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ORTHOPAEDICS NEW RECRUIT EXAMINATION

March 26th, 2012
MULTIPLE CHOICE QUESTIONS

1. The most commonly dislocated joint in the human body is:
a. Ankle joint
b. Elbow joint
c. Hip joint
d. Knee joint
e. Shoulder joint

2. The most common type of elbow joint dislocation is:
a. Anterolateral dislocation
b. Medial dislocation
c. Lateral dislocation
d. Posterolateral dislocation
e. Divergent dislocation

3. The peripheral nerve that innervates the triceps brachii muscle is:
a. Axillary N.
b. Median N.
c. Musculocutaneous N.
d. Radial N.
e. Ulnar N.

4. Meralgia paraesthetica is a compression syndrome that involves:
a. Femoral N.
b. Lateral Femoral Cutaneous N.
c. Peroneal N.
d. Sciatic N.
e. Sural N.

5. The Sciatic nerve is made of which nerve roots:
a. L1-L2-L3-L4-L5
b. L2-L3-L4
c. L4-L5-S1-S2-S3
d. S1-S2-S3
e. S1-S2-S3-S4-S5

6. The most common hand deformities in the hand regarding to Leprosy is due to
involvement of:
a. Axillary N.
b. Median N.
c. Musculocutaneous N.
d. Radial N.
e. Ulnar N.


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7. The muscle that inserts in the lesser trochanter of the femur is:
a. Adductor brevis m.
b. Adductor magnus m.
c. Gluteus medius m.
d. Gluteus maximus m.
e. Iliopsoas m.

8. Which of these muscles insert in the coracoid process of the scapula:
a. Infraspinatus m.
b. Latissimus dorsi m.
c. Pectoralis major m.
d. Pectoralis minor m.
e. Subscapularis m.

9. The boxers fracture or the street fighters fracture involves :
a. 1st metacarpal neck
b. 2nd metacarpal neck
c. 3rd metacarpal neck
d. 4th metacarpal neck
e. 5th metacarpal neck

10. Radionuclide imaging is commonly used as and adjuncts to orthopaedic
examinations. To differ between active infection and chronic inflamation, leucocytes
can be labelled with:
a. Gallium-67
b. Indium-111
c. Phosphate-79
d. Radium-44
e. Technisium-99

11. In a normal developmental milestone, a child is expected to be able to walk in:
a. 6-12 months
b. 9-12 months
c. 9-18 months
d. 12-15 months
e. 15-18 months

12. These muscles are innervated by the median nerve, except:
a. 1st and 2nd lumbrical mm.
b. Abductor pollicis brevis m.
c. Adductor pollicis m.
d. Flexor pollicis brevis m.
e. Opponens pollicis m.

13. Which muscles lie in the anterior osteofascial compartment of the leg :
a. Popliteus, Tibialis posterior, Flexor digitorum longus, Flexor hallucis longus
b. Plantaris, Soleus, Gastrocnemius
c. Peroneus longus, Peroneus brevis

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d. Tibialis anterior, Extensor hallucis longus, Extensor digitorum longus,
Peroneus tertius
e. Peroneus longus, Peroneus brevis, Peroneus tertius

14. The only rotator cuff muscle of the shoulder that is innervated by the Axillary nerve
is:
a. Infraspinatus m.
b. Subscapularis m.
c. Supraspinatus m.
d. Teres major m.
e. Teres minor m.

15. The strongest ligament in the elbow is:
a. Annular ligament
b. Anterior bundle of the MCL
c. Coopers ligament
d. Lateral ulnar collateral ligament
e. Posterior bundle of the MCL

16. The most sensitive test to assess the anterior cruciate ligament of the knee is:
a. Anterior drawer test
b. Lachman test
c. McMurray test
d. Posterior drawer test
e. Valgus and varus test in 30 degree flexion

17. These are the borders of the quadrangular space of the shoulder, except:
a. Humerus
b. Scapula
c. Teres major m.
d. Teres minor m.
e. Triceps brachii m.

18. Achondroplasia is related to which genetic defect:
a. CBFA1
b. COMP
c. FGFR3
d. PTHRP
e. Type II Collagen

19. The main defect in Gauchers disease is a deficiency in:
a. Acid phosphatase
b. Alkaline phosphatase
c. Creatine kinase
d. Glucocerebrosidase
e. Lactate dehydrogenase

20. The distal articulation between tibia and fibula represents which type of joint:
a. Symphisis

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b. Synchondrosis
c. Syndesmosis
d. Synostosis
e. Synovial joint

21. The so called deltoid ligament of the foot consists of the following ligaments, except:
a. Anterior tibiotalar
b. Medial talocalcaneal
c. Posterior tibiotalar
d. Tibiocalcaneal
e. Tibionavicular

22. The Trendelenburg test of the hip is a test to assess :
a. Effectivity of the abductor mechanism of the hip
b. Flexion contracture of the hip
c. Extension contracture of the hip
d. Effectivity of the adductor mechanism of the hip
e. Adduction contracture of the hip

23. Sickle-cell patients are more prone to suffer from acute osteomyelitis that is caused
by:
a. Gonococcus
b. Mycobacterium
c. Pseudomonas
d. Salmonella
e. Spirochaeta

24. The most suitable growth media for M.tuberculosis culture is:
a. Agarose
b. Bile media
c. Blood media
d. Lowenstein-Jensen
e. Ziehl-Nielsen

25. Which skeletal muscle fibre type has the lowest contraction strength, contraction
speed, and anaerobic capacity:
a. Type I
b. Type II
c. Type IIa
d. Type IIb
e. Type III

26. A chronic, progressive, destructive process affecting bone architecture and joint
alignment in people lacking protective sensastion is called:
a. Chronic inflammatory arthritis
b. Charcot arthropathy
c. Chemical arthropathy
d. Eichenholtz arthropathy
e. Osteoarthritis

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27. The neurotransmitter that is stored in motor end-plates is:
a. Acetylcholine
b. Adrenaline
c. Epinephrine
d. Norepinephrine
e. Noradrenaline

28. The most abundant type of collagen that forms the cartilage matrix is :
a. Type I
b. Type II
c. Type III
d. Type IX
e. Type X

29. Vitamin-D has an important role in calcium homeostasis, to become active, this
hormone is hydroxilized in the:
a. Skin and kidney
b. Guts and kidney
c. Liver and guts
d. Liver and kidney
e. Skin and liver

30. The synonim for proximal ulnar shaft fracture that is associated with proximal radio-
ulnar joint dislocation is :
a. Bennet fracture
b. Galeazzi fracture
c. Monteggia fracture
d. Pilon fracture
e. Salter-Harris fracture

31. The Thomas test of the hip is a test to assess:
a. Adduction contracture of the hip
b. Effectivity of the hip abductors
c. Effectivity of the hip adductors
d. Extension contracture of the hip
e. Flexion contracture of the hip

32. The most important structures that prevent bowstringing of the flexor tendons in
the hand are:
a. A1 and A3 pulleys
b. A1, A2, and A3 pulleys
c. A1, A3, and A5 pulleys
d. A2 and A4 pulleys
e. A2, A3, and A4 pulleys

33. A 35-year old male suffered a proximal fibular fracture after hitting the pavement
after his bike slipped. He found himself unable to extend his ankle and his toes. The
most logical explanation for his muscle weakness is:

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a. Extensor digitorum longus muscle rupture
b. Peroneal nerve injury
c. Sural nerve injury
d. Tibialis anterior muscle rupture
e. Tibial nerve injury

34. In Klippel-Feil syndrome, the patient has all of the following clinical features except:
a. Bilateral neck webbing
b. Bilateral shortness of sternocleidomastoideus muscles
c. Gross limitations of neck movements
d. Low posterior hair line
e. None of the above

35. Heberdens arthropathy affects:
a. Distal interphalangeal joints of the hand
b. spine
c. Symmetrically large joints
d. Sacroiliac joints
e. Wrist joints

36. All of the following areas are commonly involved sites in pelvic fracture except:
a. Acetabulum
b. Alae of ilium
c. Ischial tuberosities
d. Pubic rami
e. Pubic symphysys

37. Subtrochanteric fractures of femur can be treated by all of the following methods
except:
a. Condylar blade plate
b. Enders nail
c. Proximal femoral nail
d. Skeletal traction on Thomas splint
e. Smith-Petersen nail

38. A 45 year old was given steroids after renal transplant. After 2 years he had difficulty
in walking and pain in both hips. Which one of the following is most likely cause?
a. Alumunium toxicity
b. Avascular necrosis
c. Primary osteoarthritis
d. Septic arthritis
e. Tuberculous coxitis

39. A 30 year old man had a road traffic accident and sustained fracture of femur. Two
days later he developed sudden breathlessness. The most probable cause can be:
a. Bronchial asthma
b. Congestive heart failure
c. Fat embolism
d. Pneumonia

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e. Undetected hemato/pneumothorax

40. Osteoblastic metastases are characteristic of primary malignancy of:
a. Breast
b. Kidney
c. Lungs
d. Prostate
e. Thyroid

41. Brown tumors are seen in:
a. Hyperparathyroidism
b. Neurofibromatosis
c. Osteomalacia
d. Osteoporosis
e. Pigmented villonodular synovitis

42. The anterior interosseous nerve of the forearm is a branch of:
a. Axillary N.
b. Median N.
c. Musculocutaneous N.
d. Radial N.
e. Ulnar N.

43. All the statements are true about exotosis, except:
a. Growth continues after skeletal maturity
b. It is covered by cartilaginous cap
c. It occurs at the growing end of bone
d. It is related to anomaly of EXT gene
e. Malignant transformation may occur

44. Rugger Jersey Spine is seen in:
a. Achondroplasia
b. Ankylosing spondylitis
c. Fluorosis
d. Marfans syndrome
e. Renal osteodystrophy

45. A 15 year old boy is injured while playing football. X-rays of the leg rule out of a
possible fracture. The radiologist reports the boy has an evidence of aggressive bone
tumor with both bone destruction and soft tissue mass. The bone biopsy reveals a
bone cancer with neural differentiation. Which of the following is the most likely
diagnosis?
a. Chondroblastoma
b. Ewings sarcoma
c. Neuroblastoma
d. Osteosarcoma
e. Malignant periphereal nerve sheath tumor


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46. Which of the following is the most unlikely complication in a supracondylar fracture
of the humerus in children:
a. Compartment syndrome
b. Median nerve injury
c. Myositis ossificans
d. Malunion
e. Non-union

47. You are having your shift at the emergency department when a 30 year-old male
comes to your ER with a spinal injury 6 hours ago. There is no life-threatening
injuries and the patient seems stable. You have done your ATLS protocols and you
find out that there is an unstable burst fracture of the L1 vertebrae. You are planning
to give the patient corticosteroid. What is the recommended dose for this patient?
a. Methylprednisolone 30mg/kg initial bolus, followed by 5.4mg/kg/h for 23
hours
b. Methylprednisolone 30mg/kg initial bolus, followed by 5.4mg/kg/h for 48
hours
c. Dexamethasone 10 mg bolus, followed by 6,g every 6 hours for 24 hours
d. Dexamethasone 10 mg bolus, followed by 6,g every 6 hours for 48 hours
e. No corticosteroid needed

48. All of the following are the causes of increase in pain in osteochondroma, except:
a. Bursitis
b. Degenerative changes
c. Fracture
d. Pressure on a nearby nerve
e. Sarcomatous changes

49. Which of the following tumors arise from epiphysis:
a. Ewings sarcoma
b. Chondroma
c. Giant cell tumor
d. Hemangioma
e. Osteosarcoma

50. Primary bone healing will occur if a fracture is treated by:
a. Closed reduction and casting
b. Compression plate
c. Continuous traction
d. Fracture bracing
e. Intramedullary nailing









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ESSAY QUESTIONS

1. Please explain about Congenital Talipes Equinovarus (CTEV)


2. Please describe the following X-ray and what is your working diagnosis?




3. Please explain about polytrauma