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MCQ orthopedics posting

1. Regarding osteoarthritis
a. It is a non-inflammatory joint dz T (degenerative disease)
b. The pathogenesis involve increased hydration of articular cartilage F
c. The reparative process results in osteophyte formation T
d. The primary generalized type involve small joint of hand F
e. Synovectomy is one of the treatment F (synovectomy is for RA)
2. Regarding osteoporosis
a. Hypocalcaemia is a known cause F
b. The coupling action of osteoblast and osteoclats is lost T
c. Calcitonin is given in acute cases of fracture T (Calcitonin in a dose of 50
to 100 IU daily, given subcutaneously or intranasally, should be offered to
all patients with serious pain related to acute vertebral fractures for
symptom relief and to facilitate mobilization)
d. Selective estrogen receptor modulator have increased risk of venous
thromboembolism T
e. Vertebroplasty is a therapy for fractures of vertebrae body T
(Vertebroplasty is a valuable tool in the treatment of painful osteoporotic
vertebral fractures, providing acute pain relief and early mobilization in
appropriate patients)
3. Regarding carpal tunnel syndrome
a. It is known as ulnar neuropathy of the wrist F
b. Clinically the patient is unable to flex the PIPJ of index finger F
c. Compression test performed over the transverse carpal ligaments is
diagnostic T
d. Pregnancy is one of its causes T
e. In diabetics, carpal tunnel released is the preferred treatment T
4. Regarding anterior cruciate ligaments injury
a. It is cause by a posteriorly directed force to the front of tibia T
b. Occurs more commonly among female athletes T
c. It predisposes to early osteoarthritis T
d. It is usually associated with medial meniscus injury T
e. The avulsion type is treated with screw fixation T
5. Regarding osteomyelitis
a. Trauma is a predisposing factor T
b. In young children, haemohilus influenza is the common pathogen T-x
c. Ceftazidime is the antibiotic of choice T (third gen)-x
d. Sequestrum is a layer of new bone growth outside existing bone F
e. Joint dislocation is one of its complication F
6. Regarding developmental dysplasia of hip (DDH)

a.
b.
c.
d.
e.

Female is commonly affected than male T


Strapping baby with extended hip is a predisposing factor T
Waddling gait is a presenting feature in unilateral DDH F (bilateral)
Generalized joint laxity predispose to DDH T
Barlows test is diagnostic for dislocatable hip T

7. Indication for internal fixation in children include


a. Lateral condyle fracture of humerus F (unless displaced)
b. Displaced acetabulum fracture T
c. Displaced tibia plateau fracture T
d. Femoral neck fracture T
e. Femoral shaft fracture F (unless in teenagers with unsatisfactory
reduction)-x
8. Indication of external fixation include
a. Fracture a/w severe soft tissue damage T
b. Closed fracture midshaft of tibia F
c. Open book fracture of pelvis T
d. Arthrodesis of ankle T
e. Intraarticular fracture T-x
9. Regarding osteosarcoma
a. It is a highly malignant osteoid forming tumor T
Usually presented with very painful mass around the knee F-x
b. Codmanns triangle on plain radiograph is specific to osteosarcoma F
c. Neoadjuvant chemotherapy is given pre and post operatively F
d. Is frequently metastases to vertebral bone T-x
10. Regarding acute compartment syndrome
a. It occurs more commonly in lower limbs T
b. 20 mmHg difference between intracompartmental pressure and diastolic
pressure is diagnostic T (< 30)
c. Volkmanns contracture is its late sequalae T
d. If cast is applied, it should be bivalve immediately T
e. Left untreated it can lead to renal failure T
11. Regarding prolapsed intervertebral disc
a. Commonly occur at L4/L5 level T
b. Characterized by radiating pain to the anterior aspect of knee F
c. Listing to the opposite side of painful limb indicates a shoulder lesion T
d. Loss of ankle reflex is seen in L5/S1 prolapse T
e. Treatment is usually operative F
12. Features of FES include
a. CNS depression t
b. Occurs within 12 hr of skeletal trauma-f

c. Presence of fat globule in urine-f


d. Sudden drop in platelet level-f
e. Cannon ball appearance on chest xray-f
13. An elderly women was admitted with fracture neck of femur
a. The injury that causes the fracture is usually trivial-f
b. The affected limb is usually in externally rotated position-t
c. Sciatic nerve is commonly injured-t
d. Conservative treatment is the choice of treatment -f
e. The fracture usually unites within 6 weeks-f
14. Regarding fracture non union
a. The fracture site is painful on movement-f
b. Hyperthrophic non union have poor blood supply at the end of fragments-f
c. Lower third of tibia is a common site of non union-t
d. External fixation is a known cause of non union-f
e. Treatment of non union requires internal fixation and bone grafting-t
15. Regarding musculoskeletal tumor
a. GCT classically gives soap-bubble appearance on xray-t
b. Multiple enchondromas also known as Olliers dz-t
c. Fibrous dysplasia causes shepherd crook deformity of proximal tumor-t
d. Osteoblastoma usually turn into malignancy-f
e. Pain in osteoid osteoma typically relieve by aspirin-t
16. Regarding spine TB
a. Narrowing disc space is the earliest sign seen on plain radiograph-f
b. Drug therapy is given only after the culture is found to be positive with
mycobacterium-f
c. PCR is diagnostic test for TB-t
d. Ethambutol has a bactericidal action against mycobacterium organism-f
e. In children progressive kyphosis is one of its complication-t
17. Regarding durg used in orthopaedic practice
a. COX-2 inhibitors is known to cause CVS complication-t
b. Indometahcin is used to prevents myositis ossificans-t
c. Gabapentin is used to treat neuropathic pain-t
d. Glucosamine is given in early OA case-f
e. alendronate is used in osteoporotic fracture-t
18. Regarding outpatient orthopaedic
a. DeQuervains tenosynovitis is diagnosed by Finkelsteins test-t
b. Lateral epicondylitis is also known as tennis elbow-t
c. Plantar fasciitis commonly present with pins and needles over the hind
foot-t
d. Morton euroma is a cause of metatarsalgia-t

e. Trigger finger rarely occur in infants-t


19. Regarding metastatic bone dz
a. The pain is severe at night disturbing sleep pattern T
b. Osteolysis is commonly seen in prostate cancer pt F
c. Hypercalcaemia is a potential life-threatening complication T
d. Internal fixation is contraindicated F
e. radiograph of spine shows pedicle erosions F (vertebral collapse)
20. Regarding peripheral nerve injury
a. Wallerian degeneration occurs in proximal segment of injured nerve F
b. Causalgia is one of its complication F
c. Finger drop without wrist drop indicates that the lesion is at the radial
groove of the humerus F (PIN)
d. Migrating positive tinel sign is an indication of nerve recovery T
e. Gabapentin is given for painful condition resulting from this injury T
MCQ orthopedics (group6)
1. Open fracture tibia
a. Occur at high velocity injury T
b. Common infection is by Staph. epidermidis F (common in foreign implant)
c. Anaerobic infection occur in farmer injury T
d. Can have complication of fat embolism F
e. External fixator need for management T
2. Causes of impairment consciousness with bilateral femoral # include:
a. Hypovolamic shock T
b. Pneumothorax
c. Subarachnoid hemorrhage
d. Fat embolism syndrome T
3. The incidence of vessel injury is higher in the following:
a. Scapulo-thoracic dislocation
b. Shoulder dislocation -axillary a
c. Supracondylar # of humerus (brachia artery)
d. Knee dislocation (pop artery )
e. # of shaft of humerus wrist drop radial n
4. In the hand:
a. Froment test is used to test adducted pollicis longus
b. Abductor pollicis longus supplied by radial nerve
c. FDP of little finger supplied by median nerve
d. Tinel test is to test for carpal tunnel syndrome
e. Ulnar nerve supply extensor carpi ulnaris

5. Emergency cervical radiology include:


a. Lateral view T
b. Oblique view
c. Open mouth view T
d. Swimmer view
e. Flexion and entension view
6. Unstable lumbar spine injury include:
a. Chance #
b. Anterior wedge #
c. Burst #
d. Spinous process #
e. Transverse process#
7. What is true about hip?
a. SLR is to test fixed abduction
b. Thomas test is to test fixed adduction
c. Hip is externally rotated in femoral neck #
d. ?
e. DDH present with true shortening
8. Which of the following condition is assciated with excessive osteoclastic activity
a. Osteogenous imperfecta
b. Osteopetrosis
c. Osteoporosis
d. Uncompensated osteomalacia
e. Hyperparathyroidism
9. Which of the following is true relating to femoral neck # in osteoporotic women:
a. Happen in trivial injury
b. Presented as externally rotated
c. a/w AVN
d. best treated with total hip replacement
e. shenton line is disrupted
10. regarding RA:
a. affects articular cartilage
b. a/w HLA-DR4
c. most commonly in women
d. DIP joint most commonly affected
e. Extraarticular manifestation in 10-20%
11. Regarding gouty athritis:
a. Assymetrical involvement of joint
b. Periarticular sclerosis
c. Eccentric soft tissue swelling

12. Organism isolated in septic arthritis of IVDU:


a. Staph. Aureus
b. Pseudomonas aerugenosa T
c. Diplococci
d. Streptococci
e. Haemophilus influenza
13. Common occurance at knee jt:
a. Osteoid osteoma
b. Osteosarcoma
c. Chondrosarcoma
d. Enchondroma
e. Bursitis
14. Regarding osteomalacia:
a. Vit D deficiency
b. Cause prox myopathy
c. Pseudo-#
d. Serum Ca2+ increase
e. Diagnose with bone biopsy
15. Radiological features in non-accidental injury include:
a. Multiple # in different stage of healing
b. Excessive callus
c. Posterior rib #
d. Metaphysis corner #
e. Short oblique #
16. Common Fracture-dislocation and nerve injury:
a. Hip sciatic nerve
b. Shoulder radial nerve
c. Supracondylar of humerus ulnar nerve
d. Wrist dislocation- median nerve
e. Fibula neck- peroneal nerve
17. Regarding# of femur in children:
a. # in pre-walking child suggests child abuse
b. Fat embolism common than in adult
c. Shortening 2-3cm is acceptable
d. Treated with traction and hip spica
e. Surgery indicated wit polytrauma
18. Regarding archilles tendon injury:
a. a/w inappropriate footwear
b. pain is induced with plantar flexion against resistence
c. tendon rupture is a complication

d. steroid injection is given in chronic cases


e. plantar heel pad is contraindicated?
19. AVN occur in # of:
a. Base of metacarpal
b. Femoral neck T
c. Supracondylar
d. Talus T
e. Tibia plateu

Medic 5 group 1 (07/08)


1. A 32 years old labourer complained of severe backache radiating down to the left leg.
Features of L% nerve root compression includes
A. Absence of left superficial cremasteric reflexF
B. Weak extensor of the kneeF
D. Loss of sensation over lateral calf dorsal foot left leg.T
E. Elevated ESRF
2. Lumbar spondylosis
A. Common in young adultF
B. Weakness of the lower limb is very common
C. Majority of the patients have significant history of trauma to the back
D. Spondylolithesis is one of the complicationsT
E. Most of the patients require surgical decompression.F
3. Causes of irritable hip
A. Transient osteoporosisT
B. Slipped capital femoral epiphysis
C. Perthes diseaseT
D. Acetabular fracture
E. Rheumatoid arthritis
4. Frozen Shoulder
A. Limitation of movement is the earliest presentationF
D. Radiological of the shoulder helps in diagnosingF
5. Radiological features suggesting malignant disease includes
A. Minimal periosteal reaction
B. Obvious soft tissue shadow
C. Narrow transition zone
D. Geographical lytic lesion
E. Sclerosed cystic margin
6. Regarding osteoarthritis of the knee
A. Increase water content of the cartilage
B. Valgus deformity is more common than varus deformity

C. Radiological features are similar to those of rheumatoid arthritis


D. Corrective osteotomy is one of the treatment options
7. Regarding gout
A. Joint aspiration fluid is cloudy, yellowish in colour
B. Serum uric acid is always high
C. X-Ray shows large periarticcular excavation
D. Colchinine is used for prophylaxis following recurrent attack
8. Diabetic foot
A. most of the patients presented with painful ulcer
B. May be associated with charcoat joint
C. Foot infection is typically caused by staphylococcus aureus
D. Ankle Brachial Index (ABSI) is a useful method of assessing level of amputation
E. Dirty ulcer should be dressed with strong erosive chemical solution
9. Regarding elbow joint
A. Pain on resistant (extension dorsiflex of the hand) in tennis elbow
B. Early passive movement is encouraged in elbow injury
10. Fat embolism
A. It takes place after 2nd week of long bone fracture
B. Associated with petechial hemorrhage over the chest, neck and face
C. Arterial Blood Gases will show low pCO2
D. Chest X-ray is normal
E. Presence of fat globules in the sputum and in the urine
11. Early complication of isolated cervical spine fracture with tetraplegia include
A. Stress ulcer
B. Hypovolemic shock
C. Bradycardia
D. Lung collapse
E. Painful muscle spasm
12. In congenital Hip dislocation
A. A baby with sign of hip instabily should be examined with ultrasonography
B. Barlows test is done by abduction and flexion of hip to reduce dislocation
C. Untreated case lead to avascular necrosis
D. More in breech presentation
E. Operation should be done as soon as the diagnosis is made
13. Indication for external fixation include
A. Certain pelvic fracture
B. Arthrodesis of knee
C. Closed communited unstable fracture of distal radius
D. Severe soft tissue damage

E. Correction of complex congenital limb deformity


14. Osteomyelitis
A. In adult it is more common in vertebral body
B. It often mimics osteoid osteoma in subacute type
C. It can cause limb length discrepancy in childrenT
D. Diffuse periosteal reaction along the diaphysis is characteristic in syphilitic casesT
E. Vancomycin is treatment of choice in MRSA
15. In spinal tuberculosis
A. The infection develops in intervertebral discF
B. New bone formation is minimal in active infectionT
C. Radiograph shows gross vertebral body destructionT
D. More extensive in childrenT
16. Regarding bone tumour
A. Fibrous dysplasia is not a true tumourT
B. Myositis ossificans mimics osteosarcoma histologically
C. Chodroblastoma occurs in epiphysisT
D. Benign tumour can be treated with irradiationF
E. 20% eosinophilic granuloma can progress to Hand-Schuller syndrome
17. Penetrating wound with median nerve palsy
A. Pointing index finger
B. There is loss of sensation over the thenar eminence
C. Loss of flexion of the lateral 3 fingers
D. Weak hand grip
18. Regarding supracondylar fracture of humerus
A. In children, is usually extraarticular
B. Anterior fat pad sign is the feature of fracture
C. Cubitus valgus is more common than cubitus varus
D. Posterior interosseous verve is commonly injured
E. Percutaneous pinning is a treatment for open surgery
19. Regarding meniscus of the knee
A. Medial meniscus is more prone to be injured
B. Lachman test is positive
MCQ ORTHO GROUP 1 , 2
1. Regarding # of clavicle
A. usually involves the middle 1/3 of the clavicle
B. non-union is common
C. # is diagnosed from plain radiograph
D. cx include brachial plexus injury

E. usually treated conservatively with arm sling

T,F,T,T,F

2. Regarding # of humerus
A. surgical neck of humerus is a common # site
B. open # is treated w IF & antibiotic
C. radial nerve is the most common nerve to be injured
D. can be treated w U-slab
E. lat. Condyle is # > common then medial condyle

T,T,T,T,T

3. Shoulder dislocation
C. Axillary view can diff. Between post dislc. & ant.
E. Habitual dislocation is painless
T,T
5. Regarding open #
A. tibia > common
B. grade 3C high risk of amputation
C. grade 1A can be primarily sutured
D. external fixator can be use if skeletal traction not available
A.
B.
C.
D.
E.

6. About posterior dislocation of LL


more common than antr dislocation
leg held in internal rotation and abduction
femoral artery injury is uncommon
sciatic nerve injury causes foot drop
failed close reduction need surgical reduction

A.
B.
C.
D.
E.

7. Regarding Perthes ds :
genetic factor has a role in its pathogenesis
occurs frequently in male
patient is typically obese
medial knee pain is one of its presentation
worse prognosis in younger age
8. Regarding # of tibia and fibula :
A. Pilon # is a # of intraarticular T
9. # of tibia
A. a/w lower fibula # causes ankle instability
B. # of distal tibia is a/w delayed or non-union
C. pilon # is an intraarticular # of distal tibia
D. PTB cast is appropriate for distal tibia #
10. Regarding # neck of femur
A. extracapsular # carries better prognosis
B. the affected leg is adducted
C. garden 2 # is a partially displaced #

T,F,F,T,T

F,T,F,F,F

T,T,T,T

D. undisplaced # in elderly pt is treated conservatively


E. hemiarthroplasty is Rx of choice for neglected # in elderly T,F, F,F,T
10. Possible traction cx following conservative Rx
A. compartment syndr
B. foot drop
C. joint stiffness
D. press sore
E. disuse osteoporosis
T,T,T,T,T
11. Perthes dz
A. present b4/after 10 yr
B. d/t AVN of prox femoral epiphyses
C. > female
D. plain x-ray show femoral head smaller & flatter
E. require surgical intervention
F,T,F,T,F
12. Diabetic foot
A. sensory neuropathy coz dryness/fissures of foot
B. infection is superficial
C. improper nail cutting disastreous
D. level of amputation depend on its vascularity .....
E. charcot joints usually involved ankle joint
F,F,T,T,T
13. Regarding knee pain
A. knee & hip x-ray required
B. locked knee means inability to extend knee fully
C. immediate knee swelling suggest meniscus injury
D. hemarthrosis in haemophilic pt treated w knee aspiration
E. meniscus calcification suggest gouty arthritis
T,T,F,F,F
14. Diabetic foot
A. sensory neuropathy coz dryness/fissures of foot
B. infx is superficial
C. improper nail cutting disastreous
D. level of amputation depend on its vascularity
E. charcot joints usually involved ankle joint

F,F,T,T,T

15. Chronic OM
A. chronic d/c is pathognomonic
B. it may follow close # if treated w internal fixation
C. radiologically may mimic Ewing sarcoma
D. pathological # is a known cx
E. prolonged antibiotic w/out surgery is usually sufficient for treatment
16. Regarding OA of the knee

F,T,F,T,F

A. 20 OA occur following previous Septic arthritis


B. valgus deformity
C. blood ix-elevated ALP
D. radiographically knee jt appear osteopenic
E. TKR indicated for pt <45 y.o
T,T,F,F,F
17. Peripheral nerve injury
A. median nerve injury coz weakness of abduction muscle
B. malunion of supracondylar # in children coz tardy ulnar nerve lesion
C. Tinels sign indicate nerve regeneration
D. injury of radial nerve at humerus unable to extend elbow
E. in carpal tunnel syndr sensation in the thenar eminence is lost T,F,T,T,F
18. Regarding Spinal injury
A. hangman # is # of pedicle of C2
B. posterior column injury alone is stable injury
C. cervical injury show decrease in prevertebral shadow
D. overdose steroid lead upper GIT bleeding
E. facet dislocation can be treated with skull traction T,T,F,T,T
19. Regarding capacity
A. regarding pt ability to make decision
B. pt loss his right when involved life saving decision
C. severely depressed pt have no capacity
D. ultimate judge of capacity is Hospital directive and consultant
E. there is no aids to assess capacity

T,F,T,F,T

20. Regarding moral principles of Dr-pt relationship


A. non-maleficience:dr should do everything possible to benefit pts health
B. beneficience:dr should not harm pts health
C. autonomy:pt should respect dr freedom to decide on Rx
D. justice:dr treat all pt fairly
E. capacity:ability to understand information relevant to decision making F,F,F,T,T
MCQ ORTHOPAEDICS GROUP 7 & 6
1. Regarding compartment syndrome
A- can occur both upper and lower limb
B- pain worsen on passive movement
C- should bivalve immediately
D- elective OT list
2. Chronic osteomylitis
A- calceneum OM-pseudomonas infection
B- ESR usually > 100mm/h
C- sequestrum help in diagnostic

D- technetium is diagnostic
E- infected implant must removed eventhouh non-union
3- Septic arthritis
A- is an emergency
B- X-ray of the hip helps in diagnosis
D- ultrasonography is a diagnostic
E- Tx with Ab and joint aspiration
4- Regarding diabetic foot
A- trauma ulcer d/t loss of sensory
B- Claw toes d/t autonomic neuropathy
C- Blood sugar level hard to control
D- peripheral vascular pulse example reliable in diagnostic level of amputation
T,F,T,T
5. Recognised features of polymyalgia rheumatica include
A- weakness of distal muscle group
B- elevated serum creatinine kinase activity
C- is associated with bronchial CA
D- weight loss
E- peak incidence in 4th decade of life
7. Regarding prolapsed intervertebral disc
10. Regarding MSK tumour
A- most common bone tumour is osteosarcoma
B- spine tenderness must always be excluded during physical examination
C- hypocalcemia is one of the common complication following 2 bone metastases
D- CT scan delineates bone marrow extension of bone tumour
E- Tx osteosarcoma is generally surgical excision and radiotherapy
11. regarding fracture of clavicle
A- usually involve the middle 1/3 of the clavicle
B- non-union is not common
C- fracture is diagnosed from plain radiograph
D- Cx include brachial plexus injury
E- usually treated conservatively
14. Management of major trauma
A- peripheral circulation should be assessed before airway is assessed
B- airway is assessed in cervical spine injury
C- CT-scanning is useful in unexplained shock
D- Jaw thrust is done to maintain airway in suspected cervical spine injury
16. A motorcyclist was admitted with open fracture of the tibia and fibula. True

regarding management
A- IV antibiotic is started immediately
B- wound debridement is done as soon as possible
C- the wound is sutured immediately to prevent contamination
D- IF is done when ext. fixator is not available
E- 10 amputation is one of the option for open fracture grade 3C in post tibial fracture
injury
18. Fat embolism syndrome
A- CNS depression
B- hypoxemia
C- presence of fat in urine and sputum
D- Unexplained drop in Hct or platelet value
E- usually within 72 hr after injury
19. Regarding finger injury
A- industrial causes most common causes
B- should be operated 6-8 hours if not preserved
C- should direct preserved with ice
D- nerve neuroma is the most complication
20. Regarding supracondylar fractureof the humerus
A- in children,it usually intraarticular
B- anterior fat pad sign is a feature in X-ray
C- cubitus valgus is common compared to cub. Varus
D- post. Interossioeus veins is the commonly injured
E- percutaneous pinning is a tx for open surgery
MCQ Orthopedic Year 4 Group 4 09/10
1. Acute compartment syndrome
a. Lower limb most commonly affected
b. 20mmHg difference between intracompartmental pressure and diastolic
blood pressure is diagnostic
c. Volkmanns contracture is a late complication
d. Cast should bivalve immediately
e. Renal failure if left untreated
2. Prolapsed intervertebral disc
a. L4-L5 is the most commonly affected site
b. Pain radiating to the anterior of knee
c. L5-S1 causes ankle reflex loss
d. Surgery is the main treatment
e. Listing to the side opposite to the painful side indicates a shoulder lesion
3. Fat emboli syndrome
a. Causes CNS depression

b.
c.
d.
e.

Occurs in 12 hours in skeletal trauma


Acute reduce in platelet level
Urine containing fat globule
Canon ball lesion on chest X-ray

4. Fracture of femoral neck in elderly


a. Caused by trivial injury
b. Usually cause sciatic nerve injury
c. Leg is in the externally rotated position
d. Should treat conservatively
e. Union in 6 week
5. Non-union
a. Painful on moving the fracture site
b. Low blood supply in hypertrophic non-union
c. Distal 1/3 tibia is common
d. External fixation is a known cause
e. Treat with internal fixation and bone graft
6. Musculoskeletal tumour
a. Pain caused by Osteoid osteoma is characteristically relieved by aspirin
b. Fibrous dysplasia causes shepherd crook deformity in proximal femur
c. Osteoblastoma usually change to malignant
d. Giant cell tumour causes soap bubble appearance in X-ray
e. Multiple enchondroma is also known as olliers disease
7. Spine TB
a. Reduce intervertebral space is the earliest manifestation in X-ray
b. Start treatment after the culture come back positive
c. PCR is diagnostic
d. Ethambuthol is bactericidal
e. Progressive kyphosis in children
8. Drug in musculoskeletal
a. COX-2 causes cardiovascular problem
b. gabapentin is used for neuropathic pain
c. Indomethacine is used for myositis ossificans
d. Alendronite is used for osteoporotic fracture
e. Glucosamine is used for early OA
9. Development dysplasia of hip
a. Female is more common than male
b. Waddling gait is a presenting feature In unilateral hip dislocation
c. Generalized joint laxity is predispose to DDH
d. Barlow test is diagnostic for dislocatable hip
e. Strapping baby in an extended leg is a risk factor

10. Internal fixation in children


a. Displaced fracture of acetabulum
b. Fracture of lateral condyle of humerus
c. Fracture of tibial plateau
d. Fracture neck of femur
e. Femur shaft fracture
11. External fixation indication
a. Severe soft tissue injury
b. Pelvic Open book fracture
c. Arthrodesis of ankle
d. Intra-articular fracture
e. Closed fracture of tibia
12. Osteosarcoma
a. Characteristic highly malignant osteoid forming tumour
b. Codmans triangle is specific feature for osteosarcoma
c. Neoadjuvant chemotherapy is given pre and post operatively
d. Commonly metastasis to vertebra
e. A young patient usually presented with painful knee
13. Osteoarthritis
a. Non-inflammatory synovial joint disease
b. Increased hydration of hyaline cartilage is the early pathology
c. Generalized primary osteoarthritis commonly affects small joint of hand
d. Osteophyte formation is due to the reparative process
e. Synovectomy is the early treatment in osteoarthritis
14. Osteoporosis
a. Hypocalcemia is a cause
b. Loss of coupling of osteoclastic and osteoblastic activity
c. Calcitonin is used for treatment of fracture of femoral neck
d. Selective estrogen receptor modulator increases the risk of
thromboembolism
e. Vertebral collapse is treated with vertebroplasty
15. Carpal tunnel syndrome
a. Is an Ulnar nerve entrapment disease
b. Compression on the transverse carpal ligament is diagnostic
c. Unable to flex the proximal interphalangeal joint of index finger
d. Pregnancy is a cause
e. Carpal tunnel release is preferred in diabetic patient
16. Anterior cruciate ligament injury
a. More common in female athlete
b. Posteriorly directed force on the anterior of tibia

c. Causes early osteoarthritis


d. Avulsion type treat with screw fixation
e. Associated with medial meniscus injury
17. Osteomyelitis
a. Haemophilus influenza is a common cause in children
b. Trauma is a predisposing factor
c. Cef.?? (should be a third generation cephalosporin) is the preferred
treatment
d. Dislocation is a complication
e. Sequestrum is the new bone formation
18. Out patient orthopaedics
a. Dequervain disease is confirmed by finkelstein
b. Lateral epicondilytis is also known as tennis elbow
c. Plantar fasciitis causes pin and needle sensation on hindfoot
d. Mortons disease is a cause of metatarsalgia
e. Trigger finger is rare in infant
19. Metastasis bone disease
a. Pedicle erosion is a finding of spine X-ray
b. Metastasis from prostate causes osteolytic lesion
c. Hypercalcemia is a life threatening complication
d. Night pain disturbing sleep
e. internal fixation for the fracture
20. Peripheral nerve injury
a. gabapentin is a treatment
b. finger drop without wrist drop is due to radial nerve injury at radial groove
of humerus]
c. wallerian degeneration occurs proximal to the injury site
d. causes causalgia
e. migratory tinnel sign indicates healing
Ortho MCQ group 5 (10/11)
1.compartment syndrome
a)tight case is a cause
b)ischemic pain is the earliest sign
c)opiod in high dose is a treatment if detected early
d)compartment release is indicated
e)rest,ice,compression,elevated before surgery
2. fat embolism
a) present with CNS depression
b) within 12 hours of skeletal trauma
c)presence of fat globule in urine

d) sudden drop in platlet level


e) cannon ball appearances in xray
3. Regarding scaphoid #
a)commonest carpal bone fracture
b)fracture of prox part of scaphoid can cause AVN
c)Tenderness over anatomical snuffbox
d) treated in glass holding cast
e)normal x-ray changes can exlude diagnosis of #
4) upper limb peripheral nerve injuries
a) injury in median nerve results in wrist drop
b) injury in musculocutaneous nerve results in weakness in shoulder abduction
c) injury in radial nerve results in loss of sensation in anatomical snuffbox
d) injury to ulnar nerve results in claw hand
e) injury to axillary nerve results in loss of sensation in axillary region
5. osteosarcoma
a) it affects epiphysis of long bones
b) it is common in flat bones
c) hematogenous spread results in pulmonary metastasis
d) it is exclusive to adolescence
e) x-ray shows a sunburst appearance
6. lumbar spinal stenosis
a) claudication pain is the hallmark of condition
b) pain is referred to gluteal region
c) clinical signs is commonly minimal or absent
d) commonly needs surgical treatment
e) symptoms is relieved with stooping position
7. perthe's disease
a) usually presents before 10 years of age.
b) d/t avascular necrose of distal femoral epiphysis.
c) is more common in girls
d)plain-x-ray shows flatting of the capital femoral epiphysis.
e) is related to childhood obesity.
8. regarding developmental dysplasia of hip DDH
a) more common in girls
b) more common in left hip
c) 80% unilateral
d) generalised joint laxity predisposed to DDH
e) breech position with leg extended during birth is a risk factor.
9. cause of primary osteoporosis:
a) senile
b) oophorectomy
c) postmenopausal

d) corticosteroids
e) rheumatoid arthritis
10. regarding # of the femoral neck in osteoporosis
a) caused by trivial injury
b) affected limb is externally rotated
c) cause AVN of femoral head
d) best treated by hip replacement
11. x ray changes in gouty arthritis
A. asymmetrical joints involvement
B. Eccentric soft tissue swelling
C. sclerotic margin around bony erosion
D. subluxated joints
E. severe osteoporosis
12. OA of hip
a) limitation of movement in early OA
b) fibrillation of aritcular cartilage is late stage
c) a walking aid is used on the same side of the OA hip
d) hip replacement surgery is surgical option
e) hip arthrodesis is indicated in severe OA in young patient
13. Radiological changes in osteomyelitis:
a) changes from previous xray
b)poor defined areas of osteolysis
c) thin linear periosteal reaction
d) sequestrum
e) onion peel effect
14. synovial aspitate analysis:
Viscosity low
WBC- 20000
PMN- 50%
Findings compatible with:
a) degenerative joint disease
b) pigmented villo-nodular synovitis
c) septic arthritis
d) RA
e) gouty arthritis
15.osteosarcoma
a)common in epipyhsis
b)common in flat bone
c)haematogenous spread cause lung metastasis
d)exclusively in adolesensce
e)sunburst appearance in x ray

16. # non union


a. painful on movement
b. hypertropic non-union has poor blood supply at its bone ends
c. most common site at distal 1/3 of tibia
d. external fixator is a known cause
e. treat with internal fixation and bone graft
17. supracondylar # of humerus in children causes
a) cubital carus
b) distal fragment displaces posteriorly by action of the triceps
c) elbow triangle relationship is disrupted
d) forearm compartment syndrome
e) non-union
18. Early emergency operation include
a) dislocated knee
b) #neck of femur
c) #proximal 1/3 of tibia
d) displaced # of acetabulum
e) lock dislocation of hip
19. ankle sprain
a) medial side is more common
b) inversion type of injury
c) anterior drawer test is one of diagnostic assessment
d) cast is indicated
e) rest, ice, compression and elevation therapy is needed in early
20. regarding P.E in orthopaedic
a.contraction is weak but able to move against gravity graded MRC 3
b.thomas test is to test fixed flexion of the knee joint
c. scissory gait is due to tightness of adductor in the thigh
d.sensory loss at C6 dermatome due to Ulnar nerve lesion/palsy?
e.antalgic gait due to short stance of the ipsilateral leg
21.component of Colles' fracture
a.impaction
b.dorsal angulation
c.intra-articular extension
d.ulna deviation
e.pronation
22. growth plate # in children
a) more commonly than joint dislocation
b) metaphyseal extension type requites surgery
c) causes overgrowth
d) causes angular deformity
23. regarding anterior cruciate ligament injuries at the knee
a. it causes a positive anterior drawers test
b. presents with delayed haemarthosis

c. twisting injuries on a static foot is a cause


d. mid substance injury is repaired primarily
e. lachman test is diagnostic
24. radio feature in non-accidental injury include:
a) multiple # in different stage of healing
b) excessive callus
c) posterior rib #
d) metaphysis corner #
e) short oblique #
25)shoulder dislocation
a) posterior are more common
b) prolong immobilisation is treatment in the elderly
c) axillary view is diagnostic
d) hill-sachs lesion - recurrent dislocation
e) Kocher's method- closed reduction
Ortho MCQ
Sclerotic bone lesion include
a. Osteoid osteoma t
b. Solitary bone cyst f
c. Paget disease f
d. Aneurismal bone cyst f
e. Osteopetrosis t
Causes of aggressive periosteal reaction include
a. Osteoid osteoma f
b. Brodies abscess f
c. Acute osteomyelitis t
d. Ewing sarcoma t
e. Chrondosarcoma t
Lytic bone lesion include
a. Prostate metastasis f
b. Breast metastasis t
c. Thyroid metastasis t
d. Renal metastasis t
e. Lung metastasis t
Regarding radiological investigation in orthopaedic practice
a. Haemangioma often shows calcification on plain radiograph f
b. MRI cannot identify a skip lesion in long bone affected with osteosarcoma
c. Loss of end plate and preservation of pedicle on plain radiograph of spine are
suggestive of spine metastasis
d. Normal finding on ultrasound examination of hip excludes septic arthritis
e. MRI is able to detect changes of vascular necrosis of the femoral earlier than
bone scan

Pertaining to benign bone tumors


a. Bone pain secondary to osteoid osteoma is not easily reduce by aspirin f
b. Fibrous dysplasia gives soup-bubble appearance on plain radiograph t
c. Solitary bone cyst shows multiple septations on radiological examination t
d. Osteochondroma has no malignant potential f
e. Giants cell tumors is hardly seen before closure of the physis t
Pertaining to musculocutaneous nerve
a. It supplies sensation over the medial aspect of the arm f
b. It does not have sensory supply to the elbow joint
c. Forearm supination is weakened if it is injured t
d. It is the nerve paralysed in Saturday-night palsy f
e. Wallerian degeneration occurs in axonotmesis of musculocutaneous nerve t
Regarding orthopaedic infection
a. Cloaca seen on radiological investigation indicates chronic osteomylitis f
b. The commonest organism causing septic arthritis in newborn is haemophilus
influenza f
c. Healing of tuberculosis arthritis is by bony ankylosis t
d. Brodies abcess needs emergency drainage and debridement f
e. Brown tumor is a malignant sequel of chronic osteomyelitis f
Regarding fracture or dislocation around the elbow
a. Salter harris fracture type III is an extra articular fracture f
b. Fracture of the radial head causes loss of isosceles elbow triangle f
c. fat- pad sign seen on plain radiograph indicates a complete triangle f
d. Anterior elbow dislocation is more common than posterior dislocation t
e. Volkmanns ischemic of the forearm is a potential complication of supracondylar
fracture
Regarding fracture of the upper limbs
a. Monteggia fracture is a fracture of the radius associated with distal radioulnar
joint dislocation f
b. Supracondylar fracture of the humerus is intraarticular f
c. Cubitus varus is a recognized potential complication of supracondylar fracture of
humerus
d. dinner-fork deformity is a typical features associated with Collers fracture t
e. Tenderness over the anatomical snuff box is suggestive of scaphoid fracture t
Regarding open fracture
a. The wound of the open fracture is primarily closed f
b. Internal fixation is used to stabilized the fracture during debridement f
c. Antibiotics administration and proper irrigation and debridement are important to
prevent contamination to become an established infection t
d. Osteomyelitis is a recognized late complication t
e. Open fracture occurring at farm yard is considered as grade III open fracture t

Regarding osteoarthritis
a. It is more common in obese patients t
b. It is associated with raised serum calcium f
c. Intercondylar distance is measured in supine position f
d. Intraarticular steroid injection is recommended for acute exacerbation t
e. Total knee replacement is indicated in young active patient f
Regarding bioethics in orthopaedics practice
a. Patients religious belief should be respected although contraindicating with the
treatment plan
b. Patient is allowed to discuss with his/her family before giving consent t
c. Informed consent is irreversible t
d. In life threatening event, a surgeon can perform a life-saving surgery in
unconscious patient even without any consent from anyone t
e. Treatment options are given and patient is allowed to choose based on
discussion with the treating practitioner t
Regarding paediatric hip disorder
a. Waddling gait is seen in unilateral neglected congenital hip dislocation f
b. Excessive hip abduction in treating Developmental Dysplasia of Hip with hip
spica leads to avascular necrosis of femoral head t
c. Positive Barlow test signifies that the hip is totally dislocated but reducible
d. Transient synovitis of hip commonly shows joint effusion on ultrasound
e. Slipped capital femoral epiphysis is common in age less than 8 years
Regarding orthopaedic infections
a. Staphylococcus aureus is the predominant causative organism in necrotic
fasciitis
b. Streptococcus Group A is the predominant causative organism in gas gangrene
c. Streptococcus Group B is the predominant causative organism in cellulitis
d. Pseudomonas sp is the predominant causative organism in penetrative in injury
of the foot
e. Staphylococcus epidermidis is the predominant causative organism in abscess
Ortho MCQ 2009 group 3
1) Regarding ACL injury
a. It is cause by a posteriorly directed force to the front of tibia
b. It is common among female
c. It is usually associated with lateral collateral ligament injury
d. It is usually associated with medial meniscus injury
e. It can be treated with patella tendon autograft
( T,T,F,T,T)
2) Regarding PCL injuries
a. It is more common compare to ACL injury

b. It is usually an isolated tear


c. It is associated with dashboard injury
d. In grade 3 injury the tibia subluxates posterior to the anterior aspect of the
femoral condyle.
e. Surgical reconstruction is the treatment of choice of most case
(F,N,F,N,T)
3) This factor predict wound healing
a. Albumin level of 20g/dl F(>35)
b. Transcutaneous oxygen tension of 305
c. Ankle brachial systolic index of 0.9T
d. HBa1c level of 6%T
e. Toe pressure measurement of 20mmhg

(T,T,T,T,F)

4) Regarding the diabetic foot ulcer


a. Can be treated with antibiotic only
b. Wagner 2 ulcer associated with osteomyelitis
c. Associated with painful neuropathy
d. Wound debridement is frequently needed
e. Wegner 5 probably need below knee amputation

(F,F,F,T,T)

5) Regarding the carpal tunnel syndrome


a. There is presence of hypoaesthesia at the palm F
b. There is presence of chondroid metaplasia of the tunnel lining
c. Pointing index finger is a sign (severe case)
d. Phalen sign positive
e. Injection of steroid into wrist joint is a treatment (F,T,F,T,T)
6) Regarding trigger finger and its treatment
a. Stenosing of A5 pulley is a cause
b. The flexor digitorum profundus gets trapped at A1 pulley
c. Release of the A1 pulley causes bowstringing
d. Fibrous metaplasia occur at the pulleyT
e. Occur in rheumatoid arthritis
(F,T,F,N,T)
7) Regarding rheumatoid arthritis
a. Causes symmetrical arthritis
b. Affect the intervertebral disc
c. Rheumatoid factor is an abnormal immunoglobulin
d. Periarticular osteoporosis is a radiological feature
e. Methotrexate is a disease modifying drug of choice

(T,F,T,T,T)

8) In relation to gout
a. Abnormal protein metabolism is a cause
b. Tophi is a feature of acute case
c. Dietary restriction of white meat is part of the treatment

d. Consumption of fish oil is contraindicated


e. NSAIDs is the treatment of acute gout
(T,F,F,F,T)
9) Regarding osteomyelitis
a. The causal organism is usually staphylococcus aureus
b. In young children, Hemophilus influenza is the most common agent
causing osteomyelitis
c. Sequestrum are often found within the thickened cortex and are boared by
the reactive bone and chronic granulation
d. Involucrum contains the sequestered, necrotic marrow and the endosteal
bone
e. Chronic abscess can violate the skin by means of sinus tract lead to
chronic ulceration and drainage
(T,T,T,T,T)
10)Regarding the bone mass
a. Peaks at age 30 yrs old
b. 0.3% bone loss per yr in men after peak bone mass
c. 0.5% bone loss per yr in female after peak bone mass
d. In early menopause, bone loss is cause by excessive osteoclast-mediated
reabsorption(estrogen loss,less restrained osteoclastic resorption)
e. In late postmenopausel, bone loss is due to suppression of osteoblast
activity (T,N,N,T,T)
11) Regarding osteoporosis
a. Serum calcium is normal
b. Associated with poor fracture healing
c. Early premature menopause is a high risk
d. Can be treated successfully with calcium supplement alone
e. Osteoporotic related fracture usually occur in metaphyseal region
(T,T,T,F,F)
12)Non-modifiable factor of osteoporosis includes
a. Family history of osteoporosis in first degree relativesT
b. Advancing ageT
c. Personal history of fracture as an adultT
d. Excessive alcohol intakeF
e. Corticosteroid medication

(T,T,T,T,T)

13)Specific investigation of osteoporosis includes:


a. Dual-energy X-ray absorptiometry (DEXA)
b. Quantitative computer tomography (QCT)
c. Single energy X-ray absorptiometry (SXA)
d. Quantitative ultrasound (QUS)
e. Urinary deoxypyridinoline (DPD)

(T,T,N,N,T)

14)Regarding Developmental Dysplasia of the Hip (DDH)


a. Female is commonly affected than male

b.
c.
d.
e.

Left hip is more commonly affected then right hip


80% is unilateral
Generalize joint laxity predispose to DDH
A breech position with extended legs predispose to DDH
(T,T,T,T,T)

15)Pathoanatomy of DDH include


a. Shallow acetabulum
b. Femoral anteversion
c. Inverted labrum
d. Formation of Pulvinar
e. Contracted transverse acetabular ligament
(T,N,N,N.N)
16)Secondary osteoarthritis is cause by
a. Obesity
b. Septic arthritis
c. Recurrent dislocation
d. Pseudogout
e. Perthes disease
17)Indication of internal fixation includes
a. Open fracture grade 3A
b. Displaced acetabulum fracture
c. Displaced tibial plateau fracture
d. Femoral neck fracture in young adult
e. Pathological fracture
(F,T,T,T,T)
18)Indication of external fixation includes
a. Fracture associated with severe soft tissue damage
b. Closed fracture midshaft of tibia
c. Open book fracture of pelvis
d. Aseptic non-union of femur
e. Intraarticular fracture
(T,F,T,F,F)
19)Regarding osteosarcoma
a. It is a highly malignant primary bone forming tumor
b. More common in males compared to females
c. Peak incidents 10 20 years
d. Commonest at metaphyseal of long bone
e. Classical osteosacroma is extramedullary
(T,T,T,T,F)
20)Plain x-ray features commonly seen in osteosarcoma includes
a. Osteoclastic changes

(F,T,T,T,T)

b. Wide zone of transition


c. Sun ray spicules
d. Codmans triangle
e. Cortical breach
(F,T,T,T,T)