e ‘De Gastn Hussain PIMS Hospital Unit FCPS Il Orthopedics Jan 2017 ‘A fisherman got non haling ulcer on dorsum index finger since 6 months. Biopsy shows granulomatous inflammation, most likely due to, ‘Mycobacterium Tuberculosis, Mycobacterium Marinum Mycobacterium Ulcerans Mycobacterium Kansasil Mycobacterium Avium eansp Post Traumatic severe Osteoarthritis hip joint in a 35 years old labor, which option is best for him to continue his near normal life? a. Hipresurfacing ve. arthnclesis b. Cementless THR ©. Cemented THR d. Bipolar arthroplasty 45 year old male office worker has right hip joint severe arthritis and has difficulty in sitting due to decreased hip joint motion. Best treatment option? a. Cemented THR ©) Cementiess THR . Hip resurfacing 4. Bipolar arthroplasty ‘A 35 year old man is diagnosed case of ankylosing spondylosis involving lower spine and painful both hip joints. Right side hip is more painful and flexion contracture with ROM 70 degree while ROM left hip is 30 to 100 degree. Best treatment for hip is? ‘a. Left side THR ©) Right side THR ¢, Bilateral THR 4. Arthrodesis . A40 year old patient since 3 years on hemodialysis got fracture neck of femur, He is declared very high risk for surgery. Treatment option? ‘a, Mobilize with fracture b. Hemiarthroplasty c. Resection arthroplasty d. Cemented THR While doing TKR, found 2 cm defects which are 2.5cm wide, Manage defect with? a, Bone cement b. Metal augments -. Bone graft d. Wide tibia tray Most of orthopedic implants are, a. Alloy b. Chromium <<. Slainless steel 316L d. CobaltDr Qasim Hussain PIMS Hospital Unit I ainful right hip. He had DDH which was operated in childhood. X rays . thows ‘oma road's partially incovered. Osteoarthritis noted in hip joint. Best option? ‘a. Acetabular rotational oteotomy and later THR b, Acetabular rotational osteotomy and pelvic redirectional osteotomy, later THR c. Femur varus osteotomy d. Early THR 9. Investigation of DDH in 9 month old child? Ultrasound . Xray MRI |. Barlow and Ortolani CT scan » b. ©. 4. e. 10. Most common post op complication of SCFE is? ‘a. Chondrolysis b. AVN ¢. Pain d. Painful arthritis, 11. Which of the following is correct about SCFE? ‘a. Occurs through hypertrophic zone b 2 3? a7? 42. Camera port for knee arthroscopy? a. Lateral b. Medial c. Anterior d, Posteriomedial 1. Medial epicondy! fracture in 8 year old child must be fixed to avid in future? a, Cubits varus b. Tardy unlar nerve palsy c. Decrease range of motion d. Decreased growth 14.3 year old boy has painful hip movements, fever 40, pulse 120/min, since 48 hours. Best ir ation is? 16, Most common site for cervical spine disc prolapsed? a. Anterior b. Posterior ©. Posterolateral‘Dr Qasim Hussain PIMS Hospital Unit d. Anterolateral 16. 53 year old female has got humerus fracture after trivial injury. She has mastectomy 10 years ago. Treatment option? a. Closed interlocking nail b. Open interlocking nail ¢. Dynamic compression plate 4. Uslab 17. A patient has lateral winging scapula. Strengthening exercise of which muscle you will advise him? Deltoid Serratus anterior Trapezius Latessimus Dorsi nese 18. Most common nail bed tumor? a. Angiosarcoma b. Malignant melanoma ¢. Squamous cell carcinoma 4. Osteoid osteoma 19. A young female got femur fracture. She has also renal stones. X rays showing thinning of bone cortex. Diagnosis? a. Osteomalascia b. Primary hyperparathyroidism c. Secondary hyperparathyroidism d. Osteoporosis, 20. 50 years female who has 4 children has developed myalgias, bony aches. Serum calcium and phosphate normal. But raised hydroxyprolene in urine. Diagnosis? a. Osteomalascia b. Post-menopausal osteoporosis ¢. Multiple Myeloma d. Metastatic tumor 21. X ray of proximal tibia of young man shows large cystic lesion with thinning of cortexes. ‘Serum Calcium is normal, alkaline phosphatase is raised. Biopsy shows GCT. Diagnosis? a, Brown tumor b. GCT ©. Unicameral bone cyst 4. ABC 22, Most common tumor of old age? a. GCT b. Chondrosarcoma °c. 2? d. 22 23. A wrestler's shoulder was dislocated 7 times in year. X ray and MRI are normal. Best Rx? a. Capsulorraphy b. Laterjet procedure1 Gasim Hussain PIMS Hospital Unit c. Putti-plate procedure d. Megnusum procedure e. Bankart repair 24. Treitz syndrome most commonly involves? a. 1% and 2” rib b. 2 and 3rd c. 3 and 4" rib d. 4" and 5" 25. In thoracic outlet syndrome, NCS most likely shows, ‘a. Decreased latency in Ulnar nerve b. Increased F weave cc. SNAP? 4. 7? 26. In Idiopathic scoliosis most common curve is? a. Large left thoracic b. Large right thoracic ¢. Large left lumber d._ Large right lumber 27. A patent after RTA got femur fracture and has lung injury. Best treatment for him Close ream interlocking femur nail b. Open ream interlocking femur nail c. Skeletal traction 4. e. |. Mizarov Broad dynamic compression plate 28. A man fall from 200f height and got calcanium fracture, In addition most common fracture might be? a. Tibial platue b. Femur shaft c._Neck of femur d. Lumbosacral spine 29. A patients comes with Hip dislocation after 6 weeks. IIs painful and he is walking with crutches. Treatment? ‘Open reduction Close reduction n ae ees 30. Regarding bone fracture, sn Tensional force causes bending at center b. Compression force causes bone shortening ¢. Distraction force causes elongation @._ Tensional force causes transverse fracture 31, Using Henry approach for proximal 1/3 radius?Dr Qasim Hussain PIMS Hospital Unit t Between FCR and Brachioradialis Pronator Teres and Brachioradialis 2 2 pers 32. A patient got median nerve palsy at the wrist. Most likely deficit is a. Unable to flex thumb b. Unable to adduct thumb ¢. Unable to abduct thumb d._ Sensory loss over a portion of thumb 33. PIN injury results in deficit of? a. Loss of extension at metacarpophalangeal joints b. Wrist drop c. Loss of pinch action a? 34. AIN injury results in deficit of? a. Loss of pinch action b. Wrist drop ¢. Loss of dorsum hand sensations d. 227 35. A manual worker comes with palpabe nodule in palm and gradually stuck 2" and 3° fingers in flexion. This is most likely due to? ‘a. Thickened palmar fascia b. Subcutaneous thickness c. Pathology in tendon sheath d. Tendon 36. 10 years old boy got radial neck fracture 80 degree ‘angulations. Best treatment? a. Close reduction b. Close reduction and k wire ¢. Open reduction and k wire d, Excision 37, 6 year old child presents with Garland type Il fracture 6 weeks O18 ROM at elbow is 0-100 degree, He was managed by street bone setters. Best treatment fr him is? ‘a, Passive stretching b. Active stretching c, ORIF d, Manipulation under Anesthesia 38, Emergency reversal of warfarin is? a, Fresh frozen plasma b, Vitamin K ¢. Whole blood d. Factor 8De asim Hussain PIMS Hostal Unit i 39. What level of factor 8 and 9s! eee should be for major surgery? b. 80% c, 60% d. 40% 40. Best Antibiotic for Gram +ve organisms? ‘a. Aminoglycoside b. Cephalosporin 2 a? 41, Booster dose for tetanus prophylaxis is? a. 2years b. Syears c. 10years ._ Each time when get injury 42. Life threatening after open fracture maybe due to? ‘a. Gram ve infection b. Anaerobes c. Gram +ve d._ Bacili 143, Apatient after RTA comes wit fracture tibia, Distal pulses were not palpable so found 1 Bipected biood vessel in thigh and Tigated. What type of fracture is i? a, Close B. Gustilo Anderson type Il e Gustilo Anderson type IIb §. Gustilo Anderson type Ile ‘4. Most specific for $1 nerve Foot injury at spine level? . SLR +ve 2 Lost knee reflex Lost Ankle reflex “Ankle dorsifiexion and planter flexion eos 45. When compared surgical treatment of AC joint injury type Il! to conservative treatment, in young athlete, results are? a, Better b. Poor ¢. Persistent pain d._ Instability ge. Best treatment option 1 Ke joint type lin young athlete? A. AC joint k wire and CC reconstruction 8 Excision of distal clavicle c. Ac and CC . Sorew fixationDr Qasim Hussain PIMS Hospital Unit 47, Minimum stump for BKA for prosthesis to work is? a, Sem b. 8m c. 12cm d. 15cm 48. Patient admitted with Femur fracture and injury to head. After 48 Hours patient developed altered conscious, tachycardia, petechial rashes over chest. Most likely is the diagnosis? a. Fat embolism b. Closed Head injury c. DVT d. Dehydration 49. A patient has painful Morton neuroma on foot. Best treatment? a. NSAIDS b. Excision c, Arches d._ Steroid injections 50. Union of distal 1/3" tibia depends on? a. Blood supply at fracture site b. ? c 2? a? 51, Most common ligament repture in ankle sprain ? ‘a. Anterior tibio fibular ligament b. Deltoid ligament ¢. Posterior tibio fibular ligament d. Anterior tibio talar ligament 52. A patient comes in emergency with ankle sprain 2 hours ago with severe pain on weight bearing. X rays shows increased medial joint space increased. Next investigation will be? a. Mortise view b. Harris View c, CT scan d. MRI 53. Talar head blood supply is from? Tarsal canal vessels Mainly from dorsal pedis artery Peroneal branch vessels Posterior tibial artery aes 54. After Talar neck fracture ‘a. Talar Neck has chances of AVN b. Talar body has chances of ANN 7? a. ?Dr Qasim Hussain PIMS Hospital Unit 55. A patient had Pilon fracture which was treated conservatively. 6 months lat severe ed is Tibio Talar joint. Arthrodesis effectively achieved by? ana Chamlay clamp Blair fusion 4.5mm cortical screw 6.5mm Cancellous screws paese 56. Talus fracture fixation achieved best by a. 3.5mm cortical screw b. 4.5mm malleolar screw 2 d. 6.5mm cortical screw 57.50 year old male has metastatic blastic lesion in femur, Most ikely itis metastasized from? a. Testis b. Thyroid c. Kidneys d. Adrenals e. Prostate 58, Painful Bony lesion in proximal tia wit sclerotic margins and radiolucent cavity 0” X rays. Pain responds to aspirin. Which futher investigation needed? CT scan MRI CBCESR CRP Bone scan passe 59. A young foot ball player had knee injury 6 months ago. Now he has knee locking and pain. X rays show medial side of at ral eondyis irregular lesion. Diagnosis? “a. Osteochritis dissicans ACL injury ¢. Osteoarthritis . Meniscl injury 60, A3 years old child brought in emergency with fracture femur. He has previous history of ‘multiple fractures also which united unevenly. Diagnosis? ia Osteogenesis imperfecta b. Rickets ¢. Osteoporosis 4? 61. A patient developed Volkmann ischemic contracture on right leg due to quack managed fracture tibia fibula. Deformity of foot in this condition is? a. Claw toes b, Equinovarus footDr Qasim Hussain PIMS Hospital Unit c. Cavus foot d. Planovalgus foot 62. A 50 year old fervale had radial steloid fracture 6 months ago which was treated wih ‘compression bandage. Now she has restricted ROM at wrist, severe pain and shinny skin. Diagnosis? a. Sudeck's dystrophy b. 2 «2 a? 63, When compared surgical treatment of 4 pat fracture in young patients, older patient better tolerate a. Hemiarthroplasty b. ORIF c. Non operative treatment a. ? 64, Missed injuries in well established trauma center? 10% <10% <5% 20-30% epsD 65. A cadet presents in OPD with pain in right tibia during walking for 6 weeks. Local A Gmination shows tenderness. X ray normal. Next diagnosis? MRI b. CT scan c. Bone Scan d. C Reactive Protein 66. A patient has Gustto Type Il fracture femur. Definitive Treatment in this condition? ‘a. Closed ream IM/IL nail b. Open Ream IMIL nail c, DCP d. Skeletal traction 67. Quadrilateral space syndrome? ‘a. On axillary artery b. Posterior humeral artery ¢. Anterior circumflex humeral artery 4. Axillary nerve and posterior circumflex humeral artery 68, Patient had rotator cuff tear 6 months ago. Now pain is due to? ‘a. Inflamation at margins of teat tendons rotator cuff b. Calcific tendinitis c. Bicipetal tendinitisDr Qasim Hussain PIMS Hospital Uniti a? 69. A polio patient developed right foot drop. You will advise him? a, Patellar tendon brace b. Double sided foot below knee orthosis ¢, Double sided flexible? a7 70. A 30 year old patient has severe backache. Has low grade fever since 3 months. X rays. spine shows D9-D11 lesion in body. Best treatment? a. Posterior spine stabilazition b. Anterior spine stabilization c. Thoracoscopic decompression d. Combined anterior and posterior spine decompression 71. Fracture of spine is mostly stable in? ‘a, Tear drop fracture b. 2 ° 2? a? 72. Anterior approach to humerus a? b 2 ea 4? 73. Ankle arthrodesis is done in? ‘a. S.degree valgus 10 degree ER b. 2 74, Coventry did High tibial osteotomy in young patients and success rates are a? b ? 0? 4? 75. A9 year old child child got fractures supracondylar humerus. He presents within 3 hours in emergency. Distal pulses not palpable. X ray shows fracture fragments are displaced posteriorly. Next step? ‘a, Surgical exploration of artery b. Close Manipulation, apply straight arm back stab ©. Apply POP cast in elbow flexion 90 degree a? 76, Gout is diagnosed on a. +ve birefringence crystals on aspirationDr Qasim Hussain PIMS Hospital Unit b. -ve birefringence crystals on aspiration c. Serum uric Acid >9 4? 77. Asthrogryposis is ? a. Straightening of joints b. Multiple joints contractures. ©, Increased joint space 4? 78. In Osteosarcoma, Sun ray appearance and elevated periostium is due to? a. Periosteal reaction and New bone formation below the periostium b. Bone edema c. Periosteal reaction d. Tumor calcification 79, Most reliable test of ACL tear a. Lachman b. Anterior drawer c. Pivot shift 4.2 80. Diagnosed case of GCT size 4cm in proximal fibula. MRI shows intracompratmental location, Metastatic workup is normal. Treatment? Extensive curettage and bone cement Extensive curettage and bone graft Excision of proximal fibula and a rim of tibia Excision of proximal fibula and reattach lateral ligaments complex aooDMCQs FCPS Il Oct 2016 1. Boyed and grafin type Ill #. Best treatment? 2. Placement of DHS screw recommended in which place femoral neck? 3. Regarding smith-peterson approach, which structure most likely to damage? Ans. Lateral femoral cutaneus nerve 4. Best treatment SCFE? Place threaded single screw 5. Visceral injuries suspected in which type of pelvic fracture? 6. Most common site of failure of ACL reconstruction is? 7. After RTA, patient has obvious knee deformity. Tibia sagging posteriorly. 10mm medial joint line opening. Best treatment? Ans? ACL reconstruction+MCL reconstruction 8. Most reliable clinical test of ACL injury? 9. A patint has ankie trauma. Skin at the site of anterior tibiofibular ligament is bruised. Treatment? a. Icet crap bandage b. POP cast c. Heating d. Surgery e. None 10. Medial malleolus fracture and medial joint space in 2mm on x ray. Best study to evaluate? a. Mortise view 11. Basic pathology in congenital vertical talus? 12. Divergent injury at all tarsometatarsal joints, Best treatment? a. Pinning 1,2 b. Pinning 3,4, © Pinning 1,5 13. Infantile blount disease Lengenskiold Ill, Best treatment? 14. Most common cause of failure of THR? 15. Best surgical approach for TB spine?16, Mid-clavicle fracture, Best treatment? 17. AC joint type Il! injury. Best treatment? 418, Neer Ill proximal humerus fracture. Best treatment? a. ORIF b. Percutaneous pinning Nail 4d, 6 weeks old Medial condyl humerus fracture in children should be operated because of? 419. Surgical Henary approach to Radius which structures fs least likely to damage? 20. n PIN injury what movements at hand affected? 21, NCS shows some structure damaged in guyon canal. What will Be clinical sign in hand? 22, Patient has periarticular and periacetabular osteopenia. isgnosis? 23, in a trauma, dominant hand distal phalanx of index finger was amputated. After simple dressing after stump, hand was immobilized for 4 weeks. Now she has no grip in hand. Diagnosis? 24, Radial Head type Il fracture and coronaid fracture. Best treatment? 25, Normal insal Salvati ratio ? .08-1.2 26, Minimal stump for BKA for the prosthesis to workis ? 27. In TKA, extension gap explains? a. Distal femoral cut to proximal tibial cut 28, Patient has anterior shoulder dislocation due to anterior glenold loss, best treated with? a. Anterior transfer of coracoid process