Orthopaedic MCQ

1) Regarding ACL injury

a. It is cause by a posteriorly directed force to the front of tibia T
b. It is common among female T (Female athletes are known to have a
higher risk of injuring their ACL while participating in competitive sports)
c. It is usually associated with lateral collateral ligament injury F (medial
collateral ligament)
d. It is usually associated with medial meniscus injury T
e. It can be treated with patella tendon autograft T (reconstruction)

2) Regarding PCL injuries

a. It is more common compare to ACL injury F (ACL more common)
b. It is usually an isolated tear T
c. It is associated with dashboard injury T (The most common mechanism
of injury of the PCL is the so-called "dashboard injury)
d. In grade 3 injury, the tibia subluxates posterior to the anterior aspect of the
femoral condyle T
e. Surgical reconstruction is the treatment of choice of most case F (only
grade III)

3) These factors predict wound healing

a. Albumin level of 20g/dl T
b. Transcutaneous oxygen tension of 305 T
c. Ankle brachial systolic index of 0.9 T
d. HBa1c level of 6% T
e. Toe pressure measurement of 20mmHg F

4) Regarding diabetic foot ulcer

a. Can be treated with antibiotic only F
b. Wagner 2 ulcer associated with osteomyelitis F (Wagner 2 is deep ulcer)
c. Associated with painful neuropathy F
d. Wound debridement is frequently needed T
e. Wegner 5 probably need below knee amputation T

5) Regarding carpal tunnel syndrome

a. There is presence of hypoesthesia at the palm F (palmar cutaneous
branch of median nerve does not pass through carpal tunnel)
b. There is presence of chondroid metaplasia of the tunnel lining T
c. Pointing index finger is a sign F
d. Phalen sign positive T
e. Injection of steroid into wrist joint is a treatment T

6) Regarding trigger finger and its treatment

a. Stenosing of A5 pulley is a cause F
b. The flexor digitorum profundus gets trapped at A1 pulley T
c. Release of the A1 pulley causes bowstringing T
 d. Fibrous metaplasia occur at the pulley F
e. Occur in rheumatoid arthritis T

7) Regarding rheumatoid arthritis

a. Causes symmetrical arthritis T
b. Affect the intervertebral disc F
c. Rheumatoid factor is an abnormal immunoglobulin T
d. Periarticular osteoporosis is a radiological feature T
e. Methotrexate is a disease modifying drug of choice T

8) In relation to gout
a. Abnormal protein metabolism is a cause T
b. Tophi is a feature of acute case F
c. Dietary restriction of white meat is part of the treatment F (red meat)
d. Consumption of fish oil is contraindicated F
e. NSAIDs is the treatment of acute gout T

9) Regarding osteomyelitis
a. The causal organism is usually staphylococcus aureus T
b. In young children, Haemophilus influenzae is the most common agent
causing osteomyelitis T
c. Sequestrum is often found within the thickened cortex and are boared by
the reactive bone and chronic granulation T
d. Involucrum contains the sequestered, necrotic marrow and the endosteal
bone T
e. Chronic abscess can violate the skin by means of sinus tract lead to
chronic ulceration and drainage T

10)Regarding bone mass

a. Peaks at age 30 yrs old T
b. 0.3% bone loss per year in men after peak bone mass T
(After attaining peak bone mass at age 30, men and women lose bone at
a rate of approximately 0.3% and 0.5% per year, respectively)
c. 0.5% bone loss per year in female after peak bone mass T
d. In early menopause, bone loss is cause by excessive osteoclast-mediated
reabsorption T
e. In late postmenopausel, bone loss is due to suppression of osteoblast
activity T

11) Regarding osteoporosis

a. Serum calcium is normal T
b. Associated with poor fracture healing T
c. Early premature menopause is a high risk T
d. Can be treated successfully with calcium supplement alone F
e. Osteoporotic related fracture usually occur in metaphyseal region T
12)Non-modifiable factor of osteoporosis includes
a. Family history of osteoporosis in first degree relatives T
b. Advancing age T
c. Personal history of fracture as an adult F
d. Excessive alcohol intake F (modifiable)
e. Corticosteroid medication F(modifiable)

13)Specific investigation of osteoporosis includes:

a. Dual-energy X-ray absorptiometry (DEXA) T
b. Quantitative computer tomography (QCT) T
c. Single energy X-ray absorptiometry (SXA) T
d. Quantitative ultrasound (QUS) T
e. Urinary deoxypyridinoline (DPD) T

14)Regarding developmental dysplasia of the hip (DDH)

a. Female is commonly affected than male T
b. Left hip is more commonly affected then right hip T
c. 80% is unilateral T (1 in 5 cases is bilateral)
d. Generalize joint laxity predispose to DDH T
e. A breech position with extended legs predispose to DDH T

15)Pathoanatomy of DDH include

a. Shallow acetabulum T
b. Femoral anteversion T
c. Inverted labrum T
d. Formation of Pulvinar T
e. Contracted transverse acetabular ligament F

16)Secondary osteoarthritis is cause by

a. Obesity F
b. Septic arthritis T
c. Recurrent dislocation T
d. Pseudogout T
e. Perthe’s disease T

17)Indication of internal fixation includes

a. Open fracture grade 3A T
b. Displaced acetabulum fracture T
c. Displaced tibial plateau fracture T
d. Femoral neck fracture in young adult T
e. Pathological fracture T

18)Indication of external fixation includes

a. Fracture associated with severe soft tissue damage T
b. Closed fracture midshaft of tibia F
c. Open book fracture of pelvis T
 d. Aseptic non-union of femur F
e. Intraarticular fracture T

19)Regarding osteosarcoma
a. It is a highly malignant primary bone forming tumor T
b. More common in males compared to females T
c. Peak incidents 10- 20 years T
d. Commonest at metaphyseal of long bone T
e. Classical osteosarcoma is extramedullary F (“classic” central
medullary osteosarcomas)

20)Plain x-ray features commonly seen in osteosarcoma includes

a. Osteoclastic changes T (osteolytic changes)
b. Wide zone of transition T
c. Sun ray spicules T
d. Codman’s triangle T
e. Cortical breach T