Multiple Choice Questions
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19. Patient is seen post op after their wrist arthroscopy and is concerned about a firm lump just proximal to one of their portal sites .
What injury should you check for?
A) Nerve injury
C) Loose Body
D) retropulsion of thumb fracture
E) Extending the little finger
18. A patient presents to your clinic with both hands in this position.
What medications might they be on?
B) Beta blocker’s
17. An amateur boxer presents to your clinic, she is worried as after her most recent match she cannot extend her finger.
If she straightens with her other hand she can hold it straight and it stays up
This is because:
A) partial tendon tear
B) posterior interosseous nerve compression from the fight
C) complete tendon rupture
D) saggittal band rupture
E) MCP subluxation
16. The ulnar paradox relates to:
A) Cubital tunnel syndrome is rarely associated with carpal tunnel syndrome
B) A proximal compression of the nerve leads to a worse deformity
C) After cubital tunnel release the deformity gets worse before it gets better
D)Cubital tunnel syndrome is always bilateral
E) Double pinch syndrome has a far worse outcome
15. Nail bed injury in the adult might be associated with which of the following:
A) Seymour fracture
B) Tuft fracture
C) Fracture of middle phalanx
D)Proximal phalanx fracture
E) Avulsion of central slip
14. A 19-year-old volleyball player injured her right thumb during a game.
A magnetic resonance image (MRI) through the metacarpophalangeal joint is shown .
What is the diagnosis:
A) Extensor tendon disruption
B) Complete ulnar collateral ligment tear
C) Volar plate disruption
D) Incomplete ulnar collateral ligament tear
E) Ulnar collateral
13. When applying a POSI splint, which of the following is true?
A) The wrist should be extended 10-45 degrees
B) PIPJ flexed to 90 degrees
C) DIPJ flexed to 30 degrees
D) Thumb in maximum abduction
E) MCPJ full extension
12. Macrodactyly is associated with all of the following syndromes except:
B) Proteus syndrome
C) Klippel-Trenaunay syndrome
D) Marfan syndrome
E) Multiple enchondromatosis
11. A 16-year-old male high school rugby player was making a tackle when he felt sudden pain in his right long finger.
He has swelling and tenderness along the volar aspect of the injured digit. He is unable to actively flex the distal interphalangeal joint of the injured digit.
Radiographs are negative for fracture.
Recommended treatment should include:
B) Splinting of the distal interphalangeal joint in extension
C) Splinting of the distal interphalangeal joint in flexion
D) Immediate active range of motion exercises
E) Surgical repair
10. During a wrist arthroscopy in a basketball player who has ulnar-sided wrist pain, the articular disk of the triangular fibrocartilage complex is observed.
A probe is inserted and the disk is free floating without tension, a negative “trampoline test”.
What does this signify:
A) Flexor carpi ulnaris subluxation
B) Distal radioulnar joint disruption
C) Scapholunate instability
D) Tear in either the central or peripheral portion of the TFCC
E) Ulnar abutment syndrome
9. A golfer sustained a hook of the hamate fracture .
After 12 weeks of splinting and therapy, the hand is still symptomatic.
What is the most appropriate management to allow return to competitive activity?
A) Continued observation
B) Open reduction and internal fi xation of the fracture
C) Excision of the hook of the hamate
D) Carpal tunnel release
E) Guyon canal release
8. What is the most appropriate indication for replantation in an otherwise healthy 35y old man?
A) Isolated transverse amputation of the thumb through the middle of the nail bed
B) Isolated transverse amputation of the index fi nger through the proximal phalanx
C) Isolated transverse amputation of the ring finger through the proximal phalanx
D) Isolated transverse amputation of the hand at the level of the wrist
E) Forearm amputation with a 10-hour warm ischemia time
7. A 59 years old man attended A&E with hand infection. Blood culture grow Eikonella Corrodens .
Which injury is associated with this organism?
A) Human bites
B) Cat bites
C) Dog bites
D) Pyogenic flexor tenosynovitis
6. The following statements about Dupuytren’s contracture are true except that:
A) It is due to contraction of the palmar fascia which starts as an indurated nodule on the ulnar border of the hand.
B) The ring and little fingers are severely affected.
C) The deformity consists of flexion of the MCP and PIP joints with extension of the terminal joint.
D) The skin overlying the indurated fascia is often puckered and immobile.
E) The joint capsules and flexor tendons are not affected.
5. During replantation of a digit; what is the sequence of repairing structures:
A) Bone; Extensor tendon; Flexor tendons; Arteries; Veins; Nerves
B) Nerves; Arteries; Bone; Veins; Extensor tendon; Flexor tendons
C) Arteries; Bone; Flexor tendons; Extensor tendon; Veins; Nerves
D) Bone; Arteries; Nerves; Veins; Flexor tendons; Extensor tendon
E) Bone; Extensor tendon; Flexor tendons; Arteries; Nerves; Veins
4. In Wassel classification of thumb polydactyly.
What is the most common type?
A) Type I
B) Type II
C) Type III
D) Type IV
E) Type V
3. Regarding wrist arthroscopy, The Lister tubercle lies between two dorsal wrist compartments .
What are they and their contents?
A) ECRL and EDC
B) APL and ECRB
C) EPB and ECRL
D) EPL and extensor indicis proprius
E) ECRB and EPL
2. Which of the following is considered the most common primary bone tumor that occurs in the bones of the hand?
A) Giant cell tumor
B) Epithelioid sarcoma
C) Intraosseous ganglion
1.What two flexor pulleysthat are the most important for maintaining the integrity of finger flexion?