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Orthopedic Prometric MCQs - Chapter 3 Part 1

Orthopedic Prometric MCQs - Chapter 3 Part 40

25 Apr 2026 19 min read 2 Views
Orthopedic Prometric MCQs - Chapter 3 Part 40

Welcome to Chapter 3 Part 40 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.

Use the Study Mode to view detailed explanations instantly, or switch to Exam Mode to test your speed and accuracy under simulated testing conditions.

Prometric Exam Simulator


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Question 1

The primary restraint to anterior translation of the abducted and externally rotated glenohumeral joint is the:





Explanation

The inferior glenohumeral ligament is the primary restraint to anterior translation of the abducted and externally rotated glenohumeral joint. The Bankart lesion is an avulsion of the inferior glenohumeral ligament and represents the primary pathoanatomy of traumatic anterior shoulder dislocation.

Question 2

The quadriceps angle or Q angle is defined as the angle formed by a line connecting the:





Explanation

The quadriceps angle, or Q angle, is used to evaluate patellofemoral alignment. It is defined as the angle formed by a line connecting the anterior superior iliac spine to the center of the patella and a line connecting the center of the patella to the center of the tibial tuberosity. A normal angle is up to 10° in men and up to 15° in women. Unfortunately, no standard technique exists for measuring the Q angle, and its reliability and usefulness have recently come under question.

Question 3

Innervation to the anterior cruciate ligament is provided by a branch of the:





Explanation

The posterior articular branch of the posterior tibial nerve provides pain fibers and mechanoreceptors to the anterior cruciate ligament.

Question 4

All of the following represent mechanisms of injury to the posterior cruciate ligament except:





Explanation

All of the above except application of valgus force to a flexed and externally rotated knee have been described in posterior cruciate ligament injuries. Application of a valgus force to a flexed and externally rotated knee would more likely result in an anterior cruciate ligament injury.

Question 5

Which of the following sets of compartment measurements confirms the diagnosis of exertional compartment syndrome:





Explanation

If pressures at preexercise are >15 mm Hg, 1-minute postexercise >30 mm Hg, 5-minute postexercise >20 mm Hg, it will confirm a diagnosis of exertional compartment syndrome. Exertional compartment syndrome is becoming increasingly recognized as a source of pain in runners and cyclists. The onset of pain is gradual during exercise and ultimately restricts performance. Activity modification usually is effective. Refractory cases may require fasciotomy.

Question 6

The most common adverse side effect of dietary supplementation with creatine in athletes is:





Explanation

Creatine has recently become a popular dietary supplement among athletes. The long-term effects of creatine are not known. However, it appears to cause muscle cramping and heat intolerance.

Question 7

When testing an elbow for insufficiency of the medial collateral ligament, valgus stress should be applied with the elbow positioned at:





Explanation

When testing the medial collateral ligament of the elbow, it is important to apply valgus stress with the elbow flexed approximately 20° to 30° to disengage the olecranon from the olecranon fossa. It is always important to examine and compare the injured and uninjured side.

Question 8

Internal impingement of the shoulder between the posterosuperior glenoid rim and the rotator cuff typically occurs with the arm in this position:





Explanation

Internal impingement of the shoulder occurs with the arm in the abducted, externally rotated, and extended position. This entity may be responsible for shoulder pain commonly occurring in overhead and throwing athletes. Initial treatment is focused on therapy that strengthens the anterior structures and scapular retractors and stretches the posterior structures. If nonoperative treatment fails, arthroscopic debridement, thermal capsular shrinkage, and humeral derotational osteotomy have all been used with varying degrees of success.

Question 9

The following structure is most responsible for anterior stability of the glenohumeral joint with the arm in 45° of abduction:





Explanation

The middle glenohumeral ligament, although absent in up to one third of shoulders, is the largest contributor to anterior stability of the shoulder with the arm abducted 45°. The inferior glenohumeral ligament is the primary restraint to anterior instability with the arm abducted to 90° and externally rotated.

Question 10

The following structure is most responsible for resisting inferior translation of the glenohumeral joint with the arm at the side:





Explanation

The coracohumeral ligament coupled with the superior glenohumeral ligament provides the primary restraint to inferior translation of the glenohumeral joint with the arm at the side. The coracohumeral ligament also provides restraint to external rotation with the arm at the side.

Question 11

Maximal external rotation of the shoulder occurs during which phase of pitching:





Explanation

The pitching motion can be divided into 6 phases: wind-up, early cocking, late cocking, acceleration, deceleration, and follow through. Maximal external rotation at the shoulder occurs during late cocking.

Question 12

A 35-year-old avid rock climber complains of persistent anterior elbow pain with climbing, particularly when pulling himself up with his arms. The following muscle would most likely show increased activity on an electromyogram:





Explanation

Brachialis tendonitis, or climberâ s elbow, causes pain in the anterior elbow with the forearm in the pronated and flexed position. An electromyogram typically shows increased activity in the brachialis muscle.

Question 13

A 16-year-old baseball pitcher complains of dominant-sided elbow pain when pitching. He has recently been removed from the pitching rotation because of "control" problems. Physical examination reveals pain when a supinated, flexed, and valgus stressed elbow is brought into progressive extension. The most likely diagnosis is:





Explanation

The process described is posteromedial impingement syndrome of the elbow. It typically presents as vague elbow pain with loss of control in pitchers. The valgus extension overload test typically elicits pain and sometimes crepitus. The pathological changes in posteromedial impingement syndrome start with chondromalacia on the medial aspect of the trochlear groove and may progress to osteophyte formation and loose bodies necessitating arthroscopic debridement.

Question 14

This slide is a computed tomogram of the shoulder of a 22-year-old rugby player. The most likely diagnosis is:

Orthopedic Prometric Exam Chapter 3 Image





Explanation

The computed tomogram shows a posterior avulsion of the glenoid rim and an impaction fracture of the anterior aspect of the humeral head consisted with a prior posterior dislocation.

Question 15

This slide is a computed tomogram of the dominant shoulder of a 45-year- old male tennis player. The most likely diagnosis is:

Orthopedic Prometric Exam Chapter 3 Image





Explanation

Synovial osteochondromatosis is a rare condition typically affecting middle- aged men. The computed tomogram demonstrates the osteocartilaginous nodules. Early in the disease, arthroscopic removal of loose bodies and synovectomy usually results in an acceptable outcome. In cases of progressive disease resulting in secondary shoulder arthrosis, shoulder arthroplasty may be required.

Question 16

Weight training that employs constant resistance throughout the arc of motion is referred to as:





Explanation

Isotonic training employs a constant resistance throughout the arc of joint motion

Question 17

Weight training that employs a constant velocity and variable resistance is referred to as:





Explanation

Isokinetic training employs constant velocity and variable resistance. Special equipment, such as a C ybex device (C ybex, Medway, Mass), is required for isokinetic training.

Question 18

During arthroscopic repair of a medial meniscal tear, the following structure is at greatest risk for damage:





Explanation

No matter what technique for arthroscopic medial meniscal repair is used, the saphenous nerve must be protected to avoid a painful neuroma postoperatively.

Question 19

During arthroscopic repair of a lateral meniscal tear, the following structure is at greatest risk for damage:





Explanation

When performing arthroscopic lateral meniscal repair, the peroneal nerve must be protected from insult.

Question 20

A 15-year-old male football player is discovered to have a reproducible painless pop with meniscal testing during a routine preparticipation physical examination. The patient states that he has never experienced any knee problems other than an occasional audible pop. His family physician orders a magnetic resonance image. It shows a discoid lateral meniscus without evidence of tearing. Recommended management should include:





Explanation

A discoid lateral meniscus can be complete, incomplete, or a Wrisberg variant. If asymptomatic, the patient can simply be observed without restriction. In patients with symptoms, the preferred treatment is excision of the central portion of the meniscus. In individuals with a discoid meniscus and a peripheral tear, repair of the tear is performed with excision of the central portion of the meniscus.

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Dr. Mohammed Hutaif
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Prof. Dr. Mohammed Hutaif
Consultant Orthopedic & Spine Surgeon
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