FMGE 2026 Practice Questions

Q: Which of the following intravenous agents is commonly used for outpatient procedures?

Propofol. ***Propofol*** - It is the **drug of choice** for outpatient anesthesia due to its **rapid onset** and short duration of action, allowing for a **rapid recovery** profile. - It possesses **anti-emetic properties** and provides clear-headed recovery, making it ideal for **day-case surgery**. *Ketamine* - It is a **dissociative anesthetic** associated with **post-operative emergence delirium** and hallucinations in adults. - While useful in emergency or pediatric settings, it causes **increased salivation** and **increased intracranial/intraocular pressure**, limiting its routine outpatient use. *Thiopental* - An ultrashort-acting **barbiturate** that was historically used for induction but has a long redistribution phase, leading to a **prolonged hang-over effect**. - Its use is largely obsolete in outpatient settings due to **cardiovascular depression** and a slower recovery compared to newer agents. *Etomidate* - Known for cardiovascular stability, but it causes **adrenocortical suppression** with prolonged infusion, making it less suitable for anything beyond single-dose induction. - Frequently associated with **post-operative nausea and vomiting (PONV)** and **myoclonus**, which can interfere with the immediate post-operative experience in a day-care setting.

Q: Arrange the following in sequence. 1. Evaluation 2. Execution 3. Planning 4. Delegation

3, 2, 4, 1. ***3, 2, 4, 1*** - The administrative/management cycle in public health follows a logical progression starting with **Planning** (identifying objectives and strategies), followed by **Execution** (the active implementation phase). - This is sequentially followed by **Delegation** (assigning tasks to appropriate personnel) and finally **Evaluation** (assessing outcomes against initial objectives to close the loop). *1, 3, 4, 2* - This sequence incorrectly positions **Evaluation** at the beginning, whereas evaluation must occur after the activity has been executed. - Placing **Execution** at the end ignores the need for systematic delegation and assessment before the project concludes. *3, 1, 2, 4* - Starting with **Planning** is correct, but placing **Evaluation** immediately after it is premature since no implementation has occurred yet. - This order fails to recognize the necessary sequence of active **Execution** before performance can be reviewed or delegated effectively. *3, 1, 2 , 4* - Similar to the previous incorrect option, it erroneously skips the implementation and delegation phases before jumping to evaluation. - **Evaluation** is a retrospective monitoring process and cannot logically precede the functional implementation or delegation of tasks.

Q: Regarding the transition from HFA → MDG → SDG, which of the following is correct?

Targets on time. ***Targets on time*** - The transition from the **Health for All (HFA)** strategy (Alma-Ata Declaration) to the **Millennium Development Goals (MDG)** and subsequently the **Sustainable Development Goals (SDG)** reflects a shift towards specific, time-bound targets and measurable global indicators. - These frameworks evolved to ensure accountability and track progress on critical health determinants like **maternal mortality**, **child survival**, and **non-communicable diseases** across defined timeframes (e.g., 2015 for MDGs, 2030 for SDGs). *Only communicable diseases* - Unlike early vertical public health programs, the MDG and SDG frameworks transitioned towards a more comprehensive **holistic health approach** encompassing both **communicable and non-communicable diseases**. - The agenda significantly expanded to include issues such as **mental health**, **universal health coverage (UHC)**, and environmental health, rather than being restricted to infectious diseases. *Only Lower Socio economic status* - The principles of the HFA, MDG, and SDG frameworks are grounded in the concept of **universal applicability** and **equity**, aiming to reach populations across all socioeconomic strata. - They emphasize that health is a **universal right**, pushing for the inclusion of vulnerable and marginalized groups everywhere rather than focusing exclusively on low-income nations or demographics. *Applicable only to developing countries* - A key distinction in the SDG framework, compared to earlier models, is that it is **universally applicable** to both developed and developing nations. - The global agenda recognizes that health challenges, such as chronic disease, air pollution, and health inequality, affect all countries regardless of their **economic development status**.

Q: A pregnant woman avoids a particular fruit due to a commonly held belief that its consumption can induce abortion, despite there being no scientific evidence to support this claim. Which of the following fruits is most commonly associated with this misconception? Options:

Papaya. ### ***Papaya*** - Unripe or semi-ripe **papaya** contains **latex** which is rich in enzymes like **papain** and **chymopapain**, which some traditional beliefs claim can trigger uterine contractions. - While large amounts of latex from raw papaya might theoretically cause uterine contractions, ripe papaya is safe, but the persistent social misconception often leads many pregnant women to avoid the fruit entirely. *Banana* - **Banana** is highly recommended during pregnancy as it is a rich source of **potassium**, **fiber**, and **B-vitamins**. - There are no cultural or medical myths associating banana consumption with adverse pregnancy outcomes or abortion. *Grapes* - **Grapes** are considered a healthy inclusion in a pregnancy diet due to their high content of **antioxidants** and **vitamins**. - While individual women might develop food aversions, there is no common stigma or belief regarding grapes as abortifacients. *Orange* - **Oranges** are well-regarded during pregnancy for their high **Vitamin C** content, which aids in iron absorption and immune function. - This fruit is universally considered safe and beneficial, with no myths suggesting it causes pregnancy complications or abortion.

Q: A patient sustained an elbow dislocation that was treated locally. Due to improper healing, the patient later developed a tingling sensation in the palm. Which nerve is most likely involved?

Ulnar nerve. ***Ulnar nerve*** - The **ulnar nerve** runs posterior to the **medial epicondyle** of the humerus, a site highly susceptible to injury during an **elbow dislocation** or subsequent **valgus deformity** (tardy ulnar nerve palsy). - Compression or entrapment of this nerve leads to sensory loss and a **tingling sensation** in the medial aspect of the palm, the little finger, and the medial half of the ring finger. *Median nerve* - The **median nerve** is located on the anterior aspect of the elbow, making it more prone to injury during **supracondylar fractures** of the humerus rather than posterior dislocations. - Injury here typically presents with a 'hand of benediction' sign and sensory deficits in the lateral aspect of the palm. *Radial nerve* - The **radial nerve** is primarily associated with **mid-shaft fractures** of the humerus, where it travels in the **spiral groove**. - A lesion here classically results in **wrist drop** and sensory loss on the dorsum of the hand, not the palm. *Axillary nerve* - The **axillary nerve** is commonly injured in **shoulder dislocations** or fractures of the **surgical neck of the humerus**. - Clinical presentation involves weakness of the **deltoid muscle** and loss of sensation over the 'regimental badge' area on the lateral shoulder.

Q: A 28-year-old male is brought to the emergency department following a high -speed motor vehicle collision in which his knee struck the dashboard. On physical examination, the right lower limb is shortened, adducted, and internally rotated. An anteroposte rior X- ray of the pelvis is shown below. Based on the clinical presentation and radiographic findings, what is the most likely diagnosis?

Posterior hip dislocation. ***Posterior hip dislocation*** - The mechanism of injury, known as the **dashboard injury**, where the knee strikes the dashboard, pushes the femoral head posteriorly out of the acetabulum. - The characteristic clinical presentation is a limb that is **shortened, adducted, and internally rotated**. *Anterior hip dislocation* - This presentation is typically associated with **abduction and external rotation** of the affected limb. - It is usually caused by excessive abduction and external rotation forces, rather than the forward force typical of a dashboard injury. *Intertrochanteric fracture* - In hip fractures, the leg is typically **shortened and externally rotated**, distinguishing it from the internal rotation seen here. - There is often history of a fall in an elderly patient, though it can occur in high-energy trauma, it does not classically present with internal rotation. *Fracture of acetabulum* - While this can occur in high-speed crashes and involve injury to the hip joint, it is a broad diagnosis that describes a bony injury rather than the **dislocation** itself. - This diagnosis would require definitive confirmation via imaging for the presence of a fracture line, whereas the specific posture of adduction/internal rotation is pathognomonic for a posterior dislocation.

Q: A 9-year-old child presents with pain and swelling over the mid -shaft of the tibia, associated with low -grade fever and an elevated erythrocyte sedimentation rate (ESR). An X-ray of the affected limb is shown below. Based on the clinical features and radiographic findings, what is the most likely diagnosis?

Ewing sarcoma. ***Ewing sarcoma*** - Classically presents in the **diaphysis** (mid-shaft) of long bones in children and adolescents, causing localized pain, swelling, and systemic symptoms like fever and elevated **ESR** that mimic infection. - Radiographic findings typically show an **

Q: A 28-year-old female presents to the clinic with a complaint of dull, aching pain in her left hand after accidentally striking her finger against a door frame. On physical examination, there is mild tenderness over the affected area, but the range of m otion is preserved. An X -ray of the hand is shown below. Based on the clinical presentation and radiographic findings, what is the most likely diagnosis?

Enchondroma. ### ***Enchondroma*** - This is the most common **benign tumor of the small bones of the hands and feet**, typically appearing as a **well-circumscribed lytic lesion** with internal **calcifications** (often described as 'popcorn' or 'ring and arc'). - While often asymptomatic, they frequently present after a **pathological fracture** following minor trauma, as seen in this patient, and do not typically limit the range of motion unless a fracture has occurred. *Giant cell tumor* - Typically presents as an **epiphyseal, lytic lesion** that extends to the subchondral bone, most commonly around the **knee region** (distal femur, proximal tibia). - Radiographically, it is often described as a **'soap-bubble' appearance** and is generally more locally aggressive than an enchondroma. *Brown tumor* - This is not a true neoplasm but rather a manifestation of **hyperparathyroidism**, characterized by osteoclastic resorption and fibrous replacement of bone. - Diagnosis requires evaluation of serum **calcium, phosphate, and parathyroid hormone (PTH)** levels, and it is usually associated with **renal osteodystrophy**. *Aneurysmal bone cyst* - Classically appears as an **expansile, lytic lesion** with internal septations on plain radiography, often described as an **'eggshell' cortex**. - It is more common in the **metaphysis of long bones** and the posterior elements of the spine rather than the phalanges of the hand.

Q: Based on the image provided below, what is the most likely diagnosis?

Synovial chondromatosis. ***Synovial chondromatosis*** - This condition is characterized by **multiple cartilaginous nodules** within the synovial space, which typically appear as **multiple radiopaque, loose bodies** (calcified or ossified) on imaging. - It is a **metaplastic process** where synovial cells differentiate into chondrocytes, leading to the formation of these characteristic intra-articular bodies. *Pseudogout* - Caused by the deposition of **calcium pyrophosphate dihydrate (CPD)** crystals, primarily appearing as linear **chondrocalcinosis** within articular cartilage. - Usually presents as an **acute inflammatory monoarthritis** rather than the numerous distinct, loose ossified bodies seen in synovial chondromatosis. *Osteochondritis dissecans* - Typically presents as a **focal subchondral bone necrosis** usually involving the lateral aspect of the medial femoral condyle. - Often results in a **single loose body** or a crater defect, unlike the multiple, widespread nodules seen in synovial chondromatosis. *Tumoral calcinosis* - Manifests as **large, periarticular calcified masses** found in soft tissues outside the joint capsule. - It does not present as multiple small loose bodies floating within the synovial space, but rather as distinct **calcified deposits** in juxta-articular regions.

Question 1

Which of the following intravenous agents is commonly used for outpatient procedures?

Accepted Answer

Propofol

Answer

Ketamine

Answer

Thiopental

Answer

Etomidate

Question 2

Define net reproduction rate

Accepted Answer

Total number of girl children born during the reproductive age of a woman taking into account mortality/Average no of female children a newborn girl will bear during her reproductive age assuming age specific fertility and mortality rates

Answer

Total number of children born during the reproductive age of a woman

Answer

Total number of girl children born during the reproductive age of a woman

Answer

Average number of live births per woman during her reproductive lifespan

Question 3

Arrange the following in sequence. 1. Evaluation 2. Execution 3. Planning 4. Delegation

Accepted Answer

3, 2, 4, 1

Answer

1, 3, 4, 2

Answer

3, 1, 2, 4

Answer

3, 1, 2 , 4

Question 4

Regarding the transition from HFA → MDG → SDG, which of the following is correct?

Accepted Answer

Targets on time

Answer

Only communicable diseases

Answer

Only Lower Socio economic status

Answer

Applicable only to developing countries

Question 5

A pregnant woman avoids a particular fruit due to a commonly held belief that its consumption can induce abortion, despite there being no scientific evidence to support this claim. Which of the following fruits is most commonly associated with this misconception? Options:

Accepted Answer

Papaya

Answer

Banana

Answer

Grapes

Answer

Orange

Question 6

A patient sustained an elbow dislocation that was treated locally. Due to improper healing, the patient later developed a tingling sensation in the palm. Which nerve is most likely involved?

Accepted Answer

Ulnar nerve

Answer

Median nerve

Answer

Radial nerve

Answer

Axillary nerve

Question 7

A 28-year-old male is brought to the emergency department following a high -speed motor vehicle collision in which his knee struck the dashboard. On physical examination, the right lower limb is shortened, adducted, and internally rotated. An anteroposte rior X- ray of the pelvis is shown below. Based on the clinical presentation and radiographic findings, what is the most likely diagnosis?

Accepted Answer

Posterior hip dislocation

Answer

Anterior hip dislocation

Answer

Intertrochanteric fracture

Answer

Fracture of acetabulum

Question 8

A 9-year-old child presents with pain and swelling over the mid -shaft of the tibia, associated with low -grade fever and an elevated erythrocyte sedimentation rate (ESR). An X-ray of the affected limb is shown below. Based on the clinical features and radiographic findings, what is the most likely diagnosis?

Accepted Answer

Ewing sarcoma

Answer

Osteosarcoma

Answer

Acute osteomyelitis

Answer

Osteoid osteoma

Question 9

A 28-year-old female presents to the clinic with a complaint of dull, aching pain in her left hand after accidentally striking her finger against a door frame. On physical examination, there is mild tenderness over the affected area, but the range of m otion is preserved. An X -ray of the hand is shown below. Based on the clinical presentation and radiographic findings, what is the most likely diagnosis?

Accepted Answer

Enchondroma

Answer

Giant cell tumor

Answer

Brown tumor

Answer

Aneurysmal bone cyst

Question 10

Based on the image provided below, what is the most likely diagnosis?

Accepted Answer

Synovial chondromatosis

Answer

Pseudogout

Answer

Osteochondritis dissecans

Answer

Tumoral calcinosis

FMGE 2026

Anesthesiology

Community Medicine

Orthopaedics