Multiple Choice Questions
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60. Comparing manual traction and finger trap traction in reducing distal radius fracture
A) Manual traction may better correct dorsal tilt
B) Finger traction may better restore ulnar height
C) There is lower incidence of CRPS with finger trap traction
D) There is higher incidence of carpal tunnel syndrome with finger trap traction
E) Manual pain cause less pain during reduction than finger trap reduction
59. What percentage of women with osteoporotic fractures develop kyphosis:
58. An 18-year-old man presents to the emergency department after sustaining a high-velocity gunshot wound to the umbilical region of the abdomen.
An exit wound is found at the L3-L5 region of the lower back. Neurological examination shows grade 0/5 strength in his tibialis anterior muscles, gastrocnemius/soleus muscles, and extensor hallucis longus muscles bilaterally. His quadriceps and hamstrings strength is grade 2/5 bilaterally.
A bullet fragment was seen at L4 within the spinal canal on computed tomography (CT) imaging. The patient sustained significant gastrointestinal trauma as a result of the bullet traversing his body.
Management should consist of:
A) Administration of a broad-spectrum antibiotic for 14 days
B) Removal of the bullet fragment at L4
C) Continued serial neurologic examinations
D) Intravenous administration of dexamethasone for 24 hours
E) A, B, and C
57. Which of the following statements regarding lesions of the spinal cord caused by bullet wounds is true:
A) Twenty-five percent of patients with complete lesions recover one motor level after 1 year
B) Thirty-three percent of patients with incomplete lesions usually have a partial or complete recovery after 1 year
C) Complete lesions occur in more than 50% of all gunshot wounds to the spine
D) 75% of patients in whom the bullet has passed through the spinal canal will experience a complete lesion
E) All of the above
56. 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
55. A type 3 traumatic spondylolisthesis of the axis, as classified by Levine and Edwards, is best treated with which of the following:
A) Soft collar immobilization
B) Hard Philadelphia cervical orthosis
C) Halo vest immobilization
D) Open reduction and operative posterior stabilization
E) Gardner-Wells tongs application and awake reduction, then posterior stabilization
54. What are the main findings of medial tibial stress syndrome on a bone scan?
A) Delayed uptake of tracer and nonfocal uptake over the posteromedial tibial border
B) Lack of uptake of tracer in all phases
C) Focal uptake of tracer in early phase only
D) Focal uptake of tracer in delayed phases
E) Nonspecific uptake of tracer in all phases
53. Which best describes a type IIA distal clavicle fracture?
A) The fracture is lateral to the coracoclavicular ligaments
B) The fracture involves intra-articular injury of the acromioclavicular joint
C) The fracture line is between the conoid and trapezoid ligaments
D) The fracture is medial to the coracoclavicular ligaments
E) The fracture involves comminuted distal clavicle fracture