MSK EXAM AND PRACTICE EXAM NEWEST 2026 TEST
BANK| COMPLETE 550 REAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
ALREADY GRADED A+ (MOST RECENT!!)
1. A patient presents with shoulder pain and a positive
O’Brien test (pain with resisted downward pressure while the
arm is in 90° flexion, 10° adduction, and full internal rotation;
the pain is reduced with the arm supinated). Which structure is
MOST likely involved?
A) Supraspinatus tendon
B) Long head of biceps tendon / superior labrum (SLAP)
C) Subacromial bursa
D) Acromioclavicular joint
Correct Answer: B
Rationale: O’Brien test is specific for superior labrum anterior to
posterior (SLAP) lesions or biceps tendinopathy. The reduction of
pain with supination (thumb up) differentiates from
acromioclavicular joint pain which does not change with forearm
rotation.
2. A patient has a positive Lachman test with a soft endpoint.
Next, a pivot shift test is also positive. This combination is
1
,MOST consistent with:
A) Isolated posterior cruciate ligament tear
B) Partial anterior cruciate ligament tear
C) Complete anterior cruciate ligament tear with secondary
instability
D) Medial collateral ligament tear
Correct Answer: C
Rationale: A soft endpoint on Lachman indicates ACL
insufficiency; a positive pivot shift indicates rotational instability,
which is seen in complete ACL tears. Partial tears may have a
firm endpoint.
3. A 55-year-old female has pain over the lateral elbow that
worsens with resisted wrist extension and gripping. Which
special test would be MOST specific for lateral
epicondylalgia?
A) Mills test
B) Tinel sign over ulnar nerve
C) Cozen test (resisted wrist extension)
D) Medial epicondylitis test
Correct Answer: C
Rationale: Cozen test (resisted wrist extension with forearm
2
,pronated) is sensitive for lateral epicondylitis (tennis elbow). Mills
test (passive wrist flexion with elbow extended) is also specific
but Cozen is more commonly used in active testing.
4. A patient with chronic knee pain has a positive McMurray
test (click on medial side with the knee in flexion and external
rotation). This finding suggests a tear of the:
A) Lateral meniscus, anterior horn
B) Medial meniscus, posterior horn
C) Medial meniscus, anterior horn
D) Lateral meniscus, posterior horn
Correct Answer: B
Rationale: McMurray test for medial meniscus: external rotation
and valgus stress while extending the knee from full flexion. A
palpable/audible click on the medial side suggests posterior
horn tear of the medial meniscus.
5. A 22-year-old athlete has anterior knee pain that worsens
with sitting for long periods, squatting, and going down
stairs. The patellar grind test (Clarke’s sign) is positive. The
MOST likely diagnosis is:
A) Patellar tendinopathy
B) Osteochondritis dissecans of the patella
3
, C) Patellofemoral pain syndrome
D) Prepatellar bursitis
Correct Answer: C
Rationale: Patellofemoral pain syndrome is common in young
athletes; it presents with anterior knee pain aggravated by
activities that increase patellofemoral compression (squatting,
stairs, prolonged sitting — “theater sign”). Clarke’s sign
(compression of patella during quadriceps contraction)
reproduces pain.
6. A patient reports low back pain radiating to the right lateral
foot. A straight leg raise (SLR) on the right reproduces the pain
at 35°, and a crossed SLR on the left also reproduces right leg
pain. This presentation MOST strongly suggests:
A) Piriformis syndrome
B) Central disc herniation (large)
C) Sacroiliac joint dysfunction
D) Lumbar facet syndrome
Correct Answer: B
Rationale: A positive crossed SLR (pain in the symptomatic leg
when lifting the asymptomatic leg) is highly specific for a large,
4
BANK| COMPLETE 550 REAL EXAM QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
ALREADY GRADED A+ (MOST RECENT!!)
1. A patient presents with shoulder pain and a positive
O’Brien test (pain with resisted downward pressure while the
arm is in 90° flexion, 10° adduction, and full internal rotation;
the pain is reduced with the arm supinated). Which structure is
MOST likely involved?
A) Supraspinatus tendon
B) Long head of biceps tendon / superior labrum (SLAP)
C) Subacromial bursa
D) Acromioclavicular joint
Correct Answer: B
Rationale: O’Brien test is specific for superior labrum anterior to
posterior (SLAP) lesions or biceps tendinopathy. The reduction of
pain with supination (thumb up) differentiates from
acromioclavicular joint pain which does not change with forearm
rotation.
2. A patient has a positive Lachman test with a soft endpoint.
Next, a pivot shift test is also positive. This combination is
1
,MOST consistent with:
A) Isolated posterior cruciate ligament tear
B) Partial anterior cruciate ligament tear
C) Complete anterior cruciate ligament tear with secondary
instability
D) Medial collateral ligament tear
Correct Answer: C
Rationale: A soft endpoint on Lachman indicates ACL
insufficiency; a positive pivot shift indicates rotational instability,
which is seen in complete ACL tears. Partial tears may have a
firm endpoint.
3. A 55-year-old female has pain over the lateral elbow that
worsens with resisted wrist extension and gripping. Which
special test would be MOST specific for lateral
epicondylalgia?
A) Mills test
B) Tinel sign over ulnar nerve
C) Cozen test (resisted wrist extension)
D) Medial epicondylitis test
Correct Answer: C
Rationale: Cozen test (resisted wrist extension with forearm
2
,pronated) is sensitive for lateral epicondylitis (tennis elbow). Mills
test (passive wrist flexion with elbow extended) is also specific
but Cozen is more commonly used in active testing.
4. A patient with chronic knee pain has a positive McMurray
test (click on medial side with the knee in flexion and external
rotation). This finding suggests a tear of the:
A) Lateral meniscus, anterior horn
B) Medial meniscus, posterior horn
C) Medial meniscus, anterior horn
D) Lateral meniscus, posterior horn
Correct Answer: B
Rationale: McMurray test for medial meniscus: external rotation
and valgus stress while extending the knee from full flexion. A
palpable/audible click on the medial side suggests posterior
horn tear of the medial meniscus.
5. A 22-year-old athlete has anterior knee pain that worsens
with sitting for long periods, squatting, and going down
stairs. The patellar grind test (Clarke’s sign) is positive. The
MOST likely diagnosis is:
A) Patellar tendinopathy
B) Osteochondritis dissecans of the patella
3
, C) Patellofemoral pain syndrome
D) Prepatellar bursitis
Correct Answer: C
Rationale: Patellofemoral pain syndrome is common in young
athletes; it presents with anterior knee pain aggravated by
activities that increase patellofemoral compression (squatting,
stairs, prolonged sitting — “theater sign”). Clarke’s sign
(compression of patella during quadriceps contraction)
reproduces pain.
6. A patient reports low back pain radiating to the right lateral
foot. A straight leg raise (SLR) on the right reproduces the pain
at 35°, and a crossed SLR on the left also reproduces right leg
pain. This presentation MOST strongly suggests:
A) Piriformis syndrome
B) Central disc herniation (large)
C) Sacroiliac joint dysfunction
D) Lumbar facet syndrome
Correct Answer: B
Rationale: A positive crossed SLR (pain in the symptomatic leg
when lifting the asymptomatic leg) is highly specific for a large,
4
