MCQ Questions on Orthopedics .
1- Sesamoid chondromalacia
a- Is a term coined by Apley at 1966.
b- Used to explain changes such as fragmentation and cartilage fibrillation of the lateral sesamoid.
c- X-rays show a sclerosis medial sesamoid.
d- Is often mistaken for a gout.
e- Treated by application of cast for 3 months.
2- Freiberg’s disease
a- Osteochondritis of first metatarsal head in young children.
b- Is probably a type of atraumatic osteonecrosis of the subarticular bone.
c- It usually affects the second metatarsal head (rarely the third) in young adults, mostly women.
d- The patient complains of pain at the IP joint.
e- A bony lump is palpable and tender at the MTP joint of big toe.
3- Stress fracture
a- Usually of the first metatarsal, occurs in young adults after unaccustomed activity.
b- Usually of the first metatarsal, occurs in in women with postmenopausal osteoporosis.
c- The sole of the foot may be edematous and the affected shaft tender.
d- The x-ray appearance is at first normal, but later shows fusiform callus around a fine transverse fracture.
e- Long before x-ray signs appear, a radioisotope scan will show decreased activity.
4- The ABC system for resuscitation of shock with catastrophic external bleeding
a- A for airway is the first.
b- B for breathing is second step.
c- The C for circulation is the third
d- Control of the external bleeding takes precedence.
e- Follow the ABC sequence.
5- The majority of patients presenting with shock following a major injury will be suffering from
a- Hypovolemic shock.
b- Septic shock.
c- Neurogenic shock.
d- Anaphylactic shock.
e- Cardiogenic shock.
6- The systolic blood pressure may not drop significantly
a- Until 10 per cent of the patient’s blood volume has been lost.
b- Until 15 per cent of the patient’s blood volume has been lost.
c- Until 20 per cent of the patient’s blood volume has been lost.
d- Until 25 per cent of the patient’s blood volume has been lost.
e- Until 30 per cent of the patient’s blood volume has been lost.
7- Fracture of the pelvis
a- Can result in devastating retroperitoneal hemorrhage.
b- Bleeding cannot reduced by compressing the pelvis to approximate the bleeding fracture sites.
c- Compression to reduce hemorrhage cannot achieved manually with a towel or blanket.
d- Compression by external fixation of the pelvis is useless.
e- MAST trousers are practicable and commonly used.
8- High-energy (velocity) fractures
a- Cause only moderate soft-tissue damage.
b- Cause severe soft-tissue damage, no matter whether the fracture is open or closed.
c- There is little or no displacement.
d- The displacement does not matter initially.
e- The reduction is unlikely to succeed.
9- Open reduction
a- Is the first step to internal fixation.
b- Used for most fractures in children
c- For fractures that are stable after reduction
d- Can held in some form of splint or cast.
e- Avoids direct manipulation of the fracture site.
10- Contraindications to nonoperative methods of fracture treatment is
a- Fracture of long bones.
b- Inherently unstable fractures.
c- Rotated fractures.
d- Fracture in metaphyseal region.
e- Supracondylar fractures of lower humerus.
11- Soft tissue edema following fracture can be treated by
a- Elevation of limb.
b- Firm support.
c- Elevation and firm support.
d- Exercise.
e- Coban wrap around a limb to control swelling during treatment.
12- The incidence of wound infection in open fractures correlates directly with
a- The type of antibiotics used.
b- Duration of injury.
c- The extent of soft-tissue damage.
d- The site of injury in the limbs.
e- The type and quality of treatment in open fracture.
13- Antibiotics at debridement for open fractures grade II are
a- Gentamicin and vancomycin.
b- Co-amoxiclav.
c- Penicillin and gentamicin.
d- Penicillin and cefuroxime.
e- Gentamicin and clindamycin.
14- In wound debridement viable muscle can be recognized by
a- Its purplish color.
b- Its mushy consistency.
c- Its failure to contract when stimulated.
d- Its failure to bleed when cut.
e- Its tone preserved.
15- To irrigate open fracture grade II, use
a- 1- 2 liters of normal saline.
b- 2- 4 liters of normal saline.
c- 3- 6 liters of normal saline.
d- 6- 12 liters of normal saline.
e- 12- 24 liters of normal saline.
16- If wound cover is delayed in open fracture
a- The external fixation is safer.
b- The skeletal traction is safer.
c- The back slab splint is safer.
d- The non-reamed intramedullary nail is safer.
e- The minimal contact plate is safer.
17- Early infection of open fracture presented as
a- Discharging wound.
b- Inflamed wound with discharge.
c- Inflamed wound without discharge.
d- Black discoloration of wound surface.
e- Red and swollen tissue with yellowish slough.
18- Gunshot injuries are contaminated by
a- Metallic forging body. b- Necrotic tissue.
c- Derbies sucked into wound.
d- Tract of bullet.
e- Hematoma inside wound.
19- The common nerve injury in Monteggia fracture dislocation is
a- Median nerve.
b- Radial nerve.
c- Ulnar nerve.
d- Anterior interosseous.
e- Posterior interosseous.
20- If vascular repair undertaken in close fracture
a- The fracture should reduce and hold by POP.
b- The fracture should reduce and hold by traction.
c- The fracture should reduce and hold by internal fixation.
d- The fracture should reduce and hold by external fixation.
e- The fracture should reduce and hold by cast brace.
21- The early symptom of compartment syndrome is
a- Severe pain.
b- Paresthesia.
c- Pallor,
d- Paralysis.
e- Pulselessness.
22- The earliest sing of compartment in upper limb
a- Pallor of finger.
b- Painful dorsiflexion of finger.
c- Anesthesia.
d- Pulselessness.
e- Paralysis.
23- Symptomatic hypertrophic nonunion is treated by
a- Bone graft.
b- Bone graft and rigid internal fixation.
c- Rigid internal fixation.
d- Low frequency pulsed ultrasound with cast brace.
e- Pulsed electromagnetic field and cast brace.
24- Hypertrophic non-union –treatment by the Ilizarov technique is
a- Treated by compression.
b- Treated by compression and realignment in external fixator.
c- Treated by bone transposition in external fixator.
d- Treated by gradual distraction and realignment in an external fixator.
e- Treated by rigid external fixation and bone grafting.
25- Early treatment of myositis ossificans
a- Muscles stretching exercise.
b- Splintage in position of rest followed by active exercise.
c- Splintage in position of function followed active exercise.
d- Manipulation under anesthesia followed by passive exercise.
e- Manipulation under anesthesia followed by active exercise.
26- In rupture of extensor pollicis longus tendon, all true except
a- May occur 2–4 weeks after a fracture of the lower radius.
b- Cause mallet index.
c- Follow displaced lower radius fracture.
d- Direct suture is possible.
e- Treated by transferring the extensor indicis proprius tendon to the distal stump of the ruptured tendon.
27- The common cause of joint stiffness are , except
a- Injuries of articular.
b- Injuries of synovial membrane and capsule.
c- Haemarthrosis of joint lead to synovial adhesion.
d- Edema and fibrosis of capsule and muscles.
e- Complex regional pain syndrome.
28- Characteristic x-ray feature of complex regional pain syndrome is
a- Generalized reduction in bone density.
b- Localized increase in bone density.
c- Patchy rarefaction in the affected part.
d- Regional osteoporosis of affected part.
e- Patchy osteosclerosis in affected part.
29- Localized disease that cause pathological fracture is
a- Osteoporosis.
b- Osteomalacia.
c- Paget's disease.
d- Infection.
e- Myelomatosis.
30- In children, the physeal injuries forms
a- Five% of children fractures.
b- Ten % of children fractures .
c- 15 % of children fractures .
d- 20 % of children fractures .
e- 25 % of children fractures .
31- Middle-aged men with pathological fracture, may result from
a- Severe osteoporosis.
b- Osteomalacia.
c- Skeletal metastases or myeloma.
d- Paget's disease.
e- Hyperparathyroidism.
32- Secondary metastases in femur mostly result from
a- Kidney tumor.
b- Breast carcinoma.
c- Bronchogenic carcinoma.
d- Prostate carcinoma.
e- Thyroid carcinoma.
33- Secondary metastases fracture near a bone end can often be treated by
a- Internal fixation.
b- Internal fixation and bone graft.
c- Prophylactic internal fixation and arthrodesis.
d- Excision and prosthetic replacement; this is especially true of femoral neck fractures.
e- Internal fixation; if necessary the site packed with acrylic cement.
34- Femoral fracture in Paget's disease treated by
a- Systemic medical treatment for Paget's disease.
b- Internal fixation is almost essential.
c- Custom made prosthesis.
d- Bone cement with plate and screws.
e- Bisphosphonate, calcium, Vit D, fluoride and external fixation.
35- In battered baby syndrome
a- The history fit with injuries.
b- The fractures are pathological
c- The fracture caused by accident.
d- There is only fractures.
e- The fractures at different stage of healing.
36- In types 5 and 6 epiphyseal fractures
a- If properly reduced, have an excellent prognosis.
b- Bone growth is not adversely affected.
c- The size and position of the bony bridge across the physis assessed by x-ray.
d- Complications such as malunion or non-union may also occur
e- If the bridge is relatively small, it excised and replaced by a fat graft.
37- sprain is
a- Ligaments tear.
b- Any painful wrenching (twisting or pulling) movement of a joint.
c- Associated with articular cartilage damage.
d- Compression of articular surfaces.
e- Associate with physis fracture separation in children.
38- Displaced lateral third fractures of clavicle
a- Are stable injuries.
b- Have a lower than usual rate of non-union if treated non-operatively.
c- Surgery to stabilize the fracture is rarely recommended.
d- Operations for these fractures have a high complication rate.
e- The best surgical treatment is intramedullary fixation.
39- The incidence of nonunion in clavicle is higher in
a- Displaced middle third fracture.
b- Comminuted middle third fracture.
c- Lateral part fracture.
d- Medial part fracture.
e- Comminuted medial part.
40- Malunion of clavicle with shortening of more than 2 cm
a- Is rare.
b- Do not produce symptoms.
c- Some may go on to develop periscapular pain.
d- Treated by physiotherapy.
e- Operative treatment not indicated.
41- The finding arose suspicion of scapulothoracic dissociation is
a- The scapula exposed to indirect trauma.
b- The limb abducted end externally rotated.
c- The diagnosis depend on CT scan finding.
d- There is swelling below the scapula.
e- A distraction of more than 1 cm of a fractured clavicle in x-ray.
42- Posterior sternoclavicular dislocation
a- Is common and less serious.
b- There is mild discomfort.
c- There may be pressure on the trachea or large vessels.
d- Reduction is not necessary.
e- Open reduction is not justified.
43- After reduction of anterior dislocation of shoulder, the arm is rested in a sling for
a- About one week in those under 30 years of age .
b- About two weeks in those under 30 years of age.
c- For only three weeks in those over 30.
d- For only two weeks in those over 30.
e- For only one week in those over 30 .
44- The axillary nerve injury after anterior dislocation of the shoulder
a- Is uncommon injury.
b- The patient is able to contract the deltoid muscle and there may be a large patch of anesthesia over the muscle.
c- The inability to abduct must be distinguished from a rotator cuff tear.
d- The nerve lesion is usually a neurotmesis, which recovers after a few months.
e- The results of surgical repair are satisfactory if the delay is less than a few months.
45- To reduce incidence of recurrence in anterior dislocation of shoulder
a- The use of external rotation splints.
b- The use of immobilization.
c- Continue their sports (particularly contact sports).
d- Arthroscopic anterior stabilization surgery after early detection of Bankart's
e- The value of early surgery had been confirmed.
46- Postural downward displacement of the humerus
a- Is similar to true inferior dislocation.
b- The condition is harmful.
c- Not resolves as muscle tone regained.
d- May results quite commonly from tear of ligaments and following laxity of the muscles around the shoulder.
e- Occurs after trauma and shoulder splintage.
47- The Neer‘s classification of proximal neck fracture based on x-ray appearances
a- Fragment displacement defined as greater than 25 degrees of angulation or 0.5 cm of separation.
b- However many fracture lines there are, if the fragments are undisplaced it is regarded as a one-part fracture .
c- If one segment is separated from the others, it is a one-part fracture;
d- If two fragments are displaced, that is a two-part fracture;
e- The observers do usually agree with each other on which class a particular fracture falls into.
48- Four part fracture of proximal humerus
a- The both tuberosities displaced.
b- These are severe injuries with some risk of complications.
c- In older patients, open reduction and fixation is advisable.
d- In young patients, an attempt should be made at closed treatment.
e- The results of hemiarthroplasty are unpredictable.
49- Fractured shaft of humerus
a- Bruising is always extensive.
b- Closed transverse fracture treated by internal fixation.
c- Ready-made braces are usually not adequate in moderate displacement .
d- The conservative methods is suitable for all cases.
e- The complication rate after internal fixation of the humerus is rare.
50- In fractured shaft of humerus, it is well to remember
a- The complication rate after internal fixation of the humerus is high .
b- The great majority of humeral fractures need operative treatment.
c- There is good evidence that the union rate is higher with fixation.
d- The rate of union may be better if there is distraction with nailing .
e- The rate of union may be better if there is periosteal stripping with plating.
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