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, Ortho (OPD) Board Certification Test –
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b With Questions & Solutions (100% Corre
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•bWhatbanatomicbabnormalitybmaybpredisposebabpersonbtobdevelopbimpingementbsyndr
omeborbrotatorbcuffbtendonitis?b-bANSWERb-
bobInbgeneralbthebacromionbprocessbshouldbbebflatbinferiorlybtoballowbsmoothbpassagebof
bthebrotatorbcuff btendons,binbtypeb2borbtypeb3bacromionbprocessesbhowever,bthebundersi
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osebabpatientbtobthosebconditions.
•bAbfamilybfriendbcallsbyoubbecausebherbmotherbwasbrecentlybdiagnosedbwithbPolymyalgi
abRheumatica.bShebhasbbeenbdoingbsomebresearch,bbutbwantsbtobknowbwhatbthebusualb
treatmentbisbforbthisbcondition.bWhichbofbthebfollowingbwouldbbebyourbresponse?b-
bANSWERb-bobLowbdosebcorticosteroidsbforbabcouplebofbyearsbandbclosebfollow-
upbwithbRheumatology
•bAbpatientbwhobhasbrecentlybbegunbtreatmentbforbsystemicblupusberythematosusbwithbh
ydroxychloroquinebreturnsbtobyourbclinicbbecausebshebisbexperiencingbsidebeffectsbfromb
thebmedication.bWhichbofbthebfollowingbisbmostblikelybherbcomplaint?b-bANSWERb-
bobHydroxychloroquinebmaybcausebmacularbdamage,bandbthusbresultbinbimpairedbnightb
visionbinbpatientsbtakingbthisbmedication.bPatientsbwithbSLEbshouldbbebmonitoredbatblea
stbyearlybbybanbophthalmologistbtobmonitorbforbthesebretinalbchanges.bAllbotherbsidebeffe
ctsbarebnotbcommonlybassociatedbwithbthebusebofbthisbmedicationbforbtreatmentbofbSLE.
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exambrevealsbnon-
tenderbbonybprotuberancesbonbthebdistalbfemurbandbproximalbtibia.bWhichbofbthebfollowi
ngbisbthebmostblikelybdiagnosis?b-bANSWERb-bobOsteochondroma
•bAb23byearboldbmale,bwhobisbanbavidbskier,bpresentsbafterbsustainingbanbinjurybwhilebskii
ngbearlierbthisbweek.bHebreportsbthatbhebfellbwhilebbracingbhimselfbwithbhisbskibpoles,band
bthinksbthatbhebmaybhavebhyperextendedbhisbthumbbjoint.bYoubelicitbtendernessbtobthebul
narbaspectbofbthebrightbmetacarpophalangealb(MCP)bjointbwithbMCPbjointblaxitybunderbv
algusbstress.bXraybofbthebhandbisbnegative.bWhichbofbthebfollowingbisbthebtreatmentbofbch
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obThisbpatientbhasbabGamekeeper'sb(akabSkier's)bThumb.bInbthisbconditionbtherebisbanbin
jurybtobthebulnarbcollateralbligamentbthatbstabilizesbthebthumb.bImmobilizationbwithbabthu
mbbspicabsplintbandbreferralbtobabhandbspecialistbisbthebgeneralbtreatment.
•bWhichbofbthebfollowingbregimensbisbacceptablebinbthebtreatmentbofbosteomyelitisbcause
dbbybStaphylococcusbaureusb?b-bANSWERb-
bobSixbweeksbofbIVbantibioticsbfollowedbbyb1-2bweeksbofboutpatientboralbantibiotics
•bWhichbofbthebfollowingbclinicalbinterventionsbisbindicatedbinbthebtreatmentbofbLegg-
Calve-Perthesbdisease?b-bANSWERb-bobLegg-Calve-
, Perthesbdiseaseb(LCPD)bresultsbfrombavascularbnecrosisbofbthebfemoralbhead,bproximal
ly.bThisbconditionbtendsbtoboccurbmostboftenbinbmales,bagesb4-
10.bThesebpatientsbshouldbbebreferredbtobanborthopedistbforbevaluationbandbtreatment.b
AbductionbsplintingbisbthebtreatmentbofbchoicebinbLCPD,bwithbthebgoalbofbmaintainingbfe
moralbheadbshapebwithinbthebacetabulumbasbitbheals.
•bAb16byearboldbmale,bwhobplaysbonbhisbschool'sbfootballbteam,bisbbroughtbtobtheburgentbc
arebwithbrightbkneebpain.bHebstatesbthatbhebwasbplayingbinbthebgameblastbnight,bandbwhil
ebrunningbwasbtackledbfrombthebrightbsidebatbtheblevelbofbhisbknee.bHebexperiencedbimm
ediatebkneebpainbandbswelling,bneitherbofbwhichbhavebsignificantlybdecreasedbovernight
,borbwithbconservativebmeasures.bOnbphysicalbexam,byoubnotebswellingbaroundbthebright
bknee,bandbpainbwithbrangebofbmotion,basbwellbasbpositivebLachman'sbandbMcMurray'sbte
sts.bYoubsuspectbACL,bandbmedialbmeniscusbdamage.bWhatbotherbstructurebmaybhaveb
beenbinjuredbinbthisbinjury?b-bANSWERb-
bobACL,bMCL,bandbmedialbmeniscalbinjurybcomposebwhatbisbreferredbtobasbtheb'Unhappy
btriad'borbtheb'TriadbofbO'Donohue'.bThesebthreebstructuresbarebcommonlybinjuredbduebto
bthebmechanismbofbinjurybdescribedbinbthisbpatient'sbpresentation,bnamelybthatbofbhaving
bthebfootbplantedbwithbthebkneebinbslightbflexion,bandblateralbimpact.
•bAb40byearboldbconstructionbworkerbpresentsbcomplainingbofbrightbwristbpainbthatbhasbw
orsenedboverbtheblastbtwobweeks.bHebadmitsbthatbthebpainbisbworsebwithbcertainbtasks,bo
rbatbnightbwhenbhebisbsleeping.bHebalsobadmitsbthatbatbtimesbpartbofbhisbhandbandbhisbfirst
bthreebdigitsbfeelbnumb.bOnbphysicalbexambyoubfindbthatbhisbgripbstrengthbisbdecreasedbo
nbthebright.bWhatbisbthebinitialbtreatmentbofbchoicebforbthisbpatient'sbcondition?b-
bANSWERb-
bobVolarbwristbsplints,balongbwithbactivitybmodification,bandbNSAIDsbarebthebfirstblinebtrea
tmentbinbcarpalbtunnelbsyndrome.
•bIndicationbofbrotatorbcuffbtearb-bANSWERb-
bobWeaknessbthatbisbnotbattributablebtobpainborbatrophybisbthebhallmarkbof brotatorbcuff btea
r.bAbdiagnosticblidocainebinjectionbmaybhelpbdeterminebifbthisbisbthebcase.
•bWhichbofbthebfollowingbphysicalbexambtests,bifbpositive,bisbmostbsuggestivebofbinferiorbi
nstabilitybofbthebglenohumeralbjoint?b-bANSWERb-
bobThebsulcusbsignbisbperformedbbybapplyingbinferiorbtractionbtobthebarmbandbobservingbt
hebshoulderbforbthebformationbofbabsulcusbatbtheblateralbedgebofbthebacromionbprocess.bT
hisbtestbisbindicativebofbinferiorbinstability.
obApprehensionbtestbisbmorebindicativebofbanteriorbdislocation
•bWhichbofbthebfollowingbjointbabnormalitiesbfollowsbanbviralbupperbrespiratorybinfection?b
-bANSWERb-
bobTransientbsynovitisbisbthebmostbcommonbcausebofbablimpbwithbassociatedbhipbpainbinbc
hildrenbagesb3-
10byearsbofbagebandbisbmorebcommonbinbmales.bItbfrequentlybfollowsbabviralbupperbrespir
atorybtractbinfection.bTherebisbcommonlybnothingbsignificantbfoundbonbCBC,bandbanbultra
soundbrevealsbnobeffusionb(asbitbwouldbinbabsepticbjoint).bTransientbsynovitisbisbtreatedbw
ithbrestbandbNSAIDs.
•bWhichbofbthebfollowingbhipbjointbabnormalitiesbfollowsbanbviralbupperbrespiratorybinfecti
on?btreatment?b-bANSWERb-
Orthob(OPD)bBoardbCertificationbTestb–bWithbQuestionsb&bSolutionsb(100%bCorrect)
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b With Questions & Solutions (100% Corre
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•bWhatbanatomicbabnormalitybmaybpredisposebabpersonbtobdevelopbimpingementbsyndr
omeborbrotatorbcuffbtendonitis?b-bANSWERb-
bobInbgeneralbthebacromionbprocessbshouldbbebflatbinferiorlybtoballowbsmoothbpassagebof
bthebrotatorbcuff btendons,binbtypeb2borbtypeb3bacromionbprocessesbhowever,bthebundersi
debofbthebacromionbisbnotbflat,bbutbcurvedborbhookedbrespectivelybandbthusbmaybpredisp
osebabpatientbtobthosebconditions.
•bAbfamilybfriendbcallsbyoubbecausebherbmotherbwasbrecentlybdiagnosedbwithbPolymyalgi
abRheumatica.bShebhasbbeenbdoingbsomebresearch,bbutbwantsbtobknowbwhatbthebusualb
treatmentbisbforbthisbcondition.bWhichbofbthebfollowingbwouldbbebyourbresponse?b-
bANSWERb-bobLowbdosebcorticosteroidsbforbabcouplebofbyearsbandbclosebfollow-
upbwithbRheumatology
•bAbpatientbwhobhasbrecentlybbegunbtreatmentbforbsystemicblupusberythematosusbwithbh
ydroxychloroquinebreturnsbtobyourbclinicbbecausebshebisbexperiencingbsidebeffectsbfromb
thebmedication.bWhichbofbthebfollowingbisbmostblikelybherbcomplaint?b-bANSWERb-
bobHydroxychloroquinebmaybcausebmacularbdamage,bandbthusbresultbinbimpairedbnightb
visionbinbpatientsbtakingbthisbmedication.bPatientsbwithbSLEbshouldbbebmonitoredbatblea
stbyearlybbybanbophthalmologistbtobmonitorbforbthesebretinalbchanges.bAllbotherbsidebeffe
ctsbarebnotbcommonlybassociatedbwithbthebusebofbthisbmedicationbforbtreatmentbofbSLE.
•bAb14byearboldbboybpresentsbtobyourbclinicbcomplainingbofb'bumps'bonbhisblegs.bPhysicalb
exambrevealsbnon-
tenderbbonybprotuberancesbonbthebdistalbfemurbandbproximalbtibia.bWhichbofbthebfollowi
ngbisbthebmostblikelybdiagnosis?b-bANSWERb-bobOsteochondroma
•bAb23byearboldbmale,bwhobisbanbavidbskier,bpresentsbafterbsustainingbanbinjurybwhilebskii
ngbearlierbthisbweek.bHebreportsbthatbhebfellbwhilebbracingbhimselfbwithbhisbskibpoles,band
bthinksbthatbhebmaybhavebhyperextendedbhisbthumbbjoint.bYoubelicitbtendernessbtobthebul
narbaspectbofbthebrightbmetacarpophalangealb(MCP)bjointbwithbMCPbjointblaxitybunderbv
algusbstress.bXraybofbthebhandbisbnegative.bWhichbofbthebfollowingbisbthebtreatmentbofbch
oicebforbthisbpatient?b-bANSWERb-
bThumbbspicabsplintbandburgentbhandbspecialistbreferral
obThisbpatientbhasbabGamekeeper'sb(akabSkier's)bThumb.bInbthisbconditionbtherebisbanbin
jurybtobthebulnarbcollateralbligamentbthatbstabilizesbthebthumb.bImmobilizationbwithbabthu
mbbspicabsplintbandbreferralbtobabhandbspecialistbisbthebgeneralbtreatment.
•bWhichbofbthebfollowingbregimensbisbacceptablebinbthebtreatmentbofbosteomyelitisbcause
dbbybStaphylococcusbaureusb?b-bANSWERb-
bobSixbweeksbofbIVbantibioticsbfollowedbbyb1-2bweeksbofboutpatientboralbantibiotics
•bWhichbofbthebfollowingbclinicalbinterventionsbisbindicatedbinbthebtreatmentbofbLegg-
Calve-Perthesbdisease?b-bANSWERb-bobLegg-Calve-
, Perthesbdiseaseb(LCPD)bresultsbfrombavascularbnecrosisbofbthebfemoralbhead,bproximal
ly.bThisbconditionbtendsbtoboccurbmostboftenbinbmales,bagesb4-
10.bThesebpatientsbshouldbbebreferredbtobanborthopedistbforbevaluationbandbtreatment.b
AbductionbsplintingbisbthebtreatmentbofbchoicebinbLCPD,bwithbthebgoalbofbmaintainingbfe
moralbheadbshapebwithinbthebacetabulumbasbitbheals.
•bAb16byearboldbmale,bwhobplaysbonbhisbschool'sbfootballbteam,bisbbroughtbtobtheburgentbc
arebwithbrightbkneebpain.bHebstatesbthatbhebwasbplayingbinbthebgameblastbnight,bandbwhil
ebrunningbwasbtackledbfrombthebrightbsidebatbtheblevelbofbhisbknee.bHebexperiencedbimm
ediatebkneebpainbandbswelling,bneitherbofbwhichbhavebsignificantlybdecreasedbovernight
,borbwithbconservativebmeasures.bOnbphysicalbexam,byoubnotebswellingbaroundbthebright
bknee,bandbpainbwithbrangebofbmotion,basbwellbasbpositivebLachman'sbandbMcMurray'sbte
sts.bYoubsuspectbACL,bandbmedialbmeniscusbdamage.bWhatbotherbstructurebmaybhaveb
beenbinjuredbinbthisbinjury?b-bANSWERb-
bobACL,bMCL,bandbmedialbmeniscalbinjurybcomposebwhatbisbreferredbtobasbtheb'Unhappy
btriad'borbtheb'TriadbofbO'Donohue'.bThesebthreebstructuresbarebcommonlybinjuredbduebto
bthebmechanismbofbinjurybdescribedbinbthisbpatient'sbpresentation,bnamelybthatbofbhaving
bthebfootbplantedbwithbthebkneebinbslightbflexion,bandblateralbimpact.
•bAb40byearboldbconstructionbworkerbpresentsbcomplainingbofbrightbwristbpainbthatbhasbw
orsenedboverbtheblastbtwobweeks.bHebadmitsbthatbthebpainbisbworsebwithbcertainbtasks,bo
rbatbnightbwhenbhebisbsleeping.bHebalsobadmitsbthatbatbtimesbpartbofbhisbhandbandbhisbfirst
bthreebdigitsbfeelbnumb.bOnbphysicalbexambyoubfindbthatbhisbgripbstrengthbisbdecreasedbo
nbthebright.bWhatbisbthebinitialbtreatmentbofbchoicebforbthisbpatient'sbcondition?b-
bANSWERb-
bobVolarbwristbsplints,balongbwithbactivitybmodification,bandbNSAIDsbarebthebfirstblinebtrea
tmentbinbcarpalbtunnelbsyndrome.
•bIndicationbofbrotatorbcuffbtearb-bANSWERb-
bobWeaknessbthatbisbnotbattributablebtobpainborbatrophybisbthebhallmarkbof brotatorbcuff btea
r.bAbdiagnosticblidocainebinjectionbmaybhelpbdeterminebifbthisbisbthebcase.
•bWhichbofbthebfollowingbphysicalbexambtests,bifbpositive,bisbmostbsuggestivebofbinferiorbi
nstabilitybofbthebglenohumeralbjoint?b-bANSWERb-
bobThebsulcusbsignbisbperformedbbybapplyingbinferiorbtractionbtobthebarmbandbobservingbt
hebshoulderbforbthebformationbofbabsulcusbatbtheblateralbedgebofbthebacromionbprocess.bT
hisbtestbisbindicativebofbinferiorbinstability.
obApprehensionbtestbisbmorebindicativebofbanteriorbdislocation
•bWhichbofbthebfollowingbjointbabnormalitiesbfollowsbanbviralbupperbrespiratorybinfection?b
-bANSWERb-
bobTransientbsynovitisbisbthebmostbcommonbcausebofbablimpbwithbassociatedbhipbpainbinbc
hildrenbagesb3-
10byearsbofbagebandbisbmorebcommonbinbmales.bItbfrequentlybfollowsbabviralbupperbrespir
atorybtractbinfection.bTherebisbcommonlybnothingbsignificantbfoundbonbCBC,bandbanbultra
soundbrevealsbnobeffusionb(asbitbwouldbinbabsepticbjoint).bTransientbsynovitisbisbtreatedbw
ithbrestbandbNSAIDs.
•bWhichbofbthebfollowingbhipbjointbabnormalitiesbfollowsbanbviralbupperbrespiratorybinfecti
on?btreatment?b-bANSWERb-
