Assistive Devices for Mobility — MCQs
Amputation is often not required in:
Which activity will be difficult to perform for a patient with an anterior cruciate deficient knee joint?
The kinetic energy of the body is least in one of the following phases of the walking cycle
Which of the following is the platinum-based chemotherapeutic agent used as first-line treatment for ovarian carcinoma?
A patient prescribed crutches for residual paralysis in poliomyelitis is a type of -
While using axillary crutches, elbow should be flexed to:
Mobile Medical Units (MMUs) under government health programs can operate through different models. Which of the following statements about MMU operations are correct? 1. MMUs are run by the government 2. MMUs are run by external agencies with medical supplies given by the government 3. MMUs are run by the government and medical supplies are also given by the government 4. MMUs are run by external agencies and medical supplies are also given by the external agency
The test performed below shows involvement of which of the following nerve?
Which of the following statement(s) is/are true?
Who invented the Jaipur foot?
Assistive Devices for Mobility Indian Medical PG Practice Questions and MCQs
Question 1: Amputation is often not required in:
- A. Buerger's
- B. Chronic osteomyelitis (Correct Answer)
- C. Diabetic gangrene
- D. Gas gangrene
Explanation: ***Chronic osteomyelitis*** - While chronic osteomyelitis can be severe, advancements in **antibiotic therapy**, **surgical debridement**, and **reconstructive procedures** often allow for limb salvage. - The goal of treatment is to eradicate infection and preserve function, making amputation a last resort when other methods fail to control infection or restore viability. *Buerger's* - **Buerger's disease** (thromboangiitis obliterans) is characterized by inflammation and thrombosis of small and medium-sized arteries and veins, primarily in the limbs, leading to severe ischemia and gangrene. - Due to progressive vascular damage and frequent lack of effective medical treatment for advanced stages, **amputation is often required** to remove necrotic tissue and manage intractable pain. *diabetic gangrene* - **Diabetic gangrene** results from a combination of **peripheral neuropathy**, **peripheral arterial disease**, and **infection**, leading to tissue death, particularly in the feet. - The compromised blood supply and impaired wound healing in diabetic patients make these lesions prone to rapid progression and severe infection, with **amputation frequently necessary** to prevent systemic sepsis and death. *Gas gangrene* - **Gas gangrene** is a rapidly progressive and life-threatening infection caused by *Clostridium* species, which produce toxins and gas within tissues. - Due to its aggressive and destructive nature, requiring immediate and extensive surgical debridement often involving **amputation of the affected limb** to remove all infected tissue and prevent widespread systemic toxicity.
Question 2: Which activity will be difficult to perform for a patient with an anterior cruciate deficient knee joint?
- A. Getting up from a sitting position
- B. Walk downhill (Correct Answer)
- C. Walk uphill
- D. Sitting cross-legged
Explanation: ***Walk downhill*** - An **anterior cruciate ligament (ACL) deficient knee** experiences anterior tibial translation, especially when the muscles can't compensate, leading to instability. - Walking downhill places higher **anterior shear forces** on the knee joint and often involves knee extension or hyperextension, which dramatically increases the risk of the tibia translating anteriorly relative to the femur. *Getting up from a sitting position* - This activity primarily involves **quadriceps muscle contraction** and a concentric movement of the knee, which stabilizes the joint. - It does not typically place significant **anterior shear stress** on the ACL, even in a deficient knee. *Walk uphill* - Walking uphill often involves knee flexion and places the knee in a more protected position against **anterior tibial translation**. - The quadriceps and hamstrings work synergistically to **stabilize the joint** during this motion, reducing stress on the ACL. *Sitting cross-legged* - This position primarily involves **hip and knee flexion and external rotation**, but it is generally a static and non-weight-bearing position. - It does not impose significant **dynamic loads** or shear forces that would cause instability in an ACL-deficient knee.
Question 3: The kinetic energy of the body is least in one of the following phases of the walking cycle
- A. Double support
- B. Mid-stance (Correct Answer)
- C. Toe-off
- D. Heel strike
Explanation: ***Mid-stance*** - During **mid-stance**, the body's center of gravity is at its **highest point**, and the vertical velocity is near zero as the body transitions from upward to downward motion, contributing to **reduced kinetic energy**. - At this phase, forward velocity is relatively constant but the body is at the apex of its vertical trajectory, representing a point of **minimal total kinetic energy** in the sagittal plane. - The body transitions from deceleration to acceleration, with the limb providing stable support as weight passes over the stance foot. *Double support* - In **double support**, both feet are on the ground during the weight transfer phase, and the body's center of gravity is at a lower position compared to mid-stance. - While some energy is dissipated during weight transfer, this phase involves active muscular work and forward momentum maintenance, with kinetic energy being variable. - This represents a transition phase between single support periods, with complex energy exchanges occurring. *Toe-off* - At **toe-off**, the propulsive phase of gait, the body is generating forward momentum with peak forward velocity, meaning there is **significant kinetic energy** as the foot pushes off the ground. - The body's center of gravity is moving upwards and forwards, indicating a higher kinetic energy state. - Ankle plantarflexors are actively propelling the body forward, maximizing kinetic energy output. *Heel strike* - **Heel strike** is a moment of initial contact where the body's forward velocity is still considerable, possessing **significant kinetic energy**. - The limb is preparing to absorb impact forces while the body's center of mass continues moving forward, representing high kinetic energy just before the deceleration phase. - This marks the beginning of the stance phase with substantial horizontal velocity maintained from the swing phase.
Question 4: Which of the following is the platinum-based chemotherapeutic agent used as first-line treatment for ovarian carcinoma?
- A. Cyclophosphamide
- B. Methotrexate
- C. Cisplatin (Correct Answer)
- D. Dacarbazine
Explanation: ***Cisplatin*** - **Cisplatin** is a platinum-based chemotherapy drug that forms **DNA cross-links**, inhibiting DNA synthesis and leading to the death of rapidly dividing cells, making it highly effective against **ovarian carcinoma**. - It is a cornerstone of chemotherapy regimens for ovarian cancer, often used in combination with other agents such as paclitaxel. *Methotrexate* - **Methotrexate** is an **antimetabolite** that inhibits dihydrofolate reductase, thereby interfering with DNA synthesis. - While it is used in various cancers like leukemia, lymphoma, and some solid tumors (e.g., breast cancer, gestational trophoblastic disease), it is **not a primary recommended drug for ovarian carcinoma**. *Cyclophosphamide* - **Cyclophosphamide** is an **alkylating agent** that causes DNA damage, leading to cell death. - It is used in many cancers, including lymphoma, breast cancer, and some leukemias, but it is **not a first-line or primary agent for ovarian carcinoma** in contemporary treatment guidelines. *Dacarbazine* - **Dacarbazine** is an **alkylating agent** primarily used in the treatment of **malignant melanoma** and Hodgkin lymphoma. - It is **not indicated for the treatment of ovarian carcinoma**.
Question 5: A patient prescribed crutches for residual paralysis in poliomyelitis is a type of -
- A. Disability limitation
- B. Primordial prevention
- C. Primary prevention
- D. Rehabilitation (Correct Answer)
Explanation: ***Rehabilitation*** - Rehabilitation is a component of **tertiary prevention** that aims to restore maximum functional ability after permanent damage has occurred from disease. - Providing crutches to a polio patient with **residual (established) paralysis** helps restore mobility and independence, allowing the patient to adapt to their permanent disability. - This intervention occurs **after the disease has run its course** and permanent sequelae have developed, which is the hallmark of rehabilitation. *Disability limitation* - Disability limitation is another component of **tertiary prevention** but focuses on **preventing progression or complications** of an already established disease. - It applies during the **disease active phase** to minimize further damage (e.g., physiotherapy during acute polio to prevent contractures, or strict glycemic control in diabetes to prevent complications). - In this case, the paralysis is **residual (fixed)**, not active, so we are beyond the disability limitation phase. *Primordial prevention* - Primordial prevention targets the underlying environmental and social determinants to prevent the emergence of risk factors at the population level. - This occurs **before any risk factors** for disease have developed (e.g., policies to prevent emergence of sedentary lifestyles). - Not applicable to a patient with established disease. *Primary prevention* - Primary prevention aims to prevent disease occurrence by reducing risk factors or increasing resistance (e.g., polio vaccination, health education). - This intervention is applied **before the disease occurs**, which is not the case for a patient with established paralysis from poliomyelitis.
Question 6: While using axillary crutches, elbow should be flexed to:
- A. 30 degrees (Correct Answer)
- B. 20 degrees
- C. 10 degrees
- D. 40 degrees
Explanation: ***30 degrees*** - A **30-degree elbow flexion** allows for proper weight bearing through the hands and prevents injury to the **axillary nerves and blood vessels**. - This angle provides the best mechanical advantage for stability and ambulation with **axillary crutches**. *20 degrees* - This degree of flexion is typically **insufficient** and would lead to the crutches being too high, potentially causing **axillary nerve compression**. - It would also make it harder to bear weight through the hands effectively. *10 degrees* - This flexion is **too small**, indicating the crutches are too long, which increases the risk of **axillary nerve damage** and poor balance. - The patient would have difficulty generating the necessary force to move forward. *40 degrees* - This degree of flexion means the crutches are **too short**, forcing the patient to bend excessively and leading to **poor posture** and increased exertion. - It would also compromise stability and could cause wrist pain due to excessive wrist extension.
Question 7: Mobile Medical Units (MMUs) under government health programs can operate through different models. Which of the following statements about MMU operations are correct? 1. MMUs are run by the government 2. MMUs are run by external agencies with medical supplies given by the government 3. MMUs are run by the government and medical supplies are also given by the government 4. MMUs are run by external agencies and medical supplies are also given by the external agency
- A. 1, 2, 3, and 4
- B. 1 and 2
- C. 1, 2, and 3 (Correct Answer)
- D. Only 1
Explanation: ***1, 2, and 3*** - This option correctly identifies the flexible operational models of **Mobile Medical Units (MMUs)** under government health programs. - MMUs can be directly managed by the **government**, managed by **external agencies** with government-provided supplies, or managed by the government with **government-provided supplies**. *1, 2, 3, and 4* - This option incorrectly includes the scenario where MMUs are run by **external agencies** and medical supplies are also provided by the **external agency**. - While external agencies can run MMUs, government health programs typically ensure that essential medical supplies are provided or funded by the **government** to maintain standardization and accessibility. *1 and 2* - This option is incomplete as it misses the model where both the MMU operation and medical supplies are provided by the **government** (statement 3). - Government health programs often have fully integrated models, especially in remote areas. *Only 1* - This option is too restrictive, as it only includes the model where MMUs are run by the **government**. - MMUs often involve partnerships with **external agencies** for operational efficiency or specialized services.
Question 8: The test performed below shows involvement of which of the following nerve?
- A. Radial nerve
- B. Axillary nerve
- C. Median nerve (Correct Answer)
- D. Ulnar nerve
Explanation: ***Median nerve*** - The image depicts the **Phalen's test**, where prolonged forced wrist flexion compresses the **median nerve** within the **carpal tunnel**. - The lightning bolt symbol indicates the characteristic **paresthesia** (tingling, numbness) experienced in the distribution of the median nerve, affecting the **thumb, index finger, middle finger, and radial half of the ring finger**. *Radial nerve* - The **radial nerve** primarily innervates the **extensor muscles** of the forearm and hand and provides sensation to the posterior aspect of the forearm and hand, as well as the dorsal side of the lateral 3.5 digits; it is not compressed by Phalen's maneuver. - Injury to the radial nerve typically causes **wrist drop** and sensory loss in a different distribution. *Axillary nerve* - The **axillary nerve** innervates the **deltoid** and **teres minor** muscles and provides sensation over the lateral shoulder. - It is not involved in conditions affecting the wrist or hand tested by maneuvers like Phalen's. *Ulnar nerve* - The **ulnar nerve** provides sensation to the **little finger** and **ulnar half of the ring finger**, and innervates most of the intrinsic hand muscles. - Compression of the ulnar nerve is typically tested by **Tinel's sign** at the **cubital tunnel** or Guyon's canal, not Phalen's test.
Question 9: Which of the following statement(s) is/are true?
- A. Normally the radial styloid is 1/2 lower than the ulnar
- B. Dinner fork deformity is characteristic of Colles' fracture (Correct Answer)
- C. All of the options
- D. Oedema & tenderness over the anatomical snuffbox is the characteristic features of Fracture of the scaphoid
Explanation: **Dinner fork deformity is characteristic of Colles' fracture** - **Colles' fracture** involves a **dorsal displacement** and angulation of the distal radius, creating a characteristic **"dinner fork" or "bayonet" deformity** of the wrist. - This specific deformity is a classic clinical sign that aids in the diagnosis of a Colles' fracture, which is an **extra-articular fracture** of the distal radius with dorsal angulation. *Normally the radial styloid is 1/2 lower than the ulnar* - The **radial styloid** normally extends approximately **1-1.5 cm (or about 1/2 inch)** *distal* to the ulnar styloid, not lower than. - This difference in length is crucial for normal wrist kinematics, and its reversal can indicate conditions like **ulnar positive variance**. *All of the options* - This option is incorrect because the statement regarding the radial styloid being lower than the ulnar is **false**. - Since one of the options provided is factually incorrect, this choice cannot be true. *Oedema & tenderness over the anatomical snuffbox is the characteristic features of Fracture of the scaphoid* - While **oedema and tenderness in the anatomical snuffbox** are hallmark signs of a **scaphoid fracture**, this statement alone does not encompass all the truth presented in the options. - This specific physical finding is highly indicative of a scaphoid fracture, necessitating further imaging to confirm the diagnosis due to **poor vascular supply** to the scaphoid and risk of **avascular necrosis**.
Question 10: Who invented the Jaipur foot?
- A. P. K. Sethi (Correct Answer)
- B. S. K. Verma
- C. B. L. Sehgal
- D. H. R. Gupta
Explanation: **Explanation:** The **Jaipur Foot** is a world-renowned prosthetic limb developed in 1968 at the Sawai Man Singh Medical College in Jaipur. **Correct Option: A. P. K. Sethi** Dr. Pramod Karan Sethi, an orthopedic surgeon, is credited with the invention of the Jaipur Foot along with Master Craftsman **Ram Chandra Sharma**. Unlike Western prosthetics (like the SACH foot), which were designed for use with shoes on flat surfaces, the Jaipur Foot was specifically engineered for the Indian lifestyle. It is made of polyurethane and vulcanized rubber, allowing for barefoot walking, squatting, sitting cross-legged, and walking on uneven terrain. Dr. Sethi was awarded the Magsaysay Award and the Padma Shri for this contribution. **Incorrect Options:** * **B. S. K. Verma:** A prominent figure in Indian orthopedics and former director of the Central Institute of Orthopaedics (Safdarjung Hospital), but not the inventor of the Jaipur Foot. * **C. B. L. Sehgal:** Not associated with the primary development of this prosthetic technology. * **D. H. R. Gupta:** While there are many contributors to Indian orthopedics, Dr. Gupta is not the recognized inventor of this specific prosthesis. **High-Yield Clinical Pearls for NEET-PG:** * **Material:** It is a **rubber-based** prosthesis (polyurethane/vulcanized rubber). * **Unique Feature:** It allows **multi-axial movements** at the ankle, facilitating squatting and cross-legged sitting (essential for rural Indian activities). * **Waterproof:** Unlike traditional wooden or leather prosthetics, it is waterproof and durable for agricultural work. * **Comparison:** While the **SACH (Solid Ankle Cushion Heel)** foot is the international standard, the Jaipur Foot is superior for patients requiring high mobility without footwear.
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