Following Antibiotic

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ich of theconcentration? A. Penicillina. Cefoxitin _

C.Clindamycin0,VancomycinE. bacitracin

3 The administration of ciprofloxacin I* rontrillndl»;*l«< In wlii'li "I <I»« following

patient populations?

A. Diabetics

B. AlcoholicsC. Intravenous drug abusers

D. Patients with renal failure

ft.Children-

I. What antibiotics works by inhibiting prplltlnjjlvi on OVUIIIPOIU .' A.

Penicillin S. Gen tarn icin -

C. Rifampin

D. Tetracycline

E. Clindamycin

5. What factor is most likely to <lr< mw tlw t ini-lih nl »» r-unml h-uh. , , , v.-.iem.'

A. Increased pin diameter

B. Increased pin number

C. Decreased pin separation -

D. Decreased pin group separation

E. Increased distance of the side but in ihr hour

following antibiotic*. II

; which of the following cell membram firoMltn fM»1M>Vl-IWHMUflnM

to tumor cells A. CD** glycoproteins B. P- glycoproteins C. Paracrine peptides

D. Matrix metalloptvteinaaea (MMPsj

E Stromelysina



«nrW.bvmh.b.t»ngDNA»«*?

7 Wh«t«nt'b«o"cwork ^ A.rtmicillin

f. c'/mtiumvon

8 What component of froten allograft bone has the least amount of immune*?-.

A Bone marrow cells

B Proteoglycan*

C. Hydrocyapatite -

D- Cytokines

£ Cell surface proteinsgreatest cOTcentratxar. df

----— r --------mechanoreceptors?

A. rVripheral one third

B. Central one third

C. Inner two thirdsD. Anterior horn

E. Posterior horn-

10. Inchildren, scurvy has the greatest effect on bone formation in the

A. Physis -

B. Diaphysis

C. Epiphysis

D. Metaphysic

E. Articular surface

11. Marfan syndrome is most likely associated with defects in which of the foBowing

structural proteins?

A. ElastinB. Fibrillin '

C. Fibronectin

D. Type Ii collagen

E. Type ill collagen

knee meniscus has thethe9 W



A. A CT M'hii urld'iouiHin

B, An Ml man nl Ihr brachial plWtUB

c\ NrriT KIII IIII I nun vriiHitv MiudlH and an eltctromyogramD, Surgical exploration and repair of the brachial plexus

E. Observation for 60 (Ih.vn before obtaining further testa

14 The nioNl wvrir mid r it)>n11\ pi ogi r smv r limn i>l < onRrmtal scoliosis IS

A Hlock vertrbra 11 SrinuM'înciiliil brum ri Irhi it (.' Fully

srûipiilfd hriiiivrlrhi.1 !) Unilateral unseKineiited Imi

K. Unilateral ii .sffjmcnlnl Inn w l ib i mill ulnlrral hemivertebra f

15. Posterior spinal fusion for scoliosis should be performed on a patients with Din beneniiisi ular dystrophy when A l/e patient in Mill iiinhulatoi\ B. Lordosis posture is present

(.' The to ne d vital < .ip.u il\ IIA'i ) in Irs?, th.in .10",, ol thr predicted value - -D. Curve

ma^mtudr measures. 2W S or greater / i htholn Miimii^niiciil la lis

16. Which of the following deformities, is most likely associated with slight valgus of the

femur, dimpling over the tibia, mild leg-length deficiency, increased heel valgus, and

tarsal coalition ?

A. Type 1 fibular hemimelia

B, Type 2 tibial hemimelia

C, Type 4 proximal femral local deficiency (PFFD)

D. Porterior medal bowing of the tibia

Congenital psnidoartlmiNis ol thr nln.t

- Which of the following types of iliac osteotomy provides the greatest potential (or

' incre*sed coverage? A. G«n*

perwcrtabutar -B Pemberton

innominate C Slater innominate D

Sutherland double innominate £

Steele triple innominate

18 Which of the following patients is considered the most appropriate candidate for

selective dorsal rhizotomy? A Nonambulatory

2-year-old with spastic diplegia

B. Nonambulatory 2-year-old with spastic quadriplegia

C. Nonambulatory 12-year-old with spastic qudriplegia

D. Ambulatory 42-year-old with spastic diplegia

E Ambulatory 9-year-old with hemiplegia and arthtosis

. A 3-year-old has a rigid 40° lumbar scoliosis that is the result of a fully segmented

1.5 hemiverteba. All other examination findings are normal. Management should

consist of

A. In situ posterior fusion

B. Hemivertebra! resection and fusion

C. Convex hemiepiphyseodesis

D. Observation with follow up in 6 months -

E. Thoracolumbosacral orthosis braching

20. Development of a valgus deformity in children after a fracture of the proximal tibial

metaphysic most likely result fromA. Lateral physeal arrest ~

hi ' r» « t UI I P O f h r l ml n l

ilrlii .... ' ...... -

A Ul»»r

1.1



B. Tethering by the fibula

C. Periosteal interposition

D. Asymmetric physeal growth —

E. Anterior tibial artery stenosis

21. The use of multiagent adjuvant chemotherapy is associated with a clear surviva

benefit in which of the following diseases?

A. Renal carcinoma

B. Osteosarcoma

C. Dedifferentiated chondrosarcoma

D. Adult soft tissue sarcoma

E. Melanoma -

h „, MKrttoi t*rt otn '* "»«w'i8ted with the worst Pr°8r'0w» in soft tissue

r n i r t O t f l N 15 cm futipfittrnenisl involvement •r of

miff.tif figure* per high power field (grade) ,,< anrottimal location

i ) whn< i« th* most common presentation of a benign bone tumor in childhood?

A Pain

ft Deformity

( r>Minlogi( frnrturei i fVesertre frf a massF (fit ifleritfll finding

n *?frft fisstie wn omas most commonly metastasize to the

f » Pegjonal nodes -V

Distant nodes

following preoperative chemotherapy, the percent of tumor necrosis has been shown to he

of prognosis value for which of the following tumors?A KhsklomvosHrroma

W rhondrosarr oma1 MetnistfltK adenocarcinoma

K f riant cell tumor of bone

■>(• Wliflt is fhp torrent 5-yeaf survival rate for patients with classic nonmetastatic, High

grade osteosarcoma of the extremity?

A 10% *

Mr , ,

I > 70% ft

90%

I What malignani disease most commonly develop* In conjunction with chronic

A fibrosarcoma H Hasal cellcarcinoma C Lymphoma DOsteosarcoma |C Squamous cellcarcinoma _

Chemotherapy is routinely included in the treatment of which of the following soft-tissue

sarcomas? A Angiosarcoma H Malignant fibrous histiocytoma C Uposarcoma O

Rhabdomyosarcoma J? Clear cell sarcoma

J*J Eosinophilic granuloma frequently occurs as a solitary lesion in the tubular long bones

After biopsy, what is the best course of action? A Neoadjuvant chemotherapy H En

bloc resection

C. Observation -

D. Amputation

E. Chemotherapy followed by radiation therapy



30 Which ol the following tumors is most likely to present with a pathologic fracture i

a child?

A. Unicameral bone cyst H

Kibious i ortit al defec t C

Osteosarcoma D Ewmg sarcoma

"~ E Giant cell tumor

-I Which fibers of the anterior cruciate ligament are tight in flexion? A

AnferomedialB. An(eroJateraJ-

C. Posteromedial

0. Posterolateral

E. Middle

& • in which of the following location? . ........ « .........„m»y

A Medial to the incision 0.Lateral to the incision

C. First web space of the footD. Medial footE. Dorsal foot

33. A posterior approach to the knee with itn Incision „| ih« superficial f»«.the small saphenous vein avoids inimv lo what situ, Imr i|, ., ,„ , " " ,' "" '«

adjacent to the small saphenous vein? ....... IA. Popliteal vein

B. Popliteal artery

C. Tibial nerve

D. Common peroneal nerve

E. Medial sural cutaneous nerve

34. Which of the following tendons a,e Ivpinillv harvested hen ,,,,, ....................... „,„ „ „ ,

cruciate ligament reconstruction with double loop l, (,msitinK

A. Semitendinous and semimembranous

B. Sartorius and semitendinous -

C. Gracilis arid semimembranous

D. Gracils and semitendinous

E. Biceps and semimembranous

35. What tendon has an intra arlinilai (intrasvnovial) location in the knee ](,iniV

A. Patellar *

B. PoplietaJ

C. Semitendinous

D. Semimembraneous

E. Biceps femoris

What is the most anatomic location for placement of the femoral runnel InMterioi cruciate

ligament reconstruction?

A. As far superior in the notch as possible

B. As far posterior as possible on the lateral femoral condyle

C. As far posterior as possible on thr medial femoral condyle

D. Directly across from the posterior cruciate femoral insertion

E. At resident's ridge





I Which of »

A Oroup A streptococcusg linipu I) streptococcusq paeudonuinas aeruginosa

i) staphylococcus aureusg Clostridium difficle

âdvantage of

polv-methylmethacrylate beads to treat infected

A Local toxicity — y Systemic toxicity r Inadequateantibiotic elution p Foreignbody reaction |, Allergicreaction

44 Which of the following preoperative findings correlates best

operative fixation of the calcaneus? A, Displacement of the

sustentaculum tali Displacement of the lateral wall Number of

major fragments of the posterior facet Diminution of Bohler's

angle -Amount of heel varus

result after

45 A 30-year-old man underwent an intramedullary nailing for a closed midthird tibial

fracture 2 months ago. He has had pain and erythema in the area of the fracture for the

past 3 days, and radiographs shown a midthird tibia fracture with an interlocking nail in

place. Which of the following tests would be most appropriate to

obtain a diagnosis? A. Erythrocyte

sedimentation rate 0. MRI scan C. CTscan

P. Aspiration of the fracture site E. Indium-labeled

white blood cell scan

46. A patient with a type IIIB open tibia fracture is treated with intravenous gentamicin and

ceftazidime for an infection. The patient experiences frequent, loose, and watery stools, and astool assay for Clostridium difficile toxin in positive Which of "ajU following antibiotics should be

administered?

Tobramycin H

Ampicillin

C. Metronidazole

D. Cefazolin

E. Clindamycin .

Mowing organism is moM commonly

themandi«J, Whusing or

con tarn i

CP.I,



47 A J\ vear old man sustained a displaced pelvic fracture aft

« «ftpld Examination reveals the presence of blood in the uJUt i 40

of thr following measures is most likely to complicate umiJ maatus. WhichA Ititmvenous pyelography uroloBrmanagrmpn,v

M llarement of a Foley catheter _ CPlacement of suprapubic catheter I)Kwlal examination I Nrtrograderyatogram

4t, Which Of the following is the most appropriate treatment for an acute commlnutad

dîat^nl? aSSOC'a,i0n With an Essex-Lopresti injury

A Radial head preservation MRadial head excision C.

Sauve-Kapandji procedure P

Darrach procedure E.

Radioulnar synostosis

Which of the following nerves is most likely to be injured during percutaneous pinning of

pediatric supracondylar humeral fractures? A. Ulnar B Median C Radial

D. Lateral antebrachial

E. Medial antebrachial

, A 23-year-old man is experiencing impotence and penile numbness following

intramedullary nailing for a femoral shaft fracture. Which of the following conditions

is a likely cause of these symptoms?A. Unrecognized urologic trauma -

B. Injury to S2-S3

C. Injury to the penis from the traction post

D. Pudendal nerve palsy

K . Posttraumatic stress

J, During four-compartment fasciotomy for compartment syndrome of the leg, what

nerves are decompressed in the anterior and lateral compartments, respectively?

A. Posterior tibial and superficial peroneal

B. Superficial peroneal and sural

C. Deep peroneal and sural

11 Deep peroneal and saphenous I >fvp penned

,md superficial peoneal

jhoBBcrsI screw that exits just snterior to th« 81 bod S»* of the following structures?

0 15 nerve root

C. SI nerve rootp S2 nerw rootc Extern*! iliac artery

55 svnicfc of the following is considered the moat common complication Massing,

mtramedullan nailing of a closed tibial fracture? A

!n*srnon B Nonunion-C Malunian Z, Ivrw pair.

£ Compartment syndrome

54 A patjent has a swollen, tender hindfoot with focal tenderness beneath the heel after failing 12feet Radiograph and a CT scan are negative. An MRI scan would

roost Jitely reveal Which of the following conditions? A.Occult subcorneal fracture of the calcaneus B Acuteosteonecrosis

C Compression of the tibial nerve (tarsal tunnel syndrome) D

Rupture of the posterior tibial tendon E. Rupture of the

plantar facia

55 Which of the following treatment principle for tarsometatarsal joint ( Lisfranc)

mianes has resulted in improved clinical outcome?

A. Early treatment of compartment syndrome

B. Early treatment of dorsal nerve injury

C Closed reduction and percutaneous pin fixation

D. Open joint reduction and internal fixation



E. R^gid transarticular fixation

Which of the following is considered the most common cause of a poor function prognosis

after an unstable posterior pelvic ring injury?

A. Resdual displacement causing a leg-length discrepancy of less than 1.0 cm

B. ifcrsstent neurologic deficit

C. Maireduced sacroiliac joint

D. Gerirtourinary dysfunction

2. Fracture nonunion _ ut# mortality ram *(\>r muUlela ^•nt of which of

tru» following *vV,ir„,,. ,M

A-6

vni..»l nervoua system

the following j« eonald

h,,norrhAgic shock? p^ the m08t relinK,n Decreased systolic blood pre.aun. ear)y finical r,n.

c Decreased hemoglobin level n Low

urine output c tachycardia

cQ Aftw under«o'ng a closed undreamt ,.t

".•soteted anterior leg compartment J, 1.tlb,al nailing a ^

A - Drop foot and nu m oZsZZlj°^ * at

B. Calcaneal deformity of the ankle WCb Space of the foot

C. Rigid equines deformity

D. Plantar foot numbness

E. Supple claw toes

& Which of the following nerve roots i« .» ■ , jtof oral screw in the treatment of sacromjtr^sT^ Pte- of

. Which o f the following CT scan will beat help evaluate a calcaneal fracture?

A. 3-D reconstructions

B. Sagittal reconstructionC. Axial and semicoronal planes

D. Sections parallel to the posterior facet of the calcaneus

£. Sections perpendicular to the anterior facet of the calcaneus

li

A.

B.

C

D.

E.

13

1A

L5

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p Conoid ligament

Acromioclavicular ligament p

Deltoid muscle origin p.

Trapezius muscle insertion

y Posterior sternoclavicular dislocation are most commonlv associated with whkh of

the following complications?

A, Chronic instability

p. Brachial plexus palsy

J, Pneumothorax

p Esophalangeal compressionE. Tracheal compression

n4 During an anterior approach to the shoulder, excessive traction on the i

tendon is most likely to result in loss of A. Elbow flexion B Shoulder flexion

C. Shoulder internal rotation

D. Shoulder abduction

E. Forearm pronation

65. Which of the following nerves is most commonly injuries when obtaining a bone

graft from the posterior ilium?

A. Lateral femoral cuteneous

B. Superior gluteal

C. Cluneal

D. L5 nerve root

E. SI nerve root

66 Which of the following ligaments is most commonly involved in posterolateral

rotator instability of the elbow?

A. Annular

B. Lateral ulnar collateral

C. Anterior band of the medial collateral

D. Radial part of the lateral collateralE. tosterior capsular

uned



f

o

Which of the following factors is consider** » .

^ ankle fracture for surgical treatment? important whenassessing an

A. Level of the fibular fracture

B. Displacement of the fibular fracture

C. Size of the posterior malleolus

D. Position of the talus in the morrise

E. Rupture of the deltoid ligament

69. After stabilizing a bimalleolar ankle fracture with a plate and leg screws for the.

fibula and two interfragmental compression screws for the medial malleolus, a

syndesmosis screw is indicated in which of the following situations?

A. In all suprasymdesmotic fibular fracture

B. In all transsyndesmotic fibular fracture

C. When there is increased medial clear space with external rotation stress

D. If the deltoid ligament is rupturedE. If the posterior malleolus in fractured

70. The primary stabilizer to valgus stress in the elbow is the

A. Radiocapitellar joint

B. Anterior oblique band of the medial collateral ligament

C. Transverse band of the medial collateral ligament

D. Posterior oblique band of the medial collateral ligament

E. Ulnar trochanter articulation

71 A 32-year-old man sustains an iliac wing fracture and a Lture twelve hours later

he has shortness of breath with and confus.on. A chest radiograph is normal. What «s

the most ukeh diagnosis.A

Fat embolism syndromeB. Adult respiratory distress syndrome

C. Pulmonary embolus

D. Tension pneumothorax

E. Sepsisve that traverses the M.

f, the long head of the tringular ,n«ernaJ .k»

applies which of the following?'m«J>ally J *? by we

hioradialis g mu*les? and 'he humeral *,

r nolliriK inn-...

% The longus coll, muscle are directlv .„. A. Prevertebral fascta w«™ >°

which of the following û lrn ->

B. Petracheal fascia s«rur.»uW

C. Esophagus

D. Vertebral arteriesE. Cervical nerve roots

A. 0*ô

B. 20%

C. 40%

D. 60

%

£. 80%

n The nerve

superioly

jyuvu Ul i u C 1Q||

A. Brachioradialis

B Flexor pollicis longus

C. Deltoid

D. Teres major

E. Pronator teres

W Hich of the following types of diSDIa , 67 atomic redu.ct.on and

internal fiv f P°sterior new ^

Sacral Iracture throURh the f °n ,0 ensure Option m

£ Sacral fracture through Z ^ C ^

c. Sacroiliac joint dislocation

p. averse fracture-dislocation of the

E. "'ac win8 fracture tne sacroiliac joint .k joint through theihun,

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75. Type 2A hangman's fracture, which has the potential to overdistract with

traction, has which of the following hallmark findings?

A. Anterior translation of greater than 3 mm

B. Severe angulation with minimal translation

C. Extension at the fracture site

D. Associated CI ring fracture

E. Association C2-3 facet dislocation

76. What spinal nerves in the cauda equine are primarily response for

innervation of the bladder?

A. LI, L2and L3B. L4 and L5

C. L5andSl

D. S2, S3andS4

E. Filum terminale

i l iii ,i patient with H h hrmiatim .u

\ I alrial shouldr, 'l0n',h* mo»< «Wy atnaon, MM m

H Kad,alio,ea,,n, thumb, and Index flnaar '

D. JJIw for«,rm i„„R r i n R r r i a n d | | u , n

f V„lai liiifrti-m and palm R

78TounclonThc' *damkiewic' r«Hcutarta. amri. ma**, 1. mo* '

A. Right side Ix-twern TS and T7" Wight side lirlui-rn I'M and Tl

1 C. Left side l>etween T5 and

T7 l> Lett side between T<)

and Tl 1 Left side l>etween 1.1

and L3

79. ( ontraindieations to cervical laminectomy a* a treatment for cervical spondybSa

myelopathy include which of the following findings? A Multilevel disease with

spinal cord compression H Anterior spinal cord compression t Posterior

spinal cord c ompreasion D Cervical kyphosis

K. i >ssi!i( ation of ihe posterior longitudinal ligament

HO What structure (s) course (s) through the quadrangular (quadrilateral) space?A CifOUrnfiM scapular artery H Radial nerve,

posterior humeral circumflex artery C. Axillary

nerve, posterior humeral circumflex artery I ) .

Radialnerve, circumflex scapular artery E, Axillary

nerve, profunda brachii artery

i I Pi oximal extension of the triceps-splinting approach to the distal humerus

limited by potential injury to what

structure? A Posterior humeral

circumflex artery H Anterior humeral

circumflex artery

C. Ulnar nerve

D,

Posterior interosseousnerve

B, Radial nerve

H J . The primary stabilizer to valgus strew in the elbow is the

A. Radiocapitellar joint

B. Anterior band of the medial collateral ligament

C Transverse band of the medial collateral ligament

0. Posterior oblique band of the radial collateral ligament

E. Ulnar trochanter articulation

83. Which of the following structures can cause nerve compression thatforearm supinationstrength7 A Transverse

carpal ligamentB. Ligament of Struthers



C. Anconeus epitrochleans

D. Arcade of FrohseE. La cert us fibrosis

84. Nerve entrapment at the spinoglenoid notch can result in artrophv of Sjfjfj MM

(si

A. Infraspinatus

B. Supraspinatus

C. Teres major

D.

Teres minorE. Supraspinatus and infraspinatus

85. What component (pullev) of the flexor tendon sheath is cor trigger

finger?

A. Al

B. A2

C. A4

D. C I

E. C2

86. Which of the following structures is typically spared in ulnar impactior ^ ' '

A. Ulnar head

B. Lunate

C.

Triquetrum D. Triangular fibrocartilage

E. Pisiform

87. A positive Froment sign indicates weakness of which of the follow >

A. First dorsal interosseous

B. Adductor pollicis

C. Opponens pollicis

D. Flexor pollicis brevis

E. Abductor pollicis longus



I 43.Varus iritertr<K.h«nii.« I followingresult,? ' ™'"tomv ,„,.

A. Decreased abduc.iw ^

B. '"creased hin (,.(«,

D. Abductor lag an/^^K'"E. Lengthening of the |eg

94. During primary total kne

line can be raised or h TurT 'W,1"« * U.r

A. 4 mm

8 8 mm

C. J 2 mm

D. 16 mm

£. 20 mm

95. During the implantation of H

arthroplasty, placement of a screwT^ • butsr compwwntthe

following structures at nsl. |n] f |"Mlr

n,1tr

'<<'' »ii|-Hiot

|(»in



A. Sciatic nerve "Wage?

B. Internal iliac vessels

C. External iliac vessels

D. Femoral vessels

E. Obturator vesels

96. Canale view best visualizes whit h ol the following strut tu r m '

A. Posterior facet of the subtalar joint

B. Lisfranc joint

C. TaJar neck

D.

Sustentaculum taliE. Lateral column of the foot

97. The abductor digiti quinti muscle of the foot is most frequerv

peripheral nerve?

A. MediaJ plantar

B. Deep peroneal

C. Saphenous

D. Sural

E. Lateral plantar



A. Deep peroneal| saphenous

C posterior tibial

D. superficial peroneal

E. medial plantar

99. Which of the following ligaments ig intraca

B. Deltoid

C. Calcaneofibular

D. Anterior talofibular

E. Inferior tibiofibular

100. Sensation on the plantar aspect of the gnat toe

following nerves?

A. Sural

B. Lateral plantarC. Medial plantar11 Lasser saphenous

F Greater saphenous

'1



JAWABAN

1. B 35. B 69. C

2. C 36. B 70. B3. E 37. C 71. A

4. A 38. A 72. A

5. E 39. B 73. D

6. - 40. C 74. B

7. D 41. D 75. B

8. C 42. A 76. D

9. A 43. D 77. B

10. A 44. C 78. D

11. B 45. D 79. D

12. D 46. C 80. C

13. E 47. B 81. E

14. E 48. A 82. B

15. D 49. A 83. E

16. A 50. D 84. E

17. A 51. E 85. A

18. D 52. B 86. E

19. D 53. D 87. B

20. D 54. E 88. A

21. B 55. D 89. C

22. E 56. C 90. A

23. E 57. C 91. E

24. B 58. E 92. B

25. D 59. A 93. D

26. D 60. C 94. B

27. E 61. C 95. C28. D 62. E 96. C

29. C 63. E 97. E

30. A 64. A 98. A

31. A 65. C 99. D

32. B 66. B 100. C

33. C 67. C

34. D 68. D

Following Antibiotic

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