Arthroscopy Indian Medical PG Practice Questions and MCQs
Practice Indian Medical PG questions for Arthroscopy. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Arthroscopy Indian Medical PG Question 1: Manoeuvre carried out for diagnosing medial meniscus injury is:
- A. McMurray's test (Correct Answer)
- B. Valgus stress test
- C. Lachmann's test
- D. Varus stress test
Arthroscopy Explanation: ***McMurray's test***
- This test is specifically designed to assess for meniscal tears, particularly the **medial meniscus**.
- A positive test involves eliciting a **click or pain** when extending the knee from a fully flexed position while internally and externally rotating the tibia.
*Valgus stress test*
- This test evaluates the integrity of the **medial collateral ligament (MCL)**.
- It involves applying a valgus (outward) force to the knee while stabilizing the thigh, looking for increased gapping or pain.
*Lachmann's test*
- This is the most sensitive test for assessing the integrity of the **anterior cruciate ligament (ACL)**.
- It involves gently pulling the tibia anteriorly with the knee flexed at 20-30 degrees, looking for excessive anterior translation.
*Varus stress test*
- This test assesses the integrity of the **lateral collateral ligament (LCL)**.
- It involves applying a varus (inward) force to the knee while stabilizing the thigh, looking for increased gapping or pain.
Arthroscopy Indian Medical PG Question 2: Pringle's maneuver is mainly used to control bleeding from which site?
- A. IVC
- B. Cystic artery
- C. Hepatic vein
- D. Liver parenchyma (Correct Answer)
Arthroscopy Explanation: ***Liver parenchyma***
- Pringle's maneuver involves **clamping the hepatoduodenal ligament**, which contains the portal triad (hepatic artery, portal vein, and bile duct), to temporarily **reduce blood flow to the liver**.
- This maneuver is primarily performed during **liver surgery** to control bleeding from the liver parenchyma itself, allowing for safer resection or repair of liver injuries.
*IVC*
- Bleeding from the **inferior vena cava (IVC)** is not directly controlled by Pringle's maneuver. The IVC is located posterior to the liver parenchyma and is not part of the hepatoduodenal ligament.
- Controlling IVC bleeding typically requires **direct repair** or other specific vascular control techniques, often involving clamps placed directly on the IVC.
*Cystic artery*
- While the **cystic artery** is a branch of the right hepatic artery (which is occluded during Pringle's maneuver), the maneuver is not *mainly* used to control isolated cystic artery bleeding.
- **Cystic artery bleeding** is typically encountered during cholecystectomy and is controlled by ligating or clipping the artery directly, rather than relying on a general liver inflow occlusion.
*Hepatic vein*
- The **hepatic veins** drain directly into the IVC from the liver parenchyma and are not part of the hepatoduodenal ligament, thus their blood flow is not directly occluded by Pringle's maneuver.
- Bleeding from the hepatic veins is a more challenging complication in liver surgery, often requiring **direct compression**, suture repair, or venovenous bypass to manage.
Arthroscopy Indian Medical PG Question 3: What is the most appropriate management option for an intra-articular fracture?
- A. External Fixation
- B. Arthrodesis
- C. Plaster of Paris
- D. Plating (Correct Answer)
Arthroscopy Explanation: ***Plating***
- Plating offers **stable fixation** for intra-articular fractures, allowing for early mobilization and preserving joint function.
- It provides **anatomic reduction**, which is crucial for restoring the smooth articular surface and preventing post-traumatic arthritis.
*Arthrodesis*
- Arthrodesis, or joint fusion, is typically reserved for **severe joint destruction** or failed previous treatments, as it sacrifices joint motion.
- It is not the primary approach for acute intra-articular fractures where the goal is to **restore joint function**.
*Plaster of Paris*
- Plaster of Paris casts often provide **insufficient stability** for complex intra-articular fractures, risking malunion or nonunion.
- While it offers immobilization, it can lead to **joint stiffness** and does not allow for early range of motion, which is vital for articular cartilage healing.
*External Fixation*
- External fixation is usually preferred for **open fractures** with significant soft tissue injury or as a temporary measure in polytrauma patients.
- It carries a risk of **pin site infections** and can be cumbersome for the patient, generally not being the definitive treatment for closed intra-articular fractures.
Arthroscopy Indian Medical PG Question 4: Which one of the following statements about Compartment Syndrome is NOT correct?
- A. Pain is on active movement but not on passive movement of muscles (Correct Answer)
- B. Fasciotomy is the treatment of choice
- C. It is commonest in a closed fracture
- D. Volkmann's Ischaemic contracture is a late complication
Arthroscopy Explanation: ***Pain is on active movement but not on passive movement of muscles***
- This statement is incorrect because pain in compartment syndrome is characteristically **out of proportion to the injury** and is **exacerbated by passive stretching of the muscles** within the affected compartment.
- While active movement can cause pain, the hallmark sign related to pain is its intensification with passive stretching due to increased pressure.
*Fasciotomy is the treatment of choice*
- **Fasciotomy** is indeed the definitive surgical treatment for compartment syndrome to relieve pressure and prevent irreversible tissue damage.
- It involves incising the fascia to decompress the affected muscle compartment.
*It is commonest in a closed fracture*
- Compartment syndrome most frequently occurs after a **closed fracture**, particularly in the tibia and forearm, because the intact fascial compartments restrict expansion, leading to increased pressure.
- The swelling and hemorrhage associated with the fracture are contained, causing pressure to rise rapidly.
*Volkmann's Ischaemic contracture is a late complication*
- **Volkmann's ischemic contracture** is a severe and debilitating late complication of unresolved or undertreated compartment syndrome, primarily affecting the forearm muscles.
- It results from prolonged ischemia, causing muscle necrosis, fibrosis, and subsequent shortening and contracture.
Arthroscopy Indian Medical PG Question 5: A 65-year-old lady presented with a swollen and painful knee. On examination, she was found to have grade III osteoarthritic changes. What is the best course of action?
- A. Conservative management
- B. Total knee replacement (Correct Answer)
- C. Arthroscopic washing
- D. Partial knee replacement
Arthroscopy Explanation: ***Total knee replacement***
- For **grade III osteoarthritis** in a 65-year-old, a total knee replacement is the most definitive and effective treatment to relieve pain and restore function in a severely damaged joint.
- This procedure addresses widespread cartilage loss and structural changes typical of advanced osteoarthritis.
*Conservative management*
- This approach is typically favored for **mild to moderate osteoarthritis**, involving physical therapy, NSAIDs, and lifestyle modifications.
- For **grade III changes** with significant pain and swelling, conservative measures are unlikely to provide sufficient relief or halt disease progression effectively.
*Arthroscopic washing*
- **Arthroscopic lavage** and debridement are rarely recommended for osteoarthritis as they have not shown sustained benefits for pain or function.
- It is sometimes used for specific mechanical symptoms, but it does not address the underlying cartilage loss and structural damage in severe osteoarthritis.
*Partial knee replacement*
- A **partial knee replacement** is suitable when osteoarthritis is confined to a single compartment of the knee, and the other compartments are healthy.
- Given the indication of "grade III osteoarthritic changes" without specifying a single compartment, a total knee replacement is generally more appropriate for widespread disease.
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