MULTIPLE CHOICE QUESTIONS IN ORTHOPAEDICS AND TRAUMA
1. Which is the strongest ligament:
A Ilio-femoral ligament
В Ischio-femoral ligament
С Pubo-femoral ligament
D Transverse acetabular ligament
E Ligamentum teres.
A Ilio-femoral ligament blends with anterior part of hip joint capsule
and is the strongest ligament at hip joint.
2. Which part of quadriceps muscle is most frequently fibrosed in post
injection quadriceps contracture:
A Rectus femoris
В Vastus medialis
С Vastus intermedius
D Vastus lateralis
E All of above.
D Vastus lateralis is most frequently affected probably because
injections are usually given in this area of thigh.
3. Radionucleide bone scanning is most useful in:
A Avascular necrosis
В Malignancy
С Rheumatoid arthritis
D Stress fractures
E Acute osteomyelitis.
В Radionucleide bone scanning is most useful in defining extent of
primary tumour, locating unsuspected metastasis and primary malignant
tumour. In all other conditions mentioned its use is more of academic interest
4. Commonest cause of failure of arthrography is:
A Extra-articular injection of contrast
В Bubbling of air in the joint
С False positive interpretation
D False negative interpretation
E Allergic reaction.
A Extra-articular injection of contrast medium is the commonest
cause of failure of arthrography especially in smaller and deep situated joints.
Allergic reaction to contrast medium is rare but when it happens examination
will have to be discontinued. Other factors also make this procedure futile.
,5. Myelography is necessary in following conditions:
A Suspicion of an intraspinal tumour
В Conflicting clinical findings and C.T. scan
С Evaluation of previously operated spine
D All of above
E Some of above.
D Due to its complications and since it is an invasive technique,
myelography has been replaced by CT scan. Now a days primary indications
of myelography are as mentioned in the question.
6. Arthroscope was invented and first used by:
A Takagi
В Watanabe
С Dandy
D Jackson
E Patel.
A First prototype of arthroscope was made and used by Takagi in 1918.
Modern day arthroscope was made by Takagi and Watanabe. Dandy, Jackson
and Patcl are some of the leaders of arthroscopic surgery nowadays.
7. What is the guideline to deltopectoral groove:
A Axillary vein
В Cephalic vein
С Musculo-cutaneous nerve
D Median nerve
E None of above.
В Cephalic vein lies in deitopedoral groove and serves as landmark in
identification of plane between deltoid and pectaralis major during anterior
exposure of shoulder.
8. Most serious complication of arthroscopy is:
A Haemorrhage in the joint
В Damage to articular cartilage
С Compartment syndrome
D S у no vial fistula
E Breakage of instrument.
В Apart from mfection, damage to articular cartilage by arthroscope,
instilments and irrigation needle is most serious complication, instrument
,breakage is not the problem with newer modern day instruments. Other
complications mentioned can occur but are uncommon.
9. Which of the following is most serious complication of myelo-
graphy:
A Allergic reaction
В Headache
С Transient neurological deficit
D Arachnoiditis
E Neck stiffness.
В If performed in proper aseptic manner, fever is not the usual
complication while all others are the dangers of myelography. These
complications are fairly common with nonabsorbable, oily contrast mediums
rather than with newer water soluble contrast medium.
10. What are contraindications of arthroscopy:
A Partial or complete ankylosis of joint
В Risk of introducing sepsis from a nearby skin lesion
С Major collateral ligamentous and capsular disruptions
D All of above
E Some of above.
D Introduction of infection can create disaster. In an ankylosed joint
instrument can not be manouvered. Major collateral ligamentous and
capsular disruptions allow irrigating solution to extravasate and make
examination difficult or impossible.
11. Commonest cause of quadriceps contracture is:
A Congenital
В Ischaemic myositis
С Following femoral shaft fracture
D Following operations on thigh
E Post injection fibrosis.
E Post injection fibrosis usually occurs after repeated intramuscular
injections or saline infusions in an infant. This is the commonest cause in
India and other causes are less common.
, 12. What is the earliest indication of Volkmann's ischaemia:
A Pain
В Pallor and poor capillary filling
С Paraesthesia in median nerve area
D Contracture of fingers
E Gnagrene of tips of fingers.
A Earliest sign of vascular compromise is persistent pain which is
exacerbated on passive extension of fingers. Action must be taken at this stage.
Pallor, poor capillary filling, absent radial pulse and paraesthesia in median
nerve area are also early signs but may not be present in every case and one
should not wait for these signs. Contracture and gangrne is a very late
phenomenon.
13. 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
В Posterior dislocation is rare and occurs due to direct injury over
medial end of clavicle
С Sternoclavicular dislocation is common compared to
acromioclavicular dislocation
D Trachea can be compressed in posterior dislocation
E Manipulative reduction is often unstable and fixation with wire
may be required.
С Dislocation of sternoclavicular joint is much less frequent than
acromioclavicular joint dislocation. All other statements are true and briefly
describe the salient features of sterooclavicular
joint dislocation.
14. Which of the following is the earliest laboratory finding in a
case of fat embolism:
A Increased serum cholestrol
В Increased serum lipase
С Increased serum fatty acids
D Lipuria
E Increased alkaline phosphatase.
D Presence of fat dropiet in urine is the earliest laboratory finding in fat
embolism. But it most be remembered that the diagnosis is mainly clinical and
one should not wait for any inves before instituting treatment.
15. First treatment priority in patient with multiple injuries is:
A Airway maintenance
1. Which is the strongest ligament:
A Ilio-femoral ligament
В Ischio-femoral ligament
С Pubo-femoral ligament
D Transverse acetabular ligament
E Ligamentum teres.
A Ilio-femoral ligament blends with anterior part of hip joint capsule
and is the strongest ligament at hip joint.
2. Which part of quadriceps muscle is most frequently fibrosed in post
injection quadriceps contracture:
A Rectus femoris
В Vastus medialis
С Vastus intermedius
D Vastus lateralis
E All of above.
D Vastus lateralis is most frequently affected probably because
injections are usually given in this area of thigh.
3. Radionucleide bone scanning is most useful in:
A Avascular necrosis
В Malignancy
С Rheumatoid arthritis
D Stress fractures
E Acute osteomyelitis.
В Radionucleide bone scanning is most useful in defining extent of
primary tumour, locating unsuspected metastasis and primary malignant
tumour. In all other conditions mentioned its use is more of academic interest
4. Commonest cause of failure of arthrography is:
A Extra-articular injection of contrast
В Bubbling of air in the joint
С False positive interpretation
D False negative interpretation
E Allergic reaction.
A Extra-articular injection of contrast medium is the commonest
cause of failure of arthrography especially in smaller and deep situated joints.
Allergic reaction to contrast medium is rare but when it happens examination
will have to be discontinued. Other factors also make this procedure futile.
,5. Myelography is necessary in following conditions:
A Suspicion of an intraspinal tumour
В Conflicting clinical findings and C.T. scan
С Evaluation of previously operated spine
D All of above
E Some of above.
D Due to its complications and since it is an invasive technique,
myelography has been replaced by CT scan. Now a days primary indications
of myelography are as mentioned in the question.
6. Arthroscope was invented and first used by:
A Takagi
В Watanabe
С Dandy
D Jackson
E Patel.
A First prototype of arthroscope was made and used by Takagi in 1918.
Modern day arthroscope was made by Takagi and Watanabe. Dandy, Jackson
and Patcl are some of the leaders of arthroscopic surgery nowadays.
7. What is the guideline to deltopectoral groove:
A Axillary vein
В Cephalic vein
С Musculo-cutaneous nerve
D Median nerve
E None of above.
В Cephalic vein lies in deitopedoral groove and serves as landmark in
identification of plane between deltoid and pectaralis major during anterior
exposure of shoulder.
8. Most serious complication of arthroscopy is:
A Haemorrhage in the joint
В Damage to articular cartilage
С Compartment syndrome
D S у no vial fistula
E Breakage of instrument.
В Apart from mfection, damage to articular cartilage by arthroscope,
instilments and irrigation needle is most serious complication, instrument
,breakage is not the problem with newer modern day instruments. Other
complications mentioned can occur but are uncommon.
9. Which of the following is most serious complication of myelo-
graphy:
A Allergic reaction
В Headache
С Transient neurological deficit
D Arachnoiditis
E Neck stiffness.
В If performed in proper aseptic manner, fever is not the usual
complication while all others are the dangers of myelography. These
complications are fairly common with nonabsorbable, oily contrast mediums
rather than with newer water soluble contrast medium.
10. What are contraindications of arthroscopy:
A Partial or complete ankylosis of joint
В Risk of introducing sepsis from a nearby skin lesion
С Major collateral ligamentous and capsular disruptions
D All of above
E Some of above.
D Introduction of infection can create disaster. In an ankylosed joint
instrument can not be manouvered. Major collateral ligamentous and
capsular disruptions allow irrigating solution to extravasate and make
examination difficult or impossible.
11. Commonest cause of quadriceps contracture is:
A Congenital
В Ischaemic myositis
С Following femoral shaft fracture
D Following operations on thigh
E Post injection fibrosis.
E Post injection fibrosis usually occurs after repeated intramuscular
injections or saline infusions in an infant. This is the commonest cause in
India and other causes are less common.
, 12. What is the earliest indication of Volkmann's ischaemia:
A Pain
В Pallor and poor capillary filling
С Paraesthesia in median nerve area
D Contracture of fingers
E Gnagrene of tips of fingers.
A Earliest sign of vascular compromise is persistent pain which is
exacerbated on passive extension of fingers. Action must be taken at this stage.
Pallor, poor capillary filling, absent radial pulse and paraesthesia in median
nerve area are also early signs but may not be present in every case and one
should not wait for these signs. Contracture and gangrne is a very late
phenomenon.
13. 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
В Posterior dislocation is rare and occurs due to direct injury over
medial end of clavicle
С Sternoclavicular dislocation is common compared to
acromioclavicular dislocation
D Trachea can be compressed in posterior dislocation
E Manipulative reduction is often unstable and fixation with wire
may be required.
С Dislocation of sternoclavicular joint is much less frequent than
acromioclavicular joint dislocation. All other statements are true and briefly
describe the salient features of sterooclavicular
joint dislocation.
14. Which of the following is the earliest laboratory finding in a
case of fat embolism:
A Increased serum cholestrol
В Increased serum lipase
С Increased serum fatty acids
D Lipuria
E Increased alkaline phosphatase.
D Presence of fat dropiet in urine is the earliest laboratory finding in fat
embolism. But it most be remembered that the diagnosis is mainly clinical and
one should not wait for any inves before instituting treatment.
15. First treatment priority in patient with multiple injuries is:
A Airway maintenance
