MCQ: bone and t tissue

Multiple Choice

An 8-year-old boy with a known history of sickle cell disease presents with pain and

swelling of the right foot. Physical examination reveals swelling of the right foot. X-ray

shows soft tissue swelling, loss or blurring of fat planes, and joint effusion. Which of the

following is the most common pathogen responsible for this condition?

• Escherichia coli

• Salmonella spp.

• Enterococci spp.

• Staphylococcus aureus

• Streptococcus pneumoniae

Multiple Choice

A 30-year-old man fell from a height, presenting with acute-onset paraparesis. On exam:

decreased anal sphincter tone, sensory loss over the perineum, decreased lower extremity

reflexes, and sciatica. X-ray: burst fracture at L3. Diagnosis?

• Central cord syndrome

• Anterior cord syndrome

• Cauda equina syndrome

• Brown-Séquard syndrome

• Complete cord syndrome

Multiple Choice

A young adult presents after a fall on an outstretched hand. Examination reveals marked

tenderness in the anatomical snuffbox. X-ray is inconclusive, but clinical suspicion of

scaphoid fracture is high. Which immobilization method is most appropriate for this

patient?

• Short arm cast

• Long arm cast

• Ulnar gutter splint

• Long arm thumb spica cast

• Volar splint

Multiple Choice

A 25-year-old man accidentally hit his finger with a hammer. Examination reveals a painful

subungual hematoma occupying >50% of the nail surface, nail bed intact. X-ray shows

no distal phalanx fracture. What is the most appropriate management?

• Complete nail removal

• Trephination of the nail

• Oral antibiotics and observation

• Splinting only

• Nail bed excision and repair

Multiple Choice

A 60-year-old man presents with several days of neck pain radiating to the right scapular

region and arm. Today he develops progressive weakness of the right arm. On examination:

decreased deep tendon reflexes of the right biceps and brachioradialis, diminished pinprick

sensation over the lateral right forearm and right thumb, MRI reveals a cervical herniated

disc. Which cervical nerve root is most likely affected?

• C4

• C5

• C6

• C7

• C8

Multiple Choice

A 35-year-old man injured his left knee in a motorcycle accident. His knee is swollen, and

he cannot fully extend or flex it. The McMurray test of his left knee is positive. X-ray

findings are normal. The range of motion (ROM), although restricted, is stable to varus and

valgus stress. Which is the most likely type of injury?

• Tibial tuberosity

• Medial meniscus

• Anterior cruciate ligament

• Posterior cruciate ligament

• Transverse genicular ligament

Multiple Choice

A 50-year-old man presents with acute pain and swelling of his right ankle for 1 day.

Examination shows monoarticular arthritis. Joint aspiration reveals needle-shaped crystals

under polarized light microscopy. Laboratory values: plasma glucose 80 mg/dL, BUN 10 mg/

dL, creatinine 1.0 mg/dL, uric acid 11.0 mg/dL. Which of the following is the most

appropriate treatment in this case of acute gouty arthritis?

• Allopurinol 300 mg orally

• Indomethacin orally

• Systemic corticosteroid

• Intraarticular corticosteroid

• Narcotic analgesic orally

Multiple Choice

A 25-year-old man presents with pain and swelling of the second finger of his right hand.

He has no history of trauma, but has a history of alcohol abuse, smoking, and is sexually

active. Physical examination: Symmetric finger swelling, Flexed posture of the finger,

Tenderness on percussion, Intense pain with passive motion. Which of the following

organisms is this patient most at risk for contracting?

• Staphylococcus aureus

• Neisseria gonorrhoeae

• Streptococcus species

• Herpes simplex virus

• Candida albicans

Multiple Choice

A 20-year-old college football player presents to the ED with leg pain and inability to stand

on tiptoes. Examination: Squeezing the calf of the prone patient with the knee flexed at

90°, the foot does not plantar flex. This patient’s injury is most consistent with which of

the following?

• Rupture of the posterior cruciate ligament

• Rupture of flexor hallucis longus

• Rupture of the Achilles tendon

• Rupture of anterior tibialis tendon

• Rupture of posterior tibialis tendon

Multiple Choice

A 30-year-old man is stabbed in the arm. There is no evidence of vascular injury, but he

cannot flex his three radial digits. Which of the following structures is injured?

• Ulnar nerve

• Radial nerve

• Median nerve

• Thenar and digital nerves at the wrist

• Flexor pollicis longus and flexor digitorum medius tendons