Menu

1. General Principles & Basic Science MCQs

Practice Set 65 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 1281

Topic: 1. General Principles & Basic Science

What is the primary function of aggrecan in the extracellular matrix of articular cartilage?

. Provides tensile strength
. Provides compressive stiffness through osmotic swelling pressure
. Anchors chondrocytes to the subchondral bone
. Facilitates gliding by providing superficial boundary lubrication
. Forms cross-banded fibrils to resist shear stress

Correct Answer & Explanation

. Provides compressive stiffness through osmotic swelling pressure

Explanation

Aggrecan is a highly sulfated proteoglycan that draws water into the cartilage matrix via Donnan osmotic pressure. This creates a swelling pressure that provides cartilage with its unique compressive stiffness.

Question 1282

Topic: Surgical Anatomy & Approaches

Which of the following muscles is innervated by the posterior interosseous nerve (PIN)?

. Extensor carpi radialis longus (ECRL)
. Brachioradialis
. Extensor carpi ulnaris (ECU)
. Flexor carpi ulnaris (FCU)
. Anconeus

Correct Answer & Explanation

. Extensor carpi ulnaris (ECU)

Explanation

The PIN innervates the extensor carpi ulnaris (ECU), extensor digitorum communis, extensor digiti minimi, and the thumb extensors. The ECRL, brachioradialis, and anconeus are innervated by the radial nerve proper prior to its bifurcation.

Question 1283

Topic: Biology, Genetics & Bone Healing
Which of the following cytokines is considered the major stimulator of osteoclast differentiation, activation, and bone resorption?
. Osteoprotegerin (OPG)
. Interleukin-10 (IL-10)
. Receptor activator of nuclear factor kappa-B ligand (RANKL)
. Transforming growth factor-beta (TGF-β)
. Bone morphogenetic protein-2 (BMP-2)

Correct Answer & Explanation

. Receptor activator of nuclear factor kappa-B ligand (RANKL)

Explanation

RANKL binds to the RANK receptor on osteoclast precursors, stimulating their differentiation and survival. Osteoprotegerin (OPG) acts as a decoy receptor for RANKL, competitively inhibiting this bone-resorbing cascade.

Question 1284

Topic: Biology, Genetics & Bone Healing

Perren's strain theory postulates specific mechanical environments for different types of bone healing. According to this theory, primary bone healing occurs without callus formation when the interfragmentary strain is maintained at:

. Less than 2%
. Between 2% and 10%
. Between 10% and 20%
. Between 20% and 30%
. Greater than 30%

Correct Answer & Explanation

. Less than 2%

Explanation

Perren's strain theory states that absolute stability with an interfragmentary strain of less than 2% is required for primary bone healing. Strains between 2% and 10% promote secondary bone healing via endochondral ossification and callus formation.

Question 1285

Topic: 1. General Principles & Basic Science

During the surgical repair of a zone II flexor tendon laceration, preservation of the flexor sheath pulleys is critical. Which two pulleys are the most biomechanically important to prevent flexor tendon bowstringing?

. A1 and A2
. A2 and A3
. A2 and A4
. A3 and A5
. A1 and A5

Correct Answer & Explanation

. A2 and A4

Explanation

The A2 and A4 pulleys arise directly from the periosteum of the proximal and middle phalanges, respectively. They are the most critical structures to preserve or reconstruct in order to maintain the mechanical advantage of the flexor tendons and prevent bowstringing.

Question 1286

Topic: Infection, Pharmacology & VTE

A 4-year-old child presents with hip pain and a limp. According to the original Kocher criteria used to differentiate septic arthritis from transient synovitis, which of the following is NOT one of the four classic predictive variables?

. Non-weight-bearing on the affected side
. Erythrocyte sedimentation rate (ESR) > 40 mm/hr
. Fever > 38.5 degrees Celsius
. Serum C-reactive protein (CRP) > 2.0 mg/dL
. Peripheral white blood cell count > 12,000/mm^3

Correct Answer & Explanation

. Serum C-reactive protein (CRP) > 2.0 mg/dL

Explanation

The original four Kocher criteria are non-weight-bearing status, ESR > 40 mm/hr, temperature > 38.5 C (101.3 F), and WBC count > 12,000/mm^3. Although CRP is highly sensitive and was added to modified algorithms later, it was not one of the original four parameters.

Question 1287

Topic: Biology, Genetics & Bone Healing

During the process of secondary bone healing following a diaphyseal fracture, which of the following signaling molecules is most directly responsible for stimulating the differentiation of multipotent mesenchymal stem cells into osteoblasts?

. Interleukin-1 (IL-1)
. Transforming growth factor-beta (TGF-beta)
. Bone morphogenetic protein-2 (BMP-2)
. Tumor necrosis factor-alpha (TNF-alpha)
. Platelet-derived growth factor (PDGF)

Correct Answer & Explanation

. Bone morphogenetic protein-2 (BMP-2)

Explanation

Bone morphogenetic proteins (BMPs), particularly BMP-2 and BMP-7, are potent osteoinductive growth factors. They play a critical role in the bone healing cascade by stimulating mesenchymal stem cell differentiation into osteoblastic lineages.

Question 1288

Topic: Infection, Pharmacology & VTE

Post-operatively, the patient was prescribed protected weight-bearing (toe-touch or 20% partial weight-bearing) for 6 weeks. What is the most critical reason for this specific weight-bearing restriction in this complex revision THA?

. To minimize post-operative pain and discomfort.
. To reduce the risk of deep vein thrombosis (DVT).
. To allow for bone ingrowth and healing of the acetabular augment fixation and trochanteric osteotomy.
. To prevent early dislocation of the newly implanted components.
. To facilitate early range of motion exercises without stressing the implant.

Correct Answer & Explanation

. To allow for bone ingrowth and healing of the acetabular augment fixation and trochanteric osteotomy.

Explanation

Correct Answer: CThe post-operative protocol section explicitly states: 'Protected weight-bearing (toe-touch or 20% partial weight-bearing) using crutches or a walker was prescribed due to the extensive acetabular reconstruction with augments and femoral impaction grafting. This protocol is crucial to allow for bone ingrowth and healing of the acetabular augment fixation and trochanteric osteotomy.' While pain management (Option A) is important, it's not the primary reason for the specific weight-bearing restriction. DVT prophylaxis (Option B) is managed pharmacologically and with early mobilization, not primarily by weight-bearing restrictions. While preventing dislocation (Option D) is a concern, it's addressed by hip precautions and stability testing, not primarily by protected weight-bearing in this context. Early ROM (Option E) is performed within precautions, but protected weight-bearing is about protecting the healing bone-implant interface. Therefore, allowing for bone ingrowth and healing of the acetabular augment fixation and trochanteric osteotomy is the most critical reason.

Question 1289

Topic: Infection, Pharmacology & VTE

A 72-year-old male with a history of chronic obstructive pulmonary disease and coronary artery disease sustains an L1 burst fracture. He is neurologically intact. The TLICS score is 2. The patient's medical comorbidities make him a high-risk surgical candidate. Based on the case's discussion of postoperative rehabilitation protocols, what is the most appropriate immediate postoperative management strategy if he were to undergo surgical stabilization?

. Strict bed rest for 2-4 weeks to allow for spinal fusion.
. Routine use of a Thoracolumbosacral Orthosis (TLSO) for 6-12 weeks, with ambulation restricted to short distances.
. Early mobilization out of bed on postoperative day one, with deep vein thrombosis prophylaxis and physical therapy focusing on transfers and ambulation.
. Active spinal range of motion exercises initiated immediately to prevent stiffness.
. Delayed chemical deep vein thrombosis prophylaxis until 72 hours postoperatively to minimize bleeding risk.

Correct Answer & Explanation

. Early mobilization out of bed on postoperative day one, with deep vein thrombosis prophylaxis and physical therapy focusing on transfers and ambulation.

Explanation

Correct Answer: CThe case explicitly states under 'Post Operative Rehabilitation Protocols': 'The traditional paradigm of prolonged bed rest has been universally abandoned due to the unacceptable rates of deep vein thrombosis, pulmonary embolism, atelectasis, and deconditioning. Patients who have undergone rigid internal fixation are typically mobilized out of bed on postoperative day one.' It also emphasizes, 'Deep vein thrombosis prophylaxis is paramount. Mechanical prophylaxis (pneumatic compression devices) is initiated immediately. Chemical prophylaxis (e.g., Low Molecular Weight Heparin) is typically started 24 to 48 hours postoperatively...' and 'Physical therapy focuses on transfers, ambulation, and isometric core strengthening.'Option A is incorrectbecause prolonged bed rest is explicitly stated as an abandoned paradigm due to high complication rates.Option B is incorrectbecause the case states that 'the use of a Thoracolumbosacral Orthosis following surgical stabilization is highly debated... modern pedicle screw constructs offer sufficient biomechanical rigidity that bracing is often unnecessary.' While it might be used as a tactile reminder, it's not a universal requirement, and ambulation is encouraged, not restricted.Option D is incorrectbecause 'Active range of motion exercises for the spine are generally restricted until radiographic evidence of early bony union is observed, typically around the 8 to 12-week mark.'Option E is incorrectbecause chemical DVT prophylaxis is typically started 24-48 hours postoperatively, not delayed until 72 hours, to mitigate the risk of DVT/PE.

Question 1290

Topic: 1. General Principles & Basic Science

A 70-year-old male is undergoing the first stage of a two-stage exchange for an infected THA. What is the ideal antibiotic-loaded bone cement mixture for the articulating spacer?

. Low-dose (1g per 40g bag) single antibiotic
. High-dose (3-4g per 40g bag) combination of heat-stable antibiotics
. Low-dose combination of heat-sensitive antibiotics
. High-dose (8g per 40g bag) of vancomycin alone
. Intravenous antibiotics mixed directly into the cement

Correct Answer & Explanation

. High-dose (3-4g per 40g bag) combination of heat-stable antibiotics

Explanation

For an articulating spacer in a two-stage exchange, high doses of heat-stable antibiotics (e.g., 3-4g total of tobramycin and vancomycin per 40g bag of cement) are used. This provides robust local elution without fatally compromising the mechanical integrity needed for the spacer.

Question 1291

Topic: 1. General Principles & Basic Science

Tranexamic acid (TXA) is widely used in primary and revision THA. What is its primary mechanism of action in reducing surgical blood loss?

. Increases the production of platelets
. Directly stimulates the intrinsic coagulation cascade
. Competitively inhibits the activation of plasminogen to plasmin
. Promotes vasoconstriction of small arterioles
. Irreversibly inhibits cyclooxygenase

Correct Answer & Explanation

. Competitively inhibits the activation of plasminogen to plasmin

Explanation

Tranexamic acid is an antifibrinolytic agent. It competitively inhibits the activation of plasminogen to plasmin, thereby preventing the degradation of fibrin clots.

Question 1292

Topic: 1. General Principles & Basic Science

During a complex femoral revision for a well-fixed extensively porous-coated stem, the surgeon decides to perform an extended trochanteric osteotomy (ETO). What is the minimum recommended length of the ETO relative to the remaining stem or diaphyseal defect to ensure appropriate healing and fixation?

. It must be at least 15 cm long to ensure abductor mechanism preservation
. It should end exactly at the tip of the existing stem
. It must maintain at least 5 cm of intact diaphysis below the osteotomy for secure fixation of the revision stem
. It should bypass the new revision stem by 2 cortical diameters
. It must leave less than 2 cm of intact isthmus

Correct Answer & Explanation

. It must maintain at least 5 cm of intact diaphysis below the osteotomy for secure fixation of the revision stem

Explanation

To achieve a stable construct when performing an ETO, the osteotomy should allow for secure fixation of the new stem in the distal intact femur. The standard recommendation is to maintain at least 4-5 cm of diaphyseal scratch fit below the osteotomy for a non-modular stem.

Question 1293

Topic: 1. General Principles & Basic Science



A 70-year-old female undergoes acetabular revision. Preoperative radiographs demonstrate a complete disruption of the anterior and posterior columns separating the superior and inferior pelvis. Intraoperatively, the discontinuity is deemed highly mobile. What is the most reliable reconstructive technique?

. A jumbo uncemented cup with multiple screws
. Impaction bone grafting with a cemented polyethylene liner
. An isolated anti-protrusio cage spanning the defect
. A custom triflange component or cup-cage construct
. A standard hemispherical cup placed high in the ilium

Correct Answer & Explanation

. A custom triflange component or cup-cage construct

Explanation

A highly mobile pelvic discontinuity requires rigid mechanical fixation bridging the superior and inferior segments. An isolated anti-protrusio cage has high failure rates due to lack of biologic fixation; custom triflange components or a cup-cage construct offer the best long-term stability.

Question 1294

Topic: Surgical Anatomy & Approaches

A 35-year-old male sustains a comminuted midshaft humerus fracture after a motor vehicle accident. He presents with a complete radial nerve palsy (wrist drop, finger drop, thumb abduction weakness, and dorsoradial hand sensory loss). Given the fracture pattern and the need for stable fixation, the surgeon plans an open reduction and internal fixation via a posterior approach. During the surgical dissection, as depicted in the image below, which of the following statements accurately describes the critical anatomical relationship of the radial nerve in the midshaft humerus?

. The radial nerve lies anterior to the brachialis muscle, accompanied by the brachial artery.
. The radial nerve spirals obliquely from posterior to lateral across the midshaft humerus within the spiral groove, deep to the lateral head of the triceps.
. The radial nerve is found in the deltopectoral interval, superficial to the pectoralis major.
. The radial nerve pierces the medial intermuscular septum to lie anterior to the medial epicondyle.
. The radial nerve is typically located between the biceps brachii and brachialis muscles in the midshaft.

Correct Answer & Explanation

. The radial nerve spirals obliquely from posterior to lateral across the midshaft humerus within the spiral groove, deep to the lateral head of the triceps.

Explanation

Correct Answer: BThe case material explicitly states: "The most critical neurovascular structure in relation to the midshaft humerus is theradial nerve. It spirals obliquely from posterior to lateral across the midshaft humerus within the spiral (radial) groove, accompanied by the profunda brachii artery. Proximally, it lies between the medial and lateral heads of the triceps." The image provided, showing the posterior aspect of the humerus, visually reinforces this anatomical course, highlighting the nerve's vulnerability in this region and its relationship to the triceps muscle.Option A (The radial nerve lies anterior to the brachialis muscle, accompanied by the brachial artery)is incorrect. The brachial artery and median nerve are typically found anteriorly, medial to the humerus, while the radial nerve is posterior and lateral in the midshaft. The radial nerve lies deep to the brachialis and brachioradialis in the distal third of the arm, not anterior to the brachialis in the midshaft.Option C (The radial nerve is found in the deltopectoral interval, superficial to the pectoralis major)is incorrect. The deltopectoral interval is an anterior approach to the proximal humerus, and the radial nerve is not found there. The cephalic vein is typically found in this interval.Option D (The radial nerve pierces the medial intermuscular septum to lie anterior to the medial epicondyle)is incorrect. The radial nerve pierces the lateral intermuscular septum to lie anterior to the lateral epicondyle. The ulnar nerve is the one that passes posterior to the medial epicondyle.Option E (The radial nerve is typically located between the biceps brachii and brachialis muscles in the midshaft)is incorrect. The musculocutaneous nerve is found between the biceps and brachialis muscles. The radial nerve is posterior and lateral in the midshaft.

Question 1295

Topic: Surgical Anatomy & Approaches

A 28-year-old male presents with a closed midshaft humerus fracture after a direct blow. On initial examination, he has a complete radial nerve palsy. Radiographs show a simple transverse fracture with minimal displacement. The orthopedic surgeon decides to initially manage the fracture non-operatively with a functional brace. Three months later, there is no clinical or electrophysiological evidence of radial nerve recovery. Based on the case material, what is the MOST appropriate next step in managing the radial nerve palsy?

. Immediate surgical exploration of the radial nerve.
. Continue observation for another 3 months, as recovery can take up to 9-12 months.
. Initiate tendon transfers to restore wrist and finger extension.
. Order a high-resolution MRI of the humerus to assess nerve integrity.
. Prescribe a course of high-dose corticosteroids to reduce nerve inflammation.

Correct Answer & Explanation

. Immediate surgical exploration of the radial nerve.

Explanation

Correct Answer: AThe case material states: "The prevailing consensus...is that radial nerve palsy in closed humerus fractures should initially be observed. Spontaneous recovery occurs in 70-90% of cases within 3-6 months. Surgical exploration is indicated if there is no clinical or electrophysiological evidence of recovery after 3-6 months..." In this scenario, 3 months have passed with no clinical or electrophysiological recovery, placing the patient at the threshold for considering exploration. Given the lack of any recovery, immediate surgical exploration is the most appropriate next step to assess the nerve's condition (e.g., entrapment, partial laceration) and potentially perform nerve repair or grafting if indicated.Option B (Continue observation for another 3 months)is incorrect. While recovery can sometimes extend beyond 6 months, the guideline specifically states exploration is indicated if no recovery is seen after 3-6 months. Waiting longer without any signs of recovery would delay potential intervention and worsen outcomes if the nerve is transected or entrapped.Option C (Initiate tendon transfers)is incorrect as a primary next step. Tendon transfers are typically considered if recovery does not occur after 9-12 months, after nerve exploration and repair attempts have failed or are deemed not feasible.Option D (Order a high-resolution MRI)is incorrect. While MRI can visualize nerve continuity, it is not the definitive diagnostic or therapeutic step when clinical and electrophysiological studies indicate no recovery. Surgical exploration remains the gold standard for direct assessment and potential repair.Option E (Prescribe corticosteroids)is incorrect. Corticosteroids are not indicated for radial nerve palsy in this context and would not promote nerve regeneration or recovery from a mechanical injury.

Question 1296

Topic: Infection, Pharmacology & VTE

A 38-year-old male presents to the emergency department 10 hours after sustaining a laceration over the dorsum of his dominant right hand during an altercation. He admits to striking another individual in the mouth. On examination, a 1.5 cm transverse laceration is noted over the metacarpophalangeal (MCP) joint of the middle finger. There is moderate swelling, tenderness, and pain with passive flexion of the digit. Plain radiographs are obtained and show no fracture or foreign body. Given these findings, which of the following is the most appropriate next step in management?

. A. Initiate oral amoxicillin-clavulanate and discharge with instructions for warm soaks and elevation.
. B. Apply a sterile dressing, splint the hand in the intrinsic plus position, and arrange for outpatient follow-up in 24 hours.
. C. Admit for intravenous broad-spectrum antibiotics and emergent surgical irrigation and debridement with joint exploration.
. D. Perform a needle aspiration of the MCP joint for Gram stain and culture, then await results before further intervention.
. E. Close the skin laceration primarily with sutures, then start oral antibiotics.

Correct Answer & Explanation

. C. Admit for intravenous broad-spectrum antibiotics and emergent surgical irrigation and debridement with joint exploration.

Explanation

Correct Answer: CThe patient's presentation (laceration over an MCP joint after striking a mouth, pain with passive flexion, swelling, and tenderness) is highly suspicious for a 'fight bite' with potential septic arthritis of the MCP joint. Even in the absence of a visible foreign body or fracture on X-ray, the mechanism and clinical signs strongly suggest joint capsule penetration and deep infection. Emergent surgical irrigation and debridement with joint exploration is the standard of care for suspected septic arthritis or deep space infection from a human bite. This allows for thorough debridement of devitalized tissue, removal of any missed foreign bodies, and copious irrigation of the joint space. Intravenous broad-spectrum antibiotics should be initiated promptly. Oral antibiotics alone (A) are insufficient for deep infections. Discharging the patient (A, B) without definitive surgical management is dangerous and can lead to rapid joint destruction. While joint aspiration (D) can confirm septic arthritis, it should not delay definitive surgical management once clinically suspected. Primary closure of the wound (E) is contraindicated in contaminated human bite wounds due to the high risk of trapping infection.

Question 1297

Topic: Infection, Pharmacology & VTE

A 45-year-old male presents with a 3-day history of worsening pain, swelling, and redness over the dorsum of his hand following a fight. He has a small, punctate wound over the third MCP joint. X-rays show no fracture or foreign body. Examination reveals significant swelling, warmth, and exquisite pain with any passive movement of the third MCP joint. He also reports a fever of 38.8°C. Which of the following is the most appropriate empiric intravenous antibiotic regimen, assuming no known allergies?

. A. Ciprofloxacin and Rifampin
. B. Amoxicillin-clavulanate (Augmentin)
. C. Doxycycline and Metronidazole
. D. Cephalexin (Keflex) alone
. E. Vancomycin and Gentamicin

Correct Answer & Explanation

. B. Amoxicillin-clavulanate (Augmentin)

Explanation

Correct Answer: BThe patient's presentation is highly suggestive of septic arthritis of the MCP joint, a severe complication of a fight bite. Empiric intravenous antibiotics are crucial. Amoxicillin-clavulanate (Augmentin) is the first-line empiric antibiotic for human bite infections. It provides excellent broad-spectrum coverage against the characteristic polymicrobial flora of human bites, including common aerobes (Staphylococcus, Streptococcus) and anaerobes (Bacteroides, Fusobacterium, Peptostreptococcus), as well as the fastidious Gram-negative rodEikenella corrodens. Ciprofloxacin and Rifampin (A) lack adequate anaerobic coverage. Doxycycline and Metronidazole (C) also have gaps in coverage for the typical fight bite pathogens. Cephalexin (D) has good Gram-positive coverage but lacks activity against anaerobes andEikenella. Vancomycin and Gentamicin (E) are typically reserved for more severe, resistant, or nosocomial infections, with Vancomycin targeting MRSA and Gentamicin providing Gram-negative coverage, but this combination is not optimal for initial empiric human bite coverage.

Question 1298

Topic: Infection, Pharmacology & VTE

During surgical exploration of a 'fight bite' over the fifth MCP joint, purulent material is found tracking along the extensor digitorum communis tendon into the wrist. This finding is most indicative of which specific complication?

. A. Isolated cellulitis
. B. Septic arthritis of the MCP joint
. C. Tenosynovitis of the extensor tendon sheath
. D. Osteomyelitis of the fifth metacarpal head
. E. Localized abscess formation

Correct Answer & Explanation

. C. Tenosynovitis of the extensor tendon sheath

Explanation

Correct Answer: CPurulent material tracking along a tendon, especially into the wrist, is a classic sign of tenosynovitis, which is an infection of the tendon sheath. The extensor digitorum communis tendon is involved here. While other pathologies like septic arthritis (B) and osteomyelitis (D) can coexist or develop from tenosynovitis, the direct observation of pus within the tendon sheath extending proximally confirms tenosynovitis. Cellulitis (A) is a superficial soft tissue infection. A localized abscess (E) would be a circumscribed collection of pus, but its extension along a tendon sheath points specifically to tenosynovitis.

Question 1299

Topic: Infection, Pharmacology & VTE

A 60-year-old diabetic patient presents with a fight bite over the fifth MCP joint, 24 hours after injury. Clinically, there is significant erythema, swelling, and purulent discharge. He has a history of penicillin allergy (anaphylaxis). Which intravenous antibiotic combination is most appropriate for initial empiric coverage?

. A. Ampicillin-sulbactam (Unasyn)
. B. Cefazolin and Metronidazole
. C. Clindamycin and Ciprofloxacin
. D. Piperacillin-tazobactam (Zosyn)
. E. Vancomycin and Aztreonam

Correct Answer & Explanation

. C. Clindamycin and Ciprofloxacin

Explanation

Correct Answer: CGiven the patient's history of penicillin allergy (anaphylaxis), beta-lactam antibiotics like Ampicillin-sulbactam (A) and Piperacillin-tazobactam (D) are contraindicated. Cefazolin (B) is a first-generation cephalosporin, which has some cross-reactivity risk with penicillin, and when combined with Metronidazole, lacks full Gram-negative coverage for organisms likeEikenella. Clindamycin provides good coverage against anaerobes and Gram-positives (Staph/Strep). Ciprofloxacin provides good coverage against Gram-negatives, includingEikenella corrodens. This combination (Clindamycin and Ciprofloxacin) is a suitable and commonly used alternative for a penicillin-allergic patient with a severe human bite infection. Vancomycin (E) would cover MRSA and Gram-positives, and Aztreonam covers Gram-negatives includingEikenella, but this combination is often reserved for resistant organisms or specific scenarios. Clindamycin and Ciprofloxacin is a common and effective alternative.

Question 1300

Topic: Infection, Pharmacology & VTE

What is the primary differentiating feature between cellulitis and a deep-seated infection (e.g., septic arthritis) in a hand with a fight bite?

. A. The presence of redness and warmth.
. B. The patient's white blood cell count.
. C. Significant pain with passive range of motion of the affected joint, disproportionate to superficial findings.
. D. The size of the skin laceration.
. E. The duration of symptoms.

Correct Answer & Explanation

. C. Significant pain with passive range of motion of the affected joint, disproportionate to superficial findings.

Explanation

Correct Answer: CWhile redness and warmth (A), elevated WBC count (B), and duration of symptoms (E) can be present in both cellulitis and deep infections, significant pain with passive range of motion (PROM) of the affected joint, especially if disproportionate to superficial findings, is the hallmark sign differentiating a deep-seated joint infection (septic arthritis) from isolated cellulitis. Cellulitis primarily involves the superficial soft tissues, while septic arthritis directly affects the joint capsule, making any movement excruciating due to stretching of the inflamed synovium. The size of the laceration (D) is not a reliable differentiator for depth of infection.

Test Yourself

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

On this Page