Welcome to Chapter 3 Part 50 of our comprehensive Orthopedic Prometric Exam Simulator. This interactive test features 47 high-yield multiple-choice questions designed to help you prepare for the Saudi Prometric (SCFHS), DHA, HAAD, SLE, and OMSB orthopedic surgery exams.
Use the Study Mode to view detailed explanations instantly, or switch to Exam Mode to test your speed and accuracy under simulated testing conditions.
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Question 1
Accelerated rehabilitation after anterior cruciate ligament reconstruction has resulted in:
Explanation
Accelerated rehabilitation focusing on gaining and maintaining full extension, early unrestricted range of motion, and progression of rehabilitation based on achieving functional goals rather than a strict timeline has resulted in earlier return to sporting activities without compromising the ultimate result.
Question 2
Strain in the anterior talofibular ligament (ATFL) _ as the ankle moves from dorsiflexion to plantarflexion.
Explanation
The ATFL primarily functions to restrict internal rotation of the talus in the mortis Strain in the ATFL increases as the ankle moves from dorsiflexion and plantarflexion, and it is the primary restraint to anterior translation and adduction in this position.
Question 3
The most commonly injured ligament after inversion ankle sprains is the:
Explanation
Isolated anterior talofibular ligament (ATFL) injuries are reported to occur in 67% of ankle sprains. The anterior talofibular ligament is the most commonly injured ligament after inversion ankle sprains.
Question 4
What is a common complication of total hip arthroplasty?
Explanation
Dislocation is a known complication of total hip arthroplasty, particularly in the early postoperative period. Careful patient education and surgical technique are crucial to minimize this risk.
Question 5
Which nerve is most commonly injured in a distal humerus fracture?
Explanation
The ulnar nerve runs posterior to the medial epicondyle and is vulnerable to injury in distal humerus fractures, particularly supracondylar fractures.
Question 6
What is the gold standard for diagnosing osteomyelitis?
Explanation
Bone biopsy with subsequent histopathological examination and culture is considered the gold standard for confirming the diagnosis of osteomyelitis.
Question 7
Which of the following describes a Salter-Harris Type III fracture?
Explanation
A Salter-Harris Type III fracture involves a fracture line extending from the physis into the epiphysis, typically involving the articular surface.
Question 8
What is the most appropriate initial treatment for a displaced femoral neck fracture in an elderly patient?
Explanation
In elderly patients with displaced femoral neck fractures, the risk of avascular necrosis and non-union is high with internal fixation, making arthroplasty (hemiarthroplasty or total hip arthroplasty) the preferred treatment.
Question 9
Which ligament prevents excessive anterior translation of the tibia relative to the femur?
Explanation
The Anterior Cruciate Ligament (ACL) is the primary restraint to anterior translation of the tibia relative to the femur, as well as to rotational forces.
Question 10
Which rotator cuff muscle is most commonly torn?
Explanation
The supraspinatus tendon is the most commonly torn of the rotator cuff muscles, often due to its position in the subacromial space and its role in abduction.
Question 11
Which type of scoliosis is most common in adolescents?
Explanation
Adolescent idiopathic scoliosis (AIS) is the most common form of scoliosis, usually developing around puberty with no clear cause.
Question 12
Avascular necrosis of the femoral head is most commonly associated with which fracture?
Explanation
Femoral neck fractures, especially displaced ones, often disrupt the blood supply to the femoral head, leading to a high risk of avascular necrosis.
Question 13
Which of the following is characteristic of osteosarcoma on imaging?
Explanation
Osteosarcoma is often characterized by an aggressive periosteal reaction on X-ray, including a "sunburst" or "Codman's triangle" appearance, indicative of rapid bone formation and destruction.
Question 14
Which classification system is used for open fractures?
Explanation
The Gustilo-Anderson classification system is widely used to describe the severity of open fractures, taking into account wound size, soft tissue damage, and contamination.
Question 15
What is the primary function of the menisci in the knee joint?
Explanation
The menisci are C-shaped cartilaginous structures that act as shock absorbers, increase the contact area between the femur and tibia, and contribute to knee joint stability.
Question 16
Which of the following is considered a hallmark sign of compartment syndrome?
Explanation
While all listed are "5 Ps" of compartment syndrome, pain out of proportion to the injury (especially with passive stretching of the muscles in the affected compartment) is often the earliest and most reliable sign.
Question 17
Which surgical approach for total hip arthroplasty is known for having a lower risk of dislocation but potentially higher risk of nerve injury?
Explanation
The direct anterior approach often involves working between muscle planes, theoretically reducing dislocation risk. However, it can put the lateral femoral cutaneous nerve (LFCN) at higher risk of injury, leading to meralgia paresthetica.
Question 18
Which bone is most commonly affected by osteosarcoma in adolescents?
Explanation
Osteosarcoma commonly affects the metaphysis of long bones, with the distal femur being the most frequent site, followed by the proximal tibia and proximal humerus.
Question 19
Which of the following is a non-weight-bearing bone of the lower leg?
Explanation
The fibula primarily serves as a site for muscle attachment and helps stabilize the ankle, but it does not bear significant weight. The tibia is the main weight-bearing bone of the lower leg.
Question 20
What is the most common cause of septic arthritis in adults?
Explanation
Staphylococcus aureus is the most common causative organism for septic arthritis across all age groups, including adults.
Question 21
Which of the following describes a Greenstick fracture?
Explanation
A greenstick fracture is an incomplete fracture in children where one side of the bone cortex is broken, and the other side is bent, resembling a breaking green branch.
Question 22
The most common site for a stress fracture in runners is the:
Explanation
The tibia, specifically the proximal or mid-shaft, is a very common site for stress fractures in runners due to repetitive loading during impact activities. Metatarsals are also common.
Question 23
What is the most common cause of shoulder instability?
Explanation
Traumatic anterior shoulder dislocation is the most common cause of glenohumeral instability, often leading to a Bankart lesion or Hill-Sachs lesion.
Question 24
Which physical exam maneuver tests for meniscal tears?
Explanation
The McMurray test is a common orthopedic test used to detect meniscal tears, producing an audible click or palpable clunk with knee flexion, extension, and rotation.
Question 25
Which vitamin deficiency is associated with rickets in children and osteomalacia in adults?
Explanation
Vitamin D deficiency leads to impaired mineralization of bone, causing rickets in children (growth plate abnormalities) and osteomalacia in adults (softening of mature bone).
Question 26
Which tendon is commonly involved in "tennis elbow"?
Explanation
Tennis elbow, or lateral epicondylitis, is an overuse injury primarily affecting the origin of the extensor carpi radialis brevis muscle at the lateral epicondyle of the humerus.
Question 27
What is the most common primary malignant bone tumor in children and young adults?
Explanation
Osteosarcoma is the most common primary malignant bone tumor in children and adolescents, typically occurring during growth spurts.
Question 28
Which structure is commonly entrapped in a supracondylar humerus fracture in children?
Explanation
The brachial artery and median nerve are most at risk for injury or entrapment in displaced supracondylar humerus fractures, potentially leading to Volkmann's ischemic contracture.
Question 29
What is the common term for degeneration of the patellar tendon due to overuse?
Explanation
Jumper's knee, or patellar tendinopathy, is a condition characterized by pain at the inferior pole of the patella, resulting from overuse and degenerative changes in the patellar tendon.
Question 30
Which of the following describes a Colles' fracture?
Explanation
A Colles' fracture is a common distal radius fracture, characterized by dorsal displacement and angulation of the distal fragment, often resulting from a fall onto an outstretched hand.
Question 31
Which anatomical structure is commonly involved in De Quervain's tenosynovitis?
Explanation
De Quervain's tenosynovitis affects the tendons of the abductor pollicis longus and extensor pollicis brevis as they pass through the first dorsal compartment of the wrist, leading to pain and swelling at the radial side of the wrist.
Question 32
What is the common term for inflammation of the plantar fascia?
Explanation
Plantar fasciitis is a common cause of heel pain, resulting from inflammation and microtears in the plantar fascia at its attachment to the calcaneus.
Question 33
Which of the following factors increases the risk of developing osteoporosis?
Explanation
Estrogen deficiency after menopause significantly accelerates bone loss, making post-menopausal women highly susceptible to osteoporosis.
Question 34
Which nerve is compressed in carpal tunnel syndrome?
Explanation
Carpal tunnel syndrome results from compression of the median nerve as it passes through the carpal tunnel in the wrist, leading to numbness, tingling, and weakness in the thumb, index, middle, and radial half of the ring finger.
Question 35
The main blood supply to the scaphoid bone comes from which artery?
Explanation
The scaphoid bone receives its primary blood supply from branches of the radial artery, particularly the dorsal carpal branch, which enters distally. This tenuous blood supply makes it prone to avascular necrosis after fracture.
Question 36
Which of the following is NOT a component of the "Terrible Triad" knee injury?
Explanation
The "Terrible Triad" (or O'Donoghue's Triad) involves simultaneous injury to the ACL, MCL, and medial meniscus. A PCL tear or lateral meniscus tear is not part of the classic triad.
Question 37
Which medication class is associated with an increased risk of Achilles tendon rupture?
Explanation
Fluoroquinolone antibiotics (e.g., ciprofloxacin, levofloxacin) are known to be associated with an increased risk of tendinopathy and tendon rupture, particularly of the Achilles tendon.
Question 38
Which of the following is a classic clinical finding in developmental dysplasia of the hip (DDH) in infants?
Explanation
Asymmetrical thigh skin folds (along with gluteal folds) are a common sign of DDH in infants, though they are not diagnostic. Ortolani and Barlow maneuvers are more definitive clinical tests.
Question 39
What is the most common primary benign bone tumor?
Explanation
Osteochondroma is the most common primary benign bone tumor, typically appearing as an outgrowth of cartilage-capped bone near the growth plate.
Question 40
Which nerve is at risk during surgical fixation of a proximal fibula fracture?
Explanation
The common fibular (peroneal) nerve wraps around the neck of the fibula, making it highly susceptible to injury during fractures or surgical procedures in this region.
Question 41
What is the most effective long-term treatment for osteoarthritis?
Explanation
While conservative treatments can manage symptoms, joint replacement (arthroplasty) is the most effective long-term treatment for severe, end-stage osteoarthritis, providing significant pain relief and improved function.
Question 42
What is the initial management for an acute Achilles tendon rupture?
Explanation
Initial management for an acute Achilles tendon rupture involves immobilization of the ankle in plantarflexion to approximate the tendon ends, followed by prompt orthopedic evaluation to determine if surgical or non-surgical treatment is best.
Question 43
Which of the following is most indicative of a disc herniation with nerve root compression?
Explanation
Radicular pain (sciatica) that radiates down the leg below the knee into specific dermatomal patterns is a classic symptom of nerve root compression due to disc herniation.
Question 44
Which condition is characterized by avascular necrosis of the femoral head in children aged 4-8 years?
Explanation
Legg-Calvé-Perthes disease is an idiopathic avascular necrosis of the femoral head in children, typically affecting boys between 4 and 8 years of age.
Question 45
Which type of fracture pattern is commonly seen in osteoporotic bone?
Explanation
Compression fractures, particularly in the vertebral bodies, are very common in osteoporotic bone due to axial loading on weakened bone.
Question 46
Which of the following describes the function of the subacromial bursa?
Explanation
The subacromial bursa is a fluid-filled sac that acts as a cushion, reducing friction between the rotator cuff tendons (especially supraspinatus) and the overlying acromion during shoulder movement.
Question 47
Which of the following is an indication for surgical intervention in scoliosis?
Explanation
Surgical intervention (spinal fusion) is generally indicated for progressive scoliosis with a Cobb angle exceeding 45-50 degrees in a growing adolescent, as these curves are likely to continue progressing even after skeletal maturity and can lead to significant deformity and potential cardiopulmonary compromise.
