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Quiz on Orthopaedics
1. Each of the following are indications for microvascular replantation, EXCEPT –
(1) Thumb amputation
(2) Index finger amputation in a child
(3) Through wrist amputation
(4) Long finger amputation through the proximal phalanx
2. All of the following variables have a negative impact on the outcomes of isolated meniscal allograft transplantation, EXCEPT-
(1) Axial malalignment
(2) Anterior cruciate ligament insufficiency
(3) The use of a fresh frozen graft
(4) Femoral condyle flattening
3. As a cemented femoral component of a total. hip arthroplasty fails by cantilever bending a plain anteroposterior (AP) pelvic radiograph will reveal-
(1) Radiolucent lines in Gruen zones 1 to 7 inclusive.
(2) Cement mantle fracture in Gruen zones 2 and 6.
(3) Radiolucent lines in Gruen zones 4 and 5.
(4) Radztolucent lines in Gruen zones 1, 2, 6 and 7.
4. Which of the following factors minimize patellar maltracking in TKA?
(1) Medialization of femoral component
(2) Medialization of patellar component
(3) Internal rotation of femoral component
(4) Internal rotation of tibial component
5. What is the most common external cause of snapping hip syndrome?
(1) Ihotibial band tightness
(2) Iliopsoas tendinitis
(3) Labral tear
(4) Femoro — acetabular impingement
6. Which nerve is responsible for referred hip pain to knee?
(1) Lateral femoral cutaneous nerve
(2) Sciatic Nerve
(3) Femoral nerve
(4) Obturator nerve
7. Indicator of ACL tear is –
(1) Pellegrini — stieda sign
(2) Squared off lateral femoral condyle sign
(3) Segond sign
(4) Double PCL sign
8. In Judet view of the pelvis, the right obturator oblique view shows best –
(1) Anterior wall and posterior column of (R) Acetabulum
(2) Anterior column and posterior wall of (R) Acetabulum
(3) (R) obturator foramen
(4) (R) Sacroiliac Joint
9. ‘Validity’ describes whether a clinical instrument or test –
(1) produces consistent scores in similar situations
(2) produces a result that is statistically significant
(3) produces measurements that represent reality or the true measurements
(4) produces similar results with repeated measurements
10. Which of the following is absolute contraindication of standard total shoulder arthroplasty?
(1) Asymmetric posterior glenoid wear
(2) Anterio-superior glenohumeral instability
(3) Irreparable supraspinatus tear
(4) Failed prior hemiarthroplasty
11. In hand surgery, which area is called no man’s land?
(1) Within the carpal tunnel
(2) Distal to insertion of Flexor Digitorum Superficialis
(3) Between distal palmar crease and flexor crease of PIP
(4) Proximal to carpal tunnel
12. Gamekeeper’s thumb is –
(1) Thumb IP joint ulnar collateral ligament rupture
(2) Thumb IP joint radial collateral ligament rupture
(3) Thumb MCP joint radial collateral ligament rupture
(4) Thumb MCP joint ulnar collateral ligament rupture
13. Structural integrity of collateral ligaments are best tested by –
(1) Varus / Valgus stress test in full extension
(2) Varus / Valgus stress test in full Flexion
(3) Varus / Valgus stress test in 30° of Flexion
(4) Varus / Valgus stress test in 90° of Flexion
14. Which of the following should be avoided during total knee arthroplasty to avoid lateral patellar subluxation?
(1) Internal rotation of the tibial component
(2) External rotation of the femoral component
(3) Lateral placement of the tibial component
(4) Lateral placement, of the femoral component’
15. A muscle contraction during which tension is constant throughout the range of motion but muscle length changes is referred to as-
16. In uncemented arthroplasty of hip, the stem remains attached to the bone by –
(1) Bone ingrowth / overgrowth over the surface of the stem
(2) Mechanical bonding between the stem and bone
(3) Press fitting of the stem in tight canal
(4) Adhesive properties of the stem
17. The medial and lateral joint surfaces have different tibiofemoral geometry. How does this affect the kinematics of normal knee movement from full extension into flexion?
(1) Tibia will externally rotate
(2) Distal femur will pivot about a medial axis of the knee
(3) Distal femur will translate anteriorly on the tibia
(4) Distal femur will pivot about a lateral axis of the knee
18. Osteochondritis dissecans of the elbow most commonly occurs at this location –
19. Calcification of menisci is seen in –
(3) Renal Osteodystrophy
20. Which of the following patient scenarios is most appropriate for reverse total shoulder arthroplasty?
(1) A 40-year-old laborer with severe glenohumeral arthritis and irreparable rotator cuff tear.
(2) A 40-year-old with a painful proximal humerus malunion.
(3) A 75-year-old woman with severe arthritis and active overhead motion.
(4) A 75-year-old man with painful arthritis and a massive irreparable rotator cuff tear.
21. What tendon has an intra-articular location in the knee joints?
(4) Biceps femoris
22. Synovial fluid of low viscosity is seen in all, EXCEPT –
(2) Septic arthritis
(4) Rheumatoid arthritis
23. Joint erosion is not a feature in –
(2) Rheumatoid arthritis
24. A 65-year-old diabetic male with forefoot gangrene is evaluated for possible amputation. When discussing the amputation levels with the patient, which of the following should be noted to require the greatest increase in energy expenditure for ambulation?
(1) Syme amputation
(2) Unilateral transtibial amputation
(3) Transfemoral amputation
(4) Bilateral transtibial amputation
25. Tarsometatarsal amputation is also known as –
(1) Syme’s amputation
(2) Chopart’s amputation
(3) Lisfranc amputation
(4) Pirogoff amputation
26. Which of the following variables is not predictive of poor healing of diabetic foot ulcers?
(1) Transcutaneous oxygen pressure < 20 mmHg
(2) Systolic blood pressure > 140 mmHg
(3) Ankle — brachial index < 0.45
(4) Albumin < 3.0 g/dL
27. Patient presents with crush injury to lower limb. Surgeon is concerned with sepsis and gangrene. Which can help to decide between amputation and limb salvage?
(1) GCS score
(3) ASIA guidelines
(4) Gustilo — Anderson classification
28. In limb reconstruction, what is done first?
(1) Artery anastomosis
(2) Vein repair
(3) Nerve repair
(4) Bone Fixation
29. Ring sequestrum is seen in –
(1) Typhoid osteomyelitis
(2) Chronic osteomyelitis
(3) Amputation stump
(4) Tuberculous osteomyelitis
30. In patients with an extremity-based osteosarcomia without metastasis, all of the following are risk factors for disease progression and poor outcomes, EXCEPT-
(1) High histologic grade
(2) Low serum level of alkaline phosphatase at diagnosis ,
(3) Large tumor volume.
(4) Inadequate surgical margins following resection
31. A 56-year-old female is referred for a second opinion after placement of an intramedullary nail through a presumed metastatic lesion in her proximal femur. Final biopsy results from the lesion show a high-grade chondrosarcoma and staging studies show this to be an isolated site of disease, what treatment should be recommended?
(1) Intramedullary nail removal and radiotherapy to the limb
(2) Systemic chemotherapy and keep nail in place to prevent fracture
(3) Wide proximal femoral resection and hemiarthroplasty followed by radiotherapy
(4) Wide resection including hip disarticulation
32. All of the following are necessary steps in bony metastasis of a malignant cell, EXCEPT-
(2) Target tissue localization
(3) Induction of angiogenesis
(4) Direct stimulation of osteoclasts
33. A 13 year old girl presents with an isolated distal femur osteosarcoma that extends into the soft tissue. Work-up is negative for metastasis, but biopsy reveals a high grade lesion. What is the stage of this tumor by the Musculoskeletal Tumor Society system?
34. A 58-year-old male is referred to your clinic for a sacral mass found on a lumbar spine MRI. He brought a pathology report from a biopsy that was performed. at an outside hospital that states primary malignant bone tumor of notochordal remnant cells.” Staging work — up showed no distant disease. Which of the following describes the best treatment strategy for this patient?
(1) Neo-adjuvant chemotherapy, surgical excision, maintenance chemotherapy
(2) Wide surgical excision
(3) Tumor debulking, chemotherapy
(4) Radiation therapy
35. A 25-year-old tourist slips on a sand dune, falling onto an outstretched right elbow. He is taken to the local teaching hospital and radiographs demonstrate a significantly comminuted radial head fracture and coronoid base fracture. His elbow is reduced and splinted. To restore stability and allow early range of motion, which of the following will most likely need to be performed in most cases?
(1) Radial head fixation or replacement
(2) Radial head fixation or replacement and coronoid fixation
(3) Radial head fixation or replacement, coronoid fixation and Lateral Ulnar Collateral Ligament (LUCL) repair
(4) Radial head fixation or replacement, coronoid fixation, LUCL and Medial Ulnar Collateral Ligament (MUCL) repair
36. Trendelenburg test is positive due to injury to –
(1) Superior Gluteal Nerve
(2) Inferior Gluteal Nerve
(3) Femoral Nerve
(4) Obturator Nerve
37. A Bennett’s fracture is difficult to maintain in a reduced position. because of the pull of the –
(1) Flexor pollicis longus
(2) Flexor pollicis brevis
(3) Abductor pollicis longus
(4) Extensor pollicis brevis
38. What is the most common clinically significant preventable complication secondary to the treatment of a displaced talar neck fracture?
(3) Mal union
39. Which of the following statement is wrong concerning the blunt trauma?
(1) Small child and a large adult have a markedly different level of energy transfer in a high speed RTA
(2) Shear strain injuries result from rapid acceleration or deacceleration
(3) Tensile strain results from direct compression of tissues
(4) The tolerance of biological tissue to trauma is directly proportional to elasticity of tissue
40. A Mangled Extremity Severity Score (MESS) of 8 indicates –
(1) Amputation should be performed.
(2) Amputation should not be performed.
(3) The likelihood of successful reconstruction is zero.
(4) The limb is severely injured, but both reconstruction or amputation maybe reasonable.
41. Putti-Platt operation involves tightening of which muscle?
(3) Pectoralis major
(4) Pectoralis minor
42. During anterior approach of the shoulder, excessive traction on the congenital tendon is most likely to result in loss of –
(1) Elbow flexion
(2) Shoulder flexion
(3) Shoulder internal rotation
(4) Shoulder Abduction
43. A 32-year-old man sustains a Lisfranc fracture dislocation. Which of the following is the most important factor in predicting a satisfactory outcome?
(1) Severity of initial injury.
(2) The state of the articular cartilage.
(3) The age of the patient.
(4) Whether or not a compensation claim is involved.
44. A 30-year-old woman is involved in a road traffic accident and is found to have a pelvic symphysis separation of 4 cm and a sacral fracture. She undergoes a normal secondary survey and is haemodynamically stable. Definitive fixation should involve which of the following?
(1) Skeletal traction for 3 months.
(2) Internal fixation of the symphysis pubis with anterior external fixation.
(3) Internal fixation of the symphysis pubis and internal fixation of the sacrum.
(4) Posterior only external fixation.
45. A football player sustains a suspected Acromioclavicular joint (ACJ) separation. Which of the following is the most appropriate radiographic view to evaluate the ACJ?
(1) Stryker notch view
(2) Serendipity view
(3) Zanca view
(4) Supraspinatus outlet view