Rehabilitation and Physical Medicine Indian Medical PG Practice Questions and MCQs
Practice Indian Medical PG questions for Rehabilitation and Physical Medicine. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Rehabilitation and Physical Medicine Indian Medical PG Question 1: Which of the following statements are correct regarding primary survey/management of traumatic head injury patient?
I. Ensure adequate oxygenation and circulation
II. Exclude hypoglycaemia
III. Check for mechanism of injury
IV. Check pupil size and response
Select the answer using the code given below :
- A. II, III and IV
- B. I, III and IV
- C. I, II and III
- D. I, II and IV (Correct Answer)
Rehabilitation and Physical Medicine Explanation: ***I, II and IV***
- **Primary survey** in trauma management, including head injury, focuses on immediately life-threatening conditions (Airway, Breathing, Circulation, Disability, Exposure). Ensuring adequate **oxygenation and circulation** (Statement I) is paramount to prevent secondary brain injury.
- Exclude **hypoglycemia** (Statement II) is critical because altered mental status due to low blood sugar can mimic head injury and delay appropriate treatment, making it an essential part of the 'D' (disability) assessment. Checking **pupil size and response** (Statement IV) is also part of the 'D' assessment, providing vital information about potential brain stem compromise or intracranial pressure changes.
*II, III and IV*
- While excluding hypoglycemia and checking pupil response are crucial parts of the primary survey, Statement III, "Check for mechanism of injury," is typically part of the **secondary survey** or initial assessment but not immediately life-saving like ABCD.
- The primary survey prioritizes immediate threats to life, and while understanding the mechanism of injury informs subsequent care, it does not directly address a patient's immediate physiologic stability.
*I, III and IV*
- This option includes checking the mechanism of injury (Statement III) as part of the primary survey, which is generally conducted after the **life-threatening conditions** are addressed.
- It omits the critical step of excluding **hypoglycemia** (Statement II), which is an immediate reversible cause of altered mental status that must be ruled out during the primary assessment.
*I, II and III*
- This option correctly includes ensuring adequate **oxygenation and circulation** (Statement I) and excluding **hypoglycemia** (Statement II) as part of the primary survey.
- However, it incorrectly includes checking for the **mechanism of injury** (Statement III) as a primary survey component and omits checking **pupil size and response** (Statement IV), which is an essential part of the 'Disability' assessment in the primary survey for head injury.
Rehabilitation and Physical Medicine Indian Medical PG Question 2: Which of the following is not a differential diagnosis of non-accidental injury?
- A. Osteogenesis imperfecta
- B. Scurvy
- C. Caffey's disease
- D. Osteopetrosis (Correct Answer)
Rehabilitation and Physical Medicine Explanation: ***Correct: Osteopetrosis***
- Osteopetrosis is a rare genetic disorder characterized by **increased bone density** due to defective osteoclast function
- While it causes bones to be brittle and prone to fracture, it has **distinctive radiological features** including diffuse sclerosis and "bone-within-bone" appearance
- The **increased bone density on X-ray** is pathognomonic and readily distinguishes it from NAI, making it **less likely to be confused** with non-accidental injury in clinical practice
- Fractures occur but the radiological pattern is diagnostic of the underlying metabolic bone disease
*Incorrect: Osteogenesis imperfecta*
- This is a **classic differential** for NAI causing **multiple brittle bone fractures** that can be mistaken for abuse
- Features include **blue sclera**, **dentinogenesis imperfecta**, **wormian bones**, and **family history**
- Often presents with multiple fractures at different stages of healing, mimicking the pattern seen in NAI
*Incorrect: Scurvy*
- Caused by **vitamin C deficiency**, leads to defective collagen synthesis
- Results in **subperiosteal hemorrhages**, **metaphyseal fractures**, and **periosteal elevation** that closely mimic NAI
- Additional features include **gingival bleeding**, **petechiae**, **follicular hyperkeratosis**, and **poor wound healing**
*Incorrect: Caffey's disease*
- Also known as **infantile cortical hyperostosis**, presents in infants under 6 months
- Causes **periosteal reactions**, **bone thickening**, and **soft tissue swelling** in long bones, ribs, and mandible
- The periosteal new bone formation can be mistaken for healing fractures from NAI, making it an important differential
Rehabilitation and Physical Medicine Indian Medical PG Question 3: Which of the following phases are directly involved in the recovery phase of the disaster cycle?
- A. Response and Rehabilitation
- B. Mitigation and Rehabilitation
- C. Response and Preparedness
- D. Rehabilitation and Reconstruction (Correct Answer)
Rehabilitation and Physical Medicine Explanation: ***Rehabilitation and Reconstruction***
- **Rehabilitation** is the short-term recovery phase focusing on restoring essential services, providing temporary shelter, medical care, and supporting affected populations to resume normal activities.
- **Reconstruction** is the long-term recovery phase involving rebuilding damaged infrastructure, permanent housing, economic restoration, and development improvements.
- These two phases together constitute the **recovery phase** of the disaster cycle according to standard disaster management frameworks (WHO, NDMA).
*Mitigation and Rehabilitation*
- While **rehabilitation** is correctly part of recovery, **mitigation** is traditionally considered a separate continuous phase or part of preparedness, focused on reducing future disaster risks.
- **Mitigation** measures are implemented throughout the disaster cycle, not specifically as a direct component of the recovery phase.
*Response and Rehabilitation*
- **Response** refers to immediate life-saving actions during and immediately after a disaster (search and rescue, emergency medical care, evacuation).
- **Response** precedes the recovery phase and is distinct from it, though **rehabilitation** is indeed part of recovery.
*Response and Preparedness*
- **Preparedness** involves planning, training, and resource allocation before a disaster occurs.
- **Response** is the immediate action during/after the disaster.
- Neither constitutes the recovery phase, which follows after the immediate response is complete.
Rehabilitation and Physical Medicine Indian Medical PG Question 4: Choose the best method of diagnosis for the clinical sign represented in the image.
- A. Serum copper
- B. Serum ceruloplasmin (Correct Answer)
- C. Karyotyping
- D. PCR
Rehabilitation and Physical Medicine Explanation: ***Serum ceruloplasmin***
- The image shows a **Kayser-Fleischer ring**, a greenish-brown discoloration in the periphery of the cornea, which is pathognomonic for **Wilson's disease**.
- **Wilson's disease** is a genetic disorder of copper metabolism characterized by **low serum ceruloplasmin** levels (the primary copper-carrying protein in the blood) and increased copper deposition in various tissues.
*Serum copper*
- While Wilson's disease involves copper accumulation, **total serum copper** can be normal or even elevated due to widespread tissue damage releasing copper into the circulation, making it an unreliable diagnostic marker on its own.
- A low serum copper level can be seen, but it is not as specific as low ceruloplasmin, as much of the copper in serum is bound to ceruloplasmin.
*Karyotyping*
- **Karyotyping** is used to analyze the number and structure of chromosomes and is primarily indicated for diagnosing chromosomal abnormalities, such as Down syndrome or Turner syndrome.
- It is not relevant for diagnosing metabolic disorders like Wilson's disease, which is caused by a mutation in a single gene (ATP7B), not a chromosomal aberration.
*PCR*
- **PCR (Polymerase Chain Reaction)** is a technique used to amplify DNA sequences and can be used for genetic testing to identify specific mutations.
- While genetic testing for the **ATP7B gene** mutation is a confirmatory test for Wilson's disease, it is not the primary or best method for initial diagnosis, especially when classic clinical signs and biochemical markers (like low ceruloplasmin) are present.
Rehabilitation and Physical Medicine Indian Medical PG Question 5: What is the correct sequence of the following levels of prevention?
1. Specific protection
2. Early diagnosis and prompt treatment
3. Disability limitation and rehabilitation
4. Health promotion
Select the correct sequence from the code given below:
- A. 3, 4, 1, 2
- B. 4, 1, 2, 3 (Correct Answer)
- C. 2, 3, 4, 1
- D. 1, 2, 3, 4
Rehabilitation and Physical Medicine Explanation: ***4, 1, 2, 3***
- The correct sequence of prevention levels starts with **health promotion** (primary prevention), followed by **specific protection** (also primary prevention, but more targeted).
- It then moves to **early diagnosis and prompt treatment** (secondary prevention), and finally to **disability limitation and rehabilitation** (tertiary prevention).
*3, 4, 1, 2*
- This sequence incorrectly places **disability limitation and rehabilitation** (tertiary prevention) at the beginning, which occurs much later in the disease process.
- It also scatters the primary prevention components (health promotion and specific protection) rather than grouping them appropriately at the start.
*2, 3, 4, 1*
- This sequence begins with **early diagnosis and prompt treatment** (secondary prevention), which is not the initial step in the comprehensive prevention model.
- It also places **health promotion** and **specific protection** later than they should be, distorting the chronological progression of preventive actions.
*1, 2, 3, 4*
- This sequence begins with **specific protection**, which is a part of primary prevention but typically follows broader **health promotion** efforts.
- It also places **health promotion** (4) as the last step, which is incorrect as it represents the fundamental and initial level of prevention.
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