PANRE Orthopedics 2 — Questions and Answers
Question 1: A 55-year-old male presents with lateral elbow pain worsened by resisted wrist extension. What is the most likely diagnosis?
- Medial epicondylitis
- Lateral epicondylitis (Correct answer)
- Olecranon bursitis
- Cubital tunnel syndrome
Correct answer: Lateral epicondylitis
Lateral epicondylitis (tennis elbow) causes pain at the lateral epicondyle worsened by resisted wrist extension due to extensor carpi radialis brevis tendinopathy.
Question 2: Which nerve is most commonly injured in a posterior shoulder dislocation?
- Radial nerve
- Ulnar nerve
- Axillary nerve (Correct answer)
- Musculocutaneous nerve
Correct answer: Axillary nerve
The axillary nerve wraps around the surgical neck of the humerus and is most vulnerable in anterior or posterior shoulder dislocations.
Question 3: A patient has a positive Lachman test but negative McMurray test. Which structure is most likely injured?
- Medial meniscus
- Posterior cruciate ligament
- Anterior cruciate ligament (Correct answer)
- Lateral collateral ligament
Correct answer: Anterior cruciate ligament
The Lachman test specifically assesses ACL integrity by checking anterior tibial translation with the knee at 20–30 degrees flexion.
Question 4: Which organism is the most common cause of septic arthritis in adults under 30 years old?
- Staphylococcus aureus
- Streptococcus pyogenes
- Neisseria gonorrhoeae (Correct answer)
- Escherichia coli
Correct answer: Neisseria gonorrhoeae
Neisseria gonorrhoeae is the most common cause of septic arthritis in sexually active adults under 30 due to hematogenous dissemination.
Question 5: A 70-year-old woman with osteoporosis falls and sustains a hip fracture. Radiograph shows the fracture line passes through the femoral neck. What type of fracture is this?
- Intertrochanteric fracture
- Subtrochanteric fracture
- Intracapsular fracture (Correct answer)
- Basicervical fracture
Correct answer: Intracapsular fracture
Femoral neck fractures are intracapsular and carry risk of avascular necrosis due to disruption of the retinacular blood supply.
Question 6: Which finding on plain radiograph is most consistent with osteomyelitis in a child?
- Periosteal reaction and bone destruction (Correct answer)
- Sclerotic margins with central lucency
- Codman triangle only
- Diffuse osteopenia
Correct answer: Periosteal reaction and bone destruction
Osteomyelitis classically shows periosteal reaction and cortical bone destruction on plain films, though these findings may take 10–21 days to appear.
Question 7: A 40-year-old male construction worker presents with pain in the first metatarsophalangeal joint after 3 days of high-purine diet and alcohol use. Joint aspiration reveals negatively birefringent, needle-shaped crystals. What is the treatment?
- Allopurinol
- Indomethacin
- Colchicine or NSAIDs (Correct answer)
- Probenecid
Correct answer: Colchicine or NSAIDs
Acute gout is treated with colchicine, NSAIDs, or corticosteroids; urate-lowering therapy like allopurinol is initiated after the acute attack resolves.
PANRE Orthopedics 2
A 55-year-old male presents with lateral elbow pain worsened by resisted wrist extension.
What is the most likely diagnosis?