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Mcqs Orthopedics PDF
Mcqs Orthopedics PDF
Orthopedics
Digitally
signed by
MedCom 2005
True/False
Notes
About SCFE (slipped capital femoral epiphysis):
a) usually due to trauma
F
[ trauma is thought to have a role in the acute presentation ]
b) Limb is internally rotated
F
[externally rotated]
c) 70% are of acute onset
F
[30%]
d) X-ray is necessary
T
2)
about MMT ( medial meniscal tear ):
a) usually no acute swelling
T
b) due to twisting
T
c) locking
T
d) may cause osteochondritis if not treated
F
[ OA (osteoathritis)]
3)
the muscle responsible for knee movement during heel stike:
a) hamstrings
b) calf muscles
c) quadriceps
T
d) gastrocnemius
4)
nerve injury in the axilla which is 1st to recover:
a) ulnar
b) radial
?
c) median
d) three together
e) variability of predilection
5)
after peripheral nerve injury , steppage gait & loss of eversion of the big toe indicates injury to:
a) femoral nerve
b) peroneal nerve
T
c) tibial nerve
[ opposite picture ]
d) sural nerve
6)
one muscle is not attached to bone:
a) lumbricals
T
[also palmaris brevis]
b) palmar interossei
c) dorsal interossei
d) adductor pollicis brevis
e) flexor digiti minimi
7)
most common fractured bone in osteoporosis:
a) femur
b) vertebra
T
8)
about osteoporoseis :
a) biochemistry is not normal
F
[ normal ]
b) can cause spontaneous fracture
T
c) dietary treatment is helpful
F
[ is useful for prevention not trearment ]
d) splintage is effective
F
[ increase regional osteoporosis ]
9)
the fracture in children that needs operation:
a) femur shaft
[ can be treated conservatively under certain
b) bilateral forearm fracture
conditions ]
c) tibia
d) humerus
e) femur neck
T
10)
about scaphoid fractures:
a) clinical diagnosis is important
T
b) leads to axascular necrosis
T
[ appearance on x-ray can be delayed for
c) X-ray is diagnostic early
F
weeks sometimes ]
11)
in hand injury one is false :
a) early operation
?
b) elevation for edema
T
c) primary care for bone before skin
F
1)
12)
MedCom 2005
13)
Orthopedics
c) androgen
d) crtisol
e) citrate
has risk of malignancy :
Ollier's disease
T
[30%]
osteoclastoma
T
[= GCT]
amyloidosis
F
[ it can result from myeloma or B-cell lymphoma ]
multiple enchondroma
T
[= Ollier's disease]
the most important slow growing killing tumor is:
a) chondrosarcoma
T
b) Ewing's sarcoma
c) malignant synovium
[ rapidly growing tumors ]
d) osteosarcoma
e) rhabdomyosarcoma
about secondary bone tumors :
a) hematogenous spread
T
b) thyroid cancer is the most common primary
F
[breast then prostate ,kidney, lung, thyroid,]
c) they may present with pathologic fracture :
T
about septic arthritis :
a) mostly caused by Staph. pyogenes
F
[Staph. aureus]
b) can cause necrosis & destruction of bone
T
c) cold lesions on bone scan has good prognosis
F
[ can be the result of severe osteomyelitis]
which is more likely diagnosis for 45yr-old male with 2yr hx knee pain that's releived by walking around :
a) osteomalacia
b) osteoporosis
c) OA
d) osteochondroma
e) osteopetrosis
all can cause knee joint swelling except :
a) OA
b) osteochondritis dissecans
c) prepatellar bursitis
[ in front of the joint not in it]
d) synovial chondromatosis
e) peripheral meniscal tear
all are cardinal signs of inflammation as described by Celsus except:
a) color
b) rubor
c) tumor
d) olor
e) loss of function
F
[ described by Virchow ]
about osteoid osteoma :
a) can cause scoliosis
T
b) causes pain worse at night & releived by antidepressants
F
[ aspirin & NSAIDs(less) ]
c) can result in leg-length discrepancy
T
all are supplied by ulnar nerve except :
a) hypothenar muscles
T
b) adductor pollicis
T
c) all interossei
T
d) ulnar 2 lumbricals
T
e) superficial head of flexor pollicis brevis
F
[ median nerve ]
abou osteocondritis dissecans :
a) the most common cause for loose bodies in young adults
T
b) calcaneal apophysis could be involved
T
c) anteromedial corner of talus can be involved
T
d) when it occurs this is certain that cancer returned
F
[ not related to malignancy ]
which is best exercise done during acute & subacute RA :
a) isometric
b) concentric
c) isokinetic
d) no exercise slould be done
about osteochondritis dissecans:
a)
b)
c)
d)
14)
15)
16)
17)
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19)
20)
21)
22)
23)
?
24)
MedCom 2005
25)
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Orthopedics
28)
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30)
31)
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?
33)
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35)
T
T
T
T
F
[ capitellum ]
T
F
T
T
F
T
F
T
T
F
T
T
F
T
T
T
F
T
F
T
T
[ on MRI ]
[ because its attachment to capsule makes it
less mobile ]
T
F
F
[ for deceleration ]
T
T?
T
T
3
MedCom 2005
36)
37)
38)
39)
?
40)
41)
42)
43)
44)
45)
46)
Skeletal traction
Skin traction
ORIF
External fixation
about cubitus valgus :
a) This ugly deformity worsens when the elbow is flexed
The best x-ray view for anterior column acetabular fracture :
a) AP
b) obturator oblique
c) Inlet view
about MMC (myelomrningocele):
a) M > F
b) Mostly lumbar
c) due to environmental and genetic factors
d) associated with Arnold-Chiari malfomatin type II in 100% of cases
e) can occur due to carbamazepine treatment during pregnancy
associated with LCS ( lumbar canal stenosis ) :
a) old age
b) restricted spinal flexion
c) Spinal claudication
d) Back pain radiating to LL
a)
b)
c)
d)
e)
47)
Orthopedics
[ extended ]
T
T
T
F
T
T
[ >95%]
[ valproic acid ]
T
T
T
F
T
MedCom 2005
48)
49)
50)
51)
?
52)
53)
54)
55)
57)
?
58)
59)
60)
Orthopedics
d) surgery is required
about understanding infection in children :
a) intercostal artery supplying 2 vertebrae
b) some bones are intracapsular
c) thick periosteum
d) pesistence of metaphyseal vessels for 5 years of age
about club foot (CTEV):
a) vertical talus
b) inversion of hind foot
c) supination
d) adduction
e) tight tendon of Achilles
about flat foot :
a) may occur in rickets
b) causes severe pain after walking
c) there are 5 arches
d) may require correction
e) associated with vertical talus
most important feature for prosthesis is :
a) cosmetic
b) functions well
c) cost
about rotator cuff syndrome :
a) mostly infraspinatus is involved
drop arm after :
a) complete rotator cuff tear
b) calcified supraspinatus tendon
c) coracoid process fracture
about Perthes' disease :
a) age usally 4-8 years
b) severe & continous pain
[ only as needed ]
?
T
T
F
F
T
T
T
T
T
F
T
T
[ supraspinatus ]
T
T
T
T
F
T
T
T
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MedCom 2005
61)
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Orthopedics
d) Codman's triangle
T
e) honey-comb
false about clavicle :
union between medial end and the rest ossifiscation center occurs
between 13-25 years old
false about pelvic fracture :
injuries of the pelvis are more dangerous than the associated soft tissue injury
most dangerous immediate complication ofpelvic fracture:
hemorrhage
best treatment for osteoporosis is :
HRT
best treatment for femoral shaft fractures is :
internal fixation
first carpal bone to ossify :
capitate
muscle inserted on 5th metatarsal bone :
peroneus brevis
most common tumor in the hand is
enchondroma
false about humeral supracondylar fracture
rarely associated with nerve & vascular injury
true about shoulder dislocation:
axillary nerve injury
false about ankle injuries:
most common in 3rd degree ( complete ) tear of the lateral
collateral ligament
false about meniscal injury :
total meniscectomy is best treatment
[ at 18-25 years ]
in order to prevent the most important complication that results in the majority of deaths in spinal injury you should order
?
respiratory therapy
fakse regarding effusions :
gout doesn't cause significant effusion
indications for fasciotomy :
a) nerve impairment
T
b) arterial/venous ligation
T
c) prolonged ischemia ( 6 hours )
T
[ should not open the already necrotic tissue &
d) missed compartment syndrome ( > 24-48 hours )
F
expose it to risk of infection ]
false about compartment syndrome :
damage is not caused by ischemia of muscle
most common fracture in elderly women is in the :
vertebra
MedCom 2005
80)
Orthopedics
fractures in children :
the closer to the growth plate , the better the healing
T
The closer to the growth plate , the smaller the callus
those with heel injury have better healing
about GCT (giant cell tumor):
a)
more comon in females
T
[ unlike most bone tumors ]
b)
occur in epiphyseo-metaphyseal junction
T
[ after physeal closure ]
c)
rare mets to lungs
T
[ <2% ]
d)
Z-ray usually increase bone density
F
[ eccentric radiolucent lesion with thin cortex ]
e)
recurrence is common after curettage
T
shoud be present in prosthesis :
a)
safe
b)
affordable
c)
very light
d)
cosmetically accepted
e)
functional
the point that lead the surgeon to be not very concerned about level of amputation is:
a)
development of prosthesis
b)
education of the pateint
c)
better diagnosis of the disease
about osteosarcoma :
a)
sun-burst appearemce
T
b)
tumor cells may perforate the cortex
T
c)
subperiosteal new bone formation
T
d)
lung mets via hematogenous spread
T
e)
usually invades the growth plate
F
[ not usual but can destroy it ]
about chondrosarcoma :
a)
grows very rapidly
F
[ slow growing ]
b)
radioressistant
T
one increases bone healing :
a)
tensile force
b)
compression
T
c)
shearing force
in histology of growth plate :
a)
resting chondrocytes
T
b)
proliferating
T
c)
maturing
T
d)
calcified
T
e)
superficial & tangential layer of chondrocytes
F
causes delayed or nonunion :
a)
extensive gap
T
b)
infection
T
c)
metabolic
T
d)
abnormal biomechanics
T
e)
sufficient immobilization
F
[ insufficient & rigid fixation can cause it ]
about transient synovitis of the hip (irritable hip ):
a)
self-limiting acute disease of the hip
T
b)
lab Ix: increase ESR .CRP & titer of Staph.aureus in blood
F
[not related to bacteria]
septic hip vs. DDH :
a)
pain
b)
resistance of hip movments
c)
asymmetric skin crease
d)
fever
about osteomyelitis:
a)
usually due to Strept. Infection
F
[ Staph. Aureus ]
CP :
a)
chondromalacia
b)
patella alta
T
[ only in 7% would be painful ]
c)
fixed knee flexion
T
a)
b)
c)
81)
82)
83)
?
84)
85)
86)
87)
88)
89)
90)
?
91)
92)
93)
a)
b)
c)
about spondylolesthesis :
more in males
degenerative type is usually > 30 years
degenerative type in L5-S1
F
F
F
[ equal ]
[ >50 years ]
[ L4/5 ]
MedCom 2005
d)
94)
a)
b)
c)
95)
?
a)
b)
c)
d)
96)
a)
b)
c)
d)
97)
Orthopedics
T
T
T
T
F
T
[ fibrosed ]
98)
99)
100)
101)
102)
103)
104)
105)
F
T
T
T
T
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MedCom 2005
b)
c)
d)
Orthopedics
a)
olecranon
lateral condyle of humerus
supracondylar humeral fracture
may have had bad healing :
lower tibia
b)
ribs
c)
d)
e)
scaphoid
segmental tibial fracture
femoral neck
anterior humeral line should pass through:
middle 1/3 of capitellum
will lead to AVN of humeral head :
surgical neck fracture
anatomical neck fracture
surgical neck fracture + avulsion of greater tuberosity
poliomyelitis can lead to
knee flexion
equinus
structural scoliosis
scoliosis can undergo rapid deterioration during
after menopause
infantile scoliosis
juvenile scoliosis
at puberty between budding of breast & menarche
about acute supraspinatus calcification
joint movement is normal during acute phase
usually improves in few days
due to decrease blood supply ( ischemia )
osteochondritis dissecans
due to trauma
uasually lateral condyle is affected
usually affects youmg males
about Perthes
bone scan is useless
usually no pain
lateral subluxation is poor prognosis
about SCFE
females > males
70% gradual onset
lateral view is important in Dx
limbs are externally rotated
most effective in treatment of CP :
tenotomy
muscle shortening
close observation in hospitals
home phydiotherapy
about loose bodies
Hx of locking
almost always symptomatic
usually seen on x-ray
maybe caused by ostecondritis dissecans
T
T
T
107)
108)
a)
109)
a)
b)
c)
110)
a)
b)
c)
111)
a)
b)
c)
d)
112)
a)
b)
c)
113)
a)
b)
c)
114)
a)
b)
c)
115)
a)
b)
c)
d)
116)
a)
b)
c)
d)
117)
a)
b)
c)
d)
118)
a)
b)
c)
d)
e)
T
F
F
T
T
F
T
[ immobile ]
[ weeks ]
F
F
T
F
T
T
T
T
T
F
T
T
? = either answer not verified from a text book or question has a defect in its form.
all other answers were confirmed from a text book.
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