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Question 4061

Topic: 10. Pathology and Oncology

A 27-year-old man sustained a nondisplaced fracture of the clavicle. The fracture is healed; however, the patient has atrophy and absent function of the clavicular head of the pectoralis major muscle. Which of the labeled structures in Figure 5 was most likely injured?

. A
. B
. C
. D
. E
. Follow-up in six months.
. AP and lateral radiographs.
. AP and lateral radiographs, and a bone scan.
. AP and lateral radiographs, and serum levels for ca, ph, and creatinine.
. AP and lateral radiographs, blood serum levels for calcium, phosphate, and creatinine, and a 24-hour urine collection for vitamin D metabolites.
. MRI scan
. Bone scan
. Arthrogram
. Axillary lateral radiograph
. CT arthrogram
. Open repair of the central slip of the extensor mechanism
. Open repair of the terminal tendon of the extensor mechanism
. Closed splinting with the proximal interphalangeal joint
. Closed splinting with the proximal interphalangeal joint in 30 degrees of flexion
. Closed splinting with the proximal interphalangeal joint in 45 degrees of flexion
. Anteriorly at 20 to 30 degrees of flexion
. Anteriorly at 70 to 90 degrees of flexion
. Posteriorly at 20 to 30 degrees of flexion
. Posteriorly at 70 to 90 degrees of flexion
. Anteriorly with the knee in full flexion
. Rett syndrome
. Cerebral palsy
. Myotonic dystrophy
. Fragile-X syndrome
. Adrenoleukodystrophy
. Endurance limit
. Failure stress
!. Critical stress
". Yield stress
#. Elastic limit
$. Ewing’s sarcoma
%. Osteogenic sarcoma
&. Multiple myeloma
'. Metastatic prostate carcinoma
(. Metastatic breast carcinoma
). Higher subsequent loosening rate of the femoral component
*. Higher subsequent polyethylene wear rate
+. Higher subsequent dislocation rate
,. Higher infection rate
-. Unaltered subsequent survival rate of the femoral component
.. Crevice corrosion
/. Oscillatory fretting
0. Oxidative degradation
1. Adhesion and abrasion
2. Fatigue and delamination
3. a total contact cast.
4. partial calcanectomy
5. Syme’s amputation
6. transtibial amputation.
7. nonweightbearing and IV antibiotics.
8. Sural artery island flap.
9. Free rectus abdominis flap.
:. Extensor digitorum brevis flap.
;. Staged cross leg flap.
<. Split-thickness skin graft.
=. An anterior cruciate functional knee brace.
>. A physical therapy program.
?. Reconstruction of the posterior cruciate ligament and the posterolateral corner.
@. Reconstruction of the posterior cruciate ligament.
A. Reconstruction of the anterior cruciate ligament.
B. Avoids the risk of marrow emboli
C. Avoids injury to the intramedullary nutrient vessels
D. Results in faster healing of fractures
E. Results in more secure fixation
F. Results in faster regeneration of the endosteal blood supply
G. Above-knee amputation
H. En bloc resection of the lesion and reconstruction with a bone graft
I. Closed reduction and immobilization in a cast
J. Open reduction and internal fixation, followed by radiation therapy
K. Open reduction, curettage, and cementing of the lesion
L. Injury to the subclavian artery
M. Injury to the brachial plexus
N. Segmental fracture
O. 100% displacement
P. Associated displaced surgical neck fracture of the humerus
Q. humeral arthroplasty2/. repair of the rotator cuff
R. closed reduction and immobilization
S. open reduction and immobilization
T. open reduction and early passive motion
U. arthroscopic capsular release
V. manipulation under anesthesia
W. a physical therapy program
X. an intra-articular corticosteroid injection
Y. administration of high-dose oral corticosteroids
Z. adding the scores, in all five body systems
[. adding the squares of the scores in the three most severely injured systems
\. doubling the cumulative score for head and chest injuries
]. combining the scores from the most and least injured systems
^. correcting the score in the most severely injured system for age
_. traumatic femoral head fracture
`. osteonecrosis
A. osteoarthritis
B. neuropathic joint
C. rheumatoid arthritis
D. low-dose radiation
E. steroid injection
F. a load-relieving insert and shoe modification
G. complete excision of the mass and the entire plantar fascia
H. wide excision of the mass with a 2 cm margin of normal fascia
I. CT scan of the chest
J. technetium bone scan
K. bone marrow aspiration
L. serum protein electrophoresis
M. lateral skull radiograph
N. high-grade histology of the initial tumor
O. multiple local recurrences after curettage
P. previous treatment of the tumor with cryotherapy
Q. previous treatment of the tumor with radiation therapy
R. extraosseous extension into two or more adjacent compartments
S. Dorsal rhizotomy and facet joint fusion
T. Multilevel corpectomy and spinal stabilization
U. Central and lateral recess decompression and bilateral foraminotomy
V. Central decompression and facet joint fusion
W. Central decompression, foraminotomy, and spinal fusion from L2 to L5.
X. Inadequate rehabilitation
Y. Displacement of the coronoid process fracture
Z. Insufficiency of the lateral ulnar collateral ligament
{. Insufficiency of the anterior band of the medial collateral ligament
|. Insufficiency of the posterior band of the medial collateral ligament
}. Osteotomy and intramedullary rod fixation
~. Electrical stimulation
. Strut-autografing the concavity the tibia
€. A patellar tendon-bearing brace
. Percutaneous injection of demineralized bone matrix
‚. digoxin
ƒ. sucralfate
„. clindamycin
…. alcohol
†. neuromuscular blocking agents
‡. Unrestrained roll-back
ˆ. Unrestrained rotational conformity
‰. Medial-Lateral conformity
Š. Anteroposterior conformity in flexion
‹. Anteroposterior conformity in extension
Œ. Arthrodesis of the MTP joint
. A Silastic implant of the MTP joint
Ž. Resection arthroplasty of the MTP joint
. Cheilctomy of the MTP joint
. Osteotomy of the base of the proximal phalanx
‘. Genu varum
’. Tarsal coalition
“. Degenerative ankle arthrosis
”. Osteochondritis dissecans of the talus
•. Hemihypertrophy of the ipsilateral lower extremity
–. Trabecular bone is preferentially resorbed in this high bone turnover state
—. Loss of water content in the disk increases impact load to the vetrebral bodies
˜. Stress is imposed by the relative stiffness of the arthrtic facet joints
™. Increased energy demands are imposed by decreased circulation to the vertebral body
š. The thick cortical bone found in the vertebral body resorbs rapidly following estrogen withdrawal
›. Increased time in stance and swing phase
œ. Addition of a double leg float phase
. Decreased vertical ground reaction forces
ž. Decreased arc of motion in the hip, knee, and ankle
Ÿ. Decreased joint reaction forces in the hip, knee, and ankle
 . Talonavicular arthrodesis
¡. Medial displacement calcaneal osteotomy
¢. Flexor digitorum longus tendon transfer with spring ligament advancement
£. Triple arthrodesis
¤. Calcaneocuboid distraction arthrodesis and repair of the posterior tibial tendon
¥. Lymphoma
¦. Hemangioma
§. Osteosarcoma
¨. TB of the spine
©. Metastatic breast carcinoma
ª. widening and shortening of the heel.
«. weakness of the gastrocnemius-soleus complex.
¬. anterior impingement from a horizontal talus.
­. unrecognized compartment syndrome of the foot.
®. degenerative arthritis of the tibiotalar joint.
¯. a corrective osteotomy
°. application of braces
±. medial physeal stapling until the varus corrects
². observation
³. application of corrective casts
´. a total contact cast.
Μ. electrical stimulation.
¶. an off the shelf fracture brace.
·. an elastic compression bandage and crutches.
¸. a hard soled shoe until the patient is asymptomatic.
¹. Ewings tumor
º. Parosteal osteosarcoma
». Dedifferentiated chondrosarcoma
¼. Low grade intramedullary chondrosarcoma
½. High grade intramedullary osteosarcoma
¾. Vascular injury
¿. Tear of the rotator cuff
À. Injury to the brachial plexus
Á. Fracture of the upper thoracic rib
Â. Fracture of the proximal humerus
Ã. Biceps
Ä. Trapezius
Å. Infraspinatus
Æ. Pectoralis major
Ç. Serratus anterior
È. Hybrid total hip arthroplasty
É. Noncemental hemiarthroplasty of the hip
Ê. Closed reduction and percutaneous pin fixation
Ë. Open reduction through an anterior approach to the hip
Ì. Excision of the head fragment
Í. a quadratus femoris pediclebone graft
Î. a proximal femoral allograft
Ï. intertrochanteric osteotomy
Ð. total hip arthroplasty
Ñ. hip hemiarthroplasty
Ò. Echocardiogram
Ó. Electrocardiogram
Ô. Radiograph of the chest
Õ. CT scan of the shoulder
Ö. Ultrasound of the shoulder
×. Ilioinguinal
Ø. Extended iliofemoral
Ù. Combined ilioinguinal and Kocher-Langenbeck (posterior)
Ú. Kocher-Langenbeck (posterior)
Û. Kocher-Langenbeck (posterior) with trochanteric osteotomy
Ü. Deltoid
Ý. Supraspinatus
Þ. Subscapularis Infraspinatus
SS. Infraspinatus
À. Infraspinatus and teres minor
Á. an orthosis.
Â. observation.
Ã. electrical stimulation.
Ä. open reduction and internal fixation.
Å. application of a nonweightbearing short leg cast.
Æ. repair of the rotator cuff.
Ç. rehabilitation of the shoulder
È. replacement of the humeral head.
É. arthroscopic acromioplasty and debridement.
Ê. immobilization is a sling until pain resolves.
Ë. Bone rotation versus torque applied
Ì. Bone deflection versus bending moment applied
Í. Axial displacement versus tension applied
Î. Lateral translation versus shear force applied
Ï. Fracture gap closing versus compressive force applied
Ð. steroid injection
Ñ. stretching of the heel cord
Ò. surgical release of the plantar fascia
Ó. application of a short leg cast for 6 to 8 weeks
Ô. wearing dorsiflexion night splints
Õ. Open bladder
Ö. Bilateral “hitchhiker’s” thumbs
÷. Bilateral defects in the midclavicles
Ø. Rhizomelic shortening of the extremities
Ù. Radiographic fragmentation of all major epiphyses
Ú. Medial patellotibial
Û. Medial patellofemoral
Ü. Medial patellomeniscal
Ý. Lateral patellofemoral
Þ. Lateral patellotibial
Ÿ. Heat
Ā. Gentle active flexion-extension exercises
Ā. Isokinetic strengthening
Ă. Electrical muscle stimulation
Ă. Immobilization of the limb with the knee in full flexion
Ą. Distal chevron osteotomy with soft-tissue release
Ą. Distal soft-tissue realignment only
Ć. Closing wedge osteotomy (Aken) of the proximal phalanx
Ć. Proximal first metatarsal osteotomy only
Ĉ. Soft-tissue realignment with a proximal metatarsal osteotomy
Ĉ. Vagus
Ċ. Phrenic
Ċ. Hypoglossal
Č. Recurrent laryngeal
Č. Inferior thyroid
Ď. Surgical exploration
Ď. Application of leeches
Đ. Stellate ganglion blocks
Đ. Intra-arterial streptokinase
Ē. Elevation and reevaluation in 1 hour
Ē. Liver profile
Ĕ. Myleogram
Ĕ. Platelet count
Ė. CT scan of the head
Ė. Angiogram of the extremity
Ę. Post spinal fusion from L5to S1
Ę. Primary repair with an iliac bone graft
Ě. Post spinal fusion of L4-5
Ě. A pantaloon body cast and 6 weeks of bed rest
Ĝ. Rest, NSAIDS, and limited dancing
Ĝ. Stress fracture of the proximal fifth metatarsal
Ğ. Stress fracture of the base of the second metatarsal
Ğ. Stress fracture of the neck of the second metatarsal
Ġ. Morton’s neuroma
Ġ. Lisfranc’s joint subluxation
Ģ. C5 radiculopathy
Ģ. Subscapularis rupture
Ĥ. Glenohumeral arthrosis
Ĥ. Rotator cuff arthropathy
Ħ. Suprascapular nerve compression at the spinoglenoid notch
Ħ. mm femoral head in combination with a metal-backed polyethylene component
Ĩ. mm femoral head in combination with an all-polyethylene acetabular component
Ĩ. mm femoral head in combination with a metal-backed polyethylene component
Ī. mm femoral head in combination with an all-polyethylene component
Ī. mm femoral head in combination with a metal-backed polyethylene component
Ĭ. Female gender
Ĭ. History of cigarette smoking
Į. L5-S1 spondylolisthesis on pre-employment radiography
Į. Decreased strength of the lower extremities on pre-employment testing
İ. Decreased flexibility of the lumbar spine on pre-employment testing
I. Size of cells
IJ. Amount of DNA in cells
IJ. Nucleus-cytoplasm ratio
Ĵ. Specific DNA sequences
Ĵ. Specific messenger RNA sequences
Ķ. Femoral and obturator nerves
Ķ. Femoral and superior gluteal nerves
ĸ. Femoral and lateral femoral cutaneous nerves
Ĺ. Obturator and superior gluteal nerves
Ĺ. Obturator and lateral femoral cutaneous nerves
Ļ. Isotonic
Ļ. Isokinetic
Ľ. Isometric
Ľ. Open kinetic chain
Ŀ. Dynamic variable resistance
Ŀ. Closed reduction and cast immobilization
Ł. Uniplanar external fixation
Ł. Open reduction and internal fixation with a dynamic compression plate
Ń. Unreamed intramedullary rod
Ń. Multiple plane external fixator
Ņ. Inlet view of the pelvis
Ņ. Outlet view of the pelvis
Ň. AP view of the hip
Ň. Ilial oblique view (external oblique) of the hip
ʼN. Obturator oblique
Ŋ. Glycolytic pathway
Ŋ. Oxidative phosphorylation
Ō. Breakdown of fat
Ō. Breakdown of protein
Ŏ. Breakdown of adenosine triphosphate
Ŏ. an MRI scan
Ő. arthroscopic examination
Ő. AP and frog-lateral radiographs of the pelvis and hips
Œ. varus and valgus stress radiographs of the knee
Œ. physical examination of the knee under anesthesia
Ŕ. extended curettage and polymethylmethacrylate cementation
Ŕ. extra-articular resection of the knee and an allograft arthrodesis
Ŗ. wide resection of the proximal tibia and custom prosthetic replacement
Ŗ. prophylactic internal fixation and postoperative irradiation
Ř. excision of the lateral condyle and reconstruction with a hemicondylar allograft
Ř. silicone implant joint replacement
Ś. metatarsophalangeal joint arthrodesis
Ś. metatarsophalangeal joint debridement
Ŝ. resection of the metatarsal head
Ŝ. resection of the base of the proximal phalanx
Ş. Fixation of the syndesmosis has failed
Ş. Widening of the ankle mortise has led to the failure of fixation
Š. Infection around the syndesmosis screw has led to osteomyelitis
Š. The syndesmosis screw is broken
Ţ. Motion between the tibia and fibula has caused loosening of the syndesmosis screw
Ţ. Microcephaly
Ť. A temporal lobe cyst
Ť. An Arnold-Chiari type 1 malformation
Ŧ. Periventricular leukomalacia
Ŧ. Agnesis of the corpus callosum
Ũ. Wolff’s
Ũ. Hooke’s
Ū. Hilton’s
Ū. Muller-Haeckel
Ŭ. Heuter-Volkmann
Ŭ. Both the anterolateral and posteromedial bands are isometric and do not significantly change with flexion
Ů. The anterolateral band is lax and becomes tight in flexion, while the posteromedial band is tight, and becomes lax in flexion
Ů. The anterolateral band is tight and becomes lax in flexion, while the posteromedial band is lax and becomes tight in flexion
Ű. Both the anterolateral and posteromedial bands are lax and become tight in flexion
Ű. Both the anterolateral and posteromedial bands are tight and become lax as the knee is flexed
Ų. UCB orthosis
Ų. Rigid orthosis with a medical arch support
Ŵ. Semi-rigid orthosis with lateral forefoot posting
Ŵ. Semi-rigid orthosis with a medial arch support
Ŷ. Medial heel wedge attached to the running shoes
Ŷ. Hallux varus
Ÿ. Osteonecrosis
Ź. Recurrence of the hallux valgus
Ź. “Transfer” second metatarsalgia
Ż. Physeal arrest of the first metatarsal
Ż. Aseptic loosening in a 70-year-old patient
Ž. Mechanical failure of a hinged knee prosthesis
Ž. Failed knee replacement complicated by reflex sympathetic dystrophy
S. Infection with soft-tissue deficit
Ƀ. A prior patellectomy
Ɓ. Knee fusion
Ƃ. Open irrigation and debridement
Ƃ. Arthroscopic irrigation and debridement
Ƅ. One-stage exchange arthroplasty
Ƅ. Two-stage exchange arthroplasty
Ɔ. Putti-platt repair
Ƈ. Open Bankart repair
Ƈ. Injection of a subacromial corticosteroid
Ɖ. Arthroscopic transglenoid capsular shift
Ɗ. Rehabilitation of the scapular and rotator cuff muscles
Ƌ. Silicone suction socket and an energy-absorbing foot
Ƌ. Silicone suction socket and a variable resistance ankle
ƍ. Plastic suction socket, telescoping pylon, and a solid ankle cushioned heel (SACH) foot
Ǝ. Plastic socket with a hinged thigh cuff and a SACH foot
Ə. Patellar tendon-bearing suction socket and a uniaxial hydraulic ankle
Ɛ. Parosteal
Ƒ. Periosteal
Ƒ. High-grade intramedullary
Ɠ. Osteosarcoma occurring in Paget’s disease
Ɣ. Osteosarcoma occurring in irradiated bone
Ƕ. Cauda equina
Ɩ. Conus medullaris
Ɨ. Genitofemoral nerve
Ƙ. Lumbar sympathetic plexus
Ƙ. Lumbar parasympathetic plexus
Ƚ. Spinal pseudoarthrosis
ƛ. Spinal cord traction injury with paralysis
Ɯ. Arterial and venous thromboses
Ɲ. Superior mesenteric artery syndrome
Ƞ. Crankshaft phenomenon
Ɵ. Inversion stress radiograph
Ơ. MRI scan
Ơ. CT scan
Ƣ. Nuclear bone scan
Ƣ. External rotation stress radiograph
Ƥ. Complex deformity with an angulation in two planes
Ƥ. Single deformity less than 20 degrees, apex posterolateral
Ʀ. Single deformity greater than 30 degrees, apex posterolateral
Ƨ. Single deformity less than 20 degrees, apex posteromedial
Ƨ. Single deformity greater than 30 degrees, apex posteromedial
Ʃ. Pronation of the foot during the stance phase of gait
ƪ. Heel inversion at the beginning of a single limb heel rise
ƫ. Active inversion of the nonweightbearing foot
Ƭ. Active plantar flexion of the first ray against resistance
Ƭ. Active plantar flexion of the foot during the push-off phase of gait
Ʈ. Observation and repeat radiographs in 4 months
Ư. Application of a thoracolumbalsacral orthosis for 22 to 24 hours per day
Ư. Electrical stimulation at night
Ʊ. Physical therapy
Ʋ. Begins to remodel and hypertrophy more quickly
Ƴ. Provides a better scaffold for osteoconduction
Ƴ. Reduces the risk of early fracture
Ƶ. Reduces technical difficulty
Ƶ. Lowers donor site morbidity
Ʒ. Anterior fusion of the lumbar curve
Ƹ. Anterior and posterior fusion of the thoracic curve
Ƹ. Posterior fusion of the thoracic curve
ƺ. Posterior fusion of the thoracic and lumbar curves
ƻ. Application of a brace until the iliac apophyses are Risser 4 or 5, followed by surgical correction
Ƽ. Subscapularis rupture
Ƽ. Type III SLAP lesion
ƾ. Disruption of capsular shift
Ƿ. Isolated traumatic subluxation
ǀ. Injury to the axillary nerve after dislocation
ǁ. hypophosphatemia
ǂ. high dietary cholesterol intake
ǃ. deficiency of lipoprotein A
DŽ. deficiency of protein S and protein C
DŽ. elevated levels of antithrombin III
DŽ. Weightbearing short leg cast
LJ. Nonweightbearing short leg cast
LJ. Removable splint and early motion
LJ. Open reduction and internal fixation
NJ. Elastic compression bandage with full weightbearing
NJ. Breast
NJ. Prostate
Ǎ. Gastrointestinal
Ǎ. Kidney
Ǐ. Multiple myeloma
Ǐ. Varus stress
Ǒ. Valgus stress
Ǒ. Torsional loading
Ǔ. Hyperextension of the knee
Ǔ. Contraction of the quadriceps while axially loaded
Ǖ. Primary internal fixation at both fracture levels
Ǖ. External fixation as definitive ttt for both #
Ǘ. Skeletal traction and delayed internal fixation of both fractures
Ǘ. Primary internal fixation of the proximal fracture and delayed fixation of the femoral fracture
Ǚ. Primary internal fixation of the femoral shaft fracture and delayed fixation of the proximal #
Ǚ. Heel spur
Ǜ. Plantar fascitis
Ǜ. Dysfunction of the tibialis posterior tendon
Ǝ. Compression of the first branch of the lateral plantar nerve
Ǟ. Compression of the calcaneal nerve
Ǟ. Displaced labral tear
Ǡ. Tear of the rotator cuff
Ǡ. Fracture of the glenoid rim
Ǣ. Palsy of the axillary nerve
Ǣ. Palsy of the musculocutaneus nerve
Ǥ. Enchondroma
Ǥ. Osteoblastoma
Ǧ. Giant cell tumor
Ǧ. Aneurysmal bone cyst
Ǩ. Fibrous dysplasia
Ǩ. Arthrogram of the wrist
Ǫ. MRI scan of both wrists
Ǫ. CT scan of both wrists in the same position
Ǭ. Radiographs of the wrist in supination and pronation
Ǭ. Radiographs of the opposite wrist in the same position
Ǯ. Secondary hyperparathyroidism
Ǯ. Phosphate retention secondary to uremia
J̌. Insufficient renal synthesis of 1, 25 dihydroxy vitamin D
DZ. Aluminum deposition in bone from oral phosphate binders
DZ. Persistent acidosis aggravating the negative calcium balance
DZ. Posterior fusion at T10-L3 with segmental instrumentation
Ǵ. Laminectomy and fusion of T12-L2 with segmental instrumentation
Ǵ. Bed rest in a hyperextension brace
Ƕ. L1 vertebrectomy and anterior decompression with strut graft fusion and instrumentation
Ƿ. Progressive ambulation as tolerated in a custom-molded thoracolumbosacral orthosis
Ǹ. Positive-pressure ventilation
Ǹ. An immediate radiograph of the chest
Ǻ. Adjustment of the position of the endotrachael tube
Ǻ. Insertion of a large-bore needle into the pericardial space
Ǽ. Insertion of a large-bore needle in the right second intercostal space, midclavicular line
Ǽ. Allowing the ends of the fracture to touch
Ǿ. Adding a second connecting bar
Ǿ. Adding one pin to each fracture fragment
Ȁ. Increasing the pin diameter from 4 mm to 6 mm
Ȁ. Decreasing the connecting bar-to-bone distance from 6 cm to 4 cm
Ȃ. Osteomyelitis
Ȃ. Malignant degeneration
Ȅ. Stress fracture
Ȅ. Local recurrence of the giant cell tumor
Ȇ. Bone resorption due to methylmethacrylate
Ȇ. Advancement of the plantar plate
Ȉ. Resection of the second metatarsal head
Ȉ. Dorsiflexion osteotomy of the second metatarsal neck
Ȋ. Transfer of the flexor digitorum longus tendon to the dorsum of the toe
Ȋ. Transfer of the extensor digitorum comminus tendon to the metatarsal neck
Ȍ. Sacral fracture
Ȍ. Burst fracture of L5
Ȏ. Cauda equina syndrome
Ȏ. Distraction-flexion injury at L3
Ȑ. Distraction-extension injury at L3
Ȑ. An MRI scan of the shoulder
Ȓ. An MRI scan of the cervical spine
Ȓ. Electromyographic and nerve conduction velocity studies
Ȕ. Immobilization in a sling and early passive range of motion exercises
Ȕ. Immediate return to the operating room for exploration of the brachial plexus
Ȗ. cerclage wiring
Ȗ. tension band wiring
Ș. removal of the patellar component
Ș. revision of the patellar component
Ț. immobilization of the knee and protected weightbearing
Ț. Liposarcoma
Ȝ. Nodular fasciitis
Ȝ. Rabdomyosarcoma
Ȟ. Malignant fibrous histiocytoma
Ȟ. Extra-abdominal desmoid tumor
Ƞ. Clubfeet
ȡ. Thrombocytopenia
Ȣ. Congenital scoliosis
Ȣ. Ventricular septal defect
Ȥ. Arnold-Chiari malformation
Ȥ. delayed primary closure
Ȧ. free flap
Ȧ. pedicle groin flap
Ȩ. full-thickness skin graft
Ȩ. split-thickness skin graft
Ȫ. Infection
Ȫ. Nonunion
Ȭ. Improper screw length
Ȭ. Osteonecrosis of the distal fragment
Ȯ. Use of a cortical screw instead of a cancellous screw
Ȯ. Infection
Ȱ. Tear of the rotator cuff
Ȱ. Loosening of the humeral component
Ȳ. Arthritis of the glenoid
Ȳ. Arthritis of the A-C joint
ȴ. Reduced morbidity
ȵ. Improved osteoinduction
ȶ. Improved osteoconduction
ȷ. More rapid revascularization
ȸ. Lower risk of disease transmission
ȹ. Manipulation Under Anesthesia
Ⱥ. Arthroscopic acromioplasty
Ȼ. Arthroscopic debridement of G-H joint
Ȼ. Replacement of the humeral head
Ƚ. Lengthening of the subscapularis and release of the anterior capsule
Ⱦ. Bacteroides
Ȿ. E. coli
Ɀ. Staph. aureus
Ɂ. group A streptococcus
Ɂ. Clostridium perforingens
Ƀ. observation and exercises
Ʉ. bracing with a thoracolumbar orthosis
Ʌ. fusion of the posterior spine
Ɇ. fusion of the anterior spine
Ɇ. fusion of the anterior and posterior spine
Ɉ. Total wrist replacement and bridge grafts
Ɉ. palmar shelf arthroplasty and tendon transfers
Ɋ. Darrach distal ulna resection, dorsal tenosynosynovectomy, and tendon transfers
Ɋ. Radioscaphate fusion, extensor tenodesis, and Darrach distal ulna resection
Ɍ. Total wrist fusion and tendon transfers
Ɍ. constrained acetabular component
Ɏ. protrusion ring with morselized graft
Ɏ. cemented metal backed acetabular component
Ɐ. cemented all-polyethylene acetabular component
Ɑ. cementless hemispherical component with screw fixation
Ɒ. application of a hip abduction brace for 22 hours per day
Ɓ. application of a hip spica under anesthesia
Ɔ. discontinuance of all bracing and repeat radiographs in 3 months
ɕ. open reduction of the hip and application of a spica cast
Ɖ. open reduction, varus osteotomy, and application of a spica cast
Ɗ. Loss of skin hair on the feet
ɘ. Absent pulses on vascular examination
Ə. Pain that originates proximally and spreads distally
ɚ. Pain that is relieved by stopping and standing
Ɛ. Pain that is worse when the patient walks uphill rather downhill
Ɜ. wrist flexors and finger flexors
ɝ. elbow flexors and wrist flexors
ɞ. elbow flexors and finger flexors
ɟ. elbow extensors and wrist flexorst Level Key Muscles4 DiaphragmDeltoid, elbow flexors, diaphragmElbow flexors, wrist extensorsElbow extensors, wrist flexorsFinger flexors (distal phalanx of middlefinger)Finger abductors (5th digit), intrinsics of hand2 Segmental innervation to intercostal muscles, abdominal and paraspinal muscles) L1, L2, L3 Hip flexors3, L4 QuadricepsTibialis anteriorToe extensors, hip abductorsAnkle plantarflexors, peronei
Ɠ. elbow extensors and wrist extensors
Ɡ. Syndactyly
ɢ. Macrodactyly
Ɣ. Camptodactyly
ɤ. Preaxial polydactyly
Ɥ. Postaxial polydactyly
Ɦ. Arthrodesis
ɧ. Rotationplasty
Ɨ. Above-knee amputation
Ɩ. Osteoarticular allograft
Ɪ. Endoprosthesis (custom arthroplasty)
Ɫ. Plantar fascia
Ɬ. Spring ligament
ɭ. Deltoid ligament
ɮ. Intrinsic tendons
Ɯ. Gastorcnemius-solelus complex
ɰ. Prevention of presynaptic release of acetylcholine
Ɱ. Prevention of synthesis of presynaptic acetylcholine
Ɲ. Activation of acetylcholinesterase at the motor end-plate
ɳ. Blockage of postsynaptic action of acetylcholine until reserves are depleted
ɴ. Stimulation of release of presynaptic acetylcholine until reserves are depleted
Ɵ. stiffness of the femoral component.
ɶ. head offset of the femoral component.
ɷ. femoral component material modulus of elasticity.
ɸ. extent of the femoral component porous coating.
ɹ. Presence of a femoral component collar.
ɺ. plantar fascia and quadratus plantae tendon.
ɻ. ligamentous structures connecting the tarsal bones.
ɼ. shape of the tarsal bones and the intervening joints.
Ɽ. activity of the intrinsic muscles of the foot.
ɾ. activity of the posterior tibialis and the peroneus longus muscles.
ɿ. scapulothoracic fusion
Ʀ. strengthening of the periscapular muscles
ʁ. pectoralis minor-fascia lata graft transfer to the scapula
Ʂ. pectoralis major-fascia lata graft transfer to the scapula
Ʃ. exploration of the long thoracic nerve, with sural nerve graft
ʄ. tricompartmental knee replacement
ʅ. unicompartmental knee replacement
ʆ. medial compartment meniscal allograft
Ʇ. valgus-producing distal femoral osteotomy
Ʈ. valgus-producing proximal tibial osteotomy
Ʉ. Internal rotation of the femoral component
Ʊ. External rotation of the tibial component
Ʋ. Lateral placement of the femoral component
Ʌ. Medial placement of the patellar component
ʍ. Excessive resection of the patella
ʎ. Hallux rigidus
ʏ. Hallux valgus
ʐ. Neuroma of the first web space
ʑ. Fracture of the sesamoid
Ʒ. Rupture of the flexor hallucis longus
ʓ. Sickle cell crisis
ʔ. Idiopathic chondrolysis
ʕ. Hemophilic arthropathy
ʖ. Osteoid osteoma of the femoral neck
ʗ. Legg-Calve-Perthes disease
ʘ. Decreased ankle jerk and positive femoral nerve stretch test
ʙ. Decreased knee jerk and positive straight-leg raising sign
ʚ. Gastrocnemius-soleus complex weakness and positive straight-leg raising sign
ʛ. Weakness of the extensor hallucis longus and positive straight-leg raising sign
ʜ. Weakness of the extensor hallucis longus and positive femoral nerve stretch test
Ʝ. Long-term administration of IV and oral antibiotics
Ʞ. Open soft-tissue debridement, retention of prosthetic components, and IV antibiotics
ʟ. Immediate exchange arthroplasty with antibiotic-impregnated cement
ʠ. Two-stage surgical prosthetic exchange and IV antibiotics
ʡ. Resection arthroplasty and IV antibiotics
ʢ. SCFE
ʣ. MED
ʤ. Perthes disease
ʥ. Hypothyroidism
ʦ. Chondrolysis
ʧ. gout.
ʨ. osteoporosis.
ʩ. eosinophilic granuloma.
ʪ. tuberculosis of the spine.
ʫ. metastatic disease of the spine.
ʬ. water content.
ʭ. Synthesis of type I collagen.
ʮ. Proteoglycan content.
ʯ. Activity of chondrocytes.
ʰ. Synthesis of hyaluronate.
ʱ. Lung
ʲ. Breast
ʳ. Prostate
ʴ. Thyroid
ʵ. Renal
ʶ. T1-low, T2-low.
ʷ. T1-low, T2-high.
ʸ. T1-moderate, T2-low.
ʹ. T1-high, T2-low.
ʺ. T1-high, T2-high.
ʻ. hypothesis is incorrect or invalid
ʼ. interobserver error rate is 4%.
ʽ. Standard deviation is 4% higher or lower than the mean.
ʾ. Sample size is 4% larger than required to be clinically significant.
ʿ. Probability that the differences noted between two study groups were due to chance alone is 4%.
ˀ. I
ˁ. II
˂. IV
˃. IX
˄. X
˅. Cranial setting
ˆ. Cranial subluxation
ˇ. Odontoid fracture
ˈ. Lysis of the arch of the atlas
ˉ. Atlantoaxial subluxation
ˊ. Retrograde collapse of the endoneurial tubes
ˋ. Irreversible atrophy of the denervated muscles
ˌ. Elongation of the axons across the zone of injury
ˍ. Sprouting of the axons at the neuromuscular junction
ˎ. Misdirection of the axons across the zone of injury
ˏ. Maximally pronated and elbow extended
ː. Maximally pronated and the elbow flexed
ˑ. Maximally supinated and the elbow flexed
˒. Maximally supinated and the elbow extended
˓. In neutral rotation, with the elbow extended
˔. open reduction and internal fixation
˕. buddy taping to the adjacent index finger
˖. early motion with application of a dynamic banjo splint
˗. application of a cast with the hand in a “safe position” for 3 weeks.
˘. dorsal extension block splinting
˙. The name of the manufacturer
˚. The manufacturer’s potential liability
˛. The physician’s clinical performance
˜. The physician’s materials testing data
˝. Any royalties the physician receives from the manufacturer
˞. Femoral
˟. Obturator
ˠ. Inferior gluteal
ˡ. Superior gluteal
ˢ. Lateral femoral cutaneous
ˣ. open biopsy and a long leg cast
ˤ. open biopsy and wide resection of the tumor
˥. a long leg cast and observation
˦. intramedullary stabilization and observation
˧. Triggering
˨. Lateral instability
˩. Swan-neck deformity
˪. Boutonniere deformity
˫. Loss of distal interphalangeal joint flexion
ˬ. Peroneus brevis to peroneus longus
˭. Peroneus tertius to extensor hallucis longus
ˮ. Peroneus tertius to superficial peroneal nerve
˯. Extensor hallucis longus to deep peroneal nerve
˰. Extensor hallucis longus to extensor digitorum longus
˱. reassurance that Medicare will pay for the treatment.
˲. consent forms that patients or their guardians are able to understand.
˳. a detailed description of the device, omitting the fact that it is part of a study.
˴. a provision that the patient’s care will be discontinued if he or she does not enroll in the study.
˵. a provision that the study will be carried out to completion, whether or not the device is as effective as those currently in existence.
˶. an onlay iliac crest bone graft.
˷. limited weightbearing and observation.
˸. removal of the implant and limited weightbearing.
˹. removal of the implant and insertion of a reamed femoral nail.
˺. removal of the implant and insertion of an unreamed femoral nail.
˻. Coronal
˼. Sagittal
˽. Anteromedial, midway between the sagittal and the coronal
˾. Proximal pins sagittal, distal pins coronal
˿. Proximal pins coronal, distal pins sagittal
̀. Rheumatoid arthritis
́. Posttraumatic arthritis
̂. Degenerative osteoarthritis
̃. Osteonecrosis of the tibial plateau
̄. Osteonecrosis of the medial femoral condyle
̅. Trapeziometacarpal arthrodesis
̆. Osteotomy of the thumb metacarpal
̇. Arthrotomy and joint debridement
̈. Ligament reconstruction using one half of the flexor carpi radialis
̉. Trapezium resection, tendon interposition, and reconstruction of the ligament
̊. Creep
̋. Relaxation
̌. Energy dissipation
̍. Plastic deformation
̎. Elastic deformation
̏. bending
̐. axial loading
̑. high-speed rotation
̒. direct impact from anteromedial
̓. crush from anteromedial to posterolateral
̔. Increase stiffness
̕. Increase fracture toughness
̖. Increase fatigue strength
̗. Decrease mechanical strength
̘. Decrease wear rate
̙. disuse osteopenia
̚. paraendocrine effect of the tumor
̛. abnormally increased density on the right side
̜. side effect of the treatment of the lesion
̝. extensive tumor involvement of the left hip
̞. Sciatic nerve
̟. Superior gluteal artery
̠. Profunda femoris artery
̡. Femoral artery and nerve
̢. External iliac artery and vein
̣. Length
̤. Moment arm
̥. Total volume
̦. Physiologic cross-sectional area
̧. Distribution of slow and fast twitch fibers
̨. decreasing initiation of action potentials.
̩. increasing action potential amplitude.
̪. blocking the opening of gated sodium channels.
̫. decreasing the number of functional motor units.
̬. slowing or stopping action potential propagation through the axon.
̭. resection of the metatarsal heads of the first through fifth toes.
̮. Silastic MP joint arthroplasties of the first through fifth toes.
̯. fusion of the hallux MP joint and resection arthroplasty of the 2nd through fifth metatarsal heads.
̰. fusion of hallux MP joint and distal osteotomy of the 2nd through 5th MT.
̱. plantar condylectomy of the 2nd through 5th MT heads & resection of proximal phx of the hallux.
̲. hemiarthroplasty
̳. open reduction and internal fixation
̴. closed reduction and percutaneous pinning
̵. a sling and early pedulum exercises
̶. a sling and swathe for 6 weeks, followed by shoulder rehabilitation
̷. open acromioplasty
̸. open Bankart repair
̹. open subscapularis tendon repair
̺. inferior capsular shift
̻. a supervised physical therapy program
̼. a sling and swathe, with pendulum exercises in 10 days
̽. open reduction and internal fixation through an anterior approach
̾. open reduction and internal fixation through a posterior approach
̿. immobilization with a splint in 45 degrees of abduction for 6 weeks
̀. arthroscopically assisted reduction and percutaneous screw fixation
́. Repair of the rotator cuff
͂. Replacement of the humeral head
̓. Resection arthroplasty
̈́. Total shoulder arthroplasty
Ι. AP and lateral radiographs of the elbow
͆. Diagnositc arthroscopy
͇. Aspiration of joint fluid
͈. An erythrocyte sedimentation rate and CBC
͉. A diagnostic lidocaine injection
͊. Insulin-like growth factor (IGF-1)
͋. Fibroblast growth factor (FGF-1)
͌. Platelet-derived growth factor (PDGF)
͍. Transforming growth factor beta (TGF-B)
͎. Bone morphogenetic proteins (BMP)
͏. clinical history and radiographic findings.
͐. technetium bone scan
͑. flow cytometry pattern of extracted chondrocytes
͒. immunohistochemical staining patterns of a biopsy specimen
͓. histologic features of a biopsy specimen stained with hematoxylin-cosin
͔. Radial
͕. Radial recurrent
͖. Posterior interosseous
͗. Superior ulnar recurrent
͘. Superficial radial circumflex
͙. Impaired hydroxylation of proline
͚. Failure of cleavage in procollagen
͛. Defective binding sites for hydroxyproline
͜. Failure to incorporate glycine into the helix
͝. Diminished production of collagen through the rough endoplasmic reticulum
͞. Asking the legal staff to seek a court injunction
͟. Copying the patient’s chart and giving it to him as he leaves
͠. Having the patient sign a written legal contract that specifies acceptable behavior
͡. Continuing care of the patient until an appropriate referral can be arranged
͢. Transferring the patient to another orthopaedic surgeon without disclosing the realreason for why the patient is being transferred
ͣ. Meta-analysis
ͤ. Confidence interval
ͥ. Analysis of variance (ANOVA)
ͦ. Statistical significance (p-value)
ͧ. Survivorship analysis (Kaplan-Meier)
ͨ. Spinal shock
ͩ. Neurogenic shock
ͪ. Hypovolemic shock
ͫ. Pulmonary embolism
ͬ. Fat embolus syndrome
ͭ. Lumbar spinal stenosis
ͮ. Metastatic disease of the spine
ͯ. Rheumatoid lumbar spondylitis
Ͱ. Isthmic spondyloloisthesis
Ͱ. Degenerative spondylolisthesis at L4-5 and L5-S1
Ͳ. Patella alta
Ͳ. A metal-backed patella
ʹ. Varus malalignment of the knee
͵. A posterior cruciate-substituting femoral component
Ͷ. Lateral subluxation of the patella on a Merchant’s view
Ͷ. The sesamoids are separated
͸. The sesamoid is fractured
͹. The proximal phx is on the neck of the metatarsal
ͺ. The dislocation is dorsal and centered
Ͻ. The proximal phalanx is hyperextended
Ͼ. Patella
Ͽ. Tibial stem
;. Distal femoral interface
Ϳ. Posterior femoral interface
΀. Sites of screw fixation for the tibia
΁. Hallux rigidus
΂. Fracture of the sesamoid
΃. Disruption of the plantar plate
΄. Osteonecrosis of the metatarsal head
΅. Rupture of the flexor hallucis longus
Ά. Gout
·. Sepsis
Έ. Old trauma
Ή. Rheumatoid arthritis
Ί. Charcot arthroplasty
΋. Aspiration and steroid injection
Ό. Biopsy, curettage, and allograft bone grafting
΍. Percutaneous Kirschner wire fixation
Ύ. Percutaneous injection of autogenous bone marrow
Ώ. Nerve roots
Ϊ́. Spinal cord
Α. Sciatic nerve
Β. Peroneal nerve
Γ. Conus medullaris
Δ. Extent of bone penetrated by reaming, prosthetic components, or acrylic cement
Ε. Periprosthetic regions that are accessible to joint fluid and particulate wear debris
Ζ. Enveloping pseudocapsular scar tissue that develops around a prosthetic hip following surgical capsulectomy
Η. Soft tissue and bone that are potentially contaminated with bacteria in the setting of a prosthetic joint infection
Θ. Potential intrapelvic joint space communication created by acetabular fixation screws or intrapelvic extruded acrylic cement
Ι. Early and late infection
Κ. Periprosthetic fracture of the femur
Λ. Failure of the patellofemoral and extensor mechanisms
Μ. Aseptic loosening of cementing tibial components
Ν. Asceptic loosening of cemented femoral components
Ξ. Acceptance of the current position of the ankle
Ο. Open reduction and fixation in the epiphysis only
Π. ORIF with a small-fragment T-plate from the malleolus up to the metaphysis
Ρ. Closed reduction by eversion of the ankle and application of a bivalved long leg cast
΢. CRUGA and fixation with a malleolar screw from the malleolus into the metaphysis
Σ. Resection arthroplasty and local radiation
Τ. In situ fusion of the hip
Υ. Excision of heterotopic bone, total hip arthroplasty, and oral indomethacin
Φ. Excision of heterotopic bone and local radiation
Χ. Excision of heterotopic bone, hemiarthroplasty, and oral indomethacin
Ψ. Closed reduction of both fractures and immediate spica casting
Ω. Bilateral skin traction for 3 weeks, followed by spica casting
Ϊ. External fixation of both femora
Ϋ. External fixation of the left femur and a long leg cast brace for the right femur
Ά. External fixation of the left femur and use of a reamed intramedullary nail in the right femur
Έ. Synovial sarcoma
Ή. Soft-tissue abcess
Ί. Rhabdomyosarcoma
Ϋ́. Eosinophilic granuloma
Α. Nodular pigmented villonodular synovitis
Β. Changing to a titanium nail
Γ. Changing to a nonslotted nail
Δ. Changing the cross-sectional shape of the nail
Ε. Increasing the diameter of the nail by 3 mm
Ζ. Increasing the diameter of the interlocking screws
Η. Fracture healing
Θ. Chondrosarcoma
Ι. Periosteal chondroma
Κ. Periosteal osteosarcoma
Λ. Dysplasia epiphysealis hemimelica
Μ. Demonstrate competence in the subject of the case
Ν. Be fellowship trained in the subject of the case
Ξ. Be paid on a contingency basis
Ο. Be board certified by the American Board of Orthopaedic Surgery
Π. Have been involved in the case as a consultant
Ρ. Diagnostic arthroscopy
Σ. Arthroscopy and subacromial decompression
Σ. Reduction and fixation of the proximal humeral epiphysis
Τ. Temporary cessation of throwing
Υ. Physical therapy for rotator cuff strengthening
Φ. Oblique popliteal ligament
Χ. Lateral capsule
Ψ. Popliteal tendon
Ω. Fibular collateral ligament
Ϊ. Posterior oblique ligament
Ϋ. Radial tear
Ό. Parrot-beak tear
Ύ. Vertical tear in the “red-red” zone
Ώ. Vertical tear in the “red-white” zone
Ϗ. Vertical tear in the “white-white” zone
Β. 0 degrees of abduction, with neural rotation
Θ. 40 degrees of flexion and 60 degrees of internal rotation
ϒ. 45 degrees of flexion and 45 degrees of external rotation
ϓ. 90 degrees of abduction with neutral rotation
ϔ. 90 degrees of abduction and 90 degrees of external rotation
Φ. Sural
Π. Saphenous and its branches
Ϗ. Posterior tibial and its branches
Ϙ. Deep peroneal and its branches
Ϙ. Superficial peroneal and its branches
Ϛ. Strength
Ϛ. Stiffness
Ϝ. Shelf life
Ϝ. Antigenicity
Ϟ. Risk of HIV transmission
Ϟ. Indemnification
Ϡ. Occurrence
Ϡ. Excess liability
Ϣ. Claims-made
Ϣ. Nose
Ϥ. Lateral Y
Ϥ. Scapular AP
Ϧ. Neutral rotation AP
Ϧ. Internal rotation AP
Ϩ. External rotation AP
Ϩ. Trauma
Ϫ. Hemophilia
Ϫ. Reiter’s syndrome
Ϭ. Rheumatoid arthritis
Ϭ. Systemic lupus erythematosus
Ϯ. Cast immobilization for 6 weeks
Ϯ. Activity modification and re-evaluation in 2 months
Κ. Internal fixation with or without bone grafting
Ρ. Retrograde drilling of the defect without articular cartilage penetration
Ϲ. Drilling of the defect directly through the articular cartilage
Ϳ. repair or reconstruction of the medial collateral ligament
ϴ. repair or reconstruction of the medialand lateral collateral ligaments
Ε. immobilization for 5 days or less
϶. immobilization for 14 days
Ϸ. immobilization for 25 days
Ϸ. Cystinosis
Ϲ. Hypophosphatemia
Ϻ. Renal osteodystrophy
Ϻ. Primary hyperparathyroidism
ϼ. Nutritional vitamin D deficiency
Ͻ. Lateral meniscus tear
Ͼ. Popliteus tenosynovitis
Ͽ. Iliotibial band friction syndrome
Ѐ. Peroneal nerve entrapment
Ё. Biceps tendinitis
Ђ. Observation
Ѓ. Removal of the prosthetic components
Є. Operative exploration and decompression of the peroneal nerve
Ѕ. Nerve conduction velocity studies
І. Loosening of the primary dressings and knee flexion to 30 degrees
Ї. I
Ј. II
Љ. III
Њ. decreased tissue tension
Ћ. decreased abductor lever arm
Ќ. decreased joint reaction force
Ѝ. increased body weight over lever arm
Ў. increased polyethylene wear rate
Џ. recurrent traumatic anterior dislocation
А. recurrent traumatic posterior dislocation
Б. traumatic subluxation with no previous dislocation
В. traumatic anterior subluxation
Г. atraumatic involuntary subluxation
Д. radial
Е. axillary
Ж. suprascapular
З. thoracodorsal
И. long thoracic
Й. Flexion
К. Extension
Л. Axial rotation
М. Left lateral bending
Н. Right lateral bending
О. Skin
П. Lung
Р. Brain
С. Heart
Т. Kidney
У. Thoracoacromial, lateral thoracic, subscapular
Ф. Thoracoacromial, anterior humeral circumflex, posterior humeral circumflex
Х. Posterior humeral circumflex, subscapular, thoracacromial
Ц. Subscapular, thoracacromial, anterior humeral circumflex
Ч. Lateral thoracic, anterior humeral circumflex, thoracacromial
Ш. Respondeat superior
Щ. Indemnity agreement
Ъ. Hold harmless agreement- attempt to shift liability from company to physician
Ы. Comparative negligence-% of involvement
Ь. Contributory negligence- resident contributed to the negligence
Э. t-type
Ю. both column
Я. transverse
А. anterior column
Б. anterior column posterior hemitransverse
В. Posterior interosseous
Г. Anterior interosseous
Д. Radial
Е. Median
Ж. Ulnar
З. Shock from hypovolemia
И. Associated rupture of the bladder
Й. Arterial bleeding on pelvic angiogram
К. Presence of a hematoma in the perineum and scrotum
Л. Fractures of both the anterior and posterior pelvic ring

Correct Answer & Explanation

. A


Explanation

Question 4062

Topic: 10. Pathology and Oncology

  • Item Deleted by AAOS Question 38 -
    Figure 6 shows the clinical photograph of a 3-year-old boy who started to walk at the age of 10 months and has a gait that is appropriate for his age. His height is in the 40th percentile for his age. Management should consist of

. Follow-up in six months.
. AP and lateral radiographs.
. AP and lateral radiographs, and a bone scan.
. AP and lateral radiographs, and serum levels for ca, ph, and creatinine.
. AP and lateral radiographs, blood serum levels for calcium, phosphate, and creatinine, and a 24-hour urine collection for vitamin D metabolites.
. MRI scan
. Bone scan
. Arthrogram
. Axillary lateral radiograph
. CT arthrogram
. Open repair of the central slip of the extensor mechanism
. Open repair of the terminal tendon of the extensor mechanism
. Closed splinting with the proximal interphalangeal joint
. Closed splinting with the proximal interphalangeal joint in 30 degrees of flexion
. Closed splinting with the proximal interphalangeal joint in 45 degrees of flexion
. Anteriorly at 20 to 30 degrees of flexion
. Anteriorly at 70 to 90 degrees of flexion
. Posteriorly at 20 to 30 degrees of flexion
. Posteriorly at 70 to 90 degrees of flexion
. Anteriorly with the knee in full flexion
. Rett syndrome
. Cerebral palsy
. Myotonic dystrophy
. Fragile-X syndrome
. Adrenoleukodystrophy
. Endurance limit
. Failure stress
. Critical stress
. Yield stress
. Elastic limit
. Ewing’s sarcoma
. Osteogenic sarcoma
!. Multiple myeloma
". Metastatic prostate carcinoma
#. Metastatic breast carcinoma
$. Higher subsequent loosening rate of the femoral component
%. Higher subsequent polyethylene wear rate
&. Higher subsequent dislocation rate
'. Higher infection rate
(. Unaltered subsequent survival rate of the femoral component
). Crevice corrosion
*. Oscillatory fretting
+. Oxidative degradation
,. Adhesion and abrasion
-. Fatigue and delamination
.. a total contact cast.
/. partial calcanectomy
0. Syme’s amputation
1. transtibial amputation.
2. nonweightbearing and IV antibiotics.
3. Sural artery island flap.
4. Free rectus abdominis flap.
5. Extensor digitorum brevis flap.
6. Staged cross leg flap.
7. Split-thickness skin graft.
8. An anterior cruciate functional knee brace.
9. A physical therapy program.
:. Reconstruction of the posterior cruciate ligament and the posterolateral corner.
;. Reconstruction of the posterior cruciate ligament.
<. Reconstruction of the anterior cruciate ligament.
=. Avoids the risk of marrow emboli
>. Avoids injury to the intramedullary nutrient vessels
?. Results in faster healing of fractures
@. Results in more secure fixation
A. Results in faster regeneration of the endosteal blood supply
B. Above-knee amputation
C. En bloc resection of the lesion and reconstruction with a bone graft
D. Closed reduction and immobilization in a cast
E. Open reduction and internal fixation, followed by radiation therapy
F. Open reduction, curettage, and cementing of the lesion
G. Injury to the subclavian artery
H. Injury to the brachial plexus
I. Segmental fracture
J. 100% displacement
K. Associated displaced surgical neck fracture of the humerus
L. humeral arthroplasty2/. repair of the rotator cuff
M. closed reduction and immobilization
N. open reduction and immobilization
O. open reduction and early passive motion
P. arthroscopic capsular release
Q. manipulation under anesthesia
R. a physical therapy program
S. an intra-articular corticosteroid injection
T. administration of high-dose oral corticosteroids
U. adding the scores, in all five body systems
V. adding the squares of the scores in the three most severely injured systems
W. doubling the cumulative score for head and chest injuries
X. combining the scores from the most and least injured systems
Y. correcting the score in the most severely injured system for age
Z. traumatic femoral head fracture
[. osteonecrosis
\. osteoarthritis
]. neuropathic joint
^. rheumatoid arthritis
_. low-dose radiation
`. steroid injection
A. a load-relieving insert and shoe modification
B. complete excision of the mass and the entire plantar fascia
C. wide excision of the mass with a 2 cm margin of normal fascia
D. CT scan of the chest
E. technetium bone scan
F. bone marrow aspiration
G. serum protein electrophoresis
H. lateral skull radiograph
I. high-grade histology of the initial tumor
J. multiple local recurrences after curettage
K. previous treatment of the tumor with cryotherapy
L. previous treatment of the tumor with radiation therapy
M. extraosseous extension into two or more adjacent compartments
N. Dorsal rhizotomy and facet joint fusion
O. Multilevel corpectomy and spinal stabilization
P. Central and lateral recess decompression and bilateral foraminotomy
Q. Central decompression and facet joint fusion
R. Central decompression, foraminotomy, and spinal fusion from L2 to L5.
S. Inadequate rehabilitation
T. Displacement of the coronoid process fracture
U. Insufficiency of the lateral ulnar collateral ligament
V. Insufficiency of the anterior band of the medial collateral ligament
W. Insufficiency of the posterior band of the medial collateral ligament
X. Osteotomy and intramedullary rod fixation
Y. Electrical stimulation
Z. Strut-autografing the concavity the tibia
{. A patellar tendon-bearing brace
|. Percutaneous injection of demineralized bone matrix
}. digoxin
~. sucralfate
. clindamycin
€. alcohol
. neuromuscular blocking agents
‚. Unrestrained roll-back
ƒ. Unrestrained rotational conformity
„. Medial-Lateral conformity
…. Anteroposterior conformity in flexion
†. Anteroposterior conformity in extension
‡. Arthrodesis of the MTP joint
ˆ. A Silastic implant of the MTP joint
‰. Resection arthroplasty of the MTP joint
Š. Cheilctomy of the MTP joint
‹. Osteotomy of the base of the proximal phalanx
Œ. Genu varum
. Tarsal coalition
Ž. Degenerative ankle arthrosis
. Osteochondritis dissecans of the talus
. Hemihypertrophy of the ipsilateral lower extremity
‘. Trabecular bone is preferentially resorbed in this high bone turnover state
’. Loss of water content in the disk increases impact load to the vetrebral bodies
“. Stress is imposed by the relative stiffness of the arthrtic facet joints
”. Increased energy demands are imposed by decreased circulation to the vertebral body
•. The thick cortical bone found in the vertebral body resorbs rapidly following estrogen withdrawal
–. Increased time in stance and swing phase
—. Addition of a double leg float phase
˜. Decreased vertical ground reaction forces
™. Decreased arc of motion in the hip, knee, and ankle
š. Decreased joint reaction forces in the hip, knee, and ankle
›. Talonavicular arthrodesis
œ. Medial displacement calcaneal osteotomy
. Flexor digitorum longus tendon transfer with spring ligament advancement
ž. Triple arthrodesis
Ÿ. Calcaneocuboid distraction arthrodesis and repair of the posterior tibial tendon
 . Lymphoma
¡. Hemangioma
¢. Osteosarcoma
£. TB of the spine
¤. Metastatic breast carcinoma
¥. widening and shortening of the heel.
¦. weakness of the gastrocnemius-soleus complex.
§. anterior impingement from a horizontal talus.
¨. unrecognized compartment syndrome of the foot.
©. degenerative arthritis of the tibiotalar joint.
ª. a corrective osteotomy
«. application of braces
¬. medial physeal stapling until the varus corrects
­. observation
®. application of corrective casts
¯. a total contact cast.
°. electrical stimulation.
±. an off the shelf fracture brace.
². an elastic compression bandage and crutches.
³. a hard soled shoe until the patient is asymptomatic.
´. Ewings tumor
Μ. Parosteal osteosarcoma
¶. Dedifferentiated chondrosarcoma
·. Low grade intramedullary chondrosarcoma
¸. High grade intramedullary osteosarcoma
¹. Vascular injury
º. Tear of the rotator cuff
». Injury to the brachial plexus
¼. Fracture of the upper thoracic rib
½. Fracture of the proximal humerus
¾. Biceps
¿. Trapezius
À. Infraspinatus
Á. Pectoralis major
Â. Serratus anterior
Ã. Hybrid total hip arthroplasty
Ä. Noncemental hemiarthroplasty of the hip
Å. Closed reduction and percutaneous pin fixation
Æ. Open reduction through an anterior approach to the hip
Ç. Excision of the head fragment
È. a quadratus femoris pediclebone graft
É. a proximal femoral allograft
Ê. intertrochanteric osteotomy
Ë. total hip arthroplasty
Ì. hip hemiarthroplasty
Í. Echocardiogram
Î. Electrocardiogram
Ï. Radiograph of the chest
Ð. CT scan of the shoulder
Ñ. Ultrasound of the shoulder
Ò. Ilioinguinal
Ó. Extended iliofemoral
Ô. Combined ilioinguinal and Kocher-Langenbeck (posterior)
Õ. Kocher-Langenbeck (posterior)
Ö. Kocher-Langenbeck (posterior) with trochanteric osteotomy
×. Deltoid
Ø. Supraspinatus
Ù. Subscapularis Infraspinatus
Ú. Infraspinatus
Û. Infraspinatus and teres minor
Ü. an orthosis.
Ý. observation.
Þ. electrical stimulation.
SS. open reduction and internal fixation.
À. application of a nonweightbearing short leg cast.
Á. repair of the rotator cuff.
Â. rehabilitation of the shoulder
Ã. replacement of the humeral head.
Ä. arthroscopic acromioplasty and debridement.
Å. immobilization is a sling until pain resolves.
Æ. Bone rotation versus torque applied
Ç. Bone deflection versus bending moment applied
È. Axial displacement versus tension applied
É. Lateral translation versus shear force applied
Ê. Fracture gap closing versus compressive force applied
Ë. steroid injection
Ì. stretching of the heel cord
Í. surgical release of the plantar fascia
Î. application of a short leg cast for 6 to 8 weeks
Ï. wearing dorsiflexion night splints
Ð. Open bladder
Ñ. Bilateral “hitchhiker’s” thumbs
Ò. Bilateral defects in the midclavicles
Ó. Rhizomelic shortening of the extremities
Ô. Radiographic fragmentation of all major epiphyses
Õ. Medial patellotibial
Ö. Medial patellofemoral
÷. Medial patellomeniscal
Ø. Lateral patellofemoral
Ù. Lateral patellotibial
Ú. Heat
Û. Gentle active flexion-extension exercises
Ü. Isokinetic strengthening
Ý. Electrical muscle stimulation
Þ. Immobilization of the limb with the knee in full flexion
Ÿ. Distal chevron osteotomy with soft-tissue release
Ā. Distal soft-tissue realignment only
Ā. Closing wedge osteotomy (Aken) of the proximal phalanx
Ă. Proximal first metatarsal osteotomy only
Ă. Soft-tissue realignment with a proximal metatarsal osteotomy
Ą. Vagus
Ą. Phrenic
Ć. Hypoglossal
Ć. Recurrent laryngeal
Ĉ. Inferior thyroid
Ĉ. Surgical exploration
Ċ. Application of leeches
Ċ. Stellate ganglion blocks
Č. Intra-arterial streptokinase
Č. Elevation and reevaluation in 1 hour
Ď. Liver profile
Ď. Myleogram
Đ. Platelet count
Đ. CT scan of the head
Ē. Angiogram of the extremity
Ē. Post spinal fusion from L5to S1
Ĕ. Primary repair with an iliac bone graft
Ĕ. Post spinal fusion of L4-5
Ė. A pantaloon body cast and 6 weeks of bed rest
Ė. Rest, NSAIDS, and limited dancing
Ę. Stress fracture of the proximal fifth metatarsal
Ę. Stress fracture of the base of the second metatarsal
Ě. Stress fracture of the neck of the second metatarsal
Ě. Morton’s neuroma
Ĝ. Lisfranc’s joint subluxation
Ĝ. C5 radiculopathy
Ğ. Subscapularis rupture
Ğ. Glenohumeral arthrosis
Ġ. Rotator cuff arthropathy
Ġ. Suprascapular nerve compression at the spinoglenoid notch
Ģ. mm femoral head in combination with a metal-backed polyethylene component
Ģ. mm femoral head in combination with an all-polyethylene acetabular component
Ĥ. mm femoral head in combination with a metal-backed polyethylene component
Ĥ. mm femoral head in combination with an all-polyethylene component
Ħ. mm femoral head in combination with a metal-backed polyethylene component
Ħ. Female gender
Ĩ. History of cigarette smoking
Ĩ. L5-S1 spondylolisthesis on pre-employment radiography
Ī. Decreased strength of the lower extremities on pre-employment testing
Ī. Decreased flexibility of the lumbar spine on pre-employment testing
Ĭ. Size of cells
Ĭ. Amount of DNA in cells
Į. Nucleus-cytoplasm ratio
Į. Specific DNA sequences
İ. Specific messenger RNA sequences
I. Femoral and obturator nerves
IJ. Femoral and superior gluteal nerves
IJ. Femoral and lateral femoral cutaneous nerves
Ĵ. Obturator and superior gluteal nerves
Ĵ. Obturator and lateral femoral cutaneous nerves
Ķ. Isotonic
Ķ. Isokinetic
ĸ. Isometric
Ĺ. Open kinetic chain
Ĺ. Dynamic variable resistance
Ļ. Closed reduction and cast immobilization
Ļ. Uniplanar external fixation
Ľ. Open reduction and internal fixation with a dynamic compression plate
Ľ. Unreamed intramedullary rod
Ŀ. Multiple plane external fixator
Ŀ. Inlet view of the pelvis
Ł. Outlet view of the pelvis
Ł. AP view of the hip
Ń. Ilial oblique view (external oblique) of the hip
Ń. Obturator oblique
Ņ. Glycolytic pathway
Ņ. Oxidative phosphorylation
Ň. Breakdown of fat
Ň. Breakdown of protein
ʼN. Breakdown of adenosine triphosphate
Ŋ. an MRI scan
Ŋ. arthroscopic examination
Ō. AP and frog-lateral radiographs of the pelvis and hips
Ō. varus and valgus stress radiographs of the knee
Ŏ. physical examination of the knee under anesthesia
Ŏ. extended curettage and polymethylmethacrylate cementation
Ő. extra-articular resection of the knee and an allograft arthrodesis
Ő. wide resection of the proximal tibia and custom prosthetic replacement
Œ. prophylactic internal fixation and postoperative irradiation
Œ. excision of the lateral condyle and reconstruction with a hemicondylar allograft
Ŕ. silicone implant joint replacement
Ŕ. metatarsophalangeal joint arthrodesis
Ŗ. metatarsophalangeal joint debridement
Ŗ. resection of the metatarsal head
Ř. resection of the base of the proximal phalanx
Ř. Fixation of the syndesmosis has failed
Ś. Widening of the ankle mortise has led to the failure of fixation
Ś. Infection around the syndesmosis screw has led to osteomyelitis
Ŝ. The syndesmosis screw is broken
Ŝ. Motion between the tibia and fibula has caused loosening of the syndesmosis screw
Ş. Microcephaly
Ş. A temporal lobe cyst
Š. An Arnold-Chiari type 1 malformation
Š. Periventricular leukomalacia
Ţ. Agnesis of the corpus callosum
Ţ. Wolff’s
Ť. Hooke’s
Ť. Hilton’s
Ŧ. Muller-Haeckel
Ŧ. Heuter-Volkmann
Ũ. Both the anterolateral and posteromedial bands are isometric and do not significantly change with flexion
Ũ. The anterolateral band is lax and becomes tight in flexion, while the posteromedial band is tight, and becomes lax in flexion
Ū. The anterolateral band is tight and becomes lax in flexion, while the posteromedial band is lax and becomes tight in flexion
Ū. Both the anterolateral and posteromedial bands are lax and become tight in flexion
Ŭ. Both the anterolateral and posteromedial bands are tight and become lax as the knee is flexed
Ŭ. UCB orthosis
Ů. Rigid orthosis with a medical arch support
Ů. Semi-rigid orthosis with lateral forefoot posting
Ű. Semi-rigid orthosis with a medial arch support
Ű. Medial heel wedge attached to the running shoes
Ų. Hallux varus
Ų. Osteonecrosis
Ŵ. Recurrence of the hallux valgus
Ŵ. “Transfer” second metatarsalgia
Ŷ. Physeal arrest of the first metatarsal
Ŷ. Aseptic loosening in a 70-year-old patient
Ÿ. Mechanical failure of a hinged knee prosthesis
Ź. Failed knee replacement complicated by reflex sympathetic dystrophy
Ź. Infection with soft-tissue deficit
Ż. A prior patellectomy
Ż. Knee fusion
Ž. Open irrigation and debridement
Ž. Arthroscopic irrigation and debridement
S. One-stage exchange arthroplasty
Ƀ. Two-stage exchange arthroplasty
Ɓ. Putti-platt repair
Ƃ. Open Bankart repair
Ƃ. Injection of a subacromial corticosteroid
Ƅ. Arthroscopic transglenoid capsular shift
Ƅ. Rehabilitation of the scapular and rotator cuff muscles
Ɔ. Silicone suction socket and an energy-absorbing foot
Ƈ. Silicone suction socket and a variable resistance ankle
Ƈ. Plastic suction socket, telescoping pylon, and a solid ankle cushioned heel (SACH) foot
Ɖ. Plastic socket with a hinged thigh cuff and a SACH foot
Ɗ. Patellar tendon-bearing suction socket and a uniaxial hydraulic ankle
Ƌ. Parosteal
Ƌ. Periosteal
ƍ. High-grade intramedullary
Ǝ. Osteosarcoma occurring in Paget’s disease
Ə. Osteosarcoma occurring in irradiated bone
Ɛ. Cauda equina
Ƒ. Conus medullaris
Ƒ. Genitofemoral nerve
Ɠ. Lumbar sympathetic plexus
Ɣ. Lumbar parasympathetic plexus
Ƕ. Spinal pseudoarthrosis
Ɩ. Spinal cord traction injury with paralysis
Ɨ. Arterial and venous thromboses
Ƙ. Superior mesenteric artery syndrome
Ƙ. Crankshaft phenomenon
Ƚ. Inversion stress radiograph
ƛ. MRI scan
Ɯ. CT scan
Ɲ. Nuclear bone scan
Ƞ. External rotation stress radiograph
Ɵ. Complex deformity with an angulation in two planes
Ơ. Single deformity less than 20 degrees, apex posterolateral
Ơ. Single deformity greater than 30 degrees, apex posterolateral
Ƣ. Single deformity less than 20 degrees, apex posteromedial
Ƣ. Single deformity greater than 30 degrees, apex posteromedial
Ƥ. Pronation of the foot during the stance phase of gait
Ƥ. Heel inversion at the beginning of a single limb heel rise
Ʀ. Active inversion of the nonweightbearing foot
Ƨ. Active plantar flexion of the first ray against resistance
Ƨ. Active plantar flexion of the foot during the push-off phase of gait
Ʃ. Observation and repeat radiographs in 4 months
ƪ. Application of a thoracolumbalsacral orthosis for 22 to 24 hours per day
ƫ. Electrical stimulation at night
Ƭ. Physical therapy
Ƭ. Begins to remodel and hypertrophy more quickly
Ʈ. Provides a better scaffold for osteoconduction
Ư. Reduces the risk of early fracture
Ư. Reduces technical difficulty
Ʊ. Lowers donor site morbidity
Ʋ. Anterior fusion of the lumbar curve
Ƴ. Anterior and posterior fusion of the thoracic curve
Ƴ. Posterior fusion of the thoracic curve
Ƶ. Posterior fusion of the thoracic and lumbar curves
Ƶ. Application of a brace until the iliac apophyses are Risser 4 or 5, followed by surgical correction
Ʒ. Subscapularis rupture
Ƹ. Type III SLAP lesion
Ƹ. Disruption of capsular shift
ƺ. Isolated traumatic subluxation
ƻ. Injury to the axillary nerve after dislocation
Ƽ. hypophosphatemia
Ƽ. high dietary cholesterol intake
ƾ. deficiency of lipoprotein A
Ƿ. deficiency of protein S and protein C
ǀ. elevated levels of antithrombin III
ǁ. Weightbearing short leg cast
ǂ. Nonweightbearing short leg cast
ǃ. Removable splint and early motion
DŽ. Open reduction and internal fixation
DŽ. Elastic compression bandage with full weightbearing
DŽ. Breast
LJ. Prostate
LJ. Gastrointestinal
LJ. Kidney
NJ. Multiple myeloma
NJ. Varus stress
NJ. Valgus stress
Ǎ. Torsional loading
Ǎ. Hyperextension of the knee
Ǐ. Contraction of the quadriceps while axially loaded
Ǐ. Primary internal fixation at both fracture levels
Ǒ. External fixation as definitive ttt for both #
Ǒ. Skeletal traction and delayed internal fixation of both fractures
Ǔ. Primary internal fixation of the proximal fracture and delayed fixation of the femoral fracture
Ǔ. Primary internal fixation of the femoral shaft fracture and delayed fixation of the proximal #
Ǖ. Heel spur
Ǖ. Plantar fascitis
Ǘ. Dysfunction of the tibialis posterior tendon
Ǘ. Compression of the first branch of the lateral plantar nerve
Ǚ. Compression of the calcaneal nerve
Ǚ. Displaced labral tear
Ǜ. Tear of the rotator cuff
Ǜ. Fracture of the glenoid rim
Ǝ. Palsy of the axillary nerve
Ǟ. Palsy of the musculocutaneus nerve
Ǟ. Enchondroma
Ǡ. Osteoblastoma
Ǡ. Giant cell tumor
Ǣ. Aneurysmal bone cyst
Ǣ. Fibrous dysplasia
Ǥ. Arthrogram of the wrist
Ǥ. MRI scan of both wrists
Ǧ. CT scan of both wrists in the same position
Ǧ. Radiographs of the wrist in supination and pronation
Ǩ. Radiographs of the opposite wrist in the same position
Ǩ. Secondary hyperparathyroidism
Ǫ. Phosphate retention secondary to uremia
Ǫ. Insufficient renal synthesis of 1, 25 dihydroxy vitamin D
Ǭ. Aluminum deposition in bone from oral phosphate binders
Ǭ. Persistent acidosis aggravating the negative calcium balance
Ǯ. Posterior fusion at T10-L3 with segmental instrumentation
Ǯ. Laminectomy and fusion of T12-L2 with segmental instrumentation
J̌. Bed rest in a hyperextension brace
DZ. L1 vertebrectomy and anterior decompression with strut graft fusion and instrumentation
DZ. Progressive ambulation as tolerated in a custom-molded thoracolumbosacral orthosis
DZ. Positive-pressure ventilation
Ǵ. An immediate radiograph of the chest
Ǵ. Adjustment of the position of the endotrachael tube
Ƕ. Insertion of a large-bore needle into the pericardial space
Ƿ. Insertion of a large-bore needle in the right second intercostal space, midclavicular line
Ǹ. Allowing the ends of the fracture to touch
Ǹ. Adding a second connecting bar
Ǻ. Adding one pin to each fracture fragment
Ǻ. Increasing the pin diameter from 4 mm to 6 mm
Ǽ. Decreasing the connecting bar-to-bone distance from 6 cm to 4 cm
Ǽ. Osteomyelitis
Ǿ. Malignant degeneration
Ǿ. Stress fracture
Ȁ. Local recurrence of the giant cell tumor
Ȁ. Bone resorption due to methylmethacrylate
Ȃ. Advancement of the plantar plate
Ȃ. Resection of the second metatarsal head
Ȅ. Dorsiflexion osteotomy of the second metatarsal neck
Ȅ. Transfer of the flexor digitorum longus tendon to the dorsum of the toe
Ȇ. Transfer of the extensor digitorum comminus tendon to the metatarsal neck
Ȇ. Sacral fracture
Ȉ. Burst fracture of L5
Ȉ. Cauda equina syndrome
Ȋ. Distraction-flexion injury at L3
Ȋ. Distraction-extension injury at L3
Ȍ. An MRI scan of the shoulder
Ȍ. An MRI scan of the cervical spine
Ȏ. Electromyographic and nerve conduction velocity studies
Ȏ. Immobilization in a sling and early passive range of motion exercises
Ȑ. Immediate return to the operating room for exploration of the brachial plexus
Ȑ. cerclage wiring
Ȓ. tension band wiring
Ȓ. removal of the patellar component
Ȕ. revision of the patellar component
Ȕ. immobilization of the knee and protected weightbearing
Ȗ. Liposarcoma
Ȗ. Nodular fasciitis
Ș. Rabdomyosarcoma
Ș. Malignant fibrous histiocytoma
Ț. Extra-abdominal desmoid tumor
Ț. Clubfeet
Ȝ. Thrombocytopenia
Ȝ. Congenital scoliosis
Ȟ. Ventricular septal defect
Ȟ. Arnold-Chiari malformation
Ƞ. delayed primary closure
ȡ. free flap
Ȣ. pedicle groin flap
Ȣ. full-thickness skin graft
Ȥ. split-thickness skin graft
Ȥ. Infection
Ȧ. Nonunion
Ȧ. Improper screw length
Ȩ. Osteonecrosis of the distal fragment
Ȩ. Use of a cortical screw instead of a cancellous screw
Ȫ. Infection
Ȫ. Tear of the rotator cuff
Ȭ. Loosening of the humeral component
Ȭ. Arthritis of the glenoid
Ȯ. Arthritis of the A-C joint
Ȯ. Reduced morbidity
Ȱ. Improved osteoinduction
Ȱ. Improved osteoconduction
Ȳ. More rapid revascularization
Ȳ. Lower risk of disease transmission
ȴ. Manipulation Under Anesthesia
ȵ. Arthroscopic acromioplasty
ȶ. Arthroscopic debridement of G-H joint
ȷ. Replacement of the humeral head
ȸ. Lengthening of the subscapularis and release of the anterior capsule
ȹ. Bacteroides
Ⱥ. E. coli
Ȼ. Staph. aureus
Ȼ. group A streptococcus
Ƚ. Clostridium perforingens
Ⱦ. observation and exercises
Ȿ. bracing with a thoracolumbar orthosis
Ɀ. fusion of the posterior spine
Ɂ. fusion of the anterior spine
Ɂ. fusion of the anterior and posterior spine
Ƀ. Total wrist replacement and bridge grafts
Ʉ. palmar shelf arthroplasty and tendon transfers
Ʌ. Darrach distal ulna resection, dorsal tenosynosynovectomy, and tendon transfers
Ɇ. Radioscaphate fusion, extensor tenodesis, and Darrach distal ulna resection
Ɇ. Total wrist fusion and tendon transfers
Ɉ. constrained acetabular component
Ɉ. protrusion ring with morselized graft
Ɋ. cemented metal backed acetabular component
Ɋ. cemented all-polyethylene acetabular component
Ɍ. cementless hemispherical component with screw fixation
Ɍ. application of a hip abduction brace for 22 hours per day
Ɏ. application of a hip spica under anesthesia
Ɏ. discontinuance of all bracing and repeat radiographs in 3 months
Ɐ. open reduction of the hip and application of a spica cast
Ɑ. open reduction, varus osteotomy, and application of a spica cast
Ɒ. Loss of skin hair on the feet
Ɓ. Absent pulses on vascular examination
Ɔ. Pain that originates proximally and spreads distally
ɕ. Pain that is relieved by stopping and standing
Ɖ. Pain that is worse when the patient walks uphill rather downhill
Ɗ. wrist flexors and finger flexors
ɘ. elbow flexors and wrist flexors
Ə. elbow flexors and finger flexors
ɚ. elbow extensors and wrist flexorst Level Key Muscles4 DiaphragmDeltoid, elbow flexors, diaphragmElbow flexors, wrist extensorsElbow extensors, wrist flexorsFinger flexors (distal phalanx of middlefinger)Finger abductors (5th digit), intrinsics of hand2 Segmental innervation to intercostal muscles, abdominal and paraspinal muscles) L1, L2, L3 Hip flexors3, L4 QuadricepsTibialis anteriorToe extensors, hip abductorsAnkle plantarflexors, peronei
Ɛ. elbow extensors and wrist extensors
Ɜ. Syndactyly
ɝ. Macrodactyly
ɞ. Camptodactyly
ɟ. Preaxial polydactyly
Ɠ. Postaxial polydactyly
Ɡ. Arthrodesis
ɢ. Rotationplasty
Ɣ. Above-knee amputation
ɤ. Osteoarticular allograft
Ɥ. Endoprosthesis (custom arthroplasty)
Ɦ. Plantar fascia
ɧ. Spring ligament
Ɨ. Deltoid ligament
Ɩ. Intrinsic tendons
Ɪ. Gastorcnemius-solelus complex
Ɫ. Prevention of presynaptic release of acetylcholine
Ɬ. Prevention of synthesis of presynaptic acetylcholine
ɭ. Activation of acetylcholinesterase at the motor end-plate
ɮ. Blockage of postsynaptic action of acetylcholine until reserves are depleted
Ɯ. Stimulation of release of presynaptic acetylcholine until reserves are depleted
ɰ. stiffness of the femoral component.
Ɱ. head offset of the femoral component.
Ɲ. femoral component material modulus of elasticity.
ɳ. extent of the femoral component porous coating.
ɴ. Presence of a femoral component collar.
Ɵ. plantar fascia and quadratus plantae tendon.
ɶ. ligamentous structures connecting the tarsal bones.
ɷ. shape of the tarsal bones and the intervening joints.
ɸ. activity of the intrinsic muscles of the foot.
ɹ. activity of the posterior tibialis and the peroneus longus muscles.
ɺ. scapulothoracic fusion
ɻ. strengthening of the periscapular muscles
ɼ. pectoralis minor-fascia lata graft transfer to the scapula
Ɽ. pectoralis major-fascia lata graft transfer to the scapula
ɾ. exploration of the long thoracic nerve, with sural nerve graft
ɿ. tricompartmental knee replacement
Ʀ. unicompartmental knee replacement
ʁ. medial compartment meniscal allograft
Ʂ. valgus-producing distal femoral osteotomy
Ʃ. valgus-producing proximal tibial osteotomy
ʄ. Internal rotation of the femoral component
ʅ. External rotation of the tibial component
ʆ. Lateral placement of the femoral component
Ʇ. Medial placement of the patellar component
Ʈ. Excessive resection of the patella
Ʉ. Hallux rigidus
Ʊ. Hallux valgus
Ʋ. Neuroma of the first web space
Ʌ. Fracture of the sesamoid
ʍ. Rupture of the flexor hallucis longus
ʎ. Sickle cell crisis
ʏ. Idiopathic chondrolysis
ʐ. Hemophilic arthropathy
ʑ. Osteoid osteoma of the femoral neck
Ʒ. Legg-Calve-Perthes disease
ʓ. Decreased ankle jerk and positive femoral nerve stretch test
ʔ. Decreased knee jerk and positive straight-leg raising sign
ʕ. Gastrocnemius-soleus complex weakness and positive straight-leg raising sign
ʖ. Weakness of the extensor hallucis longus and positive straight-leg raising sign
ʗ. Weakness of the extensor hallucis longus and positive femoral nerve stretch test
ʘ. Long-term administration of IV and oral antibiotics
ʙ. Open soft-tissue debridement, retention of prosthetic components, and IV antibiotics
ʚ. Immediate exchange arthroplasty with antibiotic-impregnated cement
ʛ. Two-stage surgical prosthetic exchange and IV antibiotics
ʜ. Resection arthroplasty and IV antibiotics
Ʝ. SCFE
Ʞ. MED
ʟ. Perthes disease
ʠ. Hypothyroidism
ʡ. Chondrolysis
ʢ. gout.
ʣ. osteoporosis.
ʤ. eosinophilic granuloma.
ʥ. tuberculosis of the spine.
ʦ. metastatic disease of the spine.
ʧ. water content.
ʨ. Synthesis of type I collagen.
ʩ. Proteoglycan content.
ʪ. Activity of chondrocytes.
ʫ. Synthesis of hyaluronate.
ʬ. Lung
ʭ. Breast
ʮ. Prostate
ʯ. Thyroid
ʰ. Renal
ʱ. T1-low, T2-low.
ʲ. T1-low, T2-high.
ʳ. T1-moderate, T2-low.
ʴ. T1-high, T2-low.
ʵ. T1-high, T2-high.
ʶ. hypothesis is incorrect or invalid
ʷ. interobserver error rate is 4%.
ʸ. Standard deviation is 4% higher or lower than the mean.
ʹ. Sample size is 4% larger than required to be clinically significant.
ʺ. Probability that the differences noted between two study groups were due to chance alone is 4%.
ʻ. I
ʼ. II
ʽ. IV
ʾ. IX
ʿ. X
ˀ. Cranial setting
ˁ. Cranial subluxation
˂. Odontoid fracture
˃. Lysis of the arch of the atlas
˄. Atlantoaxial subluxation
˅. Retrograde collapse of the endoneurial tubes
ˆ. Irreversible atrophy of the denervated muscles
ˇ. Elongation of the axons across the zone of injury
ˈ. Sprouting of the axons at the neuromuscular junction
ˉ. Misdirection of the axons across the zone of injury
ˊ. Maximally pronated and elbow extended
ˋ. Maximally pronated and the elbow flexed
ˌ. Maximally supinated and the elbow flexed
ˍ. Maximally supinated and the elbow extended
ˎ. In neutral rotation, with the elbow extended
ˏ. open reduction and internal fixation
ː. buddy taping to the adjacent index finger
ˑ. early motion with application of a dynamic banjo splint
˒. application of a cast with the hand in a “safe position” for 3 weeks.
˓. dorsal extension block splinting
˔. The name of the manufacturer
˕. The manufacturer’s potential liability
˖. The physician’s clinical performance
˗. The physician’s materials testing data
˘. Any royalties the physician receives from the manufacturer
˙. Femoral
˚. Obturator
˛. Inferior gluteal
˜. Superior gluteal
˝. Lateral femoral cutaneous
˞. open biopsy and a long leg cast
˟. open biopsy and wide resection of the tumor
ˠ. a long leg cast and observation
ˡ. intramedullary stabilization and observation
ˢ. Triggering
ˣ. Lateral instability
ˤ. Swan-neck deformity
˥. Boutonniere deformity
˦. Loss of distal interphalangeal joint flexion
˧. Peroneus brevis to peroneus longus
˨. Peroneus tertius to extensor hallucis longus
˩. Peroneus tertius to superficial peroneal nerve
˪. Extensor hallucis longus to deep peroneal nerve
˫. Extensor hallucis longus to extensor digitorum longus
ˬ. reassurance that Medicare will pay for the treatment.
˭. consent forms that patients or their guardians are able to understand.
ˮ. a detailed description of the device, omitting the fact that it is part of a study.
˯. a provision that the patient’s care will be discontinued if he or she does not enroll in the study.
˰. a provision that the study will be carried out to completion, whether or not the device is as effective as those currently in existence.
˱. an onlay iliac crest bone graft.
˲. limited weightbearing and observation.
˳. removal of the implant and limited weightbearing.
˴. removal of the implant and insertion of a reamed femoral nail.
˵. removal of the implant and insertion of an unreamed femoral nail.
˶. Coronal
˷. Sagittal
˸. Anteromedial, midway between the sagittal and the coronal
˹. Proximal pins sagittal, distal pins coronal
˺. Proximal pins coronal, distal pins sagittal
˻. Rheumatoid arthritis
˼. Posttraumatic arthritis
˽. Degenerative osteoarthritis
˾. Osteonecrosis of the tibial plateau
˿. Osteonecrosis of the medial femoral condyle
̀. Trapeziometacarpal arthrodesis
́. Osteotomy of the thumb metacarpal
̂. Arthrotomy and joint debridement
̃. Ligament reconstruction using one half of the flexor carpi radialis
̄. Trapezium resection, tendon interposition, and reconstruction of the ligament
̅. Creep
̆. Relaxation
̇. Energy dissipation
̈. Plastic deformation
̉. Elastic deformation
̊. bending
̋. axial loading
̌. high-speed rotation
̍. direct impact from anteromedial
̎. crush from anteromedial to posterolateral
̏. Increase stiffness
̐. Increase fracture toughness
̑. Increase fatigue strength
̒. Decrease mechanical strength
̓. Decrease wear rate
̔. disuse osteopenia
̕. paraendocrine effect of the tumor
̖. abnormally increased density on the right side
̗. side effect of the treatment of the lesion
̘. extensive tumor involvement of the left hip
̙. Sciatic nerve
̚. Superior gluteal artery
̛. Profunda femoris artery
̜. Femoral artery and nerve
̝. External iliac artery and vein
̞. Length
̟. Moment arm
̠. Total volume
̡. Physiologic cross-sectional area
̢. Distribution of slow and fast twitch fibers
̣. decreasing initiation of action potentials.
̤. increasing action potential amplitude.
̥. blocking the opening of gated sodium channels.
̦. decreasing the number of functional motor units.
̧. slowing or stopping action potential propagation through the axon.
̨. resection of the metatarsal heads of the first through fifth toes.
̩. Silastic MP joint arthroplasties of the first through fifth toes.
̪. fusion of the hallux MP joint and resection arthroplasty of the 2nd through fifth metatarsal heads.
̫. fusion of hallux MP joint and distal osteotomy of the 2nd through 5th MT.
̬. plantar condylectomy of the 2nd through 5th MT heads & resection of proximal phx of the hallux.
̭. hemiarthroplasty
̮. open reduction and internal fixation
̯. closed reduction and percutaneous pinning
̰. a sling and early pedulum exercises
̱. a sling and swathe for 6 weeks, followed by shoulder rehabilitation
̲. open acromioplasty
̳. open Bankart repair
̴. open subscapularis tendon repair
̵. inferior capsular shift
̶. a supervised physical therapy program
̷. a sling and swathe, with pendulum exercises in 10 days
̸. open reduction and internal fixation through an anterior approach
̹. open reduction and internal fixation through a posterior approach
̺. immobilization with a splint in 45 degrees of abduction for 6 weeks
̻. arthroscopically assisted reduction and percutaneous screw fixation
̼. Repair of the rotator cuff
̽. Replacement of the humeral head
̾. Resection arthroplasty
̿. Total shoulder arthroplasty
̀. AP and lateral radiographs of the elbow
́. Diagnositc arthroscopy
͂. Aspiration of joint fluid
̓. An erythrocyte sedimentation rate and CBC
̈́. A diagnostic lidocaine injection
Ι. Insulin-like growth factor (IGF-1)
͆. Fibroblast growth factor (FGF-1)
͇. Platelet-derived growth factor (PDGF)
͈. Transforming growth factor beta (TGF-B)
͉. Bone morphogenetic proteins (BMP)
͊. clinical history and radiographic findings.
͋. technetium bone scan
͌. flow cytometry pattern of extracted chondrocytes
͍. immunohistochemical staining patterns of a biopsy specimen
͎. histologic features of a biopsy specimen stained with hematoxylin-cosin
͏. Radial
͐. Radial recurrent
͑. Posterior interosseous
͒. Superior ulnar recurrent
͓. Superficial radial circumflex
͔. Impaired hydroxylation of proline
͕. Failure of cleavage in procollagen
͖. Defective binding sites for hydroxyproline
͗. Failure to incorporate glycine into the helix
͘. Diminished production of collagen through the rough endoplasmic reticulum
͙. Asking the legal staff to seek a court injunction
͚. Copying the patient’s chart and giving it to him as he leaves
͛. Having the patient sign a written legal contract that specifies acceptable behavior
͜. Continuing care of the patient until an appropriate referral can be arranged
͝. Transferring the patient to another orthopaedic surgeon without disclosing the realreason for why the patient is being transferred
͞. Meta-analysis
͟. Confidence interval
͠. Analysis of variance (ANOVA)
͡. Statistical significance (p-value)
͢. Survivorship analysis (Kaplan-Meier)
ͣ. Spinal shock
ͤ. Neurogenic shock
ͥ. Hypovolemic shock
ͦ. Pulmonary embolism
ͧ. Fat embolus syndrome
ͨ. Lumbar spinal stenosis
ͩ. Metastatic disease of the spine
ͪ. Rheumatoid lumbar spondylitis
ͫ. Isthmic spondyloloisthesis
ͬ. Degenerative spondylolisthesis at L4-5 and L5-S1
ͭ. Patella alta
ͮ. A metal-backed patella
ͯ. Varus malalignment of the knee
Ͱ. A posterior cruciate-substituting femoral component
Ͱ. Lateral subluxation of the patella on a Merchant’s view
Ͳ. The sesamoids are separated
Ͳ. The sesamoid is fractured
ʹ. The proximal phx is on the neck of the metatarsal
͵. The dislocation is dorsal and centered
Ͷ. The proximal phalanx is hyperextended
Ͷ. Patella
͸. Tibial stem
͹. Distal femoral interface
ͺ. Posterior femoral interface
Ͻ. Sites of screw fixation for the tibia
Ͼ. Hallux rigidus
Ͽ. Fracture of the sesamoid
;. Disruption of the plantar plate
Ϳ. Osteonecrosis of the metatarsal head
΀. Rupture of the flexor hallucis longus
΁. Gout
΂. Sepsis
΃. Old trauma
΄. Rheumatoid arthritis
΅. Charcot arthroplasty
Ά. Aspiration and steroid injection
·. Biopsy, curettage, and allograft bone grafting
Έ. Percutaneous Kirschner wire fixation
Ή. Percutaneous injection of autogenous bone marrow
Ί. Nerve roots
΋. Spinal cord
Ό. Sciatic nerve
΍. Peroneal nerve
Ύ. Conus medullaris
Ώ. Extent of bone penetrated by reaming, prosthetic components, or acrylic cement
Ϊ́. Periprosthetic regions that are accessible to joint fluid and particulate wear debris
Α. Enveloping pseudocapsular scar tissue that develops around a prosthetic hip following surgical capsulectomy
Β. Soft tissue and bone that are potentially contaminated with bacteria in the setting of a prosthetic joint infection
Γ. Potential intrapelvic joint space communication created by acetabular fixation screws or intrapelvic extruded acrylic cement
Δ. Early and late infection
Ε. Periprosthetic fracture of the femur
Ζ. Failure of the patellofemoral and extensor mechanisms
Η. Aseptic loosening of cementing tibial components
Θ. Asceptic loosening of cemented femoral components
Ι. Acceptance of the current position of the ankle
Κ. Open reduction and fixation in the epiphysis only
Λ. ORIF with a small-fragment T-plate from the malleolus up to the metaphysis
Μ. Closed reduction by eversion of the ankle and application of a bivalved long leg cast
Ν. CRUGA and fixation with a malleolar screw from the malleolus into the metaphysis
Ξ. Resection arthroplasty and local radiation
Ο. In situ fusion of the hip
Π. Excision of heterotopic bone, total hip arthroplasty, and oral indomethacin
Ρ. Excision of heterotopic bone and local radiation
΢. Excision of heterotopic bone, hemiarthroplasty, and oral indomethacin
Σ. Closed reduction of both fractures and immediate spica casting
Τ. Bilateral skin traction for 3 weeks, followed by spica casting
Υ. External fixation of both femora
Φ. External fixation of the left femur and a long leg cast brace for the right femur
Χ. External fixation of the left femur and use of a reamed intramedullary nail in the right femur
Ψ. Synovial sarcoma
Ω. Soft-tissue abcess
Ϊ. Rhabdomyosarcoma
Ϋ. Eosinophilic granuloma
Ά. Nodular pigmented villonodular synovitis
Έ. Changing to a titanium nail
Ή. Changing to a nonslotted nail
Ί. Changing the cross-sectional shape of the nail
Ϋ́. Increasing the diameter of the nail by 3 mm
Α. Increasing the diameter of the interlocking screws
Β. Fracture healing
Γ. Chondrosarcoma
Δ. Periosteal chondroma
Ε. Periosteal osteosarcoma
Ζ. Dysplasia epiphysealis hemimelica
Η. Demonstrate competence in the subject of the case
Θ. Be fellowship trained in the subject of the case
Ι. Be paid on a contingency basis
Κ. Be board certified by the American Board of Orthopaedic Surgery
Λ. Have been involved in the case as a consultant
Μ. Diagnostic arthroscopy
Ν. Arthroscopy and subacromial decompression
Ξ. Reduction and fixation of the proximal humeral epiphysis
Ο. Temporary cessation of throwing
Π. Physical therapy for rotator cuff strengthening
Ρ. Oblique popliteal ligament
Σ. Lateral capsule
Σ. Popliteal tendon
Τ. Fibular collateral ligament
Υ. Posterior oblique ligament
Φ. Radial tear
Χ. Parrot-beak tear
Ψ. Vertical tear in the “red-red” zone
Ω. Vertical tear in the “red-white” zone
Ϊ. Vertical tear in the “white-white” zone
Ϋ. 0 degrees of abduction, with neural rotation
Ό. 40 degrees of flexion and 60 degrees of internal rotation
Ύ. 45 degrees of flexion and 45 degrees of external rotation
Ώ. 90 degrees of abduction with neutral rotation
Ϗ. 90 degrees of abduction and 90 degrees of external rotation
Β. Sural
Θ. Saphenous and its branches
ϒ. Posterior tibial and its branches
ϓ. Deep peroneal and its branches
ϔ. Superficial peroneal and its branches
Φ. Strength
Π. Stiffness
Ϗ. Shelf life
Ϙ. Antigenicity
Ϙ. Risk of HIV transmission
Ϛ. Indemnification
Ϛ. Occurrence
Ϝ. Excess liability
Ϝ. Claims-made
Ϟ. Nose
Ϟ. Lateral Y
Ϡ. Scapular AP
Ϡ. Neutral rotation AP
Ϣ. Internal rotation AP
Ϣ. External rotation AP
Ϥ. Trauma
Ϥ. Hemophilia
Ϧ. Reiter’s syndrome
Ϧ. Rheumatoid arthritis
Ϩ. Systemic lupus erythematosus
Ϩ. Cast immobilization for 6 weeks
Ϫ. Activity modification and re-evaluation in 2 months
Ϫ. Internal fixation with or without bone grafting
Ϭ. Retrograde drilling of the defect without articular cartilage penetration
Ϭ. Drilling of the defect directly through the articular cartilage
Ϯ. repair or reconstruction of the medial collateral ligament
Ϯ. repair or reconstruction of the medialand lateral collateral ligaments
Κ. immobilization for 5 days or less
Ρ. immobilization for 14 days
Ϲ. immobilization for 25 days
Ϳ. Cystinosis
ϴ. Hypophosphatemia
Ε. Renal osteodystrophy
϶. Primary hyperparathyroidism
Ϸ. Nutritional vitamin D deficiency
Ϸ. Lateral meniscus tear
Ϲ. Popliteus tenosynovitis
Ϻ. Iliotibial band friction syndrome
Ϻ. Peroneal nerve entrapment
ϼ. Biceps tendinitis
Ͻ. Observation
Ͼ. Removal of the prosthetic components
Ͽ. Operative exploration and decompression of the peroneal nerve
Ѐ. Nerve conduction velocity studies
Ё. Loosening of the primary dressings and knee flexion to 30 degrees
Ђ. I
Ѓ. II
Є. III
Ѕ. decreased tissue tension
І. decreased abductor lever arm
Ї. decreased joint reaction force
Ј. increased body weight over lever arm
Љ. increased polyethylene wear rate
Њ. recurrent traumatic anterior dislocation
Ћ. recurrent traumatic posterior dislocation
Ќ. traumatic subluxation with no previous dislocation
Ѝ. traumatic anterior subluxation
Ў. atraumatic involuntary subluxation
Џ. radial
А. axillary
Б. suprascapular
В. thoracodorsal
Г. long thoracic
Д. Flexion
Е. Extension
Ж. Axial rotation
З. Left lateral bending
И. Right lateral bending
Й. Skin
К. Lung
Л. Brain
М. Heart
Н. Kidney
О. Thoracoacromial, lateral thoracic, subscapular
П. Thoracoacromial, anterior humeral circumflex, posterior humeral circumflex
Р. Posterior humeral circumflex, subscapular, thoracacromial
С. Subscapular, thoracacromial, anterior humeral circumflex
Т. Lateral thoracic, anterior humeral circumflex, thoracacromial
У. Respondeat superior
Ф. Indemnity agreement
Х. Hold harmless agreement- attempt to shift liability from company to physician
Ц. Comparative negligence-% of involvement
Ч. Contributory negligence- resident contributed to the negligence
Ш. t-type
Щ. both column
Ъ. transverse
Ы. anterior column
Ь. anterior column posterior hemitransverse
Э. Posterior interosseous
Ю. Anterior interosseous
Я. Radial
А. Median
Б. Ulnar
В. Shock from hypovolemia
Г. Associated rupture of the bladder
Д. Arterial bleeding on pelvic angiogram
Е. Presence of a hematoma in the perineum and scrotum
Ж. Fractures of both the anterior and posterior pelvic ring

Correct Answer & Explanation

. Follow-up in six months.


Explanation

Question 4063

Topic: 10. Pathology and Oncology

Item Deleted by AAOS Question 40 -

Figure 8 shows the AP radiograph of a 38-yea-old woman who has

constant pain in her shoulder as the results of a motor vehicle accident. Examination reveals marked restriction in external rotation. Which of the following studies should be ordered to aid in making a diagnosis?

. MRI scan
. Bone scan
. Arthrogram
. Axillary lateral radiograph
. CT arthrogram
. Open repair of the central slip of the extensor mechanism
. Open repair of the terminal tendon of the extensor mechanism
. Closed splinting with the proximal interphalangeal joint
. Closed splinting with the proximal interphalangeal joint in 30 degrees of flexion
. Closed splinting with the proximal interphalangeal joint in 45 degrees of flexion
. Anteriorly at 20 to 30 degrees of flexion
. Anteriorly at 70 to 90 degrees of flexion
. Posteriorly at 20 to 30 degrees of flexion
. Posteriorly at 70 to 90 degrees of flexion
. Anteriorly with the knee in full flexion
. Rett syndrome
. Cerebral palsy
. Myotonic dystrophy
. Fragile-X syndrome
. Adrenoleukodystrophy
. Endurance limit
. Failure stress
. Critical stress
. Yield stress
. Elastic limit
. Ewing’s sarcoma
. Osteogenic sarcoma
. Multiple myeloma
. Metastatic prostate carcinoma
. Metastatic breast carcinoma
. Higher subsequent loosening rate of the femoral component
. Higher subsequent polyethylene wear rate
!. Higher subsequent dislocation rate
". Higher infection rate
#. Unaltered subsequent survival rate of the femoral component
$. Crevice corrosion
%. Oscillatory fretting
&. Oxidative degradation
'. Adhesion and abrasion
(. Fatigue and delamination
). a total contact cast.
*. partial calcanectomy
+. Syme’s amputation
,. transtibial amputation.
-. nonweightbearing and IV antibiotics.
.. Sural artery island flap.
/. Free rectus abdominis flap.
0. Extensor digitorum brevis flap.
1. Staged cross leg flap.
2. Split-thickness skin graft.
3. An anterior cruciate functional knee brace.
4. A physical therapy program.
5. Reconstruction of the posterior cruciate ligament and the posterolateral corner.
6. Reconstruction of the posterior cruciate ligament.
7. Reconstruction of the anterior cruciate ligament.
8. Avoids the risk of marrow emboli
9. Avoids injury to the intramedullary nutrient vessels
:. Results in faster healing of fractures
;. Results in more secure fixation
<. Results in faster regeneration of the endosteal blood supply
=. Above-knee amputation
>. En bloc resection of the lesion and reconstruction with a bone graft
?. Closed reduction and immobilization in a cast
@. Open reduction and internal fixation, followed by radiation therapy
A. Open reduction, curettage, and cementing of the lesion
B. Injury to the subclavian artery
C. Injury to the brachial plexus
D. Segmental fracture
E. 100% displacement
F. Associated displaced surgical neck fracture of the humerus
G. humeral arthroplasty2/. repair of the rotator cuff
H. closed reduction and immobilization
I. open reduction and immobilization
J. open reduction and early passive motion
K. arthroscopic capsular release
L. manipulation under anesthesia
M. a physical therapy program
N. an intra-articular corticosteroid injection
O. administration of high-dose oral corticosteroids
P. adding the scores, in all five body systems
Q. adding the squares of the scores in the three most severely injured systems
R. doubling the cumulative score for head and chest injuries
S. combining the scores from the most and least injured systems
T. correcting the score in the most severely injured system for age
U. traumatic femoral head fracture
V. osteonecrosis
W. osteoarthritis
X. neuropathic joint
Y. rheumatoid arthritis
Z. low-dose radiation
[. steroid injection
\. a load-relieving insert and shoe modification
]. complete excision of the mass and the entire plantar fascia
^. wide excision of the mass with a 2 cm margin of normal fascia
_. CT scan of the chest
`. technetium bone scan
A. bone marrow aspiration
B. serum protein electrophoresis
C. lateral skull radiograph
D. high-grade histology of the initial tumor
E. multiple local recurrences after curettage
F. previous treatment of the tumor with cryotherapy
G. previous treatment of the tumor with radiation therapy
H. extraosseous extension into two or more adjacent compartments
I. Dorsal rhizotomy and facet joint fusion
J. Multilevel corpectomy and spinal stabilization
K. Central and lateral recess decompression and bilateral foraminotomy
L. Central decompression and facet joint fusion
M. Central decompression, foraminotomy, and spinal fusion from L2 to L5.
N. Inadequate rehabilitation
O. Displacement of the coronoid process fracture
P. Insufficiency of the lateral ulnar collateral ligament
Q. Insufficiency of the anterior band of the medial collateral ligament
R. Insufficiency of the posterior band of the medial collateral ligament
S. Osteotomy and intramedullary rod fixation
T. Electrical stimulation
U. Strut-autografing the concavity the tibia
V. A patellar tendon-bearing brace
W. Percutaneous injection of demineralized bone matrix
X. digoxin
Y. sucralfate
Z. clindamycin
{. alcohol
|. neuromuscular blocking agents
}. Unrestrained roll-back
~. Unrestrained rotational conformity
. Medial-Lateral conformity
€. Anteroposterior conformity in flexion
. Anteroposterior conformity in extension
‚. Arthrodesis of the MTP joint
ƒ. A Silastic implant of the MTP joint
„. Resection arthroplasty of the MTP joint
…. Cheilctomy of the MTP joint
†. Osteotomy of the base of the proximal phalanx
‡. Genu varum
ˆ. Tarsal coalition
‰. Degenerative ankle arthrosis
Š. Osteochondritis dissecans of the talus
‹. Hemihypertrophy of the ipsilateral lower extremity
Œ. Trabecular bone is preferentially resorbed in this high bone turnover state
. Loss of water content in the disk increases impact load to the vetrebral bodies
Ž. Stress is imposed by the relative stiffness of the arthrtic facet joints
. Increased energy demands are imposed by decreased circulation to the vertebral body
. The thick cortical bone found in the vertebral body resorbs rapidly following estrogen withdrawal
‘. Increased time in stance and swing phase
’. Addition of a double leg float phase
“. Decreased vertical ground reaction forces
”. Decreased arc of motion in the hip, knee, and ankle
•. Decreased joint reaction forces in the hip, knee, and ankle
–. Talonavicular arthrodesis
—. Medial displacement calcaneal osteotomy
˜. Flexor digitorum longus tendon transfer with spring ligament advancement
™. Triple arthrodesis
š. Calcaneocuboid distraction arthrodesis and repair of the posterior tibial tendon
›. Lymphoma
œ. Hemangioma
. Osteosarcoma
ž. TB of the spine
Ÿ. Metastatic breast carcinoma
 . widening and shortening of the heel.
¡. weakness of the gastrocnemius-soleus complex.
¢. anterior impingement from a horizontal talus.
£. unrecognized compartment syndrome of the foot.
¤. degenerative arthritis of the tibiotalar joint.
¥. a corrective osteotomy
¦. application of braces
§. medial physeal stapling until the varus corrects
¨. observation
©. application of corrective casts
ª. a total contact cast.
«. electrical stimulation.
¬. an off the shelf fracture brace.
­. an elastic compression bandage and crutches.
®. a hard soled shoe until the patient is asymptomatic.
¯. Ewings tumor
°. Parosteal osteosarcoma
±. Dedifferentiated chondrosarcoma
². Low grade intramedullary chondrosarcoma
³. High grade intramedullary osteosarcoma
´. Vascular injury
Μ. Tear of the rotator cuff
¶. Injury to the brachial plexus
·. Fracture of the upper thoracic rib
¸. Fracture of the proximal humerus
¹. Biceps
º. Trapezius
». Infraspinatus
¼. Pectoralis major
½. Serratus anterior
¾. Hybrid total hip arthroplasty
¿. Noncemental hemiarthroplasty of the hip
À. Closed reduction and percutaneous pin fixation
Á. Open reduction through an anterior approach to the hip
Â. Excision of the head fragment
Ã. a quadratus femoris pediclebone graft
Ä. a proximal femoral allograft
Å. intertrochanteric osteotomy
Æ. total hip arthroplasty
Ç. hip hemiarthroplasty
È. Echocardiogram
É. Electrocardiogram
Ê. Radiograph of the chest
Ë. CT scan of the shoulder
Ì. Ultrasound of the shoulder
Í. Ilioinguinal
Î. Extended iliofemoral
Ï. Combined ilioinguinal and Kocher-Langenbeck (posterior)
Ð. Kocher-Langenbeck (posterior)
Ñ. Kocher-Langenbeck (posterior) with trochanteric osteotomy
Ò. Deltoid
Ó. Supraspinatus
Ô. Subscapularis Infraspinatus
Õ. Infraspinatus
Ö. Infraspinatus and teres minor
×. an orthosis.
Ø. observation.
Ù. electrical stimulation.
Ú. open reduction and internal fixation.
Û. application of a nonweightbearing short leg cast.
Ü. repair of the rotator cuff.
Ý. rehabilitation of the shoulder
Þ. replacement of the humeral head.
SS. arthroscopic acromioplasty and debridement.
À. immobilization is a sling until pain resolves.
Á. Bone rotation versus torque applied
Â. Bone deflection versus bending moment applied
Ã. Axial displacement versus tension applied
Ä. Lateral translation versus shear force applied
Å. Fracture gap closing versus compressive force applied
Æ. steroid injection
Ç. stretching of the heel cord
È. surgical release of the plantar fascia
É. application of a short leg cast for 6 to 8 weeks
Ê. wearing dorsiflexion night splints
Ë. Open bladder
Ì. Bilateral “hitchhiker’s” thumbs
Í. Bilateral defects in the midclavicles
Î. Rhizomelic shortening of the extremities
Ï. Radiographic fragmentation of all major epiphyses
Ð. Medial patellotibial
Ñ. Medial patellofemoral
Ò. Medial patellomeniscal
Ó. Lateral patellofemoral
Ô. Lateral patellotibial
Õ. Heat
Ö. Gentle active flexion-extension exercises
÷. Isokinetic strengthening
Ø. Electrical muscle stimulation
Ù. Immobilization of the limb with the knee in full flexion
Ú. Distal chevron osteotomy with soft-tissue release
Û. Distal soft-tissue realignment only
Ü. Closing wedge osteotomy (Aken) of the proximal phalanx
Ý. Proximal first metatarsal osteotomy only
Þ. Soft-tissue realignment with a proximal metatarsal osteotomy
Ÿ. Vagus
Ā. Phrenic
Ā. Hypoglossal
Ă. Recurrent laryngeal
Ă. Inferior thyroid
Ą. Surgical exploration
Ą. Application of leeches
Ć. Stellate ganglion blocks
Ć. Intra-arterial streptokinase
Ĉ. Elevation and reevaluation in 1 hour
Ĉ. Liver profile
Ċ. Myleogram
Ċ. Platelet count
Č. CT scan of the head
Č. Angiogram of the extremity
Ď. Post spinal fusion from L5to S1
Ď. Primary repair with an iliac bone graft
Đ. Post spinal fusion of L4-5
Đ. A pantaloon body cast and 6 weeks of bed rest
Ē. Rest, NSAIDS, and limited dancing
Ē. Stress fracture of the proximal fifth metatarsal
Ĕ. Stress fracture of the base of the second metatarsal
Ĕ. Stress fracture of the neck of the second metatarsal
Ė. Morton’s neuroma
Ė. Lisfranc’s joint subluxation
Ę. C5 radiculopathy
Ę. Subscapularis rupture
Ě. Glenohumeral arthrosis
Ě. Rotator cuff arthropathy
Ĝ. Suprascapular nerve compression at the spinoglenoid notch
Ĝ. mm femoral head in combination with a metal-backed polyethylene component
Ğ. mm femoral head in combination with an all-polyethylene acetabular component
Ğ. mm femoral head in combination with a metal-backed polyethylene component
Ġ. mm femoral head in combination with an all-polyethylene component
Ġ. mm femoral head in combination with a metal-backed polyethylene component
Ģ. Female gender
Ģ. History of cigarette smoking
Ĥ. L5-S1 spondylolisthesis on pre-employment radiography
Ĥ. Decreased strength of the lower extremities on pre-employment testing
Ħ. Decreased flexibility of the lumbar spine on pre-employment testing
Ħ. Size of cells
Ĩ. Amount of DNA in cells
Ĩ. Nucleus-cytoplasm ratio
Ī. Specific DNA sequences
Ī. Specific messenger RNA sequences
Ĭ. Femoral and obturator nerves
Ĭ. Femoral and superior gluteal nerves
Į. Femoral and lateral femoral cutaneous nerves
Į. Obturator and superior gluteal nerves
İ. Obturator and lateral femoral cutaneous nerves
I. Isotonic
IJ. Isokinetic
IJ. Isometric
Ĵ. Open kinetic chain
Ĵ. Dynamic variable resistance
Ķ. Closed reduction and cast immobilization
Ķ. Uniplanar external fixation
ĸ. Open reduction and internal fixation with a dynamic compression plate
Ĺ. Unreamed intramedullary rod
Ĺ. Multiple plane external fixator
Ļ. Inlet view of the pelvis
Ļ. Outlet view of the pelvis
Ľ. AP view of the hip
Ľ. Ilial oblique view (external oblique) of the hip
Ŀ. Obturator oblique
Ŀ. Glycolytic pathway
Ł. Oxidative phosphorylation
Ł. Breakdown of fat
Ń. Breakdown of protein
Ń. Breakdown of adenosine triphosphate
Ņ. an MRI scan
Ņ. arthroscopic examination
Ň. AP and frog-lateral radiographs of the pelvis and hips
Ň. varus and valgus stress radiographs of the knee
ʼN. physical examination of the knee under anesthesia
Ŋ. extended curettage and polymethylmethacrylate cementation
Ŋ. extra-articular resection of the knee and an allograft arthrodesis
Ō. wide resection of the proximal tibia and custom prosthetic replacement
Ō. prophylactic internal fixation and postoperative irradiation
Ŏ. excision of the lateral condyle and reconstruction with a hemicondylar allograft
Ŏ. silicone implant joint replacement
Ő. metatarsophalangeal joint arthrodesis
Ő. metatarsophalangeal joint debridement
Œ. resection of the metatarsal head
Œ. resection of the base of the proximal phalanx
Ŕ. Fixation of the syndesmosis has failed
Ŕ. Widening of the ankle mortise has led to the failure of fixation
Ŗ. Infection around the syndesmosis screw has led to osteomyelitis
Ŗ. The syndesmosis screw is broken
Ř. Motion between the tibia and fibula has caused loosening of the syndesmosis screw
Ř. Microcephaly
Ś. A temporal lobe cyst
Ś. An Arnold-Chiari type 1 malformation
Ŝ. Periventricular leukomalacia
Ŝ. Agnesis of the corpus callosum
Ş. Wolff’s
Ş. Hooke’s
Š. Hilton’s
Š. Muller-Haeckel
Ţ. Heuter-Volkmann
Ţ. Both the anterolateral and posteromedial bands are isometric and do not significantly change with flexion
Ť. The anterolateral band is lax and becomes tight in flexion, while the posteromedial band is tight, and becomes lax in flexion
Ť. The anterolateral band is tight and becomes lax in flexion, while the posteromedial band is lax and becomes tight in flexion
Ŧ. Both the anterolateral and posteromedial bands are lax and become tight in flexion
Ŧ. Both the anterolateral and posteromedial bands are tight and become lax as the knee is flexed
Ũ. UCB orthosis
Ũ. Rigid orthosis with a medical arch support
Ū. Semi-rigid orthosis with lateral forefoot posting
Ū. Semi-rigid orthosis with a medial arch support
Ŭ. Medial heel wedge attached to the running shoes
Ŭ. Hallux varus
Ů. Osteonecrosis
Ů. Recurrence of the hallux valgus
Ű. “Transfer” second metatarsalgia
Ű. Physeal arrest of the first metatarsal
Ų. Aseptic loosening in a 70-year-old patient
Ų. Mechanical failure of a hinged knee prosthesis
Ŵ. Failed knee replacement complicated by reflex sympathetic dystrophy
Ŵ. Infection with soft-tissue deficit
Ŷ. A prior patellectomy
Ŷ. Knee fusion
Ÿ. Open irrigation and debridement
Ź. Arthroscopic irrigation and debridement
Ź. One-stage exchange arthroplasty
Ż. Two-stage exchange arthroplasty
Ż. Putti-platt repair
Ž. Open Bankart repair
Ž. Injection of a subacromial corticosteroid
S. Arthroscopic transglenoid capsular shift
Ƀ. Rehabilitation of the scapular and rotator cuff muscles
Ɓ. Silicone suction socket and an energy-absorbing foot
Ƃ. Silicone suction socket and a variable resistance ankle
Ƃ. Plastic suction socket, telescoping pylon, and a solid ankle cushioned heel (SACH) foot
Ƅ. Plastic socket with a hinged thigh cuff and a SACH foot
Ƅ. Patellar tendon-bearing suction socket and a uniaxial hydraulic ankle
Ɔ. Parosteal
Ƈ. Periosteal
Ƈ. High-grade intramedullary
Ɖ. Osteosarcoma occurring in Paget’s disease
Ɗ. Osteosarcoma occurring in irradiated bone
Ƌ. Cauda equina
Ƌ. Conus medullaris
ƍ. Genitofemoral nerve
Ǝ. Lumbar sympathetic plexus
Ə. Lumbar parasympathetic plexus
Ɛ. Spinal pseudoarthrosis
Ƒ. Spinal cord traction injury with paralysis
Ƒ. Arterial and venous thromboses
Ɠ. Superior mesenteric artery syndrome
Ɣ. Crankshaft phenomenon
Ƕ. Inversion stress radiograph
Ɩ. MRI scan
Ɨ. CT scan
Ƙ. Nuclear bone scan
Ƙ. External rotation stress radiograph
Ƚ. Complex deformity with an angulation in two planes
ƛ. Single deformity less than 20 degrees, apex posterolateral
Ɯ. Single deformity greater than 30 degrees, apex posterolateral
Ɲ. Single deformity less than 20 degrees, apex posteromedial
Ƞ. Single deformity greater than 30 degrees, apex posteromedial
Ɵ. Pronation of the foot during the stance phase of gait
Ơ. Heel inversion at the beginning of a single limb heel rise
Ơ. Active inversion of the nonweightbearing foot
Ƣ. Active plantar flexion of the first ray against resistance
Ƣ. Active plantar flexion of the foot during the push-off phase of gait
Ƥ. Observation and repeat radiographs in 4 months
Ƥ. Application of a thoracolumbalsacral orthosis for 22 to 24 hours per day
Ʀ. Electrical stimulation at night
Ƨ. Physical therapy
Ƨ. Begins to remodel and hypertrophy more quickly
Ʃ. Provides a better scaffold for osteoconduction
ƪ. Reduces the risk of early fracture
ƫ. Reduces technical difficulty
Ƭ. Lowers donor site morbidity
Ƭ. Anterior fusion of the lumbar curve
Ʈ. Anterior and posterior fusion of the thoracic curve
Ư. Posterior fusion of the thoracic curve
Ư. Posterior fusion of the thoracic and lumbar curves
Ʊ. Application of a brace until the iliac apophyses are Risser 4 or 5, followed by surgical correction
Ʋ. Subscapularis rupture
Ƴ. Type III SLAP lesion
Ƴ. Disruption of capsular shift
Ƶ. Isolated traumatic subluxation
Ƶ. Injury to the axillary nerve after dislocation
Ʒ. hypophosphatemia
Ƹ. high dietary cholesterol intake
Ƹ. deficiency of lipoprotein A
ƺ. deficiency of protein S and protein C
ƻ. elevated levels of antithrombin III
Ƽ. Weightbearing short leg cast
Ƽ. Nonweightbearing short leg cast
ƾ. Removable splint and early motion
Ƿ. Open reduction and internal fixation
ǀ. Elastic compression bandage with full weightbearing
ǁ. Breast
ǂ. Prostate
ǃ. Gastrointestinal
DŽ. Kidney
DŽ. Multiple myeloma
DŽ. Varus stress
LJ. Valgus stress
LJ. Torsional loading
LJ. Hyperextension of the knee
NJ. Contraction of the quadriceps while axially loaded
NJ. Primary internal fixation at both fracture levels
NJ. External fixation as definitive ttt for both #
Ǎ. Skeletal traction and delayed internal fixation of both fractures
Ǎ. Primary internal fixation of the proximal fracture and delayed fixation of the femoral fracture
Ǐ. Primary internal fixation of the femoral shaft fracture and delayed fixation of the proximal #
Ǐ. Heel spur
Ǒ. Plantar fascitis
Ǒ. Dysfunction of the tibialis posterior tendon
Ǔ. Compression of the first branch of the lateral plantar nerve
Ǔ. Compression of the calcaneal nerve
Ǖ. Displaced labral tear
Ǖ. Tear of the rotator cuff
Ǘ. Fracture of the glenoid rim
Ǘ. Palsy of the axillary nerve
Ǚ. Palsy of the musculocutaneus nerve
Ǚ. Enchondroma
Ǜ. Osteoblastoma
Ǜ. Giant cell tumor
Ǝ. Aneurysmal bone cyst
Ǟ. Fibrous dysplasia
Ǟ. Arthrogram of the wrist
Ǡ. MRI scan of both wrists
Ǡ. CT scan of both wrists in the same position
Ǣ. Radiographs of the wrist in supination and pronation
Ǣ. Radiographs of the opposite wrist in the same position
Ǥ. Secondary hyperparathyroidism
Ǥ. Phosphate retention secondary to uremia
Ǧ. Insufficient renal synthesis of 1, 25 dihydroxy vitamin D
Ǧ. Aluminum deposition in bone from oral phosphate binders
Ǩ. Persistent acidosis aggravating the negative calcium balance
Ǩ. Posterior fusion at T10-L3 with segmental instrumentation
Ǫ. Laminectomy and fusion of T12-L2 with segmental instrumentation
Ǫ. Bed rest in a hyperextension brace
Ǭ. L1 vertebrectomy and anterior decompression with strut graft fusion and instrumentation
Ǭ. Progressive ambulation as tolerated in a custom-molded thoracolumbosacral orthosis
Ǯ. Positive-pressure ventilation
Ǯ. An immediate radiograph of the chest
J̌. Adjustment of the position of the endotrachael tube
DZ. Insertion of a large-bore needle into the pericardial space
DZ. Insertion of a large-bore needle in the right second intercostal space, midclavicular line
DZ. Allowing the ends of the fracture to touch
Ǵ. Adding a second connecting bar
Ǵ. Adding one pin to each fracture fragment
Ƕ. Increasing the pin diameter from 4 mm to 6 mm
Ƿ. Decreasing the connecting bar-to-bone distance from 6 cm to 4 cm
Ǹ. Osteomyelitis
Ǹ. Malignant degeneration
Ǻ. Stress fracture
Ǻ. Local recurrence of the giant cell tumor
Ǽ. Bone resorption due to methylmethacrylate
Ǽ. Advancement of the plantar plate
Ǿ. Resection of the second metatarsal head
Ǿ. Dorsiflexion osteotomy of the second metatarsal neck
Ȁ. Transfer of the flexor digitorum longus tendon to the dorsum of the toe
Ȁ. Transfer of the extensor digitorum comminus tendon to the metatarsal neck
Ȃ. Sacral fracture
Ȃ. Burst fracture of L5
Ȅ. Cauda equina syndrome
Ȅ. Distraction-flexion injury at L3
Ȇ. Distraction-extension injury at L3
Ȇ. An MRI scan of the shoulder
Ȉ. An MRI scan of the cervical spine
Ȉ. Electromyographic and nerve conduction velocity studies
Ȋ. Immobilization in a sling and early passive range of motion exercises
Ȋ. Immediate return to the operating room for exploration of the brachial plexus
Ȍ. cerclage wiring
Ȍ. tension band wiring
Ȏ. removal of the patellar component
Ȏ. revision of the patellar component
Ȑ. immobilization of the knee and protected weightbearing
Ȑ. Liposarcoma
Ȓ. Nodular fasciitis
Ȓ. Rabdomyosarcoma
Ȕ. Malignant fibrous histiocytoma
Ȕ. Extra-abdominal desmoid tumor
Ȗ. Clubfeet
Ȗ. Thrombocytopenia
Ș. Congenital scoliosis
Ș. Ventricular septal defect
Ț. Arnold-Chiari malformation
Ț. delayed primary closure
Ȝ. free flap
Ȝ. pedicle groin flap
Ȟ. full-thickness skin graft
Ȟ. split-thickness skin graft
Ƞ. Infection
ȡ. Nonunion
Ȣ. Improper screw length
Ȣ. Osteonecrosis of the distal fragment
Ȥ. Use of a cortical screw instead of a cancellous screw
Ȥ. Infection
Ȧ. Tear of the rotator cuff
Ȧ. Loosening of the humeral component
Ȩ. Arthritis of the glenoid
Ȩ. Arthritis of the A-C joint
Ȫ. Reduced morbidity
Ȫ. Improved osteoinduction
Ȭ. Improved osteoconduction
Ȭ. More rapid revascularization
Ȯ. Lower risk of disease transmission
Ȯ. Manipulation Under Anesthesia
Ȱ. Arthroscopic acromioplasty
Ȱ. Arthroscopic debridement of G-H joint
Ȳ. Replacement of the humeral head
Ȳ. Lengthening of the subscapularis and release of the anterior capsule
ȴ. Bacteroides
ȵ. E. coli
ȶ. Staph. aureus
ȷ. group A streptococcus
ȸ. Clostridium perforingens
ȹ. observation and exercises
Ⱥ. bracing with a thoracolumbar orthosis
Ȼ. fusion of the posterior spine
Ȼ. fusion of the anterior spine
Ƚ. fusion of the anterior and posterior spine
Ⱦ. Total wrist replacement and bridge grafts
Ȿ. palmar shelf arthroplasty and tendon transfers
Ɀ. Darrach distal ulna resection, dorsal tenosynosynovectomy, and tendon transfers
Ɂ. Radioscaphate fusion, extensor tenodesis, and Darrach distal ulna resection
Ɂ. Total wrist fusion and tendon transfers
Ƀ. constrained acetabular component
Ʉ. protrusion ring with morselized graft
Ʌ. cemented metal backed acetabular component
Ɇ. cemented all-polyethylene acetabular component
Ɇ. cementless hemispherical component with screw fixation
Ɉ. application of a hip abduction brace for 22 hours per day
Ɉ. application of a hip spica under anesthesia
Ɋ. discontinuance of all bracing and repeat radiographs in 3 months
Ɋ. open reduction of the hip and application of a spica cast
Ɍ. open reduction, varus osteotomy, and application of a spica cast
Ɍ. Loss of skin hair on the feet
Ɏ. Absent pulses on vascular examination
Ɏ. Pain that originates proximally and spreads distally
Ɐ. Pain that is relieved by stopping and standing
Ɑ. Pain that is worse when the patient walks uphill rather downhill
Ɒ. wrist flexors and finger flexors
Ɓ. elbow flexors and wrist flexors
Ɔ. elbow flexors and finger flexors
ɕ. elbow extensors and wrist flexorst Level Key Muscles4 DiaphragmDeltoid, elbow flexors, diaphragmElbow flexors, wrist extensorsElbow extensors, wrist flexorsFinger flexors (distal phalanx of middlefinger)Finger abductors (5th digit), intrinsics of hand2 Segmental innervation to intercostal muscles, abdominal and paraspinal muscles) L1, L2, L3 Hip flexors3, L4 QuadricepsTibialis anteriorToe extensors, hip abductorsAnkle plantarflexors, peronei
Ɖ. elbow extensors and wrist extensors
Ɗ. Syndactyly
ɘ. Macrodactyly
Ə. Camptodactyly
ɚ. Preaxial polydactyly
Ɛ. Postaxial polydactyly
Ɜ. Arthrodesis
ɝ. Rotationplasty
ɞ. Above-knee amputation
ɟ. Osteoarticular allograft
Ɠ. Endoprosthesis (custom arthroplasty)
Ɡ. Plantar fascia
ɢ. Spring ligament
Ɣ. Deltoid ligament
ɤ. Intrinsic tendons
Ɥ. Gastorcnemius-solelus complex
Ɦ. Prevention of presynaptic release of acetylcholine
ɧ. Prevention of synthesis of presynaptic acetylcholine
Ɨ. Activation of acetylcholinesterase at the motor end-plate
Ɩ. Blockage of postsynaptic action of acetylcholine until reserves are depleted
Ɪ. Stimulation of release of presynaptic acetylcholine until reserves are depleted
Ɫ. stiffness of the femoral component.
Ɬ. head offset of the femoral component.
ɭ. femoral component material modulus of elasticity.
ɮ. extent of the femoral component porous coating.
Ɯ. Presence of a femoral component collar.
ɰ. plantar fascia and quadratus plantae tendon.
Ɱ. ligamentous structures connecting the tarsal bones.
Ɲ. shape of the tarsal bones and the intervening joints.
ɳ. activity of the intrinsic muscles of the foot.
ɴ. activity of the posterior tibialis and the peroneus longus muscles.
Ɵ. scapulothoracic fusion
ɶ. strengthening of the periscapular muscles
ɷ. pectoralis minor-fascia lata graft transfer to the scapula
ɸ. pectoralis major-fascia lata graft transfer to the scapula
ɹ. exploration of the long thoracic nerve, with sural nerve graft
ɺ. tricompartmental knee replacement
ɻ. unicompartmental knee replacement
ɼ. medial compartment meniscal allograft
Ɽ. valgus-producing distal femoral osteotomy
ɾ. valgus-producing proximal tibial osteotomy
ɿ. Internal rotation of the femoral component
Ʀ. External rotation of the tibial component
ʁ. Lateral placement of the femoral component
Ʂ. Medial placement of the patellar component
Ʃ. Excessive resection of the patella
ʄ. Hallux rigidus
ʅ. Hallux valgus
ʆ. Neuroma of the first web space
Ʇ. Fracture of the sesamoid
Ʈ. Rupture of the flexor hallucis longus
Ʉ. Sickle cell crisis
Ʊ. Idiopathic chondrolysis
Ʋ. Hemophilic arthropathy
Ʌ. Osteoid osteoma of the femoral neck
ʍ. Legg-Calve-Perthes disease
ʎ. Decreased ankle jerk and positive femoral nerve stretch test
ʏ. Decreased knee jerk and positive straight-leg raising sign
ʐ. Gastrocnemius-soleus complex weakness and positive straight-leg raising sign
ʑ. Weakness of the extensor hallucis longus and positive straight-leg raising sign
Ʒ. Weakness of the extensor hallucis longus and positive femoral nerve stretch test
ʓ. Long-term administration of IV and oral antibiotics
ʔ. Open soft-tissue debridement, retention of prosthetic components, and IV antibiotics
ʕ. Immediate exchange arthroplasty with antibiotic-impregnated cement
ʖ. Two-stage surgical prosthetic exchange and IV antibiotics
ʗ. Resection arthroplasty and IV antibiotics
ʘ. SCFE
ʙ. MED
ʚ. Perthes disease
ʛ. Hypothyroidism
ʜ. Chondrolysis
Ʝ. gout.
Ʞ. osteoporosis.
ʟ. eosinophilic granuloma.
ʠ. tuberculosis of the spine.
ʡ. metastatic disease of the spine.
ʢ. water content.
ʣ. Synthesis of type I collagen.
ʤ. Proteoglycan content.
ʥ. Activity of chondrocytes.
ʦ. Synthesis of hyaluronate.
ʧ. Lung
ʨ. Breast
ʩ. Prostate
ʪ. Thyroid
ʫ. Renal
ʬ. T1-low, T2-low.
ʭ. T1-low, T2-high.
ʮ. T1-moderate, T2-low.
ʯ. T1-high, T2-low.
ʰ. T1-high, T2-high.
ʱ. hypothesis is incorrect or invalid
ʲ. interobserver error rate is 4%.
ʳ. Standard deviation is 4% higher or lower than the mean.
ʴ. Sample size is 4% larger than required to be clinically significant.
ʵ. Probability that the differences noted between two study groups were due to chance alone is 4%.
ʶ. I
ʷ. II
ʸ. IV
ʹ. IX
ʺ. X
ʻ. Cranial setting
ʼ. Cranial subluxation
ʽ. Odontoid fracture
ʾ. Lysis of the arch of the atlas
ʿ. Atlantoaxial subluxation
ˀ. Retrograde collapse of the endoneurial tubes
ˁ. Irreversible atrophy of the denervated muscles
˂. Elongation of the axons across the zone of injury
˃. Sprouting of the axons at the neuromuscular junction
˄. Misdirection of the axons across the zone of injury
˅. Maximally pronated and elbow extended
ˆ. Maximally pronated and the elbow flexed
ˇ. Maximally supinated and the elbow flexed
ˈ. Maximally supinated and the elbow extended
ˉ. In neutral rotation, with the elbow extended
ˊ. open reduction and internal fixation
ˋ. buddy taping to the adjacent index finger
ˌ. early motion with application of a dynamic banjo splint
ˍ. application of a cast with the hand in a “safe position” for 3 weeks.
ˎ. dorsal extension block splinting
ˏ. The name of the manufacturer
ː. The manufacturer’s potential liability
ˑ. The physician’s clinical performance
˒. The physician’s materials testing data
˓. Any royalties the physician receives from the manufacturer
˔. Femoral
˕. Obturator
˖. Inferior gluteal
˗. Superior gluteal
˘. Lateral femoral cutaneous
˙. open biopsy and a long leg cast
˚. open biopsy and wide resection of the tumor
˛. a long leg cast and observation
˜. intramedullary stabilization and observation
˝. Triggering
˞. Lateral instability
˟. Swan-neck deformity
ˠ. Boutonniere deformity
ˡ. Loss of distal interphalangeal joint flexion
ˢ. Peroneus brevis to peroneus longus
ˣ. Peroneus tertius to extensor hallucis longus
ˤ. Peroneus tertius to superficial peroneal nerve
˥. Extensor hallucis longus to deep peroneal nerve
˦. Extensor hallucis longus to extensor digitorum longus
˧. reassurance that Medicare will pay for the treatment.
˨. consent forms that patients or their guardians are able to understand.
˩. a detailed description of the device, omitting the fact that it is part of a study.
˪. a provision that the patient’s care will be discontinued if he or she does not enroll in the study.
˫. a provision that the study will be carried out to completion, whether or not the device is as effective as those currently in existence.
ˬ. an onlay iliac crest bone graft.
˭. limited weightbearing and observation.
ˮ. removal of the implant and limited weightbearing.
˯. removal of the implant and insertion of a reamed femoral nail.
˰. removal of the implant and insertion of an unreamed femoral nail.
˱. Coronal
˲. Sagittal
˳. Anteromedial, midway between the sagittal and the coronal
˴. Proximal pins sagittal, distal pins coronal
˵. Proximal pins coronal, distal pins sagittal
˶. Rheumatoid arthritis
˷. Posttraumatic arthritis
˸. Degenerative osteoarthritis
˹. Osteonecrosis of the tibial plateau
˺. Osteonecrosis of the medial femoral condyle
˻. Trapeziometacarpal arthrodesis
˼. Osteotomy of the thumb metacarpal
˽. Arthrotomy and joint debridement
˾. Ligament reconstruction using one half of the flexor carpi radialis
˿. Trapezium resection, tendon interposition, and reconstruction of the ligament
̀. Creep
́. Relaxation
̂. Energy dissipation
̃. Plastic deformation
̄. Elastic deformation
̅. bending
̆. axial loading
̇. high-speed rotation
̈. direct impact from anteromedial
̉. crush from anteromedial to posterolateral
̊. Increase stiffness
̋. Increase fracture toughness
̌. Increase fatigue strength
̍. Decrease mechanical strength
̎. Decrease wear rate
̏. disuse osteopenia
̐. paraendocrine effect of the tumor
̑. abnormally increased density on the right side
̒. side effect of the treatment of the lesion
̓. extensive tumor involvement of the left hip
̔. Sciatic nerve
̕. Superior gluteal artery
̖. Profunda femoris artery
̗. Femoral artery and nerve
̘. External iliac artery and vein
̙. Length
̚. Moment arm
̛. Total volume
̜. Physiologic cross-sectional area
̝. Distribution of slow and fast twitch fibers
̞. decreasing initiation of action potentials.
̟. increasing action potential amplitude.
̠. blocking the opening of gated sodium channels.
̡. decreasing the number of functional motor units.
̢. slowing or stopping action potential propagation through the axon.
̣. resection of the metatarsal heads of the first through fifth toes.
̤. Silastic MP joint arthroplasties of the first through fifth toes.
̥. fusion of the hallux MP joint and resection arthroplasty of the 2nd through fifth metatarsal heads.
̦. fusion of hallux MP joint and distal osteotomy of the 2nd through 5th MT.
̧. plantar condylectomy of the 2nd through 5th MT heads & resection of proximal phx of the hallux.
̨. hemiarthroplasty
̩. open reduction and internal fixation
̪. closed reduction and percutaneous pinning
̫. a sling and early pedulum exercises
̬. a sling and swathe for 6 weeks, followed by shoulder rehabilitation
̭. open acromioplasty
̮. open Bankart repair
̯. open subscapularis tendon repair
̰. inferior capsular shift
̱. a supervised physical therapy program
̲. a sling and swathe, with pendulum exercises in 10 days
̳. open reduction and internal fixation through an anterior approach
̴. open reduction and internal fixation through a posterior approach
̵. immobilization with a splint in 45 degrees of abduction for 6 weeks
̶. arthroscopically assisted reduction and percutaneous screw fixation
̷. Repair of the rotator cuff
̸. Replacement of the humeral head
̹. Resection arthroplasty
̺. Total shoulder arthroplasty
̻. AP and lateral radiographs of the elbow
̼. Diagnositc arthroscopy
̽. Aspiration of joint fluid
̾. An erythrocyte sedimentation rate and CBC
̿. A diagnostic lidocaine injection
̀. Insulin-like growth factor (IGF-1)
́. Fibroblast growth factor (FGF-1)
͂. Platelet-derived growth factor (PDGF)
̓. Transforming growth factor beta (TGF-B)
̈́. Bone morphogenetic proteins (BMP)
Ι. clinical history and radiographic findings.
͆. technetium bone scan
͇. flow cytometry pattern of extracted chondrocytes
͈. immunohistochemical staining patterns of a biopsy specimen
͉. histologic features of a biopsy specimen stained with hematoxylin-cosin
͊. Radial
͋. Radial recurrent
͌. Posterior interosseous
͍. Superior ulnar recurrent
͎. Superficial radial circumflex
͏. Impaired hydroxylation of proline
͐. Failure of cleavage in procollagen
͑. Defective binding sites for hydroxyproline
͒. Failure to incorporate glycine into the helix
͓. Diminished production of collagen through the rough endoplasmic reticulum
͔. Asking the legal staff to seek a court injunction
͕. Copying the patient’s chart and giving it to him as he leaves
͖. Having the patient sign a written legal contract that specifies acceptable behavior
͗. Continuing care of the patient until an appropriate referral can be arranged
͘. Transferring the patient to another orthopaedic surgeon without disclosing the realreason for why the patient is being transferred
͙. Meta-analysis
͚. Confidence interval
͛. Analysis of variance (ANOVA)
͜. Statistical significance (p-value)
͝. Survivorship analysis (Kaplan-Meier)
͞. Spinal shock
͟. Neurogenic shock
͠. Hypovolemic shock
͡. Pulmonary embolism
͢. Fat embolus syndrome
ͣ. Lumbar spinal stenosis
ͤ. Metastatic disease of the spine
ͥ. Rheumatoid lumbar spondylitis
ͦ. Isthmic spondyloloisthesis
ͧ. Degenerative spondylolisthesis at L4-5 and L5-S1
ͨ. Patella alta
ͩ. A metal-backed patella
ͪ. Varus malalignment of the knee
ͫ. A posterior cruciate-substituting femoral component
ͬ. Lateral subluxation of the patella on a Merchant’s view
ͭ. The sesamoids are separated
ͮ. The sesamoid is fractured
ͯ. The proximal phx is on the neck of the metatarsal
Ͱ. The dislocation is dorsal and centered
Ͱ. The proximal phalanx is hyperextended
Ͳ. Patella
Ͳ. Tibial stem
ʹ. Distal femoral interface
͵. Posterior femoral interface
Ͷ. Sites of screw fixation for the tibia
Ͷ. Hallux rigidus
͸. Fracture of the sesamoid
͹. Disruption of the plantar plate
ͺ. Osteonecrosis of the metatarsal head
Ͻ. Rupture of the flexor hallucis longus
Ͼ. Gout
Ͽ. Sepsis
;. Old trauma
Ϳ. Rheumatoid arthritis
΀. Charcot arthroplasty
΁. Aspiration and steroid injection
΂. Biopsy, curettage, and allograft bone grafting
΃. Percutaneous Kirschner wire fixation
΄. Percutaneous injection of autogenous bone marrow
΅. Nerve roots
Ά. Spinal cord
·. Sciatic nerve
Έ. Peroneal nerve
Ή. Conus medullaris
Ί. Extent of bone penetrated by reaming, prosthetic components, or acrylic cement
΋. Periprosthetic regions that are accessible to joint fluid and particulate wear debris
Ό. Enveloping pseudocapsular scar tissue that develops around a prosthetic hip following surgical capsulectomy
΍. Soft tissue and bone that are potentially contaminated with bacteria in the setting of a prosthetic joint infection
Ύ. Potential intrapelvic joint space communication created by acetabular fixation screws or intrapelvic extruded acrylic cement
Ώ. Early and late infection
Ϊ́. Periprosthetic fracture of the femur
Α. Failure of the patellofemoral and extensor mechanisms
Β. Aseptic loosening of cementing tibial components
Γ. Asceptic loosening of cemented femoral components
Δ. Acceptance of the current position of the ankle
Ε. Open reduction and fixation in the epiphysis only
Ζ. ORIF with a small-fragment T-plate from the malleolus up to the metaphysis
Η. Closed reduction by eversion of the ankle and application of a bivalved long leg cast
Θ. CRUGA and fixation with a malleolar screw from the malleolus into the metaphysis
Ι. Resection arthroplasty and local radiation
Κ. In situ fusion of the hip
Λ. Excision of heterotopic bone, total hip arthroplasty, and oral indomethacin
Μ. Excision of heterotopic bone and local radiation
Ν. Excision of heterotopic bone, hemiarthroplasty, and oral indomethacin
Ξ. Closed reduction of both fractures and immediate spica casting
Ο. Bilateral skin traction for 3 weeks, followed by spica casting
Π. External fixation of both femora
Ρ. External fixation of the left femur and a long leg cast brace for the right femur
΢. External fixation of the left femur and use of a reamed intramedullary nail in the right femur
Σ. Synovial sarcoma
Τ. Soft-tissue abcess
Υ. Rhabdomyosarcoma
Φ. Eosinophilic granuloma
Χ. Nodular pigmented villonodular synovitis
Ψ. Changing to a titanium nail
Ω. Changing to a nonslotted nail
Ϊ. Changing the cross-sectional shape of the nail
Ϋ. Increasing the diameter of the nail by 3 mm
Ά. Increasing the diameter of the interlocking screws
Έ. Fracture healing
Ή. Chondrosarcoma
Ί. Periosteal chondroma
Ϋ́. Periosteal osteosarcoma
Α. Dysplasia epiphysealis hemimelica
Β. Demonstrate competence in the subject of the case
Γ. Be fellowship trained in the subject of the case
Δ. Be paid on a contingency basis
Ε. Be board certified by the American Board of Orthopaedic Surgery
Ζ. Have been involved in the case as a consultant
Η. Diagnostic arthroscopy
Θ. Arthroscopy and subacromial decompression
Ι. Reduction and fixation of the proximal humeral epiphysis
Κ. Temporary cessation of throwing
Λ. Physical therapy for rotator cuff strengthening
Μ. Oblique popliteal ligament
Ν. Lateral capsule
Ξ. Popliteal tendon
Ο. Fibular collateral ligament
Π. Posterior oblique ligament
Ρ. Radial tear
Σ. Parrot-beak tear
Σ. Vertical tear in the “red-red” zone
Τ. Vertical tear in the “red-white” zone
Υ. Vertical tear in the “white-white” zone
Φ. 0 degrees of abduction, with neural rotation
Χ. 40 degrees of flexion and 60 degrees of internal rotation
Ψ. 45 degrees of flexion and 45 degrees of external rotation
Ω. 90 degrees of abduction with neutral rotation
Ϊ. 90 degrees of abduction and 90 degrees of external rotation
Ϋ. Sural
Ό. Saphenous and its branches
Ύ. Posterior tibial and its branches
Ώ. Deep peroneal and its branches
Ϗ. Superficial peroneal and its branches
Β. Strength
Θ. Stiffness
ϒ. Shelf life
ϓ. Antigenicity
ϔ. Risk of HIV transmission
Φ. Indemnification
Π. Occurrence
Ϗ. Excess liability
Ϙ. Claims-made
Ϙ. Nose
Ϛ. Lateral Y
Ϛ. Scapular AP
Ϝ. Neutral rotation AP
Ϝ. Internal rotation AP
Ϟ. External rotation AP
Ϟ. Trauma
Ϡ. Hemophilia
Ϡ. Reiter’s syndrome
Ϣ. Rheumatoid arthritis
Ϣ. Systemic lupus erythematosus
Ϥ. Cast immobilization for 6 weeks
Ϥ. Activity modification and re-evaluation in 2 months
Ϧ. Internal fixation with or without bone grafting
Ϧ. Retrograde drilling of the defect without articular cartilage penetration
Ϩ. Drilling of the defect directly through the articular cartilage
Ϩ. repair or reconstruction of the medial collateral ligament
Ϫ. repair or reconstruction of the medialand lateral collateral ligaments
Ϫ. immobilization for 5 days or less
Ϭ. immobilization for 14 days
Ϭ. immobilization for 25 days
Ϯ. Cystinosis
Ϯ. Hypophosphatemia
Κ. Renal osteodystrophy
Ρ. Primary hyperparathyroidism
Ϲ. Nutritional vitamin D deficiency
Ϳ. Lateral meniscus tear
ϴ. Popliteus tenosynovitis
Ε. Iliotibial band friction syndrome
϶. Peroneal nerve entrapment
Ϸ. Biceps tendinitis
Ϸ. Observation
Ϲ. Removal of the prosthetic components
Ϻ. Operative exploration and decompression of the peroneal nerve
Ϻ. Nerve conduction velocity studies
ϼ. Loosening of the primary dressings and knee flexion to 30 degrees
Ͻ. I
Ͼ. II
Ͽ. III
Ѐ. decreased tissue tension
Ё. decreased abductor lever arm
Ђ. decreased joint reaction force
Ѓ. increased body weight over lever arm
Є. increased polyethylene wear rate
Ѕ. recurrent traumatic anterior dislocation
І. recurrent traumatic posterior dislocation
Ї. traumatic subluxation with no previous dislocation
Ј. traumatic anterior subluxation
Љ. atraumatic involuntary subluxation
Њ. radial
Ћ. axillary
Ќ. suprascapular
Ѝ. thoracodorsal
Ў. long thoracic
Џ. Flexion
А. Extension
Б. Axial rotation
В. Left lateral bending
Г. Right lateral bending
Д. Skin
Е. Lung
Ж. Brain
З. Heart
И. Kidney
Й. Thoracoacromial, lateral thoracic, subscapular
К. Thoracoacromial, anterior humeral circumflex, posterior humeral circumflex
Л. Posterior humeral circumflex, subscapular, thoracacromial
М. Subscapular, thoracacromial, anterior humeral circumflex
Н. Lateral thoracic, anterior humeral circumflex, thoracacromial
О. Respondeat superior
П. Indemnity agreement
Р. Hold harmless agreement- attempt to shift liability from company to physician
С. Comparative negligence-% of involvement
Т. Contributory negligence- resident contributed to the negligence
У. t-type
Ф. both column
Х. transverse
Ц. anterior column
Ч. anterior column posterior hemitransverse
Ш. Posterior interosseous
Щ. Anterior interosseous
Ъ. Radial
Ы. Median
Ь. Ulnar
Э. Shock from hypovolemia
Ю. Associated rupture of the bladder
Я. Arterial bleeding on pelvic angiogram
А. Presence of a hematoma in the perineum and scrotum
Б. Fractures of both the anterior and posterior pelvic ring

Correct Answer & Explanation

. MRI scan


Explanation

Question 4064

Topic: 10. Pathology and Oncology

  • A 39-year-old woman jammed her long finger playing softball 24 hours ago. She is unable to actively extend the proximal interphalangeal joint; however, when the joint is brought passively into full extension, she is able to maintain that position. Management should consist of
. Open repair of the central slip of the extensor mechanism
. Open repair of the terminal tendon of the extensor mechanism
. Closed splinting with the proximal interphalangeal joint
. Closed splinting with the proximal interphalangeal joint in 30 degrees of flexion
. Closed splinting with the proximal interphalangeal joint in 45 degrees of flexion
. Anteriorly at 20 to 30 degrees of flexion
. Anteriorly at 70 to 90 degrees of flexion
. Posteriorly at 20 to 30 degrees of flexion
. Posteriorly at 70 to 90 degrees of flexion
. Anteriorly with the knee in full flexion
. Rett syndrome
. Cerebral palsy
. Myotonic dystrophy
. Fragile-X syndrome
. Adrenoleukodystrophy
. Endurance limit
. Failure stress
. Critical stress
. Yield stress
. Elastic limit
. Ewing’s sarcoma
. Osteogenic sarcoma
. Multiple myeloma
. Metastatic prostate carcinoma
. Metastatic breast carcinoma
. Higher subsequent loosening rate of the femoral component
. Higher subsequent polyethylene wear rate
. Higher subsequent dislocation rate
. Higher infection rate
. Unaltered subsequent survival rate of the femoral component
. Crevice corrosion
. Oscillatory fretting
!. Oxidative degradation
". Adhesion and abrasion
#. Fatigue and delamination
$. a total contact cast.
%. partial calcanectomy
&. Syme’s amputation
'. transtibial amputation.
(. nonweightbearing and IV antibiotics.
). Sural artery island flap.
*. Free rectus abdominis flap.
+. Extensor digitorum brevis flap.
,. Staged cross leg flap.
-. Split-thickness skin graft.
.. An anterior cruciate functional knee brace.
/. A physical therapy program.
0. Reconstruction of the posterior cruciate ligament and the posterolateral corner.
1. Reconstruction of the posterior cruciate ligament.
2. Reconstruction of the anterior cruciate ligament.
3. Avoids the risk of marrow emboli
4. Avoids injury to the intramedullary nutrient vessels
5. Results in faster healing of fractures
6. Results in more secure fixation
7. Results in faster regeneration of the endosteal blood supply
8. Above-knee amputation
9. En bloc resection of the lesion and reconstruction with a bone graft
:. Closed reduction and immobilization in a cast
;. Open reduction and internal fixation, followed by radiation therapy
<. Open reduction, curettage, and cementing of the lesion
=. Injury to the subclavian artery
>. Injury to the brachial plexus
?. Segmental fracture
@. 100% displacement
A. Associated displaced surgical neck fracture of the humerus
B. humeral arthroplasty2/. repair of the rotator cuff
C. closed reduction and immobilization
D. open reduction and immobilization
E. open reduction and early passive motion
F. arthroscopic capsular release
G. manipulation under anesthesia
H. a physical therapy program
I. an intra-articular corticosteroid injection
J. administration of high-dose oral corticosteroids
K. adding the scores, in all five body systems
L. adding the squares of the scores in the three most severely injured systems
M. doubling the cumulative score for head and chest injuries
N. combining the scores from the most and least injured systems
O. correcting the score in the most severely injured system for age
P. traumatic femoral head fracture
Q. osteonecrosis
R. osteoarthritis
S. neuropathic joint
T. rheumatoid arthritis
U. low-dose radiation
V. steroid injection
W. a load-relieving insert and shoe modification
X. complete excision of the mass and the entire plantar fascia
Y. wide excision of the mass with a 2 cm margin of normal fascia
Z. CT scan of the chest
[. technetium bone scan
\. bone marrow aspiration
]. serum protein electrophoresis
^. lateral skull radiograph
_. high-grade histology of the initial tumor
`. multiple local recurrences after curettage
A. previous treatment of the tumor with cryotherapy
B. previous treatment of the tumor with radiation therapy
C. extraosseous extension into two or more adjacent compartments
D. Dorsal rhizotomy and facet joint fusion
E. Multilevel corpectomy and spinal stabilization
F. Central and lateral recess decompression and bilateral foraminotomy
G. Central decompression and facet joint fusion
H. Central decompression, foraminotomy, and spinal fusion from L2 to L5.
I. Inadequate rehabilitation
J. Displacement of the coronoid process fracture
K. Insufficiency of the lateral ulnar collateral ligament
L. Insufficiency of the anterior band of the medial collateral ligament
M. Insufficiency of the posterior band of the medial collateral ligament
N. Osteotomy and intramedullary rod fixation
O. Electrical stimulation
P. Strut-autografing the concavity the tibia
Q. A patellar tendon-bearing brace
R. Percutaneous injection of demineralized bone matrix
S. digoxin
T. sucralfate
U. clindamycin
V. alcohol
W. neuromuscular blocking agents
X. Unrestrained roll-back
Y. Unrestrained rotational conformity
Z. Medial-Lateral conformity
{. Anteroposterior conformity in flexion
|. Anteroposterior conformity in extension
}. Arthrodesis of the MTP joint
~. A Silastic implant of the MTP joint
. Resection arthroplasty of the MTP joint
€. Cheilctomy of the MTP joint
. Osteotomy of the base of the proximal phalanx
‚. Genu varum
ƒ. Tarsal coalition
„. Degenerative ankle arthrosis
…. Osteochondritis dissecans of the talus
†. Hemihypertrophy of the ipsilateral lower extremity
‡. Trabecular bone is preferentially resorbed in this high bone turnover state
ˆ. Loss of water content in the disk increases impact load to the vetrebral bodies
‰. Stress is imposed by the relative stiffness of the arthrtic facet joints
Š. Increased energy demands are imposed by decreased circulation to the vertebral body
‹. The thick cortical bone found in the vertebral body resorbs rapidly following estrogen withdrawal
Œ. Increased time in stance and swing phase
. Addition of a double leg float phase
Ž. Decreased vertical ground reaction forces
. Decreased arc of motion in the hip, knee, and ankle
. Decreased joint reaction forces in the hip, knee, and ankle
‘. Talonavicular arthrodesis
’. Medial displacement calcaneal osteotomy
“. Flexor digitorum longus tendon transfer with spring ligament advancement
”. Triple arthrodesis
•. Calcaneocuboid distraction arthrodesis and repair of the posterior tibial tendon
–. Lymphoma
—. Hemangioma
˜. Osteosarcoma
™. TB of the spine
š. Metastatic breast carcinoma
›. widening and shortening of the heel.
œ. weakness of the gastrocnemius-soleus complex.
. anterior impingement from a horizontal talus.
ž. unrecognized compartment syndrome of the foot.
Ÿ. degenerative arthritis of the tibiotalar joint.
 . a corrective osteotomy
¡. application of braces
¢. medial physeal stapling until the varus corrects
£. observation
¤. application of corrective casts
¥. a total contact cast.
¦. electrical stimulation.
§. an off the shelf fracture brace.
¨. an elastic compression bandage and crutches.
©. a hard soled shoe until the patient is asymptomatic.
ª. Ewings tumor
«. Parosteal osteosarcoma
¬. Dedifferentiated chondrosarcoma
­. Low grade intramedullary chondrosarcoma
®. High grade intramedullary osteosarcoma
¯. Vascular injury
°. Tear of the rotator cuff
±. Injury to the brachial plexus
². Fracture of the upper thoracic rib
³. Fracture of the proximal humerus
´. Biceps
Μ. Trapezius
¶. Infraspinatus
·. Pectoralis major
¸. Serratus anterior
¹. Hybrid total hip arthroplasty
º. Noncemental hemiarthroplasty of the hip
». Closed reduction and percutaneous pin fixation
¼. Open reduction through an anterior approach to the hip
½. Excision of the head fragment
¾. a quadratus femoris pediclebone graft
¿. a proximal femoral allograft
À. intertrochanteric osteotomy
Á. total hip arthroplasty
Â. hip hemiarthroplasty
Ã. Echocardiogram
Ä. Electrocardiogram
Å. Radiograph of the chest
Æ. CT scan of the shoulder
Ç. Ultrasound of the shoulder
È. Ilioinguinal
É. Extended iliofemoral
Ê. Combined ilioinguinal and Kocher-Langenbeck (posterior)
Ë. Kocher-Langenbeck (posterior)
Ì. Kocher-Langenbeck (posterior) with trochanteric osteotomy
Í. Deltoid
Î. Supraspinatus
Ï. Subscapularis Infraspinatus
Ð. Infraspinatus
Ñ. Infraspinatus and teres minor
Ò. an orthosis.
Ó. observation.
Ô. electrical stimulation.
Õ. open reduction and internal fixation.
Ö. application of a nonweightbearing short leg cast.
×. repair of the rotator cuff.
Ø. rehabilitation of the shoulder
Ù. replacement of the humeral head.
Ú. arthroscopic acromioplasty and debridement.
Û. immobilization is a sling until pain resolves.
Ü. Bone rotation versus torque applied
Ý. Bone deflection versus bending moment applied
Þ. Axial displacement versus tension applied
SS. Lateral translation versus shear force applied
À. Fracture gap closing versus compressive force applied
Á. steroid injection
Â. stretching of the heel cord
Ã. surgical release of the plantar fascia
Ä. application of a short leg cast for 6 to 8 weeks
Å. wearing dorsiflexion night splints
Æ. Open bladder
Ç. Bilateral “hitchhiker’s” thumbs
È. Bilateral defects in the midclavicles
É. Rhizomelic shortening of the extremities
Ê. Radiographic fragmentation of all major epiphyses
Ë. Medial patellotibial
Ì. Medial patellofemoral
Í. Medial patellomeniscal
Î. Lateral patellofemoral
Ï. Lateral patellotibial
Ð. Heat
Ñ. Gentle active flexion-extension exercises
Ò. Isokinetic strengthening
Ó. Electrical muscle stimulation
Ô. Immobilization of the limb with the knee in full flexion
Õ. Distal chevron osteotomy with soft-tissue release
Ö. Distal soft-tissue realignment only
÷. Closing wedge osteotomy (Aken) of the proximal phalanx
Ø. Proximal first metatarsal osteotomy only
Ù. Soft-tissue realignment with a proximal metatarsal osteotomy
Ú. Vagus
Û. Phrenic
Ü. Hypoglossal
Ý. Recurrent laryngeal
Þ. Inferior thyroid
Ÿ. Surgical exploration
Ā. Application of leeches
Ā. Stellate ganglion blocks
Ă. Intra-arterial streptokinase
Ă. Elevation and reevaluation in 1 hour
Ą. Liver profile
Ą. Myleogram
Ć. Platelet count
Ć. CT scan of the head
Ĉ. Angiogram of the extremity
Ĉ. Post spinal fusion from L5to S1
Ċ. Primary repair with an iliac bone graft
Ċ. Post spinal fusion of L4-5
Č. A pantaloon body cast and 6 weeks of bed rest
Č. Rest, NSAIDS, and limited dancing
Ď. Stress fracture of the proximal fifth metatarsal
Ď. Stress fracture of the base of the second metatarsal
Đ. Stress fracture of the neck of the second metatarsal
Đ. Morton’s neuroma
Ē. Lisfranc’s joint subluxation
Ē. C5 radiculopathy
Ĕ. Subscapularis rupture
Ĕ. Glenohumeral arthrosis
Ė. Rotator cuff arthropathy
Ė. Suprascapular nerve compression at the spinoglenoid notch
Ę. mm femoral head in combination with a metal-backed polyethylene component
Ę. mm femoral head in combination with an all-polyethylene acetabular component
Ě. mm femoral head in combination with a metal-backed polyethylene component
Ě. mm femoral head in combination with an all-polyethylene component
Ĝ. mm femoral head in combination with a metal-backed polyethylene component
Ĝ. Female gender
Ğ. History of cigarette smoking
Ğ. L5-S1 spondylolisthesis on pre-employment radiography
Ġ. Decreased strength of the lower extremities on pre-employment testing
Ġ. Decreased flexibility of the lumbar spine on pre-employment testing
Ģ. Size of cells
Ģ. Amount of DNA in cells
Ĥ. Nucleus-cytoplasm ratio
Ĥ. Specific DNA sequences
Ħ. Specific messenger RNA sequences
Ħ. Femoral and obturator nerves
Ĩ. Femoral and superior gluteal nerves
Ĩ. Femoral and lateral femoral cutaneous nerves
Ī. Obturator and superior gluteal nerves
Ī. Obturator and lateral femoral cutaneous nerves
Ĭ. Isotonic
Ĭ. Isokinetic
Į. Isometric
Į. Open kinetic chain
İ. Dynamic variable resistance
I. Closed reduction and cast immobilization
IJ. Uniplanar external fixation
IJ. Open reduction and internal fixation with a dynamic compression plate
Ĵ. Unreamed intramedullary rod
Ĵ. Multiple plane external fixator
Ķ. Inlet view of the pelvis
Ķ. Outlet view of the pelvis
ĸ. AP view of the hip
Ĺ. Ilial oblique view (external oblique) of the hip
Ĺ. Obturator oblique
Ļ. Glycolytic pathway
Ļ. Oxidative phosphorylation
Ľ. Breakdown of fat
Ľ. Breakdown of protein
Ŀ. Breakdown of adenosine triphosphate
Ŀ. an MRI scan
Ł. arthroscopic examination
Ł. AP and frog-lateral radiographs of the pelvis and hips
Ń. varus and valgus stress radiographs of the knee
Ń. physical examination of the knee under anesthesia
Ņ. extended curettage and polymethylmethacrylate cementation
Ņ. extra-articular resection of the knee and an allograft arthrodesis
Ň. wide resection of the proximal tibia and custom prosthetic replacement
Ň. prophylactic internal fixation and postoperative irradiation
ʼN. excision of the lateral condyle and reconstruction with a hemicondylar allograft
Ŋ. silicone implant joint replacement
Ŋ. metatarsophalangeal joint arthrodesis
Ō. metatarsophalangeal joint debridement
Ō. resection of the metatarsal head
Ŏ. resection of the base of the proximal phalanx
Ŏ. Fixation of the syndesmosis has failed
Ő. Widening of the ankle mortise has led to the failure of fixation
Ő. Infection around the syndesmosis screw has led to osteomyelitis
Œ. The syndesmosis screw is broken
Œ. Motion between the tibia and fibula has caused loosening of the syndesmosis screw
Ŕ. Microcephaly
Ŕ. A temporal lobe cyst
Ŗ. An Arnold-Chiari type 1 malformation
Ŗ. Periventricular leukomalacia
Ř. Agnesis of the corpus callosum
Ř. Wolff’s
Ś. Hooke’s
Ś. Hilton’s
Ŝ. Muller-Haeckel
Ŝ. Heuter-Volkmann
Ş. Both the anterolateral and posteromedial bands are isometric and do not significantly change with flexion
Ş. The anterolateral band is lax and becomes tight in flexion, while the posteromedial band is tight, and becomes lax in flexion
Š. The anterolateral band is tight and becomes lax in flexion, while the posteromedial band is lax and becomes tight in flexion
Š. Both the anterolateral and posteromedial bands are lax and become tight in flexion
Ţ. Both the anterolateral and posteromedial bands are tight and become lax as the knee is flexed
Ţ. UCB orthosis
Ť. Rigid orthosis with a medical arch support
Ť. Semi-rigid orthosis with lateral forefoot posting
Ŧ. Semi-rigid orthosis with a medial arch support
Ŧ. Medial heel wedge attached to the running shoes
Ũ. Hallux varus
Ũ. Osteonecrosis
Ū. Recurrence of the hallux valgus
Ū. “Transfer” second metatarsalgia
Ŭ. Physeal arrest of the first metatarsal
Ŭ. Aseptic loosening in a 70-year-old patient
Ů. Mechanical failure of a hinged knee prosthesis
Ů. Failed knee replacement complicated by reflex sympathetic dystrophy
Ű. Infection with soft-tissue deficit
Ű. A prior patellectomy
Ų. Knee fusion
Ų. Open irrigation and debridement
Ŵ. Arthroscopic irrigation and debridement
Ŵ. One-stage exchange arthroplasty
Ŷ. Two-stage exchange arthroplasty
Ŷ. Putti-platt repair
Ÿ. Open Bankart repair
Ź. Injection of a subacromial corticosteroid
Ź. Arthroscopic transglenoid capsular shift
Ż. Rehabilitation of the scapular and rotator cuff muscles
Ż. Silicone suction socket and an energy-absorbing foot
Ž. Silicone suction socket and a variable resistance ankle
Ž. Plastic suction socket, telescoping pylon, and a solid ankle cushioned heel (SACH) foot
S. Plastic socket with a hinged thigh cuff and a SACH foot
Ƀ. Patellar tendon-bearing suction socket and a uniaxial hydraulic ankle
Ɓ. Parosteal
Ƃ. Periosteal
Ƃ. High-grade intramedullary
Ƅ. Osteosarcoma occurring in Paget’s disease
Ƅ. Osteosarcoma occurring in irradiated bone
Ɔ. Cauda equina
Ƈ. Conus medullaris
Ƈ. Genitofemoral nerve
Ɖ. Lumbar sympathetic plexus
Ɗ. Lumbar parasympathetic plexus
Ƌ. Spinal pseudoarthrosis
Ƌ. Spinal cord traction injury with paralysis
ƍ. Arterial and venous thromboses
Ǝ. Superior mesenteric artery syndrome
Ə. Crankshaft phenomenon
Ɛ. Inversion stress radiograph
Ƒ. MRI scan
Ƒ. CT scan
Ɠ. Nuclear bone scan
Ɣ. External rotation stress radiograph
Ƕ. Complex deformity with an angulation in two planes
Ɩ. Single deformity less than 20 degrees, apex posterolateral
Ɨ. Single deformity greater than 30 degrees, apex posterolateral
Ƙ. Single deformity less than 20 degrees, apex posteromedial
Ƙ. Single deformity greater than 30 degrees, apex posteromedial
Ƚ. Pronation of the foot during the stance phase of gait
ƛ. Heel inversion at the beginning of a single limb heel rise
Ɯ. Active inversion of the nonweightbearing foot
Ɲ. Active plantar flexion of the first ray against resistance
Ƞ. Active plantar flexion of the foot during the push-off phase of gait
Ɵ. Observation and repeat radiographs in 4 months
Ơ. Application of a thoracolumbalsacral orthosis for 22 to 24 hours per day
Ơ. Electrical stimulation at night
Ƣ. Physical therapy
Ƣ. Begins to remodel and hypertrophy more quickly
Ƥ. Provides a better scaffold for osteoconduction
Ƥ. Reduces the risk of early fracture
Ʀ. Reduces technical difficulty
Ƨ. Lowers donor site morbidity
Ƨ. Anterior fusion of the lumbar curve
Ʃ. Anterior and posterior fusion of the thoracic curve
ƪ. Posterior fusion of the thoracic curve
ƫ. Posterior fusion of the thoracic and lumbar curves
Ƭ. Application of a brace until the iliac apophyses are Risser 4 or 5, followed by surgical correction
Ƭ. Subscapularis rupture
Ʈ. Type III SLAP lesion
Ư. Disruption of capsular shift
Ư. Isolated traumatic subluxation
Ʊ. Injury to the axillary nerve after dislocation
Ʋ. hypophosphatemia
Ƴ. high dietary cholesterol intake
Ƴ. deficiency of lipoprotein A
Ƶ. deficiency of protein S and protein C
Ƶ. elevated levels of antithrombin III
Ʒ. Weightbearing short leg cast
Ƹ. Nonweightbearing short leg cast
Ƹ. Removable splint and early motion
ƺ. Open reduction and internal fixation
ƻ. Elastic compression bandage with full weightbearing
Ƽ. Breast
Ƽ. Prostate
ƾ. Gastrointestinal
Ƿ. Kidney
ǀ. Multiple myeloma
ǁ. Varus stress
ǂ. Valgus stress
ǃ. Torsional loading
DŽ. Hyperextension of the knee
DŽ. Contraction of the quadriceps while axially loaded
DŽ. Primary internal fixation at both fracture levels
LJ. External fixation as definitive ttt for both #
LJ. Skeletal traction and delayed internal fixation of both fractures
LJ. Primary internal fixation of the proximal fracture and delayed fixation of the femoral fracture
NJ. Primary internal fixation of the femoral shaft fracture and delayed fixation of the proximal #
NJ. Heel spur
NJ. Plantar fascitis
Ǎ. Dysfunction of the tibialis posterior tendon
Ǎ. Compression of the first branch of the lateral plantar nerve
Ǐ. Compression of the calcaneal nerve
Ǐ. Displaced labral tear
Ǒ. Tear of the rotator cuff
Ǒ. Fracture of the glenoid rim
Ǔ. Palsy of the axillary nerve
Ǔ. Palsy of the musculocutaneus nerve
Ǖ. Enchondroma
Ǖ. Osteoblastoma
Ǘ. Giant cell tumor
Ǘ. Aneurysmal bone cyst
Ǚ. Fibrous dysplasia
Ǚ. Arthrogram of the wrist
Ǜ. MRI scan of both wrists
Ǜ. CT scan of both wrists in the same position
Ǝ. Radiographs of the wrist in supination and pronation
Ǟ. Radiographs of the opposite wrist in the same position
Ǟ. Secondary hyperparathyroidism
Ǡ. Phosphate retention secondary to uremia
Ǡ. Insufficient renal synthesis of 1, 25 dihydroxy vitamin D
Ǣ. Aluminum deposition in bone from oral phosphate binders
Ǣ. Persistent acidosis aggravating the negative calcium balance
Ǥ. Posterior fusion at T10-L3 with segmental instrumentation
Ǥ. Laminectomy and fusion of T12-L2 with segmental instrumentation
Ǧ. Bed rest in a hyperextension brace
Ǧ. L1 vertebrectomy and anterior decompression with strut graft fusion and instrumentation
Ǩ. Progressive ambulation as tolerated in a custom-molded thoracolumbosacral orthosis
Ǩ. Positive-pressure ventilation
Ǫ. An immediate radiograph of the chest
Ǫ. Adjustment of the position of the endotrachael tube
Ǭ. Insertion of a large-bore needle into the pericardial space
Ǭ. Insertion of a large-bore needle in the right second intercostal space, midclavicular line
Ǯ. Allowing the ends of the fracture to touch
Ǯ. Adding a second connecting bar
J̌. Adding one pin to each fracture fragment
DZ. Increasing the pin diameter from 4 mm to 6 mm
DZ. Decreasing the connecting bar-to-bone distance from 6 cm to 4 cm
DZ. Osteomyelitis
Ǵ. Malignant degeneration
Ǵ. Stress fracture
Ƕ. Local recurrence of the giant cell tumor
Ƿ. Bone resorption due to methylmethacrylate
Ǹ. Advancement of the plantar plate
Ǹ. Resection of the second metatarsal head
Ǻ. Dorsiflexion osteotomy of the second metatarsal neck
Ǻ. Transfer of the flexor digitorum longus tendon to the dorsum of the toe
Ǽ. Transfer of the extensor digitorum comminus tendon to the metatarsal neck
Ǽ. Sacral fracture
Ǿ. Burst fracture of L5
Ǿ. Cauda equina syndrome
Ȁ. Distraction-flexion injury at L3
Ȁ. Distraction-extension injury at L3
Ȃ. An MRI scan of the shoulder
Ȃ. An MRI scan of the cervical spine
Ȅ. Electromyographic and nerve conduction velocity studies
Ȅ. Immobilization in a sling and early passive range of motion exercises
Ȇ. Immediate return to the operating room for exploration of the brachial plexus
Ȇ. cerclage wiring
Ȉ. tension band wiring
Ȉ. removal of the patellar component
Ȋ. revision of the patellar component
Ȋ. immobilization of the knee and protected weightbearing
Ȍ. Liposarcoma
Ȍ. Nodular fasciitis
Ȏ. Rabdomyosarcoma
Ȏ. Malignant fibrous histiocytoma
Ȑ. Extra-abdominal desmoid tumor
Ȑ. Clubfeet
Ȓ. Thrombocytopenia
Ȓ. Congenital scoliosis
Ȕ. Ventricular septal defect
Ȕ. Arnold-Chiari malformation
Ȗ. delayed primary closure
Ȗ. free flap
Ș. pedicle groin flap
Ș. full-thickness skin graft
Ț. split-thickness skin graft
Ț. Infection
Ȝ. Nonunion
Ȝ. Improper screw length
Ȟ. Osteonecrosis of the distal fragment
Ȟ. Use of a cortical screw instead of a cancellous screw
Ƞ. Infection
ȡ. Tear of the rotator cuff
Ȣ. Loosening of the humeral component
Ȣ. Arthritis of the glenoid
Ȥ. Arthritis of the A-C joint
Ȥ. Reduced morbidity
Ȧ. Improved osteoinduction
Ȧ. Improved osteoconduction
Ȩ. More rapid revascularization
Ȩ. Lower risk of disease transmission
Ȫ. Manipulation Under Anesthesia
Ȫ. Arthroscopic acromioplasty
Ȭ. Arthroscopic debridement of G-H joint
Ȭ. Replacement of the humeral head
Ȯ. Lengthening of the subscapularis and release of the anterior capsule
Ȯ. Bacteroides
Ȱ. E. coli
Ȱ. Staph. aureus
Ȳ. group A streptococcus
Ȳ. Clostridium perforingens
ȴ. observation and exercises
ȵ. bracing with a thoracolumbar orthosis
ȶ. fusion of the posterior spine
ȷ. fusion of the anterior spine
ȸ. fusion of the anterior and posterior spine
ȹ. Total wrist replacement and bridge grafts
Ⱥ. palmar shelf arthroplasty and tendon transfers
Ȼ. Darrach distal ulna resection, dorsal tenosynosynovectomy, and tendon transfers
Ȼ. Radioscaphate fusion, extensor tenodesis, and Darrach distal ulna resection
Ƚ. Total wrist fusion and tendon transfers
Ⱦ. constrained acetabular component
Ȿ. protrusion ring with morselized graft
Ɀ. cemented metal backed acetabular component
Ɂ. cemented all-polyethylene acetabular component
Ɂ. cementless hemispherical component with screw fixation
Ƀ. application of a hip abduction brace for 22 hours per day
Ʉ. application of a hip spica under anesthesia
Ʌ. discontinuance of all bracing and repeat radiographs in 3 months
Ɇ. open reduction of the hip and application of a spica cast
Ɇ. open reduction, varus osteotomy, and application of a spica cast
Ɉ. Loss of skin hair on the feet
Ɉ. Absent pulses on vascular examination
Ɋ. Pain that originates proximally and spreads distally
Ɋ. Pain that is relieved by stopping and standing
Ɍ. Pain that is worse when the patient walks uphill rather downhill
Ɍ. wrist flexors and finger flexors
Ɏ. elbow flexors and wrist flexors
Ɏ. elbow flexors and finger flexors
Ɐ. elbow extensors and wrist flexorst Level Key Muscles4 DiaphragmDeltoid, elbow flexors, diaphragmElbow flexors, wrist extensorsElbow extensors, wrist flexorsFinger flexors (distal phalanx of middlefinger)Finger abductors (5th digit), intrinsics of hand2 Segmental innervation to intercostal muscles, abdominal and paraspinal muscles) L1, L2, L3 Hip flexors3, L4 QuadricepsTibialis anteriorToe extensors, hip abductorsAnkle plantarflexors, peronei
Ɑ. elbow extensors and wrist extensors
Ɒ. Syndactyly
Ɓ. Macrodactyly
Ɔ. Camptodactyly
ɕ. Preaxial polydactyly
Ɖ. Postaxial polydactyly
Ɗ. Arthrodesis
ɘ. Rotationplasty
Ə. Above-knee amputation
ɚ. Osteoarticular allograft
Ɛ. Endoprosthesis (custom arthroplasty)
Ɜ. Plantar fascia
ɝ. Spring ligament
ɞ. Deltoid ligament
ɟ. Intrinsic tendons
Ɠ. Gastorcnemius-solelus complex
Ɡ. Prevention of presynaptic release of acetylcholine
ɢ. Prevention of synthesis of presynaptic acetylcholine
Ɣ. Activation of acetylcholinesterase at the motor end-plate
ɤ. Blockage of postsynaptic action of acetylcholine until reserves are depleted
Ɥ. Stimulation of release of presynaptic acetylcholine until reserves are depleted
Ɦ. stiffness of the femoral component.
ɧ. head offset of the femoral component.
Ɨ. femoral component material modulus of elasticity.
Ɩ. extent of the femoral component porous coating.
Ɪ. Presence of a femoral component collar.
Ɫ. plantar fascia and quadratus plantae tendon.
Ɬ. ligamentous structures connecting the tarsal bones.
ɭ. shape of the tarsal bones and the intervening joints.
ɮ. activity of the intrinsic muscles of the foot.
Ɯ. activity of the posterior tibialis and the peroneus longus muscles.
ɰ. scapulothoracic fusion
Ɱ. strengthening of the periscapular muscles
Ɲ. pectoralis minor-fascia lata graft transfer to the scapula
ɳ. pectoralis major-fascia lata graft transfer to the scapula
ɴ. exploration of the long thoracic nerve, with sural nerve graft
Ɵ. tricompartmental knee replacement
ɶ. unicompartmental knee replacement
ɷ. medial compartment meniscal allograft
ɸ. valgus-producing distal femoral osteotomy
ɹ. valgus-producing proximal tibial osteotomy
ɺ. Internal rotation of the femoral component
ɻ. External rotation of the tibial component
ɼ. Lateral placement of the femoral component
Ɽ. Medial placement of the patellar component
ɾ. Excessive resection of the patella
ɿ. Hallux rigidus
Ʀ. Hallux valgus
ʁ. Neuroma of the first web space
Ʂ. Fracture of the sesamoid
Ʃ. Rupture of the flexor hallucis longus
ʄ. Sickle cell crisis
ʅ. Idiopathic chondrolysis
ʆ. Hemophilic arthropathy
Ʇ. Osteoid osteoma of the femoral neck
Ʈ. Legg-Calve-Perthes disease
Ʉ. Decreased ankle jerk and positive femoral nerve stretch test
Ʊ. Decreased knee jerk and positive straight-leg raising sign
Ʋ. Gastrocnemius-soleus complex weakness and positive straight-leg raising sign
Ʌ. Weakness of the extensor hallucis longus and positive straight-leg raising sign
ʍ. Weakness of the extensor hallucis longus and positive femoral nerve stretch test
ʎ. Long-term administration of IV and oral antibiotics
ʏ. Open soft-tissue debridement, retention of prosthetic components, and IV antibiotics
ʐ. Immediate exchange arthroplasty with antibiotic-impregnated cement
ʑ. Two-stage surgical prosthetic exchange and IV antibiotics
Ʒ. Resection arthroplasty and IV antibiotics
ʓ. SCFE
ʔ. MED
ʕ. Perthes disease
ʖ. Hypothyroidism
ʗ. Chondrolysis
ʘ. gout.
ʙ. osteoporosis.
ʚ. eosinophilic granuloma.
ʛ. tuberculosis of the spine.
ʜ. metastatic disease of the spine.
Ʝ. water content.
Ʞ. Synthesis of type I collagen.
ʟ. Proteoglycan content.
ʠ. Activity of chondrocytes.
ʡ. Synthesis of hyaluronate.
ʢ. Lung
ʣ. Breast
ʤ. Prostate
ʥ. Thyroid
ʦ. Renal
ʧ. T1-low, T2-low.
ʨ. T1-low, T2-high.
ʩ. T1-moderate, T2-low.
ʪ. T1-high, T2-low.
ʫ. T1-high, T2-high.
ʬ. hypothesis is incorrect or invalid
ʭ. interobserver error rate is 4%.
ʮ. Standard deviation is 4% higher or lower than the mean.
ʯ. Sample size is 4% larger than required to be clinically significant.
ʰ. Probability that the differences noted between two study groups were due to chance alone is 4%.
ʱ. I
ʲ. II
ʳ. IV
ʴ. IX
ʵ. X
ʶ. Cranial setting
ʷ. Cranial subluxation
ʸ. Odontoid fracture
ʹ. Lysis of the arch of the atlas
ʺ. Atlantoaxial subluxation
ʻ. Retrograde collapse of the endoneurial tubes
ʼ. Irreversible atrophy of the denervated muscles
ʽ. Elongation of the axons across the zone of injury
ʾ. Sprouting of the axons at the neuromuscular junction
ʿ. Misdirection of the axons across the zone of injury
ˀ. Maximally pronated and elbow extended
ˁ. Maximally pronated and the elbow flexed
˂. Maximally supinated and the elbow flexed
˃. Maximally supinated and the elbow extended
˄. In neutral rotation, with the elbow extended
˅. open reduction and internal fixation
ˆ. buddy taping to the adjacent index finger
ˇ. early motion with application of a dynamic banjo splint
ˈ. application of a cast with the hand in a “safe position” for 3 weeks.
ˉ. dorsal extension block splinting
ˊ. The name of the manufacturer
ˋ. The manufacturer’s potential liability
ˌ. The physician’s clinical performance
ˍ. The physician’s materials testing data
ˎ. Any royalties the physician receives from the manufacturer
ˏ. Femoral
ː. Obturator
ˑ. Inferior gluteal
˒. Superior gluteal
˓. Lateral femoral cutaneous
˔. open biopsy and a long leg cast
˕. open biopsy and wide resection of the tumor
˖. a long leg cast and observation
˗. intramedullary stabilization and observation
˘. Triggering
˙. Lateral instability
˚. Swan-neck deformity
˛. Boutonniere deformity
˜. Loss of distal interphalangeal joint flexion
˝. Peroneus brevis to peroneus longus
˞. Peroneus tertius to extensor hallucis longus
˟. Peroneus tertius to superficial peroneal nerve
ˠ. Extensor hallucis longus to deep peroneal nerve
ˡ. Extensor hallucis longus to extensor digitorum longus
ˢ. reassurance that Medicare will pay for the treatment.
ˣ. consent forms that patients or their guardians are able to understand.
ˤ. a detailed description of the device, omitting the fact that it is part of a study.
˥. a provision that the patient’s care will be discontinued if he or she does not enroll in the study.
˦. a provision that the study will be carried out to completion, whether or not the device is as effective as those currently in existence.
˧. an onlay iliac crest bone graft.
˨. limited weightbearing and observation.
˩. removal of the implant and limited weightbearing.
˪. removal of the implant and insertion of a reamed femoral nail.
˫. removal of the implant and insertion of an unreamed femoral nail.
ˬ. Coronal
˭. Sagittal
ˮ. Anteromedial, midway between the sagittal and the coronal
˯. Proximal pins sagittal, distal pins coronal
˰. Proximal pins coronal, distal pins sagittal
˱. Rheumatoid arthritis
˲. Posttraumatic arthritis
˳. Degenerative osteoarthritis
˴. Osteonecrosis of the tibial plateau
˵. Osteonecrosis of the medial femoral condyle
˶. Trapeziometacarpal arthrodesis
˷. Osteotomy of the thumb metacarpal
˸. Arthrotomy and joint debridement
˹. Ligament reconstruction using one half of the flexor carpi radialis
˺. Trapezium resection, tendon interposition, and reconstruction of the ligament
˻. Creep
˼. Relaxation
˽. Energy dissipation
˾. Plastic deformation
˿. Elastic deformation
̀. bending
́. axial loading
̂. high-speed rotation
̃. direct impact from anteromedial
̄. crush from anteromedial to posterolateral
̅. Increase stiffness
̆. Increase fracture toughness
̇. Increase fatigue strength
̈. Decrease mechanical strength
̉. Decrease wear rate
̊. disuse osteopenia
̋. paraendocrine effect of the tumor
̌. abnormally increased density on the right side
̍. side effect of the treatment of the lesion
̎. extensive tumor involvement of the left hip
̏. Sciatic nerve
̐. Superior gluteal artery
̑. Profunda femoris artery
̒. Femoral artery and nerve
̓. External iliac artery and vein
̔. Length
̕. Moment arm
̖. Total volume
̗. Physiologic cross-sectional area
̘. Distribution of slow and fast twitch fibers
̙. decreasing initiation of action potentials.
̚. increasing action potential amplitude.
̛. blocking the opening of gated sodium channels.
̜. decreasing the number of functional motor units.
̝. slowing or stopping action potential propagation through the axon.
̞. resection of the metatarsal heads of the first through fifth toes.
̟. Silastic MP joint arthroplasties of the first through fifth toes.
̠. fusion of the hallux MP joint and resection arthroplasty of the 2nd through fifth metatarsal heads.
̡. fusion of hallux MP joint and distal osteotomy of the 2nd through 5th MT.
̢. plantar condylectomy of the 2nd through 5th MT heads & resection of proximal phx of the hallux.
̣. hemiarthroplasty
̤. open reduction and internal fixation
̥. closed reduction and percutaneous pinning
̦. a sling and early pedulum exercises
̧. a sling and swathe for 6 weeks, followed by shoulder rehabilitation
̨. open acromioplasty
̩. open Bankart repair
̪. open subscapularis tendon repair
̫. inferior capsular shift
̬. a supervised physical therapy program
̭. a sling and swathe, with pendulum exercises in 10 days
̮. open reduction and internal fixation through an anterior approach
̯. open reduction and internal fixation through a posterior approach
̰. immobilization with a splint in 45 degrees of abduction for 6 weeks
̱. arthroscopically assisted reduction and percutaneous screw fixation
̲. Repair of the rotator cuff
̳. Replacement of the humeral head
̴. Resection arthroplasty
̵. Total shoulder arthroplasty
̶. AP and lateral radiographs of the elbow
̷. Diagnositc arthroscopy
̸. Aspiration of joint fluid
̹. An erythrocyte sedimentation rate and CBC
̺. A diagnostic lidocaine injection
̻. Insulin-like growth factor (IGF-1)
̼. Fibroblast growth factor (FGF-1)
̽. Platelet-derived growth factor (PDGF)
̾. Transforming growth factor beta (TGF-B)
̿. Bone morphogenetic proteins (BMP)
̀. clinical history and radiographic findings.
́. technetium bone scan
͂. flow cytometry pattern of extracted chondrocytes
̓. immunohistochemical staining patterns of a biopsy specimen
̈́. histologic features of a biopsy specimen stained with hematoxylin-cosin
Ι. Radial
͆. Radial recurrent
͇. Posterior interosseous
͈. Superior ulnar recurrent
͉. Superficial radial circumflex
͊. Impaired hydroxylation of proline
͋. Failure of cleavage in procollagen
͌. Defective binding sites for hydroxyproline
͍. Failure to incorporate glycine into the helix
͎. Diminished production of collagen through the rough endoplasmic reticulum
͏. Asking the legal staff to seek a court injunction
͐. Copying the patient’s chart and giving it to him as he leaves
͑. Having the patient sign a written legal contract that specifies acceptable behavior
͒. Continuing care of the patient until an appropriate referral can be arranged
͓. Transferring the patient to another orthopaedic surgeon without disclosing the realreason for why the patient is being transferred
͔. Meta-analysis
͕. Confidence interval
͖. Analysis of variance (ANOVA)
͗. Statistical significance (p-value)
͘. Survivorship analysis (Kaplan-Meier)
͙. Spinal shock
͚. Neurogenic shock
͛. Hypovolemic shock
͜. Pulmonary embolism
͝. Fat embolus syndrome
͞. Lumbar spinal stenosis
͟. Metastatic disease of the spine
͠. Rheumatoid lumbar spondylitis
͡. Isthmic spondyloloisthesis
͢. Degenerative spondylolisthesis at L4-5 and L5-S1
ͣ. Patella alta
ͤ. A metal-backed patella
ͥ. Varus malalignment of the knee
ͦ. A posterior cruciate-substituting femoral component
ͧ. Lateral subluxation of the patella on a Merchant’s view
ͨ. The sesamoids are separated
ͩ. The sesamoid is fractured
ͪ. The proximal phx is on the neck of the metatarsal
ͫ. The dislocation is dorsal and centered
ͬ. The proximal phalanx is hyperextended
ͭ. Patella
ͮ. Tibial stem
ͯ. Distal femoral interface
Ͱ. Posterior femoral interface
Ͱ. Sites of screw fixation for the tibia
Ͳ. Hallux rigidus
Ͳ. Fracture of the sesamoid
ʹ. Disruption of the plantar plate
͵. Osteonecrosis of the metatarsal head
Ͷ. Rupture of the flexor hallucis longus
Ͷ. Gout
͸. Sepsis
͹. Old trauma
ͺ. Rheumatoid arthritis
Ͻ. Charcot arthroplasty
Ͼ. Aspiration and steroid injection
Ͽ. Biopsy, curettage, and allograft bone grafting
;. Percutaneous Kirschner wire fixation
Ϳ. Percutaneous injection of autogenous bone marrow
΀. Nerve roots
΁. Spinal cord
΂. Sciatic nerve
΃. Peroneal nerve
΄. Conus medullaris
΅. Extent of bone penetrated by reaming, prosthetic components, or acrylic cement
Ά. Periprosthetic regions that are accessible to joint fluid and particulate wear debris
·. Enveloping pseudocapsular scar tissue that develops around a prosthetic hip following surgical capsulectomy
Έ. Soft tissue and bone that are potentially contaminated with bacteria in the setting of a prosthetic joint infection
Ή. Potential intrapelvic joint space communication created by acetabular fixation screws or intrapelvic extruded acrylic cement
Ί. Early and late infection
΋. Periprosthetic fracture of the femur
Ό. Failure of the patellofemoral and extensor mechanisms
΍. Aseptic loosening of cementing tibial components
Ύ. Asceptic loosening of cemented femoral components
Ώ. Acceptance of the current position of the ankle
Ϊ́. Open reduction and fixation in the epiphysis only
Α. ORIF with a small-fragment T-plate from the malleolus up to the metaphysis
Β. Closed reduction by eversion of the ankle and application of a bivalved long leg cast
Γ. CRUGA and fixation with a malleolar screw from the malleolus into the metaphysis
Δ. Resection arthroplasty and local radiation
Ε. In situ fusion of the hip
Ζ. Excision of heterotopic bone, total hip arthroplasty, and oral indomethacin
Η. Excision of heterotopic bone and local radiation
Θ. Excision of heterotopic bone, hemiarthroplasty, and oral indomethacin
Ι. Closed reduction of both fractures and immediate spica casting
Κ. Bilateral skin traction for 3 weeks, followed by spica casting
Λ. External fixation of both femora
Μ. External fixation of the left femur and a long leg cast brace for the right femur
Ν. External fixation of the left femur and use of a reamed intramedullary nail in the right femur
Ξ. Synovial sarcoma
Ο. Soft-tissue abcess
Π. Rhabdomyosarcoma
Ρ. Eosinophilic granuloma
΢. Nodular pigmented villonodular synovitis
Σ. Changing to a titanium nail
Τ. Changing to a nonslotted nail
Υ. Changing the cross-sectional shape of the nail
Φ. Increasing the diameter of the nail by 3 mm
Χ. Increasing the diameter of the interlocking screws
Ψ. Fracture healing
Ω. Chondrosarcoma
Ϊ. Periosteal chondroma
Ϋ. Periosteal osteosarcoma
Ά. Dysplasia epiphysealis hemimelica
Έ. Demonstrate competence in the subject of the case
Ή. Be fellowship trained in the subject of the case
Ί. Be paid on a contingency basis
Ϋ́. Be board certified by the American Board of Orthopaedic Surgery
Α. Have been involved in the case as a consultant
Β. Diagnostic arthroscopy
Γ. Arthroscopy and subacromial decompression
Δ. Reduction and fixation of the proximal humeral epiphysis
Ε. Temporary cessation of throwing
Ζ. Physical therapy for rotator cuff strengthening
Η. Oblique popliteal ligament
Θ. Lateral capsule
Ι. Popliteal tendon
Κ. Fibular collateral ligament
Λ. Posterior oblique ligament
Μ. Radial tear
Ν. Parrot-beak tear
Ξ. Vertical tear in the “red-red” zone
Ο. Vertical tear in the “red-white” zone
Π. Vertical tear in the “white-white” zone
Ρ. 0 degrees of abduction, with neural rotation
Σ. 40 degrees of flexion and 60 degrees of internal rotation
Σ. 45 degrees of flexion and 45 degrees of external rotation
Τ. 90 degrees of abduction with neutral rotation
Υ. 90 degrees of abduction and 90 degrees of external rotation
Φ. Sural
Χ. Saphenous and its branches
Ψ. Posterior tibial and its branches
Ω. Deep peroneal and its branches
Ϊ. Superficial peroneal and its branches
Ϋ. Strength
Ό. Stiffness
Ύ. Shelf life
Ώ. Antigenicity
Ϗ. Risk of HIV transmission
Β. Indemnification
Θ. Occurrence
ϒ. Excess liability
ϓ. Claims-made
ϔ. Nose
Φ. Lateral Y
Π. Scapular AP
Ϗ. Neutral rotation AP
Ϙ. Internal rotation AP
Ϙ. External rotation AP
Ϛ. Trauma
Ϛ. Hemophilia
Ϝ. Reiter’s syndrome
Ϝ. Rheumatoid arthritis
Ϟ. Systemic lupus erythematosus
Ϟ. Cast immobilization for 6 weeks
Ϡ. Activity modification and re-evaluation in 2 months
Ϡ. Internal fixation with or without bone grafting
Ϣ. Retrograde drilling of the defect without articular cartilage penetration
Ϣ. Drilling of the defect directly through the articular cartilage
Ϥ. repair or reconstruction of the medial collateral ligament
Ϥ. repair or reconstruction of the medialand lateral collateral ligaments
Ϧ. immobilization for 5 days or less
Ϧ. immobilization for 14 days
Ϩ. immobilization for 25 days
Ϩ. Cystinosis
Ϫ. Hypophosphatemia
Ϫ. Renal osteodystrophy
Ϭ. Primary hyperparathyroidism
Ϭ. Nutritional vitamin D deficiency
Ϯ. Lateral meniscus tear
Ϯ. Popliteus tenosynovitis
Κ. Iliotibial band friction syndrome
Ρ. Peroneal nerve entrapment
Ϲ. Biceps tendinitis
Ϳ. Observation
ϴ. Removal of the prosthetic components
Ε. Operative exploration and decompression of the peroneal nerve
϶. Nerve conduction velocity studies
Ϸ. Loosening of the primary dressings and knee flexion to 30 degrees
Ϸ. I
Ϲ. II
Ϻ. III
Ϻ. decreased tissue tension
ϼ. decreased abductor lever arm
Ͻ. decreased joint reaction force
Ͼ. increased body weight over lever arm
Ͽ. increased polyethylene wear rate
Ѐ. recurrent traumatic anterior dislocation
Ё. recurrent traumatic posterior dislocation
Ђ. traumatic subluxation with no previous dislocation
Ѓ. traumatic anterior subluxation
Є. atraumatic involuntary subluxation
Ѕ. radial
І. axillary
Ї. suprascapular
Ј. thoracodorsal
Љ. long thoracic
Њ. Flexion
Ћ. Extension
Ќ. Axial rotation
Ѝ. Left lateral bending
Ў. Right lateral bending
Џ. Skin
А. Lung
Б. Brain
В. Heart
Г. Kidney
Д. Thoracoacromial, lateral thoracic, subscapular
Е. Thoracoacromial, anterior humeral circumflex, posterior humeral circumflex
Ж. Posterior humeral circumflex, subscapular, thoracacromial
З. Subscapular, thoracacromial, anterior humeral circumflex
И. Lateral thoracic, anterior humeral circumflex, thoracacromial
Й. Respondeat superior
К. Indemnity agreement
Л. Hold harmless agreement- attempt to shift liability from company to physician
М. Comparative negligence-% of involvement
Н. Contributory negligence- resident contributed to the negligence
О. t-type
П. both column
Р. transverse
С. anterior column
Т. anterior column posterior hemitransverse
У. Posterior interosseous
Ф. Anterior interosseous
Х. Radial
Ц. Median
Ч. Ulnar
Ш. Shock from hypovolemia
Щ. Associated rupture of the bladder
Ъ. Arterial bleeding on pelvic angiogram
Ы. Presence of a hematoma in the perineum and scrotum
Ь. Fractures of both the anterior and posterior pelvic ring

Correct Answer & Explanation

. Open repair of the central slip of the extensor mechanism


Explanation

Question 4065

Topic: 10. Pathology and Oncology

  • Posterior cruciate insufficiency diagnosed using the quadriceps active test is confirmed with tibial translation
. Anteriorly at 20 to 30 degrees of flexion
. Anteriorly at 70 to 90 degrees of flexion
. Posteriorly at 20 to 30 degrees of flexion
. Posteriorly at 70 to 90 degrees of flexion
. Anteriorly with the knee in full flexion
. Rett syndrome
. Cerebral palsy
. Myotonic dystrophy
. Fragile-X syndrome
. Adrenoleukodystrophy
. Endurance limit
. Failure stress
. Critical stress
. Yield stress
. Elastic limit
. Ewing’s sarcoma
. Osteogenic sarcoma
. Multiple myeloma
. Metastatic prostate carcinoma
. Metastatic breast carcinoma
. Higher subsequent loosening rate of the femoral component
. Higher subsequent polyethylene wear rate
. Higher subsequent dislocation rate
. Higher infection rate
. Unaltered subsequent survival rate of the femoral component
. Crevice corrosion
. Oscillatory fretting
. Oxidative degradation
. Adhesion and abrasion
. Fatigue and delamination
. a total contact cast.
. partial calcanectomy
!. Syme’s amputation
". transtibial amputation.
#. nonweightbearing and IV antibiotics.
$. Sural artery island flap.
%. Free rectus abdominis flap.
&. Extensor digitorum brevis flap.
'. Staged cross leg flap.
(. Split-thickness skin graft.
). An anterior cruciate functional knee brace.
*. A physical therapy program.
+. Reconstruction of the posterior cruciate ligament and the posterolateral corner.
,. Reconstruction of the posterior cruciate ligament.
-. Reconstruction of the anterior cruciate ligament.
.. Avoids the risk of marrow emboli
/. Avoids injury to the intramedullary nutrient vessels
0. Results in faster healing of fractures
1. Results in more secure fixation
2. Results in faster regeneration of the endosteal blood supply
3. Above-knee amputation
4. En bloc resection of the lesion and reconstruction with a bone graft
5. Closed reduction and immobilization in a cast
6. Open reduction and internal fixation, followed by radiation therapy
7. Open reduction, curettage, and cementing of the lesion
8. Injury to the subclavian artery
9. Injury to the brachial plexus
:. Segmental fracture
;. 100% displacement
<. Associated displaced surgical neck fracture of the humerus
=. humeral arthroplasty2/. repair of the rotator cuff
>. closed reduction and immobilization
?. open reduction and immobilization
@. open reduction and early passive motion
A. arthroscopic capsular release
B. manipulation under anesthesia
C. a physical therapy program
D. an intra-articular corticosteroid injection
E. administration of high-dose oral corticosteroids
F. adding the scores, in all five body systems
G. adding the squares of the scores in the three most severely injured systems
H. doubling the cumulative score for head and chest injuries
I. combining the scores from the most and least injured systems
J. correcting the score in the most severely injured system for age
K. traumatic femoral head fracture
L. osteonecrosis
M. osteoarthritis
N. neuropathic joint
O. rheumatoid arthritis
P. low-dose radiation
Q. steroid injection
R. a load-relieving insert and shoe modification
S. complete excision of the mass and the entire plantar fascia
T. wide excision of the mass with a 2 cm margin of normal fascia
U. CT scan of the chest
V. technetium bone scan
W. bone marrow aspiration
X. serum protein electrophoresis
Y. lateral skull radiograph
Z. high-grade histology of the initial tumor
[. multiple local recurrences after curettage
\. previous treatment of the tumor with cryotherapy
]. previous treatment of the tumor with radiation therapy
^. extraosseous extension into two or more adjacent compartments
_. Dorsal rhizotomy and facet joint fusion
`. Multilevel corpectomy and spinal stabilization
A. Central and lateral recess decompression and bilateral foraminotomy
B. Central decompression and facet joint fusion
C. Central decompression, foraminotomy, and spinal fusion from L2 to L5.
D. Inadequate rehabilitation
E. Displacement of the coronoid process fracture
F. Insufficiency of the lateral ulnar collateral ligament
G. Insufficiency of the anterior band of the medial collateral ligament
H. Insufficiency of the posterior band of the medial collateral ligament
I. Osteotomy and intramedullary rod fixation
J. Electrical stimulation
K. Strut-autografing the concavity the tibia
L. A patellar tendon-bearing brace
M. Percutaneous injection of demineralized bone matrix
N. digoxin
O. sucralfate
P. clindamycin
Q. alcohol
R. neuromuscular blocking agents
S. Unrestrained roll-back
T. Unrestrained rotational conformity
U. Medial-Lateral conformity
V. Anteroposterior conformity in flexion
W. Anteroposterior conformity in extension
X. Arthrodesis of the MTP joint
Y. A Silastic implant of the MTP joint
Z. Resection arthroplasty of the MTP joint
{. Cheilctomy of the MTP joint
|. Osteotomy of the base of the proximal phalanx
}. Genu varum
~. Tarsal coalition
. Degenerative ankle arthrosis
€. Osteochondritis dissecans of the talus
. Hemihypertrophy of the ipsilateral lower extremity
‚. Trabecular bone is preferentially resorbed in this high bone turnover state
ƒ. Loss of water content in the disk increases impact load to the vetrebral bodies
„. Stress is imposed by the relative stiffness of the arthrtic facet joints
…. Increased energy demands are imposed by decreased circulation to the vertebral body
†. The thick cortical bone found in the vertebral body resorbs rapidly following estrogen withdrawal
‡. Increased time in stance and swing phase
ˆ. Addition of a double leg float phase
‰. Decreased vertical ground reaction forces
Š. Decreased arc of motion in the hip, knee, and ankle
‹. Decreased joint reaction forces in the hip, knee, and ankle
Œ. Talonavicular arthrodesis
. Medial displacement calcaneal osteotomy
Ž. Flexor digitorum longus tendon transfer with spring ligament advancement
. Triple arthrodesis
. Calcaneocuboid distraction arthrodesis and repair of the posterior tibial tendon
‘. Lymphoma
’. Hemangioma
“. Osteosarcoma
”. TB of the spine
•. Metastatic breast carcinoma
–. widening and shortening of the heel.
—. weakness of the gastrocnemius-soleus complex.
˜. anterior impingement from a horizontal talus.
™. unrecognized compartment syndrome of the foot.
š. degenerative arthritis of the tibiotalar joint.
›. a corrective osteotomy
œ. application of braces
. medial physeal stapling until the varus corrects
ž. observation
Ÿ. application of corrective casts
 . a total contact cast.
¡. electrical stimulation.
¢. an off the shelf fracture brace.
£. an elastic compression bandage and crutches.
¤. a hard soled shoe until the patient is asymptomatic.
¥. Ewings tumor
¦. Parosteal osteosarcoma
§. Dedifferentiated chondrosarcoma
¨. Low grade intramedullary chondrosarcoma
©. High grade intramedullary osteosarcoma
ª. Vascular injury
«. Tear of the rotator cuff
¬. Injury to the brachial plexus
­. Fracture of the upper thoracic rib
®. Fracture of the proximal humerus
¯. Biceps
°. Trapezius
±. Infraspinatus
². Pectoralis major
³. Serratus anterior
´. Hybrid total hip arthroplasty
Μ. Noncemental hemiarthroplasty of the hip
¶. Closed reduction and percutaneous pin fixation
·. Open reduction through an anterior approach to the hip
¸. Excision of the head fragment
¹. a quadratus femoris pediclebone graft
º. a proximal femoral allograft
». intertrochanteric osteotomy
¼. total hip arthroplasty
½. hip hemiarthroplasty
¾. Echocardiogram
¿. Electrocardiogram
À. Radiograph of the chest
Á. CT scan of the shoulder
Â. Ultrasound of the shoulder
Ã. Ilioinguinal
Ä. Extended iliofemoral
Å. Combined ilioinguinal and Kocher-Langenbeck (posterior)
Æ. Kocher-Langenbeck (posterior)
Ç. Kocher-Langenbeck (posterior) with trochanteric osteotomy
È. Deltoid
É. Supraspinatus
Ê. Subscapularis Infraspinatus
Ë. Infraspinatus
Ì. Infraspinatus and teres minor
Í. an orthosis.
Î. observation.
Ï. electrical stimulation.
Ð. open reduction and internal fixation.
Ñ. application of a nonweightbearing short leg cast.
Ò. repair of the rotator cuff.
Ó. rehabilitation of the shoulder
Ô. replacement of the humeral head.
Õ. arthroscopic acromioplasty and debridement.
Ö. immobilization is a sling until pain resolves.
×. Bone rotation versus torque applied
Ø. Bone deflection versus bending moment applied
Ù. Axial displacement versus tension applied
Ú. Lateral translation versus shear force applied
Û. Fracture gap closing versus compressive force applied
Ü. steroid injection
Ý. stretching of the heel cord
Þ. surgical release of the plantar fascia
SS. application of a short leg cast for 6 to 8 weeks
À. wearing dorsiflexion night splints
Á. Open bladder
Â. Bilateral “hitchhiker’s” thumbs
Ã. Bilateral defects in the midclavicles
Ä. Rhizomelic shortening of the extremities
Å. Radiographic fragmentation of all major epiphyses
Æ. Medial patellotibial
Ç. Medial patellofemoral
È. Medial patellomeniscal
É. Lateral patellofemoral
Ê. Lateral patellotibial
Ë. Heat
Ì. Gentle active flexion-extension exercises
Í. Isokinetic strengthening
Î. Electrical muscle stimulation
Ï. Immobilization of the limb with the knee in full flexion
Ð. Distal chevron osteotomy with soft-tissue release
Ñ. Distal soft-tissue realignment only
Ò. Closing wedge osteotomy (Aken) of the proximal phalanx
Ó. Proximal first metatarsal osteotomy only
Ô. Soft-tissue realignment with a proximal metatarsal osteotomy
Õ. Vagus
Ö. Phrenic
÷. Hypoglossal
Ø. Recurrent laryngeal
Ù. Inferior thyroid
Ú. Surgical exploration
Û. Application of leeches
Ü. Stellate ganglion blocks
Ý. Intra-arterial streptokinase
Þ. Elevation and reevaluation in 1 hour
Ÿ. Liver profile
Ā. Myleogram
Ā. Platelet count
Ă. CT scan of the head
Ă. Angiogram of the extremity
Ą. Post spinal fusion from L5to S1
Ą. Primary repair with an iliac bone graft
Ć. Post spinal fusion of L4-5
Ć. A pantaloon body cast and 6 weeks of bed rest
Ĉ. Rest, NSAIDS, and limited dancing
Ĉ. Stress fracture of the proximal fifth metatarsal
Ċ. Stress fracture of the base of the second metatarsal
Ċ. Stress fracture of the neck of the second metatarsal
Č. Morton’s neuroma
Č. Lisfranc’s joint subluxation
Ď. C5 radiculopathy
Ď. Subscapularis rupture
Đ. Glenohumeral arthrosis
Đ. Rotator cuff arthropathy
Ē. Suprascapular nerve compression at the spinoglenoid notch
Ē. mm femoral head in combination with a metal-backed polyethylene component
Ĕ. mm femoral head in combination with an all-polyethylene acetabular component
Ĕ. mm femoral head in combination with a metal-backed polyethylene component
Ė. mm femoral head in combination with an all-polyethylene component
Ė. mm femoral head in combination with a metal-backed polyethylene component
Ę. Female gender
Ę. History of cigarette smoking
Ě. L5-S1 spondylolisthesis on pre-employment radiography
Ě. Decreased strength of the lower extremities on pre-employment testing
Ĝ. Decreased flexibility of the lumbar spine on pre-employment testing
Ĝ. Size of cells
Ğ. Amount of DNA in cells
Ğ. Nucleus-cytoplasm ratio
Ġ. Specific DNA sequences
Ġ. Specific messenger RNA sequences
Ģ. Femoral and obturator nerves
Ģ. Femoral and superior gluteal nerves
Ĥ. Femoral and lateral femoral cutaneous nerves
Ĥ. Obturator and superior gluteal nerves
Ħ. Obturator and lateral femoral cutaneous nerves
Ħ. Isotonic
Ĩ. Isokinetic
Ĩ. Isometric
Ī. Open kinetic chain
Ī. Dynamic variable resistance
Ĭ. Closed reduction and cast immobilization
Ĭ. Uniplanar external fixation
Į. Open reduction and internal fixation with a dynamic compression plate
Į. Unreamed intramedullary rod
İ. Multiple plane external fixator
I. Inlet view of the pelvis
IJ. Outlet view of the pelvis
IJ. AP view of the hip
Ĵ. Ilial oblique view (external oblique) of the hip
Ĵ. Obturator oblique
Ķ. Glycolytic pathway
Ķ. Oxidative phosphorylation
ĸ. Breakdown of fat
Ĺ. Breakdown of protein
Ĺ. Breakdown of adenosine triphosphate
Ļ. an MRI scan
Ļ. arthroscopic examination
Ľ. AP and frog-lateral radiographs of the pelvis and hips
Ľ. varus and valgus stress radiographs of the knee
Ŀ. physical examination of the knee under anesthesia
Ŀ. extended curettage and polymethylmethacrylate cementation
Ł. extra-articular resection of the knee and an allograft arthrodesis
Ł. wide resection of the proximal tibia and custom prosthetic replacement
Ń. prophylactic internal fixation and postoperative irradiation
Ń. excision of the lateral condyle and reconstruction with a hemicondylar allograft
Ņ. silicone implant joint replacement
Ņ. metatarsophalangeal joint arthrodesis
Ň. metatarsophalangeal joint debridement
Ň. resection of the metatarsal head
ʼN. resection of the base of the proximal phalanx
Ŋ. Fixation of the syndesmosis has failed
Ŋ. Widening of the ankle mortise has led to the failure of fixation
Ō. Infection around the syndesmosis screw has led to osteomyelitis
Ō. The syndesmosis screw is broken
Ŏ. Motion between the tibia and fibula has caused loosening of the syndesmosis screw
Ŏ. Microcephaly
Ő. A temporal lobe cyst
Ő. An Arnold-Chiari type 1 malformation
Œ. Periventricular leukomalacia
Œ. Agnesis of the corpus callosum
Ŕ. Wolff’s
Ŕ. Hooke’s
Ŗ. Hilton’s
Ŗ. Muller-Haeckel
Ř. Heuter-Volkmann
Ř. Both the anterolateral and posteromedial bands are isometric and do not significantly change with flexion
Ś. The anterolateral band is lax and becomes tight in flexion, while the posteromedial band is tight, and becomes lax in flexion
Ś. The anterolateral band is tight and becomes lax in flexion, while the posteromedial band is lax and becomes tight in flexion
Ŝ. Both the anterolateral and posteromedial bands are lax and become tight in flexion
Ŝ. Both the anterolateral and posteromedial bands are tight and become lax as the knee is flexed
Ş. UCB orthosis
Ş. Rigid orthosis with a medical arch support
Š. Semi-rigid orthosis with lateral forefoot posting
Š. Semi-rigid orthosis with a medial arch support
Ţ. Medial heel wedge attached to the running shoes
Ţ. Hallux varus
Ť. Osteonecrosis
Ť. Recurrence of the hallux valgus
Ŧ. “Transfer” second metatarsalgia
Ŧ. Physeal arrest of the first metatarsal
Ũ. Aseptic loosening in a 70-year-old patient
Ũ. Mechanical failure of a hinged knee prosthesis
Ū. Failed knee replacement complicated by reflex sympathetic dystrophy
Ū. Infection with soft-tissue deficit
Ŭ. A prior patellectomy
Ŭ. Knee fusion
Ů. Open irrigation and debridement
Ů. Arthroscopic irrigation and debridement
Ű. One-stage exchange arthroplasty
Ű. Two-stage exchange arthroplasty
Ų. Putti-platt repair
Ų. Open Bankart repair
Ŵ. Injection of a subacromial corticosteroid
Ŵ. Arthroscopic transglenoid capsular shift
Ŷ. Rehabilitation of the scapular and rotator cuff muscles
Ŷ. Silicone suction socket and an energy-absorbing foot
Ÿ. Silicone suction socket and a variable resistance ankle
Ź. Plastic suction socket, telescoping pylon, and a solid ankle cushioned heel (SACH) foot
Ź. Plastic socket with a hinged thigh cuff and a SACH foot
Ż. Patellar tendon-bearing suction socket and a uniaxial hydraulic ankle
Ż. Parosteal
Ž. Periosteal
Ž. High-grade intramedullary
S. Osteosarcoma occurring in Paget’s disease
Ƀ. Osteosarcoma occurring in irradiated bone
Ɓ. Cauda equina
Ƃ. Conus medullaris
Ƃ. Genitofemoral nerve
Ƅ. Lumbar sympathetic plexus
Ƅ. Lumbar parasympathetic plexus
Ɔ. Spinal pseudoarthrosis
Ƈ. Spinal cord traction injury with paralysis
Ƈ. Arterial and venous thromboses
Ɖ. Superior mesenteric artery syndrome
Ɗ. Crankshaft phenomenon
Ƌ. Inversion stress radiograph
Ƌ. MRI scan
ƍ. CT scan
Ǝ. Nuclear bone scan
Ə. External rotation stress radiograph
Ɛ. Complex deformity with an angulation in two planes
Ƒ. Single deformity less than 20 degrees, apex posterolateral
Ƒ. Single deformity greater than 30 degrees, apex posterolateral
Ɠ. Single deformity less than 20 degrees, apex posteromedial
Ɣ. Single deformity greater than 30 degrees, apex posteromedial
Ƕ. Pronation of the foot during the stance phase of gait
Ɩ. Heel inversion at the beginning of a single limb heel rise
Ɨ. Active inversion of the nonweightbearing foot
Ƙ. Active plantar flexion of the first ray against resistance
Ƙ. Active plantar flexion of the foot during the push-off phase of gait
Ƚ. Observation and repeat radiographs in 4 months
ƛ. Application of a thoracolumbalsacral orthosis for 22 to 24 hours per day
Ɯ. Electrical stimulation at night
Ɲ. Physical therapy
Ƞ. Begins to remodel and hypertrophy more quickly
Ɵ. Provides a better scaffold for osteoconduction
Ơ. Reduces the risk of early fracture
Ơ. Reduces technical difficulty
Ƣ. Lowers donor site morbidity
Ƣ. Anterior fusion of the lumbar curve
Ƥ. Anterior and posterior fusion of the thoracic curve
Ƥ. Posterior fusion of the thoracic curve
Ʀ. Posterior fusion of the thoracic and lumbar curves
Ƨ. Application of a brace until the iliac apophyses are Risser 4 or 5, followed by surgical correction
Ƨ. Subscapularis rupture
Ʃ. Type III SLAP lesion
ƪ. Disruption of capsular shift
ƫ. Isolated traumatic subluxation
Ƭ. Injury to the axillary nerve after dislocation
Ƭ. hypophosphatemia
Ʈ. high dietary cholesterol intake
Ư. deficiency of lipoprotein A
Ư. deficiency of protein S and protein C
Ʊ. elevated levels of antithrombin III
Ʋ. Weightbearing short leg cast
Ƴ. Nonweightbearing short leg cast
Ƴ. Removable splint and early motion
Ƶ. Open reduction and internal fixation
Ƶ. Elastic compression bandage with full weightbearing
Ʒ. Breast
Ƹ. Prostate
Ƹ. Gastrointestinal
ƺ. Kidney
ƻ. Multiple myeloma
Ƽ. Varus stress
Ƽ. Valgus stress
ƾ. Torsional loading
Ƿ. Hyperextension of the knee
ǀ. Contraction of the quadriceps while axially loaded
ǁ. Primary internal fixation at both fracture levels
ǂ. External fixation as definitive ttt for both #
ǃ. Skeletal traction and delayed internal fixation of both fractures
DŽ. Primary internal fixation of the proximal fracture and delayed fixation of the femoral fracture
DŽ. Primary internal fixation of the femoral shaft fracture and delayed fixation of the proximal #
DŽ. Heel spur
LJ. Plantar fascitis
LJ. Dysfunction of the tibialis posterior tendon
LJ. Compression of the first branch of the lateral plantar nerve
NJ. Compression of the calcaneal nerve
NJ. Displaced labral tear
NJ. Tear of the rotator cuff
Ǎ. Fracture of the glenoid rim
Ǎ. Palsy of the axillary nerve
Ǐ. Palsy of the musculocutaneus nerve
Ǐ. Enchondroma
Ǒ. Osteoblastoma
Ǒ. Giant cell tumor
Ǔ. Aneurysmal bone cyst
Ǔ. Fibrous dysplasia
Ǖ. Arthrogram of the wrist
Ǖ. MRI scan of both wrists
Ǘ. CT scan of both wrists in the same position
Ǘ. Radiographs of the wrist in supination and pronation
Ǚ. Radiographs of the opposite wrist in the same position
Ǚ. Secondary hyperparathyroidism
Ǜ. Phosphate retention secondary to uremia
Ǜ. Insufficient renal synthesis of 1, 25 dihydroxy vitamin D
Ǝ. Aluminum deposition in bone from oral phosphate binders
Ǟ. Persistent acidosis aggravating the negative calcium balance
Ǟ. Posterior fusion at T10-L3 with segmental instrumentation
Ǡ. Laminectomy and fusion of T12-L2 with segmental instrumentation
Ǡ. Bed rest in a hyperextension brace
Ǣ. L1 vertebrectomy and anterior decompression with strut graft fusion and instrumentation
Ǣ. Progressive ambulation as tolerated in a custom-molded thoracolumbosacral orthosis
Ǥ. Positive-pressure ventilation
Ǥ. An immediate radiograph of the chest
Ǧ. Adjustment of the position of the endotrachael tube
Ǧ. Insertion of a large-bore needle into the pericardial space
Ǩ. Insertion of a large-bore needle in the right second intercostal space, midclavicular line
Ǩ. Allowing the ends of the fracture to touch
Ǫ. Adding a second connecting bar
Ǫ. Adding one pin to each fracture fragment
Ǭ. Increasing the pin diameter from 4 mm to 6 mm
Ǭ. Decreasing the connecting bar-to-bone distance from 6 cm to 4 cm
Ǯ. Osteomyelitis
Ǯ. Malignant degeneration
J̌. Stress fracture
DZ. Local recurrence of the giant cell tumor
DZ. Bone resorption due to methylmethacrylate
DZ. Advancement of the plantar plate
Ǵ. Resection of the second metatarsal head
Ǵ. Dorsiflexion osteotomy of the second metatarsal neck
Ƕ. Transfer of the flexor digitorum longus tendon to the dorsum of the toe
Ƿ. Transfer of the extensor digitorum comminus tendon to the metatarsal neck
Ǹ. Sacral fracture
Ǹ. Burst fracture of L5
Ǻ. Cauda equina syndrome
Ǻ. Distraction-flexion injury at L3
Ǽ. Distraction-extension injury at L3
Ǽ. An MRI scan of the shoulder
Ǿ. An MRI scan of the cervical spine
Ǿ. Electromyographic and nerve conduction velocity studies
Ȁ. Immobilization in a sling and early passive range of motion exercises
Ȁ. Immediate return to the operating room for exploration of the brachial plexus
Ȃ. cerclage wiring
Ȃ. tension band wiring
Ȅ. removal of the patellar component
Ȅ. revision of the patellar component
Ȇ. immobilization of the knee and protected weightbearing
Ȇ. Liposarcoma
Ȉ. Nodular fasciitis
Ȉ. Rabdomyosarcoma
Ȋ. Malignant fibrous histiocytoma
Ȋ. Extra-abdominal desmoid tumor
Ȍ. Clubfeet
Ȍ. Thrombocytopenia
Ȏ. Congenital scoliosis
Ȏ. Ventricular septal defect
Ȑ. Arnold-Chiari malformation
Ȑ. delayed primary closure
Ȓ. free flap
Ȓ. pedicle groin flap
Ȕ. full-thickness skin graft
Ȕ. split-thickness skin graft
Ȗ. Infection
Ȗ. Nonunion
Ș. Improper screw length
Ș. Osteonecrosis of the distal fragment
Ț. Use of a cortical screw instead of a cancellous screw
Ț. Infection
Ȝ. Tear of the rotator cuff
Ȝ. Loosening of the humeral component
Ȟ. Arthritis of the glenoid
Ȟ. Arthritis of the A-C joint
Ƞ. Reduced morbidity
ȡ. Improved osteoinduction
Ȣ. Improved osteoconduction
Ȣ. More rapid revascularization
Ȥ. Lower risk of disease transmission
Ȥ. Manipulation Under Anesthesia
Ȧ. Arthroscopic acromioplasty
Ȧ. Arthroscopic debridement of G-H joint
Ȩ. Replacement of the humeral head
Ȩ. Lengthening of the subscapularis and release of the anterior capsule
Ȫ. Bacteroides
Ȫ. E. coli
Ȭ. Staph. aureus
Ȭ. group A streptococcus
Ȯ. Clostridium perforingens
Ȯ. observation and exercises
Ȱ. bracing with a thoracolumbar orthosis
Ȱ. fusion of the posterior spine
Ȳ. fusion of the anterior spine
Ȳ. fusion of the anterior and posterior spine
ȴ. Total wrist replacement and bridge grafts
ȵ. palmar shelf arthroplasty and tendon transfers
ȶ. Darrach distal ulna resection, dorsal tenosynosynovectomy, and tendon transfers
ȷ. Radioscaphate fusion, extensor tenodesis, and Darrach distal ulna resection
ȸ. Total wrist fusion and tendon transfers
ȹ. constrained acetabular component
Ⱥ. protrusion ring with morselized graft
Ȼ. cemented metal backed acetabular component
Ȼ. cemented all-polyethylene acetabular component
Ƚ. cementless hemispherical component with screw fixation
Ⱦ. application of a hip abduction brace for 22 hours per day
Ȿ. application of a hip spica under anesthesia
Ɀ. discontinuance of all bracing and repeat radiographs in 3 months
Ɂ. open reduction of the hip and application of a spica cast
Ɂ. open reduction, varus osteotomy, and application of a spica cast
Ƀ. Loss of skin hair on the feet
Ʉ. Absent pulses on vascular examination
Ʌ. Pain that originates proximally and spreads distally
Ɇ. Pain that is relieved by stopping and standing
Ɇ. Pain that is worse when the patient walks uphill rather downhill
Ɉ. wrist flexors and finger flexors
Ɉ. elbow flexors and wrist flexors
Ɋ. elbow flexors and finger flexors
Ɋ. elbow extensors and wrist flexorst Level Key Muscles4 DiaphragmDeltoid, elbow flexors, diaphragmElbow flexors, wrist extensorsElbow extensors, wrist flexorsFinger flexors (distal phalanx of middlefinger)Finger abductors (5th digit), intrinsics of hand2 Segmental innervation to intercostal muscles, abdominal and paraspinal muscles) L1, L2, L3 Hip flexors3, L4 QuadricepsTibialis anteriorToe extensors, hip abductorsAnkle plantarflexors, peronei
Ɍ. elbow extensors and wrist extensors
Ɍ. Syndactyly
Ɏ. Macrodactyly
Ɏ. Camptodactyly
Ɐ. Preaxial polydactyly
Ɑ. Postaxial polydactyly
Ɒ. Arthrodesis
Ɓ. Rotationplasty
Ɔ. Above-knee amputation
ɕ. Osteoarticular allograft
Ɖ. Endoprosthesis (custom arthroplasty)
Ɗ. Plantar fascia
ɘ. Spring ligament
Ə. Deltoid ligament
ɚ. Intrinsic tendons
Ɛ. Gastorcnemius-solelus complex
Ɜ. Prevention of presynaptic release of acetylcholine
ɝ. Prevention of synthesis of presynaptic acetylcholine
ɞ. Activation of acetylcholinesterase at the motor end-plate
ɟ. Blockage of postsynaptic action of acetylcholine until reserves are depleted
Ɠ. Stimulation of release of presynaptic acetylcholine until reserves are depleted
Ɡ. stiffness of the femoral component.
ɢ. head offset of the femoral component.
Ɣ. femoral component material modulus of elasticity.
ɤ. extent of the femoral component porous coating.
Ɥ. Presence of a femoral component collar.
Ɦ. plantar fascia and quadratus plantae tendon.
ɧ. ligamentous structures connecting the tarsal bones.
Ɨ. shape of the tarsal bones and the intervening joints.
Ɩ. activity of the intrinsic muscles of the foot.
Ɪ. activity of the posterior tibialis and the peroneus longus muscles.
Ɫ. scapulothoracic fusion
Ɬ. strengthening of the periscapular muscles
ɭ. pectoralis minor-fascia lata graft transfer to the scapula
ɮ. pectoralis major-fascia lata graft transfer to the scapula
Ɯ. exploration of the long thoracic nerve, with sural nerve graft
ɰ. tricompartmental knee replacement
Ɱ. unicompartmental knee replacement
Ɲ. medial compartment meniscal allograft
ɳ. valgus-producing distal femoral osteotomy
ɴ. valgus-producing proximal tibial osteotomy
Ɵ. Internal rotation of the femoral component
ɶ. External rotation of the tibial component
ɷ. Lateral placement of the femoral component
ɸ. Medial placement of the patellar component
ɹ. Excessive resection of the patella
ɺ. Hallux rigidus
ɻ. Hallux valgus
ɼ. Neuroma of the first web space
Ɽ. Fracture of the sesamoid
ɾ. Rupture of the flexor hallucis longus
ɿ. Sickle cell crisis
Ʀ. Idiopathic chondrolysis
ʁ. Hemophilic arthropathy
Ʂ. Osteoid osteoma of the femoral neck
Ʃ. Legg-Calve-Perthes disease
ʄ. Decreased ankle jerk and positive femoral nerve stretch test
ʅ. Decreased knee jerk and positive straight-leg raising sign
ʆ. Gastrocnemius-soleus complex weakness and positive straight-leg raising sign
Ʇ. Weakness of the extensor hallucis longus and positive straight-leg raising sign
Ʈ. Weakness of the extensor hallucis longus and positive femoral nerve stretch test
Ʉ. Long-term administration of IV and oral antibiotics
Ʊ. Open soft-tissue debridement, retention of prosthetic components, and IV antibiotics
Ʋ. Immediate exchange arthroplasty with antibiotic-impregnated cement
Ʌ. Two-stage surgical prosthetic exchange and IV antibiotics
ʍ. Resection arthroplasty and IV antibiotics
ʎ. SCFE
ʏ. MED
ʐ. Perthes disease
ʑ. Hypothyroidism
Ʒ. Chondrolysis
ʓ. gout.
ʔ. osteoporosis.
ʕ. eosinophilic granuloma.
ʖ. tuberculosis of the spine.
ʗ. metastatic disease of the spine.
ʘ. water content.
ʙ. Synthesis of type I collagen.
ʚ. Proteoglycan content.
ʛ. Activity of chondrocytes.
ʜ. Synthesis of hyaluronate.
Ʝ. Lung
Ʞ. Breast
ʟ. Prostate
ʠ. Thyroid
ʡ. Renal
ʢ. T1-low, T2-low.
ʣ. T1-low, T2-high.
ʤ. T1-moderate, T2-low.
ʥ. T1-high, T2-low.
ʦ. T1-high, T2-high.
ʧ. hypothesis is incorrect or invalid
ʨ. interobserver error rate is 4%.
ʩ. Standard deviation is 4% higher or lower than the mean.
ʪ. Sample size is 4% larger than required to be clinically significant.
ʫ. Probability that the differences noted between two study groups were due to chance alone is 4%.
ʬ. I
ʭ. II
ʮ. IV
ʯ. IX
ʰ. X
ʱ. Cranial setting
ʲ. Cranial subluxation
ʳ. Odontoid fracture
ʴ. Lysis of the arch of the atlas
ʵ. Atlantoaxial subluxation
ʶ. Retrograde collapse of the endoneurial tubes
ʷ. Irreversible atrophy of the denervated muscles
ʸ. Elongation of the axons across the zone of injury
ʹ. Sprouting of the axons at the neuromuscular junction
ʺ. Misdirection of the axons across the zone of injury
ʻ. Maximally pronated and elbow extended
ʼ. Maximally pronated and the elbow flexed
ʽ. Maximally supinated and the elbow flexed
ʾ. Maximally supinated and the elbow extended
ʿ. In neutral rotation, with the elbow extended
ˀ. open reduction and internal fixation
ˁ. buddy taping to the adjacent index finger
˂. early motion with application of a dynamic banjo splint
˃. application of a cast with the hand in a “safe position” for 3 weeks.
˄. dorsal extension block splinting
˅. The name of the manufacturer
ˆ. The manufacturer’s potential liability
ˇ. The physician’s clinical performance
ˈ. The physician’s materials testing data
ˉ. Any royalties the physician receives from the manufacturer
ˊ. Femoral
ˋ. Obturator
ˌ. Inferior gluteal
ˍ. Superior gluteal
ˎ. Lateral femoral cutaneous
ˏ. open biopsy and a long leg cast
ː. open biopsy and wide resection of the tumor
ˑ. a long leg cast and observation
˒. intramedullary stabilization and observation
˓. Triggering
˔. Lateral instability
˕. Swan-neck deformity
˖. Boutonniere deformity
˗. Loss of distal interphalangeal joint flexion
˘. Peroneus brevis to peroneus longus
˙. Peroneus tertius to extensor hallucis longus
˚. Peroneus tertius to superficial peroneal nerve
˛. Extensor hallucis longus to deep peroneal nerve
˜. Extensor hallucis longus to extensor digitorum longus
˝. reassurance that Medicare will pay for the treatment.
˞. consent forms that patients or their guardians are able to understand.
˟. a detailed description of the device, omitting the fact that it is part of a study.
ˠ. a provision that the patient’s care will be discontinued if he or she does not enroll in the study.
ˡ. a provision that the study will be carried out to completion, whether or not the device is as effective as those currently in existence.
ˢ. an onlay iliac crest bone graft.
ˣ. limited weightbearing and observation.
ˤ. removal of the implant and limited weightbearing.
˥. removal of the implant and insertion of a reamed femoral nail.
˦. removal of the implant and insertion of an unreamed femoral nail.
˧. Coronal
˨. Sagittal
˩. Anteromedial, midway between the sagittal and the coronal
˪. Proximal pins sagittal, distal pins coronal
˫. Proximal pins coronal, distal pins sagittal
ˬ. Rheumatoid arthritis
˭. Posttraumatic arthritis
ˮ. Degenerative osteoarthritis
˯. Osteonecrosis of the tibial plateau
˰. Osteonecrosis of the medial femoral condyle
˱. Trapeziometacarpal arthrodesis
˲. Osteotomy of the thumb metacarpal
˳. Arthrotomy and joint debridement
˴. Ligament reconstruction using one half of the flexor carpi radialis
˵. Trapezium resection, tendon interposition, and reconstruction of the ligament
˶. Creep
˷. Relaxation
˸. Energy dissipation
˹. Plastic deformation
˺. Elastic deformation
˻. bending
˼. axial loading
˽. high-speed rotation
˾. direct impact from anteromedial
˿. crush from anteromedial to posterolateral
̀. Increase stiffness
́. Increase fracture toughness
̂. Increase fatigue strength
̃. Decrease mechanical strength
̄. Decrease wear rate
̅. disuse osteopenia
̆. paraendocrine effect of the tumor
̇. abnormally increased density on the right side
̈. side effect of the treatment of the lesion
̉. extensive tumor involvement of the left hip
̊. Sciatic nerve
̋. Superior gluteal artery
̌. Profunda femoris artery
̍. Femoral artery and nerve
̎. External iliac artery and vein
̏. Length
̐. Moment arm
̑. Total volume
̒. Physiologic cross-sectional area
̓. Distribution of slow and fast twitch fibers
̔. decreasing initiation of action potentials.
̕. increasing action potential amplitude.
̖. blocking the opening of gated sodium channels.
̗. decreasing the number of functional motor units.
̘. slowing or stopping action potential propagation through the axon.
̙. resection of the metatarsal heads of the first through fifth toes.
̚. Silastic MP joint arthroplasties of the first through fifth toes.
̛. fusion of the hallux MP joint and resection arthroplasty of the 2nd through fifth metatarsal heads.
̜. fusion of hallux MP joint and distal osteotomy of the 2nd through 5th MT.
̝. plantar condylectomy of the 2nd through 5th MT heads & resection of proximal phx of the hallux.
̞. hemiarthroplasty
̟. open reduction and internal fixation
̠. closed reduction and percutaneous pinning
̡. a sling and early pedulum exercises
̢. a sling and swathe for 6 weeks, followed by shoulder rehabilitation
̣. open acromioplasty
̤. open Bankart repair
̥. open subscapularis tendon repair
̦. inferior capsular shift
̧. a supervised physical therapy program
̨. a sling and swathe, with pendulum exercises in 10 days
̩. open reduction and internal fixation through an anterior approach
̪. open reduction and internal fixation through a posterior approach
̫. immobilization with a splint in 45 degrees of abduction for 6 weeks
̬. arthroscopically assisted reduction and percutaneous screw fixation
̭. Repair of the rotator cuff
̮. Replacement of the humeral head
̯. Resection arthroplasty
̰. Total shoulder arthroplasty
̱. AP and lateral radiographs of the elbow
̲. Diagnositc arthroscopy
̳. Aspiration of joint fluid
̴. An erythrocyte sedimentation rate and CBC
̵. A diagnostic lidocaine injection
̶. Insulin-like growth factor (IGF-1)
̷. Fibroblast growth factor (FGF-1)
̸. Platelet-derived growth factor (PDGF)
̹. Transforming growth factor beta (TGF-B)
̺. Bone morphogenetic proteins (BMP)
̻. clinical history and radiographic findings.
̼. technetium bone scan
̽. flow cytometry pattern of extracted chondrocytes
̾. immunohistochemical staining patterns of a biopsy specimen
̿. histologic features of a biopsy specimen stained with hematoxylin-cosin
̀. Radial
́. Radial recurrent
͂. Posterior interosseous
̓. Superior ulnar recurrent
̈́. Superficial radial circumflex
Ι. Impaired hydroxylation of proline
͆. Failure of cleavage in procollagen
͇. Defective binding sites for hydroxyproline
͈. Failure to incorporate glycine into the helix
͉. Diminished production of collagen through the rough endoplasmic reticulum
͊. Asking the legal staff to seek a court injunction
͋. Copying the patient’s chart and giving it to him as he leaves
͌. Having the patient sign a written legal contract that specifies acceptable behavior
͍. Continuing care of the patient until an appropriate referral can be arranged
͎. Transferring the patient to another orthopaedic surgeon without disclosing the realreason for why the patient is being transferred
͏. Meta-analysis
͐. Confidence interval
͑. Analysis of variance (ANOVA)
͒. Statistical significance (p-value)
͓. Survivorship analysis (Kaplan-Meier)
͔. Spinal shock
͕. Neurogenic shock
͖. Hypovolemic shock
͗. Pulmonary embolism
͘. Fat embolus syndrome
͙. Lumbar spinal stenosis
͚. Metastatic disease of the spine
͛. Rheumatoid lumbar spondylitis
͜. Isthmic spondyloloisthesis
͝. Degenerative spondylolisthesis at L4-5 and L5-S1
͞. Patella alta
͟. A metal-backed patella
͠. Varus malalignment of the knee
͡. A posterior cruciate-substituting femoral component
͢. Lateral subluxation of the patella on a Merchant’s view
ͣ. The sesamoids are separated
ͤ. The sesamoid is fractured
ͥ. The proximal phx is on the neck of the metatarsal
ͦ. The dislocation is dorsal and centered
ͧ. The proximal phalanx is hyperextended
ͨ. Patella
ͩ. Tibial stem
ͪ. Distal femoral interface
ͫ. Posterior femoral interface
ͬ. Sites of screw fixation for the tibia
ͭ. Hallux rigidus
ͮ. Fracture of the sesamoid
ͯ. Disruption of the plantar plate
Ͱ. Osteonecrosis of the metatarsal head
Ͱ. Rupture of the flexor hallucis longus
Ͳ. Gout
Ͳ. Sepsis
ʹ. Old trauma
͵. Rheumatoid arthritis
Ͷ. Charcot arthroplasty
Ͷ. Aspiration and steroid injection
͸. Biopsy, curettage, and allograft bone grafting
͹. Percutaneous Kirschner wire fixation
ͺ. Percutaneous injection of autogenous bone marrow
Ͻ. Nerve roots
Ͼ. Spinal cord
Ͽ. Sciatic nerve
;. Peroneal nerve
Ϳ. Conus medullaris
΀. Extent of bone penetrated by reaming, prosthetic components, or acrylic cement
΁. Periprosthetic regions that are accessible to joint fluid and particulate wear debris
΂. Enveloping pseudocapsular scar tissue that develops around a prosthetic hip following surgical capsulectomy
΃. Soft tissue and bone that are potentially contaminated with bacteria in the setting of a prosthetic joint infection
΄. Potential intrapelvic joint space communication created by acetabular fixation screws or intrapelvic extruded acrylic cement
΅. Early and late infection
Ά. Periprosthetic fracture of the femur
·. Failure of the patellofemoral and extensor mechanisms
Έ. Aseptic loosening of cementing tibial components
Ή. Asceptic loosening of cemented femoral components
Ί. Acceptance of the current position of the ankle
΋. Open reduction and fixation in the epiphysis only
Ό. ORIF with a small-fragment T-plate from the malleolus up to the metaphysis
΍. Closed reduction by eversion of the ankle and application of a bivalved long leg cast
Ύ. CRUGA and fixation with a malleolar screw from the malleolus into the metaphysis
Ώ. Resection arthroplasty and local radiation
Ϊ́. In situ fusion of the hip
Α. Excision of heterotopic bone, total hip arthroplasty, and oral indomethacin
Β. Excision of heterotopic bone and local radiation
Γ. Excision of heterotopic bone, hemiarthroplasty, and oral indomethacin
Δ. Closed reduction of both fractures and immediate spica casting
Ε. Bilateral skin traction for 3 weeks, followed by spica casting
Ζ. External fixation of both femora
Η. External fixation of the left femur and a long leg cast brace for the right femur
Θ. External fixation of the left femur and use of a reamed intramedullary nail in the right femur
Ι. Synovial sarcoma
Κ. Soft-tissue abcess
Λ. Rhabdomyosarcoma
Μ. Eosinophilic granuloma
Ν. Nodular pigmented villonodular synovitis
Ξ. Changing to a titanium nail
Ο. Changing to a nonslotted nail
Π. Changing the cross-sectional shape of the nail
Ρ. Increasing the diameter of the nail by 3 mm
΢. Increasing the diameter of the interlocking screws
Σ. Fracture healing
Τ. Chondrosarcoma
Υ. Periosteal chondroma
Φ. Periosteal osteosarcoma
Χ. Dysplasia epiphysealis hemimelica
Ψ. Demonstrate competence in the subject of the case
Ω. Be fellowship trained in the subject of the case
Ϊ. Be paid on a contingency basis
Ϋ. Be board certified by the American Board of Orthopaedic Surgery
Ά. Have been involved in the case as a consultant
Έ. Diagnostic arthroscopy
Ή. Arthroscopy and subacromial decompression
Ί. Reduction and fixation of the proximal humeral epiphysis
Ϋ́. Temporary cessation of throwing
Α. Physical therapy for rotator cuff strengthening
Β. Oblique popliteal ligament
Γ. Lateral capsule
Δ. Popliteal tendon
Ε. Fibular collateral ligament
Ζ. Posterior oblique ligament
Η. Radial tear
Θ. Parrot-beak tear
Ι. Vertical tear in the “red-red” zone
Κ. Vertical tear in the “red-white” zone
Λ. Vertical tear in the “white-white” zone
Μ. 0 degrees of abduction, with neural rotation
Ν. 40 degrees of flexion and 60 degrees of internal rotation
Ξ. 45 degrees of flexion and 45 degrees of external rotation
Ο. 90 degrees of abduction with neutral rotation
Π. 90 degrees of abduction and 90 degrees of external rotation
Ρ. Sural
Σ. Saphenous and its branches
Σ. Posterior tibial and its branches
Τ. Deep peroneal and its branches
Υ. Superficial peroneal and its branches
Φ. Strength
Χ. Stiffness
Ψ. Shelf life
Ω. Antigenicity
Ϊ. Risk of HIV transmission
Ϋ. Indemnification
Ό. Occurrence
Ύ. Excess liability
Ώ. Claims-made
Ϗ. Nose
Β. Lateral Y
Θ. Scapular AP
ϒ. Neutral rotation AP
ϓ. Internal rotation AP
ϔ. External rotation AP
Φ. Trauma
Π. Hemophilia
Ϗ. Reiter’s syndrome
Ϙ. Rheumatoid arthritis
Ϙ. Systemic lupus erythematosus
Ϛ. Cast immobilization for 6 weeks
Ϛ. Activity modification and re-evaluation in 2 months
Ϝ. Internal fixation with or without bone grafting
Ϝ. Retrograde drilling of the defect without articular cartilage penetration
Ϟ. Drilling of the defect directly through the articular cartilage
Ϟ. repair or reconstruction of the medial collateral ligament
Ϡ. repair or reconstruction of the medialand lateral collateral ligaments
Ϡ. immobilization for 5 days or less
Ϣ. immobilization for 14 days
Ϣ. immobilization for 25 days
Ϥ. Cystinosis
Ϥ. Hypophosphatemia
Ϧ. Renal osteodystrophy
Ϧ. Primary hyperparathyroidism
Ϩ. Nutritional vitamin D deficiency
Ϩ. Lateral meniscus tear
Ϫ. Popliteus tenosynovitis
Ϫ. Iliotibial band friction syndrome
Ϭ. Peroneal nerve entrapment
Ϭ. Biceps tendinitis
Ϯ. Observation
Ϯ. Removal of the prosthetic components
Κ. Operative exploration and decompression of the peroneal nerve
Ρ. Nerve conduction velocity studies
Ϲ. Loosening of the primary dressings and knee flexion to 30 degrees
Ϳ. I
ϴ. II
Ε. III
϶. decreased tissue tension
Ϸ. decreased abductor lever arm
Ϸ. decreased joint reaction force
Ϲ. increased body weight over lever arm
Ϻ. increased polyethylene wear rate
Ϻ. recurrent traumatic anterior dislocation
ϼ. recurrent traumatic posterior dislocation
Ͻ. traumatic subluxation with no previous dislocation
Ͼ. traumatic anterior subluxation
Ͽ. atraumatic involuntary subluxation
Ѐ. radial
Ё. axillary
Ђ. suprascapular
Ѓ. thoracodorsal
Є. long thoracic
Ѕ. Flexion
І. Extension
Ї. Axial rotation
Ј. Left lateral bending
Љ. Right lateral bending
Њ. Skin
Ћ. Lung
Ќ. Brain
Ѝ. Heart
Ў. Kidney
Џ. Thoracoacromial, lateral thoracic, subscapular
А. Thoracoacromial, anterior humeral circumflex, posterior humeral circumflex
Б. Posterior humeral circumflex, subscapular, thoracacromial
В. Subscapular, thoracacromial, anterior humeral circumflex
Г. Lateral thoracic, anterior humeral circumflex, thoracacromial
Д. Respondeat superior
Е. Indemnity agreement
Ж. Hold harmless agreement- attempt to shift liability from company to physician
З. Comparative negligence-% of involvement
И. Contributory negligence- resident contributed to the negligence
Й. t-type
К. both column
Л. transverse
М. anterior column
Н. anterior column posterior hemitransverse
О. Posterior interosseous
П. Anterior interosseous
Р. Radial
С. Median
Т. Ulnar
У. Shock from hypovolemia
Ф. Associated rupture of the bladder
Х. Arterial bleeding on pelvic angiogram
Ц. Presence of a hematoma in the perineum and scrotum
Ч. Fractures of both the anterior and posterior pelvic ring

Correct Answer & Explanation

. Anteriorly at 20 to 30 degrees of flexion


Explanation

Question 4066

Topic: 10. Pathology and Oncology

Evaluation of an 8-year-old girl for scoliosis reveals a normal gestation, birth, and family history. Her parents state that she stopped gaining new motor skills at age 6 months. Examination shows the patient can sit independently, but she is nonverbal and she makes repetitive hand clapping movements. She has a 30-degree thoracolumbar kyphoscoliosis, and mildly increased tone in the hamstrings and gastrocnemius-soleus complex. What is the most likely diagnosis?

. Rett syndrome
. Cerebral palsy
. Myotonic dystrophy
. Fragile-X syndrome
. Adrenoleukodystrophy
. Endurance limit
. Failure stress
. Critical stress
. Yield stress
. Elastic limit
. Ewing’s sarcoma
. Osteogenic sarcoma
. Multiple myeloma
. Metastatic prostate carcinoma
. Metastatic breast carcinoma
. Higher subsequent loosening rate of the femoral component
. Higher subsequent polyethylene wear rate
. Higher subsequent dislocation rate
. Higher infection rate
. Unaltered subsequent survival rate of the femoral component
. Crevice corrosion
. Oscillatory fretting
. Oxidative degradation
. Adhesion and abrasion
. Fatigue and delamination
. a total contact cast.
. partial calcanectomy
. Syme’s amputation
. transtibial amputation.
. nonweightbearing and IV antibiotics.
. Sural artery island flap.
. Free rectus abdominis flap.
!. Extensor digitorum brevis flap.
". Staged cross leg flap.
#. Split-thickness skin graft.
$. An anterior cruciate functional knee brace.
%. A physical therapy program.
&. Reconstruction of the posterior cruciate ligament and the posterolateral corner.
'. Reconstruction of the posterior cruciate ligament.
(. Reconstruction of the anterior cruciate ligament.
). Avoids the risk of marrow emboli
*. Avoids injury to the intramedullary nutrient vessels
+. Results in faster healing of fractures
,. Results in more secure fixation
-. Results in faster regeneration of the endosteal blood supply
.. Above-knee amputation
/. En bloc resection of the lesion and reconstruction with a bone graft
0. Closed reduction and immobilization in a cast
1. Open reduction and internal fixation, followed by radiation therapy
2. Open reduction, curettage, and cementing of the lesion
3. Injury to the subclavian artery
4. Injury to the brachial plexus
5. Segmental fracture
6. 100% displacement
7. Associated displaced surgical neck fracture of the humerus
8. humeral arthroplasty2/. repair of the rotator cuff
9. closed reduction and immobilization
:. open reduction and immobilization
;. open reduction and early passive motion
<. arthroscopic capsular release
=. manipulation under anesthesia
>. a physical therapy program
?. an intra-articular corticosteroid injection
@. administration of high-dose oral corticosteroids
A. adding the scores, in all five body systems
B. adding the squares of the scores in the three most severely injured systems
C. doubling the cumulative score for head and chest injuries
D. combining the scores from the most and least injured systems
E. correcting the score in the most severely injured system for age
F. traumatic femoral head fracture
G. osteonecrosis
H. osteoarthritis
I. neuropathic joint
J. rheumatoid arthritis
K. low-dose radiation
L. steroid injection
M. a load-relieving insert and shoe modification
N. complete excision of the mass and the entire plantar fascia
O. wide excision of the mass with a 2 cm margin of normal fascia
P. CT scan of the chest
Q. technetium bone scan
R. bone marrow aspiration
S. serum protein electrophoresis
T. lateral skull radiograph
U. high-grade histology of the initial tumor
V. multiple local recurrences after curettage
W. previous treatment of the tumor with cryotherapy
X. previous treatment of the tumor with radiation therapy
Y. extraosseous extension into two or more adjacent compartments
Z. Dorsal rhizotomy and facet joint fusion
[. Multilevel corpectomy and spinal stabilization
\. Central and lateral recess decompression and bilateral foraminotomy
]. Central decompression and facet joint fusion
^. Central decompression, foraminotomy, and spinal fusion from L2 to L5.
_. Inadequate rehabilitation
`. Displacement of the coronoid process fracture
A. Insufficiency of the lateral ulnar collateral ligament
B. Insufficiency of the anterior band of the medial collateral ligament
C. Insufficiency of the posterior band of the medial collateral ligament
D. Osteotomy and intramedullary rod fixation
E. Electrical stimulation
F. Strut-autografing the concavity the tibia
G. A patellar tendon-bearing brace
H. Percutaneous injection of demineralized bone matrix
I. digoxin
J. sucralfate
K. clindamycin
L. alcohol
M. neuromuscular blocking agents
N. Unrestrained roll-back
O. Unrestrained rotational conformity
P. Medial-Lateral conformity
Q. Anteroposterior conformity in flexion
R. Anteroposterior conformity in extension
S. Arthrodesis of the MTP joint
T. A Silastic implant of the MTP joint
U. Resection arthroplasty of the MTP joint
V. Cheilctomy of the MTP joint
W. Osteotomy of the base of the proximal phalanx
X. Genu varum
Y. Tarsal coalition
Z. Degenerative ankle arthrosis
{. Osteochondritis dissecans of the talus
|. Hemihypertrophy of the ipsilateral lower extremity
}. Trabecular bone is preferentially resorbed in this high bone turnover state
~. Loss of water content in the disk increases impact load to the vetrebral bodies
. Stress is imposed by the relative stiffness of the arthrtic facet joints
€. Increased energy demands are imposed by decreased circulation to the vertebral body
. The thick cortical bone found in the vertebral body resorbs rapidly following estrogen withdrawal
‚. Increased time in stance and swing phase
ƒ. Addition of a double leg float phase
„. Decreased vertical ground reaction forces
…. Decreased arc of motion in the hip, knee, and ankle
†. Decreased joint reaction forces in the hip, knee, and ankle
‡. Talonavicular arthrodesis
ˆ. Medial displacement calcaneal osteotomy
‰. Flexor digitorum longus tendon transfer with spring ligament advancement
Š. Triple arthrodesis
‹. Calcaneocuboid distraction arthrodesis and repair of the posterior tibial tendon
Œ. Lymphoma
. Hemangioma
Ž. Osteosarcoma
. TB of the spine
. Metastatic breast carcinoma
‘. widening and shortening of the heel.
’. weakness of the gastrocnemius-soleus complex.
“. anterior impingement from a horizontal talus.
”. unrecognized compartment syndrome of the foot.
•. degenerative arthritis of the tibiotalar joint.
–. a corrective osteotomy
—. application of braces
˜. medial physeal stapling until the varus corrects
™. observation
š. application of corrective casts
›. a total contact cast.
œ. electrical stimulation.
. an off the shelf fracture brace.
ž. an elastic compression bandage and crutches.
Ÿ. a hard soled shoe until the patient is asymptomatic.
 . Ewings tumor
¡. Parosteal osteosarcoma
¢. Dedifferentiated chondrosarcoma
£. Low grade intramedullary chondrosarcoma
¤. High grade intramedullary osteosarcoma
¥. Vascular injury
¦. Tear of the rotator cuff
§. Injury to the brachial plexus
¨. Fracture of the upper thoracic rib
©. Fracture of the proximal humerus
ª. Biceps
«. Trapezius
¬. Infraspinatus
­. Pectoralis major
®. Serratus anterior
¯. Hybrid total hip arthroplasty
°. Noncemental hemiarthroplasty of the hip
±. Closed reduction and percutaneous pin fixation
². Open reduction through an anterior approach to the hip
³. Excision of the head fragment
´. a quadratus femoris pediclebone graft
Μ. a proximal femoral allograft
¶. intertrochanteric osteotomy
·. total hip arthroplasty
¸. hip hemiarthroplasty
¹. Echocardiogram
º. Electrocardiogram
». Radiograph of the chest
¼. CT scan of the shoulder
½. Ultrasound of the shoulder
¾. Ilioinguinal
¿. Extended iliofemoral
À. Combined ilioinguinal and Kocher-Langenbeck (posterior)
Á. Kocher-Langenbeck (posterior)
Â. Kocher-Langenbeck (posterior) with trochanteric osteotomy
Ã. Deltoid
Ä. Supraspinatus
Å. Subscapularis Infraspinatus
Æ. Infraspinatus
Ç. Infraspinatus and teres minor
È. an orthosis.
É. observation.
Ê. electrical stimulation.
Ë. open reduction and internal fixation.
Ì. application of a nonweightbearing short leg cast.
Í. repair of the rotator cuff.
Î. rehabilitation of the shoulder
Ï. replacement of the humeral head.
Ð. arthroscopic acromioplasty and debridement.
Ñ. immobilization is a sling until pain resolves.
Ò. Bone rotation versus torque applied
Ó. Bone deflection versus bending moment applied
Ô. Axial displacement versus tension applied
Õ. Lateral translation versus shear force applied
Ö. Fracture gap closing versus compressive force applied
×. steroid injection
Ø. stretching of the heel cord
Ù. surgical release of the plantar fascia
Ú. application of a short leg cast for 6 to 8 weeks
Û. wearing dorsiflexion night splints
Ü. Open bladder
Ý. Bilateral “hitchhiker’s” thumbs
Þ. Bilateral defects in the midclavicles
SS. Rhizomelic shortening of the extremities
À. Radiographic fragmentation of all major epiphyses
Á. Medial patellotibial
Â. Medial patellofemoral
Ã. Medial patellomeniscal
Ä. Lateral patellofemoral
Å. Lateral patellotibial
Æ. Heat
Ç. Gentle active flexion-extension exercises
È. Isokinetic strengthening
É. Electrical muscle stimulation
Ê. Immobilization of the limb with the knee in full flexion
Ë. Distal chevron osteotomy with soft-tissue release
Ì. Distal soft-tissue realignment only
Í. Closing wedge osteotomy (Aken) of the proximal phalanx
Î. Proximal first metatarsal osteotomy only
Ï. Soft-tissue realignment with a proximal metatarsal osteotomy
Ð. Vagus
Ñ. Phrenic
Ò. Hypoglossal
Ó. Recurrent laryngeal
Ô. Inferior thyroid
Õ. Surgical exploration
Ö. Application of leeches
÷. Stellate ganglion blocks
Ø. Intra-arterial streptokinase
Ù. Elevation and reevaluation in 1 hour
Ú. Liver profile
Û. Myleogram
Ü. Platelet count
Ý. CT scan of the head
Þ. Angiogram of the extremity
Ÿ. Post spinal fusion from L5to S1
Ā. Primary repair with an iliac bone graft
Ā. Post spinal fusion of L4-5
Ă. A pantaloon body cast and 6 weeks of bed rest
Ă. Rest, NSAIDS, and limited dancing
Ą. Stress fracture of the proximal fifth metatarsal
Ą. Stress fracture of the base of the second metatarsal
Ć. Stress fracture of the neck of the second metatarsal
Ć. Morton’s neuroma
Ĉ. Lisfranc’s joint subluxation
Ĉ. C5 radiculopathy
Ċ. Subscapularis rupture
Ċ. Glenohumeral arthrosis
Č. Rotator cuff arthropathy
Č. Suprascapular nerve compression at the spinoglenoid notch
Ď. mm femoral head in combination with a metal-backed polyethylene component
Ď. mm femoral head in combination with an all-polyethylene acetabular component
Đ. mm femoral head in combination with a metal-backed polyethylene component
Đ. mm femoral head in combination with an all-polyethylene component
Ē. mm femoral head in combination with a metal-backed polyethylene component
Ē. Female gender
Ĕ. History of cigarette smoking
Ĕ. L5-S1 spondylolisthesis on pre-employment radiography
Ė. Decreased strength of the lower extremities on pre-employment testing
Ė. Decreased flexibility of the lumbar spine on pre-employment testing
Ę. Size of cells
Ę. Amount of DNA in cells
Ě. Nucleus-cytoplasm ratio
Ě. Specific DNA sequences
Ĝ. Specific messenger RNA sequences
Ĝ. Femoral and obturator nerves
Ğ. Femoral and superior gluteal nerves
Ğ. Femoral and lateral femoral cutaneous nerves
Ġ. Obturator and superior gluteal nerves
Ġ. Obturator and lateral femoral cutaneous nerves
Ģ. Isotonic
Ģ. Isokinetic
Ĥ. Isometric
Ĥ. Open kinetic chain
Ħ. Dynamic variable resistance
Ħ. Closed reduction and cast immobilization
Ĩ. Uniplanar external fixation
Ĩ. Open reduction and internal fixation with a dynamic compression plate
Ī. Unreamed intramedullary rod
Ī. Multiple plane external fixator
Ĭ. Inlet view of the pelvis
Ĭ. Outlet view of the pelvis
Į. AP view of the hip
Į. Ilial oblique view (external oblique) of the hip
İ. Obturator oblique
I. Glycolytic pathway
IJ. Oxidative phosphorylation
IJ. Breakdown of fat
Ĵ. Breakdown of protein
Ĵ. Breakdown of adenosine triphosphate
Ķ. an MRI scan
Ķ. arthroscopic examination
ĸ. AP and frog-lateral radiographs of the pelvis and hips
Ĺ. varus and valgus stress radiographs of the knee
Ĺ. physical examination of the knee under anesthesia
Ļ. extended curettage and polymethylmethacrylate cementation
Ļ. extra-articular resection of the knee and an allograft arthrodesis
Ľ. wide resection of the proximal tibia and custom prosthetic replacement
Ľ. prophylactic internal fixation and postoperative irradiation
Ŀ. excision of the lateral condyle and reconstruction with a hemicondylar allograft
Ŀ. silicone implant joint replacement
Ł. metatarsophalangeal joint arthrodesis
Ł. metatarsophalangeal joint debridement
Ń. resection of the metatarsal head
Ń. resection of the base of the proximal phalanx
Ņ. Fixation of the syndesmosis has failed
Ņ. Widening of the ankle mortise has led to the failure of fixation
Ň. Infection around the syndesmosis screw has led to osteomyelitis
Ň. The syndesmosis screw is broken
ʼN. Motion between the tibia and fibula has caused loosening of the syndesmosis screw
Ŋ. Microcephaly
Ŋ. A temporal lobe cyst
Ō. An Arnold-Chiari type 1 malformation
Ō. Periventricular leukomalacia
Ŏ. Agnesis of the corpus callosum
Ŏ. Wolff’s
Ő. Hooke’s
Ő. Hilton’s
Œ. Muller-Haeckel
Œ. Heuter-Volkmann
Ŕ. Both the anterolateral and posteromedial bands are isometric and do not significantly change with flexion
Ŕ. The anterolateral band is lax and becomes tight in flexion, while the posteromedial band is tight, and becomes lax in flexion
Ŗ. The anterolateral band is tight and becomes lax in flexion, while the posteromedial band is lax and becomes tight in flexion
Ŗ. Both the anterolateral and posteromedial bands are lax and become tight in flexion
Ř. Both the anterolateral and posteromedial bands are tight and become lax as the knee is flexed
Ř. UCB orthosis
Ś. Rigid orthosis with a medical arch support
Ś. Semi-rigid orthosis with lateral forefoot posting
Ŝ. Semi-rigid orthosis with a medial arch support
Ŝ. Medial heel wedge attached to the running shoes
Ş. Hallux varus
Ş. Osteonecrosis
Š. Recurrence of the hallux valgus
Š. “Transfer” second metatarsalgia
Ţ. Physeal arrest of the first metatarsal
Ţ. Aseptic loosening in a 70-year-old patient
Ť. Mechanical failure of a hinged knee prosthesis
Ť. Failed knee replacement complicated by reflex sympathetic dystrophy
Ŧ. Infection with soft-tissue deficit
Ŧ. A prior patellectomy
Ũ. Knee fusion
Ũ. Open irrigation and debridement
Ū. Arthroscopic irrigation and debridement
Ū. One-stage exchange arthroplasty
Ŭ. Two-stage exchange arthroplasty
Ŭ. Putti-platt repair
Ů. Open Bankart repair
Ů. Injection of a subacromial corticosteroid
Ű. Arthroscopic transglenoid capsular shift
Ű. Rehabilitation of the scapular and rotator cuff muscles
Ų. Silicone suction socket and an energy-absorbing foot
Ų. Silicone suction socket and a variable resistance ankle
Ŵ. Plastic suction socket, telescoping pylon, and a solid ankle cushioned heel (SACH) foot
Ŵ. Plastic socket with a hinged thigh cuff and a SACH foot
Ŷ. Patellar tendon-bearing suction socket and a uniaxial hydraulic ankle
Ŷ. Parosteal
Ÿ. Periosteal
Ź. High-grade intramedullary
Ź. Osteosarcoma occurring in Paget’s disease
Ż. Osteosarcoma occurring in irradiated bone
Ż. Cauda equina
Ž. Conus medullaris
Ž. Genitofemoral nerve
S. Lumbar sympathetic plexus
Ƀ. Lumbar parasympathetic plexus
Ɓ. Spinal pseudoarthrosis
Ƃ. Spinal cord traction injury with paralysis
Ƃ. Arterial and venous thromboses
Ƅ. Superior mesenteric artery syndrome
Ƅ. Crankshaft phenomenon
Ɔ. Inversion stress radiograph
Ƈ. MRI scan
Ƈ. CT scan
Ɖ. Nuclear bone scan
Ɗ. External rotation stress radiograph
Ƌ. Complex deformity with an angulation in two planes
Ƌ. Single deformity less than 20 degrees, apex posterolateral
ƍ. Single deformity greater than 30 degrees, apex posterolateral
Ǝ. Single deformity less than 20 degrees, apex posteromedial
Ə. Single deformity greater than 30 degrees, apex posteromedial
Ɛ. Pronation of the foot during the stance phase of gait
Ƒ. Heel inversion at the beginning of a single limb heel rise
Ƒ. Active inversion of the nonweightbearing foot
Ɠ. Active plantar flexion of the first ray against resistance
Ɣ. Active plantar flexion of the foot during the push-off phase of gait
Ƕ. Observation and repeat radiographs in 4 months
Ɩ. Application of a thoracolumbalsacral orthosis for 22 to 24 hours per day
Ɨ. Electrical stimulation at night
Ƙ. Physical therapy
Ƙ. Begins to remodel and hypertrophy more quickly
Ƚ. Provides a better scaffold for osteoconduction
ƛ. Reduces the risk of early fracture
Ɯ. Reduces technical difficulty
Ɲ. Lowers donor site morbidity
Ƞ. Anterior fusion of the lumbar curve
Ɵ. Anterior and posterior fusion of the thoracic curve
Ơ. Posterior fusion of the thoracic curve
Ơ. Posterior fusion of the thoracic and lumbar curves
Ƣ. Application of a brace until the iliac apophyses are Risser 4 or 5, followed by surgical correction
Ƣ. Subscapularis rupture
Ƥ. Type III SLAP lesion
Ƥ. Disruption of capsular shift
Ʀ. Isolated traumatic subluxation
Ƨ. Injury to the axillary nerve after dislocation
Ƨ. hypophosphatemia
Ʃ. high dietary cholesterol intake
ƪ. deficiency of lipoprotein A
ƫ. deficiency of protein S and protein C
Ƭ. elevated levels of antithrombin III
Ƭ. Weightbearing short leg cast
Ʈ. Nonweightbearing short leg cast
Ư. Removable splint and early motion
Ư. Open reduction and internal fixation
Ʊ. Elastic compression bandage with full weightbearing
Ʋ. Breast
Ƴ. Prostate
Ƴ. Gastrointestinal
Ƶ. Kidney
Ƶ. Multiple myeloma
Ʒ. Varus stress
Ƹ. Valgus stress
Ƹ. Torsional loading
ƺ. Hyperextension of the knee
ƻ. Contraction of the quadriceps while axially loaded
Ƽ. Primary internal fixation at both fracture levels
Ƽ. External fixation as definitive ttt for both #
ƾ. Skeletal traction and delayed internal fixation of both fractures
Ƿ. Primary internal fixation of the proximal fracture and delayed fixation of the femoral fracture
ǀ. Primary internal fixation of the femoral shaft fracture and delayed fixation of the proximal #
ǁ. Heel spur
ǂ. Plantar fascitis
ǃ. Dysfunction of the tibialis posterior tendon
DŽ. Compression of the first branch of the lateral plantar nerve
DŽ. Compression of the calcaneal nerve
DŽ. Displaced labral tear
LJ. Tear of the rotator cuff
LJ. Fracture of the glenoid rim
LJ. Palsy of the axillary nerve
NJ. Palsy of the musculocutaneus nerve
NJ. Enchondroma
NJ. Osteoblastoma
Ǎ. Giant cell tumor
Ǎ. Aneurysmal bone cyst
Ǐ. Fibrous dysplasia
Ǐ. Arthrogram of the wrist
Ǒ. MRI scan of both wrists
Ǒ. CT scan of both wrists in the same position
Ǔ. Radiographs of the wrist in supination and pronation
Ǔ. Radiographs of the opposite wrist in the same position
Ǖ. Secondary hyperparathyroidism
Ǖ. Phosphate retention secondary to uremia
Ǘ. Insufficient renal synthesis of 1, 25 dihydroxy vitamin D
Ǘ. Aluminum deposition in bone from oral phosphate binders
Ǚ. Persistent acidosis aggravating the negative calcium balance
Ǚ. Posterior fusion at T10-L3 with segmental instrumentation
Ǜ. Laminectomy and fusion of T12-L2 with segmental instrumentation
Ǜ. Bed rest in a hyperextension brace
Ǝ. L1 vertebrectomy and anterior decompression with strut graft fusion and instrumentation
Ǟ. Progressive ambulation as tolerated in a custom-molded thoracolumbosacral orthosis
Ǟ. Positive-pressure ventilation
Ǡ. An immediate radiograph of the chest
Ǡ. Adjustment of the position of the endotrachael tube
Ǣ. Insertion of a large-bore needle into the pericardial space
Ǣ. Insertion of a large-bore needle in the right second intercostal space, midclavicular line
Ǥ. Allowing the ends of the fracture to touch
Ǥ. Adding a second connecting bar
Ǧ. Adding one pin to each fracture fragment
Ǧ. Increasing the pin diameter from 4 mm to 6 mm
Ǩ. Decreasing the connecting bar-to-bone distance from 6 cm to 4 cm
Ǩ. Osteomyelitis
Ǫ. Malignant degeneration
Ǫ. Stress fracture
Ǭ. Local recurrence of the giant cell tumor
Ǭ. Bone resorption due to methylmethacrylate
Ǯ. Advancement of the plantar plate
Ǯ. Resection of the second metatarsal head
J̌. Dorsiflexion osteotomy of the second metatarsal neck
DZ. Transfer of the flexor digitorum longus tendon to the dorsum of the toe
DZ. Transfer of the extensor digitorum comminus tendon to the metatarsal neck
DZ. Sacral fracture
Ǵ. Burst fracture of L5
Ǵ. Cauda equina syndrome
Ƕ. Distraction-flexion injury at L3
Ƿ. Distraction-extension injury at L3
Ǹ. An MRI scan of the shoulder
Ǹ. An MRI scan of the cervical spine
Ǻ. Electromyographic and nerve conduction velocity studies
Ǻ. Immobilization in a sling and early passive range of motion exercises
Ǽ. Immediate return to the operating room for exploration of the brachial plexus
Ǽ. cerclage wiring
Ǿ. tension band wiring
Ǿ. removal of the patellar component
Ȁ. revision of the patellar component
Ȁ. immobilization of the knee and protected weightbearing
Ȃ. Liposarcoma
Ȃ. Nodular fasciitis
Ȅ. Rabdomyosarcoma
Ȅ. Malignant fibrous histiocytoma
Ȇ. Extra-abdominal desmoid tumor
Ȇ. Clubfeet
Ȉ. Thrombocytopenia
Ȉ. Congenital scoliosis
Ȋ. Ventricular septal defect
Ȋ. Arnold-Chiari malformation
Ȍ. delayed primary closure
Ȍ. free flap
Ȏ. pedicle groin flap
Ȏ. full-thickness skin graft
Ȑ. split-thickness skin graft
Ȑ. Infection
Ȓ. Nonunion
Ȓ. Improper screw length
Ȕ. Osteonecrosis of the distal fragment
Ȕ. Use of a cortical screw instead of a cancellous screw
Ȗ. Infection
Ȗ. Tear of the rotator cuff
Ș. Loosening of the humeral component
Ș. Arthritis of the glenoid
Ț. Arthritis of the A-C joint
Ț. Reduced morbidity
Ȝ. Improved osteoinduction
Ȝ. Improved osteoconduction
Ȟ. More rapid revascularization
Ȟ. Lower risk of disease transmission
Ƞ. Manipulation Under Anesthesia
ȡ. Arthroscopic acromioplasty
Ȣ. Arthroscopic debridement of G-H joint
Ȣ. Replacement of the humeral head
Ȥ. Lengthening of the subscapularis and release of the anterior capsule
Ȥ. Bacteroides
Ȧ. E. coli
Ȧ. Staph. aureus
Ȩ. group A streptococcus
Ȩ. Clostridium perforingens
Ȫ. observation and exercises
Ȫ. bracing with a thoracolumbar orthosis
Ȭ. fusion of the posterior spine
Ȭ. fusion of the anterior spine
Ȯ. fusion of the anterior and posterior spine
Ȯ. Total wrist replacement and bridge grafts
Ȱ. palmar shelf arthroplasty and tendon transfers
Ȱ. Darrach distal ulna resection, dorsal tenosynosynovectomy, and tendon transfers
Ȳ. Radioscaphate fusion, extensor tenodesis, and Darrach distal ulna resection
Ȳ. Total wrist fusion and tendon transfers
ȴ. constrained acetabular component
ȵ. protrusion ring with morselized graft
ȶ. cemented metal backed acetabular component
ȷ. cemented all-polyethylene acetabular component
ȸ. cementless hemispherical component with screw fixation
ȹ. application of a hip abduction brace for 22 hours per day
Ⱥ. application of a hip spica under anesthesia
Ȼ. discontinuance of all bracing and repeat radiographs in 3 months
Ȼ. open reduction of the hip and application of a spica cast
Ƚ. open reduction, varus osteotomy, and application of a spica cast
Ⱦ. Loss of skin hair on the feet
Ȿ. Absent pulses on vascular examination
Ɀ. Pain that originates proximally and spreads distally
Ɂ. Pain that is relieved by stopping and standing
Ɂ. Pain that is worse when the patient walks uphill rather downhill
Ƀ. wrist flexors and finger flexors
Ʉ. elbow flexors and wrist flexors
Ʌ. elbow flexors and finger flexors
Ɇ. elbow extensors and wrist flexorst Level Key Muscles4 DiaphragmDeltoid, elbow flexors, diaphragmElbow flexors, wrist extensorsElbow extensors, wrist flexorsFinger flexors (distal phalanx of middlefinger)Finger abductors (5th digit), intrinsics of hand2 Segmental innervation to intercostal muscles, abdominal and paraspinal muscles) L1, L2, L3 Hip flexors3, L4 QuadricepsTibialis anteriorToe extensors, hip abductorsAnkle plantarflexors, peronei
Ɇ. elbow extensors and wrist extensors
Ɉ. Syndactyly
Ɉ. Macrodactyly
Ɋ. Camptodactyly
Ɋ. Preaxial polydactyly
Ɍ. Postaxial polydactyly
Ɍ. Arthrodesis
Ɏ. Rotationplasty
Ɏ. Above-knee amputation
Ɐ. Osteoarticular allograft
Ɑ. Endoprosthesis (custom arthroplasty)
Ɒ. Plantar fascia
Ɓ. Spring ligament
Ɔ. Deltoid ligament
ɕ. Intrinsic tendons
Ɖ. Gastorcnemius-solelus complex
Ɗ. Prevention of presynaptic release of acetylcholine
ɘ. Prevention of synthesis of presynaptic acetylcholine
Ə. Activation of acetylcholinesterase at the motor end-plate
ɚ. Blockage of postsynaptic action of acetylcholine until reserves are depleted
Ɛ. Stimulation of release of presynaptic acetylcholine until reserves are depleted
Ɜ. stiffness of the femoral component.
ɝ. head offset of the femoral component.
ɞ. femoral component material modulus of elasticity.
ɟ. extent of the femoral component porous coating.
Ɠ. Presence of a femoral component collar.
Ɡ. plantar fascia and quadratus plantae tendon.
ɢ. ligamentous structures connecting the tarsal bones.
Ɣ. shape of the tarsal bones and the intervening joints.
ɤ. activity of the intrinsic muscles of the foot.
Ɥ. activity of the posterior tibialis and the peroneus longus muscles.
Ɦ. scapulothoracic fusion
ɧ. strengthening of the periscapular muscles
Ɨ. pectoralis minor-fascia lata graft transfer to the scapula
Ɩ. pectoralis major-fascia lata graft transfer to the scapula
Ɪ. exploration of the long thoracic nerve, with sural nerve graft
Ɫ. tricompartmental knee replacement
Ɬ. unicompartmental knee replacement
ɭ. medial compartment meniscal allograft
ɮ. valgus-producing distal femoral osteotomy
Ɯ. valgus-producing proximal tibial osteotomy
ɰ. Internal rotation of the femoral component
Ɱ. External rotation of the tibial component
Ɲ. Lateral placement of the femoral component
ɳ. Medial placement of the patellar component
ɴ. Excessive resection of the patella
Ɵ. Hallux rigidus
ɶ. Hallux valgus
ɷ. Neuroma of the first web space
ɸ. Fracture of the sesamoid
ɹ. Rupture of the flexor hallucis longus
ɺ. Sickle cell crisis
ɻ. Idiopathic chondrolysis
ɼ. Hemophilic arthropathy
Ɽ. Osteoid osteoma of the femoral neck
ɾ. Legg-Calve-Perthes disease
ɿ. Decreased ankle jerk and positive femoral nerve stretch test
Ʀ. Decreased knee jerk and positive straight-leg raising sign
ʁ. Gastrocnemius-soleus complex weakness and positive straight-leg raising sign
Ʂ. Weakness of the extensor hallucis longus and positive straight-leg raising sign
Ʃ. Weakness of the extensor hallucis longus and positive femoral nerve stretch test
ʄ. Long-term administration of IV and oral antibiotics
ʅ. Open soft-tissue debridement, retention of prosthetic components, and IV antibiotics
ʆ. Immediate exchange arthroplasty with antibiotic-impregnated cement
Ʇ. Two-stage surgical prosthetic exchange and IV antibiotics
Ʈ. Resection arthroplasty and IV antibiotics
Ʉ. SCFE
Ʊ. MED
Ʋ. Perthes disease
Ʌ. Hypothyroidism
ʍ. Chondrolysis
ʎ. gout.
ʏ. osteoporosis.
ʐ. eosinophilic granuloma.
ʑ. tuberculosis of the spine.
Ʒ. metastatic disease of the spine.
ʓ. water content.
ʔ. Synthesis of type I collagen.
ʕ. Proteoglycan content.
ʖ. Activity of chondrocytes.
ʗ. Synthesis of hyaluronate.
ʘ. Lung
ʙ. Breast
ʚ. Prostate
ʛ. Thyroid
ʜ. Renal
Ʝ. T1-low, T2-low.
Ʞ. T1-low, T2-high.
ʟ. T1-moderate, T2-low.
ʠ. T1-high, T2-low.
ʡ. T1-high, T2-high.
ʢ. hypothesis is incorrect or invalid
ʣ. interobserver error rate is 4%.
ʤ. Standard deviation is 4% higher or lower than the mean.
ʥ. Sample size is 4% larger than required to be clinically significant.
ʦ. Probability that the differences noted between two study groups were due to chance alone is 4%.
ʧ. I
ʨ. II
ʩ. IV
ʪ. IX
ʫ. X
ʬ. Cranial setting
ʭ. Cranial subluxation
ʮ. Odontoid fracture
ʯ. Lysis of the arch of the atlas
ʰ. Atlantoaxial subluxation
ʱ. Retrograde collapse of the endoneurial tubes
ʲ. Irreversible atrophy of the denervated muscles
ʳ. Elongation of the axons across the zone of injury
ʴ. Sprouting of the axons at the neuromuscular junction
ʵ. Misdirection of the axons across the zone of injury
ʶ. Maximally pronated and elbow extended
ʷ. Maximally pronated and the elbow flexed
ʸ. Maximally supinated and the elbow flexed
ʹ. Maximally supinated and the elbow extended
ʺ. In neutral rotation, with the elbow extended
ʻ. open reduction and internal fixation
ʼ. buddy taping to the adjacent index finger
ʽ. early motion with application of a dynamic banjo splint
ʾ. application of a cast with the hand in a “safe position” for 3 weeks.
ʿ. dorsal extension block splinting
ˀ. The name of the manufacturer
ˁ. The manufacturer’s potential liability
˂. The physician’s clinical performance
˃. The physician’s materials testing data
˄. Any royalties the physician receives from the manufacturer
˅. Femoral
ˆ. Obturator
ˇ. Inferior gluteal
ˈ. Superior gluteal
ˉ. Lateral femoral cutaneous
ˊ. open biopsy and a long leg cast
ˋ. open biopsy and wide resection of the tumor
ˌ. a long leg cast and observation
ˍ. intramedullary stabilization and observation
ˎ. Triggering
ˏ. Lateral instability
ː. Swan-neck deformity
ˑ. Boutonniere deformity
˒. Loss of distal interphalangeal joint flexion
˓. Peroneus brevis to peroneus longus
˔. Peroneus tertius to extensor hallucis longus
˕. Peroneus tertius to superficial peroneal nerve
˖. Extensor hallucis longus to deep peroneal nerve
˗. Extensor hallucis longus to extensor digitorum longus
˘. reassurance that Medicare will pay for the treatment.
˙. consent forms that patients or their guardians are able to understand.
˚. a detailed description of the device, omitting the fact that it is part of a study.
˛. a provision that the patient’s care will be discontinued if he or she does not enroll in the study.
˜. a provision that the study will be carried out to completion, whether or not the device is as effective as those currently in existence.
˝. an onlay iliac crest bone graft.
˞. limited weightbearing and observation.
˟. removal of the implant and limited weightbearing.
ˠ. removal of the implant and insertion of a reamed femoral nail.
ˡ. removal of the implant and insertion of an unreamed femoral nail.
ˢ. Coronal
ˣ. Sagittal
ˤ. Anteromedial, midway between the sagittal and the coronal
˥. Proximal pins sagittal, distal pins coronal
˦. Proximal pins coronal, distal pins sagittal
˧. Rheumatoid arthritis
˨. Posttraumatic arthritis
˩. Degenerative osteoarthritis
˪. Osteonecrosis of the tibial plateau
˫. Osteonecrosis of the medial femoral condyle
ˬ. Trapeziometacarpal arthrodesis
˭. Osteotomy of the thumb metacarpal
ˮ. Arthrotomy and joint debridement
˯. Ligament reconstruction using one half of the flexor carpi radialis
˰. Trapezium resection, tendon interposition, and reconstruction of the ligament
˱. Creep
˲. Relaxation
˳. Energy dissipation
˴. Plastic deformation
˵. Elastic deformation
˶. bending
˷. axial loading
˸. high-speed rotation
˹. direct impact from anteromedial
˺. crush from anteromedial to posterolateral
˻. Increase stiffness
˼. Increase fracture toughness
˽. Increase fatigue strength
˾. Decrease mechanical strength
˿. Decrease wear rate
̀. disuse osteopenia
́. paraendocrine effect of the tumor
̂. abnormally increased density on the right side
̃. side effect of the treatment of the lesion
̄. extensive tumor involvement of the left hip
̅. Sciatic nerve
̆. Superior gluteal artery
̇. Profunda femoris artery
̈. Femoral artery and nerve
̉. External iliac artery and vein
̊. Length
̋. Moment arm
̌. Total volume
̍. Physiologic cross-sectional area
̎. Distribution of slow and fast twitch fibers
̏. decreasing initiation of action potentials.
̐. increasing action potential amplitude.
̑. blocking the opening of gated sodium channels.
̒. decreasing the number of functional motor units.
̓. slowing or stopping action potential propagation through the axon.
̔. resection of the metatarsal heads of the first through fifth toes.
̕. Silastic MP joint arthroplasties of the first through fifth toes.
̖. fusion of the hallux MP joint and resection arthroplasty of the 2nd through fifth metatarsal heads.
̗. fusion of hallux MP joint and distal osteotomy of the 2nd through 5th MT.
̘. plantar condylectomy of the 2nd through 5th MT heads & resection of proximal phx of the hallux.
̙. hemiarthroplasty
̚. open reduction and internal fixation
̛. closed reduction and percutaneous pinning
̜. a sling and early pedulum exercises
̝. a sling and swathe for 6 weeks, followed by shoulder rehabilitation
̞. open acromioplasty
̟. open Bankart repair
̠. open subscapularis tendon repair
̡. inferior capsular shift
̢. a supervised physical therapy program
̣. a sling and swathe, with pendulum exercises in 10 days
̤. open reduction and internal fixation through an anterior approach
̥. open reduction and internal fixation through a posterior approach
̦. immobilization with a splint in 45 degrees of abduction for 6 weeks
̧. arthroscopically assisted reduction and percutaneous screw fixation
̨. Repair of the rotator cuff
̩. Replacement of the humeral head
̪. Resection arthroplasty
̫. Total shoulder arthroplasty
̬. AP and lateral radiographs of the elbow
̭. Diagnositc arthroscopy
̮. Aspiration of joint fluid
̯. An erythrocyte sedimentation rate and CBC
̰. A diagnostic lidocaine injection
̱. Insulin-like growth factor (IGF-1)
̲. Fibroblast growth factor (FGF-1)
̳. Platelet-derived growth factor (PDGF)
̴. Transforming growth factor beta (TGF-B)
̵. Bone morphogenetic proteins (BMP)
̶. clinical history and radiographic findings.
̷. technetium bone scan
̸. flow cytometry pattern of extracted chondrocytes
̹. immunohistochemical staining patterns of a biopsy specimen
̺. histologic features of a biopsy specimen stained with hematoxylin-cosin
̻. Radial
̼. Radial recurrent
̽. Posterior interosseous
̾. Superior ulnar recurrent
̿. Superficial radial circumflex
̀. Impaired hydroxylation of proline
́. Failure of cleavage in procollagen
͂. Defective binding sites for hydroxyproline
̓. Failure to incorporate glycine into the helix
̈́. Diminished production of collagen through the rough endoplasmic reticulum
Ι. Asking the legal staff to seek a court injunction
͆. Copying the patient’s chart and giving it to him as he leaves
͇. Having the patient sign a written legal contract that specifies acceptable behavior
͈. Continuing care of the patient until an appropriate referral can be arranged
͉. Transferring the patient to another orthopaedic surgeon without disclosing the realreason for why the patient is being transferred
͊. Meta-analysis
͋. Confidence interval
͌. Analysis of variance (ANOVA)
͍. Statistical significance (p-value)
͎. Survivorship analysis (Kaplan-Meier)
͏. Spinal shock
͐. Neurogenic shock
͑. Hypovolemic shock
͒. Pulmonary embolism
͓. Fat embolus syndrome
͔. Lumbar spinal stenosis
͕. Metastatic disease of the spine
͖. Rheumatoid lumbar spondylitis
͗. Isthmic spondyloloisthesis
͘. Degenerative spondylolisthesis at L4-5 and L5-S1
͙. Patella alta
͚. A metal-backed patella
͛. Varus malalignment of the knee
͜. A posterior cruciate-substituting femoral component
͝. Lateral subluxation of the patella on a Merchant’s view
͞. The sesamoids are separated
͟. The sesamoid is fractured
͠. The proximal phx is on the neck of the metatarsal
͡. The dislocation is dorsal and centered
͢. The proximal phalanx is hyperextended
ͣ. Patella
ͤ. Tibial stem
ͥ. Distal femoral interface
ͦ. Posterior femoral interface
ͧ. Sites of screw fixation for the tibia
ͨ. Hallux rigidus
ͩ. Fracture of the sesamoid
ͪ. Disruption of the plantar plate
ͫ. Osteonecrosis of the metatarsal head
ͬ. Rupture of the flexor hallucis longus
ͭ. Gout
ͮ. Sepsis
ͯ. Old trauma
Ͱ. Rheumatoid arthritis
Ͱ. Charcot arthroplasty
Ͳ. Aspiration and steroid injection
Ͳ. Biopsy, curettage, and allograft bone grafting
ʹ. Percutaneous Kirschner wire fixation
͵. Percutaneous injection of autogenous bone marrow
Ͷ. Nerve roots
Ͷ. Spinal cord
͸. Sciatic nerve
͹. Peroneal nerve
ͺ. Conus medullaris
Ͻ. Extent of bone penetrated by reaming, prosthetic components, or acrylic cement
Ͼ. Periprosthetic regions that are accessible to joint fluid and particulate wear debris
Ͽ. Enveloping pseudocapsular scar tissue that develops around a prosthetic hip following surgical capsulectomy
;. Soft tissue and bone that are potentially contaminated with bacteria in the setting of a prosthetic joint infection
Ϳ. Potential intrapelvic joint space communication created by acetabular fixation screws or intrapelvic extruded acrylic cement
΀. Early and late infection
΁. Periprosthetic fracture of the femur
΂. Failure of the patellofemoral and extensor mechanisms
΃. Aseptic loosening of cementing tibial components
΄. Asceptic loosening of cemented femoral components
΅. Acceptance of the current position of the ankle
Ά. Open reduction and fixation in the epiphysis only
·. ORIF with a small-fragment T-plate from the malleolus up to the metaphysis
Έ. Closed reduction by eversion of the ankle and application of a bivalved long leg cast
Ή. CRUGA and fixation with a malleolar screw from the malleolus into the metaphysis
Ί. Resection arthroplasty and local radiation
΋. In situ fusion of the hip
Ό. Excision of heterotopic bone, total hip arthroplasty, and oral indomethacin
΍. Excision of heterotopic bone and local radiation
Ύ. Excision of heterotopic bone, hemiarthroplasty, and oral indomethacin
Ώ. Closed reduction of both fractures and immediate spica casting
Ϊ́. Bilateral skin traction for 3 weeks, followed by spica casting
Α. External fixation of both femora
Β. External fixation of the left femur and a long leg cast brace for the right femur
Γ. External fixation of the left femur and use of a reamed intramedullary nail in the right femur
Δ. Synovial sarcoma
Ε. Soft-tissue abcess
Ζ. Rhabdomyosarcoma
Η. Eosinophilic granuloma
Θ. Nodular pigmented villonodular synovitis
Ι. Changing to a titanium nail
Κ. Changing to a nonslotted nail
Λ. Changing the cross-sectional shape of the nail
Μ. Increasing the diameter of the nail by 3 mm
Ν. Increasing the diameter of the interlocking screws
Ξ. Fracture healing
Ο. Chondrosarcoma
Π. Periosteal chondroma
Ρ. Periosteal osteosarcoma
΢. Dysplasia epiphysealis hemimelica
Σ. Demonstrate competence in the subject of the case
Τ. Be fellowship trained in the subject of the case
Υ. Be paid on a contingency basis
Φ. Be board certified by the American Board of Orthopaedic Surgery
Χ. Have been involved in the case as a consultant
Ψ. Diagnostic arthroscopy
Ω. Arthroscopy and subacromial decompression
Ϊ. Reduction and fixation of the proximal humeral epiphysis
Ϋ. Temporary cessation of throwing
Ά. Physical therapy for rotator cuff strengthening
Έ. Oblique popliteal ligament
Ή. Lateral capsule
Ί. Popliteal tendon
Ϋ́. Fibular collateral ligament
Α. Posterior oblique ligament
Β. Radial tear
Γ. Parrot-beak tear
Δ. Vertical tear in the “red-red” zone
Ε. Vertical tear in the “red-white” zone
Ζ. Vertical tear in the “white-white” zone
Η. 0 degrees of abduction, with neural rotation
Θ. 40 degrees of flexion and 60 degrees of internal rotation
Ι. 45 degrees of flexion and 45 degrees of external rotation
Κ. 90 degrees of abduction with neutral rotation
Λ. 90 degrees of abduction and 90 degrees of external rotation
Μ. Sural
Ν. Saphenous and its branches
Ξ. Posterior tibial and its branches
Ο. Deep peroneal and its branches
Π. Superficial peroneal and its branches
Ρ. Strength
Σ. Stiffness
Σ. Shelf life
Τ. Antigenicity
Υ. Risk of HIV transmission
Φ. Indemnification
Χ. Occurrence
Ψ. Excess liability
Ω. Claims-made
Ϊ. Nose
Ϋ. Lateral Y
Ό. Scapular AP
Ύ. Neutral rotation AP
Ώ. Internal rotation AP
Ϗ. External rotation AP
Β. Trauma
Θ. Hemophilia
ϒ. Reiter’s syndrome
ϓ. Rheumatoid arthritis
ϔ. Systemic lupus erythematosus
Φ. Cast immobilization for 6 weeks
Π. Activity modification and re-evaluation in 2 months
Ϗ. Internal fixation with or without bone grafting
Ϙ. Retrograde drilling of the defect without articular cartilage penetration
Ϙ. Drilling of the defect directly through the articular cartilage
Ϛ. repair or reconstruction of the medial collateral ligament
Ϛ. repair or reconstruction of the medialand lateral collateral ligaments
Ϝ. immobilization for 5 days or less
Ϝ. immobilization for 14 days
Ϟ. immobilization for 25 days
Ϟ. Cystinosis
Ϡ. Hypophosphatemia
Ϡ. Renal osteodystrophy
Ϣ. Primary hyperparathyroidism
Ϣ. Nutritional vitamin D deficiency
Ϥ. Lateral meniscus tear
Ϥ. Popliteus tenosynovitis
Ϧ. Iliotibial band friction syndrome
Ϧ. Peroneal nerve entrapment
Ϩ. Biceps tendinitis
Ϩ. Observation
Ϫ. Removal of the prosthetic components
Ϫ. Operative exploration and decompression of the peroneal nerve
Ϭ. Nerve conduction velocity studies
Ϭ. Loosening of the primary dressings and knee flexion to 30 degrees
Ϯ. I
Ϯ. II
Κ. III
Ρ. decreased tissue tension
Ϲ. decreased abductor lever arm
Ϳ. decreased joint reaction force
ϴ. increased body weight over lever arm
Ε. increased polyethylene wear rate
϶. recurrent traumatic anterior dislocation
Ϸ. recurrent traumatic posterior dislocation
Ϸ. traumatic subluxation with no previous dislocation
Ϲ. traumatic anterior subluxation
Ϻ. atraumatic involuntary subluxation
Ϻ. radial
ϼ. axillary
Ͻ. suprascapular
Ͼ. thoracodorsal
Ͽ. long thoracic
Ѐ. Flexion
Ё. Extension
Ђ. Axial rotation
Ѓ. Left lateral bending
Є. Right lateral bending
Ѕ. Skin
І. Lung
Ї. Brain
Ј. Heart
Љ. Kidney
Њ. Thoracoacromial, lateral thoracic, subscapular
Ћ. Thoracoacromial, anterior humeral circumflex, posterior humeral circumflex
Ќ. Posterior humeral circumflex, subscapular, thoracacromial
Ѝ. Subscapular, thoracacromial, anterior humeral circumflex
Ў. Lateral thoracic, anterior humeral circumflex, thoracacromial
Џ. Respondeat superior
А. Indemnity agreement
Б. Hold harmless agreement- attempt to shift liability from company to physician
В. Comparative negligence-% of involvement
Г. Contributory negligence- resident contributed to the negligence
Д. t-type
Е. both column
Ж. transverse
З. anterior column
И. anterior column posterior hemitransverse
Й. Posterior interosseous
К. Anterior interosseous
Л. Radial
М. Median
Н. Ulnar
О. Shock from hypovolemia
П. Associated rupture of the bladder
Р. Arterial bleeding on pelvic angiogram
С. Presence of a hematoma in the perineum and scrotum
Т. Fractures of both the anterior and posterior pelvic ring

Correct Answer & Explanation

. Rett syndrome


Explanation

Question 4067

Topic: 10. Pathology and Oncology

  • In a fatigue test, the maximum stress under which the material will not fail, regardless of how many loading cycles are applied, is defined as
. Endurance limit
. Failure stress
. Critical stress
. Yield stress
. Elastic limit
. Ewing’s sarcoma
. Osteogenic sarcoma
. Multiple myeloma
. Metastatic prostate carcinoma
. Metastatic breast carcinoma
. Higher subsequent loosening rate of the femoral component
. Higher subsequent polyethylene wear rate
. Higher subsequent dislocation rate
. Higher infection rate
. Unaltered subsequent survival rate of the femoral component
. Crevice corrosion
. Oscillatory fretting
. Oxidative degradation
. Adhesion and abrasion
. Fatigue and delamination
. a total contact cast.
. partial calcanectomy
. Syme’s amputation
. transtibial amputation.
. nonweightbearing and IV antibiotics.
. Sural artery island flap.
. Free rectus abdominis flap.
. Extensor digitorum brevis flap.
. Staged cross leg flap.
. Split-thickness skin graft.
. An anterior cruciate functional knee brace.
. A physical therapy program.
!. Reconstruction of the posterior cruciate ligament and the posterolateral corner.
". Reconstruction of the posterior cruciate ligament.
#. Reconstruction of the anterior cruciate ligament.
$. Avoids the risk of marrow emboli
%. Avoids injury to the intramedullary nutrient vessels
&. Results in faster healing of fractures
'. Results in more secure fixation
(. Results in faster regeneration of the endosteal blood supply
). Above-knee amputation
*. En bloc resection of the lesion and reconstruction with a bone graft
+. Closed reduction and immobilization in a cast
,. Open reduction and internal fixation, followed by radiation therapy
-. Open reduction, curettage, and cementing of the lesion
.. Injury to the subclavian artery
/. Injury to the brachial plexus
0. Segmental fracture
1. 100% displacement
2. Associated displaced surgical neck fracture of the humerus
3. humeral arthroplasty2/. repair of the rotator cuff
4. closed reduction and immobilization
5. open reduction and immobilization
6. open reduction and early passive motion
7. arthroscopic capsular release
8. manipulation under anesthesia
9. a physical therapy program
:. an intra-articular corticosteroid injection
;. administration of high-dose oral corticosteroids
<. adding the scores, in all five body systems
=. adding the squares of the scores in the three most severely injured systems
>. doubling the cumulative score for head and chest injuries
?. combining the scores from the most and least injured systems
@. correcting the score in the most severely injured system for age
A. traumatic femoral head fracture
B. osteonecrosis
C. osteoarthritis
D. neuropathic joint
E. rheumatoid arthritis
F. low-dose radiation
G. steroid injection
H. a load-relieving insert and shoe modification
I. complete excision of the mass and the entire plantar fascia
J. wide excision of the mass with a 2 cm margin of normal fascia
K. CT scan of the chest
L. technetium bone scan
M. bone marrow aspiration
N. serum protein electrophoresis
O. lateral skull radiograph
P. high-grade histology of the initial tumor
Q. multiple local recurrences after curettage
R. previous treatment of the tumor with cryotherapy
S. previous treatment of the tumor with radiation therapy
T. extraosseous extension into two or more adjacent compartments
U. Dorsal rhizotomy and facet joint fusion
V. Multilevel corpectomy and spinal stabilization
W. Central and lateral recess decompression and bilateral foraminotomy
X. Central decompression and facet joint fusion
Y. Central decompression, foraminotomy, and spinal fusion from L2 to L5.
Z. Inadequate rehabilitation
[. Displacement of the coronoid process fracture
\. Insufficiency of the lateral ulnar collateral ligament
]. Insufficiency of the anterior band of the medial collateral ligament
^. Insufficiency of the posterior band of the medial collateral ligament
_. Osteotomy and intramedullary rod fixation
`. Electrical stimulation
A. Strut-autografing the concavity the tibia
B. A patellar tendon-bearing brace
C. Percutaneous injection of demineralized bone matrix
D. digoxin
E. sucralfate
F. clindamycin
G. alcohol
H. neuromuscular blocking agents
I. Unrestrained roll-back
J. Unrestrained rotational conformity
K. Medial-Lateral conformity
L. Anteroposterior conformity in flexion
M. Anteroposterior conformity in extension
N. Arthrodesis of the MTP joint
O. A Silastic implant of the MTP joint
P. Resection arthroplasty of the MTP joint
Q. Cheilctomy of the MTP joint
R. Osteotomy of the base of the proximal phalanx
S. Genu varum
T. Tarsal coalition
U. Degenerative ankle arthrosis
V. Osteochondritis dissecans of the talus
W. Hemihypertrophy of the ipsilateral lower extremity
X. Trabecular bone is preferentially resorbed in this high bone turnover state
Y. Loss of water content in the disk increases impact load to the vetrebral bodies
Z. Stress is imposed by the relative stiffness of the arthrtic facet joints
{. Increased energy demands are imposed by decreased circulation to the vertebral body
|. The thick cortical bone found in the vertebral body resorbs rapidly following estrogen withdrawal
}. Increased time in stance and swing phase
~. Addition of a double leg float phase
. Decreased vertical ground reaction forces
€. Decreased arc of motion in the hip, knee, and ankle
. Decreased joint reaction forces in the hip, knee, and ankle
‚. Talonavicular arthrodesis
ƒ. Medial displacement calcaneal osteotomy
„. Flexor digitorum longus tendon transfer with spring ligament advancement
…. Triple arthrodesis
†. Calcaneocuboid distraction arthrodesis and repair of the posterior tibial tendon
‡. Lymphoma
ˆ. Hemangioma
‰. Osteosarcoma
Š. TB of the spine
‹. Metastatic breast carcinoma
Œ. widening and shortening of the heel.
. weakness of the gastrocnemius-soleus complex.
Ž. anterior impingement from a horizontal talus.
. unrecognized compartment syndrome of the foot.
. degenerative arthritis of the tibiotalar joint.
‘. a corrective osteotomy
’. application of braces
“. medial physeal stapling until the varus corrects
”. observation
•. application of corrective casts
–. a total contact cast.
—. electrical stimulation.
˜. an off the shelf fracture brace.
™. an elastic compression bandage and crutches.
š. a hard soled shoe until the patient is asymptomatic.
›. Ewings tumor
œ. Parosteal osteosarcoma
. Dedifferentiated chondrosarcoma
ž. Low grade intramedullary chondrosarcoma
Ÿ. High grade intramedullary osteosarcoma
 . Vascular injury
¡. Tear of the rotator cuff
¢. Injury to the brachial plexus
£. Fracture of the upper thoracic rib
¤. Fracture of the proximal humerus
¥. Biceps
¦. Trapezius
§. Infraspinatus
¨. Pectoralis major
©. Serratus anterior
ª. Hybrid total hip arthroplasty
«. Noncemental hemiarthroplasty of the hip
¬. Closed reduction and percutaneous pin fixation
­. Open reduction through an anterior approach to the hip
®. Excision of the head fragment
¯. a quadratus femoris pediclebone graft
°. a proximal femoral allograft
±. intertrochanteric osteotomy
². total hip arthroplasty
³. hip hemiarthroplasty
´. Echocardiogram
Μ. Electrocardiogram
¶. Radiograph of the chest
·. CT scan of the shoulder
¸. Ultrasound of the shoulder
¹. Ilioinguinal
º. Extended iliofemoral
». Combined ilioinguinal and Kocher-Langenbeck (posterior)
¼. Kocher-Langenbeck (posterior)
½. Kocher-Langenbeck (posterior) with trochanteric osteotomy
¾. Deltoid
¿. Supraspinatus
À. Subscapularis Infraspinatus
Á. Infraspinatus
Â. Infraspinatus and teres minor
Ã. an orthosis.
Ä. observation.
Å. electrical stimulation.
Æ. open reduction and internal fixation.
Ç. application of a nonweightbearing short leg cast.
È. repair of the rotator cuff.
É. rehabilitation of the shoulder
Ê. replacement of the humeral head.
Ë. arthroscopic acromioplasty and debridement.
Ì. immobilization is a sling until pain resolves.
Í. Bone rotation versus torque applied
Î. Bone deflection versus bending moment applied
Ï. Axial displacement versus tension applied
Ð. Lateral translation versus shear force applied
Ñ. Fracture gap closing versus compressive force applied
Ò. steroid injection
Ó. stretching of the heel cord
Ô. surgical release of the plantar fascia
Õ. application of a short leg cast for 6 to 8 weeks
Ö. wearing dorsiflexion night splints
×. Open bladder
Ø. Bilateral “hitchhiker’s” thumbs
Ù. Bilateral defects in the midclavicles
Ú. Rhizomelic shortening of the extremities
Û. Radiographic fragmentation of all major epiphyses
Ü. Medial patellotibial
Ý. Medial patellofemoral
Þ. Medial patellomeniscal
SS. Lateral patellofemoral
À. Lateral patellotibial
Á. Heat
Â. Gentle active flexion-extension exercises
Ã. Isokinetic strengthening
Ä. Electrical muscle stimulation
Å. Immobilization of the limb with the knee in full flexion
Æ. Distal chevron osteotomy with soft-tissue release
Ç. Distal soft-tissue realignment only
È. Closing wedge osteotomy (Aken) of the proximal phalanx
É. Proximal first metatarsal osteotomy only
Ê. Soft-tissue realignment with a proximal metatarsal osteotomy
Ë. Vagus
Ì. Phrenic
Í. Hypoglossal
Î. Recurrent laryngeal
Ï. Inferior thyroid
Ð. Surgical exploration
Ñ. Application of leeches
Ò. Stellate ganglion blocks
Ó. Intra-arterial streptokinase
Ô. Elevation and reevaluation in 1 hour
Õ. Liver profile
Ö. Myleogram
÷. Platelet count
Ø. CT scan of the head
Ù. Angiogram of the extremity
Ú. Post spinal fusion from L5to S1
Û. Primary repair with an iliac bone graft
Ü. Post spinal fusion of L4-5
Ý. A pantaloon body cast and 6 weeks of bed rest
Þ. Rest, NSAIDS, and limited dancing
Ÿ. Stress fracture of the proximal fifth metatarsal
Ā. Stress fracture of the base of the second metatarsal
Ā. Stress fracture of the neck of the second metatarsal
Ă. Morton’s neuroma
Ă. Lisfranc’s joint subluxation
Ą. C5 radiculopathy
Ą. Subscapularis rupture
Ć. Glenohumeral arthrosis
Ć. Rotator cuff arthropathy
Ĉ. Suprascapular nerve compression at the spinoglenoid notch
Ĉ. mm femoral head in combination with a metal-backed polyethylene component
Ċ. mm femoral head in combination with an all-polyethylene acetabular component
Ċ. mm femoral head in combination with a metal-backed polyethylene component
Č. mm femoral head in combination with an all-polyethylene component
Č. mm femoral head in combination with a metal-backed polyethylene component
Ď. Female gender
Ď. History of cigarette smoking
Đ. L5-S1 spondylolisthesis on pre-employment radiography
Đ. Decreased strength of the lower extremities on pre-employment testing
Ē. Decreased flexibility of the lumbar spine on pre-employment testing
Ē. Size of cells
Ĕ. Amount of DNA in cells
Ĕ. Nucleus-cytoplasm ratio
Ė. Specific DNA sequences
Ė. Specific messenger RNA sequences
Ę. Femoral and obturator nerves
Ę. Femoral and superior gluteal nerves
Ě. Femoral and lateral femoral cutaneous nerves
Ě. Obturator and superior gluteal nerves
Ĝ. Obturator and lateral femoral cutaneous nerves
Ĝ. Isotonic
Ğ. Isokinetic
Ğ. Isometric
Ġ. Open kinetic chain
Ġ. Dynamic variable resistance
Ģ. Closed reduction and cast immobilization
Ģ. Uniplanar external fixation
Ĥ. Open reduction and internal fixation with a dynamic compression plate
Ĥ. Unreamed intramedullary rod
Ħ. Multiple plane external fixator
Ħ. Inlet view of the pelvis
Ĩ. Outlet view of the pelvis
Ĩ. AP view of the hip
Ī. Ilial oblique view (external oblique) of the hip
Ī. Obturator oblique
Ĭ. Glycolytic pathway
Ĭ. Oxidative phosphorylation
Į. Breakdown of fat
Į. Breakdown of protein
İ. Breakdown of adenosine triphosphate
I. an MRI scan
IJ. arthroscopic examination
IJ. AP and frog-lateral radiographs of the pelvis and hips
Ĵ. varus and valgus stress radiographs of the knee
Ĵ. physical examination of the knee under anesthesia
Ķ. extended curettage and polymethylmethacrylate cementation
Ķ. extra-articular resection of the knee and an allograft arthrodesis
ĸ. wide resection of the proximal tibia and custom prosthetic replacement
Ĺ. prophylactic internal fixation and postoperative irradiation
Ĺ. excision of the lateral condyle and reconstruction with a hemicondylar allograft
Ļ. silicone implant joint replacement
Ļ. metatarsophalangeal joint arthrodesis
Ľ. metatarsophalangeal joint debridement
Ľ. resection of the metatarsal head
Ŀ. resection of the base of the proximal phalanx
Ŀ. Fixation of the syndesmosis has failed
Ł. Widening of the ankle mortise has led to the failure of fixation
Ł. Infection around the syndesmosis screw has led to osteomyelitis
Ń. The syndesmosis screw is broken
Ń. Motion between the tibia and fibula has caused loosening of the syndesmosis screw
Ņ. Microcephaly
Ņ. A temporal lobe cyst
Ň. An Arnold-Chiari type 1 malformation
Ň. Periventricular leukomalacia
ʼN. Agnesis of the corpus callosum
Ŋ. Wolff’s
Ŋ. Hooke’s
Ō. Hilton’s
Ō. Muller-Haeckel
Ŏ. Heuter-Volkmann
Ŏ. Both the anterolateral and posteromedial bands are isometric and do not significantly change with flexion
Ő. The anterolateral band is lax and becomes tight in flexion, while the posteromedial band is tight, and becomes lax in flexion
Ő. The anterolateral band is tight and becomes lax in flexion, while the posteromedial band is lax and becomes tight in flexion
Œ. Both the anterolateral and posteromedial bands are lax and become tight in flexion
Œ. Both the anterolateral and posteromedial bands are tight and become lax as the knee is flexed
Ŕ. UCB orthosis
Ŕ. Rigid orthosis with a medical arch support
Ŗ. Semi-rigid orthosis with lateral forefoot posting
Ŗ. Semi-rigid orthosis with a medial arch support
Ř. Medial heel wedge attached to the running shoes
Ř. Hallux varus
Ś. Osteonecrosis
Ś. Recurrence of the hallux valgus
Ŝ. “Transfer” second metatarsalgia
Ŝ. Physeal arrest of the first metatarsal
Ş. Aseptic loosening in a 70-year-old patient
Ş. Mechanical failure of a hinged knee prosthesis
Š. Failed knee replacement complicated by reflex sympathetic dystrophy
Š. Infection with soft-tissue deficit
Ţ. A prior patellectomy
Ţ. Knee fusion
Ť. Open irrigation and debridement
Ť. Arthroscopic irrigation and debridement
Ŧ. One-stage exchange arthroplasty
Ŧ. Two-stage exchange arthroplasty
Ũ. Putti-platt repair
Ũ. Open Bankart repair
Ū. Injection of a subacromial corticosteroid
Ū. Arthroscopic transglenoid capsular shift
Ŭ. Rehabilitation of the scapular and rotator cuff muscles
Ŭ. Silicone suction socket and an energy-absorbing foot
Ů. Silicone suction socket and a variable resistance ankle
Ů. Plastic suction socket, telescoping pylon, and a solid ankle cushioned heel (SACH) foot
Ű. Plastic socket with a hinged thigh cuff and a SACH foot
Ű. Patellar tendon-bearing suction socket and a uniaxial hydraulic ankle
Ų. Parosteal
Ų. Periosteal
Ŵ. High-grade intramedullary
Ŵ. Osteosarcoma occurring in Paget’s disease
Ŷ. Osteosarcoma occurring in irradiated bone
Ŷ. Cauda equina
Ÿ. Conus medullaris
Ź. Genitofemoral nerve
Ź. Lumbar sympathetic plexus
Ż. Lumbar parasympathetic plexus
Ż. Spinal pseudoarthrosis
Ž. Spinal cord traction injury with paralysis
Ž. Arterial and venous thromboses
S. Superior mesenteric artery syndrome
Ƀ. Crankshaft phenomenon
Ɓ. Inversion stress radiograph
Ƃ. MRI scan
Ƃ. CT scan
Ƅ. Nuclear bone scan
Ƅ. External rotation stress radiograph
Ɔ. Complex deformity with an angulation in two planes
Ƈ. Single deformity less than 20 degrees, apex posterolateral
Ƈ. Single deformity greater than 30 degrees, apex posterolateral
Ɖ. Single deformity less than 20 degrees, apex posteromedial
Ɗ. Single deformity greater than 30 degrees, apex posteromedial
Ƌ. Pronation of the foot during the stance phase of gait
Ƌ. Heel inversion at the beginning of a single limb heel rise
ƍ. Active inversion of the nonweightbearing foot
Ǝ. Active plantar flexion of the first ray against resistance
Ə. Active plantar flexion of the foot during the push-off phase of gait
Ɛ. Observation and repeat radiographs in 4 months
Ƒ. Application of a thoracolumbalsacral orthosis for 22 to 24 hours per day
Ƒ. Electrical stimulation at night
Ɠ. Physical therapy
Ɣ. Begins to remodel and hypertrophy more quickly
Ƕ. Provides a better scaffold for osteoconduction
Ɩ. Reduces the risk of early fracture
Ɨ. Reduces technical difficulty
Ƙ. Lowers donor site morbidity
Ƙ. Anterior fusion of the lumbar curve
Ƚ. Anterior and posterior fusion of the thoracic curve
ƛ. Posterior fusion of the thoracic curve
Ɯ. Posterior fusion of the thoracic and lumbar curves
Ɲ. Application of a brace until the iliac apophyses are Risser 4 or 5, followed by surgical correction
Ƞ. Subscapularis rupture
Ɵ. Type III SLAP lesion
Ơ. Disruption of capsular shift
Ơ. Isolated traumatic subluxation
Ƣ. Injury to the axillary nerve after dislocation
Ƣ. hypophosphatemia
Ƥ. high dietary cholesterol intake
Ƥ. deficiency of lipoprotein A
Ʀ. deficiency of protein S and protein C
Ƨ. elevated levels of antithrombin III
Ƨ. Weightbearing short leg cast
Ʃ. Nonweightbearing short leg cast
ƪ. Removable splint and early motion
ƫ. Open reduction and internal fixation
Ƭ. Elastic compression bandage with full weightbearing
Ƭ. Breast
Ʈ. Prostate
Ư. Gastrointestinal
Ư. Kidney
Ʊ. Multiple myeloma
Ʋ. Varus stress
Ƴ. Valgus stress
Ƴ. Torsional loading
Ƶ. Hyperextension of the knee
Ƶ. Contraction of the quadriceps while axially loaded
Ʒ. Primary internal fixation at both fracture levels
Ƹ. External fixation as definitive ttt for both #
Ƹ. Skeletal traction and delayed internal fixation of both fractures
ƺ. Primary internal fixation of the proximal fracture and delayed fixation of the femoral fracture
ƻ. Primary internal fixation of the femoral shaft fracture and delayed fixation of the proximal #
Ƽ. Heel spur
Ƽ. Plantar fascitis
ƾ. Dysfunction of the tibialis posterior tendon
Ƿ. Compression of the first branch of the lateral plantar nerve
ǀ. Compression of the calcaneal nerve
ǁ. Displaced labral tear
ǂ. Tear of the rotator cuff
ǃ. Fracture of the glenoid rim
DŽ. Palsy of the axillary nerve
DŽ. Palsy of the musculocutaneus nerve
DŽ. Enchondroma
LJ. Osteoblastoma
LJ. Giant cell tumor
LJ. Aneurysmal bone cyst
NJ. Fibrous dysplasia
NJ. Arthrogram of the wrist
NJ. MRI scan of both wrists
Ǎ. CT scan of both wrists in the same position
Ǎ. Radiographs of the wrist in supination and pronation
Ǐ. Radiographs of the opposite wrist in the same position
Ǐ. Secondary hyperparathyroidism
Ǒ. Phosphate retention secondary to uremia
Ǒ. Insufficient renal synthesis of 1, 25 dihydroxy vitamin D
Ǔ. Aluminum deposition in bone from oral phosphate binders
Ǔ. Persistent acidosis aggravating the negative calcium balance
Ǖ. Posterior fusion at T10-L3 with segmental instrumentation
Ǖ. Laminectomy and fusion of T12-L2 with segmental instrumentation
Ǘ. Bed rest in a hyperextension brace
Ǘ. L1 vertebrectomy and anterior decompression with strut graft fusion and instrumentation
Ǚ. Progressive ambulation as tolerated in a custom-molded thoracolumbosacral orthosis
Ǚ. Positive-pressure ventilation
Ǜ. An immediate radiograph of the chest
Ǜ. Adjustment of the position of the endotrachael tube
Ǝ. Insertion of a large-bore needle into the pericardial space
Ǟ. Insertion of a large-bore needle in the right second intercostal space, midclavicular line
Ǟ. Allowing the ends of the fracture to touch
Ǡ. Adding a second connecting bar
Ǡ. Adding one pin to each fracture fragment
Ǣ. Increasing the pin diameter from 4 mm to 6 mm
Ǣ. Decreasing the connecting bar-to-bone distance from 6 cm to 4 cm
Ǥ. Osteomyelitis
Ǥ. Malignant degeneration
Ǧ. Stress fracture
Ǧ. Local recurrence of the giant cell tumor
Ǩ. Bone resorption due to methylmethacrylate
Ǩ. Advancement of the plantar plate
Ǫ. Resection of the second metatarsal head
Ǫ. Dorsiflexion osteotomy of the second metatarsal neck
Ǭ. Transfer of the flexor digitorum longus tendon to the dorsum of the toe
Ǭ. Transfer of the extensor digitorum comminus tendon to the metatarsal neck
Ǯ. Sacral fracture
Ǯ. Burst fracture of L5
J̌. Cauda equina syndrome
DZ. Distraction-flexion injury at L3
DZ. Distraction-extension injury at L3
DZ. An MRI scan of the shoulder
Ǵ. An MRI scan of the cervical spine
Ǵ. Electromyographic and nerve conduction velocity studies
Ƕ. Immobilization in a sling and early passive range of motion exercises
Ƿ. Immediate return to the operating room for exploration of the brachial plexus
Ǹ. cerclage wiring
Ǹ. tension band wiring
Ǻ. removal of the patellar component
Ǻ. revision of the patellar component
Ǽ. immobilization of the knee and protected weightbearing
Ǽ. Liposarcoma
Ǿ. Nodular fasciitis
Ǿ. Rabdomyosarcoma
Ȁ. Malignant fibrous histiocytoma
Ȁ. Extra-abdominal desmoid tumor
Ȃ. Clubfeet
Ȃ. Thrombocytopenia
Ȅ. Congenital scoliosis
Ȅ. Ventricular septal defect
Ȇ. Arnold-Chiari malformation
Ȇ. delayed primary closure
Ȉ. free flap
Ȉ. pedicle groin flap
Ȋ. full-thickness skin graft
Ȋ. split-thickness skin graft
Ȍ. Infection
Ȍ. Nonunion
Ȏ. Improper screw length
Ȏ. Osteonecrosis of the distal fragment
Ȑ. Use of a cortical screw instead of a cancellous screw
Ȑ. Infection
Ȓ. Tear of the rotator cuff
Ȓ. Loosening of the humeral component
Ȕ. Arthritis of the glenoid
Ȕ. Arthritis of the A-C joint
Ȗ. Reduced morbidity
Ȗ. Improved osteoinduction
Ș. Improved osteoconduction
Ș. More rapid revascularization
Ț. Lower risk of disease transmission
Ț. Manipulation Under Anesthesia
Ȝ. Arthroscopic acromioplasty
Ȝ. Arthroscopic debridement of G-H joint
Ȟ. Replacement of the humeral head
Ȟ. Lengthening of the subscapularis and release of the anterior capsule
Ƞ. Bacteroides
ȡ. E. coli
Ȣ. Staph. aureus
Ȣ. group A streptococcus
Ȥ. Clostridium perforingens
Ȥ. observation and exercises
Ȧ. bracing with a thoracolumbar orthosis
Ȧ. fusion of the posterior spine
Ȩ. fusion of the anterior spine
Ȩ. fusion of the anterior and posterior spine
Ȫ. Total wrist replacement and bridge grafts
Ȫ. palmar shelf arthroplasty and tendon transfers
Ȭ. Darrach distal ulna resection, dorsal tenosynosynovectomy, and tendon transfers
Ȭ. Radioscaphate fusion, extensor tenodesis, and Darrach distal ulna resection
Ȯ. Total wrist fusion and tendon transfers
Ȯ. constrained acetabular component
Ȱ. protrusion ring with morselized graft
Ȱ. cemented metal backed acetabular component
Ȳ. cemented all-polyethylene acetabular component
Ȳ. cementless hemispherical component with screw fixation
ȴ. application of a hip abduction brace for 22 hours per day
ȵ. application of a hip spica under anesthesia
ȶ. discontinuance of all bracing and repeat radiographs in 3 months
ȷ. open reduction of the hip and application of a spica cast
ȸ. open reduction, varus osteotomy, and application of a spica cast
ȹ. Loss of skin hair on the feet
Ⱥ. Absent pulses on vascular examination
Ȼ. Pain that originates proximally and spreads distally
Ȼ. Pain that is relieved by stopping and standing
Ƚ. Pain that is worse when the patient walks uphill rather downhill
Ⱦ. wrist flexors and finger flexors
Ȿ. elbow flexors and wrist flexors
Ɀ. elbow flexors and finger flexors
Ɂ. elbow extensors and wrist flexorst Level Key Muscles4 DiaphragmDeltoid, elbow flexors, diaphragmElbow flexors, wrist extensorsElbow extensors, wrist flexorsFinger flexors (distal phalanx of middlefinger)Finger abductors (5th digit), intrinsics of hand2 Segmental innervation to intercostal muscles, abdominal and paraspinal muscles) L1, L2, L3 Hip flexors3, L4 QuadricepsTibialis anteriorToe extensors, hip abductorsAnkle plantarflexors, peronei
Ɂ. elbow extensors and wrist extensors
Ƀ. Syndactyly
Ʉ. Macrodactyly
Ʌ. Camptodactyly
Ɇ. Preaxial polydactyly
Ɇ. Postaxial polydactyly
Ɉ. Arthrodesis
Ɉ. Rotationplasty
Ɋ. Above-knee amputation
Ɋ. Osteoarticular allograft
Ɍ. Endoprosthesis (custom arthroplasty)
Ɍ. Plantar fascia
Ɏ. Spring ligament
Ɏ. Deltoid ligament
Ɐ. Intrinsic tendons
Ɑ. Gastorcnemius-solelus complex
Ɒ. Prevention of presynaptic release of acetylcholine
Ɓ. Prevention of synthesis of presynaptic acetylcholine
Ɔ. Activation of acetylcholinesterase at the motor end-plate
ɕ. Blockage of postsynaptic action of acetylcholine until reserves are depleted
Ɖ. Stimulation of release of presynaptic acetylcholine until reserves are depleted
Ɗ. stiffness of the femoral component.
ɘ. head offset of the femoral component.
Ə. femoral component material modulus of elasticity.
ɚ. extent of the femoral component porous coating.
Ɛ. Presence of a femoral component collar.
Ɜ. plantar fascia and quadratus plantae tendon.
ɝ. ligamentous structures connecting the tarsal bones.
ɞ. shape of the tarsal bones and the intervening joints.
ɟ. activity of the intrinsic muscles of the foot.
Ɠ. activity of the posterior tibialis and the peroneus longus muscles.
Ɡ. scapulothoracic fusion
ɢ. strengthening of the periscapular muscles
Ɣ. pectoralis minor-fascia lata graft transfer to the scapula
ɤ. pectoralis major-fascia lata graft transfer to the scapula
Ɥ. exploration of the long thoracic nerve, with sural nerve graft
Ɦ. tricompartmental knee replacement
ɧ. unicompartmental knee replacement
Ɨ. medial compartment meniscal allograft
Ɩ. valgus-producing distal femoral osteotomy
Ɪ. valgus-producing proximal tibial osteotomy
Ɫ. Internal rotation of the femoral component
Ɬ. External rotation of the tibial component
ɭ. Lateral placement of the femoral component
ɮ. Medial placement of the patellar component
Ɯ. Excessive resection of the patella
ɰ. Hallux rigidus
Ɱ. Hallux valgus
Ɲ. Neuroma of the first web space
ɳ. Fracture of the sesamoid
ɴ. Rupture of the flexor hallucis longus
Ɵ. Sickle cell crisis
ɶ. Idiopathic chondrolysis
ɷ. Hemophilic arthropathy
ɸ. Osteoid osteoma of the femoral neck
ɹ. Legg-Calve-Perthes disease
ɺ. Decreased ankle jerk and positive femoral nerve stretch test
ɻ. Decreased knee jerk and positive straight-leg raising sign
ɼ. Gastrocnemius-soleus complex weakness and positive straight-leg raising sign
Ɽ. Weakness of the extensor hallucis longus and positive straight-leg raising sign
ɾ. Weakness of the extensor hallucis longus and positive femoral nerve stretch test
ɿ. Long-term administration of IV and oral antibiotics
Ʀ. Open soft-tissue debridement, retention of prosthetic components, and IV antibiotics
ʁ. Immediate exchange arthroplasty with antibiotic-impregnated cement
Ʂ. Two-stage surgical prosthetic exchange and IV antibiotics
Ʃ. Resection arthroplasty and IV antibiotics
ʄ. SCFE
ʅ. MED
ʆ. Perthes disease
Ʇ. Hypothyroidism
Ʈ. Chondrolysis
Ʉ. gout.
Ʊ. osteoporosis.
Ʋ. eosinophilic granuloma.
Ʌ. tuberculosis of the spine.
ʍ. metastatic disease of the spine.
ʎ. water content.
ʏ. Synthesis of type I collagen.
ʐ. Proteoglycan content.
ʑ. Activity of chondrocytes.
Ʒ. Synthesis of hyaluronate.
ʓ. Lung
ʔ. Breast
ʕ. Prostate
ʖ. Thyroid
ʗ. Renal
ʘ. T1-low, T2-low.
ʙ. T1-low, T2-high.
ʚ. T1-moderate, T2-low.
ʛ. T1-high, T2-low.
ʜ. T1-high, T2-high.
Ʝ. hypothesis is incorrect or invalid
Ʞ. interobserver error rate is 4%.
ʟ. Standard deviation is 4% higher or lower than the mean.
ʠ. Sample size is 4% larger than required to be clinically significant.
ʡ. Probability that the differences noted between two study groups were due to chance alone is 4%.
ʢ. I
ʣ. II
ʤ. IV
ʥ. IX
ʦ. X
ʧ. Cranial setting
ʨ. Cranial subluxation
ʩ. Odontoid fracture
ʪ. Lysis of the arch of the atlas
ʫ. Atlantoaxial subluxation
ʬ. Retrograde collapse of the endoneurial tubes
ʭ. Irreversible atrophy of the denervated muscles
ʮ. Elongation of the axons across the zone of injury
ʯ. Sprouting of the axons at the neuromuscular junction
ʰ. Misdirection of the axons across the zone of injury
ʱ. Maximally pronated and elbow extended
ʲ. Maximally pronated and the elbow flexed
ʳ. Maximally supinated and the elbow flexed
ʴ. Maximally supinated and the elbow extended
ʵ. In neutral rotation, with the elbow extended
ʶ. open reduction and internal fixation
ʷ. buddy taping to the adjacent index finger
ʸ. early motion with application of a dynamic banjo splint
ʹ. application of a cast with the hand in a “safe position” for 3 weeks.
ʺ. dorsal extension block splinting
ʻ. The name of the manufacturer
ʼ. The manufacturer’s potential liability
ʽ. The physician’s clinical performance
ʾ. The physician’s materials testing data
ʿ. Any royalties the physician receives from the manufacturer
ˀ. Femoral
ˁ. Obturator
˂. Inferior gluteal
˃. Superior gluteal
˄. Lateral femoral cutaneous
˅. open biopsy and a long leg cast
ˆ. open biopsy and wide resection of the tumor
ˇ. a long leg cast and observation
ˈ. intramedullary stabilization and observation
ˉ. Triggering
ˊ. Lateral instability
ˋ. Swan-neck deformity
ˌ. Boutonniere deformity
ˍ. Loss of distal interphalangeal joint flexion
ˎ. Peroneus brevis to peroneus longus
ˏ. Peroneus tertius to extensor hallucis longus
ː. Peroneus tertius to superficial peroneal nerve
ˑ. Extensor hallucis longus to deep peroneal nerve
˒. Extensor hallucis longus to extensor digitorum longus
˓. reassurance that Medicare will pay for the treatment.
˔. consent forms that patients or their guardians are able to understand.
˕. a detailed description of the device, omitting the fact that it is part of a study.
˖. a provision that the patient’s care will be discontinued if he or she does not enroll in the study.
˗. a provision that the study will be carried out to completion, whether or not the device is as effective as those currently in existence.
˘. an onlay iliac crest bone graft.
˙. limited weightbearing and observation.
˚. removal of the implant and limited weightbearing.
˛. removal of the implant and insertion of a reamed femoral nail.
˜. removal of the implant and insertion of an unreamed femoral nail.
˝. Coronal
˞. Sagittal
˟. Anteromedial, midway between the sagittal and the coronal
ˠ. Proximal pins sagittal, distal pins coronal
ˡ. Proximal pins coronal, distal pins sagittal
ˢ. Rheumatoid arthritis
ˣ. Posttraumatic arthritis
ˤ. Degenerative osteoarthritis
˥. Osteonecrosis of the tibial plateau
˦. Osteonecrosis of the medial femoral condyle
˧. Trapeziometacarpal arthrodesis
˨. Osteotomy of the thumb metacarpal
˩. Arthrotomy and joint debridement
˪. Ligament reconstruction using one half of the flexor carpi radialis
˫. Trapezium resection, tendon interposition, and reconstruction of the ligament
ˬ. Creep
˭. Relaxation
ˮ. Energy dissipation
˯. Plastic deformation
˰. Elastic deformation
˱. bending
˲. axial loading
˳. high-speed rotation
˴. direct impact from anteromedial
˵. crush from anteromedial to posterolateral
˶. Increase stiffness
˷. Increase fracture toughness
˸. Increase fatigue strength
˹. Decrease mechanical strength
˺. Decrease wear rate
˻. disuse osteopenia
˼. paraendocrine effect of the tumor
˽. abnormally increased density on the right side
˾. side effect of the treatment of the lesion
˿. extensive tumor involvement of the left hip
̀. Sciatic nerve
́. Superior gluteal artery
̂. Profunda femoris artery
̃. Femoral artery and nerve
̄. External iliac artery and vein
̅. Length
̆. Moment arm
̇. Total volume
̈. Physiologic cross-sectional area
̉. Distribution of slow and fast twitch fibers
̊. decreasing initiation of action potentials.
̋. increasing action potential amplitude.
̌. blocking the opening of gated sodium channels.
̍. decreasing the number of functional motor units.
̎. slowing or stopping action potential propagation through the axon.
̏. resection of the metatarsal heads of the first through fifth toes.
̐. Silastic MP joint arthroplasties of the first through fifth toes.
̑. fusion of the hallux MP joint and resection arthroplasty of the 2nd through fifth metatarsal heads.
̒. fusion of hallux MP joint and distal osteotomy of the 2nd through 5th MT.
̓. plantar condylectomy of the 2nd through 5th MT heads & resection of proximal phx of the hallux.
̔. hemiarthroplasty
̕. open reduction and internal fixation
̖. closed reduction and percutaneous pinning
̗. a sling and early pedulum exercises
̘. a sling and swathe for 6 weeks, followed by shoulder rehabilitation
̙. open acromioplasty
̚. open Bankart repair
̛. open subscapularis tendon repair
̜. inferior capsular shift
̝. a supervised physical therapy program
̞. a sling and swathe, with pendulum exercises in 10 days
̟. open reduction and internal fixation through an anterior approach
̠. open reduction and internal fixation through a posterior approach
̡. immobilization with a splint in 45 degrees of abduction for 6 weeks
̢. arthroscopically assisted reduction and percutaneous screw fixation
̣. Repair of the rotator cuff
̤. Replacement of the humeral head
̥. Resection arthroplasty
̦. Total shoulder arthroplasty
̧. AP and lateral radiographs of the elbow
̨. Diagnositc arthroscopy
̩. Aspiration of joint fluid
̪. An erythrocyte sedimentation rate and CBC
̫. A diagnostic lidocaine injection
̬. Insulin-like growth factor (IGF-1)
̭. Fibroblast growth factor (FGF-1)
̮. Platelet-derived growth factor (PDGF)
̯. Transforming growth factor beta (TGF-B)
̰. Bone morphogenetic proteins (BMP)
̱. clinical history and radiographic findings.
̲. technetium bone scan
̳. flow cytometry pattern of extracted chondrocytes
̴. immunohistochemical staining patterns of a biopsy specimen
̵. histologic features of a biopsy specimen stained with hematoxylin-cosin
̶. Radial
̷. Radial recurrent
̸. Posterior interosseous
̹. Superior ulnar recurrent
̺. Superficial radial circumflex
̻. Impaired hydroxylation of proline
̼. Failure of cleavage in procollagen
̽. Defective binding sites for hydroxyproline
̾. Failure to incorporate glycine into the helix
̿. Diminished production of collagen through the rough endoplasmic reticulum
̀. Asking the legal staff to seek a court injunction
́. Copying the patient’s chart and giving it to him as he leaves
͂. Having the patient sign a written legal contract that specifies acceptable behavior
̓. Continuing care of the patient until an appropriate referral can be arranged
̈́. Transferring the patient to another orthopaedic surgeon without disclosing the realreason for why the patient is being transferred
Ι. Meta-analysis
͆. Confidence interval
͇. Analysis of variance (ANOVA)
͈. Statistical significance (p-value)
͉. Survivorship analysis (Kaplan-Meier)
͊. Spinal shock
͋. Neurogenic shock
͌. Hypovolemic shock
͍. Pulmonary embolism
͎. Fat embolus syndrome
͏. Lumbar spinal stenosis
͐. Metastatic disease of the spine
͑. Rheumatoid lumbar spondylitis
͒. Isthmic spondyloloisthesis
͓. Degenerative spondylolisthesis at L4-5 and L5-S1
͔. Patella alta
͕. A metal-backed patella
͖. Varus malalignment of the knee
͗. A posterior cruciate-substituting femoral component
͘. Lateral subluxation of the patella on a Merchant’s view
͙. The sesamoids are separated
͚. The sesamoid is fractured
͛. The proximal phx is on the neck of the metatarsal
͜. The dislocation is dorsal and centered
͝. The proximal phalanx is hyperextended
͞. Patella
͟. Tibial stem
͠. Distal femoral interface
͡. Posterior femoral interface
͢. Sites of screw fixation for the tibia
ͣ. Hallux rigidus
ͤ. Fracture of the sesamoid
ͥ. Disruption of the plantar plate
ͦ. Osteonecrosis of the metatarsal head
ͧ. Rupture of the flexor hallucis longus
ͨ. Gout
ͩ. Sepsis
ͪ. Old trauma
ͫ. Rheumatoid arthritis
ͬ. Charcot arthroplasty
ͭ. Aspiration and steroid injection
ͮ. Biopsy, curettage, and allograft bone grafting
ͯ. Percutaneous Kirschner wire fixation
Ͱ. Percutaneous injection of autogenous bone marrow
Ͱ. Nerve roots
Ͳ. Spinal cord
Ͳ. Sciatic nerve
ʹ. Peroneal nerve
͵. Conus medullaris
Ͷ. Extent of bone penetrated by reaming, prosthetic components, or acrylic cement
Ͷ. Periprosthetic regions that are accessible to joint fluid and particulate wear debris
͸. Enveloping pseudocapsular scar tissue that develops around a prosthetic hip following surgical capsulectomy
͹. Soft tissue and bone that are potentially contaminated with bacteria in the setting of a prosthetic joint infection
ͺ. Potential intrapelvic joint space communication created by acetabular fixation screws or intrapelvic extruded acrylic cement
Ͻ. Early and late infection
Ͼ. Periprosthetic fracture of the femur
Ͽ. Failure of the patellofemoral and extensor mechanisms
;. Aseptic loosening of cementing tibial components
Ϳ. Asceptic loosening of cemented femoral components
΀. Acceptance of the current position of the ankle
΁. Open reduction and fixation in the epiphysis only
΂. ORIF with a small-fragment T-plate from the malleolus up to the metaphysis
΃. Closed reduction by eversion of the ankle and application of a bivalved long leg cast
΄. CRUGA and fixation with a malleolar screw from the malleolus into the metaphysis
΅. Resection arthroplasty and local radiation
Ά. In situ fusion of the hip
·. Excision of heterotopic bone, total hip arthroplasty, and oral indomethacin
Έ. Excision of heterotopic bone and local radiation
Ή. Excision of heterotopic bone, hemiarthroplasty, and oral indomethacin
Ί. Closed reduction of both fractures and immediate spica casting
΋. Bilateral skin traction for 3 weeks, followed by spica casting
Ό. External fixation of both femora
΍. External fixation of the left femur and a long leg cast brace for the right femur
Ύ. External fixation of the left femur and use of a reamed intramedullary nail in the right femur
Ώ. Synovial sarcoma
Ϊ́. Soft-tissue abcess
Α. Rhabdomyosarcoma
Β. Eosinophilic granuloma
Γ. Nodular pigmented villonodular synovitis
Δ. Changing to a titanium nail
Ε. Changing to a nonslotted nail
Ζ. Changing the cross-sectional shape of the nail
Η. Increasing the diameter of the nail by 3 mm
Θ. Increasing the diameter of the interlocking screws
Ι. Fracture healing
Κ. Chondrosarcoma
Λ. Periosteal chondroma
Μ. Periosteal osteosarcoma
Ν. Dysplasia epiphysealis hemimelica
Ξ. Demonstrate competence in the subject of the case
Ο. Be fellowship trained in the subject of the case
Π. Be paid on a contingency basis
Ρ. Be board certified by the American Board of Orthopaedic Surgery
΢. Have been involved in the case as a consultant
Σ. Diagnostic arthroscopy
Τ. Arthroscopy and subacromial decompression
Υ. Reduction and fixation of the proximal humeral epiphysis
Φ. Temporary cessation of throwing
Χ. Physical therapy for rotator cuff strengthening
Ψ. Oblique popliteal ligament
Ω. Lateral capsule
Ϊ. Popliteal tendon
Ϋ. Fibular collateral ligament
Ά. Posterior oblique ligament
Έ. Radial tear
Ή. Parrot-beak tear
Ί. Vertical tear in the “red-red” zone
Ϋ́. Vertical tear in the “red-white” zone
Α. Vertical tear in the “white-white” zone
Β. 0 degrees of abduction, with neural rotation
Γ. 40 degrees of flexion and 60 degrees of internal rotation
Δ. 45 degrees of flexion and 45 degrees of external rotation
Ε. 90 degrees of abduction with neutral rotation
Ζ. 90 degrees of abduction and 90 degrees of external rotation
Η. Sural
Θ. Saphenous and its branches
Ι. Posterior tibial and its branches
Κ. Deep peroneal and its branches
Λ. Superficial peroneal and its branches
Μ. Strength
Ν. Stiffness
Ξ. Shelf life
Ο. Antigenicity
Π. Risk of HIV transmission
Ρ. Indemnification
Σ. Occurrence
Σ. Excess liability
Τ. Claims-made
Υ. Nose
Φ. Lateral Y
Χ. Scapular AP
Ψ. Neutral rotation AP
Ω. Internal rotation AP
Ϊ. External rotation AP
Ϋ. Trauma
Ό. Hemophilia
Ύ. Reiter’s syndrome
Ώ. Rheumatoid arthritis
Ϗ. Systemic lupus erythematosus
Β. Cast immobilization for 6 weeks
Θ. Activity modification and re-evaluation in 2 months
ϒ. Internal fixation with or without bone grafting
ϓ. Retrograde drilling of the defect without articular cartilage penetration
ϔ. Drilling of the defect directly through the articular cartilage
Φ. repair or reconstruction of the medial collateral ligament
Π. repair or reconstruction of the medialand lateral collateral ligaments
Ϗ. immobilization for 5 days or less
Ϙ. immobilization for 14 days
Ϙ. immobilization for 25 days
Ϛ. Cystinosis
Ϛ. Hypophosphatemia
Ϝ. Renal osteodystrophy
Ϝ. Primary hyperparathyroidism
Ϟ. Nutritional vitamin D deficiency
Ϟ. Lateral meniscus tear
Ϡ. Popliteus tenosynovitis
Ϡ. Iliotibial band friction syndrome
Ϣ. Peroneal nerve entrapment
Ϣ. Biceps tendinitis
Ϥ. Observation
Ϥ. Removal of the prosthetic components
Ϧ. Operative exploration and decompression of the peroneal nerve
Ϧ. Nerve conduction velocity studies
Ϩ. Loosening of the primary dressings and knee flexion to 30 degrees
Ϩ. I
Ϫ. II
Ϫ. III
Ϭ. decreased tissue tension
Ϭ. decreased abductor lever arm
Ϯ. decreased joint reaction force
Ϯ. increased body weight over lever arm
Κ. increased polyethylene wear rate
Ρ. recurrent traumatic anterior dislocation
Ϲ. recurrent traumatic posterior dislocation
Ϳ. traumatic subluxation with no previous dislocation
ϴ. traumatic anterior subluxation
Ε. atraumatic involuntary subluxation
϶. radial
Ϸ. axillary
Ϸ. suprascapular
Ϲ. thoracodorsal
Ϻ. long thoracic
Ϻ. Flexion
ϼ. Extension
Ͻ. Axial rotation
Ͼ. Left lateral bending
Ͽ. Right lateral bending
Ѐ. Skin
Ё. Lung
Ђ. Brain
Ѓ. Heart
Є. Kidney
Ѕ. Thoracoacromial, lateral thoracic, subscapular
І. Thoracoacromial, anterior humeral circumflex, posterior humeral circumflex
Ї. Posterior humeral circumflex, subscapular, thoracacromial
Ј. Subscapular, thoracacromial, anterior humeral circumflex
Љ. Lateral thoracic, anterior humeral circumflex, thoracacromial
Њ. Respondeat superior
Ћ. Indemnity agreement
Ќ. Hold harmless agreement- attempt to shift liability from company to physician
Ѝ. Comparative negligence-% of involvement
Ў. Contributory negligence- resident contributed to the negligence
Џ. t-type
А. both column
Б. transverse
В. anterior column
Г. anterior column posterior hemitransverse
Д. Posterior interosseous
Е. Anterior interosseous
Ж. Radial
З. Median
И. Ulnar
Й. Shock from hypovolemia
К. Associated rupture of the bladder
Л. Arterial bleeding on pelvic angiogram
М. Presence of a hematoma in the perineum and scrotum
Н. Fractures of both the anterior and posterior pelvic ring

Correct Answer & Explanation

. Endurance limit


Explanation

Question 4068

Topic: 10. Pathology and Oncology

  • A skeletal survey is more accurate than a bone scan for detecting skeletal involvement in which of the following neoplastic diseases?
. Ewing’s sarcoma
. Osteogenic sarcoma
. Multiple myeloma
. Metastatic prostate carcinoma
. Metastatic breast carcinoma
. Higher subsequent loosening rate of the femoral component
. Higher subsequent polyethylene wear rate
. Higher subsequent dislocation rate
. Higher infection rate
. Unaltered subsequent survival rate of the femoral component
. Crevice corrosion
. Oscillatory fretting
. Oxidative degradation
. Adhesion and abrasion
. Fatigue and delamination
. a total contact cast.
. partial calcanectomy
. Syme’s amputation
. transtibial amputation.
. nonweightbearing and IV antibiotics.
. Sural artery island flap.
. Free rectus abdominis flap.
. Extensor digitorum brevis flap.
. Staged cross leg flap.
. Split-thickness skin graft.
. An anterior cruciate functional knee brace.
. A physical therapy program.
. Reconstruction of the posterior cruciate ligament and the posterolateral corner.
. Reconstruction of the posterior cruciate ligament.
. Reconstruction of the anterior cruciate ligament.
. Avoids the risk of marrow emboli
. Avoids injury to the intramedullary nutrient vessels
!. Results in faster healing of fractures
". Results in more secure fixation
#. Results in faster regeneration of the endosteal blood supply
$. Above-knee amputation
%. En bloc resection of the lesion and reconstruction with a bone graft
&. Closed reduction and immobilization in a cast
'. Open reduction and internal fixation, followed by radiation therapy
(. Open reduction, curettage, and cementing of the lesion
). Injury to the subclavian artery
*. Injury to the brachial plexus
+. Segmental fracture
,. 100% displacement
-. Associated displaced surgical neck fracture of the humerus
.. humeral arthroplasty2/. repair of the rotator cuff
/. closed reduction and immobilization
0. open reduction and immobilization
1. open reduction and early passive motion
2. arthroscopic capsular release
3. manipulation under anesthesia
4. a physical therapy program
5. an intra-articular corticosteroid injection
6. administration of high-dose oral corticosteroids
7. adding the scores, in all five body systems
8. adding the squares of the scores in the three most severely injured systems
9. doubling the cumulative score for head and chest injuries
:. combining the scores from the most and least injured systems
;. correcting the score in the most severely injured system for age
<. traumatic femoral head fracture
=. osteonecrosis
>. osteoarthritis
?. neuropathic joint
@. rheumatoid arthritis
A. low-dose radiation
B. steroid injection
C. a load-relieving insert and shoe modification
D. complete excision of the mass and the entire plantar fascia
E. wide excision of the mass with a 2 cm margin of normal fascia
F. CT scan of the chest
G. technetium bone scan
H. bone marrow aspiration
I. serum protein electrophoresis
J. lateral skull radiograph
K. high-grade histology of the initial tumor
L. multiple local recurrences after curettage
M. previous treatment of the tumor with cryotherapy
N. previous treatment of the tumor with radiation therapy
O. extraosseous extension into two or more adjacent compartments
P. Dorsal rhizotomy and facet joint fusion
Q. Multilevel corpectomy and spinal stabilization
R. Central and lateral recess decompression and bilateral foraminotomy
S. Central decompression and facet joint fusion
T. Central decompression, foraminotomy, and spinal fusion from L2 to L5.
U. Inadequate rehabilitation
V. Displacement of the coronoid process fracture
W. Insufficiency of the lateral ulnar collateral ligament
X. Insufficiency of the anterior band of the medial collateral ligament
Y. Insufficiency of the posterior band of the medial collateral ligament
Z. Osteotomy and intramedullary rod fixation
[. Electrical stimulation
\. Strut-autografing the concavity the tibia
]. A patellar tendon-bearing brace
^. Percutaneous injection of demineralized bone matrix
_. digoxin
`. sucralfate
A. clindamycin
B. alcohol
C. neuromuscular blocking agents
D. Unrestrained roll-back
E. Unrestrained rotational conformity
F. Medial-Lateral conformity
G. Anteroposterior conformity in flexion
H. Anteroposterior conformity in extension
I. Arthrodesis of the MTP joint
J. A Silastic implant of the MTP joint
K. Resection arthroplasty of the MTP joint
L. Cheilctomy of the MTP joint
M. Osteotomy of the base of the proximal phalanx
N. Genu varum
O. Tarsal coalition
P. Degenerative ankle arthrosis
Q. Osteochondritis dissecans of the talus
R. Hemihypertrophy of the ipsilateral lower extremity
S. Trabecular bone is preferentially resorbed in this high bone turnover state
T. Loss of water content in the disk increases impact load to the vetrebral bodies
U. Stress is imposed by the relative stiffness of the arthrtic facet joints
V. Increased energy demands are imposed by decreased circulation to the vertebral body
W. The thick cortical bone found in the vertebral body resorbs rapidly following estrogen withdrawal
X. Increased time in stance and swing phase
Y. Addition of a double leg float phase
Z. Decreased vertical ground reaction forces
{. Decreased arc of motion in the hip, knee, and ankle
|. Decreased joint reaction forces in the hip, knee, and ankle
}. Talonavicular arthrodesis
~. Medial displacement calcaneal osteotomy
. Flexor digitorum longus tendon transfer with spring ligament advancement
€. Triple arthrodesis
. Calcaneocuboid distraction arthrodesis and repair of the posterior tibial tendon
‚. Lymphoma
ƒ. Hemangioma
„. Osteosarcoma
…. TB of the spine
†. Metastatic breast carcinoma
‡. widening and shortening of the heel.
ˆ. weakness of the gastrocnemius-soleus complex.
‰. anterior impingement from a horizontal talus.
Š. unrecognized compartment syndrome of the foot.
‹. degenerative arthritis of the tibiotalar joint.
Œ. a corrective osteotomy
. application of braces
Ž. medial physeal stapling until the varus corrects
. observation
. application of corrective casts
‘. a total contact cast.
’. electrical stimulation.
“. an off the shelf fracture brace.
”. an elastic compression bandage and crutches.
•. a hard soled shoe until the patient is asymptomatic.
–. Ewings tumor
—. Parosteal osteosarcoma
˜. Dedifferentiated chondrosarcoma
™. Low grade intramedullary chondrosarcoma
š. High grade intramedullary osteosarcoma
›. Vascular injury
œ. Tear of the rotator cuff
. Injury to the brachial plexus
ž. Fracture of the upper thoracic rib
Ÿ. Fracture of the proximal humerus
 . Biceps
¡. Trapezius
¢. Infraspinatus
£. Pectoralis major
¤. Serratus anterior
¥. Hybrid total hip arthroplasty
¦. Noncemental hemiarthroplasty of the hip
§. Closed reduction and percutaneous pin fixation
¨. Open reduction through an anterior approach to the hip
©. Excision of the head fragment
ª. a quadratus femoris pediclebone graft
«. a proximal femoral allograft
¬. intertrochanteric osteotomy
­. total hip arthroplasty
®. hip hemiarthroplasty
¯. Echocardiogram
°. Electrocardiogram
±. Radiograph of the chest
². CT scan of the shoulder
³. Ultrasound of the shoulder
´. Ilioinguinal
Μ. Extended iliofemoral
¶. Combined ilioinguinal and Kocher-Langenbeck (posterior)
·. Kocher-Langenbeck (posterior)
¸. Kocher-Langenbeck (posterior) with trochanteric osteotomy
¹. Deltoid
º. Supraspinatus
». Subscapularis Infraspinatus
¼. Infraspinatus
½. Infraspinatus and teres minor
¾. an orthosis.
¿. observation.
À. electrical stimulation.
Á. open reduction and internal fixation.
Â. application of a nonweightbearing short leg cast.
Ã. repair of the rotator cuff.
Ä. rehabilitation of the shoulder
Å. replacement of the humeral head.
Æ. arthroscopic acromioplasty and debridement.
Ç. immobilization is a sling until pain resolves.
È. Bone rotation versus torque applied
É. Bone deflection versus bending moment applied
Ê. Axial displacement versus tension applied
Ë. Lateral translation versus shear force applied
Ì. Fracture gap closing versus compressive force applied
Í. steroid injection
Î. stretching of the heel cord
Ï. surgical release of the plantar fascia
Ð. application of a short leg cast for 6 to 8 weeks
Ñ. wearing dorsiflexion night splints
Ò. Open bladder
Ó. Bilateral “hitchhiker’s” thumbs
Ô. Bilateral defects in the midclavicles
Õ. Rhizomelic shortening of the extremities
Ö. Radiographic fragmentation of all major epiphyses
×. Medial patellotibial
Ø. Medial patellofemoral
Ù. Medial patellomeniscal
Ú. Lateral patellofemoral
Û. Lateral patellotibial
Ü. Heat
Ý. Gentle active flexion-extension exercises
Þ. Isokinetic strengthening
SS. Electrical muscle stimulation
À. Immobilization of the limb with the knee in full flexion
Á. Distal chevron osteotomy with soft-tissue release
Â. Distal soft-tissue realignment only
Ã. Closing wedge osteotomy (Aken) of the proximal phalanx
Ä. Proximal first metatarsal osteotomy only
Å. Soft-tissue realignment with a proximal metatarsal osteotomy
Æ. Vagus
Ç. Phrenic
È. Hypoglossal
É. Recurrent laryngeal
Ê. Inferior thyroid
Ë. Surgical exploration
Ì. Application of leeches
Í. Stellate ganglion blocks
Î. Intra-arterial streptokinase
Ï. Elevation and reevaluation in 1 hour
Ð. Liver profile
Ñ. Myleogram
Ò. Platelet count
Ó. CT scan of the head
Ô. Angiogram of the extremity
Õ. Post spinal fusion from L5to S1
Ö. Primary repair with an iliac bone graft
÷. Post spinal fusion of L4-5
Ø. A pantaloon body cast and 6 weeks of bed rest
Ù. Rest, NSAIDS, and limited dancing
Ú. Stress fracture of the proximal fifth metatarsal
Û. Stress fracture of the base of the second metatarsal
Ü. Stress fracture of the neck of the second metatarsal
Ý. Morton’s neuroma
Þ. Lisfranc’s joint subluxation
Ÿ. C5 radiculopathy
Ā. Subscapularis rupture
Ā. Glenohumeral arthrosis
Ă. Rotator cuff arthropathy
Ă. Suprascapular nerve compression at the spinoglenoid notch
Ą. mm femoral head in combination with a metal-backed polyethylene component
Ą. mm femoral head in combination with an all-polyethylene acetabular component
Ć. mm femoral head in combination with a metal-backed polyethylene component
Ć. mm femoral head in combination with an all-polyethylene component
Ĉ. mm femoral head in combination with a metal-backed polyethylene component
Ĉ. Female gender
Ċ. History of cigarette smoking
Ċ. L5-S1 spondylolisthesis on pre-employment radiography
Č. Decreased strength of the lower extremities on pre-employment testing
Č. Decreased flexibility of the lumbar spine on pre-employment testing
Ď. Size of cells
Ď. Amount of DNA in cells
Đ. Nucleus-cytoplasm ratio
Đ. Specific DNA sequences
Ē. Specific messenger RNA sequences
Ē. Femoral and obturator nerves
Ĕ. Femoral and superior gluteal nerves
Ĕ. Femoral and lateral femoral cutaneous nerves
Ė. Obturator and superior gluteal nerves
Ė. Obturator and lateral femoral cutaneous nerves
Ę. Isotonic
Ę. Isokinetic
Ě. Isometric
Ě. Open kinetic chain
Ĝ. Dynamic variable resistance
Ĝ. Closed reduction and cast immobilization
Ğ. Uniplanar external fixation
Ğ. Open reduction and internal fixation with a dynamic compression plate
Ġ. Unreamed intramedullary rod
Ġ. Multiple plane external fixator
Ģ. Inlet view of the pelvis
Ģ. Outlet view of the pelvis
Ĥ. AP view of the hip
Ĥ. Ilial oblique view (external oblique) of the hip
Ħ. Obturator oblique
Ħ. Glycolytic pathway
Ĩ. Oxidative phosphorylation
Ĩ. Breakdown of fat
Ī. Breakdown of protein
Ī. Breakdown of adenosine triphosphate
Ĭ. an MRI scan
Ĭ. arthroscopic examination
Į. AP and frog-lateral radiographs of the pelvis and hips
Į. varus and valgus stress radiographs of the knee
İ. physical examination of the knee under anesthesia
I. extended curettage and polymethylmethacrylate cementation
IJ. extra-articular resection of the knee and an allograft arthrodesis
IJ. wide resection of the proximal tibia and custom prosthetic replacement
Ĵ. prophylactic internal fixation and postoperative irradiation
Ĵ. excision of the lateral condyle and reconstruction with a hemicondylar allograft
Ķ. silicone implant joint replacement
Ķ. metatarsophalangeal joint arthrodesis
ĸ. metatarsophalangeal joint debridement
Ĺ. resection of the metatarsal head
Ĺ. resection of the base of the proximal phalanx
Ļ. Fixation of the syndesmosis has failed
Ļ. Widening of the ankle mortise has led to the failure of fixation
Ľ. Infection around the syndesmosis screw has led to osteomyelitis
Ľ. The syndesmosis screw is broken
Ŀ. Motion between the tibia and fibula has caused loosening of the syndesmosis screw
Ŀ. Microcephaly
Ł. A temporal lobe cyst
Ł. An Arnold-Chiari type 1 malformation
Ń. Periventricular leukomalacia
Ń. Agnesis of the corpus callosum
Ņ. Wolff’s
Ņ. Hooke’s
Ň. Hilton’s
Ň. Muller-Haeckel
ʼN. Heuter-Volkmann
Ŋ. Both the anterolateral and posteromedial bands are isometric and do not significantly change with flexion
Ŋ. The anterolateral band is lax and becomes tight in flexion, while the posteromedial band is tight, and becomes lax in flexion
Ō. The anterolateral band is tight and becomes lax in flexion, while the posteromedial band is lax and becomes tight in flexion
Ō. Both the anterolateral and posteromedial bands are lax and become tight in flexion
Ŏ. Both the anterolateral and posteromedial bands are tight and become lax as the knee is flexed
Ŏ. UCB orthosis
Ő. Rigid orthosis with a medical arch support
Ő. Semi-rigid orthosis with lateral forefoot posting
Œ. Semi-rigid orthosis with a medial arch support
Œ. Medial heel wedge attached to the running shoes
Ŕ. Hallux varus
Ŕ. Osteonecrosis
Ŗ. Recurrence of the hallux valgus
Ŗ. “Transfer” second metatarsalgia
Ř. Physeal arrest of the first metatarsal
Ř. Aseptic loosening in a 70-year-old patient
Ś. Mechanical failure of a hinged knee prosthesis
Ś. Failed knee replacement complicated by reflex sympathetic dystrophy
Ŝ. Infection with soft-tissue deficit
Ŝ. A prior patellectomy
Ş. Knee fusion
Ş. Open irrigation and debridement
Š. Arthroscopic irrigation and debridement
Š. One-stage exchange arthroplasty
Ţ. Two-stage exchange arthroplasty
Ţ. Putti-platt repair
Ť. Open Bankart repair
Ť. Injection of a subacromial corticosteroid
Ŧ. Arthroscopic transglenoid capsular shift
Ŧ. Rehabilitation of the scapular and rotator cuff muscles
Ũ. Silicone suction socket and an energy-absorbing foot
Ũ. Silicone suction socket and a variable resistance ankle
Ū. Plastic suction socket, telescoping pylon, and a solid ankle cushioned heel (SACH) foot
Ū. Plastic socket with a hinged thigh cuff and a SACH foot
Ŭ. Patellar tendon-bearing suction socket and a uniaxial hydraulic ankle
Ŭ. Parosteal
Ů. Periosteal
Ů. High-grade intramedullary
Ű. Osteosarcoma occurring in Paget’s disease
Ű. Osteosarcoma occurring in irradiated bone
Ų. Cauda equina
Ų. Conus medullaris
Ŵ. Genitofemoral nerve
Ŵ. Lumbar sympathetic plexus
Ŷ. Lumbar parasympathetic plexus
Ŷ. Spinal pseudoarthrosis
Ÿ. Spinal cord traction injury with paralysis
Ź. Arterial and venous thromboses
Ź. Superior mesenteric artery syndrome
Ż. Crankshaft phenomenon
Ż. Inversion stress radiograph
Ž. MRI scan
Ž. CT scan
S. Nuclear bone scan
Ƀ. External rotation stress radiograph
Ɓ. Complex deformity with an angulation in two planes
Ƃ. Single deformity less than 20 degrees, apex posterolateral
Ƃ. Single deformity greater than 30 degrees, apex posterolateral
Ƅ. Single deformity less than 20 degrees, apex posteromedial
Ƅ. Single deformity greater than 30 degrees, apex posteromedial
Ɔ. Pronation of the foot during the stance phase of gait
Ƈ. Heel inversion at the beginning of a single limb heel rise
Ƈ. Active inversion of the nonweightbearing foot
Ɖ. Active plantar flexion of the first ray against resistance
Ɗ. Active plantar flexion of the foot during the push-off phase of gait
Ƌ. Observation and repeat radiographs in 4 months
Ƌ. Application of a thoracolumbalsacral orthosis for 22 to 24 hours per day
ƍ. Electrical stimulation at night
Ǝ. Physical therapy
Ə. Begins to remodel and hypertrophy more quickly
Ɛ. Provides a better scaffold for osteoconduction
Ƒ. Reduces the risk of early fracture
Ƒ. Reduces technical difficulty
Ɠ. Lowers donor site morbidity
Ɣ. Anterior fusion of the lumbar curve
Ƕ. Anterior and posterior fusion of the thoracic curve
Ɩ. Posterior fusion of the thoracic curve
Ɨ. Posterior fusion of the thoracic and lumbar curves
Ƙ. Application of a brace until the iliac apophyses are Risser 4 or 5, followed by surgical correction
Ƙ. Subscapularis rupture
Ƚ. Type III SLAP lesion
ƛ. Disruption of capsular shift
Ɯ. Isolated traumatic subluxation
Ɲ. Injury to the axillary nerve after dislocation
Ƞ. hypophosphatemia
Ɵ. high dietary cholesterol intake
Ơ. deficiency of lipoprotein A
Ơ. deficiency of protein S and protein C
Ƣ. elevated levels of antithrombin III
Ƣ. Weightbearing short leg cast
Ƥ. Nonweightbearing short leg cast
Ƥ. Removable splint and early motion
Ʀ. Open reduction and internal fixation
Ƨ. Elastic compression bandage with full weightbearing
Ƨ. Breast
Ʃ. Prostate
ƪ. Gastrointestinal
ƫ. Kidney
Ƭ. Multiple myeloma
Ƭ. Varus stress
Ʈ. Valgus stress
Ư. Torsional loading
Ư. Hyperextension of the knee
Ʊ. Contraction of the quadriceps while axially loaded
Ʋ. Primary internal fixation at both fracture levels
Ƴ. External fixation as definitive ttt for both #
Ƴ. Skeletal traction and delayed internal fixation of both fractures
Ƶ. Primary internal fixation of the proximal fracture and delayed fixation of the femoral fracture
Ƶ. Primary internal fixation of the femoral shaft fracture and delayed fixation of the proximal #
Ʒ. Heel spur
Ƹ. Plantar fascitis
Ƹ. Dysfunction of the tibialis posterior tendon
ƺ. Compression of the first branch of the lateral plantar nerve
ƻ. Compression of the calcaneal nerve
Ƽ. Displaced labral tear
Ƽ. Tear of the rotator cuff
ƾ. Fracture of the glenoid rim
Ƿ. Palsy of the axillary nerve
ǀ. Palsy of the musculocutaneus nerve
ǁ. Enchondroma
ǂ. Osteoblastoma
ǃ. Giant cell tumor
DŽ. Aneurysmal bone cyst
DŽ. Fibrous dysplasia
DŽ. Arthrogram of the wrist
LJ. MRI scan of both wrists
LJ. CT scan of both wrists in the same position
LJ. Radiographs of the wrist in supination and pronation
NJ. Radiographs of the opposite wrist in the same position
NJ. Secondary hyperparathyroidism
NJ. Phosphate retention secondary to uremia
Ǎ. Insufficient renal synthesis of 1, 25 dihydroxy vitamin D
Ǎ. Aluminum deposition in bone from oral phosphate binders
Ǐ. Persistent acidosis aggravating the negative calcium balance
Ǐ. Posterior fusion at T10-L3 with segmental instrumentation
Ǒ. Laminectomy and fusion of T12-L2 with segmental instrumentation
Ǒ. Bed rest in a hyperextension brace
Ǔ. L1 vertebrectomy and anterior decompression with strut graft fusion and instrumentation
Ǔ. Progressive ambulation as tolerated in a custom-molded thoracolumbosacral orthosis
Ǖ. Positive-pressure ventilation
Ǖ. An immediate radiograph of the chest
Ǘ. Adjustment of the position of the endotrachael tube
Ǘ. Insertion of a large-bore needle into the pericardial space
Ǚ. Insertion of a large-bore needle in the right second intercostal space, midclavicular line
Ǚ. Allowing the ends of the fracture to touch
Ǜ. Adding a second connecting bar
Ǜ. Adding one pin to each fracture fragment
Ǝ. Increasing the pin diameter from 4 mm to 6 mm
Ǟ. Decreasing the connecting bar-to-bone distance from 6 cm to 4 cm
Ǟ. Osteomyelitis
Ǡ. Malignant degeneration
Ǡ. Stress fracture
Ǣ. Local recurrence of the giant cell tumor
Ǣ. Bone resorption due to methylmethacrylate
Ǥ. Advancement of the plantar plate
Ǥ. Resection of the second metatarsal head
Ǧ. Dorsiflexion osteotomy of the second metatarsal neck
Ǧ. Transfer of the flexor digitorum longus tendon to the dorsum of the toe
Ǩ. Transfer of the extensor digitorum comminus tendon to the metatarsal neck
Ǩ. Sacral fracture
Ǫ. Burst fracture of L5
Ǫ. Cauda equina syndrome
Ǭ. Distraction-flexion injury at L3
Ǭ. Distraction-extension injury at L3
Ǯ. An MRI scan of the shoulder
Ǯ. An MRI scan of the cervical spine
J̌. Electromyographic and nerve conduction velocity studies
DZ. Immobilization in a sling and early passive range of motion exercises
DZ. Immediate return to the operating room for exploration of the brachial plexus
DZ. cerclage wiring
Ǵ. tension band wiring
Ǵ. removal of the patellar component
Ƕ. revision of the patellar component
Ƿ. immobilization of the knee and protected weightbearing
Ǹ. Liposarcoma
Ǹ. Nodular fasciitis
Ǻ. Rabdomyosarcoma
Ǻ. Malignant fibrous histiocytoma
Ǽ. Extra-abdominal desmoid tumor
Ǽ. Clubfeet
Ǿ. Thrombocytopenia
Ǿ. Congenital scoliosis
Ȁ. Ventricular septal defect
Ȁ. Arnold-Chiari malformation
Ȃ. delayed primary closure
Ȃ. free flap
Ȅ. pedicle groin flap
Ȅ. full-thickness skin graft
Ȇ. split-thickness skin graft
Ȇ. Infection
Ȉ. Nonunion
Ȉ. Improper screw length
Ȋ. Osteonecrosis of the distal fragment
Ȋ. Use of a cortical screw instead of a cancellous screw
Ȍ. Infection
Ȍ. Tear of the rotator cuff
Ȏ. Loosening of the humeral component
Ȏ. Arthritis of the glenoid
Ȑ. Arthritis of the A-C joint
Ȑ. Reduced morbidity
Ȓ. Improved osteoinduction
Ȓ. Improved osteoconduction
Ȕ. More rapid revascularization
Ȕ. Lower risk of disease transmission
Ȗ. Manipulation Under Anesthesia
Ȗ. Arthroscopic acromioplasty
Ș. Arthroscopic debridement of G-H joint
Ș. Replacement of the humeral head
Ț. Lengthening of the subscapularis and release of the anterior capsule
Ț. Bacteroides
Ȝ. E. coli
Ȝ. Staph. aureus
Ȟ. group A streptococcus
Ȟ. Clostridium perforingens
Ƞ. observation and exercises
ȡ. bracing with a thoracolumbar orthosis
Ȣ. fusion of the posterior spine
Ȣ. fusion of the anterior spine
Ȥ. fusion of the anterior and posterior spine
Ȥ. Total wrist replacement and bridge grafts
Ȧ. palmar shelf arthroplasty and tendon transfers
Ȧ. Darrach distal ulna resection, dorsal tenosynosynovectomy, and tendon transfers
Ȩ. Radioscaphate fusion, extensor tenodesis, and Darrach distal ulna resection
Ȩ. Total wrist fusion and tendon transfers
Ȫ. constrained acetabular component
Ȫ. protrusion ring with morselized graft
Ȭ. cemented metal backed acetabular component
Ȭ. cemented all-polyethylene acetabular component
Ȯ. cementless hemispherical component with screw fixation
Ȯ. application of a hip abduction brace for 22 hours per day
Ȱ. application of a hip spica under anesthesia
Ȱ. discontinuance of all bracing and repeat radiographs in 3 months
Ȳ. open reduction of the hip and application of a spica cast
Ȳ. open reduction, varus osteotomy, and application of a spica cast
ȴ. Loss of skin hair on the feet
ȵ. Absent pulses on vascular examination
ȶ. Pain that originates proximally and spreads distally
ȷ. Pain that is relieved by stopping and standing
ȸ. Pain that is worse when the patient walks uphill rather downhill
ȹ. wrist flexors and finger flexors
Ⱥ. elbow flexors and wrist flexors
Ȼ. elbow flexors and finger flexors
Ȼ. elbow extensors and wrist flexorst Level Key Muscles4 DiaphragmDeltoid, elbow flexors, diaphragmElbow flexors, wrist extensorsElbow extensors, wrist flexorsFinger flexors (distal phalanx of middlefinger)Finger abductors (5th digit), intrinsics of hand2 Segmental innervation to intercostal muscles, abdominal and paraspinal muscles) L1, L2, L3 Hip flexors3, L4 QuadricepsTibialis anteriorToe extensors, hip abductorsAnkle plantarflexors, peronei
Ƚ. elbow extensors and wrist extensors
Ⱦ. Syndactyly
Ȿ. Macrodactyly
Ɀ. Camptodactyly
Ɂ. Preaxial polydactyly
Ɂ. Postaxial polydactyly
Ƀ. Arthrodesis
Ʉ. Rotationplasty
Ʌ. Above-knee amputation
Ɇ. Osteoarticular allograft
Ɇ. Endoprosthesis (custom arthroplasty)
Ɉ. Plantar fascia
Ɉ. Spring ligament
Ɋ. Deltoid ligament
Ɋ. Intrinsic tendons
Ɍ. Gastorcnemius-solelus complex
Ɍ. Prevention of presynaptic release of acetylcholine
Ɏ. Prevention of synthesis of presynaptic acetylcholine
Ɏ. Activation of acetylcholinesterase at the motor end-plate
Ɐ. Blockage of postsynaptic action of acetylcholine until reserves are depleted
Ɑ. Stimulation of release of presynaptic acetylcholine until reserves are depleted
Ɒ. stiffness of the femoral component.
Ɓ. head offset of the femoral component.
Ɔ. femoral component material modulus of elasticity.
ɕ. extent of the femoral component porous coating.
Ɖ. Presence of a femoral component collar.
Ɗ. plantar fascia and quadratus plantae tendon.
ɘ. ligamentous structures connecting the tarsal bones.
Ə. shape of the tarsal bones and the intervening joints.
ɚ. activity of the intrinsic muscles of the foot.
Ɛ. activity of the posterior tibialis and the peroneus longus muscles.
Ɜ. scapulothoracic fusion
ɝ. strengthening of the periscapular muscles
ɞ. pectoralis minor-fascia lata graft transfer to the scapula
ɟ. pectoralis major-fascia lata graft transfer to the scapula
Ɠ. exploration of the long thoracic nerve, with sural nerve graft
Ɡ. tricompartmental knee replacement
ɢ. unicompartmental knee replacement
Ɣ. medial compartment meniscal allograft
ɤ. valgus-producing distal femoral osteotomy
Ɥ. valgus-producing proximal tibial osteotomy
Ɦ. Internal rotation of the femoral component
ɧ. External rotation of the tibial component
Ɨ. Lateral placement of the femoral component
Ɩ. Medial placement of the patellar component
Ɪ. Excessive resection of the patella
Ɫ. Hallux rigidus
Ɬ. Hallux valgus
ɭ. Neuroma of the first web space
ɮ. Fracture of the sesamoid
Ɯ. Rupture of the flexor hallucis longus
ɰ. Sickle cell crisis
Ɱ. Idiopathic chondrolysis
Ɲ. Hemophilic arthropathy
ɳ. Osteoid osteoma of the femoral neck
ɴ. Legg-Calve-Perthes disease
Ɵ. Decreased ankle jerk and positive femoral nerve stretch test
ɶ. Decreased knee jerk and positive straight-leg raising sign
ɷ. Gastrocnemius-soleus complex weakness and positive straight-leg raising sign
ɸ. Weakness of the extensor hallucis longus and positive straight-leg raising sign
ɹ. Weakness of the extensor hallucis longus and positive femoral nerve stretch test
ɺ. Long-term administration of IV and oral antibiotics
ɻ. Open soft-tissue debridement, retention of prosthetic components, and IV antibiotics
ɼ. Immediate exchange arthroplasty with antibiotic-impregnated cement
Ɽ. Two-stage surgical prosthetic exchange and IV antibiotics
ɾ. Resection arthroplasty and IV antibiotics
ɿ. SCFE
Ʀ. MED
ʁ. Perthes disease
Ʂ. Hypothyroidism
Ʃ. Chondrolysis
ʄ. gout.
ʅ. osteoporosis.
ʆ. eosinophilic granuloma.
Ʇ. tuberculosis of the spine.
Ʈ. metastatic disease of the spine.
Ʉ. water content.
Ʊ. Synthesis of type I collagen.
Ʋ. Proteoglycan content.
Ʌ. Activity of chondrocytes.
ʍ. Synthesis of hyaluronate.
ʎ. Lung
ʏ. Breast
ʐ. Prostate
ʑ. Thyroid
Ʒ. Renal
ʓ. T1-low, T2-low.
ʔ. T1-low, T2-high.
ʕ. T1-moderate, T2-low.
ʖ. T1-high, T2-low.
ʗ. T1-high, T2-high.
ʘ. hypothesis is incorrect or invalid
ʙ. interobserver error rate is 4%.
ʚ. Standard deviation is 4% higher or lower than the mean.
ʛ. Sample size is 4% larger than required to be clinically significant.
ʜ. Probability that the differences noted between two study groups were due to chance alone is 4%.
Ʝ. I
Ʞ. II
ʟ. IV
ʠ. IX
ʡ. X
ʢ. Cranial setting
ʣ. Cranial subluxation
ʤ. Odontoid fracture
ʥ. Lysis of the arch of the atlas
ʦ. Atlantoaxial subluxation
ʧ. Retrograde collapse of the endoneurial tubes
ʨ. Irreversible atrophy of the denervated muscles
ʩ. Elongation of the axons across the zone of injury
ʪ. Sprouting of the axons at the neuromuscular junction
ʫ. Misdirection of the axons across the zone of injury
ʬ. Maximally pronated and elbow extended
ʭ. Maximally pronated and the elbow flexed
ʮ. Maximally supinated and the elbow flexed
ʯ. Maximally supinated and the elbow extended
ʰ. In neutral rotation, with the elbow extended
ʱ. open reduction and internal fixation
ʲ. buddy taping to the adjacent index finger
ʳ. early motion with application of a dynamic banjo splint
ʴ. application of a cast with the hand in a “safe position” for 3 weeks.
ʵ. dorsal extension block splinting
ʶ. The name of the manufacturer
ʷ. The manufacturer’s potential liability
ʸ. The physician’s clinical performance
ʹ. The physician’s materials testing data
ʺ. Any royalties the physician receives from the manufacturer
ʻ. Femoral
ʼ. Obturator
ʽ. Inferior gluteal
ʾ. Superior gluteal
ʿ. Lateral femoral cutaneous
ˀ. open biopsy and a long leg cast
ˁ. open biopsy and wide resection of the tumor
˂. a long leg cast and observation
˃. intramedullary stabilization and observation
˄. Triggering
˅. Lateral instability
ˆ. Swan-neck deformity
ˇ. Boutonniere deformity
ˈ. Loss of distal interphalangeal joint flexion
ˉ. Peroneus brevis to peroneus longus
ˊ. Peroneus tertius to extensor hallucis longus
ˋ. Peroneus tertius to superficial peroneal nerve
ˌ. Extensor hallucis longus to deep peroneal nerve
ˍ. Extensor hallucis longus to extensor digitorum longus
ˎ. reassurance that Medicare will pay for the treatment.
ˏ. consent forms that patients or their guardians are able to understand.
ː. a detailed description of the device, omitting the fact that it is part of a study.
ˑ. a provision that the patient’s care will be discontinued if he or she does not enroll in the study.
˒. a provision that the study will be carried out to completion, whether or not the device is as effective as those currently in existence.
˓. an onlay iliac crest bone graft.
˔. limited weightbearing and observation.
˕. removal of the implant and limited weightbearing.
˖. removal of the implant and insertion of a reamed femoral nail.
˗. removal of the implant and insertion of an unreamed femoral nail.
˘. Coronal
˙. Sagittal
˚. Anteromedial, midway between the sagittal and the coronal
˛. Proximal pins sagittal, distal pins coronal
˜. Proximal pins coronal, distal pins sagittal
˝. Rheumatoid arthritis
˞. Posttraumatic arthritis
˟. Degenerative osteoarthritis
ˠ. Osteonecrosis of the tibial plateau
ˡ. Osteonecrosis of the medial femoral condyle
ˢ. Trapeziometacarpal arthrodesis
ˣ. Osteotomy of the thumb metacarpal
ˤ. Arthrotomy and joint debridement
˥. Ligament reconstruction using one half of the flexor carpi radialis
˦. Trapezium resection, tendon interposition, and reconstruction of the ligament
˧. Creep
˨. Relaxation
˩. Energy dissipation
˪. Plastic deformation
˫. Elastic deformation
ˬ. bending
˭. axial loading
ˮ. high-speed rotation
˯. direct impact from anteromedial
˰. crush from anteromedial to posterolateral
˱. Increase stiffness
˲. Increase fracture toughness
˳. Increase fatigue strength
˴. Decrease mechanical strength
˵. Decrease wear rate
˶. disuse osteopenia
˷. paraendocrine effect of the tumor
˸. abnormally increased density on the right side
˹. side effect of the treatment of the lesion
˺. extensive tumor involvement of the left hip
˻. Sciatic nerve
˼. Superior gluteal artery
˽. Profunda femoris artery
˾. Femoral artery and nerve
˿. External iliac artery and vein
̀. Length
́. Moment arm
̂. Total volume
̃. Physiologic cross-sectional area
̄. Distribution of slow and fast twitch fibers
̅. decreasing initiation of action potentials.
̆. increasing action potential amplitude.
̇. blocking the opening of gated sodium channels.
̈. decreasing the number of functional motor units.
̉. slowing or stopping action potential propagation through the axon.
̊. resection of the metatarsal heads of the first through fifth toes.
̋. Silastic MP joint arthroplasties of the first through fifth toes.
̌. fusion of the hallux MP joint and resection arthroplasty of the 2nd through fifth metatarsal heads.
̍. fusion of hallux MP joint and distal osteotomy of the 2nd through 5th MT.
̎. plantar condylectomy of the 2nd through 5th MT heads & resection of proximal phx of the hallux.
̏. hemiarthroplasty
̐. open reduction and internal fixation
̑. closed reduction and percutaneous pinning
̒. a sling and early pedulum exercises
̓. a sling and swathe for 6 weeks, followed by shoulder rehabilitation
̔. open acromioplasty
̕. open Bankart repair
̖. open subscapularis tendon repair
̗. inferior capsular shift
̘. a supervised physical therapy program
̙. a sling and swathe, with pendulum exercises in 10 days
̚. open reduction and internal fixation through an anterior approach
̛. open reduction and internal fixation through a posterior approach
̜. immobilization with a splint in 45 degrees of abduction for 6 weeks
̝. arthroscopically assisted reduction and percutaneous screw fixation
̞. Repair of the rotator cuff
̟. Replacement of the humeral head
̠. Resection arthroplasty
̡. Total shoulder arthroplasty
̢. AP and lateral radiographs of the elbow
̣. Diagnositc arthroscopy
̤. Aspiration of joint fluid
̥. An erythrocyte sedimentation rate and CBC
̦. A diagnostic lidocaine injection
̧. Insulin-like growth factor (IGF-1)
̨. Fibroblast growth factor (FGF-1)
̩. Platelet-derived growth factor (PDGF)
̪. Transforming growth factor beta (TGF-B)
̫. Bone morphogenetic proteins (BMP)
̬. clinical history and radiographic findings.
̭. technetium bone scan
̮. flow cytometry pattern of extracted chondrocytes
̯. immunohistochemical staining patterns of a biopsy specimen
̰. histologic features of a biopsy specimen stained with hematoxylin-cosin
̱. Radial
̲. Radial recurrent
̳. Posterior interosseous
̴. Superior ulnar recurrent
̵. Superficial radial circumflex
̶. Impaired hydroxylation of proline
̷. Failure of cleavage in procollagen
̸. Defective binding sites for hydroxyproline
̹. Failure to incorporate glycine into the helix
̺. Diminished production of collagen through the rough endoplasmic reticulum
̻. Asking the legal staff to seek a court injunction
̼. Copying the patient’s chart and giving it to him as he leaves
̽. Having the patient sign a written legal contract that specifies acceptable behavior
̾. Continuing care of the patient until an appropriate referral can be arranged
̿. Transferring the patient to another orthopaedic surgeon without disclosing the realreason for why the patient is being transferred
̀. Meta-analysis
́. Confidence interval
͂. Analysis of variance (ANOVA)
̓. Statistical significance (p-value)
̈́. Survivorship analysis (Kaplan-Meier)
Ι. Spinal shock
͆. Neurogenic shock
͇. Hypovolemic shock
͈. Pulmonary embolism
͉. Fat embolus syndrome
͊. Lumbar spinal stenosis
͋. Metastatic disease of the spine
͌. Rheumatoid lumbar spondylitis
͍. Isthmic spondyloloisthesis
͎. Degenerative spondylolisthesis at L4-5 and L5-S1
͏. Patella alta
͐. A metal-backed patella
͑. Varus malalignment of the knee
͒. A posterior cruciate-substituting femoral component
͓. Lateral subluxation of the patella on a Merchant’s view
͔. The sesamoids are separated
͕. The sesamoid is fractured
͖. The proximal phx is on the neck of the metatarsal
͗. The dislocation is dorsal and centered
͘. The proximal phalanx is hyperextended
͙. Patella
͚. Tibial stem
͛. Distal femoral interface
͜. Posterior femoral interface
͝. Sites of screw fixation for the tibia
͞. Hallux rigidus
͟. Fracture of the sesamoid
͠. Disruption of the plantar plate
͡. Osteonecrosis of the metatarsal head
͢. Rupture of the flexor hallucis longus
ͣ. Gout
ͤ. Sepsis
ͥ. Old trauma
ͦ. Rheumatoid arthritis
ͧ. Charcot arthroplasty
ͨ. Aspiration and steroid injection
ͩ. Biopsy, curettage, and allograft bone grafting
ͪ. Percutaneous Kirschner wire fixation
ͫ. Percutaneous injection of autogenous bone marrow
ͬ. Nerve roots
ͭ. Spinal cord
ͮ. Sciatic nerve
ͯ. Peroneal nerve
Ͱ. Conus medullaris
Ͱ. Extent of bone penetrated by reaming, prosthetic components, or acrylic cement
Ͳ. Periprosthetic regions that are accessible to joint fluid and particulate wear debris
Ͳ. Enveloping pseudocapsular scar tissue that develops around a prosthetic hip following surgical capsulectomy
ʹ. Soft tissue and bone that are potentially contaminated with bacteria in the setting of a prosthetic joint infection
͵. Potential intrapelvic joint space communication created by acetabular fixation screws or intrapelvic extruded acrylic cement
Ͷ. Early and late infection
Ͷ. Periprosthetic fracture of the femur
͸. Failure of the patellofemoral and extensor mechanisms
͹. Aseptic loosening of cementing tibial components
ͺ. Asceptic loosening of cemented femoral components
Ͻ. Acceptance of the current position of the ankle
Ͼ. Open reduction and fixation in the epiphysis only
Ͽ. ORIF with a small-fragment T-plate from the malleolus up to the metaphysis
;. Closed reduction by eversion of the ankle and application of a bivalved long leg cast
Ϳ. CRUGA and fixation with a malleolar screw from the malleolus into the metaphysis
΀. Resection arthroplasty and local radiation
΁. In situ fusion of the hip
΂. Excision of heterotopic bone, total hip arthroplasty, and oral indomethacin
΃. Excision of heterotopic bone and local radiation
΄. Excision of heterotopic bone, hemiarthroplasty, and oral indomethacin
΅. Closed reduction of both fractures and immediate spica casting
Ά. Bilateral skin traction for 3 weeks, followed by spica casting
·. External fixation of both femora
Έ. External fixation of the left femur and a long leg cast brace for the right femur
Ή. External fixation of the left femur and use of a reamed intramedullary nail in the right femur
Ί. Synovial sarcoma
΋. Soft-tissue abcess
Ό. Rhabdomyosarcoma
΍. Eosinophilic granuloma
Ύ. Nodular pigmented villonodular synovitis
Ώ. Changing to a titanium nail
Ϊ́. Changing to a nonslotted nail
Α. Changing the cross-sectional shape of the nail
Β. Increasing the diameter of the nail by 3 mm
Γ. Increasing the diameter of the interlocking screws
Δ. Fracture healing
Ε. Chondrosarcoma
Ζ. Periosteal chondroma
Η. Periosteal osteosarcoma
Θ. Dysplasia epiphysealis hemimelica
Ι. Demonstrate competence in the subject of the case
Κ. Be fellowship trained in the subject of the case
Λ. Be paid on a contingency basis
Μ. Be board certified by the American Board of Orthopaedic Surgery
Ν. Have been involved in the case as a consultant
Ξ. Diagnostic arthroscopy
Ο. Arthroscopy and subacromial decompression
Π. Reduction and fixation of the proximal humeral epiphysis
Ρ. Temporary cessation of throwing
΢. Physical therapy for rotator cuff strengthening
Σ. Oblique popliteal ligament
Τ. Lateral capsule
Υ. Popliteal tendon
Φ. Fibular collateral ligament
Χ. Posterior oblique ligament
Ψ. Radial tear
Ω. Parrot-beak tear
Ϊ. Vertical tear in the “red-red” zone
Ϋ. Vertical tear in the “red-white” zone
Ά. Vertical tear in the “white-white” zone
Έ. 0 degrees of abduction, with neural rotation
Ή. 40 degrees of flexion and 60 degrees of internal rotation
Ί. 45 degrees of flexion and 45 degrees of external rotation
Ϋ́. 90 degrees of abduction with neutral rotation
Α. 90 degrees of abduction and 90 degrees of external rotation
Β. Sural
Γ. Saphenous and its branches
Δ. Posterior tibial and its branches
Ε. Deep peroneal and its branches
Ζ. Superficial peroneal and its branches
Η. Strength
Θ. Stiffness
Ι. Shelf life
Κ. Antigenicity
Λ. Risk of HIV transmission
Μ. Indemnification
Ν. Occurrence
Ξ. Excess liability
Ο. Claims-made
Π. Nose
Ρ. Lateral Y
Σ. Scapular AP
Σ. Neutral rotation AP
Τ. Internal rotation AP
Υ. External rotation AP
Φ. Trauma
Χ. Hemophilia
Ψ. Reiter’s syndrome
Ω. Rheumatoid arthritis
Ϊ. Systemic lupus erythematosus
Ϋ. Cast immobilization for 6 weeks
Ό. Activity modification and re-evaluation in 2 months
Ύ. Internal fixation with or without bone grafting
Ώ. Retrograde drilling of the defect without articular cartilage penetration
Ϗ. Drilling of the defect directly through the articular cartilage
Β. repair or reconstruction of the medial collateral ligament
Θ. repair or reconstruction of the medialand lateral collateral ligaments
ϒ. immobilization for 5 days or less
ϓ. immobilization for 14 days
ϔ. immobilization for 25 days
Φ. Cystinosis
Π. Hypophosphatemia
Ϗ. Renal osteodystrophy
Ϙ. Primary hyperparathyroidism
Ϙ. Nutritional vitamin D deficiency
Ϛ. Lateral meniscus tear
Ϛ. Popliteus tenosynovitis
Ϝ. Iliotibial band friction syndrome
Ϝ. Peroneal nerve entrapment
Ϟ. Biceps tendinitis
Ϟ. Observation
Ϡ. Removal of the prosthetic components
Ϡ. Operative exploration and decompression of the peroneal nerve
Ϣ. Nerve conduction velocity studies
Ϣ. Loosening of the primary dressings and knee flexion to 30 degrees
Ϥ. I
Ϥ. II
Ϧ. III
Ϧ. decreased tissue tension
Ϩ. decreased abductor lever arm
Ϩ. decreased joint reaction force
Ϫ. increased body weight over lever arm
Ϫ. increased polyethylene wear rate
Ϭ. recurrent traumatic anterior dislocation
Ϭ. recurrent traumatic posterior dislocation
Ϯ. traumatic subluxation with no previous dislocation
Ϯ. traumatic anterior subluxation
Κ. atraumatic involuntary subluxation
Ρ. radial
Ϲ. axillary
Ϳ. suprascapular
ϴ. thoracodorsal
Ε. long thoracic
϶. Flexion
Ϸ. Extension
Ϸ. Axial rotation
Ϲ. Left lateral bending
Ϻ. Right lateral bending
Ϻ. Skin
ϼ. Lung
Ͻ. Brain
Ͼ. Heart
Ͽ. Kidney
Ѐ. Thoracoacromial, lateral thoracic, subscapular
Ё. Thoracoacromial, anterior humeral circumflex, posterior humeral circumflex
Ђ. Posterior humeral circumflex, subscapular, thoracacromial
Ѓ. Subscapular, thoracacromial, anterior humeral circumflex
Є. Lateral thoracic, anterior humeral circumflex, thoracacromial
Ѕ. Respondeat superior
І. Indemnity agreement
Ї. Hold harmless agreement- attempt to shift liability from company to physician
Ј. Comparative negligence-% of involvement
Љ. Contributory negligence- resident contributed to the negligence
Њ. t-type
Ћ. both column
Ќ. transverse
Ѝ. anterior column
Ў. anterior column posterior hemitransverse
Џ. Posterior interosseous
А. Anterior interosseous
Б. Radial
В. Median
Г. Ulnar
Д. Shock from hypovolemia
Е. Associated rupture of the bladder
Ж. Arterial bleeding on pelvic angiogram
З. Presence of a hematoma in the perineum and scrotum
И. Fractures of both the anterior and posterior pelvic ring

Correct Answer & Explanation

. Ewing’s sarcoma


Explanation

Question 4069

Topic: 10. Pathology and Oncology

At the time of acetabular revision, retention of well-fixed femoral components inserted with first-generation cementing technique is most commonly associated with which of the following factors?

. Higher subsequent loosening rate of the femoral component
. Higher subsequent polyethylene wear rate
. Higher subsequent dislocation rate
. Higher infection rate
. Unaltered subsequent survival rate of the femoral component
. Crevice corrosion
. Oscillatory fretting
. Oxidative degradation
. Adhesion and abrasion
. Fatigue and delamination
. a total contact cast.
. partial calcanectomy
. Syme’s amputation
. transtibial amputation.
. nonweightbearing and IV antibiotics.
. Sural artery island flap.
. Free rectus abdominis flap.
. Extensor digitorum brevis flap.
. Staged cross leg flap.
. Split-thickness skin graft.
. An anterior cruciate functional knee brace.
. A physical therapy program.
. Reconstruction of the posterior cruciate ligament and the posterolateral corner.
. Reconstruction of the posterior cruciate ligament.
. Reconstruction of the anterior cruciate ligament.
. Avoids the risk of marrow emboli
. Avoids injury to the intramedullary nutrient vessels
. Results in faster healing of fractures
. Results in more secure fixation
. Results in faster regeneration of the endosteal blood supply
. Above-knee amputation
. En bloc resection of the lesion and reconstruction with a bone graft
!. Closed reduction and immobilization in a cast
". Open reduction and internal fixation, followed by radiation therapy
#. Open reduction, curettage, and cementing of the lesion
$. Injury to the subclavian artery
%. Injury to the brachial plexus
&. Segmental fracture
'. 100% displacement
(. Associated displaced surgical neck fracture of the humerus
). humeral arthroplasty2/. repair of the rotator cuff
*. closed reduction and immobilization
+. open reduction and immobilization
,. open reduction and early passive motion
-. arthroscopic capsular release
.. manipulation under anesthesia
/. a physical therapy program
0. an intra-articular corticosteroid injection
1. administration of high-dose oral corticosteroids
2. adding the scores, in all five body systems
3. adding the squares of the scores in the three most severely injured systems
4. doubling the cumulative score for head and chest injuries
5. combining the scores from the most and least injured systems
6. correcting the score in the most severely injured system for age
7. traumatic femoral head fracture
8. osteonecrosis
9. osteoarthritis
:. neuropathic joint
;. rheumatoid arthritis
<. low-dose radiation
=. steroid injection
>. a load-relieving insert and shoe modification
?. complete excision of the mass and the entire plantar fascia
@. wide excision of the mass with a 2 cm margin of normal fascia
A. CT scan of the chest
B. technetium bone scan
C. bone marrow aspiration
D. serum protein electrophoresis
E. lateral skull radiograph
F. high-grade histology of the initial tumor
G. multiple local recurrences after curettage
H. previous treatment of the tumor with cryotherapy
I. previous treatment of the tumor with radiation therapy
J. extraosseous extension into two or more adjacent compartments
K. Dorsal rhizotomy and facet joint fusion
L. Multilevel corpectomy and spinal stabilization
M. Central and lateral recess decompression and bilateral foraminotomy
N. Central decompression and facet joint fusion
O. Central decompression, foraminotomy, and spinal fusion from L2 to L5.
P. Inadequate rehabilitation
Q. Displacement of the coronoid process fracture
R. Insufficiency of the lateral ulnar collateral ligament
S. Insufficiency of the anterior band of the medial collateral ligament
T. Insufficiency of the posterior band of the medial collateral ligament
U. Osteotomy and intramedullary rod fixation
V. Electrical stimulation
W. Strut-autografing the concavity the tibia
X. A patellar tendon-bearing brace
Y. Percutaneous injection of demineralized bone matrix
Z. digoxin
[. sucralfate
\. clindamycin
]. alcohol
^. neuromuscular blocking agents
_. Unrestrained roll-back
`. Unrestrained rotational conformity
A. Medial-Lateral conformity
B. Anteroposterior conformity in flexion
C. Anteroposterior conformity in extension
D. Arthrodesis of the MTP joint
E. A Silastic implant of the MTP joint
F. Resection arthroplasty of the MTP joint
G. Cheilctomy of the MTP joint
H. Osteotomy of the base of the proximal phalanx
I. Genu varum
J. Tarsal coalition
K. Degenerative ankle arthrosis
L. Osteochondritis dissecans of the talus
M. Hemihypertrophy of the ipsilateral lower extremity
N. Trabecular bone is preferentially resorbed in this high bone turnover state
O. Loss of water content in the disk increases impact load to the vetrebral bodies
P. Stress is imposed by the relative stiffness of the arthrtic facet joints
Q. Increased energy demands are imposed by decreased circulation to the vertebral body
R. The thick cortical bone found in the vertebral body resorbs rapidly following estrogen withdrawal
S. Increased time in stance and swing phase
T. Addition of a double leg float phase
U. Decreased vertical ground reaction forces
V. Decreased arc of motion in the hip, knee, and ankle
W. Decreased joint reaction forces in the hip, knee, and ankle
X. Talonavicular arthrodesis
Y. Medial displacement calcaneal osteotomy
Z. Flexor digitorum longus tendon transfer with spring ligament advancement
{. Triple arthrodesis
|. Calcaneocuboid distraction arthrodesis and repair of the posterior tibial tendon
}. Lymphoma
~. Hemangioma
. Osteosarcoma
€. TB of the spine
. Metastatic breast carcinoma
‚. widening and shortening of the heel.
ƒ. weakness of the gastrocnemius-soleus complex.
„. anterior impingement from a horizontal talus.
…. unrecognized compartment syndrome of the foot.
†. degenerative arthritis of the tibiotalar joint.
‡. a corrective osteotomy
ˆ. application of braces
‰. medial physeal stapling until the varus corrects
Š. observation
‹. application of corrective casts
Œ. a total contact cast.
. electrical stimulation.
Ž. an off the shelf fracture brace.
. an elastic compression bandage and crutches.
. a hard soled shoe until the patient is asymptomatic.
‘. Ewings tumor
’. Parosteal osteosarcoma
“. Dedifferentiated chondrosarcoma
”. Low grade intramedullary chondrosarcoma
•. High grade intramedullary osteosarcoma
–. Vascular injury
—. Tear of the rotator cuff
˜. Injury to the brachial plexus
™. Fracture of the upper thoracic rib
š. Fracture of the proximal humerus
›. Biceps
œ. Trapezius
. Infraspinatus
ž. Pectoralis major
Ÿ. Serratus anterior
 . Hybrid total hip arthroplasty
¡. Noncemental hemiarthroplasty of the hip
¢. Closed reduction and percutaneous pin fixation
£. Open reduction through an anterior approach to the hip
¤. Excision of the head fragment
¥. a quadratus femoris pediclebone graft
¦. a proximal femoral allograft
§. intertrochanteric osteotomy
¨. total hip arthroplasty
©. hip hemiarthroplasty
ª. Echocardiogram
«. Electrocardiogram
¬. Radiograph of the chest
­. CT scan of the shoulder
®. Ultrasound of the shoulder
¯. Ilioinguinal
°. Extended iliofemoral
±. Combined ilioinguinal and Kocher-Langenbeck (posterior)
². Kocher-Langenbeck (posterior)
³. Kocher-Langenbeck (posterior) with trochanteric osteotomy
´. Deltoid
Μ. Supraspinatus
¶. Subscapularis Infraspinatus
·. Infraspinatus
¸. Infraspinatus and teres minor
¹. an orthosis.
º. observation.
». electrical stimulation.
¼. open reduction and internal fixation.
½. application of a nonweightbearing short leg cast.
¾. repair of the rotator cuff.
¿. rehabilitation of the shoulder
À. replacement of the humeral head.
Á. arthroscopic acromioplasty and debridement.
Â. immobilization is a sling until pain resolves.
Ã. Bone rotation versus torque applied
Ä. Bone deflection versus bending moment applied
Å. Axial displacement versus tension applied
Æ. Lateral translation versus shear force applied
Ç. Fracture gap closing versus compressive force applied
È. steroid injection
É. stretching of the heel cord
Ê. surgical release of the plantar fascia
Ë. application of a short leg cast for 6 to 8 weeks
Ì. wearing dorsiflexion night splints
Í. Open bladder
Î. Bilateral “hitchhiker’s” thumbs
Ï. Bilateral defects in the midclavicles
Ð. Rhizomelic shortening of the extremities
Ñ. Radiographic fragmentation of all major epiphyses
Ò. Medial patellotibial
Ó. Medial patellofemoral
Ô. Medial patellomeniscal
Õ. Lateral patellofemoral
Ö. Lateral patellotibial
×. Heat
Ø. Gentle active flexion-extension exercises
Ù. Isokinetic strengthening
Ú. Electrical muscle stimulation
Û. Immobilization of the limb with the knee in full flexion
Ü. Distal chevron osteotomy with soft-tissue release
Ý. Distal soft-tissue realignment only
Þ. Closing wedge osteotomy (Aken) of the proximal phalanx
SS. Proximal first metatarsal osteotomy only
À. Soft-tissue realignment with a proximal metatarsal osteotomy
Á. Vagus
Â. Phrenic
Ã. Hypoglossal
Ä. Recurrent laryngeal
Å. Inferior thyroid
Æ. Surgical exploration
Ç. Application of leeches
È. Stellate ganglion blocks
É. Intra-arterial streptokinase
Ê. Elevation and reevaluation in 1 hour
Ë. Liver profile
Ì. Myleogram
Í. Platelet count
Î. CT scan of the head
Ï. Angiogram of the extremity
Ð. Post spinal fusion from L5to S1
Ñ. Primary repair with an iliac bone graft
Ò. Post spinal fusion of L4-5
Ó. A pantaloon body cast and 6 weeks of bed rest
Ô. Rest, NSAIDS, and limited dancing
Õ. Stress fracture of the proximal fifth metatarsal
Ö. Stress fracture of the base of the second metatarsal
÷. Stress fracture of the neck of the second metatarsal
Ø. Morton’s neuroma
Ù. Lisfranc’s joint subluxation
Ú. C5 radiculopathy
Û. Subscapularis rupture
Ü. Glenohumeral arthrosis
Ý. Rotator cuff arthropathy
Þ. Suprascapular nerve compression at the spinoglenoid notch
Ÿ. mm femoral head in combination with a metal-backed polyethylene component
Ā. mm femoral head in combination with an all-polyethylene acetabular component
Ā. mm femoral head in combination with a metal-backed polyethylene component
Ă. mm femoral head in combination with an all-polyethylene component
Ă. mm femoral head in combination with a metal-backed polyethylene component
Ą. Female gender
Ą. History of cigarette smoking
Ć. L5-S1 spondylolisthesis on pre-employment radiography
Ć. Decreased strength of the lower extremities on pre-employment testing
Ĉ. Decreased flexibility of the lumbar spine on pre-employment testing
Ĉ. Size of cells
Ċ. Amount of DNA in cells
Ċ. Nucleus-cytoplasm ratio
Č. Specific DNA sequences
Č. Specific messenger RNA sequences
Ď. Femoral and obturator nerves
Ď. Femoral and superior gluteal nerves
Đ. Femoral and lateral femoral cutaneous nerves
Đ. Obturator and superior gluteal nerves
Ē. Obturator and lateral femoral cutaneous nerves
Ē. Isotonic
Ĕ. Isokinetic
Ĕ. Isometric
Ė. Open kinetic chain
Ė. Dynamic variable resistance
Ę. Closed reduction and cast immobilization
Ę. Uniplanar external fixation
Ě. Open reduction and internal fixation with a dynamic compression plate
Ě. Unreamed intramedullary rod
Ĝ. Multiple plane external fixator
Ĝ. Inlet view of the pelvis
Ğ. Outlet view of the pelvis
Ğ. AP view of the hip
Ġ. Ilial oblique view (external oblique) of the hip
Ġ. Obturator oblique
Ģ. Glycolytic pathway
Ģ. Oxidative phosphorylation
Ĥ. Breakdown of fat
Ĥ. Breakdown of protein
Ħ. Breakdown of adenosine triphosphate
Ħ. an MRI scan
Ĩ. arthroscopic examination
Ĩ. AP and frog-lateral radiographs of the pelvis and hips
Ī. varus and valgus stress radiographs of the knee
Ī. physical examination of the knee under anesthesia
Ĭ. extended curettage and polymethylmethacrylate cementation
Ĭ. extra-articular resection of the knee and an allograft arthrodesis
Į. wide resection of the proximal tibia and custom prosthetic replacement
Į. prophylactic internal fixation and postoperative irradiation
İ. excision of the lateral condyle and reconstruction with a hemicondylar allograft
I. silicone implant joint replacement
IJ. metatarsophalangeal joint arthrodesis
IJ. metatarsophalangeal joint debridement
Ĵ. resection of the metatarsal head
Ĵ. resection of the base of the proximal phalanx
Ķ. Fixation of the syndesmosis has failed
Ķ. Widening of the ankle mortise has led to the failure of fixation
ĸ. Infection around the syndesmosis screw has led to osteomyelitis
Ĺ. The syndesmosis screw is broken
Ĺ. Motion between the tibia and fibula has caused loosening of the syndesmosis screw
Ļ. Microcephaly
Ļ. A temporal lobe cyst
Ľ. An Arnold-Chiari type 1 malformation
Ľ. Periventricular leukomalacia
Ŀ. Agnesis of the corpus callosum
Ŀ. Wolff’s
Ł. Hooke’s
Ł. Hilton’s
Ń. Muller-Haeckel
Ń. Heuter-Volkmann
Ņ. Both the anterolateral and posteromedial bands are isometric and do not significantly change with flexion
Ņ. The anterolateral band is lax and becomes tight in flexion, while the posteromedial band is tight, and becomes lax in flexion
Ň. The anterolateral band is tight and becomes lax in flexion, while the posteromedial band is lax and becomes tight in flexion
Ň. Both the anterolateral and posteromedial bands are lax and become tight in flexion
ʼN. Both the anterolateral and posteromedial bands are tight and become lax as the knee is flexed
Ŋ. UCB orthosis
Ŋ. Rigid orthosis with a medical arch support
Ō. Semi-rigid orthosis with lateral forefoot posting
Ō. Semi-rigid orthosis with a medial arch support
Ŏ. Medial heel wedge attached to the running shoes
Ŏ. Hallux varus
Ő. Osteonecrosis
Ő. Recurrence of the hallux valgus
Œ. “Transfer” second metatarsalgia
Œ. Physeal arrest of the first metatarsal
Ŕ. Aseptic loosening in a 70-year-old patient
Ŕ. Mechanical failure of a hinged knee prosthesis
Ŗ. Failed knee replacement complicated by reflex sympathetic dystrophy
Ŗ. Infection with soft-tissue deficit
Ř. A prior patellectomy
Ř. Knee fusion
Ś. Open irrigation and debridement
Ś. Arthroscopic irrigation and debridement
Ŝ. One-stage exchange arthroplasty
Ŝ. Two-stage exchange arthroplasty
Ş. Putti-platt repair
Ş. Open Bankart repair
Š. Injection of a subacromial corticosteroid
Š. Arthroscopic transglenoid capsular shift
Ţ. Rehabilitation of the scapular and rotator cuff muscles
Ţ. Silicone suction socket and an energy-absorbing foot
Ť. Silicone suction socket and a variable resistance ankle
Ť. Plastic suction socket, telescoping pylon, and a solid ankle cushioned heel (SACH) foot
Ŧ. Plastic socket with a hinged thigh cuff and a SACH foot
Ŧ. Patellar tendon-bearing suction socket and a uniaxial hydraulic ankle
Ũ. Parosteal
Ũ. Periosteal
Ū. High-grade intramedullary
Ū. Osteosarcoma occurring in Paget’s disease
Ŭ. Osteosarcoma occurring in irradiated bone
Ŭ. Cauda equina
Ů. Conus medullaris
Ů. Genitofemoral nerve
Ű. Lumbar sympathetic plexus
Ű. Lumbar parasympathetic plexus
Ų. Spinal pseudoarthrosis
Ų. Spinal cord traction injury with paralysis
Ŵ. Arterial and venous thromboses
Ŵ. Superior mesenteric artery syndrome
Ŷ. Crankshaft phenomenon
Ŷ. Inversion stress radiograph
Ÿ. MRI scan
Ź. CT scan
Ź. Nuclear bone scan
Ż. External rotation stress radiograph
Ż. Complex deformity with an angulation in two planes
Ž. Single deformity less than 20 degrees, apex posterolateral
Ž. Single deformity greater than 30 degrees, apex posterolateral
S. Single deformity less than 20 degrees, apex posteromedial
Ƀ. Single deformity greater than 30 degrees, apex posteromedial
Ɓ. Pronation of the foot during the stance phase of gait
Ƃ. Heel inversion at the beginning of a single limb heel rise
Ƃ. Active inversion of the nonweightbearing foot
Ƅ. Active plantar flexion of the first ray against resistance
Ƅ. Active plantar flexion of the foot during the push-off phase of gait
Ɔ. Observation and repeat radiographs in 4 months
Ƈ. Application of a thoracolumbalsacral orthosis for 22 to 24 hours per day
Ƈ. Electrical stimulation at night
Ɖ. Physical therapy
Ɗ. Begins to remodel and hypertrophy more quickly
Ƌ. Provides a better scaffold for osteoconduction
Ƌ. Reduces the risk of early fracture
ƍ. Reduces technical difficulty
Ǝ. Lowers donor site morbidity
Ə. Anterior fusion of the lumbar curve
Ɛ. Anterior and posterior fusion of the thoracic curve
Ƒ. Posterior fusion of the thoracic curve
Ƒ. Posterior fusion of the thoracic and lumbar curves
Ɠ. Application of a brace until the iliac apophyses are Risser 4 or 5, followed by surgical correction
Ɣ. Subscapularis rupture
Ƕ. Type III SLAP lesion
Ɩ. Disruption of capsular shift
Ɨ. Isolated traumatic subluxation
Ƙ. Injury to the axillary nerve after dislocation
Ƙ. hypophosphatemia
Ƚ. high dietary cholesterol intake
ƛ. deficiency of lipoprotein A
Ɯ. deficiency of protein S and protein C
Ɲ. elevated levels of antithrombin III
Ƞ. Weightbearing short leg cast
Ɵ. Nonweightbearing short leg cast
Ơ. Removable splint and early motion
Ơ. Open reduction and internal fixation
Ƣ. Elastic compression bandage with full weightbearing
Ƣ. Breast
Ƥ. Prostate
Ƥ. Gastrointestinal
Ʀ. Kidney
Ƨ. Multiple myeloma
Ƨ. Varus stress
Ʃ. Valgus stress
ƪ. Torsional loading
ƫ. Hyperextension of the knee
Ƭ. Contraction of the quadriceps while axially loaded
Ƭ. Primary internal fixation at both fracture levels
Ʈ. External fixation as definitive ttt for both #
Ư. Skeletal traction and delayed internal fixation of both fractures
Ư. Primary internal fixation of the proximal fracture and delayed fixation of the femoral fracture
Ʊ. Primary internal fixation of the femoral shaft fracture and delayed fixation of the proximal #
Ʋ. Heel spur
Ƴ. Plantar fascitis
Ƴ. Dysfunction of the tibialis posterior tendon
Ƶ. Compression of the first branch of the lateral plantar nerve
Ƶ. Compression of the calcaneal nerve
Ʒ. Displaced labral tear
Ƹ. Tear of the rotator cuff
Ƹ. Fracture of the glenoid rim
ƺ. Palsy of the axillary nerve
ƻ. Palsy of the musculocutaneus nerve
Ƽ. Enchondroma
Ƽ. Osteoblastoma
ƾ. Giant cell tumor
Ƿ. Aneurysmal bone cyst
ǀ. Fibrous dysplasia
ǁ. Arthrogram of the wrist
ǂ. MRI scan of both wrists
ǃ. CT scan of both wrists in the same position
DŽ. Radiographs of the wrist in supination and pronation
DŽ. Radiographs of the opposite wrist in the same position
DŽ. Secondary hyperparathyroidism
LJ. Phosphate retention secondary to uremia
LJ. Insufficient renal synthesis of 1, 25 dihydroxy vitamin D
LJ. Aluminum deposition in bone from oral phosphate binders
NJ. Persistent acidosis aggravating the negative calcium balance
NJ. Posterior fusion at T10-L3 with segmental instrumentation
NJ. Laminectomy and fusion of T12-L2 with segmental instrumentation
Ǎ. Bed rest in a hyperextension brace
Ǎ. L1 vertebrectomy and anterior decompression with strut graft fusion and instrumentation
Ǐ. Progressive ambulation as tolerated in a custom-molded thoracolumbosacral orthosis
Ǐ. Positive-pressure ventilation
Ǒ. An immediate radiograph of the chest
Ǒ. Adjustment of the position of the endotrachael tube
Ǔ. Insertion of a large-bore needle into the pericardial space
Ǔ. Insertion of a large-bore needle in the right second intercostal space, midclavicular line
Ǖ. Allowing the ends of the fracture to touch
Ǖ. Adding a second connecting bar
Ǘ. Adding one pin to each fracture fragment
Ǘ. Increasing the pin diameter from 4 mm to 6 mm
Ǚ. Decreasing the connecting bar-to-bone distance from 6 cm to 4 cm
Ǚ. Osteomyelitis
Ǜ. Malignant degeneration
Ǜ. Stress fracture
Ǝ. Local recurrence of the giant cell tumor
Ǟ. Bone resorption due to methylmethacrylate
Ǟ. Advancement of the plantar plate
Ǡ. Resection of the second metatarsal head
Ǡ. Dorsiflexion osteotomy of the second metatarsal neck
Ǣ. Transfer of the flexor digitorum longus tendon to the dorsum of the toe
Ǣ. Transfer of the extensor digitorum comminus tendon to the metatarsal neck
Ǥ. Sacral fracture
Ǥ. Burst fracture of L5
Ǧ. Cauda equina syndrome
Ǧ. Distraction-flexion injury at L3
Ǩ. Distraction-extension injury at L3
Ǩ. An MRI scan of the shoulder
Ǫ. An MRI scan of the cervical spine
Ǫ. Electromyographic and nerve conduction velocity studies
Ǭ. Immobilization in a sling and early passive range of motion exercises
Ǭ. Immediate return to the operating room for exploration of the brachial plexus
Ǯ. cerclage wiring
Ǯ. tension band wiring
J̌. removal of the patellar component
DZ. revision of the patellar component
DZ. immobilization of the knee and protected weightbearing
DZ. Liposarcoma
Ǵ. Nodular fasciitis
Ǵ. Rabdomyosarcoma
Ƕ. Malignant fibrous histiocytoma
Ƿ. Extra-abdominal desmoid tumor
Ǹ. Clubfeet
Ǹ. Thrombocytopenia
Ǻ. Congenital scoliosis
Ǻ. Ventricular septal defect
Ǽ. Arnold-Chiari malformation
Ǽ. delayed primary closure
Ǿ. free flap
Ǿ. pedicle groin flap
Ȁ. full-thickness skin graft
Ȁ. split-thickness skin graft
Ȃ. Infection
Ȃ. Nonunion
Ȅ. Improper screw length
Ȅ. Osteonecrosis of the distal fragment
Ȇ. Use of a cortical screw instead of a cancellous screw
Ȇ. Infection
Ȉ. Tear of the rotator cuff
Ȉ. Loosening of the humeral component
Ȋ. Arthritis of the glenoid
Ȋ. Arthritis of the A-C joint
Ȍ. Reduced morbidity
Ȍ. Improved osteoinduction
Ȏ. Improved osteoconduction
Ȏ. More rapid revascularization
Ȑ. Lower risk of disease transmission
Ȑ. Manipulation Under Anesthesia
Ȓ. Arthroscopic acromioplasty
Ȓ. Arthroscopic debridement of G-H joint
Ȕ. Replacement of the humeral head
Ȕ. Lengthening of the subscapularis and release of the anterior capsule
Ȗ. Bacteroides
Ȗ. E. coli
Ș. Staph. aureus
Ș. group A streptococcus
Ț. Clostridium perforingens
Ț. observation and exercises
Ȝ. bracing with a thoracolumbar orthosis
Ȝ. fusion of the posterior spine
Ȟ. fusion of the anterior spine
Ȟ. fusion of the anterior and posterior spine
Ƞ. Total wrist replacement and bridge grafts
ȡ. palmar shelf arthroplasty and tendon transfers
Ȣ. Darrach distal ulna resection, dorsal tenosynosynovectomy, and tendon transfers
Ȣ. Radioscaphate fusion, extensor tenodesis, and Darrach distal ulna resection
Ȥ. Total wrist fusion and tendon transfers
Ȥ. constrained acetabular component
Ȧ. protrusion ring with morselized graft
Ȧ. cemented metal backed acetabular component
Ȩ. cemented all-polyethylene acetabular component
Ȩ. cementless hemispherical component with screw fixation
Ȫ. application of a hip abduction brace for 22 hours per day
Ȫ. application of a hip spica under anesthesia
Ȭ. discontinuance of all bracing and repeat radiographs in 3 months
Ȭ. open reduction of the hip and application of a spica cast
Ȯ. open reduction, varus osteotomy, and application of a spica cast
Ȯ. Loss of skin hair on the feet
Ȱ. Absent pulses on vascular examination
Ȱ. Pain that originates proximally and spreads distally
Ȳ. Pain that is relieved by stopping and standing
Ȳ. Pain that is worse when the patient walks uphill rather downhill
ȴ. wrist flexors and finger flexors
ȵ. elbow flexors and wrist flexors
ȶ. elbow flexors and finger flexors
ȷ. elbow extensors and wrist flexorst Level Key Muscles4 DiaphragmDeltoid, elbow flexors, diaphragmElbow flexors, wrist extensorsElbow extensors, wrist flexorsFinger flexors (distal phalanx of middlefinger)Finger abductors (5th digit), intrinsics of hand2 Segmental innervation to intercostal muscles, abdominal and paraspinal muscles) L1, L2, L3 Hip flexors3, L4 QuadricepsTibialis anteriorToe extensors, hip abductorsAnkle plantarflexors, peronei
ȸ. elbow extensors and wrist extensors
ȹ. Syndactyly
Ⱥ. Macrodactyly
Ȼ. Camptodactyly
Ȼ. Preaxial polydactyly
Ƚ. Postaxial polydactyly
Ⱦ. Arthrodesis
Ȿ. Rotationplasty
Ɀ. Above-knee amputation
Ɂ. Osteoarticular allograft
Ɂ. Endoprosthesis (custom arthroplasty)
Ƀ. Plantar fascia
Ʉ. Spring ligament
Ʌ. Deltoid ligament
Ɇ. Intrinsic tendons
Ɇ. Gastorcnemius-solelus complex
Ɉ. Prevention of presynaptic release of acetylcholine
Ɉ. Prevention of synthesis of presynaptic acetylcholine
Ɋ. Activation of acetylcholinesterase at the motor end-plate
Ɋ. Blockage of postsynaptic action of acetylcholine until reserves are depleted
Ɍ. Stimulation of release of presynaptic acetylcholine until reserves are depleted
Ɍ. stiffness of the femoral component.
Ɏ. head offset of the femoral component.
Ɏ. femoral component material modulus of elasticity.
Ɐ. extent of the femoral component porous coating.
Ɑ. Presence of a femoral component collar.
Ɒ. plantar fascia and quadratus plantae tendon.
Ɓ. ligamentous structures connecting the tarsal bones.
Ɔ. shape of the tarsal bones and the intervening joints.
ɕ. activity of the intrinsic muscles of the foot.
Ɖ. activity of the posterior tibialis and the peroneus longus muscles.
Ɗ. scapulothoracic fusion
ɘ. strengthening of the periscapular muscles
Ə. pectoralis minor-fascia lata graft transfer to the scapula
ɚ. pectoralis major-fascia lata graft transfer to the scapula
Ɛ. exploration of the long thoracic nerve, with sural nerve graft
Ɜ. tricompartmental knee replacement
ɝ. unicompartmental knee replacement
ɞ. medial compartment meniscal allograft
ɟ. valgus-producing distal femoral osteotomy
Ɠ. valgus-producing proximal tibial osteotomy
Ɡ. Internal rotation of the femoral component
ɢ. External rotation of the tibial component
Ɣ. Lateral placement of the femoral component
ɤ. Medial placement of the patellar component
Ɥ. Excessive resection of the patella
Ɦ. Hallux rigidus
ɧ. Hallux valgus
Ɨ. Neuroma of the first web space
Ɩ. Fracture of the sesamoid
Ɪ. Rupture of the flexor hallucis longus
Ɫ. Sickle cell crisis
Ɬ. Idiopathic chondrolysis
ɭ. Hemophilic arthropathy
ɮ. Osteoid osteoma of the femoral neck
Ɯ. Legg-Calve-Perthes disease
ɰ. Decreased ankle jerk and positive femoral nerve stretch test
Ɱ. Decreased knee jerk and positive straight-leg raising sign
Ɲ. Gastrocnemius-soleus complex weakness and positive straight-leg raising sign
ɳ. Weakness of the extensor hallucis longus and positive straight-leg raising sign
ɴ. Weakness of the extensor hallucis longus and positive femoral nerve stretch test
Ɵ. Long-term administration of IV and oral antibiotics
ɶ. Open soft-tissue debridement, retention of prosthetic components, and IV antibiotics
ɷ. Immediate exchange arthroplasty with antibiotic-impregnated cement
ɸ. Two-stage surgical prosthetic exchange and IV antibiotics
ɹ. Resection arthroplasty and IV antibiotics
ɺ. SCFE
ɻ. MED
ɼ. Perthes disease
Ɽ. Hypothyroidism
ɾ. Chondrolysis
ɿ. gout.
Ʀ. osteoporosis.
ʁ. eosinophilic granuloma.
Ʂ. tuberculosis of the spine.
Ʃ. metastatic disease of the spine.
ʄ. water content.
ʅ. Synthesis of type I collagen.
ʆ. Proteoglycan content.
Ʇ. Activity of chondrocytes.
Ʈ. Synthesis of hyaluronate.
Ʉ. Lung
Ʊ. Breast
Ʋ. Prostate
Ʌ. Thyroid
ʍ. Renal
ʎ. T1-low, T2-low.
ʏ. T1-low, T2-high.
ʐ. T1-moderate, T2-low.
ʑ. T1-high, T2-low.
Ʒ. T1-high, T2-high.
ʓ. hypothesis is incorrect or invalid
ʔ. interobserver error rate is 4%.
ʕ. Standard deviation is 4% higher or lower than the mean.
ʖ. Sample size is 4% larger than required to be clinically significant.
ʗ. Probability that the differences noted between two study groups were due to chance alone is 4%.
ʘ. I
ʙ. II
ʚ. IV
ʛ. IX
ʜ. X
Ʝ. Cranial setting
Ʞ. Cranial subluxation
ʟ. Odontoid fracture
ʠ. Lysis of the arch of the atlas
ʡ. Atlantoaxial subluxation
ʢ. Retrograde collapse of the endoneurial tubes
ʣ. Irreversible atrophy of the denervated muscles
ʤ. Elongation of the axons across the zone of injury
ʥ. Sprouting of the axons at the neuromuscular junction
ʦ. Misdirection of the axons across the zone of injury
ʧ. Maximally pronated and elbow extended
ʨ. Maximally pronated and the elbow flexed
ʩ. Maximally supinated and the elbow flexed
ʪ. Maximally supinated and the elbow extended
ʫ. In neutral rotation, with the elbow extended
ʬ. open reduction and internal fixation
ʭ. buddy taping to the adjacent index finger
ʮ. early motion with application of a dynamic banjo splint
ʯ. application of a cast with the hand in a “safe position” for 3 weeks.
ʰ. dorsal extension block splinting
ʱ. The name of the manufacturer
ʲ. The manufacturer’s potential liability
ʳ. The physician’s clinical performance
ʴ. The physician’s materials testing data
ʵ. Any royalties the physician receives from the manufacturer
ʶ. Femoral
ʷ. Obturator
ʸ. Inferior gluteal
ʹ. Superior gluteal
ʺ. Lateral femoral cutaneous
ʻ. open biopsy and a long leg cast
ʼ. open biopsy and wide resection of the tumor
ʽ. a long leg cast and observation
ʾ. intramedullary stabilization and observation
ʿ. Triggering
ˀ. Lateral instability
ˁ. Swan-neck deformity
˂. Boutonniere deformity
˃. Loss of distal interphalangeal joint flexion
˄. Peroneus brevis to peroneus longus
˅. Peroneus tertius to extensor hallucis longus
ˆ. Peroneus tertius to superficial peroneal nerve
ˇ. Extensor hallucis longus to deep peroneal nerve
ˈ. Extensor hallucis longus to extensor digitorum longus
ˉ. reassurance that Medicare will pay for the treatment.
ˊ. consent forms that patients or their guardians are able to understand.
ˋ. a detailed description of the device, omitting the fact that it is part of a study.
ˌ. a provision that the patient’s care will be discontinued if he or she does not enroll in the study.
ˍ. a provision that the study will be carried out to completion, whether or not the device is as effective as those currently in existence.
ˎ. an onlay iliac crest bone graft.
ˏ. limited weightbearing and observation.
ː. removal of the implant and limited weightbearing.
ˑ. removal of the implant and insertion of a reamed femoral nail.
˒. removal of the implant and insertion of an unreamed femoral nail.
˓. Coronal
˔. Sagittal
˕. Anteromedial, midway between the sagittal and the coronal
˖. Proximal pins sagittal, distal pins coronal
˗. Proximal pins coronal, distal pins sagittal
˘. Rheumatoid arthritis
˙. Posttraumatic arthritis
˚. Degenerative osteoarthritis
˛. Osteonecrosis of the tibial plateau
˜. Osteonecrosis of the medial femoral condyle
˝. Trapeziometacarpal arthrodesis
˞. Osteotomy of the thumb metacarpal
˟. Arthrotomy and joint debridement
ˠ. Ligament reconstruction using one half of the flexor carpi radialis
ˡ. Trapezium resection, tendon interposition, and reconstruction of the ligament
ˢ. Creep
ˣ. Relaxation
ˤ. Energy dissipation
˥. Plastic deformation
˦. Elastic deformation
˧. bending
˨. axial loading
˩. high-speed rotation
˪. direct impact from anteromedial
˫. crush from anteromedial to posterolateral
ˬ. Increase stiffness
˭. Increase fracture toughness
ˮ. Increase fatigue strength
˯. Decrease mechanical strength
˰. Decrease wear rate
˱. disuse osteopenia
˲. paraendocrine effect of the tumor
˳. abnormally increased density on the right side
˴. side effect of the treatment of the lesion
˵. extensive tumor involvement of the left hip
˶. Sciatic nerve
˷. Superior gluteal artery
˸. Profunda femoris artery
˹. Femoral artery and nerve
˺. External iliac artery and vein
˻. Length
˼. Moment arm
˽. Total volume
˾. Physiologic cross-sectional area
˿. Distribution of slow and fast twitch fibers
̀. decreasing initiation of action potentials.
́. increasing action potential amplitude.
̂. blocking the opening of gated sodium channels.
̃. decreasing the number of functional motor units.
̄. slowing or stopping action potential propagation through the axon.
̅. resection of the metatarsal heads of the first through fifth toes.
̆. Silastic MP joint arthroplasties of the first through fifth toes.
̇. fusion of the hallux MP joint and resection arthroplasty of the 2nd through fifth metatarsal heads.
̈. fusion of hallux MP joint and distal osteotomy of the 2nd through 5th MT.
̉. plantar condylectomy of the 2nd through 5th MT heads & resection of proximal phx of the hallux.
̊. hemiarthroplasty
̋. open reduction and internal fixation
̌. closed reduction and percutaneous pinning
̍. a sling and early pedulum exercises
̎. a sling and swathe for 6 weeks, followed by shoulder rehabilitation
̏. open acromioplasty
̐. open Bankart repair
̑. open subscapularis tendon repair
̒. inferior capsular shift
̓. a supervised physical therapy program
̔. a sling and swathe, with pendulum exercises in 10 days
̕. open reduction and internal fixation through an anterior approach
̖. open reduction and internal fixation through a posterior approach
̗. immobilization with a splint in 45 degrees of abduction for 6 weeks
̘. arthroscopically assisted reduction and percutaneous screw fixation
̙. Repair of the rotator cuff
̚. Replacement of the humeral head
̛. Resection arthroplasty
̜. Total shoulder arthroplasty
̝. AP and lateral radiographs of the elbow
̞. Diagnositc arthroscopy
̟. Aspiration of joint fluid
̠. An erythrocyte sedimentation rate and CBC
̡. A diagnostic lidocaine injection
̢. Insulin-like growth factor (IGF-1)
̣. Fibroblast growth factor (FGF-1)
̤. Platelet-derived growth factor (PDGF)
̥. Transforming growth factor beta (TGF-B)
̦. Bone morphogenetic proteins (BMP)
̧. clinical history and radiographic findings.
̨. technetium bone scan
̩. flow cytometry pattern of extracted chondrocytes
̪. immunohistochemical staining patterns of a biopsy specimen
̫. histologic features of a biopsy specimen stained with hematoxylin-cosin
̬. Radial
̭. Radial recurrent
̮. Posterior interosseous
̯. Superior ulnar recurrent
̰. Superficial radial circumflex
̱. Impaired hydroxylation of proline
̲. Failure of cleavage in procollagen
̳. Defective binding sites for hydroxyproline
̴. Failure to incorporate glycine into the helix
̵. Diminished production of collagen through the rough endoplasmic reticulum
̶. Asking the legal staff to seek a court injunction
̷. Copying the patient’s chart and giving it to him as he leaves
̸. Having the patient sign a written legal contract that specifies acceptable behavior
̹. Continuing care of the patient until an appropriate referral can be arranged
̺. Transferring the patient to another orthopaedic surgeon without disclosing the realreason for why the patient is being transferred
̻. Meta-analysis
̼. Confidence interval
̽. Analysis of variance (ANOVA)
̾. Statistical significance (p-value)
̿. Survivorship analysis (Kaplan-Meier)
̀. Spinal shock
́. Neurogenic shock
͂. Hypovolemic shock
̓. Pulmonary embolism
̈́. Fat embolus syndrome
Ι. Lumbar spinal stenosis
͆. Metastatic disease of the spine
͇. Rheumatoid lumbar spondylitis
͈. Isthmic spondyloloisthesis
͉. Degenerative spondylolisthesis at L4-5 and L5-S1
͊. Patella alta
͋. A metal-backed patella
͌. Varus malalignment of the knee
͍. A posterior cruciate-substituting femoral component
͎. Lateral subluxation of the patella on a Merchant’s view
͏. The sesamoids are separated
͐. The sesamoid is fractured
͑. The proximal phx is on the neck of the metatarsal
͒. The dislocation is dorsal and centered
͓. The proximal phalanx is hyperextended
͔. Patella
͕. Tibial stem
͖. Distal femoral interface
͗. Posterior femoral interface
͘. Sites of screw fixation for the tibia
͙. Hallux rigidus
͚. Fracture of the sesamoid
͛. Disruption of the plantar plate
͜. Osteonecrosis of the metatarsal head
͝. Rupture of the flexor hallucis longus
͞. Gout
͟. Sepsis
͠. Old trauma
͡. Rheumatoid arthritis
͢. Charcot arthroplasty
ͣ. Aspiration and steroid injection
ͤ. Biopsy, curettage, and allograft bone grafting
ͥ. Percutaneous Kirschner wire fixation
ͦ. Percutaneous injection of autogenous bone marrow
ͧ. Nerve roots
ͨ. Spinal cord
ͩ. Sciatic nerve
ͪ. Peroneal nerve
ͫ. Conus medullaris
ͬ. Extent of bone penetrated by reaming, prosthetic components, or acrylic cement
ͭ. Periprosthetic regions that are accessible to joint fluid and particulate wear debris
ͮ. Enveloping pseudocapsular scar tissue that develops around a prosthetic hip following surgical capsulectomy
ͯ. Soft tissue and bone that are potentially contaminated with bacteria in the setting of a prosthetic joint infection
Ͱ. Potential intrapelvic joint space communication created by acetabular fixation screws or intrapelvic extruded acrylic cement
Ͱ. Early and late infection
Ͳ. Periprosthetic fracture of the femur
Ͳ. Failure of the patellofemoral and extensor mechanisms
ʹ. Aseptic loosening of cementing tibial components
͵. Asceptic loosening of cemented femoral components
Ͷ. Acceptance of the current position of the ankle
Ͷ. Open reduction and fixation in the epiphysis only
͸. ORIF with a small-fragment T-plate from the malleolus up to the metaphysis
͹. Closed reduction by eversion of the ankle and application of a bivalved long leg cast
ͺ. CRUGA and fixation with a malleolar screw from the malleolus into the metaphysis
Ͻ. Resection arthroplasty and local radiation
Ͼ. In situ fusion of the hip
Ͽ. Excision of heterotopic bone, total hip arthroplasty, and oral indomethacin
;. Excision of heterotopic bone and local radiation
Ϳ. Excision of heterotopic bone, hemiarthroplasty, and oral indomethacin
΀. Closed reduction of both fractures and immediate spica casting
΁. Bilateral skin traction for 3 weeks, followed by spica casting
΂. External fixation of both femora
΃. External fixation of the left femur and a long leg cast brace for the right femur
΄. External fixation of the left femur and use of a reamed intramedullary nail in the right femur
΅. Synovial sarcoma
Ά. Soft-tissue abcess
·. Rhabdomyosarcoma
Έ. Eosinophilic granuloma
Ή. Nodular pigmented villonodular synovitis
Ί. Changing to a titanium nail
΋. Changing to a nonslotted nail
Ό. Changing the cross-sectional shape of the nail
΍. Increasing the diameter of the nail by 3 mm
Ύ. Increasing the diameter of the interlocking screws
Ώ. Fracture healing
Ϊ́. Chondrosarcoma
Α. Periosteal chondroma
Β. Periosteal osteosarcoma
Γ. Dysplasia epiphysealis hemimelica
Δ. Demonstrate competence in the subject of the case
Ε. Be fellowship trained in the subject of the case
Ζ. Be paid on a contingency basis
Η. Be board certified by the American Board of Orthopaedic Surgery
Θ. Have been involved in the case as a consultant
Ι. Diagnostic arthroscopy
Κ. Arthroscopy and subacromial decompression
Λ. Reduction and fixation of the proximal humeral epiphysis
Μ. Temporary cessation of throwing
Ν. Physical therapy for rotator cuff strengthening
Ξ. Oblique popliteal ligament
Ο. Lateral capsule
Π. Popliteal tendon
Ρ. Fibular collateral ligament
΢. Posterior oblique ligament
Σ. Radial tear
Τ. Parrot-beak tear
Υ. Vertical tear in the “red-red” zone
Φ. Vertical tear in the “red-white” zone
Χ. Vertical tear in the “white-white” zone
Ψ. 0 degrees of abduction, with neural rotation
Ω. 40 degrees of flexion and 60 degrees of internal rotation
Ϊ. 45 degrees of flexion and 45 degrees of external rotation
Ϋ. 90 degrees of abduction with neutral rotation
Ά. 90 degrees of abduction and 90 degrees of external rotation
Έ. Sural
Ή. Saphenous and its branches
Ί. Posterior tibial and its branches
Ϋ́. Deep peroneal and its branches
Α. Superficial peroneal and its branches
Β. Strength
Γ. Stiffness
Δ. Shelf life
Ε. Antigenicity
Ζ. Risk of HIV transmission
Η. Indemnification
Θ. Occurrence
Ι. Excess liability
Κ. Claims-made
Λ. Nose
Μ. Lateral Y
Ν. Scapular AP
Ξ. Neutral rotation AP
Ο. Internal rotation AP
Π. External rotation AP
Ρ. Trauma
Σ. Hemophilia
Σ. Reiter’s syndrome
Τ. Rheumatoid arthritis
Υ. Systemic lupus erythematosus
Φ. Cast immobilization for 6 weeks
Χ. Activity modification and re-evaluation in 2 months
Ψ. Internal fixation with or without bone grafting
Ω. Retrograde drilling of the defect without articular cartilage penetration
Ϊ. Drilling of the defect directly through the articular cartilage
Ϋ. repair or reconstruction of the medial collateral ligament
Ό. repair or reconstruction of the medialand lateral collateral ligaments
Ύ. immobilization for 5 days or less
Ώ. immobilization for 14 days
Ϗ. immobilization for 25 days
Β. Cystinosis
Θ. Hypophosphatemia
ϒ. Renal osteodystrophy
ϓ. Primary hyperparathyroidism
ϔ. Nutritional vitamin D deficiency
Φ. Lateral meniscus tear
Π. Popliteus tenosynovitis
Ϗ. Iliotibial band friction syndrome
Ϙ. Peroneal nerve entrapment
Ϙ. Biceps tendinitis
Ϛ. Observation
Ϛ. Removal of the prosthetic components
Ϝ. Operative exploration and decompression of the peroneal nerve
Ϝ. Nerve conduction velocity studies
Ϟ. Loosening of the primary dressings and knee flexion to 30 degrees
Ϟ. I
Ϡ. II
Ϡ. III
Ϣ. decreased tissue tension
Ϣ. decreased abductor lever arm
Ϥ. decreased joint reaction force
Ϥ. increased body weight over lever arm
Ϧ. increased polyethylene wear rate
Ϧ. recurrent traumatic anterior dislocation
Ϩ. recurrent traumatic posterior dislocation
Ϩ. traumatic subluxation with no previous dislocation
Ϫ. traumatic anterior subluxation
Ϫ. atraumatic involuntary subluxation
Ϭ. radial
Ϭ. axillary
Ϯ. suprascapular
Ϯ. thoracodorsal
Κ. long thoracic
Ρ. Flexion
Ϲ. Extension
Ϳ. Axial rotation
ϴ. Left lateral bending
Ε. Right lateral bending
϶. Skin
Ϸ. Lung
Ϸ. Brain
Ϲ. Heart
Ϻ. Kidney
Ϻ. Thoracoacromial, lateral thoracic, subscapular
ϼ. Thoracoacromial, anterior humeral circumflex, posterior humeral circumflex
Ͻ. Posterior humeral circumflex, subscapular, thoracacromial
Ͼ. Subscapular, thoracacromial, anterior humeral circumflex
Ͽ. Lateral thoracic, anterior humeral circumflex, thoracacromial
Ѐ. Respondeat superior
Ё. Indemnity agreement
Ђ. Hold harmless agreement- attempt to shift liability from company to physician
Ѓ. Comparative negligence-% of involvement
Є. Contributory negligence- resident contributed to the negligence
Ѕ. t-type
І. both column
Ї. transverse
Ј. anterior column
Љ. anterior column posterior hemitransverse
Њ. Posterior interosseous
Ћ. Anterior interosseous
Ќ. Radial
Ѝ. Median
Ў. Ulnar
Џ. Shock from hypovolemia
А. Associated rupture of the bladder
Б. Arterial bleeding on pelvic angiogram
В. Presence of a hematoma in the perineum and scrotum
Г. Fractures of both the anterior and posterior pelvic ring

Correct Answer & Explanation

. Higher subsequent loosening rate of the femoral component


Explanation

Question 4070

Topic: 10. Pathology and Oncology

  • What is the primary mechanism of wear of polyethylene acetabular components?
. Crevice corrosion
. Oscillatory fretting
. Oxidative degradation
. Adhesion and abrasion
. Fatigue and delamination
. a total contact cast.
. partial calcanectomy
. Syme’s amputation
. transtibial amputation.
. nonweightbearing and IV antibiotics.
. Sural artery island flap.
. Free rectus abdominis flap.
. Extensor digitorum brevis flap.
. Staged cross leg flap.
. Split-thickness skin graft.
. An anterior cruciate functional knee brace.
. A physical therapy program.
. Reconstruction of the posterior cruciate ligament and the posterolateral corner.
. Reconstruction of the posterior cruciate ligament.
. Reconstruction of the anterior cruciate ligament.
. Avoids the risk of marrow emboli
. Avoids injury to the intramedullary nutrient vessels
. Results in faster healing of fractures
. Results in more secure fixation
. Results in faster regeneration of the endosteal blood supply
. Above-knee amputation
. En bloc resection of the lesion and reconstruction with a bone graft
. Closed reduction and immobilization in a cast
. Open reduction and internal fixation, followed by radiation therapy
. Open reduction, curettage, and cementing of the lesion
. Injury to the subclavian artery
. Injury to the brachial plexus
!. Segmental fracture
". 100% displacement
#. Associated displaced surgical neck fracture of the humerus
$. humeral arthroplasty2/. repair of the rotator cuff
%. closed reduction and immobilization
&. open reduction and immobilization
'. open reduction and early passive motion
(. arthroscopic capsular release
). manipulation under anesthesia
*. a physical therapy program
+. an intra-articular corticosteroid injection
,. administration of high-dose oral corticosteroids
-. adding the scores, in all five body systems
.. adding the squares of the scores in the three most severely injured systems
/. doubling the cumulative score for head and chest injuries
0. combining the scores from the most and least injured systems
1. correcting the score in the most severely injured system for age
2. traumatic femoral head fracture
3. osteonecrosis
4. osteoarthritis
5. neuropathic joint
6. rheumatoid arthritis
7. low-dose radiation
8. steroid injection
9. a load-relieving insert and shoe modification
:. complete excision of the mass and the entire plantar fascia
;. wide excision of the mass with a 2 cm margin of normal fascia
<. CT scan of the chest
=. technetium bone scan
>. bone marrow aspiration
?. serum protein electrophoresis
@. lateral skull radiograph
A. high-grade histology of the initial tumor
B. multiple local recurrences after curettage
C. previous treatment of the tumor with cryotherapy
D. previous treatment of the tumor with radiation therapy
E. extraosseous extension into two or more adjacent compartments
F. Dorsal rhizotomy and facet joint fusion
G. Multilevel corpectomy and spinal stabilization
H. Central and lateral recess decompression and bilateral foraminotomy
I. Central decompression and facet joint fusion
J. Central decompression, foraminotomy, and spinal fusion from L2 to L5.
K. Inadequate rehabilitation
L. Displacement of the coronoid process fracture
M. Insufficiency of the lateral ulnar collateral ligament
N. Insufficiency of the anterior band of the medial collateral ligament
O. Insufficiency of the posterior band of the medial collateral ligament
P. Osteotomy and intramedullary rod fixation
Q. Electrical stimulation
R. Strut-autografing the concavity the tibia
S. A patellar tendon-bearing brace
T. Percutaneous injection of demineralized bone matrix
U. digoxin
V. sucralfate
W. clindamycin
X. alcohol
Y. neuromuscular blocking agents
Z. Unrestrained roll-back
[. Unrestrained rotational conformity
\. Medial-Lateral conformity
]. Anteroposterior conformity in flexion
^. Anteroposterior conformity in extension
_. Arthrodesis of the MTP joint
`. A Silastic implant of the MTP joint
A. Resection arthroplasty of the MTP joint
B. Cheilctomy of the MTP joint
C. Osteotomy of the base of the proximal phalanx
D. Genu varum
E. Tarsal coalition
F. Degenerative ankle arthrosis
G. Osteochondritis dissecans of the talus
H. Hemihypertrophy of the ipsilateral lower extremity
I. Trabecular bone is preferentially resorbed in this high bone turnover state
J. Loss of water content in the disk increases impact load to the vetrebral bodies
K. Stress is imposed by the relative stiffness of the arthrtic facet joints
L. Increased energy demands are imposed by decreased circulation to the vertebral body
M. The thick cortical bone found in the vertebral body resorbs rapidly following estrogen withdrawal
N. Increased time in stance and swing phase
O. Addition of a double leg float phase
P. Decreased vertical ground reaction forces
Q. Decreased arc of motion in the hip, knee, and ankle
R. Decreased joint reaction forces in the hip, knee, and ankle
S. Talonavicular arthrodesis
T. Medial displacement calcaneal osteotomy
U. Flexor digitorum longus tendon transfer with spring ligament advancement
V. Triple arthrodesis
W. Calcaneocuboid distraction arthrodesis and repair of the posterior tibial tendon
X. Lymphoma
Y. Hemangioma
Z. Osteosarcoma
{. TB of the spine
|. Metastatic breast carcinoma
}. widening and shortening of the heel.
~. weakness of the gastrocnemius-soleus complex.
. anterior impingement from a horizontal talus.
€. unrecognized compartment syndrome of the foot.
. degenerative arthritis of the tibiotalar joint.
‚. a corrective osteotomy
ƒ. application of braces
„. medial physeal stapling until the varus corrects
…. observation
†. application of corrective casts
‡. a total contact cast.
ˆ. electrical stimulation.
‰. an off the shelf fracture brace.
Š. an elastic compression bandage and crutches.
‹. a hard soled shoe until the patient is asymptomatic.
Œ. Ewings tumor
. Parosteal osteosarcoma
Ž. Dedifferentiated chondrosarcoma
. Low grade intramedullary chondrosarcoma
. High grade intramedullary osteosarcoma
‘. Vascular injury
’. Tear of the rotator cuff
“. Injury to the brachial plexus
”. Fracture of the upper thoracic rib
•. Fracture of the proximal humerus
–. Biceps
—. Trapezius
˜. Infraspinatus
™. Pectoralis major
š. Serratus anterior
›. Hybrid total hip arthroplasty
œ. Noncemental hemiarthroplasty of the hip
. Closed reduction and percutaneous pin fixation
ž. Open reduction through an anterior approach to the hip
Ÿ. Excision of the head fragment
 . a quadratus femoris pediclebone graft
¡. a proximal femoral allograft
¢. intertrochanteric osteotomy
£. total hip arthroplasty
¤. hip hemiarthroplasty
¥. Echocardiogram
¦. Electrocardiogram
§. Radiograph of the chest
¨. CT scan of the shoulder
©. Ultrasound of the shoulder
ª. Ilioinguinal
«. Extended iliofemoral
¬. Combined ilioinguinal and Kocher-Langenbeck (posterior)
­. Kocher-Langenbeck (posterior)
®. Kocher-Langenbeck (posterior) with trochanteric osteotomy
¯. Deltoid
°. Supraspinatus
±. Subscapularis Infraspinatus
². Infraspinatus
³. Infraspinatus and teres minor
´. an orthosis.
Μ. observation.
¶. electrical stimulation.
·. open reduction and internal fixation.
¸. application of a nonweightbearing short leg cast.
¹. repair of the rotator cuff.
º. rehabilitation of the shoulder
». replacement of the humeral head.
¼. arthroscopic acromioplasty and debridement.
½. immobilization is a sling until pain resolves.
¾. Bone rotation versus torque applied
¿. Bone deflection versus bending moment applied
À. Axial displacement versus tension applied
Á. Lateral translation versus shear force applied
Â. Fracture gap closing versus compressive force applied
Ã. steroid injection
Ä. stretching of the heel cord
Å. surgical release of the plantar fascia
Æ. application of a short leg cast for 6 to 8 weeks
Ç. wearing dorsiflexion night splints
È. Open bladder
É. Bilateral “hitchhiker’s” thumbs
Ê. Bilateral defects in the midclavicles
Ë. Rhizomelic shortening of the extremities
Ì. Radiographic fragmentation of all major epiphyses
Í. Medial patellotibial
Î. Medial patellofemoral
Ï. Medial patellomeniscal
Ð. Lateral patellofemoral
Ñ. Lateral patellotibial
Ò. Heat
Ó. Gentle active flexion-extension exercises
Ô. Isokinetic strengthening
Õ. Electrical muscle stimulation
Ö. Immobilization of the limb with the knee in full flexion
×. Distal chevron osteotomy with soft-tissue release
Ø. Distal soft-tissue realignment only
Ù. Closing wedge osteotomy (Aken) of the proximal phalanx
Ú. Proximal first metatarsal osteotomy only
Û. Soft-tissue realignment with a proximal metatarsal osteotomy
Ü. Vagus
Ý. Phrenic
Þ. Hypoglossal
SS. Recurrent laryngeal
À. Inferior thyroid
Á. Surgical exploration
Â. Application of leeches
Ã. Stellate ganglion blocks
Ä. Intra-arterial streptokinase
Å. Elevation and reevaluation in 1 hour
Æ. Liver profile
Ç. Myleogram
È. Platelet count
É. CT scan of the head
Ê. Angiogram of the extremity
Ë. Post spinal fusion from L5to S1
Ì. Primary repair with an iliac bone graft
Í. Post spinal fusion of L4-5
Î. A pantaloon body cast and 6 weeks of bed rest
Ï. Rest, NSAIDS, and limited dancing
Ð. Stress fracture of the proximal fifth metatarsal
Ñ. Stress fracture of the base of the second metatarsal
Ò. Stress fracture of the neck of the second metatarsal
Ó. Morton’s neuroma
Ô. Lisfranc’s joint subluxation
Õ. C5 radiculopathy
Ö. Subscapularis rupture
÷. Glenohumeral arthrosis
Ø. Rotator cuff arthropathy
Ù. Suprascapular nerve compression at the spinoglenoid notch
Ú. mm femoral head in combination with a metal-backed polyethylene component
Û. mm femoral head in combination with an all-polyethylene acetabular component
Ü. mm femoral head in combination with a metal-backed polyethylene component
Ý. mm femoral head in combination with an all-polyethylene component
Þ. mm femoral head in combination with a metal-backed polyethylene component
Ÿ. Female gender
Ā. History of cigarette smoking
Ā. L5-S1 spondylolisthesis on pre-employment radiography
Ă. Decreased strength of the lower extremities on pre-employment testing
Ă. Decreased flexibility of the lumbar spine on pre-employment testing
Ą. Size of cells
Ą. Amount of DNA in cells
Ć. Nucleus-cytoplasm ratio
Ć. Specific DNA sequences
Ĉ. Specific messenger RNA sequences
Ĉ. Femoral and obturator nerves
Ċ. Femoral and superior gluteal nerves
Ċ. Femoral and lateral femoral cutaneous nerves
Č. Obturator and superior gluteal nerves
Č. Obturator and lateral femoral cutaneous nerves
Ď. Isotonic
Ď. Isokinetic
Đ. Isometric
Đ. Open kinetic chain
Ē. Dynamic variable resistance
Ē. Closed reduction and cast immobilization
Ĕ. Uniplanar external fixation
Ĕ. Open reduction and internal fixation with a dynamic compression plate
Ė. Unreamed intramedullary rod
Ė. Multiple plane external fixator
Ę. Inlet view of the pelvis
Ę. Outlet view of the pelvis
Ě. AP view of the hip
Ě. Ilial oblique view (external oblique) of the hip
Ĝ. Obturator oblique
Ĝ. Glycolytic pathway
Ğ. Oxidative phosphorylation
Ğ. Breakdown of fat
Ġ. Breakdown of protein
Ġ. Breakdown of adenosine triphosphate
Ģ. an MRI scan
Ģ. arthroscopic examination
Ĥ. AP and frog-lateral radiographs of the pelvis and hips
Ĥ. varus and valgus stress radiographs of the knee
Ħ. physical examination of the knee under anesthesia
Ħ. extended curettage and polymethylmethacrylate cementation
Ĩ. extra-articular resection of the knee and an allograft arthrodesis
Ĩ. wide resection of the proximal tibia and custom prosthetic replacement
Ī. prophylactic internal fixation and postoperative irradiation
Ī. excision of the lateral condyle and reconstruction with a hemicondylar allograft
Ĭ. silicone implant joint replacement
Ĭ. metatarsophalangeal joint arthrodesis
Į. metatarsophalangeal joint debridement
Į. resection of the metatarsal head
İ. resection of the base of the proximal phalanx
I. Fixation of the syndesmosis has failed
IJ. Widening of the ankle mortise has led to the failure of fixation
IJ. Infection around the syndesmosis screw has led to osteomyelitis
Ĵ. The syndesmosis screw is broken
Ĵ. Motion between the tibia and fibula has caused loosening of the syndesmosis screw
Ķ. Microcephaly
Ķ. A temporal lobe cyst
ĸ. An Arnold-Chiari type 1 malformation
Ĺ. Periventricular leukomalacia
Ĺ. Agnesis of the corpus callosum
Ļ. Wolff’s
Ļ. Hooke’s
Ľ. Hilton’s
Ľ. Muller-Haeckel
Ŀ. Heuter-Volkmann
Ŀ. Both the anterolateral and posteromedial bands are isometric and do not significantly change with flexion
Ł. The anterolateral band is lax and becomes tight in flexion, while the posteromedial band is tight, and becomes lax in flexion
Ł. The anterolateral band is tight and becomes lax in flexion, while the posteromedial band is lax and becomes tight in flexion
Ń. Both the anterolateral and posteromedial bands are lax and become tight in flexion
Ń. Both the anterolateral and posteromedial bands are tight and become lax as the knee is flexed
Ņ. UCB orthosis
Ņ. Rigid orthosis with a medical arch support
Ň. Semi-rigid orthosis with lateral forefoot posting
Ň. Semi-rigid orthosis with a medial arch support
ʼN. Medial heel wedge attached to the running shoes
Ŋ. Hallux varus
Ŋ. Osteonecrosis
Ō. Recurrence of the hallux valgus
Ō. “Transfer” second metatarsalgia
Ŏ. Physeal arrest of the first metatarsal
Ŏ. Aseptic loosening in a 70-year-old patient
Ő. Mechanical failure of a hinged knee prosthesis
Ő. Failed knee replacement complicated by reflex sympathetic dystrophy
Œ. Infection with soft-tissue deficit
Œ. A prior patellectomy
Ŕ. Knee fusion
Ŕ. Open irrigation and debridement
Ŗ. Arthroscopic irrigation and debridement
Ŗ. One-stage exchange arthroplasty
Ř. Two-stage exchange arthroplasty
Ř. Putti-platt repair
Ś. Open Bankart repair
Ś. Injection of a subacromial corticosteroid
Ŝ. Arthroscopic transglenoid capsular shift
Ŝ. Rehabilitation of the scapular and rotator cuff muscles
Ş. Silicone suction socket and an energy-absorbing foot
Ş. Silicone suction socket and a variable resistance ankle
Š. Plastic suction socket, telescoping pylon, and a solid ankle cushioned heel (SACH) foot
Š. Plastic socket with a hinged thigh cuff and a SACH foot
Ţ. Patellar tendon-bearing suction socket and a uniaxial hydraulic ankle
Ţ. Parosteal
Ť. Periosteal
Ť. High-grade intramedullary
Ŧ. Osteosarcoma occurring in Paget’s disease
Ŧ. Osteosarcoma occurring in irradiated bone
Ũ. Cauda equina
Ũ. Conus medullaris
Ū. Genitofemoral nerve
Ū. Lumbar sympathetic plexus
Ŭ. Lumbar parasympathetic plexus
Ŭ. Spinal pseudoarthrosis
Ů. Spinal cord traction injury with paralysis
Ů. Arterial and venous thromboses
Ű. Superior mesenteric artery syndrome
Ű. Crankshaft phenomenon
Ų. Inversion stress radiograph
Ų. MRI scan
Ŵ. CT scan
Ŵ. Nuclear bone scan
Ŷ. External rotation stress radiograph
Ŷ. Complex deformity with an angulation in two planes
Ÿ. Single deformity less than 20 degrees, apex posterolateral
Ź. Single deformity greater than 30 degrees, apex posterolateral
Ź. Single deformity less than 20 degrees, apex posteromedial
Ż. Single deformity greater than 30 degrees, apex posteromedial
Ż. Pronation of the foot during the stance phase of gait
Ž. Heel inversion at the beginning of a single limb heel rise
Ž. Active inversion of the nonweightbearing foot
S. Active plantar flexion of the first ray against resistance
Ƀ. Active plantar flexion of the foot during the push-off phase of gait
Ɓ. Observation and repeat radiographs in 4 months
Ƃ. Application of a thoracolumbalsacral orthosis for 22 to 24 hours per day
Ƃ. Electrical stimulation at night
Ƅ. Physical therapy
Ƅ. Begins to remodel and hypertrophy more quickly
Ɔ. Provides a better scaffold for osteoconduction
Ƈ. Reduces the risk of early fracture
Ƈ. Reduces technical difficulty
Ɖ. Lowers donor site morbidity
Ɗ. Anterior fusion of the lumbar curve
Ƌ. Anterior and posterior fusion of the thoracic curve
Ƌ. Posterior fusion of the thoracic curve
ƍ. Posterior fusion of the thoracic and lumbar curves
Ǝ. Application of a brace until the iliac apophyses are Risser 4 or 5, followed by surgical correction
Ə. Subscapularis rupture
Ɛ. Type III SLAP lesion
Ƒ. Disruption of capsular shift
Ƒ. Isolated traumatic subluxation
Ɠ. Injury to the axillary nerve after dislocation
Ɣ. hypophosphatemia
Ƕ. high dietary cholesterol intake
Ɩ. deficiency of lipoprotein A
Ɨ. deficiency of protein S and protein C
Ƙ. elevated levels of antithrombin III
Ƙ. Weightbearing short leg cast
Ƚ. Nonweightbearing short leg cast
ƛ. Removable splint and early motion
Ɯ. Open reduction and internal fixation
Ɲ. Elastic compression bandage with full weightbearing
Ƞ. Breast
Ɵ. Prostate
Ơ. Gastrointestinal
Ơ. Kidney
Ƣ. Multiple myeloma
Ƣ. Varus stress
Ƥ. Valgus stress
Ƥ. Torsional loading
Ʀ. Hyperextension of the knee
Ƨ. Contraction of the quadriceps while axially loaded
Ƨ. Primary internal fixation at both fracture levels
Ʃ. External fixation as definitive ttt for both #
ƪ. Skeletal traction and delayed internal fixation of both fractures
ƫ. Primary internal fixation of the proximal fracture and delayed fixation of the femoral fracture
Ƭ. Primary internal fixation of the femoral shaft fracture and delayed fixation of the proximal #
Ƭ. Heel spur
Ʈ. Plantar fascitis
Ư. Dysfunction of the tibialis posterior tendon
Ư. Compression of the first branch of the lateral plantar nerve
Ʊ. Compression of the calcaneal nerve
Ʋ. Displaced labral tear
Ƴ. Tear of the rotator cuff
Ƴ. Fracture of the glenoid rim
Ƶ. Palsy of the axillary nerve
Ƶ. Palsy of the musculocutaneus nerve
Ʒ. Enchondroma
Ƹ. Osteoblastoma
Ƹ. Giant cell tumor
ƺ. Aneurysmal bone cyst
ƻ. Fibrous dysplasia
Ƽ. Arthrogram of the wrist
Ƽ. MRI scan of both wrists
ƾ. CT scan of both wrists in the same position
Ƿ. Radiographs of the wrist in supination and pronation
ǀ. Radiographs of the opposite wrist in the same position
ǁ. Secondary hyperparathyroidism
ǂ. Phosphate retention secondary to uremia
ǃ. Insufficient renal synthesis of 1, 25 dihydroxy vitamin D
DŽ. Aluminum deposition in bone from oral phosphate binders
DŽ. Persistent acidosis aggravating the negative calcium balance
DŽ. Posterior fusion at T10-L3 with segmental instrumentation
LJ. Laminectomy and fusion of T12-L2 with segmental instrumentation
LJ. Bed rest in a hyperextension brace
LJ. L1 vertebrectomy and anterior decompression with strut graft fusion and instrumentation
NJ. Progressive ambulation as tolerated in a custom-molded thoracolumbosacral orthosis
NJ. Positive-pressure ventilation
NJ. An immediate radiograph of the chest
Ǎ. Adjustment of the position of the endotrachael tube
Ǎ. Insertion of a large-bore needle into the pericardial space
Ǐ. Insertion of a large-bore needle in the right second intercostal space, midclavicular line
Ǐ. Allowing the ends of the fracture to touch
Ǒ. Adding a second connecting bar
Ǒ. Adding one pin to each fracture fragment
Ǔ. Increasing the pin diameter from 4 mm to 6 mm
Ǔ. Decreasing the connecting bar-to-bone distance from 6 cm to 4 cm
Ǖ. Osteomyelitis
Ǖ. Malignant degeneration
Ǘ. Stress fracture
Ǘ. Local recurrence of the giant cell tumor
Ǚ. Bone resorption due to methylmethacrylate
Ǚ. Advancement of the plantar plate
Ǜ. Resection of the second metatarsal head
Ǜ. Dorsiflexion osteotomy of the second metatarsal neck
Ǝ. Transfer of the flexor digitorum longus tendon to the dorsum of the toe
Ǟ. Transfer of the extensor digitorum comminus tendon to the metatarsal neck
Ǟ. Sacral fracture
Ǡ. Burst fracture of L5
Ǡ. Cauda equina syndrome
Ǣ. Distraction-flexion injury at L3
Ǣ. Distraction-extension injury at L3
Ǥ. An MRI scan of the shoulder
Ǥ. An MRI scan of the cervical spine
Ǧ. Electromyographic and nerve conduction velocity studies
Ǧ. Immobilization in a sling and early passive range of motion exercises
Ǩ. Immediate return to the operating room for exploration of the brachial plexus
Ǩ. cerclage wiring
Ǫ. tension band wiring
Ǫ. removal of the patellar component
Ǭ. revision of the patellar component
Ǭ. immobilization of the knee and protected weightbearing
Ǯ. Liposarcoma
Ǯ. Nodular fasciitis
J̌. Rabdomyosarcoma
DZ. Malignant fibrous histiocytoma
DZ. Extra-abdominal desmoid tumor
DZ. Clubfeet
Ǵ. Thrombocytopenia
Ǵ. Congenital scoliosis
Ƕ. Ventricular septal defect
Ƿ. Arnold-Chiari malformation
Ǹ. delayed primary closure
Ǹ. free flap
Ǻ. pedicle groin flap
Ǻ. full-thickness skin graft
Ǽ. split-thickness skin graft
Ǽ. Infection
Ǿ. Nonunion
Ǿ. Improper screw length
Ȁ. Osteonecrosis of the distal fragment
Ȁ. Use of a cortical screw instead of a cancellous screw
Ȃ. Infection
Ȃ. Tear of the rotator cuff
Ȅ. Loosening of the humeral component
Ȅ. Arthritis of the glenoid
Ȇ. Arthritis of the A-C joint
Ȇ. Reduced morbidity
Ȉ. Improved osteoinduction
Ȉ. Improved osteoconduction
Ȋ. More rapid revascularization
Ȋ. Lower risk of disease transmission
Ȍ. Manipulation Under Anesthesia
Ȍ. Arthroscopic acromioplasty
Ȏ. Arthroscopic debridement of G-H joint
Ȏ. Replacement of the humeral head
Ȑ. Lengthening of the subscapularis and release of the anterior capsule
Ȑ. Bacteroides
Ȓ. E. coli
Ȓ. Staph. aureus
Ȕ. group A streptococcus
Ȕ. Clostridium perforingens
Ȗ. observation and exercises
Ȗ. bracing with a thoracolumbar orthosis
Ș. fusion of the posterior spine
Ș. fusion of the anterior spine
Ț. fusion of the anterior and posterior spine
Ț. Total wrist replacement and bridge grafts
Ȝ. palmar shelf arthroplasty and tendon transfers
Ȝ. Darrach distal ulna resection, dorsal tenosynosynovectomy, and tendon transfers
Ȟ. Radioscaphate fusion, extensor tenodesis, and Darrach distal ulna resection
Ȟ. Total wrist fusion and tendon transfers
Ƞ. constrained acetabular component
ȡ. protrusion ring with morselized graft
Ȣ. cemented metal backed acetabular component
Ȣ. cemented all-polyethylene acetabular component
Ȥ. cementless hemispherical component with screw fixation
Ȥ. application of a hip abduction brace for 22 hours per day
Ȧ. application of a hip spica under anesthesia
Ȧ. discontinuance of all bracing and repeat radiographs in 3 months
Ȩ. open reduction of the hip and application of a spica cast
Ȩ. open reduction, varus osteotomy, and application of a spica cast
Ȫ. Loss of skin hair on the feet
Ȫ. Absent pulses on vascular examination
Ȭ. Pain that originates proximally and spreads distally
Ȭ. Pain that is relieved by stopping and standing
Ȯ. Pain that is worse when the patient walks uphill rather downhill
Ȯ. wrist flexors and finger flexors
Ȱ. elbow flexors and wrist flexors
Ȱ. elbow flexors and finger flexors
Ȳ. elbow extensors and wrist flexorst Level Key Muscles4 DiaphragmDeltoid, elbow flexors, diaphragmElbow flexors, wrist extensorsElbow extensors, wrist flexorsFinger flexors (distal phalanx of middlefinger)Finger abductors (5th digit), intrinsics of hand2 Segmental innervation to intercostal muscles, abdominal and paraspinal muscles) L1, L2, L3 Hip flexors3, L4 QuadricepsTibialis anteriorToe extensors, hip abductorsAnkle plantarflexors, peronei
Ȳ. elbow extensors and wrist extensors
ȴ. Syndactyly
ȵ. Macrodactyly
ȶ. Camptodactyly
ȷ. Preaxial polydactyly
ȸ. Postaxial polydactyly
ȹ. Arthrodesis
Ⱥ. Rotationplasty
Ȼ. Above-knee amputation
Ȼ. Osteoarticular allograft
Ƚ. Endoprosthesis (custom arthroplasty)
Ⱦ. Plantar fascia
Ȿ. Spring ligament
Ɀ. Deltoid ligament
Ɂ. Intrinsic tendons
Ɂ. Gastorcnemius-solelus complex
Ƀ. Prevention of presynaptic release of acetylcholine
Ʉ. Prevention of synthesis of presynaptic acetylcholine
Ʌ. Activation of acetylcholinesterase at the motor end-plate
Ɇ. Blockage of postsynaptic action of acetylcholine until reserves are depleted
Ɇ. Stimulation of release of presynaptic acetylcholine until reserves are depleted
Ɉ. stiffness of the femoral component.
Ɉ. head offset of the femoral component.
Ɋ. femoral component material modulus of elasticity.
Ɋ. extent of the femoral component porous coating.
Ɍ. Presence of a femoral component collar.
Ɍ. plantar fascia and quadratus plantae tendon.
Ɏ. ligamentous structures connecting the tarsal bones.
Ɏ. shape of the tarsal bones and the intervening joints.
Ɐ. activity of the intrinsic muscles of the foot.
Ɑ. activity of the posterior tibialis and the peroneus longus muscles.
Ɒ. scapulothoracic fusion
Ɓ. strengthening of the periscapular muscles
Ɔ. pectoralis minor-fascia lata graft transfer to the scapula
ɕ. pectoralis major-fascia lata graft transfer to the scapula
Ɖ. exploration of the long thoracic nerve, with sural nerve graft
Ɗ. tricompartmental knee replacement
ɘ. unicompartmental knee replacement
Ə. medial compartment meniscal allograft
ɚ. valgus-producing distal femoral osteotomy
Ɛ. valgus-producing proximal tibial osteotomy
Ɜ. Internal rotation of the femoral component
ɝ. External rotation of the tibial component
ɞ. Lateral placement of the femoral component
ɟ. Medial placement of the patellar component
Ɠ. Excessive resection of the patella
Ɡ. Hallux rigidus
ɢ. Hallux valgus
Ɣ. Neuroma of the first web space
ɤ. Fracture of the sesamoid
Ɥ. Rupture of the flexor hallucis longus
Ɦ. Sickle cell crisis
ɧ. Idiopathic chondrolysis
Ɨ. Hemophilic arthropathy
Ɩ. Osteoid osteoma of the femoral neck
Ɪ. Legg-Calve-Perthes disease
Ɫ. Decreased ankle jerk and positive femoral nerve stretch test
Ɬ. Decreased knee jerk and positive straight-leg raising sign
ɭ. Gastrocnemius-soleus complex weakness and positive straight-leg raising sign
ɮ. Weakness of the extensor hallucis longus and positive straight-leg raising sign
Ɯ. Weakness of the extensor hallucis longus and positive femoral nerve stretch test
ɰ. Long-term administration of IV and oral antibiotics
Ɱ. Open soft-tissue debridement, retention of prosthetic components, and IV antibiotics
Ɲ. Immediate exchange arthroplasty with antibiotic-impregnated cement
ɳ. Two-stage surgical prosthetic exchange and IV antibiotics
ɴ. Resection arthroplasty and IV antibiotics
Ɵ. SCFE
ɶ. MED
ɷ. Perthes disease
ɸ. Hypothyroidism
ɹ. Chondrolysis
ɺ. gout.
ɻ. osteoporosis.
ɼ. eosinophilic granuloma.
Ɽ. tuberculosis of the spine.
ɾ. metastatic disease of the spine.
ɿ. water content.
Ʀ. Synthesis of type I collagen.
ʁ. Proteoglycan content.
Ʂ. Activity of chondrocytes.
Ʃ. Synthesis of hyaluronate.
ʄ. Lung
ʅ. Breast
ʆ. Prostate
Ʇ. Thyroid
Ʈ. Renal
Ʉ. T1-low, T2-low.
Ʊ. T1-low, T2-high.
Ʋ. T1-moderate, T2-low.
Ʌ. T1-high, T2-low.
ʍ. T1-high, T2-high.
ʎ. hypothesis is incorrect or invalid
ʏ. interobserver error rate is 4%.
ʐ. Standard deviation is 4% higher or lower than the mean.
ʑ. Sample size is 4% larger than required to be clinically significant.
Ʒ. Probability that the differences noted between two study groups were due to chance alone is 4%.
ʓ. I
ʔ. II
ʕ. IV
ʖ. IX
ʗ. X
ʘ. Cranial setting
ʙ. Cranial subluxation
ʚ. Odontoid fracture
ʛ. Lysis of the arch of the atlas
ʜ. Atlantoaxial subluxation
Ʝ. Retrograde collapse of the endoneurial tubes
Ʞ. Irreversible atrophy of the denervated muscles
ʟ. Elongation of the axons across the zone of injury
ʠ. Sprouting of the axons at the neuromuscular junction
ʡ. Misdirection of the axons across the zone of injury
ʢ. Maximally pronated and elbow extended
ʣ. Maximally pronated and the elbow flexed
ʤ. Maximally supinated and the elbow flexed
ʥ. Maximally supinated and the elbow extended
ʦ. In neutral rotation, with the elbow extended
ʧ. open reduction and internal fixation
ʨ. buddy taping to the adjacent index finger
ʩ. early motion with application of a dynamic banjo splint
ʪ. application of a cast with the hand in a “safe position” for 3 weeks.
ʫ. dorsal extension block splinting
ʬ. The name of the manufacturer
ʭ. The manufacturer’s potential liability
ʮ. The physician’s clinical performance
ʯ. The physician’s materials testing data
ʰ. Any royalties the physician receives from the manufacturer
ʱ. Femoral
ʲ. Obturator
ʳ. Inferior gluteal
ʴ. Superior gluteal
ʵ. Lateral femoral cutaneous
ʶ. open biopsy and a long leg cast
ʷ. open biopsy and wide resection of the tumor
ʸ. a long leg cast and observation
ʹ. intramedullary stabilization and observation
ʺ. Triggering
ʻ. Lateral instability
ʼ. Swan-neck deformity
ʽ. Boutonniere deformity
ʾ. Loss of distal interphalangeal joint flexion
ʿ. Peroneus brevis to peroneus longus
ˀ. Peroneus tertius to extensor hallucis longus
ˁ. Peroneus tertius to superficial peroneal nerve
˂. Extensor hallucis longus to deep peroneal nerve
˃. Extensor hallucis longus to extensor digitorum longus
˄. reassurance that Medicare will pay for the treatment.
˅. consent forms that patients or their guardians are able to understand.
ˆ. a detailed description of the device, omitting the fact that it is part of a study.
ˇ. a provision that the patient’s care will be discontinued if he or she does not enroll in the study.
ˈ. a provision that the study will be carried out to completion, whether or not the device is as effective as those currently in existence.
ˉ. an onlay iliac crest bone graft.
ˊ. limited weightbearing and observation.
ˋ. removal of the implant and limited weightbearing.
ˌ. removal of the implant and insertion of a reamed femoral nail.
ˍ. removal of the implant and insertion of an unreamed femoral nail.
ˎ. Coronal
ˏ. Sagittal
ː. Anteromedial, midway between the sagittal and the coronal
ˑ. Proximal pins sagittal, distal pins coronal
˒. Proximal pins coronal, distal pins sagittal
˓. Rheumatoid arthritis
˔. Posttraumatic arthritis
˕. Degenerative osteoarthritis
˖. Osteonecrosis of the tibial plateau
˗. Osteonecrosis of the medial femoral condyle
˘. Trapeziometacarpal arthrodesis
˙. Osteotomy of the thumb metacarpal
˚. Arthrotomy and joint debridement
˛. Ligament reconstruction using one half of the flexor carpi radialis
˜. Trapezium resection, tendon interposition, and reconstruction of the ligament
˝. Creep
˞. Relaxation
˟. Energy dissipation
ˠ. Plastic deformation
ˡ. Elastic deformation
ˢ. bending
ˣ. axial loading
ˤ. high-speed rotation
˥. direct impact from anteromedial
˦. crush from anteromedial to posterolateral
˧. Increase stiffness
˨. Increase fracture toughness
˩. Increase fatigue strength
˪. Decrease mechanical strength
˫. Decrease wear rate
ˬ. disuse osteopenia
˭. paraendocrine effect of the tumor
ˮ. abnormally increased density on the right side
˯. side effect of the treatment of the lesion
˰. extensive tumor involvement of the left hip
˱. Sciatic nerve
˲. Superior gluteal artery
˳. Profunda femoris artery
˴. Femoral artery and nerve
˵. External iliac artery and vein
˶. Length
˷. Moment arm
˸. Total volume
˹. Physiologic cross-sectional area
˺. Distribution of slow and fast twitch fibers
˻. decreasing initiation of action potentials.
˼. increasing action potential amplitude.
˽. blocking the opening of gated sodium channels.
˾. decreasing the number of functional motor units.
˿. slowing or stopping action potential propagation through the axon.
̀. resection of the metatarsal heads of the first through fifth toes.
́. Silastic MP joint arthroplasties of the first through fifth toes.
̂. fusion of the hallux MP joint and resection arthroplasty of the 2nd through fifth metatarsal heads.
̃. fusion of hallux MP joint and distal osteotomy of the 2nd through 5th MT.
̄. plantar condylectomy of the 2nd through 5th MT heads & resection of proximal phx of the hallux.
̅. hemiarthroplasty
̆. open reduction and internal fixation
̇. closed reduction and percutaneous pinning
̈. a sling and early pedulum exercises
̉. a sling and swathe for 6 weeks, followed by shoulder rehabilitation
̊. open acromioplasty
̋. open Bankart repair
̌. open subscapularis tendon repair
̍. inferior capsular shift
̎. a supervised physical therapy program
̏. a sling and swathe, with pendulum exercises in 10 days
̐. open reduction and internal fixation through an anterior approach
̑. open reduction and internal fixation through a posterior approach
̒. immobilization with a splint in 45 degrees of abduction for 6 weeks
̓. arthroscopically assisted reduction and percutaneous screw fixation
̔. Repair of the rotator cuff
̕. Replacement of the humeral head
̖. Resection arthroplasty
̗. Total shoulder arthroplasty
̘. AP and lateral radiographs of the elbow
̙. Diagnositc arthroscopy
̚. Aspiration of joint fluid
̛. An erythrocyte sedimentation rate and CBC
̜. A diagnostic lidocaine injection
̝. Insulin-like growth factor (IGF-1)
̞. Fibroblast growth factor (FGF-1)
̟. Platelet-derived growth factor (PDGF)
̠. Transforming growth factor beta (TGF-B)
̡. Bone morphogenetic proteins (BMP)
̢. clinical history and radiographic findings.
̣. technetium bone scan
̤. flow cytometry pattern of extracted chondrocytes
̥. immunohistochemical staining patterns of a biopsy specimen
̦. histologic features of a biopsy specimen stained with hematoxylin-cosin
̧. Radial
̨. Radial recurrent
̩. Posterior interosseous
̪. Superior ulnar recurrent
̫. Superficial radial circumflex
̬. Impaired hydroxylation of proline
̭. Failure of cleavage in procollagen
̮. Defective binding sites for hydroxyproline
̯. Failure to incorporate glycine into the helix
̰. Diminished production of collagen through the rough endoplasmic reticulum
̱. Asking the legal staff to seek a court injunction
̲. Copying the patient’s chart and giving it to him as he leaves
̳. Having the patient sign a written legal contract that specifies acceptable behavior
̴. Continuing care of the patient until an appropriate referral can be arranged
̵. Transferring the patient to another orthopaedic surgeon without disclosing the realreason for why the patient is being transferred
̶. Meta-analysis
̷. Confidence interval
̸. Analysis of variance (ANOVA)
̹. Statistical significance (p-value)
̺. Survivorship analysis (Kaplan-Meier)
̻. Spinal shock
̼. Neurogenic shock
̽. Hypovolemic shock
̾. Pulmonary embolism
̿. Fat embolus syndrome
̀. Lumbar spinal stenosis
́. Metastatic disease of the spine
͂. Rheumatoid lumbar spondylitis
̓. Isthmic spondyloloisthesis
̈́. Degenerative spondylolisthesis at L4-5 and L5-S1
Ι. Patella alta
͆. A metal-backed patella
͇. Varus malalignment of the knee
͈. A posterior cruciate-substituting femoral component
͉. Lateral subluxation of the patella on a Merchant’s view
͊. The sesamoids are separated
͋. The sesamoid is fractured
͌. The proximal phx is on the neck of the metatarsal
͍. The dislocation is dorsal and centered
͎. The proximal phalanx is hyperextended
͏. Patella
͐. Tibial stem
͑. Distal femoral interface
͒. Posterior femoral interface
͓. Sites of screw fixation for the tibia
͔. Hallux rigidus
͕. Fracture of the sesamoid
͖. Disruption of the plantar plate
͗. Osteonecrosis of the metatarsal head
͘. Rupture of the flexor hallucis longus
͙. Gout
͚. Sepsis
͛. Old trauma
͜. Rheumatoid arthritis
͝. Charcot arthroplasty
͞. Aspiration and steroid injection
͟. Biopsy, curettage, and allograft bone grafting
͠. Percutaneous Kirschner wire fixation
͡. Percutaneous injection of autogenous bone marrow
͢. Nerve roots
ͣ. Spinal cord
ͤ. Sciatic nerve
ͥ. Peroneal nerve
ͦ. Conus medullaris
ͧ. Extent of bone penetrated by reaming, prosthetic components, or acrylic cement
ͨ. Periprosthetic regions that are accessible to joint fluid and particulate wear debris
ͩ. Enveloping pseudocapsular scar tissue that develops around a prosthetic hip following surgical capsulectomy
ͪ. Soft tissue and bone that are potentially contaminated with bacteria in the setting of a prosthetic joint infection
ͫ. Potential intrapelvic joint space communication created by acetabular fixation screws or intrapelvic extruded acrylic cement
ͬ. Early and late infection
ͭ. Periprosthetic fracture of the femur
ͮ. Failure of the patellofemoral and extensor mechanisms
ͯ. Aseptic loosening of cementing tibial components
Ͱ. Asceptic loosening of cemented femoral components
Ͱ. Acceptance of the current position of the ankle
Ͳ. Open reduction and fixation in the epiphysis only
Ͳ. ORIF with a small-fragment T-plate from the malleolus up to the metaphysis
ʹ. Closed reduction by eversion of the ankle and application of a bivalved long leg cast
͵. CRUGA and fixation with a malleolar screw from the malleolus into the metaphysis
Ͷ. Resection arthroplasty and local radiation
Ͷ. In situ fusion of the hip
͸. Excision of heterotopic bone, total hip arthroplasty, and oral indomethacin
͹. Excision of heterotopic bone and local radiation
ͺ. Excision of heterotopic bone, hemiarthroplasty, and oral indomethacin
Ͻ. Closed reduction of both fractures and immediate spica casting
Ͼ. Bilateral skin traction for 3 weeks, followed by spica casting
Ͽ. External fixation of both femora
;. External fixation of the left femur and a long leg cast brace for the right femur
Ϳ. External fixation of the left femur and use of a reamed intramedullary nail in the right femur
΀. Synovial sarcoma
΁. Soft-tissue abcess
΂. Rhabdomyosarcoma
΃. Eosinophilic granuloma
΄. Nodular pigmented villonodular synovitis
΅. Changing to a titanium nail
Ά. Changing to a nonslotted nail
·. Changing the cross-sectional shape of the nail
Έ. Increasing the diameter of the nail by 3 mm
Ή. Increasing the diameter of the interlocking screws
Ί. Fracture healing
΋. Chondrosarcoma
Ό. Periosteal chondroma
΍. Periosteal osteosarcoma
Ύ. Dysplasia epiphysealis hemimelica
Ώ. Demonstrate competence in the subject of the case
Ϊ́. Be fellowship trained in the subject of the case
Α. Be paid on a contingency basis
Β. Be board certified by the American Board of Orthopaedic Surgery
Γ. Have been involved in the case as a consultant
Δ. Diagnostic arthroscopy
Ε. Arthroscopy and subacromial decompression
Ζ. Reduction and fixation of the proximal humeral epiphysis
Η. Temporary cessation of throwing
Θ. Physical therapy for rotator cuff strengthening
Ι. Oblique popliteal ligament
Κ. Lateral capsule
Λ. Popliteal tendon
Μ. Fibular collateral ligament
Ν. Posterior oblique ligament
Ξ. Radial tear
Ο. Parrot-beak tear
Π. Vertical tear in the “red-red” zone
Ρ. Vertical tear in the “red-white” zone
΢. Vertical tear in the “white-white” zone
Σ. 0 degrees of abduction, with neural rotation
Τ. 40 degrees of flexion and 60 degrees of internal rotation
Υ. 45 degrees of flexion and 45 degrees of external rotation
Φ. 90 degrees of abduction with neutral rotation
Χ. 90 degrees of abduction and 90 degrees of external rotation
Ψ. Sural
Ω. Saphenous and its branches
Ϊ. Posterior tibial and its branches
Ϋ. Deep peroneal and its branches
Ά. Superficial peroneal and its branches
Έ. Strength
Ή. Stiffness
Ί. Shelf life
Ϋ́. Antigenicity
Α. Risk of HIV transmission
Β. Indemnification
Γ. Occurrence
Δ. Excess liability
Ε. Claims-made
Ζ. Nose
Η. Lateral Y
Θ. Scapular AP
Ι. Neutral rotation AP
Κ. Internal rotation AP
Λ. External rotation AP
Μ. Trauma
Ν. Hemophilia
Ξ. Reiter’s syndrome
Ο. Rheumatoid arthritis
Π. Systemic lupus erythematosus
Ρ. Cast immobilization for 6 weeks
Σ. Activity modification and re-evaluation in 2 months
Σ. Internal fixation with or without bone grafting
Τ. Retrograde drilling of the defect without articular cartilage penetration
Υ. Drilling of the defect directly through the articular cartilage
Φ. repair or reconstruction of the medial collateral ligament
Χ. repair or reconstruction of the medialand lateral collateral ligaments
Ψ. immobilization for 5 days or less
Ω. immobilization for 14 days
Ϊ. immobilization for 25 days
Ϋ. Cystinosis
Ό. Hypophosphatemia
Ύ. Renal osteodystrophy
Ώ. Primary hyperparathyroidism
Ϗ. Nutritional vitamin D deficiency
Β. Lateral meniscus tear
Θ. Popliteus tenosynovitis
ϒ. Iliotibial band friction syndrome
ϓ. Peroneal nerve entrapment
ϔ. Biceps tendinitis
Φ. Observation
Π. Removal of the prosthetic components
Ϗ. Operative exploration and decompression of the peroneal nerve
Ϙ. Nerve conduction velocity studies
Ϙ. Loosening of the primary dressings and knee flexion to 30 degrees
Ϛ. I
Ϛ. II
Ϝ. III
Ϝ. decreased tissue tension
Ϟ. decreased abductor lever arm
Ϟ. decreased joint reaction force
Ϡ. increased body weight over lever arm
Ϡ. increased polyethylene wear rate
Ϣ. recurrent traumatic anterior dislocation
Ϣ. recurrent traumatic posterior dislocation
Ϥ. traumatic subluxation with no previous dislocation
Ϥ. traumatic anterior subluxation
Ϧ. atraumatic involuntary subluxation
Ϧ. radial
Ϩ. axillary
Ϩ. suprascapular
Ϫ. thoracodorsal
Ϫ. long thoracic
Ϭ. Flexion
Ϭ. Extension
Ϯ. Axial rotation
Ϯ. Left lateral bending
Κ. Right lateral bending
Ρ. Skin
Ϲ. Lung
Ϳ. Brain
ϴ. Heart
Ε. Kidney
϶. Thoracoacromial, lateral thoracic, subscapular
Ϸ. Thoracoacromial, anterior humeral circumflex, posterior humeral circumflex
Ϸ. Posterior humeral circumflex, subscapular, thoracacromial
Ϲ. Subscapular, thoracacromial, anterior humeral circumflex
Ϻ. Lateral thoracic, anterior humeral circumflex, thoracacromial
Ϻ. Respondeat superior
ϼ. Indemnity agreement
Ͻ. Hold harmless agreement- attempt to shift liability from company to physician
Ͼ. Comparative negligence-% of involvement
Ͽ. Contributory negligence- resident contributed to the negligence
Ѐ. t-type
Ё. both column
Ђ. transverse
Ѓ. anterior column
Є. anterior column posterior hemitransverse
Ѕ. Posterior interosseous
І. Anterior interosseous
Ї. Radial
Ј. Median
Љ. Ulnar
Њ. Shock from hypovolemia
Ћ. Associated rupture of the bladder
Ќ. Arterial bleeding on pelvic angiogram
Ѝ. Presence of a hematoma in the perineum and scrotum
Ў. Fractures of both the anterior and posterior pelvic ring

Correct Answer & Explanation

. Crevice corrosion


Explanation

Question 4071

Topic: 10. Pathology and Oncology

A 53-year-old man with insulin-dependent diabetes has the ulcer on his heel shown in Figure 9. Radiographs and an MRI scan are consistent with osteomyelitis of the calcaeus, contiguous with the ulcer itself. Arterial flow to the foot is adequate. Management should consist of


. a total contact cast.
. partial calcanectomy
. Syme’s amputation
. transtibial amputation.
. nonweightbearing and IV antibiotics.
. Sural artery island flap.
. Free rectus abdominis flap.
. Extensor digitorum brevis flap.
. Staged cross leg flap.
. Split-thickness skin graft.
. An anterior cruciate functional knee brace.
. A physical therapy program.
. Reconstruction of the posterior cruciate ligament and the posterolateral corner.
. Reconstruction of the posterior cruciate ligament.
. Reconstruction of the anterior cruciate ligament.
. Avoids the risk of marrow emboli
. Avoids injury to the intramedullary nutrient vessels
. Results in faster healing of fractures
. Results in more secure fixation
. Results in faster regeneration of the endosteal blood supply
. Above-knee amputation
. En bloc resection of the lesion and reconstruction with a bone graft
. Closed reduction and immobilization in a cast
. Open reduction and internal fixation, followed by radiation therapy
. Open reduction, curettage, and cementing of the lesion
. Injury to the subclavian artery
. Injury to the brachial plexus
. Segmental fracture
. 100% displacement
. Associated displaced surgical neck fracture of the humerus
. humeral arthroplasty2/. repair of the rotator cuff
. closed reduction and immobilization
!. open reduction and immobilization
". open reduction and early passive motion
#. arthroscopic capsular release
$. manipulation under anesthesia
%. a physical therapy program
&. an intra-articular corticosteroid injection
'. administration of high-dose oral corticosteroids
(. adding the scores, in all five body systems
). adding the squares of the scores in the three most severely injured systems
*. doubling the cumulative score for head and chest injuries
+. combining the scores from the most and least injured systems
,. correcting the score in the most severely injured system for age
-. traumatic femoral head fracture
.. osteonecrosis
/. osteoarthritis
0. neuropathic joint
1. rheumatoid arthritis
2. low-dose radiation
3. steroid injection
4. a load-relieving insert and shoe modification
5. complete excision of the mass and the entire plantar fascia
6. wide excision of the mass with a 2 cm margin of normal fascia
7. CT scan of the chest
8. technetium bone scan
9. bone marrow aspiration
:. serum protein electrophoresis
;. lateral skull radiograph
<. high-grade histology of the initial tumor
=. multiple local recurrences after curettage
>. previous treatment of the tumor with cryotherapy
?. previous treatment of the tumor with radiation therapy
@. extraosseous extension into two or more adjacent compartments
A. Dorsal rhizotomy and facet joint fusion
B. Multilevel corpectomy and spinal stabilization
C. Central and lateral recess decompression and bilateral foraminotomy
D. Central decompression and facet joint fusion
E. Central decompression, foraminotomy, and spinal fusion from L2 to L5.
F. Inadequate rehabilitation
G. Displacement of the coronoid process fracture
H. Insufficiency of the lateral ulnar collateral ligament
I. Insufficiency of the anterior band of the medial collateral ligament
J. Insufficiency of the posterior band of the medial collateral ligament
K. Osteotomy and intramedullary rod fixation
L. Electrical stimulation
M. Strut-autografing the concavity the tibia
N. A patellar tendon-bearing brace
O. Percutaneous injection of demineralized bone matrix
P. digoxin
Q. sucralfate
R. clindamycin
S. alcohol
T. neuromuscular blocking agents
U. Unrestrained roll-back
V. Unrestrained rotational conformity
W. Medial-Lateral conformity
X. Anteroposterior conformity in flexion
Y. Anteroposterior conformity in extension
Z. Arthrodesis of the MTP joint
[. A Silastic implant of the MTP joint
\. Resection arthroplasty of the MTP joint
]. Cheilctomy of the MTP joint
^. Osteotomy of the base of the proximal phalanx
_. Genu varum
`. Tarsal coalition
A. Degenerative ankle arthrosis
B. Osteochondritis dissecans of the talus
C. Hemihypertrophy of the ipsilateral lower extremity
D. Trabecular bone is preferentially resorbed in this high bone turnover state
E. Loss of water content in the disk increases impact load to the vetrebral bodies
F. Stress is imposed by the relative stiffness of the arthrtic facet joints
G. Increased energy demands are imposed by decreased circulation to the vertebral body
H. The thick cortical bone found in the vertebral body resorbs rapidly following estrogen withdrawal
I. Increased time in stance and swing phase
J. Addition of a double leg float phase
K. Decreased vertical ground reaction forces
L. Decreased arc of motion in the hip, knee, and ankle
M. Decreased joint reaction forces in the hip, knee, and ankle
N. Talonavicular arthrodesis
O. Medial displacement calcaneal osteotomy
P. Flexor digitorum longus tendon transfer with spring ligament advancement
Q. Triple arthrodesis
R. Calcaneocuboid distraction arthrodesis and repair of the posterior tibial tendon
S. Lymphoma
T. Hemangioma
U. Osteosarcoma
V. TB of the spine
W. Metastatic breast carcinoma
X. widening and shortening of the heel.
Y. weakness of the gastrocnemius-soleus complex.
Z. anterior impingement from a horizontal talus.
{. unrecognized compartment syndrome of the foot.
|. degenerative arthritis of the tibiotalar joint.
}. a corrective osteotomy
~. application of braces
. medial physeal stapling until the varus corrects
€. observation
. application of corrective casts
‚. a total contact cast.
ƒ. electrical stimulation.
„. an off the shelf fracture brace.
…. an elastic compression bandage and crutches.
†. a hard soled shoe until the patient is asymptomatic.
‡. Ewings tumor
ˆ. Parosteal osteosarcoma
‰. Dedifferentiated chondrosarcoma
Š. Low grade intramedullary chondrosarcoma
‹. High grade intramedullary osteosarcoma
Œ. Vascular injury
. Tear of the rotator cuff
Ž. Injury to the brachial plexus
. Fracture of the upper thoracic rib
. Fracture of the proximal humerus
‘. Biceps
’. Trapezius
“. Infraspinatus
”. Pectoralis major
•. Serratus anterior
–. Hybrid total hip arthroplasty
—. Noncemental hemiarthroplasty of the hip
˜. Closed reduction and percutaneous pin fixation
™. Open reduction through an anterior approach to the hip
š. Excision of the head fragment
›. a quadratus femoris pediclebone graft
œ. a proximal femoral allograft
. intertrochanteric osteotomy
ž. total hip arthroplasty
Ÿ. hip hemiarthroplasty
 . Echocardiogram
¡. Electrocardiogram
¢. Radiograph of the chest
£. CT scan of the shoulder
¤. Ultrasound of the shoulder
¥. Ilioinguinal
¦. Extended iliofemoral
§. Combined ilioinguinal and Kocher-Langenbeck (posterior)
¨. Kocher-Langenbeck (posterior)
©. Kocher-Langenbeck (posterior) with trochanteric osteotomy
ª. Deltoid
«. Supraspinatus
¬. Subscapularis Infraspinatus
­. Infraspinatus
®. Infraspinatus and teres minor
¯. an orthosis.
°. observation.
±. electrical stimulation.
². open reduction and internal fixation.
³. application of a nonweightbearing short leg cast.
´. repair of the rotator cuff.
Μ. rehabilitation of the shoulder
¶. replacement of the humeral head.
·. arthroscopic acromioplasty and debridement.
¸. immobilization is a sling until pain resolves.
¹. Bone rotation versus torque applied
º. Bone deflection versus bending moment applied
». Axial displacement versus tension applied
¼. Lateral translation versus shear force applied
½. Fracture gap closing versus compressive force applied
¾. steroid injection
¿. stretching of the heel cord
À. surgical release of the plantar fascia
Á. application of a short leg cast for 6 to 8 weeks
Â. wearing dorsiflexion night splints
Ã. Open bladder
Ä. Bilateral “hitchhiker’s” thumbs
Å. Bilateral defects in the midclavicles
Æ. Rhizomelic shortening of the extremities
Ç. Radiographic fragmentation of all major epiphyses
È. Medial patellotibial
É. Medial patellofemoral
Ê. Medial patellomeniscal
Ë. Lateral patellofemoral
Ì. Lateral patellotibial
Í. Heat
Î. Gentle active flexion-extension exercises
Ï. Isokinetic strengthening
Ð. Electrical muscle stimulation
Ñ. Immobilization of the limb with the knee in full flexion
Ò. Distal chevron osteotomy with soft-tissue release
Ó. Distal soft-tissue realignment only
Ô. Closing wedge osteotomy (Aken) of the proximal phalanx
Õ. Proximal first metatarsal osteotomy only
Ö. Soft-tissue realignment with a proximal metatarsal osteotomy
×. Vagus
Ø. Phrenic
Ù. Hypoglossal
Ú. Recurrent laryngeal
Û. Inferior thyroid
Ü. Surgical exploration
Ý. Application of leeches
Þ. Stellate ganglion blocks
SS. Intra-arterial streptokinase
À. Elevation and reevaluation in 1 hour
Á. Liver profile
Â. Myleogram
Ã. Platelet count
Ä. CT scan of the head
Å. Angiogram of the extremity
Æ. Post spinal fusion from L5to S1
Ç. Primary repair with an iliac bone graft
È. Post spinal fusion of L4-5
É. A pantaloon body cast and 6 weeks of bed rest
Ê. Rest, NSAIDS, and limited dancing
Ë. Stress fracture of the proximal fifth metatarsal
Ì. Stress fracture of the base of the second metatarsal
Í. Stress fracture of the neck of the second metatarsal
Î. Morton’s neuroma
Ï. Lisfranc’s joint subluxation
Ð. C5 radiculopathy
Ñ. Subscapularis rupture
Ò. Glenohumeral arthrosis
Ó. Rotator cuff arthropathy
Ô. Suprascapular nerve compression at the spinoglenoid notch
Õ. mm femoral head in combination with a metal-backed polyethylene component
Ö. mm femoral head in combination with an all-polyethylene acetabular component
÷. mm femoral head in combination with a metal-backed polyethylene component
Ø. mm femoral head in combination with an all-polyethylene component
Ù. mm femoral head in combination with a metal-backed polyethylene component
Ú. Female gender
Û. History of cigarette smoking
Ü. L5-S1 spondylolisthesis on pre-employment radiography
Ý. Decreased strength of the lower extremities on pre-employment testing
Þ. Decreased flexibility of the lumbar spine on pre-employment testing
Ÿ. Size of cells
Ā. Amount of DNA in cells
Ā. Nucleus-cytoplasm ratio
Ă. Specific DNA sequences
Ă. Specific messenger RNA sequences
Ą. Femoral and obturator nerves
Ą. Femoral and superior gluteal nerves
Ć. Femoral and lateral femoral cutaneous nerves
Ć. Obturator and superior gluteal nerves
Ĉ. Obturator and lateral femoral cutaneous nerves
Ĉ. Isotonic
Ċ. Isokinetic
Ċ. Isometric
Č. Open kinetic chain
Č. Dynamic variable resistance
Ď. Closed reduction and cast immobilization
Ď. Uniplanar external fixation
Đ. Open reduction and internal fixation with a dynamic compression plate
Đ. Unreamed intramedullary rod
Ē. Multiple plane external fixator
Ē. Inlet view of the pelvis
Ĕ. Outlet view of the pelvis
Ĕ. AP view of the hip
Ė. Ilial oblique view (external oblique) of the hip
Ė. Obturator oblique
Ę. Glycolytic pathway
Ę. Oxidative phosphorylation
Ě. Breakdown of fat
Ě. Breakdown of protein
Ĝ. Breakdown of adenosine triphosphate
Ĝ. an MRI scan
Ğ. arthroscopic examination
Ğ. AP and frog-lateral radiographs of the pelvis and hips
Ġ. varus and valgus stress radiographs of the knee
Ġ. physical examination of the knee under anesthesia
Ģ. extended curettage and polymethylmethacrylate cementation
Ģ. extra-articular resection of the knee and an allograft arthrodesis
Ĥ. wide resection of the proximal tibia and custom prosthetic replacement
Ĥ. prophylactic internal fixation and postoperative irradiation
Ħ. excision of the lateral condyle and reconstruction with a hemicondylar allograft
Ħ. silicone implant joint replacement
Ĩ. metatarsophalangeal joint arthrodesis
Ĩ. metatarsophalangeal joint debridement
Ī. resection of the metatarsal head
Ī. resection of the base of the proximal phalanx
Ĭ. Fixation of the syndesmosis has failed
Ĭ. Widening of the ankle mortise has led to the failure of fixation
Į. Infection around the syndesmosis screw has led to osteomyelitis
Į. The syndesmosis screw is broken
İ. Motion between the tibia and fibula has caused loosening of the syndesmosis screw
I. Microcephaly
IJ. A temporal lobe cyst
IJ. An Arnold-Chiari type 1 malformation
Ĵ. Periventricular leukomalacia
Ĵ. Agnesis of the corpus callosum
Ķ. Wolff’s
Ķ. Hooke’s
ĸ. Hilton’s
Ĺ. Muller-Haeckel
Ĺ. Heuter-Volkmann
Ļ. Both the anterolateral and posteromedial bands are isometric and do not significantly change with flexion
Ļ. The anterolateral band is lax and becomes tight in flexion, while the posteromedial band is tight, and becomes lax in flexion
Ľ. The anterolateral band is tight and becomes lax in flexion, while the posteromedial band is lax and becomes tight in flexion
Ľ. Both the anterolateral and posteromedial bands are lax and become tight in flexion
Ŀ. Both the anterolateral and posteromedial bands are tight and become lax as the knee is flexed
Ŀ. UCB orthosis
Ł. Rigid orthosis with a medical arch support
Ł. Semi-rigid orthosis with lateral forefoot posting
Ń. Semi-rigid orthosis with a medial arch support
Ń. Medial heel wedge attached to the running shoes
Ņ. Hallux varus
Ņ. Osteonecrosis
Ň. Recurrence of the hallux valgus
Ň. “Transfer” second metatarsalgia
ʼN. Physeal arrest of the first metatarsal
Ŋ. Aseptic loosening in a 70-year-old patient
Ŋ. Mechanical failure of a hinged knee prosthesis
Ō. Failed knee replacement complicated by reflex sympathetic dystrophy
Ō. Infection with soft-tissue deficit
Ŏ. A prior patellectomy
Ŏ. Knee fusion
Ő. Open irrigation and debridement
Ő. Arthroscopic irrigation and debridement
Œ. One-stage exchange arthroplasty
Œ. Two-stage exchange arthroplasty
Ŕ. Putti-platt repair
Ŕ. Open Bankart repair
Ŗ. Injection of a subacromial corticosteroid
Ŗ. Arthroscopic transglenoid capsular shift
Ř. Rehabilitation of the scapular and rotator cuff muscles
Ř. Silicone suction socket and an energy-absorbing foot
Ś. Silicone suction socket and a variable resistance ankle
Ś. Plastic suction socket, telescoping pylon, and a solid ankle cushioned heel (SACH) foot
Ŝ. Plastic socket with a hinged thigh cuff and a SACH foot
Ŝ. Patellar tendon-bearing suction socket and a uniaxial hydraulic ankle
Ş. Parosteal
Ş. Periosteal
Š. High-grade intramedullary
Š. Osteosarcoma occurring in Paget’s disease
Ţ. Osteosarcoma occurring in irradiated bone
Ţ. Cauda equina
Ť. Conus medullaris
Ť. Genitofemoral nerve
Ŧ. Lumbar sympathetic plexus
Ŧ. Lumbar parasympathetic plexus
Ũ. Spinal pseudoarthrosis
Ũ. Spinal cord traction injury with paralysis
Ū. Arterial and venous thromboses
Ū. Superior mesenteric artery syndrome
Ŭ. Crankshaft phenomenon
Ŭ. Inversion stress radiograph
Ů. MRI scan
Ů. CT scan
Ű. Nuclear bone scan
Ű. External rotation stress radiograph
Ų. Complex deformity with an angulation in two planes
Ų. Single deformity less than 20 degrees, apex posterolateral
Ŵ. Single deformity greater than 30 degrees, apex posterolateral
Ŵ. Single deformity less than 20 degrees, apex posteromedial
Ŷ. Single deformity greater than 30 degrees, apex posteromedial
Ŷ. Pronation of the foot during the stance phase of gait
Ÿ. Heel inversion at the beginning of a single limb heel rise
Ź. Active inversion of the nonweightbearing foot
Ź. Active plantar flexion of the first ray against resistance
Ż. Active plantar flexion of the foot during the push-off phase of gait
Ż. Observation and repeat radiographs in 4 months
Ž. Application of a thoracolumbalsacral orthosis for 22 to 24 hours per day
Ž. Electrical stimulation at night
S. Physical therapy
Ƀ. Begins to remodel and hypertrophy more quickly
Ɓ. Provides a better scaffold for osteoconduction
Ƃ. Reduces the risk of early fracture
Ƃ. Reduces technical difficulty
Ƅ. Lowers donor site morbidity
Ƅ. Anterior fusion of the lumbar curve
Ɔ. Anterior and posterior fusion of the thoracic curve
Ƈ. Posterior fusion of the thoracic curve
Ƈ. Posterior fusion of the thoracic and lumbar curves
Ɖ. Application of a brace until the iliac apophyses are Risser 4 or 5, followed by surgical correction
Ɗ. Subscapularis rupture
Ƌ. Type III SLAP lesion
Ƌ. Disruption of capsular shift
ƍ. Isolated traumatic subluxation
Ǝ. Injury to the axillary nerve after dislocation
Ə. hypophosphatemia
Ɛ. high dietary cholesterol intake
Ƒ. deficiency of lipoprotein A
Ƒ. deficiency of protein S and protein C
Ɠ. elevated levels of antithrombin III
Ɣ. Weightbearing short leg cast
Ƕ. Nonweightbearing short leg cast
Ɩ. Removable splint and early motion
Ɨ. Open reduction and internal fixation
Ƙ. Elastic compression bandage with full weightbearing
Ƙ. Breast
Ƚ. Prostate
ƛ. Gastrointestinal
Ɯ. Kidney
Ɲ. Multiple myeloma
Ƞ. Varus stress
Ɵ. Valgus stress
Ơ. Torsional loading
Ơ. Hyperextension of the knee
Ƣ. Contraction of the quadriceps while axially loaded
Ƣ. Primary internal fixation at both fracture levels
Ƥ. External fixation as definitive ttt for both #
Ƥ. Skeletal traction and delayed internal fixation of both fractures
Ʀ. Primary internal fixation of the proximal fracture and delayed fixation of the femoral fracture
Ƨ. Primary internal fixation of the femoral shaft fracture and delayed fixation of the proximal #
Ƨ. Heel spur
Ʃ. Plantar fascitis
ƪ. Dysfunction of the tibialis posterior tendon
ƫ. Compression of the first branch of the lateral plantar nerve
Ƭ. Compression of the calcaneal nerve
Ƭ. Displaced labral tear
Ʈ. Tear of the rotator cuff
Ư. Fracture of the glenoid rim
Ư. Palsy of the axillary nerve
Ʊ. Palsy of the musculocutaneus nerve
Ʋ. Enchondroma
Ƴ. Osteoblastoma
Ƴ. Giant cell tumor
Ƶ. Aneurysmal bone cyst
Ƶ. Fibrous dysplasia
Ʒ. Arthrogram of the wrist
Ƹ. MRI scan of both wrists
Ƹ. CT scan of both wrists in the same position
ƺ. Radiographs of the wrist in supination and pronation
ƻ. Radiographs of the opposite wrist in the same position
Ƽ. Secondary hyperparathyroidism
Ƽ. Phosphate retention secondary to uremia
ƾ. Insufficient renal synthesis of 1, 25 dihydroxy vitamin D
Ƿ. Aluminum deposition in bone from oral phosphate binders
ǀ. Persistent acidosis aggravating the negative calcium balance
ǁ. Posterior fusion at T10-L3 with segmental instrumentation
ǂ. Laminectomy and fusion of T12-L2 with segmental instrumentation
ǃ. Bed rest in a hyperextension brace
DŽ. L1 vertebrectomy and anterior decompression with strut graft fusion and instrumentation
DŽ. Progressive ambulation as tolerated in a custom-molded thoracolumbosacral orthosis
DŽ. Positive-pressure ventilation
LJ. An immediate radiograph of the chest
LJ. Adjustment of the position of the endotrachael tube
LJ. Insertion of a large-bore needle into the pericardial space
NJ. Insertion of a large-bore needle in the right second intercostal space, midclavicular line
NJ. Allowing the ends of the fracture to touch
NJ. Adding a second connecting bar
Ǎ. Adding one pin to each fracture fragment
Ǎ. Increasing the pin diameter from 4 mm to 6 mm
Ǐ. Decreasing the connecting bar-to-bone distance from 6 cm to 4 cm
Ǐ. Osteomyelitis
Ǒ. Malignant degeneration
Ǒ. Stress fracture
Ǔ. Local recurrence of the giant cell tumor
Ǔ. Bone resorption due to methylmethacrylate
Ǖ. Advancement of the plantar plate
Ǖ. Resection of the second metatarsal head
Ǘ. Dorsiflexion osteotomy of the second metatarsal neck
Ǘ. Transfer of the flexor digitorum longus tendon to the dorsum of the toe
Ǚ. Transfer of the extensor digitorum comminus tendon to the metatarsal neck
Ǚ. Sacral fracture
Ǜ. Burst fracture of L5
Ǜ. Cauda equina syndrome
Ǝ. Distraction-flexion injury at L3
Ǟ. Distraction-extension injury at L3
Ǟ. An MRI scan of the shoulder
Ǡ. An MRI scan of the cervical spine
Ǡ. Electromyographic and nerve conduction velocity studies
Ǣ. Immobilization in a sling and early passive range of motion exercises
Ǣ. Immediate return to the operating room for exploration of the brachial plexus
Ǥ. cerclage wiring
Ǥ. tension band wiring
Ǧ. removal of the patellar component
Ǧ. revision of the patellar component
Ǩ. immobilization of the knee and protected weightbearing
Ǩ. Liposarcoma
Ǫ. Nodular fasciitis
Ǫ. Rabdomyosarcoma
Ǭ. Malignant fibrous histiocytoma
Ǭ. Extra-abdominal desmoid tumor
Ǯ. Clubfeet
Ǯ. Thrombocytopenia
J̌. Congenital scoliosis
DZ. Ventricular septal defect
DZ. Arnold-Chiari malformation
DZ. delayed primary closure
Ǵ. free flap
Ǵ. pedicle groin flap
Ƕ. full-thickness skin graft
Ƿ. split-thickness skin graft
Ǹ. Infection
Ǹ. Nonunion
Ǻ. Improper screw length
Ǻ. Osteonecrosis of the distal fragment
Ǽ. Use of a cortical screw instead of a cancellous screw
Ǽ. Infection
Ǿ. Tear of the rotator cuff
Ǿ. Loosening of the humeral component
Ȁ. Arthritis of the glenoid
Ȁ. Arthritis of the A-C joint
Ȃ. Reduced morbidity
Ȃ. Improved osteoinduction
Ȅ. Improved osteoconduction
Ȅ. More rapid revascularization
Ȇ. Lower risk of disease transmission
Ȇ. Manipulation Under Anesthesia
Ȉ. Arthroscopic acromioplasty
Ȉ. Arthroscopic debridement of G-H joint
Ȋ. Replacement of the humeral head
Ȋ. Lengthening of the subscapularis and release of the anterior capsule
Ȍ. Bacteroides
Ȍ. E. coli
Ȏ. Staph. aureus
Ȏ. group A streptococcus
Ȑ. Clostridium perforingens
Ȑ. observation and exercises
Ȓ. bracing with a thoracolumbar orthosis
Ȓ. fusion of the posterior spine
Ȕ. fusion of the anterior spine
Ȕ. fusion of the anterior and posterior spine
Ȗ. Total wrist replacement and bridge grafts
Ȗ. palmar shelf arthroplasty and tendon transfers
Ș. Darrach distal ulna resection, dorsal tenosynosynovectomy, and tendon transfers
Ș. Radioscaphate fusion, extensor tenodesis, and Darrach distal ulna resection
Ț. Total wrist fusion and tendon transfers
Ț. constrained acetabular component
Ȝ. protrusion ring with morselized graft
Ȝ. cemented metal backed acetabular component
Ȟ. cemented all-polyethylene acetabular component
Ȟ. cementless hemispherical component with screw fixation
Ƞ. application of a hip abduction brace for 22 hours per day
ȡ. application of a hip spica under anesthesia
Ȣ. discontinuance of all bracing and repeat radiographs in 3 months
Ȣ. open reduction of the hip and application of a spica cast
Ȥ. open reduction, varus osteotomy, and application of a spica cast
Ȥ. Loss of skin hair on the feet
Ȧ. Absent pulses on vascular examination
Ȧ. Pain that originates proximally and spreads distally
Ȩ. Pain that is relieved by stopping and standing
Ȩ. Pain that is worse when the patient walks uphill rather downhill
Ȫ. wrist flexors and finger flexors
Ȫ. elbow flexors and wrist flexors
Ȭ. elbow flexors and finger flexors
Ȭ. elbow extensors and wrist flexorst Level Key Muscles4 DiaphragmDeltoid, elbow flexors, diaphragmElbow flexors, wrist extensorsElbow extensors, wrist flexorsFinger flexors (distal phalanx of middlefinger)Finger abductors (5th digit), intrinsics of hand2 Segmental innervation to intercostal muscles, abdominal and paraspinal muscles) L1, L2, L3 Hip flexors3, L4 QuadricepsTibialis anteriorToe extensors, hip abductorsAnkle plantarflexors, peronei
Ȯ. elbow extensors and wrist extensors
Ȯ. Syndactyly
Ȱ. Macrodactyly
Ȱ. Camptodactyly
Ȳ. Preaxial polydactyly
Ȳ. Postaxial polydactyly
ȴ. Arthrodesis
ȵ. Rotationplasty
ȶ. Above-knee amputation
ȷ. Osteoarticular allograft
ȸ. Endoprosthesis (custom arthroplasty)
ȹ. Plantar fascia
Ⱥ. Spring ligament
Ȼ. Deltoid ligament
Ȼ. Intrinsic tendons
Ƚ. Gastorcnemius-solelus complex
Ⱦ. Prevention of presynaptic release of acetylcholine
Ȿ. Prevention of synthesis of presynaptic acetylcholine
Ɀ. Activation of acetylcholinesterase at the motor end-plate
Ɂ. Blockage of postsynaptic action of acetylcholine until reserves are depleted
Ɂ. Stimulation of release of presynaptic acetylcholine until reserves are depleted
Ƀ. stiffness of the femoral component.
Ʉ. head offset of the femoral component.
Ʌ. femoral component material modulus of elasticity.
Ɇ. extent of the femoral component porous coating.
Ɇ. Presence of a femoral component collar.
Ɉ. plantar fascia and quadratus plantae tendon.
Ɉ. ligamentous structures connecting the tarsal bones.
Ɋ. shape of the tarsal bones and the intervening joints.
Ɋ. activity of the intrinsic muscles of the foot.
Ɍ. activity of the posterior tibialis and the peroneus longus muscles.
Ɍ. scapulothoracic fusion
Ɏ. strengthening of the periscapular muscles
Ɏ. pectoralis minor-fascia lata graft transfer to the scapula
Ɐ. pectoralis major-fascia lata graft transfer to the scapula
Ɑ. exploration of the long thoracic nerve, with sural nerve graft
Ɒ. tricompartmental knee replacement
Ɓ. unicompartmental knee replacement
Ɔ. medial compartment meniscal allograft
ɕ. valgus-producing distal femoral osteotomy
Ɖ. valgus-producing proximal tibial osteotomy
Ɗ. Internal rotation of the femoral component
ɘ. External rotation of the tibial component
Ə. Lateral placement of the femoral component
ɚ. Medial placement of the patellar component
Ɛ. Excessive resection of the patella
Ɜ. Hallux rigidus
ɝ. Hallux valgus
ɞ. Neuroma of the first web space
ɟ. Fracture of the sesamoid
Ɠ. Rupture of the flexor hallucis longus
Ɡ. Sickle cell crisis
ɢ. Idiopathic chondrolysis
Ɣ. Hemophilic arthropathy
ɤ. Osteoid osteoma of the femoral neck
Ɥ. Legg-Calve-Perthes disease
Ɦ. Decreased ankle jerk and positive femoral nerve stretch test
ɧ. Decreased knee jerk and positive straight-leg raising sign
Ɨ. Gastrocnemius-soleus complex weakness and positive straight-leg raising sign
Ɩ. Weakness of the extensor hallucis longus and positive straight-leg raising sign
Ɪ. Weakness of the extensor hallucis longus and positive femoral nerve stretch test
Ɫ. Long-term administration of IV and oral antibiotics
Ɬ. Open soft-tissue debridement, retention of prosthetic components, and IV antibiotics
ɭ. Immediate exchange arthroplasty with antibiotic-impregnated cement
ɮ. Two-stage surgical prosthetic exchange and IV antibiotics
Ɯ. Resection arthroplasty and IV antibiotics
ɰ. SCFE
Ɱ. MED
Ɲ. Perthes disease
ɳ. Hypothyroidism
ɴ. Chondrolysis
Ɵ. gout.
ɶ. osteoporosis.
ɷ. eosinophilic granuloma.
ɸ. tuberculosis of the spine.
ɹ. metastatic disease of the spine.
ɺ. water content.
ɻ. Synthesis of type I collagen.
ɼ. Proteoglycan content.
Ɽ. Activity of chondrocytes.
ɾ. Synthesis of hyaluronate.
ɿ. Lung
Ʀ. Breast
ʁ. Prostate
Ʂ. Thyroid
Ʃ. Renal
ʄ. T1-low, T2-low.
ʅ. T1-low, T2-high.
ʆ. T1-moderate, T2-low.
Ʇ. T1-high, T2-low.
Ʈ. T1-high, T2-high.
Ʉ. hypothesis is incorrect or invalid
Ʊ. interobserver error rate is 4%.
Ʋ. Standard deviation is 4% higher or lower than the mean.
Ʌ. Sample size is 4% larger than required to be clinically significant.
ʍ. Probability that the differences noted between two study groups were due to chance alone is 4%.
ʎ. I
ʏ. II
ʐ. IV
ʑ. IX
Ʒ. X
ʓ. Cranial setting
ʔ. Cranial subluxation
ʕ. Odontoid fracture
ʖ. Lysis of the arch of the atlas
ʗ. Atlantoaxial subluxation
ʘ. Retrograde collapse of the endoneurial tubes
ʙ. Irreversible atrophy of the denervated muscles
ʚ. Elongation of the axons across the zone of injury
ʛ. Sprouting of the axons at the neuromuscular junction
ʜ. Misdirection of the axons across the zone of injury
Ʝ. Maximally pronated and elbow extended
Ʞ. Maximally pronated and the elbow flexed
ʟ. Maximally supinated and the elbow flexed
ʠ. Maximally supinated and the elbow extended
ʡ. In neutral rotation, with the elbow extended
ʢ. open reduction and internal fixation
ʣ. buddy taping to the adjacent index finger
ʤ. early motion with application of a dynamic banjo splint
ʥ. application of a cast with the hand in a “safe position” for 3 weeks.
ʦ. dorsal extension block splinting
ʧ. The name of the manufacturer
ʨ. The manufacturer’s potential liability
ʩ. The physician’s clinical performance
ʪ. The physician’s materials testing data
ʫ. Any royalties the physician receives from the manufacturer
ʬ. Femoral
ʭ. Obturator
ʮ. Inferior gluteal
ʯ. Superior gluteal
ʰ. Lateral femoral cutaneous
ʱ. open biopsy and a long leg cast
ʲ. open biopsy and wide resection of the tumor
ʳ. a long leg cast and observation
ʴ. intramedullary stabilization and observation
ʵ. Triggering
ʶ. Lateral instability
ʷ. Swan-neck deformity
ʸ. Boutonniere deformity
ʹ. Loss of distal interphalangeal joint flexion
ʺ. Peroneus brevis to peroneus longus
ʻ. Peroneus tertius to extensor hallucis longus
ʼ. Peroneus tertius to superficial peroneal nerve
ʽ. Extensor hallucis longus to deep peroneal nerve
ʾ. Extensor hallucis longus to extensor digitorum longus
ʿ. reassurance that Medicare will pay for the treatment.
ˀ. consent forms that patients or their guardians are able to understand.
ˁ. a detailed description of the device, omitting the fact that it is part of a study.
˂. a provision that the patient’s care will be discontinued if he or she does not enroll in the study.
˃. a provision that the study will be carried out to completion, whether or not the device is as effective as those currently in existence.
˄. an onlay iliac crest bone graft.
˅. limited weightbearing and observation.
ˆ. removal of the implant and limited weightbearing.
ˇ. removal of the implant and insertion of a reamed femoral nail.
ˈ. removal of the implant and insertion of an unreamed femoral nail.
ˉ. Coronal
ˊ. Sagittal
ˋ. Anteromedial, midway between the sagittal and the coronal
ˌ. Proximal pins sagittal, distal pins coronal
ˍ. Proximal pins coronal, distal pins sagittal
ˎ. Rheumatoid arthritis
ˏ. Posttraumatic arthritis
ː. Degenerative osteoarthritis
ˑ. Osteonecrosis of the tibial plateau
˒. Osteonecrosis of the medial femoral condyle
˓. Trapeziometacarpal arthrodesis
˔. Osteotomy of the thumb metacarpal
˕. Arthrotomy and joint debridement
˖. Ligament reconstruction using one half of the flexor carpi radialis
˗. Trapezium resection, tendon interposition, and reconstruction of the ligament
˘. Creep
˙. Relaxation
˚. Energy dissipation
˛. Plastic deformation
˜. Elastic deformation
˝. bending
˞. axial loading
˟. high-speed rotation
ˠ. direct impact from anteromedial
ˡ. crush from anteromedial to posterolateral
ˢ. Increase stiffness
ˣ. Increase fracture toughness
ˤ. Increase fatigue strength
˥. Decrease mechanical strength
˦. Decrease wear rate
˧. disuse osteopenia
˨. paraendocrine effect of the tumor
˩. abnormally increased density on the right side
˪. side effect of the treatment of the lesion
˫. extensive tumor involvement of the left hip
ˬ. Sciatic nerve
˭. Superior gluteal artery
ˮ. Profunda femoris artery
˯. Femoral artery and nerve
˰. External iliac artery and vein
˱. Length
˲. Moment arm
˳. Total volume
˴. Physiologic cross-sectional area
˵. Distribution of slow and fast twitch fibers
˶. decreasing initiation of action potentials.
˷. increasing action potential amplitude.
˸. blocking the opening of gated sodium channels.
˹. decreasing the number of functional motor units.
˺. slowing or stopping action potential propagation through the axon.
˻. resection of the metatarsal heads of the first through fifth toes.
˼. Silastic MP joint arthroplasties of the first through fifth toes.
˽. fusion of the hallux MP joint and resection arthroplasty of the 2nd through fifth metatarsal heads.
˾. fusion of hallux MP joint and distal osteotomy of the 2nd through 5th MT.
˿. plantar condylectomy of the 2nd through 5th MT heads & resection of proximal phx of the hallux.
̀. hemiarthroplasty
́. open reduction and internal fixation
̂. closed reduction and percutaneous pinning
̃. a sling and early pedulum exercises
̄. a sling and swathe for 6 weeks, followed by shoulder rehabilitation
̅. open acromioplasty
̆. open Bankart repair
̇. open subscapularis tendon repair
̈. inferior capsular shift
̉. a supervised physical therapy program
̊. a sling and swathe, with pendulum exercises in 10 days
̋. open reduction and internal fixation through an anterior approach
̌. open reduction and internal fixation through a posterior approach
̍. immobilization with a splint in 45 degrees of abduction for 6 weeks
̎. arthroscopically assisted reduction and percutaneous screw fixation
̏. Repair of the rotator cuff
̐. Replacement of the humeral head
̑. Resection arthroplasty
̒. Total shoulder arthroplasty
̓. AP and lateral radiographs of the elbow
̔. Diagnositc arthroscopy
̕. Aspiration of joint fluid
̖. An erythrocyte sedimentation rate and CBC
̗. A diagnostic lidocaine injection
̘. Insulin-like growth factor (IGF-1)
̙. Fibroblast growth factor (FGF-1)
̚. Platelet-derived growth factor (PDGF)
̛. Transforming growth factor beta (TGF-B)
̜. Bone morphogenetic proteins (BMP)
̝. clinical history and radiographic findings.
̞. technetium bone scan
̟. flow cytometry pattern of extracted chondrocytes
̠. immunohistochemical staining patterns of a biopsy specimen
̡. histologic features of a biopsy specimen stained with hematoxylin-cosin
̢. Radial
̣. Radial recurrent
̤. Posterior interosseous
̥. Superior ulnar recurrent
̦. Superficial radial circumflex
̧. Impaired hydroxylation of proline
̨. Failure of cleavage in procollagen
̩. Defective binding sites for hydroxyproline
̪. Failure to incorporate glycine into the helix
̫. Diminished production of collagen through the rough endoplasmic reticulum
̬. Asking the legal staff to seek a court injunction
̭. Copying the patient’s chart and giving it to him as he leaves
̮. Having the patient sign a written legal contract that specifies acceptable behavior
̯. Continuing care of the patient until an appropriate referral can be arranged
̰. Transferring the patient to another orthopaedic surgeon without disclosing the realreason for why the patient is being transferred
̱. Meta-analysis
̲. Confidence interval
̳. Analysis of variance (ANOVA)
̴. Statistical significance (p-value)
̵. Survivorship analysis (Kaplan-Meier)
̶. Spinal shock
̷. Neurogenic shock
̸. Hypovolemic shock
̹. Pulmonary embolism
̺. Fat embolus syndrome
̻. Lumbar spinal stenosis
̼. Metastatic disease of the spine
̽. Rheumatoid lumbar spondylitis
̾. Isthmic spondyloloisthesis
̿. Degenerative spondylolisthesis at L4-5 and L5-S1
̀. Patella alta
́. A metal-backed patella
͂. Varus malalignment of the knee
̓. A posterior cruciate-substituting femoral component
̈́. Lateral subluxation of the patella on a Merchant’s view
Ι. The sesamoids are separated
͆. The sesamoid is fractured
͇. The proximal phx is on the neck of the metatarsal
͈. The dislocation is dorsal and centered
͉. The proximal phalanx is hyperextended
͊. Patella
͋. Tibial stem
͌. Distal femoral interface
͍. Posterior femoral interface
͎. Sites of screw fixation for the tibia
͏. Hallux rigidus
͐. Fracture of the sesamoid
͑. Disruption of the plantar plate
͒. Osteonecrosis of the metatarsal head
͓. Rupture of the flexor hallucis longus
͔. Gout
͕. Sepsis
͖. Old trauma
͗. Rheumatoid arthritis
͘. Charcot arthroplasty
͙. Aspiration and steroid injection
͚. Biopsy, curettage, and allograft bone grafting
͛. Percutaneous Kirschner wire fixation
͜. Percutaneous injection of autogenous bone marrow
͝. Nerve roots
͞. Spinal cord
͟. Sciatic nerve
͠. Peroneal nerve
͡. Conus medullaris
͢. Extent of bone penetrated by reaming, prosthetic components, or acrylic cement
ͣ. Periprosthetic regions that are accessible to joint fluid and particulate wear debris
ͤ. Enveloping pseudocapsular scar tissue that develops around a prosthetic hip following surgical capsulectomy
ͥ. Soft tissue and bone that are potentially contaminated with bacteria in the setting of a prosthetic joint infection
ͦ. Potential intrapelvic joint space communication created by acetabular fixation screws or intrapelvic extruded acrylic cement
ͧ. Early and late infection
ͨ. Periprosthetic fracture of the femur
ͩ. Failure of the patellofemoral and extensor mechanisms
ͪ. Aseptic loosening of cementing tibial components
ͫ. Asceptic loosening of cemented femoral components
ͬ. Acceptance of the current position of the ankle
ͭ. Open reduction and fixation in the epiphysis only
ͮ. ORIF with a small-fragment T-plate from the malleolus up to the metaphysis
ͯ. Closed reduction by eversion of the ankle and application of a bivalved long leg cast
Ͱ. CRUGA and fixation with a malleolar screw from the malleolus into the metaphysis
Ͱ. Resection arthroplasty and local radiation
Ͳ. In situ fusion of the hip
Ͳ. Excision of heterotopic bone, total hip arthroplasty, and oral indomethacin
ʹ. Excision of heterotopic bone and local radiation
͵. Excision of heterotopic bone, hemiarthroplasty, and oral indomethacin
Ͷ. Closed reduction of both fractures and immediate spica casting
Ͷ. Bilateral skin traction for 3 weeks, followed by spica casting
͸. External fixation of both femora
͹. External fixation of the left femur and a long leg cast brace for the right femur
ͺ. External fixation of the left femur and use of a reamed intramedullary nail in the right femur
Ͻ. Synovial sarcoma
Ͼ. Soft-tissue abcess
Ͽ. Rhabdomyosarcoma
;. Eosinophilic granuloma
Ϳ. Nodular pigmented villonodular synovitis
΀. Changing to a titanium nail
΁. Changing to a nonslotted nail
΂. Changing the cross-sectional shape of the nail
΃. Increasing the diameter of the nail by 3 mm
΄. Increasing the diameter of the interlocking screws
΅. Fracture healing
Ά. Chondrosarcoma
·. Periosteal chondroma
Έ. Periosteal osteosarcoma
Ή. Dysplasia epiphysealis hemimelica
Ί. Demonstrate competence in the subject of the case
΋. Be fellowship trained in the subject of the case
Ό. Be paid on a contingency basis
΍. Be board certified by the American Board of Orthopaedic Surgery
Ύ. Have been involved in the case as a consultant
Ώ. Diagnostic arthroscopy
Ϊ́. Arthroscopy and subacromial decompression
Α. Reduction and fixation of the proximal humeral epiphysis
Β. Temporary cessation of throwing
Γ. Physical therapy for rotator cuff strengthening
Δ. Oblique popliteal ligament
Ε. Lateral capsule
Ζ. Popliteal tendon
Η. Fibular collateral ligament
Θ. Posterior oblique ligament
Ι. Radial tear
Κ. Parrot-beak tear
Λ. Vertical tear in the “red-red” zone
Μ. Vertical tear in the “red-white” zone
Ν. Vertical tear in the “white-white” zone
Ξ. 0 degrees of abduction, with neural rotation
Ο. 40 degrees of flexion and 60 degrees of internal rotation
Π. 45 degrees of flexion and 45 degrees of external rotation
Ρ. 90 degrees of abduction with neutral rotation
΢. 90 degrees of abduction and 90 degrees of external rotation
Σ. Sural
Τ. Saphenous and its branches
Υ. Posterior tibial and its branches
Φ. Deep peroneal and its branches
Χ. Superficial peroneal and its branches
Ψ. Strength
Ω. Stiffness
Ϊ. Shelf life
Ϋ. Antigenicity
Ά. Risk of HIV transmission
Έ. Indemnification
Ή. Occurrence
Ί. Excess liability
Ϋ́. Claims-made
Α. Nose
Β. Lateral Y
Γ. Scapular AP
Δ. Neutral rotation AP
Ε. Internal rotation AP
Ζ. External rotation AP
Η. Trauma
Θ. Hemophilia
Ι. Reiter’s syndrome
Κ. Rheumatoid arthritis
Λ. Systemic lupus erythematosus
Μ. Cast immobilization for 6 weeks
Ν. Activity modification and re-evaluation in 2 months
Ξ. Internal fixation with or without bone grafting
Ο. Retrograde drilling of the defect without articular cartilage penetration
Π. Drilling of the defect directly through the articular cartilage
Ρ. repair or reconstruction of the medial collateral ligament
Σ. repair or reconstruction of the medialand lateral collateral ligaments
Σ. immobilization for 5 days or less
Τ. immobilization for 14 days
Υ. immobilization for 25 days
Φ. Cystinosis
Χ. Hypophosphatemia
Ψ. Renal osteodystrophy
Ω. Primary hyperparathyroidism
Ϊ. Nutritional vitamin D deficiency
Ϋ. Lateral meniscus tear
Ό. Popliteus tenosynovitis
Ύ. Iliotibial band friction syndrome
Ώ. Peroneal nerve entrapment
Ϗ. Biceps tendinitis
Β. Observation
Θ. Removal of the prosthetic components
ϒ. Operative exploration and decompression of the peroneal nerve
ϓ. Nerve conduction velocity studies
ϔ. Loosening of the primary dressings and knee flexion to 30 degrees
Φ. I
Π. II
Ϗ. III
Ϙ. decreased tissue tension
Ϙ. decreased abductor lever arm
Ϛ. decreased joint reaction force
Ϛ. increased body weight over lever arm
Ϝ. increased polyethylene wear rate
Ϝ. recurrent traumatic anterior dislocation
Ϟ. recurrent traumatic posterior dislocation
Ϟ. traumatic subluxation with no previous dislocation
Ϡ. traumatic anterior subluxation
Ϡ. atraumatic involuntary subluxation
Ϣ. radial
Ϣ. axillary
Ϥ. suprascapular
Ϥ. thoracodorsal
Ϧ. long thoracic
Ϧ. Flexion
Ϩ. Extension
Ϩ. Axial rotation
Ϫ. Left lateral bending
Ϫ. Right lateral bending
Ϭ. Skin
Ϭ. Lung
Ϯ. Brain
Ϯ. Heart
Κ. Kidney
Ρ. Thoracoacromial, lateral thoracic, subscapular
Ϲ. Thoracoacromial, anterior humeral circumflex, posterior humeral circumflex
Ϳ. Posterior humeral circumflex, subscapular, thoracacromial
ϴ. Subscapular, thoracacromial, anterior humeral circumflex
Ε. Lateral thoracic, anterior humeral circumflex, thoracacromial
϶. Respondeat superior
Ϸ. Indemnity agreement
Ϸ. Hold harmless agreement- attempt to shift liability from company to physician
Ϲ. Comparative negligence-% of involvement
Ϻ. Contributory negligence- resident contributed to the negligence
Ϻ. t-type
ϼ. both column
Ͻ. transverse
Ͼ. anterior column
Ͽ. anterior column posterior hemitransverse
Ѐ. Posterior interosseous
Ё. Anterior interosseous
Ђ. Radial
Ѓ. Median
Є. Ulnar
Ѕ. Shock from hypovolemia
І. Associated rupture of the bladder
Ї. Arterial bleeding on pelvic angiogram
Ј. Presence of a hematoma in the perineum and scrotum
Љ. Fractures of both the anterior and posterior pelvic ring

Correct Answer & Explanation

. a total contact cast.


Explanation

Question 4072

Topic: 10. Pathology and Oncology

A 4-year-old boy sustains the injury shown in Figures 10a and 10b as a result of being hit and dragged by a car. Wound closure is best accomplished by

. Sural artery island flap.
. Free rectus abdominis flap.
. Extensor digitorum brevis flap.
. Staged cross leg flap.
. Split-thickness skin graft.
. An anterior cruciate functional knee brace.
. A physical therapy program.
. Reconstruction of the posterior cruciate ligament and the posterolateral corner.
. Reconstruction of the posterior cruciate ligament.
. Reconstruction of the anterior cruciate ligament.
. Avoids the risk of marrow emboli
. Avoids injury to the intramedullary nutrient vessels
. Results in faster healing of fractures
. Results in more secure fixation
. Results in faster regeneration of the endosteal blood supply
. Above-knee amputation
. En bloc resection of the lesion and reconstruction with a bone graft
. Closed reduction and immobilization in a cast
. Open reduction and internal fixation, followed by radiation therapy
. Open reduction, curettage, and cementing of the lesion
. Injury to the subclavian artery
. Injury to the brachial plexus
. Segmental fracture
. 100% displacement
. Associated displaced surgical neck fracture of the humerus
. humeral arthroplasty2/. repair of the rotator cuff
. closed reduction and immobilization
. open reduction and immobilization
. open reduction and early passive motion
. arthroscopic capsular release
. manipulation under anesthesia
. a physical therapy program
!. an intra-articular corticosteroid injection
". administration of high-dose oral corticosteroids
#. adding the scores, in all five body systems
$. adding the squares of the scores in the three most severely injured systems
%. doubling the cumulative score for head and chest injuries
&. combining the scores from the most and least injured systems
'. correcting the score in the most severely injured system for age
(. traumatic femoral head fracture
). osteonecrosis
*. osteoarthritis
+. neuropathic joint
,. rheumatoid arthritis
-. low-dose radiation
.. steroid injection
/. a load-relieving insert and shoe modification
0. complete excision of the mass and the entire plantar fascia
1. wide excision of the mass with a 2 cm margin of normal fascia
2. CT scan of the chest
3. technetium bone scan
4. bone marrow aspiration
5. serum protein electrophoresis
6. lateral skull radiograph
7. high-grade histology of the initial tumor
8. multiple local recurrences after curettage
9. previous treatment of the tumor with cryotherapy
:. previous treatment of the tumor with radiation therapy
;. extraosseous extension into two or more adjacent compartments
<. Dorsal rhizotomy and facet joint fusion
=. Multilevel corpectomy and spinal stabilization
>. Central and lateral recess decompression and bilateral foraminotomy
?. Central decompression and facet joint fusion
@. Central decompression, foraminotomy, and spinal fusion from L2 to L5.
A. Inadequate rehabilitation
B. Displacement of the coronoid process fracture
C. Insufficiency of the lateral ulnar collateral ligament
D. Insufficiency of the anterior band of the medial collateral ligament
E. Insufficiency of the posterior band of the medial collateral ligament
F. Osteotomy and intramedullary rod fixation
G. Electrical stimulation
H. Strut-autografing the concavity the tibia
I. A patellar tendon-bearing brace
J. Percutaneous injection of demineralized bone matrix
K. digoxin
L. sucralfate
M. clindamycin
N. alcohol
O. neuromuscular blocking agents
P. Unrestrained roll-back
Q. Unrestrained rotational conformity
R. Medial-Lateral conformity
S. Anteroposterior conformity in flexion
T. Anteroposterior conformity in extension
U. Arthrodesis of the MTP joint
V. A Silastic implant of the MTP joint
W. Resection arthroplasty of the MTP joint
X. Cheilctomy of the MTP joint
Y. Osteotomy of the base of the proximal phalanx
Z. Genu varum
[. Tarsal coalition
\. Degenerative ankle arthrosis
]. Osteochondritis dissecans of the talus
^. Hemihypertrophy of the ipsilateral lower extremity
_. Trabecular bone is preferentially resorbed in this high bone turnover state
`. Loss of water content in the disk increases impact load to the vetrebral bodies
A. Stress is imposed by the relative stiffness of the arthrtic facet joints
B. Increased energy demands are imposed by decreased circulation to the vertebral body
C. The thick cortical bone found in the vertebral body resorbs rapidly following estrogen withdrawal
D. Increased time in stance and swing phase
E. Addition of a double leg float phase
F. Decreased vertical ground reaction forces
G. Decreased arc of motion in the hip, knee, and ankle
H. Decreased joint reaction forces in the hip, knee, and ankle
I. Talonavicular arthrodesis
J. Medial displacement calcaneal osteotomy
K. Flexor digitorum longus tendon transfer with spring ligament advancement
L. Triple arthrodesis
M. Calcaneocuboid distraction arthrodesis and repair of the posterior tibial tendon
N. Lymphoma
O. Hemangioma
P. Osteosarcoma
Q. TB of the spine
R. Metastatic breast carcinoma
S. widening and shortening of the heel.
T. weakness of the gastrocnemius-soleus complex.
U. anterior impingement from a horizontal talus.
V. unrecognized compartment syndrome of the foot.
W. degenerative arthritis of the tibiotalar joint.
X. a corrective osteotomy
Y. application of braces
Z. medial physeal stapling until the varus corrects
{. observation
|. application of corrective casts
}. a total contact cast.
~. electrical stimulation.
. an off the shelf fracture brace.
€. an elastic compression bandage and crutches.
. a hard soled shoe until the patient is asymptomatic.
‚. Ewings tumor
ƒ. Parosteal osteosarcoma
„. Dedifferentiated chondrosarcoma
…. Low grade intramedullary chondrosarcoma
†. High grade intramedullary osteosarcoma
‡. Vascular injury
ˆ. Tear of the rotator cuff
‰. Injury to the brachial plexus
Š. Fracture of the upper thoracic rib
‹. Fracture of the proximal humerus
Œ. Biceps
. Trapezius
Ž. Infraspinatus
. Pectoralis major
. Serratus anterior
‘. Hybrid total hip arthroplasty
’. Noncemental hemiarthroplasty of the hip
“. Closed reduction and percutaneous pin fixation
”. Open reduction through an anterior approach to the hip
•. Excision of the head fragment
–. a quadratus femoris pediclebone graft
—. a proximal femoral allograft
˜. intertrochanteric osteotomy
™. total hip arthroplasty
š. hip hemiarthroplasty
›. Echocardiogram
œ. Electrocardiogram
. Radiograph of the chest
ž. CT scan of the shoulder
Ÿ. Ultrasound of the shoulder
 . Ilioinguinal
¡. Extended iliofemoral
¢. Combined ilioinguinal and Kocher-Langenbeck (posterior)
£. Kocher-Langenbeck (posterior)
¤. Kocher-Langenbeck (posterior) with trochanteric osteotomy
¥. Deltoid
¦. Supraspinatus
§. Subscapularis Infraspinatus
¨. Infraspinatus
©. Infraspinatus and teres minor
ª. an orthosis.
«. observation.
¬. electrical stimulation.
­. open reduction and internal fixation.
®. application of a nonweightbearing short leg cast.
¯. repair of the rotator cuff.
°. rehabilitation of the shoulder
±. replacement of the humeral head.
². arthroscopic acromioplasty and debridement.
³. immobilization is a sling until pain resolves.
´. Bone rotation versus torque applied
Μ. Bone deflection versus bending moment applied
¶. Axial displacement versus tension applied
·. Lateral translation versus shear force applied
¸. Fracture gap closing versus compressive force applied
¹. steroid injection
º. stretching of the heel cord
». surgical release of the plantar fascia
¼. application of a short leg cast for 6 to 8 weeks
½. wearing dorsiflexion night splints
¾. Open bladder
¿. Bilateral “hitchhiker’s” thumbs
À. Bilateral defects in the midclavicles
Á. Rhizomelic shortening of the extremities
Â. Radiographic fragmentation of all major epiphyses
Ã. Medial patellotibial
Ä. Medial patellofemoral
Å. Medial patellomeniscal
Æ. Lateral patellofemoral
Ç. Lateral patellotibial
È. Heat
É. Gentle active flexion-extension exercises
Ê. Isokinetic strengthening
Ë. Electrical muscle stimulation
Ì. Immobilization of the limb with the knee in full flexion
Í. Distal chevron osteotomy with soft-tissue release
Î. Distal soft-tissue realignment only
Ï. Closing wedge osteotomy (Aken) of the proximal phalanx
Ð. Proximal first metatarsal osteotomy only
Ñ. Soft-tissue realignment with a proximal metatarsal osteotomy
Ò. Vagus
Ó. Phrenic
Ô. Hypoglossal
Õ. Recurrent laryngeal
Ö. Inferior thyroid
×. Surgical exploration
Ø. Application of leeches
Ù. Stellate ganglion blocks
Ú. Intra-arterial streptokinase
Û. Elevation and reevaluation in 1 hour
Ü. Liver profile
Ý. Myleogram
Þ. Platelet count
SS. CT scan of the head
À. Angiogram of the extremity
Á. Post spinal fusion from L5to S1
Â. Primary repair with an iliac bone graft
Ã. Post spinal fusion of L4-5
Ä. A pantaloon body cast and 6 weeks of bed rest
Å. Rest, NSAIDS, and limited dancing
Æ. Stress fracture of the proximal fifth metatarsal
Ç. Stress fracture of the base of the second metatarsal
È. Stress fracture of the neck of the second metatarsal
É. Morton’s neuroma
Ê. Lisfranc’s joint subluxation
Ë. C5 radiculopathy
Ì. Subscapularis rupture
Í. Glenohumeral arthrosis
Î. Rotator cuff arthropathy
Ï. Suprascapular nerve compression at the spinoglenoid notch
Ð. mm femoral head in combination with a metal-backed polyethylene component
Ñ. mm femoral head in combination with an all-polyethylene acetabular component
Ò. mm femoral head in combination with a metal-backed polyethylene component
Ó. mm femoral head in combination with an all-polyethylene component
Ô. mm femoral head in combination with a metal-backed polyethylene component
Õ. Female gender
Ö. History of cigarette smoking
÷. L5-S1 spondylolisthesis on pre-employment radiography
Ø. Decreased strength of the lower extremities on pre-employment testing
Ù. Decreased flexibility of the lumbar spine on pre-employment testing
Ú. Size of cells
Û. Amount of DNA in cells
Ü. Nucleus-cytoplasm ratio
Ý. Specific DNA sequences
Þ. Specific messenger RNA sequences
Ÿ. Femoral and obturator nerves
Ā. Femoral and superior gluteal nerves
Ā. Femoral and lateral femoral cutaneous nerves
Ă. Obturator and superior gluteal nerves
Ă. Obturator and lateral femoral cutaneous nerves
Ą. Isotonic
Ą. Isokinetic
Ć. Isometric
Ć. Open kinetic chain
Ĉ. Dynamic variable resistance
Ĉ. Closed reduction and cast immobilization
Ċ. Uniplanar external fixation
Ċ. Open reduction and internal fixation with a dynamic compression plate
Č. Unreamed intramedullary rod
Č. Multiple plane external fixator
Ď. Inlet view of the pelvis
Ď. Outlet view of the pelvis
Đ. AP view of the hip
Đ. Ilial oblique view (external oblique) of the hip
Ē. Obturator oblique
Ē. Glycolytic pathway
Ĕ. Oxidative phosphorylation
Ĕ. Breakdown of fat
Ė. Breakdown of protein
Ė. Breakdown of adenosine triphosphate
Ę. an MRI scan
Ę. arthroscopic examination
Ě. AP and frog-lateral radiographs of the pelvis and hips
Ě. varus and valgus stress radiographs of the knee
Ĝ. physical examination of the knee under anesthesia
Ĝ. extended curettage and polymethylmethacrylate cementation
Ğ. extra-articular resection of the knee and an allograft arthrodesis
Ğ. wide resection of the proximal tibia and custom prosthetic replacement
Ġ. prophylactic internal fixation and postoperative irradiation
Ġ. excision of the lateral condyle and reconstruction with a hemicondylar allograft
Ģ. silicone implant joint replacement
Ģ. metatarsophalangeal joint arthrodesis
Ĥ. metatarsophalangeal joint debridement
Ĥ. resection of the metatarsal head
Ħ. resection of the base of the proximal phalanx
Ħ. Fixation of the syndesmosis has failed
Ĩ. Widening of the ankle mortise has led to the failure of fixation
Ĩ. Infection around the syndesmosis screw has led to osteomyelitis
Ī. The syndesmosis screw is broken
Ī. Motion between the tibia and fibula has caused loosening of the syndesmosis screw
Ĭ. Microcephaly
Ĭ. A temporal lobe cyst
Į. An Arnold-Chiari type 1 malformation
Į. Periventricular leukomalacia
İ. Agnesis of the corpus callosum
I. Wolff’s
IJ. Hooke’s
IJ. Hilton’s
Ĵ. Muller-Haeckel
Ĵ. Heuter-Volkmann
Ķ. Both the anterolateral and posteromedial bands are isometric and do not significantly change with flexion
Ķ. The anterolateral band is lax and becomes tight in flexion, while the posteromedial band is tight, and becomes lax in flexion
ĸ. The anterolateral band is tight and becomes lax in flexion, while the posteromedial band is lax and becomes tight in flexion
Ĺ. Both the anterolateral and posteromedial bands are lax and become tight in flexion
Ĺ. Both the anterolateral and posteromedial bands are tight and become lax as the knee is flexed
Ļ. UCB orthosis
Ļ. Rigid orthosis with a medical arch support
Ľ. Semi-rigid orthosis with lateral forefoot posting
Ľ. Semi-rigid orthosis with a medial arch support
Ŀ. Medial heel wedge attached to the running shoes
Ŀ. Hallux varus
Ł. Osteonecrosis
Ł. Recurrence of the hallux valgus
Ń. “Transfer” second metatarsalgia
Ń. Physeal arrest of the first metatarsal
Ņ. Aseptic loosening in a 70-year-old patient
Ņ. Mechanical failure of a hinged knee prosthesis
Ň. Failed knee replacement complicated by reflex sympathetic dystrophy
Ň. Infection with soft-tissue deficit
ʼN. A prior patellectomy
Ŋ. Knee fusion
Ŋ. Open irrigation and debridement
Ō. Arthroscopic irrigation and debridement
Ō. One-stage exchange arthroplasty
Ŏ. Two-stage exchange arthroplasty
Ŏ. Putti-platt repair
Ő. Open Bankart repair
Ő. Injection of a subacromial corticosteroid
Œ. Arthroscopic transglenoid capsular shift
Œ. Rehabilitation of the scapular and rotator cuff muscles
Ŕ. Silicone suction socket and an energy-absorbing foot
Ŕ. Silicone suction socket and a variable resistance ankle
Ŗ. Plastic suction socket, telescoping pylon, and a solid ankle cushioned heel (SACH) foot
Ŗ. Plastic socket with a hinged thigh cuff and a SACH foot
Ř. Patellar tendon-bearing suction socket and a uniaxial hydraulic ankle
Ř. Parosteal
Ś. Periosteal
Ś. High-grade intramedullary
Ŝ. Osteosarcoma occurring in Paget’s disease
Ŝ. Osteosarcoma occurring in irradiated bone
Ş. Cauda equina
Ş. Conus medullaris
Š. Genitofemoral nerve
Š. Lumbar sympathetic plexus
Ţ. Lumbar parasympathetic plexus
Ţ. Spinal pseudoarthrosis
Ť. Spinal cord traction injury with paralysis
Ť. Arterial and venous thromboses
Ŧ. Superior mesenteric artery syndrome
Ŧ. Crankshaft phenomenon
Ũ. Inversion stress radiograph
Ũ. MRI scan
Ū. CT scan
Ū. Nuclear bone scan
Ŭ. External rotation stress radiograph
Ŭ. Complex deformity with an angulation in two planes
Ů. Single deformity less than 20 degrees, apex posterolateral
Ů. Single deformity greater than 30 degrees, apex posterolateral
Ű. Single deformity less than 20 degrees, apex posteromedial
Ű. Single deformity greater than 30 degrees, apex posteromedial
Ų. Pronation of the foot during the stance phase of gait
Ų. Heel inversion at the beginning of a single limb heel rise
Ŵ. Active inversion of the nonweightbearing foot
Ŵ. Active plantar flexion of the first ray against resistance
Ŷ. Active plantar flexion of the foot during the push-off phase of gait
Ŷ. Observation and repeat radiographs in 4 months
Ÿ. Application of a thoracolumbalsacral orthosis for 22 to 24 hours per day
Ź. Electrical stimulation at night
Ź. Physical therapy
Ż. Begins to remodel and hypertrophy more quickly
Ż. Provides a better scaffold for osteoconduction
Ž. Reduces the risk of early fracture
Ž. Reduces technical difficulty
S. Lowers donor site morbidity
Ƀ. Anterior fusion of the lumbar curve
Ɓ. Anterior and posterior fusion of the thoracic curve
Ƃ. Posterior fusion of the thoracic curve
Ƃ. Posterior fusion of the thoracic and lumbar curves
Ƅ. Application of a brace until the iliac apophyses are Risser 4 or 5, followed by surgical correction
Ƅ. Subscapularis rupture
Ɔ. Type III SLAP lesion
Ƈ. Disruption of capsular shift
Ƈ. Isolated traumatic subluxation
Ɖ. Injury to the axillary nerve after dislocation
Ɗ. hypophosphatemia
Ƌ. high dietary cholesterol intake
Ƌ. deficiency of lipoprotein A
ƍ. deficiency of protein S and protein C
Ǝ. elevated levels of antithrombin III
Ə. Weightbearing short leg cast
Ɛ. Nonweightbearing short leg cast
Ƒ. Removable splint and early motion
Ƒ. Open reduction and internal fixation
Ɠ. Elastic compression bandage with full weightbearing
Ɣ. Breast
Ƕ. Prostate
Ɩ. Gastrointestinal
Ɨ. Kidney
Ƙ. Multiple myeloma
Ƙ. Varus stress
Ƚ. Valgus stress
ƛ. Torsional loading
Ɯ. Hyperextension of the knee
Ɲ. Contraction of the quadriceps while axially loaded
Ƞ. Primary internal fixation at both fracture levels
Ɵ. External fixation as definitive ttt for both #
Ơ. Skeletal traction and delayed internal fixation of both fractures
Ơ. Primary internal fixation of the proximal fracture and delayed fixation of the femoral fracture
Ƣ. Primary internal fixation of the femoral shaft fracture and delayed fixation of the proximal #
Ƣ. Heel spur
Ƥ. Plantar fascitis
Ƥ. Dysfunction of the tibialis posterior tendon
Ʀ. Compression of the first branch of the lateral plantar nerve
Ƨ. Compression of the calcaneal nerve
Ƨ. Displaced labral tear
Ʃ. Tear of the rotator cuff
ƪ. Fracture of the glenoid rim
ƫ. Palsy of the axillary nerve
Ƭ. Palsy of the musculocutaneus nerve
Ƭ. Enchondroma
Ʈ. Osteoblastoma
Ư. Giant cell tumor
Ư. Aneurysmal bone cyst
Ʊ. Fibrous dysplasia
Ʋ. Arthrogram of the wrist
Ƴ. MRI scan of both wrists
Ƴ. CT scan of both wrists in the same position
Ƶ. Radiographs of the wrist in supination and pronation
Ƶ. Radiographs of the opposite wrist in the same position
Ʒ. Secondary hyperparathyroidism
Ƹ. Phosphate retention secondary to uremia
Ƹ. Insufficient renal synthesis of 1, 25 dihydroxy vitamin D
ƺ. Aluminum deposition in bone from oral phosphate binders
ƻ. Persistent acidosis aggravating the negative calcium balance
Ƽ. Posterior fusion at T10-L3 with segmental instrumentation
Ƽ. Laminectomy and fusion of T12-L2 with segmental instrumentation
ƾ. Bed rest in a hyperextension brace
Ƿ. L1 vertebrectomy and anterior decompression with strut graft fusion and instrumentation
ǀ. Progressive ambulation as tolerated in a custom-molded thoracolumbosacral orthosis
ǁ. Positive-pressure ventilation
ǂ. An immediate radiograph of the chest
ǃ. Adjustment of the position of the endotrachael tube
DŽ. Insertion of a large-bore needle into the pericardial space
DŽ. Insertion of a large-bore needle in the right second intercostal space, midclavicular line
DŽ. Allowing the ends of the fracture to touch
LJ. Adding a second connecting bar
LJ. Adding one pin to each fracture fragment
LJ. Increasing the pin diameter from 4 mm to 6 mm
NJ. Decreasing the connecting bar-to-bone distance from 6 cm to 4 cm
NJ. Osteomyelitis
NJ. Malignant degeneration
Ǎ. Stress fracture
Ǎ. Local recurrence of the giant cell tumor
Ǐ. Bone resorption due to methylmethacrylate
Ǐ. Advancement of the plantar plate
Ǒ. Resection of the second metatarsal head
Ǒ. Dorsiflexion osteotomy of the second metatarsal neck
Ǔ. Transfer of the flexor digitorum longus tendon to the dorsum of the toe
Ǔ. Transfer of the extensor digitorum comminus tendon to the metatarsal neck
Ǖ. Sacral fracture
Ǖ. Burst fracture of L5
Ǘ. Cauda equina syndrome
Ǘ. Distraction-flexion injury at L3
Ǚ. Distraction-extension injury at L3
Ǚ. An MRI scan of the shoulder
Ǜ. An MRI scan of the cervical spine
Ǜ. Electromyographic and nerve conduction velocity studies
Ǝ. Immobilization in a sling and early passive range of motion exercises
Ǟ. Immediate return to the operating room for exploration of the brachial plexus
Ǟ. cerclage wiring
Ǡ. tension band wiring
Ǡ. removal of the patellar component
Ǣ. revision of the patellar component
Ǣ. immobilization of the knee and protected weightbearing
Ǥ. Liposarcoma
Ǥ. Nodular fasciitis
Ǧ. Rabdomyosarcoma
Ǧ. Malignant fibrous histiocytoma
Ǩ. Extra-abdominal desmoid tumor
Ǩ. Clubfeet
Ǫ. Thrombocytopenia
Ǫ. Congenital scoliosis
Ǭ. Ventricular septal defect
Ǭ. Arnold-Chiari malformation
Ǯ. delayed primary closure
Ǯ. free flap
J̌. pedicle groin flap
DZ. full-thickness skin graft
DZ. split-thickness skin graft
DZ. Infection
Ǵ. Nonunion
Ǵ. Improper screw length
Ƕ. Osteonecrosis of the distal fragment
Ƿ. Use of a cortical screw instead of a cancellous screw
Ǹ. Infection
Ǹ. Tear of the rotator cuff
Ǻ. Loosening of the humeral component
Ǻ. Arthritis of the glenoid
Ǽ. Arthritis of the A-C joint
Ǽ. Reduced morbidity
Ǿ. Improved osteoinduction
Ǿ. Improved osteoconduction
Ȁ. More rapid revascularization
Ȁ. Lower risk of disease transmission
Ȃ. Manipulation Under Anesthesia
Ȃ. Arthroscopic acromioplasty
Ȅ. Arthroscopic debridement of G-H joint
Ȅ. Replacement of the humeral head
Ȇ. Lengthening of the subscapularis and release of the anterior capsule
Ȇ. Bacteroides
Ȉ. E. coli
Ȉ. Staph. aureus
Ȋ. group A streptococcus
Ȋ. Clostridium perforingens
Ȍ. observation and exercises
Ȍ. bracing with a thoracolumbar orthosis
Ȏ. fusion of the posterior spine
Ȏ. fusion of the anterior spine
Ȑ. fusion of the anterior and posterior spine
Ȑ. Total wrist replacement and bridge grafts
Ȓ. palmar shelf arthroplasty and tendon transfers
Ȓ. Darrach distal ulna resection, dorsal tenosynosynovectomy, and tendon transfers
Ȕ. Radioscaphate fusion, extensor tenodesis, and Darrach distal ulna resection
Ȕ. Total wrist fusion and tendon transfers
Ȗ. constrained acetabular component
Ȗ. protrusion ring with morselized graft
Ș. cemented metal backed acetabular component
Ș. cemented all-polyethylene acetabular component
Ț. cementless hemispherical component with screw fixation
Ț. application of a hip abduction brace for 22 hours per day
Ȝ. application of a hip spica under anesthesia
Ȝ. discontinuance of all bracing and repeat radiographs in 3 months
Ȟ. open reduction of the hip and application of a spica cast
Ȟ. open reduction, varus osteotomy, and application of a spica cast
Ƞ. Loss of skin hair on the feet
ȡ. Absent pulses on vascular examination
Ȣ. Pain that originates proximally and spreads distally
Ȣ. Pain that is relieved by stopping and standing
Ȥ. Pain that is worse when the patient walks uphill rather downhill
Ȥ. wrist flexors and finger flexors
Ȧ. elbow flexors and wrist flexors
Ȧ. elbow flexors and finger flexors
Ȩ. elbow extensors and wrist flexorst Level Key Muscles4 DiaphragmDeltoid, elbow flexors, diaphragmElbow flexors, wrist extensorsElbow extensors, wrist flexorsFinger flexors (distal phalanx of middlefinger)Finger abductors (5th digit), intrinsics of hand2 Segmental innervation to intercostal muscles, abdominal and paraspinal muscles) L1, L2, L3 Hip flexors3, L4 QuadricepsTibialis anteriorToe extensors, hip abductorsAnkle plantarflexors, peronei
Ȩ. elbow extensors and wrist extensors
Ȫ. Syndactyly
Ȫ. Macrodactyly
Ȭ. Camptodactyly
Ȭ. Preaxial polydactyly
Ȯ. Postaxial polydactyly
Ȯ. Arthrodesis
Ȱ. Rotationplasty
Ȱ. Above-knee amputation
Ȳ. Osteoarticular allograft
Ȳ. Endoprosthesis (custom arthroplasty)
ȴ. Plantar fascia
ȵ. Spring ligament
ȶ. Deltoid ligament
ȷ. Intrinsic tendons
ȸ. Gastorcnemius-solelus complex
ȹ. Prevention of presynaptic release of acetylcholine
Ⱥ. Prevention of synthesis of presynaptic acetylcholine
Ȼ. Activation of acetylcholinesterase at the motor end-plate
Ȼ. Blockage of postsynaptic action of acetylcholine until reserves are depleted
Ƚ. Stimulation of release of presynaptic acetylcholine until reserves are depleted
Ⱦ. stiffness of the femoral component.
Ȿ. head offset of the femoral component.
Ɀ. femoral component material modulus of elasticity.
Ɂ. extent of the femoral component porous coating.
Ɂ. Presence of a femoral component collar.
Ƀ. plantar fascia and quadratus plantae tendon.
Ʉ. ligamentous structures connecting the tarsal bones.
Ʌ. shape of the tarsal bones and the intervening joints.
Ɇ. activity of the intrinsic muscles of the foot.
Ɇ. activity of the posterior tibialis and the peroneus longus muscles.
Ɉ. scapulothoracic fusion
Ɉ. strengthening of the periscapular muscles
Ɋ. pectoralis minor-fascia lata graft transfer to the scapula
Ɋ. pectoralis major-fascia lata graft transfer to the scapula
Ɍ. exploration of the long thoracic nerve, with sural nerve graft
Ɍ. tricompartmental knee replacement
Ɏ. unicompartmental knee replacement
Ɏ. medial compartment meniscal allograft
Ɐ. valgus-producing distal femoral osteotomy
Ɑ. valgus-producing proximal tibial osteotomy
Ɒ. Internal rotation of the femoral component
Ɓ. External rotation of the tibial component
Ɔ. Lateral placement of the femoral component
ɕ. Medial placement of the patellar component
Ɖ. Excessive resection of the patella
Ɗ. Hallux rigidus
ɘ. Hallux valgus
Ə. Neuroma of the first web space
ɚ. Fracture of the sesamoid
Ɛ. Rupture of the flexor hallucis longus
Ɜ. Sickle cell crisis
ɝ. Idiopathic chondrolysis
ɞ. Hemophilic arthropathy
ɟ. Osteoid osteoma of the femoral neck
Ɠ. Legg-Calve-Perthes disease
Ɡ. Decreased ankle jerk and positive femoral nerve stretch test
ɢ. Decreased knee jerk and positive straight-leg raising sign
Ɣ. Gastrocnemius-soleus complex weakness and positive straight-leg raising sign
ɤ. Weakness of the extensor hallucis longus and positive straight-leg raising sign
Ɥ. Weakness of the extensor hallucis longus and positive femoral nerve stretch test
Ɦ. Long-term administration of IV and oral antibiotics
ɧ. Open soft-tissue debridement, retention of prosthetic components, and IV antibiotics
Ɨ. Immediate exchange arthroplasty with antibiotic-impregnated cement
Ɩ. Two-stage surgical prosthetic exchange and IV antibiotics
Ɪ. Resection arthroplasty and IV antibiotics
Ɫ. SCFE
Ɬ. MED
ɭ. Perthes disease
ɮ. Hypothyroidism
Ɯ. Chondrolysis
ɰ. gout.
Ɱ. osteoporosis.
Ɲ. eosinophilic granuloma.
ɳ. tuberculosis of the spine.
ɴ. metastatic disease of the spine.
Ɵ. water content.
ɶ. Synthesis of type I collagen.
ɷ. Proteoglycan content.
ɸ. Activity of chondrocytes.
ɹ. Synthesis of hyaluronate.
ɺ. Lung
ɻ. Breast
ɼ. Prostate
Ɽ. Thyroid
ɾ. Renal
ɿ. T1-low, T2-low.
Ʀ. T1-low, T2-high.
ʁ. T1-moderate, T2-low.
Ʂ. T1-high, T2-low.
Ʃ. T1-high, T2-high.
ʄ. hypothesis is incorrect or invalid
ʅ. interobserver error rate is 4%.
ʆ. Standard deviation is 4% higher or lower than the mean.
Ʇ. Sample size is 4% larger than required to be clinically significant.
Ʈ. Probability that the differences noted between two study groups were due to chance alone is 4%.
Ʉ. I
Ʊ. II
Ʋ. IV
Ʌ. IX
ʍ. X
ʎ. Cranial setting
ʏ. Cranial subluxation
ʐ. Odontoid fracture
ʑ. Lysis of the arch of the atlas
Ʒ. Atlantoaxial subluxation
ʓ. Retrograde collapse of the endoneurial tubes
ʔ. Irreversible atrophy of the denervated muscles
ʕ. Elongation of the axons across the zone of injury
ʖ. Sprouting of the axons at the neuromuscular junction
ʗ. Misdirection of the axons across the zone of injury
ʘ. Maximally pronated and elbow extended
ʙ. Maximally pronated and the elbow flexed
ʚ. Maximally supinated and the elbow flexed
ʛ. Maximally supinated and the elbow extended
ʜ. In neutral rotation, with the elbow extended
Ʝ. open reduction and internal fixation
Ʞ. buddy taping to the adjacent index finger
ʟ. early motion with application of a dynamic banjo splint
ʠ. application of a cast with the hand in a “safe position” for 3 weeks.
ʡ. dorsal extension block splinting
ʢ. The name of the manufacturer
ʣ. The manufacturer’s potential liability
ʤ. The physician’s clinical performance
ʥ. The physician’s materials testing data
ʦ. Any royalties the physician receives from the manufacturer
ʧ. Femoral
ʨ. Obturator
ʩ. Inferior gluteal
ʪ. Superior gluteal
ʫ. Lateral femoral cutaneous
ʬ. open biopsy and a long leg cast
ʭ. open biopsy and wide resection of the tumor
ʮ. a long leg cast and observation
ʯ. intramedullary stabilization and observation
ʰ. Triggering
ʱ. Lateral instability
ʲ. Swan-neck deformity
ʳ. Boutonniere deformity
ʴ. Loss of distal interphalangeal joint flexion
ʵ. Peroneus brevis to peroneus longus
ʶ. Peroneus tertius to extensor hallucis longus
ʷ. Peroneus tertius to superficial peroneal nerve
ʸ. Extensor hallucis longus to deep peroneal nerve
ʹ. Extensor hallucis longus to extensor digitorum longus
ʺ. reassurance that Medicare will pay for the treatment.
ʻ. consent forms that patients or their guardians are able to understand.
ʼ. a detailed description of the device, omitting the fact that it is part of a study.
ʽ. a provision that the patient’s care will be discontinued if he or she does not enroll in the study.
ʾ. a provision that the study will be carried out to completion, whether or not the device is as effective as those currently in existence.
ʿ. an onlay iliac crest bone graft.
ˀ. limited weightbearing and observation.
ˁ. removal of the implant and limited weightbearing.
˂. removal of the implant and insertion of a reamed femoral nail.
˃. removal of the implant and insertion of an unreamed femoral nail.
˄. Coronal
˅. Sagittal
ˆ. Anteromedial, midway between the sagittal and the coronal
ˇ. Proximal pins sagittal, distal pins coronal
ˈ. Proximal pins coronal, distal pins sagittal
ˉ. Rheumatoid arthritis
ˊ. Posttraumatic arthritis
ˋ. Degenerative osteoarthritis
ˌ. Osteonecrosis of the tibial plateau
ˍ. Osteonecrosis of the medial femoral condyle
ˎ. Trapeziometacarpal arthrodesis
ˏ. Osteotomy of the thumb metacarpal
ː. Arthrotomy and joint debridement
ˑ. Ligament reconstruction using one half of the flexor carpi radialis
˒. Trapezium resection, tendon interposition, and reconstruction of the ligament
˓. Creep
˔. Relaxation
˕. Energy dissipation
˖. Plastic deformation
˗. Elastic deformation
˘. bending
˙. axial loading
˚. high-speed rotation
˛. direct impact from anteromedial
˜. crush from anteromedial to posterolateral
˝. Increase stiffness
˞. Increase fracture toughness
˟. Increase fatigue strength
ˠ. Decrease mechanical strength
ˡ. Decrease wear rate
ˢ. disuse osteopenia
ˣ. paraendocrine effect of the tumor
ˤ. abnormally increased density on the right side
˥. side effect of the treatment of the lesion
˦. extensive tumor involvement of the left hip
˧. Sciatic nerve
˨. Superior gluteal artery
˩. Profunda femoris artery
˪. Femoral artery and nerve
˫. External iliac artery and vein
ˬ. Length
˭. Moment arm
ˮ. Total volume
˯. Physiologic cross-sectional area
˰. Distribution of slow and fast twitch fibers
˱. decreasing initiation of action potentials.
˲. increasing action potential amplitude.
˳. blocking the opening of gated sodium channels.
˴. decreasing the number of functional motor units.
˵. slowing or stopping action potential propagation through the axon.
˶. resection of the metatarsal heads of the first through fifth toes.
˷. Silastic MP joint arthroplasties of the first through fifth toes.
˸. fusion of the hallux MP joint and resection arthroplasty of the 2nd through fifth metatarsal heads.
˹. fusion of hallux MP joint and distal osteotomy of the 2nd through 5th MT.
˺. plantar condylectomy of the 2nd through 5th MT heads & resection of proximal phx of the hallux.
˻. hemiarthroplasty
˼. open reduction and internal fixation
˽. closed reduction and percutaneous pinning
˾. a sling and early pedulum exercises
˿. a sling and swathe for 6 weeks, followed by shoulder rehabilitation
̀. open acromioplasty
́. open Bankart repair
̂. open subscapularis tendon repair
̃. inferior capsular shift
̄. a supervised physical therapy program
̅. a sling and swathe, with pendulum exercises in 10 days
̆. open reduction and internal fixation through an anterior approach
̇. open reduction and internal fixation through a posterior approach
̈. immobilization with a splint in 45 degrees of abduction for 6 weeks
̉. arthroscopically assisted reduction and percutaneous screw fixation
̊. Repair of the rotator cuff
̋. Replacement of the humeral head
̌. Resection arthroplasty
̍. Total shoulder arthroplasty
̎. AP and lateral radiographs of the elbow
̏. Diagnositc arthroscopy
̐. Aspiration of joint fluid
̑. An erythrocyte sedimentation rate and CBC
̒. A diagnostic lidocaine injection
̓. Insulin-like growth factor (IGF-1)
̔. Fibroblast growth factor (FGF-1)
̕. Platelet-derived growth factor (PDGF)
̖. Transforming growth factor beta (TGF-B)
̗. Bone morphogenetic proteins (BMP)
̘. clinical history and radiographic findings.
̙. technetium bone scan
̚. flow cytometry pattern of extracted chondrocytes
̛. immunohistochemical staining patterns of a biopsy specimen
̜. histologic features of a biopsy specimen stained with hematoxylin-cosin
̝. Radial
̞. Radial recurrent
̟. Posterior interosseous
̠. Superior ulnar recurrent
̡. Superficial radial circumflex
̢. Impaired hydroxylation of proline
̣. Failure of cleavage in procollagen
̤. Defective binding sites for hydroxyproline
̥. Failure to incorporate glycine into the helix
̦. Diminished production of collagen through the rough endoplasmic reticulum
̧. Asking the legal staff to seek a court injunction
̨. Copying the patient’s chart and giving it to him as he leaves
̩. Having the patient sign a written legal contract that specifies acceptable behavior
̪. Continuing care of the patient until an appropriate referral can be arranged
̫. Transferring the patient to another orthopaedic surgeon without disclosing the realreason for why the patient is being transferred
̬. Meta-analysis
̭. Confidence interval
̮. Analysis of variance (ANOVA)
̯. Statistical significance (p-value)
̰. Survivorship analysis (Kaplan-Meier)
̱. Spinal shock
̲. Neurogenic shock
̳. Hypovolemic shock
̴. Pulmonary embolism
̵. Fat embolus syndrome
̶. Lumbar spinal stenosis
̷. Metastatic disease of the spine
̸. Rheumatoid lumbar spondylitis
̹. Isthmic spondyloloisthesis
̺. Degenerative spondylolisthesis at L4-5 and L5-S1
̻. Patella alta
̼. A metal-backed patella
̽. Varus malalignment of the knee
̾. A posterior cruciate-substituting femoral component
̿. Lateral subluxation of the patella on a Merchant’s view
̀. The sesamoids are separated
́. The sesamoid is fractured
͂. The proximal phx is on the neck of the metatarsal
̓. The dislocation is dorsal and centered
̈́. The proximal phalanx is hyperextended
Ι. Patella
͆. Tibial stem
͇. Distal femoral interface
͈. Posterior femoral interface
͉. Sites of screw fixation for the tibia
͊. Hallux rigidus
͋. Fracture of the sesamoid
͌. Disruption of the plantar plate
͍. Osteonecrosis of the metatarsal head
͎. Rupture of the flexor hallucis longus
͏. Gout
͐. Sepsis
͑. Old trauma
͒. Rheumatoid arthritis
͓. Charcot arthroplasty
͔. Aspiration and steroid injection
͕. Biopsy, curettage, and allograft bone grafting
͖. Percutaneous Kirschner wire fixation
͗. Percutaneous injection of autogenous bone marrow
͘. Nerve roots
͙. Spinal cord
͚. Sciatic nerve
͛. Peroneal nerve
͜. Conus medullaris
͝. Extent of bone penetrated by reaming, prosthetic components, or acrylic cement
͞. Periprosthetic regions that are accessible to joint fluid and particulate wear debris
͟. Enveloping pseudocapsular scar tissue that develops around a prosthetic hip following surgical capsulectomy
͠. Soft tissue and bone that are potentially contaminated with bacteria in the setting of a prosthetic joint infection
͡. Potential intrapelvic joint space communication created by acetabular fixation screws or intrapelvic extruded acrylic cement
͢. Early and late infection
ͣ. Periprosthetic fracture of the femur
ͤ. Failure of the patellofemoral and extensor mechanisms
ͥ. Aseptic loosening of cementing tibial components
ͦ. Asceptic loosening of cemented femoral components
ͧ. Acceptance of the current position of the ankle
ͨ. Open reduction and fixation in the epiphysis only
ͩ. ORIF with a small-fragment T-plate from the malleolus up to the metaphysis
ͪ. Closed reduction by eversion of the ankle and application of a bivalved long leg cast
ͫ. CRUGA and fixation with a malleolar screw from the malleolus into the metaphysis
ͬ. Resection arthroplasty and local radiation
ͭ. In situ fusion of the hip
ͮ. Excision of heterotopic bone, total hip arthroplasty, and oral indomethacin
ͯ. Excision of heterotopic bone and local radiation
Ͱ. Excision of heterotopic bone, hemiarthroplasty, and oral indomethacin
Ͱ. Closed reduction of both fractures and immediate spica casting
Ͳ. Bilateral skin traction for 3 weeks, followed by spica casting
Ͳ. External fixation of both femora
ʹ. External fixation of the left femur and a long leg cast brace for the right femur
͵. External fixation of the left femur and use of a reamed intramedullary nail in the right femur
Ͷ. Synovial sarcoma
Ͷ. Soft-tissue abcess
͸. Rhabdomyosarcoma
͹. Eosinophilic granuloma
ͺ. Nodular pigmented villonodular synovitis
Ͻ. Changing to a titanium nail
Ͼ. Changing to a nonslotted nail
Ͽ. Changing the cross-sectional shape of the nail
;. Increasing the diameter of the nail by 3 mm
Ϳ. Increasing the diameter of the interlocking screws
΀. Fracture healing
΁. Chondrosarcoma
΂. Periosteal chondroma
΃. Periosteal osteosarcoma
΄. Dysplasia epiphysealis hemimelica
΅. Demonstrate competence in the subject of the case
Ά. Be fellowship trained in the subject of the case
·. Be paid on a contingency basis
Έ. Be board certified by the American Board of Orthopaedic Surgery
Ή. Have been involved in the case as a consultant
Ί. Diagnostic arthroscopy
΋. Arthroscopy and subacromial decompression
Ό. Reduction and fixation of the proximal humeral epiphysis
΍. Temporary cessation of throwing
Ύ. Physical therapy for rotator cuff strengthening
Ώ. Oblique popliteal ligament
Ϊ́. Lateral capsule
Α. Popliteal tendon
Β. Fibular collateral ligament
Γ. Posterior oblique ligament
Δ. Radial tear
Ε. Parrot-beak tear
Ζ. Vertical tear in the “red-red” zone
Η. Vertical tear in the “red-white” zone
Θ. Vertical tear in the “white-white” zone
Ι. 0 degrees of abduction, with neural rotation
Κ. 40 degrees of flexion and 60 degrees of internal rotation
Λ. 45 degrees of flexion and 45 degrees of external rotation
Μ. 90 degrees of abduction with neutral rotation
Ν. 90 degrees of abduction and 90 degrees of external rotation
Ξ. Sural
Ο. Saphenous and its branches
Π. Posterior tibial and its branches
Ρ. Deep peroneal and its branches
΢. Superficial peroneal and its branches
Σ. Strength
Τ. Stiffness
Υ. Shelf life
Φ. Antigenicity
Χ. Risk of HIV transmission
Ψ. Indemnification
Ω. Occurrence
Ϊ. Excess liability
Ϋ. Claims-made
Ά. Nose
Έ. Lateral Y
Ή. Scapular AP
Ί. Neutral rotation AP
Ϋ́. Internal rotation AP
Α. External rotation AP
Β. Trauma
Γ. Hemophilia
Δ. Reiter’s syndrome
Ε. Rheumatoid arthritis
Ζ. Systemic lupus erythematosus
Η. Cast immobilization for 6 weeks
Θ. Activity modification and re-evaluation in 2 months
Ι. Internal fixation with or without bone grafting
Κ. Retrograde drilling of the defect without articular cartilage penetration
Λ. Drilling of the defect directly through the articular cartilage
Μ. repair or reconstruction of the medial collateral ligament
Ν. repair or reconstruction of the medialand lateral collateral ligaments
Ξ. immobilization for 5 days or less
Ο. immobilization for 14 days
Π. immobilization for 25 days
Ρ. Cystinosis
Σ. Hypophosphatemia
Σ. Renal osteodystrophy
Τ. Primary hyperparathyroidism
Υ. Nutritional vitamin D deficiency
Φ. Lateral meniscus tear
Χ. Popliteus tenosynovitis
Ψ. Iliotibial band friction syndrome
Ω. Peroneal nerve entrapment
Ϊ. Biceps tendinitis
Ϋ. Observation
Ό. Removal of the prosthetic components
Ύ. Operative exploration and decompression of the peroneal nerve
Ώ. Nerve conduction velocity studies
Ϗ. Loosening of the primary dressings and knee flexion to 30 degrees
Β. I
Θ. II
ϒ. III
ϓ. decreased tissue tension
ϔ. decreased abductor lever arm
Φ. decreased joint reaction force
Π. increased body weight over lever arm
Ϗ. increased polyethylene wear rate
Ϙ. recurrent traumatic anterior dislocation
Ϙ. recurrent traumatic posterior dislocation
Ϛ. traumatic subluxation with no previous dislocation
Ϛ. traumatic anterior subluxation
Ϝ. atraumatic involuntary subluxation
Ϝ. radial
Ϟ. axillary
Ϟ. suprascapular
Ϡ. thoracodorsal
Ϡ. long thoracic
Ϣ. Flexion
Ϣ. Extension
Ϥ. Axial rotation
Ϥ. Left lateral bending
Ϧ. Right lateral bending
Ϧ. Skin
Ϩ. Lung
Ϩ. Brain
Ϫ. Heart
Ϫ. Kidney
Ϭ. Thoracoacromial, lateral thoracic, subscapular
Ϭ. Thoracoacromial, anterior humeral circumflex, posterior humeral circumflex
Ϯ. Posterior humeral circumflex, subscapular, thoracacromial
Ϯ. Subscapular, thoracacromial, anterior humeral circumflex
Κ. Lateral thoracic, anterior humeral circumflex, thoracacromial
Ρ. Respondeat superior
Ϲ. Indemnity agreement
Ϳ. Hold harmless agreement- attempt to shift liability from company to physician
ϴ. Comparative negligence-% of involvement
Ε. Contributory negligence- resident contributed to the negligence
϶. t-type
Ϸ. both column
Ϸ. transverse
Ϲ. anterior column
Ϻ. anterior column posterior hemitransverse
Ϻ. Posterior interosseous
ϼ. Anterior interosseous
Ͻ. Radial
Ͼ. Median
Ͽ. Ulnar
Ѐ. Shock from hypovolemia
Ё. Associated rupture of the bladder
Ђ. Arterial bleeding on pelvic angiogram
Ѓ. Presence of a hematoma in the perineum and scrotum
Є. Fractures of both the anterior and posterior pelvic ring

Correct Answer & Explanation

. Sural artery island flap.


Explanation

Question 4073

Topic: 10. Pathology and Oncology

  • A 32-year-old man has swelling of the knee as a result of falling with the knee flexed and his foot in plantar flexion. A Lachman’s test reveals an apparent increase in anterior translation. Passive external tibial rotation at 30 degrees and 90 degrees is equal to the contralateral side, and the quadriceps active test is positive on the affected side. The neurovascular examination is normal. Treatment should consist of
. An anterior cruciate functional knee brace.
. A physical therapy program.
. Reconstruction of the posterior cruciate ligament and the posterolateral corner.
. Reconstruction of the posterior cruciate ligament.
. Reconstruction of the anterior cruciate ligament.
. Avoids the risk of marrow emboli
. Avoids injury to the intramedullary nutrient vessels
. Results in faster healing of fractures
. Results in more secure fixation
. Results in faster regeneration of the endosteal blood supply
. Above-knee amputation
. En bloc resection of the lesion and reconstruction with a bone graft
. Closed reduction and immobilization in a cast
. Open reduction and internal fixation, followed by radiation therapy
. Open reduction, curettage, and cementing of the lesion
. Injury to the subclavian artery
. Injury to the brachial plexus
. Segmental fracture
. 100% displacement
. Associated displaced surgical neck fracture of the humerus
. humeral arthroplasty2/. repair of the rotator cuff
. closed reduction and immobilization
. open reduction and immobilization
. open reduction and early passive motion
. arthroscopic capsular release
. manipulation under anesthesia
. a physical therapy program
. an intra-articular corticosteroid injection
. administration of high-dose oral corticosteroids
. adding the scores, in all five body systems
. adding the squares of the scores in the three most severely injured systems
. doubling the cumulative score for head and chest injuries
!. combining the scores from the most and least injured systems
". correcting the score in the most severely injured system for age
#. traumatic femoral head fracture
$. osteonecrosis
%. osteoarthritis
&. neuropathic joint
'. rheumatoid arthritis
(. low-dose radiation
). steroid injection
*. a load-relieving insert and shoe modification
+. complete excision of the mass and the entire plantar fascia
,. wide excision of the mass with a 2 cm margin of normal fascia
-. CT scan of the chest
.. technetium bone scan
/. bone marrow aspiration
0. serum protein electrophoresis
1. lateral skull radiograph
2. high-grade histology of the initial tumor
3. multiple local recurrences after curettage
4. previous treatment of the tumor with cryotherapy
5. previous treatment of the tumor with radiation therapy
6. extraosseous extension into two or more adjacent compartments
7. Dorsal rhizotomy and facet joint fusion
8. Multilevel corpectomy and spinal stabilization
9. Central and lateral recess decompression and bilateral foraminotomy
:. Central decompression and facet joint fusion
;. Central decompression, foraminotomy, and spinal fusion from L2 to L5.
<. Inadequate rehabilitation
=. Displacement of the coronoid process fracture
>. Insufficiency of the lateral ulnar collateral ligament
?. Insufficiency of the anterior band of the medial collateral ligament
@. Insufficiency of the posterior band of the medial collateral ligament
A. Osteotomy and intramedullary rod fixation
B. Electrical stimulation
C. Strut-autografing the concavity the tibia
D. A patellar tendon-bearing brace
E. Percutaneous injection of demineralized bone matrix
F. digoxin
G. sucralfate
H. clindamycin
I. alcohol
J. neuromuscular blocking agents
K. Unrestrained roll-back
L. Unrestrained rotational conformity
M. Medial-Lateral conformity
N. Anteroposterior conformity in flexion
O. Anteroposterior conformity in extension
P. Arthrodesis of the MTP joint
Q. A Silastic implant of the MTP joint
R. Resection arthroplasty of the MTP joint
S. Cheilctomy of the MTP joint
T. Osteotomy of the base of the proximal phalanx
U. Genu varum
V. Tarsal coalition
W. Degenerative ankle arthrosis
X. Osteochondritis dissecans of the talus
Y. Hemihypertrophy of the ipsilateral lower extremity
Z. Trabecular bone is preferentially resorbed in this high bone turnover state
[. Loss of water content in the disk increases impact load to the vetrebral bodies
\. Stress is imposed by the relative stiffness of the arthrtic facet joints
]. Increased energy demands are imposed by decreased circulation to the vertebral body
^. The thick cortical bone found in the vertebral body resorbs rapidly following estrogen withdrawal
_. Increased time in stance and swing phase
`. Addition of a double leg float phase
A. Decreased vertical ground reaction forces
B. Decreased arc of motion in the hip, knee, and ankle
C. Decreased joint reaction forces in the hip, knee, and ankle
D. Talonavicular arthrodesis
E. Medial displacement calcaneal osteotomy
F. Flexor digitorum longus tendon transfer with spring ligament advancement
G. Triple arthrodesis
H. Calcaneocuboid distraction arthrodesis and repair of the posterior tibial tendon
I. Lymphoma
J. Hemangioma
K. Osteosarcoma
L. TB of the spine
M. Metastatic breast carcinoma
N. widening and shortening of the heel.
O. weakness of the gastrocnemius-soleus complex.
P. anterior impingement from a horizontal talus.
Q. unrecognized compartment syndrome of the foot.
R. degenerative arthritis of the tibiotalar joint.
S. a corrective osteotomy
T. application of braces
U. medial physeal stapling until the varus corrects
V. observation
W. application of corrective casts
X. a total contact cast.
Y. electrical stimulation.
Z. an off the shelf fracture brace.
{. an elastic compression bandage and crutches.
|. a hard soled shoe until the patient is asymptomatic.
}. Ewings tumor
~. Parosteal osteosarcoma
. Dedifferentiated chondrosarcoma
€. Low grade intramedullary chondrosarcoma
. High grade intramedullary osteosarcoma
‚. Vascular injury
ƒ. Tear of the rotator cuff
„. Injury to the brachial plexus
…. Fracture of the upper thoracic rib
†. Fracture of the proximal humerus
‡. Biceps
ˆ. Trapezius
‰. Infraspinatus
Š. Pectoralis major
‹. Serratus anterior
Œ. Hybrid total hip arthroplasty
. Noncemental hemiarthroplasty of the hip
Ž. Closed reduction and percutaneous pin fixation
. Open reduction through an anterior approach to the hip
. Excision of the head fragment
‘. a quadratus femoris pediclebone graft
’. a proximal femoral allograft
“. intertrochanteric osteotomy
”. total hip arthroplasty
•. hip hemiarthroplasty
–. Echocardiogram
—. Electrocardiogram
˜. Radiograph of the chest
™. CT scan of the shoulder
š. Ultrasound of the shoulder
›. Ilioinguinal
œ. Extended iliofemoral
. Combined ilioinguinal and Kocher-Langenbeck (posterior)
ž. Kocher-Langenbeck (posterior)
Ÿ. Kocher-Langenbeck (posterior) with trochanteric osteotomy
 . Deltoid
¡. Supraspinatus
¢. Subscapularis Infraspinatus
£. Infraspinatus
¤. Infraspinatus and teres minor
¥. an orthosis.
¦. observation.
§. electrical stimulation.
¨. open reduction and internal fixation.
©. application of a nonweightbearing short leg cast.
ª. repair of the rotator cuff.
«. rehabilitation of the shoulder
¬. replacement of the humeral head.
­. arthroscopic acromioplasty and debridement.
®. immobilization is a sling until pain resolves.
¯. Bone rotation versus torque applied
°. Bone deflection versus bending moment applied
±. Axial displacement versus tension applied
². Lateral translation versus shear force applied
³. Fracture gap closing versus compressive force applied
´. steroid injection
Μ. stretching of the heel cord
¶. surgical release of the plantar fascia
·. application of a short leg cast for 6 to 8 weeks
¸. wearing dorsiflexion night splints
¹. Open bladder
º. Bilateral “hitchhiker’s” thumbs
». Bilateral defects in the midclavicles
¼. Rhizomelic shortening of the extremities
½. Radiographic fragmentation of all major epiphyses
¾. Medial patellotibial
¿. Medial patellofemoral
À. Medial patellomeniscal
Á. Lateral patellofemoral
Â. Lateral patellotibial
Ã. Heat
Ä. Gentle active flexion-extension exercises
Å. Isokinetic strengthening
Æ. Electrical muscle stimulation
Ç. Immobilization of the limb with the knee in full flexion
È. Distal chevron osteotomy with soft-tissue release
É. Distal soft-tissue realignment only
Ê. Closing wedge osteotomy (Aken) of the proximal phalanx
Ë. Proximal first metatarsal osteotomy only
Ì. Soft-tissue realignment with a proximal metatarsal osteotomy
Í. Vagus
Î. Phrenic
Ï. Hypoglossal
Ð. Recurrent laryngeal
Ñ. Inferior thyroid
Ò. Surgical exploration
Ó. Application of leeches
Ô. Stellate ganglion blocks
Õ. Intra-arterial streptokinase
Ö. Elevation and reevaluation in 1 hour
×. Liver profile
Ø. Myleogram
Ù. Platelet count
Ú. CT scan of the head
Û. Angiogram of the extremity
Ü. Post spinal fusion from L5to S1
Ý. Primary repair with an iliac bone graft
Þ. Post spinal fusion of L4-5
SS. A pantaloon body cast and 6 weeks of bed rest
À. Rest, NSAIDS, and limited dancing
Á. Stress fracture of the proximal fifth metatarsal
Â. Stress fracture of the base of the second metatarsal
Ã. Stress fracture of the neck of the second metatarsal
Ä. Morton’s neuroma
Å. Lisfranc’s joint subluxation
Æ. C5 radiculopathy
Ç. Subscapularis rupture
È. Glenohumeral arthrosis
É. Rotator cuff arthropathy
Ê. Suprascapular nerve compression at the spinoglenoid notch
Ë. mm femoral head in combination with a metal-backed polyethylene component
Ì. mm femoral head in combination with an all-polyethylene acetabular component
Í. mm femoral head in combination with a metal-backed polyethylene component
Î. mm femoral head in combination with an all-polyethylene component
Ï. mm femoral head in combination with a metal-backed polyethylene component
Ð. Female gender
Ñ. History of cigarette smoking
Ò. L5-S1 spondylolisthesis on pre-employment radiography
Ó. Decreased strength of the lower extremities on pre-employment testing
Ô. Decreased flexibility of the lumbar spine on pre-employment testing
Õ. Size of cells
Ö. Amount of DNA in cells
÷. Nucleus-cytoplasm ratio
Ø. Specific DNA sequences
Ù. Specific messenger RNA sequences
Ú. Femoral and obturator nerves
Û. Femoral and superior gluteal nerves
Ü. Femoral and lateral femoral cutaneous nerves
Ý. Obturator and superior gluteal nerves
Þ. Obturator and lateral femoral cutaneous nerves
Ÿ. Isotonic
Ā. Isokinetic
Ā. Isometric
Ă. Open kinetic chain
Ă. Dynamic variable resistance
Ą. Closed reduction and cast immobilization
Ą. Uniplanar external fixation
Ć. Open reduction and internal fixation with a dynamic compression plate
Ć. Unreamed intramedullary rod
Ĉ. Multiple plane external fixator
Ĉ. Inlet view of the pelvis
Ċ. Outlet view of the pelvis
Ċ. AP view of the hip
Č. Ilial oblique view (external oblique) of the hip
Č. Obturator oblique
Ď. Glycolytic pathway
Ď. Oxidative phosphorylation
Đ. Breakdown of fat
Đ. Breakdown of protein
Ē. Breakdown of adenosine triphosphate
Ē. an MRI scan
Ĕ. arthroscopic examination
Ĕ. AP and frog-lateral radiographs of the pelvis and hips
Ė. varus and valgus stress radiographs of the knee
Ė. physical examination of the knee under anesthesia
Ę. extended curettage and polymethylmethacrylate cementation
Ę. extra-articular resection of the knee and an allograft arthrodesis
Ě. wide resection of the proximal tibia and custom prosthetic replacement
Ě. prophylactic internal fixation and postoperative irradiation
Ĝ. excision of the lateral condyle and reconstruction with a hemicondylar allograft
Ĝ. silicone implant joint replacement
Ğ. metatarsophalangeal joint arthrodesis
Ğ. metatarsophalangeal joint debridement
Ġ. resection of the metatarsal head
Ġ. resection of the base of the proximal phalanx
Ģ. Fixation of the syndesmosis has failed
Ģ. Widening of the ankle mortise has led to the failure of fixation
Ĥ. Infection around the syndesmosis screw has led to osteomyelitis
Ĥ. The syndesmosis screw is broken
Ħ. Motion between the tibia and fibula has caused loosening of the syndesmosis screw
Ħ. Microcephaly
Ĩ. A temporal lobe cyst
Ĩ. An Arnold-Chiari type 1 malformation
Ī. Periventricular leukomalacia
Ī. Agnesis of the corpus callosum
Ĭ. Wolff’s
Ĭ. Hooke’s
Į. Hilton’s
Į. Muller-Haeckel
İ. Heuter-Volkmann
I. Both the anterolateral and posteromedial bands are isometric and do not significantly change with flexion
IJ. The anterolateral band is lax and becomes tight in flexion, while the posteromedial band is tight, and becomes lax in flexion
IJ. The anterolateral band is tight and becomes lax in flexion, while the posteromedial band is lax and becomes tight in flexion
Ĵ. Both the anterolateral and posteromedial bands are lax and become tight in flexion
Ĵ. Both the anterolateral and posteromedial bands are tight and become lax as the knee is flexed
Ķ. UCB orthosis
Ķ. Rigid orthosis with a medical arch support
ĸ. Semi-rigid orthosis with lateral forefoot posting
Ĺ. Semi-rigid orthosis with a medial arch support
Ĺ. Medial heel wedge attached to the running shoes
Ļ. Hallux varus
Ļ. Osteonecrosis
Ľ. Recurrence of the hallux valgus
Ľ. “Transfer” second metatarsalgia
Ŀ. Physeal arrest of the first metatarsal
Ŀ. Aseptic loosening in a 70-year-old patient
Ł. Mechanical failure of a hinged knee prosthesis
Ł. Failed knee replacement complicated by reflex sympathetic dystrophy
Ń. Infection with soft-tissue deficit
Ń. A prior patellectomy
Ņ. Knee fusion
Ņ. Open irrigation and debridement
Ň. Arthroscopic irrigation and debridement
Ň. One-stage exchange arthroplasty
ʼN. Two-stage exchange arthroplasty
Ŋ. Putti-platt repair
Ŋ. Open Bankart repair
Ō. Injection of a subacromial corticosteroid
Ō. Arthroscopic transglenoid capsular shift
Ŏ. Rehabilitation of the scapular and rotator cuff muscles
Ŏ. Silicone suction socket and an energy-absorbing foot
Ő. Silicone suction socket and a variable resistance ankle
Ő. Plastic suction socket, telescoping pylon, and a solid ankle cushioned heel (SACH) foot
Œ. Plastic socket with a hinged thigh cuff and a SACH foot
Œ. Patellar tendon-bearing suction socket and a uniaxial hydraulic ankle
Ŕ. Parosteal
Ŕ. Periosteal
Ŗ. High-grade intramedullary
Ŗ. Osteosarcoma occurring in Paget’s disease
Ř. Osteosarcoma occurring in irradiated bone
Ř. Cauda equina
Ś. Conus medullaris
Ś. Genitofemoral nerve
Ŝ. Lumbar sympathetic plexus
Ŝ. Lumbar parasympathetic plexus
Ş. Spinal pseudoarthrosis
Ş. Spinal cord traction injury with paralysis
Š. Arterial and venous thromboses
Š. Superior mesenteric artery syndrome
Ţ. Crankshaft phenomenon
Ţ. Inversion stress radiograph
Ť. MRI scan
Ť. CT scan
Ŧ. Nuclear bone scan
Ŧ. External rotation stress radiograph
Ũ. Complex deformity with an angulation in two planes
Ũ. Single deformity less than 20 degrees, apex posterolateral
Ū. Single deformity greater than 30 degrees, apex posterolateral
Ū. Single deformity less than 20 degrees, apex posteromedial
Ŭ. Single deformity greater than 30 degrees, apex posteromedial
Ŭ. Pronation of the foot during the stance phase of gait
Ů. Heel inversion at the beginning of a single limb heel rise
Ů. Active inversion of the nonweightbearing foot
Ű. Active plantar flexion of the first ray against resistance
Ű. Active plantar flexion of the foot during the push-off phase of gait
Ų. Observation and repeat radiographs in 4 months
Ų. Application of a thoracolumbalsacral orthosis for 22 to 24 hours per day
Ŵ. Electrical stimulation at night
Ŵ. Physical therapy
Ŷ. Begins to remodel and hypertrophy more quickly
Ŷ. Provides a better scaffold for osteoconduction
Ÿ. Reduces the risk of early fracture
Ź. Reduces technical difficulty
Ź. Lowers donor site morbidity
Ż. Anterior fusion of the lumbar curve
Ż. Anterior and posterior fusion of the thoracic curve
Ž. Posterior fusion of the thoracic curve
Ž. Posterior fusion of the thoracic and lumbar curves
S. Application of a brace until the iliac apophyses are Risser 4 or 5, followed by surgical correction
Ƀ. Subscapularis rupture
Ɓ. Type III SLAP lesion
Ƃ. Disruption of capsular shift
Ƃ. Isolated traumatic subluxation
Ƅ. Injury to the axillary nerve after dislocation
Ƅ. hypophosphatemia
Ɔ. high dietary cholesterol intake
Ƈ. deficiency of lipoprotein A
Ƈ. deficiency of protein S and protein C
Ɖ. elevated levels of antithrombin III
Ɗ. Weightbearing short leg cast
Ƌ. Nonweightbearing short leg cast
Ƌ. Removable splint and early motion
ƍ. Open reduction and internal fixation
Ǝ. Elastic compression bandage with full weightbearing
Ə. Breast
Ɛ. Prostate
Ƒ. Gastrointestinal
Ƒ. Kidney
Ɠ. Multiple myeloma
Ɣ. Varus stress
Ƕ. Valgus stress
Ɩ. Torsional loading
Ɨ. Hyperextension of the knee
Ƙ. Contraction of the quadriceps while axially loaded
Ƙ. Primary internal fixation at both fracture levels
Ƚ. External fixation as definitive ttt for both #
ƛ. Skeletal traction and delayed internal fixation of both fractures
Ɯ. Primary internal fixation of the proximal fracture and delayed fixation of the femoral fracture
Ɲ. Primary internal fixation of the femoral shaft fracture and delayed fixation of the proximal #
Ƞ. Heel spur
Ɵ. Plantar fascitis
Ơ. Dysfunction of the tibialis posterior tendon
Ơ. Compression of the first branch of the lateral plantar nerve
Ƣ. Compression of the calcaneal nerve
Ƣ. Displaced labral tear
Ƥ. Tear of the rotator cuff
Ƥ. Fracture of the glenoid rim
Ʀ. Palsy of the axillary nerve
Ƨ. Palsy of the musculocutaneus nerve
Ƨ. Enchondroma
Ʃ. Osteoblastoma
ƪ. Giant cell tumor
ƫ. Aneurysmal bone cyst
Ƭ. Fibrous dysplasia
Ƭ. Arthrogram of the wrist
Ʈ. MRI scan of both wrists
Ư. CT scan of both wrists in the same position
Ư. Radiographs of the wrist in supination and pronation
Ʊ. Radiographs of the opposite wrist in the same position
Ʋ. Secondary hyperparathyroidism
Ƴ. Phosphate retention secondary to uremia
Ƴ. Insufficient renal synthesis of 1, 25 dihydroxy vitamin D
Ƶ. Aluminum deposition in bone from oral phosphate binders
Ƶ. Persistent acidosis aggravating the negative calcium balance
Ʒ. Posterior fusion at T10-L3 with segmental instrumentation
Ƹ. Laminectomy and fusion of T12-L2 with segmental instrumentation
Ƹ. Bed rest in a hyperextension brace
ƺ. L1 vertebrectomy and anterior decompression with strut graft fusion and instrumentation
ƻ. Progressive ambulation as tolerated in a custom-molded thoracolumbosacral orthosis
Ƽ. Positive-pressure ventilation
Ƽ. An immediate radiograph of the chest
ƾ. Adjustment of the position of the endotrachael tube
Ƿ. Insertion of a large-bore needle into the pericardial space
ǀ. Insertion of a large-bore needle in the right second intercostal space, midclavicular line
ǁ. Allowing the ends of the fracture to touch
ǂ. Adding a second connecting bar
ǃ. Adding one pin to each fracture fragment
DŽ. Increasing the pin diameter from 4 mm to 6 mm
DŽ. Decreasing the connecting bar-to-bone distance from 6 cm to 4 cm
DŽ. Osteomyelitis
LJ. Malignant degeneration
LJ. Stress fracture
LJ. Local recurrence of the giant cell tumor
NJ. Bone resorption due to methylmethacrylate
NJ. Advancement of the plantar plate
NJ. Resection of the second metatarsal head
Ǎ. Dorsiflexion osteotomy of the second metatarsal neck
Ǎ. Transfer of the flexor digitorum longus tendon to the dorsum of the toe
Ǐ. Transfer of the extensor digitorum comminus tendon to the metatarsal neck
Ǐ. Sacral fracture
Ǒ. Burst fracture of L5
Ǒ. Cauda equina syndrome
Ǔ. Distraction-flexion injury at L3
Ǔ. Distraction-extension injury at L3
Ǖ. An MRI scan of the shoulder
Ǖ. An MRI scan of the cervical spine
Ǘ. Electromyographic and nerve conduction velocity studies
Ǘ. Immobilization in a sling and early passive range of motion exercises
Ǚ. Immediate return to the operating room for exploration of the brachial plexus
Ǚ. cerclage wiring
Ǜ. tension band wiring
Ǜ. removal of the patellar component
Ǝ. revision of the patellar component
Ǟ. immobilization of the knee and protected weightbearing
Ǟ. Liposarcoma
Ǡ. Nodular fasciitis
Ǡ. Rabdomyosarcoma
Ǣ. Malignant fibrous histiocytoma
Ǣ. Extra-abdominal desmoid tumor
Ǥ. Clubfeet
Ǥ. Thrombocytopenia
Ǧ. Congenital scoliosis
Ǧ. Ventricular septal defect
Ǩ. Arnold-Chiari malformation
Ǩ. delayed primary closure
Ǫ. free flap
Ǫ. pedicle groin flap
Ǭ. full-thickness skin graft
Ǭ. split-thickness skin graft
Ǯ. Infection
Ǯ. Nonunion
J̌. Improper screw length
DZ. Osteonecrosis of the distal fragment
DZ. Use of a cortical screw instead of a cancellous screw
DZ. Infection
Ǵ. Tear of the rotator cuff
Ǵ. Loosening of the humeral component
Ƕ. Arthritis of the glenoid
Ƿ. Arthritis of the A-C joint
Ǹ. Reduced morbidity
Ǹ. Improved osteoinduction
Ǻ. Improved osteoconduction
Ǻ. More rapid revascularization
Ǽ. Lower risk of disease transmission
Ǽ. Manipulation Under Anesthesia
Ǿ. Arthroscopic acromioplasty
Ǿ. Arthroscopic debridement of G-H joint
Ȁ. Replacement of the humeral head
Ȁ. Lengthening of the subscapularis and release of the anterior capsule
Ȃ. Bacteroides
Ȃ. E. coli
Ȅ. Staph. aureus
Ȅ. group A streptococcus
Ȇ. Clostridium perforingens
Ȇ. observation and exercises
Ȉ. bracing with a thoracolumbar orthosis
Ȉ. fusion of the posterior spine
Ȋ. fusion of the anterior spine
Ȋ. fusion of the anterior and posterior spine
Ȍ. Total wrist replacement and bridge grafts
Ȍ. palmar shelf arthroplasty and tendon transfers
Ȏ. Darrach distal ulna resection, dorsal tenosynosynovectomy, and tendon transfers
Ȏ. Radioscaphate fusion, extensor tenodesis, and Darrach distal ulna resection
Ȑ. Total wrist fusion and tendon transfers
Ȑ. constrained acetabular component
Ȓ. protrusion ring with morselized graft
Ȓ. cemented metal backed acetabular component
Ȕ. cemented all-polyethylene acetabular component
Ȕ. cementless hemispherical component with screw fixation
Ȗ. application of a hip abduction brace for 22 hours per day
Ȗ. application of a hip spica under anesthesia
Ș. discontinuance of all bracing and repeat radiographs in 3 months
Ș. open reduction of the hip and application of a spica cast
Ț. open reduction, varus osteotomy, and application of a spica cast
Ț. Loss of skin hair on the feet
Ȝ. Absent pulses on vascular examination
Ȝ. Pain that originates proximally and spreads distally
Ȟ. Pain that is relieved by stopping and standing
Ȟ. Pain that is worse when the patient walks uphill rather downhill
Ƞ. wrist flexors and finger flexors
ȡ. elbow flexors and wrist flexors
Ȣ. elbow flexors and finger flexors
Ȣ. elbow extensors and wrist flexorst Level Key Muscles4 DiaphragmDeltoid, elbow flexors, diaphragmElbow flexors, wrist extensorsElbow extensors, wrist flexorsFinger flexors (distal phalanx of middlefinger)Finger abductors (5th digit), intrinsics of hand2 Segmental innervation to intercostal muscles, abdominal and paraspinal muscles) L1, L2, L3 Hip flexors3, L4 QuadricepsTibialis anteriorToe extensors, hip abductorsAnkle plantarflexors, peronei
Ȥ. elbow extensors and wrist extensors
Ȥ. Syndactyly
Ȧ. Macrodactyly
Ȧ. Camptodactyly
Ȩ. Preaxial polydactyly
Ȩ. Postaxial polydactyly
Ȫ. Arthrodesis
Ȫ. Rotationplasty
Ȭ. Above-knee amputation
Ȭ. Osteoarticular allograft
Ȯ. Endoprosthesis (custom arthroplasty)
Ȯ. Plantar fascia
Ȱ. Spring ligament
Ȱ. Deltoid ligament
Ȳ. Intrinsic tendons
Ȳ. Gastorcnemius-solelus complex
ȴ. Prevention of presynaptic release of acetylcholine
ȵ. Prevention of synthesis of presynaptic acetylcholine
ȶ. Activation of acetylcholinesterase at the motor end-plate
ȷ. Blockage of postsynaptic action of acetylcholine until reserves are depleted
ȸ. Stimulation of release of presynaptic acetylcholine until reserves are depleted
ȹ. stiffness of the femoral component.
Ⱥ. head offset of the femoral component.
Ȼ. femoral component material modulus of elasticity.
Ȼ. extent of the femoral component porous coating.
Ƚ. Presence of a femoral component collar.
Ⱦ. plantar fascia and quadratus plantae tendon.
Ȿ. ligamentous structures connecting the tarsal bones.
Ɀ. shape of the tarsal bones and the intervening joints.
Ɂ. activity of the intrinsic muscles of the foot.
Ɂ. activity of the posterior tibialis and the peroneus longus muscles.
Ƀ. scapulothoracic fusion
Ʉ. strengthening of the periscapular muscles
Ʌ. pectoralis minor-fascia lata graft transfer to the scapula
Ɇ. pectoralis major-fascia lata graft transfer to the scapula
Ɇ. exploration of the long thoracic nerve, with sural nerve graft
Ɉ. tricompartmental knee replacement
Ɉ. unicompartmental knee replacement
Ɋ. medial compartment meniscal allograft
Ɋ. valgus-producing distal femoral osteotomy
Ɍ. valgus-producing proximal tibial osteotomy
Ɍ. Internal rotation of the femoral component
Ɏ. External rotation of the tibial component
Ɏ. Lateral placement of the femoral component
Ɐ. Medial placement of the patellar component
Ɑ. Excessive resection of the patella
Ɒ. Hallux rigidus
Ɓ. Hallux valgus
Ɔ. Neuroma of the first web space
ɕ. Fracture of the sesamoid
Ɖ. Rupture of the flexor hallucis longus
Ɗ. Sickle cell crisis
ɘ. Idiopathic chondrolysis
Ə. Hemophilic arthropathy
ɚ. Osteoid osteoma of the femoral neck
Ɛ. Legg-Calve-Perthes disease
Ɜ. Decreased ankle jerk and positive femoral nerve stretch test
ɝ. Decreased knee jerk and positive straight-leg raising sign
ɞ. Gastrocnemius-soleus complex weakness and positive straight-leg raising sign
ɟ. Weakness of the extensor hallucis longus and positive straight-leg raising sign
Ɠ. Weakness of the extensor hallucis longus and positive femoral nerve stretch test
Ɡ. Long-term administration of IV and oral antibiotics
ɢ. Open soft-tissue debridement, retention of prosthetic components, and IV antibiotics
Ɣ. Immediate exchange arthroplasty with antibiotic-impregnated cement
ɤ. Two-stage surgical prosthetic exchange and IV antibiotics
Ɥ. Resection arthroplasty and IV antibiotics
Ɦ. SCFE
ɧ. MED
Ɨ. Perthes disease
Ɩ. Hypothyroidism
Ɪ. Chondrolysis
Ɫ. gout.
Ɬ. osteoporosis.
ɭ. eosinophilic granuloma.
ɮ. tuberculosis of the spine.
Ɯ. metastatic disease of the spine.
ɰ. water content.
Ɱ. Synthesis of type I collagen.
Ɲ. Proteoglycan content.
ɳ. Activity of chondrocytes.
ɴ. Synthesis of hyaluronate.
Ɵ. Lung
ɶ. Breast
ɷ. Prostate
ɸ. Thyroid
ɹ. Renal
ɺ. T1-low, T2-low.
ɻ. T1-low, T2-high.
ɼ. T1-moderate, T2-low.
Ɽ. T1-high, T2-low.
ɾ. T1-high, T2-high.
ɿ. hypothesis is incorrect or invalid
Ʀ. interobserver error rate is 4%.
ʁ. Standard deviation is 4% higher or lower than the mean.
Ʂ. Sample size is 4% larger than required to be clinically significant.
Ʃ. Probability that the differences noted between two study groups were due to chance alone is 4%.
ʄ. I
ʅ. II
ʆ. IV
Ʇ. IX
Ʈ. X
Ʉ. Cranial setting
Ʊ. Cranial subluxation
Ʋ. Odontoid fracture
Ʌ. Lysis of the arch of the atlas
ʍ. Atlantoaxial subluxation
ʎ. Retrograde collapse of the endoneurial tubes
ʏ. Irreversible atrophy of the denervated muscles
ʐ. Elongation of the axons across the zone of injury
ʑ. Sprouting of the axons at the neuromuscular junction
Ʒ. Misdirection of the axons across the zone of injury
ʓ. Maximally pronated and elbow extended
ʔ. Maximally pronated and the elbow flexed
ʕ. Maximally supinated and the elbow flexed
ʖ. Maximally supinated and the elbow extended
ʗ. In neutral rotation, with the elbow extended
ʘ. open reduction and internal fixation
ʙ. buddy taping to the adjacent index finger
ʚ. early motion with application of a dynamic banjo splint
ʛ. application of a cast with the hand in a “safe position” for 3 weeks.
ʜ. dorsal extension block splinting
Ʝ. The name of the manufacturer
Ʞ. The manufacturer’s potential liability
ʟ. The physician’s clinical performance
ʠ. The physician’s materials testing data
ʡ. Any royalties the physician receives from the manufacturer
ʢ. Femoral
ʣ. Obturator
ʤ. Inferior gluteal
ʥ. Superior gluteal
ʦ. Lateral femoral cutaneous
ʧ. open biopsy and a long leg cast
ʨ. open biopsy and wide resection of the tumor
ʩ. a long leg cast and observation
ʪ. intramedullary stabilization and observation
ʫ. Triggering
ʬ. Lateral instability
ʭ. Swan-neck deformity
ʮ. Boutonniere deformity
ʯ. Loss of distal interphalangeal joint flexion
ʰ. Peroneus brevis to peroneus longus
ʱ. Peroneus tertius to extensor hallucis longus
ʲ. Peroneus tertius to superficial peroneal nerve
ʳ. Extensor hallucis longus to deep peroneal nerve
ʴ. Extensor hallucis longus to extensor digitorum longus
ʵ. reassurance that Medicare will pay for the treatment.
ʶ. consent forms that patients or their guardians are able to understand.
ʷ. a detailed description of the device, omitting the fact that it is part of a study.
ʸ. a provision that the patient’s care will be discontinued if he or she does not enroll in the study.
ʹ. a provision that the study will be carried out to completion, whether or not the device is as effective as those currently in existence.
ʺ. an onlay iliac crest bone graft.
ʻ. limited weightbearing and observation.
ʼ. removal of the implant and limited weightbearing.
ʽ. removal of the implant and insertion of a reamed femoral nail.
ʾ. removal of the implant and insertion of an unreamed femoral nail.
ʿ. Coronal
ˀ. Sagittal
ˁ. Anteromedial, midway between the sagittal and the coronal
˂. Proximal pins sagittal, distal pins coronal
˃. Proximal pins coronal, distal pins sagittal
˄. Rheumatoid arthritis
˅. Posttraumatic arthritis
ˆ. Degenerative osteoarthritis
ˇ. Osteonecrosis of the tibial plateau
ˈ. Osteonecrosis of the medial femoral condyle
ˉ. Trapeziometacarpal arthrodesis
ˊ. Osteotomy of the thumb metacarpal
ˋ. Arthrotomy and joint debridement
ˌ. Ligament reconstruction using one half of the flexor carpi radialis
ˍ. Trapezium resection, tendon interposition, and reconstruction of the ligament
ˎ. Creep
ˏ. Relaxation
ː. Energy dissipation
ˑ. Plastic deformation
˒. Elastic deformation
˓. bending
˔. axial loading
˕. high-speed rotation
˖. direct impact from anteromedial
˗. crush from anteromedial to posterolateral
˘. Increase stiffness
˙. Increase fracture toughness
˚. Increase fatigue strength
˛. Decrease mechanical strength
˜. Decrease wear rate
˝. disuse osteopenia
˞. paraendocrine effect of the tumor
˟. abnormally increased density on the right side
ˠ. side effect of the treatment of the lesion
ˡ. extensive tumor involvement of the left hip
ˢ. Sciatic nerve
ˣ. Superior gluteal artery
ˤ. Profunda femoris artery
˥. Femoral artery and nerve
˦. External iliac artery and vein
˧. Length
˨. Moment arm
˩. Total volume
˪. Physiologic cross-sectional area
˫. Distribution of slow and fast twitch fibers
ˬ. decreasing initiation of action potentials.
˭. increasing action potential amplitude.
ˮ. blocking the opening of gated sodium channels.
˯. decreasing the number of functional motor units.
˰. slowing or stopping action potential propagation through the axon.
˱. resection of the metatarsal heads of the first through fifth toes.
˲. Silastic MP joint arthroplasties of the first through fifth toes.
˳. fusion of the hallux MP joint and resection arthroplasty of the 2nd through fifth metatarsal heads.
˴. fusion of hallux MP joint and distal osteotomy of the 2nd through 5th MT.
˵. plantar condylectomy of the 2nd through 5th MT heads & resection of proximal phx of the hallux.
˶. hemiarthroplasty
˷. open reduction and internal fixation
˸. closed reduction and percutaneous pinning
˹. a sling and early pedulum exercises
˺. a sling and swathe for 6 weeks, followed by shoulder rehabilitation
˻. open acromioplasty
˼. open Bankart repair
˽. open subscapularis tendon repair
˾. inferior capsular shift
˿. a supervised physical therapy program
̀. a sling and swathe, with pendulum exercises in 10 days
́. open reduction and internal fixation through an anterior approach
̂. open reduction and internal fixation through a posterior approach
̃. immobilization with a splint in 45 degrees of abduction for 6 weeks
̄. arthroscopically assisted reduction and percutaneous screw fixation
̅. Repair of the rotator cuff
̆. Replacement of the humeral head
̇. Resection arthroplasty
̈. Total shoulder arthroplasty
̉. AP and lateral radiographs of the elbow
̊. Diagnositc arthroscopy
̋. Aspiration of joint fluid
̌. An erythrocyte sedimentation rate and CBC
̍. A diagnostic lidocaine injection
̎. Insulin-like growth factor (IGF-1)
̏. Fibroblast growth factor (FGF-1)
̐. Platelet-derived growth factor (PDGF)
̑. Transforming growth factor beta (TGF-B)
̒. Bone morphogenetic proteins (BMP)
̓. clinical history and radiographic findings.
̔. technetium bone scan
̕. flow cytometry pattern of extracted chondrocytes
̖. immunohistochemical staining patterns of a biopsy specimen
̗. histologic features of a biopsy specimen stained with hematoxylin-cosin
̘. Radial
̙. Radial recurrent
̚. Posterior interosseous
̛. Superior ulnar recurrent
̜. Superficial radial circumflex
̝. Impaired hydroxylation of proline
̞. Failure of cleavage in procollagen
̟. Defective binding sites for hydroxyproline
̠. Failure to incorporate glycine into the helix
̡. Diminished production of collagen through the rough endoplasmic reticulum
̢. Asking the legal staff to seek a court injunction
̣. Copying the patient’s chart and giving it to him as he leaves
̤. Having the patient sign a written legal contract that specifies acceptable behavior
̥. Continuing care of the patient until an appropriate referral can be arranged
̦. Transferring the patient to another orthopaedic surgeon without disclosing the realreason for why the patient is being transferred
̧. Meta-analysis
̨. Confidence interval
̩. Analysis of variance (ANOVA)
̪. Statistical significance (p-value)
̫. Survivorship analysis (Kaplan-Meier)
̬. Spinal shock
̭. Neurogenic shock
̮. Hypovolemic shock
̯. Pulmonary embolism
̰. Fat embolus syndrome
̱. Lumbar spinal stenosis
̲. Metastatic disease of the spine
̳. Rheumatoid lumbar spondylitis
̴. Isthmic spondyloloisthesis
̵. Degenerative spondylolisthesis at L4-5 and L5-S1
̶. Patella alta
̷. A metal-backed patella
̸. Varus malalignment of the knee
̹. A posterior cruciate-substituting femoral component
̺. Lateral subluxation of the patella on a Merchant’s view
̻. The sesamoids are separated
̼. The sesamoid is fractured
̽. The proximal phx is on the neck of the metatarsal
̾. The dislocation is dorsal and centered
̿. The proximal phalanx is hyperextended
̀. Patella
́. Tibial stem
͂. Distal femoral interface
̓. Posterior femoral interface
̈́. Sites of screw fixation for the tibia
Ι. Hallux rigidus
͆. Fracture of the sesamoid
͇. Disruption of the plantar plate
͈. Osteonecrosis of the metatarsal head
͉. Rupture of the flexor hallucis longus
͊. Gout
͋. Sepsis
͌. Old trauma
͍. Rheumatoid arthritis
͎. Charcot arthroplasty
͏. Aspiration and steroid injection
͐. Biopsy, curettage, and allograft bone grafting
͑. Percutaneous Kirschner wire fixation
͒. Percutaneous injection of autogenous bone marrow
͓. Nerve roots
͔. Spinal cord
͕. Sciatic nerve
͖. Peroneal nerve
͗. Conus medullaris
͘. Extent of bone penetrated by reaming, prosthetic components, or acrylic cement
͙. Periprosthetic regions that are accessible to joint fluid and particulate wear debris
͚. Enveloping pseudocapsular scar tissue that develops around a prosthetic hip following surgical capsulectomy
͛. Soft tissue and bone that are potentially contaminated with bacteria in the setting of a prosthetic joint infection
͜. Potential intrapelvic joint space communication created by acetabular fixation screws or intrapelvic extruded acrylic cement
͝. Early and late infection
͞. Periprosthetic fracture of the femur
͟. Failure of the patellofemoral and extensor mechanisms
͠. Aseptic loosening of cementing tibial components
͡. Asceptic loosening of cemented femoral components
͢. Acceptance of the current position of the ankle
ͣ. Open reduction and fixation in the epiphysis only
ͤ. ORIF with a small-fragment T-plate from the malleolus up to the metaphysis
ͥ. Closed reduction by eversion of the ankle and application of a bivalved long leg cast
ͦ. CRUGA and fixation with a malleolar screw from the malleolus into the metaphysis
ͧ. Resection arthroplasty and local radiation
ͨ. In situ fusion of the hip
ͩ. Excision of heterotopic bone, total hip arthroplasty, and oral indomethacin
ͪ. Excision of heterotopic bone and local radiation
ͫ. Excision of heterotopic bone, hemiarthroplasty, and oral indomethacin
ͬ. Closed reduction of both fractures and immediate spica casting
ͭ. Bilateral skin traction for 3 weeks, followed by spica casting
ͮ. External fixation of both femora
ͯ. External fixation of the left femur and a long leg cast brace for the right femur
Ͱ. External fixation of the left femur and use of a reamed intramedullary nail in the right femur
Ͱ. Synovial sarcoma
Ͳ. Soft-tissue abcess
Ͳ. Rhabdomyosarcoma
ʹ. Eosinophilic granuloma
͵. Nodular pigmented villonodular synovitis
Ͷ. Changing to a titanium nail
Ͷ. Changing to a nonslotted nail
͸. Changing the cross-sectional shape of the nail
͹. Increasing the diameter of the nail by 3 mm
ͺ. Increasing the diameter of the interlocking screws
Ͻ. Fracture healing
Ͼ. Chondrosarcoma
Ͽ. Periosteal chondroma
;. Periosteal osteosarcoma
Ϳ. Dysplasia epiphysealis hemimelica
΀. Demonstrate competence in the subject of the case
΁. Be fellowship trained in the subject of the case
΂. Be paid on a contingency basis
΃. Be board certified by the American Board of Orthopaedic Surgery
΄. Have been involved in the case as a consultant
΅. Diagnostic arthroscopy
Ά. Arthroscopy and subacromial decompression
·. Reduction and fixation of the proximal humeral epiphysis
Έ. Temporary cessation of throwing
Ή. Physical therapy for rotator cuff strengthening
Ί. Oblique popliteal ligament
΋. Lateral capsule
Ό. Popliteal tendon
΍. Fibular collateral ligament
Ύ. Posterior oblique ligament
Ώ. Radial tear
Ϊ́. Parrot-beak tear
Α. Vertical tear in the “red-red” zone
Β. Vertical tear in the “red-white” zone
Γ. Vertical tear in the “white-white” zone
Δ. 0 degrees of abduction, with neural rotation
Ε. 40 degrees of flexion and 60 degrees of internal rotation
Ζ. 45 degrees of flexion and 45 degrees of external rotation
Η. 90 degrees of abduction with neutral rotation
Θ. 90 degrees of abduction and 90 degrees of external rotation
Ι. Sural
Κ. Saphenous and its branches
Λ. Posterior tibial and its branches
Μ. Deep peroneal and its branches
Ν. Superficial peroneal and its branches
Ξ. Strength
Ο. Stiffness
Π. Shelf life
Ρ. Antigenicity
΢. Risk of HIV transmission
Σ. Indemnification
Τ. Occurrence
Υ. Excess liability
Φ. Claims-made
Χ. Nose
Ψ. Lateral Y
Ω. Scapular AP
Ϊ. Neutral rotation AP
Ϋ. Internal rotation AP
Ά. External rotation AP
Έ. Trauma
Ή. Hemophilia
Ί. Reiter’s syndrome
Ϋ́. Rheumatoid arthritis
Α. Systemic lupus erythematosus
Β. Cast immobilization for 6 weeks
Γ. Activity modification and re-evaluation in 2 months
Δ. Internal fixation with or without bone grafting
Ε. Retrograde drilling of the defect without articular cartilage penetration
Ζ. Drilling of the defect directly through the articular cartilage
Η. repair or reconstruction of the medial collateral ligament
Θ. repair or reconstruction of the medialand lateral collateral ligaments
Ι. immobilization for 5 days or less
Κ. immobilization for 14 days
Λ. immobilization for 25 days
Μ. Cystinosis
Ν. Hypophosphatemia
Ξ. Renal osteodystrophy
Ο. Primary hyperparathyroidism
Π. Nutritional vitamin D deficiency
Ρ. Lateral meniscus tear
Σ. Popliteus tenosynovitis
Σ. Iliotibial band friction syndrome
Τ. Peroneal nerve entrapment
Υ. Biceps tendinitis
Φ. Observation
Χ. Removal of the prosthetic components
Ψ. Operative exploration and decompression of the peroneal nerve
Ω. Nerve conduction velocity studies
Ϊ. Loosening of the primary dressings and knee flexion to 30 degrees
Ϋ. I
Ό. II
Ύ. III
Ώ. decreased tissue tension
Ϗ. decreased abductor lever arm
Β. decreased joint reaction force
Θ. increased body weight over lever arm
ϒ. increased polyethylene wear rate
ϓ. recurrent traumatic anterior dislocation
ϔ. recurrent traumatic posterior dislocation
Φ. traumatic subluxation with no previous dislocation
Π. traumatic anterior subluxation
Ϗ. atraumatic involuntary subluxation
Ϙ. radial
Ϙ. axillary
Ϛ. suprascapular
Ϛ. thoracodorsal
Ϝ. long thoracic
Ϝ. Flexion
Ϟ. Extension
Ϟ. Axial rotation
Ϡ. Left lateral bending
Ϡ. Right lateral bending
Ϣ. Skin
Ϣ. Lung
Ϥ. Brain
Ϥ. Heart
Ϧ. Kidney
Ϧ. Thoracoacromial, lateral thoracic, subscapular
Ϩ. Thoracoacromial, anterior humeral circumflex, posterior humeral circumflex
Ϩ. Posterior humeral circumflex, subscapular, thoracacromial
Ϫ. Subscapular, thoracacromial, anterior humeral circumflex
Ϫ. Lateral thoracic, anterior humeral circumflex, thoracacromial
Ϭ. Respondeat superior
Ϭ. Indemnity agreement
Ϯ. Hold harmless agreement- attempt to shift liability from company to physician
Ϯ. Comparative negligence-% of involvement
Κ. Contributory negligence- resident contributed to the negligence
Ρ. t-type
Ϲ. both column
Ϳ. transverse
ϴ. anterior column
Ε. anterior column posterior hemitransverse
϶. Posterior interosseous
Ϸ. Anterior interosseous
Ϸ. Radial
Ϲ. Median
Ϻ. Ulnar
Ϻ. Shock from hypovolemia
ϼ. Associated rupture of the bladder
Ͻ. Arterial bleeding on pelvic angiogram
Ͼ. Presence of a hematoma in the perineum and scrotum
Ͽ. Fractures of both the anterior and posterior pelvic ring

Correct Answer & Explanation

. An anterior cruciate functional knee brace.


Explanation

Question 4074

Topic: 10. Pathology and Oncology

  • Which of the following is considered an advantage of an unreamed intramedullary nail over a reamed intramedullary nail?
. Avoids the risk of marrow emboli
. Avoids injury to the intramedullary nutrient vessels
. Results in faster healing of fractures
. Results in more secure fixation
. Results in faster regeneration of the endosteal blood supply
. Above-knee amputation
. En bloc resection of the lesion and reconstruction with a bone graft
. Closed reduction and immobilization in a cast
. Open reduction and internal fixation, followed by radiation therapy
. Open reduction, curettage, and cementing of the lesion
. Injury to the subclavian artery
. Injury to the brachial plexus
. Segmental fracture
. 100% displacement
. Associated displaced surgical neck fracture of the humerus
. humeral arthroplasty2/. repair of the rotator cuff
. closed reduction and immobilization
. open reduction and immobilization
. open reduction and early passive motion
. arthroscopic capsular release
. manipulation under anesthesia
. a physical therapy program
. an intra-articular corticosteroid injection
. administration of high-dose oral corticosteroids
. adding the scores, in all five body systems
. adding the squares of the scores in the three most severely injured systems
. doubling the cumulative score for head and chest injuries
. combining the scores from the most and least injured systems
. correcting the score in the most severely injured system for age
. traumatic femoral head fracture
. osteonecrosis
. osteoarthritis
!. neuropathic joint
". rheumatoid arthritis
#. low-dose radiation
$. steroid injection
%. a load-relieving insert and shoe modification
&. complete excision of the mass and the entire plantar fascia
'. wide excision of the mass with a 2 cm margin of normal fascia
(. CT scan of the chest
). technetium bone scan
*. bone marrow aspiration
+. serum protein electrophoresis
,. lateral skull radiograph
-. high-grade histology of the initial tumor
.. multiple local recurrences after curettage
/. previous treatment of the tumor with cryotherapy
0. previous treatment of the tumor with radiation therapy
1. extraosseous extension into two or more adjacent compartments
2. Dorsal rhizotomy and facet joint fusion
3. Multilevel corpectomy and spinal stabilization
4. Central and lateral recess decompression and bilateral foraminotomy
5. Central decompression and facet joint fusion
6. Central decompression, foraminotomy, and spinal fusion from L2 to L5.
7. Inadequate rehabilitation
8. Displacement of the coronoid process fracture
9. Insufficiency of the lateral ulnar collateral ligament
:. Insufficiency of the anterior band of the medial collateral ligament
;. Insufficiency of the posterior band of the medial collateral ligament
<. Osteotomy and intramedullary rod fixation
=. Electrical stimulation
>. Strut-autografing the concavity the tibia
?. A patellar tendon-bearing brace
@. Percutaneous injection of demineralized bone matrix
A. digoxin
B. sucralfate
C. clindamycin
D. alcohol
E. neuromuscular blocking agents
F. Unrestrained roll-back
G. Unrestrained rotational conformity
H. Medial-Lateral conformity
I. Anteroposterior conformity in flexion
J. Anteroposterior conformity in extension
K. Arthrodesis of the MTP joint
L. A Silastic implant of the MTP joint
M. Resection arthroplasty of the MTP joint
N. Cheilctomy of the MTP joint
O. Osteotomy of the base of the proximal phalanx
P. Genu varum
Q. Tarsal coalition
R. Degenerative ankle arthrosis
S. Osteochondritis dissecans of the talus
T. Hemihypertrophy of the ipsilateral lower extremity
U. Trabecular bone is preferentially resorbed in this high bone turnover state
V. Loss of water content in the disk increases impact load to the vetrebral bodies
W. Stress is imposed by the relative stiffness of the arthrtic facet joints
X. Increased energy demands are imposed by decreased circulation to the vertebral body
Y. The thick cortical bone found in the vertebral body resorbs rapidly following estrogen withdrawal
Z. Increased time in stance and swing phase
[. Addition of a double leg float phase
\. Decreased vertical ground reaction forces
]. Decreased arc of motion in the hip, knee, and ankle
^. Decreased joint reaction forces in the hip, knee, and ankle
_. Talonavicular arthrodesis
`. Medial displacement calcaneal osteotomy
A. Flexor digitorum longus tendon transfer with spring ligament advancement
B. Triple arthrodesis
C. Calcaneocuboid distraction arthrodesis and repair of the posterior tibial tendon
D. Lymphoma
E. Hemangioma
F. Osteosarcoma
G. TB of the spine
H. Metastatic breast carcinoma
I. widening and shortening of the heel.
J. weakness of the gastrocnemius-soleus complex.
K. anterior impingement from a horizontal talus.
L. unrecognized compartment syndrome of the foot.
M. degenerative arthritis of the tibiotalar joint.
N. a corrective osteotomy
O. application of braces
P. medial physeal stapling until the varus corrects
Q. observation
R. application of corrective casts
S. a total contact cast.
T. electrical stimulation.
U. an off the shelf fracture brace.
V. an elastic compression bandage and crutches.
W. a hard soled shoe until the patient is asymptomatic.
X. Ewings tumor
Y. Parosteal osteosarcoma
Z. Dedifferentiated chondrosarcoma
{. Low grade intramedullary chondrosarcoma
|. High grade intramedullary osteosarcoma
}. Vascular injury
~. Tear of the rotator cuff
. Injury to the brachial plexus
€. Fracture of the upper thoracic rib
. Fracture of the proximal humerus
‚. Biceps
ƒ. Trapezius
„. Infraspinatus
…. Pectoralis major
†. Serratus anterior
‡. Hybrid total hip arthroplasty
ˆ. Noncemental hemiarthroplasty of the hip
‰. Closed reduction and percutaneous pin fixation
Š. Open reduction through an anterior approach to the hip
‹. Excision of the head fragment
Œ. a quadratus femoris pediclebone graft
. a proximal femoral allograft
Ž. intertrochanteric osteotomy
. total hip arthroplasty
. hip hemiarthroplasty
‘. Echocardiogram
’. Electrocardiogram
“. Radiograph of the chest
”. CT scan of the shoulder
•. Ultrasound of the shoulder
–. Ilioinguinal
—. Extended iliofemoral
˜. Combined ilioinguinal and Kocher-Langenbeck (posterior)
™. Kocher-Langenbeck (posterior)
š. Kocher-Langenbeck (posterior) with trochanteric osteotomy
›. Deltoid
œ. Supraspinatus
. Subscapularis Infraspinatus
ž. Infraspinatus
Ÿ. Infraspinatus and teres minor
 . an orthosis.
¡. observation.
¢. electrical stimulation.
£. open reduction and internal fixation.
¤. application of a nonweightbearing short leg cast.
¥. repair of the rotator cuff.
¦. rehabilitation of the shoulder
§. replacement of the humeral head.
¨. arthroscopic acromioplasty and debridement.
©. immobilization is a sling until pain resolves.
ª. Bone rotation versus torque applied
«. Bone deflection versus bending moment applied
¬. Axial displacement versus tension applied
­. Lateral translation versus shear force applied
®. Fracture gap closing versus compressive force applied
¯. steroid injection
°. stretching of the heel cord
±. surgical release of the plantar fascia
². application of a short leg cast for 6 to 8 weeks
³. wearing dorsiflexion night splints
´. Open bladder
Μ. Bilateral “hitchhiker’s” thumbs
¶. Bilateral defects in the midclavicles
·. Rhizomelic shortening of the extremities
¸. Radiographic fragmentation of all major epiphyses
¹. Medial patellotibial
º. Medial patellofemoral
». Medial patellomeniscal
¼. Lateral patellofemoral
½. Lateral patellotibial
¾. Heat
¿. Gentle active flexion-extension exercises
À. Isokinetic strengthening
Á. Electrical muscle stimulation
Â. Immobilization of the limb with the knee in full flexion
Ã. Distal chevron osteotomy with soft-tissue release
Ä. Distal soft-tissue realignment only
Å. Closing wedge osteotomy (Aken) of the proximal phalanx
Æ. Proximal first metatarsal osteotomy only
Ç. Soft-tissue realignment with a proximal metatarsal osteotomy
È. Vagus
É. Phrenic
Ê. Hypoglossal
Ë. Recurrent laryngeal
Ì. Inferior thyroid
Í. Surgical exploration
Î. Application of leeches
Ï. Stellate ganglion blocks
Ð. Intra-arterial streptokinase
Ñ. Elevation and reevaluation in 1 hour
Ò. Liver profile
Ó. Myleogram
Ô. Platelet count
Õ. CT scan of the head
Ö. Angiogram of the extremity
×. Post spinal fusion from L5to S1
Ø. Primary repair with an iliac bone graft
Ù. Post spinal fusion of L4-5
Ú. A pantaloon body cast and 6 weeks of bed rest
Û. Rest, NSAIDS, and limited dancing
Ü. Stress fracture of the proximal fifth metatarsal
Ý. Stress fracture of the base of the second metatarsal
Þ. Stress fracture of the neck of the second metatarsal
SS. Morton’s neuroma
À. Lisfranc’s joint subluxation
Á. C5 radiculopathy
Â. Subscapularis rupture
Ã. Glenohumeral arthrosis
Ä. Rotator cuff arthropathy
Å. Suprascapular nerve compression at the spinoglenoid notch
Æ. mm femoral head in combination with a metal-backed polyethylene component
Ç. mm femoral head in combination with an all-polyethylene acetabular component
È. mm femoral head in combination with a metal-backed polyethylene component
É. mm femoral head in combination with an all-polyethylene component
Ê. mm femoral head in combination with a metal-backed polyethylene component
Ë. Female gender
Ì. History of cigarette smoking
Í. L5-S1 spondylolisthesis on pre-employment radiography
Î. Decreased strength of the lower extremities on pre-employment testing
Ï. Decreased flexibility of the lumbar spine on pre-employment testing
Ð. Size of cells
Ñ. Amount of DNA in cells
Ò. Nucleus-cytoplasm ratio
Ó. Specific DNA sequences
Ô. Specific messenger RNA sequences
Õ. Femoral and obturator nerves
Ö. Femoral and superior gluteal nerves
÷. Femoral and lateral femoral cutaneous nerves
Ø. Obturator and superior gluteal nerves
Ù. Obturator and lateral femoral cutaneous nerves
Ú. Isotonic
Û. Isokinetic
Ü. Isometric
Ý. Open kinetic chain
Þ. Dynamic variable resistance
Ÿ. Closed reduction and cast immobilization
Ā. Uniplanar external fixation
Ā. Open reduction and internal fixation with a dynamic compression plate
Ă. Unreamed intramedullary rod
Ă. Multiple plane external fixator
Ą. Inlet view of the pelvis
Ą. Outlet view of the pelvis
Ć. AP view of the hip
Ć. Ilial oblique view (external oblique) of the hip
Ĉ. Obturator oblique
Ĉ. Glycolytic pathway
Ċ. Oxidative phosphorylation
Ċ. Breakdown of fat
Č. Breakdown of protein
Č. Breakdown of adenosine triphosphate
Ď. an MRI scan
Ď. arthroscopic examination
Đ. AP and frog-lateral radiographs of the pelvis and hips
Đ. varus and valgus stress radiographs of the knee
Ē. physical examination of the knee under anesthesia
Ē. extended curettage and polymethylmethacrylate cementation
Ĕ. extra-articular resection of the knee and an allograft arthrodesis
Ĕ. wide resection of the proximal tibia and custom prosthetic replacement
Ė. prophylactic internal fixation and postoperative irradiation
Ė. excision of the lateral condyle and reconstruction with a hemicondylar allograft
Ę. silicone implant joint replacement
Ę. metatarsophalangeal joint arthrodesis
Ě. metatarsophalangeal joint debridement
Ě. resection of the metatarsal head
Ĝ. resection of the base of the proximal phalanx
Ĝ. Fixation of the syndesmosis has failed
Ğ. Widening of the ankle mortise has led to the failure of fixation
Ğ. Infection around the syndesmosis screw has led to osteomyelitis
Ġ. The syndesmosis screw is broken
Ġ. Motion between the tibia and fibula has caused loosening of the syndesmosis screw
Ģ. Microcephaly
Ģ. A temporal lobe cyst
Ĥ. An Arnold-Chiari type 1 malformation
Ĥ. Periventricular leukomalacia
Ħ. Agnesis of the corpus callosum
Ħ. Wolff’s
Ĩ. Hooke’s
Ĩ. Hilton’s
Ī. Muller-Haeckel
Ī. Heuter-Volkmann
Ĭ. Both the anterolateral and posteromedial bands are isometric and do not significantly change with flexion
Ĭ. The anterolateral band is lax and becomes tight in flexion, while the posteromedial band is tight, and becomes lax in flexion
Į. The anterolateral band is tight and becomes lax in flexion, while the posteromedial band is lax and becomes tight in flexion
Į. Both the anterolateral and posteromedial bands are lax and become tight in flexion
İ. Both the anterolateral and posteromedial bands are tight and become lax as the knee is flexed
I. UCB orthosis
IJ. Rigid orthosis with a medical arch support
IJ. Semi-rigid orthosis with lateral forefoot posting
Ĵ. Semi-rigid orthosis with a medial arch support
Ĵ. Medial heel wedge attached to the running shoes
Ķ. Hallux varus
Ķ. Osteonecrosis
ĸ. Recurrence of the hallux valgus
Ĺ. “Transfer” second metatarsalgia
Ĺ. Physeal arrest of the first metatarsal
Ļ. Aseptic loosening in a 70-year-old patient
Ļ. Mechanical failure of a hinged knee prosthesis
Ľ. Failed knee replacement complicated by reflex sympathetic dystrophy
Ľ. Infection with soft-tissue deficit
Ŀ. A prior patellectomy
Ŀ. Knee fusion
Ł. Open irrigation and debridement
Ł. Arthroscopic irrigation and debridement
Ń. One-stage exchange arthroplasty
Ń. Two-stage exchange arthroplasty
Ņ. Putti-platt repair
Ņ. Open Bankart repair
Ň. Injection of a subacromial corticosteroid
Ň. Arthroscopic transglenoid capsular shift
ʼN. Rehabilitation of the scapular and rotator cuff muscles
Ŋ. Silicone suction socket and an energy-absorbing foot
Ŋ. Silicone suction socket and a variable resistance ankle
Ō. Plastic suction socket, telescoping pylon, and a solid ankle cushioned heel (SACH) foot
Ō. Plastic socket with a hinged thigh cuff and a SACH foot
Ŏ. Patellar tendon-bearing suction socket and a uniaxial hydraulic ankle
Ŏ. Parosteal
Ő. Periosteal
Ő. High-grade intramedullary
Œ. Osteosarcoma occurring in Paget’s disease
Œ. Osteosarcoma occurring in irradiated bone
Ŕ. Cauda equina
Ŕ. Conus medullaris
Ŗ. Genitofemoral nerve
Ŗ. Lumbar sympathetic plexus
Ř. Lumbar parasympathetic plexus
Ř. Spinal pseudoarthrosis
Ś. Spinal cord traction injury with paralysis
Ś. Arterial and venous thromboses
Ŝ. Superior mesenteric artery syndrome
Ŝ. Crankshaft phenomenon
Ş. Inversion stress radiograph
Ş. MRI scan
Š. CT scan
Š. Nuclear bone scan
Ţ. External rotation stress radiograph
Ţ. Complex deformity with an angulation in two planes
Ť. Single deformity less than 20 degrees, apex posterolateral
Ť. Single deformity greater than 30 degrees, apex posterolateral
Ŧ. Single deformity less than 20 degrees, apex posteromedial
Ŧ. Single deformity greater than 30 degrees, apex posteromedial
Ũ. Pronation of the foot during the stance phase of gait
Ũ. Heel inversion at the beginning of a single limb heel rise
Ū. Active inversion of the nonweightbearing foot
Ū. Active plantar flexion of the first ray against resistance
Ŭ. Active plantar flexion of the foot during the push-off phase of gait
Ŭ. Observation and repeat radiographs in 4 months
Ů. Application of a thoracolumbalsacral orthosis for 22 to 24 hours per day
Ů. Electrical stimulation at night
Ű. Physical therapy
Ű. Begins to remodel and hypertrophy more quickly
Ų. Provides a better scaffold for osteoconduction
Ų. Reduces the risk of early fracture
Ŵ. Reduces technical difficulty
Ŵ. Lowers donor site morbidity
Ŷ. Anterior fusion of the lumbar curve
Ŷ. Anterior and posterior fusion of the thoracic curve
Ÿ. Posterior fusion of the thoracic curve
Ź. Posterior fusion of the thoracic and lumbar curves
Ź. Application of a brace until the iliac apophyses are Risser 4 or 5, followed by surgical correction
Ż. Subscapularis rupture
Ż. Type III SLAP lesion
Ž. Disruption of capsular shift
Ž. Isolated traumatic subluxation
S. Injury to the axillary nerve after dislocation
Ƀ. hypophosphatemia
Ɓ. high dietary cholesterol intake
Ƃ. deficiency of lipoprotein A
Ƃ. deficiency of protein S and protein C
Ƅ. elevated levels of antithrombin III
Ƅ. Weightbearing short leg cast
Ɔ. Nonweightbearing short leg cast
Ƈ. Removable splint and early motion
Ƈ. Open reduction and internal fixation
Ɖ. Elastic compression bandage with full weightbearing
Ɗ. Breast
Ƌ. Prostate
Ƌ. Gastrointestinal
ƍ. Kidney
Ǝ. Multiple myeloma
Ə. Varus stress
Ɛ. Valgus stress
Ƒ. Torsional loading
Ƒ. Hyperextension of the knee
Ɠ. Contraction of the quadriceps while axially loaded
Ɣ. Primary internal fixation at both fracture levels
Ƕ. External fixation as definitive ttt for both #
Ɩ. Skeletal traction and delayed internal fixation of both fractures
Ɨ. Primary internal fixation of the proximal fracture and delayed fixation of the femoral fracture
Ƙ. Primary internal fixation of the femoral shaft fracture and delayed fixation of the proximal #
Ƙ. Heel spur
Ƚ. Plantar fascitis
ƛ. Dysfunction of the tibialis posterior tendon
Ɯ. Compression of the first branch of the lateral plantar nerve
Ɲ. Compression of the calcaneal nerve
Ƞ. Displaced labral tear
Ɵ. Tear of the rotator cuff
Ơ. Fracture of the glenoid rim
Ơ. Palsy of the axillary nerve
Ƣ. Palsy of the musculocutaneus nerve
Ƣ. Enchondroma
Ƥ. Osteoblastoma
Ƥ. Giant cell tumor
Ʀ. Aneurysmal bone cyst
Ƨ. Fibrous dysplasia
Ƨ. Arthrogram of the wrist
Ʃ. MRI scan of both wrists
ƪ. CT scan of both wrists in the same position
ƫ. Radiographs of the wrist in supination and pronation
Ƭ. Radiographs of the opposite wrist in the same position
Ƭ. Secondary hyperparathyroidism
Ʈ. Phosphate retention secondary to uremia
Ư. Insufficient renal synthesis of 1, 25 dihydroxy vitamin D
Ư. Aluminum deposition in bone from oral phosphate binders
Ʊ. Persistent acidosis aggravating the negative calcium balance
Ʋ. Posterior fusion at T10-L3 with segmental instrumentation
Ƴ. Laminectomy and fusion of T12-L2 with segmental instrumentation
Ƴ. Bed rest in a hyperextension brace
Ƶ. L1 vertebrectomy and anterior decompression with strut graft fusion and instrumentation
Ƶ. Progressive ambulation as tolerated in a custom-molded thoracolumbosacral orthosis
Ʒ. Positive-pressure ventilation
Ƹ. An immediate radiograph of the chest
Ƹ. Adjustment of the position of the endotrachael tube
ƺ. Insertion of a large-bore needle into the pericardial space
ƻ. Insertion of a large-bore needle in the right second intercostal space, midclavicular line
Ƽ. Allowing the ends of the fracture to touch
Ƽ. Adding a second connecting bar
ƾ. Adding one pin to each fracture fragment
Ƿ. Increasing the pin diameter from 4 mm to 6 mm
ǀ. Decreasing the connecting bar-to-bone distance from 6 cm to 4 cm
ǁ. Osteomyelitis
ǂ. Malignant degeneration
ǃ. Stress fracture
DŽ. Local recurrence of the giant cell tumor
DŽ. Bone resorption due to methylmethacrylate
DŽ. Advancement of the plantar plate
LJ. Resection of the second metatarsal head
LJ. Dorsiflexion osteotomy of the second metatarsal neck
LJ. Transfer of the flexor digitorum longus tendon to the dorsum of the toe
NJ. Transfer of the extensor digitorum comminus tendon to the metatarsal neck
NJ. Sacral fracture
NJ. Burst fracture of L5
Ǎ. Cauda equina syndrome
Ǎ. Distraction-flexion injury at L3
Ǐ. Distraction-extension injury at L3
Ǐ. An MRI scan of the shoulder
Ǒ. An MRI scan of the cervical spine
Ǒ. Electromyographic and nerve conduction velocity studies
Ǔ. Immobilization in a sling and early passive range of motion exercises
Ǔ. Immediate return to the operating room for exploration of the brachial plexus
Ǖ. cerclage wiring
Ǖ. tension band wiring
Ǘ. removal of the patellar component
Ǘ. revision of the patellar component
Ǚ. immobilization of the knee and protected weightbearing
Ǚ. Liposarcoma
Ǜ. Nodular fasciitis
Ǜ. Rabdomyosarcoma
Ǝ. Malignant fibrous histiocytoma
Ǟ. Extra-abdominal desmoid tumor
Ǟ. Clubfeet
Ǡ. Thrombocytopenia
Ǡ. Congenital scoliosis
Ǣ. Ventricular septal defect
Ǣ. Arnold-Chiari malformation
Ǥ. delayed primary closure
Ǥ. free flap
Ǧ. pedicle groin flap
Ǧ. full-thickness skin graft
Ǩ. split-thickness skin graft
Ǩ. Infection
Ǫ. Nonunion
Ǫ. Improper screw length
Ǭ. Osteonecrosis of the distal fragment
Ǭ. Use of a cortical screw instead of a cancellous screw
Ǯ. Infection
Ǯ. Tear of the rotator cuff
J̌. Loosening of the humeral component
DZ. Arthritis of the glenoid
DZ. Arthritis of the A-C joint
DZ. Reduced morbidity
Ǵ. Improved osteoinduction
Ǵ. Improved osteoconduction
Ƕ. More rapid revascularization
Ƿ. Lower risk of disease transmission
Ǹ. Manipulation Under Anesthesia
Ǹ. Arthroscopic acromioplasty
Ǻ. Arthroscopic debridement of G-H joint
Ǻ. Replacement of the humeral head
Ǽ. Lengthening of the subscapularis and release of the anterior capsule
Ǽ. Bacteroides
Ǿ. E. coli
Ǿ. Staph. aureus
Ȁ. group A streptococcus
Ȁ. Clostridium perforingens
Ȃ. observation and exercises
Ȃ. bracing with a thoracolumbar orthosis
Ȅ. fusion of the posterior spine
Ȅ. fusion of the anterior spine
Ȇ. fusion of the anterior and posterior spine
Ȇ. Total wrist replacement and bridge grafts
Ȉ. palmar shelf arthroplasty and tendon transfers
Ȉ. Darrach distal ulna resection, dorsal tenosynosynovectomy, and tendon transfers
Ȋ. Radioscaphate fusion, extensor tenodesis, and Darrach distal ulna resection
Ȋ. Total wrist fusion and tendon transfers
Ȍ. constrained acetabular component
Ȍ. protrusion ring with morselized graft
Ȏ. cemented metal backed acetabular component
Ȏ. cemented all-polyethylene acetabular component
Ȑ. cementless hemispherical component with screw fixation
Ȑ. application of a hip abduction brace for 22 hours per day
Ȓ. application of a hip spica under anesthesia
Ȓ. discontinuance of all bracing and repeat radiographs in 3 months
Ȕ. open reduction of the hip and application of a spica cast
Ȕ. open reduction, varus osteotomy, and application of a spica cast
Ȗ. Loss of skin hair on the feet
Ȗ. Absent pulses on vascular examination
Ș. Pain that originates proximally and spreads distally
Ș. Pain that is relieved by stopping and standing
Ț. Pain that is worse when the patient walks uphill rather downhill
Ț. wrist flexors and finger flexors
Ȝ. elbow flexors and wrist flexors
Ȝ. elbow flexors and finger flexors
Ȟ. elbow extensors and wrist flexorst Level Key Muscles4 DiaphragmDeltoid, elbow flexors, diaphragmElbow flexors, wrist extensorsElbow extensors, wrist flexorsFinger flexors (distal phalanx of middlefinger)Finger abductors (5th digit), intrinsics of hand2 Segmental innervation to intercostal muscles, abdominal and paraspinal muscles) L1, L2, L3 Hip flexors3, L4 QuadricepsTibialis anteriorToe extensors, hip abductorsAnkle plantarflexors, peronei
Ȟ. elbow extensors and wrist extensors
Ƞ. Syndactyly
ȡ. Macrodactyly
Ȣ. Camptodactyly
Ȣ. Preaxial polydactyly
Ȥ. Postaxial polydactyly
Ȥ. Arthrodesis
Ȧ. Rotationplasty
Ȧ. Above-knee amputation
Ȩ. Osteoarticular allograft
Ȩ. Endoprosthesis (custom arthroplasty)
Ȫ. Plantar fascia
Ȫ. Spring ligament
Ȭ. Deltoid ligament
Ȭ. Intrinsic tendons
Ȯ. Gastorcnemius-solelus complex
Ȯ. Prevention of presynaptic release of acetylcholine
Ȱ. Prevention of synthesis of presynaptic acetylcholine
Ȱ. Activation of acetylcholinesterase at the motor end-plate
Ȳ. Blockage of postsynaptic action of acetylcholine until reserves are depleted
Ȳ. Stimulation of release of presynaptic acetylcholine until reserves are depleted
ȴ. stiffness of the femoral component.
ȵ. head offset of the femoral component.
ȶ. femoral component material modulus of elasticity.
ȷ. extent of the femoral component porous coating.
ȸ. Presence of a femoral component collar.
ȹ. plantar fascia and quadratus plantae tendon.
Ⱥ. ligamentous structures connecting the tarsal bones.
Ȼ. shape of the tarsal bones and the intervening joints.
Ȼ. activity of the intrinsic muscles of the foot.
Ƚ. activity of the posterior tibialis and the peroneus longus muscles.
Ⱦ. scapulothoracic fusion
Ȿ. strengthening of the periscapular muscles
Ɀ. pectoralis minor-fascia lata graft transfer to the scapula
Ɂ. pectoralis major-fascia lata graft transfer to the scapula
Ɂ. exploration of the long thoracic nerve, with sural nerve graft
Ƀ. tricompartmental knee replacement
Ʉ. unicompartmental knee replacement
Ʌ. medial compartment meniscal allograft
Ɇ. valgus-producing distal femoral osteotomy
Ɇ. valgus-producing proximal tibial osteotomy
Ɉ. Internal rotation of the femoral component
Ɉ. External rotation of the tibial component
Ɋ. Lateral placement of the femoral component
Ɋ. Medial placement of the patellar component
Ɍ. Excessive resection of the patella
Ɍ. Hallux rigidus
Ɏ. Hallux valgus
Ɏ. Neuroma of the first web space
Ɐ. Fracture of the sesamoid
Ɑ. Rupture of the flexor hallucis longus
Ɒ. Sickle cell crisis
Ɓ. Idiopathic chondrolysis
Ɔ. Hemophilic arthropathy
ɕ. Osteoid osteoma of the femoral neck
Ɖ. Legg-Calve-Perthes disease
Ɗ. Decreased ankle jerk and positive femoral nerve stretch test
ɘ. Decreased knee jerk and positive straight-leg raising sign
Ə. Gastrocnemius-soleus complex weakness and positive straight-leg raising sign
ɚ. Weakness of the extensor hallucis longus and positive straight-leg raising sign
Ɛ. Weakness of the extensor hallucis longus and positive femoral nerve stretch test
Ɜ. Long-term administration of IV and oral antibiotics
ɝ. Open soft-tissue debridement, retention of prosthetic components, and IV antibiotics
ɞ. Immediate exchange arthroplasty with antibiotic-impregnated cement
ɟ. Two-stage surgical prosthetic exchange and IV antibiotics
Ɠ. Resection arthroplasty and IV antibiotics
Ɡ. SCFE
ɢ. MED
Ɣ. Perthes disease
ɤ. Hypothyroidism
Ɥ. Chondrolysis
Ɦ. gout.
ɧ. osteoporosis.
Ɨ. eosinophilic granuloma.
Ɩ. tuberculosis of the spine.
Ɪ. metastatic disease of the spine.
Ɫ. water content.
Ɬ. Synthesis of type I collagen.
ɭ. Proteoglycan content.
ɮ. Activity of chondrocytes.
Ɯ. Synthesis of hyaluronate.
ɰ. Lung
Ɱ. Breast
Ɲ. Prostate
ɳ. Thyroid
ɴ. Renal
Ɵ. T1-low, T2-low.
ɶ. T1-low, T2-high.
ɷ. T1-moderate, T2-low.
ɸ. T1-high, T2-low.
ɹ. T1-high, T2-high.
ɺ. hypothesis is incorrect or invalid
ɻ. interobserver error rate is 4%.
ɼ. Standard deviation is 4% higher or lower than the mean.
Ɽ. Sample size is 4% larger than required to be clinically significant.
ɾ. Probability that the differences noted between two study groups were due to chance alone is 4%.
ɿ. I
Ʀ. II
ʁ. IV
Ʂ. IX
Ʃ. X
ʄ. Cranial setting
ʅ. Cranial subluxation
ʆ. Odontoid fracture
Ʇ. Lysis of the arch of the atlas
Ʈ. Atlantoaxial subluxation
Ʉ. Retrograde collapse of the endoneurial tubes
Ʊ. Irreversible atrophy of the denervated muscles
Ʋ. Elongation of the axons across the zone of injury
Ʌ. Sprouting of the axons at the neuromuscular junction
ʍ. Misdirection of the axons across the zone of injury
ʎ. Maximally pronated and elbow extended
ʏ. Maximally pronated and the elbow flexed
ʐ. Maximally supinated and the elbow flexed
ʑ. Maximally supinated and the elbow extended
Ʒ. In neutral rotation, with the elbow extended
ʓ. open reduction and internal fixation
ʔ. buddy taping to the adjacent index finger
ʕ. early motion with application of a dynamic banjo splint
ʖ. application of a cast with the hand in a “safe position” for 3 weeks.
ʗ. dorsal extension block splinting
ʘ. The name of the manufacturer
ʙ. The manufacturer’s potential liability
ʚ. The physician’s clinical performance
ʛ. The physician’s materials testing data
ʜ. Any royalties the physician receives from the manufacturer
Ʝ. Femoral
Ʞ. Obturator
ʟ. Inferior gluteal
ʠ. Superior gluteal
ʡ. Lateral femoral cutaneous
ʢ. open biopsy and a long leg cast
ʣ. open biopsy and wide resection of the tumor
ʤ. a long leg cast and observation
ʥ. intramedullary stabilization and observation
ʦ. Triggering
ʧ. Lateral instability
ʨ. Swan-neck deformity
ʩ. Boutonniere deformity
ʪ. Loss of distal interphalangeal joint flexion
ʫ. Peroneus brevis to peroneus longus
ʬ. Peroneus tertius to extensor hallucis longus
ʭ. Peroneus tertius to superficial peroneal nerve
ʮ. Extensor hallucis longus to deep peroneal nerve
ʯ. Extensor hallucis longus to extensor digitorum longus
ʰ. reassurance that Medicare will pay for the treatment.
ʱ. consent forms that patients or their guardians are able to understand.
ʲ. a detailed description of the device, omitting the fact that it is part of a study.
ʳ. a provision that the patient’s care will be discontinued if he or she does not enroll in the study.
ʴ. a provision that the study will be carried out to completion, whether or not the device is as effective as those currently in existence.
ʵ. an onlay iliac crest bone graft.
ʶ. limited weightbearing and observation.
ʷ. removal of the implant and limited weightbearing.
ʸ. removal of the implant and insertion of a reamed femoral nail.
ʹ. removal of the implant and insertion of an unreamed femoral nail.
ʺ. Coronal
ʻ. Sagittal
ʼ. Anteromedial, midway between the sagittal and the coronal
ʽ. Proximal pins sagittal, distal pins coronal
ʾ. Proximal pins coronal, distal pins sagittal
ʿ. Rheumatoid arthritis
ˀ. Posttraumatic arthritis
ˁ. Degenerative osteoarthritis
˂. Osteonecrosis of the tibial plateau
˃. Osteonecrosis of the medial femoral condyle
˄. Trapeziometacarpal arthrodesis
˅. Osteotomy of the thumb metacarpal
ˆ. Arthrotomy and joint debridement
ˇ. Ligament reconstruction using one half of the flexor carpi radialis
ˈ. Trapezium resection, tendon interposition, and reconstruction of the ligament
ˉ. Creep
ˊ. Relaxation
ˋ. Energy dissipation
ˌ. Plastic deformation
ˍ. Elastic deformation
ˎ. bending
ˏ. axial loading
ː. high-speed rotation
ˑ. direct impact from anteromedial
˒. crush from anteromedial to posterolateral
˓. Increase stiffness
˔. Increase fracture toughness
˕. Increase fatigue strength
˖. Decrease mechanical strength
˗. Decrease wear rate
˘. disuse osteopenia
˙. paraendocrine effect of the tumor
˚. abnormally increased density on the right side
˛. side effect of the treatment of the lesion
˜. extensive tumor involvement of the left hip
˝. Sciatic nerve
˞. Superior gluteal artery
˟. Profunda femoris artery
ˠ. Femoral artery and nerve
ˡ. External iliac artery and vein
ˢ. Length
ˣ. Moment arm
ˤ. Total volume
˥. Physiologic cross-sectional area
˦. Distribution of slow and fast twitch fibers
˧. decreasing initiation of action potentials.
˨. increasing action potential amplitude.
˩. blocking the opening of gated sodium channels.
˪. decreasing the number of functional motor units.
˫. slowing or stopping action potential propagation through the axon.
ˬ. resection of the metatarsal heads of the first through fifth toes.
˭. Silastic MP joint arthroplasties of the first through fifth toes.
ˮ. fusion of the hallux MP joint and resection arthroplasty of the 2nd through fifth metatarsal heads.
˯. fusion of hallux MP joint and distal osteotomy of the 2nd through 5th MT.
˰. plantar condylectomy of the 2nd through 5th MT heads & resection of proximal phx of the hallux.
˱. hemiarthroplasty
˲. open reduction and internal fixation
˳. closed reduction and percutaneous pinning
˴. a sling and early pedulum exercises
˵. a sling and swathe for 6 weeks, followed by shoulder rehabilitation
˶. open acromioplasty
˷. open Bankart repair
˸. open subscapularis tendon repair
˹. inferior capsular shift
˺. a supervised physical therapy program
˻. a sling and swathe, with pendulum exercises in 10 days
˼. open reduction and internal fixation through an anterior approach
˽. open reduction and internal fixation through a posterior approach
˾. immobilization with a splint in 45 degrees of abduction for 6 weeks
˿. arthroscopically assisted reduction and percutaneous screw fixation
̀. Repair of the rotator cuff
́. Replacement of the humeral head
̂. Resection arthroplasty
̃. Total shoulder arthroplasty
̄. AP and lateral radiographs of the elbow
̅. Diagnositc arthroscopy
̆. Aspiration of joint fluid
̇. An erythrocyte sedimentation rate and CBC
̈. A diagnostic lidocaine injection
̉. Insulin-like growth factor (IGF-1)
̊. Fibroblast growth factor (FGF-1)
̋. Platelet-derived growth factor (PDGF)
̌. Transforming growth factor beta (TGF-B)
̍. Bone morphogenetic proteins (BMP)
̎. clinical history and radiographic findings.
̏. technetium bone scan
̐. flow cytometry pattern of extracted chondrocytes
̑. immunohistochemical staining patterns of a biopsy specimen
̒. histologic features of a biopsy specimen stained with hematoxylin-cosin
̓. Radial
̔. Radial recurrent
̕. Posterior interosseous
̖. Superior ulnar recurrent
̗. Superficial radial circumflex
̘. Impaired hydroxylation of proline
̙. Failure of cleavage in procollagen
̚. Defective binding sites for hydroxyproline
̛. Failure to incorporate glycine into the helix
̜. Diminished production of collagen through the rough endoplasmic reticulum
̝. Asking the legal staff to seek a court injunction
̞. Copying the patient’s chart and giving it to him as he leaves
̟. Having the patient sign a written legal contract that specifies acceptable behavior
̠. Continuing care of the patient until an appropriate referral can be arranged
̡. Transferring the patient to another orthopaedic surgeon without disclosing the realreason for why the patient is being transferred
̢. Meta-analysis
̣. Confidence interval
̤. Analysis of variance (ANOVA)
̥. Statistical significance (p-value)
̦. Survivorship analysis (Kaplan-Meier)
̧. Spinal shock
̨. Neurogenic shock
̩. Hypovolemic shock
̪. Pulmonary embolism
̫. Fat embolus syndrome
̬. Lumbar spinal stenosis
̭. Metastatic disease of the spine
̮. Rheumatoid lumbar spondylitis
̯. Isthmic spondyloloisthesis
̰. Degenerative spondylolisthesis at L4-5 and L5-S1
̱. Patella alta
̲. A metal-backed patella
̳. Varus malalignment of the knee
̴. A posterior cruciate-substituting femoral component
̵. Lateral subluxation of the patella on a Merchant’s view
̶. The sesamoids are separated
̷. The sesamoid is fractured
̸. The proximal phx is on the neck of the metatarsal
̹. The dislocation is dorsal and centered
̺. The proximal phalanx is hyperextended
̻. Patella
̼. Tibial stem
̽. Distal femoral interface
̾. Posterior femoral interface
̿. Sites of screw fixation for the tibia
̀. Hallux rigidus
́. Fracture of the sesamoid
͂. Disruption of the plantar plate
̓. Osteonecrosis of the metatarsal head
̈́. Rupture of the flexor hallucis longus
Ι. Gout
͆. Sepsis
͇. Old trauma
͈. Rheumatoid arthritis
͉. Charcot arthroplasty
͊. Aspiration and steroid injection
͋. Biopsy, curettage, and allograft bone grafting
͌. Percutaneous Kirschner wire fixation
͍. Percutaneous injection of autogenous bone marrow
͎. Nerve roots
͏. Spinal cord
͐. Sciatic nerve
͑. Peroneal nerve
͒. Conus medullaris
͓. Extent of bone penetrated by reaming, prosthetic components, or acrylic cement
͔. Periprosthetic regions that are accessible to joint fluid and particulate wear debris
͕. Enveloping pseudocapsular scar tissue that develops around a prosthetic hip following surgical capsulectomy
͖. Soft tissue and bone that are potentially contaminated with bacteria in the setting of a prosthetic joint infection
͗. Potential intrapelvic joint space communication created by acetabular fixation screws or intrapelvic extruded acrylic cement
͘. Early and late infection
͙. Periprosthetic fracture of the femur
͚. Failure of the patellofemoral and extensor mechanisms
͛. Aseptic loosening of cementing tibial components
͜. Asceptic loosening of cemented femoral components
͝. Acceptance of the current position of the ankle
͞. Open reduction and fixation in the epiphysis only
͟. ORIF with a small-fragment T-plate from the malleolus up to the metaphysis
͠. Closed reduction by eversion of the ankle and application of a bivalved long leg cast
͡. CRUGA and fixation with a malleolar screw from the malleolus into the metaphysis
͢. Resection arthroplasty and local radiation
ͣ. In situ fusion of the hip
ͤ. Excision of heterotopic bone, total hip arthroplasty, and oral indomethacin
ͥ. Excision of heterotopic bone and local radiation
ͦ. Excision of heterotopic bone, hemiarthroplasty, and oral indomethacin
ͧ. Closed reduction of both fractures and immediate spica casting
ͨ. Bilateral skin traction for 3 weeks, followed by spica casting
ͩ. External fixation of both femora
ͪ. External fixation of the left femur and a long leg cast brace for the right femur
ͫ. External fixation of the left femur and use of a reamed intramedullary nail in the right femur
ͬ. Synovial sarcoma
ͭ. Soft-tissue abcess
ͮ. Rhabdomyosarcoma
ͯ. Eosinophilic granuloma
Ͱ. Nodular pigmented villonodular synovitis
Ͱ. Changing to a titanium nail
Ͳ. Changing to a nonslotted nail
Ͳ. Changing the cross-sectional shape of the nail
ʹ. Increasing the diameter of the nail by 3 mm
͵. Increasing the diameter of the interlocking screws
Ͷ. Fracture healing
Ͷ. Chondrosarcoma
͸. Periosteal chondroma
͹. Periosteal osteosarcoma
ͺ. Dysplasia epiphysealis hemimelica
Ͻ. Demonstrate competence in the subject of the case
Ͼ. Be fellowship trained in the subject of the case
Ͽ. Be paid on a contingency basis
;. Be board certified by the American Board of Orthopaedic Surgery
Ϳ. Have been involved in the case as a consultant
΀. Diagnostic arthroscopy
΁. Arthroscopy and subacromial decompression
΂. Reduction and fixation of the proximal humeral epiphysis
΃. Temporary cessation of throwing
΄. Physical therapy for rotator cuff strengthening
΅. Oblique popliteal ligament
Ά. Lateral capsule
·. Popliteal tendon
Έ. Fibular collateral ligament
Ή. Posterior oblique ligament
Ί. Radial tear
΋. Parrot-beak tear
Ό. Vertical tear in the “red-red” zone
΍. Vertical tear in the “red-white” zone
Ύ. Vertical tear in the “white-white” zone
Ώ. 0 degrees of abduction, with neural rotation
Ϊ́. 40 degrees of flexion and 60 degrees of internal rotation
Α. 45 degrees of flexion and 45 degrees of external rotation
Β. 90 degrees of abduction with neutral rotation
Γ. 90 degrees of abduction and 90 degrees of external rotation
Δ. Sural
Ε. Saphenous and its branches
Ζ. Posterior tibial and its branches
Η. Deep peroneal and its branches
Θ. Superficial peroneal and its branches
Ι. Strength
Κ. Stiffness
Λ. Shelf life
Μ. Antigenicity
Ν. Risk of HIV transmission
Ξ. Indemnification
Ο. Occurrence
Π. Excess liability
Ρ. Claims-made
΢. Nose
Σ. Lateral Y
Τ. Scapular AP
Υ. Neutral rotation AP
Φ. Internal rotation AP
Χ. External rotation AP
Ψ. Trauma
Ω. Hemophilia
Ϊ. Reiter’s syndrome
Ϋ. Rheumatoid arthritis
Ά. Systemic lupus erythematosus
Έ. Cast immobilization for 6 weeks
Ή. Activity modification and re-evaluation in 2 months
Ί. Internal fixation with or without bone grafting
Ϋ́. Retrograde drilling of the defect without articular cartilage penetration
Α. Drilling of the defect directly through the articular cartilage
Β. repair or reconstruction of the medial collateral ligament
Γ. repair or reconstruction of the medialand lateral collateral ligaments
Δ. immobilization for 5 days or less
Ε. immobilization for 14 days
Ζ. immobilization for 25 days
Η. Cystinosis
Θ. Hypophosphatemia
Ι. Renal osteodystrophy
Κ. Primary hyperparathyroidism
Λ. Nutritional vitamin D deficiency
Μ. Lateral meniscus tear
Ν. Popliteus tenosynovitis
Ξ. Iliotibial band friction syndrome
Ο. Peroneal nerve entrapment
Π. Biceps tendinitis
Ρ. Observation
Σ. Removal of the prosthetic components
Σ. Operative exploration and decompression of the peroneal nerve
Τ. Nerve conduction velocity studies
Υ. Loosening of the primary dressings and knee flexion to 30 degrees
Φ. I
Χ. II
Ψ. III
Ω. decreased tissue tension
Ϊ. decreased abductor lever arm
Ϋ. decreased joint reaction force
Ό. increased body weight over lever arm
Ύ. increased polyethylene wear rate
Ώ. recurrent traumatic anterior dislocation
Ϗ. recurrent traumatic posterior dislocation
Β. traumatic subluxation with no previous dislocation
Θ. traumatic anterior subluxation
ϒ. atraumatic involuntary subluxation
ϓ. radial
ϔ. axillary
Φ. suprascapular
Π. thoracodorsal
Ϗ. long thoracic
Ϙ. Flexion
Ϙ. Extension
Ϛ. Axial rotation
Ϛ. Left lateral bending
Ϝ. Right lateral bending
Ϝ. Skin
Ϟ. Lung
Ϟ. Brain
Ϡ. Heart
Ϡ. Kidney
Ϣ. Thoracoacromial, lateral thoracic, subscapular
Ϣ. Thoracoacromial, anterior humeral circumflex, posterior humeral circumflex
Ϥ. Posterior humeral circumflex, subscapular, thoracacromial
Ϥ. Subscapular, thoracacromial, anterior humeral circumflex
Ϧ. Lateral thoracic, anterior humeral circumflex, thoracacromial
Ϧ. Respondeat superior
Ϩ. Indemnity agreement
Ϩ. Hold harmless agreement- attempt to shift liability from company to physician
Ϫ. Comparative negligence-% of involvement
Ϫ. Contributory negligence- resident contributed to the negligence
Ϭ. t-type
Ϭ. both column
Ϯ. transverse
Ϯ. anterior column
Κ. anterior column posterior hemitransverse
Ρ. Posterior interosseous
Ϲ. Anterior interosseous
Ϳ. Radial
ϴ. Median
Ε. Ulnar
϶. Shock from hypovolemia
Ϸ. Associated rupture of the bladder
Ϸ. Arterial bleeding on pelvic angiogram
Ϲ. Presence of a hematoma in the perineum and scrotum
Ϻ. Fractures of both the anterior and posterior pelvic ring

Correct Answer & Explanation

. Avoids the risk of marrow emboli


Explanation

Question 4075

Topic: 10. Pathology and Oncology

A 4-year-old girl who is undergoing chemotherapy for acute lymphocytic leukemia sustains a displaced fracture through an osteolytic lesion in the metaphysis of the distal femur as a result of a fall. Treatment should include

. Above-knee amputation
. En bloc resection of the lesion and reconstruction with a bone graft
. Closed reduction and immobilization in a cast
. Open reduction and internal fixation, followed by radiation therapy
. Open reduction, curettage, and cementing of the lesion
. Injury to the subclavian artery
. Injury to the brachial plexus
. Segmental fracture
. 100% displacement
. Associated displaced surgical neck fracture of the humerus
. humeral arthroplasty2/. repair of the rotator cuff
. closed reduction and immobilization
. open reduction and immobilization
. open reduction and early passive motion
. arthroscopic capsular release
. manipulation under anesthesia
. a physical therapy program
. an intra-articular corticosteroid injection
. administration of high-dose oral corticosteroids
. adding the scores, in all five body systems
. adding the squares of the scores in the three most severely injured systems
. doubling the cumulative score for head and chest injuries
. combining the scores from the most and least injured systems
. correcting the score in the most severely injured system for age
. traumatic femoral head fracture
. osteonecrosis
. osteoarthritis
. neuropathic joint
. rheumatoid arthritis
. low-dose radiation
. steroid injection
. a load-relieving insert and shoe modification
!. complete excision of the mass and the entire plantar fascia
". wide excision of the mass with a 2 cm margin of normal fascia
#. CT scan of the chest
$. technetium bone scan
%. bone marrow aspiration
&. serum protein electrophoresis
'. lateral skull radiograph
(. high-grade histology of the initial tumor
). multiple local recurrences after curettage
*. previous treatment of the tumor with cryotherapy
+. previous treatment of the tumor with radiation therapy
,. extraosseous extension into two or more adjacent compartments
-. Dorsal rhizotomy and facet joint fusion
.. Multilevel corpectomy and spinal stabilization
/. Central and lateral recess decompression and bilateral foraminotomy
0. Central decompression and facet joint fusion
1. Central decompression, foraminotomy, and spinal fusion from L2 to L5.
2. Inadequate rehabilitation
3. Displacement of the coronoid process fracture
4. Insufficiency of the lateral ulnar collateral ligament
5. Insufficiency of the anterior band of the medial collateral ligament
6. Insufficiency of the posterior band of the medial collateral ligament
7. Osteotomy and intramedullary rod fixation
8. Electrical stimulation
9. Strut-autografing the concavity the tibia
:. A patellar tendon-bearing brace
;. Percutaneous injection of demineralized bone matrix
<. digoxin
=. sucralfate
>. clindamycin
?. alcohol
@. neuromuscular blocking agents
A. Unrestrained roll-back
B. Unrestrained rotational conformity
C. Medial-Lateral conformity
D. Anteroposterior conformity in flexion
E. Anteroposterior conformity in extension
F. Arthrodesis of the MTP joint
G. A Silastic implant of the MTP joint
H. Resection arthroplasty of the MTP joint
I. Cheilctomy of the MTP joint
J. Osteotomy of the base of the proximal phalanx
K. Genu varum
L. Tarsal coalition
M. Degenerative ankle arthrosis
N. Osteochondritis dissecans of the talus
O. Hemihypertrophy of the ipsilateral lower extremity
P. Trabecular bone is preferentially resorbed in this high bone turnover state
Q. Loss of water content in the disk increases impact load to the vetrebral bodies
R. Stress is imposed by the relative stiffness of the arthrtic facet joints
S. Increased energy demands are imposed by decreased circulation to the vertebral body
T. The thick cortical bone found in the vertebral body resorbs rapidly following estrogen withdrawal
U. Increased time in stance and swing phase
V. Addition of a double leg float phase
W. Decreased vertical ground reaction forces
X. Decreased arc of motion in the hip, knee, and ankle
Y. Decreased joint reaction forces in the hip, knee, and ankle
Z. Talonavicular arthrodesis
[. Medial displacement calcaneal osteotomy
\. Flexor digitorum longus tendon transfer with spring ligament advancement
]. Triple arthrodesis
^. Calcaneocuboid distraction arthrodesis and repair of the posterior tibial tendon
_. Lymphoma
`. Hemangioma
A. Osteosarcoma
B. TB of the spine
C. Metastatic breast carcinoma
D. widening and shortening of the heel.
E. weakness of the gastrocnemius-soleus complex.
F. anterior impingement from a horizontal talus.
G. unrecognized compartment syndrome of the foot.
H. degenerative arthritis of the tibiotalar joint.
I. a corrective osteotomy
J. application of braces
K. medial physeal stapling until the varus corrects
L. observation
M. application of corrective casts
N. a total contact cast.
O. electrical stimulation.
P. an off the shelf fracture brace.
Q. an elastic compression bandage and crutches.
R. a hard soled shoe until the patient is asymptomatic.
S. Ewings tumor
T. Parosteal osteosarcoma
U. Dedifferentiated chondrosarcoma
V. Low grade intramedullary chondrosarcoma
W. High grade intramedullary osteosarcoma
X. Vascular injury
Y. Tear of the rotator cuff
Z. Injury to the brachial plexus
{. Fracture of the upper thoracic rib
|. Fracture of the proximal humerus
}. Biceps
~. Trapezius
. Infraspinatus
€. Pectoralis major
. Serratus anterior
‚. Hybrid total hip arthroplasty
ƒ. Noncemental hemiarthroplasty of the hip
„. Closed reduction and percutaneous pin fixation
…. Open reduction through an anterior approach to the hip
†. Excision of the head fragment
‡. a quadratus femoris pediclebone graft
ˆ. a proximal femoral allograft
‰. intertrochanteric osteotomy
Š. total hip arthroplasty
‹. hip hemiarthroplasty
Œ. Echocardiogram
. Electrocardiogram
Ž. Radiograph of the chest
. CT scan of the shoulder
. Ultrasound of the shoulder
‘. Ilioinguinal
’. Extended iliofemoral
“. Combined ilioinguinal and Kocher-Langenbeck (posterior)
”. Kocher-Langenbeck (posterior)
•. Kocher-Langenbeck (posterior) with trochanteric osteotomy
–. Deltoid
—. Supraspinatus
˜. Subscapularis Infraspinatus
™. Infraspinatus
š. Infraspinatus and teres minor
›. an orthosis.
œ. observation.
. electrical stimulation.
ž. open reduction and internal fixation.
Ÿ. application of a nonweightbearing short leg cast.
 . repair of the rotator cuff.
¡. rehabilitation of the shoulder
¢. replacement of the humeral head.
£. arthroscopic acromioplasty and debridement.
¤. immobilization is a sling until pain resolves.
¥. Bone rotation versus torque applied
¦. Bone deflection versus bending moment applied
§. Axial displacement versus tension applied
¨. Lateral translation versus shear force applied
©. Fracture gap closing versus compressive force applied
ª. steroid injection
«. stretching of the heel cord
¬. surgical release of the plantar fascia
­. application of a short leg cast for 6 to 8 weeks
®. wearing dorsiflexion night splints
¯. Open bladder
°. Bilateral “hitchhiker’s” thumbs
±. Bilateral defects in the midclavicles
². Rhizomelic shortening of the extremities
³. Radiographic fragmentation of all major epiphyses
´. Medial patellotibial
Μ. Medial patellofemoral
¶. Medial patellomeniscal
·. Lateral patellofemoral
¸. Lateral patellotibial
¹. Heat
º. Gentle active flexion-extension exercises
». Isokinetic strengthening
¼. Electrical muscle stimulation
½. Immobilization of the limb with the knee in full flexion
¾. Distal chevron osteotomy with soft-tissue release
¿. Distal soft-tissue realignment only
À. Closing wedge osteotomy (Aken) of the proximal phalanx
Á. Proximal first metatarsal osteotomy only
Â. Soft-tissue realignment with a proximal metatarsal osteotomy
Ã. Vagus
Ä. Phrenic
Å. Hypoglossal
Æ. Recurrent laryngeal
Ç. Inferior thyroid
È. Surgical exploration
É. Application of leeches
Ê. Stellate ganglion blocks
Ë. Intra-arterial streptokinase
Ì. Elevation and reevaluation in 1 hour
Í. Liver profile
Î. Myleogram
Ï. Platelet count
Ð. CT scan of the head
Ñ. Angiogram of the extremity
Ò. Post spinal fusion from L5to S1
Ó. Primary repair with an iliac bone graft
Ô. Post spinal fusion of L4-5
Õ. A pantaloon body cast and 6 weeks of bed rest
Ö. Rest, NSAIDS, and limited dancing
×. Stress fracture of the proximal fifth metatarsal
Ø. Stress fracture of the base of the second metatarsal
Ù. Stress fracture of the neck of the second metatarsal
Ú. Morton’s neuroma
Û. Lisfranc’s joint subluxation
Ü. C5 radiculopathy
Ý. Subscapularis rupture
Þ. Glenohumeral arthrosis
SS. Rotator cuff arthropathy
À. Suprascapular nerve compression at the spinoglenoid notch
Á. mm femoral head in combination with a metal-backed polyethylene component
Â. mm femoral head in combination with an all-polyethylene acetabular component
Ã. mm femoral head in combination with a metal-backed polyethylene component
Ä. mm femoral head in combination with an all-polyethylene component
Å. mm femoral head in combination with a metal-backed polyethylene component
Æ. Female gender
Ç. History of cigarette smoking
È. L5-S1 spondylolisthesis on pre-employment radiography
É. Decreased strength of the lower extremities on pre-employment testing
Ê. Decreased flexibility of the lumbar spine on pre-employment testing
Ë. Size of cells
Ì. Amount of DNA in cells
Í. Nucleus-cytoplasm ratio
Î. Specific DNA sequences
Ï. Specific messenger RNA sequences
Ð. Femoral and obturator nerves
Ñ. Femoral and superior gluteal nerves
Ò. Femoral and lateral femoral cutaneous nerves
Ó. Obturator and superior gluteal nerves
Ô. Obturator and lateral femoral cutaneous nerves
Õ. Isotonic
Ö. Isokinetic
÷. Isometric
Ø. Open kinetic chain
Ù. Dynamic variable resistance
Ú. Closed reduction and cast immobilization
Û. Uniplanar external fixation
Ü. Open reduction and internal fixation with a dynamic compression plate
Ý. Unreamed intramedullary rod
Þ. Multiple plane external fixator
Ÿ. Inlet view of the pelvis
Ā. Outlet view of the pelvis
Ā. AP view of the hip
Ă. Ilial oblique view (external oblique) of the hip
Ă. Obturator oblique
Ą. Glycolytic pathway
Ą. Oxidative phosphorylation
Ć. Breakdown of fat
Ć. Breakdown of protein
Ĉ. Breakdown of adenosine triphosphate
Ĉ. an MRI scan
Ċ. arthroscopic examination
Ċ. AP and frog-lateral radiographs of the pelvis and hips
Č. varus and valgus stress radiographs of the knee
Č. physical examination of the knee under anesthesia
Ď. extended curettage and polymethylmethacrylate cementation
Ď. extra-articular resection of the knee and an allograft arthrodesis
Đ. wide resection of the proximal tibia and custom prosthetic replacement
Đ. prophylactic internal fixation and postoperative irradiation
Ē. excision of the lateral condyle and reconstruction with a hemicondylar allograft
Ē. silicone implant joint replacement
Ĕ. metatarsophalangeal joint arthrodesis
Ĕ. metatarsophalangeal joint debridement
Ė. resection of the metatarsal head
Ė. resection of the base of the proximal phalanx
Ę. Fixation of the syndesmosis has failed
Ę. Widening of the ankle mortise has led to the failure of fixation
Ě. Infection around the syndesmosis screw has led to osteomyelitis
Ě. The syndesmosis screw is broken
Ĝ. Motion between the tibia and fibula has caused loosening of the syndesmosis screw
Ĝ. Microcephaly
Ğ. A temporal lobe cyst
Ğ. An Arnold-Chiari type 1 malformation
Ġ. Periventricular leukomalacia
Ġ. Agnesis of the corpus callosum
Ģ. Wolff’s
Ģ. Hooke’s
Ĥ. Hilton’s
Ĥ. Muller-Haeckel
Ħ. Heuter-Volkmann
Ħ. Both the anterolateral and posteromedial bands are isometric and do not significantly change with flexion
Ĩ. The anterolateral band is lax and becomes tight in flexion, while the posteromedial band is tight, and becomes lax in flexion
Ĩ. The anterolateral band is tight and becomes lax in flexion, while the posteromedial band is lax and becomes tight in flexion
Ī. Both the anterolateral and posteromedial bands are lax and become tight in flexion
Ī. Both the anterolateral and posteromedial bands are tight and become lax as the knee is flexed
Ĭ. UCB orthosis
Ĭ. Rigid orthosis with a medical arch support
Į. Semi-rigid orthosis with lateral forefoot posting
Į. Semi-rigid orthosis with a medial arch support
İ. Medial heel wedge attached to the running shoes
I. Hallux varus
IJ. Osteonecrosis
IJ. Recurrence of the hallux valgus
Ĵ. “Transfer” second metatarsalgia
Ĵ. Physeal arrest of the first metatarsal
Ķ. Aseptic loosening in a 70-year-old patient
Ķ. Mechanical failure of a hinged knee prosthesis
ĸ. Failed knee replacement complicated by reflex sympathetic dystrophy
Ĺ. Infection with soft-tissue deficit
Ĺ. A prior patellectomy
Ļ. Knee fusion
Ļ. Open irrigation and debridement
Ľ. Arthroscopic irrigation and debridement
Ľ. One-stage exchange arthroplasty
Ŀ. Two-stage exchange arthroplasty
Ŀ. Putti-platt repair
Ł. Open Bankart repair
Ł. Injection of a subacromial corticosteroid
Ń. Arthroscopic transglenoid capsular shift
Ń. Rehabilitation of the scapular and rotator cuff muscles
Ņ. Silicone suction socket and an energy-absorbing foot
Ņ. Silicone suction socket and a variable resistance ankle
Ň. Plastic suction socket, telescoping pylon, and a solid ankle cushioned heel (SACH) foot
Ň. Plastic socket with a hinged thigh cuff and a SACH foot
ʼN. Patellar tendon-bearing suction socket and a uniaxial hydraulic ankle
Ŋ. Parosteal
Ŋ. Periosteal
Ō. High-grade intramedullary
Ō. Osteosarcoma occurring in Paget’s disease
Ŏ. Osteosarcoma occurring in irradiated bone
Ŏ. Cauda equina
Ő. Conus medullaris
Ő. Genitofemoral nerve
Œ. Lumbar sympathetic plexus
Œ. Lumbar parasympathetic plexus
Ŕ. Spinal pseudoarthrosis
Ŕ. Spinal cord traction injury with paralysis
Ŗ. Arterial and venous thromboses
Ŗ. Superior mesenteric artery syndrome
Ř. Crankshaft phenomenon
Ř. Inversion stress radiograph
Ś. MRI scan
Ś. CT scan
Ŝ. Nuclear bone scan
Ŝ. External rotation stress radiograph
Ş. Complex deformity with an angulation in two planes
Ş. Single deformity less than 20 degrees, apex posterolateral
Š. Single deformity greater than 30 degrees, apex posterolateral
Š. Single deformity less than 20 degrees, apex posteromedial
Ţ. Single deformity greater than 30 degrees, apex posteromedial
Ţ. Pronation of the foot during the stance phase of gait
Ť. Heel inversion at the beginning of a single limb heel rise
Ť. Active inversion of the nonweightbearing foot
Ŧ. Active plantar flexion of the first ray against resistance
Ŧ. Active plantar flexion of the foot during the push-off phase of gait
Ũ. Observation and repeat radiographs in 4 months
Ũ. Application of a thoracolumbalsacral orthosis for 22 to 24 hours per day
Ū. Electrical stimulation at night
Ū. Physical therapy
Ŭ. Begins to remodel and hypertrophy more quickly
Ŭ. Provides a better scaffold for osteoconduction
Ů. Reduces the risk of early fracture
Ů. Reduces technical difficulty
Ű. Lowers donor site morbidity
Ű. Anterior fusion of the lumbar curve
Ų. Anterior and posterior fusion of the thoracic curve
Ų. Posterior fusion of the thoracic curve
Ŵ. Posterior fusion of the thoracic and lumbar curves
Ŵ. Application of a brace until the iliac apophyses are Risser 4 or 5, followed by surgical correction
Ŷ. Subscapularis rupture
Ŷ. Type III SLAP lesion
Ÿ. Disruption of capsular shift
Ź. Isolated traumatic subluxation
Ź. Injury to the axillary nerve after dislocation
Ż. hypophosphatemia
Ż. high dietary cholesterol intake
Ž. deficiency of lipoprotein A
Ž. deficiency of protein S and protein C
S. elevated levels of antithrombin III
Ƀ. Weightbearing short leg cast
Ɓ. Nonweightbearing short leg cast
Ƃ. Removable splint and early motion
Ƃ. Open reduction and internal fixation
Ƅ. Elastic compression bandage with full weightbearing
Ƅ. Breast
Ɔ. Prostate
Ƈ. Gastrointestinal
Ƈ. Kidney
Ɖ. Multiple myeloma
Ɗ. Varus stress
Ƌ. Valgus stress
Ƌ. Torsional loading
ƍ. Hyperextension of the knee
Ǝ. Contraction of the quadriceps while axially loaded
Ə. Primary internal fixation at both fracture levels
Ɛ. External fixation as definitive ttt for both #
Ƒ. Skeletal traction and delayed internal fixation of both fractures
Ƒ. Primary internal fixation of the proximal fracture and delayed fixation of the femoral fracture
Ɠ. Primary internal fixation of the femoral shaft fracture and delayed fixation of the proximal #
Ɣ. Heel spur
Ƕ. Plantar fascitis
Ɩ. Dysfunction of the tibialis posterior tendon
Ɨ. Compression of the first branch of the lateral plantar nerve
Ƙ. Compression of the calcaneal nerve
Ƙ. Displaced labral tear
Ƚ. Tear of the rotator cuff
ƛ. Fracture of the glenoid rim
Ɯ. Palsy of the axillary nerve
Ɲ. Palsy of the musculocutaneus nerve
Ƞ. Enchondroma
Ɵ. Osteoblastoma
Ơ. Giant cell tumor
Ơ. Aneurysmal bone cyst
Ƣ. Fibrous dysplasia
Ƣ. Arthrogram of the wrist
Ƥ. MRI scan of both wrists
Ƥ. CT scan of both wrists in the same position
Ʀ. Radiographs of the wrist in supination and pronation
Ƨ. Radiographs of the opposite wrist in the same position
Ƨ. Secondary hyperparathyroidism
Ʃ. Phosphate retention secondary to uremia
ƪ. Insufficient renal synthesis of 1, 25 dihydroxy vitamin D
ƫ. Aluminum deposition in bone from oral phosphate binders
Ƭ. Persistent acidosis aggravating the negative calcium balance
Ƭ. Posterior fusion at T10-L3 with segmental instrumentation
Ʈ. Laminectomy and fusion of T12-L2 with segmental instrumentation
Ư. Bed rest in a hyperextension brace
Ư. L1 vertebrectomy and anterior decompression with strut graft fusion and instrumentation
Ʊ. Progressive ambulation as tolerated in a custom-molded thoracolumbosacral orthosis
Ʋ. Positive-pressure ventilation
Ƴ. An immediate radiograph of the chest
Ƴ. Adjustment of the position of the endotrachael tube
Ƶ. Insertion of a large-bore needle into the pericardial space
Ƶ. Insertion of a large-bore needle in the right second intercostal space, midclavicular line
Ʒ. Allowing the ends of the fracture to touch
Ƹ. Adding a second connecting bar
Ƹ. Adding one pin to each fracture fragment
ƺ. Increasing the pin diameter from 4 mm to 6 mm
ƻ. Decreasing the connecting bar-to-bone distance from 6 cm to 4 cm
Ƽ. Osteomyelitis
Ƽ. Malignant degeneration
ƾ. Stress fracture
Ƿ. Local recurrence of the giant cell tumor
ǀ. Bone resorption due to methylmethacrylate
ǁ. Advancement of the plantar plate
ǂ. Resection of the second metatarsal head
ǃ. Dorsiflexion osteotomy of the second metatarsal neck
DŽ. Transfer of the flexor digitorum longus tendon to the dorsum of the toe
DŽ. Transfer of the extensor digitorum comminus tendon to the metatarsal neck
DŽ. Sacral fracture
LJ. Burst fracture of L5
LJ. Cauda equina syndrome
LJ. Distraction-flexion injury at L3
NJ. Distraction-extension injury at L3
NJ. An MRI scan of the shoulder
NJ. An MRI scan of the cervical spine
Ǎ. Electromyographic and nerve conduction velocity studies
Ǎ. Immobilization in a sling and early passive range of motion exercises
Ǐ. Immediate return to the operating room for exploration of the brachial plexus
Ǐ. cerclage wiring
Ǒ. tension band wiring
Ǒ. removal of the patellar component
Ǔ. revision of the patellar component
Ǔ. immobilization of the knee and protected weightbearing
Ǖ. Liposarcoma
Ǖ. Nodular fasciitis
Ǘ. Rabdomyosarcoma
Ǘ. Malignant fibrous histiocytoma
Ǚ. Extra-abdominal desmoid tumor
Ǚ. Clubfeet
Ǜ. Thrombocytopenia
Ǜ. Congenital scoliosis
Ǝ. Ventricular septal defect
Ǟ. Arnold-Chiari malformation
Ǟ. delayed primary closure
Ǡ. free flap
Ǡ. pedicle groin flap
Ǣ. full-thickness skin graft
Ǣ. split-thickness skin graft
Ǥ. Infection
Ǥ. Nonunion
Ǧ. Improper screw length
Ǧ. Osteonecrosis of the distal fragment
Ǩ. Use of a cortical screw instead of a cancellous screw
Ǩ. Infection
Ǫ. Tear of the rotator cuff
Ǫ. Loosening of the humeral component
Ǭ. Arthritis of the glenoid
Ǭ. Arthritis of the A-C joint
Ǯ. Reduced morbidity
Ǯ. Improved osteoinduction
J̌. Improved osteoconduction
DZ. More rapid revascularization
DZ. Lower risk of disease transmission
DZ. Manipulation Under Anesthesia
Ǵ. Arthroscopic acromioplasty
Ǵ. Arthroscopic debridement of G-H joint
Ƕ. Replacement of the humeral head
Ƿ. Lengthening of the subscapularis and release of the anterior capsule
Ǹ. Bacteroides
Ǹ. E. coli
Ǻ. Staph. aureus
Ǻ. group A streptococcus
Ǽ. Clostridium perforingens
Ǽ. observation and exercises
Ǿ. bracing with a thoracolumbar orthosis
Ǿ. fusion of the posterior spine
Ȁ. fusion of the anterior spine
Ȁ. fusion of the anterior and posterior spine
Ȃ. Total wrist replacement and bridge grafts
Ȃ. palmar shelf arthroplasty and tendon transfers
Ȅ. Darrach distal ulna resection, dorsal tenosynosynovectomy, and tendon transfers
Ȅ. Radioscaphate fusion, extensor tenodesis, and Darrach distal ulna resection
Ȇ. Total wrist fusion and tendon transfers
Ȇ. constrained acetabular component
Ȉ. protrusion ring with morselized graft
Ȉ. cemented metal backed acetabular component
Ȋ. cemented all-polyethylene acetabular component
Ȋ. cementless hemispherical component with screw fixation
Ȍ. application of a hip abduction brace for 22 hours per day
Ȍ. application of a hip spica under anesthesia
Ȏ. discontinuance of all bracing and repeat radiographs in 3 months
Ȏ. open reduction of the hip and application of a spica cast
Ȑ. open reduction, varus osteotomy, and application of a spica cast
Ȑ. Loss of skin hair on the feet
Ȓ. Absent pulses on vascular examination
Ȓ. Pain that originates proximally and spreads distally
Ȕ. Pain that is relieved by stopping and standing
Ȕ. Pain that is worse when the patient walks uphill rather downhill
Ȗ. wrist flexors and finger flexors
Ȗ. elbow flexors and wrist flexors
Ș. elbow flexors and finger flexors
Ș. elbow extensors and wrist flexorst Level Key Muscles4 DiaphragmDeltoid, elbow flexors, diaphragmElbow flexors, wrist extensorsElbow extensors, wrist flexorsFinger flexors (distal phalanx of middlefinger)Finger abductors (5th digit), intrinsics of hand2 Segmental innervation to intercostal muscles, abdominal and paraspinal muscles) L1, L2, L3 Hip flexors3, L4 QuadricepsTibialis anteriorToe extensors, hip abductorsAnkle plantarflexors, peronei
Ț. elbow extensors and wrist extensors
Ț. Syndactyly
Ȝ. Macrodactyly
Ȝ. Camptodactyly
Ȟ. Preaxial polydactyly
Ȟ. Postaxial polydactyly
Ƞ. Arthrodesis
ȡ. Rotationplasty
Ȣ. Above-knee amputation
Ȣ. Osteoarticular allograft
Ȥ. Endoprosthesis (custom arthroplasty)
Ȥ. Plantar fascia
Ȧ. Spring ligament
Ȧ. Deltoid ligament
Ȩ. Intrinsic tendons
Ȩ. Gastorcnemius-solelus complex
Ȫ. Prevention of presynaptic release of acetylcholine
Ȫ. Prevention of synthesis of presynaptic acetylcholine
Ȭ. Activation of acetylcholinesterase at the motor end-plate
Ȭ. Blockage of postsynaptic action of acetylcholine until reserves are depleted
Ȯ. Stimulation of release of presynaptic acetylcholine until reserves are depleted
Ȯ. stiffness of the femoral component.
Ȱ. head offset of the femoral component.
Ȱ. femoral component material modulus of elasticity.
Ȳ. extent of the femoral component porous coating.
Ȳ. Presence of a femoral component collar.
ȴ. plantar fascia and quadratus plantae tendon.
ȵ. ligamentous structures connecting the tarsal bones.
ȶ. shape of the tarsal bones and the intervening joints.
ȷ. activity of the intrinsic muscles of the foot.
ȸ. activity of the posterior tibialis and the peroneus longus muscles.
ȹ. scapulothoracic fusion
Ⱥ. strengthening of the periscapular muscles
Ȼ. pectoralis minor-fascia lata graft transfer to the scapula
Ȼ. pectoralis major-fascia lata graft transfer to the scapula
Ƚ. exploration of the long thoracic nerve, with sural nerve graft
Ⱦ. tricompartmental knee replacement
Ȿ. unicompartmental knee replacement
Ɀ. medial compartment meniscal allograft
Ɂ. valgus-producing distal femoral osteotomy
Ɂ. valgus-producing proximal tibial osteotomy
Ƀ. Internal rotation of the femoral component
Ʉ. External rotation of the tibial component
Ʌ. Lateral placement of the femoral component
Ɇ. Medial placement of the patellar component
Ɇ. Excessive resection of the patella
Ɉ. Hallux rigidus
Ɉ. Hallux valgus
Ɋ. Neuroma of the first web space
Ɋ. Fracture of the sesamoid
Ɍ. Rupture of the flexor hallucis longus
Ɍ. Sickle cell crisis
Ɏ. Idiopathic chondrolysis
Ɏ. Hemophilic arthropathy
Ɐ. Osteoid osteoma of the femoral neck
Ɑ. Legg-Calve-Perthes disease
Ɒ. Decreased ankle jerk and positive femoral nerve stretch test
Ɓ. Decreased knee jerk and positive straight-leg raising sign
Ɔ. Gastrocnemius-soleus complex weakness and positive straight-leg raising sign
ɕ. Weakness of the extensor hallucis longus and positive straight-leg raising sign
Ɖ. Weakness of the extensor hallucis longus and positive femoral nerve stretch test
Ɗ. Long-term administration of IV and oral antibiotics
ɘ. Open soft-tissue debridement, retention of prosthetic components, and IV antibiotics
Ə. Immediate exchange arthroplasty with antibiotic-impregnated cement
ɚ. Two-stage surgical prosthetic exchange and IV antibiotics
Ɛ. Resection arthroplasty and IV antibiotics
Ɜ. SCFE
ɝ. MED
ɞ. Perthes disease
ɟ. Hypothyroidism
Ɠ. Chondrolysis
Ɡ. gout.
ɢ. osteoporosis.
Ɣ. eosinophilic granuloma.
ɤ. tuberculosis of the spine.
Ɥ. metastatic disease of the spine.
Ɦ. water content.
ɧ. Synthesis of type I collagen.
Ɨ. Proteoglycan content.
Ɩ. Activity of chondrocytes.
Ɪ. Synthesis of hyaluronate.
Ɫ. Lung
Ɬ. Breast
ɭ. Prostate
ɮ. Thyroid
Ɯ. Renal
ɰ. T1-low, T2-low.
Ɱ. T1-low, T2-high.
Ɲ. T1-moderate, T2-low.
ɳ. T1-high, T2-low.
ɴ. T1-high, T2-high.
Ɵ. hypothesis is incorrect or invalid
ɶ. interobserver error rate is 4%.
ɷ. Standard deviation is 4% higher or lower than the mean.
ɸ. Sample size is 4% larger than required to be clinically significant.
ɹ. Probability that the differences noted between two study groups were due to chance alone is 4%.
ɺ. I
ɻ. II
ɼ. IV
Ɽ. IX
ɾ. X
ɿ. Cranial setting
Ʀ. Cranial subluxation
ʁ. Odontoid fracture
Ʂ. Lysis of the arch of the atlas
Ʃ. Atlantoaxial subluxation
ʄ. Retrograde collapse of the endoneurial tubes
ʅ. Irreversible atrophy of the denervated muscles
ʆ. Elongation of the axons across the zone of injury
Ʇ. Sprouting of the axons at the neuromuscular junction
Ʈ. Misdirection of the axons across the zone of injury
Ʉ. Maximally pronated and elbow extended
Ʊ. Maximally pronated and the elbow flexed
Ʋ. Maximally supinated and the elbow flexed
Ʌ. Maximally supinated and the elbow extended
ʍ. In neutral rotation, with the elbow extended
ʎ. open reduction and internal fixation
ʏ. buddy taping to the adjacent index finger
ʐ. early motion with application of a dynamic banjo splint
ʑ. application of a cast with the hand in a “safe position” for 3 weeks.
Ʒ. dorsal extension block splinting
ʓ. The name of the manufacturer
ʔ. The manufacturer’s potential liability
ʕ. The physician’s clinical performance
ʖ. The physician’s materials testing data
ʗ. Any royalties the physician receives from the manufacturer
ʘ. Femoral
ʙ. Obturator
ʚ. Inferior gluteal
ʛ. Superior gluteal
ʜ. Lateral femoral cutaneous
Ʝ. open biopsy and a long leg cast
Ʞ. open biopsy and wide resection of the tumor
ʟ. a long leg cast and observation
ʠ. intramedullary stabilization and observation
ʡ. Triggering
ʢ. Lateral instability
ʣ. Swan-neck deformity
ʤ. Boutonniere deformity
ʥ. Loss of distal interphalangeal joint flexion
ʦ. Peroneus brevis to peroneus longus
ʧ. Peroneus tertius to extensor hallucis longus
ʨ. Peroneus tertius to superficial peroneal nerve
ʩ. Extensor hallucis longus to deep peroneal nerve
ʪ. Extensor hallucis longus to extensor digitorum longus
ʫ. reassurance that Medicare will pay for the treatment.
ʬ. consent forms that patients or their guardians are able to understand.
ʭ. a detailed description of the device, omitting the fact that it is part of a study.
ʮ. a provision that the patient’s care will be discontinued if he or she does not enroll in the study.
ʯ. a provision that the study will be carried out to completion, whether or not the device is as effective as those currently in existence.
ʰ. an onlay iliac crest bone graft.
ʱ. limited weightbearing and observation.
ʲ. removal of the implant and limited weightbearing.
ʳ. removal of the implant and insertion of a reamed femoral nail.
ʴ. removal of the implant and insertion of an unreamed femoral nail.
ʵ. Coronal
ʶ. Sagittal
ʷ. Anteromedial, midway between the sagittal and the coronal
ʸ. Proximal pins sagittal, distal pins coronal
ʹ. Proximal pins coronal, distal pins sagittal
ʺ. Rheumatoid arthritis
ʻ. Posttraumatic arthritis
ʼ. Degenerative osteoarthritis
ʽ. Osteonecrosis of the tibial plateau
ʾ. Osteonecrosis of the medial femoral condyle
ʿ. Trapeziometacarpal arthrodesis
ˀ. Osteotomy of the thumb metacarpal
ˁ. Arthrotomy and joint debridement
˂. Ligament reconstruction using one half of the flexor carpi radialis
˃. Trapezium resection, tendon interposition, and reconstruction of the ligament
˄. Creep
˅. Relaxation
ˆ. Energy dissipation
ˇ. Plastic deformation
ˈ. Elastic deformation
ˉ. bending
ˊ. axial loading
ˋ. high-speed rotation
ˌ. direct impact from anteromedial
ˍ. crush from anteromedial to posterolateral
ˎ. Increase stiffness
ˏ. Increase fracture toughness
ː. Increase fatigue strength
ˑ. Decrease mechanical strength
˒. Decrease wear rate
˓. disuse osteopenia
˔. paraendocrine effect of the tumor
˕. abnormally increased density on the right side
˖. side effect of the treatment of the lesion
˗. extensive tumor involvement of the left hip
˘. Sciatic nerve
˙. Superior gluteal artery
˚. Profunda femoris artery
˛. Femoral artery and nerve
˜. External iliac artery and vein
˝. Length
˞. Moment arm
˟. Total volume
ˠ. Physiologic cross-sectional area
ˡ. Distribution of slow and fast twitch fibers
ˢ. decreasing initiation of action potentials.
ˣ. increasing action potential amplitude.
ˤ. blocking the opening of gated sodium channels.
˥. decreasing the number of functional motor units.
˦. slowing or stopping action potential propagation through the axon.
˧. resection of the metatarsal heads of the first through fifth toes.
˨. Silastic MP joint arthroplasties of the first through fifth toes.
˩. fusion of the hallux MP joint and resection arthroplasty of the 2nd through fifth metatarsal heads.
˪. fusion of hallux MP joint and distal osteotomy of the 2nd through 5th MT.
˫. plantar condylectomy of the 2nd through 5th MT heads & resection of proximal phx of the hallux.
ˬ. hemiarthroplasty
˭. open reduction and internal fixation
ˮ. closed reduction and percutaneous pinning
˯. a sling and early pedulum exercises
˰. a sling and swathe for 6 weeks, followed by shoulder rehabilitation
˱. open acromioplasty
˲. open Bankart repair
˳. open subscapularis tendon repair
˴. inferior capsular shift
˵. a supervised physical therapy program
˶. a sling and swathe, with pendulum exercises in 10 days
˷. open reduction and internal fixation through an anterior approach
˸. open reduction and internal fixation through a posterior approach
˹. immobilization with a splint in 45 degrees of abduction for 6 weeks
˺. arthroscopically assisted reduction and percutaneous screw fixation
˻. Repair of the rotator cuff
˼. Replacement of the humeral head
˽. Resection arthroplasty
˾. Total shoulder arthroplasty
˿. AP and lateral radiographs of the elbow
̀. Diagnositc arthroscopy
́. Aspiration of joint fluid
̂. An erythrocyte sedimentation rate and CBC
̃. A diagnostic lidocaine injection
̄. Insulin-like growth factor (IGF-1)
̅. Fibroblast growth factor (FGF-1)
̆. Platelet-derived growth factor (PDGF)
̇. Transforming growth factor beta (TGF-B)
̈. Bone morphogenetic proteins (BMP)
̉. clinical history and radiographic findings.
̊. technetium bone scan
̋. flow cytometry pattern of extracted chondrocytes
̌. immunohistochemical staining patterns of a biopsy specimen
̍. histologic features of a biopsy specimen stained with hematoxylin-cosin
̎. Radial
̏. Radial recurrent
̐. Posterior interosseous
̑. Superior ulnar recurrent
̒. Superficial radial circumflex
̓. Impaired hydroxylation of proline
̔. Failure of cleavage in procollagen
̕. Defective binding sites for hydroxyproline
̖. Failure to incorporate glycine into the helix
̗. Diminished production of collagen through the rough endoplasmic reticulum
̘. Asking the legal staff to seek a court injunction
̙. Copying the patient’s chart and giving it to him as he leaves
̚. Having the patient sign a written legal contract that specifies acceptable behavior
̛. Continuing care of the patient until an appropriate referral can be arranged
̜. Transferring the patient to another orthopaedic surgeon without disclosing the realreason for why the patient is being transferred
̝. Meta-analysis
̞. Confidence interval
̟. Analysis of variance (ANOVA)
̠. Statistical significance (p-value)
̡. Survivorship analysis (Kaplan-Meier)
̢. Spinal shock
̣. Neurogenic shock
̤. Hypovolemic shock
̥. Pulmonary embolism
̦. Fat embolus syndrome
̧. Lumbar spinal stenosis
̨. Metastatic disease of the spine
̩. Rheumatoid lumbar spondylitis
̪. Isthmic spondyloloisthesis
̫. Degenerative spondylolisthesis at L4-5 and L5-S1
̬. Patella alta
̭. A metal-backed patella
̮. Varus malalignment of the knee
̯. A posterior cruciate-substituting femoral component
̰. Lateral subluxation of the patella on a Merchant’s view
̱. The sesamoids are separated
̲. The sesamoid is fractured
̳. The proximal phx is on the neck of the metatarsal
̴. The dislocation is dorsal and centered
̵. The proximal phalanx is hyperextended
̶. Patella
̷. Tibial stem
̸. Distal femoral interface
̹. Posterior femoral interface
̺. Sites of screw fixation for the tibia
̻. Hallux rigidus
̼. Fracture of the sesamoid
̽. Disruption of the plantar plate
̾. Osteonecrosis of the metatarsal head
̿. Rupture of the flexor hallucis longus
̀. Gout
́. Sepsis
͂. Old trauma
̓. Rheumatoid arthritis
̈́. Charcot arthroplasty
Ι. Aspiration and steroid injection
͆. Biopsy, curettage, and allograft bone grafting
͇. Percutaneous Kirschner wire fixation
͈. Percutaneous injection of autogenous bone marrow
͉. Nerve roots
͊. Spinal cord
͋. Sciatic nerve
͌. Peroneal nerve
͍. Conus medullaris
͎. Extent of bone penetrated by reaming, prosthetic components, or acrylic cement
͏. Periprosthetic regions that are accessible to joint fluid and particulate wear debris
͐. Enveloping pseudocapsular scar tissue that develops around a prosthetic hip following surgical capsulectomy
͑. Soft tissue and bone that are potentially contaminated with bacteria in the setting of a prosthetic joint infection
͒. Potential intrapelvic joint space communication created by acetabular fixation screws or intrapelvic extruded acrylic cement
͓. Early and late infection
͔. Periprosthetic fracture of the femur
͕. Failure of the patellofemoral and extensor mechanisms
͖. Aseptic loosening of cementing tibial components
͗. Asceptic loosening of cemented femoral components
͘. Acceptance of the current position of the ankle
͙. Open reduction and fixation in the epiphysis only
͚. ORIF with a small-fragment T-plate from the malleolus up to the metaphysis
͛. Closed reduction by eversion of the ankle and application of a bivalved long leg cast
͜. CRUGA and fixation with a malleolar screw from the malleolus into the metaphysis
͝. Resection arthroplasty and local radiation
͞. In situ fusion of the hip
͟. Excision of heterotopic bone, total hip arthroplasty, and oral indomethacin
͠. Excision of heterotopic bone and local radiation
͡. Excision of heterotopic bone, hemiarthroplasty, and oral indomethacin
͢. Closed reduction of both fractures and immediate spica casting
ͣ. Bilateral skin traction for 3 weeks, followed by spica casting
ͤ. External fixation of both femora
ͥ. External fixation of the left femur and a long leg cast brace for the right femur
ͦ. External fixation of the left femur and use of a reamed intramedullary nail in the right femur
ͧ. Synovial sarcoma
ͨ. Soft-tissue abcess
ͩ. Rhabdomyosarcoma
ͪ. Eosinophilic granuloma
ͫ. Nodular pigmented villonodular synovitis
ͬ. Changing to a titanium nail
ͭ. Changing to a nonslotted nail
ͮ. Changing the cross-sectional shape of the nail
ͯ. Increasing the diameter of the nail by 3 mm
Ͱ. Increasing the diameter of the interlocking screws
Ͱ. Fracture healing
Ͳ. Chondrosarcoma
Ͳ. Periosteal chondroma
ʹ. Periosteal osteosarcoma
͵. Dysplasia epiphysealis hemimelica
Ͷ. Demonstrate competence in the subject of the case
Ͷ. Be fellowship trained in the subject of the case
͸. Be paid on a contingency basis
͹. Be board certified by the American Board of Orthopaedic Surgery
ͺ. Have been involved in the case as a consultant
Ͻ. Diagnostic arthroscopy
Ͼ. Arthroscopy and subacromial decompression
Ͽ. Reduction and fixation of the proximal humeral epiphysis
;. Temporary cessation of throwing
Ϳ. Physical therapy for rotator cuff strengthening
΀. Oblique popliteal ligament
΁. Lateral capsule
΂. Popliteal tendon
΃. Fibular collateral ligament
΄. Posterior oblique ligament
΅. Radial tear
Ά. Parrot-beak tear
·. Vertical tear in the “red-red” zone
Έ. Vertical tear in the “red-white” zone
Ή. Vertical tear in the “white-white” zone
Ί. 0 degrees of abduction, with neural rotation
΋. 40 degrees of flexion and 60 degrees of internal rotation
Ό. 45 degrees of flexion and 45 degrees of external rotation
΍. 90 degrees of abduction with neutral rotation
Ύ. 90 degrees of abduction and 90 degrees of external rotation
Ώ. Sural
Ϊ́. Saphenous and its branches
Α. Posterior tibial and its branches
Β. Deep peroneal and its branches
Γ. Superficial peroneal and its branches
Δ. Strength
Ε. Stiffness
Ζ. Shelf life
Η. Antigenicity
Θ. Risk of HIV transmission
Ι. Indemnification
Κ. Occurrence
Λ. Excess liability
Μ. Claims-made
Ν. Nose
Ξ. Lateral Y
Ο. Scapular AP
Π. Neutral rotation AP
Ρ. Internal rotation AP
΢. External rotation AP
Σ. Trauma
Τ. Hemophilia
Υ. Reiter’s syndrome
Φ. Rheumatoid arthritis
Χ. Systemic lupus erythematosus
Ψ. Cast immobilization for 6 weeks
Ω. Activity modification and re-evaluation in 2 months
Ϊ. Internal fixation with or without bone grafting
Ϋ. Retrograde drilling of the defect without articular cartilage penetration
Ά. Drilling of the defect directly through the articular cartilage
Έ. repair or reconstruction of the medial collateral ligament
Ή. repair or reconstruction of the medialand lateral collateral ligaments
Ί. immobilization for 5 days or less
Ϋ́. immobilization for 14 days
Α. immobilization for 25 days
Β. Cystinosis
Γ. Hypophosphatemia
Δ. Renal osteodystrophy
Ε. Primary hyperparathyroidism
Ζ. Nutritional vitamin D deficiency
Η. Lateral meniscus tear
Θ. Popliteus tenosynovitis
Ι. Iliotibial band friction syndrome
Κ. Peroneal nerve entrapment
Λ. Biceps tendinitis
Μ. Observation
Ν. Removal of the prosthetic components
Ξ. Operative exploration and decompression of the peroneal nerve
Ο. Nerve conduction velocity studies
Π. Loosening of the primary dressings and knee flexion to 30 degrees
Ρ. I
Σ. II
Σ. III
Τ. decreased tissue tension
Υ. decreased abductor lever arm
Φ. decreased joint reaction force
Χ. increased body weight over lever arm
Ψ. increased polyethylene wear rate
Ω. recurrent traumatic anterior dislocation
Ϊ. recurrent traumatic posterior dislocation
Ϋ. traumatic subluxation with no previous dislocation
Ό. traumatic anterior subluxation
Ύ. atraumatic involuntary subluxation
Ώ. radial
Ϗ. axillary
Β. suprascapular
Θ. thoracodorsal
ϒ. long thoracic
ϓ. Flexion
ϔ. Extension
Φ. Axial rotation
Π. Left lateral bending
Ϗ. Right lateral bending
Ϙ. Skin
Ϙ. Lung
Ϛ. Brain
Ϛ. Heart
Ϝ. Kidney
Ϝ. Thoracoacromial, lateral thoracic, subscapular
Ϟ. Thoracoacromial, anterior humeral circumflex, posterior humeral circumflex
Ϟ. Posterior humeral circumflex, subscapular, thoracacromial
Ϡ. Subscapular, thoracacromial, anterior humeral circumflex
Ϡ. Lateral thoracic, anterior humeral circumflex, thoracacromial
Ϣ. Respondeat superior
Ϣ. Indemnity agreement
Ϥ. Hold harmless agreement- attempt to shift liability from company to physician
Ϥ. Comparative negligence-% of involvement
Ϧ. Contributory negligence- resident contributed to the negligence
Ϧ. t-type
Ϩ. both column
Ϩ. transverse
Ϫ. anterior column
Ϫ. anterior column posterior hemitransverse
Ϭ. Posterior interosseous
Ϭ. Anterior interosseous
Ϯ. Radial
Ϯ. Median
Κ. Ulnar
Ρ. Shock from hypovolemia
Ϲ. Associated rupture of the bladder
Ϳ. Arterial bleeding on pelvic angiogram
ϴ. Presence of a hematoma in the perineum and scrotum
Ε. Fractures of both the anterior and posterior pelvic ring

Correct Answer & Explanation

. Above-knee amputation


Explanation

Question 4076

Topic: 10. Pathology and Oncology

  • Which of the following conditions associated with a closed fracture of the clavicle indicates the need for open reduction and internal fixation?
. Injury to the subclavian artery
. Injury to the brachial plexus
. Segmental fracture
. 100% displacement
. Associated displaced surgical neck fracture of the humerus
. humeral arthroplasty2/. repair of the rotator cuff
. closed reduction and immobilization
. open reduction and immobilization
. open reduction and early passive motion
. arthroscopic capsular release
. manipulation under anesthesia
. a physical therapy program
. an intra-articular corticosteroid injection
. administration of high-dose oral corticosteroids
. adding the scores, in all five body systems
. adding the squares of the scores in the three most severely injured systems
. doubling the cumulative score for head and chest injuries
. combining the scores from the most and least injured systems
. correcting the score in the most severely injured system for age
. traumatic femoral head fracture
. osteonecrosis
. osteoarthritis
. neuropathic joint
. rheumatoid arthritis
. low-dose radiation
. steroid injection
. a load-relieving insert and shoe modification
. complete excision of the mass and the entire plantar fascia
. wide excision of the mass with a 2 cm margin of normal fascia
. CT scan of the chest
. technetium bone scan
. bone marrow aspiration
!. serum protein electrophoresis
". lateral skull radiograph
#. high-grade histology of the initial tumor
$. multiple local recurrences after curettage
%. previous treatment of the tumor with cryotherapy
&. previous treatment of the tumor with radiation therapy
'. extraosseous extension into two or more adjacent compartments
(. Dorsal rhizotomy and facet joint fusion
). Multilevel corpectomy and spinal stabilization
*. Central and lateral recess decompression and bilateral foraminotomy
+. Central decompression and facet joint fusion
,. Central decompression, foraminotomy, and spinal fusion from L2 to L5.
-. Inadequate rehabilitation
.. Displacement of the coronoid process fracture
/. Insufficiency of the lateral ulnar collateral ligament
0. Insufficiency of the anterior band of the medial collateral ligament
1. Insufficiency of the posterior band of the medial collateral ligament
2. Osteotomy and intramedullary rod fixation
3. Electrical stimulation
4. Strut-autografing the concavity the tibia
5. A patellar tendon-bearing brace
6. Percutaneous injection of demineralized bone matrix
7. digoxin
8. sucralfate
9. clindamycin
:. alcohol
;. neuromuscular blocking agents
<. Unrestrained roll-back
=. Unrestrained rotational conformity
>. Medial-Lateral conformity
?. Anteroposterior conformity in flexion
@. Anteroposterior conformity in extension
A. Arthrodesis of the MTP joint
B. A Silastic implant of the MTP joint
C. Resection arthroplasty of the MTP joint
D. Cheilctomy of the MTP joint
E. Osteotomy of the base of the proximal phalanx
F. Genu varum
G. Tarsal coalition
H. Degenerative ankle arthrosis
I. Osteochondritis dissecans of the talus
J. Hemihypertrophy of the ipsilateral lower extremity
K. Trabecular bone is preferentially resorbed in this high bone turnover state
L. Loss of water content in the disk increases impact load to the vetrebral bodies
M. Stress is imposed by the relative stiffness of the arthrtic facet joints
N. Increased energy demands are imposed by decreased circulation to the vertebral body
O. The thick cortical bone found in the vertebral body resorbs rapidly following estrogen withdrawal
P. Increased time in stance and swing phase
Q. Addition of a double leg float phase
R. Decreased vertical ground reaction forces
S. Decreased arc of motion in the hip, knee, and ankle
T. Decreased joint reaction forces in the hip, knee, and ankle
U. Talonavicular arthrodesis
V. Medial displacement calcaneal osteotomy
W. Flexor digitorum longus tendon transfer with spring ligament advancement
X. Triple arthrodesis
Y. Calcaneocuboid distraction arthrodesis and repair of the posterior tibial tendon
Z. Lymphoma
[. Hemangioma
\. Osteosarcoma
]. TB of the spine
^. Metastatic breast carcinoma
_. widening and shortening of the heel.
`. weakness of the gastrocnemius-soleus complex.
A. anterior impingement from a horizontal talus.
B. unrecognized compartment syndrome of the foot.
C. degenerative arthritis of the tibiotalar joint.
D. a corrective osteotomy
E. application of braces
F. medial physeal stapling until the varus corrects
G. observation
H. application of corrective casts
I. a total contact cast.
J. electrical stimulation.
K. an off the shelf fracture brace.
L. an elastic compression bandage and crutches.
M. a hard soled shoe until the patient is asymptomatic.
N. Ewings tumor
O. Parosteal osteosarcoma
P. Dedifferentiated chondrosarcoma
Q. Low grade intramedullary chondrosarcoma
R. High grade intramedullary osteosarcoma
S. Vascular injury
T. Tear of the rotator cuff
U. Injury to the brachial plexus
V. Fracture of the upper thoracic rib
W. Fracture of the proximal humerus
X. Biceps
Y. Trapezius
Z. Infraspinatus
{. Pectoralis major
|. Serratus anterior
}. Hybrid total hip arthroplasty
~. Noncemental hemiarthroplasty of the hip
. Closed reduction and percutaneous pin fixation
€. Open reduction through an anterior approach to the hip
. Excision of the head fragment
‚. a quadratus femoris pediclebone graft
ƒ. a proximal femoral allograft
„. intertrochanteric osteotomy
…. total hip arthroplasty
†. hip hemiarthroplasty
‡. Echocardiogram
ˆ. Electrocardiogram
‰. Radiograph of the chest
Š. CT scan of the shoulder
‹. Ultrasound of the shoulder
Œ. Ilioinguinal
. Extended iliofemoral
Ž. Combined ilioinguinal and Kocher-Langenbeck (posterior)
. Kocher-Langenbeck (posterior)
. Kocher-Langenbeck (posterior) with trochanteric osteotomy
‘. Deltoid
’. Supraspinatus
“. Subscapularis Infraspinatus
”. Infraspinatus
•. Infraspinatus and teres minor
–. an orthosis.
—. observation.
˜. electrical stimulation.
™. open reduction and internal fixation.
š. application of a nonweightbearing short leg cast.
›. repair of the rotator cuff.
œ. rehabilitation of the shoulder
. replacement of the humeral head.
ž. arthroscopic acromioplasty and debridement.
Ÿ. immobilization is a sling until pain resolves.
 . Bone rotation versus torque applied
¡. Bone deflection versus bending moment applied
¢. Axial displacement versus tension applied
£. Lateral translation versus shear force applied
¤. Fracture gap closing versus compressive force applied
¥. steroid injection
¦. stretching of the heel cord
§. surgical release of the plantar fascia
¨. application of a short leg cast for 6 to 8 weeks
©. wearing dorsiflexion night splints
ª. Open bladder
«. Bilateral “hitchhiker’s” thumbs
¬. Bilateral defects in the midclavicles
­. Rhizomelic shortening of the extremities
®. Radiographic fragmentation of all major epiphyses
¯. Medial patellotibial
°. Medial patellofemoral
±. Medial patellomeniscal
². Lateral patellofemoral
³. Lateral patellotibial
´. Heat
Μ. Gentle active flexion-extension exercises
¶. Isokinetic strengthening
·. Electrical muscle stimulation
¸. Immobilization of the limb with the knee in full flexion
¹. Distal chevron osteotomy with soft-tissue release
º. Distal soft-tissue realignment only
». Closing wedge osteotomy (Aken) of the proximal phalanx
¼. Proximal first metatarsal osteotomy only
½. Soft-tissue realignment with a proximal metatarsal osteotomy
¾. Vagus
¿. Phrenic
À. Hypoglossal
Á. Recurrent laryngeal
Â. Inferior thyroid
Ã. Surgical exploration
Ä. Application of leeches
Å. Stellate ganglion blocks
Æ. Intra-arterial streptokinase
Ç. Elevation and reevaluation in 1 hour
È. Liver profile
É. Myleogram
Ê. Platelet count
Ë. CT scan of the head
Ì. Angiogram of the extremity
Í. Post spinal fusion from L5to S1
Î. Primary repair with an iliac bone graft
Ï. Post spinal fusion of L4-5
Ð. A pantaloon body cast and 6 weeks of bed rest
Ñ. Rest, NSAIDS, and limited dancing
Ò. Stress fracture of the proximal fifth metatarsal
Ó. Stress fracture of the base of the second metatarsal
Ô. Stress fracture of the neck of the second metatarsal
Õ. Morton’s neuroma
Ö. Lisfranc’s joint subluxation
×. C5 radiculopathy
Ø. Subscapularis rupture
Ù. Glenohumeral arthrosis
Ú. Rotator cuff arthropathy
Û. Suprascapular nerve compression at the spinoglenoid notch
Ü. mm femoral head in combination with a metal-backed polyethylene component
Ý. mm femoral head in combination with an all-polyethylene acetabular component
Þ. mm femoral head in combination with a metal-backed polyethylene component
SS. mm femoral head in combination with an all-polyethylene component
À. mm femoral head in combination with a metal-backed polyethylene component
Á. Female gender
Â. History of cigarette smoking
Ã. L5-S1 spondylolisthesis on pre-employment radiography
Ä. Decreased strength of the lower extremities on pre-employment testing
Å. Decreased flexibility of the lumbar spine on pre-employment testing
Æ. Size of cells
Ç. Amount of DNA in cells
È. Nucleus-cytoplasm ratio
É. Specific DNA sequences
Ê. Specific messenger RNA sequences
Ë. Femoral and obturator nerves
Ì. Femoral and superior gluteal nerves
Í. Femoral and lateral femoral cutaneous nerves
Î. Obturator and superior gluteal nerves
Ï. Obturator and lateral femoral cutaneous nerves
Ð. Isotonic
Ñ. Isokinetic
Ò. Isometric
Ó. Open kinetic chain
Ô. Dynamic variable resistance
Õ. Closed reduction and cast immobilization
Ö. Uniplanar external fixation
÷. Open reduction and internal fixation with a dynamic compression plate
Ø. Unreamed intramedullary rod
Ù. Multiple plane external fixator
Ú. Inlet view of the pelvis
Û. Outlet view of the pelvis
Ü. AP view of the hip
Ý. Ilial oblique view (external oblique) of the hip
Þ. Obturator oblique
Ÿ. Glycolytic pathway
Ā. Oxidative phosphorylation
Ā. Breakdown of fat
Ă. Breakdown of protein
Ă. Breakdown of adenosine triphosphate
Ą. an MRI scan
Ą. arthroscopic examination
Ć. AP and frog-lateral radiographs of the pelvis and hips
Ć. varus and valgus stress radiographs of the knee
Ĉ. physical examination of the knee under anesthesia
Ĉ. extended curettage and polymethylmethacrylate cementation
Ċ. extra-articular resection of the knee and an allograft arthrodesis
Ċ. wide resection of the proximal tibia and custom prosthetic replacement
Č. prophylactic internal fixation and postoperative irradiation
Č. excision of the lateral condyle and reconstruction with a hemicondylar allograft
Ď. silicone implant joint replacement
Ď. metatarsophalangeal joint arthrodesis
Đ. metatarsophalangeal joint debridement
Đ. resection of the metatarsal head
Ē. resection of the base of the proximal phalanx
Ē. Fixation of the syndesmosis has failed
Ĕ. Widening of the ankle mortise has led to the failure of fixation
Ĕ. Infection around the syndesmosis screw has led to osteomyelitis
Ė. The syndesmosis screw is broken
Ė. Motion between the tibia and fibula has caused loosening of the syndesmosis screw
Ę. Microcephaly
Ę. A temporal lobe cyst
Ě. An Arnold-Chiari type 1 malformation
Ě. Periventricular leukomalacia
Ĝ. Agnesis of the corpus callosum
Ĝ. Wolff’s
Ğ. Hooke’s
Ğ. Hilton’s
Ġ. Muller-Haeckel
Ġ. Heuter-Volkmann
Ģ. Both the anterolateral and posteromedial bands are isometric and do not significantly change with flexion
Ģ. The anterolateral band is lax and becomes tight in flexion, while the posteromedial band is tight, and becomes lax in flexion
Ĥ. The anterolateral band is tight and becomes lax in flexion, while the posteromedial band is lax and becomes tight in flexion
Ĥ. Both the anterolateral and posteromedial bands are lax and become tight in flexion
Ħ. Both the anterolateral and posteromedial bands are tight and become lax as the knee is flexed
Ħ. UCB orthosis
Ĩ. Rigid orthosis with a medical arch support
Ĩ. Semi-rigid orthosis with lateral forefoot posting
Ī. Semi-rigid orthosis with a medial arch support
Ī. Medial heel wedge attached to the running shoes
Ĭ. Hallux varus
Ĭ. Osteonecrosis
Į. Recurrence of the hallux valgus
Į. “Transfer” second metatarsalgia
İ. Physeal arrest of the first metatarsal
I. Aseptic loosening in a 70-year-old patient
IJ. Mechanical failure of a hinged knee prosthesis
IJ. Failed knee replacement complicated by reflex sympathetic dystrophy
Ĵ. Infection with soft-tissue deficit
Ĵ. A prior patellectomy
Ķ. Knee fusion
Ķ. Open irrigation and debridement
ĸ. Arthroscopic irrigation and debridement
Ĺ. One-stage exchange arthroplasty
Ĺ. Two-stage exchange arthroplasty
Ļ. Putti-platt repair
Ļ. Open Bankart repair
Ľ. Injection of a subacromial corticosteroid
Ľ. Arthroscopic transglenoid capsular shift
Ŀ. Rehabilitation of the scapular and rotator cuff muscles
Ŀ. Silicone suction socket and an energy-absorbing foot
Ł. Silicone suction socket and a variable resistance ankle
Ł. Plastic suction socket, telescoping pylon, and a solid ankle cushioned heel (SACH) foot
Ń. Plastic socket with a hinged thigh cuff and a SACH foot
Ń. Patellar tendon-bearing suction socket and a uniaxial hydraulic ankle
Ņ. Parosteal
Ņ. Periosteal
Ň. High-grade intramedullary
Ň. Osteosarcoma occurring in Paget’s disease
ʼN. Osteosarcoma occurring in irradiated bone
Ŋ. Cauda equina
Ŋ. Conus medullaris
Ō. Genitofemoral nerve
Ō. Lumbar sympathetic plexus
Ŏ. Lumbar parasympathetic plexus
Ŏ. Spinal pseudoarthrosis
Ő. Spinal cord traction injury with paralysis
Ő. Arterial and venous thromboses
Œ. Superior mesenteric artery syndrome
Œ. Crankshaft phenomenon
Ŕ. Inversion stress radiograph
Ŕ. MRI scan
Ŗ. CT scan
Ŗ. Nuclear bone scan
Ř. External rotation stress radiograph
Ř. Complex deformity with an angulation in two planes
Ś. Single deformity less than 20 degrees, apex posterolateral
Ś. Single deformity greater than 30 degrees, apex posterolateral
Ŝ. Single deformity less than 20 degrees, apex posteromedial
Ŝ. Single deformity greater than 30 degrees, apex posteromedial
Ş. Pronation of the foot during the stance phase of gait
Ş. Heel inversion at the beginning of a single limb heel rise
Š. Active inversion of the nonweightbearing foot
Š. Active plantar flexion of the first ray against resistance
Ţ. Active plantar flexion of the foot during the push-off phase of gait
Ţ. Observation and repeat radiographs in 4 months
Ť. Application of a thoracolumbalsacral orthosis for 22 to 24 hours per day
Ť. Electrical stimulation at night
Ŧ. Physical therapy
Ŧ. Begins to remodel and hypertrophy more quickly
Ũ. Provides a better scaffold for osteoconduction
Ũ. Reduces the risk of early fracture
Ū. Reduces technical difficulty
Ū. Lowers donor site morbidity
Ŭ. Anterior fusion of the lumbar curve
Ŭ. Anterior and posterior fusion of the thoracic curve
Ů. Posterior fusion of the thoracic curve
Ů. Posterior fusion of the thoracic and lumbar curves
Ű. Application of a brace until the iliac apophyses are Risser 4 or 5, followed by surgical correction
Ű. Subscapularis rupture
Ų. Type III SLAP lesion
Ų. Disruption of capsular shift
Ŵ. Isolated traumatic subluxation
Ŵ. Injury to the axillary nerve after dislocation
Ŷ. hypophosphatemia
Ŷ. high dietary cholesterol intake
Ÿ. deficiency of lipoprotein A
Ź. deficiency of protein S and protein C
Ź. elevated levels of antithrombin III
Ż. Weightbearing short leg cast
Ż. Nonweightbearing short leg cast
Ž. Removable splint and early motion
Ž. Open reduction and internal fixation
S. Elastic compression bandage with full weightbearing
Ƀ. Breast
Ɓ. Prostate
Ƃ. Gastrointestinal
Ƃ. Kidney
Ƅ. Multiple myeloma
Ƅ. Varus stress
Ɔ. Valgus stress
Ƈ. Torsional loading
Ƈ. Hyperextension of the knee
Ɖ. Contraction of the quadriceps while axially loaded
Ɗ. Primary internal fixation at both fracture levels
Ƌ. External fixation as definitive ttt for both #
Ƌ. Skeletal traction and delayed internal fixation of both fractures
ƍ. Primary internal fixation of the proximal fracture and delayed fixation of the femoral fracture
Ǝ. Primary internal fixation of the femoral shaft fracture and delayed fixation of the proximal #
Ə. Heel spur
Ɛ. Plantar fascitis
Ƒ. Dysfunction of the tibialis posterior tendon
Ƒ. Compression of the first branch of the lateral plantar nerve
Ɠ. Compression of the calcaneal nerve
Ɣ. Displaced labral tear
Ƕ. Tear of the rotator cuff
Ɩ. Fracture of the glenoid rim
Ɨ. Palsy of the axillary nerve
Ƙ. Palsy of the musculocutaneus nerve
Ƙ. Enchondroma
Ƚ. Osteoblastoma
ƛ. Giant cell tumor
Ɯ. Aneurysmal bone cyst
Ɲ. Fibrous dysplasia
Ƞ. Arthrogram of the wrist
Ɵ. MRI scan of both wrists
Ơ. CT scan of both wrists in the same position
Ơ. Radiographs of the wrist in supination and pronation
Ƣ. Radiographs of the opposite wrist in the same position
Ƣ. Secondary hyperparathyroidism
Ƥ. Phosphate retention secondary to uremia
Ƥ. Insufficient renal synthesis of 1, 25 dihydroxy vitamin D
Ʀ. Aluminum deposition in bone from oral phosphate binders
Ƨ. Persistent acidosis aggravating the negative calcium balance
Ƨ. Posterior fusion at T10-L3 with segmental instrumentation
Ʃ. Laminectomy and fusion of T12-L2 with segmental instrumentation
ƪ. Bed rest in a hyperextension brace
ƫ. L1 vertebrectomy and anterior decompression with strut graft fusion and instrumentation
Ƭ. Progressive ambulation as tolerated in a custom-molded thoracolumbosacral orthosis
Ƭ. Positive-pressure ventilation
Ʈ. An immediate radiograph of the chest
Ư. Adjustment of the position of the endotrachael tube
Ư. Insertion of a large-bore needle into the pericardial space
Ʊ. Insertion of a large-bore needle in the right second intercostal space, midclavicular line
Ʋ. Allowing the ends of the fracture to touch
Ƴ. Adding a second connecting bar
Ƴ. Adding one pin to each fracture fragment
Ƶ. Increasing the pin diameter from 4 mm to 6 mm
Ƶ. Decreasing the connecting bar-to-bone distance from 6 cm to 4 cm
Ʒ. Osteomyelitis
Ƹ. Malignant degeneration
Ƹ. Stress fracture
ƺ. Local recurrence of the giant cell tumor
ƻ. Bone resorption due to methylmethacrylate
Ƽ. Advancement of the plantar plate
Ƽ. Resection of the second metatarsal head
ƾ. Dorsiflexion osteotomy of the second metatarsal neck
Ƿ. Transfer of the flexor digitorum longus tendon to the dorsum of the toe
ǀ. Transfer of the extensor digitorum comminus tendon to the metatarsal neck
ǁ. Sacral fracture
ǂ. Burst fracture of L5
ǃ. Cauda equina syndrome
DŽ. Distraction-flexion injury at L3
DŽ. Distraction-extension injury at L3
DŽ. An MRI scan of the shoulder
LJ. An MRI scan of the cervical spine
LJ. Electromyographic and nerve conduction velocity studies
LJ. Immobilization in a sling and early passive range of motion exercises
NJ. Immediate return to the operating room for exploration of the brachial plexus
NJ. cerclage wiring
NJ. tension band wiring
Ǎ. removal of the patellar component
Ǎ. revision of the patellar component
Ǐ. immobilization of the knee and protected weightbearing
Ǐ. Liposarcoma
Ǒ. Nodular fasciitis
Ǒ. Rabdomyosarcoma
Ǔ. Malignant fibrous histiocytoma
Ǔ. Extra-abdominal desmoid tumor
Ǖ. Clubfeet
Ǖ. Thrombocytopenia
Ǘ. Congenital scoliosis
Ǘ. Ventricular septal defect
Ǚ. Arnold-Chiari malformation
Ǚ. delayed primary closure
Ǜ. free flap
Ǜ. pedicle groin flap
Ǝ. full-thickness skin graft
Ǟ. split-thickness skin graft
Ǟ. Infection
Ǡ. Nonunion
Ǡ. Improper screw length
Ǣ. Osteonecrosis of the distal fragment
Ǣ. Use of a cortical screw instead of a cancellous screw
Ǥ. Infection
Ǥ. Tear of the rotator cuff
Ǧ. Loosening of the humeral component
Ǧ. Arthritis of the glenoid
Ǩ. Arthritis of the A-C joint
Ǩ. Reduced morbidity
Ǫ. Improved osteoinduction
Ǫ. Improved osteoconduction
Ǭ. More rapid revascularization
Ǭ. Lower risk of disease transmission
Ǯ. Manipulation Under Anesthesia
Ǯ. Arthroscopic acromioplasty
J̌. Arthroscopic debridement of G-H joint
DZ. Replacement of the humeral head
DZ. Lengthening of the subscapularis and release of the anterior capsule
DZ. Bacteroides
Ǵ. E. coli
Ǵ. Staph. aureus
Ƕ. group A streptococcus
Ƿ. Clostridium perforingens
Ǹ. observation and exercises
Ǹ. bracing with a thoracolumbar orthosis
Ǻ. fusion of the posterior spine
Ǻ. fusion of the anterior spine
Ǽ. fusion of the anterior and posterior spine
Ǽ. Total wrist replacement and bridge grafts
Ǿ. palmar shelf arthroplasty and tendon transfers
Ǿ. Darrach distal ulna resection, dorsal tenosynosynovectomy, and tendon transfers
Ȁ. Radioscaphate fusion, extensor tenodesis, and Darrach distal ulna resection
Ȁ. Total wrist fusion and tendon transfers
Ȃ. constrained acetabular component
Ȃ. protrusion ring with morselized graft
Ȅ. cemented metal backed acetabular component
Ȅ. cemented all-polyethylene acetabular component
Ȇ. cementless hemispherical component with screw fixation
Ȇ. application of a hip abduction brace for 22 hours per day
Ȉ. application of a hip spica under anesthesia
Ȉ. discontinuance of all bracing and repeat radiographs in 3 months
Ȋ. open reduction of the hip and application of a spica cast
Ȋ. open reduction, varus osteotomy, and application of a spica cast
Ȍ. Loss of skin hair on the feet
Ȍ. Absent pulses on vascular examination
Ȏ. Pain that originates proximally and spreads distally
Ȏ. Pain that is relieved by stopping and standing
Ȑ. Pain that is worse when the patient walks uphill rather downhill
Ȑ. wrist flexors and finger flexors
Ȓ. elbow flexors and wrist flexors
Ȓ. elbow flexors and finger flexors
Ȕ. elbow extensors and wrist flexorst Level Key Muscles4 DiaphragmDeltoid, elbow flexors, diaphragmElbow flexors, wrist extensorsElbow extensors, wrist flexorsFinger flexors (distal phalanx of middlefinger)Finger abductors (5th digit), intrinsics of hand2 Segmental innervation to intercostal muscles, abdominal and paraspinal muscles) L1, L2, L3 Hip flexors3, L4 QuadricepsTibialis anteriorToe extensors, hip abductorsAnkle plantarflexors, peronei
Ȕ. elbow extensors and wrist extensors
Ȗ. Syndactyly
Ȗ. Macrodactyly
Ș. Camptodactyly
Ș. Preaxial polydactyly
Ț. Postaxial polydactyly
Ț. Arthrodesis
Ȝ. Rotationplasty
Ȝ. Above-knee amputation
Ȟ. Osteoarticular allograft
Ȟ. Endoprosthesis (custom arthroplasty)
Ƞ. Plantar fascia
ȡ. Spring ligament
Ȣ. Deltoid ligament
Ȣ. Intrinsic tendons
Ȥ. Gastorcnemius-solelus complex
Ȥ. Prevention of presynaptic release of acetylcholine
Ȧ. Prevention of synthesis of presynaptic acetylcholine
Ȧ. Activation of acetylcholinesterase at the motor end-plate
Ȩ. Blockage of postsynaptic action of acetylcholine until reserves are depleted
Ȩ. Stimulation of release of presynaptic acetylcholine until reserves are depleted
Ȫ. stiffness of the femoral component.
Ȫ. head offset of the femoral component.
Ȭ. femoral component material modulus of elasticity.
Ȭ. extent of the femoral component porous coating.
Ȯ. Presence of a femoral component collar.
Ȯ. plantar fascia and quadratus plantae tendon.
Ȱ. ligamentous structures connecting the tarsal bones.
Ȱ. shape of the tarsal bones and the intervening joints.
Ȳ. activity of the intrinsic muscles of the foot.
Ȳ. activity of the posterior tibialis and the peroneus longus muscles.
ȴ. scapulothoracic fusion
ȵ. strengthening of the periscapular muscles
ȶ. pectoralis minor-fascia lata graft transfer to the scapula
ȷ. pectoralis major-fascia lata graft transfer to the scapula
ȸ. exploration of the long thoracic nerve, with sural nerve graft
ȹ. tricompartmental knee replacement
Ⱥ. unicompartmental knee replacement
Ȼ. medial compartment meniscal allograft
Ȼ. valgus-producing distal femoral osteotomy
Ƚ. valgus-producing proximal tibial osteotomy
Ⱦ. Internal rotation of the femoral component
Ȿ. External rotation of the tibial component
Ɀ. Lateral placement of the femoral component
Ɂ. Medial placement of the patellar component
Ɂ. Excessive resection of the patella
Ƀ. Hallux rigidus
Ʉ. Hallux valgus
Ʌ. Neuroma of the first web space
Ɇ. Fracture of the sesamoid
Ɇ. Rupture of the flexor hallucis longus
Ɉ. Sickle cell crisis
Ɉ. Idiopathic chondrolysis
Ɋ. Hemophilic arthropathy
Ɋ. Osteoid osteoma of the femoral neck
Ɍ. Legg-Calve-Perthes disease
Ɍ. Decreased ankle jerk and positive femoral nerve stretch test
Ɏ. Decreased knee jerk and positive straight-leg raising sign
Ɏ. Gastrocnemius-soleus complex weakness and positive straight-leg raising sign
Ɐ. Weakness of the extensor hallucis longus and positive straight-leg raising sign
Ɑ. Weakness of the extensor hallucis longus and positive femoral nerve stretch test
Ɒ. Long-term administration of IV and oral antibiotics
Ɓ. Open soft-tissue debridement, retention of prosthetic components, and IV antibiotics
Ɔ. Immediate exchange arthroplasty with antibiotic-impregnated cement
ɕ. Two-stage surgical prosthetic exchange and IV antibiotics
Ɖ. Resection arthroplasty and IV antibiotics
Ɗ. SCFE
ɘ. MED
Ə. Perthes disease
ɚ. Hypothyroidism
Ɛ. Chondrolysis
Ɜ. gout.
ɝ. osteoporosis.
ɞ. eosinophilic granuloma.
ɟ. tuberculosis of the spine.
Ɠ. metastatic disease of the spine.
Ɡ. water content.
ɢ. Synthesis of type I collagen.
Ɣ. Proteoglycan content.
ɤ. Activity of chondrocytes.
Ɥ. Synthesis of hyaluronate.
Ɦ. Lung
ɧ. Breast
Ɨ. Prostate
Ɩ. Thyroid
Ɪ. Renal
Ɫ. T1-low, T2-low.
Ɬ. T1-low, T2-high.
ɭ. T1-moderate, T2-low.
ɮ. T1-high, T2-low.
Ɯ. T1-high, T2-high.
ɰ. hypothesis is incorrect or invalid
Ɱ. interobserver error rate is 4%.
Ɲ. Standard deviation is 4% higher or lower than the mean.
ɳ. Sample size is 4% larger than required to be clinically significant.
ɴ. Probability that the differences noted between two study groups were due to chance alone is 4%.
Ɵ. I
ɶ. II
ɷ. IV
ɸ. IX
ɹ. X
ɺ. Cranial setting
ɻ. Cranial subluxation
ɼ. Odontoid fracture
Ɽ. Lysis of the arch of the atlas
ɾ. Atlantoaxial subluxation
ɿ. Retrograde collapse of the endoneurial tubes
Ʀ. Irreversible atrophy of the denervated muscles
ʁ. Elongation of the axons across the zone of injury
Ʂ. Sprouting of the axons at the neuromuscular junction
Ʃ. Misdirection of the axons across the zone of injury
ʄ. Maximally pronated and elbow extended
ʅ. Maximally pronated and the elbow flexed
ʆ. Maximally supinated and the elbow flexed
Ʇ. Maximally supinated and the elbow extended
Ʈ. In neutral rotation, with the elbow extended
Ʉ. open reduction and internal fixation
Ʊ. buddy taping to the adjacent index finger
Ʋ. early motion with application of a dynamic banjo splint
Ʌ. application of a cast with the hand in a “safe position” for 3 weeks.
ʍ. dorsal extension block splinting
ʎ. The name of the manufacturer
ʏ. The manufacturer’s potential liability
ʐ. The physician’s clinical performance
ʑ. The physician’s materials testing data
Ʒ. Any royalties the physician receives from the manufacturer
ʓ. Femoral
ʔ. Obturator
ʕ. Inferior gluteal
ʖ. Superior gluteal
ʗ. Lateral femoral cutaneous
ʘ. open biopsy and a long leg cast
ʙ. open biopsy and wide resection of the tumor
ʚ. a long leg cast and observation
ʛ. intramedullary stabilization and observation
ʜ. Triggering
Ʝ. Lateral instability
Ʞ. Swan-neck deformity
ʟ. Boutonniere deformity
ʠ. Loss of distal interphalangeal joint flexion
ʡ. Peroneus brevis to peroneus longus
ʢ. Peroneus tertius to extensor hallucis longus
ʣ. Peroneus tertius to superficial peroneal nerve
ʤ. Extensor hallucis longus to deep peroneal nerve
ʥ. Extensor hallucis longus to extensor digitorum longus
ʦ. reassurance that Medicare will pay for the treatment.
ʧ. consent forms that patients or their guardians are able to understand.
ʨ. a detailed description of the device, omitting the fact that it is part of a study.
ʩ. a provision that the patient’s care will be discontinued if he or she does not enroll in the study.
ʪ. a provision that the study will be carried out to completion, whether or not the device is as effective as those currently in existence.
ʫ. an onlay iliac crest bone graft.
ʬ. limited weightbearing and observation.
ʭ. removal of the implant and limited weightbearing.
ʮ. removal of the implant and insertion of a reamed femoral nail.
ʯ. removal of the implant and insertion of an unreamed femoral nail.
ʰ. Coronal
ʱ. Sagittal
ʲ. Anteromedial, midway between the sagittal and the coronal
ʳ. Proximal pins sagittal, distal pins coronal
ʴ. Proximal pins coronal, distal pins sagittal
ʵ. Rheumatoid arthritis
ʶ. Posttraumatic arthritis
ʷ. Degenerative osteoarthritis
ʸ. Osteonecrosis of the tibial plateau
ʹ. Osteonecrosis of the medial femoral condyle
ʺ. Trapeziometacarpal arthrodesis
ʻ. Osteotomy of the thumb metacarpal
ʼ. Arthrotomy and joint debridement
ʽ. Ligament reconstruction using one half of the flexor carpi radialis
ʾ. Trapezium resection, tendon interposition, and reconstruction of the ligament
ʿ. Creep
ˀ. Relaxation
ˁ. Energy dissipation
˂. Plastic deformation
˃. Elastic deformation
˄. bending
˅. axial loading
ˆ. high-speed rotation
ˇ. direct impact from anteromedial
ˈ. crush from anteromedial to posterolateral
ˉ. Increase stiffness
ˊ. Increase fracture toughness
ˋ. Increase fatigue strength
ˌ. Decrease mechanical strength
ˍ. Decrease wear rate
ˎ. disuse osteopenia
ˏ. paraendocrine effect of the tumor
ː. abnormally increased density on the right side
ˑ. side effect of the treatment of the lesion
˒. extensive tumor involvement of the left hip
˓. Sciatic nerve
˔. Superior gluteal artery
˕. Profunda femoris artery
˖. Femoral artery and nerve
˗. External iliac artery and vein
˘. Length
˙. Moment arm
˚. Total volume
˛. Physiologic cross-sectional area
˜. Distribution of slow and fast twitch fibers
˝. decreasing initiation of action potentials.
˞. increasing action potential amplitude.
˟. blocking the opening of gated sodium channels.
ˠ. decreasing the number of functional motor units.
ˡ. slowing or stopping action potential propagation through the axon.
ˢ. resection of the metatarsal heads of the first through fifth toes.
ˣ. Silastic MP joint arthroplasties of the first through fifth toes.
ˤ. fusion of the hallux MP joint and resection arthroplasty of the 2nd through fifth metatarsal heads.
˥. fusion of hallux MP joint and distal osteotomy of the 2nd through 5th MT.
˦. plantar condylectomy of the 2nd through 5th MT heads & resection of proximal phx of the hallux.
˧. hemiarthroplasty
˨. open reduction and internal fixation
˩. closed reduction and percutaneous pinning
˪. a sling and early pedulum exercises
˫. a sling and swathe for 6 weeks, followed by shoulder rehabilitation
ˬ. open acromioplasty
˭. open Bankart repair
ˮ. open subscapularis tendon repair
˯. inferior capsular shift
˰. a supervised physical therapy program
˱. a sling and swathe, with pendulum exercises in 10 days
˲. open reduction and internal fixation through an anterior approach
˳. open reduction and internal fixation through a posterior approach
˴. immobilization with a splint in 45 degrees of abduction for 6 weeks
˵. arthroscopically assisted reduction and percutaneous screw fixation
˶. Repair of the rotator cuff
˷. Replacement of the humeral head
˸. Resection arthroplasty
˹. Total shoulder arthroplasty
˺. AP and lateral radiographs of the elbow
˻. Diagnositc arthroscopy
˼. Aspiration of joint fluid
˽. An erythrocyte sedimentation rate and CBC
˾. A diagnostic lidocaine injection
˿. Insulin-like growth factor (IGF-1)
̀. Fibroblast growth factor (FGF-1)
́. Platelet-derived growth factor (PDGF)
̂. Transforming growth factor beta (TGF-B)
̃. Bone morphogenetic proteins (BMP)
̄. clinical history and radiographic findings.
̅. technetium bone scan
̆. flow cytometry pattern of extracted chondrocytes
̇. immunohistochemical staining patterns of a biopsy specimen
̈. histologic features of a biopsy specimen stained with hematoxylin-cosin
̉. Radial
̊. Radial recurrent
̋. Posterior interosseous
̌. Superior ulnar recurrent
̍. Superficial radial circumflex
̎. Impaired hydroxylation of proline
̏. Failure of cleavage in procollagen
̐. Defective binding sites for hydroxyproline
̑. Failure to incorporate glycine into the helix
̒. Diminished production of collagen through the rough endoplasmic reticulum
̓. Asking the legal staff to seek a court injunction
̔. Copying the patient’s chart and giving it to him as he leaves
̕. Having the patient sign a written legal contract that specifies acceptable behavior
̖. Continuing care of the patient until an appropriate referral can be arranged
̗. Transferring the patient to another orthopaedic surgeon without disclosing the realreason for why the patient is being transferred
̘. Meta-analysis
̙. Confidence interval
̚. Analysis of variance (ANOVA)
̛. Statistical significance (p-value)
̜. Survivorship analysis (Kaplan-Meier)
̝. Spinal shock
̞. Neurogenic shock
̟. Hypovolemic shock
̠. Pulmonary embolism
̡. Fat embolus syndrome
̢. Lumbar spinal stenosis
̣. Metastatic disease of the spine
̤. Rheumatoid lumbar spondylitis
̥. Isthmic spondyloloisthesis
̦. Degenerative spondylolisthesis at L4-5 and L5-S1
̧. Patella alta
̨. A metal-backed patella
̩. Varus malalignment of the knee
̪. A posterior cruciate-substituting femoral component
̫. Lateral subluxation of the patella on a Merchant’s view
̬. The sesamoids are separated
̭. The sesamoid is fractured
̮. The proximal phx is on the neck of the metatarsal
̯. The dislocation is dorsal and centered
̰. The proximal phalanx is hyperextended
̱. Patella
̲. Tibial stem
̳. Distal femoral interface
̴. Posterior femoral interface
̵. Sites of screw fixation for the tibia
̶. Hallux rigidus
̷. Fracture of the sesamoid
̸. Disruption of the plantar plate
̹. Osteonecrosis of the metatarsal head
̺. Rupture of the flexor hallucis longus
̻. Gout
̼. Sepsis
̽. Old trauma
̾. Rheumatoid arthritis
̿. Charcot arthroplasty
̀. Aspiration and steroid injection
́. Biopsy, curettage, and allograft bone grafting
͂. Percutaneous Kirschner wire fixation
̓. Percutaneous injection of autogenous bone marrow
̈́. Nerve roots
Ι. Spinal cord
͆. Sciatic nerve
͇. Peroneal nerve
͈. Conus medullaris
͉. Extent of bone penetrated by reaming, prosthetic components, or acrylic cement
͊. Periprosthetic regions that are accessible to joint fluid and particulate wear debris
͋. Enveloping pseudocapsular scar tissue that develops around a prosthetic hip following surgical capsulectomy
͌. Soft tissue and bone that are potentially contaminated with bacteria in the setting of a prosthetic joint infection
͍. Potential intrapelvic joint space communication created by acetabular fixation screws or intrapelvic extruded acrylic cement
͎. Early and late infection
͏. Periprosthetic fracture of the femur
͐. Failure of the patellofemoral and extensor mechanisms
͑. Aseptic loosening of cementing tibial components
͒. Asceptic loosening of cemented femoral components
͓. Acceptance of the current position of the ankle
͔. Open reduction and fixation in the epiphysis only
͕. ORIF with a small-fragment T-plate from the malleolus up to the metaphysis
͖. Closed reduction by eversion of the ankle and application of a bivalved long leg cast
͗. CRUGA and fixation with a malleolar screw from the malleolus into the metaphysis
͘. Resection arthroplasty and local radiation
͙. In situ fusion of the hip
͚. Excision of heterotopic bone, total hip arthroplasty, and oral indomethacin
͛. Excision of heterotopic bone and local radiation
͜. Excision of heterotopic bone, hemiarthroplasty, and oral indomethacin
͝. Closed reduction of both fractures and immediate spica casting
͞. Bilateral skin traction for 3 weeks, followed by spica casting
͟. External fixation of both femora
͠. External fixation of the left femur and a long leg cast brace for the right femur
͡. External fixation of the left femur and use of a reamed intramedullary nail in the right femur
͢. Synovial sarcoma
ͣ. Soft-tissue abcess
ͤ. Rhabdomyosarcoma
ͥ. Eosinophilic granuloma
ͦ. Nodular pigmented villonodular synovitis
ͧ. Changing to a titanium nail
ͨ. Changing to a nonslotted nail
ͩ. Changing the cross-sectional shape of the nail
ͪ. Increasing the diameter of the nail by 3 mm
ͫ. Increasing the diameter of the interlocking screws
ͬ. Fracture healing
ͭ. Chondrosarcoma
ͮ. Periosteal chondroma
ͯ. Periosteal osteosarcoma
Ͱ. Dysplasia epiphysealis hemimelica
Ͱ. Demonstrate competence in the subject of the case
Ͳ. Be fellowship trained in the subject of the case
Ͳ. Be paid on a contingency basis
ʹ. Be board certified by the American Board of Orthopaedic Surgery
͵. Have been involved in the case as a consultant
Ͷ. Diagnostic arthroscopy
Ͷ. Arthroscopy and subacromial decompression
͸. Reduction and fixation of the proximal humeral epiphysis
͹. Temporary cessation of throwing
ͺ. Physical therapy for rotator cuff strengthening
Ͻ. Oblique popliteal ligament
Ͼ. Lateral capsule
Ͽ. Popliteal tendon
;. Fibular collateral ligament
Ϳ. Posterior oblique ligament
΀. Radial tear
΁. Parrot-beak tear
΂. Vertical tear in the “red-red” zone
΃. Vertical tear in the “red-white” zone
΄. Vertical tear in the “white-white” zone
΅. 0 degrees of abduction, with neural rotation
Ά. 40 degrees of flexion and 60 degrees of internal rotation
·. 45 degrees of flexion and 45 degrees of external rotation
Έ. 90 degrees of abduction with neutral rotation
Ή. 90 degrees of abduction and 90 degrees of external rotation
Ί. Sural
΋. Saphenous and its branches
Ό. Posterior tibial and its branches
΍. Deep peroneal and its branches
Ύ. Superficial peroneal and its branches
Ώ. Strength
Ϊ́. Stiffness
Α. Shelf life
Β. Antigenicity
Γ. Risk of HIV transmission
Δ. Indemnification
Ε. Occurrence
Ζ. Excess liability
Η. Claims-made
Θ. Nose
Ι. Lateral Y
Κ. Scapular AP
Λ. Neutral rotation AP
Μ. Internal rotation AP
Ν. External rotation AP
Ξ. Trauma
Ο. Hemophilia
Π. Reiter’s syndrome
Ρ. Rheumatoid arthritis
΢. Systemic lupus erythematosus
Σ. Cast immobilization for 6 weeks
Τ. Activity modification and re-evaluation in 2 months
Υ. Internal fixation with or without bone grafting
Φ. Retrograde drilling of the defect without articular cartilage penetration
Χ. Drilling of the defect directly through the articular cartilage
Ψ. repair or reconstruction of the medial collateral ligament
Ω. repair or reconstruction of the medialand lateral collateral ligaments
Ϊ. immobilization for 5 days or less
Ϋ. immobilization for 14 days
Ά. immobilization for 25 days
Έ. Cystinosis
Ή. Hypophosphatemia
Ί. Renal osteodystrophy
Ϋ́. Primary hyperparathyroidism
Α. Nutritional vitamin D deficiency
Β. Lateral meniscus tear
Γ. Popliteus tenosynovitis
Δ. Iliotibial band friction syndrome
Ε. Peroneal nerve entrapment
Ζ. Biceps tendinitis
Η. Observation
Θ. Removal of the prosthetic components
Ι. Operative exploration and decompression of the peroneal nerve
Κ. Nerve conduction velocity studies
Λ. Loosening of the primary dressings and knee flexion to 30 degrees
Μ. I
Ν. II
Ξ. III
Ο. decreased tissue tension
Π. decreased abductor lever arm
Ρ. decreased joint reaction force
Σ. increased body weight over lever arm
Σ. increased polyethylene wear rate
Τ. recurrent traumatic anterior dislocation
Υ. recurrent traumatic posterior dislocation
Φ. traumatic subluxation with no previous dislocation
Χ. traumatic anterior subluxation
Ψ. atraumatic involuntary subluxation
Ω. radial
Ϊ. axillary
Ϋ. suprascapular
Ό. thoracodorsal
Ύ. long thoracic
Ώ. Flexion
Ϗ. Extension
Β. Axial rotation
Θ. Left lateral bending
ϒ. Right lateral bending
ϓ. Skin
ϔ. Lung
Φ. Brain
Π. Heart
Ϗ. Kidney
Ϙ. Thoracoacromial, lateral thoracic, subscapular
Ϙ. Thoracoacromial, anterior humeral circumflex, posterior humeral circumflex
Ϛ. Posterior humeral circumflex, subscapular, thoracacromial
Ϛ. Subscapular, thoracacromial, anterior humeral circumflex
Ϝ. Lateral thoracic, anterior humeral circumflex, thoracacromial
Ϝ. Respondeat superior
Ϟ. Indemnity agreement
Ϟ. Hold harmless agreement- attempt to shift liability from company to physician
Ϡ. Comparative negligence-% of involvement
Ϡ. Contributory negligence- resident contributed to the negligence
Ϣ. t-type
Ϣ. both column
Ϥ. transverse
Ϥ. anterior column
Ϧ. anterior column posterior hemitransverse
Ϧ. Posterior interosseous
Ϩ. Anterior interosseous
Ϩ. Radial
Ϫ. Median
Ϫ. Ulnar
Ϭ. Shock from hypovolemia
Ϭ. Associated rupture of the bladder
Ϯ. Arterial bleeding on pelvic angiogram
Ϯ. Presence of a hematoma in the perineum and scrotum
Κ. Fractures of both the anterior and posterior pelvic ring

Correct Answer & Explanation

. Injury to the subclavian artery


Explanation

Question 4077

Topic: 10. Pathology and Oncology

  • Figure11 shows the shoulder radiograph of a 52-year-old woman who has severe pain in the shoulder as a result of a bicycle accident 9 months ago. Management should consist of

. humeral arthroplasty2/. repair of the rotator cuff
. closed reduction and immobilization
. open reduction and immobilization
. open reduction and early passive motion
. arthroscopic capsular release
. manipulation under anesthesia
. a physical therapy program
. an intra-articular corticosteroid injection
. administration of high-dose oral corticosteroids
. adding the scores, in all five body systems
. adding the squares of the scores in the three most severely injured systems
. doubling the cumulative score for head and chest injuries
. combining the scores from the most and least injured systems
. correcting the score in the most severely injured system for age
. traumatic femoral head fracture
. osteonecrosis
. osteoarthritis
. neuropathic joint
. rheumatoid arthritis
. low-dose radiation
. steroid injection
. a load-relieving insert and shoe modification
. complete excision of the mass and the entire plantar fascia
. wide excision of the mass with a 2 cm margin of normal fascia
. CT scan of the chest
. technetium bone scan
. bone marrow aspiration
. serum protein electrophoresis
. lateral skull radiograph
. high-grade histology of the initial tumor
. multiple local recurrences after curettage
. previous treatment of the tumor with cryotherapy
!. previous treatment of the tumor with radiation therapy
". extraosseous extension into two or more adjacent compartments
#. Dorsal rhizotomy and facet joint fusion
$. Multilevel corpectomy and spinal stabilization
%. Central and lateral recess decompression and bilateral foraminotomy
&. Central decompression and facet joint fusion
'. Central decompression, foraminotomy, and spinal fusion from L2 to L5.
(. Inadequate rehabilitation
). Displacement of the coronoid process fracture
*. Insufficiency of the lateral ulnar collateral ligament
+. Insufficiency of the anterior band of the medial collateral ligament
,. Insufficiency of the posterior band of the medial collateral ligament
-. Osteotomy and intramedullary rod fixation
.. Electrical stimulation
/. Strut-autografing the concavity the tibia
0. A patellar tendon-bearing brace
1. Percutaneous injection of demineralized bone matrix
2. digoxin
3. sucralfate
4. clindamycin
5. alcohol
6. neuromuscular blocking agents
7. Unrestrained roll-back
8. Unrestrained rotational conformity
9. Medial-Lateral conformity
:. Anteroposterior conformity in flexion
;. Anteroposterior conformity in extension
<. Arthrodesis of the MTP joint
=. A Silastic implant of the MTP joint
>. Resection arthroplasty of the MTP joint
?. Cheilctomy of the MTP joint
@. Osteotomy of the base of the proximal phalanx
A. Genu varum
B. Tarsal coalition
C. Degenerative ankle arthrosis
D. Osteochondritis dissecans of the talus
E. Hemihypertrophy of the ipsilateral lower extremity
F. Trabecular bone is preferentially resorbed in this high bone turnover state
G. Loss of water content in the disk increases impact load to the vetrebral bodies
H. Stress is imposed by the relative stiffness of the arthrtic facet joints
I. Increased energy demands are imposed by decreased circulation to the vertebral body
J. The thick cortical bone found in the vertebral body resorbs rapidly following estrogen withdrawal
K. Increased time in stance and swing phase
L. Addition of a double leg float phase
M. Decreased vertical ground reaction forces
N. Decreased arc of motion in the hip, knee, and ankle
O. Decreased joint reaction forces in the hip, knee, and ankle
P. Talonavicular arthrodesis
Q. Medial displacement calcaneal osteotomy
R. Flexor digitorum longus tendon transfer with spring ligament advancement
S. Triple arthrodesis
T. Calcaneocuboid distraction arthrodesis and repair of the posterior tibial tendon
U. Lymphoma
V. Hemangioma
W. Osteosarcoma
X. TB of the spine
Y. Metastatic breast carcinoma
Z. widening and shortening of the heel.
[. weakness of the gastrocnemius-soleus complex.
\. anterior impingement from a horizontal talus.
]. unrecognized compartment syndrome of the foot.
^. degenerative arthritis of the tibiotalar joint.
_. a corrective osteotomy
`. application of braces
A. medial physeal stapling until the varus corrects
B. observation
C. application of corrective casts
D. a total contact cast.
E. electrical stimulation.
F. an off the shelf fracture brace.
G. an elastic compression bandage and crutches.
H. a hard soled shoe until the patient is asymptomatic.
I. Ewings tumor
J. Parosteal osteosarcoma
K. Dedifferentiated chondrosarcoma
L. Low grade intramedullary chondrosarcoma
M. High grade intramedullary osteosarcoma
N. Vascular injury
O. Tear of the rotator cuff
P. Injury to the brachial plexus
Q. Fracture of the upper thoracic rib
R. Fracture of the proximal humerus
S. Biceps
T. Trapezius
U. Infraspinatus
V. Pectoralis major
W. Serratus anterior
X. Hybrid total hip arthroplasty
Y. Noncemental hemiarthroplasty of the hip
Z. Closed reduction and percutaneous pin fixation
{. Open reduction through an anterior approach to the hip
|. Excision of the head fragment
}. a quadratus femoris pediclebone graft
~. a proximal femoral allograft
. intertrochanteric osteotomy
€. total hip arthroplasty
. hip hemiarthroplasty
‚. Echocardiogram
ƒ. Electrocardiogram
„. Radiograph of the chest
…. CT scan of the shoulder
†. Ultrasound of the shoulder
‡. Ilioinguinal
ˆ. Extended iliofemoral
‰. Combined ilioinguinal and Kocher-Langenbeck (posterior)
Š. Kocher-Langenbeck (posterior)
‹. Kocher-Langenbeck (posterior) with trochanteric osteotomy
Œ. Deltoid
. Supraspinatus
Ž. Subscapularis Infraspinatus
. Infraspinatus
. Infraspinatus and teres minor
‘. an orthosis.
’. observation.
“. electrical stimulation.
”. open reduction and internal fixation.
•. application of a nonweightbearing short leg cast.
–. repair of the rotator cuff.
—. rehabilitation of the shoulder
˜. replacement of the humeral head.
™. arthroscopic acromioplasty and debridement.
š. immobilization is a sling until pain resolves.
›. Bone rotation versus torque applied
œ. Bone deflection versus bending moment applied
. Axial displacement versus tension applied
ž. Lateral translation versus shear force applied
Ÿ. Fracture gap closing versus compressive force applied
 . steroid injection
¡. stretching of the heel cord
¢. surgical release of the plantar fascia
£. application of a short leg cast for 6 to 8 weeks
¤. wearing dorsiflexion night splints
¥. Open bladder
¦. Bilateral “hitchhiker’s” thumbs
§. Bilateral defects in the midclavicles
¨. Rhizomelic shortening of the extremities
©. Radiographic fragmentation of all major epiphyses
ª. Medial patellotibial
«. Medial patellofemoral
¬. Medial patellomeniscal
­. Lateral patellofemoral
®. Lateral patellotibial
¯. Heat
°. Gentle active flexion-extension exercises
±. Isokinetic strengthening
². Electrical muscle stimulation
³. Immobilization of the limb with the knee in full flexion
´. Distal chevron osteotomy with soft-tissue release
Μ. Distal soft-tissue realignment only
¶. Closing wedge osteotomy (Aken) of the proximal phalanx
·. Proximal first metatarsal osteotomy only
¸. Soft-tissue realignment with a proximal metatarsal osteotomy
¹. Vagus
º. Phrenic
». Hypoglossal
¼. Recurrent laryngeal
½. Inferior thyroid
¾. Surgical exploration
¿. Application of leeches
À. Stellate ganglion blocks
Á. Intra-arterial streptokinase
Â. Elevation and reevaluation in 1 hour
Ã. Liver profile
Ä. Myleogram
Å. Platelet count
Æ. CT scan of the head
Ç. Angiogram of the extremity
È. Post spinal fusion from L5to S1
É. Primary repair with an iliac bone graft
Ê. Post spinal fusion of L4-5
Ë. A pantaloon body cast and 6 weeks of bed rest
Ì. Rest, NSAIDS, and limited dancing
Í. Stress fracture of the proximal fifth metatarsal
Î. Stress fracture of the base of the second metatarsal
Ï. Stress fracture of the neck of the second metatarsal
Ð. Morton’s neuroma
Ñ. Lisfranc’s joint subluxation
Ò. C5 radiculopathy
Ó. Subscapularis rupture
Ô. Glenohumeral arthrosis
Õ. Rotator cuff arthropathy
Ö. Suprascapular nerve compression at the spinoglenoid notch
×. mm femoral head in combination with a metal-backed polyethylene component
Ø. mm femoral head in combination with an all-polyethylene acetabular component
Ù. mm femoral head in combination with a metal-backed polyethylene component
Ú. mm femoral head in combination with an all-polyethylene component
Û. mm femoral head in combination with a metal-backed polyethylene component
Ü. Female gender
Ý. History of cigarette smoking
Þ. L5-S1 spondylolisthesis on pre-employment radiography
SS. Decreased strength of the lower extremities on pre-employment testing
À. Decreased flexibility of the lumbar spine on pre-employment testing
Á. Size of cells
Â. Amount of DNA in cells
Ã. Nucleus-cytoplasm ratio
Ä. Specific DNA sequences
Å. Specific messenger RNA sequences
Æ. Femoral and obturator nerves
Ç. Femoral and superior gluteal nerves
È. Femoral and lateral femoral cutaneous nerves
É. Obturator and superior gluteal nerves
Ê. Obturator and lateral femoral cutaneous nerves
Ë. Isotonic
Ì. Isokinetic
Í. Isometric
Î. Open kinetic chain
Ï. Dynamic variable resistance
Ð. Closed reduction and cast immobilization
Ñ. Uniplanar external fixation
Ò. Open reduction and internal fixation with a dynamic compression plate
Ó. Unreamed intramedullary rod
Ô. Multiple plane external fixator
Õ. Inlet view of the pelvis
Ö. Outlet view of the pelvis
÷. AP view of the hip
Ø. Ilial oblique view (external oblique) of the hip
Ù. Obturator oblique
Ú. Glycolytic pathway
Û. Oxidative phosphorylation
Ü. Breakdown of fat
Ý. Breakdown of protein
Þ. Breakdown of adenosine triphosphate
Ÿ. an MRI scan
Ā. arthroscopic examination
Ā. AP and frog-lateral radiographs of the pelvis and hips
Ă. varus and valgus stress radiographs of the knee
Ă. physical examination of the knee under anesthesia
Ą. extended curettage and polymethylmethacrylate cementation
Ą. extra-articular resection of the knee and an allograft arthrodesis
Ć. wide resection of the proximal tibia and custom prosthetic replacement
Ć. prophylactic internal fixation and postoperative irradiation
Ĉ. excision of the lateral condyle and reconstruction with a hemicondylar allograft
Ĉ. silicone implant joint replacement
Ċ. metatarsophalangeal joint arthrodesis
Ċ. metatarsophalangeal joint debridement
Č. resection of the metatarsal head
Č. resection of the base of the proximal phalanx
Ď. Fixation of the syndesmosis has failed
Ď. Widening of the ankle mortise has led to the failure of fixation
Đ. Infection around the syndesmosis screw has led to osteomyelitis
Đ. The syndesmosis screw is broken
Ē. Motion between the tibia and fibula has caused loosening of the syndesmosis screw
Ē. Microcephaly
Ĕ. A temporal lobe cyst
Ĕ. An Arnold-Chiari type 1 malformation
Ė. Periventricular leukomalacia
Ė. Agnesis of the corpus callosum
Ę. Wolff’s
Ę. Hooke’s
Ě. Hilton’s
Ě. Muller-Haeckel
Ĝ. Heuter-Volkmann
Ĝ. Both the anterolateral and posteromedial bands are isometric and do not significantly change with flexion
Ğ. The anterolateral band is lax and becomes tight in flexion, while the posteromedial band is tight, and becomes lax in flexion
Ğ. The anterolateral band is tight and becomes lax in flexion, while the posteromedial band is lax and becomes tight in flexion
Ġ. Both the anterolateral and posteromedial bands are lax and become tight in flexion
Ġ. Both the anterolateral and posteromedial bands are tight and become lax as the knee is flexed
Ģ. UCB orthosis
Ģ. Rigid orthosis with a medical arch support
Ĥ. Semi-rigid orthosis with lateral forefoot posting
Ĥ. Semi-rigid orthosis with a medial arch support
Ħ. Medial heel wedge attached to the running shoes
Ħ. Hallux varus
Ĩ. Osteonecrosis
Ĩ. Recurrence of the hallux valgus
Ī. “Transfer” second metatarsalgia
Ī. Physeal arrest of the first metatarsal
Ĭ. Aseptic loosening in a 70-year-old patient
Ĭ. Mechanical failure of a hinged knee prosthesis
Į. Failed knee replacement complicated by reflex sympathetic dystrophy
Į. Infection with soft-tissue deficit
İ. A prior patellectomy
I. Knee fusion
IJ. Open irrigation and debridement
IJ. Arthroscopic irrigation and debridement
Ĵ. One-stage exchange arthroplasty
Ĵ. Two-stage exchange arthroplasty
Ķ. Putti-platt repair
Ķ. Open Bankart repair
ĸ. Injection of a subacromial corticosteroid
Ĺ. Arthroscopic transglenoid capsular shift
Ĺ. Rehabilitation of the scapular and rotator cuff muscles
Ļ. Silicone suction socket and an energy-absorbing foot
Ļ. Silicone suction socket and a variable resistance ankle
Ľ. Plastic suction socket, telescoping pylon, and a solid ankle cushioned heel (SACH) foot
Ľ. Plastic socket with a hinged thigh cuff and a SACH foot
Ŀ. Patellar tendon-bearing suction socket and a uniaxial hydraulic ankle
Ŀ. Parosteal
Ł. Periosteal
Ł. High-grade intramedullary
Ń. Osteosarcoma occurring in Paget’s disease
Ń. Osteosarcoma occurring in irradiated bone
Ņ. Cauda equina
Ņ. Conus medullaris
Ň. Genitofemoral nerve
Ň. Lumbar sympathetic plexus
ʼN. Lumbar parasympathetic plexus
Ŋ. Spinal pseudoarthrosis
Ŋ. Spinal cord traction injury with paralysis
Ō. Arterial and venous thromboses
Ō. Superior mesenteric artery syndrome
Ŏ. Crankshaft phenomenon
Ŏ. Inversion stress radiograph
Ő. MRI scan
Ő. CT scan
Œ. Nuclear bone scan
Œ. External rotation stress radiograph
Ŕ. Complex deformity with an angulation in two planes
Ŕ. Single deformity less than 20 degrees, apex posterolateral
Ŗ. Single deformity greater than 30 degrees, apex posterolateral
Ŗ. Single deformity less than 20 degrees, apex posteromedial
Ř. Single deformity greater than 30 degrees, apex posteromedial
Ř. Pronation of the foot during the stance phase of gait
Ś. Heel inversion at the beginning of a single limb heel rise
Ś. Active inversion of the nonweightbearing foot
Ŝ. Active plantar flexion of the first ray against resistance
Ŝ. Active plantar flexion of the foot during the push-off phase of gait
Ş. Observation and repeat radiographs in 4 months
Ş. Application of a thoracolumbalsacral orthosis for 22 to 24 hours per day
Š. Electrical stimulation at night
Š. Physical therapy
Ţ. Begins to remodel and hypertrophy more quickly
Ţ. Provides a better scaffold for osteoconduction
Ť. Reduces the risk of early fracture
Ť. Reduces technical difficulty
Ŧ. Lowers donor site morbidity
Ŧ. Anterior fusion of the lumbar curve
Ũ. Anterior and posterior fusion of the thoracic curve
Ũ. Posterior fusion of the thoracic curve
Ū. Posterior fusion of the thoracic and lumbar curves
Ū. Application of a brace until the iliac apophyses are Risser 4 or 5, followed by surgical correction
Ŭ. Subscapularis rupture
Ŭ. Type III SLAP lesion
Ů. Disruption of capsular shift
Ů. Isolated traumatic subluxation
Ű. Injury to the axillary nerve after dislocation
Ű. hypophosphatemia
Ų. high dietary cholesterol intake
Ų. deficiency of lipoprotein A
Ŵ. deficiency of protein S and protein C
Ŵ. elevated levels of antithrombin III
Ŷ. Weightbearing short leg cast
Ŷ. Nonweightbearing short leg cast
Ÿ. Removable splint and early motion
Ź. Open reduction and internal fixation
Ź. Elastic compression bandage with full weightbearing
Ż. Breast
Ż. Prostate
Ž. Gastrointestinal
Ž. Kidney
S. Multiple myeloma
Ƀ. Varus stress
Ɓ. Valgus stress
Ƃ. Torsional loading
Ƃ. Hyperextension of the knee
Ƅ. Contraction of the quadriceps while axially loaded
Ƅ. Primary internal fixation at both fracture levels
Ɔ. External fixation as definitive ttt for both #
Ƈ. Skeletal traction and delayed internal fixation of both fractures
Ƈ. Primary internal fixation of the proximal fracture and delayed fixation of the femoral fracture
Ɖ. Primary internal fixation of the femoral shaft fracture and delayed fixation of the proximal #
Ɗ. Heel spur
Ƌ. Plantar fascitis
Ƌ. Dysfunction of the tibialis posterior tendon
ƍ. Compression of the first branch of the lateral plantar nerve
Ǝ. Compression of the calcaneal nerve
Ə. Displaced labral tear
Ɛ. Tear of the rotator cuff
Ƒ. Fracture of the glenoid rim
Ƒ. Palsy of the axillary nerve
Ɠ. Palsy of the musculocutaneus nerve
Ɣ. Enchondroma
Ƕ. Osteoblastoma
Ɩ. Giant cell tumor
Ɨ. Aneurysmal bone cyst
Ƙ. Fibrous dysplasia
Ƙ. Arthrogram of the wrist
Ƚ. MRI scan of both wrists
ƛ. CT scan of both wrists in the same position
Ɯ. Radiographs of the wrist in supination and pronation
Ɲ. Radiographs of the opposite wrist in the same position
Ƞ. Secondary hyperparathyroidism
Ɵ. Phosphate retention secondary to uremia
Ơ. Insufficient renal synthesis of 1, 25 dihydroxy vitamin D
Ơ. Aluminum deposition in bone from oral phosphate binders
Ƣ. Persistent acidosis aggravating the negative calcium balance
Ƣ. Posterior fusion at T10-L3 with segmental instrumentation
Ƥ. Laminectomy and fusion of T12-L2 with segmental instrumentation
Ƥ. Bed rest in a hyperextension brace
Ʀ. L1 vertebrectomy and anterior decompression with strut graft fusion and instrumentation
Ƨ. Progressive ambulation as tolerated in a custom-molded thoracolumbosacral orthosis
Ƨ. Positive-pressure ventilation
Ʃ. An immediate radiograph of the chest
ƪ. Adjustment of the position of the endotrachael tube
ƫ. Insertion of a large-bore needle into the pericardial space
Ƭ. Insertion of a large-bore needle in the right second intercostal space, midclavicular line
Ƭ. Allowing the ends of the fracture to touch
Ʈ. Adding a second connecting bar
Ư. Adding one pin to each fracture fragment
Ư. Increasing the pin diameter from 4 mm to 6 mm
Ʊ. Decreasing the connecting bar-to-bone distance from 6 cm to 4 cm
Ʋ. Osteomyelitis
Ƴ. Malignant degeneration
Ƴ. Stress fracture
Ƶ. Local recurrence of the giant cell tumor
Ƶ. Bone resorption due to methylmethacrylate
Ʒ. Advancement of the plantar plate
Ƹ. Resection of the second metatarsal head
Ƹ. Dorsiflexion osteotomy of the second metatarsal neck
ƺ. Transfer of the flexor digitorum longus tendon to the dorsum of the toe
ƻ. Transfer of the extensor digitorum comminus tendon to the metatarsal neck
Ƽ. Sacral fracture
Ƽ. Burst fracture of L5
ƾ. Cauda equina syndrome
Ƿ. Distraction-flexion injury at L3
ǀ. Distraction-extension injury at L3
ǁ. An MRI scan of the shoulder
ǂ. An MRI scan of the cervical spine
ǃ. Electromyographic and nerve conduction velocity studies
DŽ. Immobilization in a sling and early passive range of motion exercises
DŽ. Immediate return to the operating room for exploration of the brachial plexus
DŽ. cerclage wiring
LJ. tension band wiring
LJ. removal of the patellar component
LJ. revision of the patellar component
NJ. immobilization of the knee and protected weightbearing
NJ. Liposarcoma
NJ. Nodular fasciitis
Ǎ. Rabdomyosarcoma
Ǎ. Malignant fibrous histiocytoma
Ǐ. Extra-abdominal desmoid tumor
Ǐ. Clubfeet
Ǒ. Thrombocytopenia
Ǒ. Congenital scoliosis
Ǔ. Ventricular septal defect
Ǔ. Arnold-Chiari malformation
Ǖ. delayed primary closure
Ǖ. free flap
Ǘ. pedicle groin flap
Ǘ. full-thickness skin graft
Ǚ. split-thickness skin graft
Ǚ. Infection
Ǜ. Nonunion
Ǜ. Improper screw length
Ǝ. Osteonecrosis of the distal fragment
Ǟ. Use of a cortical screw instead of a cancellous screw
Ǟ. Infection
Ǡ. Tear of the rotator cuff
Ǡ. Loosening of the humeral component
Ǣ. Arthritis of the glenoid
Ǣ. Arthritis of the A-C joint
Ǥ. Reduced morbidity
Ǥ. Improved osteoinduction
Ǧ. Improved osteoconduction
Ǧ. More rapid revascularization
Ǩ. Lower risk of disease transmission
Ǩ. Manipulation Under Anesthesia
Ǫ. Arthroscopic acromioplasty
Ǫ. Arthroscopic debridement of G-H joint
Ǭ. Replacement of the humeral head
Ǭ. Lengthening of the subscapularis and release of the anterior capsule
Ǯ. Bacteroides
Ǯ. E. coli
J̌. Staph. aureus
DZ. group A streptococcus
DZ. Clostridium perforingens
DZ. observation and exercises
Ǵ. bracing with a thoracolumbar orthosis
Ǵ. fusion of the posterior spine
Ƕ. fusion of the anterior spine
Ƿ. fusion of the anterior and posterior spine
Ǹ. Total wrist replacement and bridge grafts
Ǹ. palmar shelf arthroplasty and tendon transfers
Ǻ. Darrach distal ulna resection, dorsal tenosynosynovectomy, and tendon transfers
Ǻ. Radioscaphate fusion, extensor tenodesis, and Darrach distal ulna resection
Ǽ. Total wrist fusion and tendon transfers
Ǽ. constrained acetabular component
Ǿ. protrusion ring with morselized graft
Ǿ. cemented metal backed acetabular component
Ȁ. cemented all-polyethylene acetabular component
Ȁ. cementless hemispherical component with screw fixation
Ȃ. application of a hip abduction brace for 22 hours per day
Ȃ. application of a hip spica under anesthesia
Ȅ. discontinuance of all bracing and repeat radiographs in 3 months
Ȅ. open reduction of the hip and application of a spica cast
Ȇ. open reduction, varus osteotomy, and application of a spica cast
Ȇ. Loss of skin hair on the feet
Ȉ. Absent pulses on vascular examination
Ȉ. Pain that originates proximally and spreads distally
Ȋ. Pain that is relieved by stopping and standing
Ȋ. Pain that is worse when the patient walks uphill rather downhill
Ȍ. wrist flexors and finger flexors
Ȍ. elbow flexors and wrist flexors
Ȏ. elbow flexors and finger flexors
Ȏ. elbow extensors and wrist flexorst Level Key Muscles4 DiaphragmDeltoid, elbow flexors, diaphragmElbow flexors, wrist extensorsElbow extensors, wrist flexorsFinger flexors (distal phalanx of middlefinger)Finger abductors (5th digit), intrinsics of hand2 Segmental innervation to intercostal muscles, abdominal and paraspinal muscles) L1, L2, L3 Hip flexors3, L4 QuadricepsTibialis anteriorToe extensors, hip abductorsAnkle plantarflexors, peronei
Ȑ. elbow extensors and wrist extensors
Ȑ. Syndactyly
Ȓ. Macrodactyly
Ȓ. Camptodactyly
Ȕ. Preaxial polydactyly
Ȕ. Postaxial polydactyly
Ȗ. Arthrodesis
Ȗ. Rotationplasty
Ș. Above-knee amputation
Ș. Osteoarticular allograft
Ț. Endoprosthesis (custom arthroplasty)
Ț. Plantar fascia
Ȝ. Spring ligament
Ȝ. Deltoid ligament
Ȟ. Intrinsic tendons
Ȟ. Gastorcnemius-solelus complex
Ƞ. Prevention of presynaptic release of acetylcholine
ȡ. Prevention of synthesis of presynaptic acetylcholine
Ȣ. Activation of acetylcholinesterase at the motor end-plate
Ȣ. Blockage of postsynaptic action of acetylcholine until reserves are depleted
Ȥ. Stimulation of release of presynaptic acetylcholine until reserves are depleted
Ȥ. stiffness of the femoral component.
Ȧ. head offset of the femoral component.
Ȧ. femoral component material modulus of elasticity.
Ȩ. extent of the femoral component porous coating.
Ȩ. Presence of a femoral component collar.
Ȫ. plantar fascia and quadratus plantae tendon.
Ȫ. ligamentous structures connecting the tarsal bones.
Ȭ. shape of the tarsal bones and the intervening joints.
Ȭ. activity of the intrinsic muscles of the foot.
Ȯ. activity of the posterior tibialis and the peroneus longus muscles.
Ȯ. scapulothoracic fusion
Ȱ. strengthening of the periscapular muscles
Ȱ. pectoralis minor-fascia lata graft transfer to the scapula
Ȳ. pectoralis major-fascia lata graft transfer to the scapula
Ȳ. exploration of the long thoracic nerve, with sural nerve graft
ȴ. tricompartmental knee replacement
ȵ. unicompartmental knee replacement
ȶ. medial compartment meniscal allograft
ȷ. valgus-producing distal femoral osteotomy
ȸ. valgus-producing proximal tibial osteotomy
ȹ. Internal rotation of the femoral component
Ⱥ. External rotation of the tibial component
Ȼ. Lateral placement of the femoral component
Ȼ. Medial placement of the patellar component
Ƚ. Excessive resection of the patella
Ⱦ. Hallux rigidus
Ȿ. Hallux valgus
Ɀ. Neuroma of the first web space
Ɂ. Fracture of the sesamoid
Ɂ. Rupture of the flexor hallucis longus
Ƀ. Sickle cell crisis
Ʉ. Idiopathic chondrolysis
Ʌ. Hemophilic arthropathy
Ɇ. Osteoid osteoma of the femoral neck
Ɇ. Legg-Calve-Perthes disease
Ɉ. Decreased ankle jerk and positive femoral nerve stretch test
Ɉ. Decreased knee jerk and positive straight-leg raising sign
Ɋ. Gastrocnemius-soleus complex weakness and positive straight-leg raising sign
Ɋ. Weakness of the extensor hallucis longus and positive straight-leg raising sign
Ɍ. Weakness of the extensor hallucis longus and positive femoral nerve stretch test
Ɍ. Long-term administration of IV and oral antibiotics
Ɏ. Open soft-tissue debridement, retention of prosthetic components, and IV antibiotics
Ɏ. Immediate exchange arthroplasty with antibiotic-impregnated cement
Ɐ. Two-stage surgical prosthetic exchange and IV antibiotics
Ɑ. Resection arthroplasty and IV antibiotics
Ɒ. SCFE
Ɓ. MED
Ɔ. Perthes disease
ɕ. Hypothyroidism
Ɖ. Chondrolysis
Ɗ. gout.
ɘ. osteoporosis.
Ə. eosinophilic granuloma.
ɚ. tuberculosis of the spine.
Ɛ. metastatic disease of the spine.
Ɜ. water content.
ɝ. Synthesis of type I collagen.
ɞ. Proteoglycan content.
ɟ. Activity of chondrocytes.
Ɠ. Synthesis of hyaluronate.
Ɡ. Lung
ɢ. Breast
Ɣ. Prostate
ɤ. Thyroid
Ɥ. Renal
Ɦ. T1-low, T2-low.
ɧ. T1-low, T2-high.
Ɨ. T1-moderate, T2-low.
Ɩ. T1-high, T2-low.
Ɪ. T1-high, T2-high.
Ɫ. hypothesis is incorrect or invalid
Ɬ. interobserver error rate is 4%.
ɭ. Standard deviation is 4% higher or lower than the mean.
ɮ. Sample size is 4% larger than required to be clinically significant.
Ɯ. Probability that the differences noted between two study groups were due to chance alone is 4%.
ɰ. I
Ɱ. II
Ɲ. IV
ɳ. IX
ɴ. X
Ɵ. Cranial setting
ɶ. Cranial subluxation
ɷ. Odontoid fracture
ɸ. Lysis of the arch of the atlas
ɹ. Atlantoaxial subluxation
ɺ. Retrograde collapse of the endoneurial tubes
ɻ. Irreversible atrophy of the denervated muscles
ɼ. Elongation of the axons across the zone of injury
Ɽ. Sprouting of the axons at the neuromuscular junction
ɾ. Misdirection of the axons across the zone of injury
ɿ. Maximally pronated and elbow extended
Ʀ. Maximally pronated and the elbow flexed
ʁ. Maximally supinated and the elbow flexed
Ʂ. Maximally supinated and the elbow extended
Ʃ. In neutral rotation, with the elbow extended
ʄ. open reduction and internal fixation
ʅ. buddy taping to the adjacent index finger
ʆ. early motion with application of a dynamic banjo splint
Ʇ. application of a cast with the hand in a “safe position” for 3 weeks.
Ʈ. dorsal extension block splinting
Ʉ. The name of the manufacturer
Ʊ. The manufacturer’s potential liability
Ʋ. The physician’s clinical performance
Ʌ. The physician’s materials testing data
ʍ. Any royalties the physician receives from the manufacturer
ʎ. Femoral
ʏ. Obturator
ʐ. Inferior gluteal
ʑ. Superior gluteal
Ʒ. Lateral femoral cutaneous
ʓ. open biopsy and a long leg cast
ʔ. open biopsy and wide resection of the tumor
ʕ. a long leg cast and observation
ʖ. intramedullary stabilization and observation
ʗ. Triggering
ʘ. Lateral instability
ʙ. Swan-neck deformity
ʚ. Boutonniere deformity
ʛ. Loss of distal interphalangeal joint flexion
ʜ. Peroneus brevis to peroneus longus
Ʝ. Peroneus tertius to extensor hallucis longus
Ʞ. Peroneus tertius to superficial peroneal nerve
ʟ. Extensor hallucis longus to deep peroneal nerve
ʠ. Extensor hallucis longus to extensor digitorum longus
ʡ. reassurance that Medicare will pay for the treatment.
ʢ. consent forms that patients or their guardians are able to understand.
ʣ. a detailed description of the device, omitting the fact that it is part of a study.
ʤ. a provision that the patient’s care will be discontinued if he or she does not enroll in the study.
ʥ. a provision that the study will be carried out to completion, whether or not the device is as effective as those currently in existence.
ʦ. an onlay iliac crest bone graft.
ʧ. limited weightbearing and observation.
ʨ. removal of the implant and limited weightbearing.
ʩ. removal of the implant and insertion of a reamed femoral nail.
ʪ. removal of the implant and insertion of an unreamed femoral nail.
ʫ. Coronal
ʬ. Sagittal
ʭ. Anteromedial, midway between the sagittal and the coronal
ʮ. Proximal pins sagittal, distal pins coronal
ʯ. Proximal pins coronal, distal pins sagittal
ʰ. Rheumatoid arthritis
ʱ. Posttraumatic arthritis
ʲ. Degenerative osteoarthritis
ʳ. Osteonecrosis of the tibial plateau
ʴ. Osteonecrosis of the medial femoral condyle
ʵ. Trapeziometacarpal arthrodesis
ʶ. Osteotomy of the thumb metacarpal
ʷ. Arthrotomy and joint debridement
ʸ. Ligament reconstruction using one half of the flexor carpi radialis
ʹ. Trapezium resection, tendon interposition, and reconstruction of the ligament
ʺ. Creep
ʻ. Relaxation
ʼ. Energy dissipation
ʽ. Plastic deformation
ʾ. Elastic deformation
ʿ. bending
ˀ. axial loading
ˁ. high-speed rotation
˂. direct impact from anteromedial
˃. crush from anteromedial to posterolateral
˄. Increase stiffness
˅. Increase fracture toughness
ˆ. Increase fatigue strength
ˇ. Decrease mechanical strength
ˈ. Decrease wear rate
ˉ. disuse osteopenia
ˊ. paraendocrine effect of the tumor
ˋ. abnormally increased density on the right side
ˌ. side effect of the treatment of the lesion
ˍ. extensive tumor involvement of the left hip
ˎ. Sciatic nerve
ˏ. Superior gluteal artery
ː. Profunda femoris artery
ˑ. Femoral artery and nerve
˒. External iliac artery and vein
˓. Length
˔. Moment arm
˕. Total volume
˖. Physiologic cross-sectional area
˗. Distribution of slow and fast twitch fibers
˘. decreasing initiation of action potentials.
˙. increasing action potential amplitude.
˚. blocking the opening of gated sodium channels.
˛. decreasing the number of functional motor units.
˜. slowing or stopping action potential propagation through the axon.
˝. resection of the metatarsal heads of the first through fifth toes.
˞. Silastic MP joint arthroplasties of the first through fifth toes.
˟. fusion of the hallux MP joint and resection arthroplasty of the 2nd through fifth metatarsal heads.
ˠ. fusion of hallux MP joint and distal osteotomy of the 2nd through 5th MT.
ˡ. plantar condylectomy of the 2nd through 5th MT heads & resection of proximal phx of the hallux.
ˢ. hemiarthroplasty
ˣ. open reduction and internal fixation
ˤ. closed reduction and percutaneous pinning
˥. a sling and early pedulum exercises
˦. a sling and swathe for 6 weeks, followed by shoulder rehabilitation
˧. open acromioplasty
˨. open Bankart repair
˩. open subscapularis tendon repair
˪. inferior capsular shift
˫. a supervised physical therapy program
ˬ. a sling and swathe, with pendulum exercises in 10 days
˭. open reduction and internal fixation through an anterior approach
ˮ. open reduction and internal fixation through a posterior approach
˯. immobilization with a splint in 45 degrees of abduction for 6 weeks
˰. arthroscopically assisted reduction and percutaneous screw fixation
˱. Repair of the rotator cuff
˲. Replacement of the humeral head
˳. Resection arthroplasty
˴. Total shoulder arthroplasty
˵. AP and lateral radiographs of the elbow
˶. Diagnositc arthroscopy
˷. Aspiration of joint fluid
˸. An erythrocyte sedimentation rate and CBC
˹. A diagnostic lidocaine injection
˺. Insulin-like growth factor (IGF-1)
˻. Fibroblast growth factor (FGF-1)
˼. Platelet-derived growth factor (PDGF)
˽. Transforming growth factor beta (TGF-B)
˾. Bone morphogenetic proteins (BMP)
˿. clinical history and radiographic findings.
̀. technetium bone scan
́. flow cytometry pattern of extracted chondrocytes
̂. immunohistochemical staining patterns of a biopsy specimen
̃. histologic features of a biopsy specimen stained with hematoxylin-cosin
̄. Radial
̅. Radial recurrent
̆. Posterior interosseous
̇. Superior ulnar recurrent
̈. Superficial radial circumflex
̉. Impaired hydroxylation of proline
̊. Failure of cleavage in procollagen
̋. Defective binding sites for hydroxyproline
̌. Failure to incorporate glycine into the helix
̍. Diminished production of collagen through the rough endoplasmic reticulum
̎. Asking the legal staff to seek a court injunction
̏. Copying the patient’s chart and giving it to him as he leaves
̐. Having the patient sign a written legal contract that specifies acceptable behavior
̑. Continuing care of the patient until an appropriate referral can be arranged
̒. Transferring the patient to another orthopaedic surgeon without disclosing the realreason for why the patient is being transferred
̓. Meta-analysis
̔. Confidence interval
̕. Analysis of variance (ANOVA)
̖. Statistical significance (p-value)
̗. Survivorship analysis (Kaplan-Meier)
̘. Spinal shock
̙. Neurogenic shock
̚. Hypovolemic shock
̛. Pulmonary embolism
̜. Fat embolus syndrome
̝. Lumbar spinal stenosis
̞. Metastatic disease of the spine
̟. Rheumatoid lumbar spondylitis
̠. Isthmic spondyloloisthesis
̡. Degenerative spondylolisthesis at L4-5 and L5-S1
̢. Patella alta
̣. A metal-backed patella
̤. Varus malalignment of the knee
̥. A posterior cruciate-substituting femoral component
̦. Lateral subluxation of the patella on a Merchant’s view
̧. The sesamoids are separated
̨. The sesamoid is fractured
̩. The proximal phx is on the neck of the metatarsal
̪. The dislocation is dorsal and centered
̫. The proximal phalanx is hyperextended
̬. Patella
̭. Tibial stem
̮. Distal femoral interface
̯. Posterior femoral interface
̰. Sites of screw fixation for the tibia
̱. Hallux rigidus
̲. Fracture of the sesamoid
̳. Disruption of the plantar plate
̴. Osteonecrosis of the metatarsal head
̵. Rupture of the flexor hallucis longus
̶. Gout
̷. Sepsis
̸. Old trauma
̹. Rheumatoid arthritis
̺. Charcot arthroplasty
̻. Aspiration and steroid injection
̼. Biopsy, curettage, and allograft bone grafting
̽. Percutaneous Kirschner wire fixation
̾. Percutaneous injection of autogenous bone marrow
̿. Nerve roots
̀. Spinal cord
́. Sciatic nerve
͂. Peroneal nerve
̓. Conus medullaris
̈́. Extent of bone penetrated by reaming, prosthetic components, or acrylic cement
Ι. Periprosthetic regions that are accessible to joint fluid and particulate wear debris
͆. Enveloping pseudocapsular scar tissue that develops around a prosthetic hip following surgical capsulectomy
͇. Soft tissue and bone that are potentially contaminated with bacteria in the setting of a prosthetic joint infection
͈. Potential intrapelvic joint space communication created by acetabular fixation screws or intrapelvic extruded acrylic cement
͉. Early and late infection
͊. Periprosthetic fracture of the femur
͋. Failure of the patellofemoral and extensor mechanisms
͌. Aseptic loosening of cementing tibial components
͍. Asceptic loosening of cemented femoral components
͎. Acceptance of the current position of the ankle
͏. Open reduction and fixation in the epiphysis only
͐. ORIF with a small-fragment T-plate from the malleolus up to the metaphysis
͑. Closed reduction by eversion of the ankle and application of a bivalved long leg cast
͒. CRUGA and fixation with a malleolar screw from the malleolus into the metaphysis
͓. Resection arthroplasty and local radiation
͔. In situ fusion of the hip
͕. Excision of heterotopic bone, total hip arthroplasty, and oral indomethacin
͖. Excision of heterotopic bone and local radiation
͗. Excision of heterotopic bone, hemiarthroplasty, and oral indomethacin
͘. Closed reduction of both fractures and immediate spica casting
͙. Bilateral skin traction for 3 weeks, followed by spica casting
͚. External fixation of both femora
͛. External fixation of the left femur and a long leg cast brace for the right femur
͜. External fixation of the left femur and use of a reamed intramedullary nail in the right femur
͝. Synovial sarcoma
͞. Soft-tissue abcess
͟. Rhabdomyosarcoma
͠. Eosinophilic granuloma
͡. Nodular pigmented villonodular synovitis
͢. Changing to a titanium nail
ͣ. Changing to a nonslotted nail
ͤ. Changing the cross-sectional shape of the nail
ͥ. Increasing the diameter of the nail by 3 mm
ͦ. Increasing the diameter of the interlocking screws
ͧ. Fracture healing
ͨ. Chondrosarcoma
ͩ. Periosteal chondroma
ͪ. Periosteal osteosarcoma
ͫ. Dysplasia epiphysealis hemimelica
ͬ. Demonstrate competence in the subject of the case
ͭ. Be fellowship trained in the subject of the case
ͮ. Be paid on a contingency basis
ͯ. Be board certified by the American Board of Orthopaedic Surgery
Ͱ. Have been involved in the case as a consultant
Ͱ. Diagnostic arthroscopy
Ͳ. Arthroscopy and subacromial decompression
Ͳ. Reduction and fixation of the proximal humeral epiphysis
ʹ. Temporary cessation of throwing
͵. Physical therapy for rotator cuff strengthening
Ͷ. Oblique popliteal ligament
Ͷ. Lateral capsule
͸. Popliteal tendon
͹. Fibular collateral ligament
ͺ. Posterior oblique ligament
Ͻ. Radial tear
Ͼ. Parrot-beak tear
Ͽ. Vertical tear in the “red-red” zone
;. Vertical tear in the “red-white” zone
Ϳ. Vertical tear in the “white-white” zone
΀. 0 degrees of abduction, with neural rotation
΁. 40 degrees of flexion and 60 degrees of internal rotation
΂. 45 degrees of flexion and 45 degrees of external rotation
΃. 90 degrees of abduction with neutral rotation
΄. 90 degrees of abduction and 90 degrees of external rotation
΅. Sural
Ά. Saphenous and its branches
·. Posterior tibial and its branches
Έ. Deep peroneal and its branches
Ή. Superficial peroneal and its branches
Ί. Strength
΋. Stiffness
Ό. Shelf life
΍. Antigenicity
Ύ. Risk of HIV transmission
Ώ. Indemnification
Ϊ́. Occurrence
Α. Excess liability
Β. Claims-made
Γ. Nose
Δ. Lateral Y
Ε. Scapular AP
Ζ. Neutral rotation AP
Η. Internal rotation AP
Θ. External rotation AP
Ι. Trauma
Κ. Hemophilia
Λ. Reiter’s syndrome
Μ. Rheumatoid arthritis
Ν. Systemic lupus erythematosus
Ξ. Cast immobilization for 6 weeks
Ο. Activity modification and re-evaluation in 2 months
Π. Internal fixation with or without bone grafting
Ρ. Retrograde drilling of the defect without articular cartilage penetration
΢. Drilling of the defect directly through the articular cartilage
Σ. repair or reconstruction of the medial collateral ligament
Τ. repair or reconstruction of the medialand lateral collateral ligaments
Υ. immobilization for 5 days or less
Φ. immobilization for 14 days
Χ. immobilization for 25 days
Ψ. Cystinosis
Ω. Hypophosphatemia
Ϊ. Renal osteodystrophy
Ϋ. Primary hyperparathyroidism
Ά. Nutritional vitamin D deficiency
Έ. Lateral meniscus tear
Ή. Popliteus tenosynovitis
Ί. Iliotibial band friction syndrome
Ϋ́. Peroneal nerve entrapment
Α. Biceps tendinitis
Β. Observation
Γ. Removal of the prosthetic components
Δ. Operative exploration and decompression of the peroneal nerve
Ε. Nerve conduction velocity studies
Ζ. Loosening of the primary dressings and knee flexion to 30 degrees
Η. I
Θ. II
Ι. III
Κ. decreased tissue tension
Λ. decreased abductor lever arm
Μ. decreased joint reaction force
Ν. increased body weight over lever arm
Ξ. increased polyethylene wear rate
Ο. recurrent traumatic anterior dislocation
Π. recurrent traumatic posterior dislocation
Ρ. traumatic subluxation with no previous dislocation
Σ. traumatic anterior subluxation
Σ. atraumatic involuntary subluxation
Τ. radial
Υ. axillary
Φ. suprascapular
Χ. thoracodorsal
Ψ. long thoracic
Ω. Flexion
Ϊ. Extension
Ϋ. Axial rotation
Ό. Left lateral bending
Ύ. Right lateral bending
Ώ. Skin
Ϗ. Lung
Β. Brain
Θ. Heart
ϒ. Kidney
ϓ. Thoracoacromial, lateral thoracic, subscapular
ϔ. Thoracoacromial, anterior humeral circumflex, posterior humeral circumflex
Φ. Posterior humeral circumflex, subscapular, thoracacromial
Π. Subscapular, thoracacromial, anterior humeral circumflex
Ϗ. Lateral thoracic, anterior humeral circumflex, thoracacromial
Ϙ. Respondeat superior
Ϙ. Indemnity agreement
Ϛ. Hold harmless agreement- attempt to shift liability from company to physician
Ϛ. Comparative negligence-% of involvement
Ϝ. Contributory negligence- resident contributed to the negligence
Ϝ. t-type
Ϟ. both column
Ϟ. transverse
Ϡ. anterior column
Ϡ. anterior column posterior hemitransverse
Ϣ. Posterior interosseous
Ϣ. Anterior interosseous
Ϥ. Radial
Ϥ. Median
Ϧ. Ulnar
Ϧ. Shock from hypovolemia
Ϩ. Associated rupture of the bladder
Ϩ. Arterial bleeding on pelvic angiogram
Ϫ. Presence of a hematoma in the perineum and scrotum
Ϫ. Fractures of both the anterior and posterior pelvic ring

Correct Answer & Explanation

. humeral arthroplasty2/. repair of the rotator cuff


Explanation

Question 4078

Topic: 10. Pathology and Oncology

A 47-year-old woman with no history of trauma has had a painful, stiff shoulder for the past 3 months. Treatment consisting of subacromial injection and nonsteroidal anti-inflammatory drugs has been ineffective. Her active range of motion is painful and is limited to 90 degrees of abduction, 60 degrees of elevation, 30 degrees of external rotation, and internal rotation to the posterior superior iliac spine. Plain radiographs of the cervical spine and shoulder are normal. Management at this time should consist of

. arthroscopic capsular release
. manipulation under anesthesia
. a physical therapy program
. an intra-articular corticosteroid injection
. administration of high-dose oral corticosteroids
. adding the scores, in all five body systems
. adding the squares of the scores in the three most severely injured systems
. doubling the cumulative score for head and chest injuries
. combining the scores from the most and least injured systems
. correcting the score in the most severely injured system for age
. traumatic femoral head fracture
. osteonecrosis
. osteoarthritis
. neuropathic joint
. rheumatoid arthritis
. low-dose radiation
. steroid injection
. a load-relieving insert and shoe modification
. complete excision of the mass and the entire plantar fascia
. wide excision of the mass with a 2 cm margin of normal fascia
. CT scan of the chest
. technetium bone scan
. bone marrow aspiration
. serum protein electrophoresis
. lateral skull radiograph
. high-grade histology of the initial tumor
. multiple local recurrences after curettage
. previous treatment of the tumor with cryotherapy
. previous treatment of the tumor with radiation therapy
. extraosseous extension into two or more adjacent compartments
. Dorsal rhizotomy and facet joint fusion
. Multilevel corpectomy and spinal stabilization
!. Central and lateral recess decompression and bilateral foraminotomy
". Central decompression and facet joint fusion
#. Central decompression, foraminotomy, and spinal fusion from L2 to L5.
$. Inadequate rehabilitation
%. Displacement of the coronoid process fracture
&. Insufficiency of the lateral ulnar collateral ligament
'. Insufficiency of the anterior band of the medial collateral ligament
(. Insufficiency of the posterior band of the medial collateral ligament
). Osteotomy and intramedullary rod fixation
*. Electrical stimulation
+. Strut-autografing the concavity the tibia
,. A patellar tendon-bearing brace
-. Percutaneous injection of demineralized bone matrix
.. digoxin
/. sucralfate
0. clindamycin
1. alcohol
2. neuromuscular blocking agents
3. Unrestrained roll-back
4. Unrestrained rotational conformity
5. Medial-Lateral conformity
6. Anteroposterior conformity in flexion
7. Anteroposterior conformity in extension
8. Arthrodesis of the MTP joint
9. A Silastic implant of the MTP joint
:. Resection arthroplasty of the MTP joint
;. Cheilctomy of the MTP joint
<. Osteotomy of the base of the proximal phalanx
=. Genu varum
>. Tarsal coalition
?. Degenerative ankle arthrosis
@. Osteochondritis dissecans of the talus
A. Hemihypertrophy of the ipsilateral lower extremity
B. Trabecular bone is preferentially resorbed in this high bone turnover state
C. Loss of water content in the disk increases impact load to the vetrebral bodies
D. Stress is imposed by the relative stiffness of the arthrtic facet joints
E. Increased energy demands are imposed by decreased circulation to the vertebral body
F. The thick cortical bone found in the vertebral body resorbs rapidly following estrogen withdrawal
G. Increased time in stance and swing phase
H. Addition of a double leg float phase
I. Decreased vertical ground reaction forces
J. Decreased arc of motion in the hip, knee, and ankle
K. Decreased joint reaction forces in the hip, knee, and ankle
L. Talonavicular arthrodesis
M. Medial displacement calcaneal osteotomy
N. Flexor digitorum longus tendon transfer with spring ligament advancement
O. Triple arthrodesis
P. Calcaneocuboid distraction arthrodesis and repair of the posterior tibial tendon
Q. Lymphoma
R. Hemangioma
S. Osteosarcoma
T. TB of the spine
U. Metastatic breast carcinoma
V. widening and shortening of the heel.
W. weakness of the gastrocnemius-soleus complex.
X. anterior impingement from a horizontal talus.
Y. unrecognized compartment syndrome of the foot.
Z. degenerative arthritis of the tibiotalar joint.
[. a corrective osteotomy
\. application of braces
]. medial physeal stapling until the varus corrects
^. observation
_. application of corrective casts
`. a total contact cast.
A. electrical stimulation.
B. an off the shelf fracture brace.
C. an elastic compression bandage and crutches.
D. a hard soled shoe until the patient is asymptomatic.
E. Ewings tumor
F. Parosteal osteosarcoma
G. Dedifferentiated chondrosarcoma
H. Low grade intramedullary chondrosarcoma
I. High grade intramedullary osteosarcoma
J. Vascular injury
K. Tear of the rotator cuff
L. Injury to the brachial plexus
M. Fracture of the upper thoracic rib
N. Fracture of the proximal humerus
O. Biceps
P. Trapezius
Q. Infraspinatus
R. Pectoralis major
S. Serratus anterior
T. Hybrid total hip arthroplasty
U. Noncemental hemiarthroplasty of the hip
V. Closed reduction and percutaneous pin fixation
W. Open reduction through an anterior approach to the hip
X. Excision of the head fragment
Y. a quadratus femoris pediclebone graft
Z. a proximal femoral allograft
{. intertrochanteric osteotomy
|. total hip arthroplasty
}. hip hemiarthroplasty
~. Echocardiogram
. Electrocardiogram
€. Radiograph of the chest
. CT scan of the shoulder
‚. Ultrasound of the shoulder
ƒ. Ilioinguinal
„. Extended iliofemoral
…. Combined ilioinguinal and Kocher-Langenbeck (posterior)
†. Kocher-Langenbeck (posterior)
‡. Kocher-Langenbeck (posterior) with trochanteric osteotomy
ˆ. Deltoid
‰. Supraspinatus
Š. Subscapularis Infraspinatus
‹. Infraspinatus
Œ. Infraspinatus and teres minor
. an orthosis.
Ž. observation.
. electrical stimulation.
. open reduction and internal fixation.
‘. application of a nonweightbearing short leg cast.
’. repair of the rotator cuff.
“. rehabilitation of the shoulder
”. replacement of the humeral head.
•. arthroscopic acromioplasty and debridement.
–. immobilization is a sling until pain resolves.
—. Bone rotation versus torque applied
˜. Bone deflection versus bending moment applied
™. Axial displacement versus tension applied
š. Lateral translation versus shear force applied
›. Fracture gap closing versus compressive force applied
œ. steroid injection
. stretching of the heel cord
ž. surgical release of the plantar fascia
Ÿ. application of a short leg cast for 6 to 8 weeks
 . wearing dorsiflexion night splints
¡. Open bladder
¢. Bilateral “hitchhiker’s” thumbs
£. Bilateral defects in the midclavicles
¤. Rhizomelic shortening of the extremities
¥. Radiographic fragmentation of all major epiphyses
¦. Medial patellotibial
§. Medial patellofemoral
¨. Medial patellomeniscal
©. Lateral patellofemoral
ª. Lateral patellotibial
«. Heat
¬. Gentle active flexion-extension exercises
­. Isokinetic strengthening
®. Electrical muscle stimulation
¯. Immobilization of the limb with the knee in full flexion
°. Distal chevron osteotomy with soft-tissue release
±. Distal soft-tissue realignment only
². Closing wedge osteotomy (Aken) of the proximal phalanx
³. Proximal first metatarsal osteotomy only
´. Soft-tissue realignment with a proximal metatarsal osteotomy
Μ. Vagus
¶. Phrenic
·. Hypoglossal
¸. Recurrent laryngeal
¹. Inferior thyroid
º. Surgical exploration
». Application of leeches
¼. Stellate ganglion blocks
½. Intra-arterial streptokinase
¾. Elevation and reevaluation in 1 hour
¿. Liver profile
À. Myleogram
Á. Platelet count
Â. CT scan of the head
Ã. Angiogram of the extremity
Ä. Post spinal fusion from L5to S1
Å. Primary repair with an iliac bone graft
Æ. Post spinal fusion of L4-5
Ç. A pantaloon body cast and 6 weeks of bed rest
È. Rest, NSAIDS, and limited dancing
É. Stress fracture of the proximal fifth metatarsal
Ê. Stress fracture of the base of the second metatarsal
Ë. Stress fracture of the neck of the second metatarsal
Ì. Morton’s neuroma
Í. Lisfranc’s joint subluxation
Î. C5 radiculopathy
Ï. Subscapularis rupture
Ð. Glenohumeral arthrosis
Ñ. Rotator cuff arthropathy
Ò. Suprascapular nerve compression at the spinoglenoid notch
Ó. mm femoral head in combination with a metal-backed polyethylene component
Ô. mm femoral head in combination with an all-polyethylene acetabular component
Õ. mm femoral head in combination with a metal-backed polyethylene component
Ö. mm femoral head in combination with an all-polyethylene component
×. mm femoral head in combination with a metal-backed polyethylene component
Ø. Female gender
Ù. History of cigarette smoking
Ú. L5-S1 spondylolisthesis on pre-employment radiography
Û. Decreased strength of the lower extremities on pre-employment testing
Ü. Decreased flexibility of the lumbar spine on pre-employment testing
Ý. Size of cells
Þ. Amount of DNA in cells
SS. Nucleus-cytoplasm ratio
À. Specific DNA sequences
Á. Specific messenger RNA sequences
Â. Femoral and obturator nerves
Ã. Femoral and superior gluteal nerves
Ä. Femoral and lateral femoral cutaneous nerves
Å. Obturator and superior gluteal nerves
Æ. Obturator and lateral femoral cutaneous nerves
Ç. Isotonic
È. Isokinetic
É. Isometric
Ê. Open kinetic chain
Ë. Dynamic variable resistance
Ì. Closed reduction and cast immobilization
Í. Uniplanar external fixation
Î. Open reduction and internal fixation with a dynamic compression plate
Ï. Unreamed intramedullary rod
Ð. Multiple plane external fixator
Ñ. Inlet view of the pelvis
Ò. Outlet view of the pelvis
Ó. AP view of the hip
Ô. Ilial oblique view (external oblique) of the hip
Õ. Obturator oblique
Ö. Glycolytic pathway
÷. Oxidative phosphorylation
Ø. Breakdown of fat
Ù. Breakdown of protein
Ú. Breakdown of adenosine triphosphate
Û. an MRI scan
Ü. arthroscopic examination
Ý. AP and frog-lateral radiographs of the pelvis and hips
Þ. varus and valgus stress radiographs of the knee
Ÿ. physical examination of the knee under anesthesia
Ā. extended curettage and polymethylmethacrylate cementation
Ā. extra-articular resection of the knee and an allograft arthrodesis
Ă. wide resection of the proximal tibia and custom prosthetic replacement
Ă. prophylactic internal fixation and postoperative irradiation
Ą. excision of the lateral condyle and reconstruction with a hemicondylar allograft
Ą. silicone implant joint replacement
Ć. metatarsophalangeal joint arthrodesis
Ć. metatarsophalangeal joint debridement
Ĉ. resection of the metatarsal head
Ĉ. resection of the base of the proximal phalanx
Ċ. Fixation of the syndesmosis has failed
Ċ. Widening of the ankle mortise has led to the failure of fixation
Č. Infection around the syndesmosis screw has led to osteomyelitis
Č. The syndesmosis screw is broken
Ď. Motion between the tibia and fibula has caused loosening of the syndesmosis screw
Ď. Microcephaly
Đ. A temporal lobe cyst
Đ. An Arnold-Chiari type 1 malformation
Ē. Periventricular leukomalacia
Ē. Agnesis of the corpus callosum
Ĕ. Wolff’s
Ĕ. Hooke’s
Ė. Hilton’s
Ė. Muller-Haeckel
Ę. Heuter-Volkmann
Ę. Both the anterolateral and posteromedial bands are isometric and do not significantly change with flexion
Ě. The anterolateral band is lax and becomes tight in flexion, while the posteromedial band is tight, and becomes lax in flexion
Ě. The anterolateral band is tight and becomes lax in flexion, while the posteromedial band is lax and becomes tight in flexion
Ĝ. Both the anterolateral and posteromedial bands are lax and become tight in flexion
Ĝ. Both the anterolateral and posteromedial bands are tight and become lax as the knee is flexed
Ğ. UCB orthosis
Ğ. Rigid orthosis with a medical arch support
Ġ. Semi-rigid orthosis with lateral forefoot posting
Ġ. Semi-rigid orthosis with a medial arch support
Ģ. Medial heel wedge attached to the running shoes
Ģ. Hallux varus
Ĥ. Osteonecrosis
Ĥ. Recurrence of the hallux valgus
Ħ. “Transfer” second metatarsalgia
Ħ. Physeal arrest of the first metatarsal
Ĩ. Aseptic loosening in a 70-year-old patient
Ĩ. Mechanical failure of a hinged knee prosthesis
Ī. Failed knee replacement complicated by reflex sympathetic dystrophy
Ī. Infection with soft-tissue deficit
Ĭ. A prior patellectomy
Ĭ. Knee fusion
Į. Open irrigation and debridement
Į. Arthroscopic irrigation and debridement
İ. One-stage exchange arthroplasty
I. Two-stage exchange arthroplasty
IJ. Putti-platt repair
IJ. Open Bankart repair
Ĵ. Injection of a subacromial corticosteroid
Ĵ. Arthroscopic transglenoid capsular shift
Ķ. Rehabilitation of the scapular and rotator cuff muscles
Ķ. Silicone suction socket and an energy-absorbing foot
ĸ. Silicone suction socket and a variable resistance ankle
Ĺ. Plastic suction socket, telescoping pylon, and a solid ankle cushioned heel (SACH) foot
Ĺ. Plastic socket with a hinged thigh cuff and a SACH foot
Ļ. Patellar tendon-bearing suction socket and a uniaxial hydraulic ankle
Ļ. Parosteal
Ľ. Periosteal
Ľ. High-grade intramedullary
Ŀ. Osteosarcoma occurring in Paget’s disease
Ŀ. Osteosarcoma occurring in irradiated bone
Ł. Cauda equina
Ł. Conus medullaris
Ń. Genitofemoral nerve
Ń. Lumbar sympathetic plexus
Ņ. Lumbar parasympathetic plexus
Ņ. Spinal pseudoarthrosis
Ň. Spinal cord traction injury with paralysis
Ň. Arterial and venous thromboses
ʼN. Superior mesenteric artery syndrome
Ŋ. Crankshaft phenomenon
Ŋ. Inversion stress radiograph
Ō. MRI scan
Ō. CT scan
Ŏ. Nuclear bone scan
Ŏ. External rotation stress radiograph
Ő. Complex deformity with an angulation in two planes
Ő. Single deformity less than 20 degrees, apex posterolateral
Œ. Single deformity greater than 30 degrees, apex posterolateral
Œ. Single deformity less than 20 degrees, apex posteromedial
Ŕ. Single deformity greater than 30 degrees, apex posteromedial
Ŕ. Pronation of the foot during the stance phase of gait
Ŗ. Heel inversion at the beginning of a single limb heel rise
Ŗ. Active inversion of the nonweightbearing foot
Ř. Active plantar flexion of the first ray against resistance
Ř. Active plantar flexion of the foot during the push-off phase of gait
Ś. Observation and repeat radiographs in 4 months
Ś. Application of a thoracolumbalsacral orthosis for 22 to 24 hours per day
Ŝ. Electrical stimulation at night
Ŝ. Physical therapy
Ş. Begins to remodel and hypertrophy more quickly
Ş. Provides a better scaffold for osteoconduction
Š. Reduces the risk of early fracture
Š. Reduces technical difficulty
Ţ. Lowers donor site morbidity
Ţ. Anterior fusion of the lumbar curve
Ť. Anterior and posterior fusion of the thoracic curve
Ť. Posterior fusion of the thoracic curve
Ŧ. Posterior fusion of the thoracic and lumbar curves
Ŧ. Application of a brace until the iliac apophyses are Risser 4 or 5, followed by surgical correction
Ũ. Subscapularis rupture
Ũ. Type III SLAP lesion
Ū. Disruption of capsular shift
Ū. Isolated traumatic subluxation
Ŭ. Injury to the axillary nerve after dislocation
Ŭ. hypophosphatemia
Ů. high dietary cholesterol intake
Ů. deficiency of lipoprotein A
Ű. deficiency of protein S and protein C
Ű. elevated levels of antithrombin III
Ų. Weightbearing short leg cast
Ų. Nonweightbearing short leg cast
Ŵ. Removable splint and early motion
Ŵ. Open reduction and internal fixation
Ŷ. Elastic compression bandage with full weightbearing
Ŷ. Breast
Ÿ. Prostate
Ź. Gastrointestinal
Ź. Kidney
Ż. Multiple myeloma
Ż. Varus stress
Ž. Valgus stress
Ž. Torsional loading
S. Hyperextension of the knee
Ƀ. Contraction of the quadriceps while axially loaded
Ɓ. Primary internal fixation at both fracture levels
Ƃ. External fixation as definitive ttt for both #
Ƃ. Skeletal traction and delayed internal fixation of both fractures
Ƅ. Primary internal fixation of the proximal fracture and delayed fixation of the femoral fracture
Ƅ. Primary internal fixation of the femoral shaft fracture and delayed fixation of the proximal #
Ɔ. Heel spur
Ƈ. Plantar fascitis
Ƈ. Dysfunction of the tibialis posterior tendon
Ɖ. Compression of the first branch of the lateral plantar nerve
Ɗ. Compression of the calcaneal nerve
Ƌ. Displaced labral tear
Ƌ. Tear of the rotator cuff
ƍ. Fracture of the glenoid rim
Ǝ. Palsy of the axillary nerve
Ə. Palsy of the musculocutaneus nerve
Ɛ. Enchondroma
Ƒ. Osteoblastoma
Ƒ. Giant cell tumor
Ɠ. Aneurysmal bone cyst
Ɣ. Fibrous dysplasia
Ƕ. Arthrogram of the wrist
Ɩ. MRI scan of both wrists
Ɨ. CT scan of both wrists in the same position
Ƙ. Radiographs of the wrist in supination and pronation
Ƙ. Radiographs of the opposite wrist in the same position
Ƚ. Secondary hyperparathyroidism
ƛ. Phosphate retention secondary to uremia
Ɯ. Insufficient renal synthesis of 1, 25 dihydroxy vitamin D
Ɲ. Aluminum deposition in bone from oral phosphate binders
Ƞ. Persistent acidosis aggravating the negative calcium balance
Ɵ. Posterior fusion at T10-L3 with segmental instrumentation
Ơ. Laminectomy and fusion of T12-L2 with segmental instrumentation
Ơ. Bed rest in a hyperextension brace
Ƣ. L1 vertebrectomy and anterior decompression with strut graft fusion and instrumentation
Ƣ. Progressive ambulation as tolerated in a custom-molded thoracolumbosacral orthosis
Ƥ. Positive-pressure ventilation
Ƥ. An immediate radiograph of the chest
Ʀ. Adjustment of the position of the endotrachael tube
Ƨ. Insertion of a large-bore needle into the pericardial space
Ƨ. Insertion of a large-bore needle in the right second intercostal space, midclavicular line
Ʃ. Allowing the ends of the fracture to touch
ƪ. Adding a second connecting bar
ƫ. Adding one pin to each fracture fragment
Ƭ. Increasing the pin diameter from 4 mm to 6 mm
Ƭ. Decreasing the connecting bar-to-bone distance from 6 cm to 4 cm
Ʈ. Osteomyelitis
Ư. Malignant degeneration
Ư. Stress fracture
Ʊ. Local recurrence of the giant cell tumor
Ʋ. Bone resorption due to methylmethacrylate
Ƴ. Advancement of the plantar plate
Ƴ. Resection of the second metatarsal head
Ƶ. Dorsiflexion osteotomy of the second metatarsal neck
Ƶ. Transfer of the flexor digitorum longus tendon to the dorsum of the toe
Ʒ. Transfer of the extensor digitorum comminus tendon to the metatarsal neck
Ƹ. Sacral fracture
Ƹ. Burst fracture of L5
ƺ. Cauda equina syndrome
ƻ. Distraction-flexion injury at L3
Ƽ. Distraction-extension injury at L3
Ƽ. An MRI scan of the shoulder
ƾ. An MRI scan of the cervical spine
Ƿ. Electromyographic and nerve conduction velocity studies
ǀ. Immobilization in a sling and early passive range of motion exercises
ǁ. Immediate return to the operating room for exploration of the brachial plexus
ǂ. cerclage wiring
ǃ. tension band wiring
DŽ. removal of the patellar component
DŽ. revision of the patellar component
DŽ. immobilization of the knee and protected weightbearing
LJ. Liposarcoma
LJ. Nodular fasciitis
LJ. Rabdomyosarcoma
NJ. Malignant fibrous histiocytoma
NJ. Extra-abdominal desmoid tumor
NJ. Clubfeet
Ǎ. Thrombocytopenia
Ǎ. Congenital scoliosis
Ǐ. Ventricular septal defect
Ǐ. Arnold-Chiari malformation
Ǒ. delayed primary closure
Ǒ. free flap
Ǔ. pedicle groin flap
Ǔ. full-thickness skin graft
Ǖ. split-thickness skin graft
Ǖ. Infection
Ǘ. Nonunion
Ǘ. Improper screw length
Ǚ. Osteonecrosis of the distal fragment
Ǚ. Use of a cortical screw instead of a cancellous screw
Ǜ. Infection
Ǜ. Tear of the rotator cuff
Ǝ. Loosening of the humeral component
Ǟ. Arthritis of the glenoid
Ǟ. Arthritis of the A-C joint
Ǡ. Reduced morbidity
Ǡ. Improved osteoinduction
Ǣ. Improved osteoconduction
Ǣ. More rapid revascularization
Ǥ. Lower risk of disease transmission
Ǥ. Manipulation Under Anesthesia
Ǧ. Arthroscopic acromioplasty
Ǧ. Arthroscopic debridement of G-H joint
Ǩ. Replacement of the humeral head
Ǩ. Lengthening of the subscapularis and release of the anterior capsule
Ǫ. Bacteroides
Ǫ. E. coli
Ǭ. Staph. aureus
Ǭ. group A streptococcus
Ǯ. Clostridium perforingens
Ǯ. observation and exercises
J̌. bracing with a thoracolumbar orthosis
DZ. fusion of the posterior spine
DZ. fusion of the anterior spine
DZ. fusion of the anterior and posterior spine
Ǵ. Total wrist replacement and bridge grafts
Ǵ. palmar shelf arthroplasty and tendon transfers
Ƕ. Darrach distal ulna resection, dorsal tenosynosynovectomy, and tendon transfers
Ƿ. Radioscaphate fusion, extensor tenodesis, and Darrach distal ulna resection
Ǹ. Total wrist fusion and tendon transfers
Ǹ. constrained acetabular component
Ǻ. protrusion ring with morselized graft
Ǻ. cemented metal backed acetabular component
Ǽ. cemented all-polyethylene acetabular component
Ǽ. cementless hemispherical component with screw fixation
Ǿ. application of a hip abduction brace for 22 hours per day
Ǿ. application of a hip spica under anesthesia
Ȁ. discontinuance of all bracing and repeat radiographs in 3 months
Ȁ. open reduction of the hip and application of a spica cast
Ȃ. open reduction, varus osteotomy, and application of a spica cast
Ȃ. Loss of skin hair on the feet
Ȅ. Absent pulses on vascular examination
Ȅ. Pain that originates proximally and spreads distally
Ȇ. Pain that is relieved by stopping and standing
Ȇ. Pain that is worse when the patient walks uphill rather downhill
Ȉ. wrist flexors and finger flexors
Ȉ. elbow flexors and wrist flexors
Ȋ. elbow flexors and finger flexors
Ȋ. elbow extensors and wrist flexorst Level Key Muscles4 DiaphragmDeltoid, elbow flexors, diaphragmElbow flexors, wrist extensorsElbow extensors, wrist flexorsFinger flexors (distal phalanx of middlefinger)Finger abductors (5th digit), intrinsics of hand2 Segmental innervation to intercostal muscles, abdominal and paraspinal muscles) L1, L2, L3 Hip flexors3, L4 QuadricepsTibialis anteriorToe extensors, hip abductorsAnkle plantarflexors, peronei
Ȍ. elbow extensors and wrist extensors
Ȍ. Syndactyly
Ȏ. Macrodactyly
Ȏ. Camptodactyly
Ȑ. Preaxial polydactyly
Ȑ. Postaxial polydactyly
Ȓ. Arthrodesis
Ȓ. Rotationplasty
Ȕ. Above-knee amputation
Ȕ. Osteoarticular allograft
Ȗ. Endoprosthesis (custom arthroplasty)
Ȗ. Plantar fascia
Ș. Spring ligament
Ș. Deltoid ligament
Ț. Intrinsic tendons
Ț. Gastorcnemius-solelus complex
Ȝ. Prevention of presynaptic release of acetylcholine
Ȝ. Prevention of synthesis of presynaptic acetylcholine
Ȟ. Activation of acetylcholinesterase at the motor end-plate
Ȟ. Blockage of postsynaptic action of acetylcholine until reserves are depleted
Ƞ. Stimulation of release of presynaptic acetylcholine until reserves are depleted
ȡ. stiffness of the femoral component.
Ȣ. head offset of the femoral component.
Ȣ. femoral component material modulus of elasticity.
Ȥ. extent of the femoral component porous coating.
Ȥ. Presence of a femoral component collar.
Ȧ. plantar fascia and quadratus plantae tendon.
Ȧ. ligamentous structures connecting the tarsal bones.
Ȩ. shape of the tarsal bones and the intervening joints.
Ȩ. activity of the intrinsic muscles of the foot.
Ȫ. activity of the posterior tibialis and the peroneus longus muscles.
Ȫ. scapulothoracic fusion
Ȭ. strengthening of the periscapular muscles
Ȭ. pectoralis minor-fascia lata graft transfer to the scapula
Ȯ. pectoralis major-fascia lata graft transfer to the scapula
Ȯ. exploration of the long thoracic nerve, with sural nerve graft
Ȱ. tricompartmental knee replacement
Ȱ. unicompartmental knee replacement
Ȳ. medial compartment meniscal allograft
Ȳ. valgus-producing distal femoral osteotomy
ȴ. valgus-producing proximal tibial osteotomy
ȵ. Internal rotation of the femoral component
ȶ. External rotation of the tibial component
ȷ. Lateral placement of the femoral component
ȸ. Medial placement of the patellar component
ȹ. Excessive resection of the patella
Ⱥ. Hallux rigidus
Ȼ. Hallux valgus
Ȼ. Neuroma of the first web space
Ƚ. Fracture of the sesamoid
Ⱦ. Rupture of the flexor hallucis longus
Ȿ. Sickle cell crisis
Ɀ. Idiopathic chondrolysis
Ɂ. Hemophilic arthropathy
Ɂ. Osteoid osteoma of the femoral neck
Ƀ. Legg-Calve-Perthes disease
Ʉ. Decreased ankle jerk and positive femoral nerve stretch test
Ʌ. Decreased knee jerk and positive straight-leg raising sign
Ɇ. Gastrocnemius-soleus complex weakness and positive straight-leg raising sign
Ɇ. Weakness of the extensor hallucis longus and positive straight-leg raising sign
Ɉ. Weakness of the extensor hallucis longus and positive femoral nerve stretch test
Ɉ. Long-term administration of IV and oral antibiotics
Ɋ. Open soft-tissue debridement, retention of prosthetic components, and IV antibiotics
Ɋ. Immediate exchange arthroplasty with antibiotic-impregnated cement
Ɍ. Two-stage surgical prosthetic exchange and IV antibiotics
Ɍ. Resection arthroplasty and IV antibiotics
Ɏ. SCFE
Ɏ. MED
Ɐ. Perthes disease
Ɑ. Hypothyroidism
Ɒ. Chondrolysis
Ɓ. gout.
Ɔ. osteoporosis.
ɕ. eosinophilic granuloma.
Ɖ. tuberculosis of the spine.
Ɗ. metastatic disease of the spine.
ɘ. water content.
Ə. Synthesis of type I collagen.
ɚ. Proteoglycan content.
Ɛ. Activity of chondrocytes.
Ɜ. Synthesis of hyaluronate.
ɝ. Lung
ɞ. Breast
ɟ. Prostate
Ɠ. Thyroid
Ɡ. Renal
ɢ. T1-low, T2-low.
Ɣ. T1-low, T2-high.
ɤ. T1-moderate, T2-low.
Ɥ. T1-high, T2-low.
Ɦ. T1-high, T2-high.
ɧ. hypothesis is incorrect or invalid
Ɨ. interobserver error rate is 4%.
Ɩ. Standard deviation is 4% higher or lower than the mean.
Ɪ. Sample size is 4% larger than required to be clinically significant.
Ɫ. Probability that the differences noted between two study groups were due to chance alone is 4%.
Ɬ. I
ɭ. II
ɮ. IV
Ɯ. IX
ɰ. X
Ɱ. Cranial setting
Ɲ. Cranial subluxation
ɳ. Odontoid fracture
ɴ. Lysis of the arch of the atlas
Ɵ. Atlantoaxial subluxation
ɶ. Retrograde collapse of the endoneurial tubes
ɷ. Irreversible atrophy of the denervated muscles
ɸ. Elongation of the axons across the zone of injury
ɹ. Sprouting of the axons at the neuromuscular junction
ɺ. Misdirection of the axons across the zone of injury
ɻ. Maximally pronated and elbow extended
ɼ. Maximally pronated and the elbow flexed
Ɽ. Maximally supinated and the elbow flexed
ɾ. Maximally supinated and the elbow extended
ɿ. In neutral rotation, with the elbow extended
Ʀ. open reduction and internal fixation
ʁ. buddy taping to the adjacent index finger
Ʂ. early motion with application of a dynamic banjo splint
Ʃ. application of a cast with the hand in a “safe position” for 3 weeks.
ʄ. dorsal extension block splinting
ʅ. The name of the manufacturer
ʆ. The manufacturer’s potential liability
Ʇ. The physician’s clinical performance
Ʈ. The physician’s materials testing data
Ʉ. Any royalties the physician receives from the manufacturer
Ʊ. Femoral
Ʋ. Obturator
Ʌ. Inferior gluteal
ʍ. Superior gluteal
ʎ. Lateral femoral cutaneous
ʏ. open biopsy and a long leg cast
ʐ. open biopsy and wide resection of the tumor
ʑ. a long leg cast and observation
Ʒ. intramedullary stabilization and observation
ʓ. Triggering
ʔ. Lateral instability
ʕ. Swan-neck deformity
ʖ. Boutonniere deformity
ʗ. Loss of distal interphalangeal joint flexion
ʘ. Peroneus brevis to peroneus longus
ʙ. Peroneus tertius to extensor hallucis longus
ʚ. Peroneus tertius to superficial peroneal nerve
ʛ. Extensor hallucis longus to deep peroneal nerve
ʜ. Extensor hallucis longus to extensor digitorum longus
Ʝ. reassurance that Medicare will pay for the treatment.
Ʞ. consent forms that patients or their guardians are able to understand.
ʟ. a detailed description of the device, omitting the fact that it is part of a study.
ʠ. a provision that the patient’s care will be discontinued if he or she does not enroll in the study.
ʡ. a provision that the study will be carried out to completion, whether or not the device is as effective as those currently in existence.
ʢ. an onlay iliac crest bone graft.
ʣ. limited weightbearing and observation.
ʤ. removal of the implant and limited weightbearing.
ʥ. removal of the implant and insertion of a reamed femoral nail.
ʦ. removal of the implant and insertion of an unreamed femoral nail.
ʧ. Coronal
ʨ. Sagittal
ʩ. Anteromedial, midway between the sagittal and the coronal
ʪ. Proximal pins sagittal, distal pins coronal
ʫ. Proximal pins coronal, distal pins sagittal
ʬ. Rheumatoid arthritis
ʭ. Posttraumatic arthritis
ʮ. Degenerative osteoarthritis
ʯ. Osteonecrosis of the tibial plateau
ʰ. Osteonecrosis of the medial femoral condyle
ʱ. Trapeziometacarpal arthrodesis
ʲ. Osteotomy of the thumb metacarpal
ʳ. Arthrotomy and joint debridement
ʴ. Ligament reconstruction using one half of the flexor carpi radialis
ʵ. Trapezium resection, tendon interposition, and reconstruction of the ligament
ʶ. Creep
ʷ. Relaxation
ʸ. Energy dissipation
ʹ. Plastic deformation
ʺ. Elastic deformation
ʻ. bending
ʼ. axial loading
ʽ. high-speed rotation
ʾ. direct impact from anteromedial
ʿ. crush from anteromedial to posterolateral
ˀ. Increase stiffness
ˁ. Increase fracture toughness
˂. Increase fatigue strength
˃. Decrease mechanical strength
˄. Decrease wear rate
˅. disuse osteopenia
ˆ. paraendocrine effect of the tumor
ˇ. abnormally increased density on the right side
ˈ. side effect of the treatment of the lesion
ˉ. extensive tumor involvement of the left hip
ˊ. Sciatic nerve
ˋ. Superior gluteal artery
ˌ. Profunda femoris artery
ˍ. Femoral artery and nerve
ˎ. External iliac artery and vein
ˏ. Length
ː. Moment arm
ˑ. Total volume
˒. Physiologic cross-sectional area
˓. Distribution of slow and fast twitch fibers
˔. decreasing initiation of action potentials.
˕. increasing action potential amplitude.
˖. blocking the opening of gated sodium channels.
˗. decreasing the number of functional motor units.
˘. slowing or stopping action potential propagation through the axon.
˙. resection of the metatarsal heads of the first through fifth toes.
˚. Silastic MP joint arthroplasties of the first through fifth toes.
˛. fusion of the hallux MP joint and resection arthroplasty of the 2nd through fifth metatarsal heads.
˜. fusion of hallux MP joint and distal osteotomy of the 2nd through 5th MT.
˝. plantar condylectomy of the 2nd through 5th MT heads & resection of proximal phx of the hallux.
˞. hemiarthroplasty
˟. open reduction and internal fixation
ˠ. closed reduction and percutaneous pinning
ˡ. a sling and early pedulum exercises
ˢ. a sling and swathe for 6 weeks, followed by shoulder rehabilitation
ˣ. open acromioplasty
ˤ. open Bankart repair
˥. open subscapularis tendon repair
˦. inferior capsular shift
˧. a supervised physical therapy program
˨. a sling and swathe, with pendulum exercises in 10 days
˩. open reduction and internal fixation through an anterior approach
˪. open reduction and internal fixation through a posterior approach
˫. immobilization with a splint in 45 degrees of abduction for 6 weeks
ˬ. arthroscopically assisted reduction and percutaneous screw fixation
˭. Repair of the rotator cuff
ˮ. Replacement of the humeral head
˯. Resection arthroplasty
˰. Total shoulder arthroplasty
˱. AP and lateral radiographs of the elbow
˲. Diagnositc arthroscopy
˳. Aspiration of joint fluid
˴. An erythrocyte sedimentation rate and CBC
˵. A diagnostic lidocaine injection
˶. Insulin-like growth factor (IGF-1)
˷. Fibroblast growth factor (FGF-1)
˸. Platelet-derived growth factor (PDGF)
˹. Transforming growth factor beta (TGF-B)
˺. Bone morphogenetic proteins (BMP)
˻. clinical history and radiographic findings.
˼. technetium bone scan
˽. flow cytometry pattern of extracted chondrocytes
˾. immunohistochemical staining patterns of a biopsy specimen
˿. histologic features of a biopsy specimen stained with hematoxylin-cosin
̀. Radial
́. Radial recurrent
̂. Posterior interosseous
̃. Superior ulnar recurrent
̄. Superficial radial circumflex
̅. Impaired hydroxylation of proline
̆. Failure of cleavage in procollagen
̇. Defective binding sites for hydroxyproline
̈. Failure to incorporate glycine into the helix
̉. Diminished production of collagen through the rough endoplasmic reticulum
̊. Asking the legal staff to seek a court injunction
̋. Copying the patient’s chart and giving it to him as he leaves
̌. Having the patient sign a written legal contract that specifies acceptable behavior
̍. Continuing care of the patient until an appropriate referral can be arranged
̎. Transferring the patient to another orthopaedic surgeon without disclosing the realreason for why the patient is being transferred
̏. Meta-analysis
̐. Confidence interval
̑. Analysis of variance (ANOVA)
̒. Statistical significance (p-value)
̓. Survivorship analysis (Kaplan-Meier)
̔. Spinal shock
̕. Neurogenic shock
̖. Hypovolemic shock
̗. Pulmonary embolism
̘. Fat embolus syndrome
̙. Lumbar spinal stenosis
̚. Metastatic disease of the spine
̛. Rheumatoid lumbar spondylitis
̜. Isthmic spondyloloisthesis
̝. Degenerative spondylolisthesis at L4-5 and L5-S1
̞. Patella alta
̟. A metal-backed patella
̠. Varus malalignment of the knee
̡. A posterior cruciate-substituting femoral component
̢. Lateral subluxation of the patella on a Merchant’s view
̣. The sesamoids are separated
̤. The sesamoid is fractured
̥. The proximal phx is on the neck of the metatarsal
̦. The dislocation is dorsal and centered
̧. The proximal phalanx is hyperextended
̨. Patella
̩. Tibial stem
̪. Distal femoral interface
̫. Posterior femoral interface
̬. Sites of screw fixation for the tibia
̭. Hallux rigidus
̮. Fracture of the sesamoid
̯. Disruption of the plantar plate
̰. Osteonecrosis of the metatarsal head
̱. Rupture of the flexor hallucis longus
̲. Gout
̳. Sepsis
̴. Old trauma
̵. Rheumatoid arthritis
̶. Charcot arthroplasty
̷. Aspiration and steroid injection
̸. Biopsy, curettage, and allograft bone grafting
̹. Percutaneous Kirschner wire fixation
̺. Percutaneous injection of autogenous bone marrow
̻. Nerve roots
̼. Spinal cord
̽. Sciatic nerve
̾. Peroneal nerve
̿. Conus medullaris
̀. Extent of bone penetrated by reaming, prosthetic components, or acrylic cement
́. Periprosthetic regions that are accessible to joint fluid and particulate wear debris
͂. Enveloping pseudocapsular scar tissue that develops around a prosthetic hip following surgical capsulectomy
̓. Soft tissue and bone that are potentially contaminated with bacteria in the setting of a prosthetic joint infection
̈́. Potential intrapelvic joint space communication created by acetabular fixation screws or intrapelvic extruded acrylic cement
Ι. Early and late infection
͆. Periprosthetic fracture of the femur
͇. Failure of the patellofemoral and extensor mechanisms
͈. Aseptic loosening of cementing tibial components
͉. Asceptic loosening of cemented femoral components
͊. Acceptance of the current position of the ankle
͋. Open reduction and fixation in the epiphysis only
͌. ORIF with a small-fragment T-plate from the malleolus up to the metaphysis
͍. Closed reduction by eversion of the ankle and application of a bivalved long leg cast
͎. CRUGA and fixation with a malleolar screw from the malleolus into the metaphysis
͏. Resection arthroplasty and local radiation
͐. In situ fusion of the hip
͑. Excision of heterotopic bone, total hip arthroplasty, and oral indomethacin
͒. Excision of heterotopic bone and local radiation
͓. Excision of heterotopic bone, hemiarthroplasty, and oral indomethacin
͔. Closed reduction of both fractures and immediate spica casting
͕. Bilateral skin traction for 3 weeks, followed by spica casting
͖. External fixation of both femora
͗. External fixation of the left femur and a long leg cast brace for the right femur
͘. External fixation of the left femur and use of a reamed intramedullary nail in the right femur
͙. Synovial sarcoma
͚. Soft-tissue abcess
͛. Rhabdomyosarcoma
͜. Eosinophilic granuloma
͝. Nodular pigmented villonodular synovitis
͞. Changing to a titanium nail
͟. Changing to a nonslotted nail
͠. Changing the cross-sectional shape of the nail
͡. Increasing the diameter of the nail by 3 mm
͢. Increasing the diameter of the interlocking screws
ͣ. Fracture healing
ͤ. Chondrosarcoma
ͥ. Periosteal chondroma
ͦ. Periosteal osteosarcoma
ͧ. Dysplasia epiphysealis hemimelica
ͨ. Demonstrate competence in the subject of the case
ͩ. Be fellowship trained in the subject of the case
ͪ. Be paid on a contingency basis
ͫ. Be board certified by the American Board of Orthopaedic Surgery
ͬ. Have been involved in the case as a consultant
ͭ. Diagnostic arthroscopy
ͮ. Arthroscopy and subacromial decompression
ͯ. Reduction and fixation of the proximal humeral epiphysis
Ͱ. Temporary cessation of throwing
Ͱ. Physical therapy for rotator cuff strengthening
Ͳ. Oblique popliteal ligament
Ͳ. Lateral capsule
ʹ. Popliteal tendon
͵. Fibular collateral ligament
Ͷ. Posterior oblique ligament
Ͷ. Radial tear
͸. Parrot-beak tear
͹. Vertical tear in the “red-red” zone
ͺ. Vertical tear in the “red-white” zone
Ͻ. Vertical tear in the “white-white” zone
Ͼ. 0 degrees of abduction, with neural rotation
Ͽ. 40 degrees of flexion and 60 degrees of internal rotation
;. 45 degrees of flexion and 45 degrees of external rotation
Ϳ. 90 degrees of abduction with neutral rotation
΀. 90 degrees of abduction and 90 degrees of external rotation
΁. Sural
΂. Saphenous and its branches
΃. Posterior tibial and its branches
΄. Deep peroneal and its branches
΅. Superficial peroneal and its branches
Ά. Strength
·. Stiffness
Έ. Shelf life
Ή. Antigenicity
Ί. Risk of HIV transmission
΋. Indemnification
Ό. Occurrence
΍. Excess liability
Ύ. Claims-made
Ώ. Nose
Ϊ́. Lateral Y
Α. Scapular AP
Β. Neutral rotation AP
Γ. Internal rotation AP
Δ. External rotation AP
Ε. Trauma
Ζ. Hemophilia
Η. Reiter’s syndrome
Θ. Rheumatoid arthritis
Ι. Systemic lupus erythematosus
Κ. Cast immobilization for 6 weeks
Λ. Activity modification and re-evaluation in 2 months
Μ. Internal fixation with or without bone grafting
Ν. Retrograde drilling of the defect without articular cartilage penetration
Ξ. Drilling of the defect directly through the articular cartilage
Ο. repair or reconstruction of the medial collateral ligament
Π. repair or reconstruction of the medialand lateral collateral ligaments
Ρ. immobilization for 5 days or less
΢. immobilization for 14 days
Σ. immobilization for 25 days
Τ. Cystinosis
Υ. Hypophosphatemia
Φ. Renal osteodystrophy
Χ. Primary hyperparathyroidism
Ψ. Nutritional vitamin D deficiency
Ω. Lateral meniscus tear
Ϊ. Popliteus tenosynovitis
Ϋ. Iliotibial band friction syndrome
Ά. Peroneal nerve entrapment
Έ. Biceps tendinitis
Ή. Observation
Ί. Removal of the prosthetic components
Ϋ́. Operative exploration and decompression of the peroneal nerve
Α. Nerve conduction velocity studies
Β. Loosening of the primary dressings and knee flexion to 30 degrees
Γ. I
Δ. II
Ε. III
Ζ. decreased tissue tension
Η. decreased abductor lever arm
Θ. decreased joint reaction force
Ι. increased body weight over lever arm
Κ. increased polyethylene wear rate
Λ. recurrent traumatic anterior dislocation
Μ. recurrent traumatic posterior dislocation
Ν. traumatic subluxation with no previous dislocation
Ξ. traumatic anterior subluxation
Ο. atraumatic involuntary subluxation
Π. radial
Ρ. axillary
Σ. suprascapular
Σ. thoracodorsal
Τ. long thoracic
Υ. Flexion
Φ. Extension
Χ. Axial rotation
Ψ. Left lateral bending
Ω. Right lateral bending
Ϊ. Skin
Ϋ. Lung
Ό. Brain
Ύ. Heart
Ώ. Kidney
Ϗ. Thoracoacromial, lateral thoracic, subscapular
Β. Thoracoacromial, anterior humeral circumflex, posterior humeral circumflex
Θ. Posterior humeral circumflex, subscapular, thoracacromial
ϒ. Subscapular, thoracacromial, anterior humeral circumflex
ϓ. Lateral thoracic, anterior humeral circumflex, thoracacromial
ϔ. Respondeat superior
Φ. Indemnity agreement
Π. Hold harmless agreement- attempt to shift liability from company to physician
Ϗ. Comparative negligence-% of involvement
Ϙ. Contributory negligence- resident contributed to the negligence
Ϙ. t-type
Ϛ. both column
Ϛ. transverse
Ϝ. anterior column
Ϝ. anterior column posterior hemitransverse
Ϟ. Posterior interosseous
Ϟ. Anterior interosseous
Ϡ. Radial
Ϡ. Median
Ϣ. Ulnar
Ϣ. Shock from hypovolemia
Ϥ. Associated rupture of the bladder
Ϥ. Arterial bleeding on pelvic angiogram
Ϧ. Presence of a hematoma in the perineum and scrotum
Ϧ. Fractures of both the anterior and posterior pelvic ring

Correct Answer & Explanation

. arthroscopic capsular release


Explanation

Question 4079

Topic: 10. Pathology and Oncology

  • The Injury Severity Score (ISS), using point scores from five different body systems, is a method that aids in predicting the chances of mortality in a patient with multiple injuries by
. adding the scores, in all five body systems
. adding the squares of the scores in the three most severely injured systems
. doubling the cumulative score for head and chest injuries
. combining the scores from the most and least injured systems
. correcting the score in the most severely injured system for age
. traumatic femoral head fracture
. osteonecrosis
. osteoarthritis
. neuropathic joint
. rheumatoid arthritis
. low-dose radiation
. steroid injection
. a load-relieving insert and shoe modification
. complete excision of the mass and the entire plantar fascia
. wide excision of the mass with a 2 cm margin of normal fascia
. CT scan of the chest
. technetium bone scan
. bone marrow aspiration
. serum protein electrophoresis
. lateral skull radiograph
. high-grade histology of the initial tumor
. multiple local recurrences after curettage
. previous treatment of the tumor with cryotherapy
. previous treatment of the tumor with radiation therapy
. extraosseous extension into two or more adjacent compartments
. Dorsal rhizotomy and facet joint fusion
. Multilevel corpectomy and spinal stabilization
. Central and lateral recess decompression and bilateral foraminotomy
. Central decompression and facet joint fusion
. Central decompression, foraminotomy, and spinal fusion from L2 to L5.
. Inadequate rehabilitation
. Displacement of the coronoid process fracture
!. Insufficiency of the lateral ulnar collateral ligament
". Insufficiency of the anterior band of the medial collateral ligament
#. Insufficiency of the posterior band of the medial collateral ligament
$. Osteotomy and intramedullary rod fixation
%. Electrical stimulation
&. Strut-autografing the concavity the tibia
'. A patellar tendon-bearing brace
(. Percutaneous injection of demineralized bone matrix
). digoxin
*. sucralfate
+. clindamycin
,. alcohol
-. neuromuscular blocking agents
.. Unrestrained roll-back
/. Unrestrained rotational conformity
0. Medial-Lateral conformity
1. Anteroposterior conformity in flexion
2. Anteroposterior conformity in extension
3. Arthrodesis of the MTP joint
4. A Silastic implant of the MTP joint
5. Resection arthroplasty of the MTP joint
6. Cheilctomy of the MTP joint
7. Osteotomy of the base of the proximal phalanx
8. Genu varum
9. Tarsal coalition
:. Degenerative ankle arthrosis
;. Osteochondritis dissecans of the talus
<. Hemihypertrophy of the ipsilateral lower extremity
=. Trabecular bone is preferentially resorbed in this high bone turnover state
>. Loss of water content in the disk increases impact load to the vetrebral bodies
?. Stress is imposed by the relative stiffness of the arthrtic facet joints
@. Increased energy demands are imposed by decreased circulation to the vertebral body
A. The thick cortical bone found in the vertebral body resorbs rapidly following estrogen withdrawal
B. Increased time in stance and swing phase
C. Addition of a double leg float phase
D. Decreased vertical ground reaction forces
E. Decreased arc of motion in the hip, knee, and ankle
F. Decreased joint reaction forces in the hip, knee, and ankle
G. Talonavicular arthrodesis
H. Medial displacement calcaneal osteotomy
I. Flexor digitorum longus tendon transfer with spring ligament advancement
J. Triple arthrodesis
K. Calcaneocuboid distraction arthrodesis and repair of the posterior tibial tendon
L. Lymphoma
M. Hemangioma
N. Osteosarcoma
O. TB of the spine
P. Metastatic breast carcinoma
Q. widening and shortening of the heel.
R. weakness of the gastrocnemius-soleus complex.
S. anterior impingement from a horizontal talus.
T. unrecognized compartment syndrome of the foot.
U. degenerative arthritis of the tibiotalar joint.
V. a corrective osteotomy
W. application of braces
X. medial physeal stapling until the varus corrects
Y. observation
Z. application of corrective casts
[. a total contact cast.
\. electrical stimulation.
]. an off the shelf fracture brace.
^. an elastic compression bandage and crutches.
_. a hard soled shoe until the patient is asymptomatic.
`. Ewings tumor
A. Parosteal osteosarcoma
B. Dedifferentiated chondrosarcoma
C. Low grade intramedullary chondrosarcoma
D. High grade intramedullary osteosarcoma
E. Vascular injury
F. Tear of the rotator cuff
G. Injury to the brachial plexus
H. Fracture of the upper thoracic rib
I. Fracture of the proximal humerus
J. Biceps
K. Trapezius
L. Infraspinatus
M. Pectoralis major
N. Serratus anterior
O. Hybrid total hip arthroplasty
P. Noncemental hemiarthroplasty of the hip
Q. Closed reduction and percutaneous pin fixation
R. Open reduction through an anterior approach to the hip
S. Excision of the head fragment
T. a quadratus femoris pediclebone graft
U. a proximal femoral allograft
V. intertrochanteric osteotomy
W. total hip arthroplasty
X. hip hemiarthroplasty
Y. Echocardiogram
Z. Electrocardiogram
{. Radiograph of the chest
|. CT scan of the shoulder
}. Ultrasound of the shoulder
~. Ilioinguinal
. Extended iliofemoral
€. Combined ilioinguinal and Kocher-Langenbeck (posterior)
. Kocher-Langenbeck (posterior)
‚. Kocher-Langenbeck (posterior) with trochanteric osteotomy
ƒ. Deltoid
„. Supraspinatus
…. Subscapularis Infraspinatus
†. Infraspinatus
‡. Infraspinatus and teres minor
ˆ. an orthosis.
‰. observation.
Š. electrical stimulation.
‹. open reduction and internal fixation.
Œ. application of a nonweightbearing short leg cast.
. repair of the rotator cuff.
Ž. rehabilitation of the shoulder
. replacement of the humeral head.
. arthroscopic acromioplasty and debridement.
‘. immobilization is a sling until pain resolves.
’. Bone rotation versus torque applied
“. Bone deflection versus bending moment applied
”. Axial displacement versus tension applied
•. Lateral translation versus shear force applied
–. Fracture gap closing versus compressive force applied
—. steroid injection
˜. stretching of the heel cord
™. surgical release of the plantar fascia
š. application of a short leg cast for 6 to 8 weeks
›. wearing dorsiflexion night splints
œ. Open bladder
. Bilateral “hitchhiker’s” thumbs
ž. Bilateral defects in the midclavicles
Ÿ. Rhizomelic shortening of the extremities
 . Radiographic fragmentation of all major epiphyses
¡. Medial patellotibial
¢. Medial patellofemoral
£. Medial patellomeniscal
¤. Lateral patellofemoral
¥. Lateral patellotibial
¦. Heat
§. Gentle active flexion-extension exercises
¨. Isokinetic strengthening
©. Electrical muscle stimulation
ª. Immobilization of the limb with the knee in full flexion
«. Distal chevron osteotomy with soft-tissue release
¬. Distal soft-tissue realignment only
­. Closing wedge osteotomy (Aken) of the proximal phalanx
®. Proximal first metatarsal osteotomy only
¯. Soft-tissue realignment with a proximal metatarsal osteotomy
°. Vagus
±. Phrenic
². Hypoglossal
³. Recurrent laryngeal
´. Inferior thyroid
Μ. Surgical exploration
¶. Application of leeches
·. Stellate ganglion blocks
¸. Intra-arterial streptokinase
¹. Elevation and reevaluation in 1 hour
º. Liver profile
». Myleogram
¼. Platelet count
½. CT scan of the head
¾. Angiogram of the extremity
¿. Post spinal fusion from L5to S1
À. Primary repair with an iliac bone graft
Á. Post spinal fusion of L4-5
Â. A pantaloon body cast and 6 weeks of bed rest
Ã. Rest, NSAIDS, and limited dancing
Ä. Stress fracture of the proximal fifth metatarsal
Å. Stress fracture of the base of the second metatarsal
Æ. Stress fracture of the neck of the second metatarsal
Ç. Morton’s neuroma
È. Lisfranc’s joint subluxation
É. C5 radiculopathy
Ê. Subscapularis rupture
Ë. Glenohumeral arthrosis
Ì. Rotator cuff arthropathy
Í. Suprascapular nerve compression at the spinoglenoid notch
Î. mm femoral head in combination with a metal-backed polyethylene component
Ï. mm femoral head in combination with an all-polyethylene acetabular component
Ð. mm femoral head in combination with a metal-backed polyethylene component
Ñ. mm femoral head in combination with an all-polyethylene component
Ò. mm femoral head in combination with a metal-backed polyethylene component
Ó. Female gender
Ô. History of cigarette smoking
Õ. L5-S1 spondylolisthesis on pre-employment radiography
Ö. Decreased strength of the lower extremities on pre-employment testing
×. Decreased flexibility of the lumbar spine on pre-employment testing
Ø. Size of cells
Ù. Amount of DNA in cells
Ú. Nucleus-cytoplasm ratio
Û. Specific DNA sequences
Ü. Specific messenger RNA sequences
Ý. Femoral and obturator nerves
Þ. Femoral and superior gluteal nerves
SS. Femoral and lateral femoral cutaneous nerves
À. Obturator and superior gluteal nerves
Á. Obturator and lateral femoral cutaneous nerves
Â. Isotonic
Ã. Isokinetic
Ä. Isometric
Å. Open kinetic chain
Æ. Dynamic variable resistance
Ç. Closed reduction and cast immobilization
È. Uniplanar external fixation
É. Open reduction and internal fixation with a dynamic compression plate
Ê. Unreamed intramedullary rod
Ë. Multiple plane external fixator
Ì. Inlet view of the pelvis
Í. Outlet view of the pelvis
Î. AP view of the hip
Ï. Ilial oblique view (external oblique) of the hip
Ð. Obturator oblique
Ñ. Glycolytic pathway
Ò. Oxidative phosphorylation
Ó. Breakdown of fat
Ô. Breakdown of protein
Õ. Breakdown of adenosine triphosphate
Ö. an MRI scan
÷. arthroscopic examination
Ø. AP and frog-lateral radiographs of the pelvis and hips
Ù. varus and valgus stress radiographs of the knee
Ú. physical examination of the knee under anesthesia
Û. extended curettage and polymethylmethacrylate cementation
Ü. extra-articular resection of the knee and an allograft arthrodesis
Ý. wide resection of the proximal tibia and custom prosthetic replacement
Þ. prophylactic internal fixation and postoperative irradiation
Ÿ. excision of the lateral condyle and reconstruction with a hemicondylar allograft
Ā. silicone implant joint replacement
Ā. metatarsophalangeal joint arthrodesis
Ă. metatarsophalangeal joint debridement
Ă. resection of the metatarsal head
Ą. resection of the base of the proximal phalanx
Ą. Fixation of the syndesmosis has failed
Ć. Widening of the ankle mortise has led to the failure of fixation
Ć. Infection around the syndesmosis screw has led to osteomyelitis
Ĉ. The syndesmosis screw is broken
Ĉ. Motion between the tibia and fibula has caused loosening of the syndesmosis screw
Ċ. Microcephaly
Ċ. A temporal lobe cyst
Č. An Arnold-Chiari type 1 malformation
Č. Periventricular leukomalacia
Ď. Agnesis of the corpus callosum
Ď. Wolff’s
Đ. Hooke’s
Đ. Hilton’s
Ē. Muller-Haeckel
Ē. Heuter-Volkmann
Ĕ. Both the anterolateral and posteromedial bands are isometric and do not significantly change with flexion
Ĕ. The anterolateral band is lax and becomes tight in flexion, while the posteromedial band is tight, and becomes lax in flexion
Ė. The anterolateral band is tight and becomes lax in flexion, while the posteromedial band is lax and becomes tight in flexion
Ė. Both the anterolateral and posteromedial bands are lax and become tight in flexion
Ę. Both the anterolateral and posteromedial bands are tight and become lax as the knee is flexed
Ę. UCB orthosis
Ě. Rigid orthosis with a medical arch support
Ě. Semi-rigid orthosis with lateral forefoot posting
Ĝ. Semi-rigid orthosis with a medial arch support
Ĝ. Medial heel wedge attached to the running shoes
Ğ. Hallux varus
Ğ. Osteonecrosis
Ġ. Recurrence of the hallux valgus
Ġ. “Transfer” second metatarsalgia
Ģ. Physeal arrest of the first metatarsal
Ģ. Aseptic loosening in a 70-year-old patient
Ĥ. Mechanical failure of a hinged knee prosthesis
Ĥ. Failed knee replacement complicated by reflex sympathetic dystrophy
Ħ. Infection with soft-tissue deficit
Ħ. A prior patellectomy
Ĩ. Knee fusion
Ĩ. Open irrigation and debridement
Ī. Arthroscopic irrigation and debridement
Ī. One-stage exchange arthroplasty
Ĭ. Two-stage exchange arthroplasty
Ĭ. Putti-platt repair
Į. Open Bankart repair
Į. Injection of a subacromial corticosteroid
İ. Arthroscopic transglenoid capsular shift
I. Rehabilitation of the scapular and rotator cuff muscles
IJ. Silicone suction socket and an energy-absorbing foot
IJ. Silicone suction socket and a variable resistance ankle
Ĵ. Plastic suction socket, telescoping pylon, and a solid ankle cushioned heel (SACH) foot
Ĵ. Plastic socket with a hinged thigh cuff and a SACH foot
Ķ. Patellar tendon-bearing suction socket and a uniaxial hydraulic ankle
Ķ. Parosteal
ĸ. Periosteal
Ĺ. High-grade intramedullary
Ĺ. Osteosarcoma occurring in Paget’s disease
Ļ. Osteosarcoma occurring in irradiated bone
Ļ. Cauda equina
Ľ. Conus medullaris
Ľ. Genitofemoral nerve
Ŀ. Lumbar sympathetic plexus
Ŀ. Lumbar parasympathetic plexus
Ł. Spinal pseudoarthrosis
Ł. Spinal cord traction injury with paralysis
Ń. Arterial and venous thromboses
Ń. Superior mesenteric artery syndrome
Ņ. Crankshaft phenomenon
Ņ. Inversion stress radiograph
Ň. MRI scan
Ň. CT scan
ʼN. Nuclear bone scan
Ŋ. External rotation stress radiograph
Ŋ. Complex deformity with an angulation in two planes
Ō. Single deformity less than 20 degrees, apex posterolateral
Ō. Single deformity greater than 30 degrees, apex posterolateral
Ŏ. Single deformity less than 20 degrees, apex posteromedial
Ŏ. Single deformity greater than 30 degrees, apex posteromedial
Ő. Pronation of the foot during the stance phase of gait
Ő. Heel inversion at the beginning of a single limb heel rise
Œ. Active inversion of the nonweightbearing foot
Œ. Active plantar flexion of the first ray against resistance
Ŕ. Active plantar flexion of the foot during the push-off phase of gait
Ŕ. Observation and repeat radiographs in 4 months
Ŗ. Application of a thoracolumbalsacral orthosis for 22 to 24 hours per day
Ŗ. Electrical stimulation at night
Ř. Physical therapy
Ř. Begins to remodel and hypertrophy more quickly
Ś. Provides a better scaffold for osteoconduction
Ś. Reduces the risk of early fracture
Ŝ. Reduces technical difficulty
Ŝ. Lowers donor site morbidity
Ş. Anterior fusion of the lumbar curve
Ş. Anterior and posterior fusion of the thoracic curve
Š. Posterior fusion of the thoracic curve
Š. Posterior fusion of the thoracic and lumbar curves
Ţ. Application of a brace until the iliac apophyses are Risser 4 or 5, followed by surgical correction
Ţ. Subscapularis rupture
Ť. Type III SLAP lesion
Ť. Disruption of capsular shift
Ŧ. Isolated traumatic subluxation
Ŧ. Injury to the axillary nerve after dislocation
Ũ. hypophosphatemia
Ũ. high dietary cholesterol intake
Ū. deficiency of lipoprotein A
Ū. deficiency of protein S and protein C
Ŭ. elevated levels of antithrombin III
Ŭ. Weightbearing short leg cast
Ů. Nonweightbearing short leg cast
Ů. Removable splint and early motion
Ű. Open reduction and internal fixation
Ű. Elastic compression bandage with full weightbearing
Ų. Breast
Ų. Prostate
Ŵ. Gastrointestinal
Ŵ. Kidney
Ŷ. Multiple myeloma
Ŷ. Varus stress
Ÿ. Valgus stress
Ź. Torsional loading
Ź. Hyperextension of the knee
Ż. Contraction of the quadriceps while axially loaded
Ż. Primary internal fixation at both fracture levels
Ž. External fixation as definitive ttt for both #
Ž. Skeletal traction and delayed internal fixation of both fractures
S. Primary internal fixation of the proximal fracture and delayed fixation of the femoral fracture
Ƀ. Primary internal fixation of the femoral shaft fracture and delayed fixation of the proximal #
Ɓ. Heel spur
Ƃ. Plantar fascitis
Ƃ. Dysfunction of the tibialis posterior tendon
Ƅ. Compression of the first branch of the lateral plantar nerve
Ƅ. Compression of the calcaneal nerve
Ɔ. Displaced labral tear
Ƈ. Tear of the rotator cuff
Ƈ. Fracture of the glenoid rim
Ɖ. Palsy of the axillary nerve
Ɗ. Palsy of the musculocutaneus nerve
Ƌ. Enchondroma
Ƌ. Osteoblastoma
ƍ. Giant cell tumor
Ǝ. Aneurysmal bone cyst
Ə. Fibrous dysplasia
Ɛ. Arthrogram of the wrist
Ƒ. MRI scan of both wrists
Ƒ. CT scan of both wrists in the same position
Ɠ. Radiographs of the wrist in supination and pronation
Ɣ. Radiographs of the opposite wrist in the same position
Ƕ. Secondary hyperparathyroidism
Ɩ. Phosphate retention secondary to uremia
Ɨ. Insufficient renal synthesis of 1, 25 dihydroxy vitamin D
Ƙ. Aluminum deposition in bone from oral phosphate binders
Ƙ. Persistent acidosis aggravating the negative calcium balance
Ƚ. Posterior fusion at T10-L3 with segmental instrumentation
ƛ. Laminectomy and fusion of T12-L2 with segmental instrumentation
Ɯ. Bed rest in a hyperextension brace
Ɲ. L1 vertebrectomy and anterior decompression with strut graft fusion and instrumentation
Ƞ. Progressive ambulation as tolerated in a custom-molded thoracolumbosacral orthosis
Ɵ. Positive-pressure ventilation
Ơ. An immediate radiograph of the chest
Ơ. Adjustment of the position of the endotrachael tube
Ƣ. Insertion of a large-bore needle into the pericardial space
Ƣ. Insertion of a large-bore needle in the right second intercostal space, midclavicular line
Ƥ. Allowing the ends of the fracture to touch
Ƥ. Adding a second connecting bar
Ʀ. Adding one pin to each fracture fragment
Ƨ. Increasing the pin diameter from 4 mm to 6 mm
Ƨ. Decreasing the connecting bar-to-bone distance from 6 cm to 4 cm
Ʃ. Osteomyelitis
ƪ. Malignant degeneration
ƫ. Stress fracture
Ƭ. Local recurrence of the giant cell tumor
Ƭ. Bone resorption due to methylmethacrylate
Ʈ. Advancement of the plantar plate
Ư. Resection of the second metatarsal head
Ư. Dorsiflexion osteotomy of the second metatarsal neck
Ʊ. Transfer of the flexor digitorum longus tendon to the dorsum of the toe
Ʋ. Transfer of the extensor digitorum comminus tendon to the metatarsal neck
Ƴ. Sacral fracture
Ƴ. Burst fracture of L5
Ƶ. Cauda equina syndrome
Ƶ. Distraction-flexion injury at L3
Ʒ. Distraction-extension injury at L3
Ƹ. An MRI scan of the shoulder
Ƹ. An MRI scan of the cervical spine
ƺ. Electromyographic and nerve conduction velocity studies
ƻ. Immobilization in a sling and early passive range of motion exercises
Ƽ. Immediate return to the operating room for exploration of the brachial plexus
Ƽ. cerclage wiring
ƾ. tension band wiring
Ƿ. removal of the patellar component
ǀ. revision of the patellar component
ǁ. immobilization of the knee and protected weightbearing
ǂ. Liposarcoma
ǃ. Nodular fasciitis
DŽ. Rabdomyosarcoma
DŽ. Malignant fibrous histiocytoma
DŽ. Extra-abdominal desmoid tumor
LJ. Clubfeet
LJ. Thrombocytopenia
LJ. Congenital scoliosis
NJ. Ventricular septal defect
NJ. Arnold-Chiari malformation
NJ. delayed primary closure
Ǎ. free flap
Ǎ. pedicle groin flap
Ǐ. full-thickness skin graft
Ǐ. split-thickness skin graft
Ǒ. Infection
Ǒ. Nonunion
Ǔ. Improper screw length
Ǔ. Osteonecrosis of the distal fragment
Ǖ. Use of a cortical screw instead of a cancellous screw
Ǖ. Infection
Ǘ. Tear of the rotator cuff
Ǘ. Loosening of the humeral component
Ǚ. Arthritis of the glenoid
Ǚ. Arthritis of the A-C joint
Ǜ. Reduced morbidity
Ǜ. Improved osteoinduction
Ǝ. Improved osteoconduction
Ǟ. More rapid revascularization
Ǟ. Lower risk of disease transmission
Ǡ. Manipulation Under Anesthesia
Ǡ. Arthroscopic acromioplasty
Ǣ. Arthroscopic debridement of G-H joint
Ǣ. Replacement of the humeral head
Ǥ. Lengthening of the subscapularis and release of the anterior capsule
Ǥ. Bacteroides
Ǧ. E. coli
Ǧ. Staph. aureus
Ǩ. group A streptococcus
Ǩ. Clostridium perforingens
Ǫ. observation and exercises
Ǫ. bracing with a thoracolumbar orthosis
Ǭ. fusion of the posterior spine
Ǭ. fusion of the anterior spine
Ǯ. fusion of the anterior and posterior spine
Ǯ. Total wrist replacement and bridge grafts
J̌. palmar shelf arthroplasty and tendon transfers
DZ. Darrach distal ulna resection, dorsal tenosynosynovectomy, and tendon transfers
DZ. Radioscaphate fusion, extensor tenodesis, and Darrach distal ulna resection
DZ. Total wrist fusion and tendon transfers
Ǵ. constrained acetabular component
Ǵ. protrusion ring with morselized graft
Ƕ. cemented metal backed acetabular component
Ƿ. cemented all-polyethylene acetabular component
Ǹ. cementless hemispherical component with screw fixation
Ǹ. application of a hip abduction brace for 22 hours per day
Ǻ. application of a hip spica under anesthesia
Ǻ. discontinuance of all bracing and repeat radiographs in 3 months
Ǽ. open reduction of the hip and application of a spica cast
Ǽ. open reduction, varus osteotomy, and application of a spica cast
Ǿ. Loss of skin hair on the feet
Ǿ. Absent pulses on vascular examination
Ȁ. Pain that originates proximally and spreads distally
Ȁ. Pain that is relieved by stopping and standing
Ȃ. Pain that is worse when the patient walks uphill rather downhill
Ȃ. wrist flexors and finger flexors
Ȅ. elbow flexors and wrist flexors
Ȅ. elbow flexors and finger flexors
Ȇ. elbow extensors and wrist flexorst Level Key Muscles4 DiaphragmDeltoid, elbow flexors, diaphragmElbow flexors, wrist extensorsElbow extensors, wrist flexorsFinger flexors (distal phalanx of middlefinger)Finger abductors (5th digit), intrinsics of hand2 Segmental innervation to intercostal muscles, abdominal and paraspinal muscles) L1, L2, L3 Hip flexors3, L4 QuadricepsTibialis anteriorToe extensors, hip abductorsAnkle plantarflexors, peronei
Ȇ. elbow extensors and wrist extensors
Ȉ. Syndactyly
Ȉ. Macrodactyly
Ȋ. Camptodactyly
Ȋ. Preaxial polydactyly
Ȍ. Postaxial polydactyly
Ȍ. Arthrodesis
Ȏ. Rotationplasty
Ȏ. Above-knee amputation
Ȑ. Osteoarticular allograft
Ȑ. Endoprosthesis (custom arthroplasty)
Ȓ. Plantar fascia
Ȓ. Spring ligament
Ȕ. Deltoid ligament
Ȕ. Intrinsic tendons
Ȗ. Gastorcnemius-solelus complex
Ȗ. Prevention of presynaptic release of acetylcholine
Ș. Prevention of synthesis of presynaptic acetylcholine
Ș. Activation of acetylcholinesterase at the motor end-plate
Ț. Blockage of postsynaptic action of acetylcholine until reserves are depleted
Ț. Stimulation of release of presynaptic acetylcholine until reserves are depleted
Ȝ. stiffness of the femoral component.
Ȝ. head offset of the femoral component.
Ȟ. femoral component material modulus of elasticity.
Ȟ. extent of the femoral component porous coating.
Ƞ. Presence of a femoral component collar.
ȡ. plantar fascia and quadratus plantae tendon.
Ȣ. ligamentous structures connecting the tarsal bones.
Ȣ. shape of the tarsal bones and the intervening joints.
Ȥ. activity of the intrinsic muscles of the foot.
Ȥ. activity of the posterior tibialis and the peroneus longus muscles.
Ȧ. scapulothoracic fusion
Ȧ. strengthening of the periscapular muscles
Ȩ. pectoralis minor-fascia lata graft transfer to the scapula
Ȩ. pectoralis major-fascia lata graft transfer to the scapula
Ȫ. exploration of the long thoracic nerve, with sural nerve graft
Ȫ. tricompartmental knee replacement
Ȭ. unicompartmental knee replacement
Ȭ. medial compartment meniscal allograft
Ȯ. valgus-producing distal femoral osteotomy
Ȯ. valgus-producing proximal tibial osteotomy
Ȱ. Internal rotation of the femoral component
Ȱ. External rotation of the tibial component
Ȳ. Lateral placement of the femoral component
Ȳ. Medial placement of the patellar component
ȴ. Excessive resection of the patella
ȵ. Hallux rigidus
ȶ. Hallux valgus
ȷ. Neuroma of the first web space
ȸ. Fracture of the sesamoid
ȹ. Rupture of the flexor hallucis longus
Ⱥ. Sickle cell crisis
Ȼ. Idiopathic chondrolysis
Ȼ. Hemophilic arthropathy
Ƚ. Osteoid osteoma of the femoral neck
Ⱦ. Legg-Calve-Perthes disease
Ȿ. Decreased ankle jerk and positive femoral nerve stretch test
Ɀ. Decreased knee jerk and positive straight-leg raising sign
Ɂ. Gastrocnemius-soleus complex weakness and positive straight-leg raising sign
Ɂ. Weakness of the extensor hallucis longus and positive straight-leg raising sign
Ƀ. Weakness of the extensor hallucis longus and positive femoral nerve stretch test
Ʉ. Long-term administration of IV and oral antibiotics
Ʌ. Open soft-tissue debridement, retention of prosthetic components, and IV antibiotics
Ɇ. Immediate exchange arthroplasty with antibiotic-impregnated cement
Ɇ. Two-stage surgical prosthetic exchange and IV antibiotics
Ɉ. Resection arthroplasty and IV antibiotics
Ɉ. SCFE
Ɋ. MED
Ɋ. Perthes disease
Ɍ. Hypothyroidism
Ɍ. Chondrolysis
Ɏ. gout.
Ɏ. osteoporosis.
Ɐ. eosinophilic granuloma.
Ɑ. tuberculosis of the spine.
Ɒ. metastatic disease of the spine.
Ɓ. water content.
Ɔ. Synthesis of type I collagen.
ɕ. Proteoglycan content.
Ɖ. Activity of chondrocytes.
Ɗ. Synthesis of hyaluronate.
ɘ. Lung
Ə. Breast
ɚ. Prostate
Ɛ. Thyroid
Ɜ. Renal
ɝ. T1-low, T2-low.
ɞ. T1-low, T2-high.
ɟ. T1-moderate, T2-low.
Ɠ. T1-high, T2-low.
Ɡ. T1-high, T2-high.
ɢ. hypothesis is incorrect or invalid
Ɣ. interobserver error rate is 4%.
ɤ. Standard deviation is 4% higher or lower than the mean.
Ɥ. Sample size is 4% larger than required to be clinically significant.
Ɦ. Probability that the differences noted between two study groups were due to chance alone is 4%.
ɧ. I
Ɨ. II
Ɩ. IV
Ɪ. IX
Ɫ. X
Ɬ. Cranial setting
ɭ. Cranial subluxation
ɮ. Odontoid fracture
Ɯ. Lysis of the arch of the atlas
ɰ. Atlantoaxial subluxation
Ɱ. Retrograde collapse of the endoneurial tubes
Ɲ. Irreversible atrophy of the denervated muscles
ɳ. Elongation of the axons across the zone of injury
ɴ. Sprouting of the axons at the neuromuscular junction
Ɵ. Misdirection of the axons across the zone of injury
ɶ. Maximally pronated and elbow extended
ɷ. Maximally pronated and the elbow flexed
ɸ. Maximally supinated and the elbow flexed
ɹ. Maximally supinated and the elbow extended
ɺ. In neutral rotation, with the elbow extended
ɻ. open reduction and internal fixation
ɼ. buddy taping to the adjacent index finger
Ɽ. early motion with application of a dynamic banjo splint
ɾ. application of a cast with the hand in a “safe position” for 3 weeks.
ɿ. dorsal extension block splinting
Ʀ. The name of the manufacturer
ʁ. The manufacturer’s potential liability
Ʂ. The physician’s clinical performance
Ʃ. The physician’s materials testing data
ʄ. Any royalties the physician receives from the manufacturer
ʅ. Femoral
ʆ. Obturator
Ʇ. Inferior gluteal
Ʈ. Superior gluteal
Ʉ. Lateral femoral cutaneous
Ʊ. open biopsy and a long leg cast
Ʋ. open biopsy and wide resection of the tumor
Ʌ. a long leg cast and observation
ʍ. intramedullary stabilization and observation
ʎ. Triggering
ʏ. Lateral instability
ʐ. Swan-neck deformity
ʑ. Boutonniere deformity
Ʒ. Loss of distal interphalangeal joint flexion
ʓ. Peroneus brevis to peroneus longus
ʔ. Peroneus tertius to extensor hallucis longus
ʕ. Peroneus tertius to superficial peroneal nerve
ʖ. Extensor hallucis longus to deep peroneal nerve
ʗ. Extensor hallucis longus to extensor digitorum longus
ʘ. reassurance that Medicare will pay for the treatment.
ʙ. consent forms that patients or their guardians are able to understand.
ʚ. a detailed description of the device, omitting the fact that it is part of a study.
ʛ. a provision that the patient’s care will be discontinued if he or she does not enroll in the study.
ʜ. a provision that the study will be carried out to completion, whether or not the device is as effective as those currently in existence.
Ʝ. an onlay iliac crest bone graft.
Ʞ. limited weightbearing and observation.
ʟ. removal of the implant and limited weightbearing.
ʠ. removal of the implant and insertion of a reamed femoral nail.
ʡ. removal of the implant and insertion of an unreamed femoral nail.
ʢ. Coronal
ʣ. Sagittal
ʤ. Anteromedial, midway between the sagittal and the coronal
ʥ. Proximal pins sagittal, distal pins coronal
ʦ. Proximal pins coronal, distal pins sagittal
ʧ. Rheumatoid arthritis
ʨ. Posttraumatic arthritis
ʩ. Degenerative osteoarthritis
ʪ. Osteonecrosis of the tibial plateau
ʫ. Osteonecrosis of the medial femoral condyle
ʬ. Trapeziometacarpal arthrodesis
ʭ. Osteotomy of the thumb metacarpal
ʮ. Arthrotomy and joint debridement
ʯ. Ligament reconstruction using one half of the flexor carpi radialis
ʰ. Trapezium resection, tendon interposition, and reconstruction of the ligament
ʱ. Creep
ʲ. Relaxation
ʳ. Energy dissipation
ʴ. Plastic deformation
ʵ. Elastic deformation
ʶ. bending
ʷ. axial loading
ʸ. high-speed rotation
ʹ. direct impact from anteromedial
ʺ. crush from anteromedial to posterolateral
ʻ. Increase stiffness
ʼ. Increase fracture toughness
ʽ. Increase fatigue strength
ʾ. Decrease mechanical strength
ʿ. Decrease wear rate
ˀ. disuse osteopenia
ˁ. paraendocrine effect of the tumor
˂. abnormally increased density on the right side
˃. side effect of the treatment of the lesion
˄. extensive tumor involvement of the left hip
˅. Sciatic nerve
ˆ. Superior gluteal artery
ˇ. Profunda femoris artery
ˈ. Femoral artery and nerve
ˉ. External iliac artery and vein
ˊ. Length
ˋ. Moment arm
ˌ. Total volume
ˍ. Physiologic cross-sectional area
ˎ. Distribution of slow and fast twitch fibers
ˏ. decreasing initiation of action potentials.
ː. increasing action potential amplitude.
ˑ. blocking the opening of gated sodium channels.
˒. decreasing the number of functional motor units.
˓. slowing or stopping action potential propagation through the axon.
˔. resection of the metatarsal heads of the first through fifth toes.
˕. Silastic MP joint arthroplasties of the first through fifth toes.
˖. fusion of the hallux MP joint and resection arthroplasty of the 2nd through fifth metatarsal heads.
˗. fusion of hallux MP joint and distal osteotomy of the 2nd through 5th MT.
˘. plantar condylectomy of the 2nd through 5th MT heads & resection of proximal phx of the hallux.
˙. hemiarthroplasty
˚. open reduction and internal fixation
˛. closed reduction and percutaneous pinning
˜. a sling and early pedulum exercises
˝. a sling and swathe for 6 weeks, followed by shoulder rehabilitation
˞. open acromioplasty
˟. open Bankart repair
ˠ. open subscapularis tendon repair
ˡ. inferior capsular shift
ˢ. a supervised physical therapy program
ˣ. a sling and swathe, with pendulum exercises in 10 days
ˤ. open reduction and internal fixation through an anterior approach
˥. open reduction and internal fixation through a posterior approach
˦. immobilization with a splint in 45 degrees of abduction for 6 weeks
˧. arthroscopically assisted reduction and percutaneous screw fixation
˨. Repair of the rotator cuff
˩. Replacement of the humeral head
˪. Resection arthroplasty
˫. Total shoulder arthroplasty
ˬ. AP and lateral radiographs of the elbow
˭. Diagnositc arthroscopy
ˮ. Aspiration of joint fluid
˯. An erythrocyte sedimentation rate and CBC
˰. A diagnostic lidocaine injection
˱. Insulin-like growth factor (IGF-1)
˲. Fibroblast growth factor (FGF-1)
˳. Platelet-derived growth factor (PDGF)
˴. Transforming growth factor beta (TGF-B)
˵. Bone morphogenetic proteins (BMP)
˶. clinical history and radiographic findings.
˷. technetium bone scan
˸. flow cytometry pattern of extracted chondrocytes
˹. immunohistochemical staining patterns of a biopsy specimen
˺. histologic features of a biopsy specimen stained with hematoxylin-cosin
˻. Radial
˼. Radial recurrent
˽. Posterior interosseous
˾. Superior ulnar recurrent
˿. Superficial radial circumflex
̀. Impaired hydroxylation of proline
́. Failure of cleavage in procollagen
̂. Defective binding sites for hydroxyproline
̃. Failure to incorporate glycine into the helix
̄. Diminished production of collagen through the rough endoplasmic reticulum
̅. Asking the legal staff to seek a court injunction
̆. Copying the patient’s chart and giving it to him as he leaves
̇. Having the patient sign a written legal contract that specifies acceptable behavior
̈. Continuing care of the patient until an appropriate referral can be arranged
̉. Transferring the patient to another orthopaedic surgeon without disclosing the realreason for why the patient is being transferred
̊. Meta-analysis
̋. Confidence interval
̌. Analysis of variance (ANOVA)
̍. Statistical significance (p-value)
̎. Survivorship analysis (Kaplan-Meier)
̏. Spinal shock
̐. Neurogenic shock
̑. Hypovolemic shock
̒. Pulmonary embolism
̓. Fat embolus syndrome
̔. Lumbar spinal stenosis
̕. Metastatic disease of the spine
̖. Rheumatoid lumbar spondylitis
̗. Isthmic spondyloloisthesis
̘. Degenerative spondylolisthesis at L4-5 and L5-S1
̙. Patella alta
̚. A metal-backed patella
̛. Varus malalignment of the knee
̜. A posterior cruciate-substituting femoral component
̝. Lateral subluxation of the patella on a Merchant’s view
̞. The sesamoids are separated
̟. The sesamoid is fractured
̠. The proximal phx is on the neck of the metatarsal
̡. The dislocation is dorsal and centered
̢. The proximal phalanx is hyperextended
̣. Patella
̤. Tibial stem
̥. Distal femoral interface
̦. Posterior femoral interface
̧. Sites of screw fixation for the tibia
̨. Hallux rigidus
̩. Fracture of the sesamoid
̪. Disruption of the plantar plate
̫. Osteonecrosis of the metatarsal head
̬. Rupture of the flexor hallucis longus
̭. Gout
̮. Sepsis
̯. Old trauma
̰. Rheumatoid arthritis
̱. Charcot arthroplasty
̲. Aspiration and steroid injection
̳. Biopsy, curettage, and allograft bone grafting
̴. Percutaneous Kirschner wire fixation
̵. Percutaneous injection of autogenous bone marrow
̶. Nerve roots
̷. Spinal cord
̸. Sciatic nerve
̹. Peroneal nerve
̺. Conus medullaris
̻. Extent of bone penetrated by reaming, prosthetic components, or acrylic cement
̼. Periprosthetic regions that are accessible to joint fluid and particulate wear debris
̽. Enveloping pseudocapsular scar tissue that develops around a prosthetic hip following surgical capsulectomy
̾. Soft tissue and bone that are potentially contaminated with bacteria in the setting of a prosthetic joint infection
̿. Potential intrapelvic joint space communication created by acetabular fixation screws or intrapelvic extruded acrylic cement
̀. Early and late infection
́. Periprosthetic fracture of the femur
͂. Failure of the patellofemoral and extensor mechanisms
̓. Aseptic loosening of cementing tibial components
̈́. Asceptic loosening of cemented femoral components
Ι. Acceptance of the current position of the ankle
͆. Open reduction and fixation in the epiphysis only
͇. ORIF with a small-fragment T-plate from the malleolus up to the metaphysis
͈. Closed reduction by eversion of the ankle and application of a bivalved long leg cast
͉. CRUGA and fixation with a malleolar screw from the malleolus into the metaphysis
͊. Resection arthroplasty and local radiation
͋. In situ fusion of the hip
͌. Excision of heterotopic bone, total hip arthroplasty, and oral indomethacin
͍. Excision of heterotopic bone and local radiation
͎. Excision of heterotopic bone, hemiarthroplasty, and oral indomethacin
͏. Closed reduction of both fractures and immediate spica casting
͐. Bilateral skin traction for 3 weeks, followed by spica casting
͑. External fixation of both femora
͒. External fixation of the left femur and a long leg cast brace for the right femur
͓. External fixation of the left femur and use of a reamed intramedullary nail in the right femur
͔. Synovial sarcoma
͕. Soft-tissue abcess
͖. Rhabdomyosarcoma
͗. Eosinophilic granuloma
͘. Nodular pigmented villonodular synovitis
͙. Changing to a titanium nail
͚. Changing to a nonslotted nail
͛. Changing the cross-sectional shape of the nail
͜. Increasing the diameter of the nail by 3 mm
͝. Increasing the diameter of the interlocking screws
͞. Fracture healing
͟. Chondrosarcoma
͠. Periosteal chondroma
͡. Periosteal osteosarcoma
͢. Dysplasia epiphysealis hemimelica
ͣ. Demonstrate competence in the subject of the case
ͤ. Be fellowship trained in the subject of the case
ͥ. Be paid on a contingency basis
ͦ. Be board certified by the American Board of Orthopaedic Surgery
ͧ. Have been involved in the case as a consultant
ͨ. Diagnostic arthroscopy
ͩ. Arthroscopy and subacromial decompression
ͪ. Reduction and fixation of the proximal humeral epiphysis
ͫ. Temporary cessation of throwing
ͬ. Physical therapy for rotator cuff strengthening
ͭ. Oblique popliteal ligament
ͮ. Lateral capsule
ͯ. Popliteal tendon
Ͱ. Fibular collateral ligament
Ͱ. Posterior oblique ligament
Ͳ. Radial tear
Ͳ. Parrot-beak tear
ʹ. Vertical tear in the “red-red” zone
͵. Vertical tear in the “red-white” zone
Ͷ. Vertical tear in the “white-white” zone
Ͷ. 0 degrees of abduction, with neural rotation
͸. 40 degrees of flexion and 60 degrees of internal rotation
͹. 45 degrees of flexion and 45 degrees of external rotation
ͺ. 90 degrees of abduction with neutral rotation
Ͻ. 90 degrees of abduction and 90 degrees of external rotation
Ͼ. Sural
Ͽ. Saphenous and its branches
;. Posterior tibial and its branches
Ϳ. Deep peroneal and its branches
΀. Superficial peroneal and its branches
΁. Strength
΂. Stiffness
΃. Shelf life
΄. Antigenicity
΅. Risk of HIV transmission
Ά. Indemnification
·. Occurrence
Έ. Excess liability
Ή. Claims-made
Ί. Nose
΋. Lateral Y
Ό. Scapular AP
΍. Neutral rotation AP
Ύ. Internal rotation AP
Ώ. External rotation AP
Ϊ́. Trauma
Α. Hemophilia
Β. Reiter’s syndrome
Γ. Rheumatoid arthritis
Δ. Systemic lupus erythematosus
Ε. Cast immobilization for 6 weeks
Ζ. Activity modification and re-evaluation in 2 months
Η. Internal fixation with or without bone grafting
Θ. Retrograde drilling of the defect without articular cartilage penetration
Ι. Drilling of the defect directly through the articular cartilage
Κ. repair or reconstruction of the medial collateral ligament
Λ. repair or reconstruction of the medialand lateral collateral ligaments
Μ. immobilization for 5 days or less
Ν. immobilization for 14 days
Ξ. immobilization for 25 days
Ο. Cystinosis
Π. Hypophosphatemia
Ρ. Renal osteodystrophy
΢. Primary hyperparathyroidism
Σ. Nutritional vitamin D deficiency
Τ. Lateral meniscus tear
Υ. Popliteus tenosynovitis
Φ. Iliotibial band friction syndrome
Χ. Peroneal nerve entrapment
Ψ. Biceps tendinitis
Ω. Observation
Ϊ. Removal of the prosthetic components
Ϋ. Operative exploration and decompression of the peroneal nerve
Ά. Nerve conduction velocity studies
Έ. Loosening of the primary dressings and knee flexion to 30 degrees
Ή. I
Ί. II
Ϋ́. III
Α. decreased tissue tension
Β. decreased abductor lever arm
Γ. decreased joint reaction force
Δ. increased body weight over lever arm
Ε. increased polyethylene wear rate
Ζ. recurrent traumatic anterior dislocation
Η. recurrent traumatic posterior dislocation
Θ. traumatic subluxation with no previous dislocation
Ι. traumatic anterior subluxation
Κ. atraumatic involuntary subluxation
Λ. radial
Μ. axillary
Ν. suprascapular
Ξ. thoracodorsal
Ο. long thoracic
Π. Flexion
Ρ. Extension
Σ. Axial rotation
Σ. Left lateral bending
Τ. Right lateral bending
Υ. Skin
Φ. Lung
Χ. Brain
Ψ. Heart
Ω. Kidney
Ϊ. Thoracoacromial, lateral thoracic, subscapular
Ϋ. Thoracoacromial, anterior humeral circumflex, posterior humeral circumflex
Ό. Posterior humeral circumflex, subscapular, thoracacromial
Ύ. Subscapular, thoracacromial, anterior humeral circumflex
Ώ. Lateral thoracic, anterior humeral circumflex, thoracacromial
Ϗ. Respondeat superior
Β. Indemnity agreement
Θ. Hold harmless agreement- attempt to shift liability from company to physician
ϒ. Comparative negligence-% of involvement
ϓ. Contributory negligence- resident contributed to the negligence
ϔ. t-type
Φ. both column
Π. transverse
Ϗ. anterior column
Ϙ. anterior column posterior hemitransverse
Ϙ. Posterior interosseous
Ϛ. Anterior interosseous
Ϛ. Radial
Ϝ. Median
Ϝ. Ulnar
Ϟ. Shock from hypovolemia
Ϟ. Associated rupture of the bladder
Ϡ. Arterial bleeding on pelvic angiogram
Ϡ. Presence of a hematoma in the perineum and scrotum
Ϣ. Fractures of both the anterior and posterior pelvic ring

Correct Answer & Explanation

. adding the scores, in all five body systems


Explanation

Question 4080

Topic: 10. Pathology and Oncology

-
Figure 12 shows the frog-lateral radiograph of a 45-year-old man who has a painful left hip. What is the most likely diagnosis?

. traumatic femoral head fracture
. osteonecrosis
. osteoarthritis
. neuropathic joint
. rheumatoid arthritis
. low-dose radiation
. steroid injection
. a load-relieving insert and shoe modification
. complete excision of the mass and the entire plantar fascia
. wide excision of the mass with a 2 cm margin of normal fascia
. CT scan of the chest
. technetium bone scan
. bone marrow aspiration
. serum protein electrophoresis
. lateral skull radiograph
. high-grade histology of the initial tumor
. multiple local recurrences after curettage
. previous treatment of the tumor with cryotherapy
. previous treatment of the tumor with radiation therapy
. extraosseous extension into two or more adjacent compartments
. Dorsal rhizotomy and facet joint fusion
. Multilevel corpectomy and spinal stabilization
. Central and lateral recess decompression and bilateral foraminotomy
. Central decompression and facet joint fusion
. Central decompression, foraminotomy, and spinal fusion from L2 to L5.
. Inadequate rehabilitation
. Displacement of the coronoid process fracture
. Insufficiency of the lateral ulnar collateral ligament
. Insufficiency of the anterior band of the medial collateral ligament
. Insufficiency of the posterior band of the medial collateral ligament
. Osteotomy and intramedullary rod fixation
. Electrical stimulation
!. Strut-autografing the concavity the tibia
". A patellar tendon-bearing brace
#. Percutaneous injection of demineralized bone matrix
$. digoxin
%. sucralfate
&. clindamycin
'. alcohol
(. neuromuscular blocking agents
). Unrestrained roll-back
*. Unrestrained rotational conformity
+. Medial-Lateral conformity
,. Anteroposterior conformity in flexion
-. Anteroposterior conformity in extension
.. Arthrodesis of the MTP joint
/. A Silastic implant of the MTP joint
0. Resection arthroplasty of the MTP joint
1. Cheilctomy of the MTP joint
2. Osteotomy of the base of the proximal phalanx
3. Genu varum
4. Tarsal coalition
5. Degenerative ankle arthrosis
6. Osteochondritis dissecans of the talus
7. Hemihypertrophy of the ipsilateral lower extremity
8. Trabecular bone is preferentially resorbed in this high bone turnover state
9. Loss of water content in the disk increases impact load to the vetrebral bodies
:. Stress is imposed by the relative stiffness of the arthrtic facet joints
;. Increased energy demands are imposed by decreased circulation to the vertebral body
<. The thick cortical bone found in the vertebral body resorbs rapidly following estrogen withdrawal
=. Increased time in stance and swing phase
>. Addition of a double leg float phase
?. Decreased vertical ground reaction forces
@. Decreased arc of motion in the hip, knee, and ankle
A. Decreased joint reaction forces in the hip, knee, and ankle
B. Talonavicular arthrodesis
C. Medial displacement calcaneal osteotomy
D. Flexor digitorum longus tendon transfer with spring ligament advancement
E. Triple arthrodesis
F. Calcaneocuboid distraction arthrodesis and repair of the posterior tibial tendon
G. Lymphoma
H. Hemangioma
I. Osteosarcoma
J. TB of the spine
K. Metastatic breast carcinoma
L. widening and shortening of the heel.
M. weakness of the gastrocnemius-soleus complex.
N. anterior impingement from a horizontal talus.
O. unrecognized compartment syndrome of the foot.
P. degenerative arthritis of the tibiotalar joint.
Q. a corrective osteotomy
R. application of braces
S. medial physeal stapling until the varus corrects
T. observation
U. application of corrective casts
V. a total contact cast.
W. electrical stimulation.
X. an off the shelf fracture brace.
Y. an elastic compression bandage and crutches.
Z. a hard soled shoe until the patient is asymptomatic.
[. Ewings tumor
\. Parosteal osteosarcoma
]. Dedifferentiated chondrosarcoma
^. Low grade intramedullary chondrosarcoma
_. High grade intramedullary osteosarcoma
`. Vascular injury
A. Tear of the rotator cuff
B. Injury to the brachial plexus
C. Fracture of the upper thoracic rib
D. Fracture of the proximal humerus
E. Biceps
F. Trapezius
G. Infraspinatus
H. Pectoralis major
I. Serratus anterior
J. Hybrid total hip arthroplasty
K. Noncemental hemiarthroplasty of the hip
L. Closed reduction and percutaneous pin fixation
M. Open reduction through an anterior approach to the hip
N. Excision of the head fragment
O. a quadratus femoris pediclebone graft
P. a proximal femoral allograft
Q. intertrochanteric osteotomy
R. total hip arthroplasty
S. hip hemiarthroplasty
T. Echocardiogram
U. Electrocardiogram
V. Radiograph of the chest
W. CT scan of the shoulder
X. Ultrasound of the shoulder
Y. Ilioinguinal
Z. Extended iliofemoral
{. Combined ilioinguinal and Kocher-Langenbeck (posterior)
|. Kocher-Langenbeck (posterior)
}. Kocher-Langenbeck (posterior) with trochanteric osteotomy
~. Deltoid
. Supraspinatus
€. Subscapularis Infraspinatus
. Infraspinatus
‚. Infraspinatus and teres minor
ƒ. an orthosis.
„. observation.
…. electrical stimulation.
†. open reduction and internal fixation.
‡. application of a nonweightbearing short leg cast.
ˆ. repair of the rotator cuff.
‰. rehabilitation of the shoulder
Š. replacement of the humeral head.
‹. arthroscopic acromioplasty and debridement.
Œ. immobilization is a sling until pain resolves.
. Bone rotation versus torque applied
Ž. Bone deflection versus bending moment applied
. Axial displacement versus tension applied
. Lateral translation versus shear force applied
‘. Fracture gap closing versus compressive force applied
’. steroid injection
“. stretching of the heel cord
”. surgical release of the plantar fascia
•. application of a short leg cast for 6 to 8 weeks
–. wearing dorsiflexion night splints
—. Open bladder
˜. Bilateral “hitchhiker’s” thumbs
™. Bilateral defects in the midclavicles
š. Rhizomelic shortening of the extremities
›. Radiographic fragmentation of all major epiphyses
œ. Medial patellotibial
. Medial patellofemoral
ž. Medial patellomeniscal
Ÿ. Lateral patellofemoral
 . Lateral patellotibial
¡. Heat
¢. Gentle active flexion-extension exercises
£. Isokinetic strengthening
¤. Electrical muscle stimulation
¥. Immobilization of the limb with the knee in full flexion
¦. Distal chevron osteotomy with soft-tissue release
§. Distal soft-tissue realignment only
¨. Closing wedge osteotomy (Aken) of the proximal phalanx
©. Proximal first metatarsal osteotomy only
ª. Soft-tissue realignment with a proximal metatarsal osteotomy
«. Vagus
¬. Phrenic
­. Hypoglossal
®. Recurrent laryngeal
¯. Inferior thyroid
°. Surgical exploration
±. Application of leeches
². Stellate ganglion blocks
³. Intra-arterial streptokinase
´. Elevation and reevaluation in 1 hour
Μ. Liver profile
¶. Myleogram
·. Platelet count
¸. CT scan of the head
¹. Angiogram of the extremity
º. Post spinal fusion from L5to S1
». Primary repair with an iliac bone graft
¼. Post spinal fusion of L4-5
½. A pantaloon body cast and 6 weeks of bed rest
¾. Rest, NSAIDS, and limited dancing
¿. Stress fracture of the proximal fifth metatarsal
À. Stress fracture of the base of the second metatarsal
Á. Stress fracture of the neck of the second metatarsal
Â. Morton’s neuroma
Ã. Lisfranc’s joint subluxation
Ä. C5 radiculopathy
Å. Subscapularis rupture
Æ. Glenohumeral arthrosis
Ç. Rotator cuff arthropathy
È. Suprascapular nerve compression at the spinoglenoid notch
É. mm femoral head in combination with a metal-backed polyethylene component
Ê. mm femoral head in combination with an all-polyethylene acetabular component
Ë. mm femoral head in combination with a metal-backed polyethylene component
Ì. mm femoral head in combination with an all-polyethylene component
Í. mm femoral head in combination with a metal-backed polyethylene component
Î. Female gender
Ï. History of cigarette smoking
Ð. L5-S1 spondylolisthesis on pre-employment radiography
Ñ. Decreased strength of the lower extremities on pre-employment testing
Ò. Decreased flexibility of the lumbar spine on pre-employment testing
Ó. Size of cells
Ô. Amount of DNA in cells
Õ. Nucleus-cytoplasm ratio
Ö. Specific DNA sequences
×. Specific messenger RNA sequences
Ø. Femoral and obturator nerves
Ù. Femoral and superior gluteal nerves
Ú. Femoral and lateral femoral cutaneous nerves
Û. Obturator and superior gluteal nerves
Ü. Obturator and lateral femoral cutaneous nerves
Ý. Isotonic
Þ. Isokinetic
SS. Isometric
À. Open kinetic chain
Á. Dynamic variable resistance
Â. Closed reduction and cast immobilization
Ã. Uniplanar external fixation
Ä. Open reduction and internal fixation with a dynamic compression plate
Å. Unreamed intramedullary rod
Æ. Multiple plane external fixator
Ç. Inlet view of the pelvis
È. Outlet view of the pelvis
É. AP view of the hip
Ê. Ilial oblique view (external oblique) of the hip
Ë. Obturator oblique
Ì. Glycolytic pathway
Í. Oxidative phosphorylation
Î. Breakdown of fat
Ï. Breakdown of protein
Ð. Breakdown of adenosine triphosphate
Ñ. an MRI scan
Ò. arthroscopic examination
Ó. AP and frog-lateral radiographs of the pelvis and hips
Ô. varus and valgus stress radiographs of the knee
Õ. physical examination of the knee under anesthesia
Ö. extended curettage and polymethylmethacrylate cementation
÷. extra-articular resection of the knee and an allograft arthrodesis
Ø. wide resection of the proximal tibia and custom prosthetic replacement
Ù. prophylactic internal fixation and postoperative irradiation
Ú. excision of the lateral condyle and reconstruction with a hemicondylar allograft
Û. silicone implant joint replacement
Ü. metatarsophalangeal joint arthrodesis
Ý. metatarsophalangeal joint debridement
Þ. resection of the metatarsal head
Ÿ. resection of the base of the proximal phalanx
Ā. Fixation of the syndesmosis has failed
Ā. Widening of the ankle mortise has led to the failure of fixation
Ă. Infection around the syndesmosis screw has led to osteomyelitis
Ă. The syndesmosis screw is broken
Ą. Motion between the tibia and fibula has caused loosening of the syndesmosis screw
Ą. Microcephaly
Ć. A temporal lobe cyst
Ć. An Arnold-Chiari type 1 malformation
Ĉ. Periventricular leukomalacia
Ĉ. Agnesis of the corpus callosum
Ċ. Wolff’s
Ċ. Hooke’s
Č. Hilton’s
Č. Muller-Haeckel
Ď. Heuter-Volkmann
Ď. Both the anterolateral and posteromedial bands are isometric and do not significantly change with flexion
Đ. The anterolateral band is lax and becomes tight in flexion, while the posteromedial band is tight, and becomes lax in flexion
Đ. The anterolateral band is tight and becomes lax in flexion, while the posteromedial band is lax and becomes tight in flexion
Ē. Both the anterolateral and posteromedial bands are lax and become tight in flexion
Ē. Both the anterolateral and posteromedial bands are tight and become lax as the knee is flexed
Ĕ. UCB orthosis
Ĕ. Rigid orthosis with a medical arch support
Ė. Semi-rigid orthosis with lateral forefoot posting
Ė. Semi-rigid orthosis with a medial arch support
Ę. Medial heel wedge attached to the running shoes
Ę. Hallux varus
Ě. Osteonecrosis
Ě. Recurrence of the hallux valgus
Ĝ. “Transfer” second metatarsalgia
Ĝ. Physeal arrest of the first metatarsal
Ğ. Aseptic loosening in a 70-year-old patient
Ğ. Mechanical failure of a hinged knee prosthesis
Ġ. Failed knee replacement complicated by reflex sympathetic dystrophy
Ġ. Infection with soft-tissue deficit
Ģ. A prior patellectomy
Ģ. Knee fusion
Ĥ. Open irrigation and debridement
Ĥ. Arthroscopic irrigation and debridement
Ħ. One-stage exchange arthroplasty
Ħ. Two-stage exchange arthroplasty
Ĩ. Putti-platt repair
Ĩ. Open Bankart repair
Ī. Injection of a subacromial corticosteroid
Ī. Arthroscopic transglenoid capsular shift
Ĭ. Rehabilitation of the scapular and rotator cuff muscles
Ĭ. Silicone suction socket and an energy-absorbing foot
Į. Silicone suction socket and a variable resistance ankle
Į. Plastic suction socket, telescoping pylon, and a solid ankle cushioned heel (SACH) foot
İ. Plastic socket with a hinged thigh cuff and a SACH foot
I. Patellar tendon-bearing suction socket and a uniaxial hydraulic ankle
IJ. Parosteal
IJ. Periosteal
Ĵ. High-grade intramedullary
Ĵ. Osteosarcoma occurring in Paget’s disease
Ķ. Osteosarcoma occurring in irradiated bone
Ķ. Cauda equina
ĸ. Conus medullaris
Ĺ. Genitofemoral nerve
Ĺ. Lumbar sympathetic plexus
Ļ. Lumbar parasympathetic plexus
Ļ. Spinal pseudoarthrosis
Ľ. Spinal cord traction injury with paralysis
Ľ. Arterial and venous thromboses
Ŀ. Superior mesenteric artery syndrome
Ŀ. Crankshaft phenomenon
Ł. Inversion stress radiograph
Ł. MRI scan
Ń. CT scan
Ń. Nuclear bone scan
Ņ. External rotation stress radiograph
Ņ. Complex deformity with an angulation in two planes
Ň. Single deformity less than 20 degrees, apex posterolateral
Ň. Single deformity greater than 30 degrees, apex posterolateral
ʼN. Single deformity less than 20 degrees, apex posteromedial
Ŋ. Single deformity greater than 30 degrees, apex posteromedial
Ŋ. Pronation of the foot during the stance phase of gait
Ō. Heel inversion at the beginning of a single limb heel rise
Ō. Active inversion of the nonweightbearing foot
Ŏ. Active plantar flexion of the first ray against resistance
Ŏ. Active plantar flexion of the foot during the push-off phase of gait
Ő. Observation and repeat radiographs in 4 months
Ő. Application of a thoracolumbalsacral orthosis for 22 to 24 hours per day
Œ. Electrical stimulation at night
Œ. Physical therapy
Ŕ. Begins to remodel and hypertrophy more quickly
Ŕ. Provides a better scaffold for osteoconduction
Ŗ. Reduces the risk of early fracture
Ŗ. Reduces technical difficulty
Ř. Lowers donor site morbidity
Ř. Anterior fusion of the lumbar curve
Ś. Anterior and posterior fusion of the thoracic curve
Ś. Posterior fusion of the thoracic curve
Ŝ. Posterior fusion of the thoracic and lumbar curves
Ŝ. Application of a brace until the iliac apophyses are Risser 4 or 5, followed by surgical correction
Ş. Subscapularis rupture
Ş. Type III SLAP lesion
Š. Disruption of capsular shift
Š. Isolated traumatic subluxation
Ţ. Injury to the axillary nerve after dislocation
Ţ. hypophosphatemia
Ť. high dietary cholesterol intake
Ť. deficiency of lipoprotein A
Ŧ. deficiency of protein S and protein C
Ŧ. elevated levels of antithrombin III
Ũ. Weightbearing short leg cast
Ũ. Nonweightbearing short leg cast
Ū. Removable splint and early motion
Ū. Open reduction and internal fixation
Ŭ. Elastic compression bandage with full weightbearing
Ŭ. Breast
Ů. Prostate
Ů. Gastrointestinal
Ű. Kidney
Ű. Multiple myeloma
Ų. Varus stress
Ų. Valgus stress
Ŵ. Torsional loading
Ŵ. Hyperextension of the knee
Ŷ. Contraction of the quadriceps while axially loaded
Ŷ. Primary internal fixation at both fracture levels
Ÿ. External fixation as definitive ttt for both #
Ź. Skeletal traction and delayed internal fixation of both fractures
Ź. Primary internal fixation of the proximal fracture and delayed fixation of the femoral fracture
Ż. Primary internal fixation of the femoral shaft fracture and delayed fixation of the proximal #
Ż. Heel spur
Ž. Plantar fascitis
Ž. Dysfunction of the tibialis posterior tendon
S. Compression of the first branch of the lateral plantar nerve
Ƀ. Compression of the calcaneal nerve
Ɓ. Displaced labral tear
Ƃ. Tear of the rotator cuff
Ƃ. Fracture of the glenoid rim
Ƅ. Palsy of the axillary nerve
Ƅ. Palsy of the musculocutaneus nerve
Ɔ. Enchondroma
Ƈ. Osteoblastoma
Ƈ. Giant cell tumor
Ɖ. Aneurysmal bone cyst
Ɗ. Fibrous dysplasia
Ƌ. Arthrogram of the wrist
Ƌ. MRI scan of both wrists
ƍ. CT scan of both wrists in the same position
Ǝ. Radiographs of the wrist in supination and pronation
Ə. Radiographs of the opposite wrist in the same position
Ɛ. Secondary hyperparathyroidism
Ƒ. Phosphate retention secondary to uremia
Ƒ. Insufficient renal synthesis of 1, 25 dihydroxy vitamin D
Ɠ. Aluminum deposition in bone from oral phosphate binders
Ɣ. Persistent acidosis aggravating the negative calcium balance
Ƕ. Posterior fusion at T10-L3 with segmental instrumentation
Ɩ. Laminectomy and fusion of T12-L2 with segmental instrumentation
Ɨ. Bed rest in a hyperextension brace
Ƙ. L1 vertebrectomy and anterior decompression with strut graft fusion and instrumentation
Ƙ. Progressive ambulation as tolerated in a custom-molded thoracolumbosacral orthosis
Ƚ. Positive-pressure ventilation
ƛ. An immediate radiograph of the chest
Ɯ. Adjustment of the position of the endotrachael tube
Ɲ. Insertion of a large-bore needle into the pericardial space
Ƞ. Insertion of a large-bore needle in the right second intercostal space, midclavicular line
Ɵ. Allowing the ends of the fracture to touch
Ơ. Adding a second connecting bar
Ơ. Adding one pin to each fracture fragment
Ƣ. Increasing the pin diameter from 4 mm to 6 mm
Ƣ. Decreasing the connecting bar-to-bone distance from 6 cm to 4 cm
Ƥ. Osteomyelitis
Ƥ. Malignant degeneration
Ʀ. Stress fracture
Ƨ. Local recurrence of the giant cell tumor
Ƨ. Bone resorption due to methylmethacrylate
Ʃ. Advancement of the plantar plate
ƪ. Resection of the second metatarsal head
ƫ. Dorsiflexion osteotomy of the second metatarsal neck
Ƭ. Transfer of the flexor digitorum longus tendon to the dorsum of the toe
Ƭ. Transfer of the extensor digitorum comminus tendon to the metatarsal neck
Ʈ. Sacral fracture
Ư. Burst fracture of L5
Ư. Cauda equina syndrome
Ʊ. Distraction-flexion injury at L3
Ʋ. Distraction-extension injury at L3
Ƴ. An MRI scan of the shoulder
Ƴ. An MRI scan of the cervical spine
Ƶ. Electromyographic and nerve conduction velocity studies
Ƶ. Immobilization in a sling and early passive range of motion exercises
Ʒ. Immediate return to the operating room for exploration of the brachial plexus
Ƹ. cerclage wiring
Ƹ. tension band wiring
ƺ. removal of the patellar component
ƻ. revision of the patellar component
Ƽ. immobilization of the knee and protected weightbearing
Ƽ. Liposarcoma
ƾ. Nodular fasciitis
Ƿ. Rabdomyosarcoma
ǀ. Malignant fibrous histiocytoma
ǁ. Extra-abdominal desmoid tumor
ǂ. Clubfeet
ǃ. Thrombocytopenia
DŽ. Congenital scoliosis
DŽ. Ventricular septal defect
DŽ. Arnold-Chiari malformation
LJ. delayed primary closure
LJ. free flap
LJ. pedicle groin flap
NJ. full-thickness skin graft
NJ. split-thickness skin graft
NJ. Infection
Ǎ. Nonunion
Ǎ. Improper screw length
Ǐ. Osteonecrosis of the distal fragment
Ǐ. Use of a cortical screw instead of a cancellous screw
Ǒ. Infection
Ǒ. Tear of the rotator cuff
Ǔ. Loosening of the humeral component
Ǔ. Arthritis of the glenoid
Ǖ. Arthritis of the A-C joint
Ǖ. Reduced morbidity
Ǘ. Improved osteoinduction
Ǘ. Improved osteoconduction
Ǚ. More rapid revascularization
Ǚ. Lower risk of disease transmission
Ǜ. Manipulation Under Anesthesia
Ǜ. Arthroscopic acromioplasty
Ǝ. Arthroscopic debridement of G-H joint
Ǟ. Replacement of the humeral head
Ǟ. Lengthening of the subscapularis and release of the anterior capsule
Ǡ. Bacteroides
Ǡ. E. coli
Ǣ. Staph. aureus
Ǣ. group A streptococcus
Ǥ. Clostridium perforingens
Ǥ. observation and exercises
Ǧ. bracing with a thoracolumbar orthosis
Ǧ. fusion of the posterior spine
Ǩ. fusion of the anterior spine
Ǩ. fusion of the anterior and posterior spine
Ǫ. Total wrist replacement and bridge grafts
Ǫ. palmar shelf arthroplasty and tendon transfers
Ǭ. Darrach distal ulna resection, dorsal tenosynosynovectomy, and tendon transfers
Ǭ. Radioscaphate fusion, extensor tenodesis, and Darrach distal ulna resection
Ǯ. Total wrist fusion and tendon transfers
Ǯ. constrained acetabular component
J̌. protrusion ring with morselized graft
DZ. cemented metal backed acetabular component
DZ. cemented all-polyethylene acetabular component
DZ. cementless hemispherical component with screw fixation
Ǵ. application of a hip abduction brace for 22 hours per day
Ǵ. application of a hip spica under anesthesia
Ƕ. discontinuance of all bracing and repeat radiographs in 3 months
Ƿ. open reduction of the hip and application of a spica cast
Ǹ. open reduction, varus osteotomy, and application of a spica cast
Ǹ. Loss of skin hair on the feet
Ǻ. Absent pulses on vascular examination
Ǻ. Pain that originates proximally and spreads distally
Ǽ. Pain that is relieved by stopping and standing
Ǽ. Pain that is worse when the patient walks uphill rather downhill
Ǿ. wrist flexors and finger flexors
Ǿ. elbow flexors and wrist flexors
Ȁ. elbow flexors and finger flexors
Ȁ. elbow extensors and wrist flexorst Level Key Muscles4 DiaphragmDeltoid, elbow flexors, diaphragmElbow flexors, wrist extensorsElbow extensors, wrist flexorsFinger flexors (distal phalanx of middlefinger)Finger abductors (5th digit), intrinsics of hand2 Segmental innervation to intercostal muscles, abdominal and paraspinal muscles) L1, L2, L3 Hip flexors3, L4 QuadricepsTibialis anteriorToe extensors, hip abductorsAnkle plantarflexors, peronei
Ȃ. elbow extensors and wrist extensors
Ȃ. Syndactyly
Ȅ. Macrodactyly
Ȅ. Camptodactyly
Ȇ. Preaxial polydactyly
Ȇ. Postaxial polydactyly
Ȉ. Arthrodesis
Ȉ. Rotationplasty
Ȋ. Above-knee amputation
Ȋ. Osteoarticular allograft
Ȍ. Endoprosthesis (custom arthroplasty)
Ȍ. Plantar fascia
Ȏ. Spring ligament
Ȏ. Deltoid ligament
Ȑ. Intrinsic tendons
Ȑ. Gastorcnemius-solelus complex
Ȓ. Prevention of presynaptic release of acetylcholine
Ȓ. Prevention of synthesis of presynaptic acetylcholine
Ȕ. Activation of acetylcholinesterase at the motor end-plate
Ȕ. Blockage of postsynaptic action of acetylcholine until reserves are depleted
Ȗ. Stimulation of release of presynaptic acetylcholine until reserves are depleted
Ȗ. stiffness of the femoral component.
Ș. head offset of the femoral component.
Ș. femoral component material modulus of elasticity.
Ț. extent of the femoral component porous coating.
Ț. Presence of a femoral component collar.
Ȝ. plantar fascia and quadratus plantae tendon.
Ȝ. ligamentous structures connecting the tarsal bones.
Ȟ. shape of the tarsal bones and the intervening joints.
Ȟ. activity of the intrinsic muscles of the foot.
Ƞ. activity of the posterior tibialis and the peroneus longus muscles.
ȡ. scapulothoracic fusion
Ȣ. strengthening of the periscapular muscles
Ȣ. pectoralis minor-fascia lata graft transfer to the scapula
Ȥ. pectoralis major-fascia lata graft transfer to the scapula
Ȥ. exploration of the long thoracic nerve, with sural nerve graft
Ȧ. tricompartmental knee replacement
Ȧ. unicompartmental knee replacement
Ȩ. medial compartment meniscal allograft
Ȩ. valgus-producing distal femoral osteotomy
Ȫ. valgus-producing proximal tibial osteotomy
Ȫ. Internal rotation of the femoral component
Ȭ. External rotation of the tibial component
Ȭ. Lateral placement of the femoral component
Ȯ. Medial placement of the patellar component
Ȯ. Excessive resection of the patella
Ȱ. Hallux rigidus
Ȱ. Hallux valgus
Ȳ. Neuroma of the first web space
Ȳ. Fracture of the sesamoid
ȴ. Rupture of the flexor hallucis longus
ȵ. Sickle cell crisis
ȶ. Idiopathic chondrolysis
ȷ. Hemophilic arthropathy
ȸ. Osteoid osteoma of the femoral neck
ȹ. Legg-Calve-Perthes disease
Ⱥ. Decreased ankle jerk and positive femoral nerve stretch test
Ȼ. Decreased knee jerk and positive straight-leg raising sign
Ȼ. Gastrocnemius-soleus complex weakness and positive straight-leg raising sign
Ƚ. Weakness of the extensor hallucis longus and positive straight-leg raising sign
Ⱦ. Weakness of the extensor hallucis longus and positive femoral nerve stretch test
Ȿ. Long-term administration of IV and oral antibiotics
Ɀ. Open soft-tissue debridement, retention of prosthetic components, and IV antibiotics
Ɂ. Immediate exchange arthroplasty with antibiotic-impregnated cement
Ɂ. Two-stage surgical prosthetic exchange and IV antibiotics
Ƀ. Resection arthroplasty and IV antibiotics
Ʉ. SCFE
Ʌ. MED
Ɇ. Perthes disease
Ɇ. Hypothyroidism
Ɉ. Chondrolysis
Ɉ. gout.
Ɋ. osteoporosis.
Ɋ. eosinophilic granuloma.
Ɍ. tuberculosis of the spine.
Ɍ. metastatic disease of the spine.
Ɏ. water content.
Ɏ. Synthesis of type I collagen.
Ɐ. Proteoglycan content.
Ɑ. Activity of chondrocytes.
Ɒ. Synthesis of hyaluronate.
Ɓ. Lung
Ɔ. Breast
ɕ. Prostate
Ɖ. Thyroid
Ɗ. Renal
ɘ. T1-low, T2-low.
Ə. T1-low, T2-high.
ɚ. T1-moderate, T2-low.
Ɛ. T1-high, T2-low.
Ɜ. T1-high, T2-high.
ɝ. hypothesis is incorrect or invalid
ɞ. interobserver error rate is 4%.
ɟ. Standard deviation is 4% higher or lower than the mean.
Ɠ. Sample size is 4% larger than required to be clinically significant.
Ɡ. Probability that the differences noted between two study groups were due to chance alone is 4%.
ɢ. I
Ɣ. II
ɤ. IV
Ɥ. IX
Ɦ. X
ɧ. Cranial setting
Ɨ. Cranial subluxation
Ɩ. Odontoid fracture
Ɪ. Lysis of the arch of the atlas
Ɫ. Atlantoaxial subluxation
Ɬ. Retrograde collapse of the endoneurial tubes
ɭ. Irreversible atrophy of the denervated muscles
ɮ. Elongation of the axons across the zone of injury
Ɯ. Sprouting of the axons at the neuromuscular junction
ɰ. Misdirection of the axons across the zone of injury
Ɱ. Maximally pronated and elbow extended
Ɲ. Maximally pronated and the elbow flexed
ɳ. Maximally supinated and the elbow flexed
ɴ. Maximally supinated and the elbow extended
Ɵ. In neutral rotation, with the elbow extended
ɶ. open reduction and internal fixation
ɷ. buddy taping to the adjacent index finger
ɸ. early motion with application of a dynamic banjo splint
ɹ. application of a cast with the hand in a “safe position” for 3 weeks.
ɺ. dorsal extension block splinting
ɻ. The name of the manufacturer
ɼ. The manufacturer’s potential liability
Ɽ. The physician’s clinical performance
ɾ. The physician’s materials testing data
ɿ. Any royalties the physician receives from the manufacturer
Ʀ. Femoral
ʁ. Obturator
Ʂ. Inferior gluteal
Ʃ. Superior gluteal
ʄ. Lateral femoral cutaneous
ʅ. open biopsy and a long leg cast
ʆ. open biopsy and wide resection of the tumor
Ʇ. a long leg cast and observation
Ʈ. intramedullary stabilization and observation
Ʉ. Triggering
Ʊ. Lateral instability
Ʋ. Swan-neck deformity
Ʌ. Boutonniere deformity
ʍ. Loss of distal interphalangeal joint flexion
ʎ. Peroneus brevis to peroneus longus
ʏ. Peroneus tertius to extensor hallucis longus
ʐ. Peroneus tertius to superficial peroneal nerve
ʑ. Extensor hallucis longus to deep peroneal nerve
Ʒ. Extensor hallucis longus to extensor digitorum longus
ʓ. reassurance that Medicare will pay for the treatment.
ʔ. consent forms that patients or their guardians are able to understand.
ʕ. a detailed description of the device, omitting the fact that it is part of a study.
ʖ. a provision that the patient’s care will be discontinued if he or she does not enroll in the study.
ʗ. a provision that the study will be carried out to completion, whether or not the device is as effective as those currently in existence.
ʘ. an onlay iliac crest bone graft.
ʙ. limited weightbearing and observation.
ʚ. removal of the implant and limited weightbearing.
ʛ. removal of the implant and insertion of a reamed femoral nail.
ʜ. removal of the implant and insertion of an unreamed femoral nail.
Ʝ. Coronal
Ʞ. Sagittal
ʟ. Anteromedial, midway between the sagittal and the coronal
ʠ. Proximal pins sagittal, distal pins coronal
ʡ. Proximal pins coronal, distal pins sagittal
ʢ. Rheumatoid arthritis
ʣ. Posttraumatic arthritis
ʤ. Degenerative osteoarthritis
ʥ. Osteonecrosis of the tibial plateau
ʦ. Osteonecrosis of the medial femoral condyle
ʧ. Trapeziometacarpal arthrodesis
ʨ. Osteotomy of the thumb metacarpal
ʩ. Arthrotomy and joint debridement
ʪ. Ligament reconstruction using one half of the flexor carpi radialis
ʫ. Trapezium resection, tendon interposition, and reconstruction of the ligament
ʬ. Creep
ʭ. Relaxation
ʮ. Energy dissipation
ʯ. Plastic deformation
ʰ. Elastic deformation
ʱ. bending
ʲ. axial loading
ʳ. high-speed rotation
ʴ. direct impact from anteromedial
ʵ. crush from anteromedial to posterolateral
ʶ. Increase stiffness
ʷ. Increase fracture toughness
ʸ. Increase fatigue strength
ʹ. Decrease mechanical strength
ʺ. Decrease wear rate
ʻ. disuse osteopenia
ʼ. paraendocrine effect of the tumor
ʽ. abnormally increased density on the right side
ʾ. side effect of the treatment of the lesion
ʿ. extensive tumor involvement of the left hip
ˀ. Sciatic nerve
ˁ. Superior gluteal artery
˂. Profunda femoris artery
˃. Femoral artery and nerve
˄. External iliac artery and vein
˅. Length
ˆ. Moment arm
ˇ. Total volume
ˈ. Physiologic cross-sectional area
ˉ. Distribution of slow and fast twitch fibers
ˊ. decreasing initiation of action potentials.
ˋ. increasing action potential amplitude.
ˌ. blocking the opening of gated sodium channels.
ˍ. decreasing the number of functional motor units.
ˎ. slowing or stopping action potential propagation through the axon.
ˏ. resection of the metatarsal heads of the first through fifth toes.
ː. Silastic MP joint arthroplasties of the first through fifth toes.
ˑ. fusion of the hallux MP joint and resection arthroplasty of the 2nd through fifth metatarsal heads.
˒. fusion of hallux MP joint and distal osteotomy of the 2nd through 5th MT.
˓. plantar condylectomy of the 2nd through 5th MT heads & resection of proximal phx of the hallux.
˔. hemiarthroplasty
˕. open reduction and internal fixation
˖. closed reduction and percutaneous pinning
˗. a sling and early pedulum exercises
˘. a sling and swathe for 6 weeks, followed by shoulder rehabilitation
˙. open acromioplasty
˚. open Bankart repair
˛. open subscapularis tendon repair
˜. inferior capsular shift
˝. a supervised physical therapy program
˞. a sling and swathe, with pendulum exercises in 10 days
˟. open reduction and internal fixation through an anterior approach
ˠ. open reduction and internal fixation through a posterior approach
ˡ. immobilization with a splint in 45 degrees of abduction for 6 weeks
ˢ. arthroscopically assisted reduction and percutaneous screw fixation
ˣ. Repair of the rotator cuff
ˤ. Replacement of the humeral head
˥. Resection arthroplasty
˦. Total shoulder arthroplasty
˧. AP and lateral radiographs of the elbow
˨. Diagnositc arthroscopy
˩. Aspiration of joint fluid
˪. An erythrocyte sedimentation rate and CBC
˫. A diagnostic lidocaine injection
ˬ. Insulin-like growth factor (IGF-1)
˭. Fibroblast growth factor (FGF-1)
ˮ. Platelet-derived growth factor (PDGF)
˯. Transforming growth factor beta (TGF-B)
˰. Bone morphogenetic proteins (BMP)
˱. clinical history and radiographic findings.
˲. technetium bone scan
˳. flow cytometry pattern of extracted chondrocytes
˴. immunohistochemical staining patterns of a biopsy specimen
˵. histologic features of a biopsy specimen stained with hematoxylin-cosin
˶. Radial
˷. Radial recurrent
˸. Posterior interosseous
˹. Superior ulnar recurrent
˺. Superficial radial circumflex
˻. Impaired hydroxylation of proline
˼. Failure of cleavage in procollagen
˽. Defective binding sites for hydroxyproline
˾. Failure to incorporate glycine into the helix
˿. Diminished production of collagen through the rough endoplasmic reticulum
̀. Asking the legal staff to seek a court injunction
́. Copying the patient’s chart and giving it to him as he leaves
̂. Having the patient sign a written legal contract that specifies acceptable behavior
̃. Continuing care of the patient until an appropriate referral can be arranged
̄. Transferring the patient to another orthopaedic surgeon without disclosing the realreason for why the patient is being transferred
̅. Meta-analysis
̆. Confidence interval
̇. Analysis of variance (ANOVA)
̈. Statistical significance (p-value)
̉. Survivorship analysis (Kaplan-Meier)
̊. Spinal shock
̋. Neurogenic shock
̌. Hypovolemic shock
̍. Pulmonary embolism
̎. Fat embolus syndrome
̏. Lumbar spinal stenosis
̐. Metastatic disease of the spine
̑. Rheumatoid lumbar spondylitis
̒. Isthmic spondyloloisthesis
̓. Degenerative spondylolisthesis at L4-5 and L5-S1
̔. Patella alta
̕. A metal-backed patella
̖. Varus malalignment of the knee
̗. A posterior cruciate-substituting femoral component
̘. Lateral subluxation of the patella on a Merchant’s view
̙. The sesamoids are separated
̚. The sesamoid is fractured
̛. The proximal phx is on the neck of the metatarsal
̜. The dislocation is dorsal and centered
̝. The proximal phalanx is hyperextended
̞. Patella
̟. Tibial stem
̠. Distal femoral interface
̡. Posterior femoral interface
̢. Sites of screw fixation for the tibia
̣. Hallux rigidus
̤. Fracture of the sesamoid
̥. Disruption of the plantar plate
̦. Osteonecrosis of the metatarsal head
̧. Rupture of the flexor hallucis longus
̨. Gout
̩. Sepsis
̪. Old trauma
̫. Rheumatoid arthritis
̬. Charcot arthroplasty
̭. Aspiration and steroid injection
̮. Biopsy, curettage, and allograft bone grafting
̯. Percutaneous Kirschner wire fixation
̰. Percutaneous injection of autogenous bone marrow
̱. Nerve roots
̲. Spinal cord
̳. Sciatic nerve
̴. Peroneal nerve
̵. Conus medullaris
̶. Extent of bone penetrated by reaming, prosthetic components, or acrylic cement
̷. Periprosthetic regions that are accessible to joint fluid and particulate wear debris
̸. Enveloping pseudocapsular scar tissue that develops around a prosthetic hip following surgical capsulectomy
̹. Soft tissue and bone that are potentially contaminated with bacteria in the setting of a prosthetic joint infection
̺. Potential intrapelvic joint space communication created by acetabular fixation screws or intrapelvic extruded acrylic cement
̻. Early and late infection
̼. Periprosthetic fracture of the femur
̽. Failure of the patellofemoral and extensor mechanisms
̾. Aseptic loosening of cementing tibial components
̿. Asceptic loosening of cemented femoral components
̀. Acceptance of the current position of the ankle
́. Open reduction and fixation in the epiphysis only
͂. ORIF with a small-fragment T-plate from the malleolus up to the metaphysis
̓. Closed reduction by eversion of the ankle and application of a bivalved long leg cast
̈́. CRUGA and fixation with a malleolar screw from the malleolus into the metaphysis
Ι. Resection arthroplasty and local radiation
͆. In situ fusion of the hip
͇. Excision of heterotopic bone, total hip arthroplasty, and oral indomethacin
͈. Excision of heterotopic bone and local radiation
͉. Excision of heterotopic bone, hemiarthroplasty, and oral indomethacin
͊. Closed reduction of both fractures and immediate spica casting
͋. Bilateral skin traction for 3 weeks, followed by spica casting
͌. External fixation of both femora
͍. External fixation of the left femur and a long leg cast brace for the right femur
͎. External fixation of the left femur and use of a reamed intramedullary nail in the right femur
͏. Synovial sarcoma
͐. Soft-tissue abcess
͑. Rhabdomyosarcoma
͒. Eosinophilic granuloma
͓. Nodular pigmented villonodular synovitis
͔. Changing to a titanium nail
͕. Changing to a nonslotted nail
͖. Changing the cross-sectional shape of the nail
͗. Increasing the diameter of the nail by 3 mm
͘. Increasing the diameter of the interlocking screws
͙. Fracture healing
͚. Chondrosarcoma
͛. Periosteal chondroma
͜. Periosteal osteosarcoma
͝. Dysplasia epiphysealis hemimelica
͞. Demonstrate competence in the subject of the case
͟. Be fellowship trained in the subject of the case
͠. Be paid on a contingency basis
͡. Be board certified by the American Board of Orthopaedic Surgery
͢. Have been involved in the case as a consultant
ͣ. Diagnostic arthroscopy
ͤ. Arthroscopy and subacromial decompression
ͥ. Reduction and fixation of the proximal humeral epiphysis
ͦ. Temporary cessation of throwing
ͧ. Physical therapy for rotator cuff strengthening
ͨ. Oblique popliteal ligament
ͩ. Lateral capsule
ͪ. Popliteal tendon
ͫ. Fibular collateral ligament
ͬ. Posterior oblique ligament
ͭ. Radial tear
ͮ. Parrot-beak tear
ͯ. Vertical tear in the “red-red” zone
Ͱ. Vertical tear in the “red-white” zone
Ͱ. Vertical tear in the “white-white” zone
Ͳ. 0 degrees of abduction, with neural rotation
Ͳ. 40 degrees of flexion and 60 degrees of internal rotation
ʹ. 45 degrees of flexion and 45 degrees of external rotation
͵. 90 degrees of abduction with neutral rotation
Ͷ. 90 degrees of abduction and 90 degrees of external rotation
Ͷ. Sural
͸. Saphenous and its branches
͹. Posterior tibial and its branches
ͺ. Deep peroneal and its branches
Ͻ. Superficial peroneal and its branches
Ͼ. Strength
Ͽ. Stiffness
;. Shelf life
Ϳ. Antigenicity
΀. Risk of HIV transmission
΁. Indemnification
΂. Occurrence
΃. Excess liability
΄. Claims-made
΅. Nose
Ά. Lateral Y
·. Scapular AP
Έ. Neutral rotation AP
Ή. Internal rotation AP
Ί. External rotation AP
΋. Trauma
Ό. Hemophilia
΍. Reiter’s syndrome
Ύ. Rheumatoid arthritis
Ώ. Systemic lupus erythematosus
Ϊ́. Cast immobilization for 6 weeks
Α. Activity modification and re-evaluation in 2 months
Β. Internal fixation with or without bone grafting
Γ. Retrograde drilling of the defect without articular cartilage penetration
Δ. Drilling of the defect directly through the articular cartilage
Ε. repair or reconstruction of the medial collateral ligament
Ζ. repair or reconstruction of the medialand lateral collateral ligaments
Η. immobilization for 5 days or less
Θ. immobilization for 14 days
Ι. immobilization for 25 days
Κ. Cystinosis
Λ. Hypophosphatemia
Μ. Renal osteodystrophy
Ν. Primary hyperparathyroidism
Ξ. Nutritional vitamin D deficiency
Ο. Lateral meniscus tear
Π. Popliteus tenosynovitis
Ρ. Iliotibial band friction syndrome
΢. Peroneal nerve entrapment
Σ. Biceps tendinitis
Τ. Observation
Υ. Removal of the prosthetic components
Φ. Operative exploration and decompression of the peroneal nerve
Χ. Nerve conduction velocity studies
Ψ. Loosening of the primary dressings and knee flexion to 30 degrees
Ω. I
Ϊ. II
Ϋ. III
Ά. decreased tissue tension
Έ. decreased abductor lever arm
Ή. decreased joint reaction force
Ί. increased body weight over lever arm
Ϋ́. increased polyethylene wear rate
Α. recurrent traumatic anterior dislocation
Β. recurrent traumatic posterior dislocation
Γ. traumatic subluxation with no previous dislocation
Δ. traumatic anterior subluxation
Ε. atraumatic involuntary subluxation
Ζ. radial
Η. axillary
Θ. suprascapular
Ι. thoracodorsal
Κ. long thoracic
Λ. Flexion
Μ. Extension
Ν. Axial rotation
Ξ. Left lateral bending
Ο. Right lateral bending
Π. Skin
Ρ. Lung
Σ. Brain
Σ. Heart
Τ. Kidney
Υ. Thoracoacromial, lateral thoracic, subscapular
Φ. Thoracoacromial, anterior humeral circumflex, posterior humeral circumflex
Χ. Posterior humeral circumflex, subscapular, thoracacromial
Ψ. Subscapular, thoracacromial, anterior humeral circumflex
Ω. Lateral thoracic, anterior humeral circumflex, thoracacromial
Ϊ. Respondeat superior
Ϋ. Indemnity agreement
Ό. Hold harmless agreement- attempt to shift liability from company to physician
Ύ. Comparative negligence-% of involvement
Ώ. Contributory negligence- resident contributed to the negligence
Ϗ. t-type
Β. both column
Θ. transverse
ϒ. anterior column
ϓ. anterior column posterior hemitransverse
ϔ. Posterior interosseous
Φ. Anterior interosseous
Π. Radial
Ϗ. Median
Ϙ. Ulnar
Ϙ. Shock from hypovolemia
Ϛ. Associated rupture of the bladder
Ϛ. Arterial bleeding on pelvic angiogram
Ϝ. Presence of a hematoma in the perineum and scrotum
Ϝ. Fractures of both the anterior and posterior pelvic ring

Correct Answer & Explanation

. traumatic femoral head fracture


Explanation