骨科选择题(英语)

Orthopedics-11. A 35 year old male manual labourer sustained a displaced subcapital hip fracture after falling at work. The fracture was reduced and fixed with 3 cannulated screws. Five months after the operation, he presents to your clinic with worsening hip pain. What is the most likely diagnosis?a) Nonunionb) Osteonecrosisc) Loosening of the cannulated screwsd) Malunione) Osteomyelitis2. A 25 year old professional basket ball player lands on his right foot while it is in a pronated and externally rotated position. He hears a “snap” and is unable to weight bear on his right foot. An ankle X-ray reveals significant talar shift without a visible fibular fracture. The most appropriate next step is:a) Closed reduction of the ankle mortise followed by application of a castb) Bedrest for 4 weeks followed by intense physiotherapyc) X-ray the right knee to rule out a Maisonneuve fractured) Open reduction with internal fixation of the right anklee) Splint ankle and encourage weight bearing3. A 75 year old lady slips on a throw rug in her living room and falls. An X-ray reveals a displaced subcapital hip fracture. Prior to her fall, the patient lived alone, per formed all ADLs independently and enjoyed golfing. The most appropriate management of this fracture is:a) Moores unipolar hemiarthroplastyb) Bedrest for 6 weeksc) Reduction with internal fixation using 3 cannulated screwsd) Bipolar hemiarthroplastye) Total hip replacement4. A 21 year old presents to your office after injuring her knee in a soccer game. She states that the knee clicks when she walks and has “locked” on several occasions.On exam there is an effusion and the knee is grossly stable. The most likely diagnosis is:a) Anterior cruciate ligament tearb) Meniscal tearc) Osteoarthritisd) Bursitise) Medial collateral ligament tear5. All of the following regarding Achilles tendon rupture are true, EXCEPT:a) Positive Thompsons testb) Palpable gap over Achilles tendonc) Weak plantar flexiond) May occur secondary to steroid injectione) Treat by casting foot in dorsiflexion6. Orthopedics comes from the Greek words meaning what?a) Anatomy and Surgeryb) Bone and Jointc) Straight and Childd) Healing and Body7. bony metastasis is not seen in which carcinoma ?a) testisb) breastc) pelvisd) bronchus8. tuberculosis of the spine first starts in ?a) vertebral bodyb) nucleolus pulposusc) annulus fibrosisd) paravertebral joints9. which of the following is NOT a typical symptom in a patient with a musculoskeletal tumor?a) nighttime painb) warmth over the lesionc) distal edemad) tenderness10.which of the following is the most common malignant lesion of the bone?a) Chondroblastomab) Fibrosarcomac) Ewings sarcomad) Osteosarcoma11.the maximum time continuous tourniquets can be used for hand surgery is_?a) 1hb)2hc)3hd)4h12.the most common mechanism of injury in a distal fracture of the fibula is_?a) supination with eversionb) supination without eversionc) pronation with eversiond) pronation without eversion.13.which of the following is the most common causative organism in osteomyelitis?a) salmonellab) pseudomonasc) staphylococcusd) Escherichia coliAnswers to this questions:1.b 2.c 3.d 4.b 5.e 6.c 7.a 8.a 9.d 10.d 11.c 12.c 13.cOrthopedics-2T or F questions:1.complications of pelvic fracture:a.hypovolemic shock T F b.sciatic N injury T Fc.peroneal N injury T Fd. urethral injury T Fernal iliac A injury T F2. acute Hematogenous osteomylitis:a.starts in metaphysic T Fb. early local tenderness T Fc. aspiration from maximum site of tenderness is important for investigation T Fd.no antibiotics should be given until the results of the culture appear T Fe. rarefaction of bone is seen in x-ray within 204 days T F3. osteoporosis:a. Normal serum level of minerals in senile type T Fb. decrease total mass T Fc. risk of vertebral fracture T Fd. due to vitamine D deficiency T F e. high Ca will return the bone to normal T F4. disc herniation between L5- S1:a. pain radiate to anterior thigh T Fb. +ve SLR test T Fc.absent Achilles tendon reflex T Fd. Absent knee reflex T Fe. operation should be done as soon as possible T F5. posterior hip dislocation:ernal rotation T Fb. extension T Fc. adduction T Fd.avascular necrosis (AVN) T Fe.shortening of affected part T F 6. Colles Frature:a.injury to ulnar N T Fb. Injury to median N T Fc. Fx in distal part of radius T Fd. Volkmans contracture is seen T Fe. due to blow to elbow T F7. Fx at thoracolumbar spine:a. causes quadriplegia T Fb. urine incontinence T Fc.pressure sores are not common T Fd. 1ry ttt is not important T Fe. rehabilitation is important T F8. scoliosis:a. increase AP curvature T Fb. may cause cardiopulmonary depression T Fc. common in neurofibromatosis T Fd.may need OR & fusion if not treated by other methods T Fe. mainly idiopathic T F9. Artyhroscopy:a. only for Dx T Fb. may injure popliteal Nerve T Fc. for ACL repair T Fd. only one portal is used T F10. SLR:a. +ve in sciatica T Fb. cannot be +ve bilaterally T Fc. Done in prone position T Fd. knee should be extended T Fe. +ve in lumbar disc prolapese T F11.ulnar Nerve injurya. wrist drop T Fb. due to colles fracture T Fc. weak hypothenar muscles T Fd. weak thenar muscles T Fe. weak 1st interosseus muscles T F12.club foot:a. more in males T Fb. with valgus T Fc. with equines T Fd. 1st line ttt is manipulation T Fe. with wasting of lower limb muscles T F13. congenital hip dislocation:a. more in females T Fb. 50-55 degrees T Fc. 30% bilateral T Fd. short keg T Fe. early Dx is important T F14. specific complications of Fx neck of femura. AVN T Fb. injury to sciatic nerve T Fc. ununion T Fd.need internal fixation T Fe. lead to osreoarthritis T F15. complications of Fracure: a. Volkman contractures T Fb. duputeryne contractures T Fc. sudecks atrophy T Fd. frozen shoulder T Fe.AVN T F16. TB of the spine:a. anterior part of vertebrae affected first T Fb. doesnt cuz psoas abscess T Fc. may cuz pathological frature T Fd. late backache T Fe. anti TB ttt should be taken T F17. recurrent shoulder dislocation:a. 1st ttt is important T Fb. require physiotherapy T Fc. more common anteriorly T Fd. x-ray shows necrosis T F18. scaphouid Fracture:a. associated w/ fx of carpal bones T Fb. TTT w/ POP for 3 wks T Fc. tenderness on snuff box T Fd. risk of proximal AVN T F19. osteogenic sarcoma:a. common in the age of 50 T Fb. sun-ray appearance on x-rays T Fc. common around the knee T Fd. TTT by radoiation T F20. Carpal tunnel syndromea. seen in RA T Fb. in middle-aged females T Fc. affect median Nerve T Fd. TTT by decompression T Fe. may be due to colles Fracture. T FOrthopedics-31. Side arm traction is the application of lateral-longitudinal traction to the humerus.A. True B. False2. Which of the following tendons, when ruptured, may cause a flatfoot deformity?A. AchillesB. Anterior tibialC. Posterior tibialD. Peroneus longusE. Flexor hallucis longus3. Dislocations involving the scaphoid or lunate include which one of the followingpositive clinical findings?A. History of forceful flexion of the writsB. Point tenderness at the ulnar side of the wristC. Nerve impingement in the tunnel of GuyonD. A widening of the space between the scaphoid and lunate on radiographE. A marked loss of wrist extension4. The odontoid, process of the axis (second vertebra) provides a pivot for the atlas when the head is turned from side to side.A. True B. False5. Surgical removal of a portion or all of the synovial membrane of a joint is called:A. OsteotomyB. ArthrotomyC. SynovectomyD. Capsulotomy6. Continuous passive motion (CPM)machines may be used to increase range ofmotion and prevent muscle atrophy. Question: Itmay be used to decrease risk of venousthrombosis?A. True B. False7. The bringing of the hand into a palm-up position with the elbow flexed at a 90 degree angle, brought about by the motion of the radius around the ulna is called pronation.A. True B. False8. Which of the following describes Sterners lesion of the thumb?A. Partial rupture of the radial collateral ligament, with good prognosis for healingB. Stenosing tenosynovitis of the adductor aponeurosisC. Avulsion fracture at the insertion of the extensor pollicus longusD. Entrapment of the ruptured ulnar collateral ligament outside the adductor aponeurosisE. Complete rupture of the radial collateral ligament, with need for surgical repair9. A 10-year-old boy, while playing basketball, lands on his toes and falls, forcing the foot into inversion. Which one of the following conditions best explains the subsequent symptoms of pain, tenderness and mild bruising at the base of the fifth metatarsal?A. Displaced os peroneumB. Jones fractureC. Tuberosity avulsion fractureD. Iselins diseaseE. Stress fracture of the metatarsal10. Which one of the following is the most common local problem causing secondaryadhesive capsulitis?A. Subdeltoid bursitisB. Tendinitis of the rotator cuffC. Bicipital tendonitisD. Subcromial bursitisE. Acromioclavicular joint dislocation11. The initial evaluation of a patient with an inflamed joint who is thought to be experiencing a first episode of gout should include which of the following?A. Aspiration of synovial fluid from the affected jointB. RadiologyC. Complete blood cell countD. Determination of serum uric acid level12. The active anterior drawer test (90 degree quadriceps active test) is used to assess the integrity of the:A. Anterior cruciate ligamentB. Posterior cruciate ligamentC. Posteromedial capsular structuresD. Posterolateral capsular structuresE. Anterolateral capsular structures13. Reactive arthritis (Reiters syndrome) usually involves which one of the following areas of the body?A. WristsB. FingersC. BackD. Elbow and shouldersE. Lower extremities14.Which of the following statements about anterior subluxation of the shoulder is incorrect?A. The dead arm syndrome may accompany the subluxationB. It mostly occurs in older patientsC. It may develop from over-use microtrauma and rotator cuff weaknessD. It may be associated with numbnessE. It occurs with the arm in abduction and external rotation15. Which of the following statements about posterior shoulder dislocation is/are correct?A. Posterior dislocation occurs as frequently as anterior dislocationB. The diagnosis may be missed on standard radiographic viewsC. The axillary view is the best radiographic view for identifying a posterior dislocationD. Posterior instability is more common in athletes who have subluxation as a result of repetitive microtrauma and posterior rotator cuff weakness16.Which one of the following is the most common presentation for a soft tissue sarcoma?A. Isolated painful muscleB. Pathologic fracture from a metastatic lesion in the boneC. Tissue necrosis with associated infectionD. A symptomatic lesionE. Poorly defined swelling in a limb17. The ossification and vascularization of the tarsal navicular is often referred to as:A. Severs diseaseB. Streeter dysplasiaC. Bohler fractureD. Kohlers diseaseE. Morton syndrome18. Overweight male adolescents who present with anterior hip pain during a period of rapid growth should be suspected of having which one of the following conditions?A. TendonitisB. Sports herniaC. Slipped Capital EpiphysisD. Muscles or tendon tearE. Acetabular labral tear19. An oblique fracture of the distal one-third of the humerus with potential radial nerve palsy after closed reduction in children is referred to as a:A. Holstein-Lewis fractureB. Child abuse fractureC. Piedmont fractureD. Kocher fracture20. A nontraumatic dislocation of the first cervical vertebra (atlas) is called:A. Desault dislocationB. Luxatio erecta dislocationC. Unilateral facet subluxationD. Bell-Dally dislocationE. Spondylolisthesis21. Which one of the following joints is the most commonly affected by osteochondritis dissecans?A. Talar domeB. Femoral condylesC. Tibial plateauD. Capitellum of the humerusE. Distal humerus at the elbow22. Compression of the sciatic nerve by which one of the following muscles can cause buttock and leg pain similar to radicular pain caused by lumbar nerve root impingement?A. Quadriceps groupB. PiriformisC. Hamstring groupD. Iliopsoas23. Age-related changes that may increase the risk of falls in an elderly patient include which of the following?A. Decreased vibration senseB. Increased body swayC. Decreased visual acuityD. Cerumen accumulationE. All of the above24. Which of the following are/is considered positive Waddell signs in patients with acute low back pain?A. Sensory loss over the entire footB. Pain with pelvic rotationC. Specific anatomic tenderness over the spineD. Stoic reaction to pain25. Which of the following is the most important laboratory test in the evaluation of apatient with suspected giant cell arthritis?A. Alkaline phosphatase levelB. Temporal artery biopsyC. Aminotransferase levelsD. Complete blood countE. Erythrocyte sedimentation rate26. In the elbow, the ulnar nerve is most likelyto be compressed as it passes through which one of the following structures?A. Cuboid tunnelB. Distal portion of the triceps muscleC. Two heads of the pronator teresD. Arcade of FrohseE. Lateral epicondyle of the elbow27. Hydrarthrosis describes accumulation of fluid within a joint cavity.A. True B. False28. Which of the following joints is most commonly dislocated?A. ElbowB. FingerC. ShoulderD. ToeE. Hip29. The resultant line of pull of the traction force is along the axis of the bone.A. True B. False30. Which of the following patient parameters is most directly associated with wear rates of total hip replacement?A. SexB. AgeC. HeightD.WeightE. Activity31. A complication of proximal varus osteotomy of the femur is?A. Low back painB. A persistent limpC. Decreased motionD. Contralateral hip arthritisE. Lengthening of the operated extremity32. Which of the following conditions is commonly confused with fibromyalgia?A. Somatoform disorderB. Rheumatoid arthritisC. DepressionD. Myofascial pain syndrome33. A patient has sharp, shooting, burning pain located in the lower back and radiating to the lower leg. The pain decreases with standing but increases with bending or sitting. The physical examination reveals weakness and asymmetricreflexes. The straight leg raise test is positive. Which one of the following would be the most likely diagnosis?A. SpondylolisthesisB. Acute disc herniationC. Back sprainD. Ankylosing spondylitisE. Spinal stenosis34. For flatfoot, medialward curving of the achilles tendon as viewed from behind isreferred to as:A. Babinski reflexB. Chaddock signC. Helbing signD. Homans signE. Thomas sign35. Which one of the following organisms is most commonly implicated in acutehematogenous osteomyelitis?A. Serratia marcescensB. Pseudomonas aeruginosaC. Escherichia coliD. Staphylococcus epidermidisE. Staphylococcus aureus36. Which of the following is/are cardinal signs of subacute and chronic osteomyelitis?A. Impaired range of motionB. DeformityC. Chronic edemaD. Draining sinus tracts37. The anconeus is a small muscle on the ulnar side of the elbow.A. True B. Falset38. A proximal tibia metaphyseal fracture that develops valgus deformity is known as a Cozens fracture.A. True B. False39. The metaphyseal region of which one of the following is the least common site forosteosarcoma?A. Proximal tibiaB. Proximal humerusC. Greater trochanterD. Distal femur40. Patients with osteosarcoma are usually 10 to 20 years of age and present with which one of the following?A.Weight lossB. A limpC. Dull aching pain of several months durationD. Painless massE. Shortness of breath from metastases41. Osteoporosis differs from osteomalacia in the following way: There are gross changes in the epiphyses in osteomalacia.A. True B. False42. All of the following have been associated with posterior shoulder dislocation EXCEPT:A. EthanolB. ElectricityC. ExerciseD. EpilepsyE. Encephalitis43. Which of the following is not a sign or symptom of carpal tunnel syndrome?A. Loss of sensation to the proximal palmB. Po