Practice Test Geeks(ABEM) American Board of Emergency Medicine Practice Test
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Orthopedic & Musculoskeletal Emergencies Flashcards

7 cards from real ABEM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Orthopedic & Musculoskeletal Emergencies flashcards as text

  1. A 7-year-old falls from the monkey bars and has distal radius pain. X-ray shows cortical buckling on one side without a complete fracture line. What is the most appropriate treatment?

    Answer: Posterior long-arm splint for 3-4 weeks without reduction

    Torus (buckle) fractures are inherently stable due to the intact periosteum and cortex on one side; splinting for 3-4 weeks without reduction is sufficient.

  2. A 35-year-old found after lying on a hard surface for 10 hours presents with diffuse muscle pain, dark urine, and creatinine of 3.1 mg/dL. Urine dipstick is 3+ blood with no RBCs on microscopy. What is the most critical initial treatment?

    Answer: Aggressive IV fluid resuscitation with isotonic normal saline

    Aggressive isotonic saline resuscitation targeting urine output of 200-300 mL/hr is the cornerstone of rhabdomyolysis management to prevent myoglobin-induced acute tubular necrosis.

  3. A patient arrives in hemorrhagic shock after a high-speed MVA. Pelvis is unstable on examination with an 'open book' pattern on X-ray. Despite 2L of IV crystalloid, BP remains 70/40. What is the most immediate intervention?

    Answer: Apply a pelvic binder and activate massive transfusion protocol

    A pelvic binder reduces pelvic volume and tamponades venous hemorrhage from the pelvic plexus while MTP addresses the lethal triad of coagulopathy.

  4. A 45-year-old new mother presents with radial-sided wrist pain at the base of the thumb that worsens with gripping and pinching. Finkelstein test reproduces her pain. What is the diagnosis?

    Answer: De Quervain's tenosynovitis

    De Quervain's tenosynovitis is inflammation of the APL and EPB tendons in the first dorsal compartment; Finkelstein's test (thumb in fist with ulnar deviation) is the diagnostic maneuver.

  5. A 20-year-old football player receives a direct blow to his shoulder and develops a visible step deformity with elevation of the distal clavicle. Which structures are disrupted in a grade III acromioclavicular separation?

    Answer: Both the acromioclavicular and coracoclavicular ligaments

    Grade III AC separation involves complete disruption of both the AC and coracoclavicular (conoid and trapezoid) ligaments, allowing complete clavicular elevation.

  6. A 32-year-old sustains a foot injury in a motor vehicle accident. Weight-bearing X-ray reveals a fracture at the base of the second metatarsal with widening between the first and second metatarsals. What injury does this represent?

    Answer: Lisfranc tarsometatarsal fracture-dislocation

    A fracture at the second metatarsal base is pathognomonic for Lisfranc injury; the second metatarsal base is the keystone of the tarsometatarsal joint complex.

  7. A 55-year-old presents with severe low back pain radiating bilaterally to both legs, new urinary retention, and decreased rectal sphincter tone. What is the most appropriate next step?

    Answer: Urgent MRI of the lumbar spine and neurosurgical consultation

    Cauda equina syndrome is a surgical emergency; urgent MRI is required to identify the compressive lesion and emergent neurosurgical decompression must not be delayed.