Orthopedics Part I Exam - Sample MCQs

1- Over the course of the embryologic development, the predominant location

of hemaopoiesis changes several times. Where this process does takes place
during the 11th week of life?
(A) Bone marrow
(B) Gastric fundus
(C) Liver
(D) Pancreas
(E) Yolk sac

2- A 25-year-old pregnant woman goes to her gynecologist for her 36-week

check-up. She complains of light-headedness when she goes to bed at night. In
the office, her blood pressure is 120/70 mmHg while sitting upright and 90/50
mmHg while lying supine. Which of the following is the most likely cause of this
hypotension?
(A) Cardiogenic shock
(B) Inferior vena cava compression
(C) Neurological shock
(D) Third spacing of fluid
(E) Vasodilatation

3- A 48-year-old obese man presents to his primary care physician with complaints
of lower leg pain that occurs after he walks a few city blocks and is relieved with
rest. He has no other complaints. His blood pressure is 165/85 mmHg, his pulse is
83/min and his respiratory rate is 18/min. After further questioning, he admits to
smoking two packs of cigarettes per day. Which of the following types of vessels is
most likely involved in the pathological process surrounding this patients
symptoms?
(A) Arteries
(B) Arterioles
(C) Capillaries
(D) Veins
(E) Venules

4- A 54-year-old woman presents to her physician with swelling in her

extremities. Palpitation produces significant pitting. Which of the following
conditions is the underlying physiologic basis of this physical finding?
(A) Decreased capillary permeability
(B) Decreased capillary pressure
(C) Increased interstitial fluid colloid osmotic pressure
(D) Increased interstitial fluid pressure
(E) Increased plasma protein levels

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5- A 45-year-old man comes to his primary care physician complaining of back
pain. On questioning, the patient indicates a recent history of polyuria, polydipsia,
hypertension, and weight gain. X-ray of the spine shows an L4-L5 compression
fracture. Which of the following is most likely to be elevated in this patient?
(A) Cortisol
(B) Glucagon
(C) Growth hormone
(D) Insulin
(E) Thyroid hormone

6- Glucocorticoids are important in the treatment of inflammatory diseases;

however, their use is associated with many adverse effects on multiple systems. The
utility of glucocorticoids has to be weighed against the patients ability to withstand
the problems that are likely to arise. High dosage glucocorticoid treatment can
result in which ECG changes?
(A) Appearance of delta wave
(B) Appearance of U wave
(C) Peaked T wave
(D) PR segment elongation
(E) ST segment elevation

7- A 54-year-old man with history of smoking and lung cancer develops

hypercalcemia. He is enrolled in a research study to assess the efficacy of a new
agent to treat this condition. After several days of treatment, he reports persistent
numbness and tingling around his mouth. Physical examination is significant for
facial spasm when the blood pressure
(A) Calcitonin
(B) Parathyroid hormone
(C) Parathyroid hormone-related peptile
(D) Thyroxin
(E) Vitamin D

8- Which of the following types of hepatocellilar injury is commonly seen after

acetaminophen overdose?
(A) Acute hepatitis
(B) Centrilobular necrosis
(C) Fibrosis
(D) Granuloma formation
(E) Microvesicular fatty change

9- A 20-year-old man presents to his physician with a 2 day history of fever,

vomiting, diarrhea. His laboratory studies are unremarkable except for a serum

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 albumin level of 7.5g/dL. Which of the following conditions would most likely
cause this patients abnormalities?
(A) Acute infection
(B) Chronic liver disease
(C) Dehydration
(D) Nephrotic syndrome
(E) Poor nutritional status

10-During autopsy of a 65-year-old woman, the liver is examined, revealing multiple

tumors of various sizes throughout both lobes. This pattern, along with the fact
that most tumors found in the liver are metastases, leads the pathologist to
suspect that a primary tumor exists in another organ. Which of the following is
the most likely location of the primary tumor?
(A) Breast
(B) Colon
(C) Kidney
(D) Lung
(E) Thyroid

11- A 10-year-pld boy with jaundice, splenomegaly, and chronic normocytic,

normochromic, anemia with an abnormal osmotic fragility test and increased
mean corpuscular hemoglobin concentration presents to the clinic for a consult.
He has had these symptoms for most of his life, and his parents are requesting a
definitive cure. Which of the following confess a definitive cure for this patients
disease?
(A) Blood transformation
(B) Bone marrow transplant
(C) Folate therapy
(D) Iron therapy
(E) Splenectomy

12- A 56-year-old man is diagnosed with transitional cell carcinoma and treated
with excision and chemotherapy. Which of the following risk factors most likely
led to his cancer?
(A) Alcohol use
(B) Exposure to aniline dyes
(C) Exposure to asbestos
(D) Hypertension
(E) Previous pyelonephritis
13- A patient with relapsing Hodgkins disease presents with weight gain, foot
ulcers, vision problems, elevated blood sugar, oral candidiasis, and new onset
of wildly swinging mood changes. What is the most likely etiology of this
patients psychiatric symptoms?
(A) Adverse effects of bleomycin
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 (B) Adverse effects of prednisone
(C) Adverse effects of vincristine
(D) Normal psychiatric response to having cancer
(E) Progression of disease

14- A 70-year-old man comes to his physician for a routine physical examination.
Although he is asymptomatic, a blood test shows an abnormal level of
immunoglobulin. After Further testing he is diagnosed with monoclonal
gammopathy of undetermined significance. Which of the following is the
current treatment of monoclonal gammopathy of undetermined significance?
(A) Alendronate
(B) Anticoagulation
(C) High-dose steroids
(D) No treatment
(E) Vinca alkaloids

15- An otherwise healthy infant boy born via vaginal delivery has an abnormal
appearance of his right upper limb. His arm hangs by his side, pronated and
medially rotated. Which of the following muscles is still functioning in this
patient?
(A) Biceps
(B) Deltoid
(C) Infraspinatus
(D) Supraspinatus
(E) Triceps

16- A 16-year-old gymnast presents to the emergency department after landing

awkwardly on her ankle. She is diagnosed with a sprained ankle. Which of the
following ligaments is most commonly injured in an ankle sprain?
(A) Anterior talofibular ligament
(B) Calcaneofibular ligament
(C) Talonavicular ligament
(D) Tibiocalcaneal ligament
(E) Tibiotalar ligament
17- A 13-year-old boy is admitted to the hospital with a broken tibia. This is the
fourth broken bone the patient has sustained. On physical examination, the
patient is found to have multiple poorly healing superficial wounds on his
arms and legs; he also has a blue tint to his sclera. The patient is subsequently
diagnosed with the most common form of his disease. Which of the following
would most likely be affected in this patient?
(A) Blood vessels, skin, uterus
(B) Bone, interstitial tissue
(C) Bone, tendons, skin
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 (D) Cartilage, blood vessels, vitreous humor
(E) Skin, cellular basement membrane, blood vessels

18- A 50-year-old man presents to the emergency department because of severe

pain with Even a slight abduction of his arm following a skiing accident. He is
diagnosed with a Rotator cuff tear. Which of the following is most commonly
injured in a rotator cuff tear
(A) Infraspinatus tendon
(B) Subacromial bursa
(C) Subscapularis tendon
(D) Supraspinatus tendon
(E) Teres minor tendon

19- A 50-year-old slightly obese man comes to the emergency department with his
wife at 3 am complaining of severe pain in his left great toe. He said the pain
began 5 hours ago while he was walking home after dinner, which consisted of
steak and a few beers. His serum studies are unremarkable except for negative
blood cultures and an elevated uric acid level. When asked about allergies, the
patient states that he is allergic to nonsteroidal anti-inflammatory drugs. An
aspiration of the toe reveals negatively birefringent crystals. Which of the
following is the best acute treatment for this condition?
(A) Allopurinol
(B) Ceftriaxone
(C) Colchicine
(D) Hydrochlorothiazide
(E) Ibuprofen
(F) Indomethacin
(G)Naproxen

20- A 31-year-old man comes to the clinic complaining of red and itchy eyes for the
past 8 hours. The patient has had pain on urination and diffuse joint pain for 1
month, but tested negative gonorrhea and Chlamydia on a previous visit 3 weeks
ago. He has also tested for negative for rheumatoid factor, and his human
leukocyte antigen (HLA) status is HLA-B27. When asked about any recent
illnesses, all the patient can recall is going to the emergency department 2 months
ago for a bad case of diarrhea. Which of the following is the most likely diagnosis
(A) Lyme arthritis
(B) Psoriatic arthritis
(C) Reiters syndrome
(D) Rheumatoid arthritis
(E) Systemic lupus erythematosus

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21- A 1-year-old adopted darkly pigmented boy is brought to the pediatrician for
his first well-child check-up. The adoptive parents do not know any of the infants
past medical history or family history. Physical examination reveals an unusual
widening of the childs wrists and ankles and marked enlargement of the childs
costochondral junctions. What is a characteristic laboratory finding used to
support the most likely diagnosis
(A) Increased intact parathyroid hormone level
(B) Increased serum calcium level
(C) Increased serum 1,25-dihydroxycholecalciferol level
(D) Increased serum 25-hydroxycholecalciferon level
(E) Increased serum phosphorus level

22- A 21-year-old man presents to the emergency department following an injury to

his shoulder that he sustained while playing football. His shoulder appears
flattened, and he is not able to abduct his arm. He is found to have a fracture at
the surgical neck of his humerus. The muscle that is most likely injured in this
patient receives innervations from which of the following nerve roots?
(A) C3-5
(B) C5-6
(C) C6-7
(D) C7-8
(E) C8-T1

23- A 60-year-old man presents to the physician with a limp that he has had since
childhood. When he walks, the patient takes a step with his right leg, and then
leans all the way over to his right so that he can swing his left leg to take a step. He
reports one major illness as a child, after which he developed this limp. Which of
the following nerve(s) is most likely injured in the patient?
(A) Inferior gluteal nerve
(B) L5 and S1
(C) Obturator nerve
(D) S1 and S2
(E) Superior gluteal nerve

24- A 45-year-old computer programmer notices atrophy and weakness of his

thumb. Laboratory tests reveal an increased erythrocyte sedimentation rate and
leukocyte count. Sensation to which of the following cutaneous areas is most likely
to be decreased?
(A) Dorsal aspect of fifth digit
(B) Dorsal aspect of fourth digit
(C) Palmar aspect of second digit
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 (D) Volar aspect of lateral wrist
(E) Volar aspect of medial wrist

25- A 22-year-old woman who is a professional tennis player presents to the

physician with pain on the lateral aspect of her elbow radiating down her
forearm. Repetitive use of which the following muscles most likely lead to this
patients condition?
(A) Biceps
(B) Extensor carpi radialis
(C) Extensor carpi ulnaris
(D) Flexor carpi ulnaris
(E) Pronator teres

26- A 27-year-old man comes to the physicians office with a 6-month history of low
back pain and stiffness that wakes him up during the night and is worst in the
morning. The patient was diagnosed with bilateral sacroiliatis 4 months ago
because of his tenderness to percussion of the sacroiliac joints and pain on
springing the pelvis up. He has severe limitation of motion of his lumbar spine.
Laboratory test results are negative for antinuclear antibody and rheumatoid
factor, and show the patients human leukocyte antigen status is B27 positive.
Which of the following is the most likely diagnosis?
(A) Ankylosing spondylitis
(B) Osteoarthritis
(C) Psoriatic arthritis
(D) Reiter,s syndrome
(E) Rheumatoid arthritis
(F) Vertebral compression fracture

27- A 15-year-old boy is brought to the emergency department because he has

pain in his Hand following a fist fight. The physician tells the patient that he
has broken his hand. Which of the following is the most likely site of this
patients fracture?
(A) Distal Radius
(B) Hamate
(C) Metacarpals

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 (D) Phalanges
(E) Scaphoid

28- During the autopsy of a patient who complained of a severe headache shortly
before dying , the pathologist removes the calvarium with the dura attached.
On the surface of the brain, there is a frank blood on visual inspection that she
is unable to remove by rubbing or scrapping the surface. Which of the
following types of hemorrhages most likely caused this finding?
(A) Epidural hemorrhage
(B) Intradural hemorrhage
(C) Parenchymal hemorrhage
(D) Subarachnoid hemorrhage
(E) Subdural hemorrhage

29- A 40-year-old man was admitted to the neurology service for the evaluation
of persistent numbness over his left jaw and lower face. MRI reveals a
schwannoma, which is compressing a cranial nerve as the nerve exits the skull.
The cranial nerve involved in this case exits the skull through which of the
following foramina?
(A) Foramen ovale
(B) Foramen rotundum
(C) Foramen spinosum
(D) Jugular foramen
(E) Superior orbital fissure

30- A 3-week-old infant is noted to have enlargement of the head on a routine

physical examination. His birth history is remarkable for an episode of group
B streptococcal meningitis that resolved after a course of intravenous
antibiotics. Which of the following mechanism is most likely responsible for
this patients symptoms?
(A) Accumulation of blood in the subarachnoid space
(B) Decreased absorption of cerebrospinal fluid by the arachnoid villi
(C) Increased cerebrospinal fluid reabsorption
(D) Increased production of cerebrospinal fluid
(E) Ventricular obstruction

31- A 7-year-old is brought to the emergency department after falling from a

tree; an x-ray Film shows that he has a midshaft fracture of the humerus.
Which of the following Structures could be injured with this type of
fracture?
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 (A) Anterior circumflex humeral artery
(B) Axillary nerve
(C) Median nerve
(D) Radial nerve
(E) Ulnar nerve

32- A 2-week-old girl is brought to the pediatrician for her first doctors
appointment. Physical examination reveals a tuft of hair on her lower back,
ultrasound shows no herniation of any kind. Which of the following conditions
does this baby have?
(A) Anencephaly
(B) Meningocele
(C) Meningomyelocele
(D) Spina bifida cystic
(E) Spina bifida occulta
33- Patients with renal artery stenosis may present with very high blood
pressures due to increased rennin secretion. Which of the following structures
in the kidney is responsible for sensing inadequate perfusion and secreting
rennin?
(A) Afferent arteriole
(B) Collecting duct
(C) Distal convoluted tubule
(D) Efferent arteriole
(E) Loop of Henle

34- A 48-year-old man is hospitalized for shock after massive blood loss in a
motor vehicle accident. On the patient second day in the hospital, his blood
urea nitrogen(BUN) and creatinine level begins to rise and he develops pitting
edema to his knees. A subsequent Urinalysis shows numerous granular casts.
Which of the following is the most appropriate treatment?
(A) Angioplasty
(B) Broad-spectrum antibiotics
(C) Corticosteroids
(D) Fluids and analysis
(E) Use of ultrasound to remove blockage

35- A 28-year-old woman who is 6 months pregnant presents to the emergency

department With a temperature of 38.2 C(100.8 F) and complains of shaking
chills and a pain on Her right side, which she locates by pointing to the area
above her right iliac crest. During the examination she is tender to percussion
at the junction of the lower ribs and the thoracic vertebrae. Urinalysis reveals
WBC casts. Which of the following is the most likely diagnosis?
(A) Abdominal aortic aneurysm

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 (B) Appendicitis
(C) Ectopic pregnancy
(D) Localized cystitis
(E) Premature labor
(F) Pyelonephritis

36- A 24-year-old man who is in hospital for treatment of severe gram-negative

infection Subsequently becomes oliguric. He is also having difficulty hearing
the hospital staff. Laboratory studies show elevated BUN and creatinine levels.
Which of the following is the most likely cause of this patients symptoms?
(A) Chloramphenicol
(B) Doxycycline
(C) Erythromycin
(D) Gentamicin
(E) Imipenem

37- A 59-year-old woman with type 2 diabetes mellitus comes to her primary
care physician for a routine visit. Her creatinine level has been slowly
increasing over the last decade due to the poor compliance with her medial
regimen. If her renal disease were to progress she would be at risk for
developing which of the conditions?
(A) Bacteriuria
(B) Hypokalemia
(C) Hypotension
(D) Metabolic alkalosis
(E) Osteomalacia
(F) Polycythemia

38- An 8-year-old girl presents to the emergency department complaining of

frequent urination, constant thirst, and a new strange, staining of her teeth.
She recently had a cold, and her pediatrician prescribed an antibiotic that she
said may hurt her kidneys. She did not bring the bottle with her. Which of the
following medications was the patient most likely prescribed?
(A) Acetazolamide
(B) Neomycin
(C) Norfloxacin
(D) Penicillin G
(E) Vancomycin

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39- A 53-year-old woman experiences hot flashes associated with menopause.
She calls her primary care physician to ask for advice about the risks and
benefits of hormone replacement therapy (HRT). Which of the following is a
potential benefit of HRT?
(A) Decreased risk of breast cancer
(B) Decreased risk of deep venous thrombosis
(C) Decreased risk of hip fracture
(D) Decreased risk of myocardial infarction
(E) Decreased risk of stroke

40- A 50-year-old man is treated for septic shock with multiple antibiotics. Seven
days later The patient is alert and oriented, and his tissue perfusion has
returned to normal. However, he describes a terrible feeling that the world
is spinning. Which of the following therapeutic agents is most likely
responsible for this patients symptoms?
(A) Erythromycin
(B) Gentamicin
(C) Imipenem
(D) Metronidazole
(E) Piperacillin-tazobactam

41-During dental procedures, it is possible small fragments may be aspirated into the
trachea and cause aspiration pneumonia. If the patient is sitting upright during the
procedure, which of the following is the most common site of aspiration
pneumonia?
(A) Left lower lobe
(B) Left upper lobe
(C) Lingula
(D) Right lower lobe
(E) Right upper lobe

42- While examining a patient, the physician notices decreased breath sounds at the
right lower lobe, dullness on percussion, and decreased tactile fremitus without
tracheal deviation. These findings most likely represent which of the following?
(A) Bronchial obstruction
(B) Intestinal infiltration
(C) Lobar pneumonia
(D) Pleural effusion
(E) Pneumothorax

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43- A 10-year-old boy is brought to the emergency department after becoming
less responsive following several bouts of nausea and vomiting. The patient is
tachycardic and is breathing deeply and slowly. Laboratory studies are
remarkable for a serum pH of 7.21, a serum glucose level of 700 mg/dL, a
serum bicarbonate level of 16mEq/L and a serum anion gap of 22(normal 7-
16). Intravenous fluids and insulin are administrated. Measurement and
management of which of the following electrolytes are most critical in this
patient?
(A) Bicarbonate
(B) Calcium
(C) Chloride
(D) Potassium
(E) Sodium

44- An 8-month-old girl is brought to the emergency department by her parents

because she appeared swollen. The parents weaned the child from the formula
3 weeks ago. They have been giving her rice milk for 1 month. On examination
the child has a protuberant belly and 2+ pitting edema in her wrists and shins.
This type of malnutrition is caused by deficiency of what type of nutrient?
(A) Calorie
(B) Carbohydrate
(C) Electrolyte
(D) Fat
(E) Protein

45- A 36-year-old man who completed a marathon 6 hours earlier presents to the
emergency department with severe muscle pain and swelling and complaints
of red urine. Laboratory tests show a creatine kinase level of 6800 U/L, but on
RBCs on urinalysis. Which of the following symptoms would most likely also
be present?
(A) Arrhythmia
(B) Hepatomegaly
(C) Inflammation of the metacarpophalangeal joints
(D) Pain in a dermatomal distribution
(E) Shuffling gait

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46- If either the ulnar or the radial arteries are occluded , which arteries ensure
adequate collateral arterial flow in the hand?
(A) Anterior and posterior interosseous
(B) Arcuate
(C) Common and proper palmar digitals
(D) Deep and superficial dorsalis pedis
(E) Deep and superficial palmar arch

47- A 4-year-old girl is brought to the emergency department by ambulance late

at night. Her caretaker reports that she refuses to bear weight on her left leg
and report that she fell down the stairs this morning. X-ray of the leg shows a
spiral fracture of her left femur which of the following is the most likely
diagnosis?
(A) Child abuse
(B) Normal play injury
(C) Osteogenesis imperfect
(D) Osteosarcoma
(E) Vitamin d deficiency

48- The cricoids cartilage lies opposite which vertebral level?

(A) C3
(B) C4
(C) C5
(D) C6
(E) C7

49- Which of the following muscles is innervated by the superficial peroneal

nerve?
(A) Tibialis Anterior
(B) Extensor Hallucis longus
(C) Peroneus longus
(D) Peronus tertius
(E) Extensor digitorum longus

50- All the following structures have attachment to the medial femoral condyle
EXCEPT the
(A) Adductor magnus
(B) Gastrocnemius medial head
(C) Popliteus
(D) Superficial medial collateral ligament
(E) Patellofemoral ligament
51- Which of the following muscles have their origin on the scapula and across
the elbow?
(A) Coracobrachialis and biceps
(B) Coracobrachialis and brachialis
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 (C) Brachialis and biceps
(D) Biceps and triceps
(E) Brachialis and triceps

52- All the following are physiologic effects of parathormone Except

(A) Increased hydroxylation of vitamin d in the renal tubule
(B) Decreased resorption of calcium in the proximal renal tubule
(C) Increased resorption of calcium in the proximal renal tubule
(D) Increased release of phosphate from bone
(E) Increased serum levels of phosphate

53- Which of the following features is most consistently seen in osteoporosis?

(A) Increased serum alkaline phosphate
(B) Decreased serum calcium
(C) Increased serum parathyroid hormone
(D) Impaired mineralization of osteoid
(E) Increased susceptibility to fractures

54- In acute hematogenous osteomylitis of childhood, the earliest microscopic

changes of the bone are in the
(A) Epiphysis
(B) Metaphyseal-physeal junction
(C) Subperiosteal portion of the metaphysic
(D) Subperiosteal portion of the diaphysis
(E) Metaphyseal-diaphysis junction

55-On histological examination, an aneurismal bone cyst can most easily be

confused with
(A) An osteogenic sarcoma
(B) A nonossifying fibroma
(C) A chondroblastoma
(D) A hemangioendothelioma
(E) A giant cell tumor

56- Which of the following is not a clinical of rickets

(A) Irritability
(B) Frontal bossing
(C) Localized bone pain
(D) Short stature
(E) Enlarged epiphysis

57- Which of the following clinical findings are associated with

hyperparathyroidism?
(A) Bone pain
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 (B) Brown tumors
(C) Pathologic fractures
(D) Renal stones
(E) Tetany

58- Which of the following graft types has both osteoinductive and
osteoconductive properties:
(A) Autogenous bone marrow
(B) Coral-based hydroxyapatite bone graft substitute
(C) Bone morphogenetic protein -2 (BMP-2)
(D) Recombinant bone morphogenetic protein-7 (rhBMP-7)
(E) Cancellous bone graft

59- Which of the following defines osteoporosis according to the world health
organization:
(A) 0.5 to 1.0 standard deviation(SD) below aged-matched controls
(B) 1.0 to 2.0 SD below age-matched controls
(C) 1.0 to 2.5 SD below age-matched controls
(D) More than 2.5 SD below age-matched controls
(E) 2.5 to 5.0 SD below age-matched controls

60- The Achilles tendon reflex (ankle reflex) is transmitted through which of the
following nerve root:
(A) L4
(B) L5
(C) S1
(D) S2
(E) S3

61- A 10-year-old child injures his elbow and presents with swelling and
limitations of voluntary movement. The radiographs show no obvious
fracture, but it does show a Baumann angle of 71 and an even elevation of the
posterior fat pad. You tell the parents That this most likely represents:
(A) A congenital anomaly with a valgus deformity of the elbow
(B) A medial epicondyle fracture
(C) A Salter l physeal separation
(D) An occult supracondylar fracture
(E) A variation of norma

62- Adult articular cartilage receives its nutrition through which of the following
mechanisms
(A) Fine capillary network from the synovial tissues
(B) Fine capillary network through the subchondral bone
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 (C) Fine capillary network from the perichondral ring
(D) Diffusion from the synovial fluid through large pores
(E) Diffusion from the synovial fluid through small pores

63- In which of the following groups of patients should fluoroquinolones such as

Ciprofloxacin not be used because of significant adverse effects:
(A) Young women
(B) Children
(C) Diabetic patients
(D) Elderly patients
(E) Patients with sickle cell anemia

64- Perianal sensation is derived from which of the following nerve roots:
(A) L2, L3 and L4
(B) L3, L4,and L5
(C) L5, S1 and S2
(D) S1 ,S2 and S3
(E) S2, S3, S4, and S5

65- The skin of the anterior middle third of the thigh is innervated by which of
the following sensory segmental levels:
(A) T12
(B) L1
(C) L2
(D) L3
(E) L4
66- Which of the following levels of the spinal cord principally innervates the
main flexor of the hip:
(A) T10, T11 and T12
(B) L1, L2, and L3
(C) L2, L3 and L4
(D) L4, L5 and S1
(E) L5, S1 and S2

67- During a fracture repair systemic as well as local factors come into play.
Which of the following is considered a systemic factor in fracture healing:
(A) Degree of vascular injury
(B) Degree of bone loss
(C) Age
(D) Type of bone affected
(E) Degree of immobilization

68- Which of the following bone tumors commonly occurs in patients with closed
physes between 20 and 50 years of age:
(A) Osteoid osteoma
(B) Chondromyxiod fibroma
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 (C) Solitary bone cyst
(D) Giant cell tumor
(E) Non-ossifying fibroma

69- One of the most striking features of homogeneous osteomyelitis occurring in

infant is:
(A) The high fever and toxicity
(B) The low fever and lack of toxicity
(C) The mortality rate
(D) The resistance to motion of the affect part
(E) The x-ray changes

An absolute indication for operative management of a supracondylar fracture of

the humerus in a child is:
(A) Marked displacement
(B) Severe swelling
(C) An open fracture
(D) Neurologic compromise
(E) Age over 10 years

70- The most important aspect of treatment in the earliest stages of Legg-Calve-
Perthes Disease is:
(A) Frequent observation
(B) Administration of anti-inflammatory medication
(C) Restoration of motion of the hip
(D) Containment of the femoral head within the acetabulum
(E) Aspiration of the hip

71-The following statements about Dupuytrens contracture are true EXCEPT

that:
(A) It is due to contraction of the palmar fascia which starts as an indurated nodule
on the ulnar border of the hand
(B) The ring and little finger are severely affected
(C) The deformity consists of flexion of the metacarprophalangeal and proximal
Interphalangeal joints with extension of the terminal joint
(D) The skin overlying the indurated fascia is often puckered and immobile
(E) The joint capsules and flexor tendons are not affected

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72- Non union is more common in:
(A) Fracture lateral condyle of humerus
(B) Supracondylar fracture of humerus
(C) Colles fracture
(D) Fracture of olecranon
(E) Fracture surgical neck of humerus

73-X-ray features of osteosarcoma include all EXCEPT:

(A) Sun-ray appearance
(B) Codmans triangle
(C) Ill defined margin
(D) Onion peel appearance
(E) New bone formation

74- Non-rosen view is used in:

(A) Congenital dislocation
(B) Congenital talipes equino varus
(C) Shaft of femur
(D) Scoliosis
(E) Slip upper femoral epiphysis

75- Trendelenburg test is positive due to injury of which nerve?

(A) Superior gluteal nerve
(B) Inferior gluteal nerve
(C) Pudendal nerve
(D) Obturator nerve
(E) Femoral nerve

76- Anterior dislocation of shoulder may be complicated by:

(A) Brachial plexus injury
(B) Tear of rotator cuff
(C) Fracture head of humerus
(D) All of the above

77- The most common injury following pelvic fracture is of:

(A) Bladder
(B) Urethra
(C) Rectum
(D) Vagina

78- Which of the following is not TRUE of intertrochanteric fracture of femur;

(A) Limb shortening
(B) Malunion
(C) Avascular necrosis of femoral head
(D) Internal fixation is preferred

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79- Most common complication of fracture shaft of femur is:
(A) Malunion
(B) Nonunion
(C) Knee stiffness
(D) Fat embolism

80-Spontaneous bleeding into joints in haemophilia occurs when factor Vl level is

less than:
(A) 50%
(B) 25%
(C) 10%
(D) 5%

81- Colles fracture is:

(A) A fracture of the clavicle
(B) A fracture of the ankle joint
(C) Common in elderly women
(D) A fracture of the head of the radius
(E) Fracture of the die scaphoid

82- Bennetts fracture is:

(A) Reversed Colles fracture
(B) Fracture of the scaphoid bone in the wrist
(C) Fracture of the radial styloid (chauffeurs fracture
(D) Fracture dislocation of the first metacarpal

83- A Potts fracture is a type of fracture of the :

(A) Wrist
(B) Ankle
(C) Spine
(D) Foot
(E) Skull

84- Stills disease is:

(A) Spastic diplegia
(B) Rheumatoid arthritis in childhood
(C) Rheumatoid arthritis in the elderly
(D) Post-traumatic bone formation in the lateral ligament of the knee
(E) Synonymous with Reiters disease

85- A Milwaukee brace can be used in:

(A) Sacro-iliac strain
(B) Derangement of the teeth
(C) A patient with above knee amputation
(D) Scoliosis
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 (E) Fractured clavicle

86- The name associated with joint neuropathy is that of:

(A) Cushing
(B) Osier
(C) Moon
(D) Charcot
(E) Addison
87- Tennis elbow is the term used for:
(A) Olecranon bursitis
(B) Non-articular rheumatism of the extensor muscles of forearm attached to lateral
epicondyle of the humerus
(C) Myositis ossificans of the supinator muscle
(D) A fractured head of radius
(E) Ulnar nerve neuritis

88- A Bakers cyst is:

(A) An implantation dermoid cyst occurring in the palms of those who work in a bakery
(B) A synovial cyst of the wrists of those who knead bread
(C) A prepatellar bursa
(D) A synovial cyst of the ankle
(E) A synovial cyst of the popliteal fossa

89- Recent dislocations of shoulder joint best treated by:

(A) Hippocrates method of closed reduction
(B) Kochers manipulation
(C) Modified Milchs maneuver
(D) Open reduction
(E) Putti-platts operation

90- Posterior dislocation of elbow joint is characterized by the following

EXCEPT:
(A) Gross swelling of the elbow region
(B) Loss of all movements at the elbow joint
(C) Shortening of the upper arm
(D) Absence of crepitus
(E) Loss of normal relationship of the olecranon with the two epicondyles

91-Concerning extension Monoteggias fracture-dislocation, it is UNTRUE that it:

(A) Consists of fracture of the upper third of the ulna and anterior dislocation of
the radial head
(B) Is usually due to a severe blow on the back of the forearm
(C) Can be treated by manipulative reduction in children
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 (D) Always requires surgical treatment in adults
(E) Is rarely associated with complications

92- Intestinal absorption of calcium is dependent upon:

(A) Vitamin D
(B) Parathormone
(C) Calcitonin
(D) All of the above
(E) None of the above

93- Concerning Osgood-Schlatters disease, the following statements are true

EXCEPT that it:
(A) Is an avascular necrosis of the epiphysis of the tibia tubericle
(B) Usually occurs between ages of 10 and 16 years of age
(C) Is due to traction of the patellar tendon on the tibial tubericle
(D) Is associated with no radiological signs
(E) Causes pain and swelling over the tubericle

94- Solitary bone cyst is characterized by the following features EXCEPT that it:
(A) Occurs most often in children and adolescent
(B) Usually arises in the diaphysis of a long bone
(C) Often remains symptomless until complicated by pathological fracture
(D) Appears as clear ovoid expanding cavity in the x-ray
(E) May be associated with new bone formation

95- The radiological signs of osteoclastoma include the following EXCEPT:

(A) Abrupt expansion of the bone
(B) Characteristic soap-bubble appearance
(C) Presence of an operculum obliterating the medullary cavity
(D) Absence of any new-bone formation
(E) Presence of areas of bone destruction

96- The viscosity of synovial fluid is mainly due to:

(A) Chonroitin sulphate
(B) Hyaluronidase
(C) Albumin and laucin
(D) A;pha and beta globulins
(E) Beta lipoproteins

97- Septic arthritis of infancy usually affects which of the following joints:
(A) Shoulder
(B) Elbow
(C) Wrist
(D) Hip
(E) Knee
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98- In children,the treatment of tuberculosis of the hip includes the following
EXCEPT;
(A) Tuberculostatic drugs
(B) Weight traction to correct deformity
(C) Fixation of the joint in the position of function
(D) Aspiration of cold abscess
(E) Extra-articular arthro

100-The most characteristic feature of Volkmanns contracture is:

(A) Wasting of the forearm
(B) Flexion deformity of the wrist
(C) Extension of the metacarpo-phalageal joints with flexion of the inter-phalangeal joints
(D) Volkmanns phenomena
(E) Weakness of the hand and fingers

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