Exam (elaborations)
orthopaedics practice questions
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practice questions- systems based approach(ORTHO)
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Orthopedics1) A 17 year old male was skateboarding and 3) A 45 year old female is picking apples from
fell while attempting to jump a flight of a tree when she slips and falls from a
stairs. He lands with his upper arm against height of 14 feet, landing on her feet. Her
the edge of a step and hears a crack. At right ankle is very sore after the injury so
the hospital he is told that he has suffered she proceeds to the local emergency room.
a fracture of the left humeral shaft. What According to the Ottawa Ankle Rules, which
nerve and artery are at risk in this type of of the following would be an indication for
injury? x-ray imaging of the affected ankle?
a) Ulnar nerve and axial artery a) Inability to weight bear immediately after
b) Axial nerve and radial artery the injury
c) Median nerve and brachial artery b) Inability to weight bear immediately after
d) Radial nerve and brachial artery the injury and pain in the malleolar zone
e) Musculocutaneous nerve and axillary c) Pain in the malleolar zone and body
artery tenderness over the posterior aspect of
f) Posterior interosseous nerve and dorsal the lateral malleolus
scapular artery d) Bony tenderness over the posterior
aspect of the medial malleolus
e) Bruising over the anterior aspect of the
2) A 23 year old male is playing soccer on a medial malleolus
muddy field when he is tackled from the
side. He immediately grabs his lower right
leg and to his horror feels a bone 4) A 23 year old male is involved in a multiple
protruding through the skin. At the hospital vehicle collision during morning rush hour.
he is diagnosed with an open fracture of the After arriving to the hospital via ambulance
right tibia. Which of the following initial around noon, it is discovered that the
antibiotic regimens is appropriate: gentleman is suffering, among a variety of
a) Cefazolin for 24 hours other minor injuries, from an open fracture
b) Cefazolin for 48 hours of his left distal radius. Upon questioning, it
c) Cefazolin, gentamicin and penicillin for is revealed that this gentleman is quite
72 hours healthy and taking no medications. He
d) Cefazolin and gentamicin for 48 hours denies any allergies. On physical exam,
e) Gentamicin for 48 hours the open fracture is quite obvious, although
the laceration is <2cm. A neurovascular
exam is unremarkable for any worrisome
findings. At this point, the most important
step in management would be:
a) Immobilize in a cast and follow-up in 1
week to reassess healing
b) Proceed straight to the OR for an I and
D, followed by ORIF
c) Inquire about tetanus status and
respond accordingly
d) Administer antibiotics that target gram
negative and anaerobic bacteria
e) Inquire about tetanus, give antibiotics
and book the patient for an
intraoperative I and D, and possible
ORIF, to be done the following day
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