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MSK Exams > 2018 Module Exams > Flashcards

2018 Module Exams Flashcards

1
Q

Which nerve, if injured, results in inability to sit cross-legged?

a) Tibial nerve
b) Femoral nerve
c) Anterior tibial nerve
d) Sciatic nerve.

A

b) Femoral nerve [cross-sitting is done by the sartorius muscle]

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2
Q

A patient comes into your clinic complaining of back pain that radiates to his leg and foot. What is the next step that you take?

a) Surgery for disc herniation
b) History and physical examination
c) Prescribe pain meds

A

b) History and physical examination

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3
Q

An SLE patiwnt who has been diagnosed for several years and is on immunosuppressansts develops acute arthritis. The results of arthrocentesis were as follows: turbid fluid, leukocyte count 110,00 with PMNs predominant, gram stain was negative. What is the most likely diagnosis?

a) Lupus flare
b) Septic arthritis
c) Tuberculous arthritis
d) Gout

A

b) Septic arthritis

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4
Q

Why is there no program to prevent RA?

a) It has no treatment
b) the cause is still unknown

A

b) the cause is still unknown

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5
Q

Which nerve if injured will result in incomptatibilty in sitting cross-legged?

a) Tibial nerve
b) Anteriot tibial nerve
c) Sciatic nerve
d) Femoral Nerve

A

d) Femoral Nerve

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6
Q

A physician used a piece of paper between the patient’s index and middle finger, the patient couldn’t squeeze his fingers, what muscles is he testing?

a) 1st dorsal and 1st planter interosseous
b) 2nd dorsal and 1st planter interosseous
c) 1st lumbricals and 2nd dorsal interosseous
d) 2nd planter and 1st dorsal interosseous

A

b) 2nd dorsal and 1st planter interosseous

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7
Q

Why does copper deficiency result in defective collagen formation?

a) Cleavage of procollagen C and N terminals
b) Reduced activity of lysyl oxidase
c) Reduced activity of prolyl hydroxylase
d) Reduced glycosylation of lysine

A

b) Reduced activity of lysyl oxidase

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8
Q

What contributes to the progression of osteoarthritis?

a) Increase in collagen
b) Increase in TIMPS
c) Increase in MMPs
d) Increase in aggrecan

A

c) Increase in MMPs

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9
Q

Individual proteoglycans non-covalently bind to a stem to form large aggregates. Which molecule makes up the stem?

A

a) Hyaluronic Acid

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10
Q

What is the mechanism of action of probenecid?

a) inhibits URA T1
b) inhibits SLC2A9
c) inhibits OA T4

A

a) inhibits URA T1

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11
Q

Which of the following occurs in lesch-nyhan syndrome?

a) decreased GPAT activity
b) decreased salvage pathway
c) loss of xanathine oxidase function
d) increased PRPP synthetase

A

b) decreased salvage pathway

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12
Q

What gene mutation is associated with myoclonic epilepsy & ragged-red fibers (MERRF)?

a) tRNA leu
b) tRNA lys
c) tRNA gly
d) tRNA cys

A

b) tRNA lys

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13
Q

What activates muscle phosphorylase kinase and phosphoprotein phosphatase? (Diagram)

a) NADH , AMP
b) cAMP , insulin
c) Ca+ , Ca+
d) Acetyl coA , ADP

A

c) Ca+ , Ca+

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14
Q

During exercise, the muscle switches to fatty acid consumption, why is this?

a) To conserve blood glucose
b) To conserve muscle glycogen
c) Because fatty acids provide more energy

A

b) To conserve muscle glycogen

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15
Q

Neuron conduction studies were conducted on a patient. What is the conduction velocity of the action potential (in red)?

a) 63 m/s
b) 13 m/s
c) 125 m/s
d) 25 m/s

A

c) 125 m/s

** don’t forget to convert milliseconds to s and cm to m!!!

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16
Q

What is the function of tropomyosin in skeletal muscle contraction?

a) Binds the head of myosin
b) Binds nucleotide A TP
c) Covers and uncovers actin binding site
d) Covers and uncovers ATP binding site on myosin

A

c) Covers and uncovers actin binding site

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17
Q

Which property of skeletal muscle is graded?

a) action potential in skeletal muscle
b) contraction of myofilaments in sarcomere
c) contraction of muscle fibers in motor unit
d) contraction of a whole muscle

A

d) contraction of a whole muscle

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18
Q

What diseases are associated with increased risk for developing SLE?

a) cardiovascular disease
b) rheumatoid arthritis and thyroiditis
c) Diabetes and obesity

A

b) rheumatoid arthritis and thyroiditis

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19
Q

What is the most likely reason for the expected increase in the prevalence of osteoarthritis in Kuwait over the next 20 years?

a) Improve the quality of life
b) Increase in the proportion of elderly population
c) Changing dietary pattern
d) Increase genetic susceptibility
e) Disproportionate sex rating

A

b) Increase in the proportion of elderly population

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20
Q

A shoulder radiograph of a patient with systemic lupus erythematosus who is on immunosuppressants showed subchondral focal bone necrosis 5mm x 3mm. In which of the following conditions does this symptom also occur?)

a) avascular necrosis
b) septic arthritis
c) osteoarthritis
d) osteosarcoma

A

a) avascular necrosis

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21
Q

15 y/o girl has asymptomatic idiopathic scoliosis and came with her parents deliberating if her future will be common with her normal peers, what would you tell them?

a) she will have difficult pregnancies
b) she will never be an athlete
c) higher risk of cancer
d) she can develop/have chronic lower back pain

A

d) she can develop/have chronic lower back pain

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22
Q
  1. What are the movements involved in arm when the person scratch his low back?
    a) Abduction, extension, lateral rotation
    b) Adduction, extention, medial rotation
    c) Abduction, flexion, medial rotation
    d) Adduction, extention, lateral rotation
A

b) Adduction, extention, medial rotation

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23
Q

A 25 y/o female presented with weakness and pain in her shoulder and hip. The doctor suspect a proximal myositis type of disorder rather than polyarthritis. What wouls be the best test?

a) CBC, ESR ,CRP
b) anti ds DNA, ANA
c) rheumatoid factor, complement 3&4
d) CK/LDH

A

d) CK/LDH

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24
Q

What can result from cubitus valgus deformity?

a) ape hand
b) Boutonniere deformity
c) claw hand
d) wrist drop

A

c) claw hand

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25
Q

A 30-year old man with a posterior clavicle fracture, presents with internally rotated shoulder, extended elbow, and pronated forearm. What is the reason of this presentation?

a) Avulsion of c6 and c7 nerve root injury
b) Traction of c5 and c6 nerve root injury
c) Inferior trunk injury
d) Lateral and posterior cord injury

A

b) Traction of c5 and c6 nerve root injury

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26
Q

. Which imaging modality is used to check for impingement syndrome?

a) MRI
b) X-ray
c) Nuclear medicine

A

a) MRI

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27
Q

increased uptake in lesion on a 99mTC MDP bone scan is related to which of the following?

a) Bone destruction
b) New bone formation
c) Avascular Necrosis
d) Presence of osteoporosis

A

b) New bone formation

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28
Q

What is an alkaloid drug that binds tubulin and stops mitosis?

a) Allopurinol
b) Imaticinib
c) Aspirin
d) Colchicine

A

d) Colchicine

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29
Q

A boy receives attention and acknowledgment when he uses crutches. What describes this situation?

a) Positive reinforcement behavior increases pain perception
b) Paying attention to one’s pain increases its perception

A

a) Positive reinforcement behavior increases pain perception

30
Q

Which of the following affective-cognitive processes increase pain perception in chronic pain patients?

a) Anxiety
b) Repression
c) Reaction formation
d) Sublimation

A

a) Anxiety

31
Q

Which of the following exerts its effects by selectively inhibiting COX-2 enzyme?

a) Celecoxib
b) Paracetamol
c) Aspirin
d) Indomethacin

A

a) Celecoxib

32
Q

Which of the following best describes the mechanism of action of ibuprofen?

a) reversible COX inhibitor
b) Selective COX-2 inhibitor
c) Uricolytic drug
d) Cytotoxic

A

a) reversible COX inhibitor

33
Q

Sections of a cervical lymph node in 24-year-old woman with low-grade fever, skin rash, generalised joint pain shows extensive parenchymal necrosis. There is evidence of small blood vessel necrosis with granular hematoxylin bodies in the stroma and blood vessel wall.

What is the most likely diagnosis?

a) active rheumatoid arthritis
b) systemic bacterial infection
c) systemic lupus erythematosus
d) systemic small vessel vasculitis
e) atypical mycobacterial infection

A

c) systemic lupus erythematosus

34
Q

45 yo man admitted due to acute attack of severe arthritis involving proximal IP joints of right hand. History of dark colored urine and severe right sided colicky pain. On physical exam 2 proximal joints are swollen, tender, & red. 2 subcutaneous nodules noted near the inflammed joints. Aspiration of one joint yielded few drops of fluid which was sent for microbial culture. An additional small amount is available; which additional test is essentially requested?

a) Direct Gram stain
b) Polarized microscopy
c) PCR for mycobacterium
d) Cell count for neutrophils
e) Test for glucose content

A

b) Polarized microscopy

35
Q

A 51 yo woman with RA for 24 years, came for a regular hospital visit, she gained weight compared with the last visit and her legs were edematous.

Laboratory findings:
Hb: 10
ESR: 65
Serum albumin: 25 (low, normal value given) 24 hr urine protein: 6 g/L

a) Nephrotic syndrome
b) Lupus nephritis
c) Heart failure

A

a) Nephrotic syndrom

36
Q

H&E section of skeletal muscle biopsy in a patient with muscle weakness show scattered group of small atrophic muscle fibers surrounded by large or normal muscle fibers.

What’s the diagnosis?

a) mcArdle
b) dermatomyositis
c) central core disease
d) ALS

A

d) ALS

37
Q

Which gene is strongly associated with Osteoporosis in children?

a) LRP5
b) SOST
c) OPG
d) CLCN6

A

a) LRP5

38
Q

What is the most common mutation found in patients with osteogenesis imperfecta?

a) TNFSF11
b) TNFRSF11A
c) OPG
d) COL1A1

A

d) COL1A1

39
Q

Which stage of healing of a fracture of the femur takes 70 percent of the healing time?

a) cellular proliferation
b) hematoma formation
c) cartilagenous callus formation
d) bony callus formation
e) remodeling

A

e) remodeling

40
Q

A guy had an accident and fractured his bone and a small fragment of the bone went into a tendon near it and tore past the skin. What type of fracture is this

a) Compound fracture
b) cominuted fracture
c) stress fracture
d) Pathological fracture

A

a) Compound fracture

41
Q

A 75 year-old man being investigated for metastasis. An entire CT showed multiple sclerotic lesions in the vertebrae.

What is the most likely primary site of the tumor?

a) lung
b) brain
c) prostate
d) testis

A

c) prostate

42
Q

A 14-year old girl presented with retroperitoneal mass confirmed on MRI. Biopsy revealed tumor cells with atypical nuclei. Showed positive cytoplasmic desmin and positive nuclear MyoD1. What is a possible chromosomal translocation?
a) t(11:22)

b) t(2:13)
c) t(12:22)
d) t(13:22)
e) t(12:16)

A

b) t(2:13)

43
Q

What is the main immunological pathogenesis of systemic lupus erythematosus?

a) Increased CD8 cells
b) Increased NK cells
c) Polyclonal activation of B cells
d) Increased Il-2

A

c) Polyclonal activation of B cells

44
Q

What is implicated in SLE?

a) HLA DR2
b) apoptosis of B cell
c) TNF gamma

A

a) HLA DR2

45
Q

A patient has AIDS, which of the following conditions would he probably have?

a) muscle wasting
b) tendon rupture
c) osteoarthritis
d) gout

A

a) muscle wasting

46
Q

Which cytokine would you block to treat rheumatoid arthritis?

a) IL-4
b) IL-10
c) IFN-B
d) TNF-a

A

d) TNF-a

47
Q

Which auto antigen does Rheumatoid factor targets?

a) synovial antigen
b) bone antigen
c) chondral antigen
d) lgG

A

d) lgG

48
Q

Woman presented with pain, redness, and swelling on the right knee. She is sexually active. Gram stain of joint fluid showed gram negative diplococci

a) Neisseria gonorrhoeae
b) Neisseria meningitides
c) Staph aureus
d) Haemophilus influenza

A

a) Neisseria gonorrhoeae

49
Q

A 5-year old girl has fever and left knee pain. Physical examination revealed swollen, red, warm, and tender left knee. A gram stain on the synovial fluid reveals many neutrophils and gram positive cocci in clusters. What is the causative agent?

a) Staphylococcus aureus
b) Strep Agalactiae
c) Salmonella enteritidis
d) Haemophilus influenza

A

a) Staphylococcus aureus

50
Q

A 40-year-old woman with 7-month duration of right knee swelling. No history of bleeding tendencies and not taking anticoagulant drugs. On physical examination, temperature was 37 and there’s right knee effusion. Knee aspiration shows hemorrhagic synovial fluid. What investigation is appropriate to confirm the diagnosis?

a) Microscopy for crystal
b) Anti-nuclear antibody serology
c) Synovial biopsy
d) Partial thromboplastin time (PT)

A

c) Synovial biopsy

51
Q

Which of the following is an important clinical feature of osteoarthritis?

a) develops insidiously and progresses quickly
b) decreases with age
c) duration of joint stiffness is less than 30 minutes
d) ankle joint is the most frequent affected bearing joint

A

c) duration of joint stiffness is less than 30 minutes

52
Q

Which congenital problem is caused by improper ossification of the vertebra?

a) Spina bifida
b) Scoliosis
c) Torticollis
d) Amelia

A

b) Scoliosis

53
Q

Which congenital problem is caused by improper fusion of the arches?

a) spina bifida
b) scoliosis
c) achondroplasia
d) torticollis

A

a) spina bifida

54
Q

A 45-year old male patient presented to ER wuth 3 day history of right knee pain, swelling, fever, and chills. On examination, his temperature was 39, pulse rate 96 beat/min, and there was right knee effusion. Which one of the following initial investigations is essential in this case?

a) Joint aspiration and analysis
b) Blood cultures
c) X-ray of the right knee joint
d) Synovial biopsy
e) ESR

A

a) Joint aspiration and analysis

55
Q

A chordoma is tumor of what?

a) Notochord
b) Vertebral bodies
c) Axial skeleton

A

a) Notochord

56
Q

A 50 y/o who sustained a back trauma with a herniated back disc experiences pain in the lateral side of his sole. Which nerve root is affected?

a) L3
b) L4
c) S1
d) S2

A

c) S1

57
Q

Hyperextension of the spine causes injury to which structure?

a) Anterior longitudinal ligament
b) Interspinous ligament
c) Supraspinous ligament
d) Posterior longitudinal ligament

A

a) Anterior longitudinal ligament

58
Q

What is the characteristic of C6 vertebrae that may predispose to anterior slipping upon injury to the base of the neck?

a) Horizontally oriented facet
b) Sagittal oriented facet
c) Coronal oriented facet
d) Weak facet capsule
e) Weak intervertebral disc

A

a) Horizontally oriented facet

59
Q

. The medial and lateral malleoli articulate with which bone?

a) Acetabulum
b) Head of the femur
c) Ischial tuberosity
d) Calcaneus
e) Talus

A

e) Talus

60
Q

Damage of which of the following nerves affect knee extension?

a) Nerve to Quadratus femoris
b) Nerve to obturator internis
c) Tibial nerve
d) Femoral nerve
e) Superior gluteal nerve

A

d) Femoral nerve

61
Q

What structure is related to the tendon of rectus femoris and the neck of the fibula?

a) Femoral nerve
b) Tibial nerve
c) Common fibular nerve
d) Obturator nerve
e) Biceps femoris

A

c) Common fibular nerve

62
Q

If the sciatic nerve is injured near the greater sciatic foramen, which action of hip will be affected?

a) abduction
b) external rotation
c) internal rotation
d) flexion
e) extension

A

e) extension

63
Q

Due to injury to which of the following nerves the patient is unable to hold the pelvic girdle level while standing on one foot?

a) Inferior gluteal nerve
b) Superficial fibular nerve
c) Superior gluteal nerve
d) Deep fibular nerve
e) Obturator nerve

A

c) Superior gluteal nerve

64
Q

What muscle is responsible for hip flexion and knee extension?

a) Vastus lateralis
b) Vastus medialis
c) Rectus femoris
d) Iliopsoas

A

c) Rectus femoris

65
Q

Which muscle retracts the scapula?

a) latissimus dorsi
b) Rhomboid major
c) levator scapulae
d) Deltoid
e) Trapezius

A

b) Rhomboid major

66
Q

What prevents superior dislocation of the shoulder joint/humerus? a) Coracoclavicular ligament

b) Acromioclavicular ligament
c) Coracoacromial ligament

A

c) Coracoacromial ligament

67
Q

A 20-year-old female presented with right shoulder pain after falling from a bicycle. X-ray revealed fracture of the clavicle. Upon examination, the arm was pulled forwards and medially rotated.

Which of the following muscles is responsible for this position?

a) Pectoralis minor
b) Pectoralis major
c) Supraspinatus
d) Infraspinatus
e) Deltoid

A

b) Pectoralis major

68
Q

Which nerve is affected in pronater teres syndrome?

a) musculocutaneous
b) radial
c) median
d) ulnar

A

c) median

69
Q

Which combination of actions of the thumb may get affected in carpal tunnel syndrome?

a) Opposition/Flexion/Abduction
b) Adduction/Flexion/Extension
c) Extension/Opposition/Adduction
d) Flexion/Extension/Opposition

A

a) Opposition/Flexion/Abduction

70
Q

An injury to the musculocutaneous nerve, flexion and supination of the elbow joint is not completely lost due to the function of which nerve?

a) Axillary
b) Radial
c) Median
d) Ulnar

A

b) Radial

MSK Exams (13 decks)

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