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Question 4081

Topic: 10. Pathology and Oncology

A 30-year-old man has had a slowly enlarging mass on the plantar medial aspect of the foot for the past 6 months. The mass is now 1 cm in diameter, adherent to the plantar fascia, and painful with weightbearing. The overlying skin is mobile. Management at this time should consist of

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

Correct Answer & Explanation

. low-dose radiation


Explanation

Question 4082

Topic: 10. Pathology and Oncology

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

Correct Answer & Explanation

. CT scan of the chest


Explanation

Question 4083

Topic: 10. Pathology and Oncology

  • What factor is most commonly associated with malignant transformation of a giant cell tumor?
. 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
!. 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
-. 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
0. Decreased vertical ground reaction forces
1. Decreased arc of motion in the hip, knee, and ankle
2. Decreased joint reaction forces in the hip, knee, and ankle
3. Talonavicular arthrodesis
4. Medial displacement calcaneal osteotomy
5. Flexor digitorum longus tendon transfer with spring ligament advancement
6. Triple arthrodesis
7. Calcaneocuboid distraction arthrodesis and repair of the posterior tibial tendon
8. Lymphoma
9. 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.
A. degenerative arthritis of the tibiotalar joint.
B. a corrective osteotomy
C. application of braces
D. medial physeal stapling until the varus corrects
E. observation
F. application of corrective casts
G. a total contact cast.
H. electrical stimulation.
I. an off the shelf fracture brace.
J. an elastic compression bandage and crutches.
K. a hard soled shoe until the patient is asymptomatic.
L. Ewings tumor
M. Parosteal osteosarcoma
N. Dedifferentiated chondrosarcoma
O. Low grade intramedullary chondrosarcoma
P. High grade intramedullary osteosarcoma
Q. Vascular injury
R. Tear of the rotator cuff
S. Injury to the brachial plexus
T. Fracture of the upper thoracic rib
U. Fracture of the proximal humerus
V. Biceps
W. Trapezius
X. Infraspinatus
Y. Pectoralis major
Z. 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. a proximal femoral allograft
B. intertrochanteric osteotomy
C. total hip arthroplasty
D. hip hemiarthroplasty
E. Echocardiogram
F. Electrocardiogram
G. Radiograph of the chest
H. CT scan of the shoulder
I. Ultrasound of the shoulder
J. Ilioinguinal
K. Extended iliofemoral
L. Combined ilioinguinal and Kocher-Langenbeck (posterior)
M. Kocher-Langenbeck (posterior)
N. Kocher-Langenbeck (posterior) with trochanteric osteotomy
O. Deltoid
P. Supraspinatus
Q. Subscapularis Infraspinatus
R. Infraspinatus
S. Infraspinatus and teres minor
T. an orthosis.
U. observation.
V. electrical stimulation.
W. open reduction and internal fixation.
X. application of a nonweightbearing short leg cast.
Y. repair of the rotator cuff.
Z. 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
ƒ. 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
ˆ. Open bladder
‰. Bilateral “hitchhiker’s” thumbs
Š. Bilateral defects in the midclavicles
‹. Rhizomelic shortening of the extremities
Œ. Radiographic fragmentation of all major epiphyses
. Medial patellotibial
Ž. Medial patellofemoral
. Medial patellomeniscal
. 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
š. Proximal first metatarsal osteotomy only
›. Soft-tissue realignment with a proximal metatarsal osteotomy
œ. Vagus
. Phrenic
ž. Hypoglossal
Ÿ. Recurrent laryngeal
 . Inferior thyroid
¡. Surgical exploration
¢. Application of leeches
£. Stellate ganglion blocks
¤. Intra-arterial streptokinase
¥. Elevation and reevaluation in 1 hour
¦. Liver profile
§. Myleogram
¨. Platelet count
©. CT scan of the head
ª. Angiogram of the extremity
«. Post spinal fusion from L5to S1
¬. Primary repair with an iliac bone graft
­. Post spinal fusion of L4-5
®. A pantaloon body cast and 6 weeks of bed rest
¯. Rest, NSAIDS, and limited dancing
°. Stress fracture of the proximal fifth metatarsal
±. Stress fracture of the base of the second metatarsal
². Stress fracture of the neck of the second metatarsal
³. Morton’s neuroma
´. Lisfranc’s joint subluxation
Μ. C5 radiculopathy
¶. Subscapularis rupture
·. Glenohumeral arthrosis
¸. Rotator cuff arthropathy
¹. Suprascapular nerve compression at the spinoglenoid notch
º. mm femoral head in combination with a metal-backed polyethylene component
». mm femoral head in combination with an all-polyethylene acetabular component
¼. mm femoral head in combination with a metal-backed polyethylene component
½. mm femoral head in combination with an all-polyethylene component
¾. mm femoral head in combination with a metal-backed polyethylene component
¿. Female gender
À. History of cigarette smoking
Á. L5-S1 spondylolisthesis on pre-employment radiography
Â. Decreased strength of the lower extremities on pre-employment testing
Ã. Decreased flexibility of the lumbar spine on pre-employment testing
Ä. Size of cells
Å. Amount of DNA in cells
Æ. Nucleus-cytoplasm ratio
Ç. Specific DNA sequences
È. Specific messenger RNA sequences
É. Femoral and obturator nerves
Ê. Femoral and superior gluteal nerves
Ë. Femoral and lateral femoral cutaneous nerves
Ì. Obturator and superior gluteal nerves
Í. Obturator and lateral femoral cutaneous nerves
Î. Isotonic
Ï. Isokinetic
Ð. Isometric
Ñ. Open kinetic chain
Ò. Dynamic variable resistance
Ó. Closed reduction and cast immobilization
Ô. Uniplanar external fixation
Õ. Open reduction and internal fixation with a dynamic compression plate
Ö. Unreamed intramedullary rod
×. Multiple plane external fixator
Ø. Inlet view of the pelvis
Ù. Outlet view of the pelvis
Ú. AP view of the hip
Û. Ilial oblique view (external oblique) of the hip
Ü. Obturator oblique
Ý. Glycolytic pathway
Þ. Oxidative phosphorylation
SS. Breakdown of fat
À. Breakdown of protein
Á. Breakdown of adenosine triphosphate
Â. an MRI scan
Ã. arthroscopic examination
Ä. AP and frog-lateral radiographs of the pelvis and hips
Å. varus and valgus stress radiographs of the knee
Æ. physical examination of the knee under anesthesia
Ç. extended curettage and polymethylmethacrylate cementation
È. extra-articular resection of the knee and an allograft arthrodesis
É. wide resection of the proximal tibia and custom prosthetic replacement
Ê. prophylactic internal fixation and postoperative irradiation
Ë. excision of the lateral condyle and reconstruction with a hemicondylar allograft
Ì. silicone implant joint replacement
Í. metatarsophalangeal joint arthrodesis
Î. metatarsophalangeal joint debridement
Ï. resection of the metatarsal head
Ð. resection of the base of the proximal phalanx
Ñ. Fixation of the syndesmosis has failed
Ò. Widening of the ankle mortise has led to the failure of fixation
Ó. Infection around the syndesmosis screw has led to osteomyelitis
Ô. The syndesmosis screw is broken
Õ. Motion between the tibia and fibula has caused loosening of the syndesmosis screw
Ö. Microcephaly
÷. A temporal lobe cyst
Ø. An Arnold-Chiari type 1 malformation
Ù. Periventricular leukomalacia
Ú. Agnesis of the corpus callosum
Û. Wolff’s
Ü. Hooke’s
Ý. Hilton’s
Þ. Muller-Haeckel
Ÿ. Heuter-Volkmann
Ā. Both the anterolateral and posteromedial bands are isometric and do not significantly change with flexion
Ā. The anterolateral band is lax and becomes tight in flexion, while the posteromedial band is tight, and becomes lax in flexion
Ă. The anterolateral band is tight and becomes lax in flexion, while the posteromedial band is lax and becomes tight in flexion
Ă. Both the anterolateral and posteromedial bands are lax and become tight in flexion
Ą. Both the anterolateral and posteromedial bands are tight and become lax as the knee is flexed
Ą. UCB orthosis
Ć. Rigid orthosis with a medical arch support
Ć. Semi-rigid orthosis with lateral forefoot posting
Ĉ. Semi-rigid orthosis with a medial arch support
Ĉ. Medial heel wedge attached to the running shoes
Ċ. Hallux varus
Ċ. Osteonecrosis
Č. Recurrence of the hallux valgus
Č. “Transfer” second metatarsalgia
Ď. Physeal arrest of the first metatarsal
Ď. Aseptic loosening in a 70-year-old patient
Đ. Mechanical failure of a hinged knee prosthesis
Đ. Failed knee replacement complicated by reflex sympathetic dystrophy
Ē. Infection with soft-tissue deficit
Ē. A prior patellectomy
Ĕ. Knee fusion
Ĕ. Open irrigation and debridement
Ė. Arthroscopic irrigation and debridement
Ė. One-stage exchange arthroplasty
Ę. Two-stage exchange arthroplasty
Ę. Putti-platt repair
Ě. Open Bankart repair
Ě. Injection of a subacromial corticosteroid
Ĝ. Arthroscopic transglenoid capsular shift
Ĝ. Rehabilitation of the scapular and rotator cuff muscles
Ğ. Silicone suction socket and an energy-absorbing foot
Ğ. Silicone suction socket and a variable resistance ankle
Ġ. Plastic suction socket, telescoping pylon, and a solid ankle cushioned heel (SACH) foot
Ġ. Plastic socket with a hinged thigh cuff and a SACH foot
Ģ. Patellar tendon-bearing suction socket and a uniaxial hydraulic ankle
Ģ. Parosteal
Ĥ. Periosteal
Ĥ. High-grade intramedullary
Ħ. Osteosarcoma occurring in Paget’s disease
Ħ. Osteosarcoma occurring in irradiated bone
Ĩ. Cauda equina
Ĩ. Conus medullaris
Ī. Genitofemoral nerve
Ī. Lumbar sympathetic plexus
Ĭ. Lumbar parasympathetic plexus
Ĭ. Spinal pseudoarthrosis
Į. Spinal cord traction injury with paralysis
Į. Arterial and venous thromboses
İ. Superior mesenteric artery syndrome
I. Crankshaft phenomenon
IJ. Inversion stress radiograph
IJ. MRI scan
Ĵ. CT scan
Ĵ. Nuclear bone scan
Ķ. External rotation stress radiograph
Ķ. Complex deformity with an angulation in two planes
ĸ. Single deformity less than 20 degrees, apex posterolateral
Ĺ. Single deformity greater than 30 degrees, apex posterolateral
Ĺ. Single deformity less than 20 degrees, apex posteromedial
Ļ. Single deformity greater than 30 degrees, apex posteromedial
Ļ. Pronation of the foot during the stance phase of gait
Ľ. Heel inversion at the beginning of a single limb heel rise
Ľ. Active inversion of the nonweightbearing foot
Ŀ. Active plantar flexion of the first ray against resistance
Ŀ. Active plantar flexion of the foot during the push-off phase of gait
Ł. Observation and repeat radiographs in 4 months
Ł. Application of a thoracolumbalsacral orthosis for 22 to 24 hours per day
Ń. Electrical stimulation at night
Ń. Physical therapy
Ņ. Begins to remodel and hypertrophy more quickly
Ņ. Provides a better scaffold for osteoconduction
Ň. Reduces the risk of early fracture
Ň. Reduces technical difficulty
ʼN. Lowers donor site morbidity
Ŋ. Anterior fusion of the lumbar curve
Ŋ. Anterior and posterior fusion of the thoracic curve
Ō. Posterior fusion of the thoracic curve
Ō. Posterior fusion of the thoracic and lumbar curves
Ŏ. Application of a brace until the iliac apophyses are Risser 4 or 5, followed by surgical correction
Ŏ. Subscapularis rupture
Ő. Type III SLAP lesion
Ő. Disruption of capsular shift
Œ. Isolated traumatic subluxation
Œ. Injury to the axillary nerve after dislocation
Ŕ. hypophosphatemia
Ŕ. high dietary cholesterol intake
Ŗ. deficiency of lipoprotein A
Ŗ. deficiency of protein S and protein C
Ř. elevated levels of antithrombin III
Ř. Weightbearing short leg cast
Ś. Nonweightbearing short leg cast
Ś. Removable splint and early motion
Ŝ. Open reduction and internal fixation
Ŝ. Elastic compression bandage with full weightbearing
Ş. Breast
Ş. Prostate
Š. Gastrointestinal
Š. Kidney
Ţ. Multiple myeloma
Ţ. Varus stress
Ť. Valgus stress
Ť. Torsional loading
Ŧ. Hyperextension of the knee
Ŧ. Contraction of the quadriceps while axially loaded
Ũ. Primary internal fixation at both fracture levels
Ũ. External fixation as definitive ttt for both #
Ū. Skeletal traction and delayed internal fixation of both fractures
Ū. Primary internal fixation of the proximal fracture and delayed fixation of the femoral fracture
Ŭ. Primary internal fixation of the femoral shaft fracture and delayed fixation of the proximal #
Ŭ. Heel spur
Ů. Plantar fascitis
Ů. Dysfunction of the tibialis posterior tendon
Ű. Compression of the first branch of the lateral plantar nerve
Ű. Compression of the calcaneal nerve
Ų. Displaced labral tear
Ų. Tear of the rotator cuff
Ŵ. Fracture of the glenoid rim
Ŵ. Palsy of the axillary nerve
Ŷ. Palsy of the musculocutaneus nerve
Ŷ. Enchondroma
Ÿ. Osteoblastoma
Ź. Giant cell tumor
Ź. Aneurysmal bone cyst
Ż. Fibrous dysplasia
Ż. Arthrogram of the wrist
Ž. MRI scan of both wrists
Ž. CT scan of both wrists in the same position
S. Radiographs of the wrist in supination and pronation
Ƀ. Radiographs of the opposite wrist in the same position
Ɓ. Secondary hyperparathyroidism
Ƃ. Phosphate retention secondary to uremia
Ƃ. Insufficient renal synthesis of 1, 25 dihydroxy vitamin D
Ƅ. Aluminum deposition in bone from oral phosphate binders
Ƅ. Persistent acidosis aggravating the negative calcium balance
Ɔ. Posterior fusion at T10-L3 with segmental instrumentation
Ƈ. Laminectomy and fusion of T12-L2 with segmental instrumentation
Ƈ. Bed rest in a hyperextension brace
Ɖ. L1 vertebrectomy and anterior decompression with strut graft fusion and instrumentation
Ɗ. Progressive ambulation as tolerated in a custom-molded thoracolumbosacral orthosis
Ƌ. Positive-pressure ventilation
Ƌ. An immediate radiograph of the chest
ƍ. Adjustment of the position of the endotrachael tube
Ǝ. Insertion of a large-bore needle into the pericardial space
Ə. Insertion of a large-bore needle in the right second intercostal space, midclavicular line
Ɛ. Allowing the ends of the fracture to touch
Ƒ. Adding a second connecting bar
Ƒ. Adding one pin to each fracture fragment
Ɠ. Increasing the pin diameter from 4 mm to 6 mm
Ɣ. Decreasing the connecting bar-to-bone distance from 6 cm to 4 cm
Ƕ. Osteomyelitis
Ɩ. Malignant degeneration
Ɨ. Stress fracture
Ƙ. Local recurrence of the giant cell tumor
Ƙ. Bone resorption due to methylmethacrylate
Ƚ. Advancement of the plantar plate
ƛ. Resection of the second metatarsal head
Ɯ. Dorsiflexion osteotomy of the second metatarsal neck
Ɲ. Transfer of the flexor digitorum longus tendon to the dorsum of the toe
Ƞ. Transfer of the extensor digitorum comminus tendon to the metatarsal neck
Ɵ. Sacral fracture
Ơ. Burst fracture of L5
Ơ. Cauda equina syndrome
Ƣ. Distraction-flexion injury at L3
Ƣ. Distraction-extension injury at L3
Ƥ. An MRI scan of the shoulder
Ƥ. An MRI scan of the cervical spine
Ʀ. Electromyographic and nerve conduction velocity studies
Ƨ. Immobilization in a sling and early passive range of motion exercises
Ƨ. Immediate return to the operating room for exploration of the brachial plexus
Ʃ. cerclage wiring
ƪ. tension band wiring
ƫ. removal of the patellar component
Ƭ. revision of the patellar component
Ƭ. immobilization of the knee and protected weightbearing
Ʈ. Liposarcoma
Ư. Nodular fasciitis
Ư. Rabdomyosarcoma
Ʊ. Malignant fibrous histiocytoma
Ʋ. Extra-abdominal desmoid tumor
Ƴ. Clubfeet
Ƴ. Thrombocytopenia
Ƶ. Congenital scoliosis
Ƶ. Ventricular septal defect
Ʒ. Arnold-Chiari malformation
Ƹ. delayed primary closure
Ƹ. free flap
ƺ. pedicle groin flap
ƻ. full-thickness skin graft
Ƽ. split-thickness skin graft
Ƽ. Infection
ƾ. Nonunion
Ƿ. Improper screw length
ǀ. Osteonecrosis of the distal fragment
ǁ. Use of a cortical screw instead of a cancellous screw
ǂ. Infection
ǃ. Tear of the rotator cuff
DŽ. Loosening of the humeral component
DŽ. Arthritis of the glenoid
DŽ. Arthritis of the A-C joint
LJ. Reduced morbidity
LJ. Improved osteoinduction
LJ. Improved osteoconduction
NJ. More rapid revascularization
NJ. Lower risk of disease transmission
NJ. Manipulation Under Anesthesia
Ǎ. Arthroscopic acromioplasty
Ǎ. Arthroscopic debridement of G-H joint
Ǐ. Replacement of the humeral head
Ǐ. Lengthening of the subscapularis and release of the anterior capsule
Ǒ. Bacteroides
Ǒ. E. coli
Ǔ. Staph. aureus
Ǔ. group A streptococcus
Ǖ. Clostridium perforingens
Ǖ. observation and exercises
Ǘ. bracing with a thoracolumbar orthosis
Ǘ. fusion of the posterior spine
Ǚ. fusion of the anterior spine
Ǚ. fusion of the anterior and posterior spine
Ǜ. Total wrist replacement and bridge grafts
Ǜ. palmar shelf arthroplasty and tendon transfers
Ǝ. Darrach distal ulna resection, dorsal tenosynosynovectomy, and tendon transfers
Ǟ. Radioscaphate fusion, extensor tenodesis, and Darrach distal ulna resection
Ǟ. Total wrist fusion and tendon transfers
Ǡ. constrained acetabular component
Ǡ. protrusion ring with morselized graft
Ǣ. cemented metal backed acetabular component
Ǣ. cemented all-polyethylene acetabular component
Ǥ. cementless hemispherical component with screw fixation
Ǥ. application of a hip abduction brace for 22 hours per day
Ǧ. application of a hip spica under anesthesia
Ǧ. discontinuance of all bracing and repeat radiographs in 3 months
Ǩ. open reduction of the hip and application of a spica cast
Ǩ. open reduction, varus osteotomy, and application of a spica cast
Ǫ. Loss of skin hair on the feet
Ǫ. Absent pulses on vascular examination
Ǭ. Pain that originates proximally and spreads distally
Ǭ. Pain that is relieved by stopping and standing
Ǯ. Pain that is worse when the patient walks uphill rather downhill
Ǯ. wrist flexors and finger flexors
J̌. elbow flexors and wrist flexors
DZ. elbow flexors and finger flexors
DZ. 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
DZ. elbow extensors and wrist extensors
Ǵ. Syndactyly
Ǵ. Macrodactyly
Ƕ. Camptodactyly
Ƿ. Preaxial polydactyly
Ǹ. Postaxial polydactyly
Ǹ. Arthrodesis
Ǻ. Rotationplasty
Ǻ. Above-knee amputation
Ǽ. Osteoarticular allograft
Ǽ. Endoprosthesis (custom arthroplasty)
Ǿ. Plantar fascia
Ǿ. Spring ligament
Ȁ. Deltoid ligament
Ȁ. Intrinsic tendons
Ȃ. Gastorcnemius-solelus complex
Ȃ. Prevention of presynaptic release of acetylcholine
Ȅ. Prevention of synthesis of presynaptic acetylcholine
Ȅ. Activation of acetylcholinesterase at the motor end-plate
Ȇ. Blockage of postsynaptic action of acetylcholine until reserves are depleted
Ȇ. Stimulation of release of presynaptic acetylcholine until reserves are depleted
Ȉ. stiffness of the femoral component.
Ȉ. head offset of the femoral component.
Ȋ. femoral component material modulus of elasticity.
Ȋ. extent of the femoral component porous coating.
Ȍ. Presence of a femoral component collar.
Ȍ. plantar fascia and quadratus plantae tendon.
Ȏ. ligamentous structures connecting the tarsal bones.
Ȏ. shape of the tarsal bones and the intervening joints.
Ȑ. activity of the intrinsic muscles of the foot.
Ȑ. activity of the posterior tibialis and the peroneus longus muscles.
Ȓ. scapulothoracic fusion
Ȓ. strengthening of the periscapular muscles
Ȕ. pectoralis minor-fascia lata graft transfer to the scapula
Ȕ. pectoralis major-fascia lata graft transfer to the scapula
Ȗ. exploration of the long thoracic nerve, with sural nerve graft
Ȗ. tricompartmental knee replacement
Ș. unicompartmental knee replacement
Ș. medial compartment meniscal allograft
Ț. valgus-producing distal femoral osteotomy
Ț. valgus-producing proximal tibial osteotomy
Ȝ. Internal rotation of the femoral component
Ȝ. External rotation of the tibial component
Ȟ. Lateral placement of the femoral component
Ȟ. Medial placement of the patellar component
Ƞ. Excessive resection of the patella
ȡ. Hallux rigidus
Ȣ. Hallux valgus
Ȣ. Neuroma of the first web space
Ȥ. Fracture of the sesamoid
Ȥ. Rupture of the flexor hallucis longus
Ȧ. Sickle cell crisis
Ȧ. Idiopathic chondrolysis
Ȩ. Hemophilic arthropathy
Ȩ. Osteoid osteoma of the femoral neck
Ȫ. Legg-Calve-Perthes disease
Ȫ. Decreased ankle jerk and positive femoral nerve stretch test
Ȭ. Decreased knee jerk and positive straight-leg raising sign
Ȭ. Gastrocnemius-soleus complex weakness and positive straight-leg raising sign
Ȯ. Weakness of the extensor hallucis longus and positive straight-leg raising sign
Ȯ. Weakness of the extensor hallucis longus and positive femoral nerve stretch test
Ȱ. Long-term administration of IV and oral antibiotics
Ȱ. Open soft-tissue debridement, retention of prosthetic components, and IV antibiotics
Ȳ. Immediate exchange arthroplasty with antibiotic-impregnated cement
Ȳ. Two-stage surgical prosthetic exchange and IV antibiotics
ȴ. Resection arthroplasty and IV antibiotics
ȵ. SCFE
ȶ. MED
ȷ. Perthes disease
ȸ. Hypothyroidism
ȹ. Chondrolysis
Ⱥ. gout.
Ȼ. osteoporosis.
Ȼ. eosinophilic granuloma.
Ƚ. tuberculosis of the spine.
Ⱦ. metastatic disease of the spine.
Ȿ. water content.
Ɀ. Synthesis of type I collagen.
Ɂ. Proteoglycan content.
Ɂ. Activity of chondrocytes.
Ƀ. Synthesis of hyaluronate.
Ʉ. Lung
Ʌ. Breast
Ɇ. Prostate
Ɇ. Thyroid
Ɉ. Renal
Ɉ. T1-low, T2-low.
Ɋ. T1-low, T2-high.
Ɋ. T1-moderate, T2-low.
Ɍ. T1-high, T2-low.
Ɍ. T1-high, T2-high.
Ɏ. hypothesis is incorrect or invalid
Ɏ. interobserver error rate is 4%.
Ɐ. Standard deviation is 4% higher or lower than the mean.
Ɑ. Sample size is 4% larger than required to be clinically significant.
Ɒ. Probability that the differences noted between two study groups were due to chance alone is 4%.
Ɓ. I
Ɔ. II
ɕ. IV
Ɖ. IX
Ɗ. X
ɘ. Cranial setting
Ə. Cranial subluxation
ɚ. Odontoid fracture
Ɛ. Lysis of the arch of the atlas
Ɜ. Atlantoaxial subluxation
ɝ. Retrograde collapse of the endoneurial tubes
ɞ. Irreversible atrophy of the denervated muscles
ɟ. Elongation of the axons across the zone of injury
Ɠ. Sprouting of the axons at the neuromuscular junction
Ɡ. Misdirection of the axons across the zone of injury
ɢ. Maximally pronated and elbow extended
Ɣ. Maximally pronated and the elbow flexed
ɤ. Maximally supinated and the elbow flexed
Ɥ. Maximally supinated and the elbow extended
Ɦ. In neutral rotation, with the elbow extended
ɧ. open reduction and internal fixation
Ɨ. buddy taping to the adjacent index finger
Ɩ. early motion with application of a dynamic banjo splint
Ɪ. application of a cast with the hand in a “safe position” for 3 weeks.
Ɫ. dorsal extension block splinting
Ɬ. The name of the manufacturer
ɭ. The manufacturer’s potential liability
ɮ. The physician’s clinical performance
Ɯ. The physician’s materials testing data
ɰ. Any royalties the physician receives from the manufacturer
Ɱ. Femoral
Ɲ. Obturator
ɳ. Inferior gluteal
ɴ. Superior gluteal
Ɵ. Lateral femoral cutaneous
ɶ. open biopsy and a long leg cast
ɷ. open biopsy and wide resection of the tumor
ɸ. a long leg cast and observation
ɹ. intramedullary stabilization and observation
ɺ. Triggering
ɻ. Lateral instability
ɼ. Swan-neck deformity
Ɽ. Boutonniere deformity
ɾ. Loss of distal interphalangeal joint flexion
ɿ. Peroneus brevis to peroneus longus
Ʀ. Peroneus tertius to extensor hallucis longus
ʁ. Peroneus tertius to superficial peroneal nerve
Ʂ. Extensor hallucis longus to deep peroneal nerve
Ʃ. Extensor hallucis longus to extensor digitorum longus
ʄ. reassurance that Medicare will pay for the treatment.
ʅ. consent forms that patients or their guardians are able to understand.
ʆ. a detailed description of the device, omitting the fact that it is part of a study.
Ʇ. a provision that the patient’s care will be discontinued if he or she does not enroll in the study.
Ʈ. a provision that the study will be carried out to completion, whether or not the device is as effective as those currently in existence.
Ʉ. an onlay iliac crest bone graft.
Ʊ. limited weightbearing and observation.
Ʋ. removal of the implant and limited weightbearing.
Ʌ. removal of the implant and insertion of a reamed femoral nail.
ʍ. removal of the implant and insertion of an unreamed femoral nail.
ʎ. Coronal
ʏ. Sagittal
ʐ. Anteromedial, midway between the sagittal and the coronal
ʑ. Proximal pins sagittal, distal pins coronal
Ʒ. Proximal pins coronal, distal pins sagittal
ʓ. Rheumatoid arthritis
ʔ. Posttraumatic arthritis
ʕ. Degenerative osteoarthritis
ʖ. Osteonecrosis of the tibial plateau
ʗ. Osteonecrosis of the medial femoral condyle
ʘ. Trapeziometacarpal arthrodesis
ʙ. Osteotomy of the thumb metacarpal
ʚ. Arthrotomy and joint debridement
ʛ. Ligament reconstruction using one half of the flexor carpi radialis
ʜ. Trapezium resection, tendon interposition, and reconstruction of the ligament
Ʝ. Creep
Ʞ. Relaxation
ʟ. Energy dissipation
ʠ. Plastic deformation
ʡ. Elastic deformation
ʢ. bending
ʣ. axial loading
ʤ. high-speed rotation
ʥ. direct impact from anteromedial
ʦ. crush from anteromedial to posterolateral
ʧ. Increase stiffness
ʨ. Increase fracture toughness
ʩ. Increase fatigue strength
ʪ. Decrease mechanical strength
ʫ. Decrease wear rate
ʬ. disuse osteopenia
ʭ. paraendocrine effect of the tumor
ʮ. abnormally increased density on the right side
ʯ. side effect of the treatment of the lesion
ʰ. extensive tumor involvement of the left hip
ʱ. Sciatic nerve
ʲ. Superior gluteal artery
ʳ. Profunda femoris artery
ʴ. Femoral artery and nerve
ʵ. External iliac artery and vein
ʶ. Length
ʷ. Moment arm
ʸ. Total volume
ʹ. Physiologic cross-sectional area
ʺ. Distribution of slow and fast twitch fibers
ʻ. decreasing initiation of action potentials.
ʼ. increasing action potential amplitude.
ʽ. blocking the opening of gated sodium channels.
ʾ. decreasing the number of functional motor units.
ʿ. slowing or stopping action potential propagation through the axon.
ˀ. resection of the metatarsal heads of the first through fifth toes.
ˁ. 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
ˆ. open reduction and internal fixation
ˇ. closed reduction and percutaneous pinning
ˈ. a sling and early pedulum exercises
ˉ. a sling and swathe for 6 weeks, followed by shoulder rehabilitation
ˊ. open acromioplasty
ˋ. open Bankart repair
ˌ. open subscapularis tendon repair
ˍ. inferior capsular shift
ˎ. a supervised physical therapy program
ˏ. a sling and swathe, with pendulum exercises in 10 days
ː. open reduction and internal fixation through an anterior approach
ˑ. 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)
ˠ. Transforming growth factor beta (TGF-B)
ˡ. Bone morphogenetic proteins (BMP)
ˢ. clinical history and radiographic findings.
ˣ. technetium bone scan
ˤ. 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
ˬ. Impaired hydroxylation of proline
˭. Failure of cleavage in procollagen
ˮ. 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
̶. 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
Ι. 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
͡. Vertical tear in the “red-white” zone
͢. 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
ͩ. Saphenous and its branches
ͪ. Posterior tibial and its branches
ͫ. Deep peroneal and its branches
ͬ. Superficial peroneal and its branches
ͭ. Strength
ͮ. Stiffness
ͯ. Shelf life
Ͱ. Antigenicity
Ͱ. Risk of HIV transmission
Ͳ. Indemnification
Ͳ. Occurrence
ʹ. Excess liability
͵. Claims-made
Ͷ. Nose
Ͷ. Lateral Y
͸. Scapular AP
͹. Neutral rotation AP
ͺ. Internal rotation AP
Ͻ. External rotation AP
Ͼ. Trauma
Ͽ. Hemophilia
;. Reiter’s syndrome
Ϳ. Rheumatoid arthritis
΀. Systemic lupus erythematosus
΁. Cast immobilization for 6 weeks
΂. Activity modification and re-evaluation in 2 months
΃. Internal fixation with or without bone grafting
΄. Retrograde drilling of the defect without articular cartilage penetration
΅. Drilling of the defect directly through the articular cartilage
Ά. repair or reconstruction of the medial collateral ligament
·. repair or reconstruction of the medialand lateral collateral ligaments
Έ. immobilization for 5 days or less
Ή. immobilization for 14 days
Ί. immobilization for 25 days
΋. Cystinosis
Ό. Hypophosphatemia
΍. Renal osteodystrophy
Ύ. Primary hyperparathyroidism
Ώ. Nutritional vitamin D deficiency
Ϊ́. Lateral meniscus tear
Α. Popliteus tenosynovitis
Β. Iliotibial band friction syndrome
Γ. Peroneal nerve entrapment
Δ. Biceps tendinitis
Ε. Observation
Ζ. Removal of the prosthetic components
Η. Operative exploration and decompression of the peroneal nerve
Θ. Nerve conduction velocity studies
Ι. Loosening of the primary dressings and knee flexion to 30 degrees
Κ. I
Λ. II
Μ. III
Ν. decreased tissue tension
Ξ. decreased abductor lever arm
Ο. decreased joint reaction force
Π. increased body weight over lever arm
Ρ. increased polyethylene wear rate
΢. recurrent traumatic anterior dislocation
Σ. recurrent traumatic posterior dislocation
Τ. traumatic subluxation with no previous dislocation
Υ. traumatic anterior subluxation
Φ. atraumatic involuntary subluxation
Χ. radial
Ψ. axillary
Ω. suprascapular
Ϊ. thoracodorsal
Ϋ. long thoracic
Ά. Flexion
Έ. Extension
Ή. Axial rotation
Ί. Left lateral bending
Ϋ́. Right lateral bending
Α. Skin
Β. Lung
Γ. Brain
Δ. Heart
Ε. Kidney
Ζ. Thoracoacromial, lateral thoracic, subscapular
Η. Thoracoacromial, anterior humeral circumflex, posterior humeral circumflex
Θ. Posterior humeral circumflex, subscapular, thoracacromial
Ι. Subscapular, thoracacromial, anterior humeral circumflex
Κ. Lateral thoracic, anterior humeral circumflex, thoracacromial
Λ. Respondeat superior
Μ. Indemnity agreement
Ν. Hold harmless agreement- attempt to shift liability from company to physician
Ξ. Comparative negligence-% of involvement
Ο. Contributory negligence- resident contributed to the negligence
Π. t-type
Ρ. both column
Σ. transverse
Σ. anterior column
Τ. anterior column posterior hemitransverse
Υ. Posterior interosseous
Φ. Anterior interosseous
Χ. Radial
Ψ. Median
Ω. Ulnar
Ϊ. Shock from hypovolemia
Ϋ. Associated rupture of the bladder
Ό. Arterial bleeding on pelvic angiogram
Ύ. Presence of a hematoma in the perineum and scrotum
Ώ. Fractures of both the anterior and posterior pelvic ring

Correct Answer & Explanation

. high-grade histology of the initial tumor


Explanation

Question 4084

Topic: 10. Pathology and Oncology

  • A 69-year-old man has neurogenic claudication after walking one block, but he does not report significant back pain. Management consisting of exercise, nonsteroidal anti-inflammatory drugs, and epidural steroids over a period of 6 months has failed to provide relief. Plain radiographs show degenerative changes, but no abnormality in alignment or instability. CT myelography shows central and lateral recess at L3-4 and L4-5, and foraminal stenosis bilaterally at L3-

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

Correct Answer & Explanation

. Dorsal rhizotomy and facet joint fusion


Explanation

Question 4085

Topic: 10. Pathology and Oncology

  • Item Deleted by AAOS Question 63 -

    A 27-year-old woman has recurrent subluxation and pain in the elbow 1

    year after sustaining a right posterolateral dislocation of the elbow with an associated fracture involving the tip of the coronoid process. What is the most likely cause of the persistent instability?

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

Correct Answer & Explanation

. Inadequate rehabilitation


Explanation

Question 4086

Topic: 10. Pathology and Oncology

An 18-month-old child has a congenital anterolateral bowing of the tibia. The radiograph shown in Figure 13 reveals increased density with obliteration of the medullary canal at the apex of the 40-degree bow. Treatment should consist of

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

Correct Answer & Explanation

. Osteotomy and intramedullary rod fixation


Explanation

Question 4087

Topic: 10. Pathology and Oncology

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

Correct Answer & Explanation

. digoxin


Explanation

Question 4088

Topic: 10. Pathology and Oncology

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

Correct Answer & Explanation

. Unrestrained roll-back


Explanation

Question 4089

Topic: 10. Pathology and Oncology

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

Correct Answer & Explanation

. Arthrodesis of the MTP joint


Explanation

Question 4090

Topic: 10. Pathology and Oncology

Which of the following conditions is typically associated with the ankle deformity shown in figure 14?

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

Correct Answer & Explanation

. Genu varum


Explanation

Question 4091

Topic: 10. Pathology and Oncology

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

Correct Answer & Explanation

. Trabecular bone is preferentially resorbed in this high bone turnover state


Explanation

Question 4092

Topic: 10. Pathology and Oncology

Which of the following changes in the parameters of the gait cycle occurs in the transition from normal walking to running?

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

Correct Answer & Explanation

. Increased time in stance and swing phase


Explanation

Question 4093

Topic: 10. Pathology and Oncology

  • A 67-year-old woman has chronic left foot pain that has failed to improve despite appropriate brace and shoe modifications. Examination reveals the absence of single limb heel rise on the affected side, an obvious unilateral flatfoot deformity, loss of posterior tibial tendon function, mild subfibular tenderness, and fixed hindfoot valgus. The best surgical option available for this patient is
. 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
. 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 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
. 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
). 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
0. intertrochanteric osteotomy
1. total hip arthroplasty
2. hip hemiarthroplasty
3. Echocardiogram
4. Electrocardiogram
5. Radiograph of the chest
6. CT scan of the shoulder
7. Ultrasound of the shoulder
8. Ilioinguinal
9. Extended iliofemoral
:. Combined ilioinguinal and Kocher-Langenbeck (posterior)
;. Kocher-Langenbeck (posterior)
<. Kocher-Langenbeck (posterior) with trochanteric osteotomy
=. Deltoid
>. Supraspinatus
?. Subscapularis Infraspinatus
@. Infraspinatus
A. Infraspinatus and teres minor
B. an orthosis.
C. observation.
D. electrical stimulation.
E. open reduction and internal fixation.
F. application of a nonweightbearing short leg cast.
G. repair of the rotator cuff.
H. rehabilitation of the shoulder
I. replacement of the humeral head.
J. arthroscopic acromioplasty and debridement.
K. immobilization is a sling until pain resolves.
L. Bone rotation versus torque applied
M. Bone deflection versus bending moment applied
N. Axial displacement versus tension applied
O. Lateral translation versus shear force applied
P. Fracture gap closing versus compressive force applied
Q. steroid injection
R. stretching of the heel cord
S. surgical release of the plantar fascia
T. application of a short leg cast for 6 to 8 weeks
U. wearing dorsiflexion night splints
V. Open bladder
W. Bilateral “hitchhiker’s” thumbs
X. Bilateral defects in the midclavicles
Y. Rhizomelic shortening of the extremities
Z. Radiographic fragmentation of all major epiphyses
[. Medial patellotibial
\. Medial patellofemoral
]. Medial patellomeniscal
^. Lateral patellofemoral
_. Lateral patellotibial
`. Heat
A. Gentle active flexion-extension exercises
B. Isokinetic strengthening
C. Electrical muscle stimulation
D. Immobilization of the limb with the knee in full flexion
E. Distal chevron osteotomy with soft-tissue release
F. Distal soft-tissue realignment only
G. Closing wedge osteotomy (Aken) of the proximal phalanx
H. Proximal first metatarsal osteotomy only
I. Soft-tissue realignment with a proximal metatarsal osteotomy
J. Vagus
K. Phrenic
L. Hypoglossal
M. Recurrent laryngeal
N. Inferior thyroid
O. Surgical exploration
P. Application of leeches
Q. Stellate ganglion blocks
R. Intra-arterial streptokinase
S. Elevation and reevaluation in 1 hour
T. Liver profile
U. Myleogram
V. Platelet count
W. CT scan of the head
X. Angiogram of the extremity
Y. Post spinal fusion from L5to S1
Z. Primary repair with an iliac bone graft
{. Post spinal fusion of L4-5
|. A pantaloon body cast and 6 weeks of bed rest
}. Rest, NSAIDS, and limited dancing
~. Stress fracture of the proximal fifth metatarsal
. Stress fracture of the base of the second metatarsal
€. Stress fracture of the neck of the second metatarsal
. Morton’s neuroma
‚. Lisfranc’s joint subluxation
ƒ. C5 radiculopathy
„. Subscapularis rupture
…. Glenohumeral arthrosis
†. Rotator cuff arthropathy
‡. Suprascapular nerve compression at the spinoglenoid notch
ˆ. mm femoral head in combination with a metal-backed polyethylene component
‰. mm femoral head in combination with an all-polyethylene acetabular component
Š. mm femoral head in combination with a metal-backed polyethylene component
‹. mm femoral head in combination with an all-polyethylene component
Œ. mm femoral head in combination with a metal-backed polyethylene component
. Female gender
Ž. History of cigarette smoking
. L5-S1 spondylolisthesis on pre-employment radiography
. Decreased strength of the lower extremities on pre-employment testing
‘. Decreased flexibility of the lumbar spine on pre-employment testing
’. Size of cells
“. Amount of DNA in cells
”. Nucleus-cytoplasm ratio
•. Specific DNA sequences
–. Specific messenger RNA sequences
—. Femoral and obturator nerves
˜. Femoral and superior gluteal nerves
™. Femoral and lateral femoral cutaneous nerves
š. Obturator and superior gluteal nerves
›. Obturator and lateral femoral cutaneous nerves
œ. Isotonic
. Isokinetic
ž. Isometric
Ÿ. Open kinetic chain
 . Dynamic variable resistance
¡. Closed reduction and cast immobilization
¢. Uniplanar external fixation
£. Open reduction and internal fixation with a dynamic compression plate
¤. Unreamed intramedullary rod
¥. Multiple plane external fixator
¦. Inlet view of the pelvis
§. Outlet view of the pelvis
¨. AP view of the hip
©. Ilial oblique view (external oblique) of the hip
ª. Obturator oblique
«. Glycolytic pathway
¬. Oxidative phosphorylation
­. Breakdown of fat
®. Breakdown of protein
¯. Breakdown of adenosine triphosphate
°. an MRI scan
±. arthroscopic examination
². AP and frog-lateral radiographs of the pelvis and hips
³. varus and valgus stress radiographs of the knee
´. physical examination of the knee under anesthesia
Μ. extended curettage and polymethylmethacrylate cementation
¶. extra-articular resection of the knee and an allograft arthrodesis
·. wide resection of the proximal tibia and custom prosthetic replacement
¸. prophylactic internal fixation and postoperative irradiation
¹. excision of the lateral condyle and reconstruction with a hemicondylar allograft
º. silicone implant joint replacement
». metatarsophalangeal joint arthrodesis
¼. metatarsophalangeal joint debridement
½. resection of the metatarsal head
¾. resection of the base of the proximal phalanx
¿. Fixation of the syndesmosis has failed
À. Widening of the ankle mortise has led to the failure of fixation
Á. Infection around the syndesmosis screw has led to osteomyelitis
Â. The syndesmosis screw is broken
Ã. Motion between the tibia and fibula has caused loosening of the syndesmosis screw
Ä. Microcephaly
Å. A temporal lobe cyst
Æ. An Arnold-Chiari type 1 malformation
Ç. Periventricular leukomalacia
È. Agnesis of the corpus callosum
É. Wolff’s
Ê. Hooke’s
Ë. Hilton’s
Ì. Muller-Haeckel
Í. Heuter-Volkmann
Î. Both the anterolateral and posteromedial bands are isometric and do not significantly change with flexion
Ï. The anterolateral band is lax and becomes tight in flexion, while the posteromedial band is tight, and becomes lax in flexion
Ð. The anterolateral band is tight and becomes lax in flexion, while the posteromedial band is lax and becomes tight in flexion
Ñ. Both the anterolateral and posteromedial bands are lax and become tight in flexion
Ò. Both the anterolateral and posteromedial bands are tight and become lax as the knee is flexed
Ó. UCB orthosis
Ô. Rigid orthosis with a medical arch support
Õ. Semi-rigid orthosis with lateral forefoot posting
Ö. Semi-rigid orthosis with a medial arch support
×. Medial heel wedge attached to the running shoes
Ø. Hallux varus
Ù. Osteonecrosis
Ú. Recurrence of the hallux valgus
Û. “Transfer” second metatarsalgia
Ü. Physeal arrest of the first metatarsal
Ý. Aseptic loosening in a 70-year-old patient
Þ. Mechanical failure of a hinged knee prosthesis
SS. Failed knee replacement complicated by reflex sympathetic dystrophy
À. Infection with soft-tissue deficit
Á. A prior patellectomy
Â. Knee fusion
Ã. Open irrigation and debridement
Ä. Arthroscopic irrigation and debridement
Å. One-stage exchange arthroplasty
Æ. Two-stage exchange arthroplasty
Ç. Putti-platt repair
È. Open Bankart repair
É. Injection of a subacromial corticosteroid
Ê. Arthroscopic transglenoid capsular shift
Ë. Rehabilitation of the scapular and rotator cuff muscles
Ì. Silicone suction socket and an energy-absorbing foot
Í. Silicone suction socket and a variable resistance ankle
Î. Plastic suction socket, telescoping pylon, and a solid ankle cushioned heel (SACH) foot
Ï. Plastic socket with a hinged thigh cuff and a SACH foot
Ð. Patellar tendon-bearing suction socket and a uniaxial hydraulic ankle
Ñ. Parosteal
Ò. Periosteal
Ó. High-grade intramedullary
Ô. Osteosarcoma occurring in Paget’s disease
Õ. Osteosarcoma occurring in irradiated bone
Ö. Cauda equina
÷. Conus medullaris
Ø. Genitofemoral nerve
Ù. Lumbar sympathetic plexus
Ú. Lumbar parasympathetic plexus
Û. Spinal pseudoarthrosis
Ü. Spinal cord traction injury with paralysis
Ý. Arterial and venous thromboses
Þ. Superior mesenteric artery syndrome
Ÿ. Crankshaft phenomenon
Ā. Inversion stress radiograph
Ā. MRI scan
Ă. CT scan
Ă. Nuclear bone scan
Ą. External rotation stress radiograph
Ą. Complex deformity with an angulation in two planes
Ć. Single deformity less than 20 degrees, apex posterolateral
Ć. Single deformity greater than 30 degrees, apex posterolateral
Ĉ. Single deformity less than 20 degrees, apex posteromedial
Ĉ. Single deformity greater than 30 degrees, apex posteromedial
Ċ. Pronation of the foot during the stance phase of gait
Ċ. Heel inversion at the beginning of a single limb heel rise
Č. Active inversion of the nonweightbearing foot
Č. Active plantar flexion of the first ray against resistance
Ď. Active plantar flexion of the foot during the push-off phase of gait
Ď. Observation and repeat radiographs in 4 months
Đ. Application of a thoracolumbalsacral orthosis for 22 to 24 hours per day
Đ. Electrical stimulation at night
Ē. Physical therapy
Ē. Begins to remodel and hypertrophy more quickly
Ĕ. Provides a better scaffold for osteoconduction
Ĕ. Reduces the risk of early fracture
Ė. Reduces technical difficulty
Ė. Lowers donor site morbidity
Ę. Anterior fusion of the lumbar curve
Ę. Anterior and posterior fusion of the thoracic curve
Ě. Posterior fusion of the thoracic curve
Ě. Posterior fusion of the thoracic and lumbar curves
Ĝ. Application of a brace until the iliac apophyses are Risser 4 or 5, followed by surgical correction
Ĝ. Subscapularis rupture
Ğ. Type III SLAP lesion
Ğ. Disruption of capsular shift
Ġ. Isolated traumatic subluxation
Ġ. Injury to the axillary nerve after dislocation
Ģ. hypophosphatemia
Ģ. high dietary cholesterol intake
Ĥ. deficiency of lipoprotein A
Ĥ. deficiency of protein S and protein C
Ħ. elevated levels of antithrombin III
Ħ. Weightbearing short leg cast
Ĩ. Nonweightbearing short leg cast
Ĩ. Removable splint and early motion
Ī. Open reduction and internal fixation
Ī. Elastic compression bandage with full weightbearing
Ĭ. Breast
Ĭ. Prostate
Į. Gastrointestinal
Į. Kidney
İ. Multiple myeloma
I. Varus stress
IJ. Valgus stress
IJ. Torsional loading
Ĵ. Hyperextension of the knee
Ĵ. Contraction of the quadriceps while axially loaded
Ķ. Primary internal fixation at both fracture levels
Ķ. External fixation as definitive ttt for both #
ĸ. Skeletal traction and delayed internal fixation of both fractures
Ĺ. Primary internal fixation of the proximal fracture and delayed fixation of the femoral fracture
Ĺ. Primary internal fixation of the femoral shaft fracture and delayed fixation of the proximal #
Ļ. Heel spur
Ļ. Plantar fascitis
Ľ. Dysfunction of the tibialis posterior tendon
Ľ. Compression of the first branch of the lateral plantar nerve
Ŀ. Compression of the calcaneal nerve
Ŀ. Displaced labral tear
Ł. Tear of the rotator cuff
Ł. Fracture of the glenoid rim
Ń. Palsy of the axillary nerve
Ń. Palsy of the musculocutaneus nerve
Ņ. Enchondroma
Ņ. Osteoblastoma
Ň. Giant cell tumor
Ň. Aneurysmal bone cyst
ʼN. Fibrous dysplasia
Ŋ. Arthrogram of the wrist
Ŋ. MRI scan of both wrists
Ō. CT scan of both wrists in the same position
Ō. Radiographs of the wrist in supination and pronation
Ŏ. Radiographs of the opposite wrist in the same position
Ŏ. Secondary hyperparathyroidism
Ő. Phosphate retention secondary to uremia
Ő. Insufficient renal synthesis of 1, 25 dihydroxy vitamin D
Œ. Aluminum deposition in bone from oral phosphate binders
Œ. Persistent acidosis aggravating the negative calcium balance
Ŕ. Posterior fusion at T10-L3 with segmental instrumentation
Ŕ. Laminectomy and fusion of T12-L2 with segmental instrumentation
Ŗ. Bed rest in a hyperextension brace
Ŗ. L1 vertebrectomy and anterior decompression with strut graft fusion and instrumentation
Ř. Progressive ambulation as tolerated in a custom-molded thoracolumbosacral orthosis
Ř. Positive-pressure ventilation
Ś. An immediate radiograph of the chest
Ś. Adjustment of the position of the endotrachael tube
Ŝ. Insertion of a large-bore needle into the pericardial space
Ŝ. Insertion of a large-bore needle in the right second intercostal space, midclavicular line
Ş. Allowing the ends of the fracture to touch
Ş. Adding a second connecting bar
Š. Adding one pin to each fracture fragment
Š. Increasing the pin diameter from 4 mm to 6 mm
Ţ. Decreasing the connecting bar-to-bone distance from 6 cm to 4 cm
Ţ. Osteomyelitis
Ť. Malignant degeneration
Ť. Stress fracture
Ŧ. Local recurrence of the giant cell tumor
Ŧ. Bone resorption due to methylmethacrylate
Ũ. Advancement of the plantar plate
Ũ. Resection of the second metatarsal head
Ū. Dorsiflexion osteotomy of the second metatarsal neck
Ū. Transfer of the flexor digitorum longus tendon to the dorsum of the toe
Ŭ. Transfer of the extensor digitorum comminus tendon to the metatarsal neck
Ŭ. Sacral fracture
Ů. Burst fracture of L5
Ů. Cauda equina syndrome
Ű. Distraction-flexion injury at L3
Ű. Distraction-extension injury at L3
Ų. An MRI scan of the shoulder
Ų. An MRI scan of the cervical spine
Ŵ. Electromyographic and nerve conduction velocity studies
Ŵ. Immobilization in a sling and early passive range of motion exercises
Ŷ. Immediate return to the operating room for exploration of the brachial plexus
Ŷ. cerclage wiring
Ÿ. tension band wiring
Ź. removal of the patellar component
Ź. revision of the patellar component
Ż. immobilization of the knee and protected weightbearing
Ż. Liposarcoma
Ž. Nodular fasciitis
Ž. Rabdomyosarcoma
S. Malignant fibrous histiocytoma
Ƀ. Extra-abdominal desmoid tumor
Ɓ. Clubfeet
Ƃ. Thrombocytopenia
Ƃ. Congenital scoliosis
Ƅ. Ventricular septal defect
Ƅ. Arnold-Chiari malformation
Ɔ. delayed primary closure
Ƈ. free flap
Ƈ. pedicle groin flap
Ɖ. full-thickness skin graft
Ɗ. split-thickness skin graft
Ƌ. Infection
Ƌ. Nonunion
ƍ. Improper screw length
Ǝ. Osteonecrosis of the distal fragment
Ə. Use of a cortical screw instead of a cancellous screw
Ɛ. Infection
Ƒ. Tear of the rotator cuff
Ƒ. Loosening of the humeral component
Ɠ. Arthritis of the glenoid
Ɣ. Arthritis of the A-C joint
Ƕ. Reduced morbidity
Ɩ. Improved osteoinduction
Ɨ. Improved osteoconduction
Ƙ. More rapid revascularization
Ƙ. Lower risk of disease transmission
Ƚ. Manipulation Under Anesthesia
ƛ. Arthroscopic acromioplasty
Ɯ. Arthroscopic debridement of G-H joint
Ɲ. Replacement of the humeral head
Ƞ. Lengthening of the subscapularis and release of the anterior capsule
Ɵ. Bacteroides
Ơ. E. coli
Ơ. Staph. aureus
Ƣ. group A streptococcus
Ƣ. Clostridium perforingens
Ƥ. observation and exercises
Ƥ. bracing with a thoracolumbar orthosis
Ʀ. fusion of the posterior spine
Ƨ. fusion of the anterior spine
Ƨ. fusion of the anterior and posterior spine
Ʃ. Total wrist replacement and bridge grafts
ƪ. palmar shelf arthroplasty and tendon transfers
ƫ. Darrach distal ulna resection, dorsal tenosynosynovectomy, and tendon transfers
Ƭ. Radioscaphate fusion, extensor tenodesis, and Darrach distal ulna resection
Ƭ. Total wrist fusion and tendon transfers
Ʈ. constrained acetabular component
Ư. protrusion ring with morselized graft
Ư. cemented metal backed acetabular component
Ʊ. cemented all-polyethylene acetabular component
Ʋ. cementless hemispherical component with screw fixation
Ƴ. application of a hip abduction brace for 22 hours per day
Ƴ. application of a hip spica under anesthesia
Ƶ. discontinuance of all bracing and repeat radiographs in 3 months
Ƶ. open reduction of the hip and application of a spica cast
Ʒ. open reduction, varus osteotomy, and application of a spica cast
Ƹ. Loss of skin hair on the feet
Ƹ. Absent pulses on vascular examination
ƺ. Pain that originates proximally and spreads distally
ƻ. Pain that is relieved by stopping and standing
Ƽ. Pain that is worse when the patient walks uphill rather downhill
Ƽ. wrist flexors and finger flexors
ƾ. elbow flexors and wrist flexors
Ƿ. elbow flexors and finger flexors
ǀ. 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
ǁ. elbow extensors and wrist extensors
ǂ. Syndactyly
ǃ. Macrodactyly
DŽ. Camptodactyly
DŽ. Preaxial polydactyly
DŽ. Postaxial polydactyly
LJ. Arthrodesis
LJ. Rotationplasty
LJ. Above-knee amputation
NJ. Osteoarticular allograft
NJ. Endoprosthesis (custom arthroplasty)
NJ. Plantar fascia
Ǎ. Spring ligament
Ǎ. Deltoid ligament
Ǐ. Intrinsic tendons
Ǐ. Gastorcnemius-solelus complex
Ǒ. Prevention of presynaptic release of acetylcholine
Ǒ. Prevention of synthesis of presynaptic acetylcholine
Ǔ. Activation of acetylcholinesterase at the motor end-plate
Ǔ. Blockage of postsynaptic action of acetylcholine until reserves are depleted
Ǖ. Stimulation of release of presynaptic acetylcholine until reserves are depleted
Ǖ. stiffness of the femoral component.
Ǘ. head offset of the femoral component.
Ǘ. femoral component material modulus of elasticity.
Ǚ. extent of the femoral component porous coating.
Ǚ. Presence of a femoral component collar.
Ǜ. plantar fascia and quadratus plantae tendon.
Ǜ. ligamentous structures connecting the tarsal bones.
Ǝ. shape of the tarsal bones and the intervening joints.
Ǟ. activity of the intrinsic muscles of the foot.
Ǟ. activity of the posterior tibialis and the peroneus longus muscles.
Ǡ. scapulothoracic fusion
Ǡ. strengthening of the periscapular muscles
Ǣ. pectoralis minor-fascia lata graft transfer to the scapula
Ǣ. pectoralis major-fascia lata graft transfer to the scapula
Ǥ. exploration of the long thoracic nerve, with sural nerve graft
Ǥ. tricompartmental knee replacement
Ǧ. unicompartmental knee replacement
Ǧ. medial compartment meniscal allograft
Ǩ. valgus-producing distal femoral osteotomy
Ǩ. valgus-producing proximal tibial osteotomy
Ǫ. Internal rotation of the femoral component
Ǫ. External rotation of the tibial component
Ǭ. Lateral placement of the femoral component
Ǭ. Medial placement of the patellar component
Ǯ. Excessive resection of the patella
Ǯ. Hallux rigidus
J̌. Hallux valgus
DZ. Neuroma of the first web space
DZ. Fracture of the sesamoid
DZ. Rupture of the flexor hallucis longus
Ǵ. Sickle cell crisis
Ǵ. Idiopathic chondrolysis
Ƕ. Hemophilic arthropathy
Ƿ. Osteoid osteoma of the femoral neck
Ǹ. Legg-Calve-Perthes disease
Ǹ. Decreased ankle jerk and positive femoral nerve stretch test
Ǻ. Decreased knee jerk and positive straight-leg raising sign
Ǻ. Gastrocnemius-soleus complex weakness and positive straight-leg raising sign
Ǽ. Weakness of the extensor hallucis longus and positive straight-leg raising sign
Ǽ. Weakness of the extensor hallucis longus and positive femoral nerve stretch test
Ǿ. Long-term administration of IV and oral antibiotics
Ǿ. Open soft-tissue debridement, retention of prosthetic components, and IV antibiotics
Ȁ. Immediate exchange arthroplasty with antibiotic-impregnated cement
Ȁ. Two-stage surgical prosthetic exchange and IV antibiotics
Ȃ. Resection arthroplasty and IV antibiotics
Ȃ. SCFE
Ȅ. MED
Ȅ. Perthes disease
Ȇ. Hypothyroidism
Ȇ. Chondrolysis
Ȉ. gout.
Ȉ. osteoporosis.
Ȋ. eosinophilic granuloma.
Ȋ. tuberculosis of the spine.
Ȍ. metastatic disease of the spine.
Ȍ. water content.
Ȏ. Synthesis of type I collagen.
Ȏ. Proteoglycan content.
Ȑ. Activity of chondrocytes.
Ȑ. Synthesis of hyaluronate.
Ȓ. Lung
Ȓ. Breast
Ȕ. Prostate
Ȕ. Thyroid
Ȗ. Renal
Ȗ. T1-low, T2-low.
Ș. T1-low, T2-high.
Ș. T1-moderate, T2-low.
Ț. T1-high, T2-low.
Ț. T1-high, T2-high.
Ȝ. hypothesis is incorrect or invalid
Ȝ. interobserver error rate is 4%.
Ȟ. Standard deviation is 4% higher or lower than the mean.
Ȟ. Sample size is 4% larger than required to be clinically significant.
Ƞ. Probability that the differences noted between two study groups were due to chance alone is 4%.
ȡ. I
Ȣ. II
Ȣ. IV
Ȥ. IX
Ȥ. X
Ȧ. Cranial setting
Ȧ. Cranial subluxation
Ȩ. Odontoid fracture
Ȩ. Lysis of the arch of the atlas
Ȫ. Atlantoaxial subluxation
Ȫ. Retrograde collapse of the endoneurial tubes
Ȭ. Irreversible atrophy of the denervated muscles
Ȭ. Elongation of the axons across the zone of injury
Ȯ. Sprouting of the axons at the neuromuscular junction
Ȯ. Misdirection of the axons across the zone of injury
Ȱ. Maximally pronated and elbow extended
Ȱ. Maximally pronated and the elbow flexed
Ȳ. Maximally supinated and the elbow flexed
Ȳ. Maximally supinated and the elbow extended
ȴ. In neutral rotation, with the elbow extended
ȵ. open reduction and internal fixation
ȶ. buddy taping to the adjacent index finger
ȷ. early motion with application of a dynamic banjo splint
ȸ. application of a cast with the hand in a “safe position” for 3 weeks.
ȹ. dorsal extension block splinting
Ⱥ. The name of the manufacturer
Ȼ. The manufacturer’s potential liability
Ȼ. The physician’s clinical performance
Ƚ. The physician’s materials testing data
Ⱦ. Any royalties the physician receives from the manufacturer
Ȿ. Femoral
Ɀ. Obturator
Ɂ. Inferior gluteal
Ɂ. Superior gluteal
Ƀ. Lateral femoral cutaneous
Ʉ. open biopsy and a long leg cast
Ʌ. open biopsy and wide resection of the tumor
Ɇ. a long leg cast and observation
Ɇ. intramedullary stabilization and observation
Ɉ. Triggering
Ɉ. Lateral instability
Ɋ. Swan-neck deformity
Ɋ. Boutonniere deformity
Ɍ. Loss of distal interphalangeal joint flexion
Ɍ. Peroneus brevis to peroneus longus
Ɏ. Peroneus tertius to extensor hallucis longus
Ɏ. Peroneus tertius to superficial peroneal nerve
Ɐ. Extensor hallucis longus to deep peroneal nerve
Ɑ. Extensor hallucis longus to extensor digitorum longus
Ɒ. reassurance that Medicare will pay for the treatment.
Ɓ. consent forms that patients or their guardians are able to understand.
Ɔ. a detailed description of the device, omitting the fact that it is part of a study.
ɕ. a provision that the patient’s care will be discontinued if he or she does not enroll in the study.
Ɖ. a provision that the study will be carried out to completion, whether or not the device is as effective as those currently in existence.
Ɗ. an onlay iliac crest bone graft.
ɘ. limited weightbearing and observation.
Ə. removal of the implant and limited weightbearing.
ɚ. removal of the implant and insertion of a reamed femoral nail.
Ɛ. removal of the implant and insertion of an unreamed femoral nail.
Ɜ. Coronal
ɝ. Sagittal
ɞ. Anteromedial, midway between the sagittal and the coronal
ɟ. Proximal pins sagittal, distal pins coronal
Ɠ. Proximal pins coronal, distal pins sagittal
Ɡ. Rheumatoid arthritis
ɢ. Posttraumatic arthritis
Ɣ. Degenerative osteoarthritis
ɤ. Osteonecrosis of the tibial plateau
Ɥ. Osteonecrosis of the medial femoral condyle
Ɦ. Trapeziometacarpal arthrodesis
ɧ. Osteotomy of the thumb metacarpal
Ɨ. Arthrotomy and joint debridement
Ɩ. Ligament reconstruction using one half of the flexor carpi radialis
Ɪ. Trapezium resection, tendon interposition, and reconstruction of the ligament
Ɫ. Creep
Ɬ. Relaxation
ɭ. Energy dissipation
ɮ. Plastic deformation
Ɯ. Elastic deformation
ɰ. bending
Ɱ. axial loading
Ɲ. high-speed rotation
ɳ. direct impact from anteromedial
ɴ. crush from anteromedial to posterolateral
Ɵ. Increase stiffness
ɶ. Increase fracture toughness
ɷ. Increase fatigue strength
ɸ. Decrease mechanical strength
ɹ. Decrease wear rate
ɺ. disuse osteopenia
ɻ. paraendocrine effect of the tumor
ɼ. abnormally increased density on the right side
Ɽ. side effect of the treatment of the lesion
ɾ. extensive tumor involvement of the left hip
ɿ. Sciatic nerve
Ʀ. Superior gluteal artery
ʁ. Profunda femoris artery
Ʂ. Femoral artery and nerve
Ʃ. External iliac artery and vein
ʄ. Length
ʅ. Moment arm
ʆ. Total volume
Ʇ. Physiologic cross-sectional area
Ʈ. Distribution of slow and fast twitch fibers
Ʉ. decreasing initiation of action potentials.
Ʊ. increasing action potential amplitude.
Ʋ. blocking the opening of gated sodium channels.
Ʌ. decreasing the number of functional motor units.
ʍ. slowing or stopping action potential propagation through the axon.
ʎ. resection of the metatarsal heads of the first through fifth toes.
ʏ. Silastic MP joint arthroplasties of the first through fifth toes.
ʐ. fusion of the hallux MP joint and resection arthroplasty of the 2nd through fifth metatarsal heads.
ʑ. fusion of hallux MP joint and distal osteotomy of the 2nd through 5th MT.
Ʒ. plantar condylectomy of the 2nd through 5th MT heads & resection of proximal phx of the hallux.
ʓ. hemiarthroplasty
ʔ. open reduction and internal fixation
ʕ. closed reduction and percutaneous pinning
ʖ. a sling and early pedulum exercises
ʗ. a sling and swathe for 6 weeks, followed by shoulder rehabilitation
ʘ. open acromioplasty
ʙ. open Bankart repair
ʚ. open subscapularis tendon repair
ʛ. inferior capsular shift
ʜ. a supervised physical therapy program
Ʝ. a sling and swathe, with pendulum exercises in 10 days
Ʞ. open reduction and internal fixation through an anterior approach
ʟ. open reduction and internal fixation through a posterior approach
ʠ. immobilization with a splint in 45 degrees of abduction for 6 weeks
ʡ. arthroscopically assisted reduction and percutaneous screw fixation
ʢ. Repair of the rotator cuff
ʣ. Replacement of the humeral head
ʤ. Resection arthroplasty
ʥ. Total shoulder arthroplasty
ʦ. AP and lateral radiographs of the elbow
ʧ. Diagnositc arthroscopy
ʨ. Aspiration of joint fluid
ʩ. An erythrocyte sedimentation rate and CBC
ʪ. A diagnostic lidocaine injection
ʫ. Insulin-like growth factor (IGF-1)
ʬ. Fibroblast growth factor (FGF-1)
ʭ. Platelet-derived growth factor (PDGF)
ʮ. Transforming growth factor beta (TGF-B)
ʯ. Bone morphogenetic proteins (BMP)
ʰ. clinical history and radiographic findings.
ʱ. technetium bone scan
ʲ. flow cytometry pattern of extracted chondrocytes
ʳ. immunohistochemical staining patterns of a biopsy specimen
ʴ. histologic features of a biopsy specimen stained with hematoxylin-cosin
ʵ. Radial
ʶ. Radial recurrent
ʷ. Posterior interosseous
ʸ. Superior ulnar recurrent
ʹ. Superficial radial circumflex
ʺ. Impaired hydroxylation of proline
ʻ. Failure of cleavage in procollagen
ʼ. Defective binding sites for hydroxyproline
ʽ. Failure to incorporate glycine into the helix
ʾ. Diminished production of collagen through the rough endoplasmic reticulum
ʿ. Asking the legal staff to seek a court injunction
ˀ. Copying the patient’s chart and giving it to him as he leaves
ˁ. 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
ˆ. Analysis of variance (ANOVA)
ˇ. Statistical significance (p-value)
ˈ. Survivorship analysis (Kaplan-Meier)
ˉ. Spinal shock
ˊ. Neurogenic shock
ˋ. Hypovolemic shock
ˌ. Pulmonary embolism
ˍ. Fat embolus syndrome
ˎ. Lumbar spinal stenosis
ˏ. Metastatic disease of the spine
ː. Rheumatoid lumbar spondylitis
ˑ. 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
ˠ. Posterior femoral interface
ˡ. Sites of screw fixation for the tibia
ˢ. Hallux rigidus
ˣ. Fracture of the sesamoid
ˤ. Disruption of the plantar plate
˥. Osteonecrosis of the metatarsal head
˦. Rupture of the flexor hallucis longus
˧. Gout
˨. Sepsis
˩. Old trauma
˪. Rheumatoid arthritis
˫. Charcot arthroplasty
ˬ. Aspiration and steroid injection
˭. Biopsy, curettage, and allograft bone grafting
ˮ. 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
̗. 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
̯. Vertical tear in the “red-white” zone
̰. 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
̷. Saphenous and its branches
̸. Posterior tibial and its branches
̹. Deep peroneal and its branches
̺. Superficial peroneal and its branches
̻. Strength
̼. Stiffness
̽. Shelf life
̾. Antigenicity
̿. Risk of HIV transmission
̀. Indemnification
́. Occurrence
͂. Excess liability
̓. Claims-made
̈́. Nose
Ι. Lateral Y
͆. Scapular AP
͇. Neutral rotation AP
͈. Internal rotation AP
͉. External rotation AP
͊. Trauma
͋. Hemophilia
͌. Reiter’s syndrome
͍. Rheumatoid arthritis
͎. Systemic lupus erythematosus
͏. Cast immobilization for 6 weeks
͐. Activity modification and re-evaluation in 2 months
͑. Internal fixation with or without bone grafting
͒. Retrograde drilling of the defect without articular cartilage penetration
͓. Drilling of the defect directly through the articular cartilage
͔. repair or reconstruction of the medial collateral ligament
͕. repair or reconstruction of the medialand lateral collateral ligaments
͖. immobilization for 5 days or less
͗. immobilization for 14 days
͘. immobilization for 25 days
͙. Cystinosis
͚. Hypophosphatemia
͛. Renal osteodystrophy
͜. Primary hyperparathyroidism
͝. Nutritional vitamin D deficiency
͞. Lateral meniscus tear
͟. Popliteus tenosynovitis
͠. Iliotibial band friction syndrome
͡. Peroneal nerve entrapment
͢. Biceps tendinitis
ͣ. Observation
ͤ. Removal of the prosthetic components
ͥ. Operative exploration and decompression of the peroneal nerve
ͦ. Nerve conduction velocity studies
ͧ. Loosening of the primary dressings and knee flexion to 30 degrees
ͨ. I
ͩ. II
ͪ. III
ͫ. decreased tissue tension
ͬ. decreased abductor lever arm
ͭ. decreased joint reaction force
ͮ. increased body weight over lever arm
ͯ. increased polyethylene wear rate
Ͱ. recurrent traumatic anterior dislocation
Ͱ. recurrent traumatic posterior dislocation
Ͳ. traumatic subluxation with no previous dislocation
Ͳ. traumatic anterior subluxation
ʹ. atraumatic involuntary subluxation
͵. radial
Ͷ. axillary
Ͷ. suprascapular
͸. thoracodorsal
͹. long thoracic
ͺ. Flexion
Ͻ. Extension
Ͼ. Axial rotation
Ͽ. Left lateral bending
;. Right lateral bending
Ϳ. Skin
΀. Lung
΁. Brain
΂. Heart
΃. Kidney
΄. Thoracoacromial, lateral thoracic, subscapular
΅. Thoracoacromial, anterior humeral circumflex, posterior humeral circumflex
Ά. Posterior humeral circumflex, subscapular, thoracacromial
·. Subscapular, thoracacromial, anterior humeral circumflex
Έ. Lateral thoracic, anterior humeral circumflex, thoracacromial
Ή. Respondeat superior
Ί. Indemnity agreement
΋. Hold harmless agreement- attempt to shift liability from company to physician
Ό. Comparative negligence-% of involvement
΍. Contributory negligence- resident contributed to the negligence
Ύ. t-type
Ώ. both column
Ϊ́. transverse
Α. anterior column
Β. anterior column posterior hemitransverse
Γ. Posterior interosseous
Δ. Anterior interosseous
Ε. Radial
Ζ. Median
Η. Ulnar
Θ. Shock from hypovolemia
Ι. Associated rupture of the bladder
Κ. Arterial bleeding on pelvic angiogram
Λ. Presence of a hematoma in the perineum and scrotum
Μ. Fractures of both the anterior and posterior pelvic ring

Correct Answer & Explanation

. Talonavicular arthrodesis


Explanation

Question 4094

Topic: 10. Pathology and Oncology

Figures 15a and 15b show the AP and lateral radiographs of the lumbar spine of a 51 year old woman who has had back pain that radiates into the right thigh for the past 3 months. Her medical history is unremarkable except for a mastectomy for breast cancer 12 years ago. What is the most likely diagnosis?

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

Correct Answer & Explanation

. Lymphoma


Explanation

Question 4095

Topic: 10. Pathology and Oncology

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

Correct Answer & Explanation

. widening and shortening of the heel.


Explanation

Question 4096

Topic: 10. Pathology and Oncology

A radiograph of a 27 month old child with bilateral genu valgum and internal tibial torsion shows the metaphyseal-diaphyseal angle of Levine and Drennen is 12 degrees on the right and 13 degrees on the left. Based on this finding, management should consist of

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

Correct Answer & Explanation

. a corrective osteotomy


Explanation

Question 4097

Topic: 10. Pathology and Oncology

  • A 50 year old man who has insulin-dependent diabetes mellitus with associated neuropathy has a stress fracture of the fourth metatarsal. Examination of the foot reveals acute swelling, warmth, and erythema; however, the patient reports very little pain. Treatment should include
. 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
. 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
. 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
. 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
). Deltoid
*. Supraspinatus
+. Subscapularis Infraspinatus
,. Infraspinatus
-. Infraspinatus and teres minor
.. an orthosis.
/. observation.
0. electrical stimulation.
1. open reduction and internal fixation.
2. application of a nonweightbearing short leg cast.
3. repair of the rotator cuff.
4. rehabilitation of the shoulder
5. replacement of the humeral head.
6. arthroscopic acromioplasty and debridement.
7. immobilization is a sling until pain resolves.
8. Bone rotation versus torque applied
9. 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
A. wearing dorsiflexion night splints
B. Open bladder
C. Bilateral “hitchhiker’s” thumbs
D. Bilateral defects in the midclavicles
E. Rhizomelic shortening of the extremities
F. Radiographic fragmentation of all major epiphyses
G. Medial patellotibial
H. Medial patellofemoral
I. Medial patellomeniscal
J. Lateral patellofemoral
K. Lateral patellotibial
L. Heat
M. Gentle active flexion-extension exercises
N. Isokinetic strengthening
O. Electrical muscle stimulation
P. Immobilization of the limb with the knee in full flexion
Q. Distal chevron osteotomy with soft-tissue release
R. Distal soft-tissue realignment only
S. Closing wedge osteotomy (Aken) of the proximal phalanx
T. Proximal first metatarsal osteotomy only
U. Soft-tissue realignment with a proximal metatarsal osteotomy
V. Vagus
W. Phrenic
X. Hypoglossal
Y. Recurrent laryngeal
Z. Inferior thyroid
[. Surgical exploration
\. Application of leeches
]. Stellate ganglion blocks
^. Intra-arterial streptokinase
_. Elevation and reevaluation in 1 hour
`. Liver profile
A. Myleogram
B. Platelet count
C. CT scan of the head
D. Angiogram of the extremity
E. Post spinal fusion from L5to S1
F. Primary repair with an iliac bone graft
G. Post spinal fusion of L4-5
H. A pantaloon body cast and 6 weeks of bed rest
I. Rest, NSAIDS, and limited dancing
J. Stress fracture of the proximal fifth metatarsal
K. Stress fracture of the base of the second metatarsal
L. Stress fracture of the neck of the second metatarsal
M. Morton’s neuroma
N. Lisfranc’s joint subluxation
O. C5 radiculopathy
P. Subscapularis rupture
Q. Glenohumeral arthrosis
R. Rotator cuff arthropathy
S. Suprascapular nerve compression at the spinoglenoid notch
T. mm femoral head in combination with a metal-backed polyethylene component
U. mm femoral head in combination with an all-polyethylene acetabular component
V. mm femoral head in combination with a metal-backed polyethylene component
W. mm femoral head in combination with an all-polyethylene component
X. mm femoral head in combination with a metal-backed polyethylene component
Y. Female gender
Z. History of cigarette smoking
{. L5-S1 spondylolisthesis on pre-employment radiography
|. Decreased strength of the lower extremities on pre-employment testing
}. Decreased flexibility of the lumbar spine on pre-employment testing
~. Size of cells
. Amount of DNA in cells
€. Nucleus-cytoplasm ratio
. Specific DNA sequences
‚. Specific messenger RNA sequences
ƒ. Femoral and obturator nerves
„. Femoral and superior gluteal nerves
…. Femoral and lateral femoral cutaneous nerves
†. Obturator and superior gluteal nerves
‡. Obturator and lateral femoral cutaneous nerves
ˆ. Isotonic
‰. Isokinetic
Š. Isometric
‹. Open kinetic chain
Œ. Dynamic variable resistance
. Closed reduction and cast immobilization
Ž. Uniplanar external fixation
. Open reduction and internal fixation with a dynamic compression plate
. Unreamed intramedullary rod
‘. Multiple plane external fixator
’. Inlet view of the pelvis
“. Outlet view of the pelvis
”. AP view of the hip
•. Ilial oblique view (external oblique) of the hip
–. Obturator oblique
—. Glycolytic pathway
˜. Oxidative phosphorylation
™. Breakdown of fat
š. Breakdown of protein
›. Breakdown of adenosine triphosphate
œ. an MRI scan
. arthroscopic examination
ž. AP and frog-lateral radiographs of the pelvis and hips
Ÿ. varus and valgus stress radiographs of the knee
 . physical examination of the knee under anesthesia
¡. extended curettage and polymethylmethacrylate cementation
¢. extra-articular resection of the knee and an allograft arthrodesis
£. wide resection of the proximal tibia and custom prosthetic replacement
¤. prophylactic internal fixation and postoperative irradiation
¥. excision of the lateral condyle and reconstruction with a hemicondylar allograft
¦. silicone implant joint replacement
§. metatarsophalangeal joint arthrodesis
¨. metatarsophalangeal joint debridement
©. resection of the metatarsal head
ª. resection of the base of the proximal phalanx
«. Fixation of the syndesmosis has failed
¬. Widening of the ankle mortise has led to the failure of fixation
­. Infection around the syndesmosis screw has led to osteomyelitis
®. The syndesmosis screw is broken
¯. Motion between the tibia and fibula has caused loosening of the syndesmosis screw
°. Microcephaly
±. A temporal lobe cyst
². An Arnold-Chiari type 1 malformation
³. Periventricular leukomalacia
´. Agnesis of the corpus callosum
Μ. Wolff’s
¶. Hooke’s
·. Hilton’s
¸. Muller-Haeckel
¹. Heuter-Volkmann
º. Both the anterolateral and posteromedial bands are isometric and do not significantly change with flexion
». The anterolateral band is lax and becomes tight in flexion, while the posteromedial band is tight, and becomes lax in flexion
¼. The anterolateral band is tight and becomes lax in flexion, while the posteromedial band is lax and becomes tight in flexion
½. Both the anterolateral and posteromedial bands are lax and become tight in flexion
¾. Both the anterolateral and posteromedial bands are tight and become lax as the knee is flexed
¿. UCB orthosis
À. Rigid orthosis with a medical arch support
Á. Semi-rigid orthosis with lateral forefoot posting
Â. Semi-rigid orthosis with a medial arch support
Ã. Medial heel wedge attached to the running shoes
Ä. Hallux varus
Å. Osteonecrosis
Æ. Recurrence of the hallux valgus
Ç. “Transfer” second metatarsalgia
È. Physeal arrest of the first metatarsal
É. Aseptic loosening in a 70-year-old patient
Ê. Mechanical failure of a hinged knee prosthesis
Ë. Failed knee replacement complicated by reflex sympathetic dystrophy
Ì. Infection with soft-tissue deficit
Í. A prior patellectomy
Î. Knee fusion
Ï. Open irrigation and debridement
Ð. Arthroscopic irrigation and debridement
Ñ. One-stage exchange arthroplasty
Ò. Two-stage exchange arthroplasty
Ó. Putti-platt repair
Ô. Open Bankart repair
Õ. Injection of a subacromial corticosteroid
Ö. Arthroscopic transglenoid capsular shift
×. Rehabilitation of the scapular and rotator cuff muscles
Ø. Silicone suction socket and an energy-absorbing foot
Ù. Silicone suction socket and a variable resistance ankle
Ú. Plastic suction socket, telescoping pylon, and a solid ankle cushioned heel (SACH) foot
Û. Plastic socket with a hinged thigh cuff and a SACH foot
Ü. Patellar tendon-bearing suction socket and a uniaxial hydraulic ankle
Ý. Parosteal
Þ. Periosteal
SS. High-grade intramedullary
À. Osteosarcoma occurring in Paget’s disease
Á. Osteosarcoma occurring in irradiated bone
Â. Cauda equina
Ã. Conus medullaris
Ä. Genitofemoral nerve
Å. Lumbar sympathetic plexus
Æ. Lumbar parasympathetic plexus
Ç. Spinal pseudoarthrosis
È. Spinal cord traction injury with paralysis
É. Arterial and venous thromboses
Ê. Superior mesenteric artery syndrome
Ë. Crankshaft phenomenon
Ì. Inversion stress radiograph
Í. MRI scan
Î. CT scan
Ï. Nuclear bone scan
Ð. External rotation stress radiograph
Ñ. Complex deformity with an angulation in two planes
Ò. Single deformity less than 20 degrees, apex posterolateral
Ó. Single deformity greater than 30 degrees, apex posterolateral
Ô. Single deformity less than 20 degrees, apex posteromedial
Õ. Single deformity greater than 30 degrees, apex posteromedial
Ö. Pronation of the foot during the stance phase of gait
÷. Heel inversion at the beginning of a single limb heel rise
Ø. Active inversion of the nonweightbearing foot
Ù. Active plantar flexion of the first ray against resistance
Ú. Active plantar flexion of the foot during the push-off phase of gait
Û. Observation and repeat radiographs in 4 months
Ü. Application of a thoracolumbalsacral orthosis for 22 to 24 hours per day
Ý. Electrical stimulation at night
Þ. Physical therapy
Ÿ. Begins to remodel and hypertrophy more quickly
Ā. Provides a better scaffold for osteoconduction
Ā. Reduces the risk of early fracture
Ă. Reduces technical difficulty
Ă. Lowers donor site morbidity
Ą. Anterior fusion of the lumbar curve
Ą. Anterior and posterior fusion of the thoracic curve
Ć. Posterior fusion of the thoracic curve
Ć. Posterior fusion of the thoracic and lumbar curves
Ĉ. Application of a brace until the iliac apophyses are Risser 4 or 5, followed by surgical correction
Ĉ. Subscapularis rupture
Ċ. Type III SLAP lesion
Ċ. Disruption of capsular shift
Č. Isolated traumatic subluxation
Č. Injury to the axillary nerve after dislocation
Ď. hypophosphatemia
Ď. high dietary cholesterol intake
Đ. deficiency of lipoprotein A
Đ. deficiency of protein S and protein C
Ē. elevated levels of antithrombin III
Ē. Weightbearing short leg cast
Ĕ. Nonweightbearing short leg cast
Ĕ. Removable splint and early motion
Ė. Open reduction and internal fixation
Ė. Elastic compression bandage with full weightbearing
Ę. Breast
Ę. Prostate
Ě. Gastrointestinal
Ě. Kidney
Ĝ. Multiple myeloma
Ĝ. Varus stress
Ğ. Valgus stress
Ğ. Torsional loading
Ġ. Hyperextension of the knee
Ġ. Contraction of the quadriceps while axially loaded
Ģ. Primary internal fixation at both fracture levels
Ģ. External fixation as definitive ttt for both #
Ĥ. Skeletal traction and delayed internal fixation of both fractures
Ĥ. Primary internal fixation of the proximal fracture and delayed fixation of the femoral fracture
Ħ. Primary internal fixation of the femoral shaft fracture and delayed fixation of the proximal #
Ħ. Heel spur
Ĩ. Plantar fascitis
Ĩ. Dysfunction of the tibialis posterior tendon
Ī. Compression of the first branch of the lateral plantar nerve
Ī. Compression of the calcaneal nerve
Ĭ. Displaced labral tear
Ĭ. Tear of the rotator cuff
Į. Fracture of the glenoid rim
Į. Palsy of the axillary nerve
İ. Palsy of the musculocutaneus nerve
I. Enchondroma
IJ. Osteoblastoma
IJ. Giant cell tumor
Ĵ. Aneurysmal bone cyst
Ĵ. Fibrous dysplasia
Ķ. Arthrogram of the wrist
Ķ. MRI scan of both wrists
ĸ. CT scan of both wrists in the same position
Ĺ. Radiographs of the wrist in supination and pronation
Ĺ. Radiographs of the opposite wrist in the same position
Ļ. Secondary hyperparathyroidism
Ļ. Phosphate retention secondary to uremia
Ľ. Insufficient renal synthesis of 1, 25 dihydroxy vitamin D
Ľ. Aluminum deposition in bone from oral phosphate binders
Ŀ. Persistent acidosis aggravating the negative calcium balance
Ŀ. Posterior fusion at T10-L3 with segmental instrumentation
Ł. Laminectomy and fusion of T12-L2 with segmental instrumentation
Ł. Bed rest in a hyperextension brace
Ń. L1 vertebrectomy and anterior decompression with strut graft fusion and instrumentation
Ń. Progressive ambulation as tolerated in a custom-molded thoracolumbosacral orthosis
Ņ. Positive-pressure ventilation
Ņ. An immediate radiograph of the chest
Ň. Adjustment of the position of the endotrachael tube
Ň. Insertion of a large-bore needle into the pericardial space
ʼN. Insertion of a large-bore needle in the right second intercostal space, midclavicular line
Ŋ. Allowing the ends of the fracture to touch
Ŋ. Adding a second connecting bar
Ō. Adding one pin to each fracture fragment
Ō. Increasing the pin diameter from 4 mm to 6 mm
Ŏ. Decreasing the connecting bar-to-bone distance from 6 cm to 4 cm
Ŏ. Osteomyelitis
Ő. Malignant degeneration
Ő. Stress fracture
Œ. Local recurrence of the giant cell tumor
Œ. Bone resorption due to methylmethacrylate
Ŕ. Advancement of the plantar plate
Ŕ. Resection of the second metatarsal head
Ŗ. Dorsiflexion osteotomy of the second metatarsal neck
Ŗ. Transfer of the flexor digitorum longus tendon to the dorsum of the toe
Ř. Transfer of the extensor digitorum comminus tendon to the metatarsal neck
Ř. Sacral fracture
Ś. Burst fracture of L5
Ś. Cauda equina syndrome
Ŝ. Distraction-flexion injury at L3
Ŝ. Distraction-extension injury at L3
Ş. An MRI scan of the shoulder
Ş. An MRI scan of the cervical spine
Š. Electromyographic and nerve conduction velocity studies
Š. Immobilization in a sling and early passive range of motion exercises
Ţ. Immediate return to the operating room for exploration of the brachial plexus
Ţ. cerclage wiring
Ť. tension band wiring
Ť. removal of the patellar component
Ŧ. revision of the patellar component
Ŧ. immobilization of the knee and protected weightbearing
Ũ. Liposarcoma
Ũ. Nodular fasciitis
Ū. Rabdomyosarcoma
Ū. Malignant fibrous histiocytoma
Ŭ. Extra-abdominal desmoid tumor
Ŭ. Clubfeet
Ů. Thrombocytopenia
Ů. Congenital scoliosis
Ű. Ventricular septal defect
Ű. Arnold-Chiari malformation
Ų. delayed primary closure
Ų. free flap
Ŵ. pedicle groin flap
Ŵ. full-thickness skin graft
Ŷ. split-thickness skin graft
Ŷ. Infection
Ÿ. Nonunion
Ź. Improper screw length
Ź. Osteonecrosis of the distal fragment
Ż. Use of a cortical screw instead of a cancellous screw
Ż. Infection
Ž. Tear of the rotator cuff
Ž. Loosening of the humeral component
S. Arthritis of the glenoid
Ƀ. Arthritis of the A-C joint
Ɓ. Reduced morbidity
Ƃ. Improved osteoinduction
Ƃ. Improved osteoconduction
Ƅ. More rapid revascularization
Ƅ. Lower risk of disease transmission
Ɔ. Manipulation Under Anesthesia
Ƈ. Arthroscopic acromioplasty
Ƈ. Arthroscopic debridement of G-H joint
Ɖ. Replacement of the humeral head
Ɗ. Lengthening of the subscapularis and release of the anterior capsule
Ƌ. Bacteroides
Ƌ. E. coli
ƍ. Staph. aureus
Ǝ. group A streptococcus
Ə. Clostridium perforingens
Ɛ. observation and exercises
Ƒ. bracing with a thoracolumbar orthosis
Ƒ. fusion of the posterior spine
Ɠ. fusion of the anterior spine
Ɣ. fusion of the anterior and posterior spine
Ƕ. Total wrist replacement and bridge grafts
Ɩ. palmar shelf arthroplasty and tendon transfers
Ɨ. Darrach distal ulna resection, dorsal tenosynosynovectomy, and tendon transfers
Ƙ. Radioscaphate fusion, extensor tenodesis, and Darrach distal ulna resection
Ƙ. Total wrist fusion and tendon transfers
Ƚ. constrained acetabular component
ƛ. protrusion ring with morselized graft
Ɯ. cemented metal backed acetabular component
Ɲ. cemented all-polyethylene acetabular component
Ƞ. cementless hemispherical component with screw fixation
Ɵ. application of a hip abduction brace for 22 hours per day
Ơ. application of a hip spica under anesthesia
Ơ. discontinuance of all bracing and repeat radiographs in 3 months
Ƣ. open reduction of the hip and application of a spica cast
Ƣ. open reduction, varus osteotomy, and application of a spica cast
Ƥ. Loss of skin hair on the feet
Ƥ. Absent pulses on vascular examination
Ʀ. Pain that originates proximally and spreads distally
Ƨ. Pain that is relieved by stopping and standing
Ƨ. Pain that is worse when the patient walks uphill rather downhill
Ʃ. wrist flexors and finger flexors
ƪ. elbow flexors and wrist flexors
ƫ. elbow flexors and finger flexors
Ƭ. 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
Ƭ. elbow extensors and wrist extensors
Ʈ. Syndactyly
Ư. Macrodactyly
Ư. Camptodactyly
Ʊ. Preaxial polydactyly
Ʋ. Postaxial polydactyly
Ƴ. Arthrodesis
Ƴ. Rotationplasty
Ƶ. Above-knee amputation
Ƶ. Osteoarticular allograft
Ʒ. Endoprosthesis (custom arthroplasty)
Ƹ. Plantar fascia
Ƹ. Spring ligament
ƺ. Deltoid ligament
ƻ. Intrinsic tendons
Ƽ. Gastorcnemius-solelus complex
Ƽ. Prevention of presynaptic release of acetylcholine
ƾ. Prevention of synthesis of presynaptic acetylcholine
Ƿ. Activation of acetylcholinesterase at the motor end-plate
ǀ. Blockage of postsynaptic action of acetylcholine until reserves are depleted
ǁ. Stimulation of release of presynaptic acetylcholine until reserves are depleted
ǂ. stiffness of the femoral component.
ǃ. head offset of the femoral component.
DŽ. femoral component material modulus of elasticity.
DŽ. extent of the femoral component porous coating.
DŽ. Presence of a femoral component collar.
LJ. plantar fascia and quadratus plantae tendon.
LJ. ligamentous structures connecting the tarsal bones.
LJ. shape of the tarsal bones and the intervening joints.
NJ. activity of the intrinsic muscles of the foot.
NJ. activity of the posterior tibialis and the peroneus longus muscles.
NJ. scapulothoracic fusion
Ǎ. strengthening of the periscapular muscles
Ǎ. pectoralis minor-fascia lata graft transfer to the scapula
Ǐ. pectoralis major-fascia lata graft transfer to the scapula
Ǐ. exploration of the long thoracic nerve, with sural nerve graft
Ǒ. tricompartmental knee replacement
Ǒ. unicompartmental knee replacement
Ǔ. medial compartment meniscal allograft
Ǔ. valgus-producing distal femoral osteotomy
Ǖ. valgus-producing proximal tibial osteotomy
Ǖ. Internal rotation of the femoral component
Ǘ. External rotation of the tibial component
Ǘ. Lateral placement of the femoral component
Ǚ. Medial placement of the patellar component
Ǚ. Excessive resection of the patella
Ǜ. Hallux rigidus
Ǜ. Hallux valgus
Ǝ. Neuroma of the first web space
Ǟ. Fracture of the sesamoid
Ǟ. Rupture of the flexor hallucis longus
Ǡ. Sickle cell crisis
Ǡ. Idiopathic chondrolysis
Ǣ. Hemophilic arthropathy
Ǣ. Osteoid osteoma of the femoral neck
Ǥ. Legg-Calve-Perthes disease
Ǥ. Decreased ankle jerk and positive femoral nerve stretch test
Ǧ. Decreased knee jerk and positive straight-leg raising sign
Ǧ. Gastrocnemius-soleus complex weakness and positive straight-leg raising sign
Ǩ. Weakness of the extensor hallucis longus and positive straight-leg raising sign
Ǩ. Weakness of the extensor hallucis longus and positive femoral nerve stretch test
Ǫ. Long-term administration of IV and oral antibiotics
Ǫ. Open soft-tissue debridement, retention of prosthetic components, and IV antibiotics
Ǭ. Immediate exchange arthroplasty with antibiotic-impregnated cement
Ǭ. Two-stage surgical prosthetic exchange and IV antibiotics
Ǯ. Resection arthroplasty and IV antibiotics
Ǯ. SCFE
J̌. MED
DZ. Perthes disease
DZ. Hypothyroidism
DZ. Chondrolysis
Ǵ. gout.
Ǵ. osteoporosis.
Ƕ. eosinophilic granuloma.
Ƿ. tuberculosis of the spine.
Ǹ. metastatic disease of the spine.
Ǹ. water content.
Ǻ. Synthesis of type I collagen.
Ǻ. Proteoglycan content.
Ǽ. Activity of chondrocytes.
Ǽ. Synthesis of hyaluronate.
Ǿ. Lung
Ǿ. Breast
Ȁ. Prostate
Ȁ. Thyroid
Ȃ. Renal
Ȃ. T1-low, T2-low.
Ȅ. T1-low, T2-high.
Ȅ. T1-moderate, T2-low.
Ȇ. T1-high, T2-low.
Ȇ. T1-high, T2-high.
Ȉ. hypothesis is incorrect or invalid
Ȉ. interobserver error rate is 4%.
Ȋ. Standard deviation is 4% higher or lower than the mean.
Ȋ. Sample size is 4% larger than required to be clinically significant.
Ȍ. Probability that the differences noted between two study groups were due to chance alone is 4%.
Ȍ. I
Ȏ. II
Ȏ. IV
Ȑ. IX
Ȑ. X
Ȓ. Cranial setting
Ȓ. Cranial subluxation
Ȕ. Odontoid fracture
Ȕ. Lysis of the arch of the atlas
Ȗ. Atlantoaxial subluxation
Ȗ. Retrograde collapse of the endoneurial tubes
Ș. Irreversible atrophy of the denervated muscles
Ș. Elongation of the axons across the zone of injury
Ț. Sprouting of the axons at the neuromuscular junction
Ț. Misdirection of the axons across the zone of injury
Ȝ. Maximally pronated and elbow extended
Ȝ. Maximally pronated and the elbow flexed
Ȟ. Maximally supinated and the elbow flexed
Ȟ. Maximally supinated and the elbow extended
Ƞ. In neutral rotation, with the elbow extended
ȡ. open reduction and internal fixation
Ȣ. buddy taping to the adjacent index finger
Ȣ. early motion with application of a dynamic banjo splint
Ȥ. application of a cast with the hand in a “safe position” for 3 weeks.
Ȥ. dorsal extension block splinting
Ȧ. The name of the manufacturer
Ȧ. The manufacturer’s potential liability
Ȩ. The physician’s clinical performance
Ȩ. The physician’s materials testing data
Ȫ. Any royalties the physician receives from the manufacturer
Ȫ. Femoral
Ȭ. Obturator
Ȭ. Inferior gluteal
Ȯ. Superior gluteal
Ȯ. Lateral femoral cutaneous
Ȱ. open biopsy and a long leg cast
Ȱ. open biopsy and wide resection of the tumor
Ȳ. a long leg cast and observation
Ȳ. intramedullary stabilization and observation
ȴ. Triggering
ȵ. Lateral instability
ȶ. Swan-neck deformity
ȷ. Boutonniere deformity
ȸ. Loss of distal interphalangeal joint flexion
ȹ. Peroneus brevis to peroneus longus
Ⱥ. Peroneus tertius to extensor hallucis longus
Ȼ. Peroneus tertius to superficial peroneal nerve
Ȼ. Extensor hallucis longus to deep peroneal nerve
Ƚ. Extensor hallucis longus to extensor digitorum longus
Ⱦ. reassurance that Medicare will pay for the treatment.
Ȿ. consent forms that patients or their guardians are able to understand.
Ɀ. a detailed description of the device, omitting the fact that it is part of a study.
Ɂ. a provision that the patient’s care will be discontinued if he or she does not enroll in the study.
Ɂ. a provision that the study will be carried out to completion, whether or not the device is as effective as those currently in existence.
Ƀ. an onlay iliac crest bone graft.
Ʉ. limited weightbearing and observation.
Ʌ. removal of the implant and limited weightbearing.
Ɇ. removal of the implant and insertion of a reamed femoral nail.
Ɇ. removal of the implant and insertion of an unreamed femoral nail.
Ɉ. Coronal
Ɉ. Sagittal
Ɋ. Anteromedial, midway between the sagittal and the coronal
Ɋ. Proximal pins sagittal, distal pins coronal
Ɍ. Proximal pins coronal, distal pins sagittal
Ɍ. Rheumatoid arthritis
Ɏ. Posttraumatic arthritis
Ɏ. Degenerative osteoarthritis
Ɐ. Osteonecrosis of the tibial plateau
Ɑ. Osteonecrosis of the medial femoral condyle
Ɒ. Trapeziometacarpal arthrodesis
Ɓ. Osteotomy of the thumb metacarpal
Ɔ. Arthrotomy and joint debridement
ɕ. Ligament reconstruction using one half of the flexor carpi radialis
Ɖ. Trapezium resection, tendon interposition, and reconstruction of the ligament
Ɗ. Creep
ɘ. Relaxation
Ə. Energy dissipation
ɚ. Plastic deformation
Ɛ. Elastic deformation
Ɜ. bending
ɝ. axial loading
ɞ. high-speed rotation
ɟ. direct impact from anteromedial
Ɠ. crush from anteromedial to posterolateral
Ɡ. Increase stiffness
ɢ. Increase fracture toughness
Ɣ. Increase fatigue strength
ɤ. Decrease mechanical strength
Ɥ. Decrease wear rate
Ɦ. disuse osteopenia
ɧ. paraendocrine effect of the tumor
Ɨ. abnormally increased density on the right side
Ɩ. side effect of the treatment of the lesion
Ɪ. extensive tumor involvement of the left hip
Ɫ. Sciatic nerve
Ɬ. Superior gluteal artery
ɭ. Profunda femoris artery
ɮ. Femoral artery and nerve
Ɯ. External iliac artery and vein
ɰ. Length
Ɱ. Moment arm
Ɲ. Total volume
ɳ. Physiologic cross-sectional area
ɴ. Distribution of slow and fast twitch fibers
Ɵ. decreasing initiation of action potentials.
ɶ. increasing action potential amplitude.
ɷ. blocking the opening of gated sodium channels.
ɸ. decreasing the number of functional motor units.
ɹ. slowing or stopping action potential propagation through the axon.
ɺ. resection of the metatarsal heads of the first through fifth toes.
ɻ. Silastic MP joint arthroplasties of the first through fifth toes.
ɼ. fusion of the hallux MP joint and resection arthroplasty of the 2nd through fifth metatarsal heads.
Ɽ. fusion of hallux MP joint and distal osteotomy of the 2nd through 5th MT.
ɾ. plantar condylectomy of the 2nd through 5th MT heads & resection of proximal phx of the hallux.
ɿ. hemiarthroplasty
Ʀ. open reduction and internal fixation
ʁ. closed reduction and percutaneous pinning
Ʂ. a sling and early pedulum exercises
Ʃ. a sling and swathe for 6 weeks, followed by shoulder rehabilitation
ʄ. open acromioplasty
ʅ. open Bankart repair
ʆ. open subscapularis tendon repair
Ʇ. inferior capsular shift
Ʈ. a supervised physical therapy program
Ʉ. a sling and swathe, with pendulum exercises in 10 days
Ʊ. open reduction and internal fixation through an anterior approach
Ʋ. open reduction and internal fixation through a posterior approach
Ʌ. immobilization with a splint in 45 degrees of abduction for 6 weeks
ʍ. arthroscopically assisted reduction and percutaneous screw fixation
ʎ. Repair of the rotator cuff
ʏ. Replacement of the humeral head
ʐ. Resection arthroplasty
ʑ. Total shoulder arthroplasty
Ʒ. AP and lateral radiographs of the elbow
ʓ. Diagnositc arthroscopy
ʔ. Aspiration of joint fluid
ʕ. An erythrocyte sedimentation rate and CBC
ʖ. A diagnostic lidocaine injection
ʗ. Insulin-like growth factor (IGF-1)
ʘ. Fibroblast growth factor (FGF-1)
ʙ. Platelet-derived growth factor (PDGF)
ʚ. Transforming growth factor beta (TGF-B)
ʛ. Bone morphogenetic proteins (BMP)
ʜ. clinical history and radiographic findings.
Ʝ. technetium bone scan
Ʞ. flow cytometry pattern of extracted chondrocytes
ʟ. immunohistochemical staining patterns of a biopsy specimen
ʠ. histologic features of a biopsy specimen stained with hematoxylin-cosin
ʡ. Radial
ʢ. Radial recurrent
ʣ. Posterior interosseous
ʤ. Superior ulnar recurrent
ʥ. Superficial radial circumflex
ʦ. Impaired hydroxylation of proline
ʧ. Failure of cleavage in procollagen
ʨ. Defective binding sites for hydroxyproline
ʩ. Failure to incorporate glycine into the helix
ʪ. Diminished production of collagen through the rough endoplasmic reticulum
ʫ. Asking the legal staff to seek a court injunction
ʬ. Copying the patient’s chart and giving it to him as he leaves
ʭ. Having the patient sign a written legal contract that specifies acceptable behavior
ʮ. Continuing care of the patient until an appropriate referral can be arranged
ʯ. Transferring the patient to another orthopaedic surgeon without disclosing the realreason for why the patient is being transferred
ʰ. Meta-analysis
ʱ. Confidence interval
ʲ. Analysis of variance (ANOVA)
ʳ. Statistical significance (p-value)
ʴ. Survivorship analysis (Kaplan-Meier)
ʵ. Spinal shock
ʶ. Neurogenic shock
ʷ. Hypovolemic shock
ʸ. Pulmonary embolism
ʹ. Fat embolus syndrome
ʺ. Lumbar spinal stenosis
ʻ. Metastatic disease of the spine
ʼ. Rheumatoid lumbar spondylitis
ʽ. Isthmic spondyloloisthesis
ʾ. Degenerative spondylolisthesis at L4-5 and L5-S1
ʿ. Patella alta
ˀ. A metal-backed patella
ˁ. 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
ˆ. The proximal phx is on the neck of the metatarsal
ˇ. The dislocation is dorsal and centered
ˈ. The proximal phalanx is hyperextended
ˉ. Patella
ˊ. Tibial stem
ˋ. Distal femoral interface
ˌ. Posterior femoral interface
ˍ. Sites of screw fixation for the tibia
ˎ. Hallux rigidus
ˏ. Fracture of the sesamoid
ː. Disruption of the plantar plate
ˑ. 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
ˠ. Conus medullaris
ˡ. Extent of bone penetrated by reaming, prosthetic components, or acrylic cement
ˢ. Periprosthetic regions that are accessible to joint fluid and particulate wear debris
ˣ. Enveloping pseudocapsular scar tissue that develops around a prosthetic hip following surgical capsulectomy
ˤ. 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
ˬ. Open reduction and fixation in the epiphysis only
˭. ORIF with a small-fragment T-plate from the malleolus up to the metaphysis
ˮ. 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
̖. Fibular collateral ligament
̗. 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
̞. 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
̣. Saphenous and its branches
̤. Posterior tibial and its branches
̥. Deep peroneal and its branches
̦. Superficial peroneal and its branches
̧. Strength
̨. Stiffness
̩. Shelf life
̪. Antigenicity
̫. Risk of HIV transmission
̬. Indemnification
̭. Occurrence
̮. Excess liability
̯. Claims-made
̰. Nose
̱. Lateral Y
̲. Scapular AP
̳. Neutral rotation AP
̴. Internal rotation AP
̵. External rotation AP
̶. Trauma
̷. Hemophilia
̸. Reiter’s syndrome
̹. Rheumatoid arthritis
̺. Systemic lupus erythematosus
̻. Cast immobilization for 6 weeks
̼. Activity modification and re-evaluation in 2 months
̽. Internal fixation with or without bone grafting
̾. Retrograde drilling of the defect without articular cartilage penetration
̿. Drilling of the defect directly through the articular cartilage
̀. repair or reconstruction of the medial collateral ligament
́. repair or reconstruction of the medialand lateral collateral ligaments
͂. immobilization for 5 days or less
̓. immobilization for 14 days
̈́. immobilization for 25 days
Ι. Cystinosis
͆. Hypophosphatemia
͇. Renal osteodystrophy
͈. Primary hyperparathyroidism
͉. Nutritional vitamin D deficiency
͊. Lateral meniscus tear
͋. Popliteus tenosynovitis
͌. Iliotibial band friction syndrome
͍. Peroneal nerve entrapment
͎. Biceps tendinitis
͏. Observation
͐. Removal of the prosthetic components
͑. Operative exploration and decompression of the peroneal nerve
͒. Nerve conduction velocity studies
͓. Loosening of the primary dressings and knee flexion to 30 degrees
͔. I
͕. II
͖. III
͗. decreased tissue tension
͘. decreased abductor lever arm
͙. decreased joint reaction force
͚. increased body weight over lever arm
͛. increased polyethylene wear rate
͜. recurrent traumatic anterior dislocation
͝. recurrent traumatic posterior dislocation
͞. traumatic subluxation with no previous dislocation
͟. traumatic anterior subluxation
͠. atraumatic involuntary subluxation
͡. radial
͢. axillary
ͣ. suprascapular
ͤ. thoracodorsal
ͥ. long thoracic
ͦ. Flexion
ͧ. Extension
ͨ. Axial rotation
ͩ. Left lateral bending
ͪ. Right lateral bending
ͫ. Skin
ͬ. Lung
ͭ. Brain
ͮ. Heart
ͯ. Kidney
Ͱ. Thoracoacromial, lateral thoracic, subscapular
Ͱ. Thoracoacromial, anterior humeral circumflex, posterior humeral circumflex
Ͳ. Posterior humeral circumflex, subscapular, thoracacromial
Ͳ. Subscapular, thoracacromial, anterior humeral circumflex
ʹ. Lateral thoracic, anterior humeral circumflex, thoracacromial
͵. Respondeat superior
Ͷ. Indemnity agreement
Ͷ. Hold harmless agreement- attempt to shift liability from company to physician
͸. Comparative negligence-% of involvement
͹. Contributory negligence- resident contributed to the negligence
ͺ. t-type
Ͻ. both column
Ͼ. transverse
Ͽ. anterior column
;. anterior column posterior hemitransverse
Ϳ. Posterior interosseous
΀. Anterior interosseous
΁. Radial
΂. Median
΃. Ulnar
΄. Shock from hypovolemia
΅. Associated rupture of the bladder
Ά. Arterial bleeding on pelvic angiogram
·. Presence of a hematoma in the perineum and scrotum
Έ. Fractures of both the anterior and posterior pelvic ring

Correct Answer & Explanation

. a total contact cast.


Explanation

Question 4098

Topic: 10. Pathology and Oncology

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

Correct Answer & Explanation

. Ewings tumor


Explanation

Question 4099

Topic: 10. Pathology and Oncology

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

Correct Answer & Explanation

. Vascular injury


Explanation

Question 4100

Topic: 10. Pathology and Oncology

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

Correct Answer & Explanation

. Biceps


Explanation