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Orthopaedic MCQ

1) Regarding ACL injury


a. It is cause by a posteriorly directed force to the front of tibia T
b. It is common among female T (Female athletes are known to have a
higher risk of injuring their ACL while participating in competitive sports)
c. It is usually associated with lateral collateral ligament injury F (medial
collateral ligament)
d. It is usually associated with medial meniscus injury T
e. It can be treated with patella tendon autograft T (reconstruction)
2) Regarding PCL injuries
a. It is more common compare to ACL injury F (ACL more common)
b. It is usually an isolated tear T
c. It is associated with dashboard injury T (The most common mechanism
of injury of the PCL is the so-called "dashboard injury)
d. In grade 3 injury, the tibia subluxates posterior to the anterior aspect of the
femoral condyle T
e. Surgical reconstruction is the treatment of choice of most case F (only
grade III)
3) These factors predict wound healing
a. Albumin level of 20g/dl T
b. Transcutaneous oxygen tension of 305 T
c. Ankle brachial systolic index of 0.9 T
d. HBa1c level of 6% T
e. Toe pressure measurement of 20mmHg F
4) Regarding diabetic foot ulcer
a. Can be treated with antibiotic only F
b. Wagner 2 ulcer associated with osteomyelitis F (Wagner 2 is deep ulcer)
c. Associated with painful neuropathy F
d. Wound debridement is frequently needed T
e. Wegner 5 probably need below knee amputation T
5) Regarding carpal tunnel syndrome
a. There is presence of hypoesthesia at the palm F (palmar cutaneous
branch of median nerve does not pass through carpal tunnel)
b. There is presence of chondroid metaplasia of the tunnel lining T
c. Pointing index finger is a sign F
d. Phalen sign positive T
e. Injection of steroid into wrist joint is a treatment T
6) Regarding trigger finger and its treatment
a. Stenosing of A5 pulley is a cause F
b. The flexor digitorum profundus gets trapped at A1 pulley T
c. Release of the A1 pulley causes bowstringing T

d. Fibrous metaplasia occur at the pulley F


e. Occur in rheumatoid arthritis T
7) Regarding rheumatoid arthritis
a. Causes symmetrical arthritis T
b. Affect the intervertebral disc F
c. Rheumatoid factor is an abnormal immunoglobulin T
d. Periarticular osteoporosis is a radiological feature T
e. Methotrexate is a disease modifying drug of choice T
8) In relation to gout
a. Abnormal protein metabolism is a cause T
b. Tophi is a feature of acute case F
c. Dietary restriction of white meat is part of the treatment F (red meat)
d. Consumption of fish oil is contraindicated F
e. NSAIDs is the treatment of acute gout T
9) Regarding osteomyelitis
a. The causal organism is usually staphylococcus aureus T
b. In young children, Haemophilus influenzae is the most common agent
causing osteomyelitis T
c. Sequestrum is often found within the thickened cortex and are boared by
the reactive bone and chronic granulation T
d. Involucrum contains the sequestered, necrotic marrow and the endosteal
bone T
e. Chronic abscess can violate the skin by means of sinus tract lead to
chronic ulceration and drainage T
10)Regarding bone mass
a. Peaks at age 30 yrs old T
b. 0.3% bone loss per year in men after peak bone mass T
(After attaining peak bone mass at age 30, men and women lose bone at
a rate of approximately 0.3% and 0.5% per year, respectively)
c. 0.5% bone loss per year in female after peak bone mass T
d. In early menopause, bone loss is cause by excessive osteoclast-mediated
reabsorption T
e. In late postmenopausel, bone loss is due to suppression of osteoblast
activity T
11) Regarding osteoporosis
a. Serum calcium is normal T
b. Associated with poor fracture healing T
c. Early premature menopause is a high risk T
d. Can be treated successfully with calcium supplement alone F
e. Osteoporotic related fracture usually occur in metaphyseal region T

12)Non-modifiable factor of osteoporosis includes


a. Family history of osteoporosis in first degree relatives T
b. Advancing age T
c. Personal history of fracture as an adult F
d. Excessive alcohol intake F (modifiable)
e. Corticosteroid medication F(modifiable)
13)Specific investigation of osteoporosis includes:
a. Dual-energy X-ray absorptiometry (DEXA) T
b. Quantitative computer tomography (QCT) T
c. Single energy X-ray absorptiometry (SXA) T
d. Quantitative ultrasound (QUS) T
e. Urinary deoxypyridinoline (DPD) T
14)Regarding developmental dysplasia of the hip (DDH)
a. Female is commonly affected than male T
b. Left hip is more commonly affected then right hip T
c. 80% is unilateral T (1 in 5 cases is bilateral)
d. Generalize joint laxity predispose to DDH T
e. A breech position with extended legs predispose to DDH T
15)Pathoanatomy of DDH include
a. Shallow acetabulum T
b. Femoral anteversion T
c. Inverted labrum T
d. Formation of Pulvinar T
e. Contracted transverse acetabular ligament F
16)Secondary osteoarthritis is cause by
a. Obesity F
b. Septic arthritis T
c. Recurrent dislocation T
d. Pseudogout T
e. Perthes disease T
17)Indication of internal fixation includes
a. Open fracture grade 3A T
b. Displaced acetabulum fracture T
c. Displaced tibial plateau fracture T
d. Femoral neck fracture in young adult T
e. Pathological fracture T
18)Indication of external fixation includes
a. Fracture associated with severe soft tissue damage T
b. Closed fracture midshaft of tibia F
c. Open book fracture of pelvis T

d. Aseptic non-union of femur F


e. Intraarticular fracture T
19)Regarding osteosarcoma
a. It is a highly malignant primary bone forming tumor T
b. More common in males compared to females T
c. Peak incidents 10- 20 years T
d. Commonest at metaphyseal of long bone T
e. Classical osteosarcoma is extramedullary F (classic central
medullary osteosarcomas)
20)Plain x-ray features commonly seen in osteosarcoma includes
a. Osteoclastic changes T (osteolytic changes)
b. Wide zone of transition T
c. Sun ray spicules T
d. Codmans triangle T
e. Cortical breach T

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