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A teenaged girl complains of pain in knee on climbing stairs and on getting up after sitting for a long time. What is the probable diagnosis?
A. Chondromalacia patellae
B. Plica syndrome
C. Bipartite patella
D. Patello-femoral osteoarthritis

ans:chondromalacia patella




Plica Syndrome (also known as Synovial Plica Syndrome) occurs when the plica (an extension of the protective synovial capsule of the knee) becomes irritated or inflamed.

Presentation and pathophysiology

This inflammation is typically caused by the plica being caught on the femur, or pinched between the femur and the patella. The most common location of plica tissue is along the medial (inside) side of the knee. The plica can tether the patella to the femur, be located between the femur and patella, or be located along the femoral condyle. If the plicae tethers the patella to the femoral condyle, the symptoms may cause it to be mistaken for Patello-femoral Syndrome. Because of this similarity in symptoms, Plica Syndrome is frequently misdiagnosed as Patello-femoral Syndrome. Diagnosis is often complicated by the thin structures of plicae, fenestrated septum or unfenestrated septum all being too fine to resolve well even in MRI.
The plica themselves are remnants of the fetal stage of development where the knee is divided into three compartments. The plica normally diminish in size during the second trimester of fetal development, as the three compartments develop into the synovial capsule. In adults, they normally exist as sleeves of tissue called synovial folds. The plica are usually harmless and unobtrusive; Plica Syndrome only occurs when the synovial capsule becomes irritated, which thickens the plica themselves (making them prone to irritation/inflammation, or being caught on the femur).

Which of the following is not included in parenteral nutrition?
A. Fat
B. Carbohydrate
C. Fiber
D. Micronutrients

ans:fiber

q7.All of the following are pneumatic bones except?
A. Frontal
B. Ethmoid
C. Mandible
D. Maxilla

ans: mandible

all other bone has air sinuses

q6.Which of the following is not a contraindication for pregnancy?
A. WPW syndrome
B. Pulmonary hypertension
C. Eisenmenger syndrome
D. Marfan syndrome with aortic root dilatation



ans:wpw syndrome

q4.Low dose oral contraceptive pill contains?
A. Levonorgestrel
B. Norgestrel
C. Desogestrel
D. Norethihisterone

ans:norethisterone

Which of the following antihypertensive drugs is contraindicated in a patient on Lithium in order to prevent toxicity?
A. Clonidine
B. Beta blockers
C. Calcium channel blockers
D. Diuretics

ans: diuretics it increases lithium toxicity

DRUG INTERACTIONS: Non-steroidal anti-inflammatory drugs (NSAIDs), [for example, ibuprofen , naproxen , indomethacin, nabumetone, diclofenac , ketorolac , reduce the kidney's ability to eliminate lithium and lead to elevated levels of lithium in the blood and lithium side effects. Blood concentrations of lithium may need to be measured for 4 to 7 days after an NSAID is either added or stopped during lithium therapy. Aspirin and sulindac do not appear to affect lithium concentrations in the blood.

Diuretics should be used cautiously in patients receiving lithium. Diuretics that act at the distal renal tubule, [for example, hydrochlorothiazide, spironolactone triamterene , can increase blood concentrations of lithium. Diuretics that act at the proximal tubule, [for example, acetazolamide (Diamox)], are more likely to reduce blood concentrations of lithium. Diuretics such as furosemide and bumetanide may have no affect on lithium concentrations in blood.

Q2.Which of the following contraception method is to be avoided in women with epilepsy?

A. Oral Contraceptive pill
B. IUCD
C. Condom
D. Mifepristone

ANS:ORAL CONTARCEPTIVE PILL


Epileptic women can use oral contraceptives safely, but some drugs (Phenobarbitol, Phenytoin, Carbamazepine, Primidone, Ethosuxamide and Topiramate) used in the treatment of epilepsy may reduce the contraceptive effectiveness of combined OCPs. The use of combined OCP preparations containing more than 35 ug of ethinyl estradiol is recommended for contraception in conjunction with these medications but other alternative contraception options should be considered first. Certain antiepileptic drugs may have teratogenic effects and therefore contraceptive reliability is important for a woman with epilepsy.

AIPGMEE 2011 :QUESTION & ANSWERS WITH EXPLANATIONS

Q1.Most common nerve injured in supracondylar fracture humerus?

A. Median
B. Radial
C. Ulnar
D. Anterior interosseous nerve

ANS:ANTERIOR INTEROSSEOUS NERVE



Nerve injury in supracondylar fracture of humerus


Nerve injuries occur in about 40% of type III (Gartland’s classification) supracondylar fractures

Earlier literature stated that radial nerve was the most commonly injured nerve in supracondylar fractures

But recent studies indicate that the anterior interosseous branch of median nerve is mostly affected

Nerve involvement differ with the type of fracture
Anterior interosseous nerve is mostly affected during posterolateral displacement of the distal fragment
Radial nerve is mostly affected with posteromedial displacement
Ulnar nerve is involved in flexion type of supracondylar fracture

AIPGMEE 2011 :QUESTION & ANSWERS WITH EXPLANATIONS

AIPGMEE 2011 QUESTION AND ANSWERS
RELIABLE EXPLANATIONS