1. General Principles & Basic Science MCQs

During a massive rotator cuff repair, the surgeon opts to perform an open subpectoral biceps tenodesis. If retractor placement and dissection drift too far medial to the short head of the biceps/coracobrachialis, which nerve is at greatest risk of iatrogenic injury?

A 21-year-old football player sustains a valgus blow to the knee. MRI confirms an isolated, acute grade III injury to the medial collateral ligament (MCL) at the femoral attachment. What is the recommended treatment?

A 32-year-old male weightlifter feels a sharp pop in his anterior chest/axilla while performing a heavy bench press. Examination reveals a cosmetic defect, loss of the anterior axillary fold, and weakness with adduction and internal rotation. The rupture most likely involves which anatomical location?

A 35-year-old man presents with anterior shoulder pain and internal rotation weakness following a fall onto an outstretched hand. The examiner notes a positive belly-press test. Which of the following nerves innervates the primary muscle evaluated by this specific test?

A 28-year-old bodybuilder feels a pop in his anterior axilla while performing a heavy bench press. Examination reveals an asymmetric axillary fold and weakness in internal rotation and adduction. Which aspect of the pectoralis major is most commonly ruptured in this specific scenario?

A 4-year-old boy presents with a 2-day history of right hip pain and refusing to bear weight. His temperature is 38.8 Celsius (101.8 F). Laboratory studies show a WBC count of 13,000/mm3, ESR of 45 mm/hr, and CRP of 3.0 mg/dL. Radiographs of the hip are normal. Based on these findings, what is the most appropriate next step?

A 5-year-old boy presents with a limp, a temperature of 38.9°C (102°F), and an inability to bear weight on his right leg. Laboratory tests show an ESR of 55 mm/hr and a WBC count of 14,000/mm3. According to the modified Kocher criteria, what is the predictive probability that this child has septic arthritis of the hip?

A 6-year-old boy falls on an outstretched hand and sustains an extension-type supracondylar humerus fracture, which is displaced posteromedially. Which nerve is most commonly at risk with this specific displacement pattern?

A 4-year-old boy with blue sclerae and a history of four extremity fractures after minimal trauma is diagnosed with severe Osteogenesis Imperfecta (OI). Which of the following pharmacological therapies is currently the standard of care to decrease fracture incidence and increase bone mineral density in this patient?

A 3-year-old girl with blue sclerae and dentinogenesis imperfecta presents with her third low-energy long bone fracture. Genetic testing confirms a mutation affecting type I collagen. Which of the following systemic pharmacological treatments is most commonly indicated to decrease fracture incidence and improve bone mass in this condition?

A 28-year-old woman sustains a posterior hip dislocation during a high-speed collision. After closed reduction, she exhibits a foot drop and decreased sensation over the dorsum of her foot. Which portion of the sciatic nerve is most vulnerable in this injury, and what specific area of sensory loss is most diagnostic for its isolated injury?

A 68-year-old woman with a 9-year history of alendronate therapy reports an insidious onset of right thigh pain. Radiographs reveal focal lateral cortical thickening of the proximal femoral diaphysis with a subtle, transverse radiolucent line extending through the lateral cortex. What is the most appropriate management?

Which of the following clinical postures is most characteristic of a patient presenting with an obturator-type anterior hip dislocation?

A 28-year-old unrestrained driver is involved in a motor vehicle collision. In the emergency department, his right lower extremity is shortened, adducted, and internally rotated. He is unable to dorsiflex his right foot or extend his toes. What is the most likely direction of his hip dislocation and the specific injured nerve branch?

A 25-year-old skier crashes and presents to the emergency department with severe groin pain. On examination, his right hip is held in a position of marked flexion, abduction, and external rotation. Radiographs confirm an anterior hip dislocation. Which anatomical structure is most at risk of injury in this specific dislocation pattern?

The primary blood supply to the weight-bearing dome of the adult femoral head is derived from which of the following vessels?

A 30-year-old man suffers a posterior hip dislocation. Two attempts at closed reduction under conscious sedation are unsuccessful. During the subsequent open reduction via a posterior Kocher-Langenbeck approach, which of the following structures is most likely found to be obstructing the reduction?