MCQs Flashcards
In acromio‐clavicular joint involvement, which sign is the most reliable?
- Painful arch 60‐120 o is indicative of AC‐joint involvement
- Cross‐body adduction is a reliable sign
- The Neer test is positive
- The Speed sign may be positive
- Painful arch 120‐160 o is indicative of AC‐joint involvement
Cross‐body adduction is a reliable sign
Painful arch 120‐160 o is indicative of AC‐joint involvement
A diabetic patient develops a progressive stiff and painful shoulder. The most likely diagnosis is:
- Infection of the shoulder
- A frozen shoulder
- Arthritis of the shoulder
- Rotator cuff tendinitis
- Artrodesis
A frozen shoulder
Clinical sign: Finkelstein
Diagnosis?
De Quervain
Clinical sign: Phalen
Diagnosis?
Carpal tunnel syndrome
Clinical sign: Neer
Diagnosis?
Impingement
Clinical sign: Pain with resisted wrist extension
Diagnosis?
Tennis elbow
Which one of the following statements is correct regarding scoliosis?
1. The clinical diagnosis of structional scoliosis is made by asking the patient to bend forwards
and to look at the spine from the back
2. The majority of patients with scoliosis are subjected to surgery
3. Spinal support is commonly used in treatment of scoliosis
4. Scoliosis is a painful condition
5. All of the above
The clinical diagnosis of structional scoliosis is made by asking the patient to bend forwards
and to look at the spine from the back
Spinal support is commonly used in treatment of scoliosis
The condition shown on the X‐ray ( R ) is:
- Artritis
- Lunate dislocation
- Lunate fracture
- Spondylolisthesis
- Hip dislocation
Lunate dislocation
The condition in the photo ( R ) is:
- Clawhand
- Gout
- Dupuytren’s contracture
- Rheumatoid arthritis
Dupuytren’s contracture
Slipper upper femoral epiphysis
Age?
10-18yr
Perthe’s disease
Age?
5-10yr
Septic arthritis
Age?
Any age
Congenital dislocation
Age?
0-5yr
Osteoarthritis
Age?
40-90yr
Herniation of the intervertebral disc between the 5th and 6th cervical vertebrae will compress the
● Fourth cervical nerve root
● Sixth cervical nerve root
● Fifth cervical nerve root
● Seventh and eighth cervical nerve roots
● Seventh cervical nerve root
Sixth cervical nerve root
A baby presents with the history of developmental hip dysplasia. Which of the following clinical
methods will you apply in order to make the correct diagnosis?
● Ortolani’s test
● Barlow’s test
● Hip sonography
● AP x‐ray of the pelvis
Ortolani’s test
A 40y female patient presents with the complaints of pain and numbness that wakes her at night. The diagnosis is: ● De Quervain’s ● Carpal tunnel syndrome ● Gout ● Dupuytren’s contracture ● Trigger finger
Carpal tunnel syndrome
Which of the following statements is true:
● Abduction is movement away from the body in the coronal plane
● Metaphysis refers to the shaft of a long bone
● Genu valgum is an angular deformity of the knee
● The neutral stance of the knee is 180°
Abduction is movement away from the body in the coronal plane
Genu valgum is an angular deformity of the knee
The correct approach to an adult suffering from low backache is:
● Get him back to work as soon as possible, even if he still is not free of pain
● In the presence of an absent ankle reflex and weakness of the triceps surae, surgery is
mandatory
● Incontinence of urine sometimes is an indication for surgery
● For the patient who suffers from multiple herniated discs, a fusion is essential and will
prevent future attacks of backache
● A decision as to the advisability of surgery should be taken within the first 2 weeks
Get him back to work as soon as possible, even if he still is not free of pain
Incontinence of urine sometimes is an indication for surgery
A 62y old female has been diagnosed with osteo‐arthritis of the lumbar spine. She complains of
considerable pain but does not have radicular symptoms or signs. The correct treatment is:
● A lumbo‐sacral support
● After radiological examination and imaging an operation to fuse the lumbar spine
● An epidural injection with local anaesthetic an steroids
● Analgesic medication for pain relief, physiotherapy, increased activity and reassurance
Analgesic medication for pain relief, physiotherapy, increased activity and reassurance
A 35y old male presents with mid‐palmar pain and tenderness. You suspect Kiënboch’s disease, because: ● A positive Phalen test ● Sclerosis of the scaphoid on x‐rays ● Pain with flexion of the wrist ● Sclerosis of the lunate on x‐rays
Sclerosis of the lunate on x‐rays
A 17y old girl suffering from scoliosis presents herself at your office. Which one of the following
statements is correct?
● Scoliosis is a lateral curve of the spine
● Scoliosis is a lateral curve of the spine with rotation
● Scoliosis is always congenital
● Scoliosis is more common in males than in females
● Scoliosis can be corrected with exercise
Scoliosis is a lateral curve of the spine with rotation
Which of the following statements are correct?
● SUFE typically is seen in obese boys of about 6 years old
● Otolani’s test is done by abduction of the hip and tests for reduceability of the hip, and is a
safe test to do
● Daughters of mothers that smoke fall into the highest risk group for Perthe’s disease
● A Pavlik harness is a safe treatment for SUFE as long as the patient is followed‐up regularly
● A boy with the diagnosis of Perthe’s of his hip must be referred to an Orthopaedic Surgeon
as an emergency
Otolani’s test is done by abduction of the hip and tests for reduceability of the hip, and is a
safe test to do
The effects of 1,25‐(OH) 2 D 3 in the body are
● ↑plasma phosphate; ↑urinary phosphate; ↑plasma calcium; ↓urinary calcium
● ↑plasma phosphate; ↓urinary phosphate; ↑plasma calcium; ↓urinary calcium
● ↓plasma phosphate; ↑urinary phosphate; ↑plasma calcium; ↓urinary calcium
● ↓plasma phosphate; ↑urinary phosphate; ↓plasma calcium; ↑urinary calcium
● ↓plasma phosphate; ↑urinary phosphate; ↑plasma calcium; ↑urinary calcium
↑plasma phosphate; ↓urinary phosphate; ↑plasma calcium; ↓urinary calcium
The aetiology of rotator cuff tears include ● Trauma ● Degeneration ● Diabetes ● Hyperthyroidism ● Impingement
Trauma
Degeneration
Impingement
The causes of Impingement can include ● Instability ● Hyperthyroidism ● Muscle imbalance ● Outlet impingement ● Diabetes
Instability
Muscle imbalance
Outlet impingement
Which of the following statements are true?
● Septic arthritis can be treated with antibiotics only
● Septic arthritis must be drained and treated with appropriate antibiotics
● Perthe’s disease is common in 5y old boys
● Perthe’s disease is common in 15y old girls
Septic arthritis must be drained and treated with appropriate antibiotics
Perthe’s disease is common in 5y old boys
What is the most common cause of pain over the deltoid area? ● Instability ● Degeneration of the AC‐joint ● Rotator cuff impingement ● Cervical syndrome
Rotator cuff impingement
A 30y old gentleman complains of severe low backache for 3 months. With clinical examination
you find limited movements of his back and a chest expansion of 2cm. What is the most likely
diagnosis?
● A herniated disc
● A previous injury to his back
● Marie Strumpell’s disease (Bamboo spine)
● Rheumatoid arthritis
Marie Strumpell’s disease (Bamboo spine)
Positive Lachmann
Diagnosis?
ACL tear
Painful arc right shoulder
Diagnosis?
Impingement
Tenderness over calcaneus plantar aspect
Diagnosis?
Plantar fasciitis
Pins and needles on radial aspect of hand
Diagnosis?
Carpal tunnel syndrome
The potential for remodeling to spontaneous, complete correction in fractures in children is
enhanced. Which statement is INCORRECT?
● Better, the younger the child is
● Better, when the fracture site is closer to the physis
● When there is relative alignment of the angulation in the normal plane of motion of the
joint
● When spontaneous correction of angular deformities in other directions (relative to normal
joint motion), such as a cubitis varus following a supracondylar fracture of the humerus,
normally show a good response
● Rotational deformities usually do not correct spontaneously
When spontaneous correction of angular deformities in other directions (relative to normal
joint motion), such as a cubitis varus following a supracondylar fracture of the humerus,
normally show a good response
Which of the following refers to a reduction in bone mass? ● Osteomalacia ● Rickets ● Hypocalcaemia ● Osteoporosis ● Hyper‐parathyroidism
Osteoporosis
A patient got hit by a motorcar while walking across the street. You are the doctor that sees him an hour later in casualties. His (L) leg lies in external rotation. What injury did he most likely sustain? ● Anterior dislocation of the hip ● Fracture of the shaft of the femur ● Posterior dislocation of the hip ● Dislocation of his knee ● Injury to his spine
Anterior dislocation of the hip
Regarding Dupuytren’s contracture, which of the following statements are true?
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● Dupuytren’s contracture is a thickening of the fibrous flexor sheaths in the hand
● Pain is a common complaint
● Nodules must always be excised
● Operation is only indicated if the patient develops a flexion contracture of the fingers
Operation is only indicated if the patient develops a flexion contracture of the fingers
Which statement is TRUE regarding a fracture of the proximal third of the ulna, with shortening
and angulation?
● Will lead to a fracture of the radial head
● Will lead to a dislocation of the radial head
● Is called a Galleazi fracture
● Will usually be treated by manipulative reduction and a plaster cast
Will lead to a dislocation of the radial head
In “sacral sparing” in cervical cord injury, which statement is TRUE?
● Is a feature of the Brown Sequard syndrome
● Implies an incomplete upper motor neuron (UMN) lesion
● Is a bad prognostic sign
● Suggests the need for early surgical decompression
Implies an incomplete upper motor neuron (UMN) lesion
A teenage female complains of anterior knee pain, which is aggravated by climbing stairs and
exercises. She may be suffering from which one of the following most likely causes?
● A torn meniscus
● Osteo‐chondritis dissecans
● Synovitis
● Chondromalacia of the patella
● Medial ligament instability
Chondromalacia of the patella
With examination of the hip, which statement is FALSE?
● A painful knee may be the only symptom of hip pathology
● Pain from the hip is often felt behind the joint
● A flexion contracture is tested by fully flexing the contra‐lateral hip
● Hip rotation can be assessed with the hip flexed or extended
● Both legs must be in a similar position with respect to the pelvis for true leg lengths to be
assessed
Pain from the hip is often felt behind the joint
The characteristic features of a compartment syndrome are:
● Absent distal radial pulse at wrist
● Excessive pain out of proportion of the injury
● Pallor of the fingers
● Claw hand
● Blue discolouring of the hand
Excessive pain out of proportion of the injury
A 45y old female patient complains of shoulder pain. Your management will be:
● Take x‐rays and treat accordingly
● Infiltrate the bicipital groove with steroids, if the patient has a positive Neer’s sign
● Give physiotherapy and an intra‐articular injection for the impingement syndrome
● Do a thorough clinical examination of the patient’s shoulder, neck and chest
● Examine the patient for an impingement syndrome and treat accordingly
Do a thorough clinical examination of the patient’s shoulder, neck and chest
Which diagnosis is the most possible one in case of a 5y old child presenting with torticollis, an
abnormal gait, neck pain and increased reflexes of the lower limbs?
● Congenital muscular torticollis
● Juvenile chronic arthritis
● Strabismus
● Klippel‐Feil syndrome
● Neurogenic neoplasm of the cervical spinal cord
Neurogenic neoplasm of the cervical spinal cord
A 79y old female has a pertrochanteric fracture of the femur. Which one of the following
statements is TRUE?
● Conservative treatment is advised
● Non‐union is the probable outcome
● Surgery is contraindicated, because of the anaesthetic risk
● Internal fixation is the treatment of choice
● Is treated in a Thomas splint
Internal fixation is the treatment of choice
In the interpretation of x‐rays of a patient with an acutely injured neck, which one of the
following statements is TRUE?
● The AP view is the most important film
● A negative x‐ray report excludes pathology
● It is of utmost importance that the T1 vertebrae be visible on the lateral view
● Stress views (flexion/extension) are essential as an emergency measure
● Open mouth views are necessary
It is of utmost importance that the T1 vertebrae be visible on the lateral view
Shoulder dislocation
Complication?
Axillary nerve injury
Knee dislocation
Complication?
Vascular injury
Lunate dislocation
Complication?
Median nerve injury
Compartment syndrome
Complication?
Ischaemic contracture
Hip dislocation
Complication?
Avascular necrosis
Humeral fracture
Complication?
Radial nerve injury
Cervical spine fracture dislocation
Complication?
Quadriplegia
Pelvis fracture
Complication?
Bleeding
Femoral shaft fracture
Complication?
Fat embolism syndrome
Which one of the following is not usually associated with reactive arthritis? ● Uretritis ● Conjuctivitis ● Spondylarthritis ● Keratoderma blenorrhagica ● Pleuritis pleurisy
Pleuritis pleurisy
Which one of the following statements are CORRECT regarding compound fractures of the tibia?
● After having done a proper debridement, the wound should be closed by using loose
stitches
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● Debridement should be accompanied by a plate and screws in order to maintain reduction
● These fractures are always treated by using some form of internal fixation
● A thorough debridement can be followed by suturing of the wound
● The wound is never closed primarily
Wound is never closed primarily
Which movement shall a patient suffering from a paralyzed anterior tibial muscle not be able to carry out? ● Stand on the lateral part of the foot ● Stand on the heel ● Stand on the toes ● Stand on the inner part of the foot
Stand on the heel
When measuring the extent of trauma you will need different types of data sources. Choose the incorrect data source. ● Morbidity data ● Mortality data ● Self report ● Media reports ● Community surveys
Media reports
The main cause of non fatal trauma in hospitals is? ● Interpersonal violence ● MVA ● Suicide ● None of the above
Interpersonal violence
Choose the incorrect answer regarding the following statement. A nodule at the elbow can be caused by: ● Gout ● Limph node ● Rumatoid arthritis ● Bursitis ● Nerve impingement
Nerve impingement
Which of the following can be cause of a stiff shoulder? ● Frozen shoulder ● Missed Posterior Dislocation ● Osteoarthritis ● Previous Surgery ● All of the above
All of the above
The following statements regarding tennis elbow are true
● The patients complain of tenderness over the medial epicondyle
● The patients complain of tenderness over the lateral epicondyle
● Pain on wrist flexion against resistance
● Pins and needles in the ulnar two fingers
● Pain on wrist extension against resistance
The patients complain of tenderness over the lateral epicondyle
Pain on wrist extension against resistance
De Quervain tendosinovitis
Presentation?
Radial sided wrist pain
Carpal tunnel syndrome
Presentation?
Pain and paraesthesia of the radial three fingers
Z-deformity of the thumb
Cause?
Rheumatoid arthritis
Golfer’s elbow
Presentation
Medial epicondylitis
Cubital ulnar nerve compression
Medial elbow pain
Choose the correct answer. Rotatorcuff tears are associated with: ● Trauma ● Degeneration ● Chronic impingement ● All of the above ● None of the above
All of the above
Which signs will be positive in a patient with a history of recurrent shoulder instability? ● Neer’s sign ● Apprehension sign ● Relocation sign ● The shoulder sign ● All of the above
Apprehension sign
Relocation sign
Choose the correct answer. Complications after a lunate dislocation is ● Median nerve compressions ● Recurrent Carpal instability ● Late osteoarthritis ● All of the above ● None of the above
All of the above
The word orthopaedics comes from ● Straight kid ● Bone fractures ● Orthos + pais ● All of the above ● None of the above
Straight kid
Ortho + pais
Which of the following statements are true? Carpal tunnel syndrome may present with
● Wrist pain
● Parestesia of the thumb, index and middle finger
● Parastesia of the middle, ring and little finger
● Wrist pain when driving long distances
● Weakness and difficulty opening taps
Wrist pain
Paresthesia of the thumb, index and middle finger
Wrist pain when driving long distances
Weakness and difficulty opening taps
Supraspinatus strength
Test?
Jobe’s thumb down test
Infrapsinatus strength
Test?
External rotation
Subscapularis strength
Test?
Lift-off test
Serratus anterior
Test?
Push up test
Elbow instability
Test?
Chair test
A neonate presents one week after birth with a pseudo‐paralysis of his (L) arm. This arm is in a
position of internal rotation, adduction and flexion of his wrist. The baby does not cry with
movement of the arm. The mother gave the history that she had a complicated vaginal delivery
and noticed this problem immediately after birth. The most likely diagnosis is
● Clavicle/humerus fracture
● Septic arthritis of the shoulder
● C5/6 Erb Duchenne paralysis
● Torticollis
● C8/T1 Klumpke paralysis
C5/6 Erb Duchenne paralysis
A Mother of a 2y old child is worried about his genu varum. What is the most likely cause? ● Postural ● Rachitis ● Meningocoele ● Fragilitas ossium
Postural
Which one of the following statements is correct in the treatment of low backache in children?
● Tuberculosis is common
● Marie Strumpell disease commonly occurs
● Typhoid is very often encountered
● An acute herniated disc is treated surgically
● Lumbar punctures cannot cause osteitis
Tuberculosis is common
On the x‐rays of the lumbar spine of a teenage athlete you notice a spondylolisthesis. This
diagnosis can fit in with
● A spondylolysis
● A common cause of disc herniation
● The most common level is L 3
● Usually they can continue with their sport activity
A spondylosis
A 35y old male presents with an acute herniated lumbar disc prolapse. Indications for surgery
will be
● Absent ankle reflex with sensory impairment
● Progressive motor weakness
● Positive bowstring test
● Persistent symptoms for more than 3 weeks
Progressive motor weakness
In cervical myelopathy
● The reflexes in the lower limbs will be increased and in the upper limbs may be increased or
decreased
● The reflexes in the lower limbs will be decreased and in the upper limbs increased
● Reflexes will be decreased in upper and lower limbs
● The Hoffman reflex will be negative
● The Lhermitte’s sign will be negative
The reflexes in the lower limbs will be increased and in the upper limbs may be increased or
decreased
Which one of the following statements is correct regarding scoliosis?
● The clinical diagnosis of scoliosis is made by asking the patient to bend forwards and to look
at the spine from the side
● The majority of patients with scoliosis are subjected to surgery
● Spinal support is commonly used in treatment of scoliosis
● Scoliosis is a painful condition
● All of the above
Spinal support is commonly used in treatment of scoliosis
Kyphosis is ● An increased concave curve ● An increased convex curve ● An increased lateral curve ● An increased rotational curve ● None of the above
An increased convex curve
Which nerve is most likely to be injured at the obturator foramen? ● Femoral nerve ● Sciatic nerve ● Obturator nerve ● Tibial nerve ● Peroneal nerve
Obturator nerve
Identify the indicated structure. ● Coracoid process ● Greater tubercle ● Lesser tubercle ● Glenoid fossa ● Spine of scapula
Coracoid process
Which nerve runs through the muscle indicated and supplies the motor supply to the anterior compartment of the arm? ● Median nerve ● Axillary nerve ● Musculocutaneous nerve ● Ulnar nerve ● Radial nerve`
Musculocutaneous nerve
The marked muscle has the following function on the shoulder joint:
● Elevation
● Adduction
● Flexion
● Extension
● Abduction (through suprascapularis and deltoid’s actions)
Abduction (through suprascapularis and deltoid’s actions)
Which powerful supinator inserts on the marked area?
● Triceps brachii
● Anconeus
● Biceps brachii (on the proximal radius)
● Brachialis
● Coracobrachialis
Biceps brachii (on the proximal radius)
The X‐ray shows a dislocation of the elbow joint. Which nerve in the cubital fossa may be injured? ● Musculocutaneous nerve ● Median nerve ● Axillary nerve ● Ulnar nerve ● Radial nerve
Median nerve
Which nerve supplies the tip of the index finger? ● Musculocutaneous nerve ● Axillary nerve ● Median nerve ● Ulnar nerve ● Radial nerve
Median nerve
The following nerve may be injured during a midshaft humerus fracture: ● Musculocutaneous nerve ● Axillary nerve ● Median nerve ● Ulnar nerve ● Radial nerve
Radial nerve
Which nerve is involved with carpal tunnel syndrome? ● Musculocutaneous nerve ● Axillary nerve ● Median nerve ● Ulnar nerve ● Radial nerve
Median nerve
Your patient’s left shoulder is hanging after a stab wound in the neck. Trapezius is supplied by? ● The axillary nerve ● The accessory nerve ● The facial nerve ● The suprascapular nerve ● The long thoracic nerve
The accessory nerve
Identify the marked structure. ● Scaphoid bone ● Lunate bone ● Hamate bone ● Trapezium ● Pisiform bone
Lunate bone
Identify the marked structure. ● Abductor pollicis brevis ● Lumbrical muscle ● Adductor pollicis ● Interosseus muscle ● Abductor pollicis longus
Adductor pollicis
The pelvic brim surrounding the pelvic inlet includes the following parts: ● Linea terminalis ● Sacrospinous ligament ● Sacrotuberous ligament ● Coccyx ● Subpubic angle
Linea terminalis
The radiograph indicates a spiral fracture of the left femur with many bony fragments. Choose the correct statement: ● This patient is an adolescent male ● This patient is an adolescent female ● This patient is an adult male ● This patient is an adult female ● This patient is an elderly male
The patient is an adolescent male
This patient was shot in the lower limb. Which bursa is affected by the wound encircled by the yellow line? ● Suprapatellar bursa ● Deep infrapatellar bursa ● Prepatellar bursa ● Superficial infrapatellar bursa ● Popliteal bursa
Suprapatellar bursa
A 20y old student was involved in a motor vehicle accident. Radiographs of the ankle joint were
requested to determine the integrity of the malleoli. The marked structure in the radiograph:
● Forms the point of attachment for the posterior talofibular ligament
● Is the bony landmark to palpate the pulse of the anterior tibial artery
● Is used as bony landmark to find the greater saphenous vein
● The posterior relations of the marked structure in the radiograph includes the fibularis
longus and brevis
● The skin covering the marked structure in the radiograph is supplied by the deep fibular
nerve
Is used as bony landmark to find the greater saphenous vein
The photograph shows a patient with laceration of the right foot. The following structure(s) are in danger ● Posterior tibial artery ● Tibial nerve ● Greater saphenous vein ● Extensor digitorium longus ● Saphenus nerve
Posterior tibial artery
Tibial nerve
A fracture that is indicated by the RED line on the radiograph
● Is only found in people older than 60 years
● Results in the one leg being shorter than the other due to the strong action of the adductors
● Results in avascular necrosis of the head of the femur
● Interrupts the blood supply to the femur head by the external pudendal artery
● Results in the foot being rotated medially due to the strong action of the adductor muscles
Results in avascular necrosis of the head of the femur
A fracture on the level as indicated by the line on the radiograph endangers one of the following ● Common fibular nerve ● Tibial nerve ● Sciatic nerve ● Sural nerve ● Saphenous nerve
Common fibular nerve
On the radiograph
● A is the attachment for the patellar ligament
● B is a ball and socket joint
● B is the area where the superior patellar bursa is found
● C is classified as a flat bone
● C is classified as a short bone
A is the attachment for the patellar ligament
Which one of the following joints is commonly involved in osteo‐arthritis?
● Ankels
● Metacarpo‐phalangegal joints
● First carpo‐metacarpal joints (PIP joints)
● Wrist joints
First carpo‐metacarpal joints (PIP joints)
Where does the spinal cord end in the vertebral canal in an adult? ● L 1/2 ● L 3 ● L 3/4 ● L 5 ● L 2/3
L1/2
To assess the function of the axillary nerve after a shoulder dislocation you need to look at
deltoid as the axillary nerve supplies the deltoid. Deltoid mainly allows the shoulder joint to
● Extend
● Abduct
● Flex
● Rotate
● Adduct
Abduct
These radiographs show a patient with fractures of the distal leg. The radiographs indicate ● Unilateral malleolar fractures ● Dislocation of the talo‐calcano joint ● Fractures of the calcaneus ● Dislocation of the syndesmosis ● Multiple malleolar and talus fractures
Dislocation of the syndesmosis
The marked structure in the radiograph is
● Femoral artery
● Deep femoral artery
● Do not contribute to the cruciate anastomosis of the lower limb
● In the end responsible formation of the foot pulse
● In direct relation to the femoral nerve
Deep femoral artery
Which blood vessel supplies the head of the femur via the marked structure ( lig. teres) ? ● Obturator artery ● Medial circumflex femoral artery ● Lateral circumflex femoral artery ● Deep femoral artery ● Deep circumflex iliac artery
Obturator artery
The marked structure ( medial lig. ) is
● In danger with inversion injuries of the ankle joint
● In danger with eversion injuries of the ankle joint
● Known as the coracoid ligament
● Attaches to the talus, calcaneus and cuboid bones
● Attaches superiorly to the lateral malleolus
In danger with eversion injuries of the ankle joint
Calcium absorption from the intestine is dependent on: ● Vitamin D only ● Parathyroid hormone only ● Vitamin A level in blood ● Vitamin D and parathyroid hormone ● Alkaline phospatase
Vitamin D and parathyroid hormone
Nutritional factors that have been associated with an increased risk of osteoporosis are all of the following except: ● Low calcium intake ● High protein or phosphate diet ● Caffeine ● High intake of alcohol ● High intake of vitamin D
High intake of Vitamin D
A patient gets run over by a motorcar and you are the doctor that examines him in casualties.
His complaint is that of acute pain next to one side of his pelvis and that he cannot move his
ankle or foot. Which nerve did he most likely injure?
● Sciatic nerve
● Femoral nerve
● Obturator nerve
● Saphenous nerve
● Lumbosacral trunk
Sciatic nerve
The risk factors involved in osteoporosis include all, except ● Smoking ● Little exercise ● Being overweight ● Alcohol ● High intake of caffeine
Being overweight
The best way to diagnose osteoporosis is by ● X‐rays ● Urinary excretion of OH‐proline ● Bone densitometry ● Bone biopsy and histology ● Clinical examination
Bone densitometry
Treatment of osteoporosis include all of the following, except ● Calcium supplementation ● Magnesium supplementation ● Vitamin D supplementation ● Vitamin C supplementation ● Weight bearing exercises
Magnesium supplementation
The approach to the control of trauma includes?
● Hand washing
● Surgery
● Primary prevention
● Secondary prevention
● Primary prevention & secondary prevention
Primary prevention and secondary prevention
The ecological model for understanding violence includes all, except ● Individuals ● Relationships ● Community ● Society ● Global perspectives
Global perspectives
A 90y old lady tripped at home and fell. She sustained neck of femur fracture. The following mode of treatment is inappropriate: ● Open reduction and internal fixation ● Hemi‐arthroplasty ● Closed reduction plus Thomas’ splint ● Total hip arthroplasty
Closed reduction plus Thomas’ splint
A 31y old patient fell off a tree. He sustained a burst fracture of the lumbar spine. Typical
radiological features are
● Only the anterior column is affected
● There is only involvement of the anterior and posterior columns
● There is loss of vertebral body height
● The anterior and middle columns are involved
● Retropulsion typically involves the posterior column
● Retropulsion is not a typical characteristic of burst fracture
There is loss of vertebral body height
The anterior and middle columns are involve
Complete spinal cord injury refers to
● Complete loss of sensory function below the level of injury
● Complete loss of only the motor function below the level of injury
● Complete loss of all functions below the level of L 2
● Complete loss of all cord functions below the level of injury except the sphincter functions
● Complete loss of all cord functions at and below the spinal cord injury level
Complete loss of all cord functions at and below the spinal cord injury level
A young rugby player with symptoms of giving way of the knee may have a ● An osteochondral lesion ● Anterior cruciate ligament tear ● Torn meniscus ● All of the above ● None of the above
All of the above
What important points must be asked when taking a history in a patient with Scoliosis? ● Obstetric History ● Milestones / Development ● Growth ● Family history (1 st degree relative) ● When curve was first noticed ● Pain ● Deformity (What bothers the patient) ● Neurological deficits / Functional impairment ● Other Diseases ● All of the above ● None of the above
All of the above
The clinical signs and symptoms of osteoporosis include all, except
● Kyphosis
● Vertebral compression fractures
● Fracture of the distal radius & ulna
● Tibial plateau fracture
● Hip fracture
Tibial plateau fracture
The two most common primary malignant bone tumours in children are ● Osteosarcoma ● Multiple myeloma ● Ewing’s sarcoma ● Chondrosarcoma ● Enchondroma
Osteosarcoma
Ewing’s sarcoma
The two most common primary malignant bone tumours in adults are ● Osteosarcoma ● Multiple myeloma ● Ewing’s sarcoma ● Chondrosarcoma ● Enchondroma
Osteosarcoma
Multiple myeloma
The treatment approach of an acute injury entails the acronym PRICE, which means the following. Which one is incorrect? ● P – Prevention ● R – Rubbing ● I – Ice ● C – Compression ● E – Elevation
R – Rubbing
ITB (ileo‐tibial bursitis) is a prominent soft tissue injury in ● Divers ● Weight lifters ● Wrestlers ● Runners ● Ballet dancers
Runners
All of the following are effects of long‐term systemic prednisone treatment for rheumatoid
arthritis, except
● Increased blood glucose
● Increased muscle mass
● Suppression of the immune system
● Suppression of the hypophysis‐adrenal axis
● Osteoporosis
Increased muscle mass
A patient complains of a burning pain under the sole of the foot. What is the most likely
diagnosis?
● Interdigital neuroma
● Tarsal tunnel syndrome
● Tendonitis of the posterior tibial tendon
● A stress fracture of the second metatarsal bone
Tarsal tunnel syndrome
Which characteristic is not true regarding Paget’s disease?
● Fractures may occur
● Heart failure may occur
● Arthritis is common
● Serum acid phosphatase is usually high
● Serum calcium and phosphate are usually normal
Serum acid phosphotase is usually high
Ewing sarcoma predominantly occurs in
● Small bones of the hand in patients above 40 years of age
● Long bones of children between 5 and 11 years of age
● Bones of the skull in children below the age of 4 years
● Long bones, as a complication of chronic osteomyelitis
● Pelvic bones of elderly people with Paget’s disease of bone
Long bones of children between 5 and 11 years of age
Which of the following statements are true in connection with osteoid osteoma?
● Pain is usually relieved by aspirin
● Pain is usually relieved by rest
● It is a small malignant tumour
● It consists of osteoied and newly formed bone
● Excision of the affected area cures the pain
Pain is usually relieved by aspirin
It consists of osteoid and newly formed bone
Excision of the affected area cures the pain
Which of the following are causes of a painful hip? ● Osteoarthritis ● Lumbar disc prolapse ● Hiatus hernia ● Infection ● Cervical spondylosis
Osteoarthritis
Lumbar disc prolapse
Infection
The correct treatment of septic arthritis is
● Antibiotics
● Plaster casts
● Surgical drainage, appropriate antibiotics and rest
● Physiotherapy
Surgical drainage, appropriate antibiotics and rest
A Baker’s cyst is
● A swelling directly over the patella
● A swelling that must be distinguished from a popliteal aneurysm
● Unrelated to chronic arthritis of the knee
● A fluctuant swelling in the politeal fossa
A swelling that must be distinguished from a popliteal aneurysm
A fluctuant swelling in the politeal fossa
The following tumours often metastasize to bone ● Thyroid Ca ● Stomach Ca ● Breast Ca ● Prostate Ca ● Liver Ca
Thyroid Ca
Breast Ca
Prostate Ca
