MCQ Questions on Orthopedics .
1- Synovial chondromatosis
a- Is a common disorder in which the joint comes to contain multiple loose bodies.
b- The usual explanation is that synovium undergo cartilage neoplasia and may ossify.
c- X-rays reveal few loose bodies.
d- Arthrography shows multiple ossified loose bodies.
e- The loose bodies removed arthroscopically; an attempt should be made to remove all abnormal synovium.
2- The Plica syndrome of knee
a- An adult complains of an ache in the side of the knee (occasionally both knees).
b- Characteristic feature is tenderness near the upper pole of the patella and over the femoral condyle.
c- There is no history of trauma or markedly increased activity.
d- Exercise or climbing stairs relieve symptoms.
e- Movement of the knee may cause loud painful click in joint line.
3- Rheumatoid arthritis of knee distinguished from osteoarthritis by
a- Diminution of the joint space,
b- Osteopenia.
c- Marginal erosions.
d- The complete absence of osteophytes.
e- Subchondral cystic changes.
4- If only the patello-femoral joint is affected, suspect
a- Gout.
b- Pyrophosphate arthropathy.
c- Osteoarthritis. d- Reiter's disease.
e- Rheumatoid arthritis.
5- Charcot’s disease (neuropathic arthritis) of knee is treated by
a- Molded splint.
b- Arthroscopic debridement.
c- Open debridement and synovectomy.
d- Arthrodesis.
e- Arthroplasty.
6- Rupture of extensor mechanism above patella
a- Patient is usually young.
b- Patient had history of long steroid treatment.
c- There is diffuse swelling of the anterior part of thigh.
d- Function of quadriceps muscle usually bad.
e- Patient need early surgical repair.
7- Osgood Schlatter disease
a- Is uncommon disease of adolescent.
b- Always there is history of trauma.
c- Is usually unilateral.
d- Patients is a young adult complain of pain without activity and of a lump.
e- Spontaneous recovery is usual.
8- In Pellegrini-Stieda disease
a- X-ray shows osteolytic lesion on lateral condyle.
b- X-ray shows osteolytic lesion on medial condyle .
c- X-rays show a plaque of bone lying next to the femoral condyle under the lateral collateral ligament.
d- X-rays show a plaque of bone lying next to the femoral condyle under the medial collateral ligament .
e- Occasionally this is a source of pain on the lateral side of knee.
9- In chronic knee swelling, the most important condition to exclude is
a- Pseudogout.
b- Tuberculosis.
c- Pigmented Villonodular synovitis.
d- Rheumatoid arthritis.
e- Synovial chondromatosis.
10- Prepatellar bursitis
a- There is hard swelling confined to the front of the patella.
b- The knee joint itself is abnormal.
c- This is an infected bursitis due to constant friction between skin and bone.
d- Seen mainly in carpet layers, floor cleaners and miners who use protective kneepads.
e- In chronic cases, the best treatment is lump excision.
11- The semimembranosus bursa
a- It presents usually as a painful lump behind the knee, slightly to the medial side of the midline.
b- Is most conspicuous with the knee flexed.
c- The lump is fluctuant and the fluid can pushed into the joint.
d- The knee joint is normal.
e- The best treatment is excision through a transverse incision.
12- The knee varus osteotomy
a- Is required for active patients with isolated medial compartment disease.
b- This performed at the upper proximal part of tibia.
c- The method most commonly employed is a medial opening wedge osteotomy,
d- The fragments should firmly fixed with a blade-plate.
e- In many cases postoperative cast immobilization not needed.
13- The most important early complication of tibial osteotomy is
a- Compartment syndrome in the leg.
b- Peroneal nerve palsy.
c- Failure to correct the deformity.
d- Delayed union and non-union.
e- Mechanical failure of internal fixation.
14- Contraindication to knee arthrodesis is
a- Failed knee replacement.
b- Problems in the ipsilateral hip or ankle.
c- Osteoarthritis of contralateral knee.
d- Rheumatoid arthritis.
e- Limited peri-articular bone loss.
15- Unicompartmental knee replacement
a- Has firmly established.
b- Early results for medial compartment osteoarthritis were excellent.
c- Longer-term studies have highlighted the need to avoid low revision rates.
d- Following a successful operation, restoration of function is not impressive.
e- Is reserved for older patients.
16- Patellar resurfacing is
a- A kind of partial replacement performed in osteoarthritis.
b- A kind of partial replacement rheumatoid arthritis.
c- A kind of partial replacement rarely performed alone.
d- A kind of partial replacement, performed alone .
e- Used in treatment of chondromalacia patella.
17- Infection in total knee replacement
a- Prevention is the most important.
b- For established infection treated by antibiotics.
c- The safest salvage procedure is by exchange replacement in one stage.
d- The safest salvage procedure is by exchange replacement in two stage.
e- Intractable infection treated by debridement.
18- Meniscus are prone to injury
a- Particularly during unguarded movements of extension and rotation on the weight bearing leg.
b- Particularly during unguarded movements of flexion and rotation on the weight bearing leg .
c- Particularly during unguarded movements of hyperextension and rotation on the weight bearing leg .
d- In maximum flexion of knee.
e- In maximum internal rotation.
19- Lateral collateral ligaments
a- Attached to the lateral meniscus.
b- Situated more anteriorly.
c- Blend with capsule of knee.
d- Separated from lateral collateral by popliteus tendon.
e- Is fan shape.
20- Forward subluxation of lateral tibial condyles is prevented by
a- Lateral collateral ligament.
b- Posterolateral capsule.
c- Posterior cruciate ligament.
d- Posterior cruciate ligament and arcuate ligament.
e- Anterior cruciate ligament.
21- The tibia subluxated forward when
a- Anterior cruciate ligament and medial collateral ligament.
b- Anterior cruciate ligament and posterior cruciate ligament.
c- Posterior cruciate ligament
d- Anterior cruciate ligament.
e- Medial collateral ligament.
22- Backward subluxation of the tibia is prevented by
a- The anterior cruciate ligament.
b- The posterior cruciate ligament.
c- The posterior cruciate ligament with the arcuate ligament and the posterior oblique ligament.
d- Anterior cruciate ligament and medial collateral ligament.
e- The posterior cruciate ligament and lateral collateral ligament.
23- The gait may be disturbed by
a- Pain.
b- Muscles weakness.
c- Deformity.
d- Stiffness.
e- All of above.
24- Pain and tenderness posterior to medial malleolus indicates
a- Fracture of medial malleolus.
b- Tarsal tunnel syndrome.
c- Tibialis posterior tendinitis.
d- Impingement from osteophyte.
e- Achilles Para tendonitis.
25- The last deformity to be corrected in conservative treatment of idiopathic club foot is
a- Fore foot adduction.
b- Forefoot supination.
c- Forefoot varus.
d- Hindfoot equinus.
e- Hindfoot varus.
26- In metatarsus adducts
a- There is varus of hindfoot.
b- There is equinus of hindfoot.
c- Deformity is limited to the forefoot.
d- Had classical pattern of severity.
e- Most of cases need surgical treatment.
27- Congenital vertical talus
a- Passive correction is impossible .
b- The hindfoot is in calcaneus and valgus.
c- The talus points almost horizontally towards the sole.
d- The forefoot is abducted, supinated and dorsiflexed.
e- The tendons and ligaments on the dorsolateral side of the foot are usually lengthened.
28- Peroneal spastic flatfoot
a- Young children sometimes present with a painful, rigid flatfoot.
b- Flexor tendons are in spasm.
c- X-rays show typical talonavicular coalitions.
d- Pain may be due to abnormal tarsal stress or even fracture of an ossified bar.
e- The picture differs from that of the more common ‘idiopathic’ flatfoot by the small concave foot.
29- Flexible flatfoot in young children
a- Required no treatment.
b- Treated by stretching and plaster splint.
c- Treated by orthotic splintage.
d- Treated by physiotherapy.
e- Treated by insole and moulded heel-cup.
30- Accessory navicular
a- Associated with rigid flatfoot.
b- Complain of tenderness on medial border of the midfoot.
c- Symptoms are due to bone.
d- Treated by surgical removal.
e- Treated by below knee orthosis and insole.
31- Acquired painful flatfoot in adult commonly due to
a- Ligament laxity.
b- Tarsal coalition.
c- Tibialis posterior dysfunction.
d- Neuropathy.
e- Degenerative arthritis.
32- Surgical treatment of painful flatfoot includes
a- Reconstruction of tendon Achilles.
b- Tenosynovectomy of peroneal tendons.
c- Pantalar arthrodesis.
d- Ankle arthrodesis.
e- Triple arthrodesis.
33- Hallux valgus
a- Is one of the common foot deformity.
b- Result from valgus angulation of the first metatarsal bone.
c- Is uncommon in rheumatoid arthritis.
d- There is excessive lateral angulation of big toe.
e- Positive family history obtained in 30% of cases.
34- When hallux valgus exceed 40 degrees
a- The great toe rotate in supination.
b- The great toe rotates in pronation.
c- The sesamoid bone displaced medially.
d- The extensor tendon stretched.
e- The intact adductor halluces prevent progress of deformity.
35- The hallux valgus in elderly is best treated by
a- Shoes modification.
b- Arthrodesis.
c- Arthroplasty.
d- Distal osteotomy.
e- Proximal osteotomy.
36- Adolescent with hallux valgus less than 25 degrees is treated by
a- Bunionectomy.
b- A soft tissue rebalancing operation.
c- A distal osteotomy combined with a corrective osteotomy of the base of the proximal phalanx.
d- Keller’s operation.
e- Arthrodesis.
37- Diagnostic feature of hallux rigidus
a- A pain on walking, especially on slopes.
b- The patient develop altered gait.
c- The great toe is straight with callosity.
d- The MTP joint feel knobby with tender dorsal bunion.
e- The MTP joint dorsiflexion is restricted and painful.
38- Hammer toe characterized by
a- Hyperextension at the MTP joint and flexion of both IP joint
b- Acute flexion deformity of proximal IP joint only and hyperextension of MTP joint.
c- Flexion of the distal IP joint and extension of proximal IP joint.
d- The MTP joint is dislocated and the little toe sits on the dorsum of the metatarsal head.
e- An irritating or painful bunionette may form over an abnormally prominent fifth metatarsal head.
39- A 40 years old patients with rheumatoid arthritis suddenly develop a painful valgus foot, the most probable cause is
a- Mid-tarsal subluxation.
b- Subtalar arthritis.
c- Rupture of peroneus longus tendon.
d- Rupture of tibialis posterior tendon.
e- Rupture of planter fascia.
40- The common site for osteochondritis of the ankle is
a- Anterolateral part of the articular part of talus.
b- Anteromedial part of the articular part of talus .
c- Posteromedial part of the articular part of talus .
d- Posterolateral part of the articular part of talus .
e- Central part of the articular part of talus .
41- The atraumatic osteonecrosis of talus involving
a- Posterolateral part of the talar dome.
b- Posteromedial part of the talar dome .
c- Anterolateral part of the talar dome .
d- Anteromedial part of the talar dome.
e- Central part of the talar dome .
42- Insufficiency fracture in diabetic foot should be treated
a- By prolonged cast.
b- Without immobilization.
c- By internal fixation.
d- By internal fixation with bone cement.
e- By external fixation.
43- The foot rotates about an axis running through
a- Fifth metatarsal.
b- Fourth metatarsal.
c- Third metatarsal.
d- Second metatarsal.
e- First metatarsal.
44- The plantar fascia
a- Is a dense fibrous structure that originates from the calcaneum, superficial to the heel fat pad.
b- Runs distally to the dome of the foot, with slips to each toe distal phalanx.
c- The plantar fascia stiffens and becomes more pliable with age.
d- There may be micro-tears in the fascia, and the fascia thickens.
e- The condition is not associated with gout, ankylosing spondylitis and Reiter’s disease.
45- Painful fat pad
a- Acute pain and tenderness directly over the fat pad under the heel.
b- Sometimes follows a direct blow to the area, e.g. in a fall from a height.
c- The condition seen in old patients and has been attributed variously to separation of the fat pad from the bone.
d- Chronic specific ‘inflammation’ has been blamed.
e- Treatment is surgical by debridement of necrotic and inflamed tissue.
46- Heel nerve entrapment
a- Entrapment of the second branch of the lateral plantar nerve has been reported as a cause of heel pain.
b- The commonest complaint is pain and numbness at rest.
c- Characteristically, tenderness is maximal on the medial aspect of the heel.
d- Diagnosis is easy, because the symptoms and signs differ from plantar fasciitis.
e- Treatment should be surgical decompression of the nerve.
47- Kohler's disease
a- Is common cause of pain in the mid-tarsal region in children.
b- The bony nucleus of the medial cuneiform becomes dense and fragmented.
c- The child, over the age of 10 year, has a painful limp.
d- On examination, a tender warm thickening over navicular bone.
e- If symptoms are severe, a surgical decompression of bone helps.
48- Metatarsalgia
a- Is a common expression of foot strain.
b- It result from bone osteopenia.
c- Result from foot neuropathy.
d- Aching felt under the forefoot and the foot arch may have flattened out.
e- There may even be callosities over IP joint of toes.
49- Brailsford’s disease
a- A ridge of bone develops on the dorsal surfaces of the medial cuneiform.
b- The navicular becomes dense, then altered in shape and later the mid-tarsal joint may degenerate.
c- In children, especially if the arch is high, the over bone develop.
d- A lump behind heel, which feels bony and may become bigger and tender if the shoe presses on it.
e- Surgical removal of heel lump provide relief of the symptom.
50- Sesamoiditis
a- Is part of rheumatoid arthritis manifestation of foot.
b- May be initiated by direct trauma or unaccustomed stress.
c- Acute sesamoid pain and tenderness should signal the possibility of sesamoid displacement.
d- Sudden pain may result from local infection (particularly in a diabetic patient).
e- Acute pain result from avascular necrosis.
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