LE2 SUBSURG2 Flashcards
- Partial or complete tear of muscle
A. Dislocation
B. Subluxation
C. Sprain
D. Strain
D. Strain
- A type of displaced fracture which shows overlapping of bones on xray
A. Angulation
B. Shortening
C. Rotation
D. Translation
B. Shortening
3.What fracture pattern occurs in diseased bone such as tumors and metabolic disorder?
A. Oblique
B. Spiral
C. Comminuted
D. Segmental
E. Pathologic
E. Pathologic
- What is the most effective initial management for a patient with suspected fracture?
A. Ice
B. Compression
C. Splinting
D. Elevation
C. Splinting
5.Which is true about the basics of splinting
A. Cannot use a pillow as a splint
B. Relieves pain
C. Prevents further soft injury
D. A and B
E. B and C
E. B and C
- Which of the following phases of healing of a bone fracture secretes growth fractures
A. Hematoma formation
B. Migration of hematopoietic cells in the hematoma
C. Granulation formation
D. Primary Callus formation
E. Remodelling
B. Migration of hematopoietic cells in the hematoma
- Factors which influence fracture healing except:
A. Bone ends must be kept in apposition
B. Sufficient blood supply at fracture site
C. Bone fragments must be adequately immobilized
D. Soft tissue interposition at the fracture site
D. Soft tissue interposition at the fracture site
- A patient 24/M sustained a closed spiral fracture of the right distal humerus. He complained of “wrist drop”. What would be the likely nerve injured?
A. Axillary
B. Ulnar
C. Median
D. Radial
E. Ulnar and median
D. Radial
- 18/F sustained a closed fracture of the medial epicondyle. What would the nerve most likely to be injured? Select one:
a. Axillary nerve
b. Ulnar nerve
c. Median nerve
d. Radial nerve
b. Ulnar nerve
- What would be the initial and appropriate management of a 35/M brought to the ER because of fracture of the right tibia and humerus? Select one:
a. Airway, Breathing, Circulation
b. Evaluate head, chest, abdomen, spine injuries
c. Identify all injuries to the extremities
d. Assess neurovascular status of extremities
e. Assess skin and soft tissue damage to extremities
a. Airway, Breathing, Circulation
- A 44/M while riding his motorcycle fell on the pavement sustaining an oblique fracture of the middle 3rd of the radius with an open wound measuring 2cm with minimal soft tissue damage?
A. Close oblique fracture of middle 3rd of the radius
B. Open oblique fracture of middle 3rd of the radius type 1
C. Open oblique fracture of middle 3rd of the radius type 2
D. Open oblique fracture of middle 3rd of the radius type 3
C. Open oblique fracture of middle 3rd of the radius type 2
- What is the most appropriate initial management?
A. Clean the wound
B. Apply splint
C. Give anti tetanus
D. A and B
E. AOTA
E. AOTA
- A 44/M while riding his motorcycle fell on the pavement sustaining an oblique fracture on the middle third of the radius with an open wound measuring 2 cm with minimal soft tissue damage.
What would be the most appropriate antibiotic regimen?
A. 1st gen Cephalosporin
B. 1st gen Cephalosporin + Aminoglycoside
C. 1st gen Cephalosporin + Aminoglycoside + Penicillin G
D. 1st gen Cephalosporin + Aminoglycoside + Metronidazole
E. All of the above
B. 1st gen Cephalosporin + Aminoglycoside
- A 44/M while riding his motorcycle fell on the pavement sustaining an oblique fracture on the middle third of the radius with an open wound measuring 2 cm with minimal soft tissue damage.
What would be the most appropriate definitive management in this case?
A. Closed reduction with circular cast
B. Open reduction with circular cast
C. Open reduction with external fixation
D. Open reduction with internal fixation
D. Open reduction with internal fixation
- A 28F sustained the injury below because of vehicular crash. What is the most likely type of open fracture?
A. Type I
B. Type II
C. Type IIIA
D. Type IVB
E. Type C
C. Type IIIA
- Which of the following statements are true regarding pelvic fractures except?
A. Most are result of fall
B. Commonly associated with other injuries
C. Pelvis contains many important structures (iliac vessels, urogenital organs, nerve plexi)
D. Patients can sustain large volume blood loss
A. Most are result of fall
17.A 52/M sustained multiple abrasions from a car accident. Which of the following findings will make you suspect of pelvic fractures except:
A. Femur fracture
B. Pelvic instability with stressing
C. Blood at urethral meatus
D. High riding prostate
E. None of the above
E. None of the above
- Which among the following fractures will cause the least volume of hypovolemic shock?
A. Pelvic
B. Femoral
C. Humerus
D. tibia/fibula
E. None of the above
C. Humerus
- A 16 year old male sustained a close comminuted fracture of the middle third of the right femur. He was initially resuscitated and managed at the ER. He was stable. What would be the next step of management?
A. Do close reduction, circular cast and send the patient home.
B. Admit, apply skin retraction on the right leg, elective open reduction, internal fixation
C. Admit, apply skin retraction on the right leg, elective open reduction, external fixation
D. Admit, emergency open reduction and external fixation
B. Admit, apply skin traction on the right leg, elective open reduction, internal fixation
- After 48 hours, there was rapid cardiopulmonary and neurological deterioration, agitation, tachypnea and tachycardia.
A. Compartment syndrome
B. Pulmonary embolism
C. Fat embolism
D. ARDS
C. Fat embolism
Which of the following orthopedic conditions is considered an orthopedic emergency?
A. Open fracture
B. Compartment syndrome
C. Septic arthritis
D. A and B
E. AOTA
E. AOTA
The following are findings in chronic osteomyelitis EXCEPT:
A. Callus formation
B. Involucrum
C. Cloaca
D. Sequestrum
A. Callus formation
Which type of arthritis is a chronic, systemic autoimmune inflammatory disease affecting synovial joints as well as skin, eyes, cardiovascular system, bronchopulmonary system, spleen, and nervous system?
A. Septic
B. Osteo
C. Rheumatoid arthritis
D. Gouty
C. Rheumatoid arthritis
Boutonnière deformities of the hand are seen in:
A. Septic arthritis
B. Osteoarthritis
C. Rheumatoid arthritis
D. Gouty arthritis
C. Rheumatoid arthritis
A 20 y/o female complains of right and left knee pain and swelling. She has associated fever, limited ROM, erythema, and tenderness of the knees. What is the most likely diagnosis?
A. Septic arthritis
B. Osteoarthritis
C. Rheumatoid arthritis
D. Gouty arthritis
A. Septic arthritis
Rationale: The patient’s presentation of bilateral knee pain and swelling with associated fever, limited range of motion (ROM), erythema, and tenderness is highly suggestive of septic arthritis, a joint infection that causes inflammation, pain, and systemic symptoms such as fever. The rapid onset of symptoms and systemic signs help distinguish septic arthritis from conditions like osteoarthritis, rheumatoid arthritis, or gout, which typically have a more chronic or specific presentation.
A 20 y/o female complains of right and left knee pain and swelling. She has associated fever, limited ROM, erythema, and tenderness of the knees.
What test will be the most accurate to diagnose the patient?
A. X-ray of both knees APL
B. Both knee joints aspirate with GS/CS
C. MRI of both knees
D. CT scan of both knees
B. Both knee joints aspirate with GS/CS
Rationale: The most accurate test for diagnosing septic arthritis is a joint aspirate with Gram stain and culture sensitivity (GS/CS), as it allows direct identification of the infectious organism causing the joint infection. Imaging tests like X-ray, MRI, or CT scan may show changes in the joint but are not diagnostic for infection and do not provide information about the causative pathogen.
A 20 y/o female complains of right and left knee pain and swelling. She has associated fever, limited ROM, erythema, and tenderness of the knees.
What will be the initial management?
A. IV antibiotics
B. Joint aspirate
C. Arthrotomy
D. A and B
E. All of the above
D. A and B (IV antibiotics and joint aspirate)
Rationale: The initial management for septic arthritis includes joint aspiration to confirm the diagnosis and identify the causative organism, along with starting IV antibiotics as soon as the diagnosis is suspected. Early antibiotic treatment is crucial to prevent joint destruction and systemic spread of infection. Arthrotomy (surgical drainage) may be needed if the condition does not respond to initial management.
A 20 y/o female complains of right and left knee pain and swelling. She has associated fever, limited ROM, erythema, and tenderness of the knees.
If the patient after 3 days did not show signs of improvement, what would be the appropriate management?
A. Change IV antibiotics
B. Joint aspirate
C. Arthrotomy
D. A and B
E. All of the above
E. All of the above
Rationale: If the patient does not improve after 3 days of treatment, changing the IV antibiotics based on culture results is necessary, and repeating a joint aspiration may be warranted to assess the joint space and ensure the infection is being adequately treated. If conservative measures fail, arthrotomy (surgical drainage) should be considered to remove infected material and alleviate pressure. All of these steps would be appropriate for a patient not responding to initial treatment.
The majority of clavicular fractures are managed conservatively. Which of the following indications will require surgical intervention? Select one:
A. Floating shoulder
B. Open fracture
C. Neurovascular injury
D. A and C
E. All of the above
E. All of the above
What do you call this fracture? Select one:
A. Colle’s fracture
B. Galeazzi fracture
C. Monteggia’s fracture
D. Ulnar fracture
C. Monteggia’s fracture
The right Gonadal vein drains to the:
A. Inferior vena cava
B. Right renal vein
C. Superior vena cava
D. Right adrenal vein
A. Inferior vena cava
Surrounding all the three corporal bodies are the outer dartos and inner:
A. Camper’s fascia
B. Cremasteric fascia
C. Buck’s fascia
D. Scarpa’s fascia
C. Buck’s fascia
Persistent erection for greater than 4 hours unrelated to sexual stimulation is called:
A. Penile fracture
B. Erectile dysfunction
C. Priapism
D. Peyronie’s plaque
C. Priapism
This reflex is absent in testicular torsion, to differentiate it from orchitis:
A. Bulbocavernous reflex
B. Tendon reflex
C. Cremasteric reflex
D. Iliohypogastric reflex
C. Cremasteric reflex
This procedure is the first step for all bladder masses to allow adequate staging:
A. Cystectomy
B. TURP
C. Transurethral resection of bladder tumor
D. Percutaneous biopsy
C. Transurethral resection of bladder tumor
The cremasteric fascia is contiguous with the ____ in the abdominal wall:
A. Transversus abdominis
B. Transversalis fascia
C. Internal oblique
D. External oblique
C. Internal oblique
This type of testicular cancer is highly responsive to radiotherapy:
A. Leydig cell tumor
B. Nonseminomatous
C. Mixed
D. Pure seminoma
D. Pure seminoma
Prostate cancer is graded according to:
A. Karnofsky score
B. Partin’s score
C. ECOG score
D. Gleason’s score
D. Gleason’s score
Bosniak classification of an irregular thickened wall cyst with enhancing solid components:
A. Bosniak I
B. Bosniak II
C. Bosniak III
D. Bosniak IV
D. Bosniak IV
Bosniak Classification of a thin-walled cyst with water density, no septations or calcifications:
A. Bosniak I
B. Bosniak II
C. Bosniak III
D. Bosniak IV
A. Bosniak I
The Sinusoidal tissue is innervated by cavernosal nerves, which are autonomic nerves from the:
A. Lumbar Plexus
B. Pampiniform Plexus
C. Hypogastric Plexus
D. Obturator Plexus
C. Hypogastric Plexus
These are paired cylinder-like structures and are the main erectile bodies of the penis:
A. Tunica albuginea
B. Corpus cavernosum
C. Dartos
D. Corpus spongiosum
B. Corpus cavernosum
Used to rapidly assess the presence of two functional kidneys and the extent of injury in kidney trauma:
A. One-shot IVP
B. CT scan
C. KUB ultrasound
D. KUB x-ray
A. One-shot IVP
This gland lies superomedially to the kidneys within Gerota’s fascia:
A. Thyroid gland
B. Pituitary gland
C. Adrenal gland
D. Gonad
C. Adrenal gland
Diagnostic imaging of choice for urethral injury?
A. KUB Ultrasound
B. Retrograde Urethrography
C. IVP
D. CT scan
B. Retrograde Urethrography
The left gonadal vein drains to the:
A. Left adrenal vein
B. Left inferior vena cava
C. Superior vena cava
D. Left renal vein
D. Left renal vein
Low ureteral injuries (below the iliac vessels) most often require:
A. Nephrectomy
B. Ureteral reimplantation
C. Trans-uretero-ureterostomy
D. Uretero-ureterostomy
B. Ureteral reimplantation
Doppler ultrasound finding in testicular torsion:
A. Increased intratesticular blood flow relative to contralateral testis
B. Absent ipsilateral testis
C. Decreased intratesticular blood flow relative to contralateral testis
D. Redundant testis
C. Decreased intratesticular blood flow relative to contralateral testis
Medication/s that may precipitate acute urinary retention include:
A. B-agonists
B. All
C. Opiates
D. Anticholinergics
D. Anticholinergics
Inability to void despite a full bladder is called:
A. Acute urinary retention
B. Urgency
C. Hesitancy
D. Intermittency
A. Acute urinary retention
The form of bladder cancer that may result from chronic irritation from catheters, bladder stones, or schistosomiasis infection:
A. Transitional cell ca
B. Squamous cell ca
C. Adenocarcinoma
D. Mucinous cell ca
B. Squamous cell ca
Hydroceles form in between the parietal and visceral:
A. Tunica albuginea
B. Tunica vaginalis
C. External spermatic fascia
D. Internal spermatic fascia
B. Tunica vaginalis
Painful swelling of the penile foreskin distal to a phimotic ring is called:
A. Priapism
B. Hypospadias
C. Phimosis
D. Paraphimosis
D. Paraphimosis
The kidneys are covered by a fibro-fatty layer called:
A. Denonvilliers’ fascia
B. Gerota’s fascia
C. Camper’s fascia
D. Scarpa’s fascia
B. Gerota’s fascia
In ureteral surgeries, it is important to remember that the blood supply of the proximal ureter is on its:
A. Medial side
B. Lateral side
C. Anterior side
D. Posterior side
A. Medial side
This is the anatomic barrier between the prostate and rectum that prevents prostate cancer from regularly penetrating the rectum:
A. Gerota’s fascia
B. Levator Ani
C. Urogenital diaphragm
D. Denonvilliers Fascia
D. Denonvilliers Fascia
The standard treatment for muscle-invasive bladder tumors is:
A. Partial cystectomy
B. Radiotherapy
C. Chemotherapy
D. Radical cystectomy with extended lymph node dissection
D. Radical cystectomy with extended lymph node dissection
Penile fracture involves rupture of the:
A. Tunica albuginea
B. Urethra
C. Penile bone
D. Tunica vaginalis
A. Tunica albuginea
Results from poor gubernaculum fixation of the testis to the scrotal wall:
A. Inguinal hernia
B. Communicating hydrocele
C. Undescended testis
D. Bell-clapper deformity
D. Bell-clapper deformity
Choose the correct sequence of branching of the renal artery:
A. Renal - lobar - segmental - arcuate - interlobar - afferent
B. Renal - segmental - lobar - arcuate - interlobar - afferent
C. Renal - lobar - interlobar - segmental - arcuate - afferent
D. Renal - segmental - lobar - interlobar - arcuate - afferent
D. Renal - segmental - lobar - interlobar - arcuate - afferent
Varicocele is the dilation of:
A. Vas deferens
B. Spermatic cord
C. Spermatic artery
D. Pampiniform plexus
D. Pampiniform plexus
Most common form of bladder cancer:
A. Mucinous
B. Transitional
C. Squamous cell
D. Adenocarcinoma
B. Transitional
Tissue folds located in the prostatic urethra that can cause bladder outlet obstruction and a damaging cause of bilateral hydronephrosis in a newborn boy:
A. Vesicouteral Reflux
B. Uterocele
C. Uteropelvic junction obstruction
D. Posterior urethral valves
D. Posterior urethral valves
Diagnostic imaging of choice for bladder injury:
A. KUB ultrasound
B. IVP
C. Cystogram
D. KUB X-ray
C. Cystogram
The mainstay of endoscopic surgical BPH treatment:
A. Open prostatectomy
B. Transurethral incision of the prostate
C. Transurethral resection of the prostate
D. Radical prostatectomy
C. Transurethral resection of the prostate
The golden period in testicular torsion, beyond which the testis could be unsalvageable:
A. 6 hrs
B. 48 hrs
C. 12 hrs
D. 24 hrs
A. 6 hrs
Medical treatment for benign prostatic hyperplasia that acts on alpha receptors in the smooth muscle of the prostate and decreases its tone:
A. Anticholinergics
B. Beta-blockers
C. Alpha-blockers
D. 5-alpha reductase inhibitors
C. Alpha-blockers
Most common site of spread of testicular cancer:
A. Inguinal lymph nodes
B. Retroperitoneal lymph nodes
C. Brain
D. Scrotum
B. Retroperitoneal lymph nodes
Most serious outcome of PUV due to intrauterine oligohydramnios:
A. Pulmonary hypoplasia
B. Renal atresia
C. Ectopic ureter
D. Duplicating system
A. Pulmonary hypoplasia
Necrotizing fasciitis of the male genitalia and perineum that can be rapidly progressing and fatal:
A. Testicular torsion
B. Fournier’s gangrene
C. Epididymo-orchitis
D. Emphysematous pyelonephritis
B. Fournier’s gangrene
This intravesical agent acts by induction of an effective immunologic antitumor response:
A. Mitomycin C
B. Cyclophosphamide
C. BCG
D. Thalidomide
C. BCG
The renal pelvis tapers into the _____ where it joins the ureter:
A. Renal papillae
B. Calyx
C. Renal pyramids
D. Ureteropelvic junction
D. Ureteropelvic junction
True of the association of the kidney to nearby organs/muscles except:
A. Psoas muscle - posteromedially
B. Spleen - superolateral left
C. Quadratus lumborum - posterolateral
D. D2 - left renal hilum
D. D2 - left renal hilum
Eggplant deformity of the penis accompanied with ecchymosis throughout the perineum (butterfly sign) involves disruption up to this level:
A. Cremaster
B. Tunica vaginalis
C. Buck’s fascia
D. Dartos
C. Buck’s fascia
Explanation:
The eggplant deformity and butterfly sign (ecchymosis throughout the perineum) occur when there is disruption of Buck’s fascia, allowing blood to extravasate into the superficial tissues, including the perineum. Buck’s fascia contains the deep structures of the penis, including the corpora cavernosa and corpus spongiosum.
If Buck’s fascia is disrupted, blood can spread into the superficial space, leading to the characteristic appearance.
Management of Fournier gangrene includes:
A. Broad-spectrum antibiotic
B. Prompt debridement of nonviable tissue
C. All
D. Tissue glucose control
C. All
During hysterectomy, the ureter is prone to injury because it courses under the:
A. Round ligament
B. Uterine artery
C. Ovarian artery
D. Broad ligament
B. Uterine artery
The most common solid malignancy in men ages 15-35 years old is:
A. Testicular cancer
B. Prostate cancer
C. Renal cancer
D. Penile cancer
A. Testicular cancer
Prompt initial treatment for acute urinary retention:
A. Diuretics
B. Placement of urethral catheter
C. Cystectomy
D. Stop precipitating medications
B. Placement of urethral catheter
Most common cause of hydronephrosis in prenatal ultrasound:
A. Vesicoureteral reflux
B. Ureteropelvic junction obstruction
C. Ureterocele
D. Posterior urethral valves
B. Ureteropelvic junction obstruction
Twisting of the spermatic cord within the tunica vaginalis is called:
A. Testicular torsion
B. Cryptorchidism
C. Orchitis
D. Undescended testis
A. Testicular torsion
