image based Q. 88 - Manage damage

Q.  The term ' damage control Orthopaedics (DCO)' is a recognised element of emergency trauma care. Where does the term damage control relates to?


a. Anti- earthquake agencies
b. Armed forces
c. Red Cross
d. U.S. Navy
e. Space programmes

Answer -
d

U.S. Navy initially gave concept of damage control.  ' .... the capacity of ship to absorb damage and maintain mission integrity..' was the initial references for it.
in trauma settings, all efforts are directed for survival of patient and that requires careful management in damage control Orthopaedics.

image based Q. 87 - cotton and wool

Q.   Loose cotton swabs or sponges as retained foreign object during surgery later present and referred as all except?

a. Textiloma
b. Gossypiboma
c. Cottonoid
d. Incidentaloma

Answer -
d

All the rest options are synonymous to the problem described in the question.

Incidentaloma are incidental intraoperative findings when the clinician is least suspecting it and are usually reserved to neoplastic lesions.

image based Q. 86 - License to drill

Q.  Which of these is not associated with chronic osteomyelitis surgical  management?


a. Saucerization
b. Paprika sign
c. Curettage
d. Fenestration
e. Bone drilling
f. Sequestrectomy

Answer -
d

Bone drilling helps reduce intraosseous pressure and remove purulent material if any. It is also first step as a cortical window is made after multiple drilling followed by Curreattage of medullary bone for debridement and also sample collection.

Saucerization is another operation to achieve similar outcome.

Bone is curretted and debridement is done till all dead or diseased tissue is removed and multiple capillary bleeds are visible from normal native bone - multiple bleeding surface is also referred as 'paprika sign'.

Fenestration, on the other hand is spine surgical procedure for degenerative disorders.

image based Q. 85 - OPPL

Q.   OPPL ( ossification of posterior longitudinal ligament ) is a major cause of degenerative cervical spine myelopathy. All among below are associated with OPPL except?


a. Genetic/ environmental factor
b. Asian population
c. Advanced age
d. Higher periopertive complication
e. Ectopic bone formation

Answer -
c

OPPL has been more commonly found in Asian population but predominantly it affects younger age group .

image based Q. 84 - 'Why'

Q.  The letter 'Y' has association with following entities in orthopaedics except?


a. Ligament
b. Plate
c. Radiographic view
d. Angle

Answer -
d

Y ligament if Bigelow is also called iliofemoral ligament and is one of the strongest ligament of body that protects hip joint anteriorly.

Y plate is shaped in y shape and is used in distal humerus fractures or deformity corrections.
Scapular 'Y' view is true lateral view of shoulder showing scapula with glenoid as centre and scapula spine, body and rest in a Y shape.

There is no Y angle, however Q angle (quadriceps angle) is used for clinical study of various knee disorders.

image based Q. 83 - 'Pee's and 'Q's

Q.  Urine of long standing catheterization in an orthopaedic patient may at times likely be


a. Black
b. Purple
c. Cola coloured
d. Colourless
e. Dark yellow

Answer-
b

Purple urine or purple urine  bag syndrome (PUBS) is uncommon entity following prolonged indwelling catheterization. Urinary pigments following bacterial infection may result in indigo and indirubin pigment production the combination of indigo(blue) and indirubin(red) results in purple urine.

Dark yellow urine indicates cobcentrated urune with low fluid intake.

Cola coloured or black urine may result from myoglobulinuria, following conditions with muscle damage or injuries.

image based Q. 82 - genetic connection

Q.   The below case was diagnosed as osteosarcoma recently. Which of these genes is not associated in this condition as risk factor?



a. RECQL 4
b. RB 1
c. P 53
d. GNAS 1

Answer-
d

 The above three genes have been associated with heritable syndromes leading to increased risk of osteosarcoma.

RB 1 - congenital bilateral retinoblastoma.
RECQL 4 - Rothmund- Thomson syndrome
p 53 - Li Fraumeni syndrome

GNAS 1 has been associated with McCune Albright syndrome with link to Fibrous dysplasia ( in association with precocious puberty)