Orthopedic Board Review: Mock Exam Set #974 | 100 High-Yield MCQs for ABOS, OITE & FRCS

What is the most accurate description of the relationship between gender and knee loading during landing while playing basketball?

During total shoulder replacement for rheumatoid arthritis, fracture of the humeral shaft occurs. An intraoperative radiograph shows a displaced short oblique fracture at the tip of the prosthesis. At this point, the surgeon should

A 60-year-old woman has a mass in the right scapula. Figures 25a and 25b show a CT scan and a biopsy specimen. The cells are lymphocyte common antigen positive, Ewing's specific antigen (CD99) negative, and keratin negative. What is the next step in management?

A 40-year-old woman has a symptomatic mass on the anterior aspect of the ankle. She reports no constitutional symptoms. An MRI scan is shown in Figure 12. What is the most likely diagnosis?

A 56-year-old man underwent right total shoulder arthroplasty 2 months ago. Recently while reaching with his shoulder in a flexed and adducted position, he noted shoulder pain and afterwards he could not externally rotate his arm. An axillary radiograph is shown in Figure 30. What is the most likely cause of this problem?

An adult patient has an 8- x 4- x 10-cm soft-tissue mass located within the adductor compartment of the thigh. Staging studies should consist of

Figure 42 shows the radiograph of a patient with spinal muscular atrophy. Examination reveals good upper extremity function, and she can tie her shoes and propel a manual wheelchair. Posterior instrumentation and fusion may result in

An Asian 45-year-old man has bilateral upper extremity dysfunction. Figure 35a shows a T2-weighted sagittal MRI scan of the cervical spine, and Figure 35b shows a T2-weighted axial MRI scan at the level of the C3 vertebral body. What is the most likely pathologic process?

Patients with which of the following primary carcinomas have the shortest overall survival rate after a solitary metastasis to bone?

Figure 2a shows the radiograph of a 48-year-old man who was involved in a motorcycle accident. A CT scan is shown in Figure 2b. The patient underwent pelvic angiography for persistent hypotension despite resuscitation. What vessel is most likely to be injured?

What is the most common problem seen following epiphysiodesis for limb-length discrepancy?

Which of the following results cannot be achieved with an in-shoe orthosis?

New painful paresthesias near the site of the incision after an ulnar nerve transposition is the result of injury to what nerve?

A 22-month-old child has scrapes and bruises on his head and a severe deformity of the forearm after being thrown from a car as an unrestrained passenger in a motor vehicle accident. Examination reveals a Glasgow Coma Scale score of 12. Prior to treatment of the forearm, management should include

In patients who have undergone nonsurgical management for idiopathic adhesive capsulitis, long-term follow-up studies have shown which of the following results?

Which of the following clinical disorders is the result of a mutation in fibroblast growth factor recepter 3 (FGFR3)?

What is the best initial screening test for a patient with a limb-length discrepancy?

A 42-year-old man with a history of renal cell carcinoma has progressive weakness in the lower extremities for the past 3 weeks. The patient desires intervention. A sagittal T2-weighted MRI scan is shown in Figure 9a, and a sagittal contrast enhanced T1-weighted MRI scan is shown in Figure 9b. He currently ambulates minimal distances with a walker. His life expectancy is 8 months. Treatment of the spine lesion should consist of

Degenerative spondylolisthesis of the cervical spine is most commonly seen at which of the following levels?

A distal radius fracture in an elderly man is strongly predictive for what subsequent injury?

A healthy 25-year-old man sustains a grade IIIB open tibial fracture. Following appropriate debridement, irrigation, and stabilization with an external fixator, the soft-tissue injury is shown in Figure 30. What is the most appropriate definitive soft-tissue coverage procedure?

The dorsal (Thompson) approach to the proximal forearm uses which of the following intermuscular intervals?

A 16-year-old boy has had a painful ingrown nail on his great toe for the past 3 months. When initial management consisting of soaking the foot in Epsom salts and trimming the nail failed to provide relief, his family physician recommended 2 weeks of oral antibiotics. His symptoms persist, and he is now seeking a second opinion. A clinical photograph is shown in Figure 18. Management should now consist of

A 21-year-old woman with Marfan syndrome is seeking evaluation of her scoliosis. She reports no back or leg pain, and the neurologic examination is normal. Lateral and bending radiographs are shown in Figures 7a through 7e. Management should consist of

The medial collateral ligament complex of the elbow originates on what portion of the medial epicondyle?

What is the best surgical approach for the scapular fracture shown in Figure 46?

A 16-year-old girl has a painful foot mass. A radiograph, MRI scan, and biopsy specimens are shown in Figures 35a through 35d. What is the most likely diagnosis?

An olecranon fracture-dislocation of the elbow in which the fracture line exits distal to the coronoid process is best managed by open reduction and

A 24-year-old female soccer player has had lateral joint line pain and a recurrent effusion in the left knee after sustaining a twisting injury 6 weeks ago. She reports that symptoms worsen with athletic activities. MRI scans are shown in Figures 2a through 2c. What is the most likely diagnosis?

A 17-year-old high school soccer player sustains an anterior cruciate ligament (ACL) tear at the beginning of the season. An MRI scan confirms a complete ACL tear with no meniscal injuries. The patient plans an early return to play and would like to avoid surgery. Therefore, the patient and family should be advised that nonsurgical management consisting of rehabilitative exercises and the use of a functional knee brace will most likely result in

Figure 16 shows the radiograph of a 7-year-old boy who sustained a pathologic fracture of the left humerus 1 day ago. Initial management should consist of

What acetabular procedure for developmental dysplasia of the hip does not require a concentric reduction of the femoral head in the acetabulum?

The biopsy specimens seen in Figures 55a and 55b are from a lytic lesion in the sacrum of a 58-year-old man. What is the most likely diagnosis?

Titanium and its alloys are unsuitable candidates for which of the following implant applications?

A 12-year-old boy with hemophilia A and no known inhibitors sustains a tibia fracture and has pain with passive motion of the deep toe flexors. Appropriate management should consist of

Failure of high tibial osteotomy (HTO) is most closely associated with which of the following factors?

Examination of a 13-year-old boy with asymptomatic poor posture reveals increased thoracic kyphosis that is fairly rigid and accentuates during forward bending. The neurologic examination is normal. Spinal radiographs show 10 degrees of scoliosis at Risser stage 2, and there is no evidence of spondylolisthesis. A standing lateral view of the thoracic spine is shown in Figure 41. The kyphosis corrects to 50 degrees. Management should consist of

In the treatment of thoracic disk herniations, what approach is associated with the highest risk of iatrogenic paraplegia?

What is the most appropriate orthotic management for the lesion shown in Figure 6?

What is the most frequent complication of both lateral closing wedge high tibial osteotomy and medial opening wedge osteotomy?

A 28-year-old woman has left shoulder pain and a tender soft-tissue mass. Based on the MRI scan and biopsy specimens shown in Figures 74a through 74c, what is the most likely diagnosis?

A 30-year-old right hand-dominant woman is seen in the trauma unit after a high-speed motor vehicle accident. She sustained a right shoulder anterior dislocation that is gently reduced under sedation. A CT scan is shown in Figure 3. If left untreated, the patient is at greatest risk for

A 47-year-old woman has a right bunion that has been symptomatic despite modifications in shoe wear. She requests surgical correction. An AP radiograph is shown in Figure 37. Treatment should consist of

Of the following clinical situations, which is most likely to lead to osteonecrosis associated with a slipped capital femoral epiphysis (SCFE)?

A 72-year-old woman who underwent right total hip arthroplasty 7 years ago now reports right hip pain and limb shortening. Studies for infection are negative. AP and lateral radiographs are shown in Figures 13a and 13b. What is the most appropriate management?

A 32-year-old man sustained a fracture of his upper arm in a motor vehicle accident. Radiographs are shown in Figure 32. Because of other associated injuries, surgical stabilization is chosen. What technique will result in the least complications and the best outcome?

A healthy 70-year-old man has a swollen knee after undergoing a knee replacement 10 years ago. Aspiration of the knee reveals cloudy, viscous synovial fluid. Laboratory studies show an erythrocyte sedimentation rate of 10 mm/h and a C-reactive protein level of less than 0.5. What is the most likely diagnosis?

A 6-year-old boy with acute hematogenous osteomyelitis of the distal femur is being treated with intravenous antibiotics. The most expeditious method to determine the early success or failure of treatment is by serial evaluations of which of the following studies?

The safest surgical approach to the insertion of the tibial posterior cruciate ligament uses the interval between which of the following muscles?

Figures 12a through 12e show the radiograph, MRI scans, and biopsy specimens of a 17-year-old boy. What is the most likely diagnosis?

A right-handed 20-year-old college baseball pitcher has had a 6-month history of vague right elbow pain while pitching. Examination reveals full flexion of the elbow and a loss of only a few degrees of full extension. The elbow is stable, but palpation reveals tenderness over the olecranon. Plain radiographs are inconclusive. MRI and CT scans are shown in Figures 20a and 20b. Management should consist of

A 38-year-old man who is an avid runner reports a several month history of right hip pain. Based on the radiograph and cross-sectional CT scan shown in Figures 33a and 33b, what is the most likely diagnosis for the lesions seen on the femoral neck?

Which of the following ligaments are the primary static restraints to inferior translation of the arm when the shoulder is in 0 degrees of abduction and neutral rotation?

Figures 40a and 40b show the pre- and postoperative radiographs of an 82-year-old woman with bilateral hip pain who has had staged total hip arthroplasties. To minimize potential injury to the sciatic nerve at the time of surgery, the surgeon should

Which of the following treatment regimens for thromboembolic prophylaxis meets the American College of Chest Physicians Guidelines for 10-day treatment after total hip arthroplasty and total knee arthroplasty?

A 2-year-old girl has had a swollen right knee for the past 7 weeks. There is no history of significant trauma, and she has not had a fever or been ill. Her parents report that she is stiff in the morning but otherwise does not report pain. A CBC count and erythrocyte sedimentation rate are normal. Treatment with naproxen at appropriate doses for the past 2 weeks has resulted in some improvement. Radiographs show only soft-tissue swelling. Examination reveals a healthy-appearing child with a warm and swollen right knee that is only slightly tender but lacks full extension by 20 degrees. What is the next most appropriate step in management?

A 55-year-old man reports increasing weakness in his arms that has progressed to his lower limbs, resulting in frequent tripping and falling. Examination reveals weakness in shoulder abduction and external and internal rotation bilaterally. Fasciculation is noted. He also has weakness in elbow flexion and extension bilaterally, and his grip strength is diminished. An electromyogram and nerve conduction velocity studies show decreased amplitude of compound motor action potential, slightly slowed motor conduction velocity, and denervation signs with decreased recruitment in all extremities. The sensory study is normal. Based on these findings, what is the most likely diagnosis?

A 20-year-old man has a symptomatic lesion of fibrous dysplasia in the femoral neck. Management should consist of

An otherwise healthy 57-year-old man has persistent, severe hip pain after undergoing total hip arthroplasty 3 months ago. What is the next most appropriate step in management?

Which of the following is an indication for surgical management of a Weber type B distal fibular fracture?

A 62-year-old man has cervical myelopathy with no evidence of cervical radiculopathy. MRI reveals stenosis at C4-5 and C5-6 with severe cord compression. Examination will most likely reveal which of the following findings?

A 21-year-old man with neurofibromatosis and multiple cutaneous neurofibromas has a rapidly enlarging painless mass on his buttock. Examination reveals a nontender, well-defined 6- x 6-cm soft-tissue mass that is deep to the fascia. The best course of action should be to order

Figure 39 shows the AP radiograph of a 62-year-old man with degenerative osteoarthritis secondary to trauma. History reveals that he underwent total elbow arthroplasty 3 years ago. He continues to report instability and constant pain. A complete work-up, including aspiration and cultures, is negative. Treatment should consist of removal of the components and

What is the incidence and significance of anterior cruciate ligament laxity following tibial eminence fractures in skeletally immature individuals?

Figure 48 shows an MRI scan of the knee. The arrow is pointing to what structure?

Figure 24 shows the radiograph of a 10-year-old boy who sustained a valgus injury to the knee. Examination reveals grade III medial laxity. Initial management should consist of

What is the primary limiting membrane and mechanical support for the periphery of the physis?

Which of the following clinical scenarios represents an appropriate indication for convex hemiepiphysiodesis/hemiarthrodesis in the treatment of a child with a congenital spinal deformity?

The MRI findings shown in Figure 51 would most likely create which of the following signs and symptoms?

A 21-year-old patient has had pain and a marked decrease in active and passive shoulder motion after having had a seizure 2 months ago as the result of alcohol abuse. Current AP and axillary radiographs and a CT scan are shown in Figures 26a through 26c. Management should consist of

The rate of complications after in situ pinning of a chronic slipped capital femoral epiphysis is highest with placement of the screw in what quadrant of the femoral head?

A 6-year-old child sustained a closed nondisplaced proximal tibial metaphyseal fracture 1 year ago. She was treated with a long leg cast with a varus mold, and the fracture healed uneventfully. She now has a 15-degree valgus deformity. What is the next step in management?

An otherwise healthy 78-year-old woman has low back and buttock pain. Rectal examination reveals a large sacral mass. Figures 7a and 7b show a CT scan and a sagittal MRI scan of the lumbosacral spine. A biopsy specimen is shown in Figure 7c. What is the most likely diagnosis?

A 27-year-old woman with Down syndrome has a severe bunion with pain and deformity in the left forefoot. Nonsurgical management has failed to provide relief. She does not use any assistive ambulatory devices. A radiograph is shown in Figure 21. Treatment should now consist of

A sagittal T1-weighted MRI scan of the knee joint is shown in Figure 23. What structure is identified by the arrow?

A 35-year-old man who snowboards sustained the injury shown in Figures 4a through 4c. What is the mechanism of injury?

A newborn with bilateral talipes equinovarus undergoes serial manipulation and casting. What is the primary goal of manipulation?

A 12-year-old girl has had pain in her right knee for 1 month that started as activity-related and progressed to night pain. Radiographs are shown in Figures 16a and 16b, and a biopsy specimen is shown in Figure 16c. What is the recommended treatment?

Figures 10a and 10b show the radiographs of an athletic 9-year-old boy who has activity-related anterior knee pain with intact active knee extension. Examination reveals tenderness to palpation over the inferior pole of the patella. There is no effusion or ligamentous instability. Initial management should consist of

A 45-year-old man seen in the emergency department reports a 1-week history of worsening low back pain and a progressive neurologic deficit in the S1 distribution. Examination reveals 2/5 strength in the gastrocnemius. Laboratory studies show a WBC count of 13,500/mm3 and an erythrocyte sedimentation rate of 74 mm/h. Radiographs of the lumbosacral spine show narrowing of the L5-S1 disk space, with irregularity of the end plates. A sagittal T2-weighted MRI scan is shown in Figure 8. Definitive management should consist of

Figures 32a and 32b show the radiographs of a 13-year-old boy who sustained a fracture while playing football 1 week ago. Management at the time of injury included application of a cast and the use of crutches. A follow-up office visit reveals a normal neurologic examination, and the patient reports no discomfort with the cast and crutches. Management should now include

What muscle is most often encountered during surgical approaches to C5-6?

A 14-year-old boy reports pain in the distal thigh. He denies any history of trauma. Examination reveals tenderness and swelling of the distal thigh without effusion. A radiograph and CT scan are shown in Figures 10a and 10b. A biopsy specimen is shown in Figure 10c. Management should consist of

A 52-year-old man has had back pain radiating to the left leg for the past 5 weeks. A radiograph, MRI scans, and biopsy specimens are shown in Figures 23a through 23f. What is the most likely diagnosis?

What is the primary mechanism of injury for the fracture shown in Figures 33a and 33b?

Creatine is currently being used by athletes as a dietary supplement in an attempt to enhance performance. What is the physiologic basis for its use?

A 45-year-old man is seen in the emergency department after returning from a 2-hour airplane flight. He is reporting severe pain in his right leg but has no trouble moving his ankle, leg, or knee. Venous doppler testing reveals no evidence of deep venous thrombosis. He is placed on IV cephazolin but continues to worsen. On the third day in the hospital he has increased pain, some respiratory distress, and trouble maintaining his blood pressure. His leg takes on the appearance seen in Figure 15. An urgent MRI scan shows thickening of the subcutaneous tissues and superficial swelling in the leg but no evidence of an abscess. What is the next most appropriate step in management?

Figures 33a and 33b show the radiographs of a 10-year-old girl who reports a 4-month history of medial foot pain after she was kicked while playing soccer. The pain is worse with activity and partially relieved by rest. Examination reveals tenderness directly over a prominent navicular tuberosity. Management should consist of

Which of the following methods of meniscal repair has the highest load to failure strength?

Patients in compensated shock (normal vital signs) are thought to be at risk for which of the following?

Fixed hyperextension of the metatarsophalangeal joint is associated with

A 21-year-old soccer player reports pain and is unable to straighten his knee following an acute injury during a game. He is unable to continue to play. An MRI scan is shown in Figure 3. What is the next most appropriate step in management?

A 63-year-old woman reports giving way of the knee and pain after undergoing primary total knee arthroplasty (TKA) 1 year ago. Examination reveals that the knee is stable in full extension but has gross anteroposterior instability at 90 degrees of flexion. The patient can fully extend her knee with normal quadriceps strength. Studies for infection are negative. AP and lateral radiographs are shown in Figures 12a and 12b, respectively. What is the appropriate management?

The need for postoperative allogeneic blood transfusions after total hip arthroplasty has been shown to be reduced when using

Which of the following is considered an advantage of metal femoral heads compared with ceramic heads?

A 52-year-old man has had right shoulder pain in the deltoid region that increases at night for the past 2 months. He denies any history of trauma. Examination reveals mild tenderness over the greater tuberosity, and the Neer and Hawkins impingement signs are positive. AP and outlet lateral radiographs are shown in Figures 24a and 24b. Initial management should consist of

Contraindications to cervical laminectomy as a treatment for cervical spondylotic myelopathy include which of the following findings?

What is the most common bone tumor in the hand?

Medial dislocation of the long head of the biceps tendon in the shoulder is most commonly caused by a

A 47-year-old male tennis player has pain in his nondominant shoulder that has failed to respond to 4 months of nonsurgical management. Examination reveals acromial tenderness and pain at the supraspinatus tendon insertion. He has a positive impingement sign, pain on forward elevation, and minimal cuff weakness. The MRI scans are shown in Figures 30a and 30b. To completely resolve his symptoms, treatment should consist of