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Medical Sciences Questions and Answers April 15, 2020

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Which of the following is most true about displaced intercondylar fracture (T-Y fracture) of distal femur: A Can be treated adequately by skin traction It should be accurately reduced and internally fixed Following good reduction and fixation there is no danger of knee stiffness D Non union is not uncommon E Percutaneous pin fixation is best

Which of following is the commonest cause of loose body in the knee joint. A Tibial spine fracture Osteochondritis dissecans Intra-articular fractures D Synovial osteochondromatosis E Torn meniscus.

Which of the following is preferable treatment for six weeks old intrascapular fracture of femoral neck in a thirty five year old man: A Hemireplacement arthroplasty Me Murray Osteotomy Smith Peterson Nailing D Moore's pin fixation E Plaster spica.

Best treatment for a sixty five year old patient with four week old intracapsular femoral neck fracture is: A Internal fixation Internal fixation with muscle pedicle graft Me Murray osteotomy D Hemireplacement arthroplasty E Total Hip replacement.

Which of the following fractures of femoral shaft are most suitable to internal fixation by Kuntschner nail: A Transverse fracture of mid shaft Spiral fracture of mid shaft Oblique fracture of distal third of shaft D Subtrochanteric fracture E Very comminuted fracture of mid shaft.

In cases of leg fractures, above knee plaster is applied with knee slightly flexed for which of the following reason: A To avoid stretching posterior capsule of knee joint keep the cruciate ligaments relaxed allow easier ambulation D To prevent rotational movements being transmitted to the fracture site E Plaster application is easier with knee

Concerning intra-articular fractures at knee which of the following statement is true: A Early knee mobilization is inadvisable Intercondylar fracture of femur quite often leads to avascular necrosis Non-union of tibial condyle fracture is common D Extraarticular adhesions play no role in producing joint stiffness E Displaced intra-articular

Abduction, external rotation injury produces both the Dupuytren's and Maisonneuve fracture. Which of the following injury differentiates one from the other: A Level of fracture in medial malleolus Level of fracture in lateral malleolus Level of fracture in fibula D Presence or absence of diastasis of inferior tibio-fibular joint E Presence or

Which of the following injury is called "Aviator's fracture' A Pott's fracture Total dislocation of talus Fracture neck of metatarsal D Subtalar dislocation E Fracture of neck of talus.

In ankle sprain, the commonest ligament torn is: A Tibio-talar ligament Deltoid ligament Posterior talo-fibular ligament D Calcaneo fibular ligament E Anterior talo-fibular ligament.

Which is the strongest ligament A Iliofemoral ligament B Ischiofemoral ligament C Pubofemoral ligament D Transverse acetabular ligament E Ligamentum teres.

Which part of quadriceps muscle is most frequently fibrosed in post injection quadriceps contracture: A Rectus femoris Vastus medialis Vastus intermedius D Vastus lateralis E All of above.

Radionucleide bone scanning is most useful in: A Avascular necrosis Malignancy Rheumatoid arthritis D Stress fractures E Acute osteomyelitis.

Commonest cause of failure of arthrography is: A Extra-articular injection of contrast Bubbling of air in the joint False positive interpretation D False negative interpretation E Allergic reaction.

Myelography is necessary in following conditions: A Suspicion of an intraspinal tumour Conflicting clinical findings and C.T. scan Evaluation of previously operated spine D All of above E Some of above.

Arthroscope was invented and first used by: A Takagi Watanabe Dandy D Jackson E Patel.

What is the guideline to deltopectoral groove: A Axillary vein Cephalic vein Musculo-cutaneous nerve D Median nerve E None of above.

Most serious complication of arthroscopy is: A Haemorrhage in the joint Damage to articular cartilage Compartment syndrome D S no vial fistula E Breakage of instrument.

Which of the following is most serious complication of myelography: A Allergic reaction Headache Transient neurological deficit D Arachnoiditis E Neck stiffness.

What are contraindications of arthroscopy: A Partial or complete ankylosis of joint Risk of introducing sepsis from a nearby skin lesion Major collateral ligamentous and capsular disruptions D All of above E Some of above.

Commonest cause of quadriceps contracture is: A Congenital Ischaemic myositis Following femoral shaft fracture D Following operations on thigh E Post injection fibrosis.

What is the earliest indication of Volkmann's ischaemia: A Pain Pallor and poor capillary filling Paraesthesia in median nerve area D Contracture of fingers E Gnagrene of tips of fingers.

Which of the following is incorrect about dislocation of sternoclavicular joint: A Anterior dislocation occurs due to indirect injury and is common type of dislocation Posterior dislocation is rare and occurs due to direct injury over medial end of clavicle Sternoclavicular dislocation is common compared to acromioclavicular dislocation D

Which of the following is the earliest laboratory finding in a case of fat embolism: A Increased serum cholestrol Increased serum lipase Increased serum fatty acids D Lipuria E Increased alkaline phosphatase.

First treatment priority in patient with multiple injuries is: A Airway maintenance Bleeding control Circulatory volume restoration D Splinting of fractures E Reduction of dislocation.

Which of the following fracture does not usually need open reduction and internal fixation: A Mid shaft fracture of femur Pathological fractures Trochanteric fracture in elderly D Displaced intra-articular fractures E Displaced fracture of both bones of forearm in adults.

Commonest cause of failure of internal fixation is: A Infection Corrosion Metal reaction D Immune deficient patient E Stress fracture of implant.

Death 3 days after pelvic fracture is most likely to be due to: A Haemorrhage Pulmonary embolism Fat embolism D Respiratory distress E Infection.

Internal fixation of fracture is contraindicated in which situation: A Active infection When bone gap is present In epiphyseal injuries D In compound fracture E In pathological fractur.

Most often open reduction of fracture is required in: A Closed fracture with nerve injury Compound fracture Fracture in children D Unsatisfactory closed reduction E Non union.

In few days old fracture which of the following does not occur: A Capillary proliferation Proliferation of osteogenic cells over endosteum and bone ends Local pH is acid D Local pH is alkaline E There is very little rise in level of alkaline phosphatase at fracture site.

Fracture disease can be prevented by: A Plaster immobilization of fracture Cast brace treatment of fracture Internal fixation of fracture D External fixation of fracture E Physiotherapy

Which of the following is commonest material used to make orthopaedic implant: A Titanium Stainless steel Polyethylene (UHMWPE) D Methyl-methacrylate E Carbon.

Bone graft works by providing following mechanisms. Which of these is most important. A Bone induction factor Osteogenic cells Living osteoblasts D Mineral scaffold for vascular proliferation E Bridging the bone gap.

Commonest complication while using external fixator is: A Pin tract infection Compartment syndrome Loosening of pins D Fixation of muscles E Joint stiffness.

A patient who has sustained open wound on leg is bleeding profusely. Before patient arrives in hospital the safest method to stop bleeding is: A Elevation of leg Local pressure on wound and elevation of leg Ligation of bleeding vessel D Use of tourniquet E Pressure over femoral artery in groin.

Which of the following is an absolute contraindication of open reduction: A Active infection Small sized fragment Very soft bone D General medical complications E Severe scarring of adjacent soft tissues.

Which of the following is the best way to preserve amputated part for replantation: A Immersion in cold saline Immersion in cold ringer lactate Immersion in cold antibiotic solution D Dry cooling with ice E Deep freezing.

Which of the following fracture is slowest to heal and often develops non-union: A Intracapsular femoral neck fracture Scaphoid Lower third of tibia D Proximal humerus E Distal femur.

Commonest cause of failure of internal fixation of fracture is: A Infection Fatigue fracture of implant Corrosion in implant D Loosening of implant E Metal reaction.

Chemically Plaster of Paris is: A Calcium carbonate Calcium phosphate Calcium sulphate D Anhydrous calcium sulphate E Hemihydrated calcium sulphate.

Which of the following is not seen in a case of fat embolism: A Fat globules in urine Left heart strain on ECG Snow storm appearance on chest X-Ray D Normal carbon dioxide tension in arterial blood E Low oxygen tension in arterial blood.

Closed reduction with percutaneous K-wire fixation is best suitable for: A Bennett fracture Lateral malleolus fracture Medial malleolus fracture D Lateral tibial condyle fracture E Clavicle fracture.

In a healing fracture amount of cartilage formation increased by: A Rigid immobilization Movement at fracture site Necrosis of bone ends D Compression plating E Infection.

Most successful method of treatment of non-union is: A Compression plating Compression by external fixator Addition of B.M.P. D Bone grafting E Electrical stimulation

Which of the following muscle does not form rotator cuff of shoulder: A Subscapularis Supraspinatus Infraspinatus D Teres minor E Teres major.

What is the commonest complication of fracture of mid shaft of humerus: A Malunion Non union Radial nerve paralysis D Brachial artery injury E Ulnar nerve injury.

Commonest cause of cubitus varus deformity following malunited supracondylar fracture of humerus is: A Rotational malalignment Medial displacement Proximal displacement D Posterior displacement E Epiphyseal damage.

Most commonly fractured bone is: A Hamate Triquetrum Lunate D Capitate E Scaphoid.

What is the most serious complication of internal fixation of fracture of both bones of forearm: A Infection Cross union Limitation of forearm rotation D Refracture E Non union.

Which of the following bursa produces symptoms in shoulder impingement syndrome: A Subacromial bursa Subdeltoid bursa Bursa in relation of subscapularis tendon D Bursa in relation to latissimus dorsi E Bursa between coracoid process and capsule.

What is the commonest complication of supracondyla fracture of humerus: A Malunion Myositis ossificans Stiffness of elbow D Volkmann's contracture E Non union.

Which of the following is true about Monteggia fracture: A It is usually associated with posterior interosseous nerve paralysis It can be usually treated conservatively in adults It is not an injury of children D It is a combination of fracture of radius with distal radio-ulnar joint dislocation E It is a combination of fractures of proximal

A collar and cuff bandage will be most suitable treatment for which of the following injury: A Midshaft fracture of humerus Undisplaced fracture of neck of humerus Monteggia fracture D Dislocation of elbow E Fracture of radial head.

Which of the following is not applicable to radial neck fracture: A It is a common injury in children than adults Angulation can usually be reduced by manipulation Open reduction is sometimes required D Mechanism of injury is fall on outstretched hand E It is an epiphyseal injury of salter type-V.

Which of the following statement is true about supracondylar fracture of humerus: A Anterior displacement of distal fragment is common than posterior displacement Cubitus valgus is common than cubitus varus following maiunion Neurological complications are usually transitory D Weakness of elbow flexion is a common complication of this injury E

Which of the following scaphoid fracture is most prone to develop avascular necrosis: A Fracture of waist of scaphoid Fracture of tubercle Fracture of distal pole D All of above E None of above.

Pull of which of the following muscle makes it difficult to maintain reduction of Bennett's fracture: A Flexor pollicis longus Flexor pollicis brevis Extensor pollicis longus D Opponens pollicis E Abductor pollicis longus.

Putti-Platt operation is used for: A Non union of humerus Dislocation of patella Dislocation of radial head D Recurrent dislocation of shoulder E Recurrent dislocation of peroneal tendons.

Best treatment for humeral neck fracture in a 60 year old patient will be: A Collar and cuff bandage followed by physiotherapy Open reduction and plaster spica Open reduction and internal fixation D Closed manipulation and plaster spica E Hanging cast

Inability to extend interphalangeal joint of thumb few weeks after Colles' fracture indicates development of: A Compartment syndrome Posterior interosseous nerve palsy Avulsion of insertion of extensor pollicis longus D Attrition rupture of extensor pollicis longus tendon at the site of fracture E Tear of extensor pollicis longus muscle belly.

What is the usual treatment for symptomatic old acromioclavicular dislocation: A Arthrodesis of acromio-clavicular joint -wire fixation of joint Lag screw fixation of joint D Resection of outer end of clavicle E Acromionplasty.

Regarding fracture of clavicle which of the following statement is incorrect: A Fracture is commonest in medial third Non union is rare Most cases can be treated conservatively D Fracture usually occurs due to indirect injury E Fracture is common in middle third.

Which of the following is incorrect about dislocation of lunate: A Dislocated lunate appears triangular instead of rectangular on A.P. x-ray Dislocation is most easily recognised on lateral view x-ray Avascular necrosis is common following dislocation D Lunate dislocates posteriorly E Median nerve compression can occur.

Which of the following is not applicable to scaphoid fracture: A Mechanism of injury is fall on outstretched hand. It is common in adults than elderly persons Often non union develops D Fracture at waist is commonest E Avascular necrosis is rare.

Which of the following statement is true about dislocation of interphalangeal joint of finger: A It is a flexion injury It is an extension injury Reduction is often unstable D Distal phalanx is displaced anteriorly in relation to the proximal phalanx E There is no need to test for stability after reduction of dislocation.

What is usual treatment for symptomatic nonunion of scaphoid in a young patient: A Drilling of fragments of scaphoid Drilling of fragments of scaphoid and bone grafting Bone grafting and excision of radial styloid D Arthrodesis of wrist E Excision of scaphoid.

Which of the following injury is "Gamekeeper's thumb": A Rupture of ulnar collateral ligament of wrist Rupture of ulnar collateral ligament of metacarpophalangeal joint of thumb Rupture of ulnar collateral ligament of interphalangeal joint of thumb D Fracture of base of thumb metacarpal E Fracture of neck of thumb metacarpal.

Which of the following is not true about posterior dislocation of shoulder: A Recurrent dislocation can develop Reduction can be unstable Patients with unreduced dislocation can have good function D Clinical diagnosis is easy E Axillary nerve injury is uncommon.

Commonest cause of deformity in a long bone is: A Osteoporosis Rickets Paget's disease D Malunited fracture E Fibrous dysplasia.

What is the second most important aspect in the treatment of fractures of long bones: A Adequate nutrition of patient Accurate anatomical reduction Immobilization D Restoration of bone alignment E Antibiotics.

Which deformity in malunited fracture is most likely to correct with remodelling: A Angular deformity in the middle of diaphysis in the plane of motion of nearby joint Angular deformity in plane of motion of nearby joint when deformity is in metaphyseal area Rotational malalignment D Angular deformity near end of bone when angulation is in a

What is most important aspect of the treatment of crush syndrome involving an extremity: A Amputation Fluid and electrolyte balance Dialysis D Antibiotics E Hyberbaric oxygen.

In interfragmentary fixation screw works by producing: A Compression Distraction Antiglide mechanism D Increased shear E None of above.

Basic treatment of most non-unions is: A Compression plating Continuation of external splintage Electrical stimulation D Bone grafting E Phemister grafting.

External fixator is not indicated in: A Comminuted fracture Fracture associated with severe soft tissue damage Infected fractures D Simple closed fracture of humeral shaft E Fracture associated with burns.

Commonest cause of refracture after removal of external fixator is: A Pin tract infection Fracture through pin tract Absence of periosteal callus D Destressing producing cancellation of cortex E Avascular necrosis of bone fragments.

Following femoral shaft fracture, knee stiffness occurs due to: A Fibrosis of vastus intermedius Shortening of rectus femoris Fibrosis of patellar retinacula D Adhesion of patella to femoral condyles E All of above

What is the most serious disadvantage of external fixator: A Pin tract infection Loosening of pins Stress protection osteoporosis D Fracture can not be compressed E Another fracture can occur through pin tract.

What is the best treatment for an oblique tibia! shaft fracture which has redisplaced after initial good closed reduction and plaster immobilization A Wedging of plaster Remanipulation and plaster Open reduction and internal fixation D Skeletal traction E Cast bracing.

Bumper fracture is the name given to: A Fracture of tibia and fibula Fracture of lateral tibia! condyle Fracture of patella D Fracture of lateral femoral condyle E Fracture of tibial spine.

Intramedullary nailing of femoral shaft fracture is contraindicated: A When there is compounding When the fracture is transverse When fracture is in narrowest part of bone D In non union in adults E In a child.

A patient develops compartment syndrome (swelling, pain and numbness) following manipulation and plaster for fracture of both bones of leg. What is the best treatment: A Split the plaster Elevate the leg Infusion of low molecular weight dextran D Elevate the leg after splitting the plaster E Do operative decompression of facial compartment.

Which of the following is most important step when K-nailing is done for fixation of fresh femoral shaft fractures. A Good reaming of medullary canal to take in widest diameter nail No reaming of medullary canal Closed nailing should be done D Bone grafting must always be done along with E Small diameter nail should be selected.

Which of the following is commonest complication of Colles' fracture: A Stiffness of fingers Stiffness of wrist Stiffness of shoulder D Subluxation of inferior radio ulnar joint with pain E Sudeck's osteodystrophy.

Malunited Colles' fracture produces Which of the following deformity: A Garden spade deformity Dinner fork deformity Madelung deformity D Swan neck deformity E Boutonniere deformity.

Which of the following statement is not correct about ankle fractures A Undisplaced maleolar fracture can be satisfactorily treated by plaster immobilization Stress view X-Rays are required to understand full extent of injury in ankle fractures Accurate reduction is necessary to prevent development of osteoarthritis of ankle D External rotation

A 26 year old man was assaulted with lathis during a protest by local public in his area and attends the emergency department where he was shifted by ambulance. He is talking but appears confused. He cooperates with examination and follows the commands he is given. He opens his eyes to voice. What is the Glasgow coma scale (GCS) score of this

Highlight four (4) nursing considerations in the administration of antimicrobials. (4 mks) (b) Mention six (6) common adverse effects that may be experienced by a patient receiving antifungals.(6 mks) (c) Classify cytotoxic agents into their groups.(5 mks) (d) Highlight ten (10) conditions that can be treated effectively using cephalosporin.(5 mks)

Mr. Brown, a 35year old Mason fell from a height in a construction site and sustained a fracture of the left femur. He was admitted into your ward and placed on a traction. (a) With the aid of a large, well labelled diagram, describe the affected bone. (6 mks) (b) List six (6) types of traction commonly applied in the orthopaedic ward.(3mks) (c)

A 44yearold woman who has rheumatic heart disease with aortic stenosis undergoes valve replacement with abioprosthesis. She remains stable for the next 8 years and then develops diminished exercise tolerance. Which of the following complications involving the biopros thesis has most likely occurred (A) Paravalvular leak (B) Stenosis (C) Hemolysis

In a clinical study of tetralogy of Fallot, patients are examined before surgery to determine predictors observed onechocardiography that correlate with the severity of the disease and the need for more careful monitoring. A subs et of patients is found to have more severe congestive heart failure, poor exercise tolerance, and decreased arterial

A 12yearold boy was brought to the physician with a sore throat and fever 3 weeks ago, and a throat culture was positive for group A Bhemolytic streptococcus. On the followup examination, the child is afebrile. His pulse is 85min, respirations are 18min, and blood pressure is 9050 mm Hg. On auscultation, a murmur of mitral regurgitation is

(E) Restrictive cardiomyopathy 468105,The parents of a 5yearold child notice that he is not as active as other children his age. During the past 9 month thechild has had several episodes of respiratory difficulty following exertion. On physical examination, h temperature is 36.9C, pulse is 81min, respirations are 19min, and blood pressure is 9560

A 68yearold man with a history of diabetes mellitus had chest pain and an elevated serum troponin I level 1 year ago. He was treated in the hospital with antiarrhythmic agents for 1 week. An echocardiogram showed an ejection fraction of 28 He now has markedly reduced exercise tolerance. On physical examination, his temperature is 37C, pulse is

A 25yearold man was found dead at home by the apartment manager, who had been called by the decedents employer because of failure to report to work for the past 3 days. An external examination by the medical examiner showed splinter hemorrhages under the fingernails and no signs of trauma. The gross appearance of the heart at autopsy is shown in

A 10yearold girl who is normally developed has chronic progressive exercise intolerance. On physical examination,temperature is 37.1C, pulse is 70min, respirations are 14min, and blood pressure is 10060 mm Hg. A chest radiograph shows cardiomegaly and mild pulmonary edema. An echocardiogram shows severe left ventricular hypertrophy and a prominent

(E) Staphylococcus aureus,For the past 2 years, a 49yearold woman has had a chronic cough that produces a small amount of whitish sputum. The sputum occasionally is bloodstreaked. On physical examination, her temperature is 37.9C, pulse is 71min, respirations are 17min, and blood pressure is 12580 mm Hg. Crackles are heard on auscultation over the

A 27yearold woman has had a fever for 5 days. On physical examination, her temperature is 38.2C, pulse is 100min, respirations are 19min, and blood pressure is 9060 mm Hg. A cardiac murmur is heard on auscultation. The sensorium is clouded, but there are no focal neurologic deficits. Laboratory findings include hemoglobin, 13.1 gdL platelet count,

A 19yearold man has had a lowgrade fever for 3 weeks. On physical examination, his temperature is 38.3C, pulse is 104min, respirations are 28min, and blood pressure is 9560 mm Hg. A tender spleen tip is palpable. There are splinter hemorrhages under the fingernails and tender hemorrhagic nodules on the palms and soles. A heart murmur is heard on