Musculoskeletal Practice Questions Flashcards
When does the anterior fontanelle (AF) typically close in infants?**
a) 2-3 months
b) 4-6 months
c) 9-12 months
d) By 18 months
Correct Answer: d) By 18 months
Which type of fracture is commonly associated with the thicker periosteum and elasticity found in children’s bones?*
a) Comminuted fracture
b) Greenstick fracture
c) Compound fracture
d) Transverse fracture
*Correct Answer: b) Greenstick fracture
What is the term used to describe the abnormal inward bending of a limb toward the body’s midline?**
a) Valgus
b) Adduction
c) Varus
d) Abduction
Correct Answer: c) Varus*
By what age do muscles reach maximum diameter in girls?**
a) 8 years
b) 10 years
c) 12 years
d) 14 years
Correct Answer: b) 10 years
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Which of the following assessments is important when evaluating a child’s joints?
a) Muscle tone
b) Symmetry of movements
c) Recent dietary habits
d) Eye-hand coordination
Correct Answer: b) Symmetry of movements*
What characterizes a strain injury?**
a) Tearing of ligaments
b) Rupture of cartilage
c) Injury of muscle or tendon
d) Inflammation of the bone
Correct Answer: c) Injury of muscle or tendon*
What occurs when a tendon grows in length during a child’s development?**
a) The bone becomes more brittle
b) The muscle decreases in diameter
c) Ligaments become weaker
d) Bones grow through the lengthening of tendons
Correct Answer: d) Tendons grow in length
What skeletal maturity milestone is typically reached by the age of 20?**
a) Skull reaches adult size
b) Closure of all fontanelles
c) Complete ossification
d) Skeletal maturation is complete
Correct Answer: d) Skeletal maturation is complete
What term describes movement away from the midline of the body?**
a) Adduction
b) Abduction
c) Valgus
d) Varus
Correct Answer: b) Abduction
During assessment, what might crepitus indicate in a child’s joint?**
a) Muscle inflammation
b) Cartilage erosion
c) Smooth joint function
d) Bone growth
Correct Answer: b) Cartilage erosion
What is the most common foot abnormality seen in newborns?**
a) Flatfoot
b) Metatarsus adductus
c) Clubfoot
d) Talipes planus
Correct Answer: b) Metatarsus adductus*
What is the typical cause of metatarsus adductus in infants?**
a) Genetic mutation
b) Nutritional deficiency
c) In utero positioning
d) Birth trauma
Correct Answer: c) In utero positioning*
What is the primary treatment for mild metatarsus adductus?**
a) Surgical correction
b) Passive range of motion (ROM) exercises
c) Antihypertensive medication
d) Electrical stimulation therapy
Correct Answer: b) Passive range of motion (ROM) exercises
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Clubfoot, also known as Talipes Equinovarus, occurs more frequently in which gender?
a) Boys
b) Girls
c) Equally in boys and girls
d) More data is needed
Correct Answer: a) Boys*
*Clubfoot is genetically predisposed and is associated with which condition?**
a) Down syndrome
b) Spina bifida
c) Developmental dysplasia of the hip (DDH)
d) Osteogenesis imperfecta
Correct Answer: c) Developmental dysplasia of the hip (DDH)*
After initial casting for clubfoot, which additional procedure might be necessary to achieve full correction?**
a) Leg-lengthening surgery
b) Knee arthroscopy
c) Achilles tenotomy
d) Subtalar fusion
Correct Answer: c) Achilles tenotomy*
*Which treatment is most commonly used for correcting clubfoot, involving manipulation and casting?**
a) Ilizarov procedure
b) Spica casting
c) Ponseti casting
d) Stretch-and-inflate casting
Correct Answer: c) Ponseti casting*
*In severe cases of clubfoot, what is one potential long-term complication if correction is not successful?**
a) Complete immobility of the foot
b) Development of arthritis
c) Increased incidence of fractures
d) Rapid bone growth
Correct Answer: b) Development of arthritis*
How often is a cast typically changed when using Ponseti casting for clubfoot correction?**
a) Every 6 months
b) Every 3-4 days
c) Every 1-2 weeks
d) Every month
Correct Answer: c) Every 1-2 weeks
What is a common nursing intervention for infants with metatarsus adductus?**
a) Electrical stimulation
b) Cast care and education
c) Bed rest
d) Vitamin D supplementation
Correct Answer: b) Cast care and education*
What is the common age range by which bow legs (genu varum) typically resolve in children?**
a) 6 months to 1 year
b) 1 to 2 years
c) 2 to 3 years
d) 4 to 5 years
Correct Answer: c) 2 to 3 years*
A persistent abnormality of bow legs beyond the typical age range may indicate which condition?**
a) Osteoporosis
b) Rickets
c) Scoliosis
d) Achondroplasia
Correct Answer: b) Rickets*
What is the recommended treatment for severe cases of bow legs that do not resolve?**
a) Vitamin supplementation
b) Physical therapy exercises
c) Night braces and surgery
d) Radiation therapy
Correct Answer: c) Night braces and surgery*
At what age do knock knees (genu valgum) typically become noticeable in children?**
a) 6 months
b) 12 months
c) 2 to 3 years
d) 5 to 6 years
Correct Answer: c) 2 to 3 years
Which hip condition is common in newborns and more frequent in females, often detected through the Barlow and Ortolani maneuvers?**
a) Genu valgum
b) Femoral anteversion
c) Developmental dysplasia of the hip (DDH)
d) Osteogenesis imperfecta
Correct Answer: c) Developmental dysplasia of the hip (DDH)
- **What is the purpose of the Pavlik harness in treating developmental dysplasia of the hip?*
a) Increase leg length
b) Provide hip flexion and extension
c) Keep hips in an abducted position
d) Correct a splayed foot position
Correct Answer: c) Keep hips in an abducted position
Which side of the hip is more commonly affected in developmental dysplasia due to prenatal positioning?**
a) Right hip
b) Left hip
c) Both sides equally
d) Varies depending on delivery mode
Correct Answer: b) Left hip*
For which conditions is the Pavlik harness contraindicated due to major muscle imbalances?**
a) Cerebral palsy
b) Spina bifida and arthrogryposis
c) Down syndrome
d) Kawasaki disease
Correct Answer: b) Spina bifida and arthrogryposis
Which position should the hips be kept in with the use of a Pavlik harness to ensure effective treatment?**
a) Extended and internally rotated
b) Flexed and adducted
c) Flexed and abducted
d) Extended and abducted
Correct Answer: c) Flexed and abducted
What is a positive Trendelenberg sign indicative of in musculoskeletal examination?**
a) Spinal curvature disorder
b) Anomaly of the knee joint
c) Abnormal downward tilt of the pelvis when bearing weight
d) Reduced range of ankle motion
Correct Answer: c) Abnormal downward tilt of the pelvis when bearing weight*
In cases of DDH that do not respond to a Pavlik harness, what is the next step in treatment for children older than 6 months?**
a) Physical therapy
b) Spica cast
c) Surgical intervention
d) Nighttime bracing
Correct Answer: b) Spica cast*
Which of the following is a potential complication of excessive abduction in DDH treatment?**
a) Hypoplasia of the acetabulum
b) Avascular necrosis of the femoral head
c) Scoliosis
d) Dislocation of the patella
Correct Answer: b) Avascular necrosis of the femoral head*
When caring for a child in a spica cast, what should parents be instructed to do to avoid damaging the cast?**
a) Elevate the cast only when necessary
b) Use heat lamps to dry the cast
c) Use the palms of their hands to handle the cast until it dries
d) Submerge the cast in water for cleaning
Correct Answer: c) Use the palms of their hands to handle the cast until it dries*
Legg-Calve-Perthes Disease**
Which demographic is most commonly affected by Legg-Calve-Perthes disease?
a) Females under 5 years
b) Males aged 2-12 years
c) Adolescents aged 15-19 years
d) Newborns to 1 year of age
Correct Answer: b) Males aged 2-12 years*
What is the primary management goal for a patient with Legg-Calve-Perthes disease?**
a) Encourage spontaneous recovery without intervention
b) Ensure the femoral head remains in the socket until ossification is complete
c) Immediate surgical intervention
d) Limit activity to prevent exacerbation of symptoms
Correct Answer: b) Ensure the femoral head remains in the socket until ossification is complete*
Slipped Capital Femoral Epiphysis (SCFE)**
-
Slipped capital femoral epiphysis most commonly occurs in which type of patient?
a) Adolescent, obese males
b) Prepubescent athletic females
c) Infants with developmental delays
d) Elderly individuals with osteoporosis
Correct Answer: a) Adolescent, obese males
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Which diagnostic view is recommended to assess SCFE?
a) AP hip x-ray view
b) Sunrise knee x-ray view
c) Lateral hip/femur radiograph with frog leg position
d) Axial ankle x-ray view
Correct Answer: c) Lateral hip/femur radiograph with frog leg position*
What is the primary treatment step for a child diagnosed with SCFE?**
a) Prescribing NSAIDs and rest
b) Arthroscopic surgery
c) Referral to an orthopedic surgeon for intervention
d) Immobilization with a full body cast
Correct Answer: c) Referral to an orthopedic surgeon for intervention*
*A child with SCFE presents with hip pain and limps, with pain that may be referred where?**
a) The back
b) The medial side of the knee or thigh
c) The heel
d) The shoulder
Correct Answer: b) The medial side of the knee or thigh*
Duchenne Muscular Dystrophy (DMD)**
-
What is a common early sign of Duchenne Muscular Dystrophy in young boys?
a) Hyperactivity
b) Chronic cough
c) Gower’s sign
d) Excessive growth
Correct Answer: c) Gower’s sign
Which lab test is often elevated in children with Duchenne Muscular Dystrophy?**
a) White blood cell count
b) Serum creatine kinase (CK) level
c) Blood glucose
d) Cholesterol level
Correct Answer: b) Serum creatine kinase (CK) level
*Duchenne Muscular Dystrophy is inherited in which pattern?**
a) Autosomal dominant
b) Autosomal recessive
c) X-linked recessive
d) Mitochondrial
Correct Answer: c) X-linked recessive
uvenile Rheumatoid Arthritis (JRA) / Juvenile Idiopathic Arthritis (JIA)**
-
What is the most common type of juvenile idiopathic arthritis?
a) Oligoarticular
b) Polyarticular
c) Systemic
d) Enthesitis-related
Correct Answer: a) Oligoarticular*
Which of the following is a diagnostic criterion for juvenile idiopathic arthritis?**
a) Fever lasting for one week
b) Arthritis in one or more joints for at least 6 weeks
c) Osteopenia on x-ray
d) Positive rheumatic fever titer
Correct Answer: b) Arthritis in one or more joints for at least 6 weeks*
Which medication is commonly first-line in the management of juvenile idiopathic arthritis?**
a) Methotrexate
b) Prednisone
c) NSAIDs
d) Hydroxychloroquine
Correct Answer: c) NSAIDs
Scoliosis**
-
What degree of spinal curvature is generally used as a threshold for diagnosing scoliosis?
a) 5 degrees
b) 10 degrees
c) 15 degrees
d) 20 degrees
Correct Answer: b) 10 degrees
*At what age is scoliosis screening commonly performed in children?**
a) Preschool
b) Early elementary
c) Late elementary to early adolescence
d) Late adolescence
Correct Answer: c) Late elementary to early adolescence*
What is the most common treatment for mild scoliosis in children?**
a) Surgery
b) Physical therapy
c) Observation and regular monitoring
d) Casting
Correct Answer: c) Observation and regular monitoring
*In pediatric patients, which type of fracture involves the breaking of the bone with a bend only on one side?**
a) Comminuted fracture
b) Compound fracture
c) Greenstick fracture
d) Spiral fracture
Correct Answer: c) Greenstick fracture*
Which factor is the most critical to evaluate initially in a child with suspected fracture?**
a) School performance
b) Neurovascular status of the affected limb
c) Past medical history
d) Nutritional status
Correct Answer: b) Neurovascular status of the affected limb
*What is the typical recommended management for a simple, non-displaced fracture in a child?**
a) Immediate surgical intervention
b) Closed reduction and immobilization
c) Physical therapy only
d) Over-the-counter pain medications
Correct Answer: b) Closed reduction and immobilization*
