XVII. Ortho Previous quesions

XVII. Ortho

1 Young adult with irreparable rotator cuff injury, which of the following procedures can be done?

Acromioplasty
Tendon transfer
Total shoulder replacement
Reverse shoulder replacement

Answer B. tendon transfer

Card test for?

Dorsal interossei
Palmar interossei
Lumbricals
Thenar muscles

Answer:palmar mnemonic– P”AD

Which traction nt used in lower limb?

perkins
bryants
dunlop

ANSWER c Dunlop
4. Jersey finger is due to rupture of?

extensor digiti minimi
extensor pollicis
FDP
FDS

Ans: A Jersey finger (also called Rugby finger or Sweater finger) describes a type of injury where there is avulsion of the flexor digitorum profundus (FDP) at the base of the distal interphalangeal joint (DIP)

What is not done while removing intervertebral disc?

Laminectomy
Laminotomy.
Laminoplasty
Hemilaminectomy

Most active part of bone

Cortical bone
Cancellous bone
Periosteum
Endosteum

osteoporosis

low calcium high alk phosphate
normalalcium high alk phosphate
lowalcium low alk phosphate
?

16. A person falls from building and lands on foot. What #’s correspond to this injury

Cervical #
Pond#
Lumbar #
base of skull #.

Judet view is for

Pelvis
Calcaneum
Scaphoid
?

ANSWER 2. Calcaneum

muscle not attached at greater tubercle ?

supraspinatus
subscapularis
infraspinatus
teres minor

Ans: subscapularis

XVIII. Dermat

  1. A 65 year old male with itchy bullae over erythematous areas and normal skin

    a) bullous pemphigoid
    b) dermatitis herpetiformis
    c) IgA pemphigus
    d) pemphigus vulgaris

Ans: A

  1. A 23 yr old pregnant diabetic female comes with lake of pus lesions on skin. Treatment is

    a) methotrexate
    b) azathioprine
    c) retinoids

d)Cyclosporine

Ans: Cyclosporine

  1. Young female with blue macules on forehead and ocular macules. The diagnosis is

    a) Mongolian spot
    b) Nevus of ota
    c) Nevus of ito
    d) Beckers nevus

Ans: nevus of ota

  1. 50 year old male from bihar came with symmetrical juicy papules and nodules with hypopigmentation on face and trunk. There was no hypoaesthesia and nerve thickening. There was fever in childhood

    a) LL
    b) Post kala azar dermal leishmaniasis
    c) BL
    d) Mycosis fungoides

Ans: post kala azar dermal leiahmaniasis

5)patient comes with more than 30% skin blistering with lip involvement. common cause.

a) bacteria
b) virus
c) drugs
d) malignancy

Ans: drugs (This was a question on TEN)

  1. Picture was that of a lady with two white patches over the neck and chin associated with leucotrichia options were

    Segmental vitiligo
    Acne vulgaris
    Focal vitiligo
    Piebaldism

Ans: Segmental vitiligo

  1. Papular lesions on dorsum of hands ,shaft of penis in a child (confusion as to what this question was- itchy? Non-itchy? Since 7 days?). Hence not answering this.

    a) lichen planus
    b) Lichen niditus
    c) Lichen scrofulosorum
    d) Scabies

Ans:? Lichen nitidus ? Scabies

  1. A picture with hyperpigmented margins with central hypopigmentation whose margins looked ike punched out lesions:

    a) BB
    b) BL
    c) LL
    d) Histoid hansens

Ans: BB

  1. A face of a lady was shown with red macular lesions on central part of face around the cheek and chin with flushing on sun exposure and increasing with emotional disturbance

    a) Acne vulgaris
    b) Acne rosacea
    c) SLE
    d) DLE

Ans: Rosacea

  1. 70 yr old man with vesicular rash on lower limb after a course of steroids. Tzanck smear shows multinucleate giant cells.

    a) VZV
    b) Vaccinia
    c) Molluscum
    d) M. Tb

Ans: VZV

Radiology

1• Judet view of X-ray is for : Acetabulum (pelvis is best answer)

2• Shenton line is seen in X ray of Hip

3• IOC for acute appendicitis in children :USG

4• Investigation of choice in stress fracture: MRI

5• Investigation of choice for biliary atresia in a 2 month old is : Hepatic scintigraphy

6• Patient with h/o tachyarrhythmias is on Implantable cardioverter defibrillator. He develops shock. Best method to know the integrity of ICD is to do : Plain Radiograph

7• Expansion of the subarachnoid space is seen in intradural extramedullary tumours

8• Safe & accurate for viability at 6 weeks is USG

9• Best non invasive investigation for myocardial viability is FDG PET

10• Hypertensive hemorrhage most commonly affects: Basal ganglia

Anatomy

Lower part of sternum fused by age
a) 12 years
b) 14 years
c) 18 years
d) 10 years

Answer: 14 years

Explanation:

In cartilaginous sternum, five double bony centres appear from above downwards during fifth, sixth, seventh, eighth and ninth fetal months.

The upper centre forms the manubrium.

Remaining four form body of sternum and fuse with one another from below to upwards.

Lower two centres fuse at age of 14 years and upper two centres fuse between 14 to 25 years.

The centre of xiphoid process appears during the third years or later and fuses with the body at about 40 years.

Reticular fibres of collagen tissues are present in all except
a) Thymus
b) Bone marrow
c) Spleen
d) Lymph node

Answer: Thymus

Explanation:

Reticular fibres are regarded as one variety of collagen fibre.

In many situations, these fibres form supporting networks of the cells.

In bone marrow, spleen and lymph nodes the reticular network is closely associated with reticular cells.

Most of these cells are fibroblasts, but some may be macrophage.

Cranial nerve nucleus lying deep to facial colliculus
a) Facial
b) Abducent
c) Glosso-pharyngeal
d) Trigeminal

Answer: Abducent

Explanation:

The facial colliculus is an anatomical elevation in the floor of the fourth ventricle.

The facial colliculus is not formed by the facial nerve nucleus, but by the abducens nerve nucleus and the motor fibres of facial nerve loop dorsal to the 6th (Abducent) CN nucleus before leaving the brainstem.

Collagen typical of basement membrane
a) Type I
b) Type V
c) Type IV
d) Type III

Answer: Type IV

Explanation:

Type of collagen:

Fibril Forming Collagens:

Collagens Type I- Bone, Tendon, Skin, Cornea and Blood Vessels

Collagens Type II- Cartilage, Inter-vertebral Disk, Vitrous Body

Collagens Type III-Blood Vessels and Fetal skin

Network Forming Collagens:

Collagens Type IV- Basement membrane

Collagens Type VII- Beneath stratified squamous epithelia

Fibril Associated Collagens:

Collagens Type IX- Cartilage

Collagens Type XII- Tendon, Ligament

Muscle not inserted on greater trochanter
a) Teres minor
b) Supra-spinatus
c) Infra-spinatus
d) Sub-scapularis

Answer: Sub-scapularis

Explanation:

Muscle- Inserted on greater tubercle

Supra-spinatus- Upper most impression

Infra-spinatus- Middle impression

Teres Minor-Lower impression

Not a branch of external carotid artery
a) Trans-cervical artery
b) Lingual
c) Superior thyroid artery
d) Ascending pharyngeal

Answer: Trans-cervical artery

Explanation:

External carotid artery is the chief artery of supply to structures in front of the neck and in the face.

External carotid artery gives eight branches.

Anterior: Superior thyroid, lingual and facial

Posterior: Occipital and posterior auricular

Middle: Ascending pharyngeal

Terminal: Maxillary and superficial temporal

Card test done for
a) Lumbricals
b) Dorsal interossei
c) Palmar interossei
d) Adductor pollicis

Answer: Palmar interossei

Explanation:

Card test is for palmar interossei of the finger and tested by placing a piece of paper between fingers and seeing how firmly it can be held.

First dorsal interossei can be separately examined by asking the patient to abduct the index finger against the resistance.

Microvilli are seen in all; except
a) Duodenum
b) Gall bladder
c) PCT
d) Collecting duct

Answer: Collecting duct

Explanation:

Microvilli are finger like projections from the cell surface that can be seen by EM.

Each microvillus consists of an outer covering of plasma membrane and cytoplasmic core in which there are numerous microfilaments (Actin filaments).

Microvilli are seen most typically at sites of active absorption e.g. the intestine and proximal and distal convoluted tubules of kidney.

The inner surface of the gall bladder is covered by the mucosa. The surface is made up of a simple columnar epithelium. The epithelial cells have microvilli, and look like absorptive cells in the intestine.

Metabolically active part in bone
a) Periosteum
b) Endosteum
c) Cancellous bone
d) Cortical bone

Answer:

Explanation:

Special visceral efferent carries all the cranial nerve except
a) Facial
b) Vagus nerve
c) Olfactory
d) Glosso-pharyngeal

Answer: Olfactory

Explanation:

Special visceral efferent (SVE) refers to efferent nerves that provide motor innervations to the muscles of the pharyngeal arches in humans.

The only nerves containing SVE fibers are cranial nerves: the trigeminal nerve (V), the facial nerve (VII), the glosso-pharyngeal nerve (IX), the vagus nerve (X) and the accessory nerve (XI).

Meso-nephric ducts and tubules give rise to all except
a) Glomeruli
b) Paroophoron
c) Epididymis
d) Vas deference

Answer: Glomeruli

Explanation:

Fate of meso-nephric duct and tubules in the female:

Collecting tubules, calyces, renal pelvic, ureter

Trigone of bladder

Epoophoron

Paroophoron

Fate of meso-nephric duct and tubules in the male:

Collecting tubules, calyces, renal pelvic, ureter

Trigone of bladder

Posterior wall of the part of the prostatic urethra

Epididymis, Ductus deference, Vas deference, Seminal vesicle, Ejaculatory duct

Meso-dermal part of prostate

The excretory tubules or nephrons are derived from the lower part of the nephrogenic cord.

Meso-rectal fascia doesn’t contain which of the following
a) Inferior rectal vein
b) Para-rectal node
c) Superior rectal vein
d) Inferior mesenteric plexus

Answer: Inferior rectal vein

Explanation:

Peri-rectal fat separated by the rectal fascia – the so-called meso-rectum – contains Superior rectal vessels, meso-rectal fat, lymphatic vessels and nodes.

It is the first area of local rectal cancer dissemination.

Thus, its removal along with the rectum affected by the tumor is essential for preventing local tumor recurrence.

Which of these is not a support of the uterus?
a) Urogenital diaphragm
b) Pelvic diaphragm
c) Perineal body
d) Recto-vaginal septum

Answer: Recto-vaginal septum

Explanation:

Primary support of the uterus:

Muscular or active support:

Pelvic diaphragm

Perineal body

Urogenital diaphragm

Fibro-muscular or mechanical support:

Uterine axis

Pubo-cervical ligament

Transverse cervical ligament of Mackenrodt

Utero-sacral ligament

Round ligament of uterus

Bosentan- used in pulmonary artery hypertension.

3… Drugs contraindicated in pregnancy? Methotrexate, azathioprine, cyclosporine, retinoids

Visual questions: Acne rosacea.



Carbetocin dosage in postpartum hemorrhage. Answer is 100 microgram over 2 minutes either intramuscularly or intravenously.



Artery supply to juvenile nasopharyngeal angiofibroma?



For hypertensive hemorrhage. Most common site among given option was basal ganglia. Usually putamen is most common site.

8… Trochlear nerve supply to the eye muscle and related action was asked.

Oncotype Dx test was asked.



Card test used for: palmar interossei



Visual question



Breast lump of 2.5 cm, sonography was normal. What was the next line of investigation. Or treatment.

14…

15.Atracurium is given for both liver and kidney failure patient.

Human papilloma virus, doesn’t cause nasopharyngeal cancer.

18.Japanese encephalitis vaccine.

Direct ophthalmoscopy.

20.Evisceration and 4 conditions. Panophthalmitis, etc…

21.Cherry red spots seen in ? CRAO or CRVO ?

22.Cherry red spot and history of blunt trauma. Is it berlin’s edema.?

23.Inguinal hernia in 3 years old child … Herniotomy.

24.One question was asked. Laparotomy was done in suspected ovarian tumour. Bilateral ovarian tumour seen with signet ring appearance. Is it krukenberg tumour?

25.One picture of bullous pemphigoid or lupus vulgaris.

26.For diaphragmatic surgery, we prefer circumferential incision. Isn’t it ?

27.Microfilariae something asked and parasite name was given . i am sure about brugia malayi, wuchereria bancrofti, onchocerca. The remaining option was answer. Isn’t it ?

28.Orthopedic question regarding traction used for lower limbs except… ? Dunlop, bryants , etc.

29.Shenton’s line seen in ? Hip, knee, elbow etc.

30.After operating for inguinal hernia. Accidently tackers were applied near illio pubic tract . patient had pain near the right thigh. Is it due to involvement of lateral cutaneous nerve of thigh ?

41.Judet view used for ? Pelvic, calcaneal, scaphoid etc.

For sexual assault. Now the age is 16 years. Initially it was 18 years. Right.

43.Hearing loss caused by all except… Option metronidazole, amikacin, gentamicin , chloroquine .

44.Corenal dystrophy and stain used ?

45.One question on mesenteric cyst or duplication of intestine.

Ioc for biliary atresia.. Ct of hepatic scintigraphy.



H1N1 and pregnancy. I guess , option -2 was the answer. As we do testing for H1N1 in case of category-B. If not wrong.

48.Rat hole injury etc… Forensic. Is it fire arm ?

Both gulconeogenesis and glycolysis requires the same enzyme. ?

50.One question on von-Grieke disease. Fasting hypoglycemia+ hepatomegaly.

Choera toxin related question. Is it causes hemidesmosome damage?

52.Recent streptococcal pharyngitis is diagnosed by ASO antibody titre.

53.One clincal history given , were patient was on diabetic drug ie metformin 500 mg bd and glipizide 5 mg od. Develops hypoglycemic attacks , met with head injury , remains unconscious in emergency room. We will draw a blood sample test , run a test for glucose measurement, give iv dextrose , once stable NCCT of head.

Along with maintaining of airway.

53.One blunt injury to the chest. Female pregnant lady. Immediate measurement is needle puncture to the right chest.

54.Missed abortion (5 times). Options by exclusion in making a diagnosis. Ie anti phospholipid syndrome , karyotyping , lupus anti coagulant , vdrl for both husband and wife.

55.Primary amenorrhea. Given estrogen and progesterone, for 6 months . No menstrual bledding. Is it turner syndrome , premature ovarian failure, androgen resistence

56.Which liver enzymes get’s elevated in lead poisoning.?

57.Retinoblastoma spreads through ? Vascular invasion, lymphatics, direct spread.

69… In one person, 10 gm mannitol was given Intravenously. After sometime urinalysis revealed 10% excreted in urine and plasma concentration was 20mg/100 ml… What is extracellular fluid volume…

5 liter
18 liter
24 liter

76.which of the following is not part of

Duke criteria

-splenomegaly, fever above104, blood culture positive .

79.Pregnant female should not be

executed for hanging according to s

416 crpc

: 80.If radius of artery increased 50

% .blood increase by 5 % is the answer

.

81.26 y old man from Bihar with nodules

over face, over back-hypopigmented,

normoaesthetic macules with no

nerve thickening. h/o prolonged fever

present in childhood

image of lesions on the back.

82.post kala azar dermal leishmaniasis

Ans pelvis.

:83.A Jersey finger is an injury to an

FDP tendon

image based…

84.Nevus of ota was the answer

:

85.Judicial hanging – knot below jaw

angle

Reticular fibres of collagen tissues

are Kashima operation done for

Vocal cord

nikshay is govt softwere for TB

survillence

which of the following is not part of

Duke criteria

-splenomegaly

Pregnant female should not be

executed for hanging according to s

416 crpc

: If radius of artery increased 50

% .blood increase by 5 %. ans

Pharmacology

26 y old man from Bihar with nodules

over face, over back-hypopigmented,

normoaesthetic macules with no

nerve thickening. h/o prolonged fever

present in childhood

image of lesions on the back

pst kala azar dermal leishmaniasis

Ans pelvis

: A Jersey finger is an injury to an

FDP tendon

image based

Nevus of ota was the answer: Judicial hanging – knot below jaw

angle

Reticular fibres of collagen tissues

are present in all except

a) Thymus ✅
b) Bone marrow
c) Spleen
d) Lymph node

Collagen typical of basement

membrane TYPE 4

rathole injury seen in firearm in all except

a) Thymus
b) Bone marrow
c) Spleen
d) Lymph node.
Collagen typical of basement

membrane TYPE 4.

In one person, 10 gm mannitol was given Intravenously. After sometime urinalysis revealed 10% excreted in urine and plasma concentration was 20 mg/100 ml… What is extracellular fluid volume…

5 liter
18 liter
24 liter

6.Histrionic and avoidant anxious type of personality?

Type A
Type B
Type C
Type D

ANSWER C. anxious avoidant is C, histrionic is B,ye well known hai… Ab weightage of C seems more here.

Question: Nephropathy most commonly associated with malignancy. 1- fsgs 2-mcd 3-membranous 4- mpgn

HADDON MATRIX-The Haddon Matrix is the most commonly used paradigm in the injury prevention field.

Developed by William Haddon in 1970, the matrix looks at factors related to personal attributes, vector or agent attributes, and environmental attributesbefore, during and after an injury or death. By utilizing this framework, one can then think about evaluating the relative importance of different factors and design interventions.