Orthopaedic MCQ

1. Regarding fracture of neck of femur in osteoporosis

a. Due to trivial injury T
b. Hip is externally rotated T (laterally rotated if the fracture is displaced)
c. Causes avascular necrosis T
d. Hip replacement is treatment of choice T
e. Shenton's line is preserved F (Shenton's line is an imaginary line drawn
along the inferior border of the superior pubic ramus (superior border of
the obturator foramen) and along the inferomedial border of the neck
of femur. This line should be continuous and smooth. Interruption of
Shenton's line can indicate developmental dysplasia of the hip (DDH) and
fractured neck of femur)
2. Lumbar spinal stenosis
a. Claudication pain is the hallmark of conditionT
b. Pain is referred to gluteal regionT
c. Clinical sign is commonly minimal or absent F
d. Commonly needs surgical treatmentF
e. Symptom is relieved with stooping positionT
3. Radiography features in gouty arthritis
a. Asymmetrical joints involvementT
b. Eccentric soft tissue swelling T
c. Sclerotic margin around bony erosionT
d. Subluxated jointsF
e. Severe osteoporosis F
4. Regarding open fracture of tibia
a. It is caused by high velocity injury T
b. Loss of 2-3 litres of blood F (1 litre)
c. External fixation is the treatment T
d. Common organism is the StrepepidermidisF (aureus)
e. Anaerobic infection is the common in farmer T (soil contaminated)
5. Loss of consciousness in bilateral femur fracture
a. Hypovolemic shock T
b. Pneumothorax F (chest pain, SOB)
c. Subarachnoid hemorrhageF (thunderclap headache)
d. Fat embolism syndrome T
e. Fracture-dislocation C5 and C6 vertebrae F (quadriplegia)
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6. The incidence of vessel injury is higher in the following

a. Scapula-thoracic dislocation T (brachial artery, subclavian artery)
b. Shoulder dislocation T (axillary artery)
c. Supracondylar femoral fractureT (popliteal artery)
d. Knee dislocation T (popliteal artery)
e. Mid shaft humeral fractureT (brachial artery)
7. Regarding peripheral nerve of upper limb
a.
b.
c.
d.
e.

supination of forearm in flexed elbow is contributed by median nerve

anconeus muscle is supplied by ulnar nerve
abductor digitiminimi is supplied by ulnar nerve
adductor pollicislongus supplied by radial nerve
lesion median nerve at wrist cause pointing index finger

8. Disruption of Shenton line are due to

a. Neck of femur fractureT
b. Septic arthritis F
c. DDH T
d. Collapsed AVN of femoral head T
e. Slipped capital femoral epiphyseal T
9. Unstable lumbar fracture includes (**more than 2 column)
a. Chance fractureT
b. Anterior wedge fractureF
c. Burst fractureT
d. Spinous process fractureF
e. Transverse process fractureF
10. Regarding the examination of hip
a. SLRT is used to assess fixed flexion deformity F (Thomas Test)
b. Bryants triangle used to measure adduction deformity F (limb length
discrepancy on femur)
c. Lumbar lordosis increased correspond to fixed flexion deformity T
d. Apparent shortening of lower limb is ipsilateral to the deformity T
e. True shortening is resent in DDH F
11. Perthe's disease
a. Usually presents before 10 years of ageT (4-8)
b. Due to avascular necrosis of distal femoral epiphysis F(proximal)
c. Is more common in girlsF(boys)
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d. Plain X-ray shows flatting of the capital femoral epiphysisT(fragmentation

and flattening mushroom head appearance)
e. Is related to childhood obesityF (this is in slipped upper femoral epiphysis)
12. Increase in osteoclastic activity and bone resorption
a. OsteogenesisimperfectaF (failure of collagen III to I)
b. OsteopetrosisF (failure of osteoclasts)
c. Osteoporosis T
d. Uncompensated osteomalaciaF (no increase in PTH)
e. Hyperparathyroidism T
13. Organisms isolated in septic arthritis of IV drug user
a. Staph aureusT (commonest in all kind of septic arthritis, include IVDU
category)
b. Pseudomonas aeruginosaT (also E. coli)
c. DiplococciF (Neisseria gonorrhea in young adults)
d. Strep F
e. HaemophilusinfluenzaeF
14. Radiographic changes in chronic OM
a. Changes from previous X-ray T
b. Poorly defined area of osteolytic F(well defined)
c. Thin linear periosteal reaction T
d. Sequestration T
e. Onion peeling T (laminated lytic and sclerotic periosteal reaction seen on
plain films. While the reaction has been described in benign conditions
e.g., osteomyelitis, pulmonary hypertrophic osteoarthropathy, rickets, it
classically occurs in malignant conditions, especially Ewing sarcoma)
15. Radiological feature of non-accidental injury include
a. Excessive callus formation T
b. Posterior rib fracture T
c. Multiple fracture with different stage of healing T
d. Metaphyseal corner fracture T
e. Short oblique fracture T
16. True combination of fracture-dislocation and nerve injury
a. Hip dislocation - sciatic nerve T
b. Shoulder dislocation - radial nerve F (axillary nerve)
c. Supracondylar fracture - ulnar nerve F (median nerve AIN)
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d. Wrist dislocation - median nerve T

e. Fibular neck fracture -peroneal nerve T
17. Regarding the femur fracture in children
a. Fracture in non-walker suggests child abuse T
b. Fat embolism syndrome is more common than in adult F (childs marrow
more hematopoetic than fat)
c. Shortening 2-3cm with normal function is acceptable T
d. Is better treated with traction than spica cast T
e. Surgery is indicated in polytraumaT (ORIF)
18. Achilles tendinitis
a. Associated with inappropriate footwear F (weekend warriors)
b. Pain is induced by plantar flexion against resistance T
c. Tendon rupture is complication T
d. Steroid injection in chronic case F (can cause tendon rupture; Cochrane
showed no benefit)
e. Plantar heel pad is contraindicated F (indicated is a treatment)
19. Regarding elbow dislocation
a. Elbow triangle is preserved F (lost)
b. Coronoid process fracture is an association T
c. Brachial artery injury is an association T
d. Elbow is immobilized in extension F (in 90 degrees flexion)
e. Myositis ossificans is a late complication T
20. AVN following fracture occurs in
a. Head of femur t (can occur in head of femur as well)
b. Medial femoral condyle T (also in femoral and humeral condyles)
c. Avulsion posterior tibial spine F
d. Neck of talus T
e. Base of 5th metatarsal F (in proximal scaphoid, lunate)
21. Drug in musculoskeletal system
a. COX-2 causes cardiovascular complicationsT
b. Gabapentin is used for neurapathic pain T
c. Indomethacin is used to inhibit myositis ossificansT
d. Alendronite is used for osteoporotic fractureT (bisphophonate)
e. Glucosamine is used for early OA T
22. Osteomalacia
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a. As a result of low vit A F (vitamin D)

b. Cause proximal myopathy T (muscle weakness)
c. Cause pseudofractureT (new bone formation over what looks like an
incomplete fracture)
d. Increased serum Ca2+ F (reduced)
e. Diagnose with bone biopsy F (x-ray + blood PTH and Ca level)
23. Diseases that commonly occur around the knee joint
a. Osteoid osteoma in young T
b. Osteosarcoma in young T
c. ChondrosarcomaF (scapula and pelvis)
d. EnchondromaF (hand)
e. Bursitis T (maids knees,clergyman)
24. X-rays should be taken in patient with acute cervical injury
a. Flexion-extension F (can worsen injury, for spondylolithesis)
b. Oblique F (for # of pars interarticularis break of neck of scotty dog)
c. Swimmer T
d. Lateral T (also AP)
e. Open mouth T
25. regarding peripheral nerves
a. tinel's sign is specific for carpal tunnel syndrome
b. ulna nerve innervates the extensor carpi ulnaris
c. radial nerve innervates abductor policislongus
d. froment's sign is to test adductor policislongus
e. anconeus is innervated by median nerve

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