Orthopaedics

Question 1

What is the most common paediatric hip condition?

Transient synovitis
SUFE
Perthe’s disease
DDH

Answer 1

Transient synovitis

Question 2

Which gender is more commonly affected by Perthe’s disease and SUFE?

Answer 2

Male

Question 3

Males age 10-15 yrs are most affected by which hip condition?

Transient synovitis
SUFE
Perthe’s disease
DDH

Answer 3

SUFE

Question 4

Which scan method is used to assess Perthe’s disease and SUFE?

Answer 4

X-ray

Question 5

Which scan method is used to assess DDH if needed?

Answer 5

USS

Question 6

Name 3 risk factors for AVN of the femoral head.

Answer 6

Steroids
Sickle cell
Alcoholism
Trauma
Osteoarthritis
HIV
Caisson disease (divers)

Question 7

Which imagining modality is best for Avascular necrosis?

Answer 7

MRI

Question 8

Femoroacetabular impingement leads to pain on which hip movement?

Internal rotation
External rotation
Extension

Answer 8

Internal rotation

Question 9

What are the differentials for orthopaedic groin pain?

Answer 9

Osteoarthritis
Femoroacetabular impingement
Avascular necrosis
Tumour

Question 10

Name 3 potential complications of THR and their chances of happening?

Answer 10

Infection 1%
DVT 5%
Fatal PE 0.5%
Sciatic nerve pain 0.3%
Leg length deformity 25%
Dislocation <9%
Fracture 0.5%

Question 11

SUFE can be treated by which surgery?

Answer 11

Fixation

Osteotomy

Question 12

Name the 8 carpal bones of the wrist.

Answer 12

Scaphoid
Lunate
Triquetrum
Pisiform
Trapezium
Trapezoid
Capitate
Hamate

Question 13

The thenar, hypothenar, interosseous and lumbrical muscles are the _______ muscles of the hand.

Answer 13

Intrinsic

Question 14

Loss of thumb abduction suggests a palsy in which nerve?

Answer 14

Median

Question 15

The trapping of the median nerve under the flexor retinaculum happens in which condition?

Answer 15

Carpal tunnel syndrome

Question 16

A lateral ankle sprain occurs due to excessive ______ of the foot.

Answer 16

Inversion

Question 17

What may occur as a complication of ankle sprain/ fracture, often years later?

Answer 17

Ankle arthritis

Question 18

Gold standard surgical treatment for ankle arthritis is what?

Answer 18

Ankle arthodesis = joint fusion

Question 19

Which nerve is trapped under the flexor retinaculum ligament in tarsal tunnel syndrome?

Answer 19

Posteior tibial nerve

Question 20

Name 2 or more features found in a patient with posterior tibial tendon dysfunction.

Answer 20

Medial malleolar swelling and pain
Hindfoot valgus
“Too many toes” visible laterally
Pes planus (flat foot)

Question 21

The plantar fascia connects the metatarsal bones to the _________.

Answer 21

Calcaneus

Question 22

List a treatment ladder for plantar fasciitis.

Answer 22

Exercises- stretching of tendon
Weight loss
Orthotics
ESWT shock wave therapy
Steroid injection (but increased risk tendon rupture)
Surgery- calf release

Question 23

Eccentric loading means loading the muscle while it is _________.

Answer 23

Lengthening

Question 24

Hallux valgus (bunion) is a deformity of which joint?

Answer 24

1st Metatarsophalangeal joint

Question 25

Hallux _____ is osteoarthritis of the 1st metatarsophalangeal joint.

Answer 25

Rigidus

Question 26

Which toe movement is lost/ decreased in hallux ridigus?

Answer 26

Dorsiflexion

Question 27

Interdigital neuroma can be diagnosed using which imaging technique?

Answer 27

Ultrasound

Question 28

A callus affects which side of the foot?

Answer 28

Plantar

Question 29

A corn affects which side of the foot?

Answer 29

Dorsal

Question 30

The subtalar joint is the articulation between which 2 bones?

Answer 30

Talus | Calcaneus

Question 31

Name the 6 tendons and vessels that pass behind the medial malleolus of the foot under the flexor retinaculum.

Answer 31

Tibialis posterior Flexor digitorum longus Posterior tibial artery, vein and nerve Flexor hallucis longus

Question 32

What are the 5 nerves that supply the foot?

Answer 32

Medial and lateral plantar Sural Saphenous Medial calcaneal

Question 33

Acquired adult flat foot (Pes planus) is caused by dysfunction of which tendon?

Answer 33

Posterior tibial tendon

Question 34

Which 2 antibiotics are usually given for 6 weeks IV in patients with osteomyelitis?

Answer 34

Vancomycin | Cefotaxime

Question 35

Which rotator cuff muscles are responsible for external rotation?

Answer 35

Infraspinatus | Teres minor

Question 36

What are the 3 common phases of adhesive capsulitis?

Answer 36

1. Painful phase (decreased shoulder abduction and decreased external rotation) 2. Frozen phase (stiffness) 3. Thawing phase (regain of movement)

Question 37

Cuff arthopathy is loss of cartilage and ________________.

Answer 37

Rotator cuff tears

Question 38

What test is used for a TUBS dislocation?

Answer 38

MRI

Question 39

What does AMBRI stand for?

Answer 39

``` Atraumatic Multidirectional Bilateral Rehabilitation Internal capsule shift ```

Question 40

Which knee ligament is most commonly injured?

Answer 40

MCL

Question 41

Give 2 examples of why knee surgery may need revising?

Answer 41

Infection Asceptic loosening Instability Periprosthetic fracture

Question 42

Patella maltracking occurs due to failure of which muscle?

Answer 42

Vastus medialis

Question 43

Which arteries supply the hip joint?

Answer 43

Medial and lateral circumflex

Question 44

Primary curvature of the spine involves the thoracic and sacral __________.

Answer 44

Kyphosis

Question 45

At what level is the conus medullaris?

Answer 45

L1/2

Question 46

Do IV discs have their own blood supply?

Answer 46

No Rely on cartilagenous end plates

Question 47

Schueurmann's disease is the commonest cause of __________ in 13-16 year olds. Lordosis Scoliosis Kyphosis

Answer 47

Kyphosis

Question 48

Kyphosis is an excessive _______ spinal curvature over 40 degrees

Answer 48

Sagittal

Question 49

Give 2 features/ symptoms of cervical stenosis.

Answer 49

1. UMN lesion = spasticity, hyper-reflexia, hypertonia, Babinski sign, clonus 2. Loss of fine motor skills 3. Broad based shuffling gait 4. Upper limb radiculopathy 5. Neck pain/ stiffness 6. Pyramidal pattern weakness

Question 50

Give 2 features/ symptoms of lumbar stenosis.

Answer 50

1. CNS signs are rare 2. Spinal claudication 3. Pain on extension 4. Pain on walking

Question 51

What is the gold standard imaging method for suspected cauda equina?

Answer 51

MRI

Question 52

Metastatic cord compression (MSCC) usually affects which part of the spine?

Answer 52

Thoracic (70%)

Question 53

What is the gold standard imaging method for suspected metastatic cord compression?

Answer 53

MRI

Question 54

Pott's disease is _____ of the spine.

Answer 54

TB

Question 55

Which vertebrae is usually displaced onto the one below it in spondylolithesis?

Answer 55

L5

Question 56

Which hand nerve supplies the interosseous, hypothenar and medial 2 lumbricals?

Answer 56

Ulnar

Question 57

Palsy of which nerve can lead to claw hand?

Answer 57

Ulnar

Question 58

Palsy of which nerve can lead to wrist drop?

Answer 58

Radial

Question 59

Tennis elbow involves pain on the _______ epicondyl.

Answer 59

Lateral