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1 / 100

Which of the following muscles would be affected if a 6-month-old child sustains a birth-related brachial plexopathy affecting C5 nerve root?

2 / 100

What is the most appropriate treatment for a 65-year-old female with a 100-pack year tobacco history who presents with a new painful lytic lesion in her femoral diaphysis?

3 / 100

First treatment priority in patient with multiple injuries is:

4 / 100

A 13-year-old boy is diagnosed with osteosarcoma of his distal femur. The treating surgeon samples the bone marrow from the resection margin of the femur during definitive limb salvage surgery and finds microscopic evidence of tumor. Assuming no change in the resection level, what type of resection would this be considered?

5 / 100

A 4-year-old boy with Klippel-Feil syndrome has elevation of the left scapula since birth. Spine radiographs shows no evidence of scoliosis. What shoulder motion is likely to be most limited?

6 / 100

All of the following can be found on the Electromyography (EMG) portion of an electrodiagnostic study during the evaluation of a patient with carpal tunnel syndrome EXCEPT:

7 / 100

Acute Haematogenous Osteomyelitis affects which zone of the growth plate?

8 / 100

During lumbar decompression at L4/5, which of the following decompression techniques will destabilize the spine and require a L4/5 fusion.

9 / 100

An 8-year-old boy complains of left shoulder pain after a collision with his younger brother. He was asymptomatic prior to the incident. Which of the following treatments is most appropriate at this time?

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10 / 100

What are the two most common lesions seen in abused children?

11 / 100

A 48-year-old male is involved in a motorycycle accident and arrives in the trauma bay in hypovolemic shock. He receives 6 units of packed red blood cells during his resuscitation. Which of the following viral microbes is he most at risk of exposure from the transfusions?

12 / 100

What percentage of patients with a spinal cord injury suffer from Major Depressive Disorder?

13 / 100

A 14-year-old male patient with a leg-length discrepancy undergoes a distal femoral and proximal tibial epiphysiodesis on the longer leg. What is the anticipated amount of correction achieved with this procedure in this child?

14 / 100

What is the most common presenting sign of child abuse?

15 / 100

A 14-year-old boy has complete growth arrest of his left proximal tibia after a skateboarding injury. He currently has a 3mm leg-length discrepancy with left shorter than the right. A radiograph of the patients left hand, wrist, and fingers demonstrate a bone-age of 14 years. What is the most appropriate management of this patient?

16 / 100

What structure provides dynamic glenohumeral stability by compressing the humeral head against the glenoid?

17 / 100

While recent studies have failed to demonstrate a significant clinical difference, proximal biceps tenodesis compared to tenotomy is felt to possibly result in a lower incidence of which of the following?

18 / 100

What is a potential complication of an amputation at the level of the distal interphalangeal joint?

19 / 100

All of the following are predisposing factors for lateral patellar dislocation in a native knee EXCEPT?

20 / 100

According to the recommendations made by the AAOS in their clinical guidelines for the treatment of osteoarthritis (OA) of the knee, all of the following nonoperative modalities are supported by the literature EXCEPT:

21 / 100

A mutation in a G(s) alpha protein (activating G protein that increases cAMP) results in which of the following diseases?

22 / 100

A 22-year-old female with hereditary osteochondromas has difficulty supinating and pronating her forearm. Radiographs are shown in Figure A. Which of the following procedures would most effectively improve forearm rotation in this patient?

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23 / 100

A 41-year-old male has steroid-induced avascular necrosis of the hip and decides to undergo metal on polyethylene total hip arthroplasty. His 80-year-old, sedentary father had a total hip replacement 5 years ago. With comparison to his father, the patient should be informed of the following risk?

24 / 100

Which of the following is the best way to preserve amputated part for replantation:

25 / 100

Myelography is necessary in following conditions:

26 / 100

In adult patients with scoliosis, severity of symptoms correlates with which of the following variables?

27 / 100

A 44-year-old man presents with ulnar-sided right wrist pain and mild constant tingling in the fourth and fifth digits after injuring his wrist while playing golf. Although pain and function have improved with conservative treatment 6 months following the injury, he still reports difficulty with his golf game. Which of the following should initially be obtained in this patient to aide in the diagnosis?

28 / 100

A patient sustains a comminuted calcaneus fracture. Three months after the injury the patient complains of shoewear problems secondary to clawing of the lesser toes. What is the most likely explanation for this deformity?

29 / 100

A 45-year-old woman is scheduled to undergo a TKA. Which of the following implant designs theoretically reduces poylethylene wear and reduces boneimplant-interface stress?

30 / 100

Arthroscopic subacromial decompression with acromioplasty has been shown to yield lower subjective satisfaction scores in patients with which of the following preoperative factors?

31 / 100

Bleeding tendency is least likely in which one of the following conditions?

32 / 100

Failure to achieve reduction of a dislocated hip in an otherwise healthy 6 month old infant following 4 weeks in a Pavlik harness with the hips flexed to 90 degrees and abduction of 50 degrees is best treated with which of the following?

33 / 100

During total knee arthroplasty, an excessive posterior femoral resection will lead to which of the following scenarios?

34 / 100

All of the following are acceptable indications for use of a constrained acetabular component EXCEPT:

35 / 100

An 8-day-old infant is admitted back to the hospital for septic arthritis of the hip. Which of the following will most likely be the causative organism by culture?

36 / 100

All of the following are possible sites of compression for the ulnar nerve EXCEPT:

37 / 100

Which of the following is the most common cause of early revision surgery (<20 weeks) following a hip resurfacing arthroplasty?

38 / 100

Flexor tendons of the fingers within Zone 2 receive their primary nutritional supply from:

39 / 100

Which of the following treatments of an oligotrophic supracondylar femoral nonunion has been shown to have the best outcome?

40 / 100

A 3-year-old boy was referred to you for evaluation of a bowing deformity of his leg and a persistent limp. Radiograph is shown. What is the most likely diagnosis?

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41 / 100

Growth at the distal humerus physis accounts for what percentage of humeral length?

42 / 100

What is the second most common presenting sign of child abuse?

43 / 100

A 6-month-old boy is brought to the emergency department by his mother because he has been irritable for the last week. Initially the mother reports no history of trauma, but later she says that he may have fallen from a changing table. Radiographs of the knee demonstrate metaphyseal corner lesions of the distal femur and proximal tibia. White blood cell count and erythrocyte sedimentation rate values are normal. What is the most appropriate next step in treatment?

44 / 100

When comparing in situ decompression with intramuscular transposition of ulnar nerve for compressive neuropathy which of the following statements is most correct?

45 / 100

Which of the following components of the clubfoot deformity should be addressed first when using the Ponseti method?

46 / 100

What is the appropriate treatment for a 10-year-old boy with Ewing’s sarcoma isolated to the proximal femur?

47 / 100

Atlantoaxial instability due to hypoplasia of the odontoid is most commonly seen in which type of mucopolysaccharidosis?

48 / 100

Which of the following most accurately lists the most common location of osteosarcoma in decreasing frequency?

49 / 100

In wound healing, inflammation is triggered by

50 / 100

In biomechanical testing, which of the following tissues has the highest maximum load to failure?

51 / 100

All of the following have been recognized as risk factors for nonunion or delayed union following subtalar arthrodesis EXCEPT:

52 / 100

You are preparing to cast a child with a both-bone forearm fracture in the emergency room. During cast application, all of the following are directly related to the risk of thermal injury except?

53 / 100

Rotator cuff tears (full thickness and partial thickness) in asymptomatic individuals are seen on MRI or ultrasound in what percentage of patients over the age of 60?

54 / 100

Which of the following mechanisms of injury to the ankle is most likely to result in peroneal tendon instability?

55 / 100

A 45-year-old carpenter reports pain and restricted dorsiflexion of the great toe. An x-ray reveals mild osteoarthritis of the first metatarsophalangeal joint and a prominent dorsal osteophyte. Orthotics have failed to provide relief. What is the most appropriate intervention at this time?

56 / 100

Which of the following statements regarding the use of continuous passive motion (CPM) devices following total knee arthroplasty is true?

57 / 100

What is the preferred treatment for a symptomatic acute acromioclavicular separation where there is a 20% increase in the coracoclavicular distance on AP radiograph compared to the opposite uninjured side?

58 / 100

A reduction in plasma sodium ion concentration will result in an increase in production and release of?

59 / 100

A 2-year-old child falls down a flight of stairs and is found to have spinal cord injury without radiographic abnormality (SCIWORA). What is the most important predictor of her neurologic outcome?

60 / 100

A 14-year-old boy sustains a significant distal femoral physeal fracture. Assuming that he has a complete growth arrest, what is the predicted leg length discrepency?

61 / 100

A 42-year-old sustains a left finger injury while attempting to catch a baseball for his son. He presents with left, long finger pain and an inability to extend his middle finger at the distal interphalangeal joint. A radiograph after closed reduction and splinting is shown in Figure A. What is the best course of treatment?

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62 / 100

You are taking care of an adult patient with significant scar contracture in her first web space after a thermal burn. Which of the following techniques will allow you to lengthen her scar approximately 75%?

63 / 100

A 67 year-old woman sustained an ACL tear while playing basketball when she was 35 years-old. She has noted progressive leg deformity and episodes of giving way, and now has pain preventing activity. Non-operative management has failed to provide relief. Treatment should consist of?
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64 / 100

An 11-year-old female sustains a open right femoral shaft fracture and closed left both-bone forearm fracture after being struck by a motor vehicle. She is 5’1” and weighs 146 lbs. No neurovascular deficits are noted in any of her extremities. Which of the following is a contraindication to elastic intramedullary nail fixation of her femur fracture?

65 / 100

In patients with ipsilateral femoral neck and shaft fractures, what percent of femoral neck fractures are diagnosed on a delayed basis?

66 / 100

Metastatic bony lesions that occur distal to the elbows or knees are most likely to originate from which one of the following primary organs?

67 / 100

During total knee replacement with the trial components in place, the knee acheives full extension but experiences tightness in flexion with a range to only 90 degrees. What is the most appropriate action?

68 / 100

Which of the following is true regarding closure of the rotator interval in patients undergoing arthroscopic shoulder stabilization?

69 / 100

Which of the following treatment options does not have Grade A recommendations supporting its utilization by the American Academy of Orthopaedic Surgeons (AAOS) Guidelines for Treatment of Knee Arthritis (OA)?

70 / 100

During anterior cruciate ligament reconstruction, a graft that is tight in flexion but lax in extension may be due to which technical error?

71 / 100

Which of the following is true regarding the conversion of hip arthrodesis to total hip arthroplasty?

72 / 100

All of the following injuries are highly suggestive of child abuse EXCEPT:

73 / 100

Which of the following statements regarding osteoporosis is true?

74 / 100

In an uninjured proximal tibia which statement best describes the shape and position of the medial tibial plateau relative to the lateral tibial plateau?

75 / 100

A high school softball player has chronic activity-related anterior knee pain without a history of instability. Which radiographic measurement is used to indicate when a lateral retinacular release may be helpful?

76 / 100

During fracture healing, differentiation of the progenitor cells depends on local oxygen tension and strain. Based on this theory, the following promotes formation of woven bone during fracture healing:

77 / 100

In relation to the femoral insertion of the popliteus, the femoral attachment of the lateral collateral ligament is

78 / 100

All of the following are necessary steps in metastasis of a malignant cell EXCEPT?

79 / 100

Osteoprotegrin (OPG) binds to what structure to inhibit particle-induced osteolysis?

80 / 100

Which of the following is true regarding rigid locking plate constructs in fracture fixation?

81 / 100

Chronic injury to what anatomic structure can lead to a boutonneire deformity of the finger?

82 / 100

Repair of a nailbed injury with 2-octylcyanoacrylate (Dermabond) provides what distinct advantage over standard suture repair?

83 / 100

Which of the following structures is the primary site of force transfer between the hindfoot and forefoot during the stance phase of gait?

84 / 100

A 59-year-old female presents with a metastatic spinal tumor and has a lytic lesion in the T12 vertebral body. The process of bone resorption in her lytic lesion is mediated by :

85 / 100

Tyrosine kinase inhibitors are currently used in the medical treatment of which of the following?

86 / 100

Increased ACL injury rates in women athletes compared to male athletes may be due to muscular imbalance and relative weakness in which of the following muscle groups?

87 / 100

Resection of the coracoacromial ligament during shoulder arthroscopy results in which of the following?

88 / 100

All of the following features of metal-on-metal total hip arthroplasty allows for improved fluid film lubrication between the components EXCEPT:

89 / 100

Internal rotation of the femoral component during total knee arthroplasty can result in which of the following?

90 / 100

A 45-year-old male falls off his motorcycle and injures his arm. AP and lateral radiographs reveal an ulnar shaft fracture, 30 degrees apex anterior, and a radial head dislocation. Which direction is the radial head most likely dislocated?

91 / 100

All of the following techniques can help to prevent apex-anterior angulation during intramedullary nailing of proximal one-third tibia fractures EXCEPT:

92 / 100

Which of the following concepts regarding pediatric hips is true?

93 / 100

A 24-year-old female sprains her ankle playing tennis. After 3 months of bracing, physical therapy, and NSAID treatment she continues to complain of pain and a popping sensation over the lateral ankle. Physical exam is notable for tenderness over the lateral malleolus. Figure A shows the ankle at rest. Figure B shows the ankle during active eversion. Which of the following structures has been injured?

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94 / 100

Hypercalcaemia may present with all of the following clinical signs EXCEPT:

95 / 100

Anterior perforation of the distal femur from antegrade femoral nailing has been attributed to what factor?

96 / 100

A 65-year-old male presents with a painful right total knee arthroplasty, which was performed ten years ago. CRP is 15 mg/L. Knee aspiration reveals 2,100 WBC’s with 78% PMN’s. Which of the following is the best management option?

97 / 100

In the adult spine, which of the following pedicles have the smallest average transverse diameter.

98 / 100

Which of the following is most serious complication of myelography:

99 / 100

Which of the following is a characteristic change in cartilage involved in moderate osteoarthritis?

100 / 100

When utilizing the pectoralis major tendon as a reference for restoring humeral height during shoulder hemiarthroplasty, at what level cephalad to the proximal edge of the tendon should the top of the prosthesis sit?

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