Soal soal essay orthopaedics part 2

In India, there are two ways a medical graduate can train himself to be an orthopaedic surgeon.  two orthopaedic degrees are recognised: Master of Surgery inOrthopaedics (MS-Orth) and Diplomate of National Board (DNB-Orth). This question below is example of national board examination theory exam. Enjoy

DNB Orthopaedics June 2012 Theory Paper:

PAPER 1

1. Define MDR Tuberculosis. Discuss the clinical features, diagnosis and treatment of a case of MDR tuberculosis of spine (1+2+3+4)
2. Discuss the pathophysiology, clinical manifestations and Differential Diagnosis of Heterotopic Ossification (3+3+4)
3. Discuss treatment options of the focal cartilage defect over the medial femoral condyle in a 40 yr old man (10)
4. Discuss the management of deep vein thrombosis in orthopaedic patients
5. Describe the illustrative diagrams of the surgical exposure of radius at various levels (10)
6. Describe the surgical reconstruction in a case of one and a half yr old common peroneal nerve palsy (10)
7. Describe the principles of stabilization of foot
8. write in brief (5+5)
a.Ceramic bearing surfaces in arthroplasty
b.Bone scan in musculoskeletal disorder.
9. Enumerate causes of claw hand deformity. Discuss its management in short (3+7)
10. write brief notes on 4+(3+3)
a. Alendronate induced fractures
b.Diagnosis and treatment of osteomalacia

PAPER 2

1.Describe the treatment of acute flexor tendon injuries in various zones of hand (10)
2.Describe the Aetiopathogenesis, diagnosis and treatment of Madelung deformity(3+3+4)
3.Describe the clinical features ,diagnosis and management of tuberculosis hip in children(3+3+4)
4.Discuss the differential diagnosis and investigation in an 8 yr old child with persistent limp((5+5)
5.Classify congenital skeletal limb deficiencies(10)
6.Discuss in brief(5+5) a.Sequelae of pyogenic arthritis of hip in infancy
b.Intoeing gait
7.Describe the aetiopathology and management of SCFE(4+6)
8.write SN on (5+5)
a.FRO
b.IT(interferential therapy)
9.WRite brief notes on (5+5)
a.Role of orthosis in treatmnt of clubfoot
b.patellar tendon bearing prosthesis
10.write brief notes on (5+5)
a.Clinical and radiological diagnosis of scurvy
b.Adolescnt coxa vara

PAPER 3

1. Describe the management of failed osteosynthesis of fracture neck of femur in a young adult(10)
2.Discuss the management of diaphyseal gap nonunion with 5 cm bone loss in a young adult(10)
3.Describe the tension band principle and how it is used in fracture care(5+5)
4.describe the classification of thoracolumbar injuries and discuss the treatment of burst fracture L1(5+5)
5.Describe the classification, clinical features and management of Lisfranc’s fracture dislocation(3+3+4)
6.Describe the Sander’s classification of calcaneal fractures and discuss the treatment of each type (4+6)
7.Describe the classification of the distal humeral fractures in adults. Describe the surgical approaches used for internal fixation of these fractures (4+6)
8.Describe the blood supply of scaphoid. Discuss the treatment of nonunion of scaphoid (4+6)
9.Describe the mechanism of injury of Radial head fracture. Discuss its classification and management (3+3+4)
10.write SN on (5+5)
a.External fixator in musculoskeletal injuries
b.Antimicrobial prophylaxis to prevent surgical site infection.

PAPER 4

1.Describe the structure of bone with illustrative diagram(s) (10)
2. List the factors affecting Ca metabolism. Describe the radiological features of rickets (5+5)
3.write SN on nuclear medicine and its applications in orthopaedics (5+5)
4.Discuss the anatomical basis of thoracic outlet syndrome and its management (5+5)
5.Discuss the therapeutical potential of stem cells in musculoskeletal disorders (10)
6.Describe the musculoskeletal manifestations in sickle cell anaemia(10)
7.Describe the clinical features, laboratory findings and management of gout (3+3+4)
8.Describe the gait cycle .List various types of gait with diagnostic features (4+6)
9.Describe the methods used for augmentation of fracture healing (10)
10. Describe the role of Ultrasonography in musculoskeletal disorders (10)

December 2010

Paper I
1. Define neuropathic joint. List the causes of neuropathic joint. Mention in brief the clinical features, diagnosis and treatment of neuropathic joint.
2. Define gout. Describe in brief its clinical features, diagnosis and treatment?
3. Describe the broad principles of tendon transfer. Enumerate the tendon transfer for high radial nerve palsy.
4. Discuss the indications of surgery in TB spine with or without neurological complications.
5. Draw a labeled diagram of brachial plexus. Classify brachial plexus injury. Describe the clinical features and management of lower brachial plexus injury.
6. Describe various types of lumbar root anomalies. List the complications of lumbar disc surgery.
7. Define “Fat Embolism Syndrome”. Describe in brief the clinical – features, diagnosis and management of “Fat Embolism Syndrome”.
8. Define Giant Cell Tumor (GCT) of bone. Describe in brief clinical
features, diagnosis and management principles of GCT of upper end of tibia.
9. Describe aetiopathogenesis of avascular necrosis of hip. Classifyavascular necrosis of hip. Comment on broad principles of its
management.
10. Define ochronotic arthropathy. Describe its clinical features, diagnosis and management.

Paper II

1. Define congenital muscular torticollis. List the differential diagnosis and outline the management of congenital muscular torticollis.
2. Describe the blood supply of scaphoid. Describe the clinical features, diagnosis and management of nonunion of scaphoid.
3. Define ulnar claw hand. Enumerate the causes of ulnar claw hand. Discuss its management.
4. Describe Dupuytren disease and its characteristic f,eatures. Describe in brief its pathogenesis prognosis and management.
5. Describe the hand deformities in rheumatoid arthritis. Describe in brief the Patho-anatomy and treatment of “Boutonneire deformity”.
6. Define pseudoarthrosis of tibia. Describe its pathogenesis, diagnosis, classification and management
7. Define Legg Calves Perthes disease. Describe its clinical features, diagnosis and management
8. Classify physeal injuries. Describe the management and complications of various types of physeal injuries.
9. List the causes of limp in a child.
10. Describe the Pathology and radiological signs in rickets and scurvy.

Paper III

I. Classify proximal humerus fracture. Discuss the management options for various types. Outline the management for type IV fracture in elderly females.
2. Describe pitfalls in using the Locking Compression Plate.
3. Classify open fractures of tibia. Describe the management of type 3 b open fracture of tibia.
4. Describe briefly the etiology, clinical features, diagnosis, investigations and treatment of painful elbow following injury around elbow.
5. Describe classification of Monteggia fracture dislocation and its management.
6. Define nonunion. Describe the classification and broad principles of management of diaphyseal nonunion.
7. Define Tension Band principle. Describe the use of Tension Band principle in fracture surgery.
8. Define external fixation. Classify the external fixators. Describe the advantages and disadvantages of external fixation.
9. Classify thoracolumbar spine injuries. Give radiological classification of burst fracture. Outline the management of burst fracture of LI vertebra.
10. Describe various methods of treatment of distal radius fracture with their principles.

Paper IV

1. Describe different types of bone grafts along with their properties.
2. Describe the phases of normal gait and the types of muscle contractions in gait cycle.
3. Write short note on Nuclear medicine and its applications in Orthopedics.
4. What is flap reconstruction? Write its classification.
5. What are the types of epiphysis? Describe the types, various methods and indications of epiphysiodesis.
6. Write short note on Coxa Vara.
7. Describe pathogenesis of acute compartment syndrome and its diagnosis.
8. Name biomaterials used in orthopedics. Describe in brief their features.
9. Describe nerve injuries, Sunderland Classification, outcome expected and basis of repair.
10. Describe the various foot and ankle deformities in cerebral palsy and their management.

June 2010

Paper I
1.   Acute compartment syndrome
2.   Gene therapy in orthopaedics
3.   Vitamin D resistant rickets
4.   Advances in medical treatment  of rheumatoid arthritis
5.   Management of multiple rib fractures with haemothorax
6.   Differentiating features of head injury from cerebral symptoms of fat embolism syndrome
7.   Haemophilic arthropathy
8.   PET scan in orthopaedics practice
9.   Automatic bladder
10.   Electrodiagnostic studies

Paper II
1.   Salter Harris classification of epiphyseal injuries and it’s relevance to skeletal growth.
2.   Principles of management of radial nerve injury
3.   Ponseti method of CTEV management
4.   Salter’s osteotomy
5.   Floor reaction orthosis
6.   Klippel  Feil syndrome
7.   Claw hand
8.   Tom Smith arthritis
9.   Principle of amputation of lower limbs in children
10.   Patho-anatomy and management of congenital vertical talus

Paper III
1.   Principles, merits & demerits of locking plates
2.   Damage control orthopaedics
3.   Describe the pathophysiology and pharmacological treatment of acute spinal cord injury
4.   Classify distal radius fractures. What are the recent trends in their management?
5.   Methods for reducing risks of blood transfusion
6.   Evaluation and principles of management of fracture acetabulum
7.   Classify peri-prosthetic fractures following THR. Outline theis management strategies.
8.   Shoulder instability
9.   Distraction histiogenesis
10.   Classify fracture calcaneum and describe their management.

Paper IV
1.   Biological enhancement of fracture healing
2.   High tibial osteotomy
3.   Concepts of total knee replacement
4.   Recent advances in bearing surfaces of total hip arthroplasty
5.   DVT  prophylaxis
6.   Management of metastasis in spine
7.   Describe blood supply of long bones and effects of various modalities of fixation on this
8.   Multi-organ dysfunction syndrome
9.   Management of congenital scoliosis
10.   Enumerate various diagnostic tests with their relative merit for post-operative infection. Outline the treatment of post-operative infection after internal fixation

Dec 2009

Paper I

1. Post-operative pain management. Describe patient control analgesia.
2. Clinical features and management of stove in chest.
3. Indications of Limb salvage surgery in malignant bone tumors. Describe the techniques of limb salvage in osteosarcoma.
4. Uses of botulinum neurotoxin in Orthopaedic surgery.
5. Define pigmented villonodular synovitis. Describe pathology, clinical features, diagnosis & its treatment.
6. Give a functional classification of muscles around the shoulder. Enumerate the indications for shoulder arthrodesis. What are the pre-requisites for a good result? Describe any one technique of shoulder arthrodesis.
7. Describe pathophysiology of nerve compression (entrapment) syndromes. Enumerate various syndromes of nerve entrapment. Give an outline of the management of Tarsal Tunnel Syndrome.
8. What is traumatic arthrotomy of the knee joint? What is fluid challenge test to confirm the diagnosis in doubtful cases? Outline the principles of management.
9. What are the various causes of late onset paraplegia in tuberculosis of spine? Describe the investigative modalities and outline the principles of management.
10. Describe the management of unicompartmental osteoarthrosis knee.

Paper II

1. Management of septic arthritis in children,
2. Pathophysiology, types and clinical features of Osteogenesis Imperfecta
3. Prognostic factors and outcome in the treatment of Perthe’s disease
4. Describe Madelung deformity, classification, clinical features and management of Perthe’s disease
5. Classify congenital dislocation of knee. Comment on differential diagnosis and management
6. Draw a diagram of Floor Reaction Orthosis, What is a good indication for its use. Describe mechanism of action
7. Orthopaedic manifestation of neurofibromatosis
8. Describe muscular dynamics in calcaneovalgus deformity. Describe management in patients before and after attaining skeletal maturity
9. Classification of neurogenic bladder and management
10. What are closed chain and open chain exercises and discuss ACL rehabilitation protocol

Paper III

1. Classification, management and complication of fractures of the femoral head and neck in children
2. What are Monteggia equivalents, discuss the principles of management of Monteggia fracture dislocation in children
3. Principles of management of a pulseless hand after supracondylar fractures in children
4. Role of ultrasound in fracture healing
5. Subacromial impingement syndrome
6. Describe indications for amputation, Principles of lower limb amputation in children
7. What is Mangled Extremity severity score(MESS), describe principles of flap coverage in proximal one third of tibia
8. Classify ankle fractures, which pattern has syndesmotic instability, what is their management?
9. What are biodegradable implants, what is their chemical composition? Mention the indications of their use, advantage and disadvantage of their use
10. What is central cord syndrome, describe its clinical presentation. How will you manage such a case?

Paper IV

1. Osteochondral allograft transplantation. Mention indications for the procedure
2. Role of Pamidronate in bone metastasis
3. What do you understand by patellar instability, describe the principles of management, before and after skeletal maturity?
4. Enumerate modalities leading to biological enhancement of fracture healing. Mention the methods of preservation of allogenic bone grafts. Comment on mode of action, advantages and disadvantages
5. Describe the pathogenesis of hallux valgus deformity; describe the role of metatarsus primary varus in the pathogenesis. How will you manage an adolescent girl with severe hallux valgus?
6. Describe various types of rickets; describe biochemical changes and clinical presentation of various types of rickets!
7. Define osteoporosis. Comment on types, causes and management
8. What is highly cross linked polyethylene? How is it manufactured? How has it affected modern total hip arthroplasty?
9. Anatomy of Lisfranc joint, and management of injuries around the joint
10. Describe gate control theory of pain. What is transcutaneous nerve stimulation and its indications?

June 2009

Paper I

1) Briefly describe the stages of fracture healing. Discuss physical or chemical modalities to enhance fracture healing.
2) Discuss prophylaxis against secondary complications of patient with polytrauma.
3) Ganz antishock pelvic fixator.
4) Describe musculoskeletal manifestations of HIV infected patients.
5) Describe pathogenesis of medial compartment osteoarthrosis. Discuss pros & cons of HTO vs unicondylar replacement.
6) Femoroacetabular impingement syndrome.
7) Osteofibrous Dysplasia
8) Enumerate indications & various techniques for shoulder arthrodesis. What are the prerequisites for a good result?
9) What is malalignment test? Discuss principles of focal dome osteotomy.
10) Gene therapy in Orthopedics.

Paper II

1) Enumerate the causes of intoeing gait. How will you treat intoeing gait because of hip disorders.
2) What is congenital coxa vara? Describe its pathophysiology and outline principles of management.
3) Ober’s test.
4) Briefly discuss the clinical features and pathology of Ewing’s Sarcoma. Outline the principles of treatment in a case of Ewing’s Sarcoma of upper end of humerus.
5) How will you evaluate a child with genu valgum deformity? Outline the principles of management. What is timed epiphysiodesis?
6) Thermoplastic splints
7) Classify nerve injuries. What is the role of electrodiagnosis in differentiating various nerve lesions?
8) Discuss the principles of rehabilitation of a paraplegic patient.
9) Briefly describe the principles & steps of Ponsetti’s method of CTEV correction.
10) Enumerate various causes of claw hand. What is the pathogenesis of clawing? Discuss the principles of surgical correction.

Paper – III

1) Classify fractures of calcaneum. Outline the principles of management.
2) Elaborate the principles of LCP. What are the applications in periarticular fractures?
3) Classify epiphyseal injuries. Describe the complications. What is Langenskiold’s procedure?
4) Current concepts in the management of fracture neck & head of radius in children and adults.
5) Classify flexor tendon injuries of the hand. Describe the treatment of neglected ruptures of flexor tendons in Zone II.
6) Outline the principles of management in a case of infected non union of a long bone. How will you treat infected non union of tibia?
7) Classify fractures of the acetabulum. Discuss radiographic evaluation of acetabular trauma.
8) How will you manage a case of knee dislocation with absent distal pulsations?
9) Describe instability patterns after wrist trauma. Discuss the management of VISI (Volar Intercalated Segment Instability)
10) How will you differentiate between the cerebral sign as a result of head injury vs fat embolism syndrome? Describe in brief management of fat embolism syndrome.

Paper – IV

1) Autologous Transfusion.
2) Describe the anatomy of Distal Radio Ulnar Joint. Describe indications & technique of performing Kapandji’s procedure.
3) Sexual Dimorphism in orthopedic practice.
4) Brown Tumor.
5) Surgical Dislocation of Hip.
6) Describe anatomical classification of chronic osteomyelitis. Discuss the principles of management based on this classification. How will you fill the dead space after excision of infected tissue?
7) Describe the presentation of tourniquet palsy and its causes. What precautions are taken to prevent it?
8) Describe the anatomy of PCL. Discuss its significance in Total Knee Arthroplasty.
9) Describe the basic principle of PET scan and discuss its role in orthopedics.
10) What is pelvic support osteotomy? Outline its principles and operative technique.

Dec. 2008

Paper I

1. Discuss Anatomy of rotator cuff. What is rotator cuff disease? Discuss its pathogenesis and management.
2. Define and classify Rickets. Describe pathogenesis, clinical features and management of hypophosphatemic rickets.
3. What are Biochemical markers for bone formation and bone resorption. Discuss their role in management of osteoporosis.
4. Discuss causes of loosening after a total hip replacement. Discuss its clinical features, diagnosis and management.
5. Discuss various methods available for treatment of Giant cell tumor of proximal tibia in a 30 yr. old man.
6. What is claudication? Classify it and discuss its cause specific management.
7. Discuss the etiology, Pathology , diagnosis, and management of Gas Gangrene of the Lower Extremity.
8. Discuss approach to find out a primary tumor in a 65 yr. Old man presenting with vertebral metastasis and low backache.
9. Discuss differential diagnosis in a 25 yr. old male presenting with mono-articular arthritis of knee joint. Tabulate the management in an algorithmic manner.
10. What is Marfan’s syndrome? What is its orthopaedic management?

Paper II

1) Classify elbow dislocation. How will you manage an unreduced posterior dislocation elbow in 10 yr. old child?
2) Define and classify cerebral palsy. Describe crouched gait and its management in a 10 yr. old child.
3) Describe various systems, implants available for limb length equalization. Discuss their underlying principle.
4) Give one example each of concentric and eccentric contraction during gait cycle. How will paralysis of tibialis anterior affect normal gait.
5) Describe Salter’s osteotomy. What are its indications, merits and demerits.
6) What is thoracic outlet syndrome? Discuss its Anatomy . How will you diagnose it in OPD?
7) Discuss sexual and bladder rehabilitation of a 30 yr. old male following a complete spinal injury at D12 vertebral level.
8) Discuss indications, merits and demerits of talectomy.
9) Discuss orthotic management in a High Radial Nerve Palsy.
10) Discuss various functions of hand. How will you attain key pinch in a quadriplegic with no useful power?

Paper III

1) What is Polytrauma? Describe the scoring method & principles of management of a patient with polytrauma in accident & emergency department.
2) Describe clinical features, diagnostic criteria and treatment of fat embolism syndrome.
3) What is floating knee? Discuss its management in a 25 yr. Old adult.
4) Describe various clinical methods to diagnose anterior cruciate ligament injury. Describe post operative management of ACL reconstruction by a bone patellar tendon bone graft.
5) Discuss the principles of management of Non-Union fracture Neck of Femur in an adult.
6) What is a Toddler’s fracture? Discuss its differential diagnosis and management.
7) How will you transport an organ after amputation to a sterilized centre for re-implantation? What is the order of implantation in a below elbow amputation?
8) Classify peri prosthetic fracture following a total hip replacement. Discuss their management.
9) Discuss the principles and the biomechanics of intra-medullary nailing.
10) Classify Pilon fractures and discuss their management.

Paper IV

1) What is multi system organ failure? What are indicators of mortality? Write briefly about diagnosis and management.
2) Define and classify VIC. Describe its surgical and orthotic management in Grade II VIC of forearm.
3) Describe arches of foot. Classify Flat Foot & briefly discuss the management principles of flat feet in a child.
4) What are the anatomical & physiological differences between neck shaft angle and version in a child and adult?
5) Discuss principle of chondroplasty in osteoarthritis of knee joint.
6) Define multidirectional instability of shoulder joint. Discuss its management.
7) Discuss the role of injectable steroids following spinal injury.
8) Discuss various methods of preventing deep vein thrombosis following total knee replacement. Discuss their merits & demerits.
9) What are indications of arthrography in a hip? Discuss various approaches to aspirate the hip joint.
10) What is the indication & principle behind parathormone therapy for treatment of osteoporosis? What are its merits & demerits?

June 2008

Paper I

1) Femoro acetabular impingement syndrome.
2) Chronic recurrent multifocal osteomyelitis. Diagnosis and management.
3) Management of Brachial artery injury in association with supracondylar fracture of humerus.
4) Differentiating features between Osteonecrosis and transient migratory osteoporosis.
5) Discuss the diagnosis and clinical features of DVT in orthopedic surgery. Outline the management. What special precautions are required if post-operative epidural analgesia is used for 4 – 5 days.
6) Discuss the approach to a patient with suspected bony metastasis with unknown primary tumor.
7) Enumerate the radiological types of Tuberculosis Hip. How does this classification help us in prognostication?
8) Discuss the approach to a patient of pelvic fracture with a suspected abdominal injury.
9) Enumerate various methods of ACL Reconstruction. Discuss the pros & cons of each method.
10) Bone defects encountered during total knee replacement and their management.

Paper II

1) Discuss the types of equines contracture in cerebral palsy and its management.
2) Describe the Anatomy of iliotibial band and the effect of its contracture on the lower limb. How do you clinically detect the contracture?
3) Renal Osteodystrophy
4) Scheurmans disease.
5) Pathophysiology of claw hand and its treatment.
6) Discuss the management of flexor tendon injury in zone II.
7) Describe the orthotic management of an asensate foot particularly in reference to leprosy.
8) What are the various types of exercises? Discuss the benefits and indications of isometric exercises.
9) What is paraffin wax? How is it useful in treatment of orthopedic conditions? What are the indications and contraindications of wax bath therapy?
10)Define ankle foot orthosis. What are the plastic materials used in fabrication. Describe indications and care during daily use.

Paper III

1) Describe the causes of ulnar wrist pain after healing of a distal radial fracture and discuss the management.
2) Damage control orthopaedics .
3) Classify fractures of acetabulum and role of conventional radiology in the classification
4) Classify ankle injuries. Which fracture patterns have syndesmotic instability & how do you manage it?
5) Classify fractures of the proximal humerus. What is the relevance of blood supply of humerus in planning management? How will you treat four part fractures?
6) Discuss the advances in the management of periarticular fractures.
7) Describe the mechanism of injury & clinical presentation of various incomplete spinal cord syndromes.
8) Differentiating features in the patho Anatomy & management of intracapsular fracture neck of femur in children & adults.
9) Advances in treatment of osteoporotic fractures.
10)Discuss the clinical features & management of Achilles tendinopathy in athletes.

Paper IV

1) Biological therapy in inflammatory arthritis.
2) Trochanteric flip osteotomy in surgical exposures of the hip joint.
3) Rationale for using metallic implants in osteoarticular tuberculosis.
4) Clinical differentiation between pre-ganglionic and postganglionic lesions of brachial plexus & its effect on the management.
5) Transcutaneous nerve stimulation.
6) Define femoral anteversion. How do you detect it clinically? Discuss the role of anteversion in orthopaedics diagnosis & management
7) Pathophysiology of lumbar canal stenosis.
8) What are bisphosphonates? Discuss the role of Bisphosphonates in various orthopedic disorders.
9) Describe the blood supply of a long bone. Discuss the effects of various modalities of internal fixation on the blood supply.
10)Biodegradable orthopedic implants

Dec 2007

Paper I

1. management of multiple rib fracture with Haemopneumothorax
2. filum terminale syndrome
3. management of skeletal metastasis
4. round cell tumour. Discuss the management of multiple myeloma
5. osteoporosis
6. management of fat embolism
7. exertional compartment syndrome
8. management of haemarthrosis of knee developing in an injury
9. role of labeled WBC and multiphasic bone scan in bone Pathology
10. tuberculosis of hip joint

Paper II

1. etiology and pathological Anatomy of DDH
2. Mid carpal instability
3. surgical principles of flexor tendon repair
4. klippel feil syndrome
5. indications of amputation. Describe surgical principles of amputation in children and adults
6. pes planus
7. role and mode of action of pharmacological treatment in CP
8. Calcaneovalgus deformity. Disscuss the treatment issues in mature and immature foot
9. madelung deformity
10. shoulder instability

Paper III

1. indications of Valgus osteotomy for fracture neck of femur. Discuss the preoperative planning, Implant choice, advantages and disadvantages of the procedure/
2. guiding principles of removal of orthopaedic implants after fracture union. What are the current recommendations for removal of implant in commonly encountered fractures
3. classify Periprosthetic fractures around the knee. Outline the treatment strategy
4. Classify fractures of the Capitullumn and discuss the management of each type
5. Surgical Anatomy of AC joint along with classification of AC joint injuries. Briefly discuss the management.
6. what are the various protocols which have been used for pharmacological intervention in spinal cord injuries.what is the current opinion on pharmacological intervention
7. classify fractures of pelvis briefly discuss the management of rotationally unstable and vertically stable injuries
8. Various methods of fixing severely osteoporotic fractures.
9. what is LISS. Discuss its role in stabilizing fractures of distal femur.
10. what is ballistics. Briefly describe the current management of ballistic injuries of the spine.

Paper IV

1. Biological enhancement of fracture healing
2. Bearing surface of total hip arthroplasty
3. Causes and treatment of thoracic outlet syndrome
4. what are the musculo skeletal manifestations of retroviral infection
5. high tibial osteotomy
6. discuss the pharmacological treatment of rheumatoid arthritis
7. Structure and function of articular cartilage
8. Sickle cell disease
9. Classify Spondylolisthesis. Describe the management
10. Renal Rickets.

June 2007

Paper I

1. DIC
2. Enumerate bleeding disorders . How will you manage a grossly arthritic Knee in haemophilia?
3. Tension Pneumothorax
4. Decribe the various myocutaneous flaps used to cover tibia in different levels.
5. primitive neuroectodermal tumours
6. pathogenesis of lumbar canal stenosis? What is the differentiating feature between vascular & neurogenic claudication
7. Briefly discuss the principles and priorities in managing polytrauma
8. loose bodies in knee – etiology? How will u manage a case of 30 year old sportsmanwho presents with locked knee due to loose body
9. how will u differentiate structural scoliosis from nonstructural scoliosis?describe infantile idiopathic scoliosis. What is the importance of rib vertebral angle?
10. how will u manage a case of recalcitrant tennis elbow?

Paper II

1. Classify radial club hand. Describe the pathological Anatomy & management of a 1 yr old child?
2. Classify Coxa Vara. Describe the management of adolescent coax vara
3. describe the DD of cystic lesion in upper end of humerus in a 10 year old child. Describe the management of SBC in same child
4. Classify fracture neck of femur in children. Describe its management and complications briefly
5. Define Gait. Describe the aetiopathogenesis and causes of trendleberg gait
6. what is symes amputation? Desribe the indications and complications. What is the prosthesis suitable for symes amputation?
7. Describe briefly the clinical features and management of SCFE?
8. Neurological deficit in caries spine; types, pathogenesis and prognostic factors?
9. A one year old child has been successfully treated for CTEV. Describe the orthotic management from this time to the completion of treatment?
10. Describe the pathological Anatomy of the bursae of the hand. Discuss the etiology, clinical feature and management of acute infection in those bursae?

Paper III

1. Peritalar dislocation
2. Chronic compartment syndrome
3. Hanging cast 4. what is unstable trochanteric fracture? Briefly describe the various methods of managing unstable trochanteric fracture
5. discuss the indications pros and cons of reamed Vs undreamed intramedullary nailing
6. discuss the management of closed fracture shaft of humerus with radial nerve palsy
7. Carpal instability – types, clinical features and radiological assessment
8. Describe the Anatomy of Subacromial space. What is the morphology of acromion process in the pathogenesis of rotator cuff tears? How will you manage full thickness tear?
9. what is locked compression plate? Discuss the principles, clinical situations where it is particularly usefull
10. how will you manage a case of acute Hemarthrosis Knee?

Paper IV

1. Describe Bone remodeling unit. Briefly describe the drugs which influence remodeling
2. PET Scan
3. Wallerian degeneration
4. Briefly describe the relevant biomechanics of the lower limb, particularly in relation to bone cuts in total knee replacement
5. gate control theory of pain
6. what is neuropraxia? How will you differentiate it from axonometsis during first few days of injury
7. tribology
8. tumour induced osteomalacia
9. describe the histological zones of growth plate. Discuss the anatomical changes which takes place in rickets and Slipped capital femoral epiphysis
10. Discuss the pathogenesis of acute hematogenous osteomyelitis. How does it differ in different age groups

Dec 2006

Paper I

1) Autologous Chondrocyte Implantation
2) Features which differentiate head injury from the cerebral symptoms of Fat Embolism syndrome.
3) Synovioma
4) Otto Pelvis
5) Principles of surface replacement arthroplasty of hip. What do you think are the reasons of failure of previous historical designs compared to the modern successful design?
6) What are the various methods of closing gaps between nerve ends during nerve repair?
7) What are the indications of spinal osteotomy in ankylosing spondylitis? Describe the various techniques.
8) Pathophysiology of septic shock.
9) Management of a patient having fracture pelvis with urinary retention. Restrict yourself to the management of his urinary problem.
10)Kienbock’s disease.

Paper II

1) Name the prehensile movements of hand. What are the tendon transfers described for opponens deficit hand?
2) Describe briefly indications, contraindications and principle technical steps of Salter’s osteotomy.
3) How do principles of amputation differ in children as compared to adults? What is pylon prosthesis? What are advantages and disadvantages?
4) What is the pathological Anatomy of carpal tunnel? Describe briefly the diagnosis and management of carpal tunnel syndrome.
5) What are the hand deformities in rheumatoid arthritis? Describe the pathological Anatomy and treatment of Boutannaire’s deformity.
6) Describe briefly the aetiology, clinical features and principles of treatment of Tom Smith arthritis.
7) Outline the calcium metabolism. What do you mean by Vitamin D resistant rickets? Describe its clinical features and management.
8) What is crutch palsy? Describe the orthotic management of wrist drop.
9) Describe the pathological Anatomy , clinical features and management of post polio calcaneus deformity in a 12 yr. Old patient.
10)What is Floor Reaction Orthosis? Describe its parts and mechanism of function. What are its indications and contraindications?

Paper III

1) Describe the mechanism of injury and clinical presentation of various incomplete spinal cord syndromes.
2) What is Lisfranc joint? Classify injuries around this joint and principles of management.
3) Classify calcaneal fractures. Discuss the management based on classification system. Enumerate the complications.
4) Enumerate Biodegradable implants. What are the advantages and disadvantages of their use?
5) Classify periprosthetic fractures around the knee and discuss their management.
6) Classify fracture acetabulum and outline the indications of surgical treatment.
7) Classify ankle injuries. Which fracture patterns have syndesmotic instability and how do you manage that?
8) Classify fractures of the proximal humerus in elderly. What is the relevance of blood supply of the humeral head in planning management? How will you treat four part
fracture?
9) What is Gas Gangrene? Discuss the clinical features, bacteriology and principles of management.
10)Describe the causes of ulnar wrist pain after healing of distal radius fractures. Discuss the management of DRUJ disorders.

Paper IV

1) Describe the Physiology of micturition. Briefly discuss the management of automatic bladder in spinal injuries.
2) Describe the arches of foot. Discuss the clinical features and management of peroneospastic flat foot.
3) Describe the blood supply of femoral head. How does it differ in children and adults?
4) Describe the properties of synovial fluids. How does it help in differentiating various types of arthritis?
5) What are the stages of fracture healing? Discuss the factors regulating fracture healing.
6) What are bone graft substitutes? How do they work?
7) Describe the metabolism of Vitamin D and its clinical significance.
8) What are Giant cell variants? Describe in brief their differential diagnosis.
9) What is DOTS? What is its rationale?
10)Pathoanatomy, radiology and diagnosis of Congenital vertical Talus.

June 2006

Paper I

1) Discuss the Pathology of osteoarthritis of knee with special reference to the role of ACL rupture in the pathogenesis of osteoarthritis knee.
2) Briefly describe the clinical features, types and management of osteoid osteoma.
3) Describe in detail the synovial fluid analysis. How do you differentiate various types of arthritides based on the analysis?
4) Video Assisted Thoracoscopy
5) Osteochondritis Dessicans
6) Transient Migratory Osteoporosis of the hips
7) Describe various types of skin grafts. Discuss the stages of biological incorporation of skin grafts.
8) Discuss the pathogenesis of neurospinal claudication.
9) Automatic Dysreflexia.
10)Control of air quality in a modern orthopaedic operation theatre.

Paper II

1) Anterior Interosseous Nerve syndrome – Aetiology, clinical features, differential diagnosis and management.
2) Dwyer’s osteotomy for CTEV – Indications, steps and complications.
3) Sprengel’s Deformity. Etio pathogenesis, clinical features and management.
4) Coxa Plana – Clinical, Radiological features, Differential diagnosis and principles of treatment.
5) Boutannaire deformity – etiology, pathomechanics and management.
6) Ultrasonic Therapy – Physiological effects, clinical applications and contraindications.
7) Quadriceps Paralysis Gait – pathomechanics, compensation employed and corrective measures.
8) Suction Socket Prosthesis – principles, indications and advantages over conventional prosthesis and main points in its construction.
9) Bowing of Tibia in children – Causes, types and management of Congenital Bowing
10)Equinus Deformity in cerebral palsy – Etiopathogenesis, evaluation and treatment.

Paper III

1) Fracture Talus.
2) Bennet’s Fracture dislocation
3) Hangman’s Fracture.
4) Motor March
5) Principles of Tendon Transfer.
6) Anterior Cruciate Ligament Injury.
7) Acromio clavicular Disruption
8) Lateral Condyle fracture of Humerus
9) Perilunar Dislocation.
10)Fracture Disease.

Paper IV

1) Etiopathogenesis, Pathology and management of DIC.
2) Congenital postural deformities associated with in-utero position.
3) Raloxifene.
4) Biomechanics of Knee in relation to total knee replacement.
5) Structure and Biochemistry of articular cartilage.
6) Bryant’s Traction.
7) Biochemical markers of Bone formation and resorption.
8) Describe pathological Anatomy and radiology in CTEV.
9) Stewart and Harnaley ankle arthrodesis.
10)Enumerate various deformities of foot and ankle seen in Post Polio Residual Paralysis (PPRP). Describe in detail the management of Talipes Calcaneus

Dec. 2005

Paper I

1) Define entrapment syndrome. Enumerate various entrapment syndromes. Discuss the entrapment syndrome in relation to the ulnar nerve in detail.
2) Bony changes in hyperparathyroidism and hypoparathyroidism along with relevant pathophysiology.
3) Sports related injuries to soft tissues.
4) Suture Materials.
5) Finger Injuries.
6) Enumerate various classical levels of lower limb amputations. Discuss AK amputation in detail. What is the difference in energy consumption by the patient in AK amputation as compared to a BK amputation?
7) Respiratory Distress Syndrome.
8)Cool Intravenous Regional Anaesthesia in orthopedic practice.
9) Day Care Surgery.
10)Surgical audit.

Paper II

1) Congenital vertical Talus – Etiology, Pathology , clinical, radiological features and management.
2) Chiari Osteotomy – indications, advantages, steps of surgery.
3) Claw Hand – Etiology, patho-mechanics,principles of various corrective procedures.
4) Bowing of Tibia in children – Causes, types, clinical features & management of congenital bowing of tibia.
5) Klippel-Fiel syndrome – Etiology, Pathology , clinical & radiological features, differential diagnosis & management.
6) Microwave Diathermy – its physiogical effects, clinical applications & contraindications.
7) Describe various types of Crutches ; gait pattern with crutches.
8)Cool Skew Flap Amputation – indications, advantages of conventional amputation,steps of operation and complications.
9) Post – polio equinus deformity of foot – etiopathology, evaluation & management.
10)Floor reaction Orthosis – indications, principles and advantages.

Paper III

1) Enumerate the types of spinal cord lesions following fracture dislocation of C5-6 vertebrae and discuss clinical features, treatment and prognosis of each type of lesion in adult. 25 marks
2) Describe the following in brief 15 marks each
i) Treatment of fractures of distal end of radius.
ii) Management of fracture of fracture shaft of femur that
has become infected after intramedullary fixation
iii) Treatment of radial head and neck fractures in children
iv) Management of Trochnanteric fractures in elderly.
v) Principles of management of Lisfranc injuries of foot.

Paper IV

1) Massive Transfusion.
2) Harmon’s approach of Tibia with applied Anatomy .
3) Strength – Duration Curve.
4) Biomechanics of hip joint and its clinical applications.
5) Radionuclide bone scanning
6) Allopurinol
7) Tension band principle and its application in treatment of fractures using a wire and plate.
Cool Pathology of tuberculous arthritis and correlation with clinical staging.
9) Growth plate – Anatomy and pathological states affecting it.
10) Radiological and biochemical features of renal osteodystrophy and their interpretation.

June 2005

Paper I

Part A
1) Draw a flow chart of disaster planning at state level. What is the concept of triage?
2) Pathology , clinical features and management of diabetic foot.
3) Nosocomial infection on orthopaedics – common organism and preventive measures.
4) Post operative DVT – Prevention, clinical features and treatment.
5) Post Menopausal Osteoporosis – Prevention and management.

Part B

1) Crystal Synovitis.
2) Incoporation of Bone Grafts. How does it differ for cancellous and cortical grafts?
3) Preparation and precautions required to operate HIV positive patients.
4) Chemotherapy for osteosarcoma.
5) How does a neurological claudication differ from vascular claudication? Enumerate the etiology of the two.

Paper II

Part A

1) Clinical features and management of slipped capital femoral epiphysis.
2) Ewing’s Sarcoma
3) Pollicisation – Indications and prerequisites
4) What are parts of a shoe? Describe the modifications of a CTEV shoe.
5) What is modified Jone’s transfer for a high radial nerve palsy? How does it differ from original transfer?

Part B

1) Pylon prosthesis – Indications, prerequisites and advantages.
2) Botulin in cerebral palsy patients.
3) PTB prosthesis – Indications and principles.
4) Radial club hand.
5) Salter osteotomy for DDH.

Paper III

1) Describe the biology of fracture healing and the influence of intra medullary rods and plates in healing. Discuss the role of various modalities in stimulation of osteogenesis
(25 marks)
2) Describe in brief on the following (15 marks each)
i) Treatment of odontoid fracture in adults.
ii) Enumerate the complications of femoral neck fractures in children and discuss the management in any one of the complications.
iii) Classification and treatment of acromioclavicular dislocation.
iv) Stress, Strain, Modulus of elasticity and strength in relation to metallic implants.
v) Rotator cuff injury in sportsmen.

Paper IV

Part A

1) Trendelenberg test with its anatomical basis and clinical applications
2) Madura foot.
3) Synovial fluid and its analysis in various arthritis
4) Blood supply of head of femur and its clinical significance.
5) Morbid Anatomy , radiological and laboratory features of Multiple Myeloma

Part B

1) Thompsons approach of radius with applied Anatomy .
2) Paralytic Bladder.
3) Methotrexae as a DMARD.
4) Therapeutic ultrasound.
5) Prophylaxis in thrombo-embolic disease.

Dec. 2004

Paper I

1) Describe etiopathogenesis of thoracic outlet syndrome and its management
2) Short notes on
i) Shock
ii) Haemophiliac arthropathy
iii) Compartment syndrome
iv) Ehler-Danlos syndrome
v) Acute rupture of Achilles Tendon

Paper II

1) Discuss etiology, pathogenesis and management of Perthe’s disease.
2) Write short notes on
i) Principles of amputation of lower limb in children
ii) Dupuytren’s contracture
iii) Carpal Tunnel Syndrome
v) Nuclear Imaging.
iv) F.R.O.

Paper III

1) Classify pelvic fractures and discuss the management.
2) Write short notes on
i) Fracture Talus
ii) Calcaneovalgus Deformity
iii) Myositis Ossificans
iv) Biomechanics of Hip
v) Habitual Dislocation of Patella

Paper IV

1) Describe calcium metabolism. Discuss the etiology, clinical features, diagnosis and management of nutritional rickets.
2) Write short notes on
i) Arches of foot
ii) Core decompression
iii) Bone graft substitutes
iv) Pathology of osteoarthritis
v) Sudeck’s osteodystrophy

June 2004

Paper I

1) Osteoporosis – Definition, Etiology, Clinical features, Investigations, Prevention and Treatment.
2) Short notes on
i) Surgery for habitual dislocation of patella
ii) Triple arthrodesis for equinus
iii) Shoe modification for valgoid tilt
iv) Fascio-cutaneous skin graft
v) Ideal stump

Paper II

1) Discuss the merits & demerits of operative & non-operative treatment of simple diaphyseal fracture of tibia.
2) Short notes on
i) Bristow’s procedure
ii) Classification of Distal Radius fracture
iii) Classification of Rotatory knee instability
iv) Management of Pelvic fractures
v) Old metacarpo phalangeal dislocation

Paper III

1) Discuss mechanism & classification of injury around ankle joint. Discuss diagnosis and treatment.
2) Short notes on
i) Discuss Pathology & management of infected non-union.
ii) Fracture Neck of Femur – Classification and treatment
iii) Compression & Distraction in Orthopaedics
iv) Role of Ligamentotaxis in fractures
v) Tension band wiring principle.

Paper IV

1) Describe bone tumour. Classification, diagnosis and treatment modalities for Multiple Myeloma.
2) Short notes on
i) Bone Cement
ii) Intrinsic Hand
iii) Shoulder Hand Syndrome
iv) Gait Cycle
v) Osteoclast.

Dec. 2003

Paper I

1) Define Gangrene. Describe the aetiological classification & Mx of gas gangerene?
2) Short Notes on :
i) Skin grafting
ii) Madura foot
iii) Mortons metatarsalgia
iv) DVT
v) Ewings tumour

Paper II

1. Management of ankle fractures in children
2. Pathophysiology & presentation of TB spine in children
3. Juvenile Chronic arthritis – DD & investigations
4. Osteochondritis dessicans
5. Congenital amputations of lower limb in children
6. Haemophilia knee
7. Compound palmar ganglia
8. Ulnar claw hand
9. Pes planus
10. Mono ostotoc fibrous dysplasia

Paper III

1) Recent advances in the management of intraarticular fractures of upper end of tibia
2) Short notes on :
i) Rationale of surgical treatment of recurrent dislocation of shoulder
ii) Hangmans fracture
iii) Calcaneum fracture
iv) Orthopaedic complications of high dose steroid
v) Sudeks Osteodystrophy

Paper IV

1) Describe the mechanism of calcium homeostasis by parathyroid hormone and the skeletal changes that occur as a result of hyperparathyroidism. Discuss the uses and limitations of lab investigations in the diagnosis of primary hyperparathyroidism
2) Short notes on :
i) BMP
ii) 2nd line of ATT
iii) Acute ankle sprain
iv) Growth plate & its functions
v) Stress, strain & modulus of elasticity in relationship to implants.

Dec. 2002

Paper I

1) Aetiology, Pathology & Mx of Spinal canal stenosis
2) Short notes on :
i) Tension pneumpthorax
ii) Non specific synovitis
iii) Painful arc syndrome
iv) metastatic lesion of bone & tis management
v) Crush Syndrome

Paper II

1) Pathogenesis, Clinical features & management of Caries spine in a child 10 yrs old
2) Short notes on :
i) Intrinsic muscles hand
ii) fibrous dysplasia
iii) Habittual dislocation patella
iv) LASER Therapy
v) Amputations in children

Paper III

1) Management of fracture pelvis and their complications
2) Short notes on :
i) Cerebral diplegia? Line of Management?
ii) Multiple myelpma – Investigations & Management?
iii) Pes Planus –etiology & Management?
iv) Investigations of Pain in Hand?
v) Rationale of surgical Rx for recurrent anterior dislocation shoulder?

Paper IV

1) Blood supply of head of femur in diff age groups?Management of Idiopathic AVN of Femur?
2) Short notes on :
i) Osteogenesis imperfecta
ii) Cubitus Varus
iii) Renal Rickets
iv) Sudecks dystrophy
v) Neurogenic Bladder

June 2002

Paper I

1) Describe the various approaches to the spine
2) Short notes on :
i) Recurrent dislocation of patella
ii) Compression plating
iii) Hallux valgus
iv) Volkmans ischaemic contracture
v) Ewings sarcoma

Paper II

1) Describe the management of claw hand
2) Short notes on :
i) CTEV
ii) Septic arthritis of hip in a child below 5 years and above 3years
iii) Epiphyseal injuries
iv) Principles of amputation in children
v) Calcaneovalgus foot

Paper III

1.Treatment of ununited fracture neck of femur
2.Treatment of intercondylar fracture of humerus
3.Investigation of collapse of a vertebra
4.Osteomalacia
5.Osteogenesis imperfecta
6.Post Polio Residual Paralysis
7.Diagnostic criteria of osteolytic lesion in upper end tibia
8.Pilon fracture
9.Brodies abscess
10. Costo clavicular syndrome

Paper IV

1) Describe the Anatomy of recurrent dislocation shoulder? Discuss Management
2) Short notes on :
i) Ceramics In Orthopaedics
ii) Bone grafts
iii) Hyper parathyroidism
iv) Pigmented villonodular synovitis
v) Pes planus

2001

Paper I

1. OA Knee – pathophysiology. Discuss rationale of surgical management of OA Knee
2. Short notes on :
i) Renal Rickets – Pathophysiology
ii) Thoracic Outlet Syndrome
iii) Hand to Knee gait in Polio
iv) Wallerian Degenration
v) Endotoxic Shock

Paper II

1. Pathomechanics, Clincal features & Management of various deformities in RA – hand?
2. Short notes on :
i) Pseudoarthrosis
ii) Neglected Cong. Talipes Equino varus
iii) Electromyography
iv) Osteochondromatosis
v) Suction socket prosthesis

Paper III

1.Discuss the pathological alterations of femoral neck & head in neglected & ununited femoral neck fractures and their management?
2. Short notes on :
i) Traumatic paraplegia
ii) Fractures at the upper end of humerus
iii) Intercarpal instability
iv) Two level fracture of shaft of tibia
v) Fractures and dislocation of talus

Paper IV

1. Describe the development of vertebral column.Pathogenesis and management of potts paraplegia. Discuss the treatment of resistant cases?
2. Short notes on :
i) Biodegradable implants
ii) Rigid flat foot
iii) wrist drop
iv) Compartment Syndrome
v) Symes amputation

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