Orthopedics Long Examination 1. Dr.

jess Belocura
EXAMINATION PROPER

In which of the following bone injuries, the bone is not actually broken.

A. simple fracture
B. CONTUSSION
C. multiple
D. hairline fracture

Reorganize the following steps that happen during bone healing. I. weight bearing -
cartilaginous callus formation II. weight bearing - granular tissue formation III.
remodelling to original bone contour IV. lamellar bone deposition V. formation of
blood clot and inflamation

A. V, I, III, IV, II
B. V, II, I, IV, III
C. IV, III, I, II, V
D. I,II,IV, V III

In medical terminology, what is the difference between Superior & Inferior and
Cranial & Caudal?

A. Superior & Inferior is used for animals while Cranial & Caudal is used for plants
B. Superior & Inferior is for large structures while Cranial & Caudal is for those in and
around the brain and tail
C. No difference
D. SUPERIOR & INFERIOR IS USED FOR HUMANS WHILE CRANIAL &
CAUDAL IS USED FOR ANIMALS

A. frontal
B. central
C. parallel
D. LATERAL

Proximal stands for away from the root of the structure while distal stands for
towards the root of the structure.

a. true
b. FALSE

A. DEEP
B. superficial
C. internal
D. external

In the diagram below, the red line cuts the body in which section?

A. Coronal
B. SAGITTAL
C. Horizontal
D. Para Sagittal

movement will take the humerus away from the radius and ulna?

A. deflection
B. reflexion
C. abduction
D. EXTENSION

The difference between rotation and circumduction is __________

A. ROTATION IS THE CIRCULAR MOVEMENT ALONG THE SAGITTAL AXIS OF

THE BODY WHILE CIRCUMDUCTION IS THE CONICAL MOVEMENT OF THE
BODY AROUND THE SAGITTAL AXIS OF THE BODY
B. circumduction is any circular movement while rotation is circular movement
around something
C. rotation is any circular movement while circumduction is circular movement
around something
D. circumduction is the circular movement along the sagittal axis of the body while
rotation is the conical movement of the body around the sagittal axis of the body
The reason why people have joint pain in old age is because _____________

A. the bones become weak

B. the blood supply to the joints reduces
C. the bones become too strong
D. THE CHONDROCYTES IN ARTICULAR CARTILAGE BECOME LESSER IN
NUMBER

Which of these is a multi-axial joint?

A. thumb joint
B. ball and Socket joint
C. shoulder joint
D. elbow joint

In a synovial joint, the bones are connected to each other.

A. TRUE
B. False

Label the diagram.

A. 1 Hyaline Cartilage, 2 Fibrous Capsule, 3 Periosteum, 4 Synovial Cavity, 5

Synovial Capsule
B. 1 Hyaline Cartilage, 2 Fibrous Capsule, 3 Synovial Cavity, 4 Periosteum, 5
Synovial Capsule
C. 1 PERIOSTEUM, 2 FIBROUS CAPSULE, 3 HYALINE CARTILAGE, 4
SYNOVIAL CAVITY, 5 SYNOVIAL CAPSULE
D. 1 Periosteum, 2 Fibrous Capsule, 3 Synovial Cavity, 4 Hyaline Cartilage, 5
Synovial Capsule
E.
Radionucleide bone scanning is most useful in:

A. Rheumatoid arthritis
B. Acute osteomyelitis.
C. MALIGNANCY
D. Avascular necrosis
E. Stress fractures

What is the earliest indication of Volkmann's ischaemia:

A. PAIN
B. Gnagrene of tips of fingers
C. Contracture of fingers
D. Paraesthesia in median nerve area
E. Pallor and poor capillary filling

First treatment priority in patient with multiple injuries is:

A. Circulatory volume restoration

B. Reduction of dislocation.
C. Bleeding control
D. AIRWAY MAINTENANCE
E. Splinting of fractures

Commonest cause of failure of internal fixation is:

A. INFECTION
B. Immune deficient patient
C. Corrosion
D. Stress fracture of implant.
E. Metal reaction

Death, 3 days after pelvic fracture is most likely to be due to:

A. Infection.
B. Pulmonary embolism
C. FAT EMBOLISM
D. Haemorrhage
E. Respiratory distress

Internal fixation of fracture is contraindicated in which situation:

A. In compound fracture
B. In epiphyseal injuries
C. When bone gap is present
D. ACTIVE INFECTION
E.

In few days old fracture which of the following does not occur:

A. Capillary proliferation
B. There is very little rise in level of alkaline phosphatase at fracture site.
C. LOCAL PH IS ALKALINE
D. Proliferation of osteogenic cells over endosteum and bone ends
E. Local pH is acid

In a healing fracture, amount of cartilage formation is increased by:

A. Infection.
B. Necrosis of bone ends
C. Compression plating
D. Rigid immobilization
E. MOVEMENT AT FRACTURE SITE

What is the second most important aspect in the treatment of fractures of long
bones?

A. Adequate nutrition of patient

B. Accurate anatomical reduction
C. Antibiotics.
D. Restoration of bone alignment
E. IMMOBILIZATION

Which deformity in malunited fracture is most likely to correct with remodelling?;

A. Shortening of bone length.

B. Angular deformity near end of bone when angulation is in a plane 90° to the plane
of motion of nearby joint
C. Angular deformity in the middle of diaphysis in the plane of motion of nearby joint
D. Rotational malalignment
E. ANGULAR DEFORMITY IN PLANE OF MOTION OF NEARBY JOINT WHEN
DEFORMITY IS IN METAPHYSEAL AREA

External fixator is not indicated in:

A. SIMPLE CLOSED FRACTURE OF HUMERAL SHAFT

B. Infected fractures
C. Fracture associated with severe soft tissue damage
D. Fracture associated with burns.
E. Comminuted fracture
A patient develops compartment syndrome (swelling, painand numbness) following
manipulation and plaster for fracture of both bones of leg. What is the best
treatment?:

A. Split the plaster

B. DO OPERATIVE DECOMPRESSION OF FACIAL COMPARTMENT.
C. Elevate the leg after splitting the plaster
D. Infusion of low molecular weight dextran
E. Elevate the leg

First hint of a bone tumor's presence

A. palpable mass
B. none of the above
C. PATHOLOGIC FRACTURE
D. pain and tenderness

malignant tumor in which the cancerous cells produce osteoid matrix or mineralized
bone

A. enchodroma
B. OSTEOSARCOMA
C. osteoma
D. osteoblastoma

Site of development of osteochondroma

A. localized pain, usually at night and relieved by NSAIDS

B. Epiphysis of long bone specially around the knee
C. based on mitotic activity, atypia, and necrosis present in tumor
D. DEVELOP ONLY IN BONES WITH ENCHODRAL ORIGIN

most common benign bone tumor

A. osteosarcoma
B. enchondroma
C. OSTEOCHONDROMA
D. hematopoetic

most common hematopoietic bone tumor

A. Pathologic fracture
B. multiple enchondromas
C. Ollier syndrome
D. MULTIPLE MYELOMA

have pleomorphic nuclei (osteosarcoma)

A. PATHOLOGIC FRACTURES
B. Giant cell osteosarcoma
C. craniofacial skeleton
D. presence of ifiltrative margins

Account for the majority of primary bone tumors characterized by formation of

hyaline and myxoid cartilage

A. Telangiectatic
B. CARTILAGE FORMING TUMORS
C. Enchondroma
D. Giant cell osteosarcoma

craniofacial skeleton

A. true
B. FALSE

A. true
B. FALSE

-white, mimicking normal

boneNidus is well-demarcatedDark red and gritty and is surrounded by dense
sclerotic bone usually less than 2 cm

A. TRUE
B. false

A. TRUE
B. False

Which part of a joint does osteoarthritis usually affect?

A. All of the above

B. Tendon
C. CARTILAGE
D. Bone
Which of these makes it more likely to get osteoarthritis?

A. Back pain
B. None of the above
C. Young age
D. EXCESS BODY WEIGHT
E. Too little body weight

When a person gets osteoarthritis of the hip, where else might the pain show up?

A. Feet
B. Shoulders
C. GROIN
D. Arm
E. All of the above

How can an X-ray help a healthcare provider diagnose osteoarthritis?

A. It can show bone spurs

B. It can show cartilage loss
C. It can show bone damage
D. ALL OF THE ABOVE

Which of these medicines is used to treat osteoarthritis?

A. Aspirin
B. Acetaminophen
C. Corticosteroid injections
D. ALL OF THE ABOVE

Which of the following is a pro-inflammatory cytokine?

A. IL-10
B. Serum amyloid precursor protein
C. CRP
D. interleukin 4 (IL-4)
E. TUMOUR NECROSIS FACTOR-ALPHA

A 72-year-old man presents with an acutely painful right knee. On examination, he

had a temperature of 37 degree C with a hot, swollen right knee. Of relevance
knee X-ray revealed reduced joint space and calcification of the articular cartilage.
Culture of aspirated fluid revealed no growth. What is the most likely diagnosis?

A. Gout
B. Septic arthritis
C. PSEUDOGOUT
D. Psoriatic monoarthropathy
E. Rheumatoid arthiritis

A 69-year-old woman taking hydralazine for hypertension presents with joint pain
and chest pain. On cardiac examination, the patient has a pericardial rub. What is
the diagnosis?

A. SLE
B. Polymyalgia rheumatic
C. Dermatomyositis
D. Felty syndrome

A 64 year old man with a 15 year history of seropositive polyarticular rheumatoid

arthritis is currently treated with prednisolone 5 mg daily and methotrexate 12.5 mg
weekly. He is diabetic and treated with oral hypoglycaemic drugs. For the past three
weeks his right knee has become progressively painful. Examination shows warm
synovitis and obvious knee effusion in the right knee with stress pain. The left knee
shows no synovitis. The other affected joints in his hands, wrists, elbows, and
forefeet show some minor abnormalities but no synovitis. Which of the following
would you do at that clinic visit?

A. Aspirate and inject the right knee with steroid.

B. Undertake an x ray examination of the knee.
C. Increase methotrexate to 15 mg weekly and offer the patient a steroid injection
into the knee.
D. ADMIT THE PATIENT STRAIGHT TO THE WARD.
E. take blood for C reactive protein, full blood count, erythrocyte sedimentation rate,
and await results until the next clinic appointment.

What type of arthritis do you have if the lining of the joint becomes inflamed?

A. Traumatic arthritis
B. Psoriatic arthritis
C. osteoarthritis
D. RHEUMATOID ARTHRITIS

Rheumatic arthritis is an inherited disease. This statement is

A. TRUE
B. False
Osteoarthritis, characterized by breakdown of cartilage, is associated with aging
alone

A. True
B. FALSE

Spondylitis is a type of

A. OSTEOARTHRITIS
B. Rheumatoid arthritis
C. Psoriatic arthritis
D. none of the above

Your child may have juvenile arthritis if s/he complains of -

A. Pain and stiffness in the joint

B. Swelling and redness of the skin
C. Fever along with fatigue
D. ALL OF THE ABOVE

Arthritis related pain and disability can be prevented or reduced by

A. Early diagnosis
B. Physiotherapy and occupational therapy
C. Weight control and physical activity
D. ALL OF THE ABOVE

Accupuncture cn relieve pain and stiffness in arthritis

A. TRUE
B. false

Lifestyle goals to complement your arthritis treatment, should include

A. A HEALTHY DIET, RGULAR PHYSICAL ACTIVITY, 8-10 HRS OF SLEEP, AND

STRESS REDUCTION
B. Jogging regularly, avoiding fruits and vegetables, and sleeping for 8-10 hrs a day
C. Heavy exercising, meditation, and minimal food cosumption

Depression can worsen arthritic pain in older people

A. TRUE
B. False
How can an X-ray help a healthcare provider diagnose osteoarthritis?

A. It can show cartilage loss

B. It can show bone damage
C. It can show bone spurs
D. ALL OF THE ABOVE

Surgery can sometimes be done to treat arthritis.

A. TRUE
B. False

When a person gets osteoarthritis of the hip, where else might the pain show up?

A. Arm
B. GROIN
C. Feet
D. Shoulders
E. All of the above

The term arthritis refers to stiffness in the joints.

A. True
B. FALSE

What are early signs and symptoms of rheumatoid arthritis (RA)?

A. Joint pain, tenderness, redness and swelling

B. Loss of joint range of motion
C. Limping
D. ALL OF THE ABOVE

A. Generally occurs above the waist

B. occurs below the waist
C. IS SYMMETRICAL AFFECTING BOTH RIGHT AND LEFT SIDES OF THE
BODY
D. It is more painful than other forms

A. Men
B. WOMEN
People with rheumatoid arthritis experience the most stiffness at night.

A. true
B. FALSE

Surgery is the only way to treat RA.

A. True
B. FALSE

Rheumatoid arthritis can be cured if diagnosed and treated early.

A. True
B. FALSE

A. FLARE
B. Burst
C. outbreak
D. Eruption

With rheumatoid arthritis, deformity of the joints is caused by chronic inflammation.

A. TRUE
B. False

A 13-year-old otherwise healthy patient who develops osteomyelitis most likely

would have the infection in which bone?

A. Mandible
B. TIBIA
C. Sternum
D. Vertebra

How long should a patient with acute S. aureus osteomyelitis optimally be treated?

A. 3 weeks of high-dose injectable cefazolin therapy

B. 4 weeks of oral ciprofloxacin therapy
C. 4 TO 6 WEEKS OF INJECTABLE CEFTRIAXONE THERAPY
D. 4 weeks of oral dicloxacillin therapy
The most important therapeutic interventions for infectious arthritis are

A. culture and sensitivity analysis along with 3 weeks of intravenous antibiotics.

B. passive range-of-motion exercises and high-dose antibiotics.
C. surgical debridement and optimal antibiotic selection.
D. APPROPRIATE ANTIBIOTICS, JOINT DRAINAGE, AND JOINT REST.

Which of the following would be a clinical cure of acute osteomyelitis?

A. NO CLINICAL SYMPTOMS AND A NORMAL ERYTHROCYTE

SEDIMENTATION RATE AFTER 4 TO 6 WEEKS OF ANTIBIOTICS
B. No involucrum present in the infected area
C. Completion of a 6-week course of intravenous antibiotics
D. Resolution of bone pain and a normal WBC count

Which of the following terms is inaproppriate for the condition of osteomyelitis

A. Sequestrum
B. MYELOCOELE
C. Cloacae
D. Involucrum

The most common cause of monoarthritis in children

A. SEPTIC ARTHRITIS
B. Any of the above
C. Rheumatoid arthritis
D. Tuberculous arthritis

Tuberculosis of the spine is known as

A. Perthe's disease
B. Sheurmann's disease
C. Frieberg disease
D. POTT'S DISEASE

Ostietis fibrosa cystica is see in

A. Hypoparathyroidism
B. Hypothyroidism
C. HYPERPARATHYROIDISM
D. hyperthyroidism

Complications of Paget's disease

A. Osteosarcoma
B. heart failure
C. deafness
D. ALL OF THE ABOVE

Which of the following is seen in congenital dislocation of the hip?

A. Shenton's line is broken

B. TRENDELENBERG TEST POSITIVE
C. waddling gait
D. Allis test positive

Treatment of CETV should begin

A. SOON AFTER BIRTH

B. After discharge from the hospital
C. After 1 month
D. At 6 mos

Most important pathology in club foot

A. tightening of tendoachilles
B. CONGENITAL TALO NAVICULAR DISLOCATION
C. Calcaneal fracture
D. lateral derangement

Phocomelia is best described as :

A. Defect in the development of flat bones

B. Defect of intramembranous ossification
C. Defect of cartilage replacement by bone
D. DEFECT IN THE DEVELOPMENT OF LONG BONES

The most common cause of genu valgum in children is

A. paget's disease
B. RICKETS
C. Rheumatoid arthritis
D. Osteoarthritis

Barlow's sign isrelated to the diagnosis of

A. Ulnar nerve palsy

B. Genu varum
C. Talipes equinovarus
D. CONGENITAL HIP DISLOCATION

Sprengel's shoulder is due a deformity in

A. Proximal humerus
B. Clavicle
C. SCAPULA
D. Sternum

Multiple fracture in a new born is seen in

A. Syphilis
B. OSTEOGENESIS IMPERFECTA
C. Morquio's syndrome
D. Scurvy

Shepherd's crook deformity is seen in

A. Hypothyroidism
B. Gaucher's disease
C. Achondroplasia
D. FIBROUS DYSPLASIA

Wormian bones are seen in

A. Sheurmann's disease
B. Paget's disease
C. OSTEOGENESIS IMPERFECTA
D. Osteoclastoma

Spina bifida Oculta is

A. Congenital fussion of the body of the vertebra

B. CONGENITAL NON-FUSSION OF THE SPINAL LAMINA
C. Infection of the spine
D. Traumatic fracture of the spine

Congenital pseudoarthrosis is seen in the following

A. Femur
B. TIBIA FIBULA
C. Hip Joint
D. Radius ulna
Most common site of eosinophilic granuloma

A. mandible
B. radius
C. Skull
D. FEMUR

Vitamin require for collagen synthesis is

A. Vit E
B. Vit d
C. VIT C
D. Vit A

Multiple osteolytic lessions in a 2 year old child's skull and long bones are due to

A. Neuroblastoma
B. Multiple myeloma
C. histiocytosis- x
D. WILM'S TUMOR
E. Thalasemia major

Bamboo spine is seen in

A. ANKYLOSIS SPONDYLOSIS
B. tuberculosis
C. Ochronosis
D. rheumatoid arthritis

Swan neck deformity is a feature of

A. Syphilis
B. Osteoarthritis
C. RHEUMATOID ARTHRITIS
D. Gouty arthritis