Q-11. Brown tumors are seen in
a) Hyperparathyroidism
b) Pigmented villo-nodular Synovitis
c) Osteomalacia
d) Neurofibromatosis
Answer: Hyperparathyroidism
Explanation:
The brown tumor is a bone lesion that arises in settings of excess osteoclast activity, such as hyperparathyroidism.
Most of brown tumors are associated with secondary hyperparathyroidism.
Hemosiderin imparts the brown color (hence the name of the lesions). It is not a true neoplasm.
Brown tumors are radiolucent on x-ray.
Q-12. Which of the following malignant tumors is radio-resistant?
a) Ewing’s sarcoma
b) Retinoblastoma
c) Osteosarcoma
d) Neuroblastoma
Answer: Osteosarcoma
Explanation:
Radio-resistant tumors are those that do not respond to radiotherapy. This group includes:
Bone and Cartilage Tumors:
Osteogenic sarcoma
Ewing’s sarcoma
Fibro-sarcoma of bone
Chondrosarcoma
Soft tissue tumors:
Fibro-sarcoma
Lipo-sarcoma
Myosarcoma
Q-13. Expansile lytic osseous metastases are characteristics of primary malignancy of
a) Kidney
b) Bronchus
c) Breast
d) Prostate
Answer: Kidney
Explanation:
Osteolytic metastasis:
Kidney (Expansile)
Thyroid
Lung
GI Tract
Breast (Occasionally)
Q-14. Rugger Jersey spine is seen in
a) Fluorosis
b) Achondroplasia
c) Marfan’s syndrome
d) Renal Osteo-dystrophy
Answer: Renal Osteo-dystrophy
Explanation:
Renal Osteo-dystrophy:
It is the constellation of musculoskeletal abnormalities that occur in patients with chronic renal failure, due to concurrent and superimposed:
Osteomalacia/ rickets
Secondary hyperparathyroidism (abnormal calcium and phosphate metabolism)
Aluminum intoxication, e.g. if the patient is on dialysis
Imaging findings:
Osteopaenia: often seen early
Thinning of cortices and trabeculae
Salt and pepper skull
Sub-periosteal re-sorption: characteristic sub-periosteal re-sorption may be seen on radial aspects of middle phalanges of index and long fingers.
Rugger-jersey spine: sclerosis of the vertebral body end plates
Demineralization
Soft tissue calcification
Amyloid deposition
Fractures
Q-15. Which of the following is a marker of new bone formation?
a) Acid phosphatase
b) Alkaline phosphatase
c) Telo-peptidase
d) Hydroxy-proline
Answer: Alkaline phosphatase
Explanation:
List of bone formation markers is as follows:
Serum total alkaline phosphatase
Serum bone–specific alkaline phosphatase
Serum osteocalcin
Serum type 1 pro-collagen (C-terminal/N-terminal): C1NP or P1NP
List of bone re-sorption markers is as follows:
Urinary hydroxy-proline
Urinary total pyridinoline (PYD)
Urinary free deoxy-pyridinoline (DPD)
Urinary collagen type 1 cross-linked N-telo-peptide (NTX)
Urinary or serum collagen type 1 cross-linked C-telo-peptide (CTX)
Bone sialo-protein (BSP)
Tartrate-resistant acid phosphatase 5b
Q-16. Tube cast applied in fracture around
a) Shoulder
b) Hip
c) Pelvis
d) Knee
Answer: Knee
Explanation:
Tube cast or cylinder cast is used for un-displaced fracture of patella.
Q-17. Which is not a deep heat therapy?
a) Short wave diathermy
b) Infrared therapy
c) Ultra sound therapy
d) Interferential therapy
Answer: Infrared therapy
Explanation:
Superficial heat therapy:
Hot water bottle/ Warm bath/ Wax bath
Infra-red lamp
Deep heat therapy:
Short wave diathermy
Ultra sound therapy
Interferential therapy
Microwaves
Q-18. Claw hand is caused by lesion involving:
a) Ulnar nerve
b) Median nerve
c) Radial nerve
d) Posterior interosseous nerve
Answer: Ulnar nerve
Explanation:
Claw hand is characterized by hyper-extension at metacarpo-phalangeal joint and flexion at inter-phalangeal joints.
It is caused by paralysis of lumbricals. Lateral two lumbricals are supplied by median nerve and medial two lumbricals are supplied by ulnar nerve.
Ulnar claw hand is caused by ulnar nerve paralysis.
Complete or total claw hand: Combined ulnar and median nerve palsy
Q-19. Meralgia paresthetica is due to the involvement of
a) Medial cutaneous nerve of thigh
b) Lateral cutaneous nerve of thigh
c) Sural nerve
d) Femoral nerve
Answer: Lateral cutaneous nerve of thigh
Explanation:
Nerve entrapment syndromes result from chronic injury to a nerve as it travels through an osseo-ligamentous tunnel; the compression is typically between the ligamentous canal and bony surfaces.
Other potential anatomical sites for entrapment include the muscular arcade of the supinator (Arcade of Frohse)) for the posterior interosseous nerve, and the thoracic outlet for the lower trunk of the brachial plexus.
Carpal tunnel syndrome, compression of the median nerve at the wrist, is the most common entrapment neuropathy.
Cubital tunnel syndrome is the second most common and is caused by a compression of ulnar nerve at the elbow.
Other rare nerve entrapment syndromes include the supra-scapular nerve of upper girdle pain symptoms, and meralgia paresthetica, which is a compression of the lateral cutaneous nerve of thigh in the groin.
Q-20. All of the following nerves are involved in entrapment neuropathy except
a) Femoral nerve
b) Median nerve
c) Ulnar nerve
d) Lateral cutaneous nerve of thigh
Answer: Femoral nerve
Explanation: See above explanation