Menu

1. General Principles & Basic Science MCQs

Practice Set 6 of 789

This practice set contains high-yield board review questions covering key concepts in 1. General Principles & Basic Science. Each clinical scenario is designed to test your diagnostic and management skills relevant to this subspecialty.

Question 101

Topic: 1. General Principles & Basic Science

In a professional jumper suffering from chronic refractory patellar tendinopathy, eccentric decline squat protocols are prescribed. Which of the following best describes the mechanical rationale for this therapy?

. It stimulates isolated hypertrophy of the vastus medialis obliquus (VMO)
. It generates high tendinous loads promoting collagen synthesis and structural remodeling
. It reduces the tension on the patellar tendon by improving hamstring flexibility
. It acts by permanently stretching the patellar tendon length
. It selectively inhibits nociceptive pathways in the infrapatellar fat pad

Correct Answer & Explanation

. It generates high tendinous loads promoting collagen synthesis and structural remodeling

Explanation

Eccentric loading protocols subject the tendon to high mechanical tension, which stimulates tenocytes to upregulate collagen synthesis and reorganize collagen alignment, aiding structural remodeling of the tendinopathic tissue.

Question 102

Topic: 1. General Principles & Basic Science

Which of the following statements is true regarding Platelet-Rich Plasma (PRP) preparations for orthopedic conditions?

. Leukocyte-rich PRP is preferred for intra-articular knee osteoarthritis injections.
. Leukocyte-poor PRP has been shown to be superior for the treatment of patellar tendinopathy.
. Leukocyte-poor PRP results in a greater pro-inflammatory response compared to leukocyte-rich PRP.
. Leukocyte-rich PRP contains a higher concentration of neutrophils which may have deleterious effects on cartilage.
. PRP relies primarily on the delivery of exogenous stem cells to promote tissue healing.

Correct Answer & Explanation

. Leukocyte-rich PRP contains a higher concentration of neutrophils which may have deleterious effects on cartilage.

Explanation

Leukocyte-rich PRP (LR-PRP) contains neutrophils that release matrix metalloproteinases (MMPs) and pro-inflammatory cytokines, which can degrade cartilage. Therefore, leukocyte-poor PRP (LP-PRP) is generally preferred for intra-articular injections like knee osteoarthritis.

Question 103

Topic: Biology, Genetics & Bone Healing

The "Female Athlete Triad" is characterized by the interrelatedness of low energy availability, menstrual dysfunction, and low bone mineral density. The primary physiological driver of bone loss in this syndrome is:

. Hypercortisolism secondary to physical stress
. Hypoestrogenism secondary to disruption of the hypothalamic-pituitary-ovarian axis
. Hyperparathyroidism secondary to inadequate calcium intake
. Direct inhibition of osteoblasts by lactic acid accumulation
. Chronic vitamin D deficiency

Correct Answer & Explanation

. Hypoestrogenism secondary to disruption of the hypothalamic-pituitary-ovarian axis

Explanation

Low energy availability suppresses the hypothalamic release of GnRH, leading to decreased LH/FSH and subsequent hypoestrogenism. This lack of estrogen accelerates bone resorption and halts bone formation, leading to low bone mineral density.

Question 104

Topic: 1. General Principles & Basic Science

Which of the following accurately describes the anatomy of the coracoclavicular (CC) ligaments?

. The conoid ligament is lateral to the trapezoid ligament.
. The conoid ligament is the primary restraint to anterior displacement of the clavicle.
. The trapezoid ligament is the primary restraint to superior displacement of the clavicle.
. The conoid ligament inserts more posteromedially on the clavicle compared to the trapezoid.
. Both ligaments originate from the acromion.

Correct Answer & Explanation

. The conoid ligament inserts more posteromedially on the clavicle compared to the trapezoid.

Explanation

The coracoclavicular ligaments consist of the conoid and trapezoid. The conoid ligament is medial, posterior, and cone-shaped, acting as the primary restraint to superior translation, while the trapezoid is lateral and anterior.

Question 105

Topic: Biomechanics & Biomaterials

During anterior cruciate ligament (ACL) reconstruction, tensioning the graft at which of the following knee flexion angles most closely restores intact knee kinematics when using a single-bundle construct?

. Full extension
. 20 to 30 degrees of flexion
. 45 to 60 degrees of flexion
. 90 degrees of flexion
. 120 degrees of flexion

Correct Answer & Explanation

. 20 to 30 degrees of flexion

Explanation

Tensioning an ACL graft at 20 to 30 degrees of flexion optimizes anterior-posterior stability and most closely reproduces normal knee kinematics. Tensioning in full extension can capture the knee and limit terminal extension.

Question 106

Topic: 1. General Principles & Basic Science

According to current guidelines, autologous chondrocyte implantation (ACI) is most appropriate for which of the following femoral condyle cartilage defects?

. A 1.0 cm2 symptomatic lesion in a 55-year-old patient
. A 3.5 cm2 focal unipolar contained defect in a 25-year-old patient
. A 4.0 cm2 kissing lesion of the medial compartment in a 40-year-old
. A 0.5 cm2 asymptomatic incidental focal defect in a 30-year-old
. A 2.5 cm2 osteochondral defect with 15 mm of bone loss in a 20-year-old

Correct Answer & Explanation

. A 3.5 cm2 focal unipolar contained defect in a 25-year-old patient

Explanation

ACI is indicated for large (>2 cm2), symptomatic, focal, contained unipolar defects in young, active patients. Kissing lesions, small defects, and significant unaddressed bone loss are relative or absolute contraindications.

Question 107

Topic: 1. General Principles & Basic Science

The primary blood supply to the peripheral aspect of the menisci is derived from which of the following vessels?

. Middle geniculate artery
. Medial and lateral superior and inferior geniculate arteries
. Popliteal artery branches directly supplying the inner avascular zone
. Descending genicular artery
. Anterior tibial recurrent artery

Correct Answer & Explanation

. Medial and lateral superior and inferior geniculate arteries

Explanation

The peripheral 10-30% of the menisci is vascularized by the perimeniscal capillary plexus, which originates from the medial and lateral superior and inferior geniculate arteries. The inner portions are avascular and receive nutrition via diffusion.

Question 108

Topic: 1. General Principles & Basic Science

A 28-year-old bodybuilder admits to chronic use of anabolic-androgenic steroids to enhance performance. Which of the following lipid profile alterations is most characteristic of anabolic steroid abuse?

. Increased HDL and increased LDL
. Decreased HDL and increased LDL
. Increased HDL and decreased LDL
. Decreased HDL and decreased LDL
. Normal HDL but significantly elevated triglycerides

Correct Answer & Explanation

. Decreased HDL and increased LDL

Explanation

Anabolic-androgenic steroid abuse is strongly associated with adverse cardiovascular risk profiles, most notably a severe depression of high-density lipoprotein (HDL) and an elevation of low-density lipoprotein (LDL).

Question 109

Topic: Surgical Anatomy & Approaches

Innervation to the anterior cruciate ligament is provided by a branch of the:

. Sciatic nerve
. Obturator nerve
. Saphenous nerve
. Posterior tibial nerve
. Femoral nerve

Correct Answer & Explanation

. Posterior tibial nerve

Explanation

The posterior articular branch of the posterior tibial nerve provides pain fibers and mechanoreceptors to the anterior cruciate ligament.

Question 110

Topic: Biology, Genetics & Bone Healing

The most common adverse side effect of dietary supplementation with creatine in athletes is:

. Friable tendons
. Muscle cramping
. Myopathy
. Diabetes
. Osteoporosis

Correct Answer & Explanation

. Muscle cramping

Explanation

Creatine has recently become a popular dietary supplement among athletes. The long-term effects of creatine are not known. However, it appears to cause muscle cramping and heat intolerance.

Question 111

Topic: Physiology & Rehabilitation

Weight training that employs constant resistance throughout the arc of motion is referred to as:

. Isometric
. Isotonic
. Isokinetic
. Plyometric
. Functional

Correct Answer & Explanation

. Isotonic

Explanation

Isotonic training employs a constant resistance throughout the arc of joint motion

Question 112

Topic: Physiology & Rehabilitation

Weight training that employs a constant velocity and variable resistance is referred to as:

. Isometric
. Isotonic
. Isokinetic
. Plyometric
. Functional

Correct Answer & Explanation

. Isokinetic

Explanation

Isokinetic training employs constant velocity and variable resistance. Special equipment, such as a C ybex device (C ybex, Medway, Mass), is required for isokinetic training.

Question 113

Topic: 1. General Principles & Basic Science

During arthroscopic repair of a medial meniscal tear, the following structure is at greatest risk for damage:

. Popliteal artery
. Popliteal vein
. Saphenous nerve
. Sural nerve
. Popliteus tendon

Correct Answer & Explanation

. Saphenous nerve

Explanation

No matter what technique for arthroscopic medial meniscal repair is used, the saphenous nerve must be protected to avoid a painful neuroma postoperatively.

Question 114

Topic: 1. General Principles & Basic Science

During arthroscopic repair of a lateral meniscal tear, the following structure is at greatest risk for damage:

. Popliteal artery
. Popliteal vein
. Peroneal nerve
. Sural nerve
. Popliteus tendon

Correct Answer & Explanation

. Peroneal nerve

Explanation

When performing arthroscopic lateral meniscal repair, the peroneal nerve must be protected from insult.

Question 115

Topic: 1. General Principles & Basic Science

A 15-year-old male football player is discovered to have a reproducible painless pop with meniscal testing during a routine preparticipation physical examination. The patient states that he has never experienced any knee problems other than an occasional audible pop. His family physician orders a magnetic resonance image. It shows a discoid lateral meniscus without evidence of tearing. Recommended management should include:

. No intervention
. Abstinence from participation in football only
. Abstinence from participation in any sport requiring pivoting or
. Excision of the central portion of the discoid meniscus
. Lateral meniscectomy

Correct Answer & Explanation

. No intervention

Explanation

A discoid lateral meniscus can be complete, incomplete, or a Wrisberg variant. If asymptomatic, the patient can simply be observed without restriction. In patients with symptoms, the preferred treatment is excision of the central portion of the meniscus. In individuals with a discoid meniscus and a peripheral tear, repair of the tear is performed with excision of the central portion of the meniscus.

Question 116

Topic: Physiology & Rehabilitation

During open kinetic chain knee extension, the "screw-home" mechanism ensures maximal joint congruency in terminal extension. This mechanism is primarily characterized by which of the following coupled kinematic motions?

. External rotation of the tibia on the femur
. Internal rotation of the tibia on the femur
. Valgus angulation of the tibia
. Varus angulation of the tibia
. Posterior translation of the tibia

Correct Answer & Explanation

. External rotation of the tibia on the femur

Explanation

The screw-home mechanism is an obligatory 10 degrees of external rotation of the tibia on the femur during the final 30 degrees of open-chain terminal knee extension. It occurs due to the asymmetry of the femoral condyles and the tension of the cruciate ligaments.

Question 117

Topic: 1. General Principles & Basic Science

During a pectoralis major tendon repair, a surgeon must restore normal anatomical footprints. How does the sternal head of the pectoralis major muscle normally insert on the humerus relative to the clavicular head?

. Anterior and superior
. Posterior and superior
. Anterior and inferior
. Posterior and inferior
. Directly distal in the same plane

Correct Answer & Explanation

. Posterior and superior

Explanation

The pectoralis major tendon undergoes a 180-degree twist before its insertion. As a result, the sternal (lower) head crosses deep to the clavicular head and inserts posterior and superior to the clavicular (upper) head.

Question 118

Topic: Physiology & Rehabilitation

A physical therapist is designing a rehabilitation protocol for a patient with severe patellofemoral osteoarthritis. To minimize patellofemoral joint reaction forces during open kinetic chain (OKC) knee extension exercises, the patient should avoid which arc of motion?

. 120 to 90 degrees of flexion
. 90 to 60 degrees of flexion
. 30 to 0 degrees of flexion
. Isometric holds at 90 degrees of flexion
. Open kinetic chain forces are minimal throughout the entire arc

Correct Answer & Explanation

. 30 to 0 degrees of flexion

Explanation

In open kinetic chain (OKC) knee extension, patellofemoral joint reaction forces are highest in terminal extension (30 to 0 degrees of flexion). Conversely, in closed kinetic chain exercises (e.g., squats), these forces are highest in deep flexion.

Question 119

Topic: 1. General Principles & Basic Science

Which of the following closely approximates the anticipated increase in contact stresses within the medial compartment of the knee following a complete medial meniscectomy?

. 10% to 20%
. 30% to 50%
. 60% to 80%
. 100% to 150%
. Greater than 300%

Correct Answer & Explanation

. 100% to 150%

Explanation

The meniscus dramatically increases joint contact area. A complete medial meniscectomy reduces contact area by approximately 50% to 70%, which leads to a corresponding 100% (or roughly double) increase in medial compartment peak contact stresses.

Question 120

Topic: 1. General Principles & Basic Science

Which of the following ligamentous structures is the strongest in the human body and serves as the primary static restraint to hyperextension and external rotation of the hip joint?

. Ischiofemoral ligament
. Pubofemoral ligament
. Iliofemoral ligament
. Ligamentum teres
. Transverse acetabular ligament

Correct Answer & Explanation

. Iliofemoral ligament

Explanation

The iliofemoral ligament (also known as the Y ligament of Bigelow) is the thickest and strongest ligament in the body. It plays a critical role in hip biomechanics by checking hyperextension and external rotation.

Test Yourself

Switch to an interactive, timed exam simulation to truly master this topic.

On this Page