6) Tuberculosis of the spine most likely originates from:
a. Intervertebral disk.
b. Cancellous vertebral body.
c. Ligamentous structures.
1) Origin of bone is from: d. Paravertebral soft tissue.
b. Mesoderm. 7) In Pott's spine, the disease starts in the:
c. Endoderm. a. Intervertebral disk.
d. All of the above. b. Anterior vertebral margin.
c. Posterior vertebral margin.
2) Acute osteomyelitis is commonly caused by: d. Paravertebral soft tissue.
a. Staph aureus.
b. S. pyogenes. 8) Melon seed bodies in joint fluid are characteristic of:
c. H. influenzae. a. Rheumatoid arthritis.
d. Salmonella. b. Tuberculous arthritis.
c. Septic arthritis.
3) Acute osteomyelitis usually begins at: d. None of the above.
b. Metaphysis. 9) The earliest sign of TB hip in X-ray is:
c. Diaphysis. a. Narrow joint space.
d. Any of the above. b. Irregular moth eaten femoral head.
c. Periarticular osteoporosis.
4) What is not True of acute pyogenic osteomyelitis: d. Dislocation.
a. Trauma is a predisposing factor.
b. Common infecting agent is Staph. Aureus. 10) Healing of tuberculous arthritis can lead to:
c. Infection is usually blood borne. a. Calcification.
d. All are true. b. Fibrous ankylosis.
c. Boney ankylosis.
5) What is not True of Brodie's abscess: d. None of the above.
a. A form of chronic osteomyelitis.
b. Intermittent pain and swelling. 11) Osteoid osteoma originates from:
c. Common to diaphysis. a. Periosteum.
d. Excision is very often required. b. Cortex.
c. Medullary cavity.
d. All of the above.
12) Sun ray appearance of osteosarcoma is because of: 18) An adamantinoma historically contains:
a. Periosteal reaction. a. Squamous cell rests.
b. Osteonecrosis. b. Pallisading cells.
c. Calcification along vessels. c. Cells resembling basilar cells.
d. None of the above. d. All of the above.
13) Bone metastasis in male commonly arises from 19) Osteomalacia predominantly affects the:
cancer of: a. Spine.
a. Lung. b. Pelvis.
b. Prostate. c. Skull bones.
c. Kidney. d. Metatarsals.
d. Thyroid. 20) The enzyme found in osteoclasts but not in osteoblasts
14) Osteoblastic bone secondaries commonly arise from is:
cancer of: a. Alkaline phosphatase.
a. Breast. b. Acid phosphatase.
b. Lung. c. Elastase.
c. Prostate. d. Cytochrome oxidase.
d. Adrenal. 21) A Gigli saw is:
15) Bone metastasis can be best evaluated by: a. An electrically driven circular bone saw.
a. X-ray. b. A pneumatically driven bone saw.
b. 99mTC bone scan. c. A short straight bone saw.
c. 111Indium scan. d. A long twisted wire bone saw.
d. Calcium-alkaline phosphatase elevation. 22) Osteoclasis can be used to:
16) The synonym for Paget's disease is: a. Correct deformity of the tibia due to rickets.
a. Osteitis fibrosa. b. Curette an osteoclastoma.
b. Osteitis proliferans. c. Correct deformity.
c. Osteitis deformans. d. Correct a ricketery rosary.
d. None of the above. 23) In Dupuytren's contracture which one of the
17) Multiple myeloma tumor cells resemble: following statements incorrect:
a. Granulocytes. a. It is a contracture of the flexor tendons to the ring and
b. Plasma cells. little fingers.
c. Lymphocytes. b. It is a contracture of the palmar fascia.
d. Chondrocytes. 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 29) Internal reduction is considered in presence of:
femur: a. Reduction impossible to the achieved or maintained.
a. No blood can be lost without obvious swelling. b. Healing is expected to be delayed.
b. No blood can be lost without obvious bruising. c. Pathological fracture.
c. Two liters of blood can be lost without obvious swelling d. All of the above.
d. There is no possibility of death from hemorrhagic 30) Which one of these statements is True in diagnosis
shock. of congenital hip dislocation in the first few days of life:
a. It is impossible to diagnose it.
25) A greenstick fracture: b. The sign of telescoping is the best way of diagnosing it.
a. Occurs chiefly in the elderly. c. It is possible to diagnose it by the Van Rosen/Barlow
b. Does not occur in children. Test.
c. Is a spiral fracture- of tubular bone. d. The Trendelenberg test is the most useful.
d. Is a fracture where part of the cortex is intact and part
is crumpled or cracked. 31) Trendelenburg's sign is used in the diagnosis of:
a. Varicose veins.
26) Spiral fracture is due to: b. Congenital dislocation of the hip.
a. Blunt trauma. c. Carcinoma of the stomach.
b. Axial compression. d. Pulmonary embolism.
d. Direct impact. 32) If an unstable hip is detected at birth the
management policy is:
27) The single most important factor in fracture healing a. Do nothing and re-examine every six months as only a
is: minority of hips develop into a persistent dislocation.
a. Correct bone alignment. b. Use a splint to keep the hip joint in 45° flexion and
b. Accurate reduction. adduction.
c. Immobilization. c. Use a splint to keep the hip joint in 90° flexion and
d. Organization of clot. abduction.
d. Advise operative stabilization.
28) Immobilization is not required in fracture involving:
a. Scapula. 33) The essential examination of the hip in order to
b. Wings of ilium. clinch the diagnosis of chronic slipped femoral
c. Rib. epiphysis is:
d. Proximal humerus in elderly. a. Measuring for shortening of the leg.
e. All of the above. 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: 39) The term delayed union is employed when the
a. The detection of shortening of the leg on physical fracture fails to unite within:
examination. a. 1.5 times the normal union time.
b. A radiological feature of the pelvis applied to the b. Twice the normal union time.
diagnosis of congenital dislocation of the hip. c. 2.5 times the normal union time.
c. A radiological feature of the lungs applied to the d. None of the above.
diagnosis of pulmonary vein thrombosis.
d. A physical sign applied to the diagnosis of adrenal 40) First bone to ossify in foetal life is:
deficiency. a. Femur.
35) Perthes' disease is common to age group of: c. Clavicle.
a. 1-5. d. Sternum.
c. 11-15. 41) What is True of clavicle fracture:
d. 16-20. a. Non-union is rare.
b. Malunion is of no functional significance.
36) The average duration of Perthes' disease is: c. Reduction even if achieved is difficult to maintain.
a. 1-2 years. d. All are true.
b. 3- 4 years.
c. 1 month - 6 months. 42) The joint most likely to have recurrent dislocation is:
d. 6 months - 1 year. a. Ankle.
37) In Perthes' disease the hip movements restricted are: c. Shoulder.
a. Abduction and external rotation. d. Patella.
b. Abduction and internal rotation.
c. Adduction and external rotation. 43) Anterior dislocation of shoulder may be complicated
d. All of the above. by:
a. Brachial plexus injury.
38) The sequestrum in X-ray appears: b. Tear of rotator cuff.
a. Dense. c. Fracture head of humerus.
b. Light. d. All of the above.
c. Isodense as surrounding bone.
d. Any of the above. 44) What is not True about fracture surgical neck of
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 fr of humerus 51) Fracture involving which part of humerus can cause
involving: delayed ulnar palsy:
a. Surgical neck. a. Shaft.
b. Shaft. b. Surgical neck.
c. Lower end. c. Medial epicondyle.
d. At all of the above locations. d. Lateral epieondyle.
46) The most common form of supracondylar fracture 52) The deformity of wrist in Colles' fracture is:
humerus in children is of which type: a. Madelung's deformity.
a. Flexion. b. Dinner fork deformity.
b. Extension. c. Buttonaire deformity.
c. Combination of A & B d. None of the above.
d. None of the above.
53) Colles' fracture can be complicated by late rupture of:
47) Myositis ossificans commonly occurs around: a. Extensor pollicis longus.
a. Shoulder. b. Abductor pollicis longus.
b. Elbow. c. Adductor pollicis longus.
c. Wrist. d. Flexor pollicis longus.
54) What is True of Sudeck's atrophy of hand:
48) Volkman's ischemia commonly occurs following: a. Hand is painful and swollen.
a. Fracture shaft humerus. b. Osteoporosis of carpals and metacarpals.
b. Supracondylar fracture. c. There is increased blood flow to para-articular areas.
c. Colles' fracture. d. Cervical sympathectomy may be of help.
d. Monteggia fracture. e. All are true.
49) The single dependable sign of early Volkmann's
55) The carpal bone most commonly fractured is:
a. Cyanosis of fingers.
b. Obliteration of radial pulse.
c. Paralysis of flexor muscles of forearm.
d. Pallor of fingers.
e. Pain. 56) Which nerve is compressed in carpal tunnel
50) Cubitus valgus of elbow commonly follows fracture syndrome:
of: a. Ulnar.
a. Lateral condyle. b. Median.
b. Medial condyle. c. Radial.
c. Capitalum. d. All of the above.
d. Lower third of humerus.
57) The most common injury following pelvic fracture is 63) Which of the following is not True of intertrochanteric
of: fracture of femur:
a. Bladder. a. Limb shortening.
b. Urethra. b. Malunion.
c. Rectum. c. Avascular necrosis of femoral head.
d. Vagina. d. Internal fixation is preferred.
58) Limb shortening with adduction and internal rotation 64) Most common complication of fracture shaft femur
occurs in which type of hip dislocation: is:
a. Anterior. a. Malunion.
b. Posterior. b. Nonunion.
c. Central. c. Knee stiffness.
d. All of the above. d. Fat embolism.
59) Nelaton's line joins anterior superior iliac spine to: 65) Spontaneous bleeding into joints in haemophilia
a. Xiphisternum. occurs when factor VI level is less than:
b. Pubic tubercle. a. 50%.
c. Ischial tuberosity. b. 25%.
d. Ischial spine. c. 10%.
60) Bryant's triangle helps to assess:
a. Fracture neck of femur. 66) Recurrence of Baker's cyst should make the surgeon
b. Iliac crest displacement. suspect:
c. Trochanteric displacement. a. Neoplastic change.
d. None of the above. b. Undiagnosed pathology within knee.
c. Incomplete removal of the cyst.
61) Normal neck-shaft angle of femur is: d. The communication to the joint is persisting.
b. 120°. 67) Flexion of distal interphalangeal joint with fixing the
c. 150°. proximal interphalangeal joint (PIP) tests:
d. 170°. a. Flexor digitorum profundus.
b. Flexor digitorum superficials.
62) Fracture femoral neck can be diagnosed from: c. Palmaris longus.
a. Limb shortening. d. All of the above.
b. External rotation.
d. A + B.
68) Stenosing tenovaginitis commonly affects: 73) Bennett's fracture is
a. Abductor pollicis. a. reversed Colles' fracture
b. Flexor pollicis longus. b. fracture of the scaphoid bone in the wrist
c. Opponens pollicis. c. fracture of the radial styloid (chauffeur's fracture)
d. All of the above. d. fracture dislocation of the first metacarpal
e. cause of mallet finger
69) A sequestrum is
a. a piece of soft dead tissue 74) Supracondylar fracture of the humerus in a child
b. a piece of dead skin a. is due to a fall on the point of the elbow
c. a dead tooth b. is usually compound
d. a piece of dead bone c. requires admission of the patient after reduction
e. a retained swab d. requires immediate open reduction
e. is a fracture dislocation
70) Union of a simple uncomplicated transverse fracture
of the tibia in an adult normally takes 75) A fracture of the midshaft of the clavicle is best
a. 6 weeks treated by
b. 8 weeks a. clavicle rings
c. 12 weeks b. a figure-of-eight bandage
d. 18 weeks c. open reduction and plating
e. 26 weeks d. an intramedullary nail
e. a broad arm sling and analgesics
71) Fractures which do not impact include
a. fracture of tile vault of the skull 76) A Pott's fracture is a type of fracture of the
b. a compression fracture a. wrist
c. a simple fracture b. ankle
d. a transverse fracture of the patella c. spine
e. fracture of the neck of the femur d. foot
72) Colles' fracture is
a. a fracture of the clavicle 77) Treatment of a severe comminuted fracture of the
b. a fracture about the ankle joint patella includes
c. common in elderly women a. physiotherapy alone
d. a fracture of the head of the radius b. insertion of a figure-of-eight tension band
e. fracture of die scaphoid c. patellectomy
d. inserting screws or wire
e. skin traction
78) Malunion of a fracture is 83) Pott's paraplegia is due to
a. a fracture which unites in a position of deformity a. hematomyelia following trauma
b. delayed union of a fracture b. damage to the cord by a piece of bone when vertebrae
c. non-union of a fracture collapse in tuberculosis of the spine
d. followed by pseudoarthrosis c. tuberculous pus and angulation in tuberculosis of the
e. due to tuberculosis spine
d. damage to die corda equina after a fall
79) Volkmann's contracture e. fracture dislocation of cervical vertebrae
a. affects the palmar fascia
b. develops at the ankle in a case of chronic venous ulcer 84) Still's disease is
c. follows ischemia of the forearm muscles a. spastic diplegia
d. is due to excessive scarring of the skin of the axilla b. rheumatoid arthritis in childhood
following a burn c. rheumatoid arthritis in the elderly
e. follows ulnar nerve palsy d. post-traumatic bone formation in the lateral ligament of
80) A Brodie's abscess is e. synonymous with Reiter's disease
a. a subperiosteal abscess due to infection of the mastoid
air cells 85) A benign tumor forming osteoid is
b. a type pf breast abscess a. a synovioma
c. a chronic abscess of the bone b. a chondroma
d. an abscess arising in the inguinal lymph nodes c. an osteoma
e. an abscess forming in an infected varicose vein d. a fibroma
e. an adenoma
81) The initial abnormality in primary osteoarthritis is
a. in the synovial membrane 86) Ewing's tumor affecting the humerus
b. sclerosis of cartilage a. is a metastasis from carcinoma of the thyroid
c. fibrillation of cartilage b. should be treated by immediate amputation
d. an osteophyte c. looks like a cut onion on x-ray
e. a pannus d. has a soap-bubble appearance on x-ray
e. displays sun-ray spicules on x-ray
82) The initial abnormality in rheumatoid arthritis is
a. fibrillation of cartilage 87) Barlow's sign is related to the diagnosis of
b. sclerosis of cartilage a. talipes equinus varus
c. in the synovial membrane b. congenital dislocation of the hip
d. in the capsule c. ulnar nerve palsy
e. proliferation of bone d. genu varum
e. fractured neck of femur
88) The reported incidence of unstable hips per 1000 at 93) Legg-Calve-Perthe's disease is
birth is as much as a. osteochondritis of the spine
a. 0.5 b. tuberculosis of the hip joint
b. 2-5 c. slipped proximal femoral epiphysis
c. 8-20 d. osteochondritis of the proximal femoral epiphysis
d. 25-30 e. osteomalacia
94) The name associated with joint neuropathy is that of
89) The word talipes refers to a. Cushing
a. long feet with spidery toes b. Osier
b. knock knee c. Moon
c. flat feet d. Charcot
d. hammer toes e. Addison
e. club feet
95) Adrenocorticosteroids administered in excess cause
90) Bone dysplasia is due strictly to a. osteoporosis
a. faulty nutrition b. osteosclerosis
b. osteomyelitis c. osteochondritis
c. parathyroid tumor d. endochondral ossification
d. trauma e. osteosarcoma
e. faulty development
96) 'Tennis elbow' is the term used for
91) Idiopathic scoliosis is a a. olecranon bursitis
a. lateral curvature of the spine b. 'non-articular rheumatism' of the extensor muscles of
b. rotation of the spine forearm attached to lateral epicondyle of the humerus
c. lateral curvature with rotation of the spine c. myositis ossificans of the supinator muscle
d. flexion deformity of the spine d. a fractured head of radius
e. congenital disease with hemivertebrae e. ulnar nerve neuritis
92) A Milwaukee brace can be used in 97) An adventitious bursa is
a. sacro-iliac strain a. an anatomical bursa overlying any joint
b. derangement of the teeth b. a type of degeneration of adventitia of popliteal artery
c. a patient with an above knee amputation c. an acquired bursa generated from connective tissue
d. scoliosis d. a pseudocyst in the lesser sac (omental bursa)
e. fractured clavicle e. an infected knee
98) A trigger finger is 103) In the following types of fractures of long bones,
a. an inflamed index finger crepitus can be elicited only in:
b. an atrophic index finger in a median nerve palsy a. Fissures
c. due to stenosing tenovaginitis affecting one of the b. Subperiosteal cracks
flexor tendons in the palm c. Greenstick fractures
d. an essential feature of the carpal tunnel syndrome d. Spiral and oblique fractures
e. a component of syndactyly e. Impacted fractures
99) A Baker's cyst is 104) The most severe growth disturbance results from
a. an implantation dermoid cyst occurring in the palms of which of the following types of epiphyseal injuries:
those who work in a bakery a. Separation of the epiphysis at the metaphyseal side of
b. a synovial cyst of the wrists of those who knead bread the epiphyseal plate
c. a prepatellar bursa b. Separation of the epiphysis with a triangular fragment
d. a synovial cyst of the ankle of the metaphysic
e. a synovial cyst of the popliteal fossa c. Intra-articular fracture involving the articular cartilage
epiphysis and epiphyseal plate
100) Immobilization of fractures of long bones should d. Intra-articular fracture extending from the joint surface
include through the epiphysis and epiphyseal plate to the
a. Fractured bone only metaphysic
b. Joint involved in the fracture e. Crashing injuries compressing the epiphyseal plate
c. Proximal joint without displacement
d. Both proximal and distal joints
e. Distal joint 105) Local complications of closed fractures do not
101) Non-union is common in fractures of the following a. Malunion
bones except the: b. Non-union
a. Carpal scaphoid c. Infection
b. Neck of the femur d. Sudek's atrophy
c. Lower third of the tibia e. Joint stiffness
e. Tuberosity of the fifth metatarsal 106) Non-union in closed fractures may due to any of the
102) The signs of fractured shaft of a bone do not include: a. Inadequate immobilization
a. Swelling b. Interposition of soft parts
b. Deformity c. Impaired blood supply
c. Loss of all movements in the limb d. Inpsction of the fragments
d. Acute localized bone tenderness e. Wide separation of the fragments
e. Abnormal mobility in the line of the bone
107) Causes of gangrene after fracture in a limb do not 112) The incorrect statement about anterior
include: dislocation of the shoulder joint is that:
a. Direct crushing of the tissues a. shoulder loses its rounded contour & becomes
b. Injury to the main vessels flattened
c. Tight plasters b. The elbow is abducted from the side
d. Septic infection c. All movements of the shoulder are limited and
e. Clostridial infection painful
d. The anterior and posterior folds of the axilla are
108) The correct ttt of traumatic myositis ossificans is by: elevated
a. Prolonged immobilization e. The hand cannot be placed on the opposite
b. Active exercises shoulder (Duga's test)
c. Passive stretching and massage
d. Both A and B 113) Recent dislocations of shoulder joint are best
e. Both B and C treated by:
a. Hippocrates' method of closed reduction
109) Concerning fracture of the shaft of the clavicle, it is b. Kocher's manipulation
untrue that it: c. Modified Milch's manoevre
a. Is usually due to direct trauma d. Open reduction
b. Commonly involves the middle third e. Putti-platt1s operation
c. Is often associated with overriding of fragments
d. Causes dropping and deformity of shoulder 114) Recurrent shoulder joint dislocation is best
e. Is usually treated by figure-of-eight bandage treated by:
110) A child with midclavicular fracture and overriding of b. Nicola's operation
the fragments is best treated by: c. Bankart's operation
a. Supine bed rest with interscapsular sandbag support d. Putti-Platt's operation
b. Open reduction and internal fixation e. Arthrodesis of the joint
c. Figure-of-eight bandage
d. Closed reduction and plaster fixation 115) Fractures of the shaft of the humerus are best
e. Manipulative reduction and abduction splint treated by:
a. Closed reduction and shoulder spica
111) In shoulder dislocations, the humeral head usually b. Continuous skeletal traction
dislocates primarily in which of the following directions: c. Open reduction and internal fixation
a. Inferiorly d. Hanging plaster cast
b. Superiorly e. Coaptation plaster splint with a Velpeau dressing
116) The most vulnerable structure in supracondylar 120) An elderly ♀ sustained Colles' fracture which was
fracture of the humerus is the: properly treated. However, she developed severe pain &
a. Median cubital vein stiffness of the wrist with coldness and cyanosis of the
b. Brachial artery hand. X-ray examination revealed diffuse decalcification
c. Median nerve of the bones. She proved to be suffering from:
d. Ulnar nerve a. Causalgia
e. Radial nerve b. Tuberculous arthritis of wrist joint
c. Traumatic tenosynovitis
117) Posterior dislocation of elbow joint is characterized d. Sudek's atrophy
by the following except: e. Osteoarthritis of wrist joint
a. Gross swellinq of the elbow region
b. Loss of all movements at the elbow joint 121) Following a stumble on stairs, a 70-year-old ♂ felt
c. Shortening of the upper arm severe pain in the hip and could not stand up. O/E, there
d. Absence of crepitus was shortening of the limb, external rotation deformity
e. Loss of the normal relationship of the olecranon with and tender thickening of the greater trochanter. X-ray
the two eoicondvles examination revealed:
a. Intracapsular fracture of the neck of the femur
118) In fracture of the olecranon process of the ulna, the b. Pertochanteric fracture of the femur
following statements are true except that it: c. Dislocation of hip
a. Is usually due to a fall on the elbow d. Fracture of acetabulum
b. Can be felt as a gap between the olecranon and the e. Fracture of greater trochanter
c. Is rarely associated with hemarthrosis 122) Tears of the meniscus of the knee result from which
d. May be complicated by anterior dislocation of the of the following strain:
elbow joint a. Hyperextension
e. Always requires surgical treatment b. Abduction
119) Concerning extension Monoteggia's fracture- c. Adduction
dislocation, it is untrue that it: d. Rotation
a. Consists of fracture of the upper third of the ulna and e. Combined flexion and rotation
anterior dislocation of the radial head
b. Is usually due to a severe blow on the back of the
c. Can be treated by manipulative reduction in children
d. Always requires surgical treatment in adults
e. Is rarely associated with complications
123) In a football game, an athlete felt severe pain in his Rt 127) An irregular epiphyseal line with calcifying periosteal
knee while turning to the left side with the joint flexed haematc found on X-ray examination is indicative of:
and taking the body weight. Soon after, the joint became a. Infantile rickets
swollen and painful but recovery followed rest for 3 b. Scurvy
weeks. Thereafter, the patient suffered from recurrent c. Hemophilia
locking with pain and a feeling of quot;giving wayquot; in the d. Hypoparathyroidism
joint. The most probable diagnosis is: e. Hypervitaminosis A
a. Solitary loose body
128) Osteoporosis is a deficiency in:
b. Fracture of the tibial spine
a. Calcium metabolism
c. Rupture of the medial ligament
b. Calcium deposition
d. Rupture of the medial semillunar cartilage
c. Protein supporting tissue
e. Fracture of the patella
d. All of the above
124) A lateral blow at the level of the knee joint may e. None of the above
cause: 129) Which of the following statements is untrue
a. Rupture of anterior cruciate ligament concerning the enzyme alkaline phosphatase:
b. Rupture of medial collateral ligament a. Has a normal serum concentration of 3-13 KA units
c. Avulsion of medial meniscus b. Is present in high concentrations in liver cells
d. Bumper fracture of tibia c. Is excreted in the bile
e. All of the above d. Is elevated in the serum of patients with healing
125) A march fracture most frequently results from: fractures
a. Direct trauma e. Is ↑ in the serum of patients with rickets and
b. Jumping from a height osteomalacia
c. Muscle fatigue from prolonged walking 130) Localized bone sclerosis may be due to:
d. Use of high-healed shoes a. Syphilis
e. Osteoporosis b. Sclerosing osteoperiostitis
126) Intestinal absorption of calcium is dependent upon:
d. Bone tumors
a. Vitamin D
e. All of the above
d. All of the above
e. None of the above
131) Enlarged tender epiphyses with bowing of long 135) Concerning Ollier's disease, which of the following
bones and X-ray evidence of delayed carpal ossification statements is incorrect:
suggest the diagnosis of: a. There is a strong hereditary predisposition
a. Scurvy b. Multiple enchondromata occur in small long bones of
b. Infantile rickets hands and feet
c. Syphilitis epiphysitis c. The affected bones are stunted
d. Osteogenesis imperfecta d. Deformities may arise from unequal affection of
e. Achondroplasia metaphyses
e. Chonrosarcoma may develop in one of the
132) Osteomalacia may be due to the following factors enchonromata
a. Starvation 136) The following statements about diaphyseal aclasis
b. Repeated pregnancies are true except that it:
c. Idiopathic steatorrhea a. Is a common hereditary condition
d. Increased renal excretion of calcium and b. Never affects membrane bones
phosphorus c. Is characterized by multiple exostoses
e. Prolonged recumbency d. May be associated with dwarfism
e. Spares the metaphyses of long bones
133) Achondroplasia is characterized by the following
features except: 137) Concerning Osgood-Schlatter's disease, the
a. Short extremities following statements are true except that it:
b. Normal trunk length a. Is an avascular necrosis of the epiphysis of the tibia
c. Normal intelligence tubercle
d. Enlarged head b. Usually occurs between ages of 10 and 16 years
e. Normal ossification of cartilage c. Is due to traction of the patellar tendon on the tibial
134) Osteogenesis imperfecta is characterized by the d. Is associated with no radiological signs
following features except: e. Causes pain and swelling over the tubercle
a. Blue sclerae
b. Brittle shell-like bones 138) Generalized osteitis fibrosa cystica is characterized
c. Multiple fractures by the following features except:
d. Osteoporosis a. Deficiency of parathormone
e. Familial tendency b. Diffuse decalcification and softening of bones
c. Cysts containing Brwonish fluid
d. Multiple gaint-cell tumors
e. Urinary symptoms due to renal calculi
139) The following statements about Paget's disease of 143) A 9-year-old boy presented with limping and pain in
bones are true except that it: the right knee two days after a fall in the street. On
a. Affects elderly subjects, particularly males examination he looked ill and in severe pain with high
b. Is a generalized bone dystrophy of obscure etiology fever and swelling of the knee region extending to the
c. Causes deformities in the skull, spine, pelvis and thigh which was warm and very tender. The most
lower limbs probable diagnosis is:
d. Produces no pressure symptoms a. Traumatic synovitis
e. Is often associated with cardiovascular b. Hemarthrosis
complications c. Acute osteomyelitis of the femur
d. Septic arthritis of knee
140) Which of the following statements is untrue in e. Bone sarcoma
a. The bones are greatly thickened and very vascular 144) Solitary bone cyst is characterized by the following
b. Cranial nerve palsies may occur features except that it:
c. Spontaneous fractures are rare a. Occurs most often in children and adolescents
d. X-ray examination of the skull is diagnostic b. Usually arises in the diaphysis of a long bone
e. Osteogenic sarcoma occurs in over 5% of cases c. Often remains symptomless until complicated by
141) Which statement is untrue in renal rickets: d. Appears as clear ovoid expanding cavity in the X-ray
a. Results from renal insufficiency in infancy e. May be associated with new-bone formation
b. Is due to deficient phosphorus, excretion
c. Manifests itself by marked dwarfism 145) The most common tumor of the small bones of the
d. Causes no deformities in the limbs hands and feet is:
e. Ends fatally from uraemia at puberty a. Enchondroma
142) A 7-year-old child presented with intermittent limp c. Osteoclastoma
and pain in the right hip and knee. On examination, d. Cancellous osteoma
flexion and extension movements were free and there e. Bone sarcoma
was no tenderness and no muscle wasting. X-ray
examination confirmed the diagnosis of: 146) Which of the following is most common in the small
a. Early tuberculous arthritis of the hip joint bones of the hands and feet:
b. Traumatic arthritis a. Osteochondroma
c. Perthes' disease b. Enchondroma
d. Slipped upper femoral epiphysis c. Osteoid osteoma
e. Coxa vara d. Osteochondritis juvinelis
e. Tuberculous osteitis
147) Concerning osteoclastoma, the following statements 151) The following statements about bone sarcoma are
are correct except that it: true except that it:
a. Usually occurs between the ages of 15 and 40 years a. Arises from osteoblasts of the periosteum or bone
b. Always arises in metaphyseal region of cartilaginous cortex
bones b. Forms a fusiform mass ensheathing the bone
c. Consists of large giant cells in a very vascular c. Often invades the epiphyseal cartilage and
stroma of spindle cells neighbouring joint
d. Presents as a painless globular swelling with well- d. Produces characteristic new bone formation in the
defined edge X-ray
e. Produces diagnostic radiological signs e. Disseminates rapidly by the blood stream
148) The radiological signs of osteoclastoma include the 152) Which one of the following statements is untrue
following except: concerning chondro-sarcoma:
a. Abrupt expansion of the bone a. Occurs most often between the ages 20 and 60 yrs
b. Characteristic soap-bubble appearance b. Is always a primary malignant tumor of bone
c. Presence of an operculum obliterating the medullary c. Most commonly affects scapula, pelvis, ribs &
d. Absence of any new-bone formation d. Causes bone expansion and destruction with
e. Presence of areas of bone destruction irregular opacities in the X-ray
e. Is radioresistant
149) The treatment of osteoclastoma includes the
following measures except: 153) Ewing's sarcoma is characterized by the following
a. Curettage of tumor tissue & packing cavity with bone except that it:
chips a. Is a common tumor of children
b. Excision with safety margin of bone b. Always arises in the metaphysis of a long bone
c. Amputation c. Presents as a fusiform swelling with inflammatory
d. Radiotherapy changes in the overlying soft tissues
e. Chemotherapy d. May be associated with leucocytosis
e. Produces characteristic radiological signs
150) The following statements about multiple myeloma are
true except that it:: 154) The most important DD of Ewing's tumor is:
a. Is a primary malignant tumor of bone marrow a. Chondrosarcoma
b. Occurs between the ages of 40 and 60 years b. Osteogenic sarcoma
c. Usually presents with bone pain especially in the back c. Acute osteomyelitis
d. Is rarely associated with fever and anemia d. Malignant metastasis
e. May cause paraplegia with girdle pains e. Reticulum cell sarcoma
155) The most common osteolytic metastases in bones 159) The differential diagnosis of osteoid osteoma
are derived from the: includes all the following except:
a. Lung a. Brodies' abscess
b. Breast b. Ossifying fibroma
c. Stomach c. Ewing's tumor
d. Kidney d. Metastatic thyroid nodule
e. Prostate e. Bone sarcoma
156) The most pain-sensitive structure in a joint is the:
a. Bone end 160) Ivory osteomata occur most often in the:
b. Articular cartilage a. Skull
c. Joint capsule b. Spine
d. Synovial membrane c. Humerus
e. Skin and subcutaneous tissues d. Femur
157) Ostaomalacia is characterized by the following
features except: 161) Sensory end organs are absent from the:
a. Deficient protein metabolism a. Muscle
b. Demineralization of the bones b. Periostium
c. Slow epiphyseal closure c. Synovial membrane
d. Skeletal deformities d. Articular cartilage
e. X-ray Looser 's zones e. Joint capsule
158) The following statements about solitary bone cyst are 162) The viscosity of synovial fluid is mainly due to:
true except that it: a. Chondroitin sulphate
a. Occurs most often in children and adolescents b. Hyaluronidase
b. Is commonest in the humerus , femur and tibia c. Albumin and laucin
c. Arises in the diaphysis of the bone d. Alpha and beta globulins
d. Assumes an avoid shape and may cause bone e. Beta lipoproteins
expansion 163) Septic arthritis of infancy usually affects which of the
e. May remain innoticed until complicated by following joints:
pathological fracture a. Shoulder
164) The treatment of acute septic synovitis includes the 168) Bloody or coffee-ground fluid obtained by aspiration
following except: of the knee joint is suggestive of:
a. Massive antibiotics a. Septic arthritis
b. Splintage in the position of function b. Hemophilic joint
c. Aspiration and antibiotic injection c. Synovial chondromatosis
d. Arthrotony and drainage d. Pigmented villonodular synovitis
e. Excision and Winnett Orr-treatment e. Charcot's joint
165) Rheumatoid arthritis primarily involves the: 169) Correct statements regarding the carpal tunnel
a. Articular cartilage syndrome include the following except that it:
b. Subchondral bone a. Is always due to compression of the median nerve in
c. Synovial membrane the carpal tunnel
d. Capsule b. May follow a wrist fracture
e. Ligaments c. May occur in patients with rheumatoid arthritis
d. Frequently first appears during pregnancy
166) Complications of rheumatoid arthritis in the hands e. Is often associated with vascular disorders
a. Tenosynovitis 170) A 60-year-old male with 3 months history of severe
b. Rupture of extensor tendons back-ache anemia and loss of weight, developed severe
c. Carpal tunnel syndrome girdle pains with weakness of the lower limbs.
d. Ulnar deviation at the metacarpophalangeal joints Examination revealed low grade fever with marked
e. Bony ankylosis of affected joints tenderness over the spine, ribs, sternum, skull and
pelvic bones. X-ray examination of the skeleton
167) A 20-year-old male presented because of increasing revealed multiple punched out defects without any new
pain in his left lower thigh. Examination revealed tender bone formation. The most probable diagnosis is:
fusiform thickening of the lower end of the femur with a a. Bone metastases from an occult primary
small effusion into the knee joint. The overlying skin b. Multiple myeloma
was warm and the seat of dilated veins but movements c. Osteitis fibrosa cystica
of the knee were free and painless. X-ray examination d. Hand Schuller-Christian's disease
revealed: e. Paget's disease
a. Acute osteomyelitis of the lower end of the femur
b. Brodie's abscess
c. Bone sarcoma
d. Parosteal fibrosarcoma
e. Ewing's tumor
171) 12-year-old boy developed bilateral painless effusion 174) The X-ray findings in tuberculosis of the hip include
of both knees together with blurring of vision and the following except :
impairment of hearing. He should be suspected to be a. Diffuse decalcification of the bones.
suffering1 from: b. Blurring of the joint outline.
a. Traumatic synovitis. c. Diminution of the joint space.
b. Tuberculous arthritis. d. Wandering acetabulum.
c. Inherited syphylis. e. Downward tilting of the pelvis.
d. Rheumatic arthritis.
e. Rheumatoid arthritis. 175) In children, the treatment of tuberculosis of the hip
includes the following except :
172) A 40-year-old male presented with a grossly swollen a. Tuberculostatic drugs.
painless left knee. Examination revealed a flail joint with b. Weight traction to correct deformity.
irregularly thickened bone ends, palpably swollen c. Fixation of the joint in the position of function.
synovial membrane and marked grating and creaking d. Aspiration of cold abscess.
on passive movement of the joint. The first diagnostic e. Extra-articular arthrodesis.
a. Examination of the nervous system. 176) In Sprengel's shoulder, the following statements are
b. Serological tests. correct except that :
c. X-ray examination of the joint. a. There is congenital elevation & maldevelopment of
d. Examination of aspirated synovial fluid. scapula.
e. Arthroscopy and synovial biopsy. b. An ugly prominence in the neck is produced by the
173) A 9-year-old boy developed an intermittent limp c. A band of fibrocartilage or bone anchors the medial
which soon became constant and associated with pain border of the scapula to the spine.
in the Rt hip & knee. Examination revealed a flexion d. There is no limitation of shoulder movements.
deformity of the Rt hip with limitation of flexion and e. No ttt is required apart from excision of the supermedial
extension movements, wasting of the thigh muscles angle of scapula to improve the appearance.
and upward tilting of the pelvis. The most probable
diagnosis is : 177) The following statements about cubitus valgus
a. Congenital dislocation of the hip. deformity are correct except that :
b. Legg-Perthes' disease. a. It may be due to malunited supracondylar fr of the
c. Septic arthritis of infancy. humerus or non united fr of the lateral condyle
d. Tuberculous arthritis. b. The deformity is most obvious when elbow is fully flexed
e. Slipped upper femoral epiphysis. c. It predisposes to delayed ulnar neuritis
d. Treatment of supracondylar osteotomy is necessary
only when the deformity is severe
178) A 25 years old male complained of limitation of 181) The most effective ttt of sever Dupuytren's
wrist movements, especially dorsiflexion, and contracture is:
weakness of the hand, especially the grip. a. Repeated stretching and night splintage.
Examination revealed radial deviation of the hand b. Local injections of fibrinolysin or hydrocortisone.
with abnormal prominence of the ulna. He gave a c. X-ray therapy.
history of a fall on the outstretched hand in children. d. Subcutaneous fasciotomy.
The correct diagnosis is : e. Radical excision of the palmar fascia.
a. Rheumatoid arthritis of the wrist joint.
b. Non-united fracture of the scaphoid. 182) The most diagnostic sign of congenital hip dysplasia
c. Malunited Colles' fracture. in the newly borne is :
d. Madelung's deformity. a. Widening of the perineum.
e. Persistent dislocation of the lunate. b. Asymmetry of the buttocks.
c. Ortalani's sign.
179) The most characteristic feature of Volkmann's d. Limitation of hip abduction with hip and knees flexed
contracture is : to 90°.
a. Wasting of the forearm. e. Apparent shortening of the thigh with the hips and
b. Flexion deformity of the wrist. knees flexed to 90°.
c. Extension of the metacarprophalangeal joints with
flexion of the interphalangeal joints. 183) The earliest radiological sign in congenital hip
d. Vokamann's phenomenon. dislocation in infants is :
e. Weakness of the hand and fingers. a. The small shallow acetabulum.
b. The hypoplastic femoral head.
180) The following statements about Dupuytren's c. The shortened anteverted femoral neck.
contracture are true except that : d. Distortion of Shenton's line.
a. It is due to contraction of the palmar fascia which e. Displacement of the femoral head from the
starts as an indurated nodule on the ulnar border of acetabulum.
b. The ring and little fingers are severely affected. 184) In congenital dislocation of the hip (CDH), the
c. The deformity consists of flexion of the pathological changes include the following except :
metacarprophalangeal and proximal interphalangeal a. Small shallow acetabulum.
joints with extension of the terminal joint. b. Snail flattened femoral head lying outside the
d. The skin overlying the indurated fascia is often acetabulum.
puckered and immobile. c. Elongated femoral neck.
e. The joint capsules and flexor tendons are not d. Thickened adherent joint capsule with an hour-glass
e. Shortened hamstrings and adductors.
185) Trenderburg' s sign can be elicited in all of the 189) A 4-year-old rachitic child developed severe genu
following except : varum. The best line of treatment is by :
a. Congenital dislocation of the hip. a. Antirachitic treatment.
b. Infantile paralysis of the gluteal muscles. b. Repeated moulding.
c. Coxa vara. c. Corrective splints.
d. Tuberculous arthritis of the hip joint. d. Osteoclasis of the tibia.
e. Non-united fracture of the femoral neck. e. Tibial osteotomy.
186) A 10-year-old male with neglected congenital 190) A 13-year-old boy presented for consultation
dislocation of the hip presented because of increasing because his knees tend to knock together and he tends
pain in the back with limping and fatigue. The to fall during running. Examination revealed separation
appropriate management should be : of the medial malleoli by 3 inches when standing with
a. Analgesics and anti-inflammatory drugs. the knees in contact with each other and the feet
b. Raising the heel of the right shoe. directed forwards. The correct diagnosis is :
c. Open reduction with deepening the acetabulum by a a. Coxa vara.
shelf procedure. b. Genu valgum.
d. Colonna's arthroplasty. c. Genu varum.
e. Lorenz's bifurcation osteotomy. d. Talipes calcaneovalgus.
e. Bilateral flat foot.
187) The clinical features of coxa vara include the
following except : 191) The most common congenital deformity of the
a. Shortening, addution and eversion of the limb. hindfoot is talipes :
b. Raising of the greater trochanter above Nelaton's a. Calcaneus.
line. b. Equinus.
c. Limitation of all movements of the hip. c. Eguinovarus.
d. Positive Trendelenburg's sign. d. Varus.
e. Limping and difficulty in kneeling, riding and e. Valgus.
separating the legs.
192) Paralytic talipes is differentiated from, congenital
188) Treatment of genu valgum includes the following talipes by the following features except that :
except: a. The deformity appears later after birth.
a. Physiotherapy. b. The limb is atrophied, cyanosed and cold.
b. Wedged shoes. c. The muscles are wasted and flabby.
c. Night splints. d. Usually both sides are affected.
d. Osteoclasis of the tibia. e. The deformity can be corrected easily by
e. McEwen's osteotomy of the femur. manipulation.
193) An 8-year-old child with neglected congenital
equinovarus is best treated by : 197) A 25-year-old male suffered from painful swelling of
a. Repeated manipulation under anaesthesia. the feet and ankles over the last 6 weeks. On
b. Denis-Browne splint. examination, the arches were preserved but the skin
c. Plantar fasciotomy and elongation of the tendo was congested and localized tenderness could be
Achilles. elicited over the navicular bone and the spring, deltoid
d. Wedge tarsectomy. and plantar ligaments. The correct diagnosis is :
e. Dunn's triple arthrodesis. a. Sprain of the ankle joint.
b. Plantar fasciitis.
194) The commonest form of acquired talipes is the : c. Incipient flat foot.
a. Paralytic. d. Spasmodic flat foot.
b. Spastic. e. Talonavicular arthritis.
d. Cicatricial. 198) An adolescent male complained of severe pain in the
e. Compensatory. foot and leg after prolonged standing. Examination
revealed that the foot is flat and fixed in extreme
195) The best treatment for pes cavus causing severe eversion by spastic contraction of the peroneal
local pressure on the metatarsal-heads is by : muscles and long extensors of the toes. The most likely
a. Toe exercises. diagnosis is :
b. Electric stimulation of the intrinsic muscles. a. Incipient flat foot.
c. Steindler's operation. b. Spasmodic flat foot.
d. Lambrinudi's operation. c. Tuberculosis of the ankle joint.
e. Dunn's triple arthrodesis. d. Sprain of the ankle.
e. Retrocalcanean bursitis.
196) The commonest variety of flat foot is the :
a. Congenital. 199) Which of the following is associated with
b. Spasmodic. neurofibromatosis ?
c. Paralytic. a. Talipes equinovarus.
d. Statis. b. Metatarsus varus.
e. Traumatic. c. Pseudarthrosis of the tibia.
d. Genu recurvatum.
e. Congenital hip dysplasia.
200) Regarding hallux valgus, the following statements 203) The ideal amputation should fulfill the following
are true except that it: requirements except that it should:
a. Consists of outward deviation of the great toe at the a. Be as long as possible.
metatarso-phalangeal joint. b. Have a smoothly rounded cone-shaped end.
b. Is usually due to badly fitting shoes. c. Not include muscle over the bone end.
c. Is not progressive. d. Have a linear freely movable scar not exposed to
d. Causes hammer-toe deformity in the other toes. pressure.
e. Predisposes to several painful complications. e. Be painless with a freely movable joint above and a
smooth bone end elbow.
201) The causes of hammer-toe include the following
except: 204) Syme's amputation is better than a below-knee
a. Overcrowding of the toes by ill-fitting shoes. amputation except that it:
b. Hallux valgus. a. Is less quot;catastrophicquot; to the patient.
c. Pes cavus. b. Allows the patient to walk around in his room without
d. Talipes equinus. prosthesis.
e. Rupture of the extensor expansion. c. Maintains, the pleasure of quot;earth feedingquot;.
d. Requires a cheap stump boot.
202) The following statements about provisional e. Is not attended with serious complications.
amputation for infective gangrene are true except that
it: 205) Reimplantation of a traumatically amputated limb
a. May be urgently needed to control infection and requires all of the following except:
toxemia. a. Limb preservation.
b. Should be made through the healthy limb above the b. Shortening of bone.
infected area. c. Immediate arterial and venous repair.
c. Should be done as low as possible to allow d. Routine angiograms.
reamputation at the optimum level. e. Delayed repair of nerves.
d. Should provide free drainage.
e. May be carried out by the guillotine or flap method
True & False
5. Fractures of the clavicle
a. Are usually of the greenstick variety in children under
b. are usually the result of direct violence
1. A fracture is said to be c. are frequently associated with injury to the subclavian
a. closed if an overlying skin laceration has been sutured vessels
b. simple when there is a single fracture line d. can be recognized by the abnormal elevation of the
c. comminuted if there has been associated damage to fragment
adjacent nerves or vessels e. are usually treated by internal fixation
d. a fatigue fracture if it occurs through a diseased bone
e. pathological if it occurs through a bony metastasis 6. Fractures of the neck of the scapula
a. are often due to a fall on the outstretched hand
2. In a healing fracture b. are frequently associated with chest wall injury
a. the hematoma is initially invaded by osteoblasts c. are often associated with dislocation of the
b. the tissue formed by the invading osteoblasts is termed acromioclavicular
osteoid d. can usually be managed without surgical intervention
c. osteoid tissue is formed in an acid pH e. are often associated with fracture of the corocoid
d. calcium salts are laid down in the osteoid tissue process
e. the final stage of repair is the remodeling of the callus
7. Recurrent dislocation of the shoulder
3. Non-union is often seen in a. is usually in the posterior position
a. fractures of the fourth metatarsal b. is usually in young adults
b. fractures of the neck of the femur c. is more common after associated damage to the
c. fractures of the condyle of the mandible glenoid labrum
d. Colles’ fractures d. usually requires surgical repair
e. scaphoid fractures e. is surgically managed by tightening the soft tissues
4. Dislocation of the sternoclavicular joint over the inferior aspect of the joint
a. is usually caused by a fall on the outstretched hand 8. In fractures of the surgical neck of the humerus the
b. displaces the clavicle upwards and medially a. lesion is usually due to indirect violence
c. is usually treated by internal fixation b. fracture line usually passes between the greater and
d. very rarely causes any compression of the trachea or lesser tuberosities
vessels in the neck c. fragments are usually impacted
e. is usually accompanied by fracture of the first rib d. proximal fragment Is usually internally rotated
e. distal fragment is usually adducted
9. In a fracture of the distal 1/3 of the shaft of the humerus 13. In a Colles' fracture the distal radial fragment
a. the distal fragment is usually posteriorly angulated by a. is dorsally angulated on the proximal radius
the action of biceps b. is usually torn from the intra-articular triangular disc
b. the radial nerve is frequently damaged c. is deviated to the ulnar side
c. delayed radial nerve palsy is usually due to edema d. is usually impacted
d. late onset of radial nerve palsy is usually due to the e. commonly damages the median nerve
involvement of the nerve with callus
e. ulnar nerve palsy is usually of late onset 14. Fractures of the radial styloid
a. extend into the wrist joint
10. A supracondylar fracture of the humerus b. typically have an anterior dislocation of the bony
a. is a fracture commonly seen in young adults fragment
b. is particularly subject to the complication of ischemic c. are commonly associated with fractures of the triquetral
muscle contracture bone
c. is held in the position of reduction by the tendon of d. are commonly associated with fractures of scaphoid
brachioradialis e. are commonly associated with dislocation of the wrist joint
d. when properly reduced has the index finger pointing
approximately to the tip of shoulder of the same side 15. A transverse fracture of the scaphoid is
e. is commonly accompanied by ulnar nerve palsy a. the commonest carpal injury
b. prone to infection
11. Fractures of the head of the radius c. usually seen in young men
a. do not occur in isolation d. prone to avascular necrosis
b. are usually associated with dislocation of the radius e. usually seen on an early scaphoid radiograph
c. may be associated with dislocation of the elbow joint
d. may require surgical excision of the head 16. In pelvic fractures
e. are usually accompanied by damage to the median nerve a. avulsion injuries are usually treated by early mobilization
b. undisplaced lesions of the ischial or pubic rami are
12. In a Monteggia fracture dislocation usually treated by early mobilization
a. the dislocation of the distal radio-ulnar joint brings the c. extraperitoneal urinary extravasation may be due to
ulnar styloid process anterior to the capitulum damage either to the membranous urethra or to the
b. the radial fracture is usually at the junction of the base of the bladder
middle and distal thirds d. extraperitoneal urinary extravasation may be due to
c. internal fixation is usually required in the adult damage of the base of the bladder
d. the causative injury is often a blow on the extensor e. which are unstable, one half of the pelvis is displaced
surface of the forearm with the elbow flexed proximally by the flank muscles
e. the commonest neurological injury is to the posterior f. Reduction may need 40 to 50 Ib (18 to 23 kg) of
branch of the radial nerve traction