ORTHO NL part2 2025

A term newborn experience left shoulder dystocia during vaginal delivery. PE. Left arm flaccid (motor 0/5), absent moro reflex on the left, but intact grasp reflex. No bruising or deformities. What is the most appropriate initial investigation?

• Nerve conduction velocity

• MRI C spine

• Film C-spine

• Film left humerus & clavicle

A 50 year old woman present with acute left knee pain, swelling, erythema for 4 days. PE. BT38.5c, swollen knee with effusion &warm, positive ballotment test. Lab WBC15000/mm3 88% neutrophil. No prior trauma/arthritis.

What is the most appropriate initial management?

• Diclofenac

• Colchicine

• Empirical antibiotic

• Knee arthrocentesis

A 28 year old male has 1 week of low back pain radiating to both legs with  numbness. PE. Motor power 5/5, sensory loss at L5/S1, reduced anal sphincter tone. What is the most likely diagnosis?

• Guillain-Barre syndrome

• Transverse myelitis

• Spinal stenosis

• Cauda equina syndrome

A 7 year old boy underwent close reduction and cast application for left supracondylar humeral fracture 8 hours ago. He now report paresthesia in his left fingers. Distal pulse are palpable. What is the most appropriate initial action ?

• Fasciotomy

• Elevate left arm

• Spit cast and padding

• Morphine IV

A 70 year old female present with Rt. Knee pain 2 years, she has morning stiffness. PE: crepitus and ballottement positive Rt. knee with no inflammation.

What is the diagnosis ?

• Pseudogout

• Gout

• OA

• Rheumatoid arthritis

Male 30 year car accident 4 hour ago present with severe pain at left leg.

PE: BP130/90mmHg, PR90/min, no open wound, tense and contusion along left leg, no deformity, dorsals pedis 2+, but numbness at 1st web space of foot and

severe pain after plantar flexion.

What is the etiology of numbness ?

• Nerve injury

• Compartment syndrome

• Artery injury

• Spinal injury

A 30 year old has refer to ER due to traffic injury. V/S BP normal, PR90/min, RR18/min, laceration wound 3 cm at left shin,

open wound minimal contamination, expose fragmented bone, nerve good.

What is the appropriate antimicrobial treatment ?

• cefazolin

• penicilin

• ceftriaxone

• gentamicin