Distance Learning for orthopaedic residents

MCQ paper : The following questions have one correct or most appropriate answer.
email your answers to dr_pbala@yahoo.com.sg
1. A six month old infant has residual equinus deformity after manipulation and casting
from birth for congenital club foot . The next step in the treatment is
A.
B.
C.
D.
E.

Dennis Brown splint

Hinged AFO
Tenotomy of tendoachilles
Posteromedial release
Continued manipulation and casting

2. The main cause of death after a successful ATLS in the management of polytrauma is
A.
B.
C.
D.
E.

Ischaemia reperfusion injury

Significant elevation of interleukin levels in the first 24 hours
Severe systemic inflammatory response syndrome SIRS
Genomic predisposition
Surgery during the second post-trauma week

3. A 3-year old girl was febrile and refused to walk for 24 hours. She had no recent
infection or injury. Clinical examination showed warmth and redness over the proximal
tibia. Her temperature was 38 degrees Centrigrade, WBC 18,000/mm3, ESR 55mm/hr.
Radiographs of the leg were normal. The next step in the management is
A.
B.
C.
D.
E.

Technetium-99 bone scan

CT scan
Gallium scan
Aspiration of proximal tibia
Incision and debridement of proximal tibia

4. A 25-year old girl has pain and swelling of the proximal meatphysis of tibia of six
months duration. Radiographs were reported as typical intracompartmental osteosarcoma
of tibia. The next step in her management is
A.
B.
C.
D.
E.

Neoadjuvant chemotherapy
CT scan of lungs
Needle- biopsy of the tumour
Arteriogram of the tumour
Limb preservation surgery

5. An elderly female has moderate primary osteoarthritis of her knees , and her surgeon
has decided to give intra-articular injection to her knees . Which one of the following
statements is correct regarding the choice of her medication?
A. Hyaluronic acid increases synovial fluid viscosity
B. Cortocosteroid injections improve pain
C. Cortocosteroids have a negative effect on cartilage matrix
D. Corticosteroids are cheaper than hyaluronic acid
E. Neither treatment has been shown to be convincingly superior in altering the course
of osteoarthritis
6. A motorcyclist has a brachial plexus lesion involving C5 and C6 nerve roots as a
result of a road traffic accident. On clinical examination, he is likely to have
A.
B.
C.
D.
E.

Simian hand
Ptosis
Pronation deformity of forearm
Loss of flexion of wrist
Anaesthesia of little finger

7. A 25- year old female has pain in her limbs and difficulty in walking of six months
duration. Clinical examination showed that she was tender over her bones. Radiographs
of lower limbs showed stress fracture lines in the neck and mid-shaft of femur and
neck of scapula. The most likely diagnosis is
A.
B.
C.
D.
E.

Stress fractures
Pagets disease
Histiocytosis X
Osteomalacia
Fibrous dysplasia

8. A 15-year old boy has haemophilic arthropathy of his knee. Radiographs showed
widening of the intercondylar notch of femur and squaring off of patella. The next
step in his management is
A.
B.
C.
D.
E.

Joint aspiration
Synovectomy
Replacement of factor VIII
Traction in bed to correct flexion deformity
Total knee replacement

9. A 50-year old man has painless nodular thickening of planter aponeurosis in the nonweight bearing areas of foot. The most likely diagnosis is
A.
B.
C.
D.
E.

Xanthomatosis
Callosities
Gout
Dupuytrens contracture
Reiters syndrome

10. A 16-year old football player has two weeks of aching pain in his low back during
the game. Clinical examination was normal except for mild paraspinal muscle spasm.
Radiographs showed bilateral spondylolysis of L5 vertebra with no spondylolisthesis.
The most appropriate initial treatment is
A.
B.
C.
D.
E.

Bed rest for 2 weeks

Cessation of sports for 3 months
Immobilization in a cast
Limitation of activity as determined by symptoms
Spinal fusion.

Distance Learning Orthopaedics : lesson 2

11. A middle aged diabetic had a trans-tibial amputation for gangrene of foot.
During his visit to the rehabilitation clinic six weeks later, he complained of having
severe pain in the foot-region of the amputated limb. This is due to
A.
B.
C.
D.
E.

Phantom limb
Phantom pain
Painful neuroma
Causalgia
Diabetic neuropathy