7.1 and 7.2 practice

Question 1

Fx common in younger individuals engaged in high energy activities include? Select all that apply
a) ASIS and sartorius avulsion Fx
b) Lesser trochanter and iliopsoas avulsion Fx
c) Ischial tuberosity and hamstring avulsion Fx
d) Angulated closed Fx of radial shaft

Answer 1

a) ASIS and sartorius avulsion Fx
b) Lesser trochanter and iliopsoas avulsion Fx
c) Ischial tuberosity and hamstring avulsion Fx

Question 2

Dorsally angulated distal radius fracture is called ____________, whereas a Volar/palmar angulated distal radius fracture is called _______________ from falling on the back of the hand.
a) Colles Fracture; Smith Fracture
b) Smith Fracture; Colles fracture

Answer 2

a) Colles Fracture; Smith Fracture

Question 3

The most common “fracture” in children with a noticeable bulge is?
a) Greenstick Fracture
b) Buckle Fracture
c) Radial Head Fracture
d) Supracondylar Humerus Fracture

Answer 3

b) Buckle Fracture

Question 4

Most common adult elbow fracture anteriorly (sail sign) and posteriorly (fat-pad) is _____________; the most common pediatric elbow Fx is _____________
a) Radial Head Fracture; Supracondylar Humerus Fracture
b) Supracondylar Humerus Fracture; Radial Head Fracture

Answer 4

b) Supracondylar Humerus Fracture; Radial Head Fracture

Question 5

_________ Fx is of the 5th metatarsal, whereas the ____________ Fx is of the 5th metacarpal
a) Jones; Boxer’s
b) Boxer’s; Jones

Answer 5

a) Jones; Boxer’s

Question 6

Pseudoarthrosis may form at the site, even developing a synovial lining with what fracture healing complication?
a) Delayed union
b) Malunion
c) Nonunion

Answer 6

c) Nonunion

Question 7

Which compression fractures are the most common? Select three
a) T6
b) T6
c) T12
d) L1
e) L2
f) L3

Answer 7

c) T12
d) L1
e) L2

Question 8

A pt arrives to the ER after diving and hitting his head at the bottom of the pool. What Fx is most likely?
a) Jefferson Fracture
b) Hangman’s fracture
c) Compression Fracture
d) Chance Fracture

Answer 8

a) Jefferson Fracture

Question 9

What Fx is classically from MVC with patient wearing only a lap belt?
a) Jefferson Fracture
b) Hangman’s fracture
c) Compression Fracture
d) Chance Fracture

Answer 9

d) Chance Fracture

Question 10

What Salter-Harris class goes through the physis and epiphysis, enters the joint space, and may lead to arthritis and asymmetric healing?
I
II
III
IV
V

Answer 10

III

Question 11

Which disorder does NOT cause increased bone density?
a) Osteoblastic metastatic disease
b) Avascular necrosis
c) Paget’s disease
d) Hyperparathyroidism

Answer 11

d) Hyperparathyroidism

Question 12

Which metastases are NOT osteolytic? Select all that apply
a) Breast
b) Lung
c) Thyroid
d) Prostate
e) Kidneys

Answer 12

a) Breast
d) Prostate (prostate is osteoblastic (important))

Question 13

When Osteoblastic Metastatic Disease affects the bone __________, it causes a periosteal reaction
a) Medulla
b) Cortex

Answer 13

b) Cortex

Question 14

Study of choice for detecting skeletal metastases is what?
a) CT w IV contrast
b) CT w/o contrast
c) Bone scan
d) MRI

Answer 14

c) Bone scan

Question 15

Crescent sign and “Snow-capping” can indicate what?
a) Osteoblastic Metastatic Disease
b) Avascular Necrosis
c) Paget’s Disease
d) Osteoporosis

Answer 15

b) Avascular Necrosis

Question 16

What is the most sensitive method for detecting AVN?
a) CT w IV contrast
b) CT w/o contrast
c) Bone scan
d) MRI

Answer 16

d) MRI

Question 17

Thickened cortex and a coarse, trabecular pattern on imaging indicate what?
a) Osteoblastic Metastatic Disease
b) Avascular Necrosis
c) Paget’s Disease
d) Osteoporosis

Answer 17

c) Paget’s Disease

Question 18

Osteopenia is a T score of ____________
Between 0 and -1
Between -1 and -2.5
Between -1.5 and -2.0
Between -2.5 and 3.0

Answer 18

Between -1 and -2.5

Question 19

Which are findings in hyperparathyroidism? Select all that apply
a) Subperiosteal bone resorption
b) Acroosteolysis
c) Brown tumor
d) Distal clavicle erosion

Answer 19

a) Subperiosteal bone resorption
b) Acroosteolysis
c) Brown tumor
d) Distal clavicle erosion

Question 20

Out of the below options, which is the most sensitive imaging for Osteolytic Metastatic Disease?
a) CT w IV contrast
b) CT w/o contrast
c) MRI
d) XR

Answer 20

c) MRI

Question 21

“Expansile” or “Soap-bubbly” lesions, Pedicle sign / winking owl sign, and no periosteal rxn are indicative of?
a) Osteoblastic Metastatic Disease
b) Osteolytic Metastatic Disease

Answer 21

b) Osteolytic Metastatic Disease

Question 22

A solitary soap-bubble expansile lesion is one of the presentations of the most common primary bone malignancy in adults, which is?
a) Osteoblastic Metastatic Disease
b) Osteolytic Metastatic Disease
c) Myeloma
d) Osteomyelitis

Answer 22

c) Myeloma

(can also present as “Punched out, lytic lesions” if disseminated)

Question 23

Which was not mentioned as a radiographic finding in osteomyelitis?
a) Focal cortical bone destruction
b) Periosteal new bone formation
c) Soft-tissue swelling
d) Joint space narrowing

Answer 23

d) Joint space narrowing

Question 24

Osteomyelitis can take 10 days to show XR signs, so what is an alternative?
a) Indium-labelled WBC scan
b) Indium-labelled RBC scan
c) CT
d) MRI

Answer 24

a) Indium-labelled WBC scan

Question 25

What is the study of choice for detect arthritis? a) CT b) MRI c) XR

Answer 25

c) XR

Question 26

Which is NOT an example of hypertrophic arthritis? a) Primary OA b) Secondary OA c) Charcot arthropathy d) CPPD e) Psoriatic

Answer 26

e) Psoriatic (psoriatic is erosive)

Question 27

What are the 4 signs of primary OA? Select all that apply a) Joint space narrowing b) Sclerosis c) Osteophytes d) Subchondral cysts e) Asymmetry

Answer 27

a) Joint space narrowing b) Sclerosis c) Osteophytes d) Subchondral cysts

Question 28

What has the most dramatic joint destruction of any arthritis? a) RA b) Psoriatic arthritis c) Charcot arthropathy d) CPPD

Answer 28

c) Charcot arthropathy

Question 29

“Pencil-in-cup” deformity is indicative of? a) RA b) Psoriatic arthritis c) Charcot arthropathy d) CPPD

Answer 29

b) Psoriatic arthritis

Question 30

Mycobacterium tuberculosis can cause ______________ infectious arthritis a) Pyogenic b) Nonpyogenic

Answer 30

b) Nonpyogenic (do XR or MRI for both types)

Question 31

Where does the spinal cord terminate? a) T12-L1 b) L1-L2 c) L3-L4 d) L5

Answer 31

b) L1-L2

Question 32

Nerves exit ___________ the vertebrae from C1-C7, and C8 exists C7-T1, and below that they exit _____________ the vertebrae a) above; below b) below; above

Answer 32

a) above; below

Question 33

“Scotty dog view” detects spondylolysis; what is another name for this projection? a) AP b) PA c) Lateral d) Oblique

Answer 33

d) Oblique

Question 34

_________ is the study of choice for evaluating disc herniation or spinal stenosis a) XR b) CT c) MRI d) Bone scan

Answer 34

c) MRI

Question 35

T/F: Facet joints of the spine are true synovial joints

Answer 35

True Facet Arthropathy often occurs with DDD

Question 36

Diffuse idiopathic skeletal hyperostosis (DISH) is the bridging ossification of at least _______ contiguous vertebral bodies (with normal SI joints, unlike AS)

Answer 36

4

Question 37

Sacroiliitis and bamboo spine are the main findings in? a) DISH b) Spinal stenosis c) Ankylosing Spondylitis (AS) d) All of the above

Answer 37

c) Ankylosing Spondylitis (AS)

Question 38

You note suspicious posterior compression Fx, so you get the study of choice for Spinal Malignancy, which is? a) XR b) CT c) MRI d) Bone scan

Answer 38

d) Bone scan