4/4/24, 8:54 PM MSK Formative Final Examination

MSK Formative Final Examination

115 MCQS covering the 66 lectures (10weeks) / Exam points is out of 100 marks
(This test is to build your knowledge and assess weakness and strength points but not to
test your knowledge)
Prepared by : Hussein Al-Hafeth

* Indicates required question

1. 1- A 32 year old male present to the ER with pain , swelling and restricted * 1 point
ROM , Imaging studies shows a fracture just below the Humerus tuberosities
, Which of the following statements is most accurate regarding the case ?

Mark only one oval.

A) Inability to initiate abduction

B) Anterior circumflex humeral artery will be affected

C) Affected neurovascular structures will pass via the triangular interval

D) Patient will exhibit weakness during lateral rotation

E) Teres major will be paralyzed

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2. 2- A 22 year old male present to the ER department and was involved in an 1 point

automobile accident that resulted in rotate his arm internally upon examination
, medical team suspect paralysis due to nerves lesion , which couple of nerves
were most likely involved ?

Mark only one oval.

A) Suprascapular and axillary

B) Lower subscapular and radial

C) Long thoracic and upper subscapular

D) Dorsal scapular and suprascapular

E) Thoracodorsal and lower subscapular

3. 3- A first-year surgical resident rushes to a table and prepares for emergent 1 point
tracheostomy for an elderly man chocking from his food after Heimlich
procedure have failed .He locates the manubrium of the sternum and recalls
that it is free from articulation with which of the
following structures?

Mark only one oval.

A) Collar bone

B) First rib

C) 2nd rib

D) 3rd rib

E) Angle of louis

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4. 4- A 22-year-old patient comes with a gunshot that affected his part of * 1 point
axillary artery that lie inferior to muscle inserting into coracoid process and
required surgical intervention , which of the following branches will sustain
normal function before surgery ?

Mark only one oval.

A) Anterior humeral circumflex artery

B) Thoracodorsal artery

C) Clavicular artery

D) Subscapular artery

E) Circumflex scapular artery

5. 5- A 28-year-old cyclist, fell off her bike and fractured her right humerus. * 1 point
After receiving treatment and fracture reduction at the hospital, she was
discharged. However, a few days later, She returned, complaining of severe
pain and an inability to start abduction and preform a maneuver to lift her
arm with her contralateral arm and complete abduction normally ,which of
the following groups in the brachial plexus is affected in this case ?

Mark only one oval.

A) Roots

B) Trunks

C) Divisions

D) Cords

E) Branches

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6. 6- A 3 month old male present with policeman tip position , Where his * 1 point

shoulder was adducted , medially rotated accompanied with extended elbow

and dysfunctional supinator’s , in this patient all of the following nerves have
been dysfunctional except ?

Mark only one oval.

A) n. to subclavius

B) Suprascapular nerve

C) Axillary nerve

D) Ulnar nerve

E) Musculocutaneous nerve

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7. 7- A 22-year-old man present to the physician with a weaken extension * 1 point

adduction and internal rotation of the arm after an accident which resulted in
a vertical fracture to the humerus affecting the place where the long head of
biceps being placed in , which of the following do match the nerve supplying
the affected muscle ?

Mark only one oval.

A) Has A RV of C5,C6,C7

B) Has A RV of C5,C6

C) Nerve affected also supply teres major

D) Has A RV of C6,C7,C8

E) Musculocutaneous nerve

8. 8–A 19-year-old male loses the ability to extend his elbow ,wrist and fingers * 1 point
after an accident causing fracture to the bone articulating with radius and
ulna distally .which of the following is most likely to be the site of the
fractured bone ?

Mark only one oval.

A) Medial epicondyle fracture

B) Supracondylar fracture

C) Surgical neck fracture

D) Between two lateral heads of triceps brachii

E) Lateral epicondyle fracture

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9. 9- A 33-year-old man, experiences a traumatic injury to his upper arm, * 1 point

resulting in the pathology clarified below . As a consequence, blood flow to
the distal part of his arm was compromised. arterial anastomoses were fixed
by the surgeon , which of the following arteries were most likely to be
involved in the ligation procedure?

Mark only one oval.

A) Superior Ulnar collateral

B) Anterior ulnar recurrent

C) Posterior interosseous recurrent

D) Anterior interosseous recurrent

E) Radial recurrent

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10. 10- A 25-year-old rushes into the emergency room clutching her right * 1 point
forearm, wincing in pain. She had fallen off her bike and landed on her
outstretched hand. X-rays confirm a fracture of her right radius, the
attending physician decides to assess the radial pulse using the anatomical
snuff box. Between which dorsal compartments can the physician palpate
the radial pulse in this location?

Mark only one oval.

A) 1st and 2nd

B) 2nd and 3rd

C) 1st and 3rd

D) 4th and 3rd

E) 5th and 6th

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11. 11- In order to check the pulse of a man whose forearm is in a cast, a * 1 point
physician presses her finger into the "anatomical snuffbox". The tendon
lying immediately medial (ulnar) to the physician's finger belongs to which
of the following muscles?

Mark only one oval.

A) Brachioradialis

B) Extensor carpi radialis brevis

C) Extensor pollicis longus

D) Abductor pollicis longus

E) Extensor carpi radialis longus

12. 12- A 49 year old programmer who has been suffering from neck pain that * 1 point
continued for the last 3 years , recently he develops paresthesia over the
middle finger , his GP tells him this is more likely to be due to cervical disk
prolapse , which of the following discs were more likely to be involved ?

Mark only one oval.

A) C3-C4

B) C4-C5

C) C6-C7

D) C7-T1

E) none of the above

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13. 13- How many muscle is inserted on the 2nd finger ? * 1 point

Mark only one oval.

A) 2

B) 4

C) 6

D) 7

E) 8

14. 14- A 65 year old postmenopausal women presents with extremely low * 1 point
estrogen levels which of the following hormones is more likely to be high in
her blood responding to low estrogen ?

Mark only one oval.

A) An 84 amino acid protein based hormone

B) A 32 amino acid protein based hormone

C) A 64 amino acid protein based hormone

D) Vitamin D

E) Testosterone hormone

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15. 15- The synthesis of active Vitamin D3 involves a series of sequential steps * 1 point

occurring in the skin, liver, and kidney. Arrange the correct order of reactions
for the synthesis of active Vitamin D3:

a) 25 hydroxyvitamin D
b) Inactive Vitamin D
c) 7 dehydrocholesterol
d) 1, 25 dihydroxy vitamin D
e) 1 alpha-hydroxylase

Mark only one oval.

A) b, c, e, a, d

B) c, b, e, a, d

C) c, e, b, a, d

D) c, e, a, b, d

E) c, b, a, e, d

16. 16- which prostaglandin is NOT cell-specific? * 1 point

Mark only one oval.

A) PGA2

B) PGE2

C) PGH2

D) PGF2α

E) none of the answers

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17. 17- A medical student, is studying the impact of a deficiency in * 1 point

Cyclooxygenase 1 , What would be a likely a result of this deficiency in
terms of eicosanoid presence in the human body?

Mark only one oval.

A) Augmented blood clotting

B) Enhanced thromboxane A2 synthesis

C) Augmented bronchoconstriction

D) Augmented prostacyclin formation

E) none of the answers

18. 18- A 32-year-old bodybuilder has decided to go on a diet consisting of only * 1 point
egg whites to ensure optimal protein for muscle growth. After a few weeks,
he notices decreased energy and is found to be hypoglycemic. A nutritionist
tells the patient that he most likely has a functional X deficiency because of
high avidin. Which of the following enzymes is unable to catalyze a key step
in synthesizing glucose from pyruvate?

Mark only one oval.

A) Fructose 1,6-bisphosphatase

B) Phosphoglycerate kinase

C) Phosphoenolpyruvate carboxykinase

D) Pyruvate carboxylase

E) none of the answers

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19. 19- A 5-year-old boy was born with a disorder that caused a mutation in a * 1 point
complex that don’t pump protons in the ETC, electron transfer from which
substrate would be impaired?

Mark only one oval.

A) Malate

B) α-Ketoglutarate

C) Isocitrate

D) succinate

E) pyruvate

20. 20- if 4 FADH2 molecules were produced during TCA cycle , calculate total * 1 point
yield ATP molecules from produced NADH during the procedure , knowing
that 1 NADH =3 ATPs

Mark only one oval.

A) 12 ATPs

B) 24 ATPs

C) 28 ATPs

D) 34 ATPs

E) 36 ATPs

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21. 21- A 40-year-old woman, has been experiencing joint pain, stiffness, and * 1 point

swelling, particularly in her hands and wrists, for the past few months ,
rheumatologist confirms a diagnosis of rheumatoid arthritis (RA). However,
despite her symptoms, Laura's blood tests reveal a negative rheumatoid
factor (RF) but a positive anti-cyclic citrullinated peptide (ACPA) antibody
result , Which of the following Auto Immune mechanisms is applied in this
case ?

Mark only one oval.

A) Bystander T cell activation

B) Presence of cryptic epitopes

C) Polyclonal lymphocyte activation

D) Altered self

E) Sequestered antigens

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22. 22- A 55-year-old man, has been experiencing joint pain, stiffness, and * 1 point
swelling for several months, particularly in his hands and knees, blood test
reveals a positive rheumatoid factor (RF), which of the following from the
picture below is more likely the type of RF antibody ?

Mark only one oval.

A) A

B) B

C) C

D) D

E) none of the answers

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23. 23- in the morgue a surgeon is examining brain tissues from a dead * 1 point
cadaver. he observes intracytoplasmic inclusions consisting of aggregates
of viral nucleocapsids. Which of the following symptoms where the patient
suffering from before passing away ?

Mark only one oval.

A) Shingels

B) Postherpetic neuralgia

C) Hypopigmented skin

D) Hydrophobia

E) UMN lesion

24. 24-A 40-year-old woman, experiences a painful rash with blisters distributed * 1 point
in a specific dermatome. The healthcare provider suspects shingles caused
by the reactivation of Varicella-Zoster Virus . Which term best describes the
phenomenon where VZV becomes inactive in sensory nerves and later gets
reactivated, causing nerve problems?

Mark only one oval.

A) MATs

B) Preherpetic neuralgia

C) Latency-associated transcripts

D) Lytic infection

E) Persistent infections in lymphocytes

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4/4/24, 8:54 PM MSK Formative Final Examination

25. 25-A 36 year old male has recently recovered from a case of chickenpox. * 1 point
Concerned about potential complications, the individual visits a healthcare
provider seeking advice on vaccination. What recommendation should the
healthcare provider give regarding varicella vaccination in this scenario?

Mark only one oval.

A) No need for varicella vaccination after recovery

B) Administer a booster dose of chickenpox vaccine

C) Schedule a follow-up for a varicella titer test.

D) Administer the varicella vaccine immediately.

E) none of the above

26. 26- A 9-year-old girl, has been experiencing muscle weakness and difficulty * 1 point
walking for several months. Concerned, her parents take her to see a
pediatrician. After a thorough examination and diagnostic tests, She is
diagnosed with Duchenne Muscular Dystrophy (DMD), which of the
following sentences do match this case regarding the underlying genetic
cause of her condition?

Mark only one oval.

A) Autosomal dominant inheritance pattern

B) Autosomal recessive inheritance pattern

C) Turner syndrome

D) Skewed x activation

E) Misdiagnosed / A female could be just a carrier

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27. 27- A 6 year old male was diagnosed with DMD , his western plot results * 1 point
were compared to an adult patient who was diagnosed with BMD , which of
the following is true regarding the difference between DMD & BMD ?

Mark only one oval.

A) The mode of inheritance

B) The location of the mutated gene on the chromosome

C) DMD is associated with less aggresive symptoms

D) BMD mutations cause a defect in a diffirent protein

E) DMD happens due to a different type of mutations

28. 28- A 31-year-old man has an automobile accident that completely * 1 point

eliminates all nerve traffic in the right half of the spinal cord at C4 , loss of
which functions will be experienced by this patient ?

Mark only one oval.

A) Pain sensation & Crude touch

B) Crude touch & temperature

C) Crude touch and Vibration

D) Vibration and & motor function

E) Vibration & pain sensation

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29. 29- A 45-year-old man, was involved in a car accident and suffered a spinal * 1 point
cord injury. As a result, he experiences numbness and loss of sensation on
the left side of his body below the level of his waist , which of the following
statements mostly match this case ?

Mark only one oval.

A) there will be loss of proprioception on the sole of right foot

B) left DCML pathway was damaged

C) Right DCML pathway was damaged

D) left Spinothalamic pathway will be damaged

E) Loss of temperature will be exhibited on the left side

30. 30- 19-year-old patient presents with Brown-Sequard syndrome following a * 1 point
road traffic accident. Neurological examination of the upper limbs reveals
hypoesthesia and flaccid weakness of the right-hand muscles , further
examination using a tuning fork will reveal the absence of vibration in which
of the following bony parts ?

Mark only one oval.

A) Left side of the mandible

B) Medial malleolus , left side

C) Shin of tibia , right side

D) styloid process of radius , right side

E) olecranon process of ulna , left side

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31. 31- You are driving along a winding mountain road, Suddenly, a deer darts * 1 point
out from the forest, crossing the road directly in front of your car. Reacting
swiftly, you instinctively turn your head and eyes to track the movement of
the deer as it disappears into the wilderness, Which neural pathway in your
brain is primarily responsible for initiating the rapid reflexive head and eye
movements required to track the deer's movement?

Mark only one oval.

A) Corticospinal tract

B) Vestibulospinal tract

C) Tectospinal tract

D) Reticulospinal tract

E) All of the above

32. 32- Which of the following is the correct lamina where the 2nd-order neuron * 1 point
of the pathway which is responsible for unconscious proprioception
ascend?

Mark only one oval.

A) Lamina II

B) Lamina III

C) Lamina III &V

D) Lamina VI

E) Lamina VII

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33. 33- Which of the following during the embryologic period is responsible for * 1 point

aligning the big toe to be medial in the lower limb and the thumb to be
lateral in the upper limb ?

Mark only one oval.

A) AER

B) ZPA

C) HOX gene

D) UMC

E) none of the above

34. 34- From which of the following do Supraspinatus arise? * 1 point

Mark only one oval.

A) Lateral plate mesoderm

B) Anterior condensation

C) Posterior condensation

D) Epimere

E) sclerotome

35. 35- Which of the following is a correct statement regarding the development * 1 point
of spinal cord ?

Mark only one oval.

A) Anterior horn cells are derived from the floor plate of the neural tube

B) Dorsal root of the spinal nerves are formed by the axonal outgrowth of the
dorsal sensory horn cells

C) Myelination of the spinal cord tracts is the function of the neural crest cells

D) Pyramidal tract develops from the mantle layer of the neural tube

E) Substaina gelatinosa are derived from the alar plate of the neural tube

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36. 36- A 28-year-old woman, notices a new mole on her back while changing * 1 point
clothes. Concerned about its irregular shape and color, Upon examination,
the dermatologist observes asymmetry, uneven borders, color variation, and
a diameter larger than a pencil eraser in the mole. which of the following
cells originate from the same derivative of the cells causing the pathology
clarified?

Mark only one oval.

A) Skull bones

B) Aortico-pulmonary septum of the heart.

C) Mesoderm

D) Sensory ganglia of the cranial nerves.

E) Enteric parasympathetic ganglia of the gut

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37. 37- 68-year-old man comes to the office due to difficulty performing normal * 1 point

day-to-day activities with his hands. He has had pain in his finger joints,
wrists, and knees for many years and has been taking over-the-counter
analgesics. The patient has been evaluated by doctors for "joint problems"
in the past but declined their treatment recommendations. He has smoked
a pack of cigarettes daily for 30 years. Vital signs are normal. Examination
findings of the patient's hands are shown in the image below.

Mark only one oval.

A) Calcific degeneration of the cartilage

B) Cartilage thinning and subchondral sclerosis

C) Synovial pannus formation

D) DNA/anti-DNA immune complex deposition

E) Uric acid crystal deposition

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38. 38- A 6 year old boy brought to the pediatrician by his mother and mentions * 1 point
her son history of 2 previous fractures despite minor trauma upon physical
examination , poor dentition , diminished auditory acuicity and clear
choroidal veins were Identified , which of the following sentences do match
with this boy diagnosis ?

Mark only one oval.

A) A defect in the dystrophin

B) A defect in the fibrilin

C) A defect in type I collagen

D) A defect in type II collagen

E) Paget's disease

39. 39- A 55 year old postmenopausal women seeks medical advie after noting * 1 point
high fracture rate in her wrist and hib despite minor trauma as well as height
shortening , Serum calcium , phosphorus , ALP and PTH were normal ,
which of the following factors is responsible for her bone softness?

Mark only one oval.

A) Low RANK/RANKL signaling

B) High senstivity to PTH

C) Low osteoprotegrin secretion

D) Low IL6 secretion

E) Low TNF secretion

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40. 40- A 10-year-old boy, presents with a history of frequent fractures and * 1 point
bone pain. His parents report that he often complains of feeling tired and
has difficulty seeing at night. Upon physical examination, the physician
notices that he has short stature and frontal bossing. X-rays reveal a
characteristic "bone within bone" appearance , blood work reveals
leukoerythblastmosis , which of the following do match the diagnosis of
this patient ?

Mark only one oval.

A) A defective type I collagen

B) High RANK/RANKL signaling

C) Abnormal Ruffled membrane

D) increased TNF secretion

E) Ewing sarcoma

41. 41- A 15-year-old boy presents to his pediatrician with pain in his right leg * 1 point

pain , a biopsy reveals a malignancy in the distal femur , He has a family

history of eye cancer , which of the following is most likely to be his
diagnosis ?

Mark only one oval.

A) Chondrosarcoma

B) Osteosarcoma

C) Ewing Sarcoma

D) Giant cell tumor

E) Osteochondroma

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42. 42- A 16-year-old boy, undergoes diagnostic tests after experiencing * 1 point
persistent pain and swelling in his left leg. His physician suspects bone
tumor based on clinical findings and orders laboratory investigations and x-
ray revealing onion-like appearnce. blood sample is analyzed, revealing
abnormal results indicative of this malignancy, Which translocation is
commonly associated with Ewing sarcoma, as evidenced by the abnormal
laboratory findings in the blood sample?

Mark only one oval.

A) Translocation t(9;22)

B) Translocation t(11;22)

C) Translocation t(14;18)

D) Translocation t(15;17)

E) none of the answers

43. 43- 25-year-old office worker, presents with a history of persistent pain in * 1 point
her right forearm. She describes the pain as intermittent, worse at night, and
partially relieved by OTC mediactions. Physical examination reveals
localized tenderness over the radial aspect of her forearm. X-rays show
radiolucent 1cm mass, which of the following is the most likely diagnosis?

Mark only one oval.

A) Osteochondroma

B) Osteoblastoma

C) Osteoid Osteoma

D) Chondrosarcoma

E) Osteoma

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44. 44- A 17-year-old male, presents to the clinic with complaints of persistent * 1 point

lower back pain that has been bothering her for several months. The pain is
described as dull and localized to the lumbar region and not relived by OTC
medications, On examination, there is tenderness over the spinous process
of the L4 vertebra, Which of the following sentences do match the diagnosis
?

Mark only one oval.

A) Diagnosis is Osteoid Osteoma

B) Diameter is more likely to be less than 1 inch

C) Cells involved in the tumor are chondrocytes

D) Radio opaque on x ray

E) Elevated ALP

Other:

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45. 45- A 60-year-old male, presents to the clinic with complaints of progressive * 1 point

pain and stiffness in his knees. He reports that the pain is worse after
prolonged periods of standing or walking and is relieved by rest. On
examination, there are crepitus and tenderness upon palpation of the knee
joints, along with limited range of motion. Radiographic evaluation reveals
joint space narrowing, osteophyte formation, and subchondral sclerosis ,
Which of the following statements is the most accurate regarding the
pathogenesis of the disease ?

Mark only one oval.

A) Autoimmune disease causing deposition of immune complexes and therefore

inflamed synovium

B) Osteopenia of subchondral bone develop in response to damaged cartilage

C) Damage to the Cartilage is due to increased metalloproteinases and decrease in

their inhibitors

D) The water content of the articular cartilage decrease early in the pathogenesis
of this disease

E) Prostaglandins induced by COX-1 are important mediators of inflammation in

the pathogenesis of this disease

46. 46- A 10-year-old girl, has been experiencing recurrent joint pain and * 1 point

swelling for the past few months. Her parents bring her to the pediatric
rheumatology clinic for evaluation. On examination, the pediatric
rheumatologist observes swelling and tenderness in multiple small and
large joints bilaterally, Which of the following is more likely to be positive in
this patient ?

Mark only one oval.

A) Antinuclear antibody

B) Rheumatoid factor

C) Anti-CCP

D) Anti-double-stranded DNA

E) All of the above

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47. 47- A 7-year-old boy, is brought to the pediatric clinic by his parents due to * 1 point

concerns about his delayed motor milestones and frequent falls. On

examination, he exhibits calf muscle hypertrophy, a positive Gower's sign,
and difficulty rising from the floor. Based on clinical findings and family
history, the pediatrician suspects Duchenne muscular dystrophy after
looking at the muscle biopsy below , At what approximate age do you
expect him to experience loss of ambulation?

Mark only one oval.

A) 8 years old

B) 9 Years old

C) 12 years old

D) 15 years old

E) 18 years old

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4/4/24, 8:54 PM MSK Formative Final Examination

48. 48- A 5-year-old boy, is brought to the pediatric clinic by his parents due to * 1 point
concerns about his delayed motor milestones and frequent falls. his parents
report that he struggles with activities such as running and climbing stairs
and appears to have weaker muscles compared to his peers. On
examination, he exhibits calf muscle hypertrophy and difficulty rising from
the floor, raising suspicion muscular dystrophy. However, a muscle biopsy is
performed to confirm the diagnosis, based on the history and the biopsy
taken from vastus lateralis , what's is the most likely diagnosis ?

Mark only one oval.

A) Autosomal dominant DMD

B) X-linked recessive BMD

C) X-linked recessive DMD

D) Autosomal dominant BMD

E) none of the above

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4/4/24, 8:54 PM MSK Formative Final Examination

49. 49- A 32 year old male presented to the ER with symptoms of CSF leak , * 1 point
Emergency physician instructed him to preform spinal tap , during the
procedure , the needle was inserted in the interspace between L3/L4 at the
subarachnoid space , Which of the following is the origin of the first
meningeal layer pierced during the procedure ?

Mark only one oval.

A) Cranial neural crest cells

B) Truncal neural crest cells

C) Endoderm

D) Mesoderm

E) Ectoderm

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4/4/24, 8:54 PM MSK Formative Final Examination

50. 50- A 37 year old pregnant women present to her gynecology physician as * 1 point

part of regular pregnancy follow-ups , Lab results reveals elevated alpha-

feto protein which do indicate a NTD , her physician tried to dig into her
history to find that she was diagnosed with a joint problem and she was
fairly adherent to her medication but forgot to B9 supplements prior to her
pregnancy , which of the following joint/Bone problems she was more likely
suffering from ?

Mark only one oval.

A) Osteoarthritis

B) Ankylosing Spondylitis

C) Rheumatoid Arthritis

D) Osteoporosis

E) Gout

51. 51- A 44-year-old patient was prescribed morphine after a severe injury. The * 1 point

analgesic effect is observed due to the inhibition of neuronal activity, Which

mechanism contributes to the reduced pain by morphine ?

Mark only one oval.

A) Presynaptic Increased calcium influx

B) Postsynaptic Decreased calcium influx

C) Presynaptic Enhancing cAMP production

D) Presynaptic Decreased K efflux

E) Postsynaptic Increased K efflux

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4/4/24, 8:54 PM MSK Formative Final Examination

52. 52- A 31 year old drunk man present to the ER department and appear to be * 1 point

visually upset , he mentions the intake of cardio protective medication with

a specific dose of 81mg that he is strictly adherent to , Which of the
following could be seen as a consequence of the dual intake of this med
with alcohol ?

Mark only one oval.

A) Nose bleeding

B) Whooping cough

C) Red skin discoloration

D) Melena

E) Pulmonary fibrosis

53. 53- A 65-year-old patient presents with post-surgery pain * 1 point

following a recent history of myocardial infarction. The physician is cautious

about choosing an analgesic due to the patient's cardiovascular history as
well as peptic ulcers. Which of the following analgesics is most appropriate
for this patient ?

Mark only one oval.

A) Morphine

B) Acetaminophen

C) Asprin

D) Naproxen

E) All of the above

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4/4/24, 8:54 PM MSK Formative Final Examination

54. 54- A 54-year-old male, diagnosed with osteoarthritis, is prescribed a COX-2 * 1 point
inhibitor for arthritis pain, 2 months later he presemts with elevated BP ,
What cardiovascular consideration makes COX-2 to elevate BP ?

Mark only one oval.

A) Increased risk of thromboxane-induced vasoconstriction

B) Suppression of prostacyclin-mediated vasodilation

C) Decrease platelet aggregation

D) Suppression of thromboxane-mediated vasoconstriction

E) Reduced risk of myocardial infarction

55. 55- A 33-year-old pregnant women who is suffering from Rheumatoid * 1 point

arthritis was prescribed a DMARD that is considered relatively safe , Which

of the following complication is this women more likely to exhibit in case of
overuse ?

Mark only one oval.

A) Pneumonia-like symptoms

B) Flu-like syndrome

C) Cirrhosis

D) Alopecia

E) Skin color change

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4/4/24, 8:54 PM MSK Formative Final Examination

56. 56-A 56-year-old patient with Rheumatoid Arthritis has been on long- term * 1 point
methotrexate therapy. Regular monitoring has shown stable liver function
tests, but the patient develops symptoms suggestive of interstitial lung
disease . Which of the following should have been Co-administered to avoid
mentioned complication ?

Mark only one oval.

A) Tetrahydro folic acid

B) Leflunomide

C) Folinic acid

D) Hydroxychloroquine

E) Nothing could have avoided the complication

57. 57- A 35-year-old patient undergoes general anesthesia for surgery. Shortly * 1 point
after administration, the patient exhibits symptoms of M.H, including
elevated body temperature, muscle rigidity, and metabolic acidosis. What is
the best initial management in this scenario?

Mark only one oval.

A) Administer Acetylcholinesterase inhibitors

B) Administer Non-depolarizing blockers

C) Administer Depolarizing blockers

D) Administer Presynaptic α2 receptors agonists

E) Administer Ryanodine receptors antagonist

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4/4/24, 8:54 PM MSK Formative Final Examination

58. 58- A 30-year-old patient undergoes surgery and is administered a * 1 point

depolarizing neuromuscular blocker for muscle relaxation. However, despite

the completion of the surgical procedure, the patient's muscle paralysis
persists longer than expected. What is the likely cause of the prolonged
effect of administered agent in this case ?

Mark only one oval.

A) Low pseudocholinesterase

B) Allergic reaction to succinylcholine

C) Excessive amount of acetylcholinesterase

D) Low amount of acetylcholinesterase

E) Elevated pseudocholinesterase

59. 59- A 59-year-old postmenopausal woman, is diagnosed with Paget's * 1 point

disease of bone after experiencing localized bone pain and deformities. Her
physician prescribe her pamidronate to help manage her symptoms and
prevent further bone complications. Which of the following clinical
conditions is not an approved use for pamidronate ?

Mark only one oval.

A) Paget's disease

B) Prevention and treatment of postmenopausal osteoporosis

C) Hypercalcemia

D) Rheumatoid arthritis

E) Treatment of bone metastases in malignancy

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4/4/24, 8:54 PM MSK Formative Final Examination

60. 60- A 60-year-old postmenopausal woman, visits her physician complaining * 1 point

of bone pain and fractures related to osteoporosis, she was unresponsive to

bisphosphonates and prescribed a medication derived from salmon that 3
months later caused rhinitis and a breast malignancy , which of the
following is true regarding the prescribed medication ?

Mark only one oval.

A) Targets receptor activator of nuclear factor kappa-B ligand

B) A recombinant form of a hormone consists of the 34 biologically active amino

acids

C) prescription higher the risk of venous thromboembolism

D) Most likely to be prescribed intranasally

E) Should be taken at least 30 minutes BEFORE meals or medications

61. 61- A 61-year-old woman, is diagnosed with severe osteoporosis after * 1 point

experiencing multiple fragility fractures. Her physician suggests teriparatide

after irresponsiveness to bisphosphonates , which of the following is true
regarding the mechanism of teriparatide ?

Mark only one oval.

A) Targets receptor activator of nuclear factor kappa-B ligand

B) By inhibiting osteoclast activity and bone resorption

C) By decreasing the attachment of osteoclasts to bone surfaces

D) By decreasing bone turnover and remodeling

E) By stimulating osteoblastic activity and bone formation

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4/4/24, 8:54 PM MSK Formative Final Examination

62. 62- A 35-year-old smoker, has been considering quitting smoking for a * 1 point

while. She is aware of the health risks associated with smoking but has
been struggling to quit despite several attempts in the past. Which stage of
change in the Transtheoretical Model best describes her current situation?

Mark only one oval.

A) Precontemplation

B) Contemplation

C) Preparation

D) Action

E) Maintenance

63. 63- A first year medical student, recently lost his girl friend in a tragic car * 1 point
accident last month. Since her passing, he has been experiencing
overwhelming feelings of sadness, longing, and disbelief as he also find it
difficult to focus in his studies. his appetite has decreased, and he struggles
to sleep at night, often waking up with a feeling of emptiness as he also
wear her jacket to the college to remind himself with her

Which of the following best describes the situation ?

Mark only one oval.

A) PTSD

B) Adjustment disorder

C) Generalized anxiety disorder

D) Bereavement Grief reaction

E) Pain Catastrophizing

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4/4/24, 8:54 PM MSK Formative Final Examination

64. 64- A 22-year-old individual who recently experienced a minor injury during * 1 point
Horse riding . However, his response to the pain goes beyond the physical
sensations, and he finds himself dwelling on the worst possible outcomes
and magnifying the severity of the injury , which components of the Pain
Catastrophizing Model are evident in his response?

Mark only one oval.

A) Magnification, Rumination, and Avoidance

B) Helplessness , Rumination, and Magnification

C) Minimization, Distraction, and Control

D) Catastrophe, Endurance, and Resilience

E) All of the above

65. 65 -A 33-year-old patient with a chronic condition consistently takes an * 1 point

extra dose of medication to "Race the pain", deviating from the prescribed
schedule. The patient sometimes skip doses as well. What factor related to
drug adherence is evident?

Mark only one oval.

A) Intentional non-adherence

B) Unintentional non-adherence

C) Non-conforming non-adherence

D) Non-persistence non-adherence

E) Non-fulfilment non adherence

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4/4/24, 8:54 PM MSK Formative Final Examination

66. 66-A 66-year-old, diagnosed with dementia, frequently forgets to take his * 1 point
prescribed medications. His memory impairment becomes a significant
barrier to adherence , Which of the following is the determinant for drug
non-adherence in this case ?

Mark only one oval.

A) Prescriber related

B) Patient related

C) Illness related

D) Access related

E) All of the above

67. 67- According to the shape of the muscle , Biceps Brachii is classified as : * 1 point

Mark only one oval.

A) Parallel

B) Fusiform

C) Convergent

D) Bipennate

E) Multipennate

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4/4/24, 8:54 PM MSK Formative Final Examination

68. 68- The body axis that the mini body is rotating around in the mini foosball * 1 point

game is parallel to which body plane?

Mark only one oval.

A) Sagittal plane

B) Paramedian plane

C) frontal plane

D) transverse plane

E) All of the above

69. 69- Which of the following joints is paired correctly with its type? * 1 point

Mark only one oval.

A) radioulnar joints . . . condyloid type of synovial joint

B) intercarpal joints . . . pivot type of synovial joints

C) metacarpophalangeal joints . . . ellipsoid type of synovial joints

D) interphalangeal joints . . . ellipsoid type of synovial joints

E) Epiphyseal joint . . . Synchondrosis type of cartlingous joints

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4/4/24, 8:54 PM MSK Formative Final Examination

70. 70- A 65-year-old man, presents to the orthopedic clinic with severe back * 1 point

pain following a fall. Imaging studies reveal a vertebral compression

fracture. During surgery to stabilize the fracture, the surgeon notices
abnormal bone tissue characterized by disorganized trabeculae and
irregularly arranged osteocytes, Which of the following best describes the
microscopic features observed in his bone tissue?

Mark only one oval.

A) Lamellar bone

B) Woven bone

C) Compact bone

D) Cancellous bone

E) Haversian bone

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4/4/24, 8:54 PM MSK Formative Final Examination

71. 71- A 43 year old patient experiences * 1 point

radiating pain and weakness in the left
leg after lifting a heavy object , MRI
shows a disk herniating , which causses
loss of cutaneous sensation in a certain
dermatome in the L.L , which letter
represents the affected dermatome ?

Mark only one oval.

A) H

B) I

C) E

D) F

E) D

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4/4/24, 8:54 PM MSK Formative Final Examination

72. 72-A 21-year-old male involved in a head-on collision car accident presents * 1 point
with severe neck pain. Imaging studies reveal a fracture-dislocation of the
cervical spine and the odontoid process of axis crushing the spinal cord , 3
hours later the patient passed away . Which ligament was most likely
injured in this scenario?

Mark only one oval.

A) Anterior Longitudinal Ligament

B) Posterior Longitudinal Ligament

C) Ligamentum flavum

D) Transverse ligament of Axis

E) Transverse Ligament of the Atlas

73. 73-In lumbar puncture, what is the correct sequence of structures that the * 1 point

needle passes through as it is advanced into the subarachnoid space to

withdraw CSF ?

Mark only one oval.

A) ligamentum flavum, interspinous ligament, supraspinous ligament,epidural

space.

B) Skin, subcutaneous tissue, supraspinous ligament, interspinous ligament, dura

mater,pia matter.

C) Skin, subcutaneous tissue, epidural space, ligamentum flavum, interspinous

ligament.

D) interspinous ligament, supraspinous ligament, dura mater, arachnoid mater,

subarachnoid space.

E) interspinous ligament, ligamentum flavum, epidural space, dura mater, arachnoid

mater.

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4/4/24, 8:54 PM MSK Formative Final Examination

74. 74- A 32-year-old male is involved in a fall where he lands on his back. * 1 point

Following the incident, he experiences severe back pain and neurological

symptoms. Radiological examination reveals a hemorrhage in the epidural
space. Which vertebral vein is most likely to be ruptured in this case ?

Mark only one oval.

A) Anterior Spinal Vein

B) Basivertebral Vein

C) Internal Vertebral Venous Plexus

D) External Vertebral Venous Plexus

E) Posterior Spinal Vein

75. 75- a 65-year-old man, presents to the clinic with complaints of difficulty * 1 point

walking and frequent falls. Upon examination, it is observed that he has a

stooped posture with forward flexion of the trunk and knees, and he takes
small, propulsive steps with reduced arm swing , Which of the following
best describes the gait pattern observed in this gait ?

Mark only one oval.

A) Weak Knee extensors

B) High steppage gait

C) Weak Gluteus maximus

D) Antalgic gait

E) Parkinsonian gait

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4/4/24, 8:54 PM MSK Formative Final Examination

76. 76- A 55-year-old woman, presents to the clinic with complaints of difficulty * 1 point

walking and standing. Upon examination, it is noted that she exhibits

anterior trunk bending during walking. All of the following statements are
true regarding her gait pattern except:

Mark only one oval.

A) Forward flexion of the trunk early in the stance phase.

B) Compensates for the weakness of the Rectus femoris

C) The line of ground reaction force passes behind the axis of the knee joint.

D) The reaction force passes in front of the axis of the knee

E) Subjects will keep one hand on the affected thigh while walking to stabilize the
knee.

77. 77- A 77 year old man presents to his physician with a bulge in his scrotum , * 1 point
he is diagnosed with inguinal hernia , On postoperative day he complains of
paresthesia of his scrotum region , Which nerve root contribute to the
affected nerve ?

Mark only one oval.

A) L1

B) L1,L2

C) L2,L3

D) L2,L3,L4

E) L4-S3

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4/4/24, 8:54 PM MSK Formative Final Examination

78. 78- A 5 year old child was involve in an accident that resulted in hip joint * 1 point
dislocation , imaging studies reveals avascular necrosis of left femoral head
, which of the following is true regarding the origin of the artery that caused
the avascular necrosis ?

Mark only one oval.

A) External iliac artery

B) Superior gluteal

C) Medial circumflex femoral

D) Posterior obturator

E) Anterior obturator

79. 79- A 25-year-old man presents to the ER following a dashboard motor * 1 point

vehicle accident He was sitting on the front seat when it collided head-on
with a truck. He felt a pain pop in his right hip. Radiological imaging
revealed posterior dislocation of the hip with fractured lip of the
acetabulum. Which of the following ligaments would likely be torn?

Mark only one oval.

A) iliofemoral

B) Pubofemoral

C) Ischiofemoral

D) Sacrospinous

E) Lacunar

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4/4/24, 8:54 PM MSK Formative Final Examination

80. 80- Following a sport injury to the knee region, a 17-year-old student is * 1 point

unable to prevent anterior displacement of the femur on the tibia when the
knee is flexed during stepping down stairs. Which of the following
ligaments is likely damaged ?

Mark only one oval.

A) ACL

B) PCL

C) MCL

D) LCL

E) All of the above

81. 81- Which of the following is true regarding the pathology clarified below ? * 1 point

Mark only one oval.

A) Pathology is Genu Varum

B) Angle of inclination is above 135 degrees

C) Pressure on the medial compartment of the knee

D) Rapture of medial collateral ligament

E)Angle of inclination is below 120 degrees

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4/4/24, 8:54 PM MSK Formative Final Examination

82. 82- A 31 year old football player present to the orthopedic clinic with chief * 1 point

complain of pain in his Right Knee , inability to pray on the floor and
instability of the joint during running down the stairs , footage of the injury
mechanism is clarified below , which of the following statements' is the
most accurate regarding the clinical condition & assessment of this patient
?

Mark only one oval.

A) McMurray's test will be positive for both menisci

B) Lateral collateral ligament is most likely to be damaged

C) We Suspect a positive MacMurray's test especially when the foot is Everted

D) Anterior drawer test will yield a negative result

E) We should palpate the joint line and look for the MTP medially

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4/4/24, 8:54 PM MSK Formative Final Examination

83. 83- A 40 year old male was brought to the ER with Ataxic gait that don't * 1 point

improve with vision , On examining the patellar jerk reflex the result was
positive for Cerebellar ataxia , Which of the following is true regarding the
nerve that carried the afferent impulses up to the CNS ?

Mark only one oval.

A) Obturator nerve

B) Has a RV of L4-S3

C) Deep peroneal nerve

D) nerve supplying psoas major

E) nerve supplying Iliacus

84. 84- A 24 year old male present to the ER with a gun-shot in his mid-thigh , * 1 point

During surgery ( the muscle that flexes Hib and knee) as the structures deep
to it were found to be damaged , Which of the following will be saved from
this injury ?

Mark only one oval.

A) Saphenous nerve

B) Femoral vein

C) Femoral artery

D) nerve to vastus medialis

E) profunda femoris

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4/4/24, 8:54 PM MSK Formative Final Examination

85. 85- A 35 year old male was involved in a gang fight and present with severe * 1 point

knee pain , imaging revealed fractured neck of the fibula , which of the
following statements do apply for this patient case ?

Mark only one oval.

A) Paresthesia on the sole of the foot

B) Inability to invert the foot

C) numbness on the dorsum of the foot

D) loss of sensation over the lateral border of the foot

E) Weakness during plantar flexion of the foot

86. 86- A first year medical student was demonstrating the procedure of * 1 point

Intramuscular injection during his OSCE exam and mentions that he is going
to inject the upper lateral quadrant to avoid hitting a nerve , Which of the
following is true regarding the procedure ?

Mark only one oval.

A) pierced muscle is supplied by a nerve with RV of L5,S1,S2

B) Student avoid hitting a nerve with a RV of L5-S3

C) pierced muscle is a powerful hip extensor

D) RV of the pierced muscle is L4-S1

E) pierced muscle insert into ITB

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4/4/24, 8:54 PM MSK Formative Final Examination

87. 87- A 44 year old male present to the ER with severe hip pain and restricted * 1 point

Range of motion , imaging studies revealed a fracture of the femur bone at

the site of trochanteric anastomosis , Which of the following muscles will
not exhibit dysfunction ?

Mark only one oval.

A) Gluteus maximus

B) Gluteus medius

C) Gluteus minimus

D) Obturator internus

E) Inferior gamelli

88. 88- A 43 year old man is unable to preform the movement clarified below , * 1 point

after involving in an accident , which of the following nerve(s) is damaged in

this patient ?

Mark only one oval.

A) Deep peroneal nerve

B) Superficial & Deep peroneal nerves

C) Deep peroneal nerve

D) Tibial & Deep peroneal nerves

E) medial & lateral plantar nerves

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4/4/24, 8:54 PM MSK Formative Final Examination

89. 89- A 32 year old female present with sensory lose over the first webbed * 1 point

space between first and second toe as well as weakened dorsiflexion , at

which layer are the affected muscles at the sole of the foot ?

Mark only one oval.

A) 1st layer

B) 2nd layer

C) 3rd layer

D) 4th layer

E) none of the above

90. 90- A 2 year old barefoot child steps on a broken bottle and severs a nerve * 1 point
and vessels on the medial side of the plantar surface of the foot. Which of
the following muscles of the foot will be saved ?

Mark only one oval.

A) Abductor hallucis

B) First lumbrical

C) Flexor hallucis brevis

D) Flexor digitorum accessories

E) Flexor digitorum brevis

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4/4/24, 8:54 PM MSK Formative Final Examination

91. 91- Referring to the attached image below , Which of the following best * 1 point

describes the nature of the post synaptic impulses in response to the

applied stimulus ?

Mark only one oval.

A) Twitch

B) Tetanus

C) Temporal summation

D) Spatial summation

E) Convergence

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4/4/24, 8:54 PM MSK Formative Final Examination

92. 92- A physiology experiment is conducted in which a motor neuron that * 1 point
normally innervates a predominantly fast type II muscle is anastomosed to
a predominantly slow type I muscle. Which of the following is most likely to
decrease in the type I muscle after the reinnervation surgery?

Mark only one oval.

A) Fiber diameter

B) Glycolytic activity

C) Maximum contraction velocity

D) Mitochondrial content

E) Myosin ATPase activity

93. 93- A 63-year-old man and known alcoholic has been unable to afford * 1 point
alcohol. He now presents with hypertension and profuse sweating, During
the examination, he loses consciousness and begins to seize on the
stretcher. The seizure-induced muscle contractions result in which of the
following changes in length within each sarcomere?

Mark only one oval.

A) Lengthening of A band; no change in H band; shortening of I band

B) No change in A band; lengthening of H band; lengthening of I band

C) No change in A band; shortening of H band; shortening of I band

D) Shortening of A band; no change in H band; shortening of I band

E) Shortening of A band; shortening of H band; no change in I band

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4/4/24, 8:54 PM MSK Formative Final Examination

94. 94- A 17-year-old soccer player sustained a fracture to the left tibia. After * 1 point
her lower leg has been in a cast for 8 weeks, she is surprised to find that the
left gastrocnemius muscle is significantly smaller in circumference than it
was before the fracture. What is the most likely explanation?

Mark only one oval.

A) Decrease in the number of individual muscle fibers in the left gastrocnemius

B) Decrease in blood flow to the muscle caused by constriction from the cast

C) Temporary reduction in actin and myosin protein synthesis

D) Increase in glycolytic activity in the affected muscle

E) Progressive denervation

95. 95- A 55-year-old patient presents with complaints of occasional * 1 point

unsteadiness and difficulty maintaining balance, particularly when standing

with feet close together and eyes closed. The physician suspects sensory
ataxia and decides to perform a Romberg test, Which function(s) is not
working during Romberg test of this patient ?

Mark only one oval.

A) Visual system

B) Dorsal column medial lemniscus pathway

C) Vestibular

D) Vestibular and visual

E) Vestibular and DCML

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4/4/24, 8:54 PM MSK Formative Final Examination

96. 96- In a postgraduate research on measuring nerve conduction velocity , 5 * 1 point

nerves of 2 types were tested ,were A fibers is surrounded by myelin like

substance , knowing that the diameters was as the following : A1-2mm, A2-
3mm,B1-2mm,B2-4mm,B3-7mm, Which of the following fibers will exhibit
fastest nerve conduction velocity ?

Mark only one oval.

A) A1

B) A2

C) B1

D) B2

E) B3

97. 97- Vibratory sensation depends on the detection of rapidly changing, * 1 point
repetitive sensations. The high-frequency end of the repetitive stimulation
scale is detected by which structure ?

Mark only one oval.

A) Merkel discs

B) Meissner corpuscles

C) Pacinian corpuscles

D) Free nerve endings

E) All of the answers

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4/4/24, 8:54 PM MSK Formative Final Examination

98. 98- A 24-year-old tennis player is suffering from anterior shoulder pain just * 1 point

below the acromion. The patient is not able to raise the arm overhead and
reports pain associated with shoulder abduction. X-rays showed no signs of
structural changes around the shoulder but only revealed calcifications
around the rotator cuff tendon.The most sensitive clinical test to confirm a
diagnosis for this case is ?

Mark only one oval.

A) Jobe

B) Neer

C) Biceps load I

D) Hawkins Kennedy

E) Apprehension

99. 99- A 22 year old male present with painful shoulder , restricted active ROM * 1 point
and a passive ROM that exceed the active one , which of the following
represent the net movement of the humerus in this case ?

Mark only one oval.

A) 1.5 mm up

B) 3.00 mm up

C) 1.5 mm down

D) 3.00 mm down

E) 0.00 mm

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4/4/24, 8:54 PM MSK Formative Final Examination

100. 100- A 50-year-old individual with osteoarthritis of the knee seeks * 1 point

treatment to alleviate pain and improve joint function. Which type of

strengthening exercise would be most beneficial for this patient to
strengthen the quadriceps muscles without exacerbating joint friction?

Mark only one oval.

A) Isometrics

B) Concentric isotonics

C) Eccentric isotonics

D) Static

E) Isokinetic

101. 101- A 45-year-old construction worker complains of shoulder pain, * 1 point

particularly during overhead activities. On examination, there is evidence

of subacromial impingement syndrome. Which of the following treatments
would be most effective in reducing inflammation and pain in this patient's
shoulder ?

Mark only one oval.

A) Continues Ultra sound

B) Ice therapy for 12 minutes daily

C) Pulsed Ultra sound

D) Isometric strengthening exercises

E) TENS

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4/4/24, 8:54 PM MSK Formative Final Examination

102. 102- A 60-year-old patient is recovering from a hip fracture and has been * 1 point

bedridden for several weeks. The physical therapist wants to implement a

treatment plan to prevent muscle wasting and improve circulation in the
lower extremities. Which type of electrical stimulation would be most
suitable for this patient?

Mark only one oval.

A) TENS

B) Faradaic current

C) Russian currents

D) Diathermia

E) US

103. 103- A 40-year-old individual experiences chronic low back pain * 1 point

exacerbated by prolonged standing. Physical examination reveals

tightness in the paraspinal muscles . Which therapeutic modality would be
most effective in alleviating muscle tension and improving flexibility in this
patient?

Mark only one oval.

A) Quick stretching

B) Isometric strengthening exercises

C) Traction therapy

D) Ballistic stretching of the erector spinae muscles

E) Sustained stretching of the Trapezius muscles

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4/4/24, 8:54 PM MSK Formative Final Examination

104. 104- A 16-year-old high school athlete presents to the emergency * 1 point

department with complaints of severe pain and swelling in the left ankle
following a fall during a basketball game. On examination, there is
tenderness and swelling over the medial aspect of the left ankle,
emergency physician suspected a fracture to the tibia ,X-ray imaging
reveals a well-defined, lucent lesion with a sclerotic border in the distal
tibia. The lesion does not show signs of fracture, Bone tumor was detected
by mistake. What is the most likely diagnosis based on these findings?

Mark only one oval.

A) Osteosarcoma

B) Ewing sarcoma

C) Giant cell tumor

D) Osteochondroma

E) Non ossifying fibroma

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4/4/24, 8:54 PM MSK Formative Final Examination

105. 105- A 38-year-old , presents to her primary care physician with * 1 point

complaints of pain and swelling on the thumb side of her wrist. She
mentions that the pain worsens with activities involving gripping or
pinching motions. Upon examination, there is tenderness and swelling over
the radial styloid process , Which test should be performed to confirm her
diagnosis ?

Mark only one oval.

A) Phalen's Test

B) Tinel's Sign

C) Finkelstein's Test

D) Allen's Test

E) Grind Test

106. 106- A 55-year-old man, presents to the emergency department * 1 point

complaining of sudden onset weakness and numbness in both legs. He

reports difficulty walking and bladder dysfunction. Upon examination, the
physician notes decreased sensation in the saddle area, loss of anal
sphincter tone, and bilateral lower extremity weakness, with intact upper
extremity strength. patient also mentions recent back pain and a history of
trauma due to a fall from a ladder.

What is the most likely cause of his symptoms?

Mark only one oval.

A) Lumbar Disc Herniation

B) Spinal Stenosis

C) Cauda Equina Syndrome

D) Sciatica

E) Multiple Sclerosis

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4/4/24, 8:54 PM MSK Formative Final Examination

107. 107- a 40-year-old athlete, sustains a fractured patella and requires * 1 point

surgical intervention. Which method of maintaining reduction is commonly

used for a fractured patella ?

Mark only one oval.

A) External fixator

B) Surface traction

C) Intramedullary nail

D) Plates and screws

E) Kirschner wires

108. 108- While assessing tendon reflexes, you observe clonus in the patient's * 1 point

upper limb. What grade of reflex response does clonus typically represent,
and which type of neurological lesion is commonly associated with it ?

Mark only one oval.

A) Grade 1+; lower motor neuron lesion

B) Grade 2+; upper motor neuron lesion

C) Grade 3+; lower motor neuron lesion

D) Grade 4+; upper motor neuron lesion

E) Grade 5+; extrapyramidal lesion

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4/4/24, 8:54 PM MSK Formative Final Examination

109. 109- While examining a patient, you observe involuntary twitches over a * 1 point
muscle belly at rest. Tapping on the muscle belly further stimulates these
twitches. What term describes this finding, and which neurological
condition is commonly associated with it?

Mark only one oval.

A) Fasciculations; upper motor neuron lesion

B) Fasciculations; lower motor neuron lesion

C) Clonus; upper motor neuron lesion

D) Clonus; lower motor neuron lesion

E) Rigidity; extrapyramidal lesion

110. 110- Which test is used to assess coordination in the lower limbs and * 1 point
confirm the diagnosis of ipsilateral cerebellar lesion ?

Mark only one oval.

A) Finger-nose test

B) Romberg's test

C) Heel-to-shin test

D) Tandem walking

E) All of the following

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4/4/24, 8:54 PM MSK Formative Final Examination

111. 111- 18 YEARS OLD MALE PATIENT WITH HISTORY OF TRAUMA , which of the * 1 point
following is the most likely diagnosis ?

Mark only one oval.

A) Buckle fracture at the distal side of first metacarpal

B) transverse fracture of the scaphoid

C) Hairline fracture of the 2nd metacarpal

D) Avulsion fracture of the middle phalanx 3rd finger

E) Normal study

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4/4/24, 8:54 PM MSK Formative Final Examination

112. 112- 55 YEARS OLD PATIENT WITH HISTORY OF TRAUMA TO THE * 1 point

SHOULDER , Which of the following is the most likely diagnosis ?

Mark only one oval.

A) Anterior shoulder dislocation

B) Posterior shoulder dislocation

C) Scapula comminuted fracture

D) Clavicle mid-shaft fracture

E) 8th rib ftacture

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4/4/24, 8:54 PM MSK Formative Final Examination

113. 113- 35 YEARS OLD MALE PATIENT WITH HISTORY OF FALL DOWN AND * 1 point

LT SHOULDER PAIN AND DECREASES ROM , Which of the following is the

most likely diagnosis ?

Mark only one oval.

A) Anterior shoulder dislocation

B) Posterior shoulder dislocation

C) Acromioclavicular joint separation

D) Clavicle mid-shaft fracture

E) None of the above

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4/4/24, 8:54 PM MSK Formative Final Examination

114. 114- 43 YEARS OLD MALE PATIENT WITH BILATERAL HIP PAIN , which of * 1 point

the following is the most likely diagnosis ?

Mark only one oval.

A) Bilateral Acetabulum fracture

B) Bilateral Avascular necrosis

C) Bilateral intertrochanteric fracture

D) Bilateral hip joint effusion

E) None of the above

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4/4/24, 8:54 PM MSK Formative Final Examination

115. 115- A 99 year old patient present with left hip pain after falling down , which of * 1 point

the following is the most likely diagnosis based on the MRI below ?

Mark only one oval.

A) Avascular necrosis of the left femoral head

B) left Hip joint effusion

C) Sub capital fracture of the left hip

D) Intertrochanteric anastomosis of the left hip

E) Normal study

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