Multiple Choice Questions

1.Bone metastasis can best be evaluated by

a)X-ray

b)99mTCbone scan

c)111Indium scan

d)Calcium-alkaline phosphatase elevation

2.The enzyme found in osteoclasts but not in osteoblasts is

a)Alkaline phosphatase

b)Acid phosphatase

c) Elastase

d) Cytochrome oxidase

3. The isotopes specific for ostesarcoma are:

Choose 3 answers

a. Radioactive hg 203.
b. Radioactive strontium 85 or 87.
c. Radioactive iodine.
d. Radioactive selenium methionine.
e. Radioactive tc99m pyrophosphate.

4 The ideal amputation should fulfill the following requirementsexcept that it should:

a. Be as long as possible.
b. Have a smoothly rounded cone-shaped end.
c. Not include muscle over the bone end.
d. Have a linear freely movable scar not exposed to pressure.

e. Be painless with a freely movable joint above and a

smooth bone end elbow
5.An 8-year-old child with neglected congenital

equinovarus is best treated by :

a. Repeated manipulation under anaesthesia.
b. Denis-Browne splint.
c. Plantar fasciotomy and elongation of the tendo
Achilles.
d. Wedge tarsectomy.
e. Dunn's triple arthrodesis.

6.What is not True about fracture surgical neck of

humerus:

a. Occurs due to fall on outstretched hand.

b. Common to children.
c. Osteoporosis is an important risk factor.
d. Non-union is uncommon.

7.Supracondylar fracture of the humerus in a child

a. is due to a fall on the point of the elbow

b. is usually compound
c. requires admission of the patient after reduction
d. requires immediate open reduction
e. is a fracture dislocation

8.The essential examination of the hip in order to

clinch the diagnosis of chronic slipped femoral
epiphysis is:

a. Measuring for shortening of the leg.

b. Palpation of the femoral head.
c. A-P plain x-ray view of the hip.
d. Lateral x-ray view of the hip

9. Investigation not required in osteosarcoma ?

a) MRI femur
b) Bone marrow biopsy
c) CT chest
d) Bone Scan
10.Tophi in gout are seen in a/e :.

a)Articular cartilage
b)Joint capsule
c)Synovium
d)Muscles
e)Skin

11.A 18 year old boy presented in OPD wiht Lt mono articular knee pain. Possible
is/are :

Choose 2 of the following options.

a)Gout
b)Osteoarthitis
c)R.A.
d)Reiter's disease
e)Gonococcal arthritis

12. Which of the following reduces bone resorption as well as

stimulates bone formation ?
A) Calcitonin
B) Teriparatide
C) Ibandronate
D) Strontium

13.Bisphosphonates act by ?
A) Increasing the osteoid formation
B) Increasing the mineralisation of osteoid
C) Decreasing the osteoclast mediated resorption of bone
D) Decreasing the parathyroid hormone secretion

14. Which one of the following is the investigation of choice for

evaluation of suspected Perthes' disease ?
A) Plain X-Ray
B) Ultrasonography (US)
C) Computed Tomography (CT)
D) Magnetic Resonance Imaging (MRI)

15. In Radionuclide imaging the most useful radiopharmaceutical for

skeletal imaging is ?
A) Gallium 67 (67Ga)
B) Technetium-sulphur-colloid (99mTc-Sc)
C) Technetium-99m (99m Tc)
D) Technetium-99m linked to Methylene disphosphonate (99m Tc-MDP)

16. A child presents with perisoteal reaction, fever and raised ESR
after a 1 month trauma. Investigation of choice in this case is ?

A) CT Scan
B) MRI Scan
C) PET Scan
D) Core Biopsy

17. Synovial fluid – True statements are A/E

a) Secreted by Type A cells
b) Follows Non-Newtonian fluid kinetics
c) Contains hyaluronic acid
d) Viscosity is variable

18.Posterior glenohumeral instability is tested by

a) Jerk test
b) Crank test
c) Sulcus test
d) Fulcrum test

19 . Which of the following is the earliest laboratory finding in a

case of fat embolism:

A Increased serum cholestrol

В Increased serum lipase

С Increased serum fatty acids

D Lipuria

E Increased alkaline phosphatase.

20. Most often open reduction of fracture is required in:

A Closed fracture with nerve injury

В Compound fracture

С Fracture in children

D Unsatisfactory closed reduction

E Non union.
21.. Bone graft works by providing following mechanisms.

Which of these is most important.

A Bone induction factor

В Osteogenic cells

С Living osteoblasts

D Mineral scaffold for vascular proliferation

E Bridging the bone gap.

22 Pull of which of the following muscle makes it difficult to maintain reduction of Bennett's
fracture:

A Flexor pollicis longus

В Flexor pollicis brevis

С Extensor pollicis longus

D Opponens pollicis

E Abductor pollicis longus.

23.What is the usual treatment for symptomatic old acromio-

clavicular dislocation:

A Arthrodesis of acromio-clavicular joint

В К-wire fixation of joint

С Lag screw fixation of joint

D Resection of outer end of clavicle

E Acromionplasty.
24.Which of the following is incorrect about dislocation of lunate:

A Dislocated lunate appears triangular instead of rectangular on

A.P. x-ray

В Dislocation is most easily recognised on lateral view x-ray

С Avascular necrosis is common following dislocation

D Lunate dislocates posteriorly

E Median nerve compression can occur.

25.Which of the following is not true about posterior dislocation of shoulder

A Recurrent dislocation can develop

В Reduction can be unstable

С Patients with unreduced dislocation can have good function

D Clinical diagnosis is easy

E Axillary nerve injury is uncommon.

Answers: 1 b
2.b
3.a,b,e
4.a
5.d
6.b
7.c
8.d
9.b
10.d
11.d,e
12.d
13.c
14.d
15.d
16.d
17.a
18.a
19.d
20.d
21.d
22.e
23.d
24.d
25.d