8. Foot and Ankle MCQs

A newborn is diagnosed with a congenital vertical talus. Which of the following is the defining pathological anatomic relationship in this condition?

A 12-year-old boy presents with a painful, rigid flatfoot and a history of recurrent ankle sprains. An oblique radiograph of the foot demonstrates the 'anteater nose' sign. Which of the following is the most likely diagnosis?

A 14-year-old boy presents with a rigid flatfoot, recurrent ankle sprains, and peroneal spasm. Radiographs show the 'anteater nose' sign. Which specific pathology does this radiographic finding represent?

When correcting a clubfoot by the Ponseti method, the lateral mold on the foot must be placed against which of the following structures:

Which of the following bones of the foot is normally ossified at birth:

An 11-year-old girl presents with pain in the area of the second metatarsophalangeal joint. Pain is increased with joint motion. Radiographs show increased density and flattening of the metatarsal head. Recommended treatment is:

A 13-year-old boy sustains a twisting ankle injury resulting in a juvenile Tillaux fracture. Avulsion by which of the following ligaments is primarily responsible for this specific fracture pattern?

A 12-year-old boy presents with rigid flat feet and recurrent ankle sprains. CT imaging reveals a talocalcaneal coalition. Which of the following clinical signs is most classic for this condition on physical examination?

A 12-year-old boy presents with rigid flatfeet and recurrent ankle sprains. Radiographs reveal the "anteater nose" sign. Which of the following is the most likely diagnosis?

A 14-year-old boy presents with a rigid flatfoot and recurrent ankle sprains. Radiographs show a "C sign" on the lateral view. Which of the following is the most appropriate initial diagnostic imaging to characterize this specific condition?

A 71-year-old man comes to the Respiratory Clinic for review. He has a history of chronic obstructive pulmonary disease (COPD) managed with high-dose Seretide and tiotropium, and right heart failure for which he takes ramipril and bumetanide. He has an exercise tolerance of 80 m and has had two COPD exacerbations in the past year. On examination his BP is 135/85 mmHg; pulse is 75/min and regular. Auscultation reveals bilateral poor air entry and wheeze. He has bilateral pitting oedema to just above the ankles. His BMI is 23. Investigations: Hb 13.8 g/dl, WCC 9.3 × 10^9/l, PLT 189 × 10^9/l, Na+ 138 mmol/l, K+ 4.3 mmol/l, Bicarbonate 32 mmol/l, Creatinine 122 μmol/l, pH 7.44, pO2 7.8 kPa (7.7 kPa 3 months earlier), pCO2 6.5 kPa. Which of the following is the most important argumentation justifying prescription of long-term oxygen therapy (LTOT) in this patient?

A 28-year-old construction worker drops a heavy beam on his midfoot. Radiographs demonstrate widening of the space between the bases of the first and second metatarsals, with a small bony avulsion fragment in the interval. The Lisfranc ligament connects which two structures?

A 30-year-old male complains of severe midfoot pain after falling from a horse with his foot caught in the stirrup. Examination reveals significant swelling and plantar ecchymosis. Radiographs show widening between the base of the 1st and 2nd metatarsals. Which structure is primarily injured?

A patient presents with midfoot pain and plantar ecchymosis after a twisting injury to the foot. Radiographs reveal a 'fleck sign'. The critical ligament injured in this scenario connects which two osseous structures?

A 45-year-old recreational tennis player lunges for a ball and feels a snap in the back of his heel, followed by difficulty walking. Which physical examination test is most sensitive and specific for diagnosing this acute injury?

A 40-year-old weekend warrior feels a 'pop' in his distal calf while playing tennis. He has a positive Thompson test. He opts for non-operative management of his acute Achilles tendon rupture. Which rehabilitation protocol provides the lowest re-rupture rate comparable to surgical repair?

An obese 40-year-old woman with a history of asthma presents with progressive breathlessness. On examination she has a raised jugular venous pressure, ankle oedema, right parasternal heave, and a murmur consistent with tricuspid regurgitation. Chest auscultation is clear. You understand from her husband that she has had progressively worsening symptoms over the past year. He has noticed that she has had particular problems with snoring and stopping breathing at night since he met her. Arterial blood gas results show: pH 7.39, PO2 7.3 kPa (normal range 11.3–12.6 kPa), PCO2 4.9 kPa (4.7–6.0 kPa). What is the most likely diagnosis?

A 40-year-old man feels a "pop" in his posterior ankle while playing basketball. He has a positive Thompson test. Which of the following functional outcomes is most consistently improved with surgical repair of this injury compared to conservative management?

A 45-year-old male feels a sudden pop in his posterior heel while playing tennis. On examination, the Thompson test is positive. Which vascular territory is most prone to degeneration and rupture in the Achilles tendon?

A 21-year-old gymnast presents with midfoot pain and swelling after landing awkwardly. Radiographs demonstrate a subtle widening of the space between the base of the first and second metatarsals, with a small bony fragment visible in this space (the "fleck sign"). Which ligament is critically injured?