Orthopedic

mcqs past paper 2 april 2015

1) 25 year old male with external rotation injury right ankle got spiral fracture of
the fibula treatment options
a) pop cast
b) buttress plate
c) lag screw and neutral plate

2) 30 year old patient got twisting injury of the ankle developed swelling on the
medial side xray shows no fracture but increased medial gap (lateral shift of the
talus) what next to do for the diagnosis
a) xray ankle mortise view
b) xray stress view
c) complete xray sources including proximal tibia and fibula

3) mostly non union site after triple arthrodesis
a) talo navicular
b) subtalar
c) calcaneo cuboid

4)best treatment of the congenital verticle talus at the age over 3 years
a) grice green subtalar fusion
b) talonavicular and calcaneocuboid reduction + mid foot fixation
c) talectomy
d) casting

5) 35 years old known diabetic has clawing foot with recurrent ulcers for last 2
months under metatarsal heads , proprioception intact treatment options are
a) johns procedure
b) metatarsal bar
c) excision of the metatarsal heads

6) cause of hypoglycemia in diabetic patients in post operative period after big
toe amputation
a) anesthesia drug
b) hypothermia
c) septicemia
d) decreased requirement insulin after amputation

7) 45 year old male got gun shot injury to the right buttock patient developed
foot drop and sensation loss below the knee 2 years back now he developed
chronic heal ulcers xray shows chronic osteomyelitis heal treatment options are
a) amputation
b) nerve repair
c) nerve graft
d) tendon transfer



8) 25 year old volley ball player got type 3 AC dislocation treatment options
a) open reduction + AC ligament repair
b) open reduction + coracoclavicular ligament repair
c) open reduction k wire fixation coracoclavicular ligament repair
d) Bosworth screw fixation

9) in game keeper thumb which structure prevent healing
a) adductor pollicis aponeurosis
b) extensor pollicis brevis aponeurosis
c) volar plate
d) dorsal capsule

10, 11, 12) description of the bennet and Rolando fracture game keeper thumb

13) 7 year age child had supracondylar fracture 6 weeks back treated by bone
reduction now has malunion and 90 100 degree ROM treatment options are
a) active exercise
b) passive exercise
c) ORIF
d) corrective osteotomy

14) 5 year child has displaced medial condyle fracture 4 weeks back ORIF is
advised why ?
a) prevention of cubitus varus
b) prevention of instability

15) 40 year old patient has biopsy proven GCT proximal fibula with mild pain
and few mitotic figures treatment options
a) curettage and bone grafting
b) curettage and bone cement
c) extended curreatage and bone cement
d) fibula head excision

16) what is meant by extension gap
a) gap between proximal tibia and anterior femur cut
b) gap between proximal tibia and posterior femur cut
c) gap between proximal tibia and distal femoral cut

17) chance of most damaged nerve in anterior approach to cervical spine
surgery is
a) ansa cervicalis
b) recurrent laryngeal nerve
c) nerve roots






18) description of instability of cervical spine after injury
a) saggital displacement 1.5 cm rotataion 10 degrees
b) sagittal displacement 2.5 cm rotation 10 degrees
c) sagittal displacement 3.5 cm rotation 20 degrees
d) saggital displacement 4.5 cm rotation 10 degrees
d) saggital displacement 5.5 cm rotation 10 degrees

19) 14 year female has idiopathic scoliosis angle of 30 degrees at D8 treatment
options are
a) observation
b) boston brace
c) Milwaukee brace
d) corrective osteotomy

20) L1 traumatic fracture with 50 percent height loss + neurologic deficit
treatment options
a) anterior decompression
b) posterior decompression
c) posterior fixation with pedicle screw and rod

21) kienbock stage 4 disease treatment
a) lunate excision
b) proximal row carpectomy
c) wrist arthrodesis

22) 25 year male got elbow injury with type 4 coronoid fracture type 3 radial
head fracture treatment option
a) coronoid fixation and radial head excision now
b) coronoid fixation and radial head excision later

23) 15 year old boy complains of pain in the right hip for the last 6 weeks with
mild limping abduction and internal rotation in restricted diagnosis ?
a) SCFE
b) leg calve perthes disease

24) polytrauma patient needs heavy blood transfusion cross matching should be
done after
a) each transfusion
b) after 2 pints
c) 3 pints
d) 4 pints
e) 5 pints






25) 30 year male with DDH has high seated femoral head there is proximal
limping he can perform his duties c/o occasional mild pain which responds to
NSAIDS treatment options are
a) arthrodesis
b) arthroplasty
c) osteotomy
d) NSAIDs and follow up

26) 25 year old labourer got upper cervical injury 2 years back he has complete
paralysis of deltoid + external rotation and winging of scapula 3/5 levator
scapulae + rhomboid treatment options are
a) arthrodesis
b) tendon transfer

27) 25 year old child got minor injury to left leg 4 days back now developed pain
below the knee with swelling + fever which investigation will confirm diagnosis
a) blood cp
b) CRP
c) aspitation C/S
d) xrays

28) 26 year old male got gun shot injury to right mid arm and developed severe
burning sensation at the dorsum of the thumb and web between thumb and
index finger what is the severity of injury
a) complete radial nerve injury
b) partial radial nerve injury
c) sudeck syndrome

29) patient with tennis elbow taking NSAIDS for the last 6 months steroid also
injected but not improving treatment options are
a) rest
b) brace
c) ECRB tendon release

30) 27 year old electrician had electric shock 1 year back now he has subluxation
of the shoulder (recurrent) treatment options are
a) muscle relaxant
b) muscle strengthening excercises
c) surgery
d) steroid injection

31) most common complication after SCFE treatment
a) osteonecrosis
b) chodrolysis
c) coxa magna
d) proximal migration of greater trochanter



32) 40 year old patient treated for distal femur tumor + sent for radiotherapy
which type of tumor would it be
a) GCT
b) fibrosarcoma
c) malignant fibrous histiocytoma

33) 13 year old patient with fusiform shaped lytic lesion of tibial diaphysis
diagnosis
a) GCT
b) ewings sarcoma
c) fibrous dysplasia
d) chondroblastoma

34) 15 year old boy of SCFE has difficulty in abducting internal rotating of right
hip no difficulty in daily activity occasional mild pain what to do
a) osteotomy cuniform
b) cheliectomy
c) trochanteric osteotomy


35) 16 year boy of SCFE has neck shaft angle AP100 and lateral 130 what to
do
a) trochanteric osteotomy
b) cuniform neck osteotomy
c) salter osteotomy
d) chiari osteotomy

36) standard portal for arthroscope in knee arthroscopy
a) medial
b) lateral
c) posteromedial
d) central patellar

37) 7 year old child has pain right hip for the last 6 months diagnosed as perthes
disease herring type C (lateral pillar classification ) bad prognosis is because of
a) symptoms of long duration
b) age is more
c) late diagnosis of disease

38) 8 year old child has got minimal injury right knee has has mild pain in the
knee giving history of locking and giving way mild tenderness on the medial joint
line when he flexes his knee to 90 degrees diagnosis
a) meniscal cyst
b) discoid meniscus
c) lose body
d) OCD




39) treatment of neglected CTEV in 8 year old boy
a )PMR
b) PMR and evans osteotomy
c) talectomy
d) triple arthrodesis

40) anterior approach to radius
a) go between brachioradiais and common extensors
b) go between brachioradialis and pronator quadratus
c) elevate supinator subperiostally and retract laterally
d) keep the forearm pronated during proximal end of radius


41) 50 year old patient had shaft of femur fracture for which 8 hole broad DCP
fixation performed , after 6 months he presented with broken implant it is due to
a) metal fatigue
b) early weight bearing
c) non union

42) locking plate tibia gustillo type 1 performed 6 months back patient has
discharge from the wound since his surgery on and off fever xray shows 2cm
sequestered bone treatment
a) sequestrectomy
b) bone graft
c) removal plate
d) apply exfix and bone graft

43) ILN in tibia performed 4 months back patient has now discharge from the
fracture site xray shows healed fibula but tibial fracture is visible treatment
options
a) sequestrectomy
b) fibular osteotomy + dynamization
c) implant removal
d) bone grafting and exfix

44) 40 year patient has traumatic dislocation he has bankart lesion best
treatment option
a) putti plat procedure
b) attachment labrum to glenoid and anterior capsular plication
c) laterjet procedure

45) 27 year old lady got injury to her shoulder in RTA , her external rotation is
extremely painful xray AP view are normal which xray view will be advised
a) axillary view
b) lateral scapular view
c) AP view in 90 degree internal rotation of the arm
d) west point view
e) stryker notch view

46) 45 year old lady has 5 kids c/o generalized body aches serum calcium and
phosphate normal , alkaline phosphatase increased 24 hour urine increased
calcium
a) osteomalacia
b) primary hyper parathyroidism
c) secondary hyperparathyroidism

47) 40 year old patient has got fracture right shaft of femur with trivial trauma
xray KUB shows single renal stone diagnosis
a) renal carcinoma
b) hyperparathyroidism
c) renal osteodystrophy

48) 35 year old patient in RTA got both SOF fracture that were fixed with
external fixation he developed next day altered sensorium , breathlessness ,
petechiae haemorrage , difficulty breathing diagnosis
a) ARDS
b) pulmonary embolism
c) fat embolism

49) 25 year old patient has pain in the right mid thigh which is at night and
responds to NSAIDS no assosciated fever best modality of diagnosis is
a) xrays
b) CT scan
c) MRI
d) bone scan

50) 8 weeks of child with DDH treated with pavlik harness what is the best
modality at this stage for checking DDH
a) ultrasound
b) arthrogram
c) clinical examination
d) xray

51) 9 year old boy with post polio paralysis right lower limb has normal hip knee
has 20 degree flexion contracture quads 2/5 hamstring 5/5 ankle has equinus
3cm shortening what to do for knee straingtning
a) posterior capsulotomy + anterior transfer of hamstring
b) s/c extension osteotomy of femur + anterior transfer of hamstring

52) how much of the normal will be factor 8 and 9 level in hemophiliac patient
for major surgery
a) 20%
b) 40%
c) 60%
d) 80%
e) 100%

53) 14 year of age patient with SCFE has his hip stable is 55 degree internal
rotation , 15 flexion 15 degree abduction which osteotomy should be done
a) salter
b) chiari
c) femoral derotation
d) shelf osteotomy

54) weight bearing surface of THR which one has high coefficient of friction
a) metal on metal
b) ceramic on ceramic
c) metal on polyethylene
d) metal on higher cross linked polyethylene

55) in TKR lateral tibial condyle deficiency of 2 to 2.5 cm should be corrected by
a) osteotomy
b) cement augmentation and screws
c) bone grafting
d) metal wedge augmentation

56) while reducing the knee in TKR it is tight in extension and loose in flexion
what should be done
a) use this insert
b) use small femoral component
c) increase distal femoral cut
d) use large femoral implant
e) increase proximal tibial cut

57) which screw should be used in talar fixation
a) 3.5 mm cortical
b) 4mm cancellous
c) 4mm malleolar

58) what the locking screw does
a) compression
b) lagging
c) keeps the direction at 90 degrees to the diaphysis

59) hyperextension of DIP flexion of PIP is caused by
a) central slip tear
b) lateral band tear
c) volar plate tear

60) TA rupture 2 months old with 4cm gap should be treated with
a) primary end to end repair
b) reconstruction with tibialis posterior
c) AFO for equinus

61) 15 degrees of cubitus varus in 8 year old child should be treated with
a) lateral closing wedge osteotomy
62) acute gout is diagnosed by
a) positively charged crystals
b) negatively charged crystals
c) signs of acute inflammation in the joints like swelling and erythema

63) degenerative disk when I/V space is lost the stress comes on which structure
a) soft tissue
b) spinal cord
c) facet joints

64) treatment for boyd and griffin type 2 (reverse oblique) p/t fracture
a) dhs
b) DCS
c) ILN
d) P/C locking plate
e) closed proximal femoral nail

65) 2 month old fracture at junction of lateral 1/3 and middle third of clavicle in
30 year male with obvious gap he complains of pain treatment
a) rest in collar and cuff sling
b) ORIF
c) bone grafting
d) excercises

66) 11 year old child has transcervical neck of femur fracture
a) closed reduction and fixation with compression screws
b) closed reduction and hip spica
c) open reduction and DHS

67) scenario of chondroblastoma

68) 4 year old boy taking ATT c/o blurring of vision which drug causes that
a) pyrazinamide
b) ethambutol
c) isoniazid
d) streptomycin

69) 45 yr old lady taking treatment of RA c/o tinnitus which drug is causing it
a) ethambutol
b) methotrexate
c) pyrazinamide
d) isoniazid
e) streptomycin