Infection, Pharmacology & VTE MCQs

A 55-year-old male with a history of diabetes mellitus and chronic kidney disease presents with acute onset, severe left foot pain and swelling, warmth, and erythema, but no history of trauma. Radiographs show disorganization of the midfoot joints, fragmentation, and 'rocker-bottom' deformity. What is the most likely diagnosis?

A 68-year-old male presents with sudden onset of right knee pain and swelling. On aspiration, the synovial fluid is cloudy and contains negatively birefringent, needle-shaped crystals. What is the most appropriate management for this condition?

A 72-year-old male is undergoing debridement and implant retention (DAIR) for an acute staphylococcal periprosthetic joint infection of the hip. Which of the following antibiotics is most critical to include in the postoperative regimen due to its specific efficacy against organisms in a biofilm?

Upon arrival at the emergency department, the patient with an acute flexor tendon laceration in Zone II received prophylactic intravenous antibiotics. Given the mechanism of injury (kitchen knife) and the location, which of the following antibiotic choices is most appropriate for initial empiric coverage?

The patient is progressing well in rehabilitation. As part of long-term management and prevention of recurrence, what is the most crucial advice to provide to this patient, particularly given his occupational history?

A patient with confirmed Hypothenar Hammer Syndrome is started on medical therapy while continuing to work with modified tools. Which of the following medication classes and lifestyle modifications represent the mainstay of non-operative management?

A 50-year-old construction worker presents with suspected Hypothenar Hammer Syndrome. He has mild symptoms and normal digital perfusion at rest. As part of initial non-operative management, which of the following pharmacological agents is most appropriate to prescribe?

A 35-year-old carpenter is diagnosed with mild, non-ischemic hypothenar hammer syndrome. He reports cold intolerance and mild pain but has no signs of digital ulceration. What is the recommended first-line medical therapy alongside smoking cessation and avoidance of trauma?

A 28-year-old factory worker presents with a suspected high-pressure injection injury to his ring finger, sustained 2 hours ago. The entry wound is small, and he reports only mild discomfort. To aid in pre-operative planning and identify the extent of injected material and potential bony involvement, which diagnostic imaging modality is considered essential for initial evaluation, according to the case?

Two weeks after undergoing a reverse radial forearm flap with split-thickness skin grafting to the donor site, a patient presents with graft loss over the distal forearm. The flexor carpi radialis tendon is exposed and devoid of paratenon. What is the most appropriate management to prevent tendon rupture?

A 4-year-old child presents with a high fever, refusal to bear weight on the right leg, and significant pain on passive hip motion. Radiographs are normal. Labs show elevated ESR and CRP, and a white blood cell count of 18,000/µL. What is the most appropriate next diagnostic step?

From an orthopedic perspective, why is it important to differentiate a Richter hernia in the femoral region from conditions like adductor tendinopathy or hip flexor strain?

A 45-year-old female is undergoing a brachial plexus block for wrist surgery. Minutes after the injection of bupivacaine, she develops tinnitus, perioral numbness, and subsequent generalized tonic-clonic seizures. What is the most appropriate targeted rescue therapy?

To maximize efficacy in preventing surgical site infections, when must the prophylactic preoperative dose of cefazolin be completely administered?

A patient with suspected lateral epicondylitis has undergone a corticosteroid injection at the common extensor origin. They return three months later with recurrent, slightly worse pain. What is the MOST appropriate next step in management, assuming initial non-operative treatment (PT, NSAIDs) was also attempted without success?

A 48-year-old male undergoes open repair of an acute Achilles tendon rupture. Post-operatively, he develops a wound dehiscence with signs of superficial infection. Despite oral antibiotics and local wound care, the wound continues to show poor healing. Which of the following complications is he at highest risk for, and what is a common salvage strategy for significant wound issues in this region?

An 18-year-old female sustains an unstable pelvic fracture. She is successfully stabilized in the ICU. The surgical team plans for internal fixation on hospital day 3. According to major orthopedic trauma guidelines, what is the optimal strategy for deep vein thrombosis (DVT) prophylaxis in this patient?