George and Dans MCQ’s feb 2011

1) what is the main knee stabiliser to 30% valgus stress

A: superficial MCL
B: deep MCL
C: ACL
D: PLC
E: popliteus

2) Which is the most sensitive marker for post op infection in a 6 week

TKR in an RA patient

A: CRP
B: ESR
C: bone scan
D: WCC >12
E: effusion on x-ray

3) Which condition is associated with anteromedial bowing

A: neurofibromatosis
B: congential pseudoarthrosis
C: fibular hemiemilia
D: none of the above

4) Child presents with painful joint and on examination they have

asymmetric pupils. Which is the most likely

A: HLA B27 +ve

B: RF –ve
C: ANA +ve
D: HLA B27 –ve
E: ANA –ve
F RF +ve

5) With regards to Ank Spond, which is the most likely

A: ANA -ve, RF –ve, HLA b27 +ve, ESR +ve

B ANA –ve RF +ve HLA b27 –ve, ESR +ve
C ANA +ve, RF –ve HLA B27 +ve, ESR +ve
D: ANA +ve, RF –ve, HLA B27 –ve, ESR –ve

6) Major blood supply to proximal humerus

A: thoracoacromial artery
B: supreme thoracic artery
C: anterior branch of humeral circumflex
D: posterior branch of humeral circumflex
7) Major blood supply to femoral neck in adults

A: ascending branch of medial circumflex from profunda

B: lateral circumflex
C: femoral
D: ligamentum teres
E: trochanteric anastomoses from the profunda

8) Patient cannot flex IPJ of thumb and has weakness in FDP of index

A: PIN
B: median
C: AIN
D: ulnar

9) Which of the following is not a cause of compression for radial/PIN

A: fibrous bands
B ECRL
C: leash of henry
D: Holstein Lewis fracture
E: Supinator
F: Arcade of Frosche

10)which is not associated with a ball and socket ankle

A: cavovarus foot
B: fibula hemiemilia
C: short femur
D: Absent lateral rays

11)which injury would be expected with a positive dial test at 30

degrees

A: ACL
B: PCL
C: MCL
D: PLC
E: LCL

12)Which of the following produces synovial fluid

A: Type A cells
B: Type B cells
C: Type C cells
D: chondrocytes
 13)Which nerve passes superior to pirifomris

A: pudendal
B: obturator
B: sciatic
C: superior gluteal
D: Inferior gluteal
E: nerve to quadratus

14)Which of the following procedures should be conducted

simultaenously with MCPJ arthroplasty in an RA patient

A: repair extensor tendons

B: radial deviation of wrist
C: Suave Kapandje procedure
D: ulna shortening

15). Parents attend concerned about the shape of their childs feet (approx 6
years?). They are worried about the fully correctable flat footed appearance.
Treatment should consist of:

A. Calcaneal osteotomy
B. Medial column fusion
C. Lateral lengthening
D. Functional foot orthosis until adolescence when arch should be
reconstituted
E. FFO for symptomatic relief

16). Patient with RA in waiting room. Initially unable to extend little finger, but
has progressed to ring finger in waiting room. Index and EPL functioning OK.
Likely diagnosis
A. Mannerfelt syndrome
B. Caput ulnae
C. PIN palsy
D. AIN palsy
E. Sindig Larsson syndrome

17). BMP 2-7 members of which family

A. Collagens
B. TGF beta
C. VEGFs
D. PDGFs
E. Interferons
F. TGF alpha
18) Elderly patient falls on to left hip and sustains an isolated undisplaced
Greater Trochanter fracture. The following should be suspected and excluded:

A. Contralateral hip fracture

B. Subcapital extension
C. Intertroch extension
D. Ipsilateral wrist fracture
E. Pelvic ring fracture

19). Not a sign of cervical spine instability

A. 15% wedge
B. Asymmetrical spinous process on AP film
C. Lateral displacement 3mm on AP film
D. Facet joint injury

20) . 25 year old back pain. Otherwise well. XR shows vertical striations. Most
likely diagnosis?

A. Infection
B. Osteoid osteoma
C. Haemangioma
D. Ewings sarcoma
E. Eiosinophillic granuloma

21). With regards to CETV treatment, the Ponsetti method involves

A. supinate & abduct

B. Plaster every 2 week for 12 weeks
C. Stop treatment at a year
D. Need to release FHL

22). Which of the following is most likely to result in sarcomatous change?

A. Osteoid osteoma
B. Gauchers disease
C. Diaphyseal aclasia
D. MED
E. Diastrophic dysplasia

23). Which of the following is most likely to explain Lytic XR findings with
Madelungs, proximal humeral and elbow deformities and no skin lesions

A. Mafucci’s
B. Diaphyseal aclasia
C. Ollier’s
D. Infection
E. Marfans
24). With regards to ACL injuries

A. Rarely associated with a meniscal tear

B. Should be reconstructed acutely
C. More common in professional sportswomen than sportsmen when
competing at a similar level
D. Is associated with avulsion fracture from medial tibial plateau
E. Prevents the return to top-level sport

25). Popliteus

A. Internally rotates femur

B. Obturator nerve supplies
C. Not always present
D. Only intrarticular tendon
E. Originates from femur

26). 3 part radial head fracture is to be treated with a T plate

A. neutral forearm position laterally

B. neutral forearm position medially
C. semi prone forearm laterally
D. Never plate

27). A golfer hits a club into the ground. Feels pain in wrist with parasthesiae
in the medial 1 and ½ digits

A. Pisiform fracture
B. Hamate fracture
C. Cubital tunnel syndrome
D. Golfer’s elbow
E. Carpal tunnel syndrome

28). Which of the following is correct of Cement and/or its properties

A. Strong in tension
B. Weak in compression
C. Low viscosity better in thr
D. Expands with exothermic reaction

29). With regards to polyethelene wear

A. Delamination commonly is the wear pattern in THR

B. Bone and PMMA debris increases wear
C. Is not affected by polyethylene thickness in TKR
D. Is no different between THR and TKR
30). Most common mode of stem fracture failure is

A. Type 1a pistoning
B. Cantilever bending
C. Calcar pivot
D. Type 1b pistoning

31). Worst outcome from uni knee replacement

A. Patellofemoral OA with medial compartment changes

B. Medial OA with fixed flexion 5 degrees
C. Correctable 5 degrees varus
D. Post traumatic medial OA
E. RA

32). Most likely Neurological injury in ilioinguinal approach to both column

acetabular fracture

A. Ilioinguinal nerve
B. Sciatic nerve
C. Anterior division of obturator nerve
D. Genitofemoral nerve
E. Lateral femoral cutaneous nerve o thigh

33). Best position of shoulder

A. 30 external rotation, 30 flexion, 30 abduction

B. 30 internal rotation, 30 flexion, 30 abduction
C. Blah
D. Blah
E. blah

34). Least likely to cause hypercalcaemia?

A. Hyperthyroidism
B. Renal osteodystrophy
C. Metastatic disease
D. Prolonged immobilisation

35). Which of the following may mimic a lumbar radiculopathy

A. Pagets disease
B. Piriformis syndrome
C. Trochanteric bursitis
36). Pain back of knee medially, particularly when squatting. 3 month onset.
Small effusion. No trauma.

A. Osteonecrosis
B. OCD
C. Medial meniscal tear
D. Posterior horn tear

37). Painless lack of forearm rotation in congenital dislocation of radial head in

16 year old.

A. Resection
B. Open reduction
C. Rotional osteotomy
D. Radial head replacement
E. Suave-Kapandji procedure

38). A&E reg says he has flexor tendon injury at zone IV. Which anatomical
location?

A. In forearm
B. Distal to PIPJ
C. Level of deep arterial arch of palm
D. Carpal tunnel
E. Who knows? Like A&E Reg can be trusted!

39). 26 year old flung from his bike 2 days previously and sustains Iliac wing
and femoral fracture. Delayed onset SOB and shoulder tip pain. ABGs normal

A. ARDS
B. Fat embolism syndrome
C. PE
D. Delayed splenic rupture
E. Diaphragmatic rupture

40). Lateral compression pelvic fracture with rectal tear. Urgent treatment
should include

A. Posteriorly applied Ex fix

B. Apply pelvic binder
C. Hartmans procedure
D. Colostomy and explore rectum
E. C- clamp application
41). Which nerve supplies 2nd dorsal webspace

A. deep peroneal
B. superficial peroneal
C. Baxter’s nerve
D. Sural nerve
E. Saphenous nerve

42). Most likely structure to be damaged during tibial nailing

A. EHL
B. FHL
C. Peroneal artery
D. TIb ant

43). Articular cartilage properties include

A. Viscoelastic properties in compression

B. Reduced permeability in compression
C. Reduced water content in OA
D. Decreased proteoglycan in OA

44). A property of a viscoelastic substance includes

A. Always has same Modulus of elasticity

B. Rate of application affects properties
C. Will not undergo hysteresis

45) Concentric contraction during swing phase

A.Tib post
B.Gastroc
C.Semimembranosis
D.FDL

46) CVT associated with which of the following

A. Arthrogryposis multiplex
B. Fibula Hemiemilia
C. Oligohydramnios
D. Calcaneovalgus
47)Condition associated with Widened foramina

A. Neurofibromatosis
B. Gauchers
C. MED
D. TB

48) With regards to Osteogenesis imperfecta which of the following

is true

A. Problem with collagen II

B. Not helped with calcium supllemetation
C. Bisphosphonates useful by enhancing osteoclasts

49)Likely diagnosis when unable to do pressups

A. LUCL
B. MCL
C. Radial head fracture
D. RUCL

50)Least likely to develop oa of the elbow

A. Posterolateral instability
B. Radial head fracture
C. MCL injury
D. Fracture dislocation of the elbow

51)Causes pain and catching on extension of the loaded knee in

TKR

A. Patellar clunk
B. Osgood schlatters
C. Sinding Larsen Johanssen
D. Patella button instability

52)Which of the following is true of trapezectomy

A FCR interposition leads to no improvement in grip strength

compared to Trapeziectomy alone
B Arthroplasty confers better function
C FCR interposition leads to significant improvement in grip
strength compared to Trapeziectomy alone