Multiple Choice Questions

Paediatric Orthopaedics

Test your knowledge , learn more and get ready for your orthopaedic exam

 82. In the child with acute onset discitis, what is the earliest radiographic finding?

A) Loss of normal lumbar lordosis Correct option
B) Narrowing of the intervertebral disk space
C) Scalloping of the inferior vertebral body incorrect option
D) Scalloping of the superior vertebral body
E) Vertebra magna

 

81. A 12-year-old girl has a complete growth arrest of her left proximal tibia.

She currently has a 3 cm leg-length discrepancy with left shorter than the right. A radiograph of the patient’s left hand, wrist, and fingers demonstrate a bone age of 12 years.

What is the most appropriate management of this patient?

A) Left tibial lengthening
B) Observation
C) Observation and shoe lift
D) Right medial femoral partial epiphysiodesis
E) Right tibia and femur complete epiphysiodesis

 

80. All statements below are true EXCEPT: 

A) Perthes rarely affects both hips at the same time
B) Four times as many boys are diagnosed with Perthes
C) Complete re-vascularisation of the epiphysis occurs in 60% of affected patients
D) >20% of femoral head extrusion causes irreversible femoral head changes
E) Restricted abduction and internal rotation are typical clinical findings

 

79. Which of the following is a radiographic head at risk sign in children with Perthes? 

A) Epiphyseal sclerosis
B) Widened growth plate
C) Blanch sign of Steel
D) Gage sign
E) Herring sign

 

78. Which of the following is TRUE regarding strong evidence in the international literature with regards to Developmental Dysplasia of the hip?

A) Pavlik harness is superior compared to other harness-types
B)  Anterior open reduction has superior results compared to medial open reduction
C) The surgeon needs to wait for the ossific nucleus of the dislocated hip to appear before proceeding to open reduction
D) Pre-operative traction is highly effective prior to open reduction of dislocated hips
E)  Salter osteotomy should not ideally be performed on children over 8 years of age

 

77. Which of the following is TRUE regarding Developmental Dysplasia of the hip? 

A) Asymmetrical creases are not present in babies with normal hips
B) Up to 90% of hips with Barlow (+) sign in the first 6 weeks will have a normal USS at 6 weeks
C) There can be up to 10% Pavlik harness failure rate with Ortolani (+)ve sign
D) Babies undergoing Pavlik harness treatment need to be followed up to skeletal maturity
E) There is no residual dysplasia after successful Pavlik harness treatment

 

76. he most recent NIPE guidelines (2021) define as primary risk factors for DDH all EXCEPT (Single Choice)*

A) Metatarsus adductus
B) First degree family history
C) Breech presentation >28 weeks regardless of External Cephalic Version
D) Clinical instability
E) Multiple pregnancy

 

75. Which of the following assertions on Perthe’s disease is not correct :

A) It usually presents with a painful limp
B) It may present with pain in the Knee 
C) It frequently presents with limitation of all hip movements, especially internal rotation and abduction
D) It is associated with an intermittent pyrexia in the early stages
E) It may occasionally be an incidental finding on radiographs taken for an unrelated problem

 

74. Which of the following is not a typical deformity/gait disturbance seen in cerebral palsy?

A) Toe walking
B) Hip adduction
C) Forearm supination
D) Wrist flexion
E) Wide-based gait

 

73. At which age do patients most commonly present with dysplasia epiphysialis hemimelia (DEH):

A) Birth
B) Between early childhood and early teen years
C) Early adulthood
D) Middle age
E) Older than 60 years

 

72. Which of the following conditions is represented by this radiograph :

(A) Developmental dysplasia of the hip
(B) Juvenile rheumatoid arthritis
(C) Hemophilic arthropathy
(D) Legg-Calvé-Perthes disease
(E) Rickets

 

71. The lesion indicated in this computed tomography most likely represents:

(A) Brodie’s abscess
(B) Eosinophilic granuloma
(C) Osteosarcoma
(D) Osteoid osteoma
(E) Osteoma

 

70. Epiphyseal osteochondroma is also known as:

(A) Mafucci’s syndrome
(B) Freiberg’s fracture
(C) Larsen-Johansson disease
(D) Trevor’s disease
(E) Iselin’s disease

 

69. The mother of a 4-month-old boy brings him to a physician to be evaluated for a swollen leg . 

The most likely diagnosis is:

(A) Rickets
(B) Osteogenesis imperfecta (OI)
(C) Scurvy
(D) Nonaccidental injury
(E) Caffey’s disease

 

68. The surgical reconstruction of a congenitally dislocated patella includes all of the following elements except:

(A) Advancement of the vastus medialis insertion
(B) Lengthening or release of the iliotibial band
(C) Lengthening or release of the biceps femoris muscle
(D) Lateral capsular release
(E) Lateral transfer of the patellar tendon insertion

 

67. Which of the following pulse sequences is best for imaging the pediatric growth plate:

(A) T1-weighted images
(B) T2-weighted images
(C) Proton density images
(D) Fat-suppressed T2-weighted images
(E) Gradient echo sequence

 

66. A 10-year-old boy with diplegic cerebral palsy walks with his knees turned in significantly. He has the appearance of severe valgus when walking. 

When examined in a supine position, there is no excessive valgus of the knees. His popliteal angle is 45°. An Ely test is negative. His hip internal rotation in the prone position is 80°, while his external rotation is 15°. 

The surgeon wishes to improve the patient’s knee position during gait. 

The intervention most likely to accomplish this is:

(A) Botulinum toxin injection to the hamstrings
(B) Hamstring lengthening, medially
(C) Hamstring lengthening, medially and laterally
(D) Rectus transfer into the biceps
(E) Femoral derotation osteotomy

 

65. Which of the following procedures is most likely to correct idiopathic toe walking with a single treatment:

(A) Stretching program
(B) Ankle foot orthosis
(C) Stretching cast
(D) Botulinum toxin injection
(E) Percutaneous tendoachilles lengthening

 

64. Which of the following disorders is due to a defect in anterior horn cells:

(A) Charcot-Marie-Tooth
(B) Duchenne dystrophy
(C) Friedreich’s ataxia
(D) Spinal muscular atrophy
(E) Rett syndrome

 

63. Which of the following regions of the physis has the highest degree of proteoglycan aggregation in the matrix:

(A) Reserve zone
(B) Proliferative zone
(C) Hypertrophic zone
(D) Zone of degeneration
(E) Metaphysis

 

62. A newborn boy presents with an abnormal right lower extremity. The right ankle is at the same level as the midshaft of the right tibia. The foot is also abnormal, and appears to be in a position of equinus and valgus. 

Radiographs confirm the equinovalgus of the foot, as well as absence of two lateral rays. There is also an absence of the fibula and anterolateral bowing of the tibia. 

Treatment of the lower extremity should consist of:

(A) Trans-tibial amputation
(B) Limb lengthening
(C) Observation
(D) Syme amputation
(E) Tibial osteotomy

 

61. The origin of “dumbbell lesions” found in radiographs of patients with neurofibromatosis 1 (NF1) is:

A) Flattening of the intervertebral disk with enlargement on the lateral borders
B) Thinning of the midshaft of the tibia giving this bone the appearance of a dumbbell
C) Neurofibromas or meningoceles that protrude through spinal foramina
D) Subperiostial bone proliferation
E) Two closely spaced cysts within a bone

 

60. Which of the following zones of the physis is involved in Salter Harris Type I and II fractures?

(A) Proliferative zone
(B) Perichondrial ring
(C) Reserve zone
(D) Node of Ranvier
(E) Zone of provisional calcification

 

59. An 11-year-old girl presents with low back pain for 2 months’ duration. She is an elite gymnast and has missed 2 meets because of the pain. 

Physical exam reveals pain with hyperextension of the lumbar spine. Her neurological exam is normal. 

Radiographs of the lumbar spine, including oblique views, are normal. The recommendation is:

A) Rest, with slow return to training in 4 weeks
B) Custom lumbosacral orthosis
C) Magnetic resonance imaging of the spinal cord
D) Physical therapy exercises
E) Bone scan with single photon emission computed tomography imaging

 

58. Placing a highly tensioned soft tissue graft across the open femoral physis during anterior cruciate ligament reconstruction results in which of the following outcomes

A) Premature closure of the physis 
B) No growth disturbance 
C) Development of femoral varus 
D) Development of femoral valgus 
E) Femoral overgrowth 

 

57. What is the histological difference between avascular necrosis of the femoral head in children versus adults ?

A) Children have less creeping substitution than adults
B) Children do not demonstrate osseous collapse
C) Large areas of fibrovascular tissue do not form in children
D) There is no osteoclastic resorption in children
E) Children do not have any residual changes after 2 years

 

56. All of the disorders listed below are examples of osteochondrosis except:

A) Legg-Calvé-Perthes disease
B) Scheuermann’s disease 
C) Osgood Schlatter disorder 
D) Gorham’s disease
E) Blount disease

 

55. The result of treatment of developmental dysplasia of the hip with Salter osteotomy is is worse with which of the following:

A) A higher degree of the dislocation before treatment (Tonnis grade)
B) Bilaterality 
C) Higher preoperative acetabular index
D) Increased age at surgery 
E) Performing open reduction at a separate surgery than the osteotomy

 

54. An 11-year-old boy sustains a fall while jumping on a trampoline. He has moderate back pain, an L-5 radiculopathy, and weakness of the right extensor hallucis longus. 

Radiographs and a computerized tomography scan of the lumbar spine demonstrate a slipped vertebral apophysis. 

The recommended treatment is:

A) Laminectomy and excision of annulus and vertebral bony margin
B) Bed rest
C) Thoracolumbosacral orthosis
D) Physical therapy
E) Spinal traction

 

53. A 12-year-old girl presents to the clinic with scoliosis detected by school screening. 

Her past medical history includes ophthalmologic observation for Lisch nodules of the iris. She has just started her menstrual periods. 

On physical exam, she has axillary freckles and normal neurological function. 

Standing radiographs of the spine illustrate a 32° right thoracic curve from T4 to T10 and rib pencilling. In the sagittal plane, she has a thoracic kyphosis of 30°. 

The most likely diagnosis is:

A) Adolescent idiopathic scoliosis
B) Congenital kyphoscoliosis
C) Neurofibromatosis-1 (NF-1)
D) Neurofibromatosis-2 (NF-2)
E) Stickler disease

 

52. What is the most common site of pelvic avulsion fracture in a skeletally immature athlete?

A) Anterior inferior iliac spine (AIIS)
B) Ischial tuberosity
C) Anterior superior iliac spine (ASIS)
D) Iliac crest
E) Pubic symphysis

 

51. Which of the following conditions does not produce valgus of a 4-year-old child:

A) Physiologic valgus
B) Prior proximal metaphyseal fracture
C) Multiple exostoses
D) Chondroectodermal dysplasia 
E) Infantile Blount disease

 

50. In which muscle does Ely’s test detect spasticity or contracture:

A) Biceps femoris 
B) Rectus femoris
C) Gastrocnemius 
D) Soleus 
E) Semimembranosus 

 

49. A 1-year-old patient presents with a pseudarthrosis of the left clavicle. 

Which of the following conditions is most likely to coexist with pseudarthrosis of the left clavicle?

A) Neurofibromatosis
B) Proteus syndrome 
C) Osteogenesis imperfecta
D) Fibrous dysplasia
E) Dextrocardia

 

48. All of the disorders listed below are examples of osteochondrosis except:

A) Legg-Calvé-Perthes disease
B) Scheuermann’s disease 
C) Osgood Schlatter disorder 
D) Gorham’s disease
E) Blount disease

 

47. The parameter most often recommended to follow the reciprocal relationship of the femoral head to the acetabulum in patients with cerebral palsy is known as the:

A) Migration index of Reimer
B) Epiphyseal extrusion index
C) Stulberg index 
D) Acetabular index
E) Tonnis index

 

46. Which population of patients with cerebral palsy is at greatest risk of neuromuscular hip subluxation:

A) Monoplegics
B) Spastic hemiplegics
C) Spastic diplegics 
D) Total-involvement 
E) Athetoid

 

45. Which of the following iliac osteotomies provides the greatest freedom of mobilization of the acetabular segment:

A) Salter osteotomy
B) Pemberton osteotomy
C) Steel osteotomy
D) Chiari osteotomy
E) Ganz osteotomy

 

44. In the absence of surgery, which of the following parameters in children with cerebral palsy tends to remain static with increasing age:

A) Knee range of motion
B) Ankle range of motion 
C) Normalized walking velocity
D) Femoral anteversion
E) Knee stiffness

 

43. Macrodactyly is associated with all of the following syndromes except:

A) Neurofibromatosis
B) Proteus syndrome
C) Klippel-Trenaunay syndrome
D) Marfan syndrome
E) Multiple enchondromatosis

 

42. Klippel-Trenaunay syndrome is characterized by cutaneous capillary venous malformation, varicose veins, and which of the following:

A) Multiple enchondromas
B) Multiple osteochondromas
C) Limb hypertrophy
D) Seizure disorder 
E) Congenital pseudarthrosis of the tibia 

 

41. Which of the following conditions is least commonly seen in patients with congenital dislocation of the patella:

Congenital Dislocation of Patella - Pediatrics - Orthobullets

A) Fibrosis of the vastus lateralis 
B) Contracture of the iliotibial band
C) Hypoplasia of the vastus medialis
D) Enlarged patella 
E) Flexion contracture 

 

40. A mutation in type II collagen is responsible for all of the following conditions except:

A) Stickler syndrome
B) Spondyloepiphyseal dysplasia congenita
C) Kniest syndrome
D) Strudwick dysplasia
E) Achondroplasia 

 

39. According to National Institutes of Health (NIH) criteria, what is the minimum number of 15-mm café-au-lait macules required as a diagnostic criterion for neurofibromatosis in postpubertal patients:

A) One
B) Two 
C) Three
D) Four
E) Six

 

38. The protein neurofibromin normally acts in which of the following ways:

A) Inhibits fibroblast growth factor 
B) Promotes proteoglycan assembly
C) Down regulates Ras protein 
D) Causes nerve cells to divide
E) Promotes tumor formation

 

37. What is the histological difference between avascular necrosis of the femoral head in children versus adults:

A) Children have less creeping substitution than adults
B) Children do not demonstrate osseous collapse
C) Large areas of fibrovascular tissue do not form in children. 
D) There is no osteoclastic resorption in children
E) Children do not have any residual changes after 2 years

 

36. Polyostotic fibrous dysplasia is caused by a mutation in which of the following genes:

A) GNAS 1
B) EXT 1 
C) Fibroblast growth factor receptor protein
D) CFBA1
E) COL1A1 

 

35. The result of treatment of developmental dysplasia of the hip with Salter osteotomy is worse with which of the following:

A) A higher degree of the dislocation before treatment (Tonnis grade)
B) Bilaterality 
C) Higher preoperative acetabular index
D) Increased age at surgery 
E) Performing open reduction at a separate surgery than the osteotomy

 

34. Chronic recurrent multifocal osteomyelitis is caused by which of the following:

A) Staphylococcus epidermidis
B) Corynebacterium
C) Spirochetal infection
D) Viral infection
E) No organism has been isolated

 

33. Which of the following is found less often in children with lumbosacral agenesis as compared to controls:

A) Cervical spine anomalies
B) Maternal diabetes 
C) Hip dislocation 
D) Spina bifida
E) Genu recurvatum

 

32. Which of the following by itself is not an indication for surgery in a child with acute haematogenous osteomyelitis:

A) Fever higher than 38.5°
B) Subperiosteal abscess
C) Presence of a sequestrum
D) Intramedullary abscess
E) Adjacent septic arthritis

 

31. A 13-year-old girl is seen in clinic for bunion. She is asymptomatic but has a hallux valgus angle of 29°, an intermetatarsal angle of 15°, and a medial prominence over the first metatarsal head. 

The family asks whether anything can be done to prevent future problems with the foot. 

You recommend:

A) Osteotomy of the first metatarsal base
B) Hemiepiphyseodesis of the medial physis of the first metatarsal 
C) Double osteotomy of the first metatarsal
D) Mitchell osteotomy
E) Shoe modifications if symptoms develop 

 

30. Which of the following symptoms is not characteristic of McCune-Albright’s syndrome:

A) Café-au-lait spots with irregular borders 
B) Café-au-lait spots with smooth borders 
C) Precocious puberty
D) Diabetes mellitus
E) Hyperthyroidism

 

29. After the bone age of 15 years, boys will achieve the most growth from which of the following regions:

A) Distal femoral epiphysis
B) Proximal tibial epiphysis
C) Distal tibial epiphysis
D) Ilium and pelvis 
E) Spine

 

28. Nine days after surgery, a 16-year-old boy with idiopathic scoliosis has a temperature of 39.5° C. 

Wound aspiration reveals gram-positive cocci . 

Your next step in management is:

A) Begin intravenous cephalosporin and monitor the response
B) Begin intravenous vancomycin and monitor the response 
C) Begin hyperbaric oxygen and intravenous antibiotics
D) Open and debride the wound, leaving the instrumentation in place 
E) Open and debride the wound, and remove the instrumentation

 

27. Homeobox genes are best characterized by which of the following descriptions:

A) Homeobox genes regulate fracture healing
B) Homeobox genes are involved in immune system regulation
C) Homeobox genes are a series of genes that regulate limb genesis
D) Homeobox genes regulate spinal development
E) Homeobox genes regulate vascular invasion of the physis

 

26. Which of the following is known about the genetics of multiple hereditary exostosis (MHE):

A) There is no genetic pattern for this condition.
B) MHE follows an x-linked inheritance pattern. 
C) MHE follows an autosomal recessive pattern. 
D) MHE involves a defect in biosynthesis of heparan sulfate. 
E) MHE involves a defect in fibroblast growth factor. 

 

25. Which of the following best predicts the risk of nonaccidental injury in young children who sustain a fracture of the femur:

A) The fracture pattern
B) The location of the fracture
C) The socioeconomic status of the family
D) Whether the child was previously able to walk
E) Coexistence of other disabilities

 

24. A patient with L4 level myelomeningocele has developed a full-thickness pressure sore on the heel that has a central necrosis and is draining. While undergoing debridement in the local emergency department, the patient develops labored respiration and a nondetectable blood pressure. 

The most likely cause is:

A) Latex allergy
B) Aortic dissection 
C) Septic shock
D) Spontaneous tension pneumothorax 
E) Shunt failure

 

23. A 12-year-old boy with achondroplasia has a gradual 40° thoracolumbar kyphosis. He is unable to walk more than two blocks. Magnetic resonance imaging reveals spinal stenosis, and the patient is scheduled to undergo posterior decompression from T12-S1. 

In addition to this procedure, you recommend:

A) Observation with serial radiographs every 4 months 
B) Postoperative brace for 6 months
C) In situ fusion with bone graft 
D) Posterior fusion across the kyphosis with instrumentation
E) Anterior corpectomy and fusion of T12

 

22. Which of the following conditions is not associated with an increased risk of congenital vertical talus?

A) Cerebral palsy
B) Myelomeningocele
C) Arthrogryposis
D) Nail patella syndrome
E) Larsen syndrome 

 

21. Pleiotropy is demonstrated by which of the following examples:

A) Patients with osteogenesis imperfecta differ in the number of fractures they have received
B) Patients with hemophilia A have different target joints
C) Hurler syndrome is usually not present in prior generations of an affected patient
D) Some patients with Marfan syndrome have scoliosis or pectus carinatum, while others with Marfan syndrome do not
E) Patients with Ollier disease often have more involvement on one side of the body

 

20. Morquio syndrome is caused by a deficiency in:

A) Alpha-L-iduronidase
B) Galactose-6-sulfatase
C) Beta-glucuronidase
D) Fibroblast growth factor receptor protein
E) Sulfate transport protein

 

19. A 12-year-old girl is referred because of a positive school scoliosis screen. She has a curve of 16° from T5 to T12, convex to the right. She also complains of mild back pain over the region of the curve several times per week. Neurologic examination is normal. 

Recommended treatment includes:

A) Magnetic resonance imaging
B) Technetium bone scintigraphy with SPECT
C) Treatment with a thoracolumbosacral orthosis
D) Computed tomography of the thoracic spine 
E) Home exercises and re-examination in follow-up

 

18. Which of the following is a true statement regarding the results of surgery for a contracted joint in arthrogryposis:

A) The joint range of motion can easily be doubled.
B) The joint cannot be changed. 
C) The beginning and end of the range may change, but the total amount of motion remains about the same. 
D) The joint usually becomes stiffer. 
E) There is not an indication for such surgery. 

 

17. A 6-year-old girl with osteogenesis imperfecta has severe bowing of both femurs. The family is interested in surgery to correct the condition. 

This method will give her the longest interval between procedures in the future:

A) Closed osteoclasis and cast application
B) Multiple osteotomies and realignment over a single smooth rod
C) Multiple osteotomies and realignment over parallel rods 
D) Multiple osteotomies and realignment over telescoping rods
E) Excision of the abnormal bone and replacement with allograft

 

16. Prior to treatment, which pathologic finding characterizes clubfoot:

A) The talar head and neck are deviated medially
B) The dome of the talus is flattened
C) The navicular is positioned more laterally than normal
D) The foot has a rocker deformity
E) The tendoachilles inserts in a more lateral position than normal

 

15. A 15-year-old basketball player has mild scoliosis, pes planus, pectus carinatum, and long slender fingers. 

In order to determine if he has Marfan syndrome and should be allowed to continue playing basketball, it is most useful to order a:

A) Cardiac echo 
B) Magnetic resonance image of the lumbosacral spine 
C) Slit lamp examination
D) Chest radiograph
E) Dermal fibroblast assay 

14. Which ancillary test is not helpful in the diagnosis of Charcot-Marie-Tooth disease (CMT):

A) Electromyography (EMG)
B) Nerve conduction velocity (NCV)
C) Nerve biopsy
D) Muscle biopsy
E) Muscle enzymes

13. A 7-year-old boy presents with bilateral high arches. His parents report that they are having difficulty finding shoes that comfortably fit him. The patient denies any foot pain. The father had similar problems with his feet and was diagnosed with a “mild” neurologic condition. 

On exam, the child has bilateral pes cavus with a supple hindfoot. 

Treatment of the feet at this time should consist of:

A) Soft tissue procedures alone
B) Soft tissue procedures and calcaneal osteotomy
C) Triple arthrodesis 
D) Bracing 
E) Observation

12. Following tibial eminence fractures in skeletally-immature patients, all of the following sequelae have been described except:

A) Residual anterior cruciate ligament laxity
B) Lengthening of the tibial spine
C) Loss of knee flexion
D) Hypertrophy of the tibial spine
E) Loss of terminal knee extension

 

10. A genetic mutation accounts for the manifestations of achondroplasia. 

Which of the following proteins has a genetic mutation that has been linked to achondroplasia?

A) Fibroblast growth factor (FGF) receptor 3
B) Type I collagen 
C) Fibrillin 
D) Type II collagen 
E) Cartilage oligomeric matrix protein (COMP) 

 

9. 13y old boy injured his knee playing basketball and is now unable to bear weight. 

Examination reveals tenderness and swelling at the proximal anterior tibia, with a normal neurologic examination. 

AP and lateral radiographs are shown in figures attached. 

Management should consist of

A) MRI
B) a long leg cast
C) fasciotomy of the anterior compartment
D) open reduction and internal fixation
E) patellar advancement

 

8. A 6y old child sustained a closed nondisplaced proximal tibial metaphyseal fracture 1 year ago. 

She was treated with a long leg cast with a varus mould, and the fracture healed uneventfully. 

She now has a 15° valgus deformity. 

What is the next step in management?

A) Proximal tibial/fibular osteotomy with acute correction and pin fixation
B) Proximal tibial/fibular osteotomy with gradual correction and external fixation
C) MRI of the proximal tibial physis
D) Medial proximal tibial hemiepiphysiodesis
E) Continued observation

 

7. A 9y old child sustains a proximal tibial physeal fracture with a hyperextension mechanism. 

What structure is at most risk for serious injury?

A) Tibial nerve
B) Popliteal artery
C) Common peroneal nerve
D) Posterior cruciate ligament
E) Popliteus muscle

 

6. In obstetric Brachial plexus injury, return of which of the following by 3 months is considered an indicator of plexus recovery:

A) Biceps
B)  Brachioradialis
C) Triceps
D) Latissimus
E) Brachialis 

 

5. An 18 month old boy is brought with clawing deformity of his right hand. The parent’s informed that he was born full term after a difficult delivery by shoulder dystocia. The patient had right clavicle fracture. 

A week later the parents noticed the child did not flex the fingers of his right hand. 

After 2 years the child is brought to you. On Examination, his right hand has extension at all the metacarpophalangeal joint  of the fingers while his PIP and DIP joints are flexed. His thumb is adducted and is difficult to passively bring it to full abduction. There is obvious wasting of the hand and Forearm. The child is able to move the arm well with no abnormalities of the shoulder, elbow and wrist. There is no evidence of horner’s syndrome, diaphragmatic palsy and absent grasp reflex. 

The diagnosis of the boy’s condition is:

A) Erb’s Palsy
B) Cerebrovascular Accident
C) Klumpke’s palsy
D) Ulnar and Median combined nerve injury
E) Pseudoparalysis

 

4. The ACL is mostly deficient in which of the following abnormalities:

A) Achondroplasia
B) Proximal Femoral Focal Deficiency
C) Congenital Radial Head Dislocation
D) Apert Syndrome
E) Cleidocranial dyslexia

 

3. Which is most important function that needs to be restored in Brachial plexus injury?

A) Shoulder Abduction
B) Elbow Flexion
C) Shoulder Elevation
D) Wrist Extension
E) Wrist Flexion

 

2.  A 15 year old boy presents with increasing foot deformity. The boy was diagnosed with cavovarus deformity associated with Charcot Marie Tooth Disease. 

Coleman block test reveals Correctable Hindfoot deformity and Achilles reflex is diminished bilaterally. 

Which procedure is associated with improved clinical outcome in patients with the above described condition?

A) Triple athrodesis
B) Split Tibialis Anterior Transfer to Lateral column
C) Transfer of peroneus brevis to peroneus longus
D) Lateral column lengthening calcaneal osteotomy
E) Posterior tibial tendon transfer through the interosseous membrane to dorsum of the foot

 

1. A 18 year old male patient presented with progressive foot deformity for one year. Has pain along the lateral border of the foot while walking. 

His father had similar problems with both feet throughout his life. 

On examination his foot showed cavo-varus deformity. 

Proper management includes evaluating for?

A) Cervical Stenosis
B) Acetabular Dysplasia
C) Uveitis
D) Hypoplastic thumb
E) Thrombocytopenia

 

5. Which of the following conditions is represented by this radiograph :

(A) Developmental dysplasia of the hip
(B) Juvenile rheumatoid arthritis
(C) Hemophilic arthropathy
(D) Legg-Calvé-Perthes disease
(E) Rickets

 

4. The lesion indicated in this computed tomography most likely represents:

(A) Brodie’s abscess
(B) Eosinophilic granuloma
(C) Osteosarcoma
(D) Osteoid osteoma
(E) Osteoma

 

3. The mother of a 4-month-old boy brings him to a physician to be evaluated for a swollen leg . 

The most likely diagnosis is:

(A) Rickets
(B) Osteogenesis imperfecta (OI)
(C) Scurvy
(D) Nonaccidental injury
(E) Caffey’s disease

 

2. Which of the following conditions is least commonly seen in patients with congenital dislocation of the patella:

Congenital Dislocation of Patella - Pediatrics - Orthobullets

A) Fibrosis of the vastus lateralis 
B) Contracture of the iliotibial band
C) Hypoplasia of the vastus medialis
D) Enlarged patella 
E) Flexion contracture 

 

1. 13y old boy injured his knee playing basketball and is now unable to bear weight. 

Examination reveals tenderness and swelling at the proximal anterior tibia, with a normal neurologic examination. 

AP and lateral radiographs are shown in figures attached. 

Management should consist of:

A) MRI
B) Long leg cast
C) Fasciotomy of the anterior compartment
D) Open reduction and internal fixation
E) Patellar advancement

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