Page 1 of 4: CONTROVERSIAL PREVIOUS YR AIIMS QUESTIONS

dragonlives4ever · Credits: 16805 My Scrapbook

LET US DISCUSS SOME CONTROVERSIAL PREVIOUS YR AIIMS AND AIPGE QUESTIONS HERE

dragonlives4ever · Credits: 16805 My Scrapbook

AIIMS NOV 07

BOY WITH PES EXCAVATUM,DENIES HISTORY OF COUGH AND DYSPNEA ON COUGHING,BUT O/E HAD MILD WHEEZING ,INDICATION OF SURGERY?
A)FEV1/FVC<0.6
B)LIMITATION OF MAX INSPIRATION ON EXERCISE
C)PEAK WORK CAPACITY 60% OF EXPECTED
D)FUNCTIONAL WORK CAPACITY 80% OF EXPECTED

The postoperative values for forced expiratory volume in 1 s (FEV1) and VC expressed as percentage of expected were decreased in all groups

The low normal vital capacities in excavatum patients were unchanged by operation, but a small improvement in the total lung capacity and a significant improvement in the maximal voluntary ventilation were seen. Exercise tolerance improved in those with pectus excavatum after operation, as determined both by total exercise time and maximal oxygen consumption

In addition, at any given workload, those with pectus excavatum demonstrated a lower heart rate, stable oxygen consumption, and higher minute ventilation after repair.

As early as 1951, Brown and Cook performed pulmonary evaluations on patients before and after surgical repair.[17] They demonstrated that although vital capacity (VC) was normal, the maximum breathing capacity was diminished (50% or more) in 9 of 11 cases and increased an average of 31% after surgical repair

REF:Sellke: Sabiston & Spencer Surgery of the Chest, 7th ed

HENCE PT IN CHOICE C WILL BENEFIT MORE FROM SURGERY.

dragonlives4ever · Credits: 16805 My Scrapbook

dragonlives4ever · Credits: 16805 My Scrapbook

AIIMS MAY 2008

Best prognosis after nerve repair
a)radial nerve
b)median nerve
c)sciatic nerve
d)common peroneal nerve

ans-radial nerve

Prognosis
Neurapraxia always recovers fully, axonotmesis usually recovers well, neurotmesis has the worse prognosis
80 - 90% of nerve injuries associated with closed fractures recover spontaneously
The higher the lesion the worse the prognosis
The prognosis is better in children than in adults and purely motor or purely sensory nerves recover better than mixed nerves
Beyond a critical resection length grafting is not successful (?15cm)
After a few months recovery following suture becomes progressively less likely with delay of repair® loss of 1% of neural function for each week of delay beyond the third week
With the passage of time the prospect of recovery is reduced because the activity of the sprouting axons diminishes after 7 - 12 days and the schwann tubes become narrow, motor end plates degenerate and muscles atrophy, the brain also forgets how to use the muscle
[/size]In the upper limb radial nerve repairs have a better prognosis than the median and the ulna nerve has the poorest prognosis and in the lower limb tibial nerve have a more favourable prognosis than the peroneal nerve[size=24]

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dragonlives4ever · Credits: 16805 My Scrapbook

this thread is to discuss any prev yr q ,not only controversial.

jayakrishnav55 · Credits: 12587 My Scrapbook

thanks dragon for these excellant, informative discussions.reg best prognosis after repair, pl see campbells operative orthopaedics. vol 4 10 th ed. page 3257.
after repair of the radial nerve , the prognosis for regeneration is more favorable than for any other major nerve in the upper extremity, primarily. because it is predominantly a motor nerve and secondarily, because the muscles innervated by it are not involved in the finrer movements of the fingers and hand.
often in AIIMS pgee, direct questions from campbell are asked.

dragonlives4ever · Credits: 16805 My Scrapbook

dragonlives4ever · Credits: 16805 My Scrapbook

AIPGE 07

A new born baby presents with absent anal orfice and meconuria.whats most
approp m/m?
a) transverse colostomy
b)sigmoid colostomy
c)anoplasty
d)left transverse colostomy

speed has given ans B TRANSVERSE COLOSTOMY while in its question option it has sigmoid colostomy as choice B,moreover from its explation no conclusion regarding ans could be drawn

...............?....................................?....................

jayakrishnav55 · Credits: 12587 My Scrapbook

shoulder pain in laparoscopy is due to ;
1.subphrenic abscess.
2.co2 narcosis.
3.positioning of patient,
4.compredssion of lungs.pl anser. bipin daga gave anser option b.is it a correct anser. this question is bound to be rpytd in nov 08 AIIMS .what is ythe anser given by speed

dragonlives4ever · Credits: 16805 My Scrapbook

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