ORTHO AMC

Question 1

flattening of the round shoulder contour

Answer 1

Dislocated glenohumeral joint

Question 2

lateral step deformity of the shoulder tip

Answer 2

Dislocated acromioclavicular joint

Question 3

Answer 3

Dislocated sternoclavicular joint

Question 4

most common form of shoulder joint disloaction

Answer 4

Dislocated glenohumeral joint; anteroinferior dislocation

Question 5

Prolapse of a lumbosacral L5-S1 intervertebral disc

Answer 5

• acute low back pain following a lifting strain
• pain radiate to the buttock and down to the back of the leg to the foot with pins and needles
• unable to walk on toes
• diminished ankle jerk
• dminished sensation to the outer 2 toes extending to the sole

Question 6

Positive straight leg raise

Answer 6

irritation to the L5-S1

Question 7

trauma to the knee with transmitted violence to the hip

Answer 7

posterior dislocation of the hip

Question 8

posterior dislocation of the hip appearance

Answer 8

leg is painful, shortened at the hip and flexed and internally rotated at the hip

Question 9

acute rupture of the rotator cuff mechanism in the supraspinatus / torn rotator cuff

Answer 9

inability to abduct the arm more than 40 deg in a presence of an actively contacting deltoid muscles

Question 10

Achilles tendon rupture manifestation (2)

Answer 10

• weakness on plantar flexion of the ankle with inability to stand on toes
  increase range of passive dorsiflexion and extesnion of the ankle

Question 11

Recurrent anterior glenohumeral shoulder dislocation is caused by

Answer 11

traumatic Hill Sachs deformity

Question 12

Which muscle is supplied by the axillary nerve

Answer 12

Deltoid

Question 13

Spondylolysis

Answer 13

slippage of a vertebra, causing more pronounced symptoms, especially if nerves are compressed.

Question 14

Spondylolisthesis

Answer 14

degenerative changes, which are typically age-related and cause chronic pain.

Question 15

Supportive stick for walking assistance should be held on the

Answer 15

unaffected side.

Question 16

Most common cause of joint infection

Answer 16

Staphylococcus aureus

Question 17

Treatment of choice for S. aureus joint infection

Answer 17

Flucloxacillin

Question 18

Displaced subcapital fracture of the femur compication

Answer 18

Non union

Question 19

Microscopic findings of gout

Answer 19

negatively birefringent crystals with needle like morphology

Question 20

Microscopic findings of pseudogout/chondrocalcinosis

Answer 20

rhomboid and positively birefringent crystals

Question 21

cause of chondrocalcinosis

Answer 21

deposition of calcium pyrophosphate

Question 22

Long term treatment for gout

Answer 22

Allopurinol introduced 4 weeksa fter attack

Question 23

Medication for symptomatic relief during an acute flare of gout

Answer 23

Indomethacin

Question 24

Progressive muscle weakness and skin rashes (erythematous scaly eruptions over the knuckles of the IP and MCP joints) + CK elevation

Answer 24

Dermatomyositis

Question 25

Multiple joint pains + fever + elevated blood pressure + digital infarcts + foot drop

Answer 25

Polyarteritis nodosa

Question 26

Findings of PAN on biopsy shows

Answer 26

histological evidence of nectroizing vasculitis affecting the small arteries

Question 27

Ulnar nerve injury hand deformity

Answer 27

Claw hand deformity

Question 28

Radial nerve

Answer 28

Wrist drop

Question 29

Median nerve

Answer 29

Ape hand or Hand of Benediction

Question 30

Pinch sign (or O sign)

Answer 30

Anterior interosseous nerve palsy (branch of the median nerve)

Question 31

Klumpke’s palsy or Total claw hand

Answer 31

Lower brachial plexus injury (C8-T1)

Question 32

Polymyalgia rheumatica

Answer 32

fever + weight loss + symmetrical proximal muscle pain and stiffness (shoulder, neck, hips) + worse in the morning + normal muscle strength + associated with GCA/temporal arteritis + elevated ESR CRP + normal CK

Question 33

Features of flexor tenosynovitis

Answer 33

• pain on passive extension
• finger locking

Question 34

fall on outstretched arm + severe shoulder pain + cant elevate arm

Answer 34

dislocated glenohumeral joint

Question 35

Contraindications to starting indomethacin (relative contraindications)

Answer 35

peptic ulcer
gastritis and gerd
significant renal failure (sc >200 mmol/L)
congestive heart failure

Question 36

history of headache + sudden persisting visual loss

Answer 36

temporal arteritis

Question 37

Pain aggravated by walking and requiring recumbency for relief

Answer 37

Spinal canal stenosis

Question 38

Shooting pain then resulting from the low back down the back of the leg and extending to the inner toes
Numbness or paresthesia
‘pins and needles’ ‘electric shocks’ ‘loss of feeling

Answer 38

Focal L4 to L5 prolapse

Question 39

Foot drop

Answer 39

L5

Question 40

Saturday night palsy or wrist drop

Answer 40

Radial nerve