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  • Question 1 - A 56-year-old woman complains of back pain, muscle spasms, weakness, and a burning...

    Correct

    • A 56-year-old woman complains of back pain, muscle spasms, weakness, and a burning sensation that radiates from her left hip to her toes. What's the most likely diagnosis?

      Your Answer: Herniated nucleus pulposus

      Explanation:

      A herniated disk will produce sensory disturbances, causing pain that radiates along the course of the sciatic nerve which is typically burning or stabbing, with or without back pain. The herniation is usually caused by age-related degeneration although trauma, injuries, or straining may also trigger it.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      12.7
      Seconds

  • Question 2 - Which of the following statements is true of Colles’ fracture? ...

    Incorrect

    • Which of the following statements is true of Colles’ fracture?

      Your Answer: Results in palmar displacement of the distal fractured fragment

      Correct Answer: Is a cause of carpal tunnel syndrome

      Explanation:

      Colles’ fracture is a distal fracture of the radius that is a known cause of carpal tunnel syndrome (compression of the median nerve in the carpal tunnel). It rarely results in ulnar nerve compression. A Colles’ fracture is extra-articular and does not extend into the wrist joint, otherwise this would make it an intra-articular fracture (Barton’s fracture). The distal fragment in a Colles’ fracture is displaced dorsally, unlike in a Smith’s fracture where the distal fragment is displaced volarly (ventrally). Associated fracture of the ulnar styloid process may occur and is a common associated injury.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      23.3
      Seconds

  • Question 3 - A 60-year-old man complains of pain in his left thigh. An X-ray reveals...

    Correct

    • A 60-year-old man complains of pain in his left thigh. An X-ray reveals bowing of the affected femur, increased bone density, bony enlargement, abnormal bone architecture with coarse cortical trabeculations, and stress microfractures. Which is the most likely diagnosis in this case?

      Your Answer: Paget’s disease of bone

      Explanation:

      Paget’s disease of bone is a chronic disorder of the adult skeleton in which bone turnover is accelerated in localised areas, replacing normal matrix with softened and enlarged bone and causing gradual pain and deformity in some cases. It is more predominant in men over the age of 40. Characteristic X-ray findings include increased bone density, abnormal architecture with coarse cortical trabeculation or cortical thickening, bowing and bony enlargement; there might also be stress microfractures of the tibia or femur.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      20.7
      Seconds

  • Question 4 - A 13-year-old boy's mother notices he has a lump in his arm, near...

    Correct

    • A 13-year-old boy's mother notices he has a lump in his arm, near his right shoulder. An X-ray reveals a lateral projection in the metaphyseal region of his humerus. The lesion is removed and it is found to be composed of bony cortex, capped by cartilage. What's the most likely diagnosis in this case?

      Your Answer: Osteochondroma

      Explanation:

      Osteochondromas, or osteocartilaginous exostoses, are the most common benign bone tumours, and tend to appear near the ends of long bones. The overgrowth can occur in any bone where cartilage forms bone, and they are capped by cartilage. They are most common in people between the ages of 10-20 years old.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      17.5
      Seconds

  • Question 5 - A teenager presents with pain and swelling in a limb which increases after...

    Incorrect

    • A teenager presents with pain and swelling in a limb which increases after activity. X-rays reveal an expansible, eccentric, lytic lesion in the metaphysis distally in the affected bone surrounded by new bone. What is the most likely diagnosis?

      Your Answer: Osteosarcoma

      Correct Answer: Aneurysmal bone cyst

      Explanation:

      Aneurysmal bone cysts tend to develop in patients younger than 20 years old. They usually occur in the metaphyseal region of long bones, and are cystic lesions composed of numerous blood filled channels that grow slowly. In X-rays, they show up as circumscribed lesions, sometimes surrounded by new bone.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      21.9
      Seconds

  • Question 6 - An elderly, diabetic man has firm, tender nodules at the base of his...

    Incorrect

    • An elderly, diabetic man has firm, tender nodules at the base of his left middle and ring fingers, which he can't extend fully. What's the most likely diagnosis?

      Your Answer: Granulomatous inflammation

      Correct Answer: Fibromatosis

      Explanation:

      This case is suggestive of Dupuytren’s contracture due to palmar fibromatosis. Its incidence is higher in men over the age of 45 years, and it increases in patients with diabetes, alcoholism, or epilepsy. These nodules are benign, usually appearing as a tender nodule in the palm which becomes painless. The disease has an aggressive clinical behaviour and recurs frequently.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      37.5
      Seconds

  • Question 7 - If a patient takes long-term corticosteroid therapy, which of the following diseases is...

    Correct

    • If a patient takes long-term corticosteroid therapy, which of the following diseases is most likely to develop?

      Your Answer: Osteoporosis

      Explanation:

      One of the complications of long-term intake of corticosteroids is osteoporosis. Some guidelines recommend prophylactic calcium and vitamin D supplementation in patients who take more than 30 mg hydrocortisone or 7.5 mg of prednisolone daily.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      6.4
      Seconds

  • Question 8 - A 55-year-old woman complains of pain in the proximal and distal interphalangeal joins,...

    Correct

    • A 55-year-old woman complains of pain in the proximal and distal interphalangeal joins, and back pain which has increased over the last 4 years and worsens after activity. X-rays reveal Heberden’s and Bouchard’s nodes in her interphalangeal joints and the presence of osteophytes in her spine. What is the most likely diagnosis?

      Your Answer: Osteoarthritis

      Explanation:

      Osteoarthritis is most common in older adults, predominating in women between the ages of 40 and 70; after this age, men and women are affected equally. It affects an entire joint, with disruption and potential loss of joint cartilage, along with other joint changes, including bone hypertrophy (osteophyte formation). The pain is usually gradual and is worse after activity, with occasional joint swelling. X-ray findings include marginal osteophytes, narrowing of the joint space, increased density of the subchondral bone, subchondral cyst formation, bony remodelling and joint effusions.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      7.9
      Seconds

  • Question 9 - A 58-year-old woman presents with signs of inflammation in the first metatarsophalangeal joint:...

    Correct

    • A 58-year-old woman presents with signs of inflammation in the first metatarsophalangeal joint: redness, swelling and pain. The analysis of synovial fluid reveals needle-shaped, strongly negatively birefringent crystals. What's the most likely diagnosis in this case?

      Your Answer: Gout

      Explanation:

      Gout is a rheumatic disease caused by the precipitation of monosodium urate crystals into tissues, usually joints. This causes acute or chronic pain; the acute illness initially affects only one joint, often the first metatarsophalangeal joint. The diagnosis of the disease requires the identification of crystal in the synovial fluid. These crystals are needle-shaped and strongly negatively birefringent.

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      14.9
      Seconds

  • Question 10 - Which of these HLA alleles is most likely to be present in ankylosing...

    Incorrect

    • Which of these HLA alleles is most likely to be present in ankylosing spondylitis?

      Your Answer: HLA-B3

      Correct Answer: HLA-B27

      Explanation:

      Ankylosing spondylitis usually appears between the ages of 20-40 years old and is more frequent in men. It is strongly associated with HLA-B27, along with other spondyloarthropathies, which can be remembered through the mnemonic PAIR (Psoriasis, Ankylosing spondylitis, Inflammatory bowel disease, and Reactive arthritis).

    • This question is part of the following fields:

      • Orthopaedics
      • Pathology
      7.3
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Orthopaedics (6/10) 60%
Pathology (6/10) 60%
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