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Correct Answer: A) Emergency
fasciotomy
Explanation:
The patient has acute compartment syndrome with critically elevated intracompartmental pressure (90 mmHg), requiring emergency fasciotomy to relieve pressure, restore perfusion, and prevent irreversible muscle and nerve damage.
It is referred to as increased pressure within a closed osteofascial compartment, causing compromised circulation and tissue perfusion.
Raised compartment pressure causes:
Compromised tissue perfusion
Muscle ischemia
Nerve injury
Irreversible tissue necrosis if untreated
Clinical features:
β
Severe pain out of proportion to injury
Pain on passive stretch
O Tense swollen compartment
Paresthesia and paralysis in late stages
Management: Emergency fasciotomy is the treatment of choice
Relieves pressure within compartment
γ Restores circulation to muscles and nerves
Prevents permanent disability and limb loss.
Fasciotomy:
Two longitudinal incisions are given, one on the medial side and one on the lateral side.
The skin, subcutaneous fat, and fascia are incised during fasciotomy.
The muscle bulges through the fascia after decompression
Observation and limb elevation (Option B): Observation is inappropriate in established compartment syndrome with markedly elevated compartment pressure. Delay in decompression can lead to irreversible ischemic damage.
Closed reduction and cast application (Option C): Applying a cast may further increase compartment pressure and worsen ischemia if a fasciotomy is not performed first.
Fracture fixation alone (Option D): It does not relieve elevated intracompartmental pressure.
Surgical decompression is mandatory before definitive fracture management
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Explanation:
Neuropraxia is characterised by a physiological conduction block without structural disruption of the axon or surrounding connective tissue.
It is the mildest form of peripheral nerve injury.
Commonly caused by compression or mild traction injury.
There is a temporary interruption of nerve conduction without structural damage.
Features:
Physiological conduction block occurs.
The axon remains intact.
Ξ No Wallerian degeneration occurs.
Clinical manifestations:
Temporary motor weakness and sensory loss may occur.
Recovery is usually complete within days to weeks.
Examples:
Ξ Saturday night palsy
Transient nerve compression injuries.
Axonal disruption (Option B) occurs
in axonotmesis and neurotmesis, associated with Wallerian degeneration distal to injury
Nerve trunk damage (Option C):
Severe injury involving the entire nerve trunk is seen in neurotmesis, and recovery is poor without surgical repair
Perineurium damage (Option D):
Damage to the perineurium suggests more severe nerve injury than neuropraxia and is associated with axonotmesis or neurotmesis.
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Dyspnea, and the presence of petechiae all over the body in a male patient who has broken a long bone in a car accident could be signs of the hazardous medical disorder known as fat embolism syndrome (FES)
Fat embolism syndrome (FES) is a serious medical condition that can occur after a bone fracture or other traumatic injury.
Symptoms of FES include dyspnea, decreased oxygen saturation, and petechiae all over the body.
Air embolism (Option B) :occurs when air bubbles obstruct blood flow, risking organ damage or death.
Venous thromboembolism (VTE)
(Option C): forms blood clots in veins, often traveling to the lungs, leading to pulmonary embolism and potential fatality.
Pulmonary hypertension (PH)
(Option D): causes high blood pressure in lung arteries, straining the heart and leading to eventual failure
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Correct Answer: B) Osteogenesis Imperfecta
Explanation:
Multiple long bone fractures seen on an ultrasound during the 13th week of pregnancy are typically indicative of osteogenesis imperfecta, a genetic disorder.
Osteogenesis Imperfecta:
Osteogenesis imperfecta is a genetic condition that affects bone strength and causes brittle bones. Hearing issues, dental deformities, and discolored sclera (the whites of the eyes) are further signs of osteogenesis imperfecta.
Ultrasound imaging can detect multiple long bone fractures in a fetus with osteogenesis imperfecta.
Defective Type 1 collagen.
Genetic Disorders and Prenatal Screening:
Prenatal screening tests can detect genetic disorders such as osteogenesis imperfecta during pregnancy.
Most commonly COL1A1 and COL1A2.
Radiological features:
Wormian bones: Supernumerary bones of the skull that form as a result of extra-ossification centres during development in utero. These are classic osteogenesis imperfecta and are usually within and surrounded by the suture lines.
Frontal and mastoid sinus
enlargement: Observed in some patients.
Thin cortices of long bones:
General demineralization and thinning of bone cortices
Frontal and mastoid sinus enlargement: Observed in some patients
Reduction in bone density: Notable in severe forms of osteogenesis imperfecta.
Codfish vertebra: Biconcave appearance of vertebrae (esp. Lumbar vertebrae) noted in imaging studies.
Fracture deformities: Mid-diaphyseal deformities (e.g., apex anterior) due to fragility fractures.
Protrusio acetabuli: Common hip finding.
Shepherd's crook deformity:
Common in femurs and is classically associated with fibrous dysplasia
Radiolucent scalloping with radio-dense rims: "Popcorn" appearance in metaphyses.
Trumpet-like metaphysis:
Characteristic deformity seen in radiology.
Management of Osteogenesis Imperfecta
Physiotherapy & Mobility Aids:
Ξ Walking aids and orthotics to maximize mobility and reduce fracture risk.
Pharmaceutical Agents:
Bisphosphonates:
IV Zoledronate:
Commonly used in children to enhance bone strength by inhibiting osteoclastic bone resorption.
Increases cortical thickness.
Cycles of intravenous bisphosphonates reduce bone pain and fracture incidence.
Surgical Intervention:
Sheffield Procedure:
Used in children with bowed long bones.
O Involves the insertion of expanding intramedullary rods or telescopic rods to improve weight-bearing and correct deformities
Sofield-Miller or Kebab Osteotomy:
Involves multiple osteotomies of bowed long bones in children to correct severe deformities and enhance bone stability.
Intramedullary fixation systems are often utilized to stabilize load-bearing bones.
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Correct Answer: B) Synovial Fluid
Analysis
Explanation:
Acute gout can be diagnosed with certainty by identifying urate crystals in synovial fluid, bursa or aspirate of tophus. In acute gout synovial fluid is highly inflammatory, with white blood cell counts of β₯2,000 cells/mm3.
Even when uric acid crystals are seen, the joint fluid should also be examined for the simultaneous presence of other crystals, especially calcium pyrophosphate crystals, and should undergo Gram stain and culture to rule out co-infection.
Gout
Inflammatory arthritis caused by the deposition of monosodium urate crystals in joints and tissues due to hyperuricemia
Clinical Presentation:
Acute Gouty Attack- Sudden onset of intense joint pain, typically affecting the big toe, but can also involve other joints such as the ankle, knee, wrist, or elbow
Chronic Gout- Recurrent attacks of joint inflammation, development of tophi (deposits of urate crystals) in joints and soft tissues
Diagnosis:
Medical History- History of recurrent joint pain, sudden onset, and self-limiting nature of attacks.
Physical Examination- Joint examination revealing signs of inflammation (redness, swelling, warmth)
Synovial Fluid Analysis-Detection of monosodium urate crystals in synovial fluid aspirated from an affected joint.
Serum Uric Acid Level- Elevated serum uric acid levels (>6.8 mg/dL) may support the diagnosis, but levels can be normal during an acute attack. Repeated estimations of serum uric acid levels is of great value.
Treatment:
Acute Attack- Nonsteroidal anti-
inflammatory drugs (NSAIDs), colchicine, corticosteroids for pain relief and inflammation control
Long-term Management-
Lifestyle modifications (dietary changes, weight loss), medications to lower uric acid levels (allopurinol, febuxostat) to prevent further attacks.
Serum Uric Acid Level (Option A):
Serum uric acid levels are often normal during an attack of acute gout, repeated estimations of serum uric acid levels is helpful.
Urine Uric Acid Levels (Option C):
Urine uric acid levels are not typically used as a diagnostic test for gout.
Although increased urinary excretion of uric acid may be observed in some cases of gout, it is not a specific or reliable marker for diagnosing the condition.
X-Ray Changes (Option D): X-ray changes, such as the presence of joint erosions or bone damage, may occur in advanced stages of gout (chronic gout) or if there have been recurrent episodes of inflammation over time.
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Correct Answer: D) Neuropraxia
Explanation:
Given clinical scenario is suggestive of Saturday night palsy, which is caused by compression of the radial nerve against the humerus.
The compression produces a temporary conduction block without disruption of the axon. This type of nerve injury is called neuropraxia (neurapraxia).
Radial nerve dysfunction causes weakness of the wrist and finger extensors, resulting in the characteristic wrist drop.
Neurotmesis (Option A): Complete
transection of both the axon and surrounding connective tissue sheaths (requires surgical repair).
Neurolysis (Option B): A surgical procedure to release a nerve from scar tissue or adhesions, not a category of nerve injury.
Axonotmesis (Option C): Disruption of the internal axon and myelin sheath leading to Wallerian degeneration, though the outer nerve sheaths remain intact.
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advanced arthritis
Explanation:
Presence of hip pain and true shortening of the limb is suggestive of Stage-III TB hip, known as Stage of advanced arthritis.
Babulkar and Pandey Clinico-Radiological Classification of TB Hip
Babulkar and Pandey Clinico-Radiological Classification of TB Hip stages:
Stage 1:
Synovitis
Clinical findings :
Irritable hip
Increased FABER (Flexion, Abduction, External Rotation)
Apparent lengthening due to FABER (Position of ease due to synovitis)
Terminal movements are restricted by 25%
X ray findings:
Normal or haziness of the articular margins
Stage 2 early arthritis:
Clinical features:
. Early joint pain, stiffness
. Increased FADIR ( Flexion,adduction, internal rotation)
. Apparent shortening due to FADIR
. Gluteal and quadriceps shortening
. ROM restricted by 50%
X ray findings
. Osteopenia and narrowing of joint space
Stage 3 late arthritis
Clinical features
Marked FADIR
True shortening
Gross restriction of movements
X ray :
Marked subchondral erosion and destruction.
Stage 4 severe arthritis:
. Marked FADIR
. Gross shortening
X ray :
Wandering and travelling acetabulum
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2660) A 6-year-old presents with a fracture through the growth plate and metaphysis, with the epiphysis unaffected. This is best classified as which Salter-Harris type?
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Anonymous Quiz
8%
A) Type I
60%
B) Type II
28%
C) Type III
4%
D) Type IV
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2660) A 6-year-old presents with a fracture through the growth plate and metaphysis, with the epiphysis unaffected. This is best classified as which Salter-Harris type?
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2660) Answer: B) Type II
Explanation
Type II is the most common Salter-Harris fracture β fracture line runs through the physis and exits through the metaphysis, sparing the epiphysis. Type I is purely through the physis; Type III involves physis + epiphysis; Type IV crosses metaphysis, physis, and epiphysis
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Explanation
Type II is the most common Salter-Harris fracture β fracture line runs through the physis and exits through the metaphysis, sparing the epiphysis. Type I is purely through the physis; Type III involves physis + epiphysis; Type IV crosses metaphysis, physis, and epiphysis
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2662) Answer: C) Brachial artery
Explanation
The brachial artery lies just anterior to the distal humerus and is at risk in extension-type supracondylar fractures, potentially leading to Volkmann's ischemic contracture if unrecognized.
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Explanation
The brachial artery lies just anterior to the distal humerus and is at risk in extension-type supracondylar fractures, potentially leading to Volkmann's ischemic contracture if unrecognized.
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NBEMS is set to release the NEET PG 2026 Answer Key for the first time, following the Supreme Courtβs direction to make the raw scores, answer key and normalisation details publicly available.
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