Revision Questions 2 Flashcards
Which statement regarding conservative treatment in orthopaedics is most appropriate?
Select one:
a. Should only be considered if operation is not possible
b. Usually requires the patient to be given a general anaesthetic
c. Can result in excellent outcome measures in appropriate cases
d. It usually results in a sub-optimal outcome for the patient
e. It is rarely appropriate for young patients
c. Can result in excellent outcome measures in appropriate cases
Making an accurate orthopaedic diagnosis for a patient
Select one:
a. Reduces patient confidence in the treating clinician
b. In the majority of patients is not required
c. Allows the clinician to research the most appropriate patient treatments
d. Is rarely a good use of medical resources
e. Is not required for many clinical research projects
c. Allows the clinician to research the most appropriate patient treatments
In treating a child with acute osteomyelitis of the tibia, which test is most helpful?
Select one:
a. A white cell count of 15x109/L
b. A C Reactive Protein (CRP) of 20mg/L (normal<4mg/L)
c. Positive blood cultures
d. Normal serum electrolytes
e. An Erythrocyte Sedimentation Rate (ESR) of 10mm/Hr
The correct answer is: Positive blood cultures
In a patient with chronic osteomyelitis where can cultures be most reliably obtained in order to identify the primary causative organism? Select one: a. Pus draining from the sinus b. The nose and pharynx of the patient c. The sinus tract d. Unbroken skin of the affected limb e. Biopsy of the affected bone
The correct answer is: Biopsy of the affected bone
Which treatment option is least appropriate in acute tibial osteomyelitis management
Select one:
a. Regular, appropriate analgesia
b. Commencing high dose IV antibiotics to cover likely organisms
c. Encouraging regular weight-bearing exercise on the limb
d. Optimising nutritional state
e. Immobilising the affected limb in a splint
The correct answer is: Encouraging regular weight-bearing exercise on the limb
In a patient with chronic osteomyelitis, which statement is most accurate
Select one:
a. This could be a life-long condition for them
b. Skin cancer arising from a dry sinus is very likely
c. A 2 week course of appropriate antibiotics is likely to cure the problem
d. Production of an involucrum will prevent pathological fracture
e. A sequestrum can usually be located by using an U/S scan
The correct answer is: This could be a life-long condition for them
Which complication of severe, distal femoral acute osteomyelitis in a child is least likely?
Select one:
a. Angular deformity of the limb
b. Limb length discrepancy
c. Bacterial endocarditis
d. Chronic localised osteomyelitis with a sinus
e. Arthritis of the hip
The correct answer is: Arthritis of the hip
What clinical presentation is least likely with TB of the knee joint?
Select one:
a. Involuntary weight loss over several months
b. Ongoing treatment of HIV
c. Swelling of the knee with restricted movement
d. Knee pain worse on exercise and relieved by rest
e. No close contact with a person known to have TB
The correct answer is: Knee pain worse on exercise and relieved by rest
In an established high brachial plexus (Erb’s) palsy, what clinical finding would you expect in a cooperative adult? Select one: a. Diminished power of wrist extension b. Diminished, power of elbow extension c. Normal power of elbow flexion d. Normal power of shoulder abduction e. Diminished power of wrist flexion
The correct answer is: Diminished power of wrist extension
In a patient with a fracture of the humeral mid-shaft with an associated, isolated, radial nerve palsy, which clinical findings are most likely in ipsilateral hand?
Select one:
a. Numbness over the dorsum of the little finger
b. Numbness over the volar aspect of the index finger
c. Numbness over the dorsum of the middle finger
d. Numbness over the dorsum of the hand in the first web space
e. Numbness over the volar aspect of the little finger
The correct answer is: Numbness over the dorsum of the hand in the first web space
Which clinical finding is most consistently seen in patients suffering from carpal tunnel syndrome?
Select one:
a. Weakness of power of DIPJ flexion of the little finger of the affected hand
b. Weakness in the power of finger abduction in the affected hand
c. Reduced sensation in the palm of the affected hand
d. Weakness in the power of thumb abduction in the affected hand
e. Numbness of the tip of the little finger on the volar aspect of the affected hand
The correct answer is: Weakness in the power of thumb abduction in the affected hand
In the primary treatment of osteoarthritis, which factor most contributes to personal ability to manage symptoms?
Select one:
a. Belief that avoidance of exercise with minimise disease progression
b. Unsympathetic employer and work colleagues
c. A natural optimistic outlook on life
d. Regular sleep disturbance because of symptoms
e. lack of family support
The correct answer is: A natural optimistic outlook on life
What is the most important factor in deciding if a patient requires surgery for an osteoarthritic joint?
Select one:
a. The patient has a full understanding of the recovery process
b. The patient has a complete understanding of the risks involved
c. The patient often limps at work
d. The patient has required to limit sporting activities
e. The patient has exhausted conservative strategies but still exhibits persistent, intrusive symptoms
The correct answer is: The patient has exhausted conservative strategies but still exhibits persistent, intrusive symptoms
What is the most important reason for MSK being a core component of medical undergraduate training?
Select one:
a. MSK pathology forms the basis for a large proportion of GP consultations
b. Many students are asked questions by family members on MSK conditions
c. Orthopaedics wish to stay the largest surgical speciality in the UK
d. It allows sporting students to manage their own injuries
e. The government wish spending on MSK conditions to be minimised
The correct answer is: MSK pathology forms the basis for a large proportion of GP consultations
When examining a suspicious mass which characteristic is most suggestive of malignancy?
Select one:
a. A hard, irregular swelling that has expanded over a short period
b. A well circumscribed, smooth outline
c. A superficial swelling near a joint that transilluminates
d. Non tender on palpation
e. A soft, lobulated, non-tender 1cm swelling superficial to deep fascia
The correct answer is: A hard, irregular swelling that has expanded over a short period
Which characteristic is not typical of a benign bone tumour?
Select one:
a. The lesion is well circumscribed on x-ray
b. An aggressive periosteal reaction around the lesion without a trauma history
c. A fractures occurring through the lesion after minimal trauma
d. A sclerotic margin between the lesion and surrounding bone
e. No evidence of surrounding tissue infiltration on MRI scanning
The correct answer is: An aggressive periosteal reaction around the lesion without a trauma history
What information can you not obtain from an MRI scan of a malignant bone tumour?
Select one:
a. An assessment of the reaction of the surrounding structures to the tumour
b. The likelihood of tumour involvement of near-by joints
c. The anatomical relationship of the tumour to vital neurovascular structures
d. The definitive diagnosis
e. The local extent of the tumour
The correct answer is: The definitive diagnosis
Which patient with a known primary malignancy is least likely to develop bone metastasis? Related to the original pathology?
Select one:
a. A 60 year old man 1 year after resection of a renal tumour with local spread
b. An 80 year old man with known prostate cancer on no treatment
c. A 45 year old lady with a large breast tumour and axillary lymph node involvement
d. A 70 year old man with a treated, superficial bladder transitional cell tumour
e. A 50 year old smoker receiving palliative radiotherapy for lung cancer
The correct answer is: A 70 year old man with a treated, superficial bladder transitional cell tumour
