Welcome to Chapter 3 Part 48 of our comprehensive Orthopedic Prometric Exam Simulator. This interactive test features 20 high-yield multiple-choice questions designed to help you prepare for the Saudi Prometric (SCFHS), DHA, HAAD, SLE, and OMSB orthopedic surgery exams.

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Question 1

Histology of chronic Achilles tendinosis DOES NOT reveal which of the following:

Explanation

Histological analysis of Achilles tedinosis has revealed abnormal fiber structure, focal hypercellularity, and vascular proliferation. Inflammatory cells are not present in patients with chronic Achilles tendinosis.

Question 2

Initial management of a symptomatic Haglundâ s deformity in a runner consists of:

Explanation

Haglunds deformity is characterized by a prominence about the posterosuperior calcaneus that can lead to retrocalcaneal bursitis and Achilles tendon injury just proximal to its insertion. The initial treatment involves relieving pressure from the affected area with a heel lift and soft heel counter. Resistant cases may benefit from excision of the prominence and debridement of the bursa and tendon.

Question 3

Which of the following is not consistent with a complete rupture of the Achilles tendon:

Explanation

Patients who sustain an Achilles tendon rupture will often feel as if they were kicked in the back of the leg. They experience the sudden onset of pain and may present with a palpable defect. The patients may note plantarflexion weakness but may demonstrate active plantarflexion of the foot as a result of other muscles that cross posterior to the ankle such as the flexor hallucis longus and tibialis posterior muscles. The Thompson test (midcalf squeeze) will typically illicit no plantarflexion of the foot.

Question 4

The primary collagen type found in the knee meniscus is:

Explanation

Type I collagen makes up 90% of the collagen in the meniscus. The remainder is made up of types II, III, V, and VI collagen. Type II makes up the majority of collagen in articular cartilage.

Question 5

The transverse intermensical ligament is occasionally the only site of attachment for the:

Explanation

Although the majority of the time the anterior horn of the medial meniscus has a firm bony attachment, the transverse intermeniscal ligament is the only site of anterior attachment in 3% to 14% of cases.

Question 6

With regard to the meniscofemoral ligaments, the ligament of Humphrey runs ___ to the posterior cruciate ligament (PC L) and the ligament of Wrisberg runs _____ to the PC L.

Explanation

The anterior meniscofemoral ligament of Humphrey runs from the femur to the posterior horn of the lateral meniscus anterior to the PC L. The ligament of Wrisberg runs posterior to the PCL. It is occasionally the only posterior horn attachment site for a discoid lateral meniscus and can result in excessive motion and posterior horn instability.

Question 7

The ligament that has an association with an unstable lateral discoid meniscus is:

Explanation

The anterior meniscofemoral ligament of Humphrey runs from the femur to the posterior horn of the lateral meniscus anterior to the posterior cruciate ligament (PC L). The ligament of Wrisberg runs posterior to the PC L. It is occasionally the only posterior horn attachment site for a discoid lateral meniscus and can result in excessive motion and posterior horn instability. The medial and lateral collateral ligaments are not the attachment sites for the posterior horn of some lateral discoid meniscal variants.

Question 8

Vascularity of the adult meniscus is limited to the:

Explanation

Studies show that only the peripheral 10% to 25% of the lateral meniscus and 10% to 30% of the medial meniscus is vascular. The vascularity arises from the medial and lateral genicular arteries.

Question 9

The most important structure that resists anterior tibial translation in the anterior cruciate ligament (AC L)-deficient knee is the:

Explanation

One study evaluated the role of the meniscus in anteroposterior stability of the AC L-deficient knee. The researchers found that the posterior horn of the medial meniscus was the most important structure resisting an applied anterior tibial force in an AC Ldeficient knee. The peripheral portion of the meniscus is essential for both load transmission and stability.

Question 10

Approximately what percentage of middle-aged tennis players are able to return to tennis after rotator cuff surgery:

Explanation

In a series evaluating the results of surgical treatment of rotator cuff tears in 51 middle-aged tennis players, Sonnery-C ottet and colleagues discovered that approximately 80% of patients returned to tennis at latest follow-up.

Question 11

Proximal humeral anatomy is variable. Which of the following measurements most accurately describe the range of diameters of the humeral head (length of line AB):

Explanation

Proximal humeral anatomy is variable. The high variability is the basis for radical changes in design of shoulder arthroplasty. The diameter of the humeral head ranges from approximately 35 mm to 55 mm. Orthopedic Prometric Exam Chapter 3 Image

Orthopedic Prometric Exam Chapter 3 Image

Question 12

Which of the following statements best describes the relationship of humeral head diameter to humeral head thickness:

Explanation

Humeral head diameter and humeral head thickness have a directly proportional linear relationship.

Question 13

Proximal humeral anatomy is variable. Which of the following measurements most accurately describe the range of radius of curvature of the humeral head (length of line AB):

Explanation

Proximal humeral anatomy is variable. This high variability is the basis for radical changes in design of shoulder arthroplasty. The humeral head radius of curvature ranges from approximately 20 mm to 30 mm.

Question 14

The proximal humeral articular surface can be described as a portion of a sphere. The center of this sphere has which of the following anatomic relationships to the long axis of the humerus:

Explanation

Anatomically, a sphere can be fit to the proximal humerus with the articular surface comprising a portion of that spher The center of this sphere is offset 3 mm to 11 mm medially and 1 mm to 6 mm posteriorly with respect to the long axis of the humerus.

Question 15

Which of the following pitch types is associated with the development of shoulder pain in baseball pitchers between the ages of 9 and 14 years:

Explanation

A study following 476 young baseball pitchers for one season demonstrated that the use of the curveball in this age group was associated with a 52% increased risk of the development of shoulder pain.

Question 16

Which of the following pitch types is associated with the development of elbow pain in baseball pitchers between the ages of 9 and 14 years:

Explanation

A study following 476 young baseball pitchers for one season demonstrated that use of the slider in this age group was associated with an 86% increased risk of the development of elbow pain.

Question 17

It is recommended to limit youth baseball pitchers (9 to 14 years of age) to how many pitches per game

Explanation

In young baseball pitchers, high pitch counts are associated with increased risk of shoulder pain. Based on a study of 476 youth baseball pitchers, it is recommended to limit pitch counts to 75 pitches per gam.

Question 18

It is recommended to limit youth baseball pitchers (9 to 14 years of age) to how many game situation pitches per baseball season:

Explanation

Question 19

Which of the following statements is true regarding traumatic anterior shoulder instability:

Explanation

dynamic shoulder stabilizers. A study evaluating glenohumeral translation and muscle activity related traumatic and atraumatic shoulder instability demonstrated that patients with traumatic shoulder instability have abnormal glenohumeral translation mainly in the provocative position of 90° abduction and external rotation. This translation is corrected by contraction of the dynamic shoulder stabilizers.

Question 20

Which of the following is the most common radiographic finding in patients with lateral epicondylitis:

Explanation

In a radiographic analysis of 294 patients with lateral epicondylitis, 20 patients had lateral soft tissue calcification, 14 patients had coronoid osteophytes, nine patients had olecranon osteophytes, two patients had intraosseous cysts, and two patients had osteochondritis dessicans. The author concluded that routine radiography is not warranted in the initial management of lateral epicondylitis.

Full Question & Answer Text (for Search Engines)

Question 1:

Histology of chronic Achilles tendinosis DOES NOT reveal which of the following:

Options:

Abnormal fiber structure
Focal hypercellularity
Vascular proliferation
Abundant inflammatory cells
All of the above are noted

Correct Answer: Abundant inflammatory cells

Explanation:

Question 2:

Initial management of a symptomatic Haglundâ s deformity in a runner consists of:

Options:

Intratendinous steroid injection
Debridement of the tendon
Excision of the posterosuperior calcaneal prominence
Heel lift and soft shoe counter
A firm heel counter and medial heel wedge

Correct Answer: Heel lift and soft shoe counter

Explanation:

Question 3:

Which of the following is not consistent with a complete rupture of the Achilles tendon:

Options:

A palpable defect 3 cm to 4 cm proximal to the Achilles insertion
Ability to plantarflex the foot against gravity
Sensation of being kicked in the calf
Plantarflexion of the foot with the Thompson test
No previous symptoms of Achilles related pain

Correct Answer: Plantarflexion of the foot with the Thompson test

Explanation:

Question 4:

The primary collagen type found in the knee meniscus is:

Options:

Type I
Type II
Type III
Type V
Type VI

Correct Answer: Type I

Explanation:

Type I collagen makes up 90% of the collagen in the meniscus. The remainder is made up of types II, III, V, and VI collagen. Type II makes up the majority of collagen in articular cartilage.

Question 5:

The transverse intermensical ligament is occasionally the only site of attachment for the:

Options:

Anterior horn lateral meniscus
Anterior horn medial meniscus
Posterior horn lateral meniscus
Posterior horn medial meniscus
None of the above

Correct Answer: Anterior horn lateral meniscus

Explanation:

Question 6:

With regard to the meniscofemoral ligaments, the ligament of Humphrey runs ___ to the posterior cruciate ligament (PC L) and the ligament of Wrisberg runs _____ to the PC L.

Options:

Posterior, anterior
Anterior, posterior
Anterior, anterior
Posterior, posterior
Medial, lateral

Correct Answer: Anterior, posterior

Explanation:

Question 7:

The ligament that has an association with an unstable lateral discoid meniscus is:

Options:

Ligament of Humphrey
Medial collateral ligament
Lateral collateral ligament
Ligament of Wrisberg
Anterior cruciate ligament

Correct Answer: Ligament of Humphrey

Explanation:

Question 8:

Vascularity of the adult meniscus is limited to the:

Options:

Inner 10% to 30%
Inner 30% to 50%
Peripheral 10% to 30%
Peripheral 30% to 50%
Entire meniscus is vascular

Correct Answer: Peripheral 10% to 30%

Explanation:

Studies show that only the peripheral 10% to 25% of the lateral meniscus and 10% to 30% of the medial meniscus is vascular. The vascularity arises from the medial and lateral genicular arteries.

Question 9:

The most important structure that resists anterior tibial translation in the anterior cruciate ligament (AC L)-deficient knee is the:

Options:

Anterior horn medial meniscus
Anterior horn lateral meniscus
Posterior horn medial meniscus
Posterior horn lateral meniscus
Lateral collateral ligament

Correct Answer: Posterior horn medial meniscus

Explanation:

Question 10:

Approximately what percentage of middle-aged tennis players are able to return to tennis after rotator cuff surgery:

Options:

20%
40%
60%
80%
100%

Correct Answer: 80%

Explanation:

Question 11:

Proximal humeral anatomy is variable. Which of the following measurements most accurately describe the range of diameters of the humeral head (length of line AB):

Options:

25 mm to 35 mm
35 mm to 45 mm
45 mm to 55 mm
25 mm to 45 mm
35 mm to 55 mm

Correct Answer: 35 mm to 55 mm

Explanation:

Question 12:

Which of the following statements best describes the relationship of humeral head diameter to humeral head thickness:

Options:

Humeral head diameter and humeral head thickness are independent of one another.
Humeral head diameter and humeral head thickness have a directly proportional linear relationship.
Humeral head diameter and humeral head thickness have an inversely proportional linear relationship.
Humeral head diameter and humeral head thickness have a directly proportional logarithmic relationship.
Humeral head diameter and humeral head thickness have an inversely proportional logarithmic relationship.

Correct Answer: Humeral head diameter and humeral head thickness are independent of one another.

Explanation:

Humeral head diameter and humeral head thickness have a directly proportional linear relationship.

Question 13:

Proximal humeral anatomy is variable. Which of the following measurements most accurately describe the range of radius of curvature of the humeral head (length of line AB):

Options:

5 mm to 10 mm
10 mm to 15 mm
15 mm to 20 mm
20 mm to 30 mm
30 mm to 40 mm

Correct Answer: 20 mm to 30 mm

Explanation:

Question 14:

The proximal humeral articular surface can be described as a portion of a sphere. The center of this sphere has which of the following anatomic relationships to the long axis of the humerus:

Options:

The center of this sphere lies on the long axis of the humerus.
The center of this sphere is offset medially with respect to the long axis of the humerus.
The center of this sphere is offset posteriorly with respect to the long axis of the humerus.
The center of this sphere is offset anteriorly with respect to the long axis of the humerus.
The center of this sphere is offset medially and posteriorly with respect to the long axis of the humerus.

Correct Answer: The center of this sphere lies on the long axis of the humerus.

Explanation:

Question 15:

Which of the following pitch types is associated with the development of shoulder pain in baseball pitchers between the ages of 9 and 14 years:

Options:

Fastball
C hange-up
C urveball
Slider
Knuckle ball

Correct Answer: C urveball

Explanation:

A study following 476 young baseball pitchers for one season demonstrated that the use of the curveball in this age group was associated with a 52% increased risk of the development of shoulder pain.

Question 16:

Which of the following pitch types is associated with the development of elbow pain in baseball pitchers between the ages of 9 and 14 years:

Options:

Fastball
C hange-up
C urveball
Slider
Knuckle ball

Correct Answer: Slider

Explanation:

A study following 476 young baseball pitchers for one season demonstrated that use of the slider in this age group was associated with an 86% increased risk of the development of elbow pain.

Question 17:

It is recommended to limit youth baseball pitchers (9 to 14 years of age) to how many pitches per game

Options:

Correct Answer: 75

Explanation:

Question 18:

It is recommended to limit youth baseball pitchers (9 to 14 years of age) to how many game situation pitches per baseball season:

Options:

200
400
600
800
1000

Correct Answer: 600

Explanation:

Question 19:

Which of the following statements is true regarding traumatic anterior shoulder instability:

Options:

Abnormal glenohumeral translation occurs mainly in the provocative position of 90° abduction and external rotation, and this translation is corrected by contraction of the dynamic shoulder stabilizers.
Abnormal glenohumeral translation occurs in multiple arm positions, and this translation is corrected by contraction of the dynamic shoulder stabilizers.
Abnormal glenohumeral translation occurs mainly in the provocative position of 90° abduction and external rotation, and this translation is not corrected by contraction of the dynamic shoulder stabilizers.
Abnormal glenohumeral translation occurs in multiple arm positions, and this translation is not corrected by contraction of the
No abnormal glenohumeral translation occurs in traumatic shoulder instability.

Correct Answer: Abnormal glenohumeral translation occurs mainly in the provocative position of 90° abduction and external rotation, and this translation is corrected by contraction of the dynamic shoulder stabilizers.