@ Fracture-ala-signature is:

A.Gutter fracture B.Depressed fracture C.Ring fracture D.Sutural separation Ans B.Depressed fracture a)Depressed Fracture: It is caused by a heavy weapon with a small striking surface eg. hammer. The fracture bone is depressed inwards and its shape indicates the type of weapon used,thus alsoknown as Fracture-ala-signature or Signature fracture.

Depressed Skull Fracture b)Fissured Fracture(Linear Fracture):

 It is a linear fracture or crack involving the inner or outer table or both. It can not be detected on an x-ray.It can only be detected at biopsy c)Pond or Indented Fracture: These fractures are seen in children because of the elasticity of their bones. These occurs due to forcible impact against some protruding project d)Gutter Fracture When a bullet causes a glancing blow,it removes a part of thickness of the skull bone resembling a gutter. Usually the inner table is also involved and shows an irregular depressed fracture e)Comminuted Fracture: The bone is broken into two or more pieces f)Penetrating Fracture: Its a clean cut opening due to a penetrating weapon such as a dagger or a bullet. g)Elevated Fracture: It results due to moderately heavy sharp edged weapon eg. axe,which lifts one end of the fractured bone above the surface of skull while the other end is depressed down in the cranial cavity injuring the underlying brain.

h)Ring Fracture: This term is commonly used to signify any fracture around the foramen magnum. Technically,it means a fissured fracture about 3.5 cm outside the foramen magnum at the back,involving middle ear on sides,and roof of nose anteriorly. Its rare fracture and requires a lot of force to produce it. It results from fall from height on feet or buttocks.
@ difficulty in identifying entry and exit wounds due to surgical alteration is also known as: a. mac naughten's rule b. kennedy's phenomenon c. alec jeffrey's rule d. Puppes rule

Ans b

# pSYCHIATRY @ According to Weschlers scale for IQ , Which is average score a) 20 b) 110 c) 70

d) 90 Ans D Wechsler's classification IQ Range ("Deviation IQ") Intelligence Classification 130 and over Gifted 120129 High 110119 High Average 90109 Average 8089 Low Average 7079 Borderline Below 69 Extremely Low @ Anticraving drug used in alcohol intoxication a) Disulfiram b) Naltrexone c) Acamprosoate

Ans b Naltrexone is the first drug ever approved by the FDA that reduces the drinkers craving for alcohol. When taken by persons motivated to stop drinking, who also participate in personal and group counseling session

@ Treatment of alcohol withdrawl syndrome a) phenytoin b) diazepam c) clonidine

Ans b
@ study of brain and behaviour in a normal and diseased brain called as a) neuropsychology b) neuro developmental psychiatry c) neuropsychiatry d) criminal psychology Neuropsychology studies the structure and function of the brain as they relate to specific psychological processes and behaviors. It is seen as a clinical and experimental field of psychology that aims to study, assess, understand and treat behaviors directly related to brain functioning. The term neuropsychology has been applied to lesion studies in humans and animals. It has also been applied to efforts to record electrical activity from individual cells (or groups of cells) in higher primates (including some studies of human patients).[1] It is scientific in its approach, making use of neuroscience, and shares an information processing view of the mind with cognitive psychology and cognitive science. @opioid receptor for dysphoria a) KAPPA

Ans A It has long been understood that -opioid receptor agonists are dysphoric[9] but dysphoria from -opioid receptor agonists has been shown to differ between the sexes.

# Radiology @ Acute pyelonephritis on ultrasound a) Hypoechoic leision b) Perenephric fluid collection c) Diffuse enlargement

Ans A Acute pyelonephritis on ultrasound

Ultrasound is insensitive to the changes of acute pyelonephritis, with most patients having 'normal' scan, and abnormalities only identified in 20-24% of cases 1. Possible features include: particulate matter in the collecting system gas bubbles (emphysematous pyelonephritis) abnormal echogenicity of the renal parenchyma focal / segmental hypoechoic regions mass like change Ultrasound is however useful in assessing for local complications such as hydronephrosis, renal abscess formation, renal infarction, perinephric collections, and thus guiding management.

In acute pyelonephritis, the kidney shows renal enlargement, and in complicated pyelonephritis, hypoechoic lesions (arrow) may be observed
@ t2 weighted hypoechoic leisions in liver and lower pole of kidney in child ? a) Nephroblastoma b) Wilms c) VonHippel Lindau syndrome d) Neuroblastoma
Ans c von Hippel-Lindau syndrome. Sagittal T2-weighted MRI (same patient as in the previous 2 images) shows a cerebellar lesion with a large septate cystic component

VHL is characterized by a predisposition to bilateral and multicentric retinal angiomas, central nervous system (CNS) hemangioblastomas; renal cell carcinomas; pheochromocytoma s; islet cell tumors of the pancreas; endolymphatic sac tumors[1] ; and renal, pancreatic, and epididymal cysts.[2, 3] CNS hemangioblastoma (Lindau tumor) is the most commonly recognized manifestation of VHL and occurs in 40% of patient @ MR + Rhabdomyoma of liver and kidney is seen in a) Tuberous sclerosis b) ARPKD c) Nuerofibromatosis

Ans A
classical triad of epilepsy, mental retardation, and adenoma sebaceum Cardiac rhabdomyoma, renal angiomyolipoma, and neurologic involvement encompassing cortical or subependymal tubers and white matter abnormalities are the common radiologic findings.

tuberous sclerosis can involve bone, liver, and the alimentary tract
# Orthopaedics @After injury to forearm a patient presented with wrist stiffness, shiny skin and diffuse calcification . Diagnosis is a) Sudeck dytrophy

Ans A
@ osteoblastic metastasis are seen in carcinoma a) breast b) cx c) endometrium d) uterus Ans a

Metastases that are typically purely lytic o Kidney o Thyroid Metastases that are usually mixed lytic and sclerotic o Lung o Breast Metastases that are usually purely blastic o Prostate o Medulloblastoma o Bronchial carcinoid
@ limb shortening, abduction and extrenal rotation is seen in which dislocation of hip: a. anterior b. posterior c. lateral d. central Ans D

Posterior hip dislocations are the most common. The usual cause is a motor vehicle accident with the passenger's knee hitting the dashboard and forcing the femoral head out of the acetabulum posteriorly. The limb is shortened, and the hip flexed, the foot is in internal rotation. With an anterior dislocation the lower limb is lengthened, the hip abducted and the foot is in external rotation
Central dislocation: The leg is shortened, abducted or adducted and internally or externally rotated depending on the

type and extent of penetration into the pelvis.