4th Year Orthopaedics

Question 1

Name 2 risk factors for developmental dysplasia of the hip?

Answer 1

Family history
Breech presentation
Foot deformity
Female gender

Question 2

What is the Ortolani test?

Answer 2

Abduction and relocation of the dislocated hip

Question 3

What is the Barlow test?

Answer 3

Adduction and dislocation of the hip

Question 4

When would ortolani and Barlow tests be positive?

Answer 4

Only in the neonate

Question 5

How should a diagnosis of DDH be confirmed in a child aged up to 3-6 months?

Answer 5

Ultrasound

Question 6

How should a diagnosis of DDH be confirmed In a child >6months?

Answer 6

X-ray - due to calcified epiphysis

Question 7

How should DDH be treated In children up to 6 months?

Answer 7

Splint - pavlik harness - abduction and flexion

Question 8

What treatment of DDH may be necessary in children over 2 years?

Answer 8

Surgery - osteotomy

Question 9

How might an older child present with DDH if not diagnosed as a neonate?

Answer 9

A limp ever since they started walking

Question 10

What are the 4 main signs of septic arthritis in a child?

Answer 10

Inability to weight bear
Fever >38
ESR >40
WCC >12

Question 11

What may precede transient synovitis?

Answer 11

URTI

Question 12

What is Perthes?

Answer 12

Idiopathic avascular necrosis of the hip

Question 13

What ages does Perthes typically present in?

Answer 13

3-12

Question 14

What is the typical child who gets Perthes?

Answer 14

Small active boys

Question 15

How is Perthes managed?

Answer 15

Younger children, milder cases - Non operatively, limit activity
Older children, severe cases -femoral or acetabular osteotomy

Question 16

What is osteochondritis dissecans?

Answer 16

Avascularity of the lateral side of the medial femoral condyle

Question 17

What symptoms are present in osteochondritis dissecans?

Answer 17

Intermittent locking and pain

Question 18

What is osgood-schlatters disease?

Answer 18

Idiopathic aseptic necrosis of the tibial tuberosity - knee pain in adolescence

Question 19

What age does SUFE typically present?

Answer 19

10-16 years

Question 20

What groups are more likely to get SUFE?

Answer 20

Overweight boys

Question 21

Where might the pain of SUFE be felt?

Answer 21

In the knee

Question 22

What investigations should be performed in suspected SUFE?

Answer 22

LATERAL x-ray

Question 23

What is the main complication of SUFE?

Answer 23

AVN - 47%

Question 24

What should be ruled out in any adolescent who is unable to weight bear?

Answer 24

SUFE - do not weight bear until x-ray is performed

Question 25

Intratrochanteric hip fracture - intra or extra capsular?

Answer 25

Extra - dynamic hip screw

Question 26

What is chondromalacia patellae?

Answer 26

Softening of the patellar cartilage, seen in teenage girls, anterior knew pain, common when walking up and down stairs

Question 27

What is Osgod schlatters?

Answer 27

Sporty teenagers, pain tenderness and swelling over the tibial tuberosity

Question 28

What is osteochondritis dissecans?

Answer 28

Pain after exercise, intermittent swelling and locking

Question 29

What is patellar tendonitis?

Answer 29

Pain below the patella, seen in boys after running

Question 30

What are the 5 categories of salter harris fracture?

Answer 30

1. S - straight across 2. A - above 3. L - lower or lateral 4. T - through two 5. Crush

Question 31

Symptoms of common peroneal nerve damage?

Answer 31

Weakness of ankle dorsi flexion

Question 32

The is the straight leg raised +ve?

Answer 32

Sciatica

Question 33

Which nerve damage causes wrist drop?

Answer 33

Radial nerve

Question 34

First line treatment in Ank spend?

Answer 34

NSAIDS and exercise

Question 35

What is pages disease?

Answer 35

Increased but uncontrolled bone turnover - disorder of osteoclasts

Question 36

Signs of pagers disease?

Answer 36

Bowing tibia, bossing of skull, raised ALP. Ca and PO3 usually normal

Question 37

Treatment of pagets?

Answer 37

Bisphosphonate

Question 38

APTT and platelets in anti phospholipid syndrome?

Answer 38

ATT - prolonged | Platelets - low

Question 39

Supply and function of anterior compartment of arm?

Answer 39

Flexors | Musculocutaneous

Question 40

Supply and function of posterior compartment of arm?

Answer 40

Extensor | Radial Nerve

Question 41

Supply and function of anterior compartment of forearm?

Answer 41

Flexor and pronator | Median nerve

Question 42

Supply and function of posterior compartment of forearm?

Answer 42

Extensor and supinator | Radial nerve

Question 43

4 muscles of rotator cuff?

Answer 43

Supraspinatous Infraspinatous Teres minor Subscapularis

Question 44

5 nerves of brachial plexus?

Answer 44

``` Musculocutaneous Median Ulnar Axillary Radial ```

Question 45

Supply to palm of hand?

Answer 45

Median and ulnar

Question 46

Supply to back of hand?

Answer 46

Radial and median

Question 47

Supply and function of anterior compartment of thigh?

Answer 47

Hip flexors and knee extensors | Femoral nerve

Question 48

Supply and function of medial compartment of thigh?

Answer 48

Hip adductor | Obturator nerve

Question 49

Supply and function of posterior compartment of thigh?

Answer 49

Extension of hip and flexion of knee | Sciatic nerve

Question 50

Supply and function of lateral compartment of leg?

Answer 50

Eversion of foot | Superficial fibular nerve

Question 51

Supply and function of anterior compartment of leg?

Answer 51

Dorsiflexion of ankle, extension of toes, inversion of ankle | Deep fibular nerve

Question 52

Supply and function of posterior compartment of leg?

Answer 52

Plantar flexion Flexion of toes Inversion Tibial nerve

Question 53

Where is the doralis pedis pulse located?

Answer 53

Lateral to the tendon of extensor hallicus longus