Orthopaedic Surgery MCQs
Orthopaedic Surgery MCQs
Orthopaedic Surgery MCQs
MCQs
1)
Origin of bone is from: a. Ectoderm. b. Mesoderm. c. Endoderm. d. All of the
above.
Acute osteomyelitis is commonly caused by: a. Staph aureus. b. S. pyogenes.
c. H. influenzae. d. Salmonella.
Acute osteomyelitis usually begins at: a. Epiphysis. b. Metaphysis. c.
Diaphysis. d. Any of the above.
What is not True of acute pyogenic osteomyelitis: a. Trauma is a predisposing
factor. b. Common infecting agent is Staph. Aureus. c. Infection is usually
blood borne. d. All are true.
What is not True of Brodie's abscess: a. A form of chronic osteomyelitis. b.
Intermittent pain and swelling. c. Common to diaphysis. d. Excision is very
often required. 2)
6)
Tuberculosis of the spine most likely originates from: a. Intervertebral disk. b.
Cancellous vertebral body. c. Ligamentous structures. d. Paravertebral soft
tissue.
In Pott's spine, the disease starts in the: a. Intervertebral disk. b. Anterior
vertebral margin. c. Posterior vertebral margin. d. Paravertebral soft tissue.
Melon seed bodies in joint fluid are characteristic of: a. Rheumatoid arthritis.
b. Tuberculous arthritis. c. Septic arthritis. d. None of the above.
The earliest sign of TB hip in X-ray is: a. Narrow joint space. b. Irregular moth
eaten femoral head. c. Periarticular osteoporosis. d. Dislocation.
Healing of tuberculous arthritis can lead to: a. Calcification. b. Fibrous
ankylosis. c. Boney ankylosis. d. None of the above.
11
In an adult patient with a fracture of the shaft of the femur: a. No blood can be
lost without obvious swelling. b. No blood can be lost without obvious bruising.
c. Two liters of blood can be lost without obvious swelling or bruising. d. There
is no possibility of death from hemorrhagic shock.
A greenstick fracture: a. Occurs chiefly in the elderly. b. Does not occur in
children. c. Is a spiral fracture- of tubular bone. d. Is a fracture where part of
the cortex is intact and part is crumpled or cracked.
26
Spiral fracture is due to: a. Blunt trauma. b. Axial compression. c. Twist. d.
Direct impact.
The single most important factor in fracture healing is: a. Correct bone
alignment b. Accurate reduction c. Immobilization d.Organization of clot.
Immobilization is not required in fracture involving: a. Scapula. b. Wings of
ilium. c. Rib. d. Proximal humerus in elderly. e. All of the above.
Internal reduction is considered in presence of: a. Reduction impossible to the
achieved or maintained. b. Healing is expected to be delayed. c. Pathological
fracture. d. All of the above.
Which one of these statements is True in diagnosis of congenital hip
dislocation in the first few days of life: a. It is impossible to diagnose it. b. The
sign of telescoping is the best way of diagnosing it. c. It is possible to
diagnose it by the Van Rosen/Barlow Test. d. The Trendelenberg test is the
most useful.
31
Trendelenburg's sign is used in the diagnosis of: a. Varicose veins. b.
Congenital dislocation of the hip. c. Carcinoma of the stomach. d. Pulmonary
embolism.
If an unstable hip is detected at birth the management policy is: a. Do nothing
and re-examine every six months as only a minority of hips develop into a
persistent dislocation. b. Use a splint to keep the hip joint in 45 flexion and
adduction. c. Use a splint to keep the hip joint in 90 flexion and abduction. d.
Advise operative stabilization.
The essential examination of the hip in order to clinch the diagnosis of chronic
slipped femoral epiphysis is: a. Measuring for shortening of the leg. b.
Palpation of the femoral head. c. A-P plain x-ray view of the hip. d. Lateral xray view of the hip.
Shenton's line is a sign applicable to: a. The detection of shortening of the leg
on physical examination. b. A radiological feature of the pelvis applied to the
diagnosis of congenital dislocation of the hip. c. A radiological feature of the
lungs applied to the diagnosis of pulmonary vein thrombosis. d. A physical
sign applied to the diagnosis of adrenal deficiency.
Perthes' disease is common to age group of: a. 1-5. b. 6-10. c. 11-15. d. 1620.
36
The average duration of Perthes' disease is: a. 1-2 years. b. 3- 4 years. c. 1
month - 6 months. d. 6 months - 1 year.
In Perthes' disease the hip movements restricted are: a. Abduction and
external rotation. b. Abduction and internal rotation. c. Adduction and external
rotation. d. All of the above.
The sequestrum in X-ray appears: a. Dense. b. Light. c. Isodense as
surrounding bone. d. Any of the above.
The term delayed union is employed when the fracture fails to unite within: a.
1.5 times the normal union time. b. Twice the normal union time. c. 2.5 times
the normal union time. d. None of the above.
First bone to ossify in foetal life is: a. Femur. b. Tibia. c. Clavicle. d. Sternum.
41
What is True of clavicle fracture: a. Non-union is rare. b. Malunion is of no
functional significance. c. Reduction even if achieved is difficult to maintain. d.
All are true.
The joint most likely to have recurrent dislocation is: a. Ankle. b. Knee. c.
Shoulder. d. Patella.
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.
What is not True about fracture surgical neck of humerus: a. Occurs due to fall
on outstretched hand. b. Common to children. c. Osteoporosis is an important
risk factor. d. Non-union is uncommon.
Radial nerve palsy may occur in fr of humerus involving: a. Surgical neck. b.
Shaft. c. Lower end. d. At all of the above locations.
46
The most common form of supracondylar fracture humerus in children is of
which type: a. Flexion. b. Extension. c. Combination of A & B d. None of the
above.
Myositis ossificans commonly occurs around: a. Shoulder. b. Elbow. c. Wrist.
d. Knee.
Volkman's ischemia commonly occurs following: a. Fracture shaft humerus. b.
Supracondylar fracture. c. Colles' fracture. d. Monteggia fracture.
The single dependable sign of early Volkmann's contracture is: a. Cyanosis of
fingers. b. Obliteration of radial pulse. c. Paralysis of flexor muscles of
forearm. d. Pallor of fingers. e. Pain.
Cubitus valgus of elbow commonly follows fracture of: a. Lateral condyle. b.
Medial condyle. c. Capitalum. d. Lower third of humerus.
51)
Fracture involving which part of humerus can cause delayed ulnar palsy: a.
Shaft. b. Surgical neck. c. Medial epicondyle. d. Lateral epicondyle. C
The deformity of wrist in Colles' fracture is: a. Madelung's deformity. b. Dinner
fork deformity. c. Buttonaire deformity. d. None of the above. B
Colles' fracture can be complicated by late rupture of: a. Extensor pollicis
longus. b. Abductor pollicis longus. c. Adductor pollicis longus. d. Flexor
pollicis longus. A
What is True of Sudeck's atrophy of hand: a. Hand is painful and swollen. b.
Osteoporosis of carpals and metacarpals. c. There is increased blood flow to
para-articular areas. d. Cervical sympathectomy may be of help. e. All are
true. E
The carpal bone most commonly fractured is: a. Triquetrum. b. Hamate. c.
Capitate. d. Scaphoid. D
56
Which nerve is compressed in carpal tunnel syndrome: a. Ulnar. b. Median. c.
Radial. d. All of the above.
The most common injury following pelvic fracture is of: a. Bladder. b. Urethra.
c. Rectum. d. Vagina.
Limb shortening with adduction and internal rotation occurs in which type of
hip dislocation: Ba. Anterior. b. Posterior. c. Central. d. All of the above.
Nelaton's line joins anterior superior iliac spine to: a. Xiphisternum. b. Pubic
tubercle. c. Ischial tuberosity. d. Ischial spine.
Bryant's triangle helps to assess:C a. Fracture neck of femur. b. Iliac crest
displacement. c. Trochanteric displacement. d. None of the above.
61
Normal neck-shaft angle of femur is:B a. 90. b. 120. c. 150. d. 170.
Fracture femoral neck can be diagnosed from:D a. Limb shortening. b.
External rotation. c. Abduction. d. A + B.
Which of the following is not True of intertrochanteric fracture of femur:C a.
Limb shortening. b. Malunion. c. Avascular necrosis of femoral head. d.
Internal fixation is preferred.
Most common complication of fracture shaft femur is:C a. Malunion. b.
Nonunion. c. Knee stiffness. d. Fat embolism.
Spontaneous bleeding into joints in haemophilia occurs when factor VI level is
less than:D a. 50%. b. 25%. c. 10%. d. 5%.
66
Recurrence of Baker's cyst should make the surgeon suspect: a. Neoplastic
change. b. Undiagnosed pathology within knee. c. Incomplete removal of the
cyst. d. The communication to the joint is persisting.
Flexion of distal interphalangeal joint with fixing the proximal interphalangeal
joint (PIP) tests: a. Flexor digitorum profundus. b. Flexor digitorum
superficials. c. Palmaris longus. d. All of the above.
Stenosing tenovaginitis commonly affects: a. Abductor pollicis. b. Flexor
pollicis longus. c. Opponens pollicis. d. All of the above.
A sequestrum is a. a piece of soft dead tissue b. a piece of dead skin c. a
dead tooth d. a piece of dead bone e. a retained swab
Union of a simple uncomplicated transverse fracture of the tibia in an adult
normally takes a. 6 weeks b. 8 weeks c. 12 weeks d. 18 weeks e. 26 weeks
71
Fractures which do not impact include:D a. fracture of tile vault of the skull b.
a compression fracture c. a simple fracture d. a transverse fracture of the
patella e. fracture of the neck of the femur
Colles' fracture is :C .a a fracture of the clavicle b. a fracture about the ankle
joint c. common in elderly women d. a fracture of the head of the radius e.
fracture of the scaphoid
Bennett's fracture is :D a. reversed Colles' fracture b. fracture of the scaphoid
bone in the wrist c. fracture of the radial styloid (chauffeur's fracture) d.
fracture dislocation of the first metacarpal e. cause of mallet finger
Supracondylar fracture of the humerus in a child :C a. is due to a fall on the
point of the elbow b. is usually compound c. requires admission of the patient
after reduction d. requires immediate open reduction e. is a fracture
dislocation
A fracture of the midshaft of the clavicle is best treated by: E a. clavicle rings
b. a figure-of-eight bandage c. open reduction and plating d. an intramedullary
nail e. a broad arm sling and analgesics
76
A Pott's fracture is a type of fracture of the:B a. wrist b. ankle c. spine d. foot
e. skull
Treatment of a severe comminuted fracture of the patella includes a.
physiotherapy alone b. insertion of a figure-of-eight tension band c.
patellectomy d. inserting screws or wire e. skin traction
Malunion of a fracture is :A a. a fracture which unites in a position of deformity
b. delayed union of a fracture c. non-union of a fracture d. followed by
pseudoarthrosis e. due to tuberculosis
Volkmann's contracture a. affects the palmar fascia b. develops at the ankle in
a case of chronic venous ulcer c. follows ischemia of the forearm muscles d.
is due to excessive scarring of the skin of the axilla following a burn e. follows
ulnar nerve palsy
A Brodie's abscess is a. a subperiosteal abscess due to infection of the
mastoid air cells b. a type pf breast abscess c. a chronic abscess of the bone
d. an abscess arising in the inguinal lymph nodes e. an abscess forming in an
infected varicose vein
81
Tears of the meniscus of the knee result from which of the following strain: a.
Hyperextension b. Abduction c. Adduction d. Rotation e. Combined flexion
and rotation
121)
In fracture of the olecranon process of the ulna, the following statements are
true except that it: a. Is usually due to a fall on the elbow b. Can be felt as a
gap between the olecranon and the shaft c. Is rarely associated with
hemarthrosis d. May be complicated by anterior dislocation of the elbow joint
e. Always requires surgical treatment
Concerning extension Monoteggia's fracturedislocation, 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 d. Always requires
surgical treatment in adults e. Is rarely associated with complications
In a football game, an athlete felt severe pain in his Rt knee while turning to
the left side with the joint flexed and taking the body weight. Soon after, the
joint became swollen and painful but recovery followed rest for 3 weeks.
Thereafter, the patient suffered from recurrent locking with pain and a feeling
of "giving way" in the joint. The most probable diagnosis is: a. Solitary loose
body b. Fracture of the tibial spine c. Rupture of the medial ligament d.
Rupture of the medial semillunar cartilage e. Fracture of the patella
A lateral blow at the level of the knee joint may cause: a. Rupture of anterior
cruciate ligament b. Rupture of medial collateral ligament c. Avulsion of medial
meniscus d. Bumper fracture of tibia e. All of the above
A march fracture most frequently results from: a. Direct trauma b. Jumping
from a height c. Muscle fatigue from prolonged walking d. Use of high-healed
shoes e. Osteoporosis
126
Intestinal absorption of calcium is dependent upon: a. Vitamin D b.
Parathoraone c. Calcitonin d. All of the above e. None of the above
An irregular epiphyseal line with calcifying periosteal haematc found on X-ray
examination is indicative of: a. Infantile rickets b. Scurvy c. Hemophilia d.
Hypoparathyroidism e. Hypervitaminosis
A Osteoporosis is a deficiency in: a. Calcium metabolism b. Calcium
deposition c. Protein supporting tissue d. All of the above e. None of the
above
Which of the following is most common in the small bones of the hands and
feet: a. Osteochondroma b. Enchondroma c. Osteoid osteoma d.
Osteochondritis juvinelis e. Tuberculous osteitis
Concerning osteoclastoma, the following statements are correct except that it:
a. Usually occurs between the ages of 15 and 40 years b. Always arises in
metaphyseal region of cartilaginous bones c. Consists of large giant cells in a
very vascular stroma of spindle cells d. Presents as a painless globular
swelling with welldefined edge e. Produces diagnostic radiological signs
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
The treatment of osteoclastoma includes the following measures except: a.
Curettage of tumor tissue & packing cavity with bone chips b. Excision with
safety margin of bone c. Amputation d. Radiotherapy e. Chemotherapy
The following statements about multiple myeloma are true except that it:: a. Is
a primary malignant tumor of bone marrow b. Occurs between the ages of 40
and 60 years c. Usually presents with bone pain especially in the back d. Is
rarely associated with fever and anemia e. May cause paraplegia with girdle
pains
151)
The following statements about bone sarcoma are true except that it: a. Arises
from osteoblasts of the periosteum or bone cortex b. Forms a fusiform mass
ensheathing the bone c. Often invades the epiphyseal cartilage and
neighbouring joint d. Produces characteristic new bone formation in the X-ray
e. Disseminates rapidly by the blood stream
Which one of the following statements is untrue concerning chondro-sarcoma:
a. Occurs most often between the ages 20 and 60 yrs b. Is always a primary
malignant tumor of bone c. Most commonly affects scapula, pelvis, ribs &
sternum d. Causes bone expansion and destruction with irregular opacities in
the X-ray e. Is radioresistant
Ewing's sarcoma is characterized by the following except that it: a. Is a
common tumor of children b. Always arises in the metaphysis of a long bone
c. Presents as a fusiform swelling with inflammatory changes in the overlying
soft tissues d. May be associated with leucocytosis e. Produces characteristic
radiological signs
The following statements about Dupuytren's 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 fingers 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.
181)
The most effective ttt of sever Dupuytren's contracture is: a. Repeated
stretching and night splintage. b. Local injections of fibrinolysin or
hydrocortisone. c. X-ray therapy. d. Subcutaneous fasciotomy. e. Radical
excision of the palmar fascia.
The most diagnostic sign of congenital hip dysplasia in the newly borne is : a.
Widening of the perineum. b. Asymmetry of the buttocks. c. Ortalani's sign. d.
Limitation of hip abduction with hip and knees flexed to 90. e. Apparent
shortening of the thigh with the hips and knees flexed to 90.
The earliest radiological sign in congenital hip dislocation in infants is : a. The
small shallow acetabulum. b. The hypoplastic femoral head. c. The shortened
anteverted femoral neck. d. Distortion of Shenton's line. e. Displacement of
the femoral head from the acetabulum.
In congenital dislocation of the hip (CDH), the pathological changes include
the following except : a. Small shallow acetabulum. b. Snail flattened femoral
head lying outside the acetabulum. c. Elongated femoral neck. d. Thickened
adherent joint capsule with an hour-glass constriction. e. Shortened
hamstrings and adductors.
Trenderburg' s sign can be elicited in all of the following except : a. Congenital
dislocation of the hip. b. Infantile paralysis of the gluteal muscles. c. Coxa
vara. d. Tuberculous arthritis of the hip joint. e. Non-united fracture of the
femoral neck.
186
A 10-year-old male with neglected congenital dislocation of the hip presented
because of increasing pain in the back with limping and fatigue. The
appropriate management should be : a. Analgesics and anti-inflammatory
drugs. b. Raising the heel of the right shoe. c. Open reduction with deepening
the acetabulum by a shelf procedure. d. Colonna's arthroplasty. e. Lorenz's
bifurcation osteotomy.
The clinical features of coxa vara include the following except : a. Shortening,
addution and eversion of the limb. b. Raising of the greater trochanter above
A 25-year-old male suffered from painful swelling of the feet and ankles over
the last 6 weeks. On examination, the arches were preserved but the skin was
congested and localized tenderness could be elicited over the navicular bone
and the spring, deltoid and plantar ligaments. The correct diagnosis is : a.
Sprain of the ankle joint. b. Plantar fasciitis. c. Incipient flat foot. d. Spasmodic
flat foot. e. Talonavicular arthritis.
An adolescent male complained of severe pain in the foot and leg after
prolonged standing. Examination revealed that the foot is flat and fixed in
extreme eversion by spastic contraction of the peroneal muscles and long
extensors of the toes. The most likely diagnosis is : a. Incipient flat foot. b.
Spasmodic flat foot. c. Tuberculosis of the ankle joint. d. Sprain of the ankle.
e. Retrocalcanean bursitis.
Which of the following is associated with neurofibromatosis ? a. Talipes
equinovarus. b. Metatarsus varus. c. Pseudarthrosis of the tibia. d. Genu
recurvatum. e. Congenital hip dysplasia.
Regarding hallux valgus, the following statements are true except that it: a.
Consists of outward deviation of the great toe at the metatarso-phalangeal
joint. b. Is usually due to badly fitting shoes. c. Is not progressive. d. Causes
hammer-toe deformity in the other toes. e. Predisposes to several painful
complications.
201
The causes of hammer-toe include the following except: a. Overcrowding of
the toes by ill-fitting shoes. b. Hallux valgus. c. Pes cavus. d. Talipes equinus.
e. Rupture of the extensor expansion.
The following statements about provisional amputation for infective gangrene
are true except that it: a. May be urgently needed to control infection and
toxemia. b. Should be made through the healthy limb above the infected area.
c. Should be done as low as possible to allow reamputation at the optimum
level. d. Should provide free drainage. e. May be carried out by the guillotine
or flap method without closure.
The ideal amputation should fulfill the following requirements except that it
should: a. Be as long as possible. b. Have a smoothly rounded cone-shaped
end. c. Not include muscle over the bone end. d. Have a linear freely movable
scar not exposed to pressure. e. Be painless with a freely movable joint above
and a smooth bone end elbow.
Syme's amputation is better than a below-knee amputation except that it: a. Is
less "catastrophic" to the patient. b. Allows the patient to walk around in his
room without prosthesis. c. Maintains, the pleasure of "earth feeding". d.
Requires a cheap stump boot. e. Is not attended with serious complications.
MCQs Answers
1. 2. 3. 4. 5. B A B D C
6. 7. 8. 9. 10. B B B C B
11. 12. 13. 14. 15. B C B C B
16. 17. 18. 19. 20. C B D A B
21. 22. 23. 24. 25 D A A C D
26. 27. 28. 29. 30. C C E D C
31. 32. 33. 34. 35. B C D B B
36. 37. 38. 39. 40. A B A A C
41. 42. 43. 44. 45. D C D B B
46. 47. 48. 49. 50 B B B E A
51. 52. 53. 54. 55. D B A E D
56. 57. 58. 59. 60. B B B C C
61. 62. 63. 64. 65 B D C C D.
66. 67. 68. 69. 70 B A A D C
71. 72. 73. 74. 75. D C D C E
76. 77. 78. 79. 80 B C A C C.
81. 82. 83. 84. 85 C C C B C.
86. 87. 88. 89. 90. C B C E E
91. 92. 93. 94. 95 C D D D A
96. 97. 98. 99. 100. B C C E D
101. 102. 103. 104. 105. E C D E C
106. 107. 108. 109. 110 D D A A C
111. 112. 113. 114. 115. C D C C E
116. 117. 118. 119. 120. B C C E D
121. 122. 123. 124. 125 B E D E C.
126. 127. 128. 129. 130. A B C E E
131. 132. 133. 134. 135. B D E D A
136. 137. 138. 139. 140. E D A D C
141. 142. 143. 144. 145D C C E A
146. 147. 148. 149. 150. B B E E D
151. 152. 153. 154. 155. C B B C B
156. 157. 158. 159. 160. C A C D A
161. 162. 163. 164. 165. C B D E C
166. 167. 168. 169. 170E C C E B
171. 172. 173. 174. 175. C A D E E
176. 177. 178. 179. 180. D B D D E
181. 182. 183. 184. 185 E C D C D.
186. 187. 188. 189. 190. E C D D B
191. 192. 193. 194. 195C D D A D
196. 197. 198. 199. 200. D C B C C
201. 202. 203. 204. 205. E B A E D