Mcq Flashcards
(120 cards)
1
Q
- Which of the following is a feature of Blount’s disease?
a. Most commonly found between 2-4 years of age
b. Genu valgum
c. Typically found in obese children
d. Presents most often with hip pain
e. Coxa vara
A
Typically found in obese children
2
Q
- Which of the following represents a relative contraindication for antegrade intramedullary nailing of a femoral shaft fracture?
a. Metastatic disease
b. Femoral nerve palsy
c. Morbid obesity
d. Open fracture
e. Subtrochanteric fracture
A
Morbid obesity
3
Q
- In a trigger finger, where is the level of tendon constriction found?
a. Distal interphalangeal joint
b. Proximal interphalangeal joint
c. Metacarpal shaft
d. Middle phalanx
e. Metacarpophalangeal joint
A
Metacarpophalangeal joint
4
Q
- Which segment of the scaphoid has the poorest blood supply?
a. Volar surface
b. Distal pole
c. Proximal pole
d. Medial aspect
e. Lateral aspect
A
Proximal pole
5
Q
- Which of the following is NOT a method used to reduce an anterior shoulder dislocation?
a. Allis maneuver
b. Hippocratic technique
c. Stimson’s technique
d. Traction-Counter traction
e. Kocher’s maneuver
A
Allis maneuver
6
Q
- Which of the following statements with respect to clavicle fractures is true?
a. In babies, a body cast is required due to their small body habitus and inability to comply with instructions
b. Most clavicular fractures in adults require surgical stabilization
c. Middle third fractures have an approximately 25% chance of non-union
d. Once minimally displaced, will heal in 6-8 weeks
e. Distal third fractures are the most common type
A
Once minimally displaced, will heal in 6-8 weeks
7
Q
- With respect to knee replacement surgery, which of the following is true?
a. Total knee prostheses must be changed after 10 years in situ
b. The cruciate ligaments are conserved in most condylar knee prostheses
c. Most degenerative knees are valgus e.
d. Postoperative infection is a rare and easily treated complication
e. Demand for this surgery is increasing worldwide
A
e. Demand for this surgery is increasing worldwide
8
Q
- Which of these statements about patients with active rheumatoid arthritis is true?
a. Radiographs regularly show periarticular osteopenia
b. Manifestations in adults and children are quite similar
c. The white cell count (WBC) is characteristically 7-11000 WBC/mm3
d. Once treated adequately, the patient can expect to have normal joint function
e. Joint movements are normally pain-free
A
Radiographs regularly show periarticular osteopenia
9
Q
- In a patient with a lumbar disc prolapse:
a. Sensory deficit on the anterior aspect of the leg indicates a second lumbar nerve root lesion
b. Loss of the ankle reflex indicates a first sacral root lesion
c. Sensory deficit on the sole indicates a fourth lumbar nerve root lesion
d. Loss of the knee reflex indicates a second lumbar nerve root lesion
e. Loss of dorsiflexion of the great toe indicates a third lumbar nerve root lesion
A
Loss of the ankle reflex indicates a first sacral root lesion
10
Q
- A mallet finger refers to:
a. A hammer shaped deformity of the index finger
b. Avulsion of the flexor tendon at the base of the middle phalanx
c. Avulsion of the extensor tendon at the base of the distal phalanx
d. Avulsion of the extensor tendon at the base of the middle phalanx
e. Avulsion of the flexor tendon at the base of the distal phalanx
A
Avulsion of the extensor tendon at the base of the distal phalanx
11
Q
- Lachmann’s test of the knee is used to detect:
a. Lateral collateral ligament injury
b. Meniscal tears
c. Patellar instability
d. Medial collateral ligament injury
e. Anterior cruciate ligament injury
A
Anterior cruciate ligament injury
12
Q
- Which of the following is not a principle for applying a below knee cast?
a. The fibular head and the plantar aspect of the foot should be well padded
b. The cast should support the metatarsal heads
c. The ankle should be in neutral
d. The cast should extend to the inferior pole of the patella
e. The toes should have freedom of movement
A
The cast should extend to the inferior pole of the patella
13
Q
- Which of the following statements regarding compartment syndrome is false?
a. There are three compartments in the forearm
b. After adequate fasciotomy, the skin and subcutaneous fat are often left open
c. Can be seen after open fractures
d. Is a complication of femoral shaft fractures
e. In head injured patients, compartment pressure monitoring is useful for establishing the diagnosis
A
In head injured patients, compartment pressure monitoring is useful for establishing the diagnosis - ICP monitoring sustained > 20 mmHg leads to death of brain tissue
14
Q
Which of the following statements about humeral shaft fractures is true?
a. Intramedullary nailing is the surgical treatment of choice
b. Generally require internal fixation to achieve union
c. Fat embolism is a common complication
d. Varus angulation up to 30 degrees is well tolerated
e. Collar and cuff slings are commonly used for conservative treatment
A
Varus angulation up to 30 degrees is well tolerated
15
Q
Which of the following statements concerning osteoarthritis of the hip joint is true?
a. Total hip replacements are only used in elderly patients
b. May occur as a sequelae of Perthes disease
c. The joint capsule is stretched and lax
d. Radiographs typically show periarticular cysts and erosions
e. The lower limb is usually abducted and internally rotated
A
May occur as a sequelae of Perthes disease
16
Q
- In the Gustilo-Andersen classification of open fractures, all of the following are considered
parameters except:
a. Velocity of the injury
b. Potential wound contamination
c. Size of the soft tissue injury
d. Patient physiological status
e. Presence of vascular injuries
A
Patient physiological status
17
Q
- Falls onto the feet causing fractures of the calcaneum are most often associated with fractures of
the:
a. Tibia
b. Pelvis
c. Neck of femur
d. Vertebrae
e. Acetabulum
A
Vertebrae
18
Q
- Ortolani’s test is used in the diagnosis of what condition?
a. Slipped upper femoral epiphysis
b. Developmental dysplasia of the hip
c. Limb length discrepancy
d. Osgood-Schlatter’s disease
e. Patella dislocation
A
Developmental dysplasia of the hip
19
Q
All of the following features may be found in a 13 year old girl with scoliosis (Cobb angle of 35 degrees) except:
a. Apparent leg length inequality
b. Truncal shift
c. Spontaneous correction of the curve
d. Rib hump on Adams Forward bending test
e. Cafe au lait spots
A
Spontaneous correction of the curve
20
Q
- A 22 year old footballer sustains an acute knee haemarthrosis following a non-contact injury.
Which statement below regarding this condition is true?
A
Pivot Shift test is the most appropriate clinical examination
21
Q
- Which of the following occurs earliest in fracture healing?
A
Haematoma formation
22
Q
- A 52 year old man is diagnosed with rotator cuff tendinopathy. Which of the following statements
concerning the diagnosis is true?
A
Clinical presentation is typically with a painful arc of movement
23
Q
- Which of the following structures do not pass through the carpal tunnel?
a. Flexor digitorum profundus tendons
b. Median nerve
c. Flexor digitorum superficialis tendons
d. Palmaris longus tendon
e. Flexor pollicis longus tendon
A
Palmaris longus tendon
24
Q
- Which of the following statements regarding birth trauma involving the fifth and sixth cervical
nerve roots of the brachial plexus is true?
A
The characteristic deformity is pronation of the forearm, extension of the elbow and
internal rotation of the arm
25
25. The most common cause of carpal tunnel syndrome is:
Idiopathic
26
26. Which of the following statements about the radial nerve is true?
It is a terminal branch of the posterior cord of the brachial plexus
27
27. A 3 year old child presents to A&E with a 2 day history of fever and a painful limp. There is erythema and tenderness over the distal tibia. Which of the following statements concerning management is true?
In suspected osteomyelitis, antibiotics should be started prior to return of blood culture results
28
28. A 2 year old child is brought to A&E with a fractured tibia. Which of the following features are not suggestive of non-accidental injury (NAI)?
Parent who seems upset and concerned about their child’s injury
29
29. Which of the following statements concerning femoral neck (hip) fractures is true?
The intertrochanteric line defines the anterior extent of the hip capsule and is used to
classify fractures as extra or intracapsular
30
30. Which of the following statements is true with respect to Salter-Harris fractures?
Type 2 is the most common pattern of injury
31
31. Which of the following statements regarding ankle fractures is true?
Can be classified based on the level of the fracture in relation to the syndesmosis
32
32. A 45 year old man cannot extend his knee after a fall. X-ray films show no fractures. Which of the following is the most likely diagnosis?
Quadriceps tendon rupture
33
33. Which of the following statements about femoral shaft fractures is true?
Open reduction and intramedullary nailing is the treatment of choice
34
34. Which of the following statements regarding carpal tunnel syndrome is false?
Nerve conduction studies and electromyography are required to make the diagnosis
35
35. All of the following statements regarding congenital talipes equinovarus (CTEV) are true except:
Serial casting is best started at about three months of age
36
36. Which of the following statements about shoulder dislocations is true?
In young patients, recurrent dislocation may require a Bankart Procedure
37
37. Which of the following statements concerning the knee joint is true?
It is lined by fibrocartilage
38
38. Radial head fractures are most often associated with:
Restricted pronation/supination at the elbow
39
39. A 19 year old presents with a 6 month history of worsening pain in the proximal leg associated
with a palpable, diffuse, firm swelling. Which of the following investigations would give the most
information?
MRI of the leg
40
40. Which of the following statements about external fixation is false?
Is not used in children
41
41. You are asked to see a patient on the ward, day 2 after a right total hip replacement (THR). He has
Parkinson’s disease and had been slow to get out of bed after the operation. Whilst climbing off a
commode he suddenly complained of pain in the right groin and was unable to weight bear. The
nurses hoisted him into bed and noticed that the right leg was externally rotated and shorter than
the left. The most likely cause of his pain is:
Anterior dislocation of the prosthesis
42
42. Regarding the anatomy of the upper limb, which of the following is false?
Weakness of the flexor pollicis longus can be observed in carpal tunnel syndrome
43
43. A felon:
Can lead to osteomyelitis
44
44. Which of the following principles of applying proximal tibial skeletal traction is incorrect?
The posterior compartment should be avoided
45
45. Which fracture pattern is typical in the pediatric age group?
Torus fracture
46
46. The scaphoid is known to have an unusual blood supply which makes it more prone to non-union
when fractured. Which other bone in the body is similar in this fashion to the scaphoid?
Talus
47
47. A 50 year old man presents with a stiff painful knee. He has had no treatment to date. He works
as a chef and has a BMI of 40. He is otherwise fit and well. Examination reveals a range of
movement of 0-120 degrees with mild crepitus throughout. Alignment of the knee is normal. X-rays show early osteoarthritis of medial and lateral compartments. The first line treatment
should include:
Physiotherapy, activity modification and lifestyle changes
48
48. Spina bifida occulta refers to which of the following?
Non-fusion of the spinal laminae
49
49. All of the features below are Kanavel’s signs except:
Erythema of the digit
50
50. When examining the hip, Thomas’ test detects:
Fixed flexion of the hip
51
51. Femoral shaft fractures:
Open intramedullary nailing is the treatment of choice
52
52. Which of the following structures passes through the carpal tunnel?
Median nerve
53
53. Which of the following is not a method used to reduce an anterior shoulder dislocation?
Bigelow’s technique
54
54. A positive pivot shift test on knee examination is due to injury of which structure?
Anterior cruciate ligament
55
55. Which fracture pattern is produced by purely compressive forces?
Wedge compression
56
56. In a trigger finger, where is the level of tendon constriction found?
Metacarpophalangeal joint
57
57. Which of the following statements is true with respect to clavicle fractures?
Middle third fractures have approximately 5% chance of non-union
58
58. The last thing to occur in fracture healing is
Remodeling
59
59. Radial head fractures can be associated with which of the following?
Essex Lopresti injury
60
60. Mallet finger refers to:
Avulsion of the extensor tendon at the base of the distal phalanx
61
61. Ankle fractures:
Ottawa rules allow judicious requesting of radiographs in the acute setting
62
62. In acute knee haemarthrosis following a non-contact injury in a footballer:
Lachman’s test may be positive
63
63. Intracapsular hip fractures:
Young patients may require open reduction and internal fixation
64
64. Where does the blood supply to the scaphoid enter the bone?
Distal pole
65
65. With respect to knee replacement surgery:
Most degenerative knees are varus rather than valgus
66
66. Rotator cuff tendinopathy:
Type III acromion is typically associated with major tears
67
67. Compartment syndrome:
May occur in open fractures
68
68. With regard to anatomy of the upper limb:
The axillary nerve passes through the quadrangular space
69
69. Which of the following is not a principle for applying a below knee cast?
The ankle needs to be in equinus during application
70
70. Humeral shaft fractures:
Varus angulation up to 20 degrees is well tolerated
71
71. What is the position of the forefoot if it is rotated so that the great toe is elevated and the fifth toe
is depressed?
Varus
72
72. Which of the following is an indication for intramedullary nailing of a humeral shaft fracture?
Metastatic disease
73
73. Extracapsular hip fractures:
Dynamic Hip Screw fixation allows for improved blood supply which facilitates healing
74
74. The scaphoid is known to have an unusual blood supply which makes it more prone to non-union
when fractured. Which bone in the foot is similar in this fashion to the scaphoid?
Talus
75
75. The test whereby a snapping sound is heard or felt while abducting and maintain traction on a
developmental dysplastic hip is known as:
Ortolani’s sign
76
76. Which of the following statements is false regarding carpal tunnel syndrome (CTS)?
Diagnosis is confirmed by a positive Finklestein’s test - This test is positive in de
quervain's tenosynovitis
77
77. Shoulder dislocation:
Axillary nerve injury may occur
78
78. What is the most critical clinical sign of compartment syndrome?
Pain out of proportion
79
79. Which of the following principles of applying tibial skeletal traction is false?
The pin is placed from medial to lateral
80
80. In septic arthritis:
Once treated adequately, the patient can expect to have normal joint function - Delayed diagnosis can lead to profound, extensive cartilage damage within 8 hours
81
81. Falls onto the feet so as to fracture the calcaneum are most often associated with fractures of
which of the following?
Vertebrae
82
82. All of the following are Kanavel’s signs except:
a. Tenderness along tendon sheath
b. Petechial hemorrhages at the pulp space
c. Pain on passive extension
d. Flexed position of digit
e. Fusiform swelling of the digit
Petechial hemorrhages at the pulp space
83
83. What is the most common cause of carpal tunnel syndrome?
Idiopathic
84
84. Which of the following is not an indication for ORIF of a fractured clavicle?
Severe pain
85
85. With regard to anterior cruciate ligament surgery:
Acute injuries are more often associated with lateral meniscus tears than medial ones -
Lateral meniscal tear is commonly associated with acute ACL injury, while medial meniscal tear with chronic ACL injury
86
86. Which of the following statements concerning Gustillo-Anderson Type III B injuries is true?
Periosteal stripping is present and the bone cannot be covered
87
87. A 60 year old patient falls and then cannot extend the knee. X-ray films show no fractures. Which
of the following is most likely?
Quadriceps tendon rupture
88
88. A felon is:
A distal pulp space infection
89
89. With respect to the clavicle:
Collar and cuff immobilization is adequate treatment for clavicular fractures
90
90. Which of the following statements is true with respect to Salter Harris fractures?
Type 5 fractures are often not easily recognizable on plain radiographs
91
91. a This is the fundamental condition underlying the propensity for patients to sustain Colles fractures:
Osteoporosis
92
91. b This structure is used in tendon transfers after complicated Colles fractures:
Extensor Indicis
93
91. c This condition may occur after a Colles fracture and is characterized by swollen stiff fingers and patchy osteopenia on radiograph:
Complex Regional Pain Syndrome
94
91 e This tendon can be ruptured following a minimally displaced Colles fracture:
Extensor
Pollicis Longus
95
A 30 year old motorcyclist sustains a fracture of the tibia where the skin and muscle have
been ripped off over a distance of 10cm
External Fixator
96
A 65 year old woman falls and sustains a distal radial fracture which is very angulated. It
is reduced but it will not stay in position
Kirschner (K) Wires
97
A 25 year old rugby player falls and suffers transverse displaced midshaft fractures of
both the radius and ulna
Plates and Screws
98
A 2 year old child is involved in a road traffic accident and sustains a fracture across the
midshaft of the femur
Balance
Brace
99
A 70 year old man with metastatic carcinoma of the lung presents with a pathological
fracture through the upper third of the femur. Up until now he was reasonably well.
Dynamic Hip Screw
100
The structure is fractured by axial loading (as in a fall from a height)
Tibial plafond;
101
What is the most common type of ankle fracture
Weber B;
102
A diastasis screw is usually employed when treating these fractures
Weber C;
103
Which ligament is most commonly injured in simple ankle sprains
Anterior Talofibular Ligament
104
A 42 year old man presents with pain over the palmar aspect of his right ring finger and
“locking” for the past 3 months. He is able to passively extend the finger.
Stenosing Flexor Tenosynovitis
105
A 55 year old diabetic fisherman presents with pain and swelling of his right index finger.
He reports getting stuck by a fish bone on that finger 4 days earlier. There is tenderness
on the volar side and passive extension is very painful.
Pyogenic Flexor Tenosynovitis
106
A 21 year old student presents with a painless lump on the volar aspect of her right wrist
for the past 6 months which fluctuates in size. It is firm, transilluminates and is not
pulsatile.
Ganglion;
107
A 28 year old chef sustains a laceration to the volar aspect of his left index finger. He has
no active flexion at the distal interphalangeal joint of that finger.
Flexor Digitorum Profundus Laceration;
108
A 35 year old secretary presents with a 2 month history of increasing pain on the radial
side of her right wrist. She has difficulty holding coffee mugs. There is pain on passive
wrist adduction.
De Quervain’s Tenosynovitis
109
95. Osgood Schlatter disease, what is affected?
Tibial tuberosity
110
96. Risk factor for carpal tunnel syndrome
Pregnancy
111
98. How much blood loss is stage III shock?
1500 - 2000 ml i.e. 30% - 40%
112
99. Which fracture is most at risk of malunion?
Radial and ulnar shaft fracture placed in cast
113
Which of the following would be used to fix a dislocated hip?
Bigalow’s method
114
104. Which of the following are compression fractures in children?
Torus
115
106. Rotator cuff tendinopathy:
Clinical presentation is typically with a painful arc of movement
116
107. Commonly ruptured in a “dashboard injury”; Is C shaped; Rupture produces a tense
hemarthrosis; Attached to the lateral meniscus; Is important in the blood supply to the patella
tendon
Posterior cruciate ligament
117
108. Ganglions:
Normally contain a clear gelatinous material
118
109. Idiopathic adolescent scoliosis:
Is more common in girls than boys
119
110. Slipped upper femoral epiphysis
Endocrine abnormalities predispose to the condition being bilateral
120
111. Is an unstable fracture; Is based on the level of the fibular fracture only; Used in Weber C
fractures mostly
Diastasis screw
