AIIMS NOV. 2018 – DeCoded !

AIIMS NOV. 2018 – DeCoded !

1. Which of the following bones doesn’t form the wrist joint ?

a. Radius

b. Scaphoid

c. Ulna

d. Triqueterum

 

Answer : C – Ulna

The wrist joint is formed by:

  • Distally – The proximal row of the carpal bones (except the pisiform).
  • Proximally – The distal end of the radius, and the articular disk (see below).

The ulna is not part of the wrist joint – it articulates with the radius, just proximal to the wrist joint, at the distal radioulnar joint. It is prevented from articulating with the carpal bones by a fibrocartilaginous ligament, called the articular disk, which lies over the superior surface of the ulna.

Fig 1.0 - Articular surfaces of the wrist joint.

 

2. What is the diagnosis of the condition shown in the Xray attached

Image result for gct xray

a. GCT

b. ABC

c. Osteosarcoma

d. Osteoclastoma

Answer : 🙁

Even we can’t tell the answer this both A and D are the same. Anyways following is the discussion.

There are four characteristic radiographic features when a giant cell tumour is located in a long bone:

  • occurs only with a closed growth plate
  • abuts articular surface: 84-99% come within 1 cm of the articular surface
  • well-defined with non-sclerotic margin (though <5% may show some sclerosis )
  • eccentric: if large this may be difficult to assess

 

3. Normal Curvature in Lumbar Spine is :

a. Kyphosis

b. Scoliosis

c. Lordosis

d. Recurvatum

 

Answer : C  Lordosis

Lordosis is the normal inward lordotic curvature of the lumbar and cervical regions of the human spine. The normal outward (convex) curvature in the thoracic and sacral regions is termed kyphosis or kyphotic. The term comes from the Greek lordōsis, from lordos (“bent backward”)

 

4. First Reflex to recover after Spinal Shock is :

a. Ankle Jerk

b. Plantar Jerk

c. Cremasteric Reflex

d. Bulbocavernous Reflex

 

Answer : D

 

The bulbocavernosus reflex is an oligosynaptic reflex mediated through the S2–S4 spinal cord segments that is elicited by electrical stimulation of the dorsal penis/clitoris nerves with the reflex response recorded from any pelvic floor muscles. The afferent paths of the bulbocavernosus reflex are the sensory fibers of the pudendal nerves and the reflex center in the S2–S4 spinal segment. The efferent paths are the motor fibers of the pudendal nerves and anal sphincter muscles.

 

5. In patellar clunk syndrome hyperplastic scar tissue is present at :
A. Superior pole of patella and impinging on femoral component during flexion
B. Superior pole of patella and impinging on femoral component during extension
C. Inferior pole of patella and impinging on femoral component during flexion
D. Inferior pole of patella and impinging on femoral component during extension

Answer : B

 

Patellar Clunk Syndrome is a painful condition associated with a mechanical catching or clunking during active extension following total knee arthroplasty (TKA). The syndrome is caused by growth of interposing soft tissue usually at the superior pole of the patella. This interposed soft tissue cannot be visualized on plain radiographs

 

6. Earliest sign of Compartment Syndrome of Leg :

a. Skin Mottling

b. Loss of pulse

c. Tingling

d. Pain on Passive Stretching of toes

Answer : D

Pain out of proportion to clinical situation is usually first symptom in Compartment Syndrome of leg while Pain on passive stretching is most sensitive sign prior to onset of ischemia

 

7. This is the Xray of a 7 year old child. Identify the diagnosis

 

a. Coxa Vara

b. Coxa Magna

c. Coxa Valga

d. Coxa Saltans

Answer : A

Coxa Vara : Coxa vara describes a deformity of the hip where the angle formed between the head and neck of the femur and its shaft (Mikulicz angle) is decreased, usually defined as less than 120 degrees.

8. Identify the deformity below :

Image result for mallet finger

a. Mallet Finger

b. Jersey Finger

c. Swan Neck Finger

d. Bouttoniere Deformity

Answer : A

Mallet Finger : A finger deformity caused by disruption of the terminal extensor tendon distal to DIP joint

  • the disruption may be bony or tendinous

 

9. A 8 year old child presents with fever and wound with discharging pus from right thigh for 4 months. Given below is the Xray with labelled structure. Identify

a. Involucrum

b. Sequesterum

c. Cloacae

d. Woven Bone

 

Answer : A

 

10. A patient presented with pain in his ankle.  Xray was done which shows osteolytic lesion with sclerotic rim. HPE findings are attached. What is your diagnosis ?

a. Eumycosis

b. Ochronosis

c. Hemophiliac Pseudotumor

d. PVNS

 

Answer : C

X-ray is useful in diagnosing intraosseous pseudotumours. They appear as well-defined, unilocular or multiloculated, lytic, expansile lesions of variable size. It can involve metaphysis, diaphysis and epiphysis of long bones.

Other findings include endosteal scalloping, perilesional sclerosis, cortical thinning or thickening, trabeculations and septations. Pathological fractures can also be present.

About the author: Dr. Tushar Mehta

An Orthopaedic Surgeon who is a blend of academic excellence and entrepreneurship with interest in all aspects of Bones and Joints. contach him at [email protected]

29 comments to “AIIMS NOV. 2018 – DeCoded !”

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  1. Abhishek Chaudhuri - 20/11/2018 at 12:15 am Reply

    Sir the sequestrum portion was marked in question

  2. PAJESH JP - 20/11/2018 at 1:09 am Reply

    Sir the 9th question it was different image and less radio dense marked area was asked inside normal femur

  3. Aparajita Singh - 20/11/2018 at 1:14 am Reply

    Sir, sequestrum was marked in the question…

  4. Eshwar Patel - 20/11/2018 at 1:38 am Reply

    Thank you sir

  5. SACHIN SHIVAJI KAMBLE - 20/11/2018 at 1:58 am Reply

    thank u sir

  6. Prasanjeet - 20/11/2018 at 2:14 am Reply

    Sir sequestrum was marked, I think. Thank you 😃

  7. Sivakumar - 20/11/2018 at 5:23 am Reply

    Tqq sir☺️

  8. Amitava - 20/11/2018 at 6:34 am Reply

    In Question 9 was 2nd xray was there. Ans. B sir

  9. Jajnadatta - 20/11/2018 at 7:30 am Reply

    Thank you sir…

  10. Syeda Naghma - 20/11/2018 at 7:52 am Reply

    Thank you sir !!

  11. Neha Dutt - 20/11/2018 at 8:10 am Reply

    Thank u sir

  12. Anjuna - 20/11/2018 at 8:21 am Reply

    Thank you sir.. And 9th question, Second xray was asked pointing to sequestrum.

  13. Mohibul Islam - 20/11/2018 at 9:52 am Reply

    Thnak you sir… Got 6/10😐

  14. Rohan sharma - 20/11/2018 at 10:41 am Reply

    Phosphaturia and Osteomalacia is seen in,
    1. Osteosarcoma
    2. Peripheral sheath nerve tumor
    3.****
    4.****

  15. Saiu nc - 20/11/2018 at 10:57 am Reply

    Thannku sir

  16. Thejashwini - 20/11/2018 at 11:09 am Reply

    Thank you 🙂

  17. BrijBRI KASAUDHAN - 20/11/2018 at 11:16 am Reply

    Sir, I think answer to Q.2 is ABC??

  18. Shraddha Lalan - 20/11/2018 at 11:19 am Reply

    Thank you sir

  19. Athma - 20/11/2018 at 11:22 am Reply

    Sir , i think the portion of sequestrum was marked

  20. Shashank Bagali - 20/11/2018 at 12:19 pm Reply

    Sir I think in Q 4: one of the option was abdominal reflex, I don’t remember having bulbocavernous reflex as an option
    Everyone please confirm.!!

  21. Shaily - 20/11/2018 at 2:36 pm Reply

    Sir sequestrum was marked in aiims question. Thankyou !

  22. MOHAMMAD SAAD - 20/11/2018 at 3:17 pm Reply

    Thankfully except for 1 or 2 all other questions were from class notes only.

  23. Mamta Gupta - 20/11/2018 at 9:51 pm Reply

    Thanku sir

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