AIPGMEE 2016 MCQ orthopedics

In relation to Tillaux fractures, in which order does the distal tibial physis close?

a. Central – medial – lateral; anterior – posterior.
b. Central – lateral – medial; anterior – posterior.
c. Central – medial – lateral; posterior – anterior.
d. Central – lateral – medial; posterior – anterior.
e. Medial – central – lateral; posterior – anterior.

Ans- c. Central – medial – lateral; posterior – anterior.

A Tillaux fracture is a Salter–Harris III avulsion injury of the anterolateral distal tibial
physis by the anterior tibiofibular ligament (ATFL). It occurs following a low energy
external rotation injury mechanism between the ages of 11 and 15 more commonly in girls
and during sporting activities. It is the sequence of physeal closure at the distal tibia
which accounts for this pattern of injury. Physeal closure begins with the central third,
followed by the medial third and lastly the lateral third. Closure also occurs in a posterior to
anterior direction and therefore, with injury, the strong ATFL avulses the relatively weak
anterolateral portion of the epiphysis. The fragment is usually displaced anterolaterally and
there may be associated diastasis. The Tillaux fragment should be fixed if displacement
is >2 mm.

AIPGMEE 2016 MCQ

A 3-year-old girl is brought to the emergency department by her mother with a chief
complaint of abdominal pain for 2 hours. Fever, vomiting, and diarrhea are denied by
the mother, who has been drinking alcohol. Vital signs are blood pressure 86/40
mmHg, pulse 130 beats per minute, respirations 24 per minute, temperature 37°C, and
room air oxygen saturation 100%. The child's abdomen is distended and tender. A
contusion is visible in the right upper quadrant, and bowel sounds are diminished.
Older bruises are seen on the upper arms, anterior thighs, and buttocks. A screening
ultrasound reveals fluid between the liver and the kidney. The mother denies trauma
but becomes very tearful. An IV is started, and blood is sent to the laboratory.
What is the next MOST appropriate sequence of events?
(A) Consult surgery, and contact social services.
(B) Ask the child what happened, consult surgery, and contact social services.
(C) Contact social services, then consult surgery.
(D) Contact surgery, and notify law enforcement directly.

The answer is B
In cases of suspected child abuse it is important and
useful to ask the child what happened and to record the response verbatim.
Regardless of the child's answer, her intra-abdominal injury takes immediate
priority, so consult surgery, then social services. The EP is obligated to report
all cases of suspected child abuse. Most EDs have social services workers to
facilitate notification of child protective services, which would coordinate any
immediate need for law enforcement. Along with head injuries, intra-abdominal
injuries are the two most common causes of death from child abuse. Abdominal
symptoms include pain, tenderness, vomiting, decreased bowel sounds, and distension.
Obvious trauma may be absent or denied historically. Potential injuries include
duodenal hematoma, hepatic or splenic rupture, intestinal perforation, traumatic
pancreatitis, renal trauma, and ruptured intra-abdominal blood vessels.

AIPGMEE 2016 MCQ Neurology Medicine

A 60-year-old man consulted a neurologist with a complaint of transient episodes consisting of light-headedness, vision disturbances, nausea, and unsteadiness. Angiographic examination revealed that the patient had a vascular occlusion of the right middle cerebral artery. A computed tomography (CT) scan revealed the presence of lesions in the inferior aspect of the right temporal lobe. The visual disorder most likely experienced by the patient is:
a. Total loss of vision in the left eye
b. Inability to see objects in the temporal visual fields of both eyes
c. Inability to see objects in the left superior quadrants of both eyes
d. Inability to see objects in the left inferior quadrants of both eyes
e. Inability to see objects in the left visual field of both eyes
Answer: c
A lesion in the inferior temporal lobe is likely to damage Meyer's loop. This loop contains fibers from the inferior halves of the retinae that carry information about the superior visual fields. Since the damage is in the right Meyer's loop, the vision will be lost in both eyes: the superior quadrant of the nasal visual field of the right eye and the superior quadrant of the temporal visual field of the left eye. This disorder is referred to as a “superior left homonymous quadrantanopia,” “contralateral superior homonymous quadrantanopia,” or “pie in the sky visual defect.

AIPGMEE 2016 MCQ Medicine CNS

An adult male suffering from chills, fever, headache, nausea,
vomiting, and pain in the back was admitted to the
emergency room and diagnosed as having meningococcal
meningitis. Which of the following changes are most
likely in the composition of the cerebrospinal fl uid of this
patient?
a. Increased protein, decreased glucose, and increased
polymorphonuclear white blood cells
b. Increased protein, normal glucose, and excessive
number of lymphocytes
c. Increased protein, normal glucose, and a few white
blood cells
d. Increased protein, normal glucose, and presence of
tumor cells and white blood cells
e. Increased protein, increased glucose, and a few white
blood cells
Answer: a
Increased protein, decreased glucose, and increased polymorphonuclear
WBCs are observed in the cerebrospinal fl uid
(CSF) of patients with bacterial meningitis. The glucose levels
in CSF decrease because the bacteria present in CSF (usually
meningococcus, pneumococcus, and Haemophilus infl uenzae
organisms) use glucose. The CSF glucose levels are low in
tubercular meningitis also; however, in this condition, the cells
in CSF are predominantly lymphocytes. In viral meningitis, the
glucose levels in CSF remain normal because, in this condition,
the viruses do not use glucose. In addition, the number of
lymphocytes present in the CSF is excessive.

AIPGMEE 2016 MCQ Physiology Special Senses

Which of the following taste sensations is the most sensitive (i.e., has the lowest stimulation threshold)?
(A) Acid
(B) Bitter
(C) Salty
(D) Sour
(E) Sweet
Answer
(B) The bitter taste sense is much more sensitive than the others because it provides an important pro
tective function against many dangerous toxins in food.

AIPGMEE 2016 MCQ Surgery

The reticuloendothelial function of the liver is primarily dependent on which of the following cells?
A. Hepatocytes
B. Kupffer cells
C. Histiocytes
D. Ito cells
E. All of the above

COMMENTS: The reticuloendothelial system (RES) functions
to clear the circulation of particulate matter and microbes. The RES
consists of fixed phagocytic cells located primarily in the liver,
spleen, and lungs. Kupffer cells are responsible for the reticuloendothelial
function of the liver. Located along the lining of the
hepatic sinusoids (along with the sinusoidal endothelial cells), they
are uniquely positioned to phagocytize and process gut antigens
from the splanchnic and systemic circulation. Kupffer cells play an
important role in the production and control of various cytokines
and inflammatory regulators. Histiocytes are macrophages in connective
tissue. Ito cells, also call hepatic stellate cells, are perisinusoidal
cells involved in collagen and vitamin A metabolism.

A N S W E R : B

MCQ Anatomy AIPGMEE 2016

Which of the following is an example of a cartilaginous joint?
(A) Humeroulnar joint
(B) Middle radioulnar joint
(C) Intervertebral disc joint
(D) Cranial sutural joint