1. General Principles & Basic Science MCQs

During a surgical approach to the anterior elbow (Henry approach), which interval is utilized to access the proximal radius, and which nerve must be protected?

A 16-year-old male sustains a posterior sternoclavicular joint dislocation. He presents with mild dyspnea and dysphagia. Which of the following is the most appropriate initial management step in the emergency department?

A patient with long-standing rheumatoid arthritis presents with a sudden inability to extend the small and ring fingers at the MCP joints. What is the most likely etiology?

A 60-year-old male with poorly controlled diabetes mellitus presents with a chronic, draining neuropathic ulcer under the 3rd metatarsal head. A probe easily contacts bone at the base of the ulcer. MRI demonstrates high T2 signal and low T1 signal replacing the marrow fat of the 3rd metatarsal head. What is the single most common causative organism for osteomyelitis in this clinical setting?

A 35-year-old landscaper accidentally steps on a nail that completely penetrates through the sole of his athletic rubber-soled sneaker into his foot. He presents two weeks later with signs of osteomyelitis. What is the most likely causative organism specific to this mechanism?

A 58-year-old diabetic patient presents with a swollen, red, and warm foot.

Radiographs show no fractures but severe osteopenia. To differentiate clinically between an acute Charcot neuroarthropathy and cellulitis/osteomyelitis, the physician performs the leg elevation test. What is the expected result if the diagnosis is acute Charcot?

A 26-year-old male sustains a complete anterior knee dislocation (KD-IV) during a motorcycle accident and presents with absent distal pulses. The popliteal artery is at high risk of injury in this scenario due to anatomic tethering. At which two anatomical points is the popliteal artery firmly fixed, making it susceptible to traction injury?

A surgeon is performing an inside-out meniscal repair for a longitudinal tear involving the posterior horn of the lateral meniscus. To protect neurovascular structures, a retractor must be properly placed. Which of the following structures is at the highest risk of iatrogenic injury during suture passage in this specific area?

A 30-year-old weightlifter feels a pop in his anterior chest while performing a heavy bench press. Examination reveals an asymmetric chest wall and weakness in internal rotation. Which portion of the pectoralis major tendon is most commonly ruptured and during which phase of the bench press?

A 19-year-old female collegiate cross-country runner presents with a femoral neck stress fracture. She reports oligomenorrhea and restrictive eating habits. This triad of conditions is primarily driven by which of the following underlying physiological deficits?

During an open subpectoral biceps tenodesis, the surgeon inadvertently places a medial retractor too aggressively on the humerus. The patient postoperatively demonstrates weakness in elbow flexion and numbness over the lateral forearm. Which nerve was most likely injured?

A 32-year-old competitive weightlifter feels a tearing sensation in his anterior chest while performing a heavy bench press. MRI confirms a complete pectoralis major rupture. Which of the following describes the typical pathoanatomy of the torn tendinous insertion?

During a direct anterior (Smith-Petersen) approach for a total hip arthroplasty, the surgeon dissects through the superficial internervous plane. This plane separates muscles innervated by which two nerves?

In the direct anterior approach for THA (Smith-Petersen interval), the superficial internervous plane is developed between which of the following pairs of muscles?

During a primary TKA for a severe varus deformity, the medial compartment remains excessively tight in both flexion and extension after standard bone resections. Which of the following soft tissue structures should ideally be released first to correct this imbalance?

The direct anterior (Smith-Petersen) approach to the hip utilizes an internervous plane between muscles supplied by which two specific nerves?

A 66-year-old male with severe varus osteoarthritis is undergoing a primary TKA. During the procedure, the medial gap remains tight in both flexion and extension despite removal of peripheral osteophytes. What is the most appropriate sequential release to balance this varus deformity?

A surgeon utilizes the direct anterior approach for a primary THA. This approach exploits an internervous and intermuscular plane. Which of the following accurately describes the superficial interval used in this approach?

A surgeon is utilizing the direct anterior approach for a primary THA. This approach exploits a true internervous plane. Between which two muscles is the superficial surgical interval developed?