1

1) The most important in fractures healing is:

1- Immobilization 2- Proper blood supply 3- Callus formation 4- Reduction 5- Fixation

2) All of the following are early complications of bone fractures, except:

1- Mal union 2- DVT 3- Shock 4- Fat embolism 5- Tetanus

3) All of these fractures can occur due to indirect forces, except:

1- Comminuted fractures 2- Transverse fractures 3- Oblique fractures 4- Spiral fractures

4) Regarding bone tumors, all of the following are correct, except:

Metastatic prostatic tumors cause osteolytic bone tumors.

[They cause UosteoblasticU bone tumors]

5) The tarsal bone that is most prone to vascular compromise is the:

1- Calcaneus 2- Navicular 3- Talus 4- Cuboid

Orthopedics Past Exam Qs

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6) All are risk factors for DDH, except:

1- Mutligravida 2- Female 3- Family history 4- First child

7) One of the following is not part of the proximal carpal bones:

1- Trapezium 2- Scaphoid 3- Pisiform 4- Triqetral

8) The function of the interossei and lambrical muscles:

Both flex metacarpophalangial joints and extend interphalangeal joints

9) Regarding hand infections, which is false?

Felon is an infection of the hand web space

10) Origin of bone is from:

Mesoderm

11) What are the muscles involved in De Quaverian disease?

Abductor policis longus and extensor policis brevis

12) Which is true regarding osteosarcoma?

It has two peaks: one is at adolescence and the second is after 40 years of age

13) All are true, except:

Ostoid osteoma highly attempt to become malignant

3

14) Flexion of distal interphalangeal (DIP) joint with fixing the proximal interphalangeal (PIP) joint tests:

1- Flexor digitorum profundus 2- Flexor digitorum superficialis 3- Palmaris longus 4- All of the above

15) Whats wrong regarding osteochondroma?

1- Appears as exostosis on X-ray 2- Mostly in the diaphysis of long bones 3- The hereditary type is AD

16) Wrong with carpal tunnel syndrome:

Thenar wasting is an early sign

17) Which of the following is true?

Metastasis is most commonly to the axial bones

18) You see all these in infants with DDH, except:

Hyperlordosis

[not seen in infants, but in older children when they start to walk.]

19) Mallet finger is caused by:

Rupture of the extensor tendon of the distal phalanx

20) Volkmann's contracture:

1- Affects palmar fascia 2- Develops at the ankle in case of chronic venous ulcer 3- Follows ischemia of the forearm muscles 4- Is due to excessive scarring of the skin of the axilla

following a brun 5- Follows ulnar nerve palsy

4

21) Trigger finger:

Stenosing tenosynovitis in the affected finger

22) The earliest and most reliable sign of Volkman's ischemic contracture is:

1- Cyanosis 2- Digits pallor 3- Absent radial pulse 4- Pain out of proportion

23) All are used in assessing the knee capsule, except:

1- Anterior drawer Sign 2- Apprehension test 3- Posterior Sag Sign (for PCL) 4- McMurray test 5- Apleys test

[According to Dr. Rami, McMurray assess the menisci which have no role in supporting the capsule.] 24) All are true about Talipes Equinovarus, except:

1- Vertical talas 2- Forefoot adducted 3- Plantar flexion 4- Inversion 5- Varus of the heel

25) Neurogenic claudication differs from cardiac claudication in all of the following, except:

1- Increased by upstairs 2- Relieved by setting 3- Increased by downhill 4- It is associated with achondroplasia 5- Relieved by anterior bending of the spine

5

26) All of the following stabilize the knee joint, except:

1- Medial & lateral collateral ligaments 2- Anterior & posterior cruciate ligaments 3- Bony congruity of the bone 4- Medial & lateral menisci 5- Popliteus muscle

27) Mainly responsible for keeping the arch of the foot:

1- Tendon Achillis 2- Tibialis posterior (mostly) 3- Peroneus longus

[The 4 muscles responsible for plantar arch support: tibialis anterior, tibialis posterior, peroneus longus, flexor hallucis longus.]

28) All should be considered in reading x-ray, except:

1- Patient's profile 2- Rule of two: two views, two sides,. 3- Always look for dynamic views 4- Look for pathology on x-ray 5- Quality of x-ray

29) Most important of hand nerves:

1- Median nerve 2- Ulnar nerve 3- Radial nerve

30) About DDH, not a line in radiographs:

1- H line 2- P line 3- Shentons line 4- Acetabular index 5- Shaft neck line

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31) About DDH, not a risk factor:

1- Female 2- Breech 3- First child 4- Barlow positive 5- Ortolani positive

32) Most important in stability of shoulder joint:

Rotator cuff [According to Dr. Waleed Haddad, its the labrum

[Note: least important in stability of shoulder joint (2012 Q for A1): Coracoacromial ligament.]

!]

33) Doesnt occur in closed fracture:

1- Infection 2- Nerve compression 3- Compartment syndrome 4- Non-union

34) Which of this is not true about x-ray finding of osteoarthritis?

1- Narrowing of the joint space 2- Subchondral sclerosis 3- Joint deformity and mal-alignment 4- Osteophytes at the joint edges 5- Periarticular bone resorption

35) All are signs of septic hip, except:

Baby looks healthy

36) All interfere with the process of healing, except:

Mal-rotation

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37) The most important complication of fracture of neck of femur:

1- Avascular necrosis of the head femur 2- Coxa vara

38) All of the following can be used to maintain acceptable reduction of acute fracture, except:

1- Plaster of paris 2- Skin traction 3- Functional brace 4- Skeletal traction 5- External fixation

39) All of the following are clinical findings in UMNL, except:

1- Increased cremasteric (scrotal) reflex 2- Diminished superficial reflexes 3- Absence of abdominal reflex 4- Exaggeration of deep reflexes 5- Muscle contracture 6- Clonus

40) Positive Finkelstein's test in:

1- Mallet finger 2- Trigger finger 3- De Quervain's disease 4- Boutonniere deformity

41) About carpal tunnel syndrome (CTS), all are correct, except:

1- Occur in patients with rheumatoid arthritis 2- Common in wrist fractures 3- Usually happen as first time in pregnant ladies 4- Usually with vascular disorders

8

42) Erb's palsy:

1- C5,C6,C7 2- C8, T1 3- Both 4- None

[Erbs palsy results from injury to nerve roots C5 and C6, with C7 also affected in 50% of instances.]

43) Most common malignant bone tumor:

1- Osteochondroma 2- Giant cell tumor 3- Osteosarcoma 4- Ewing sarcoma

44) Factors lead to Non-union:

1- Immobilization 2- Decrease blood supply 3- Both 4- None

45) Onion peel appearance of plain x-ray of the bone is characteristic of the following tumor:

1- Osteoclastoma 2- Osteosarcoma of the osteogenic type 3- Osteolytic osteosarcoma 4- Fibrosarcoma 5- Ewing's sarcoma

46) All can occur in acute suppurative inflammation, except: Pseudogout

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47) Callus is:

1- Secondary healing 2- Indirect healing 3- Both 4- None

48) Regarding clinical assessment of the knee ligaments, all are true, except:

1- Valgus stressing of the knee will detect medial collateral ligament instability

2- Varus stressing of the knee will detect lateral collateral ligament instability

3- Positive McMurry's test indicates posterior cruciate ligament injury

4- Anterior drawer sign is positive in case of anterior cruciate ligament injury

5- Lachman's test is positive when the anterior cruciate ligament is torn

49) Common complication during manipulation

of SCFE:

1- Avascular Necrosis 2- Chondrolysis 3- Both 4- None

50) Barlow test is for:

1- ACL tear 2- Meniscal tear 3- DDH 4- SCFE

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51) Most common type of shoulder dislocation is: 1- Anterior 2- Posterior 3- Multidirectional

52) "Claw Hand" occurs due to injury of:

1- Median Nerve 2- Ulnar Nerve 3- Radial Nerve

53) Longitudinal growth of bone occurs at:

1- Epiphyseal plate 2- Epiphysis 3- Diaphysis 4- Metaphysis

54) Axial rash seen in:

1- DVT 2- Tetanus 3- Fat embolism

55) The earliest sign of compartment syndrome:

1- Bursting pain 2- Pallor 3- Parasthesia 4- Pulseless

56) All of the following tests are used in knee examination, except:

Thompson test

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57) All of the following occur after a fracture, except:

1- Loss of all movements of the limb 2- Localized tenderness at the site of fracture 3- Abnormal movement of the limb 4- Deformity

58) Rotator cuff muscles, except:

1- Supraspinatus 2- Teres major 3- Teres minor 4- Subscapularis

59) All are true about acute suppurative arthritis, except:

1- The pathogenesis could be related to an adjacent bone infection

2- H. Influenza is an important pathogen in infants 3- Rheumatoid Arthritis could be a predisposing factor 4- Destruction of the intra-articular cartilage in the early

phase 5- Pseudoparesis is a common presentation in children

60) All of the following are possible complications for acute osteomyelitis, except:

Amlyloidosis

61) Which of the following combinations is "not true"?

OK Sign Posterior Interosseous

[Ok sign is for Anterior Interosseous (branch of median nerve)]

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62) All of the following fractures can be managed conservatively, except:

1- Displaced patellar fracture 2- Comminuted humerus fracture 3- Colles fracture of the wrist 4- Scaphoid fracture 5- Both legs closed bone fractures

63) About shoulder dislocation, all are true, except:

It is usually associated with Acromio-Clavicular disruption

64) Knee dislocation might lead to injury to which of the following nerves:

Common Peroneal Nerve

65) All of the following are false about fractures in children, except:

Supra-condylar fractures of the elbow require proper reduction and surgical fixation

66) About DDH, all are false, except:

1- First presentation might be limping 2- Usually associated with severe pain 3- Ortolanis and Barlows tests are very sensitive 4- Infants are treated surgically 5- Pavlik Harness for 3 years and above

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67) Which of the following is false about foot?

1- Pes Planus is flat foot 2- Pes Cavus is usually associated with neurological problems 3- Serial casting is the treatment for TEV 4- Vertical Talus causes Pes Cavus 5- TEV is club foot

68) Regarding growth plate injuries, all are true, except:

In Salter-Harris type 2 fractures, the metaphyseal bone fragment is located on the tension side of the fracture, while the periosteum is torn on the compression side

69) The most common concomitant injury with ACL tear is:

Lateral meniscus tear

70) All are true about Ewings Sarcoma, except:

Spindle cells on the x-ray

71) All of the following are supplied by the ulnar nerve, except:

1- 1st

2- Interossei two lumbricals

3- Sensation on medial aspect of fingers 4- Adductor policis 5- All hypothernar muscles

72) About crushed limb syndrome (crush syndrome), all are true, except:

Hypercalcemia can arrest the heart

[Its actually HYPOcalcemia that would arrest the heart.]

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73) All of the following muscles are supplied by the median nerve in the forearm, except:

Flexor Carpi Ulnaris

74) 16 y old boy (long history); el mohem ennu multiple traction trauma & adolescent, so the answer is:

Osgood-Schlatter disease

[Irritation of patellar ligament & tibial tuberosity; it is characterized by painful lumps just below the knee and is most often seen in young adolescents.]

75) Compartment decompression is indicated if:

The difference between the diastolic blood pressure and the compartment pressure is less than 30 mm Hg.

76) All of the following regarding DDH at 6 months are true, except:

1- Mostly managed by closed means 2- Limited abduction of hip joint 3- Positive Galeazi sign 4- Positive Ortolani test 5- Ortolani limitation of abduction

77) All of the following concerning osteoarthritis are true, except:

Always treated by arthroplasty

78) About Hallux Valgus, all are true, except:

1- Commonest foot deformity 2- Most commonly seen in women 3- Pain is a common presentation

[Pain is not a common presentation, but is the commonest indication for surgery.]

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79) We see waddling gait in all of the following, except:

1- Bilateral injury to the superior gluteal nerve 2- Bilateral coxavara 3- Bilateral coxavalga 4- Muscle dystrophy 5- Bilateral DDH

80) All are part of the shoulder joint, except:

1- Glenohumeral joint 2- Sternoclavicular joint 3- Acromioclavicular joint 4- Acromiohumeral joint 5- Scapulothoracic joint

81) All are true about UrigidU club foot (talipesequinovarus), except:

1- Vertical talus 2- Uncorrectable type (or difficult to correct) 3- Planter flexion and inversion

82) All are stabilizers of the shoulder joint, except:

1- Rotator cuff 2- Glenoid 3- Bony configuration 4- Negative pressure inside the capsule 5- Trapezium ligament (something like that!)

83) The most important complication of posterior hip dislocation is:

1- Sciatic nerve injury 2- Femoral nerve injury 3- Femoral artery injury 4- Obturator nerve injury 5- Obturator artery injury

16

84) Regarding Perthes disease, all are true, except:

1- It is avascular necrosis of part or whole of the femoral head

2- Affect children between 4-10 years 3- Always bilateral 4- Self-limited disease 5- Boys are affected more than girls

85) All of the following are clinical and radiological signs of Uanterior U shoulder dislocation, except:

1- External rotation of the shoulder joint 2- Loss of normal deltoid contour 3- Bankart lesion is seen on X-ray and MRI 4- Hill sachs lesion on the humeral head anteriorly 5- Absence of the ovale-crossed area between glenoid and

humeral head

86) Treatment of open fracture includes all of the following, except:

1- Wound debridement 2- Immediate skin closure 3- Intra venous antibiotics 4- Tetanus prophylaxis 5- Stabilization of fracture

87) All of the following are unfavorable factors that affect bone union, except:

1- Poor blood supply 2- Comminuted fracture 3- Infection 4- Immobilization

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88) All of the following are orthopedic top emergency, except:

1- Fracture shaft of femur 2- Compartment syndrome 3- Septic arthritis 4- Dislocated joint 5- Compound fracture

89) Regarding DDH, all are true, except:

1- Associated with positive family history 2- Affects male more than female 3- Associated with capsular laxity 4- Could be part of syndrome 5- Breech presentation can be a cause of it

90) Knee effusion can be due to all, except:

1- Rheumatoid arthritis 2- Osteoarthritis 3- Rickets 4- Hemophilia 5- Pseudogout

91) Radiological features of primary osteoarthritis include all, except:

1- Osteoporosis of the bone adjacent to the joint 2- Subchondral sclerosis 3- Loss of joint space 4- Osteophytes of the joint margins 5- Subchondral cysts

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92) All of the following about carpal tunnel syndrome are true, except:

1- Most common in females 2- Bilateral presentation is common 3- Pain & numbness at night are characteristic 4- Tinel's sign is usually positive 5- Wasting of thenar muscles present early in the disease

93) One of the following is not considered in describing scoliosis:

1- Side 2- Site 3- Type 4- Instability 5- Size of the curve

94) All of the following are presenting symptoms of the tumors, except:

1- Night pain 2- Swelling 3- Accidental 4- Fever 5- Pathological fracture

[Rarely, people with bone cancer may have symptoms such as fever, generally feeling unwell, weight loss, and anemia.]

95) Sulcus sign indicates:

1- Anterior instability 2- Posterior instability 3- Inferior instability 4- Cuff tear 5- Biceptal tendonitis

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96) All of the following are recognized signs of DDH, except:

1- Positive Ortolani test 2- Positive Barlow test 3- Positive Galleazzi sign 4- Limited adduction 5- Positive Trendelenberg

97) Tennis elbow is the term used for:

1- Olecranon bursitis 2- Non-articular inflammation of origin of the extensor

muscles of forearm attached to lateral epicondyle of the humerus

3- Myositis ossificans of the supinator muscle 4- Fractured head of radius 5- Ulnar nerve neuritis

98) We use Barlow test in diagnosis of: DDH 99) A common site for avascular necrosis: head of femur 100) The most likely affected nerve in anterior shoulder dislocation is:

1- Radial nerve 2- Axillary nerve

101) Osteosarcoma, all of the following are true, except: It affects the epiphysis 102) Most common microorganism that causes osteomyelitis: Staph. aureus

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103) Best investigation for the evaluation of bone metastasis is:

1- Tc99 bone scan 2- X ray 3- Alkaline phosphatase level

104) Wrong about CTS: associated with vascular disorders 105) Wrong about hip joint: it's the most movable joint in the body 106) Wrong about menisci importance: its important for nutrition 107) Fibula fracture: loss of dorsiflexion of the foot

108) All of the following are considered malignant or premalignant lesions, except:

1- Osteosarcoma 2- Giant cell tumor 3- Paget's disease of the bone 4- Osteoid osteoma

109) All of the following are risk factors for developing osteoarthritis, except:

1- Joint dysplasia 2- Osteoporosis 3- Occupation 4- Family history 5- Obesity

110) All of the following are true about bone tumors, except:

All of the benign lesions should be treated surgically

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111) Commonest nerve to be injured in anterior shoulder dislocation:

1- Radial nerve in axilla 2- Musculocutaneous nerve 3- Post cord of brachial plexus 4- Axillary nerve 5- Suprascapular nerve

112) All are true in club foot, except:

1- The foot is in dorsiflexion 2- There is abnormal tarsal, subtarsal, midtarsal joints

113) All are true about septic arthritis in newborn, except:

1- Normal ESR 2- Pyrexia

114) A high incidence of AVN of the femoral head occurs with: Femoral neck fractures 115) Common investigations used to detect knee disorders include all, except:

1- Plain x-ray 2- Arteriography 3- MRI 4- Joint aspiration 5- Arthroscopy

116) Regarding diagnosis of DDH, all are true, except:

1- High index of suspicion is a must 2- Proper clinical examination is the best way of diagnosis 3- Immediate x-ray at birth is diagnostic 4- Ultrasound is a helpful way of investigations 5- Screening of high risk families for DDH is rewarding

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117) Acute hematogenous osteomyelitis, all the following are true, except:

1- Delayed treatment have no effects 2- It is infection of a bone 3- Can affect all ages mainly children 4- Can cause serious complications 5- Usually affect the growing bone

118) Regarding DDH, all are true, except:

1- Positive trendelenburg test means weak hip joint abductors 2- Positive ortolani test means the hip joint is dislocated 3- Positive Galeazzi test means limb elongation 4- Positive barlow's test means dislocatable hip 5- Waddling gait means bilateral hip dislocation

119) All of the following are risk factors for DDH, except:

1- First birth 2- Hyperlaxity 3- Family history 4- x-ray during pregnancy

120) All have positive Trendelenburg test, except:

1- Coxavalga 2- Weak hip abductors 3- Injury to the superior gluteal nerve

121) All are unfavorable for fracture healing, except:

1- Cancellous bone 2- Age > 70 years 3- Fracture through bone cyst 4- Poor blood supply

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122) Regarding bone tumors, all the following are true, except:

1- They can be either primary or secondary bone tumors 2- Primary bone tumors can either be benign or malignant

bone tumors 3- The commonest secondary bone tumors originated from

the breast , bronchus, thyroid ,prostate or kidneys 4- Secondary bone tumors are always osteolytic lesions 5- They are named according to the original cell type

123) Regarding treatment of acute osteomyelitis, all of the followings are true, except:

1- Immobilization to rest the diseased part is essential 2- Antibiotic should be given IV 3- antibiotic should be chosen according to the culture and

sensitivity test 4- Surgery has no place in treatment 5- Antibiotic course should be extended up to 6 weeks

124) Regarding compound fractures, all are true, except:

1- It is potentially contaminated fracture 2- It can be a comminuted fracture 3- Usually it is caused by a high energy force 4- Its treatment is the same as any other fracture 5- It is the same as an open fracture

125) Regarding fractures, all are true, except:

1- Traumatic fractures are the commonest type 2- Compound fracture is the one which communicate with the

air 3- Displaced fracture is a fracture in which the fragments

are away from each other 4- Compound fracture is the same as comminuted fracture 5- Greenstick fracture is a children fracture

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126) All the definitions are true, except:

1- A fracture is discontinuity of the bone tissue 2- Subluxation is complete separation of articular surface 3- Sprain is a tear in the ligament 4- Strain is a tear in the musculocutaneous junction 5- A wound is a discontinuity of the skin

127) All of the following are true, except:

1- Median nerve injury: weakening in the thenar muscles 2- Ulnar nerve injury: weakening in the hypothenar muscles 3- Radial nerve injury: weakening of the flexion at the

metacarpophalangeal joint

128) Regarding peripheral nerve injuries, all are true, except:

1- Neuropraxia means minor contusion or compression of the nerve

2- Neurotmesis means complete cut of the nerve 3- Axonotmesis means interruption of the axons while the

endoneural tube is preserved 4- All types of injuries are treated surgically 5- Can be caused by a trauma or a disease

129) Regarding peripheral nerve injuries, all are true, except:

1- In neuropraxia, complete recovery of the nerve function is expected

2- In axonotmesis, nerve recovery is expected 3- In neurotmesis, spontaneous recovery is almost impossible 4- Surgical treatment is either by direct suturing or nerve

grafting 5- Crutch palsy is an example of neurotmesis

[Its a form of pressure paralysis affecting the arm and caused by compression of the infraclavicular brachial plexus or radial nerve by the crosspiece of a crutch.]

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130) Regarding clinical picture of acute osteomyelitis, all the following are true, except:

1- It is the same in infants and older children 2- In children, pain and fever are the presenting symptoms 3- Tenderness at the site of infection is always positive 4- Swelling at the site of infection is possible 5- Loss of function (mobility) is evident

131) Regarding osteoarthritis of the hip joint, all are true, except:

1- It is more prevalent in the east than the west 2- Associated with pain and joint stiffness 3- X-rays might show reduction in joint space 4- Blood chemistry is usually normal 5- End stage disease will need total joint replacement

132) All of the following concerning avulsion fractures are true, except:

1- Mostly they need internal fixation 2- Fracture of the olecranon of ulna is an example 3- Difficult to obtain closed reduction 4- Occur at the site of attachment of tendon or ligament 5- Usually occur at the midshaft of long bones

133) Hemoarthrosis can be caused by all, except:

1- Hemophilia 2- Patellar fracture 3- Peripheral tear of meniscus 4- Central tear of meniscus 5- Anterior cruciate ligament tear

134) All of the following are true about flat foot, except:

Always need surgery

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135) All of the following are general complications of fractures, except:

1- DVT and pulmonary embolism 2- Fat embolism 3- Hypovolemic shock 4- Myositis ossificans 5- Tetanus

136) All are true about shoulder dislocation, except:

Posterior dislocation is the commonest 137) Least important knee symptom:

1- Locking 2- Giving away 3- Click 4- Pain 5- Swelling

138) All of the following are true about hand anatomy, except:

Median nerve innervates the medial four interossei

139) Regarding fractures in children, all of the following are true, except:

1- Non-union is common 2- Mal-union is frequent 3- Remodeling potential is high 4- The majority is treated conservatively 5- Growth plates injury sometimes end up with permanent

deformity

140) Most common bone tumor is: Metastasis

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141) Scoliosis is: Lateral curvature and rotation of the spine

142) One is wrong about osteoid osteoma:

If not treated, will transform to malignant 143) All of the following are true concerning compartment syndrome, except: Managed by aspiration of hematoma 144) Meniscus tear injury can occur in:

1- Twisting force 2- Twisting force while the knee is flexed

145) Regarding radiological bony lesion, all are considered, except:

1- Location 2- Consistency 3- Bony reaction 4- Edges 5- Motility

146) Spiral fracture is caused by:

1- Bending force 2- Direct force 3- Twisting force 4- Axial compression 5- Blunt trauma

147) Osteomyelitis of patient with sickle cell disease is mostly caused by:

1- Staph aureus 2- Salmonella 3- Streptococcus pyogenes

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148) Which of the following is the most important complication in posterior dislocation of the hip?

1- Osteoarthritis 2- Osteonecrosis 3- Femoral artery injury 4- Obturator nerve injury

149) A 55-year old female patient sustained an undisplaced fracture of the greater tuberosity of the humerus managed by sling. After 2 months, the sling was removed and the shoulder was stiff in all directions. The most probable cause of the stiffness is:

1- Non-union 2- Post-traumatic stiffness 3- Mal-union 4- Reflex sympathetic dystrophy 5- Frozen shoulder (adhesive capsulitis)

150) Avascular necrosis of the head of femur is caused by:

1- Intertrochanteric fracture 2- Subtrochantric fracture 3- Femur shaft fracture 4- Fracture of the neck of femur

151) All are true regarding Ewings sarcoma, except:

1- Common malignancy of children 2- It always arises from the metaphysis

152) What is the definition of coxavara?

The angle between the head of femur and the shaft is less than 120

29

153) Meniscal tear is caused by a force while:

Flexion with torsion

154) In lumbar spinal canal stenosis, one is true:

1- Pain is due to ischemia of the calf muscle 2- Pain is along sciatic nerve distribution 3- Pain is due to venous congestion around the nerve root 4- Relived by standing in erect posture 5- Increased by going up stairs

155) A greenstick fracture:

1- Occurs chiefly in the elderly 2- Does not occur in children 3- Is a spiral fracture of tubular bone 4- Is a fracture where part of the cortex is intact and

part is crumpled or cracked 156) All of the following can be found in the first few days of acute osteomyelitis, except:

1- Elevated leukocyte count in blood count 2- Positive aspiration cultures 3- Cortical & medullary lucencies on x-ray (x-ray changes) 4- Raised ESR 5- Positive blood culture

157) Which one of these statements is true in diagnosis of congenital hip dislocation in the first few days of life?

1- It is impossible to diagnose it 2- The sign of telescoping is the best way of diagnosis it 3- It is possible to diagnose it by Ortolani/Barlow test 4- Trendelenberg test is the most useful

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158) Trendelenburg sign is used in the diagnosis of:

1- Varicose venis 2- Congenital dislocation of the hip 3- Carcinoma of the stomach 4- Pulmonary embolism

159) The sequestrum on x-ray appears:

1- Dense 2- Light 3- lsodense as surrounding bone 4- Any of the above

[In osteomyelitis, x-ray films may reveal sequestra, which appear as ill defined areas of radiolucency containing a radiopaque island of nonvital bone.] 160) The joint that most likely has recurrent dislocation is:

1- Ankle 2- Knee 3- Shoulder 4- Patella

161) Volkman's ischemic contracture commonly occurs following:

1- Fracutre shaft of humerus 2- Supraccndylar fracture 3- Colle's fracture 4- Monteeggia fracture

162) The carpal bone most commonly fractured is:

1- Triquetrum 2- Hamate 3- Capitate 4- Scaphoid

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163) The single dependable sign or symptom of early compartment syndrome is (1st

1- Cyanosis of fingers

sign of compartment syndrome):

2- Obliteration of radial pulse 3- Paralysis of flexor muscle of forearm 4- Pallaor of fingers 5- Pain out of proportion (bursting pain)

164) Which nerve is compressed in carpal tunnel syndrome?

1- Ulnar 2- Median 3- Radial 4- All of the above

165) The most common injury following pelvic fracture is of:

1- Bladder 2- Urethra 3- Rectum 4- Vagina

166) Limb shortening with adduction and internal rotation occurs in which type of hip dislocation?

1- Anterior 2- Posterior 3- Central 4- All of the above

167) What is Talipes Equinovarus?

1- Club foot 2- Flatfoot 3- Pes cavus

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168) All of the following are associated with intertrochanteric fracture of femur, except:

1- Limb shortening 2- Malunion 3- Vascular necrosis of femoral head 4- Internal fixation is preferred

169) All of the following are complications of fracture shaft femur, except:

1- Malunion

2- Nonunion 3- Knee stiffness 4- Fat embolism 5- Vascular nercrosis of femoral head

170) Malunion of fracture is

1- Fracture which unites in a position of deformity

:

2- Delayed union of a fracture 3- Non-union of fracture 4- Followed by psedudoarthrosis 5- Due to tuberculosis

171) The initial abnormality in primary osteoarthritis is:

1- Synovial membrane irritation 2- Sclerosis of the articular cartilage 3- Fibrillation of the articular cartilage 4- Osteophyte formation

172) The initial abnormality in rheumatoid arthritis is:

1- Fibrillation of cartilage 2- Sclerosis of cartilage 3- In the synovial membrane 4- In the capsule 5- Proliferation of bone

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173) A benign tumor forming osteoid is:

1- Synovioma 2- Chondroma 3- Osteoma 4- Fibroma 5- Adenoma

174) Acute osteomyelitis usually begins at:

1- Epiphysis 2- Metaphysis 3- Diaphysis 4- Any of the above

175) A 10 year-old boy had swelling over tibial tuberosity (or infrapatellar region) after playing football, no history of direct trauma, what is the diagnosis?

1- Neoplasm 2- Meniscal injury 3- Osgood-Schlatter disease (mostly this is the answer)

176) Which bone ossifies first during neonatal period?

1- Scapula 2- Clavicle 3- Femur

[The clavicle is the 1st

bone to begin the process of ossification during development of the embryo. However, it is one of the last bones to finish ossification at about 2125 years of age.]

177) Interruption of Shenton's line: DDH 178) Colles fracture is: fracture of the distal radius

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179) All of the following are early complications of fractures, except:

1- Shock 2- Joint stiffness 3- Pulmonary embolism 4- Tetanus 5- Fat embolism

180) All of the following are common sites of avascular necrosis, except:

1- Femur 2- Proximal scaphoid 3- Distal scaphoid 4- Talus 5- Lunate

181) Upon evaluation of bone tumor on plain x-ray, all of the following can be assessed, except:

1- Cortical erosion 2- Degree of calcification 3- Matrix or consistency 4- Margin 5- Bone activity

182) Three-year-old boy presented with septic arthritis of the knee, the main causative organism is:

1- Haemophilous influenzae 2- Streptococcus pyogenes 3- Salmonella 4- Staphylococcus aureus 5- Pseudomonas

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183) A 32 year old woman fell on her outstretched hand 4 weeks ago. Initial radiographs revealed no evidence of fracture. Management consisted of a wrist splint. She now reports increased swelling of entire hand, intense burning pain, and a mottled skin color appearance. Repeated radiographs are normal. What is the most likely diagnosis?

1- Compartment syndrome of the forearm 2- Allergic reaction to the splint material 3- Carpal tunnel syndrome 4- Complex regional pain syndrome 5- Rupture of the extensor pollicis longus tendon

184) All of the following go with septic arthritis, except:

1- Fever 2- High ESR 3- Pain 4- Polyarticular involvement 5- Effusion

185) All of the following are innervated by L5 nerve root, except:

1- Gluteus medius 2- Extensor digitorum brevis 3- Flexor digitorum longus 4- Tibialis anterion 5- Extensor hallucis longus

186) Which of the following muscles is not supplied by the median nerve?

1- Abductor policis brevis 2- Pronator teres 3- Adductor policis 4- Second lumbrical 5- Flexor carpi radialis

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187) All of the following may be a result of direct trauma to the leg except:

1- Transverse fracture 2- Comminuted fracture 3- Compound fracture 4- Spiral fracture 5- No fracture

188) Regarding pathological fracture, all are true, except:

1- Occurs in an abnormal bone 2- Needs a minor force to happen 3- Osteoporosis is the commonest cause of pathological

fracture 4- Usually it heals on time 5- Best treated by surgical fixation

189) A 20 year old male patient admitted with fracture of right femur. Second day he complained of shortness of breath and restlessness. On examination, he was found to have tachypnea, tachycardia with good air entry bilateral on auscultation, petechial rash on upper chest. Urgent arterial blood gas revealed low oxygen saturation. The most probable diagnosis is:

1- Deep vein thrombosis 2- Hemothorax secondary to undetected chest trauma 3- Pulmonary embolism 4- Fat embolism syndrome

190) Wrong about metastatic tumors of bone: Don't respond to hormonal therapy 191) Differential pressure for diagnosing compartment syndrome:

Difference between diastolic and compartment pressure less than 30mmHg

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192) All of the following are true regarding osteochondroma, except:

1- Multiple form (multiple hereditary exostosis) is inherited as AD

2- Patient typically has night pain and relieved by NSAIDS 3- Characterized by the presence of cartilaginous exostosis 4- Most common site is the metaphysis of long bones 5- Increase in size after the age of maturity is considered as

a worrying sign of malignant transformation 193) All are true regarding bone healing, except:

1- Healing in adults is better than children 2- Intraarticular fractures heal poorly 3- The 1st

4- The last stage is remodeling stage is hematoma

5- Healing of spongy bone is better than cortical 194) All of the following are considered advantages of ORIF (open reduction, internal fixation), except:

1- Less chance of joint stiffness 2- Easier rehabilitation 3- Less chance of deep vein thrombosis 4- Less chance of malunion 5- Less chance of sepsis

195) Flexion and extension is in which plane? Sagittal 196) Perthes disease occurs at which age: 4 - 10 years

197) All muscles are supplied by the median nerve, except:

Abductor pollicis longus

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198) All of the following are features of algodystrophy (complex regional pain syndrome), except:

1- Fever 2- Pain 3- Stiffness

199) Not a feature of talipes equinovarus: abducted mid/fore foot

200) Brodie's abscess is a finding for: Subacute osteomyelitis

201) False about osteoid osteoma:

Metacarpal bones are commonest involved 202) What's wrong about infantile scoliosis?

Convexity to the right 203) The first detectable radiological change in a baby with DDH is:

Distortion of Shentons line 204) The most common site of origin of bone metastasis in a male is: Prostate CA (The other choices were rare tumors such as adrenal and bladder CA.) 205) Green stick fracture is: A fracture in which the bone buckles on the side opposite to the causal force, where periosteum remains intact 206) Mallet finger, the deformity is in the: Distal phalanx

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207) Trigger finger is:

Tenovaginosis of flexor tendon of affected finger [Stenosing tendosynovitis of flexor tendon, usually due to over activity with preexisting risk factors like DM.]

208) All of the following are true about osteoarthritis, except:

MRI & CT are essentials for diagnosis 209) The mainstay for diagnosis of carpal tunnel syndrome:

1- History and physical examination 2- Nerve study 3- MRI 4- EMG

210) All of the following are true regarding management of knee osteoarthritis, except:

1- Weight bearing AP x-ray should be done 2- Dynamic x-rays (varus & valgus) are indicated 3- NSAIDS are used 4- Irrigation of the knee joint may relieve symptoms 5- Intraarticular injection may improve symptoms

211) The most common site for compartment syndrome is:

1- Radius 2- Supracondylar fracture 3- Proximal humerus fracture 4- Tibial fracture

212) All of the following are true about osteosarcoma, except:

1- Chemotherapy and surgery are part of the treatment 2- Usually occurs in old age 3- It's the most common primary malignant bone tumor

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213) A 7 years old boy, presented with 2 days history

1- Increase bone uptake in bone scan

of localized pain, hotness, warmth at the right proximal tibia, with fever and malaise. What is not a finding?

2- Osteolytic changes 3- High ESR, CRP 4- High WBC count

214) All of the following are classic findings in pyogenic tenosynovitis of the hand, except:

1- Symmetrical swollen finger 2- Pain radiates to the wrist 3- Ereythema extends to the wrist 4- Partialy flexed hand

215) What is the best definition of shock?

1- Decrease blood pressure and level of consciousness 2- Decrease tissue perfusion 3- Decrease oxygen Po in blood

216) All of the following are signs of fat emboli syndrome, except:

1- Hypertension 2- Low grade fever 3- Tachycardia 4- Confusion

217) The most accurate test for ACL tear is:

1- Sag sign test 2- Lachmann's test 3- Anterior drawer test 4- Appley's test

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218) 50 year old lady had distal tibial fracture underwent ORIF. 4 months later she presented with painful ankle, swelling, hotness, tenderness, and atrophy localized to the foot. The most likely Dx:

1- Complex Regional sympathetic dystrophy (algodystrophy) 2- Compartment syndrome 3- DVT

219) The most common cause of pain in osteomyelitis:

1- Ligaments inflammation 2- Increased interosseus pressure 3- Joint stretching 4- Meniscial tear

220) A 50 year old female, presented to you with limited movement of the shoulder especially external rotation, no X-ray findings, what is your Dx?

1- Frozen shoulder 2- Impingement syndrome 3- Shoulder subluxation

221) The definition of scoliosis:

1- Lateral deviation of the vertebral column 2- Three dimensional abnormal curvature of the spine 3- Two dimensional deformity 4- Rotation of the column

222) About lumbar canal stenosis, one is correct:

1- The pain is due to congestion of the blood vessels 2- The pain increases when bending forward 3- The pain decreases in flexion in the erect position

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223) 10 years old boy with supracondylar fracture, you did internal fixation for him. He presented after 2 days with swelling of the hand, pain and hotness. Which of the following is not considered in the treatment?

1- Admission to the hospital 2- Give appropriate does of analgesics to reduce pain 3- Do the neouro-muscular tests for the hand 4- Consider fasciotomy as a part of treatment

224) Which of the following is a support for the plantar arch?

1- Peroneus longus 2- Peroneus brevis 3- Flexor hallucis brevis 4- Extensor hallucis longus 5- Achilles tendon

225) A fast stabilization of a femoral fracture within the 1st

24 hours in a poly-traumatic patient is to prevent:

1- Infection 2- Pulmonary complications 3- Osteoarthritis 4- Non-union

226) Which is true about the meniscus?

1- Inner 30% is vascular 2- Peripheral 50% is vascular 3- Entire meniscus is vascular 4- Peripheral 30% is vascular 5- Inner 10 30% is vascular

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227) The single most important factor in developing hypertrophic non-union is:

1- Inadequate immobilization 2- Poor blood supply 3- Organization of clot 4- Poor reduction 5- Correct bone alignment

228) A patient sustained a comminuted fracture of the proximal fibula. The most likely neurological findings would be:

1- Loss of dorsiflexion of the foot & sensations over the dorsal surface

2- Loss of sensation over the lateral plantar surface & inability to invert the foot

3- Loss of sensation over the medial plantar surface and inability to evert the foot

4- Isolated paralysis of the extensor digitorum brevis muscle 5- Isolated sensory loss over the lateral plantar surface

229) A 3 year old child has septic arthritis of the hip and osteomyelitis of the ipsilateral proximal femur. What is probably accounting for this finding?

1- Simultaneous hematogenous infection of the proximal femur epiphysis and the hip joint

2- Spread of infection from the proximal femur epiphysis to the hip joint

3- Spread of infection from the proximal femur metaphysis to the hip joint

4- Spread of infection from the hip joint to proximal femur metaphysis

5- Immunocompromised host allowing for the concomitant septic arthritis and osteomyelitis

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230) All are differences between true & pseudosciatica, except:

1- Pseudosciatica is referred pain 2- True sciatica is associated with sensory disturbance 3- True sciatica is associated with positive straight leg

raising test 4- True sciatica is caused by spinal cord compression 5- Pseudosciatica is not associated with myotome disturbance

[Sciatica is caused by nerve root compression not spinal cord compression.] 231) A man was hit by a metal pipe on the medial side of his forearm. Whats the most likely type of fracture?

1- Butterfly fracture of the ulna 2- Transverse fracture of the ulna

232) Which of the following is not used to examine the knee joint?

1- Anterior drawer test 2- Straight leg raising test 3- Lachmann test 4- Apprehension test

233) Complications of osteomyelitis in 6 year old children include all of the following, except:

1- Generalized sepsis 2- Chronic osteomyelitis 3- Pathological fracture 4- Bone deformity 5- Septic knee

234) A patient with suspected foot compartment syndrome, what is the most reliable sign/symptom to aid in the diagnosis?

1- Pulseless foot 2- Progressive pain & swelling 3- Pain on dorsiflexion

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235) Regarding metastatic bone disease, which is true?

1- Thyroid, renal, & lung CA give osteoblastic lesions while prostate CA gives osteolytic lesions

2- They are less common that primary bone malignancies 3- Axial skeleton & proximal femur are the most common

involved sites 4- Life expectancy should not be considered when taking

decision of surgical intervention 5- There is no role for medical therapy such as

Bisphosphonates, and hormonal therapy 236) All are true concerning the hip joint, except:

1- Its a ball & socket joint 2- Nerve supply is by all nerves traversing the pelvic girdle to

lower limb 3- Being a ball & socket joint, its the most movable joint in

the body 4- Stabilized by bony structures, ligaments, and muscles 5- Artery of the ligamentum teres (from obturator artery) is

important in young children and atrophied mostly by age of 7 237) The best indicator to antibiotics response used for treatment of hematogenous osteomyelitis is:

1- WBC 2- ESR 3- CRP serial 4- Isotope bone scan

238) Anterior shoulder dislocation may be complicated with:

1- Brachial plexus injury 2- Tear of rotator cuff 3- Fracture head of humerus 4- (1) & (2) 5- All of the above

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239) A march fracture most frequently results from:

1- Direct trauma 2- Jumping from a height 3- Muscle fatigue from prolonged walking 4- Use of high-healed shoes 5- Osteoporosis

[March fracture is a fatigue fracture (stress fracture) of metatarsal

bone after prolonged walking.]

240) Regarding osteosarcoma, which of the following is true?

1- Affects the epiphysis of long bones 2- Are most commonly seen around the hip and distal humerus 3- Hematogenous spread can result in pulmonary metastases 4- Usually treated by surgical resection followed by

chemotherapy 5- X-ray shows a metaphyseal nidus of less than 1.5 cm

241) Regarding upper limb peripheral nerve injuries, which of the following is false?

1- Injury to the radial nerve results in a wrist drop 2- Injury to the median nerve results in loss of sensation

over the palmar aspect of the index finger 3- Injury to the radial nerve results in loss of sensation in

the anatomical snuffbox 4- Injury to the ulnar nerve results in a claw hand 5- Injury to the ulnar nerve results in loss of sensation

over the thumb 242) All of the following are true about menisci, except:

1- Lateral meniscus is more common to be injured than median

2- The lateral 1\3 of the meniscus is the only vascularized part

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243) In a football match between R. Madrid & F.C Barcelona, C. Ronaldo felt pain in his right knee while turning to the left side with his knee flexed and taking the body weight. However, he continued the game. Few days later, the joint became swollen and painful. Thereafter, he suffered from recurrent locking with feeling of "giving way" & "clicking" sounds in the joint. The most probable diagnosis is:

1- ACL rupture 2- Fracture of the tibial spine 3- Rupture of the medial ligament 4- Meniscal tear 5- Fracture of the patella

244) In posterior dislocation of the shoulder, Hill-Sachs lesion is found on:

1- The posteriolateral part of the humeral head 2- The anteriolateral part of the humeral head 3- The anteriomedial part of the humeral head 4- The posteriomedial part of the humeral head 5- No such lesion in posterior dislocation

245) All of the following are considered as tenosynovitis of the hand, except:

1- Trigger finger 2- Trigger finger kman w7deh bs bt5talif 3n el 2oola 3- De Quervain disease 4- Mallet finger

246) The immediate fixation of fracture:

1- Plaster of Paris (POP) 2- Internal fixation 3- External fixation 4- Back slab

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247) All of the following need ORIF (open reduction, internal fixation), except:

1- Femur shaft fracture in a 30 years man 2- Supracondylar fracture 3- Non-union fracture 4- Vertebral fracture

248) All these investigations are used in evaluation of bone tumors except:

1- MRI of the lesion 2- CT scan of the lesion 3- CT scan of thorax, abdomen & pelvis 4- Brain CT scan 5- Bone Scan

249) Which of the following is mismatched?

1- +ve Anterior Drawer Sign - ACL tear 2- +ve Posterior Drawer Sign - PCL tear 3- Lachman sign - ACL tear 4- Jamming - Meniscal tear

250) All the following are x-ray findings that go with knee osteoarthritis, except:

1- Osteophytes 2- Subchondral sclerosis 3- Subchondral cyst 4- Varus deformities 5- Symmetrical involvement of both compartments of the

knee

1- Occurs chiefly in the elderly2- Does not occur in children3- Is a spiral fracture of tubular bone4- Is a fracture where part of the cortex is intact and part is crumpled or cracked156) All of the following can be found in the first few days of acute osteomyelitis, except:1- Elevated leukocyte count in blood count2- Positive aspiration cultures3- Cortical & medullary lucencies on x-ray (x-ray changes)4- Raised ESR5- Positive blood culture157) Which one of these statements is true in diagnosis of congenital hip dislocation in the first few days of life?1- It is impossible to diagnose it2- The sign of telescoping is the best way of diagnosis it3- It is possible to diagnose it by Ortolani/Barlow test4- Trendelenberg test is the most useful158) Trendelenburg sign is used in the diagnosis of:1- Varicose venis2- Congenital dislocation of the hip3- Carcinoma of the stomach4- Pulmonary embolism159) The sequestrum on x-ray appears:1- Dense2- Light3- lsodense as surrounding bone4- Any of the above165) The most common injury following pelvic fracture is of:1- Bladder2- Urethra3- Rectum4- Vagina