MSK CAP TEST QUESTIONS

Question 1

If a patient is on the ground and you suspect a fracture, what is the initial management?

Answer 1

ABCDE always

Question 2

If a fracture is intra-articular, what is usually the answer?

Answer 2

Carry out open reduction and internal fixation usually

Question 3

IF the fracture is an open fracture, what is usually the treatment?

Answer 3

Treatment would be to debride and follow up with internal or external fixation provided thorough debridement

Question 4

Which fracture has the biggest risk of compartment syndrome? What is the longest bone in the body?

Answer 4

Tibia holds the biggest risk of compartment syndrome Longest bone in the body would be the femur

Question 5

If there is too much swelling to give treatment for a fracture, eg an ankle fracture, what can be done before internal fixation?

Answer 5

Use external fixation to keep the fracture in place

Question 6

What is the mandatory view to have on a Monteggia fracture? It separates monteggia fracture dislocation from a nightshift (ulna) fracture

Answer 6

This would be a lateral xray view Need to be able to see the radial dislocation at the elbow (proximal radioulnar joint)

Question 7

Metatarsal stress fractures, Lisfranc fractures and scaphoid fractures are all difficult to view on the standard AP xray What must be done?

Answer 7

Metatarsal stress fracture - carry out bone scan eg techentium bone scan to detect the fracture Lisfrance fractures - CT scan if clinical suspicion - Typically grossly swollen, bruised foot, unable to weight bear Scaphoid fracture - 4 views - AP, Lateral & 2 Oblique

Question 8

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Answer 8

E - In reality the growth plate or (physis) of the developing skeleton is relatively week

Question 9

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Answer 9

Ulnar neuropathy

Question 10

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Answer 10

F - intervertebral disc polapse C - Spondylolysis - stress fracture – breaking of the pars interaticularis I - burst fracture

Question 11

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Answer 11

D - Trochanteric bursitis from prominent metalwork

Question 12

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Answer 12

D - closed reduction, application of a sling and mobilization after 4 weeks

Question 13

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Answer 13

E - Dupuytren’s contracture

Question 14

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Answer 14

E - Pain out of proportion is the most common symptom

Question 15

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Answer 15

A - prosthesis loosening

Question 16

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Answer 16

1. E - tibia 2. I - ilium 3. C -radius

Question 17

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Answer 17

A - injury to the ulnar nerve results in a claw hand

Question 18

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Answer 18

1. B - common peroneal nerve 2. A - anterior cruciate ligament

Question 19

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Answer 19

1. I - ANCA (probs has wegener’s, ENT-lung-kidney) 2. C - Anti Ro and La antibdoies 3. F -Anti dsDNA antibody

Question 20

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Answer 20

1. H - fibromyalgia 2. G - prolapsed intervertebral disc 3. F -dermatomyositis - heliotrope rash (can have shawl rash around neck)

Question 21

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Answer 21

C -Multiple bruises of different ages on shins of a two and a half year old

Question 22

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Answer 22

1. F -diclofenac , can cause GI ulcers and bleeds 2. G - Prednisolone, patinet can become osteoporotic leading to wedge fractures 3. H - hydroxychloroquine

Question 23

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Answer 23

1. F - wound debridement, ligamentaxosus and external fixation 2. G - Open reduction with a volar plate and median nerve decompression