Ortho - practice questions- Multiple Choice with
Verified Correct Answers | Guaranteed A+
. A 22-year-old female person was playing basketball when she tripped and landed on
the
pavement with her hands outstretched. She presents complaining of abrasions on the
right thenar
eminence and "wrist pain." Physical examination reveals tenderness to palpation
between the
extensor pollicis longus and the extensor pollicis brevis. Assessment of the median,
ulnar, and
radial nerves reveals no sensor or motor changes when compared with the left hand.
Radial and
ulnar pulses are 2+ bilaterally with capillary refill less than 2 seconds on all five fingers of
the
right hand. Posterior-anterior view radiographs of the wrist and posterior-anterior wrist
radiographs with the wrist in ulnar deviation reveal no fractures or dislocations. What is
the
appropriate management for this patient at this time?
(A) immediate orthopedic referral
(B) cock-up splint until symptoms resolve
(C) physical therapy referral for assessment an - ✔✔(D) thumb spica splint and repeat
radiographs in 3 weeks
. A 53-year-old patient of Scandinavian descent presents with pain in the ring finger of
the right
hand. The patient states that he/she has pain when he/she extends his/her finger after
making a
,fist. The finger will not extend on its own, requiring the patient to manually extend the
finger, a
maneuver that produces both an audible snap and considerable pain. What is the most
likely
diagnosis?
(A) jersey finger
(B) trigger finger
(C) Dupuytren contracture
(D) gamekeeper finger
(E) ganglion cyst - ✔✔(B) trigger finger
. A 27-year-old woman with no significant medical history presents complaining of left
elbow
pain for 3 days. The patient states that over the last 3 days, her left elbow has become
increasingly red, swollen, and painful. The patient is left-hand-dominant. The patient is
employed as a chiropractor, she is sexually active but denies a history of sexually
transmitted
infections. The patient is currently having her menses, denies any recent foreign travel,
and
acknowledges that while she regularly plays tennis, she does not recall any history of
elbow
trauma. On physical examination, you discover an elbow joint that is markedly
erythematous,
warm to touch, and tender to palpation. Range of motion is decreased secondary to
edema and
pain. Radiograph of the elbow reveals only soft tissue swelling but no fracture or
dislocation.
Joint aspiration is performed and a gram-negative diplococcus is identified on
cytological
,exa - ✔✔(C) Neisseria gonorrhoeae
. A 53-year-old woman presents with pain in her right wrist. The pain is aggravated by
movement
of the thumb and when she makes a fist. She also notes that when she moves her
thumb, there is
an occasional locking sensation in the radial aspect of her wrist. Physical examination of
the
wrist reveals swelling and tenderness over the distal radius, and full flexion of the
thumb into the
palm, with ulnar deviation of the wrist, produces pain. Radiographic evaluation of the
wrist
shows no bone abnormalities. Which of the following would be the treatment of choice
in this
patient presentation?
(A) immobilization of the wrist with a thumb spica splint
(B) tendon sheath corticosteroid injection
(C) operative treatment to restore functionality
(D) prompt neurological evaluation
(E) proceed to bone scan to evaluate the area of pain - ✔✔(A) immobilization of the
wrist with a thumb spica splint
. Which of the following most accurately describes the physical examination findings
suggestive of
a boutonniere deformity?
(A) hyperextension of the proximal interphalangeal joint with fixed flexion of the distal
interphalangeal joint
(B) persistent extension of the proximal interphalangeal joint with hyperflexion of the
distal interphalangeal joint
, (C) hyperextension of the distal interphalangeal joint with flexion of the proximal
interphalangeal joint
(D) persistent flexion of the proximal interphalangeal joint with hyperextension of the
distal interphalangeal joint
(E) hyperextension of the distal interphalangeal joint with extension of the proximal
interphalangeal joint - ✔✔(D) persistent flexion of the proximal interphalangeal joint
with hyperextension of the distal interphalangeal joint
. You have been following a 52-year-old man with a complaint of back pain over the past
7 weeks. During the first 5 weeks of his condition, Abraham's back pain was steadily
declining and his neurological findings on physical examination were decreasing. Over
the past 2 weeks, Abraham has complained of worsening pain that is currently
unrelenting, especially at night. On physical examination, Abraham demonstrates
findings on both the straight leg raise and crossed straight leg raise tests. His muscle
weakness has likewise accelerated over the past 2 weeks, and he is no longer able to
heel walk using his left ankle. What is the most appropriate management strategy at this
time?
(A) conservative therapy including application of ice and physical therapy referral for
muscle
stretching and strengthening
(B) plain radiographs of the spine
(C) computed tomography (CT) of the spine
(D) MRI of the spine - ✔✔(D) MRI of the spine
. A 10-year-old boy is brought to the emergency department after falling during the
recess at
school. The patient states that he was running with a football when two of his
classmates tackled
him. He complains of pain in his right wrist. Radiographs reveal a fracture to the right
radius. The fracture line runs diagonally from the epiphysis through the metaphyseal
bone. By definition, how would you classify this patient's fracture?
Verified Correct Answers | Guaranteed A+
. A 22-year-old female person was playing basketball when she tripped and landed on
the
pavement with her hands outstretched. She presents complaining of abrasions on the
right thenar
eminence and "wrist pain." Physical examination reveals tenderness to palpation
between the
extensor pollicis longus and the extensor pollicis brevis. Assessment of the median,
ulnar, and
radial nerves reveals no sensor or motor changes when compared with the left hand.
Radial and
ulnar pulses are 2+ bilaterally with capillary refill less than 2 seconds on all five fingers of
the
right hand. Posterior-anterior view radiographs of the wrist and posterior-anterior wrist
radiographs with the wrist in ulnar deviation reveal no fractures or dislocations. What is
the
appropriate management for this patient at this time?
(A) immediate orthopedic referral
(B) cock-up splint until symptoms resolve
(C) physical therapy referral for assessment an - ✔✔(D) thumb spica splint and repeat
radiographs in 3 weeks
. A 53-year-old patient of Scandinavian descent presents with pain in the ring finger of
the right
hand. The patient states that he/she has pain when he/she extends his/her finger after
making a
,fist. The finger will not extend on its own, requiring the patient to manually extend the
finger, a
maneuver that produces both an audible snap and considerable pain. What is the most
likely
diagnosis?
(A) jersey finger
(B) trigger finger
(C) Dupuytren contracture
(D) gamekeeper finger
(E) ganglion cyst - ✔✔(B) trigger finger
. A 27-year-old woman with no significant medical history presents complaining of left
elbow
pain for 3 days. The patient states that over the last 3 days, her left elbow has become
increasingly red, swollen, and painful. The patient is left-hand-dominant. The patient is
employed as a chiropractor, she is sexually active but denies a history of sexually
transmitted
infections. The patient is currently having her menses, denies any recent foreign travel,
and
acknowledges that while she regularly plays tennis, she does not recall any history of
elbow
trauma. On physical examination, you discover an elbow joint that is markedly
erythematous,
warm to touch, and tender to palpation. Range of motion is decreased secondary to
edema and
pain. Radiograph of the elbow reveals only soft tissue swelling but no fracture or
dislocation.
Joint aspiration is performed and a gram-negative diplococcus is identified on
cytological
,exa - ✔✔(C) Neisseria gonorrhoeae
. A 53-year-old woman presents with pain in her right wrist. The pain is aggravated by
movement
of the thumb and when she makes a fist. She also notes that when she moves her
thumb, there is
an occasional locking sensation in the radial aspect of her wrist. Physical examination of
the
wrist reveals swelling and tenderness over the distal radius, and full flexion of the
thumb into the
palm, with ulnar deviation of the wrist, produces pain. Radiographic evaluation of the
wrist
shows no bone abnormalities. Which of the following would be the treatment of choice
in this
patient presentation?
(A) immobilization of the wrist with a thumb spica splint
(B) tendon sheath corticosteroid injection
(C) operative treatment to restore functionality
(D) prompt neurological evaluation
(E) proceed to bone scan to evaluate the area of pain - ✔✔(A) immobilization of the
wrist with a thumb spica splint
. Which of the following most accurately describes the physical examination findings
suggestive of
a boutonniere deformity?
(A) hyperextension of the proximal interphalangeal joint with fixed flexion of the distal
interphalangeal joint
(B) persistent extension of the proximal interphalangeal joint with hyperflexion of the
distal interphalangeal joint
, (C) hyperextension of the distal interphalangeal joint with flexion of the proximal
interphalangeal joint
(D) persistent flexion of the proximal interphalangeal joint with hyperextension of the
distal interphalangeal joint
(E) hyperextension of the distal interphalangeal joint with extension of the proximal
interphalangeal joint - ✔✔(D) persistent flexion of the proximal interphalangeal joint
with hyperextension of the distal interphalangeal joint
. You have been following a 52-year-old man with a complaint of back pain over the past
7 weeks. During the first 5 weeks of his condition, Abraham's back pain was steadily
declining and his neurological findings on physical examination were decreasing. Over
the past 2 weeks, Abraham has complained of worsening pain that is currently
unrelenting, especially at night. On physical examination, Abraham demonstrates
findings on both the straight leg raise and crossed straight leg raise tests. His muscle
weakness has likewise accelerated over the past 2 weeks, and he is no longer able to
heel walk using his left ankle. What is the most appropriate management strategy at this
time?
(A) conservative therapy including application of ice and physical therapy referral for
muscle
stretching and strengthening
(B) plain radiographs of the spine
(C) computed tomography (CT) of the spine
(D) MRI of the spine - ✔✔(D) MRI of the spine
. A 10-year-old boy is brought to the emergency department after falling during the
recess at
school. The patient states that he was running with a football when two of his
classmates tackled
him. He complains of pain in his right wrist. Radiographs reveal a fracture to the right
radius. The fracture line runs diagonally from the epiphysis through the metaphyseal
bone. By definition, how would you classify this patient's fracture?
