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?
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• 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?