ortho rosh UPDATED ACTUAL Questions and CORRECT Answers
1. A 27-year-old woman with no reported medical history CT angiogram of left upper
presents to the emergency department after falling extremity
onto her left shoulder while playing soccer. Vital signs
today include a heart rate of 70 bpm, blood pressure
of 120/80 mm Hg, respiratory rate of 22 breaths per
minute, pulse oxygenation of 99% on room air, and
temperature of 98.6°F. Physical examination reveals a
regular heart rate and rhythm. She has tenderness,
edema, and bruising at the mid-aspect of her left clav-
icle. Her sensation is intact in her bilateral extremities,
and her radial pulse is noted to be decreased on the
left side. A plain radiograph shows a displaced fracture
of the left clavicle. Which of the following is the best
next step in management?
2. A 14-year-old boy presents to clinic with a one month positive o brien test
history of right shoulder pain. The patient is a compet-
itive tennis player. Symptoms began during a match
when the patient was serving. He experienced a pop in
the shoulder and had immediate pain. Magnetic reso-
nance imaging of the shoulder shows a superior labral
tear from anterior to posterior (SLAP lesion). Which of
the following is the most likely physical exam finding?
3. neer test impingment test of sub-
scalpular n/supraspinatus
4. hawkins test Pain indicates rotator cuff
tear or impingement. Flex
elbow to 90 degrees and
abduct the arm to nine-
, ty and internally rotate
humerus.
5. treatment for myofascial pain syndrome Physical therapy
"Spray and stretch"
method
Painful area is iced or
sprayed with a coolant and
then stretched
Topical patches
Trigger point injections
Massage, acupuncture,
biofeedback, ultrasound
CBT
cyclobenzaprine
6. A 9-year-old boy is brought in by his mom for bizarre antistreptolysin O titer
behavior. She states that he has had intermittent
fevers for the past week and is now complaining of acute rheumatic fever
joint pain and swelling. Most concerning for the mom
is the writhing, purposeless, and uncontrollable move-
ments of her son's hands that she observed this morn-
ing. On exam, a diastolic murmur is noted at the right
upper sternal border. Which of the following tests is
most likely to confirm the diagnosis?
7. primary closure Surgical closure of a fresh,
clean wound, leading to
primary intention heal-
ing. cosmetically deform-
, ing/face even iff from dog
bite
8. Which of the following is an indication for plain radi- history of prostate cancer
ographs of the lumbosacral spine in the setting of low
back pain?
9. red flags of back pain - night pain and weight
loss
- fever chills sweats
- acute bony tenderness
- morning stiffness >30
min in young adult
- urinary/bowel retention,
saddle anesthesia
- recent spinal instrumen-
tation
- immunodeficiency
- extremes of age
- coagulopathy
10. A 55-year-old man presents with groin pain of insidi- avascular osteonecrosis
ous onset that began 5 months ago. His medical his-
tory includes sickle cell anemia. He currently abuses
alcohol. Examination reveals painful hip rotation and
decreased range of motion. There is no midline pelvic
pain with resisted hip adduction. Pelvic radiographs
reveal mild subchondral sclerosis about the femoral
head, but no joint space narrowing or osteophytosis.
Which of the following is the most likely diagnosis?
11. A 29-year-old woman is concerned with a rash. On systemic lupus erythe-
inspection, you appreciate a central facial rash. You no- matosus
1. A 27-year-old woman with no reported medical history CT angiogram of left upper
presents to the emergency department after falling extremity
onto her left shoulder while playing soccer. Vital signs
today include a heart rate of 70 bpm, blood pressure
of 120/80 mm Hg, respiratory rate of 22 breaths per
minute, pulse oxygenation of 99% on room air, and
temperature of 98.6°F. Physical examination reveals a
regular heart rate and rhythm. She has tenderness,
edema, and bruising at the mid-aspect of her left clav-
icle. Her sensation is intact in her bilateral extremities,
and her radial pulse is noted to be decreased on the
left side. A plain radiograph shows a displaced fracture
of the left clavicle. Which of the following is the best
next step in management?
2. A 14-year-old boy presents to clinic with a one month positive o brien test
history of right shoulder pain. The patient is a compet-
itive tennis player. Symptoms began during a match
when the patient was serving. He experienced a pop in
the shoulder and had immediate pain. Magnetic reso-
nance imaging of the shoulder shows a superior labral
tear from anterior to posterior (SLAP lesion). Which of
the following is the most likely physical exam finding?
3. neer test impingment test of sub-
scalpular n/supraspinatus
4. hawkins test Pain indicates rotator cuff
tear or impingement. Flex
elbow to 90 degrees and
abduct the arm to nine-
, ty and internally rotate
humerus.
5. treatment for myofascial pain syndrome Physical therapy
"Spray and stretch"
method
Painful area is iced or
sprayed with a coolant and
then stretched
Topical patches
Trigger point injections
Massage, acupuncture,
biofeedback, ultrasound
CBT
cyclobenzaprine
6. A 9-year-old boy is brought in by his mom for bizarre antistreptolysin O titer
behavior. She states that he has had intermittent
fevers for the past week and is now complaining of acute rheumatic fever
joint pain and swelling. Most concerning for the mom
is the writhing, purposeless, and uncontrollable move-
ments of her son's hands that she observed this morn-
ing. On exam, a diastolic murmur is noted at the right
upper sternal border. Which of the following tests is
most likely to confirm the diagnosis?
7. primary closure Surgical closure of a fresh,
clean wound, leading to
primary intention heal-
ing. cosmetically deform-
, ing/face even iff from dog
bite
8. Which of the following is an indication for plain radi- history of prostate cancer
ographs of the lumbosacral spine in the setting of low
back pain?
9. red flags of back pain - night pain and weight
loss
- fever chills sweats
- acute bony tenderness
- morning stiffness >30
min in young adult
- urinary/bowel retention,
saddle anesthesia
- recent spinal instrumen-
tation
- immunodeficiency
- extremes of age
- coagulopathy
10. A 55-year-old man presents with groin pain of insidi- avascular osteonecrosis
ous onset that began 5 months ago. His medical his-
tory includes sickle cell anemia. He currently abuses
alcohol. Examination reveals painful hip rotation and
decreased range of motion. There is no midline pelvic
pain with resisted hip adduction. Pelvic radiographs
reveal mild subchondral sclerosis about the femoral
head, but no joint space narrowing or osteophytosis.
Which of the following is the most likely diagnosis?
11. A 29-year-old woman is concerned with a rash. On systemic lupus erythe-
inspection, you appreciate a central facial rash. You no- matosus
