CORRECT DETAILED ANSWERS/NEWEST UPDATE!!!
Question 1
A 40-year-old male presents with posterior ankle swelling. He reports that he heard a "pop" from
his ankle when he landed awkwardly after a jump. Which orthopedic test is most appropriate to
perform?
A) Simmonds-Thompson Test
B) Drawer Test
C) Lachman’s Test
D) McMurray’s Test
E) Homan’s Sign
Correct Answer: A) Thompson
Rationale: The Thompson test (or Simmonds-Thompson) is used to assess the integrity of
the Achilles tendon. A "pop" felt or heard during a jump followed by swelling in the
posterior ankle is a classic presentation for an Achilles tendon rupture. A positive test is
indicated by a lack of plantarflexion when the calf muscle is squeezed.
Question 2
The case history of a patient with Guillain-Barré Syndrome is most likely to include which of the
following?
A) Recent history of a heavy lifting injury
B) Recent viral infection or vaccination
C) Chronic history of cigarette smoking
D) Family history of muscular dystrophy
E) History of Vitamin B12 deficiency
Correct Answer: B) recent vaccination
Rationale: Guillain-Barré Syndrome (GBS) is an acute inflammatory demyelinating
polyneuropathy. It is frequently preceded by an immune-triggering event, most commonly
a respiratory or gastrointestinal viral infection (like Campylobacter jejuni) or, less
frequently, a recent vaccination.
Question 3
Which of these complaints is most characteristic of cervical spondylotic myelopathy?
A) Unilateral thumb numbness and wrist drop
B) Difficulty walking and neck pain
C) Sharp radiating pain during coughing only
D) Sudden loss of vision and jaw claudication
E) Morning stiffness in the hands that lasts for hours
Correct Answer: B) difficulty walking and neck pain
Rationale: Cervical spondylotic myelopathy involves compression of the spinal cord due to
degenerative changes. It typically presents with a combination of neck pain and "upper
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motor neuron" signs in the lower extremities, such as gait disturbances, balance issues, and
difficulty walking.
Question 4
A patient with recurring unilateral periorbital pain, lacrimation, and rhinorrhea is most likely to
report which of the following?
A) The pain is relieved by eating
B) Lying in a dark room helps the pain
C) The pain occurs primarily in the morning
D) The episodes last for 48 to 72 hours
E) The pain is bilateral and band-like
Correct Answer: B) lying in a dark room helps
Rationale: This presentation describes a cluster headache (unilateral, periorbital, autonomic
symptoms). While cluster headache patients are often restless, those with severe headaches
frequently find that a dark, quiet environment (common for migraine overlap) or oxygen
therapy helps mitigate the distress of the attack.
Question 5
Which of these patient statements is most characteristic of facet joint Osteoarthritis (OA)?
A) The pain is sharpest when I am sitting for long periods
B) I have constant pain in my low back that radiates to my foot
C) The pain is at its worst upon awakening but decreases with activity
D) My pain is relieved when I arch my back into extension
E) The pain only occurs when I am lying flat on my back
Correct Answer: C) the pain is at its worst upon awakening but decreases with activity
Rationale: Facet syndrome and OA are characterized by "gelling"—stiffness and pain after
periods of inactivity (morning stiffness). As the joint moves and "lubricates" with activity,
the pain typically lessens, though it may return with excessive use late in the day.
Question 6
Which of these sports has a high incidence of stress fracture of the pars interarticularis?
A) Basketball
B) Gymnastics
C) Swimming
D) Cycling
E) Long-distance running
Correct Answer: B) gymnastics
Rationale: Spondylolysis (pars fracture) is common in sports that require repetitive
hyperextension of the lumbar spine. Gymnasts, linemen in football, and divers are at high
risk due to the mechanical stress placed on the neural arch during these movements.