d.

Remodeling [6th step]

Surgical Ortho Midterm 13. Fracture healing with abnormal angulation of bone is an
example of
1. Considered as father of operative Orthopedic Surgery
a. Malunion
a. Hugh Owen Thomas
b. Delayed union
b. Nicholas Andry
c. Non union
c. Robert Jones
d. All of the above
d. W. Morton
14. Common indication(s) for open reduction of fractures
2. The term “orthopedic” originally appeared in 1741 in the
a. Salter and Harris Type III and IV
book published by
b. Displaced intraarticular fractures
a. Nicholas Andry
c. Fractures of the patella
b. Hugh Owen Thomas
d. All of the above
c. Robert Jones
15. The following situations may require open reduction for
d. W. Morton
clavicular fracture, EXCEPT
3. Direct visualization of the joint using a specialty designed
a. Non union
endoscope
b. Neurovascular involvement
a. Arthrography
c. Fracture of m/3rd
b. Arthroclessis
d. Persistent wide separation of the fragments
c. Arthroplasty
16. The most complication of Colle’s fracture is loss of finger
d. Arthroscopy
motion and grip strength due to
4. Surgical removal of articular hyaline cartilage for bone
a. Edema with injury
fusion
b. Weakness from disuse
a. Arthotomy
c. Both
b. Arthrodesis
d. Neither
c. Arthroplasty
17. Garden’s Stage II Femoral neck fracture
d. Arthroscopy
a. Fracture with full displacement
5. The most common indication for total hip arthroplasty
b. Fracture with partial displacement
a. Femoral neck fracture
c. Incomplete fracture
b. Intertrochanteric fx
d. Complete fracture without displacement
c. Femoral head fx
18. Separation of the common extensor tendon from its
d. None of the above [mc ind = osteoarthiritis;
insertion into the base of the distal phalanx
total hip arthroplasty involves acetabellum]
a. Baseball finger
6. The most common indication for partial hip arthroplasty
b. Mallet finger
a. Femoral neck fracture
c. Dropped finger
b. Intertrochanteric fx
d. All of the above
c. Femoral head fx 19. Dislocation involving the mid--‐tarsal joints
d. None of the above
7. Turning the palmar surface of the hand toward the posterior a. Listranc’s
surface of the body b. Chance’s
a. Supination c. Boyd’s
b. Pronation d. Chopart’s
c. Internal rotation 20. Fracture of the radius at the junction of the middle and
d. External rotation distal thirds, associated with subluxation of the distal ulna
8. Deformity which occurs as a result of the patient’s own a. Galeazzi
muscle action b. Monteggia
a. Postural deformity c. Alli
b. Static deformity d. Duputren
c. Dynamic deformity 21. Two vertical fractures involving one side of the pelvic ring
d. Structural deformity a. Maisonneuve
9. Deformity which is relatively resistant to passive correction b. Gossein
a. Postural deformity c. Malgaigne
b. Static deformity d. Monteggia
c. Dynamic deformity 22. Fracture of the lateral condyle of the humerus
d. Structural deformity [ = fixed deformity] a. Salter Harris Type I
10. Adduction deformity of the great toe through the b. Salter Harris Type II
metatarsophalangeal joint c. Salter Harris Type III
a. Hallux valgus d. Salter Harris Type IV
b. Hallux varus 23. “The Thurston--‐Holland Sign”
c. Both a. Salter Harris Type I
d. Neither b. Salter Harris Type II
11. Fracture consisting of three or more fragments c. Salter Harris Type III
a. Bursting d. Salter Harris Type IV
b. Compression 24. Limb equalization methods such as shortening the opposite,
c. Spiral lengthening the affected side or stapling the opposite
d. Comminuted epiphysis is related to
12. First step in fracture repair a. Salter Harris Type III
a. Collagen synthesis by osteoblasts [2nd step] b. Salter Harris Type IV
b. Inflammatory response (blood clot or c. Salter Harris Type V
hematoma) d. None of the above
c. External callus from periosteum [3rd step] 25. Congenital dislocation of the hip
 a. More common in boys than in girls c. Lifranc’s fx
b. Bilateral involvement more than unilateral d. Chopart’s fx
c. Left hip involved more than right hip 36. The best management for this patient
d. All of the above a. Application of elastic bandae
26. Obturatorcoxo femoral line b. Long leg circular cast
a. Shenten’s line c. Short leg circular cast
b. Menard’s line d. ORIF
c. Both 37. On PE, patient’s right lower extremity was noted to be
d. Neither externally rotated. Positive tenderness right hip area.
27. Congenital constricting bands Possible diagnosis is
a. Streeter’s dysplasia a. Femoral neck fracture
b. Subcutaneous tissue replaced by hyperplastic b. Intertrochanteric fx
collagenous and elastic tissue c. Hip dislocation
c. Occurs most commonly in fingers than in toes d. Acetabular fx
d. All of the above 38. The position of the right lower extermity (external rotation)
28. Syndactyly in which the skin interconnection extends to the is secondary to the action of
tips of the involved digits a. Short lateral rotators of the hip
a. Simple [web contain only skin and soft tissue b. Hip adductors
without bony fusion] c. Hamstring muscles
b. Complex [bony interconnection between the d. Quadriceps muscles
digits] 39. Common complication of this fracture
c. Complete a. Femoral nerve injury
d. Incomplete [interconnection does not reach the b. Avascular necrosis of the femoral head
fingertip] c. Sciatic nerve injury
29. The least common type of syndactyly d. All of the above
a. Between long and ring fingers [57%] 40. Prior to admission, this should be done at the ER
b. Between little and ring [27%] a. Skeletal traction
c. Between long and index [14%] b. Skin traction
d. Between thumb and index [3%] c. Spica cast
d. Multiple pinning of the hip
Case 1: a 36y/o male sustained open fracture distal portion right leg 41. In the treatment of degenerative joint disease, it is most
secondary to motorcycle accident. important to rule out this disease entity from
a. Gouty arthritis
30. Xray to be requested in this patient b. Pott’s disease
a. xray right leg including knee APL c. Rheumatoid arthritis
b. xray right leg AP view d. Arthritis defromans
c. xray right leg including ankle APL e. Osgood--‐Schlatter’s disease
d. xray right leg APL 42. The treatment of Septic Arthritis of the hip in neonates and
31. Management in this type of patient children should be aggressive to prevent the serious
a. Long leg circular cast complication of
b. Debridement and application of external a. Destruction of the physis andepiphysis,
fixator resulting in leg length discrepancy
c. Debridement and intramedullary nailing b. Absorption of the synovial fluid resulting in a dry
d. Open reduction internal fixation and squeaky joint
32. The golden period in the management of this patient c. Involvement of the Batson’s Plexus o veins
a. 2hrs d. Flexion contracture of the hip resulting to
b. 10hrs ankylosis.
c. 6hrs e. None of the above
d. 8hrs 43. Hallmarks of hypertrophic osteoarthritis
a. Bony excresences or osterophytes
Case 2: KL, a 30y/o male, while playing basketball had inversion b. Subchondral bone cysts
injury at his right ankle. PPE:swollen right ankle joint, (+) tenderness, c. Narrowing of the joint space
limited ROM d. Deformity with progressive loss of motion
e. All of the above
33. Possible diagnosis in the above case 44. Pain on activity which is often relieved by rest with
a. Ankle sprain exacerbation of the symptoms in areas of low barometric
b. Fracture medial malleolus pressure are the major symptoms relating to
c. Fracture post, lip of tibia a. Legg--‐Calve--‐Perthe’s disease
d. All
b. Osgood--‐Schlatter’s disease
34. Xray of the ankle and foot was done and showed fracture of
medial and lateral melleoli. Diagnosis is c. Arthritis Deformans
a. Pott’s fracture d. All of the above
b. Cotton’s fracture [trimalleolar fx] e. None of the above [osteoarthritis]
c. Lisfranc’s fracture 45. 45. In gouty arthritis, the uric acid crystals deposited in the
d. Gosselin’s fracture joints, peri--‐articular areas and subcutaneous tissues. This
35. 35. If the above xray finding is accompanied by fracture of is due to the loss of the governing enzyme
the posterior lip of the tibia, the diagnosis would be a. Amylase
a. Pott’s fx b. Beta peptidase
b. Cotton’s fx c. Bradikinin oxidase
 d. Xanthine oxidase c. Supracondylar fracture
e. None of the above [HGPRT] d. None of the above
46. Pott’s disease or Tuberculosis Spondylitis is basically a 6. A decrease in the normal carrying angle of the elbow:
tuberculous infection of the a. Coxa vera
a. Corpus of the vertebra b. Genu valgus
b. Pedicle of the spine c. Cubitus valgus
c. Transverse process of the posterior elements d. Cubitus varus
d. Spinous process of the vertebra 7. Bone graft taken from the ileum and trasferred to the same
e. All of the above individual:
47. Once the tubercle bacilli lodges in the spine the progressive a. Hemograft
destruction of the vertebral segment is typically termed b. Heterograft
a. Avascular necrosis c. Autograft
b. Caseation necrosis d. Paragraft
c. Septic spondylitis 8. Drug that can delay fracture healing:
d. All of the above a. Heparin
e. None of the above b. Corticosteroids
48. The following are the typical symptomatology of children c. Dicumerol
with juvenile rheumatoid arthritis, except d. All of the above
a. Splenomegaly 9. The “Golden period” in the management of open fracture:
b. Bi--‐gemini fever spikes a. 6 hrs
c. Butterfly rash b. 16 hrs
d. Anorexia and malaise c. 2 hrs
e. Anemia d. 8 hrs
49. The collapse to the L3 vertebral body in Pott’s Disease with 10. The last stage in fracture healing:
retropulsed posterior wall of the body including disc a. Inflammation
fragments and pus will inevitably compress the neural b. Formation of blood clot
elements causing c. Hydroxypatite deposition
a. Paraplegia of active disease d. Remodeling
b. Spinal cord lesions 11. Overlapping of fragments can result to:
c. Loss of motor power and sensory perception with a. Angulation
flaccid paralysis b. Shortening
d. All of the above c. Rotation
e. None d. None of the above
50. In the diagnosis of Pott’s disease, the earliest radiologic 12. Contraindication for open reduction:
picture of the affected spine segment is a. Active infection
a. Collapse of the vertebral body b. Undisplaced fracture
b. Paravertbral abscess shadow c. Bone so weak
c. Diminution of the disc space d. All of the above
d. Gibbus formation 13. Boyd & Griffin is a classification for:
e. All of the above a. Femoral neck fracture
b. Femoral shaft fracture
OTHER SAMPLEX: c. Intertrochanteris fracture
d. Pott’s fracture
1. Y--‐shaped intraarticular fracture base of 1st metacarpal: 14. Partially displaced femoral neck fracture:
a. Garden’s I (incomplete)
a. Bennet’s fracture
b. Garden’s II (complete w/o displacement)
b. Manteggla’s fracture
c. Garden’s III (complete w/ displacement)
c. Jefferson’s fracture
d. Garden’s IV (complete w/ full displacement)
d. Rolando’s fracture
15. Cubitus varus is an example of:
2. Thurstan--‐Holland sign: Salter--‐Harrus (Epiphyseal injury
a. Non--‐union
children)
b. Mal--‐union
a. Type I
b. Type II c. Delayed union
c. Type III d. A & C
d. Type IV 16. Period of observation for spontaneous recovery of radial
3. In Barlow’s test the hip is being: nerve injury:
a. Dislocated a. 4 wks
b. Peduced (Ortolany) b. 8 wks
c. Both c. 12 wks
d. Neither d. 16 wks
4. Most common complication of supracondylar fracture of 17. Fracture neck of 5th metacarpal:
the humerous: a. Maliet finger
a. Volkmann’s ischemic contracture b. Boxer’s fracture
b. Cubitus varus c. Baseball finger
c. Genu varus d. Rolando’s fracture
d. Radial nerve palsy 18. Special x--‐ray technique allowing visualization of the
5. Pauwel’s classification is related to: spinal cord:
a. Intertrochanteric fracture a. Discography
b. Femoral neck fracture (Powel’s + Gardener’s) b. Myelography
 c. Arthography c. Inflammatory arthritis
d. MRI d. Hemorrhagic arthritis
19. Abduction deformity of the great toe through the 30. Herberden’s node are bony enlargement of the:
metatarsophalageal joint: a. Distal interphallangeal joints of the fingers
a. Hallux valgus b. DIP joints of the foot
b. Heel valgus c. Medial compartment of the knee
c. Metatarsal adducts d. Metacarpophallangeal joints of the hand
d. Tolipes equinovarus e. None of the above
20. Femoral neck shaft angle of 95 degree: 31. A patient manifesting with ulcers on the palms and soles
a. Genu varum with urethritis is suffering from:
b. Coxa varum a. Ankylosing spondylitis
c. Genu valgum b. Juvenile rheumatoid arthritis
d. Coxa valgum c. Gouty arthritis
21. A fracture in a bone weakened by an underlying disease: d. Fungal arthritis
a. Stress fracture e. None of the above
b. Comminuted fracture 32. Reiter’s syndrome is manifested as EXCEPT:
c. Patholic fractures a. Triad of urethritis conjunctivitis and
d. All of the above oligoarticular arthritis
22. Fractures heal by formation of: b. Predominant in adult females
a. Hematoma c. Keratodermic lesions
b. Collus d. All of the above
c. Scar e. None of the above
d. Clot 33. Systemic manifestation of Rheumatoid Arthritis includes
23. Maintenance of reduction can be achieve by: EXCEPT:
a. External fixation a. Vasculitis
b. Internal fixation b. Podagra
c. Traction c. Pericarditis
d. All of the above d. Pulmonary disease
24. Absolute indications for open reduction: e. GI bleed
a. No union 34. Charcot Joint is usually a manifestation of:
b. Delayed union a. Tabes Dorsalis
c. Multiple fractures b. Syringomyelia
d. All of the above c. Hansen’s Disease
25. Fat fad sign is related to: d. All of the above
a. Clavicle fracture e. None of the above
b. Supracondylar fracture humerus 35. Pigmented villonodular synovitis is one of the:
c. Colle’s fracture a. Hemorrhagic arthritis
d. None of the above b. Infectious arthritis
26. The current treatment for osteoporosis due to menopause c. Non--‐inflammatory arthritis
are the following EXCEPT: d. Inflammatory arthritis
a. Estrogen because it decreases the calcium e. None of the above
excretion 36. Corrective osteotomy is one of the surgical measures to:
b. Vitamin D which slows the resorption of bone a. Prevent secondary arthritis
mineral b. Re--‐aligning the weight bearing surface of a
c. Giving parathyroid hormone
joint
d. Administration of androgens as a sodium
c. Improve cosmetic appearance of a deformed limb
retentive effect
d. Improve the function of a diseased joint
e. Fluoride treatment to cause new bone matrix to
e. All of the above
be deposited in the trabeculae
37. Total joint replacement arthroplasty is reserved for:
27. A slowly progressive disease of synovial lined joints
a. Older arthritic individuals
occurring late in life characterized by focal degeneration of
b. Severe joint destruction
articular cartilage, subchondral bone thickening, osteophyte
c. Exquisite pain on motion of a deformed weight
formation and deformity is known as EXCEPT:
bearing joint
a. Osteoarthritis
d. Limitation of motion of a joint due to disease
b. Osteoarthrosis
e. All of the above
c. Paget’s disease
38. Still’s disease is manifested by all EXCEPT:
d. Degenerative arthritis
a. Fever with rash
e. Hypertrophic arthritis
b. Splenomegaly
f. Arthritis deformans
c. Lymphadenopathy
28. In severe and disabling degenerative arthritis of the knee,
d. Bouchard’s nodes
the surgical treatment of choice is:
e. Iridocyclitis
a. Intraarticular steroid injection of steroids
39. Gout is a condition of disturbed uric acid metabolism in
b. Total knee replacement arthoplasty
which ureate salts are deposited in the articular,
c. Fusion of the joint
periarticular and subcutaneous tissues is characterized to
d. Physical therapy
be:
e. None of the above
a. Hereditary
29. Sickle cell joint disease is an example of:
b. Of male preponderance
a. Non--‐inflammatory arthritis
c. Predilection to 2nd to 4th decade of life
b. Infectious arthritis
 d. Decreased urinary 17--‐ketosteroids a. Femoral neck fx
e. All of the above b. Femoral shaft fx
f. None of the above c. Intertrochanteric fx
40. In degenerative arthritis the causative factors are: d. Pott’s fx
a. Age 51. In development dysplasia of the hip, if we do Barlow’s test,
b. Hereditary the hip is being
c. Obesity a. Dislocation
d. All of the above b. Reduced
e. None of the above c. Abducted
41. Non--‐inflammatory arthritis includes EXCEPT: d. Adducted
a. Osteoarthritis
b. Neuroplathic arthropathy
c. Acute rheumatic fever
d. Gout
e. All of the above
42. Secondary arthritis is a resultant of:
a. No underlying cause is present
b. Cartilage is worn out because of disuse
c. Previous trauma or congenital deformities
d. All of the above
43. RF (rheumatoid factor) is negative in:
a. Rheumatic fever
b. Ankylosing spondylitis
c. Osteoarthritis
d. All of the above
e. None of the above
44. Sausage digits is a hallmark of:
a. Psoriatic arthritis
b. Tuberculous arthritis
c. Gouty arthritis
d. Ankylosing spondylitis
e. None of the above
45. Except one, acute hematogenous osteomyelitis is the:
a. The most frequent and common type of bone
infection
b. Affects more males than females
c. Affects the diaphyseal part of the bone
d. Usually caused by cateremia
e. All of the above
46. Stripping of the periosteum in acute hematogenous
osteomyelitis provokes an osteoblastic response producing
a sleeve of new bone formation known as:
a. Cloaca
b. Sequestra
c. Pereostitis
d. Myositis ossificans
e. Involurun
47. In the neonates, the most common causative organisms
isolated is osteomyelitis is:
a. Staphylococcus
b. Enteric bacilli
c. Group B hemolytic streptococcus
d. None of the above
e. All of the above
48. In the early stage of acute hematogenous osteomyelitis, the
most constant finding is:
a. Positive x--‐ray picture
b. Leukocytosis
c. Positive blood culture
d. None of the above
e. All of the above
49. All is true in subacute osteomyelitis EXCEPT:
a. Elevated ESR
b. Blood culture is usually positive
c. Loss of function of the limb is minimal
d. Pain is mild to moderate
e. WBC is normal
50. Boyd and Griffin is a classification for