1. General Principles & Basic Science MCQs

A 70-year-old woman on long-term alendronate therapy reports a 3-month history of vague thigh pain. Radiographs reveal lateral cortical thickening and a transverse radiolucent line in the subtrochanteric region. What is the most appropriate prophylactic surgical management for this impending fracture?

A 65-year-old man with a history of hypertrophic osteoarthritis and prior contralateral heterotopic ossification (HO) undergoes a THA. What is the most appropriate prophylactic regimen to prevent recurrence of HO in this high-risk patient?

During a direct anterior approach for a total hip arthroplasty, the surgeon utilizes the internervous plane between which of the following muscles?

Current evidence suggests that in elderly patients undergoing hemiarthroplasty for a displaced femoral neck fracture, the use of a cemented femoral stem compared to an uncemented stem is associated with which of the following?

The main blood supply to the adult femoral head is the lateral epiphyseal artery. This artery is a terminal branch of which of the following vessels?

During a direct anterior approach for total hip arthroplasty, the surgeon dissects between the sartorius and the tensor fasciae latae. Which of the following neurologic structures is at highest risk of iatrogenic injury during the exposure of this specific internervous interval?

A 68-year-old woman on long-term alendronate for osteoporosis presents with a 3-month history of prodromal anterior thigh pain.

Radiographs demonstrate a transverse, nondisplaced radiolucency in the lateral cortex of the subtrochanteric region with localized periosteal "beaking." What is the most appropriate next step in management?

Following a primary THA using a posterior approach, the patient demonstrates a foot drop and inability to extend the great toe. Sensation is decreased over the dorsum of the foot. Which specific neural structure was most likely injured?

When performing an anterior approach to the hip (Smith-Petersen), the internervous plane utilized is between muscles innervated by which two nerves?

Highly cross-linked polyethylene is now commonly used in THA. The primary negative biomechanical effect of increasing the cross-linking radiation dose in polyethylene is:

Following surgical fixation of an osteoporotic intertrochanteric hip fracture, when is the optimal time to initiate intravenous zoledronic acid to reduce the risk of subsequent fractures without delaying fracture union?

During a total hip arthroplasty utilizing the direct anterior (Smith-Petersen) approach, which of the following internervous planes is utilized superficially?

A surgeon utilizes the direct anterior approach (Smith-Petersen) for a primary total hip arthroplasty. Which of the following is an expected potential neurologic complication specific to this surgical approach?

According to recent anatomic studies, which of the following arteries provides the dominant blood supply to the humeral head?

During open reduction and internal fixation of a proximal humerus fracture via an extended deltopectoral approach, which nerve is at greatest risk of iatrogenic injury when placing retractors beneath the deltoid or splitting its distal fibers?

A 42-year-old man undergoes arthroscopic rotator cuff repair. During the procedure, the surgeon decides to place an anchor in the posterosuperior aspect of the greater tuberosity. What structure is most at risk if the anchor is misplaced too medially near the glenoid articular margin?

A 65-year-old man falls on his outstretched dominant arm. He has a 3-part proximal humerus fracture with varus alignment. He undergoes ORIF with a locking plate. Postoperatively, he is noted to have inability to actively extend his wrist and fingers. What is the most likely cause?

A 32-year-old male bodybuilder feels a sudden "pop" and tearing sensation in his anterior axilla while performing a heavy bench press. Examination reveals loss of the anterior axillary fold. During the bench press motion, which portion of the injured muscle typically ruptures first?

A 33-year-old man presents with vague posterior shoulder pain and numbness over the lateral deltoid after a blunt trauma to the posterior shoulder. An MRI reveals an isolated fluid collection in the quadrilateral space. Which nerve is most likely compressed in this space?

A 40-year-old man presents with vague posterior shoulder pain and isolated atrophy of the teres minor on physical examination. MRI confirms fatty infiltration isolated to the teres minor. Compression of which nerve in the quadrilateral space is the most likely cause?