ABOS Part I Comprehensive Review - Batch 83

Question 1

A 7-year-old boy with a known diagnosis of Duchenne Muscular Dystrophy is brought to the orthopedic clinic. His parents report that he has been falling more frequently, struggles to climb stairs, and often uses his hands to push off his thighs when t

Accepted Answer

Significant thoracolumbar scoliosis (Cobb angle > 40°)

Question 2

A 12-year-old non-ambulatory boy with Duchenne Muscular Dystrophy is scheduled for a posterior spinal fusion for progressive thoracolumbar scoliosis. Preoperative imaging reveals significant osteopenia. During the surgical planning phase, the orthope

Accepted Answer

Pedicle screws are favored due to their three-column purchase and superior pull-out strength, even in osteopenic bone.

Question 3

A 10-year-old boy with Duchenne Muscular Dystrophy is undergoing preoperative evaluation for a planned Achilles tendon lengthening procedure to address a severe equinus contracture. His medical history includes chronic corticosteroid use. Which of th

Accepted Answer

Baseline FVC of 25% predicted with significant CO2 retention

Question 4

A 9-year-old boy with Duchenne Muscular Dystrophy is scheduled for a posterior spinal fusion. During the multidisciplinary preoperative assessment, the anesthesiologist raises concerns about anesthetic management. Which of the following anesthetic ag

Accepted Answer

Succinylcholine

Question 5

A 14-year-old non-ambulatory boy with Duchenne Muscular Dystrophy presents with a progressive, long C-shaped thoracolumbar scoliosis measuring 55° Cobb angle, accompanied by significant pelvic obliquity. He experiences discomfort while sitting and hi

Accepted Answer

Profoundly atrophic paraspinal musculature replaced by fatty and fibrous tissue

Question 6

A 6-year-old boy with Duchenne Muscular Dystrophy presents with a progressive equinus contracture of the ankle, making it difficult to wear his Ankle-Foot Orthoses (AFOs) and affecting his balance during ambulation. Non-operative management with stre

Accepted Answer

Meticulous technique to avoid overcorrection and damage to neurovascular structures.

Question 7

A 13-year-old boy with Duchenne Muscular Dystrophy, who lost ambulation two years prior, presents with a rapidly progressing thoracolumbar scoliosis (Cobb angle 48°) and increasing difficulty with sitting balance. His FVC is 45% predicted. His cardio

Accepted Answer

To improve sitting balance, reduce pain, and preserve pulmonary function.

Question 8

A 10-year-old boy with Duchenne Muscular Dystrophy is undergoing preoperative planning for a posterior spinal fusion. Given his chronic corticosteroid use, the orthopedic team is particularly concerned about bone health. Which of the following assess

Accepted Answer

DEXA scan to assess bone mineral density

Question 9

A 15-year-old non-ambulatory patient with Duchenne Muscular Dystrophy is recovering from a posterior spinal fusion. On postoperative day 2, the patient develops increasing shortness of breath, decreased oxygen saturation, and a weak cough. Which of t

Accepted Answer

Respiratory insufficiency/failure; Prolonged mechanical ventilation and aggressive pulmonary hygiene.

Question 10

A 5-year-old boy with Duchenne Muscular Dystrophy is noted to have a waddling gait and uses his hands to push off his knees to stand up from the floor. His parents report he frequently falls. These findings are primarily indicative of weakness in whi

Accepted Answer

Proximal hip extensors and quadriceps

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Key Takeaway