Orthopedics MCQ : SET-02

MCQ Questions on Orthopedics . 

Answer are given in bold highlight . 

1- Osteosarcoma 

1. Presented by pain increased by activity. 
2. Affect most commonly long bone diaphysis. 
3. Serum alkaline phosphatase is normal. 
4. ESR is usually normal. 
5. Characterized by malignant stromal cell showing osteoid formation. 

2- Osteosarcoma 

1. Usually graded as IA or IB. 
2. Usually graded as IIA or IIB. 
3. Usually graded as III. 
4. Multi-agent neoadjuvant chemotherapy given for 8-12 weeks before biopsy. 
5. Centrally, large pulmonary metastases may be completely resected. 

3- Adamantinoma 

1. Is low-grade tumor. 
2. Has predilection to posterior cortex of tibia. 
3. X-rays shows atypical bubble like defect in the posterior cortex of tibia. 
4. X-rays shows bone rarefaction and punched-out defect in the posterior cortex of tibia. 
5. The patients is usually old female. 

4- Periosteal osteosarcoma 

1. May changed to more aggressive dedifferentiated Periosteal osteosarcoma. 
2. Situated on the surface of the bone. 
3. Occurs in the children. 
4. X-rays shows defect of medullary canal. 
5. X-rays shows thick periosteal reaction. 

5- Paget's sarcoma 

1. Is the commonest complication of Paget's disease. 
2. Presented as a painless mass. 
3. Is the commonest osteosarcoma in patients older than 50 years. 
4. Metastasis is late. 
5. Graded as IIA. 

6- Hypercalcemia may be treated by 

1. Ensuring adequate hydration, 
2. Reducing the phosphate intake, 
3. Vit D supplement. 
4. Increasing the phosphate intake. 
5. Avoid administering bisphosphonates. 

7- Spastic cerebral palsy 

1. Associated with damage to the extra- pyramidal system. 
2. Associated with damage to the pyramidal system. 
3. Due to cerebellar damage. 
4. Catheterized by increased muscle tone and hyporeflexia. 
5. Appears in the form of muscular incoordination during voluntary movement. 

8- Giant cell tumor of the tendon sheath identical to 

1. Ganglion. 
2. Giant cell tumor of bone. 
3. Non-specific synovitis. 
4. Pigmented villi- nodular synovitis. 
5. Synovial sarcoma. 

9- Synovial sarcoma involve the joint in 

1. 10 %. 
2. 20 %. 
3. 40 %. 
4. 60 %. 
5. 80 %. 

10- Operative correction is indicated if the hip flexion deformity in cerebral palsy 

1. Is more than 10 degrees. 
2. Is more than 20 degrees. 
3. Is more than 30 degrees. 
4. Is more than 40 degrees. 
5. Is more than 50 degrees. 

11- Preganglionic lesion of brachial plexus injuries 

1. Are surgically repairable. 
2. Potentially capable of recovery. 
3. Have good prognosis. 
4. Recovered spontaneously but mild residual symptoms may persist. 
5. Cannot recover and it is surgically irreparable. 

12- Spastic flexion deformity of knee in cerebral palsy may be revealed only when 

1. The hip is flexed to 20 degrees. 
2. The hip is flexed to 40 degrees. 
3. The hip is flexed to 50 degrees. 
4. The hip is flexed to 70 degrees. 
5. The hip is flexed to 90 degrees. 

13- In Erb’s palsy 

1. A reliable indicator of recovery is return of biceps activity by the third month. 
2. Absence of biceps activity by third month completely rule out later recovery. 
3. Is due to injury of C8 and T1. 
4. The baby lies with the arm supinated and the elbow flexed. 
5. Reflexes are absent and there may be a unilateral Horner’s syndrome. 

14- Winging of the scapula 

1. Occurs if the latissimus dorsi paralyzed. 
2. Demonstrated by the patient pushing forwards against the wall. 
3. Results from the injury of the long thoracic nerve (C8, T1). 
4. It usually recovers spontaneously, though this may take a week or longer. 
5. It usually requires operative stabilization by transferring pectoralis minor or major to the lower part of the scapula. 

15- Very high lesions radial nerve injury 

1. May caused by fractures of the humerus or after prolonged tourniquet pressure. 
2. Are usually due to fractures or dislocations at the elbow. 
3. Cannot extend the metacarpophalangeal joints of the hand. There is an obvious 
4. There is wrist drop, as well as inability to extend the metacarpophalangeal joints or elevate the thumb. 
5. There is wrist drop, the triceps paralyzed and the triceps reflex is absent. 

16- Wrist drop following closed fracture 

1. Is usually third degree lesions. 
2. Can afford to wait for 4 weeks to see if it starts to recover. 
3. If it does not recover by 4 weeks , then EMG should be performed 
4. The nerve should explored, if the EMG at 12 weeks shows denervation potentials and no active potentials. 
5. Should be explored and the nerve repaired or grafted as soon as possible if there is good surgical facilities. 

17- Isolated anterior interosseous nerve lesions 

1. Are extremely common. 
2. The signs are similar to those of a high median nerve injury. 
3. The usual cause is brachial neuritis. 
4. There is no sensory loss. 
5. The thenar eminence is wasted. 

18- The femoral nerve injury 

1. May be injured by a gunshot, shell, by pressure or traction during an operation. 
2. The patient is able to extend the knee actively. 
3. There is numbness of the anterior thigh and anterior aspect of the leg. 
4. The knee reflex is normal. 
5. Severe neurogenic pain is uncommon. 

19- The superficial peroneal nerve 

1. Innervating the tibialis anterior muscle. 
2. Innervating the extensor digitorum longus. 
3. Innervating the extensor hallux longus. 
4. Descends along the fibula. 
5. Injury resulting in paraesthesia and numbness on the dorsum around the first web space. 

20- Tourniquet pressure as a cause of nerve injury 

1. Is an uncommon cause of nerve injury in orthopedic operations. 
2. Damage is due prolonged ischemia. 
3. Damage is due to direct pressure. 
4. Injury is therefore more likely with a pneumatic tourniquet. 
5. Injury is therefore more likely with a wide cuff. 

21- Chronic compartment syndrome 

1. Long-distance runners sometimes develop pain along the postero-lateral aspect of the calf. 
2. Pain brought on night after muscular exertion. 
3. Swelling of the postero-lateral calf muscles. 
4. The condition diagnosed from the history and confirmed by measuring the compartment pressure before exercise. 
5. Release of the fascia is curative. 

22- The use of thromboprophylaxis 

1. DVT can be reduced by one-thirds by prolonging thromboprophylaxis. 
2. The ideal duration of thromboprophylaxis is not known. 
3. Current evidence supports 30 days for knee replacement. 
4. Current evidence supports 14 days for hip replacement and hip fracture. 
5. Should not be prolonged after discharge from hospital. 

23- The angle between the anatomical axis of the femur and the axis of the femoral neck is 

1. Approximately 128 degrees (±3 degrees). 
2. Approximately 128 degrees (±5 degrees). 
3. Approximately 125 degrees (±5 degrees). 
4. Approximately 125 degrees (±3 degrees). 
5. Approximately 122 degrees (±3 degrees). 

24- The angle between the anatomical axis of the femur and a tangent to the joint line of the knee is, On the lateral aspect 

1. Approximately 75 degrees (±5 degrees). 
2. Approximately 80 degrees (±2 degrees). 
3. Approximately 85 degrees (±5 degrees). 
4. Approximately 90 degrees (±2 degrees). 
5. Approximately 90 degrees (±5 degrees). 

25- General complication of osteotomy and deformity correction is 

1. Under- and over - correction of the deformity. 
2. Tension on a nearby nerve. 
3. Compartment syndrome. 
4. Infection. 
5. Non-union. 

26- Bone allografts 

1. Cannot be stored. 
2. There is no potential for transfer of infection. 
3. Sterilization done by ethylene oxide without alteration in the physical properties. 
4. Sterilization done by ionizing radiation with alteration in the physical properties. 
5. Antigenicity cannot reduced by freezing, freeze-drying or by ionizing radiation. 

27- Hair removal 

1. Shaving before surgery is useful. 
2. Shaving before surgery is safe. 
3. Shaving day before surgery reduced wound infection. 
4. Depilatory creams used the day before surgery increased wound problems. 
5. Depilatory creams used the day before surgery without an increase in wound problems. 

28- Risk of asymptomatic venous thromboembolism in hip fracture is 

1. 10%. 
2. 20%. 
3. 40%. 
4. 60%. 
5. 80%. 

29- Low molecular weight heparin 

1. Its safety similar to unfractionated heparin. 
2. Need constant monitoring. 
3. Effectively reduces the prevalence of venographic DVT in hip replacement surgery. 
4. Not reduces the prevalence of venographic DVT in knee replacement surgery. 
5. It is effective as the unfractionated heparin. 

30- Unlocked elastic intramedullary nails 

1. Are rigid rods. 
2. Increasingly used in the treatment of long-bone shaft fractures in children . 
3. Inserted through the physes at either end of the long bone. 
4. Function as rigid internal fixation. 
5. Insufficient reaming potentially risks the bone splitting. 

31- Cancellous autografts 

1. Incorporated by a process analogous to fracture healing. 
2. Carried risk for transfer of infection. 
3. Induce an inflammatory response in the host 
4. Incorporated more rapidly into host bone. 
5. Are particularly useful when large defects to be filled. 

32- Referred shoulder pain syndrome results from 

1. Tendinitis. 
2. Glenohumeral arthritis. 
3. Suprascapular nerve entrapment. 
4. Subluxation. 
5. Cardiac ischemia 

33- Active shoulder movements are best examined 

1. From left side the patient. 
2. From right side the patient. 
3. From both sides the patient. 
4. From behind the patient. 
5. From front the patient. 

34- The commonest cause of pain around the shoulder is 

1. A disorder of the rotator cuff. 
2. Glenohumeral arthritis. 
3. Nerves lesions. 
4. Subluxation. 
5. Cardiac ischemia 

35- Chronic shoulder tendinitis 

1. Pain and slight stiffness would not restrict simple activities. 
2. Pain persist and not affected by activities. 
3. The patient usually aged between 20 and 30. 
4. Characteristically pain is sever with activities. 
5. Characteristically pain is worse at night. 

36- A full thickness tear of rotator cuff of shoulder 

1. Always follow a long period of chronic tendinitis. 
2. Always follow a jerking injury of the shoulder. 
3. There is sudden pain and the patient is unable to abduct the arm 
4. There is sudden pain and the patient is able to abduct the arm. 
5. Injecting a local anesthetic into the sub-acromial space restore abduction. 

37- Ultrasonography of shoulder 

1. Is not accurate like MRI for identifying and measuring the size of rotator cuff tears. 
2. It has the advantage that it can identify the quality of the muscles. 
3. Cannot always be accurate in predicting the reparability of the tendons. 
4. Are usually normal in the early stages of the cuff dysfunction. 
5. Is not save imaging. 

38- Arthroscopic acromioplasty 

1. Cannot achieve the same basic objectives as open acromioplasty. 
2. This procedure has now become the gold standard. 
3. The outer side of the acromion trimmed. 
4. If a complete cuff tear encountered, then open repair indicated. 
5. Delayed the postoperative rehabilitation. 

39- Acute calcific tendinitis of shoulder 

1. Acute pain always follows deposition of calcium hydroxyapatite crystals. 
2. Affects 20–30 year-olds . 
3. Is thought that vascular reaction leads to fibrocartilaginous metaplasia and deposition of crystal. 
4. Pain due to the calcification. 
5. Affects 30–50 year-olds. 

40- Asymptomatic calcification of the shoulder rotator cuff 

1. Is uncommon. 
2. It is painful after exercises. 
3. Appears as an incidental finding in shoulder x-rays. 
4. The tendon is thick and hypertrophies. 
5. Treatment should directed to the calcification rather than the impingement. 

41- Frozen shoulder 

1. Is a well-defined disorder characterized by progressive painless stiffness of the shoulder. 
2. Stiffness become complete followed by pain. 
3. Is usually resolves spontaneously after about 18 months. 
4. The condition not associated with diabetes. 
5. The condition not appears after recovery from neurosurgery. 

42- Condensing osteitis of the clavicle 

1. May be no more than a reaction to the mechanical stress. 
2. Is usually seen in men of 40–60. 
3. Present with pain at the lateral end of the clavicle. 
4. Pain aggravated by adducting the arm. 
5. X-rays reveal sclerosis and lytic lesion in the lateral end of the clavicle. 

43- Sterno-costo-clavicular hyperostosis 

1. Is seen in younger people. 
2. Is usually unilateral. 
3. Patients develops painless swelling. 
4. The histological changes are non-specific. 
5. The Microorganisms can be identified. 

44- Indications for shoulder arthroplasty is 

1. Osteoarthritis of acromioclavicular joint. 
2. Early rheumatoid arthritis 
3. Fracture- dislocation of the proximal humerus. 
4. Early avascular necrosis of the humeral head. 
5. Severe arthritis with cuff arthropathy. 

45- The commonest complication for shoulder arthroplasty is 

1. Infection 
2. Loosening of the components. 
3. Implant failure. 
4. Peri-prosthetic fracture. 
5. Rotator cuff failure. 

46- Arthrodesis of the gleno-humeral joint 

1. Is commonly performed. 
2. Is still a useful operation for severe shoulder dysfunction. 
3. Postoperative function is limited. 
4. Caused painful restriction of gleno-humeral movement. 
5. The optimal position is 10 degrees of flexion, 10 degrees of abduction and 10 degrees of internal rotation. 

47- Medial epicondyle epiphysis appears at 

1. 2 years. 
2. 4 years. 
3. 6 years. 
4. 8 years. 
5. 10 years. 

48- Proximal radio-ulnar synostosis 

1. Is acquired deformity. 
2. Is uncommon. 
3. Function is usually good. 
4. Surgical separation improved forearm rotation. 
5. A rotation osteotomy are more suitable. 

49- Posttraumatic unreduced dislocation of the head of radius 

1. Surgical treatment would not improve function. 
2. Is usually associated with cubitus Varus. 
3. May follow unreduced old Monteggia fracture. 
4. Is usually bilateral. 
5. Is commonly associated with old supracondylar fracture. 

50- Severe rheumatoid arthritis of the elbow 

1. Treated by arthrodesis. 
2. Joint replacement is usually successful. 
3. Treated by arthroscopic debridement. 
4. Synovectomy is worthwhile. 
5. Treated by excision of the radial head.   

Thanks for Visiting us