Q-21. Bohler’s angle is measured in the fractures involving
a) Calcaneum
b) Talus
c) Navicular
d) Cuboid
Answer: Calcaneum
Explanation:
Bohler’s angle and the crucial angle of Gissane are being used to assess calcaneal fractures.
Normal Bohler’s angle: 24-40 degree
Normal Crucial angle of Gissane: Approx 100 degree
Important point:
Reduction of normal Bohler’s angle or an increase in crucial angle of Gissane indicates intra-articular fracture of calcaneum.
Q-8. Most common force involved in fracture of the spine
a) Flexion
b) Extension
c) Rotation
d) Compression
Answer: Flexion
Explanation:
Flexion is the most common force operative in spinal injury.
Q-22. Mechanism of violence in burst fracture of spine
a) Compression violence
b) Flexion violence
c) Extension violence
d) Distraction violence
Answer: Compression violence
Explanation:
The burst fracture is a specific form of compression fracture of the vertebral.
Q-23. Which of bone tumor occurs in the epiphysis?
a) Osteoclastoma
b) Ewing’s sarcoma
c) Chondro – myxoid fibroma
d) Osteosarcoma
Answer: Osteoclastoma
Explanation:
Epiphyseal location of tumors:
Osteo-blastoma
Osteoclastoma
Q-24. 15 year old boy presented with a mass In the distal femur. X-ray from the lesion showed features of Codman’s triangle and sunray appearance. The diagnosis is
a) Osteosarcoma
b) Ewing’s sarcoma
c) Osteoclastoma
d) Chondroblastoma
Answer: Osteosarcoma
Explanation:
Radiological characteristics of tumors:
Osteosarcoma: Codman’s triangle and sun ray appearance
Osteoclastoma: Soap bubble appearance
Ewing’s sarcoma: Onion peel appearance
Chondroblastoma: Sclerotic border with scattered calcification
Important point:
Codman’s triangle although typical of osteosarcoma, can also be seen in Ewing’s sarcoma.
Q-25. Which of the following investigations is not required in osteosarcoma?
a) MRI femur
b) Bone marrow biopsy
c) CT chest
d) Bone scan
Answer: Bone marrow biopsy
Explanation:
Osteosarcoma: Staging investigations
CT/ MRI of lesion
Bone scan
X-ray chest/ CT chest
Osteosarcoma: Grading
Biopsy from lesion
Important point:
Bone marrow biopsy is not indicated in osteosarcoma.
Q-26. Which of the following is a pulsating tumor of bone?
a) Osteosarcoma
b) Chondrosarcoma
c) Ewing’s sarcoma
d) Eosinophilic granuloma
Answer: Osteosarcoma
Explanation:
Primary tumors that may present as pulsating lesions:
Telangiectatic Osteogenic sarcoma
Angio-endothelioma/Angio-sarcoma of bone
Aneurysmal bone cyst
Giant cell tumor (rarely)
Q-27. A patient presents with hetero-topic ossification around the knee joint. The laboratory investigation of choice in him is
a) Serum calcium
b) Serum alkaline phosphatase
c) Serum phosphorus
d) Serum Acid phosphatase
Answer: Serum alkaline phosphatase
Explanation:
Fibro-dysplasia ossificans progressiva is a disorder in which muscle tissue and connective tissue such as tendons and ligaments are gradually replaced by bone (ossified), forming bone outside the skeleton (extra-skeletal or hetero-topic bone) that constrains movement.
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
Q-28. Which of these muscles undergoes wasting first in osteoarthritis knee?
a) Quadriceps only
b) Hamstrings only
c) Both quadriceps and hamstrings
d) Gastrocnemius
Answer: Quadriceps only
Explanation:
All per-articular muscles around the knee joint may undergo wasting in advanced osteoarthritis knee.
Quadriceps is the earliest muscle to undergo wasting.
Q-29. Autologous bone graft is commonly taken from
a) Tibial tuberosity
b) Iliac crest
c) Greater trochanters
d) Fibula
Answer: Iliac crest
Explanation:
Autogenous bone grafting:
The iliac crest is currently the most common donor site for obtaining autogenous bone graft. The ilium has been identified as an excellent source of both cortical and cancellous bone. Both the anterior and posterior portions of the iliac crest are often used for the purpose of bone grafting.
Autologous bone is typically harvested from extra-oral sources as the iliac crest, the fibula, the ribs, the mandible and even parts of the skull or intra-oral sources as the chin.
Bone can be harvested in oral and maxillofacial surgery, from the mandibular symphysis (chin area) or anterior mandibular ramus (the coronoid process)
Q-30. Which of the following statement about “Low radial nerve palsy” is not true?
a) Loss of nerve supply to brachio-radialis
b) Loss of nerve supply to extensor carpi radialis brevis
c) Loss of nerve supply to extensor pollicis brevis
d) Loss of sensation over first dorsal web space
Answer: Loss of nerve supply to brachio-radialis
Explanation:
High radial nerve palsy (Above level of elbow joint): Motor loss
Proximal to spiral groove: Triceps (Long and medial head)
In spiral groove: Triceps and Anconeus
Between spiral groove and lateral condyle: Triceps, Anconeus, Brachialis, Brachio-radialis, and Extensor carpi radialis longus
Low radial nerve palsy (At the level of elbow joint): Motor loss
Muscles supplied by radial nerve in distal arm including brachio-radialis, and extensor carpi radialis longus are spared.