Basic science MCQ V2

  1. During an extended iliofemoral approach, you pull excessively and give the patient a superior gluteal nerve palsy. Which of these will be affected?



    D)

    Obturator internus: nerve to OI

    Piriformis: Nerve to piriformis

    Glut max: Inferior gluteal nerve

    Nerves exiting below piriformis

    POPS IQ

    Pudendal > obturator internus > posteriror cutaneous nerve thigh > inferior gluteal > nerve to QF
  2. Which of these medial thigh muscles is not exclusively innervated by the obturator nerve?



    D)

    Dual innervation obturator and sciatic

    Gracilis: Obturator
  3. About intimate partner violence, which is true?



    A)
  4. Which of these does not inhibit bone resorption?



    A)

    Teriparatide: teriparatide > activates osteoblasts

    Denozumab: RANKL inhibitis osteoclast

    Ris/alendronate: Bisphosphonate >
  5. 10- What is the mechanism of action of teriparatide (rPTH)?



    D)
  6. Which of the following is true for patients with sickle cell?



    C)
  7. Strain strenght graph:
    Plastic deformation
    Elastic modulus
    Strongest
    Stiffest
    • The further to the right the more plastic
    • Point where stress and strain increase
    • Highest starin
    • Steepest
  8. What property of Cobalt-chromium-molybdenum alloy gives it its resistance to corrosion?



    B)
  9. In Kaplan-Meier survival analysis, what to you do when people fail?
    You calculate the survival by dividing by the remaining survivors

    kaplan survival = Number subjects living at the start - number subjects died / number subjects living at the start
  10. How do you limit the Hawthorne effect?

    a) Blind the patients to the exact parameter assessed
    b) Proper randomization
    A

    Hawthorne effect: 

    It is the process where human subjects of an experiment change their behavior, simply because they are being studied. This is one of the hardest inbuilt biases to eliminate or factor into the design.
  11. What is true of X-linked hypophosphatemic rickets?


    A)

    It is X linked dominant
  12. 55- During lateral approach to proximal 1/3 femur, you place a Hohmann retractor posterior and encounter arterial bleeding. Which vessel?



    B)
  13. 72- What is an example of an anisotropic material?



    C)

    Anisotropic: Materials that posess different mechanical properties depending on the direction of the applied load
  14. 99- Where would you expect to find obturator nerve exiting obturator foramen?



    A)
  15. 125- How do biofilms protect bacteria from antibiotics?



    B)

    Called glycocalix
  16. Which of the following medications is used to treat RA?



    C)
  17. All are true regarding returning to driving after orthopedic surgery EXCEPT



    B)
  18. Which is a closed chain exercise



    D)

    Distal end is fixed
  19. Regarding the mechanical axis in the tibia, all are true except?



    B)
  20. Which of these anticoagulation therapies postop TJA has the lowest evidence supporting its use?



    B)
  21. Which of the following is true for patients with sickle cell?




    E)
  22. What is the last bone to ossify? REPEAT



    D)
  23. What is the meaning of the area under a stress strain curve? REPEAT 2012



    B)
  24. Which is a dynamic restraint to proximal migration of the humerus?



    A)
  25. All of the following may cause scapular winging except REPEAT



    B)
  26. What is the limiting factor in treating obese patients?



    C)
  27. What is true about muscle activity in mid-swing (mid stance) phase of gait? REPEAT



    C)
  28. Technical difficulty with FCR approach to distal radius?



    B)
  29. What muscle-tendon units are activated in the mid-swing phase of gait?


    B)
  30. Which of the following is associated with thoracic outlet syndrome?



    A)

    • Watson test for SLAC
    • Compression is btw anterior and middle scalene

    It is depression of scapula
  31. 6 risk factors for thoracic outlet syndrome
    • Cervical rib
    • Descent of scapula (trap palsy)
    • Congenital bands btw 1st rib and cervical rib
    • Obesity
    • Large breasts
    • Female > make
  32. 3 tests for thoracic outlet sydnrome
    Adson: arm adducted+ head extended + turn to affected side

    Wrights: arm abducted + ER + deep breath 

    Roos
  33. Which of the following study designs will convey level IV evidence?



    D)

    Level 1: RCT high quality

    Level 2: Less quality RCT , retrospective study 

    Level 3: case control

    Level 4: case series

    Level 5: expert opinion
  34. With a noncompliant patient, at what point is the physician released from responsibility?




    B)
  35. A patient needs to undergo an elective orthopaedic procedure. Which of the following describes informed consent?




    A)

    3 key elements to informed consent:

    Voluntary

    Pt capable:

    Appropiate disclosure
  36. What cells produce hyaluronic acid for the synovial fluid?



    C)

    type B synoviocytes: synovial lining cells
  37. A patient is unconscious & needs emergency surgery. No family members are available. What should you do?



    c) Contact the hospital legal/ethics board (& wait for their decision)
    A)
  38. You are shown a diagram of a cross-section of the thigh at the adductor canal (similar but not identical to the one below). What muscle is the arrow pointing to?
    a) Sartorius
    b) Adductor longus
    c) Adductor magnus
    d) Gracilis
    Learn cross sectional anatomy!
  39. What is true regarding intimate partner violence?



    A)

    1/6 pts in ortho clinic have experienced abuse

    1/50 present as a direct concequence
  40. Regarding a hip fracture patient on Plavix (clopidogrel), which of the following is true?



    A)
  41. Which embryonic layer forms the vertebral body?



    D)
  42. Which is the correct order of materials according to Young’s Modulus (from highest to lowest)?



    B)

    High to low:

    • Cermic
    • Cobalt-chrome
    • Stainless steel
    • Titanium
    • Cortical bone
    • PMMA
    • POlyethylene
    • Cancellous bone
  43. Which of the following describes hydrodynamic lubrication?



    C)

    Elastodynamic: join motion > articular carilage. 

    Boosted: lubricating fluid pools in regions contained by articular surface

    weeping: lubricating fluid sshifts from articular surface towards load bearign regions
  44. What is the main blood supply to the scaphoid?



    D)
  45. All of the following are true, EXCEPT?



    B)
  46. All are true EXCEPT?



    C)
  47. All the following are components of the rotator cuff interval EXCEPT?



    A)

    Rotator interval

    • Capsule
    • SGHL
    • Coracohumeral ligament that bridge the gap between supraspinatus and subscap
  48. All are true regarding observational studies EXCEPT?



    A)
  49. The main branch of the medial femoral circumflex artery is anterior to all of the following structures EXCEPT?



    A)

    Deep branch MFCA passes behind obturator externus then it goes anterior to obturator internus/sup/inf gemellus

    Perforates capsule at the level of sup gemellus
  50. With regards to osteoporosis and proximal femur fractures, everything is true EXCEPT:


    B)

    B controversial
  51. In the lateral corticospinal and spinothalamic tracts, which fibers are located on the lateral aspect of each?



    D)

    Spinothalamic tract from central to peripheral: Cervical thoracic lumbar sacral

    Posterior columns:med to lat > sacral > lumbar > thoracic >cervical
  52. Guy fell off a ladder 5 weeks ago, initially had lots of shoulder and neck pain, now c/o numbness lateral arm, weak shoulder abduction, also has winging. What is the lesion? (C5 root was NOT an option).


    A)
  53. All of the following are regarding HIT are true except.



    D)

    HIT timing: fall platelets >50 usually 5-10 days after initiation of therapy

    Big problem is thrombosis
  54. What is mode of inheritance for duchennes?



    C)
  55. What would you find with hypophosphotasia?



    B)

    have low alk phos, high calcium, high phosphate
  56. Increase in urine phosphoethanolamine: dx
    Hypophosphotasia
  57. All are true re: bisphosphonates in kids except?


    A)

    A has slow decrease in calcium
  58. Retrograde ejaculation caused by? Repeat from way back



    • C)
    • the sympathetic superior hypogastric plexus anterior to L5
  59. All of the following are potential causes of knee pain EXCEPT?



    B)
  60. Patient with RA. Which of the following medications must be stopped pre-operatively?
    a) Hydroxychloroquine
    b) Methotrexate
    c) Vitamin K
    d) Tylenol
    B: stop in diabetics, elderly or ppl with liver, kidney, lung disease undergoing major procedures
  61. Which of the following allow you to become stronger during initial phase of training?



    D)

    increase in muscle cross sectional area due to increase in size of muscle fibers, not due to additional muscles
  62. Pt has MRSA. Best periop abx? High rate MRSA your hospital



    D)
  63. What is interval for ant. Approach to hip?



    B)
  64. Hypovolemic shock, ATP depleted. What happens intracellular?



    D)
  65. Patient in hypovolemic shock is fluid ressuscitated with NS. What will labs show?


    C)
  66. All of the following make up the quadrangular space except?



    D)

    Quadrangular space: posterior circumflex humeral artery + axillary artery

    • Teres major
    • teres minor
    • humerus
    • Long head triceps
  67. What is the main stabilizer to posterior shoulder translation when the shoulder is in flexion, adduction, and internal rotation?



    D)

    SGHL and coracohumeral: Limit inferior translation + ER when arm adducted.......limit posterior translation when arm flexed adducted IR

    MGHL: Limit ER with addcuted humeurs + Ant/post with partially abducted humerus

    IGHL: Primary restraint to anterior posterior at 45-90 degrees of elevation
  68. Shown Cross section of thigh at adductor canal. What is the arrow pointing to? Note: the diagram was essentially identical to this one from Netter’s. However, it was a left thigh, not right as shown here.



    D)
  69. Weird question on functional loads in stable joint, all except?


    C)
  70. Transient osteoporosis, all except
    a) Usually healthy, middle-aged men
    b) Usually no trauma
    c) Roughly 50% of cases in the upper extremity
    d) Physical exam usually reveals minimal restriction in ROM
    C: occurs only in lower extremity

    • usually health middle aged men and pregnant women
    • Minimal restriction to ROM on exam
  71. Mechanism of botox?
    a) Inhibition of postsynaptic acetylcholine receptor
    b) Inhibition of ACh release from presynaptic vesicles
    b)

    Competitive inhibitor of presynaptic cholinergic receptors with a finite lifetime (usually lasts 2-3 months)
  72. Most common cause of upper extremity neuropathic arthropathy?



    D)

    Most common overall is diabetes
  73. What is the most sensitive test when evaluation for musculoskeletal infection?



    D)
  74. C-diff, all true except?



    B)
  75. All of the following practices can prevent HIV transmission except?



    A)
  76. What amount of force do the hip abductors need to generate to keep pelvis level in single leg stance?



    D)
  77. Articular cartilage, all true except


    C)  

    Cartilage made of sulfated PG: chondroitin and keratin sulfate

    Weight: 60% collagen, 35% PG
  78. All of the following cell types are present during the inflammatory phase of bone healing EXCEPT:



    C)
  79. Which of the following is the correct order of cartilaginous zones from metaphysis to physis?



    A)

    reserve is closest to epiphysis
  80. Which of the following are responsible for formation of verterbrae?



    C)

    • Mesoderm is responsible for MSK
    • Ectoderm is responsible for neural tube
  81. Which of the following is the correct ranking in order of Young’s Modulus of Elasticity from Highest to Lowest?



    C)

    High young smodulus means stiffer

    Youngs modulus is the slope of stress strain curve
  82. Which of the following antibiotics are appropriate for treatment of Eikenella

    Corrodens due to a human bite injury?



    B)  

    Usually treatment is amox/clav
  83. All of the following are true with ADH in shock EXCEPT:



    C)

    Promotos mesenteric vasoconstriction of smooth muscle
  84. Post approach to knee what is landmark?



    D)

    Specifically medial sural cutaneous that leads to tibial N

    Usually along with small saphenus vein
  85. Young’s Modulus: High to low (Make list in order)

    a) Steel
    b) Cobalt Chrome
    c) Cement
    d) Cortical Bone
    e) Titanium
    • Ceramic
    • Cobalt chrome
    • STeel
    • Titanium
    • Cortical bone
    • PMMA
    • Cancellous bone
  86. Hydrodynamic lubrication (old question):
    Answer: This is a form of LUBRICATION in articular cartilage.




    Elastohydrodynamic lubrication is the predominant mechanism during dynamic joint motion.
  87. Hyaluronic acid is made by…



    A)
  88. All of the following are about fiberglass compared to Plaster EXCEPT:



    B)
  89. All of the following are true regarding cement compared to bone graft for GCT

    EXCEPT:



    C)
  90. Which of the following structures is the main landmark for the posterior approach to the popliteal fossa?



    D)
  91. Which of the following collagen orientations are most resistant to hoop stresses in the menisci?



    C)
  92. Peak maximum vascularity of fracture callus



    C)

    Normalizes after 3-5 months
  93. Pressure injury of tourniquet


    C)

    • EMG normal 1 year
    • Wider is better
    • Injury is at the level of the cuff
  94. Which of the following is true in regards to synovial fluid?



    A)
  95. Which nerve(s) are contained within the carotid sheath along with the Internal Jugular Vein and Common Carotid Artery?



    B)

    • Other structures in sheath
    • Internal jugular vein
    • COmmon carotid A
    • Deep cervical LN
  96. A 16 y.o. female patient with long-standing seizure disorder has used Phenytoin (Dilantin) for many years. She is found to have osteomalacia. What is the reason?



    C)

    • VIT D GETS 25 FROM LIVER
    • Vit D gets 1 from kidney
    • SUn makes pre vit D to Vit D
  97. Polyarticular sepsis is often seen with which underlying diagnosis:



    D)
  98. Multiple septic arthritis is most often associated with which of the following disorders:



    C)

    Pnemococcal pneumonia is predictor of mortality
  99. In polyarticular septic arthritis which joints are most commonly involved (each stem had 4 choices and you needed to pick the one with all 4 right joints).
    a) hip, shoulder, elbow, ankle
    b) hip shoulder, knee, elbow
    a)
  100. In necrotizing fasciitis, what is the most consistent initial symptom:




    E)
  101. Which of the following constructs can be used by utilizing the tension band principle except:



    A)
  102. Which of the following is true for titanium plates (LC-DCP) compared to stainless steel:




    D)
  103. All help to increase stability for an ex-fix, except



    D)
  104. Which is true: these are probably misworded stems but you get the gist
    a) GAG are sulfated
    b) Cartilage is viscoelastic
    c) The annulus is viscoelastic
    d) The nucleus pulposus has mainly hydrostatic pressure
    a?
  105. Which of the following is osteoinductive?



    B)

    Osteoconductive: Scaffold

    OSteoinductive: BMP, stimulates cells

    Osteogenic: Cancellouys allograft...has Stem cells
  106. Cartilage- which is not true




    E)
  107. Secondary bone healing with all except



    B)
  108. With respect to associations, All except:



    D)

    OI Glycine defect on COLA1

    Ehler dahnlos COL5
  109. Boundary lubrication is



    A)
  110. Illustration of proximal femur given (antero-lateral view given and asked what muscle attaches to anterior aspect of GT—the key is to recognize that this is anterior, not posterior).



    A)
  111. Which is TRUE regarding the effect of anabolic steroids on tendons:



    C)
  112. Pasteurella multocida all true except:



    D)

    • It is a gram negative facultative anaerobe
    • Killed by penicillin
  113. With regards to the organism Pasteurella multocida all the following are true expect




    E)
  114. Clostridium perfringens exerts it effect through


    A)
  115. Which of the following procedures is most likely to cause injury to the superior gluteal nerve (Injury causing dennervation of Glut Med?)



    B)
  116. Which of the following procedures is most likely to cause injury to the superior gluteal nerve? EXCEPT?


    B)
  117. Deltopectoral approach - which vessel to watch for that supplies humeral head (AVN to humeral head in 4 part # caused by which artery)?



    D)
  118. Which is most important in regulating Ca++ absorption in the gut:



    B)
  119. The mechanism of action of bisphosphonates works:



    C)

    • Bind to hydroxyapatitie > osteoclast unable to attach
    • Direct inhibition of osteoclast
  120. What is the overall effect of thyrotoxicosis on bone?



    C)
  121. All of the following are true with respect to TKA in Hemophilliacs EXCEPT



    A)

    Hemophiliac at risk of stiffness
  122. Likelihood ratio, which will have highest post-test probability of disease?



    D)

    Higher than one means higher chance than pre test
  123. Muscle strain usually occurs with:




    D)
  124. The location of the lateral femoral cutaneous nerve as it courses over the pelvic brim can be best described by which of the following?



    A)
  125. Allograft question, frozen, using it in tibia, what is true:




    d) ? rejection or something?
    B)
  126. Proximal tibia bone frozen allograft for depressed tibial fracture. What is true



    C)
  127. All happen with tourniquet EXCEPT?



    D)

    Usually increase in CVP
  128. These decrease radiation exposure to surgeon EXCEPT?



    C)
  129. Picture of arm in tourniquet and circle drawn on Lateral Condyle, blood supply is:




    C)
  130. The following Rx cause osteoporosis EXCEPT:



    B)
  131. Which is not a part of the superior shoulder suspensory complex:




    C)
  132. What is true about gait pattern here?



    C)
  133. All of the following contribute to the strength of # callus except? McGill: Repeat on adds to bone healing strength, EXCEPT?



    C)
  134. Interosseus membrane, all true EXCEPT?



    B)

    A also wrong

    Runs from proximal radial to distal ulna
  135. Which is guide to the posterior knee in approach?
    a) Tibial nerve
    b) Medial sural cutaneous
    c) Short saphenous vein
    d) CP nerve
    B and C
  136. Which is not a cause of winging?



    C)
  137. All in sciatic notch, except?



    A)

    Greater sciatic notch contents

    • Piriformis
    • SGN and IGN
    • Sciatic N
    • Internal pudendal N
    • Nerves to obt internus and QF

    Lesser Sciatic: Obturator nerve
  138. Recurrent laryngeal nerve is a branch of



    D)
  139. Effect of T3 and T4 on bone



    C)
  140. Which of the following would not be completely innervated by the AIN:



    D)

    FDP ring and small is ulnar
  141. Which does not have Wallerian degeneration?



    A)

    Walerian degeneration after complete transection
  142. Your hospital has 35% infection rate with MRSA, pre op Abx should be what?



    C)
  143. Time-dependent deformation due to stress is? McGill: When you hit an object below the amount that would cause failure repetitively, this would lead to change in it’s described as what?



    C)

    PLastic is not time dependent

    Anisotropic materials: different properties depending on direction of load
  144. What is in the carotid sheath:



    D)
  145. Woven bone has the following characteristics



    C)


    Woven: disorganized

    Lamellar: organized with haversian canals
  146. Tendon repair which has highest pullout strength?



    A)
  147. Patient with sciatica and trendelenberg, and otherwise normal hip exam.       Which nerve root?



    D)
  148. A question on what you will find in muscle injury?
    Muscles that cross 2 joints usually affected
  149. Extracellular Articular cartilage is mostly (65-80%) what by weight?



    A)
  150. Type 1 muscle fibers have



    A)

    Weak but low fatigue

    Type 2: strong but fatigue quick
  151. Hydrodynamic lubrication is defined as:



    B)
  152. As we age the muscle changes that occur are:



    B)
  153. The PIN innervates



    A)
  154. Corticosteriods affect calcium metabolism by



    B)
  155. When you compare ligaments to tendons


    B)

    • Tendon stronger
    • Ligaments have more elastin content
  156. Dorsal approach to forearm, what interval to start in




    E)
  157. Most common form of rickets in western society


    C)

    • Familial hypophosphatemic rickets
    • Loq calcium, High ALP, Low phosphate
    • Treat with phosphate replacement
  158. Radial nerve, all are false, except?



    B)
  159. Osteotomy of long bone – what % of cortical blood disruption



    B)
  160. Everything correct (? wrong) about cartilage aging except



    B)
  161. Best anatomical landmark for obturator nerve



    D)
  162. Most radiation exposure



    C)
  163. Components of proteoglycan – what’s not a part of the structure



    B)
  164. With regard to the effect of demineralized bone matrix:



    C)
  165. Autonomic dysfunction in spinal cord injury (couldn’t remember the choices too well)



    D)
  166. which is a dynamic constraint of the elbow:




    E)

    Only muscles are dynamic: brachialis, triceps, anconeous
  167. Relationship between synovial fluid coefficient of viscosity and shear forces



    A)
  168. drug treatment for a late presenting cat bite to the hand with pus, following I and D,



    A)
  169. Distraction osteosynthesis – all except



    B)
  170. Why are locking plates advantageous?



    D)
  171. What causes osteoporosis



    A)
  172. Tourniquet complications are minimized with all EXCEPT



    D)
  173. Posteromedial plateau with anterior fragment. What is best approach?



    C)
  174. What’s the type of lubrication when the load is borne by the fluid extruded from the surfaces



    B)
  175. Free nerve endings exist:



    B)

    No nerves in nucleous
  176. repeat: during posterolateral approach to hip, lateral branch (Common Peroneal) from sciatic going to:
    a) Long head biceps
    b) Short head biceps
    b)

    • Tibial branch goes to long head
    • Peroneal branch goes to short head
  177. Medial patellofemoral ligament attaches to patella:



    A)
  178. RF in RA, all true, EXCEPT?



    A)

    It is an IgM
  179. Patient lacks proximal lateral sensation to arm, shoulder abduction, elbow flexion, scapular winging. Lesion?:



    B)
  180. Radial nerve, all TRUE, EXCEPT



    A)
  181. With respect to the recurrent laryngeal nerve palsy in anterior Cervical surgery, all of the following increase the risk of injury EXCEPT?



    A)
  182. Virchows triad except



    D)
  183. Static stabilizer of shoulder



    A)
  184. What does AIN supply in forearm @ level of Pronator Teres



    B)
  185. Vancomycin. All are true EXCEPT



    C)

    Better to measure trough
Author
egusnowski
ID
345809
Card Set
Basic science MCQ V2
Description
Basic science mcq v2
Updated