Orthopaedic Surgery MCQs:

1) Origin of bone is from:

a. Ectoderm.

b. Mesoderm.

c. Endoderm.

d. All of the above.

2) Acute osteomyelitis is commonly caused by:

a. Staph aureus.

b. S. Pyogenes.c.

H. influenzae.

d. Salmonella.

3) Acute osteomyelitis usually begins at:

a. Epiphysis.

b. Metaphysis.

c. Diaphysis.

d. Any of the above.

4) 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.

5) 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.

6) Tuberculosis of the spine most likely originates from:

a. Intervertebral disk.

b. Cancellous vertebral body.

c. Ligamentous structures.

d. Paravertebral soft tissue.

7) In Pott’s spine, the disease starts in the:

a. Intervertebral disk.

b. Anterior vertebral margin.

c. Posterior vertebral margin.

d. Paravertebral soft tissue.

8) Melon seed bodies in joint fluid are characteristic of:

a. Rheumatoid arthritis.

b. Tuberculous arthritis.

c. Septic arthritis.

d. None of the above.

9) 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.

10) Healing of tuberculous arthritis can lead to:

a. Calcification.

b. Fibrous ankylosis.

c. Boney ankylosis.

d. None of the above.

11) Osteoid osteoma originates from:

a. Periosteum.

b. Cortex.

c. Medullary cavity.

d. All of the above.

12) Sun ray appearance of osteosarcoma is because of:

a. Periosteal reaction.

b. Osteonecrosis.

c. Calcification along vessels.

d. None of the above.

13) Bone metastasis in male commonly arises from cancer of:

a. Lung.

b. Prostate.

c. Kidney.

d. Thyroid.

14) Osteoblastic bone secondaries commonly arise from cancer of:

a. Breast.

b. Lung.

c. Prostate.

d. Adrenal.

15) Bone metastasis can be best evaluated by:

a. X-ray.

b. 99mTC bone scan.

c. 111Indium scan.

d. Calcium-alkaline phosphatase elevation.

16) The synonym for Paget’s disease is:

a. Osteitis fibrosa.

b. Osteitis proliferans.

c. Osteitis deformans.

d. None of the above.

17) Multiple myeloma tumor cells resemble:

a. Granulocytes.

b. Plasma cells.

c. Lymphocytes.

d. Chondrocytes.

18) An adamantinoma historically contains:

a. Squamous cell rests.

b. Pallisading cells.

c. Cells resembling basilar cells.

d. All of the above.

19) Osteomalacia predominantly affects the:

a. Spine.

b. Pelvis.

c. Skull bones.

d. Metatarsals.

20) The enzyme found in osteoclasts but not in osteoblastsis:

a. Alkaline phosphatase.

b. Acid phosphatase.

c. Elastase.

d. Cytochrome oxidase.

21) A Gigli saw is:

a. An electrically driven circular bone saw.

b. A pneumatically driven bone saw.

c. A short straight bone saw.

d. A long twisted wire bone saw.

22) Osteoclasis can be used to:

a. Correct deformity of the tibia due to rickets.

b. Curette an osteoclastoma.

c. Correct deformity.

d. Correct a ricketery rosary.

23) In Dupuytren’s contracture which one of the following statements incorrect:

a. It is a contracture of the flexor tendons to the ring and little fingers.

b. It is a contracture of the palmar fascia.

c. It may occur in the plantar fascia.

d. There is an association with cirrhosis of the liver.

24) 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 litters of blood can be lost without obvious swelling or bruising.

d. There is no possibility of death from hemorrhagic shock.

25) 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.

27) The single most important factor in fracture healing is:

a. Correct bone alignment.

b. Accurate reduction.

c. Immobilization.

d. Organization of clot.

28) 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.

29) 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.

30) 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.

32) 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.

33) 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 x-ray view of the hip

34) 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.

35) Perthes’ disease is common to age group of:

a. 1-5.

b. 6-10.

c. 11-15.

d. 16-20.

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.

37) 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.

38) The sequestrum in X-ray appears:

a. Dense.

b. Light.

c. Isodense as surrounding bone.

d. Any of the above.

39) 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.

40) 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.

42) The joint most likely to have recurrent dislocation is:

a. Ankle.

b. Knee.

c. Shoulder.

d. Patella.

43) 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.

44) 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.

45) Radial nerve palsy may occur in fracture 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.

47) Myositis ossificans commonly occurs around:

a. Shoulder.

b. Elbow.

c. Wrist.

d. Knee.

48) Volkman’s ischemia commonly occurs following:

a. Fracture shaft humerus.

b. Supracondylar fracture.

c. Colles’ fracture.

d. Monteggia fracture.

49) The single dependable sign of early Volkmann’scontracture is:

a. Cyanosis of fingers.

b. Obliteration of radial pulse.

c. Paralysis of flexor muscles of forearm.

d. Pallor of fingers.

e. Pain.

50) Cubitus valgus of elbow commonly follows fractureof:

a. Lateral condyle.

b. Medial condyle.

c. Capitalum.

d. Lower third of humerus.

51) Fracture involving which part of humerus can causedelayed ulnar palsy:

a. Shaft.

b. Surgical neck.
c. Medial epicondyle.

d. Lateral epieondyle.

52) The deformity of wrist in Colles’ fracture is:

a. Madelung’s deformity.

b. Dinner fork deformity.

c. Buttonaire deformity.

d. None of the above.

53) 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.

54) 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.

55) The carpal bone most commonly fractured is:

a. Triquetrum.

b. Hamate.

c. Capitate.

d. Scaphoid.

56) Which nerve is compressed in carpal tunnel syndrome:

a. Ulnar.

b. Median.
c. Radial.

d. All of the above.

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

a. Bladder.

b. Urethra.

c. Rectum.

d. Vagina.

58) Limb shortening with adduction and internal rotation occurs in which type of hip dislocation:

a. Anterior.

b. Posterior.

c. Central.

d. All of the above.

59) Nelaton’s line joins anterior superior iliac spine to:

a. Xiphisternum.

b. Pubic tubercle.

c. Ischial tuberosity.

d. Ischial spine.

60) Bryant’s triangle helps to assess:

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:

a. 90°.

b. 120°.

c. 150°.
d. 170°.

62) Fracture femoral neck can be diagnosed from:

a. Limb shortening.

b. External rotation.

c. Abduction.

d. A + B.

63) 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.

64) Most common complication of fracture shaft femur is:

a. Malunion.

b. Nonunion.

c. Knee stiffness.

d. Fat embolism.

65) Spontaneous bleeding into joints in haemophilia occurs when factor VI level is less than:

a. 50%.

b. 25%.

c. 10%.

d. 5%.

66) Recurrence of Baker’s cyst should make the surgeon suspect:

a. Neoplasti

c change.

b. Undiagnosed pathology within knee.

c. Incomplete removal of the cyst.

d. The communication to the joint is persisting.

67) 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.

68) Stenosing tenovaginitis commonly affects:

a. Abductor pollicis.

b. Flexor pollicis longus.

c. Opponens pollicis.

d. All of the above.

69) 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

70) 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

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

72) Colles’ fracture is

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 die scaphoid

73) Bennett’s fracture is

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

74) Supracondylar fracture of the humerus in a child

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

75) A fracture of the mid shaft of the clavicle is best treated by

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

a. wrist

b. ankle

c. spine

d. foot

e. skull

77) 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

78) Malunion of a fracture is

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

79) 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

80) 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) The initial abnormality in primary osteoarthritis is

a. in the synovial membrane

b. sclerosis of cartilage

c. fibrillation of cartilage

d. an osteophyte

e. a pannus

82) The initial abnormality in rheumatoid arthritis is

a. fibrillation of cartilage

b. sclerosis of cartilage

c. in the synovial membraned. In the capsule

e. proliferation of bone

83) Pott’s paraplegia is due to

a. hematomyelia following trauma

b. damage to the cord by a piece of bone when vertebrae collapse in tuberculosis of the spine

c. tuberculous pus and angulation in tuberculosis of the spine

d. damage to die corda equina after a fall

e. fracture dislocation of cervical vertebrae

84) Still’s 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 Reiter’s disease

85) A benign tumor forming osteoid is

a. a synovioma

b. a chondroma

c. an osteoma

d. a fibroma

e. an adenoma

86) Ewing’s tumor affecting the humerus

a. is a metastasis from carcinoma of the thyroid

b. should be treated by immediate amputation

c. looks like a cut onion on x-ray

d. has a soap-bubble appearance on x-ray

e. displays sun-ray spicules on x-ray

87) Barlow’s sign is related to the diagnosis of

a. talipes equinus varus

b. congenital dislocation of the hip

c. ulnar nerve palsy

d. genu varum

e. fractured neck of femur

88) The reported incidence of unstable hips per 1000 at birth is as much as

a. 0.5

b. 2-5

c. 8-20

d. 25-30

e. 35-40

89) The word talipes refers to

a. long feet with spidery toes

b. knock knee

c. flat feet

d. hammer toes

e. club feet

90) Bone dysplasia is due strictly to

a. faulty nutrition

b. osteomyelitis

c. parathyroid tumor

d. trauma

e. faulty development

91) Idiopathic scoliosis is a

a. lateral curvature of the spine

b. rotation of the spine

c. lateral curvature with rotation of the spine

d. flexion deformity of the spine

e. congenital disease with hemivertebrae

92) A Milwaukee brace can be used in

a. sacro-iliac strain

b. derangement of the teeth

c. a patient with an above knee amputation

d. scoliosis

e. fractured clavicle

93) Legg-Calve-Perthe’s disease is

a. osteochondritis of the spine

b. tuberculosis of the hip joint

c. slipped proximal femoral epiphysis

d. osteochondritis of the proximal femoral epiphysis

e. osteomalacia

94) The name associated with joint neuropathy is that of

a. Cushing

b. Osier

c. Moon

d. Charcot

e. Addison

95) Adrenocorticosteroids administered in excess cause

a. osteoporosis

b. osteosclerosis

c. osteochondritis

d. endochondral ossification

e. osteosarcoma

96) ‘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

97) An adventitious bursa is

a. an anatomical bursa overlying any joint

b. a type of degeneration of adventitia of popliteal artery

c. an acquired bursa generated from connective tissue

d. a pseudocyst in the lesser sac (omental bursa)

e. an infected knee
98) A trigger finger is

a. an inflamed index finger

b. an atrophic index finger in a median nerve palsy

c. due to stenosing tenovaginitis affecting one of the flexor tendons in the palm

d. an essential feature of the carpal tunnel syndrome

e. a component of syndactyly

99) A Baker’s 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

100) Immobilization of fractures of long bones should include

a. Fractured bone only

b. Joint involved in the fracture

c. Proximal joint

d. Both proximal and distal joints

e. Distal joint

101) Non-union is common in fractures of the following bones

Except the:

a. Carpal scaphoid

b. Neck of the femur

c. Lower third of the tibia

d. Talus

e. Tuberosity of the fifth metatarsal

102) The signs of fractured shaft of a bone

Do not include:

a. Swelling

b. Deformity

c. Loss of all movements in the limb

d. Acute localized bone tenderness

e. Abnormal mobility in the line of the bone

103) In the following types of fractures of long bones,crepitus can be elicited only in:

a. Fissures

b. Subperiosteal cracks

c. Greenstick fractures

d. Spiral and oblique fractures

e. Impacted fractures

104) The most severe growth disturbance results from which of the following types of epiphyseal
injuries:

a. Separation of the epiphysis at the metaphyseal side of the epiphyseal plate

b. Separation of the epiphysis with a triangular fragment of the metaphysic

c. Intra-articular fracture involving the articular cartilage epiphysis and epiphyseal plate

d. Intra-articular fracture extending from the joint surface through the epiphysis and epiphyseal
plate to the metaphysic

e. Crashing injuries compressing the epiphyseal plate without displacement

105) Local complications of closed fractures

Do not include:

a. Malunion

b. Non-union

c. Infection

d. Sudek’s atrophy

e. Joint stiffness

106) Non-union in closed fractures may due to any of the following

Except :

a. Inadequate immobilisation

b. Interposition of soft parts

c. Impaired blood supply

d. Inspection of the fragments

e. Wide separation of the fragments

107) Causes of gangrene after fracture in a limb

Do not include:

a. Direct crushing of the tissues

b. Injury to the main vessels

c. Tight plasters

d. Septic infection

e. Clostridial infection

108) The correct ttt of traumatic myositis ossificans is by:

a. Prolonged immobilisation

b. Active exercises

c. Passive stretching and massage

d. Both A and B

e. Both B and C

109) Concerning fracture of the shaft of the clavicle, it is

Untrue that it:

a. Is usually due to direct trauma

b. Commonly involves the middle third

c. Is often associated with overriding of fragments

d. Causes dropping and deformity of shoulder

e. Is usually treated by figure-of-eight bandage

110) A child with midclavicular fracture and overriding of the fragments is best treated by:
a. Supine bed rest with interscapsular sandbag support

b. Open reduction and internal fixation

c. Figure-of-eight bandage

d. Closed reduction and plaster fixation

e. Manipulative reduction and abduction splint

111) In shoulder dislocations, the humeral head usually dislocates primarily in which of the following
directions:

a. Inferiorly

b. Superiorly

c. Anteriorly

d. Posteriorly

e. Laterally

112) The incorrect statement about anterior dislocation of the shoulder joint is that:

a. shoulder loses its rounded contour & becomes flattened

b. The elbow is abducted from the side

c. All movements of the shoulder are limited and painful

d. The anterior and posterior folds of the axilla are elevated

e. The hand cannot be placed on the opposite shoulder (Duga’s test)

113) Recent dislocations of shoulder joint are best treated by:

a. Hippocrates’ method of closed reduction

b. Kocher’s manipulation

c. Modified Milch’s manoeuvre

d. Open reduction

e. Putti-platt1s operation

114) Recurrent shoulder joint dislocation is best treated by:

a. Physiotherapy

b. Nicola’s operation
c. Bankart’s operation

d. Putti-Platt’s operation

e. Arthrodesis of the joint

115) Fractures of the shaft of the humerus are best treated by:

a. Closed reduction and shoulder spica

b. Continuous skeletal traction

c. Open reduction and internal fixation

d. Hanging plaster cast

e. Coaptation plaster splint with a Velpeau dressing

MCQs Answers:

1.B

2.A

3.B

4.D

5.C

6.B

7.B

8.B

9.C

10.B

11.B

12.C

13.B

14.C

15.B

16.C
17.B

18.D

19.A

20.B

21.D

22.A

23.A

24.C

25.D

26.C

27.C

28.E

29.D

30.C

31.B

32.C

33.D

34.B

35.B

36.A

37.B

38.A

39.A

40.C

41.D

42.C

43.D

44.B

45.B

46.B

47.B
48.B

49.E

50.A

51.D

52.B

53.A

54.E

55.D

56.B

57.B

58.B

59.C

60.C

61.B

62.D

63.C

64.C

65.D

66.B

67.A

68.A

69.D

70.C

71.D

72.C

73.D

74.C

75.E

76.B

77.C

78.A
79.C

80.C

81.C

82.C

83.C

84.B

85.C

86.C

87.B

88.C

89.E

90.E

91.C

92.D

93.D

94.D

95.A

96.B

97.C

98.C

99.E

100.D

101.E

102.C

103.D

104.E

105.C

106.D

107.D

108.A

109.A
110.C

111.C

112.D

113.C

114.C

115.E