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9-24-25 CorePendium Board Review

Total questions: 15

Worksheet time: 8mins

Name
Class
Date
1.

A 25-year-old male presents after a fall while playing basketball. His right arm is held in slight abduction and external rotation. On exam, sensation is decreased over the lateral shoulder. Which of the following is the most likely diagnosis?

a)

Anterior shoulder dislocation with axillary nerve injury

b)

Posterior shoulder dislocation with radial nerve injury

c)

Clavicle fracture with brachial plexus injury

d)

Inferior shoulder dislocation with ulnar nerve injury

2.

A 40-year-old woman presents with shoulder pain after a seizure. Her arm is held in adduction and internal rotation. X-ray shows a “lightbulb sign.” What is the best next step in diagnosis?

a)

Obtain scapular Y or axillary view radiographs

b)

Perform MRI to evaluate rotator cuff injury

c)

Attempt immediate reduction without further imaging

d)

Order CT angiography of the shoulder

3.

Which of the following patients with a shoulder dislocation requires urgent orthopedic consultation before ED reduction?

a)

22-year-old male with anterior dislocation and intact neurovascular exam

b)

65-year-old female with anterior dislocation and associated humeral neck fracture

c)

30-year-old male with recurrent dislocation and Hill-Sachs lesion

d)

18-year-old female with anterior dislocation and Bankart lesion

4.

A 50-year-old man presents after a fall from a ladder. His arm is locked overhead in abduction with the forearm pronated. X-ray shows the humeral head inferior to the glenoid. What complication is most common in this injury pattern?

a)

Radial nerve palsy

b)

Axillary nerve injury

c)

Subclavian artery rupture

d)

Rotator cuff tear

5.

A 19-year-old athlete presents after a first-time anterior shoulder dislocation. Reduction is successful in the ED. Which management strategy best reduces recurrence risk?

a)

Sling immobilization for 4 weeks in internal rotation

b)

Sling immobilization for 1 week in external rotation

c)

Immediate physical therapy and return to play in 2 weeks

d)

Early orthopedic referral for discussion of surgical stabilization

6.

A 22-year-old male is brought in after a bicycle crash. He has pain and swelling over the midshaft of the clavicle. X-ray shows a midshaft clavicle fracture with >2 cm of shortening and 100% displacement. What is the best management?

a)

Figure-of-eight dressing for 6 weeks

b)

Sling immobilization and routine follow-up

c)

Orthopedic referral for surgical fixation

d)

Early physical therapy and ROM exercises

7.

A 35-year-old football player presents with shoulder pain after a direct blow during a tackle. Exam shows tenderness over the AC joint and a visible step-off deformity. X-ray demonstrates the distal clavicle elevated above the superior border of the acromion but less than twice the normal coracoclavicular distance. Which Rockwood type is this?

a)

Type II

b)

Type III

c)

Type IV

d)

Type V

8.

A 70-year-old woman falls on her outstretched hand and presents with shoulder pain. X-ray shows a displaced 3-part proximal humerus fracture. Which acute complication is she most at risk for?

a)

Axillary nerve injury

b)

Avascular necrosis of the humeral head

c)

Adhesive capsulitis (“frozen shoulder”)

d)

Glenohumeral instability

9.

A 42-year-old construction worker presents with lateral shoulder pain after lifting equipment. He cannot abduct his arm past 90°, but passive ROM is intact. Which diagnosis is most likely?

a)

Rotator cuff tear

b)

Adhesive capsulitis

c)

Shoulder impingement syndrome

d)

Acromioclavicular joint separation

10.

A 25-year-old baseball pitcher presents with vague deep shoulder pain and “clicking” during throwing. Exam is positive for O’Brien’s and Speed’s tests. Which injury is most likely?

a)

Rotator cuff tear

b)

Superior labrum anterior-to-posterior (SLAP) tear

c)

Shoulder impingement syndrome

d)

Acromioclavicular arthritis

11.

A 6-year-old boy presents after falling from a tree onto his outstretched arm. Exam shows elbow swelling, deformity, and decreased radial pulse. X-ray confirms a displaced supracondylar fracture. What is the next best step?

a)

Place in long-arm splint and arrange outpatient ortho follow-up

b)

Immediate closed reduction in the ED with orthopedic consultation

c)

Administer IV antibiotics and admit for delayed fixation

d)

Sling and swathe with repeat radiographs in 10–14 days

12.

A 3-year-old girl suddenly refuses to move her arm after being lifted by her hand while playing. She holds her arm slightly flexed and pronated, without swelling or deformity. What is the most appropriate next step?

a)

Obtain AP and lateral elbow X-rays

b)

Attempt reduction using hyperpronation technique

c)

Place in long-arm cast for 3 weeks

d)

Refer to orthopedics for operative repair

13.

A 7-year-old boy has forearm pain and swelling after a fall. X-ray shows an ulnar shaft fracture with anterior radial head dislocation. Which nerve injury is most likely?

a)

Radial nerve palsy

b)

Posterior interosseous nerve neurapraxia

c)

Median nerve entrapment

d)

Ulnar neuropathy

14.

An 8-year-old girl presents with shoulder pain after a fall. X-ray reveals a midshaft clavicle fracture with mild angulation. What is the appropriate management?

a)

Urgent orthopedic surgery

b)

Sling immobilization with outpatient follow-up

c)

Figure-of-eight brace with 8 weeks immobilization

d)

Admit for traction and inpatient monitoring

15.

A 5-year-old boy presents with elbow pain after falling on an outstretched hand. Lateral X-ray shows a posterior fat pad sign but no visible fracture line. What is the most appropriate management?

a)

Discharge without immobilization and advise return if pain persists

b)

Place in long-arm posterior splint and arrange repeat imaging in 10–14 days

c)

Immediate surgical exploration

d)

Begin early range-of-motion exercises