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MBChB IV Orthopaedics > MCQs > Flashcards

MCQs Flashcards

1
Q

In acromio‐clavicular joint involvement, which sign is the most reliable?

  1. Painful arch 60‐120 o is indicative of AC‐joint involvement
  2. Cross‐body adduction is a reliable sign
  3. The Neer test is positive
  4. The Speed sign may be positive
  5. Painful arch 120‐160 o is indicative of AC‐joint involvement
A

Cross‐body adduction is a reliable sign

Painful arch 120‐160 o is indicative of AC‐joint involvement

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2
Q

A diabetic patient develops a progressive stiff and painful shoulder. The most likely diagnosis is:

  1. Infection of the shoulder
  2. A frozen shoulder
  3. Arthritis of the shoulder
  4. Rotator cuff tendinitis
  5. Artrodesis
A

A frozen shoulder

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3
Q

Clinical sign: Finkelstein

Diagnosis?

A

De Quervain

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4
Q

Clinical sign: Phalen

Diagnosis?

A

Carpal tunnel syndrome

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5
Q

Clinical sign: Neer

Diagnosis?

A

Impingement

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6
Q

Clinical sign: Pain with resisted wrist extension

Diagnosis?

A

Tennis elbow

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7
Q

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

A

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

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8
Q

The condition shown on the X‐ray ( R ) is:

  1. Artritis
  2. Lunate dislocation
  3. Lunate fracture
  4. Spondylolisthesis
  5. Hip dislocation
A

Lunate dislocation

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9
Q

The condition in the photo ( R ) is:

  1. Clawhand
  2. Gout
  3. Dupuytren’s contracture
  4. Rheumatoid arthritis
A

Dupuytren’s contracture

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10
Q

Slipper upper femoral epiphysis

Age?

A

10-18yr

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11
Q

Perthe’s disease

Age?

A

5-10yr

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12
Q

Septic arthritis

Age?

A

Any age

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13
Q

Congenital dislocation

Age?

A

0-5yr

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14
Q

Osteoarthritis

Age?

A

40-90yr

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15
Q

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

A

Sixth cervical nerve root

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16
Q

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

A

Ortolani’s test

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17
Q 
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
A

Carpal tunnel syndrome

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18
Q

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°

A

Abduction is movement away from the body in the coronal plane

Genu valgum is an angular deformity of the knee

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19
Q

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

A

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

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20
Q

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

A

Analgesic medication for pain relief, physiotherapy, increased activity and reassurance

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21
Q 
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
A

Sclerosis of the lunate on x‐rays

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22
Q

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

A

Scoliosis is a lateral curve of the spine with rotation

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23
Q

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

A

Otolani’s test is done by abduction of the hip and tests for reduceability of the hip, and is a
safe test to do

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24
Q

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

A

↑plasma phosphate; ↓urinary phosphate; ↑plasma calcium; ↓urinary calcium

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25
Q 
The aetiology of rotator cuff tears include
● Trauma
● Degeneration
● Diabetes
● Hyperthyroidism
● Impingement
A

Trauma

Degeneration

Impingement

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26
Q 
The causes of Impingement can include
● Instability
● Hyperthyroidism
● Muscle imbalance
● Outlet impingement
● Diabetes
A

Instability

Muscle imbalance

Outlet impingement

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27
Q

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

A

Septic arthritis must be drained and treated with appropriate antibiotics

Perthe’s disease is common in 5y old boys

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28
Q 
What is the most common cause of pain over the deltoid area?
● Instability
● Degeneration of the AC‐joint
● Rotator cuff impingement
● Cervical syndrome
A

Rotator cuff impingement

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29
Q

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

A

Marie Strumpell’s disease (Bamboo spine)

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30
Q

Positive Lachmann

Diagnosis?

A

ACL tear

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31
Q

Painful arc right shoulder

Diagnosis?

A

Impingement

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32
Q

Tenderness over calcaneus plantar aspect

Diagnosis?

A

Plantar fasciitis

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33
Q

Pins and needles on radial aspect of hand

Diagnosis?

A

Carpal tunnel syndrome

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34
Q

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

A

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

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35
Q 
Which of the following refers to a reduction in bone mass?
● Osteomalacia
● Rickets
● Hypocalcaemia
● Osteoporosis
● Hyper‐parathyroidism
A

Osteoporosis

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36
Q 
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
A

Anterior dislocation of the hip

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37
Q

Regarding Dupuytren’s contracture, which of the following statements are true?
4
● 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

A

Operation is only indicated if the patient develops a flexion contracture of the fingers

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38
Q

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

A

Will lead to a dislocation of the radial head

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39
Q

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

A

Implies an incomplete upper motor neuron (UMN) lesion

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40
Q

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

A

Chondromalacia of the patella

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41
Q

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

A

Pain from the hip is often felt behind the joint

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42
Q

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

A

Excessive pain out of proportion of the injury

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43
Q

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

A

Do a thorough clinical examination of the patient’s shoulder, neck and chest

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44
Q

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

A

Neurogenic neoplasm of the cervical spinal cord

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45
Q

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

A

Internal fixation is the treatment of choice

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46
Q

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

A

It is of utmost importance that the T1 vertebrae be visible on the lateral view

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47
Q

Shoulder dislocation

Complication?

A

Axillary nerve injury

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48
Q

Knee dislocation

Complication?

A

Vascular injury

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49
Q

Lunate dislocation

Complication?

A

Median nerve injury

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50
Q

Compartment syndrome

Complication?

A

Ischaemic contracture

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51
Q

Hip dislocation

Complication?

A

Avascular necrosis

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52
Q

Humeral fracture

Complication?

A

Radial nerve injury

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53
Q

Cervical spine fracture dislocation

Complication?

A

Quadriplegia

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54
Q

Pelvis fracture

Complication?

A

Bleeding

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55
Q

Femoral shaft fracture

Complication?

A

Fat embolism syndrome

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56
Q 
Which one of the following is not usually associated with reactive arthritis?
● Uretritis
● Conjuctivitis
● Spondylarthritis
● Keratoderma blenorrhagica
● Pleuritis pleurisy
A

Pleuritis pleurisy

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57
Q

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
6
● 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

A

Wound is never closed primarily

58
Q 
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
A

Stand on the heel

59
Q 
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
A

Media reports

60
Q 
The main cause of non fatal trauma in hospitals is?
● Interpersonal violence
● MVA
● Suicide
● None of the above
A

Interpersonal violence

61
Q 
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
A

Nerve impingement

62
Q 
Which of the following can be cause of a stiff shoulder?
● Frozen shoulder
● Missed Posterior Dislocation
● Osteoarthritis
● Previous Surgery
● All of the above
A

All of the above

63
Q

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

A

The patients complain of tenderness over the lateral epicondyle

Pain on wrist extension against resistance

64
Q

De Quervain tendosinovitis

Presentation?

A

Radial sided wrist pain

65
Q

Carpal tunnel syndrome

Presentation?

A

Pain and paraesthesia of the radial three fingers

66
Q

Z-deformity of the thumb

Cause?

A

Rheumatoid arthritis

67
Q

Golfer’s elbow

Presentation

A

Medial epicondylitis

68
Q

Cubital ulnar nerve compression

A

Medial elbow pain

69
Q 
Choose the correct answer. Rotatorcuff tears are associated with:
● Trauma
● Degeneration
● Chronic impingement
● All of the above
● None of the above
A

All of the above

70
Q 
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
A

Apprehension sign

Relocation sign

71
Q 
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
A

All of the above

72
Q 
The word orthopaedics comes from
● Straight kid
● Bone fractures
● Orthos + pais
● All of the above
● None of the above
A

Straight kid

Ortho + pais

73
Q

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

A

Wrist pain

Paresthesia of the thumb, index and middle finger

Wrist pain when driving long distances

Weakness and difficulty opening taps

74
Q

Supraspinatus strength

Test?

A

Jobe’s thumb down test

75
Q

Infrapsinatus strength

Test?

A

External rotation

76
Q

Subscapularis strength

Test?

A

Lift-off test

77
Q

Serratus anterior

Test?

A

Push up test

78
Q

Elbow instability

Test?

A

Chair test

79
Q

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

A

C5/6 Erb Duchenne paralysis

80
Q 
A Mother of a 2y old child is worried about his genu varum. What is the most likely cause?
● Postural
● Rachitis
● Meningocoele
● Fragilitas ossium
A

Postural

81
Q

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

A

Tuberculosis is common

82
Q

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

A spondylosis

83
Q

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

A

Progressive motor weakness

84
Q

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

A

The reflexes in the lower limbs will be increased and in the upper limbs may be increased or
decreased

85
Q

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

A

Spinal support is commonly used in treatment of scoliosis

86
Q 
Kyphosis is
● An increased concave curve
● An increased convex curve
● An increased lateral curve
● An increased rotational curve
● None of the above
A

An increased convex curve

87
Q 
Which nerve is most likely to be injured at the obturator foramen?
● Femoral nerve
● Sciatic nerve
● Obturator nerve
● Tibial nerve
● Peroneal nerve
A

Obturator nerve

88
Q 
Identify the indicated structure.
● Coracoid process
● Greater tubercle
● Lesser tubercle
● Glenoid fossa
● Spine of scapula
A

Coracoid process

89
Q 
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`
A

Musculocutaneous nerve

90
Q

The marked muscle has the following function on the shoulder joint:
● Elevation
● Adduction
● Flexion
● Extension
● Abduction (through suprascapularis and deltoid’s actions)

A

Abduction (through suprascapularis and deltoid’s actions)

91
Q

Which powerful supinator inserts on the marked area?
● Triceps brachii
● Anconeus
● Biceps brachii (on the proximal radius)
● Brachialis
● Coracobrachialis

A

Biceps brachii (on the proximal radius)

92
Q 
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
A

Median nerve

93
Q 
Which nerve supplies the tip of the index finger?
● Musculocutaneous nerve
● Axillary nerve
● Median nerve
● Ulnar nerve
● Radial nerve
A

Median nerve

94
Q 
The following nerve may be injured during a midshaft humerus fracture:
● Musculocutaneous nerve
● Axillary nerve
● Median nerve
● Ulnar nerve
● Radial nerve
A

Radial nerve

95
Q 
Which nerve is involved with carpal tunnel syndrome?
● Musculocutaneous nerve
● Axillary nerve
● Median nerve
● Ulnar nerve
● Radial nerve
A

Median nerve

96
Q 
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
A

The accessory nerve

97
Q 
Identify the marked structure.
● Scaphoid bone
● Lunate bone
● Hamate bone
● Trapezium
● Pisiform bone
A

Lunate bone

98
Q 
Identify the marked structure.
● Abductor pollicis brevis
● Lumbrical muscle
● Adductor pollicis
● Interosseus muscle
● Abductor pollicis longus
A

Adductor pollicis

99
Q 
The pelvic brim surrounding the pelvic inlet includes the following parts:
● Linea terminalis
● Sacrospinous ligament
● Sacrotuberous ligament
● Coccyx
● Subpubic angle
A

Linea terminalis

100
Q 
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
A

The patient is an adolescent male

101
Q 
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
A

Suprapatellar bursa

102
Q

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

A

Is used as bony landmark to find the greater saphenous vein

103
Q 
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
A

Posterior tibial artery

Tibial nerve

104
Q

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

A

Results in avascular necrosis of the head of the femur

105
Q 
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
A

Common fibular nerve

106
Q

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

A is the attachment for the patellar ligament

107
Q

Which one of the following joints is commonly involved in osteo‐arthritis?
● Ankels
● Metacarpo‐phalangegal joints
● First carpo‐metacarpal joints (PIP joints)
● Wrist joints

A

First carpo‐metacarpal joints (PIP joints)

108
Q 
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
A

L1/2

109
Q

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

A

Abduct

110
Q 
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
A

Dislocation of the syndesmosis

111
Q

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

A

Deep femoral artery

112
Q 
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
A

Obturator artery

113
Q

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

A

In danger with eversion injuries of the ankle joint

114
Q 
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
A

Vitamin D and parathyroid hormone

115
Q 
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
A

High intake of Vitamin D

116
Q

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

A

Sciatic nerve

117
Q 
The risk factors involved in osteoporosis include all, except
● Smoking
● Little exercise
● Being overweight
● Alcohol
● High intake of caffeine
A

Being overweight

118
Q 
The best way to diagnose osteoporosis is by
● X‐rays
● Urinary excretion of OH‐proline
● Bone densitometry
● Bone biopsy and histology
● Clinical examination
A

Bone densitometry

119
Q 
Treatment of osteoporosis include all of the following, except
● Calcium supplementation
● Magnesium supplementation
● Vitamin D supplementation
● Vitamin C supplementation
● Weight bearing exercises
A

Magnesium supplementation

120
Q

The approach to the control of trauma includes?
● Hand washing
● Surgery
● Primary prevention
● Secondary prevention
● Primary prevention & secondary prevention

A

Primary prevention and secondary prevention

121
Q 
The ecological model for understanding violence includes all, except
● Individuals
● Relationships
● Community
● Society
● Global perspectives
A

Global perspectives

122
Q 
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
A

Closed reduction plus Thomas’ splint

123
Q

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

A

There is loss of vertebral body height

The anterior and middle columns are involve

124
Q

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

A

Complete loss of all cord functions at and below the spinal cord injury level

125
Q 
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
A

All of the above

126
Q 
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
A

All of the above

127
Q

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

A

Tibial plateau fracture

128
Q 
The two most common primary malignant bone tumours in children are
● Osteosarcoma
● Multiple myeloma
● Ewing’s sarcoma
● Chondrosarcoma
● Enchondroma
A

Osteosarcoma

Ewing’s sarcoma

129
Q 
The two most common primary malignant bone tumours in adults are
● Osteosarcoma
● Multiple myeloma
● Ewing’s sarcoma
● Chondrosarcoma
● Enchondroma
A

Osteosarcoma

Multiple myeloma

130
Q 
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
A

R – Rubbing

131
Q 
ITB (ileo‐tibial bursitis) is a prominent soft tissue injury in
● Divers
● Weight lifters
● Wrestlers
● Runners
● Ballet dancers
A

Runners

132
Q

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

A

Increased muscle mass

133
Q

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

A

Tarsal tunnel syndrome

134
Q

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

A

Serum acid phosphotase is usually high

135
Q

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

A

Long bones of children between 5 and 11 years of age

136
Q

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

A

Pain is usually relieved by aspirin

It consists of osteoid and newly formed bone

Excision of the affected area cures the pain

137
Q 
Which of the following are causes of a painful hip?
● Osteoarthritis
● Lumbar disc prolapse
● Hiatus hernia
● Infection
● Cervical spondylosis
A

Osteoarthritis

Lumbar disc prolapse

Infection

138
Q

The correct treatment of septic arthritis is
● Antibiotics
● Plaster casts
● Surgical drainage, appropriate antibiotics and rest
● Physiotherapy

A

Surgical drainage, appropriate antibiotics and rest

139
Q

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

A swelling that must be distinguished from a popliteal aneurysm

A fluctuant swelling in the politeal fossa

140
Q 
The following tumours often metastasize to bone
● Thyroid Ca
● Stomach Ca
● Breast Ca
● Prostate Ca
● Liver Ca
A

Thyroid Ca

Breast Ca

Prostate Ca

MBChB IV Orthopaedics (15 decks)

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