Shock: is defined as a state of cellular and tissue hypoxia due to reduced oxygen delivery and/or increased oxygen consumption or inadequate oxygen utilisation.

Types of Hemorrhagic Shock: The American College of Surgeons Advanced Trauma Life Support (ATLS) hemorrhagic shock classification (in a healthy 70 kg patient) as shown in the Table  below.

Also see:

Hemorrhagic Shock (https://www.ncbi.nlm.nih.gov/books/NBK470382/)

JUNE 2019

PAPER I
Part A

1. a) Define shock & classify different types of hemorrhagic shock.(2+4)
   b) Reperfusion injury & principles of treatment of hypovolemic shock.(2+2)
2. a) The different compartments of leg. 2
   b) Clinical features & management of compartment syndrome of leg. 6
   c) Whiteside’s technique. 2
3. a) Anatomy of joint capsule & its surgical importance. 3
   b) Synovial fluid analysis in various disorders, 7
4. The patho-anatomy of sciatic nerve with special surgical considerations in nerve injuries. (5+5)
5. a) Classify open fractures. 3
   b) Management of Grade IIIB open fracture of tibia. 7

Part B

6. a) Enumerate the various metabolic & endocrine diseases having skeletal manifestations. 4
   b) Clinical features of rickets. 3
   c) Radiological findings of rickets. 3
7. a) Mechanism of action and use of TENS in Orthopaedics. 5
   b) PET scan in Orthopaedics. 5
8. a) Histology of bone. 3
   b) Various factors regulating bone metabolism. 4
   c) Electric phenomena and electrical charges in bones. 3
9. a) Clinical features of gas gangrene. 3
   b) Biofilm. 3
   c) Surgical anatomy of posterior interosseous nerve. 4
10. a) Anti-tubercular therapy in musculoskeletal tuberculosis. 6
    b) Liquid culture (MGIT). 4

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PAPER II
Part A

1. a) Surgical reduction of fractures. 5
   b) Absolute & relative stability in the treatment of fractures. 5
2. a) Outline the principles of external fixation. 3
   b) Modular & hybrid external fixator & Taylor spatial frame. 4
   c) Dynamization of external fixator. 3
3. a) Causes & classifications of non-union of fractures.   5
   b) Principles of management of non-union of fractures.   5
4. Clinical features & assessment of floating knee & principles of its management.  3+3+4
5. a) Early & late onset paraplegia in spinal tuberculosis.   3
   b) Surgical approaches for Pott’s paraplegia   4
   c) Stages in tuberculosis of hip joint.    3

Part B

6. a) General principles & technique of application of plaster cast.     4
   b) Advantages & disadvantages of plaster of Paris cast. 3
   c) Functional cast brace.   3
7. a) Etiology & pathoanatomy  of old unreduced dislocation of shoulder joint.    3
   b) Clinical features & management of posterior dislocation of shoulder joint.   (3+4)
8. a) Classify nerve injury.     5
   b) Significance & interpretation of electro-diagnostic studies in nerve injuries.    5
9. Discuss the various conventional & modern methods of management of congenital pseudoarthrosis of the tibia.    5+5
10. a) Volkmann splint.    3
    b) Phemister bone grafting.    3
    c) C-clamp.       4

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PAPER III
Part A

1. a) Antibiotic prophylaxis.    5
   b) Operation theatre sterilization & antisepsis.  5
2. a) Role of embolization in orthopedic surgery.    4
   b) Floor reaction orthoses.      3
   c) Pseudo tumours.                3
3. a) Surgical anatomy of hip joint.     4
   b) Enumerate the surgical approaches of the hip, mention advantages & disadvantages of each approach.     6
4. a) Kapandji technique.    3
   b) Jaipur foot.      3
   c) Orthoses in developmental dysplasia of hip.  4
5. Principles of management including recent advances in the treatment of flail chest.      5+5

Part B

6. Indications & principles of pelvic osteotomies & their merits & demerits.  (3+3+4)
7. a) Lateral mass fixation technique.    3
   b) Proximal fibular osteotomy.      3
   c) Medial collateral ligament injury in total knee arthroplasty.       4
8. Clinical & radiological features & management of aneurysmal bone cyst of distal femur. (2+2+6)
9. a) Corticotomy.      3
   b) Custom mega prosthesis.     3
   c) Balloon kyphoplasty.    4
10. a) Skin grafts.      3
    b) Fasciocutaneous & musculocutaneous flaps. 4
    c) Free flaps.        3

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PAPER IV
Part A

1. a) Dual mobility in total hip arthroplasty.     5
   b) Orthobiologics in Orthopaedics.     5
2. a) Indications & principles of revision total hip surgery.       5
   b) Discuss the different types of acetabular defects & management.       5
3. Current concepts in the treatment of clavicle fractures.       10
4. Unreconstructable fractures in the elderly & discuss the management options.      5+5
5. Principles of early total care & damage control Orthopedics.         5+5

Part B

6. a) 3D & 4D printing in Orthopedics.      4
   b) Reamer irrigation aspiration system.    3
   c) Current concepts in treatment of osteomyelitis.       3
7. a) Patient specific instrumentation in arthroplasty.    4
   b) V A C therapy.      3
   c) Fixation devices in cruciate ligament reconstruction.        3
8. a) Role of bone marrow aspirate in Orthopedic trauma.      5
   b) Minimal invasive spine surgery.      5
9. Current concepts of classification & management of thoracolumbar spine fractures.     10
10. a) Tranexamic acid in Orthopedic surgery.    3
    b) Principles of volar locking plate.          3
    c) Robotic surgery in Orthopedics.       4

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