine 1:1000
Q206. Serum ferritin is low in: A) Anemia of chronic disease B) Iron deficiency anemia C) Hemochromatosis D) Thalassemia Answer: B) Iron deficiency anemia
Q207. Mitral stenosis opening snap - closer to S2 when: A) Mild stenosis B) Severe stenosis (high LA pressure) C) Normal D) Atrial fibrillation Answer: B) Severe stenosis (closer S2-OS interval = worse stenosis)
Q208. The most common cause of acute liver failure in developed countries: A) Hepatitis B B) Hepatitis A C) Paracetamol (acetaminophen) overdose D) Wilson's disease Answer: C) Paracetamol overdose
Q209. In DKA (diabetic ketoacidosis), which electrolyte requires careful monitoring and replacement? A) Sodium B) Potassium C) Calcium D) Magnesium Answer: B) Potassium (total body K is depleted; insulin drives K into cells)
Q210. The most common cause of hemoptysis in India (tropics): A) Lung cancer B) Tuberculosis C) Bronchiectasis D) Pulmonary embolism Answer: B) Tuberculosis
Q211. Courvoisier's law states: A) Painless jaundice + palpable gallbladder = not gallstones B) Painful jaundice + palpable gallbladder = gallstones C) Gallbladder enlarged = always malignant D) Jaundice with gallstones always causes pain Answer: A) Painless jaundice + palpable gallbladder = not gallstones (suggests malignancy)
Q212. Target cells are seen in all EXCEPT: A) Thalassemia B) HbC disease C) Iron deficiency anemia D) Spherocytosis Answer: D) Spherocytosis (spherocytes, NOT target cells)
Q213. Pleural fluid with protein >3g/dL and LDH >2/3 upper normal limit = exudate. These are: A) Westergren criteria B) Light's criteria C) Hammond's criteria D) Wells criteria Answer: B) Light's criteria
Q214. Which valvular lesion causes "water-hammer" pulse? A) Mitral stenosis B) Aortic stenosis C) Aortic regurgitation D) Pulmonary stenosis Answer: C) Aortic regurgitation
Q215. ANCA associated with Wegener's granulomatosis (GPA): A) p-ANCA (MPO-ANCA) B) c-ANCA (PR3-ANCA) C) ANA D) Anti-dsDNA Answer: B) c-ANCA (PR3-ANCA)

SURGERY (Q216-Q245)

Q216. The most common cause of intestinal obstruction in adults: A) Hernia B) Adhesions (postoperative) C) Volvulus D) Intussusception Answer: B) Adhesions (postoperative)
Q217. Duke's classification Stage C colorectal carcinoma involves: A) Confined to mucosa B) Through bowel wall, no nodes C) Regional lymph node metastasis D) Distant metastasis Answer: C) Regional lymph node metastasis
Q218. The most common cause of acute pancreatitis: A) Alcohol B) Gallstones C) Hypercalcemia D) Trauma Answer: B) Gallstones (most common overall; alcohol is 2nd)
Q219. Ranson's criteria at admission includes all EXCEPT: A) Age >55 years B) WBC >16,000 C) Blood glucose >200 mg/dL D) Serum calcium <8 mg/dL Answer: D) Serum calcium <8 mg/dL (this is a 48-hour criterion)
Q220. Charcot's triad + hypotension + altered consciousness = Reynolds pentad (cholangitis). The additional two features are: A) Jaundice + cholecystitis B) Hypotension + mental status changes C) Leukocytosis + elevated ALP D) Septic shock criteria Answer: B) Hypotension + mental status changes
Q221. The most common type of hernia in both males and females: A) Femoral hernia B) Umbilical hernia C) Indirect inguinal hernia D) Direct inguinal hernia Answer: C) Indirect inguinal hernia
Q222. Hartmann's procedure is done for: A) Complicated diverticulitis (sigmoid resection, end colostomy) B) Right hemicolectomy C) Total colectomy D) Abdomino-perineal resection Answer: A) Complicated diverticulitis
Q223. The most common site for carcinoma of esophagus (worldwide): A) Upper third B) Middle third C) Lower third D) Gastroesophageal junction Answer: B) Middle third (squamous cell carcinoma; adenocarcinoma at lower third in Western countries)
Q224. Sentinel pile is associated with: A) Hemorrhoids B) Anal fissure C) Anal fistula D) Anal abscess Answer: B) Anal fissure
Q225. Glasgow coma scale (GCS) score - minimum: A) 0 B) 1 C) 3 D) 5 Answer: C) 3 (minimum possible score)
Q226. "Half and half" nails (Lindsay's nails) are seen in: A) Liver cirrhosis B) Chronic renal failure C) Iron deficiency anemia D) Psoriasis Answer: B) Chronic renal failure
Q227. The most common complication of thyroidectomy: A) Hypothyroidism B) Hypoparathyroidism (hypocalcemia) C) Recurrent laryngeal nerve injury D) Hemorrhage Answer: C) Recurrent laryngeal nerve injury (hoarseness)
Q228. Volkmann's ischemic contracture follows: A) Nerve injury B) Unrelieved compartment syndrome (supracondylar fracture) C) Tendon injury D) Vascular aneurysm Answer: B) Unrelieved compartment syndrome
Q229. The most common site of peptic ulcer perforation: A) Lesser curvature of stomach B) Anterior wall of first part of duodenum C) Pylorus D) Greater curvature Answer: B) Anterior wall of first part of duodenum
Q230. Hinchey classification is used for: A) Pancreatitis B) Diverticular disease C) Cholecystitis D) Appendicitis Answer: B) Diverticular disease
Q231. Conn's syndrome (primary hyperaldosteronism) classically causes: A) Hypokalemia + hypertension + metabolic alkalosis B) Hyperkalemia + hypotension C) Hyponatremia + hyperkalemia D) Metabolic acidosis Answer: A) Hypokalemia + hypertension + metabolic alkalosis
Q232. Which investigation is first done in acute abdomen? A) CT scan B) Erect X-ray abdomen (pneumoperitoneum) C) MRI D) Ultrasound Answer: B) Erect X-ray abdomen
Q233. Most common benign tumor of liver: A) Hepatic adenoma B) Hepatocellular carcinoma C) Cavernous hemangioma D) FNH (focal nodular hyperplasia) Answer: C) Cavernous hemangioma
Q234. Troisier's sign (Virchow's node) is seen in: A) Left supraclavicular node enlarged due to abdominal malignancy B) Right axillary node enlarged in breast cancer C) Inguinal node in rectal cancer D) Cervical node in thyroid cancer Answer: A) Left supraclavicular lymph node
Q235. Which is the most common cause of lower GI bleed in adults? A) Colorectal carcinoma B) Diverticulosis C) Angiodysplasia D) IBD Answer: B) Diverticulosis
Q236. In fracture of femur neck, the leg is positioned: A) Shortened, externally rotated B) Lengthened, internally rotated C) Shortened, internally rotated D) Flexed at knee only Answer: A) Shortened, externally rotated
Q237. The most common organ injured in blunt abdominal trauma: A) Liver B) Spleen C) Kidney D) Pancreas Answer: B) Spleen
Q238. Whipple's triad for insulinoma: A) Hypoglycemia during fasting + symptoms relieved by glucose + glucose <50 mg/dL B) Hyperglycemia + polyuria + polydipsia C) Abdominal pain + diarrhea + hypoglycemia D) Jaundice + abdominal mass + weight loss Answer: A) Hypoglycemia during fasting + symptoms relieved by glucose + glucose <50 mg/dL
Q239. Pott's disease refers to: A) Spinal tuberculosis B) Spinal cord compression C) Ankylosing spondylitis D) Spinal stenosis Answer: A) Spinal tuberculosis
Q240. Murphy's sign is positive in: A) Acute appendicitis B) Acute cholecystitis C) Acute pancreatitis D) Renal colic Answer: B) Acute cholecystitis
Q241. Carcinoid syndrome occurs when metastasis is in the: A) Local lymph nodes B) Liver (hepatic metastasis - reaches systemic circulation) C) Lungs D) Bone Answer: B) Liver (hepatic metastasis - serotonin bypasses liver metabolism)
Q242. The most common cancer in males worldwide: A) Colorectal cancer B) Lung cancer C) Prostate cancer D) Stomach cancer Answer: C) Prostate cancer (incidence; lung cancer = mortality)
Q243. Brodie's abscess is a: A) Cold abscess in psoas B) Subacute osteomyelitis (localized abscess in bone, usually S. aureus) C) Empyema necessitans D) Pericolic abscess Answer: B) Subacute osteomyelitis
Q244. Cushing's ulcer (stress ulcer) occurs in: A) Burns B) CNS injury (raised ICP) C) Sepsis D) Post-cardiac surgery Answer: B) CNS injury (raised ICP)
Q245. Mirizzi syndrome involves: A) Compression of common bile duct by stone in Hartmann's pouch/cystic duct B) Bile duct stricture C) Choledocholithiasis D) Biliary fistula Answer: A) Compression of common bile duct by stone in Hartmann's pouch

OBSTETRICS & GYNAECOLOGY (Q246-Q265)

Q246. The most common cause of postpartum hemorrhage: A) Retained placenta B) Uterine atony C) Birth canal lacerations D) Coagulopathy Answer: B) Uterine atony
Q247. Spalding's sign (overlapping of skull bones) on X-ray indicates: A) Hydrocephalus B) IUGR C) Intrauterine fetal death D) Anencephaly Answer: C) Intrauterine fetal death
Q248. The most common ectopic pregnancy site: A) Ovary B) Abdomen C) Fallopian tube (ampullary portion) D) Cervix Answer: C) Fallopian tube (ampullary portion - 80%)
Q249. APGAR score is assessed at: A) 1 minute and 5 minutes B) 5 minutes and 10 minutes C) 0 and 5 minutes D) 2 minutes and 10 minutes Answer: A) 1 minute and 5 minutes
Q250. The drug used for cervical ripening/induction of labor: A) Oxytocin B) Misoprostol (PGE1) C) Ergometrine D) Ritodrine Answer: B) Misoprostol (PGE1) - cervical ripening; Oxytocin for induction
Q251. In eclampsia, the first-line anticonvulsant is: A) Diazepam B) Phenytoin C) Magnesium sulfate D) Lorazepam Answer: C) Magnesium sulfate
Q252. Carcinoma cervix most commonly arises from: A) Ectocervix B) Squamocolumnar junction (transformation zone) C) Endocervix D) External os Answer: B) Squamocolumnar junction
Q253. Bishop score assesses readiness for induction of labor based on: A) Fetal head station, cervical dilation, effacement, consistency, position B) Fetal weight and gestational age C) CTG findings D) Uterine contraction frequency Answer: A) Cervical dilation, effacement, consistency, position + fetal station
Q254. The most sensitive investigation for fetal cardiac activity in early pregnancy: A) Abdominal USG B) Transvaginal USG C) Doppler D) CTG Answer: B) Transvaginal USG
Q255. Pre-eclampsia is defined as: A) HTN >140/90 + proteinuria after 20 weeks gestation B) HTN >160/110 in any trimester C) Gestational HTN + seizures D) HTN + jaundice Answer: A) HTN >140/90 + proteinuria after 20 weeks
Q256. Hydatidiform mole is associated with elevated: A) AFP B) CA-125 C) Beta-hCG D) LDH Answer: C) Beta-hCG
Q257. The most common gynecological malignancy worldwide: A) Ovarian cancer B) Cervical cancer C) Endometrial cancer D) Vulvar cancer Answer: B) Cervical cancer (in low-income countries); Endometrial (in high-income countries)
Q258. Turner syndrome karyotype: A) 47, XXY B) 45, X0 C) 47, XYY D) 46, XXY Answer: B) 45, X0
Q259. In shoulder dystocia, the first maneuver is: A) Zavanelli maneuver B) McRoberts maneuver (hyperflexion of maternal hips) C) Woods screw maneuver D) Fundal pressure Answer: B) McRoberts maneuver
Q260. Asherman's syndrome is: A) Endometriosis B) Intrauterine adhesions (synechiae) - amenorrhea after D&C C) Adenomyosis D) Ovarian cysts Answer: B) Intrauterine adhesions
Q261. Test used for fetal lung maturity: A) Lecithin/sphingomyelin (L/S) ratio B) Alpha-fetoprotein C) Amniotic fluid index D) Biophysical profile Answer: A) Lecithin/sphingomyelin (L/S) ratio (>2 = mature)
Q262. The most common cause of amenorrhea in a reproductive-age woman: A) PCOS B) Hyperprolactinemia C) Pregnancy D) Hypothyroidism Answer: C) Pregnancy
Q263. HELLP syndrome = Hemolysis + Elevated Liver enzymes + Low: A) Hemoglobin B) Hematocrit C) Platelet count D) WBC Answer: C) Platelet count
Q264. Drug of choice for ectopic pregnancy (medical management): A) Mifepristone B) Methotrexate C) Misoprostol D) Heparin Answer: B) Methotrexate
Q265. The most common cause of PPH (postpartum hemorrhage) - drug used: A) Oxytocin (1st line uterotonic) B) Ergometrine C) Misoprostol D) Tranexamic acid Answer: A) Oxytocin

PEDIATRICS (Q266-Q280)

Q266. The most common cause of acute diarrhea in children: A) E. coli B) Rotavirus C) Salmonella D) Shigella Answer: B) Rotavirus
Q267. Normal birth weight of a term infant: A) 1.5-2.0 kg B) 2.0-2.5 kg C) 2.5-3.5 kg D) 3.5-4.5 kg Answer: C) 2.5-3.5 kg
Q268. Kawasaki disease features include all EXCEPT: A) Fever >5 days B) Bilateral conjunctivitis C) Lymphadenopathy (unilateral cervical) D) Photophobia and nuchal rigidity Answer: D) Photophobia and nuchal rigidity (meningism)
Q269. Age of social smile in infants: A) 2 weeks B) 6 weeks (1.5 months) C) 3 months D) 4 months Answer: B) 6 weeks (social smile)
Q270. Intussusception - the classic triad: A) Bloody diarrhea, vomiting, fever B) Intermittent colicky pain + "redcurrant jelly" stool + abdominal mass C) Abdominal distension, no stool, vomiting D) Bilious vomiting, constipation Answer: B) Colicky pain + redcurrant jelly stool + sausage-shaped mass
Q271. Congenital hypothyroidism is screened by: A) T3 level at birth B) TSH (heel prick - newborn screening, day 5) C) USG thyroid D) Thyroid antibodies Answer: B) TSH (newborn screening)
Q272. Scurvy (Vitamin C deficiency) causes: A) Rickets B) Bleeding gums, perifollicular hemorrhages, corkscrew hairs C) Night blindness D) Pellagra Answer: B) Bleeding gums, perifollicular hemorrhages, corkscrew hairs
Q273. Croup (laryngotracheobronchitis) is caused most commonly by: A) RSV B) Parainfluenza virus (type 1 most common) C) Adenovirus D) Influenza B Answer: B) Parainfluenza virus
Q274. Treatment of choice for nephrotic syndrome in children (minimal change disease): A) Cyclosporine B) Prednisolone (corticosteroids) C) Cyclophosphamide D) Mycophenolate Answer: B) Prednisolone (corticosteroids)
Q275. The vaccine NOT given at birth in India (EPI/NIS): A) BCG B) OPV C) Hep B (0 dose) D) DPT Answer: D) DPT (given at 6, 10, 14 weeks)
Q276. Milestones - a child walks without support at: A) 9 months B) 12 months C) 15 months D) 18 months Answer: B) 12 months (range 10-14 months)
Q277. Febrile seizures - prophylaxis is given when: A) First episode in any child B) Complex febrile seizure / age <12 months / family history of epilepsy C) Every child with fever D) Temperature >38.5°C Answer: B) Complex febrile seizure / specific risk factors
Q278. Classic "cherry red spot" on macula is seen in: A) Retinoblastoma B) Tay-Sachs disease (GM2 gangliosidosis) C) Phenylketonuria D) Galactosemia Answer: B) Tay-Sachs disease
Q279. Vitamin D deficiency (rickets) - the biochemical findings: A) Low Ca, Low PO4, Low ALP, High PTH B) Low Ca, Low PO4, High ALP, High PTH C) High Ca, High PO4, Low ALP D) Normal Ca, Low PO4, Normal ALP Answer: B) Low Ca, Low PO4, HIGH ALP, High PTH
Q280. Koplik spots appear: A) 4-5 days after rash B) 2-3 days before rash in measles C) At the same time as the rash D) Only in severe measles Answer: B) 2-3 days before the measles rash

PREVENTIVE & SOCIAL MEDICINE (Q281-Q300)

Q281. The epidemiological triad consists of: A) Host, agent, environment B) Incidence, prevalence, mortality C) Primary, secondary, tertiary prevention D) Sensitivity, specificity, predictive value Answer: A) Host, agent, environment
Q282. Sensitivity of a diagnostic test is defined as: A) True positives / (True positives + False positives) B) True negatives / (True negatives + False negatives) C) True positives / (True positives + False negatives) D) True negatives / (True negatives + False positives) Answer: C) TP / (TP + FN) - "Ability to detect disease when present"
Q283. Specificity of a test is: A) TP / (TP + FN) B) TN / (TN + FP) C) TP / (TP + FP) D) TN / (TN + FN) Answer: B) TN / (TN + FP)
Q284. Infant mortality rate (IMR) is defined as: A) Deaths <1 year / 1000 live births in the same year B) Deaths <28 days / 1000 live births C) Deaths <7 days / 1000 live births D) Deaths <5 years / 1000 population Answer: A) Deaths <1 year / 1000 live births
Q285. The gold standard for diagnosis of tuberculosis: A) Mantoux test B) Chest X-ray C) Sputum culture (Lowenstein-Jensen medium) D) GeneXpert (CBNAAT) Answer: C) Sputum culture (L-J medium)
Q286. The most effective sterilization method for heat-labile items: A) Autoclaving B) Dry heat (hot air oven) C) Ethylene oxide gas D) Glutaraldehyde Answer: C) Ethylene oxide gas
Q287. DOTS (Directly Observed Treatment, Short-course) is used for: A) HIV/AIDS B) Tuberculosis C) Leprosy D) Malaria Answer: B) Tuberculosis
Q288. The Rh0(D) immunoglobulin (anti-D) is given to Rh-negative mothers at: A) 24 weeks B) 28 weeks + within 72 hours of delivery C) 12 weeks D) 36 weeks Answer: B) 28 weeks + within 72 hours of delivery
Q289. Snow's hypothesis about cholera was proven by: A) Isolating Vibrio cholerae from water B) Comparing cholera rates in populations with different water sources C) Animal experiments D) Serology Answer: B) Comparing cholera rates (Broad Street pump - epidemiological evidence)
Q290. Herd immunity is defined as: A) Individual immunity from vaccination B) Community-level protection when sufficient proportion is immune C) Natural immunity after infection D) Passive immunity Answer: B) Community-level protection when sufficient proportion is immune
Q291. The CAGE questionnaire is used for screening: A) Depression B) Alcohol use disorder C) Drug abuse D) Anxiety Answer: B) Alcohol use disorder
Q292. BMI classification - Obesity Class I: A) BMI 25-29.9 B) BMI 30-34.9 C) BMI 35-39.9 D) BMI >40 Answer: B) BMI 30-34.9
Q293. The demographic transition theory states that: A) Developing countries have low birth and death rates B) Countries move from high birth/death rates to low birth/death rates with development C) Population growth is exponential D) Urbanization always reduces birth rates Answer: B) Countries transition from high to low birth/death rates
Q294. Relative risk (RR) in a cohort study: A) Incidence in exposed / Incidence in unexposed B) Prevalence in exposed / Prevalence in unexposed C) OR in case-control study D) Odds of exposure in cases / odds of exposure in controls Answer: A) Incidence in exposed / Incidence in unexposed
Q295. The most effective method of family planning (theoretical): A) Condom B) Combined oral contraceptive pill C) IUD D) Female sterilization (tubal ligation) Answer: D) Female sterilization (lowest failure rate)
Q296. Quarantine period for chicken pox (varicella): A) 5 days B) 7 days C) 21 days (maximum incubation period) D) 14 days Answer: C) 21 days
Q297. NMR (Neonatal Mortality Rate) = A) Deaths <7 days / 1000 live births B) Deaths <28 days / 1000 live births C) Deaths <1 year / 1000 live births D) Deaths <5 years / 1000 live births Answer: B) Deaths <28 days / 1000 live births
Q298. Safe drinking water chlorination - residual chlorine level should be: A) 0.01 mg/L B) 0.1-0.2 mg/L C) 0.5 mg/L D) 1 mg/L Answer: C) 0.5 mg/L (at consumer end)
Q299. The schedule for BCG vaccination: A) At birth or as early as possible in first year B) 6 weeks of age C) 3 months D) At birth only Answer: A) At birth (or as early as possible)
Q300. Positive predictive value (PPV) depends on: A) Test sensitivity and specificity only B) Prevalence of disease in the population + sensitivity + specificity C) Sample size D) Type of test (qualitative or quantitative) Answer: B) Prevalence + sensitivity + specificity

SUMMARY

Here are the 300 FMGE practice MCQs organized by subject:
SubjectQuestionsCount
AnatomyQ1-Q3030
PhysiologyQ31-Q6030
BiochemistryQ61-Q9030
PathologyQ91-Q12030
PharmacologyQ121-Q15535
MicrobiologyQ156-Q18530
MedicineQ186-Q21530
SurgeryQ216-Q24530
Obs & GynaeQ246-Q26520
PediatricsQ266-Q28015
PSMQ281-Q30020
Total300
Tips for FMGE preparation:
  • Focus on high-yield one-liners - FMGE tests quick recall
  • Pharmacology and Medicine together make up ~30% of questions
  • Practice recognizing classic clinical vignettes
  • Revise normal values (ECG intervals, lab values, milestones)
  • Surgery questions often center on anatomy + operative details
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