FMGE 2026 Practice Questions

Q: Identify the marked structure:

Body. ***Body*** - It is the central and largest portion of the **corpus callosum**, situated between the **genu** anteriorly and the **splenium** posteriorly. - It forms the roof of the **lateral ventricles** and connects the cortical areas of the frontal and parietal lobes across the midline. *Rostrum* - This is the thin, beak-like extension located most anteriorly and inferiorly, continuous with the **lamina terminalis**. - It represents the most anterior and inferior part of the **corpus callosum**, positioned ahead of the genu. *Splenium* - This is the thick, posterior-most bulbous part of the **corpus callosum** that overhangs the **midbrain**. - It contains fibers that primarily interconnect the **occipital lobes** and the temporal lobes. *Genu* - This is the anterior, knee-shaped bend of the **corpus callosum** that connects the two **frontal lobes**. - It is located between the rostrum and the body, serving as a distinct anatomical landmark in the midline sagittal section of the brain.

Q: A chest X-ray of a 6-year-old child with recurrent episodes of cyanosis is given below. What is the most probable diagnosis?

Tetralogy of Fallot. ***Tetralogy of Fallot*** - This condition is classically associated with the **'boot-shaped heart'** (coeur en sabot) on chest X-ray, caused by right ventricular hypertrophy and a small main pulmonary artery segment. - It is the most common **cyanotic congenital heart disease** presenting in childhood, characterized by the tetrad of **ventricular septal defect**, **pulmonary stenosis**, **overriding aorta**, and **right ventricular hypertrophy**. *Transposition of the great arteries* - Classically presents with an **'egg on a side'** appearance on chest X-ray due to the narrow mediastinum and abnormal positioning of the great vessels. - Typically presents with severe cyanosis in the **neonatal period** rather than recurrent episodes in a 6-year-old, unless surgical intervention has occurred. *Tricuspid atresia* - Chest X-ray typically shows a **decreased pulmonary vascular markings** and a **left axis deviation** on ECG, distinct from the radiographic features of TOF. - Characterized by the complete absence of the tricuspid valve, leading to a hypoplastic right ventricle and reliance on an **atrial septal defect** for survival. *Total anomalous pulmonary venous connection* - Often presents with the classic **'snowman'** or **'figure-of-eight'** sign on chest X-ray due to the supracardiac type of anomalous drainage. - Typically presents with **pulmonary venous congestion** and cardiomegaly, unlike the decreased pulmonary flow usually seen in Tetralogy of Fallot.

Q: A 45-year-old man with a history of chronic alcoholism had been abstinent for the last 3 months while on de -addiction therapy. He consumed 60 mL of alcohol at a social gathering. Within 15–20 minutes, he developed nausea, vomiting, red rashes, throbbing headache, and palpitations. Which of the following drug was he most likely taking for alcohol dependence?

Disulfiram. ***Disulfiram*** - This drug acts by **inhibiting aldehyde dehydrogenase**, leading to the accumulation of **acetaldehyde** in the bloodstream when alcohol is consumed. - The resulting **disulfiram-ethanol reaction** presents with characteristic symptoms like facial flushing, throbbing headache, tachycardia, nausea, and vomiting within minutes of alcohol intake. *Chlorpromazine* - This is an **antipsychotic** medication used to manage psychiatric conditions and is not indicated for alcohol dependence. - It does not interfere with alcohol metabolism or cause the specific **acetaldehyde-mediated syndrome** described. *Fomepizole* - This drug is a **competitive inhibitor of alcohol dehydrogenase**, used specifically as an antidote for **methanol** and **ethylene glycol** toxicity. - It prevents the formation of toxic metabolites from these alcohols but does not produce a hypersensitivity reaction to ethanol. *TCA / Topiramate* - **Tricyclic antidepressants (TCAs)** are sometimes used for comorbid conditions but do not cause an adverse reaction to alcohol consumption. - **Topiramate** is used for alcohol cravings but works by modulating neurotransmitter receptors and does not cause a disulfiram-like reaction.

Q: A person thinks someone wants to kill him. He cannot be convinced or explained. What is the likely phenomenon?

Delusion. ***Delusion*** - A **delusion** is a fixed, false belief that is resistant to reason or confrontation with actual fact and is not consistent with the person's cultural or educational background. - The specific type described here is a **persecutory delusion**, where the individual believes they are being conspired against or threatened with harm. *Hallucination* - **Hallucinations** are sensory perceptions that occur in the absence of an external stimulus (e.g., hearing voices or seeing things that aren't there). - Unlike delusions, which are disorders of **thought content**, hallucinations are disorders of **perception**. *Illusion* - An **illusion** is a misinterpretation of a real sensory stimulus (e.g., seeing a rope and misinterpreting it as a snake). - This differs from a delusion because it relies on an existing, tangible, external **sensory input**, whereas a delusion is an internally generated false belief. *Obsession* - An **obsession** is an intrusive, unwanted, and recurrent thought, impulse, or image that causes significant anxiety or distress. - The key difference is that the individual with an obsession typically recognizes that the thought is a product of their own mind and is **ego-dystonic**, whereas the deluded individual firmly believes their thought is ** realidade** (reality).

Q: A 29-year-old female has persistently low mood, doesn’t feel like doing anything, sleeps 15 hours a day, limbs feel heavy, eats a lot for 2 months. She feels happy when she hears her mother is coming to visit her in 2 weeks. Likely diagnosis?

MDD -Atypical features. ***MDD -Atypical features*** - This patient presents with the hallmark symptoms of **atypical depression**, which include **hypersomnia**, **hyperphagia** (increased appetite/weight gain), and **leaden paralysis** (heavy feeling in arms and legs). - A defining feature is **mood reactivity**, where the patient's mood brightens in response to positive external events (like her mother's visit), distinguishing it from melancholic depression. *Mania* - Characterized by a distinct period of **elevated or irritable mood** and **increased energy**, directly opposing the lethargy and low mood seen here. - Patients with mania typically show a **decreased need for sleep**, whereas this patient is sleeping excessively (15 hours). *Adjustment disorder* - This diagnosis requires symptoms to occur in response to an **identifiable stressor** within 3 months of the event; the vignette describes a persistent 2-month period without a specific trigger. - It is a milder condition and usually does not manifest with the specific complex of vegetative symptoms (hypersomnia/hyperphagia) seen in this case. *Anxiety disorder* - While often comorbid with depression, generalized anxiety focuses on **excessive worry** rather than the pervasive low mood and anhedonia (lack of interest) described. - The specific somatic symptoms of leaden paralysis and hyperphagia are more characteristic of depressive disorders with atypical features than primary anxiety states.

Q: A patient presents with as shown in the image (rabbit -like perioral movements) on long-term treatment. It is caused by which of the following drugs?

Risperidone. ***Risperidone*** - The patient exhibits **tardive dyskinesia**, an involuntary movement disorder characterized by **orofacial dyskinesias** such as "rabbit-like" perioral movements, commonly associated with long-term **antipsychotic** usage. - While atypical antipsychotics carry a lower risk than typical ones, **Risperidone** has a higher risk for **extrapyramidal symptoms** and tardive dyskinesia compared to other second-generation antipsychotics. *Clozapine* - Known as the antipsychotic with the **lowest risk** of inducing tardive dyskinesia, making it the preferred choice for patients who develop these movements on other agents. - Its primary side effect profile is dominated by risks of **agranulocytosis** and **metabolic syndrome**, rather than movement disorders. *Ziprasidone* - Associated with a **low risk** of inducing tardive dyskinesia, similar to other newer atypical antipsychotics. - It is more clinically noted for potential **QT interval prolongation** rather than the development of persistent orofacial involuntary movements. *Fluoxetine* - This is an **SSRI** (Selective Serotonin Reuptake Inhibitor) used for depression and anxiety, not an antipsychotic medication. - While movement disorders like tremor can occasionally occur with SSRIs, classic **tardive dyskinesia** is specifically linked to the blockade of **dopamine D2 receptors** found in antipsychotic therapy.

Q: An elderly woman is brought to psychiatry OPD by her daughter with complaints of forgetfulness. For the past one year, she has been seeing people and animals in nearby house that has been unoccupied during this period. Also has rigidity. What is the mos t likely type of dementia?

Lewy body dementia. ***Lewy body dementia*** - Characterized by the clinical triad of **visual hallucinations** (often of people or animals), **fluctuating cognition**, and **parkinsonism** (such as rigidity). - Diagnosis relies on the presence of these core features and the **dementia** occurring within a year of the onset of motor symptoms. *Alzheimer’s disease* - Primarily presents with **progressive memory loss** and executive dysfunction without early prominent motor features. - **Visual hallucinations** are typically a late-stage finding rather than an early, characteristic feature like in Lewy body dementia. *Parkinson’s disease* - Features **tremor**, **rigidity**, and **bradykinesia** as the primary symptoms, with cognitive decline occurring much later in the disease course. - If cognitive impairment occurs within one year of motor symptoms, it is clinically classified as **Dementia with Lewy Bodies** (DLB) rather than **Parkinson's Disease Dementia**. *Vascular dementia* - Characterized by a **stepwise decline** in cognitive function associated with **cerebrovascular disease** or stroke events. - Clinical findings usually show **focal neurological deficits** rather than the specific pattern of hallucinations and parkinsonism seen here.

Q: Which of the following is the mechanism involved in X -ray production?

Bremsstrahlung radiation. ***Bremsstrahlung radiation*** - This is the **primary mechanism** of X-ray production in an X-ray tube, where high-speed electrons are decelerated by the electric field of the target nucleus, emitting a photon of energy. - It produces a **continuous spectrum** of X-ray energies, making up the majority of the X-ray beam intensities. *Photoelectric effect* - This interaction involves the **complete absorption** of an incident photon by an inner-shell electron of an atom, causing it to be ejected. - It is a mechanism of **X-ray attenuation/interaction with matter** rather than X-ray production generated by an X-ray tube. *Compton effect* - This interaction involves the **scattering of a photon** by an outer-shell electron, resulting in a loss of energy and a change in direction of the incident photon. - It is the primary cause of **scatter radiation** in diagnostic imaging and occupational exposure, not a method of X-ray beam generation. *Paired production* - This process involves the interaction of a high-energy photon with the **nuclear field**, resulting in the creation of an electron and a positron. - It requires a minimum energy of **1.02 MeV**, meaning it does not occur at the diagnostic energy levels typically used in standard X-ray tubes.

Q: A 24-year-old male presents to the emergency department after a road traffic accident. Based on the given CT scan, what is the most likely diagnosis?

Epidural hematoma. ***Epidural hematoma*** - Characterized by a **biconvex (lens-shaped)** hyperdensity on CT scan that **does not cross suture lines**. - Classically associated with a **rupture of the middle meningeal artery** following a **temporal bone fracture**, often presenting with a **lucid interval**. *Subdural hematoma* - Appears as a **crescent-shaped** hyperdensity on CT that **crosses suture lines** but is limited by dural reflections. - Typically results from the **tearing of bridging veins** and is more common in **elderly patients** or alcoholics due to cerebral atrophy. *Intracerebral hemorrhage* - Presents as a **focal hyperdense collection** within the **brain parenchyma** itself, rather than in the extra-axial spaces. - Frequently caused by **hypertensive emergencies**, trauma, or **cerebral amyloid angiopathy**. *Subarachnoid hemorrhage* - Characterized by hyperdensity appearing in the **sulci, fissures, and cisterns** (following the contours of the brain) rather than causing focal mass effect. - Most typically presents with a **thunderclap headache**, often due to a **ruptured berry aneurysm**.

Q: A young female undergoes renal angiography for evaluation of secondary hypertension. Based on her angiogram, what is the most likely diagnosis?

Fibromuscular dysplasia. ### ***Fibromuscular dysplasia*** - This is the most common cause of **secondary hypertension** in **young women**, characterized classically by a **'string of beads' appearance** on angiography due to focal areas of medial fibroplasia. - It typically affects the **mid-to-distal segments** of the renal arteries, sparing the origin and proximal portions, which aids in differentiation from atherosclerotic disease. *Polyarteritis nodosa* - This systemic **necrotizing vasculitis** typically affects medium-sized vessels and is associated with **microaneurysms** on angiography rather than the typical beads appearance. - Patients usually present with distinct systemic symptoms such as **fever, weight loss, and neuropathy**, rather than isolated hypertension. *Atherosclerotic renal artery stenosis* - This condition is overwhelmingly more common in **elderly patients** with long-standing risk factors like **smoking, diabetes, and hyperlipidemia**. - Angiography typically reveals stenosis at the **ostium or proximal portion** of the renal artery, rather than the distal involvement seen in FMD. *Takayasu arteritis* - This is a large-vessel vasculitis that primarily affects the **aorta and its major branches**, leading to narrowed, thickened vessel walls. - It is typically seen in **women under 40** and is characterized by a pulse deficit, rather than the specific beaded dysplastic changes found in FMD.

Question 1

Identify the marked structure:

Accepted Answer

Body

Answer

Rostrum

Answer

Splenium

Answer

Genu

Question 2

A chest X-ray of a 6-year-old child with recurrent episodes of cyanosis is given below. What is the most probable diagnosis?

Accepted Answer

Tetralogy of Fallot

Answer

Transposition of the great arteries

Answer

Tricuspid atresia

Answer

Total anomalous pulmonary venous connection

Question 3

A 45-year-old man with a history of chronic alcoholism had been abstinent for the last 3 months while on de -addiction therapy. He consumed 60 mL of alcohol at a social gathering. Within 15–20 minutes, he developed nausea, vomiting, red rashes, throbbing headache, and palpitations. Which of the following drug was he most likely taking for alcohol dependence?

Accepted Answer

Disulfiram

Answer

Chlorpromazine

Answer

Fomepizole

Answer

TCA / Topiramate

Question 4

A person thinks someone wants to kill him. He cannot be convinced or explained. What is the likely phenomenon?

Accepted Answer

Delusion

Answer

Hallucination

Answer

Illusion

Answer

Obsession

Question 5

A 29-year-old female has persistently low mood, doesn’t feel like doing anything, sleeps 15 hours a day, limbs feel heavy, eats a lot for 2 months. She feels happy when she hears her mother is coming to visit her in 2 weeks. Likely diagnosis?

Accepted Answer

MDD -Atypical features

Answer

Mania

Answer

Adjustment disorder

Answer

Anxiety disorder

Question 6

A patient presents with as shown in the image (rabbit -like perioral movements) on long-term treatment. It is caused by which of the following drugs?

Accepted Answer

Risperidone

Answer

Clozapine

Answer

Ziprasidone

Answer

Fluoxetine

Question 7

An elderly woman is brought to psychiatry OPD by her daughter with complaints of forgetfulness. For the past one year, she has been seeing people and animals in nearby house that has been unoccupied during this period. Also has rigidity. What is the mos t likely type of dementia?

Accepted Answer

Lewy body dementia

Answer

Alzheimer’s disease

Answer

Parkinson’s disease

Answer

Vascular dementia

Question 8

Which of the following is the mechanism involved in X -ray production?

Accepted Answer

Bremsstrahlung radiation

Answer

Photoelectric effect

Answer

Compton effect

Answer

Paired production

Question 9

A 24-year-old male presents to the emergency department after a road traffic accident. Based on the given CT scan, what is the most likely diagnosis?

Accepted Answer

Epidural hematoma

Answer

Subdural hematoma

Answer

Intracerebral hemorrhage

Answer

Subarachnoid hemorrhage

Question 10

A young female undergoes renal angiography for evaluation of secondary hypertension. Based on her angiogram, what is the most likely diagnosis?

Accepted Answer

Fibromuscular dysplasia

Answer

Polyarteritis nodosa

Answer

Atherosclerotic renal artery stenosis

Answer

Takayasu arteritis

FMGE 2026

Anatomy

Pediatrics

Pharmacology

Psychiatry

Radiology