1. General Principles & Basic Science MCQs

Which type of fracture healing is typically promoted by a dynamically locked intramedullary nail in a long bone fracture?

During normal muscle contraction, which band or zone of the sarcomere does NOT change in length?

Galvanic corrosion in orthopedic implants occurs when two dissimilar metals are placed in contact within a conductive fluid. Which of the following combinations is most susceptible to significant galvanic corrosion?

Synovial fluid analysis from a swollen knee demonstrates a WBC count of 45,000 cells/mcL with 85 percent polymorphonuclear leukocytes. Under polarized light microscopy, negatively birefringent needle-shaped crystals are identified. What is the composition of these crystals?

A 30-year-old male weightlifter feels a tear in his anterior chest while performing a heavy bench press. Which segment of the pectoralis major muscle is most commonly torn in this mechanism, and where does it insert on the humerus?

In the management of a type IV SLAP lesion extending into the biceps root in a 40-year-old laborer, what is the most appropriate surgical treatment?

A 55-year-old female recreational runner presents with refractory lateral hip pain. MRI reveals a full-thickness tear of the gluteus medius tendon at its insertion. Which aspect of the greater trochanter does the main tendon of the gluteus medius insert onto?

A 50-year-old female presents with acute onset posteromedial knee pain after squatting. MRI reveals a complete radial tear of the posterior root of the medial meniscus.

Biomechanically, how does a medial meniscus posterior root tear alter the knee joint?

A 19-year-old female gymnast presents with a femoral neck stress fracture. She has a BMI of 17, secondary amenorrhea, and a history of dietary restriction. In the context of the Female Athlete Triad (now part of Relative Energy Deficiency in Sport - RED-S), which underlying pathophysiological mechanism primarily drives the decrease in bone mineral density?

Articular cartilage has a highly organized structure that responds to mechanical loading. In which zone are the collagen fibers oriented perpendicular to the articular surface to provide resistance against compressive forces?

A 32-year-old female runner complains of deep gluteal pain that radiates down the posterior thigh. Symptoms are exacerbated by long strides. MRI of the pelvis demonstrates narrowing of the space between the ischial tuberosity and the lesser trochanter. Edema and signal change are most likely to be seen in which of the following muscles?

A 48-year-old female presents with acute medial knee pain after squatting to pick up a heavy box. She felt a "pop" in the back of her knee. MRI reveals a complete radial tear of the posterior horn of the medial meniscus within 5 mm of its bony attachment.

Biomechanically, what is the consequence of nonoperative management of this specific injury pattern?

A 19-year-old female gymnast is diagnosed with a second metatarsal stress fracture. She reports amenorrhea for the last 9 months and a highly restrictive diet. Dual-energy X-ray absorptiometry (DEXA) reveals a Z-score of -1.8. According to the current consensus on the Female Athlete Triad and Relative Energy Deficiency in Sport (RED-S), what is the driving pathophysiologic factor for her compromised bone mineral density?

Recent quantitative anatomic and perfusion studies have re-evaluated the principal vascular supply to the humeral head. Which of the following arteries is now recognized as providing the majority of the blood supply to the humeral head?

A 22-year-old rugby player sustains a posterior sternoclavicular (SC) joint dislocation. Which anatomical structure lies directly posterior to the medial clavicle and is at highest risk of catastrophic injury during reduction or from the injury itself?

In a complete rupture of the pectoralis major tendon sustained during weightlifting (e.g., bench press), which specific portion of the muscle-tendon unit is anatomically most prone to failure, and what is its normal insertion pattern?

When performing an open subpectoral biceps tenodesis, deep retraction is required to expose the humerus. If retractors are placed too far medially, which nerve is at greatest risk of iatrogenic injury?

A 30-year-old male weightlifter complains of poorly localized posterior shoulder pain and numbness over the lateral deltoid. Physical examination reveals focal point tenderness in the quadrilateral space. Which vascular structure is at risk of compression in this space alongside the affected nerve?

A 22-year-old rugby player sustains a direct blow to the medial clavicle, resulting in a posterior sternoclavicular (SC) joint dislocation. Which ligamentous structure is considered the strongest and primary stabilizer preventing anterior-posterior translation of the SC joint?

A 25-year-old male bodybuilder feels a 'pop' in his anterior axilla while performing heavy bench presses. MRI confirms a complete rupture of the pectoralis major tendon. Regarding the anatomy of the pectoralis major insertion on the humerus, which of the following is true?