Saturday, December 16, 2017

December 2017 DNB Orthopaedics

1.        
a)      What is tibia vara?
b)      Classify tibia vara?
c)       Conventional management of tibia vara and recent advances in its  management

2.            Anterior Interosseous Nerve Syndrome
a)              Enumerate its etiology and clinical features
b)             What are the diagnostic tests for it?
c)              Its treatment protocol

3.        
a)                What is impingement syndrome (Shoulder)?
b)              Pathophysiology of rotator cuff tear?
c)               Various imaging modalities for it?
d)              Diagnostic tests (describe any two)
e)              Management outline

4.        
a)                Enumerate the surgical approaches to reduce and fix pilon fracture
b)              Enumerate steps of posterolateral approach
c)               Enumerate its advantage and disadvantages


5.        
a)               Define spondylolisthesis
b)              Its classification in adults
c)               Clinical features and diagnostic tests
d)              Treatment protocol

6.        
a)             Etiopathogenesis of rheumatoid arthritis
b)             Common deformities of rheumatoid hand and their mechanisms
c)              Enumerate the various drugs used for the management of rheumatoid arthritis


7.        
a)              Indications of spinal osteotomy in a young patient of ankylosing spondylitis
b)             Enumerate osteotomy techniques and their principles
c)              Potential complications of spinal osteotomy


8.         Madelung’s deformity:  
a)        Classification
b)        Pathological anatomy
c)         Management protocol


9.        
a)         Methods of closing gaps between nerve ends during nerve repair
b)         Enumerate expandable nerves
c)          Donor site morbidity of common donor nerves

10.    
a)        Steps of posterior approach to hip joint while performing total hip arthroplasty
b)        Potential complications
c)         What are its advantages and disadvantages as compared to anterior approach?



11.    
a)         Define gait
b)          Outline phases of gait
c)          Define eccentric and concentric muscle contraction.
d)         Give one example of each contraction in the gait cycle

12.    
a)        Types of brachial plexus injuries around birth
b)        Mechanism of causation
c)         Clinical features in a newborn
d)        Management of a neglected/undiagnosed erb’s palsy in a 3 year old child

13.    
a)        Level of Syme’s amputation
b)        Merits and demerits of Syme’s amputation
c)         Modification of Syme’s amputation
d)        Prosthetic management after Syme’s amputation


14.    
a)        Classification of congenital scoliosis
b)        Treatment guidelines in young children with adequate growth potential

15.    
a)        What is Virchow’s triad?
b)        Enumerate the risk factors for developing deep vein thrombosis (DVT)
c)         Prophylactic treatment for DVT


16.    
a)        Terrible triad in elbow fracture dislocation
b)        Clinical cases in acute cases
c)         Management outline
d)        Short term and long complications

17.    
a)        What is flail chest?
b)        Clinical features of flail chest and its diagnostic methods in Emergency room
c)         Acute and definitive management of flail chest

18.    
a)        Classify tibial condylar fractures
b)        Outline its management principles according to classification
c)         Potential complications of tibial condylar fractures and their management

19.    
a)      Classify odontoid fractures
b)      Mechanism of injury
c)       Clinical features of an acute odontoid fracture
d)      Management of acute odontoid fractures

20.    
a)      Classify acromioclavicular joint injuries
b)      Imaging techniques for its diagnosis
c)       Management protocol according to classification

21.    
a)        Define cerebral palsy(CP)
b)        Classify cerebral palsy
c)         Principle of dorsal root rhizotomy in management of static CP

22.    
a)        Risk factors of developing infections following total hip arthroplasty
b)        Classification of prosthetic joint infection
c)         Management protocol of joint infection

23.    
a)        What is Pes cavus?
b)        Classification of Pes cavus
c)         Causes of Pes cavus
d)        Coleman’s block test and its interpretation in Pes cavus.

24.    
a)        Enneking’s staging of benign and malignant bone tumours.
b)        Techniques of biopsy in aggressive (potentially malignant)bone tumours.

25.    
a)        Classify congenital failure of formation of limbs
b)        Pappas classification for congenital femoral deficiency
c)         Management protocol according to Pappas classification



26.    
a)        Define end vertebrae and apical vertebrae in adolescent Idiopathic scoliosis (AIS)
b)        Describe two radiological method to measure the curve in AIS
c)         Fusion technique of correction in idiopathic scoliosis

27.    
a)        Define Osteoporosis
b)        Enumerate  lab tests &  radiological tests to diagnose and prognosticate osteoporosis
c)         Mechanism of action of Teriparatide in treatment of osteoporosis
d)        Potential complication of teriparatide

28.    
a)        Orthopaedic manifestations of HIV infection
b)        Universal guidelines for surgeons while operating a patient with proven HIV infection

29.    
a)        Stulberg classification in Perthes disease
b)        What is hinged abduction
c)         Management principles/techniques for hinged abduction and coxa magna in healed Perthes disease

30.    
a)        What are synthetic bioabsorbable materials for orthopaedic surgery?
b)        Enumerate their advantages
c)         Enumerate their complications and limitations

31.    
a)        Role of posterior cruciate ligament (PCL) in total knee arthroplasty
b)        Benefits of PCL retention prosthesis
c)         Benefits of PCL substitution prosthesis

32.    
a)        Principles of Gamma Camera
b)        Radioactive substances used in Gamma Camera
c)         Indications and use of Gamma Camera

33.    
a)        Broad indications for hip arthroscopy
b)        Portal positioning for hip arthroscopy
c)         Potential complications of hip arthroscopy

34.    
a)        Causes of Intoeing of gait
b)        Radiological investigations and their interpretations in intoeing of gait
c)         Its management protocol



35.    
a)        Indication and contraindications of total elbow arthroplasty
b)        What are the complications of total elbow arthroplasty
c)         Changes in design to reduce complications

36.    
a)        Define stress fracture.
b)        Enumerate common sites for stress fractures
c)         Causes of stress fractures
d)        Clinical features, classification and management of stress fracture of femoral neck in young adults

37.    
a)        Classify proximal radial fractures in children
b)        Its management principles in fresh fractures
c)         Management principles in malunited fractures

38.    
a)        Define amputation
b)        Enumerate the indications for amputation
c)         Discuss any one objective method to decide amputation /limb salvage after traumatic limb injury
39.    
a)        Effects of polytrauma on respiratory physiology
b)        What is ‘second hit phenomena’?
c)         Principles of damage control orthopaedics.

40.    
a)        Discuss wound ballistics briefly
b)        Pathologic anatomy of ballistic wound and its management principles




Saturday, June 17, 2017

DNB Orthopaedics June 2017

1.      Part 1


  • Define osteoporosis. b) Enumerate various causes of osteoporosis. c) Enumerate techniques for bone mass measurement. d) Drug therapy available for osteoporosis.
  • 2. a) What is renal osteodystrophy? b) Enumerate its causes. c) Its clinical and radiological features. d) Management of renal osteodystrophy
  • 3. a) Role of Biofilm in implant infection in orthopedics. b) Biomechanics and clinical uses of floor reaction orthosis.
  • 4. a) Anatomy of rotator cuff. b) Clinical tests to diagnose rotator cuff tears, and outline its management.
  • a) Nerve supply of urinary bladder. b) Patho-physiology and management of autonomous bladder.
  • 6.     a) Patho-physiology of compartment syndrome. b) Clinical signs of compartment syndrome. c) Principles of management of compartment syndrome.
  • 7.       a) What is Milwaukee Shoulder Syndrome? b) Its clinical signs and symptoms. c) Its differential diagnosis and management.
  • 8.       a) Pathophysiology of peripheral nerve regeneration following axonotmesis. b) Anatomy and contents of carpal tunnel with suitable diagram(s).
  • 9.       a) Clinical signs and symptoms of a neglected Tendo-Achilles rupture in a middle aged man. b) Outline its management.
  • 10. a) Clinical and radiological features of aseptic loosening after cementless THA (Total hip arthroplasty). b) Classification of cavus deformity.
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Part 2

  •       a) Surgical anatomy of Ganz approach to hip joint. b) Indications of Ganz approach to hip joint.
  • 2.         a) Management of acute septic arthritis of hip in an infant. b) Give any one classification system for septic sequelae of hip in children.
  • 3.       a) Symptoms and clinical signs of a rigid pes planus deformity. b) Radiological features of congenital vertical tallus.
  • 4.       a) Clinical work up and laboratory diagnosis of metastatic bone tumours. b) Outline management principles of these in long bones.
  • 5.       a) Define spondylolisthesis. b) Its classification in adults c) Its clinical features and radiological signs. d) Outline its management.
  • 6.        Clinical features, radiological features, differential diagnosis and management principles of unilateral coxa vara in a toddler.
  • 7.       a) What is triple deformity of the knee? b) What are its causes? c) Its management in TB arthritis of the knee
  • 8.        a) Indication and surgical method of Zancolli’s capsulodesis. b) Clinical features and management of discoid meniscus.
  • 9.       Clinical presentation, radiological features and management of: a) Chondromyxoid fibroma of distal femur. b) Osteoid osteoma of femoral neck.
  • a) Prophylactic management of deep vein thrombosis before hip surgery. b) Fat embolism following fracture shaft femur in a young adult in casualty.
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Part 3

  • 1.       a) What is terrible triad of elbow and how will you manage it? b) Principles of management of intercondylar fracture humerus and Bryan Morrey approach (Triceps reflecting approach).
  • 2.        a) Classify the ankle fractures (Give any one system). b) How will you manage supination external rotation injury?
  • 3.       a) Perilunate fracture dislocation and its management in an acute case. b) Potential complications of a chronic perilunate fracture dislocation.
  • 4.        a) Various clinical tests to assess glenohumeral instability. b) How will you manage anterior dislocation of shoulder with Bankart lesion & Hill-Sachs lesion associated with dislocation?
  • 5.        a) What are the options available for the management of fracture of proximal third of femur in an adolescent? b) Advantages and disadvantages of each method.
  • 6.        a) What are the types of fracture healing? b) Outline stages of endochondral fracture repair
  • 7.        a) What is reconstructive ladder for open factures? b) What is negative wound therapy? c) What is fix and close protocol in open fractures?
  • 8.        a) Blood supply of scaphoid bone. b) Classify scaphoid fractures. c) Management of displaced, unstable scaphoid fractures.
  • 9.        a) How will you manage Gustilo-Anderson Type IIIb fracture of distal femur? b) Compare pros and cons of angular stable device and dynamic compression screw for distal femur fractures. c) Approach to bicondylar Hoffa’s fracture.
  • 10.    a) How will you treat unifacetal fracture dislocation of C5 C6? b) What are the types of cord injuries? c) Role of methyl prednisolone succinate in spinal cord injuries
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Part 4

  • 1.       a) Molecular tests used in multidrug resistant tuberculosis. b) Dosage & important side effects of second line drugs in osteoarticular tuberculosis. c) Role of PET to assess healing in osteoarticular tuberculosis.
  • 2.        a) What is the method to prepare Plasma Rich Plasma (PRP)? b) What are the indications of PRP in orthopedic lesions? How does it work? c) Role of local injection of steroid versus PRP in plantar fasciitis?
  • 3.       . a) Different constructs of external fixators. b) What are the latest advances in constructs of external fixator?
  • 4.         a) What is nanotechnology? b) Role of nanotechnology in orthopaedics. c) Recent advances in detection of periprosthetic joint infections.
  • 5.        a) Management of marrow oedema syndrome b) Management of SLAP lesions.
  • 6.        a) What are stem cells? How stem cells are procured for therapeutic use? b) Indications of stem cell therapy in orthopaedics. c) Role of stem cell therapy in avascular necrosis of head of femur.
  • 7.        a) Role of templating in Total Hip Arthroplasty (THA). b) Outline the steps of templating in protrusio acetabuli and a laterised hip with suitable diagrams.
  • 8.        a) What are the various types of grafts used to reconstruct ACL? b) What is double bundle ACL reconstruction? c) Steps to reconstruct multi-ligamentous injury around knee.
  • 9.        a) Role of navigation in total knee arthroplasty. b) What precautions you will take while doing total knee arthroplasty with fixed flexion and valgus deformity in knee?

  • 10.   Recent advances in cup and stem designs of cemented and uncemented hips

DNB Ortho December 2016 Papers

1. a) Physiology of calcium metabolism.
b) Role of PTH in calcium metabolism.
c) Tabulate the biochemical differences between renal tubular
and glomerular rickets.

2. a) Ganga score.
b) Vacuum assisted closure of wounds.

3. Pathophysiology, clinical features and management of septic
arthritis of hip in a neonate.

4. a) Use of Plaster of Paris in orthopaedics and precautions in
applying hip spica.
b) Principles of functional cast bracing.

5. a) Types of bone grafts
b) Principles of bone banking.

6. a) Define osteoporosis. How will you assess for osteoporosis?
b) Principles of management of fragility (osteoporotic)
fractures of long bones.

7. a) Histology of growth plate.
b) Factors causing growth disturbance.
c) Principles of guided growth modulation.

8. a) Radiological features for the diagnosis of tuberculosis of
spine.
b) Radiological features of scurvy and rickets.

9. a) Blood supply of femoral head in various age groups.
b) Role of Virchow’s triad in the pathogenesis of DVT.

10. a) Clinical features of chronic painful mid portion tendinopathy
of Achilles tendon.
b) Role of plantaris tendon in the pathogenesis of this
condition; with special emphasis on anatomy of plantaris
tendon
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Part 2
1. a) Clinical and radiological features of developmental
dyplasia of hip.
b) Types of pelvic osteotomies for acetabular dysplasia.

2. a) Classify torticollis.
b) Management of torticollis.
c) Sprengel shoulder deformity.

3. a) Intrinsic plus hand.
b) Ulnar paradox.

4. a) Patho-anatomy and Pirani scoring in congenital talipes
equino varus.
b) Steps of Ponsetti manipulation and serial cast application.

5. a) Define Perthes’ disease
b) Aetiological factors, classification systems and head-at-risk
signs of Perthes’ disease.

6. a) Staging of bone tumours.
b) Principles, indications and contraindications of limb
salvage surgery.

7. a) Outline the technical steps to achieve desired degree of
version of acetabular & femoral components during THR.
b) What is combined angle of anteversion?
c) How will you modify your version in a case of fixed lumbar
lordosis or flat back?

8. a) Pathology and clinical features of acute hematogenous
osteomyelitis in long bone.
b) Management of chronic osteomyelitis of long bone.

9. a) Pathogenesis and diagnosis of Bankart’s lesion.
b) Anterolateral decompression in tuberculosis of spine.

10. a) Aetiopathogeneis of hand to knee gait.
b) Biomechanical features of floor reaction orthosis.
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Part 3
1. a) ATLS guidelines in polytrauma management.
b) Early Total Care (ETC ) in polytrauma and its indications.

2. a) Classify nerve injuries.
b) How will you manage a 1½ year old child with median
nerve injury in the middle of the arm?

3. a) Indications & techniques of hip arthroscopy.
b) Can you manage an incongruent reduction after a reduced
hip dislocation because of loose body with hip
arthroscopy?
c) What is an absolute contraindication to manage such a
case with conventional hip arthroscopy?

4. A 5 years old child starts developing a progressive valgus
deformity of tibia after an insignificant trauma to the knee.
What is the possible cause and pathogenesis of such a
deformity? How will you treat this condition?

5. a) Classify distal femoral fractures.
b) Management algorithm for such fractures.
6. a) Management of Volar Barton’s fracture.
b) Pathological anatomy and management of trans-scaphoid
perilunate dislocation.

7. a) Classify injuries of thoraco-lumbar spine.
b) Outline management of each type.

8. a) Classify fractures around the elbow in a six year old child.
b) Myositis ossificans – Diagnosis and management.

9. a) Management of postoperative knee stiffness.
b) Anatomy of posterolateral corner of knee & various
patterns of injuries in this area.

10. a) Masquelet technique: indication and steps in an infected
nonunion.
b) Evolution of different generations of cementing techniques
in arthroplasty.
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Part 4
1. a) Bearing surfaces in total hip replacement.
b) Investigation and management of dislocation of hip after
total hip arthroplasty.

2. a) Principles of reverse shoulder replacement. Enumerate its
indications.
b) Radial head prosthesis - Design & technique of
implantation.
3. a) Endoscopic spinal surgery - technique.
b) What is sacral nutation & its role in chronic low backache.

4. a) Salient features of tensile elastic nailing & technique of
implantation.
b) Low molecular weight heparin – Indications & monitoring
during treatment.

5. a) Clinical features of transient migratory osteoporosis of hip
(TMO).
b) Tabulate the differences between osteonecrosis and
transient migratory osteoporosis of hip.
c) Enumerate the steps of managing TMO.
6. a) Management of degenerative arthritis of knee in the young
patients.
b) Visco supplementation for knee arthritis.
7. a) Enumerate the causes of painful stiff knee after total knee
replacement.
b) How will you investigate and manage such a case?

8. a) Arthroscopic management of osteochondral lesion of knee.
b) Etiology of osteochondritis dessicans.

9. a) Modified Stoppa’s approach for acetabulum fractures.
b) Classification of brachial plexus injury.

10. a) Define drug resistant tuberculosis.
b) How do you suspect drug resistance in spinal
tuberculosis?
c) How will you investigate and manage a case of suspected

drug resistant tuberculosis?