Orthopedic

·      Fractures 

1.    General Fracture Complications.

???) All of the following are causes of non-union of fracture, except:

A.    Poor blood supply at the fracture site

B.     Infection

C.     Excessive movement at the fracture site,  incomplete immobilization

D.    Interposition of soft tissue

E.     Very young age group

Answer: 5* Very young age group

·      Shoulder 

1.    Shoulder Dislocation.

???) Regarding post-traumatic dislocation of the shoulder joint, one is correct:

A.    Anterior dislocation is uncommon

B.     Posterior dislocation could be the result of electric shock injury

C.     Axillary nerve is injured in almost 90% of cases

D.    Open reduction is done immediately after the injury

E.     Recurrent dislocation usually occurs in the elderly

Answer: 2* Posterior dislocation could be the result of electric shock injury

???) In a patient with anterior dislocation of the shoulder, the nerve likely to be injured is:

Radial

Median

Axillary (circumflex)

Ulnar

Musculocutaneous

Answer: C* Axillary (circumflex)

·      Humerus 

1.    Humeral Shaft Fracture.

???) In fractured middle third of humeral shaft the structure most liable to be injured is:

A.    Radial nerve

B.     Brachial nerve

C.     Axillary nerve

D.    Median nerve

E.     Ulnar nerve

Answer: 1* Radial nerve

???) Wrist drop is a known complication of:

Elbow dislocation

Wrist fracture

Shoulder dislocation

Fracture Humerus middle third

Fracture Humerus upper third

Answer: 4* Fracture Humerus middle third

·      Wrist 

1.    Calles' Fracture.

???) Which of the following bones is involved in Colles  fracture:

A.    Femur

B.     Lumbar vertebrae

C.     Humerus

D.    Distal end of the radius

E.     Tibia and fibula

Answer: 4* Distal end of the radius

·      Spine 

1.    Spine Disorders.

***) All of the following can cause back pain, except:

A.    Tuberculosis

B.     Multiple myeloma

C.     Spinal tumor

D.    Ankylosing spondylitis

E.     Polymyalgia rheumatica

Answer: C* Spinal tumor

·      Hip  

1.    Hip Dislocation.

???) In recurrent dislocation of the hip joint all of the following true, except:

A.    It is commonly anterior dislocation

B.     It usually occurs m the elderly

C.     There is usual stripping in the capsule and labrum

D.    Apprehension test is positive

E.     Minor trauma may lead to this dislocation

Answer: 1* It is commonly anterior dislocation

???) One of the following statements about congenital hip dislocation is correct:

Normal findings on examination of the newborn infant exclude the diagnosis of CDH

Hip X-ray is usually diagnostic in the newborn

CDH is inherited as a multifactorial trait

Treatment of CDH with casts has no harmful side effects

None of the above

Answer: 3* CDH is inherited as a multifactorial trait

???) All of the following are signs of congenital hip dislocation, except:

Interrupted Shenton's line

Hip click

Full abduction during hip examination

Limbing

Dysplastic acetabulum

Answer: 3* Full abduction during hip examination

???) The commonest congenital skeletal anomaly in Arabs is:

Congenital absence of radius

Congenital deficiency of the hip joint

Congenital dislocation of the hip joint

Congenital torticollis

Congenital coxa vara

Answer: 3* Congenital dislocation of the hip joint

???) Concerning congenital dislocation of the hip (CDH) all of the following are correct, except:

It is a familial disease

It occurs more in girls

It may be unilateral or bilateral

The condition can be detected clinically at birth

Treatment should start when the child is at least two years old

Answer: 5* Treatment should start when the child is at least two years old

·      Femur 

1.    Femoral Diaphysis Fracture.

???) The method of choice of treatment of closed oblique fracture of the shaft of femur in a child is:

A.    Skin traction

B.     Skeletal traction

C.     Open reduction and internal fixation

D.    External fixation

E.     Closed reduction and immediate plaster of paris cast

Answer: 1* Skin traction

2.    Distal Femoral Fracture.

???) In femoral neck fractures all of the following are true, except:

A.    Avascular necrosis of the femoral head is fortunately uncommon

B.     Clinically there is external rotation of the affected limb

C.     Non-union is not rare

D.    Internal fixation is strongly and urgently indicated

E.     Osteoporosis may be underlying pathological cause

Answer: 1* Avascular necrosis of the femoral head is fortunately uncommon

·      Pediatric Orthopedics 

1.    Slipped Capital Femoral Epiphysis.

???) Concerning slipped upper femoral epiphysis, one of the following is true:

Usually occurs at the age between 5 and 10 years

It occurs in girls more than boys

The upper age limit of its occurrence coincides with the closure of the epiphyseal plate

Bilateral involvement occurs in more than 90% of cases

A girl who has started to menstruate is a usual candidate to this disease

Answer: 5* A girl who has started to menstruate is a usual candidate to this disease

·      Bone Tumors 

1.    Malignant Bone Tumors.

???) The most common primary malignant tumor affecting bones is:

Ewing's sarcoma

Osteosarcoma

Chondrosarcoma

Multiple myeloma

Hodgkin's lymphoma

Answer: 2* Osteosarcoma

???) Which one of the following gives usually osteosclerotic bony metastases:

Carcinoma of the breast

Carcinoma of the thyroid-gland

Carcinoma of the lung

Carcinoma of the prostate

Carcinoma of the kidney

Answer: 4* Carcinoma of the prostate

???) The bone tumor that has a typical "soap-bubble" appearance radiologically is:

Osteosarcoma

Osteoclastoma (giant cell tumor)

Chondrosarcoma

Ewing's tumor

Ostgeochondroma

Answer: 2* Osteoclastoma (giant cell tumor)

???) In osteosarcoma the following are true, except:

It is usually a tumor of the teen agers

The prognosis is mostly bad

It could complicate Paget's disease

History of trauma may precede the clinical and radiological diagnosis

It is characteristically radio-resistantc

Answer: 4* History of trauma may precede the clinical and radiological diagnosis

·      Articular Cartilage Defects 

1.    Articular Cartilage.

???) Osteochondritis dissecans at the knee usually involves:

Medial femoral condyle

Lateral femoral condyle

Patella

Lateral tibial condyle

Medial tibial condyle

Answer: 1* Medial femoral condyle

************************************************

???) Avascular necrosis of bone is a recognized complication of the following, except:

A.    SLE

B.     Renal transplantation

C.     Sickle cell disease

D.    Congestive heart failure

E.     Cushing's syndrome

Answer: D* Congestive heart failure

???) The function of quadriceps muscle on the knee joint is:

Flexion

Abduction

Adduction

Extension

Pronation

Answer: D* Extension