Chirurgie 1024-1174
Testicular cancer usually presents with: - Painless firm testicular mass
Painless firm testicular mass
The first lymph node metastases in testicular cancer are found in: - Inguinal lymph nodes - Pre sacral lymph nodes - Paraaortal and paracervical lymph nodes - Iliac lymph nodes
Paraaortal and paracervical lymph nodes
Fractures-dislocations of the femoral head are classified according to: - Garden - Black - Pipkin - Pauwels
Pipkin
Which of the following artery is most commonly used to record blood pressure in lower limb? - Femoral artery - Dorsalis pedis artery - Popliteal artery - Posterior tibial artery
Popliteal artery
What type of dislocation of the shoulder joint is most often associated with epilepsy? - Posterior
Posterior
Which of the following important injuries are commonly missed, because some X-rays may look normal? - Posterior dislocation of the shoulder - Fractured patella - Colles' fracture - Fractured neck of femur
Posterior dislocation of the shoulder
Which of the following types of dislocation has the most pronounced tendency to get stuck? - Posterior dislocation of the shoulder joint - Anterior dislocation of the shoulder joint - Dislocation of the sternoclaviucvlar joint - Dislocation of the acromioclavicular joint
Posterior dislocation of the shoulder joint
Contraindications for plain X-ray of the abdomen (frequently called KUB-film (Kidney- ureter-bladder) include: - Pregnancy - History of allergy - Impaired renal function - a+b+c
Pregnancy
Trochanteric fracture of femur is best treated by: - Proximal femoral nail or dynamic hip screw - Inlay plates - Plaster in abduction - Plaster in abduction and internal rotation
Proximal femoral nail or dynamic hip screw
In cases with supracondylar femoral fracture the popliteal artery could be injured by: - Proximal fragment - Distal fragment - Muscle hematoma - Tissue swelling
Proximal fragment?
Locally-advanced prostate cancer is BEST treated with: - Radical prostatectomy - Chemotherapy - Androgen deprivation therapy - Radiotherapy in combination with androgen deprivation therapy
Radical prostatectomy
What is the most common avulsion fracture in the pelvic area: - That of the spina iliaca anterior superior - That of the tuberculum pubicum - That of tubular sciatica - That on the spina silica posterior superior
That of the spina iliaca anterior superior
Medial malleolus fixation is done by...? - Plate
- Plate
Whats the usual period of immobilization after the first shoulder dislocation at a young age? - 60 days - 45 days - 3 weeks - 7 days
3 weeks
Dutasteride is: - Alpha-blocker - Muscarinic receptor antagonist - 5-alpha-reductase inhibitor - Phosphidesterase 5 inhibitor
5-alpha-reductase inhibitor
For which age group are the ruptures of the rotator cuff most characteristic ? - < 30y - < 25y - > 55y - < 20y
> 55y
Which statement is true: - Antimuscarinics are contraindicated for patients with benign prostatic enlargement due to the risk of urinary retention - Antimuscarinics can be used in patients with Benign prostatic enlargement if they have storage symptoms.
Antimuscarinics can be used in patients with Benign prostatic enlargement if they have storage symptoms
what is the most common clinical test for anterior shoulder instability? - Bear-hug test - Appley test - Apprehension test - O'Brien test
Apprehension test
The classification of renal cystic masses is made according to: - Bosniak - Chester - Mayo clinic - Harvard university
Bosniak
The main procedure for stabilizing the pelvic ring in emergency condition is: - Plaster splint - Orthosis - Elastic bandage - C-clamp
C-clamp
The main procedure for stabilizing the pelvic ring in emergency conditions is: - C-clamp - Plaster splint - Elastic bandage - Orthosis
C-clamp
What is the most suitable osteosynthesis implant in children with transverse fracture of the femural diaphysis? - Elastic titanium nails - locking hip nail - DHS - Semitubular plate
Elastic titanium nails
Pelvic fractures usually cause intraperitoneal bladder ruptures: - True - False
False
Compartment syndrome is treated by: - Fasciotomy - Bicarbonate - Chloride rich fluid - Early aggressive fluid
Fasciotomy
The preferred treatment for cystitis in men is: - Fluoroquinolone for 7 days (david said a/b)
Fluoroquinolone for 7 days (david said a/b)
Which are not most probable fracture sites in a patient with altitude trauma? - Head, pelvic bones - Forearm, wrist - Chest,spine - Femur, foot
Forearm, wrist
The preferred treatment for acute uncomplicated cystitis in pre-menopausal non- pregnant women is: - Fosfomycin 3gr. single dose - Ceftriaxone 1gr. i.m single dose - Ciprofloxacin 500mg. twice daily for 5-7 days - Plant extracts (eg.cranberry) for 3 days, followed by antibiotic for 3 days (e.g ciprofloxacin)
Fosfomycin 3gr. single dose
Garden's classification is applicable to: - Intertrochanteric fracture - Fracture neck of femur - Epiphyseal separation - Posterior dislocation of hip
Fracture neck of femur
The classical example of concomitant muscular injuries and internal bleeding is: - Fracture of fibula - Fracture of femur - Fracture of clavicula - All of these
Fracture of femur
Avascular necrosis is a compilation after: - Fracture of talus - Fracture of medial condyle of femur - Olecranon fracture - Radial head fracture
Fracture of medial condyle of femur
Treatment option in 65 year old male with a femoral neck fracture since 6 weeks: - Nailing - Osteotomy - Haemiarthroplasty (hip replacement) - None
Haemiarthroplasty (hip replacement)
A patient with suspected pelvic fracture, visible discrete bleeding from the urethra and inability to pass urine: - He should be encourage to pass urine after being given antibiotics and analgesics - He should be immediately catheterised in the ward - A hot water bottle should be given followed by injection of carbachol - He should be prepared for surgery and catheterisation attempted in the orthopedic trauma
He should be prepared for surgery and catheterisation attempted in the orthopedic trauma
The principles in the treatment of compound (open) fractures are as follows, except: - Wound debridement and external fixation - Immediate wound closure - Tendon repair - Internal fixation with plates
Immediate wound closure
The most clinical presentation of renal cell cancer is ( choose ONE answer): - Incidental presentation - Haematuria - Flank pain - Symptoms of systemic disease ( e.g weight loss)
Incidental presentation
A comminuted fracture of the patella should be treated by: - Inserting pins, screws and wires - Physiotherapy alone - Removal of all the patella - Removal of smallest - piece only - Plastering and immobilisation
Inserting pins, screws and wires
The base of the 5th metatarsal bone is broken by...? - Insertion of the short peroneal muscle
Insertion of the short peroneal muscle
Open fracture is treated by: - Tourniquet - Internal fixation - Cast - External fixation
Internalfixation
In cases with multiple fractures, most important is: - Airway maintenance - Blood transfusion - Intravenous fluids - Open reduction of fractures
Intravenous fluids
Which of the following statements regarding compartment syndrome are true? - It is a result of raised pressure in a compartment collapsing the veins
It is a result of raised pressure in a compartment collapsing the veins
Which statement best describes gross painless hematuria? - It is regarded as a symptom of bladder/ kidney tumor until proved otherwise
It is regarded as a symptom of bladder/ kidney tumor until proved otherwise
In which group is the risk of recurrence of traumatic anterior shoulder dislocation the highest: - Men > 55y - Woman > 55y - Woman < 20y - Men < 20 y
Men < 20 y
Stress fracture do not develop in: - Metatarsals - Metacarpals - Tibia - Calcaneum
Metacarpals
Stress fractures are most commonly seen in: - Metatarsals - Tibia - Fibula - Neck of femur
Metatarsals
Retention of the urine is: - No urine is produced by the kidneys - Obstruction of the uterus. leads eventually to hydronephrosis - a+b - Obstruction of the urinary tract below the bladder ( at the level of the prostate or the urethra)
Obstruction of the urinary tract below the bladder ( at the level of the prostate or the urethra)
A 54-year-old man with a history of metastatic lung cancer comes to the office because he had sudden onset of pain in the lower back 24 hours ago. Which of the following findings in this patient differentiates lumbar disk herniation from cauda equina syndrome as the cause of his pain? - Anesthesia of the saddle region - Bilateral weakness of the legs - Impotence - Pain radiating to one buttock - Urinary incontinence
Pain radiating to one buttock
The fixation after lisfranzi fracture dislocation is made by...? - Plate and screws
Plate and screws
What is the main blood supply to the femoral neck? - From the joint capsule - Anterograde- through a fovea capita - Mixed - Retrograde from a circumflexe femurs ant. et post.
Retrograde from a circumflexe femurs ant. et post.
Which of the following is the method of choice for osteoarthritis of the shoulder joint with massive rupture of the rotator cuff? - Reverse shoulder arthroplasty - None of the above - Anatomical shoulder arthroplasty - Arthroscopy of the shoulder joint
Reverse shoulder arthroplasty
A woman in her 80's with a hip fracture (Garden lV) is going to be operated. Whats the most appropriate surgical procedure? - Osteoplasty by jude - Osteosynthesis with cannulated screws or DHS - PFNA - Single-pole endoprosthesis
Single-pole endoprosthesis
A 12-year-old boy is brought to the office by his mother because he has had intermittent pain in the right hip during the past two weeks. The patient ambulates with difficulty. He has not had fever, chills, malaise, recent illness, or trauma to the hip. The patient is obese but otherwise healthy. On physical examination, vague pain in the groin is elicited on range of motion of the right hip. The most appropriate next step is x-ray studies to rule out which of the following conditions? - Femoral acetabular impingement syndrome - Legg-Calvé-Perthes disease - Septic arthritis - Slipped capital femoral epiphysis - Tear of the labrum
Slipped capital femoral epiphysis
Patients come with femoral fracture in an acute accident, the first thing to do is: - Secure airway and treat the shock - Splinting - Physical examination - X—rays
Splinting
Prosthetic replacement of femoral head is indicated for one of the following sites of fractures: - Intertrochanteric fracture of femoral neck - Subcapital femoral fracture - Pertrochanteric femoral fracture - Basicervical fracture
Subcapital femoral fracture
Prosthetic replacement of femoral head is indicated for one of the following sites of fractures: - Inter—trochanteric fracture of femoral neck - Subcapital femoral fracture - Transtrochanteric femoral fracture - Basicervical fracture
Subcapital femoral fracture
In the tendon of which muscle are the most common ruptures of the rotator cuff? - Suprascapularis - Subscapularis - Infraspinatous - Supraspinatous
Supraspinatous
Which symptom is characteristic of acromio-calvicular joint dislocation: - Upper drawer - Front drawer - Symptom of the paint key - None of the above
Symptom of the paint key
Intravesical chemotherapy for bladder cancer is administered for stage: - T1 N0 M0 - T1 N1 M0 - T2 N0 M0 - T3 N0 M0
T1 N0 M0
systemic therapy for advanced/metastatic renal cell cancer consists of: - Chemotherapy - Immunotherapy- interferon alpha, interleukin-2 - Targeted therapy- e.g sorafenib, sunitinib
Targeted therapy- e.g sorafenib, sunitinib ?
The surgery for testicular cancer includes removal of: - Testes, epididymis and spermatic cord
Testes, epididymis and spermatic cord
Where are the bone lesions most often located in recurrent anterior shoulder instability: - Posterior edge of the glenoid fossa - The anterior edge of the glenoid fossa and the posterior- upper surface humeral head - The distal end of the clavicle - Anterior surface of the humeral head
The anterior edge of the glenoid fossa and the posterior- upper surface humeral head
The gleason score is: - The histopathological grade of the biopsy- detected prostate cancer - The level of serum PSA divided by the ultrasound-determined prostate volume - Characterize the imagine of the prostate during MRI-study - A comorbidity scale which assesses the risk of post-operative complications prior to surgery.
The histopathological grade of the biopsy- detected prostate cancer
The peak of testicular cancer is: - 5-15 years of age - The third decade of life for non-seminoma, and in the fourth decade for pure seminoma - 50-60 years of age - over 60 years of age
The third decade of life for non-seminoma, and in the fourth decade for pure seminoma
The usual site of stress fractures includes: - Tibia - First metacarpal bone - Medial cuneiform - Third metatarsal bone
Third metatarsal bone
Pelvic fractures are classified according to: - Foster - Tile - Weber - Malgaine
Tile
Post-traumatic osteoarthritis due to acetabular fracture is indicated for: - Varicose/ valgus osteotomy - Total hip arthroplasty - Hemiarthroplasty - All listed
Total hip arthroplasty
The tumor of renal pelvis is: - Transitional cell carcinoma - Clear cell cancer - Adenocarcinoma - Neuroblastoma
Transitional cell carcinoma
Conservative treatment (bladder drainage and antibiotics) is possible for uncomplicated extraperitoneal bladder rupture after blunt trauma: - True
True
Conservative treatment (bladder drainage and antibiotics) is possible for uncomplicated extraperitoneal bladder rupture after blunt trauma: - True - False
True
Neoadjuvant Chemotherapy ( cisplatin -based is recommended before a cystectomy for: - True - False
True ?
Sunitinib (frequently used for metastatic renal cell cancer) is?
Tyrosine kinase inhibitor
The best study for a patient (man or non- pregnant woman) with a renal colic is? - Ultrasound followed by CT-scan without contrast media
Ultrasound followed by CT-scan without contrast media
the preferred treatment for urethral stones is: - Urethroscopy and lithotripsy - Extracorporeal shock-wave lithotripsy - Open operation - Alpha blockers
Urethroscopy and lithotripsy?
Incase of posterior urethral injury: - Immediate suturing of the urethral ends is recommended - Urinary diversion with urethral/ suprapubic catheter is the treatment of choice
Urinary diversion with urethral/ suprapubic catheter is the treatment of choice
In case of posterior urtheral injury: - Immediate suturing of the urtheral ends is recommended - Urinary diversion with urethral/suprapubic catheter is the treatment of choice
Urinary diversion with urethral/suprapubic catheter is the treatment of choice
All of the following regarding venous anatomy is true except : - Venous valves close in response to caudal-to-cephalad blood flow at a velocity of at least 30 cm/s2.
Venous valves close in response to caudal-to-cephalad blood flow at a velocity of at least 30 cm/s2
What is the most commonly used operation in the treatment of recurrent anterior instability of the shoulder joint with a significant bone defect of the genoid fossa: - Open bankers stabilization - Arthroscopic bankers stabilization - Capsule plication - Arthroscopic or open lateral stabilization
c) capsule plication ?? d) arthroscopic or open lateral stabilization ??
The typical renal colic: - All of the above
All of the above
What type of dislocation of the shoulder joint is most common: - Posterior - Anterior - Multidirectional - Inferior
Anterior
Pyonephritis is: - Collection of pus in pelvis, calices - Collection of pus in a renal cyst - Collection of pus around the kidney - Collection of pus in the ureter
Collection of pus in pelvis, calices
Which imaging will you prioritize in a patient with a history of pelvic trauma? - Ultrasound - Computer tomograph - Radiography - MRI
MRI
The most common clinical presentation of prostate cancer is (choose ONE answer) - No typical symptoms
No typical symptoms
Characteristic features of the acute compartment syndrome in the lower leg include all of the following, except: - Acute pain on employing the stretch test - Normal pulses - Normal sensation distally - Venous occlusion
Normal sensation distally
Which is true of vascular injuries of the extremities? - In the absence of hard signs of vascular injury if the difference between SBP in an injured limb is within 15% of the an uninjured limb..needed - Occult profound femurs injury can result in compartment syndrome and limb loss - All patients with significant hematoma should be surgically explored - Vascular injury repair should be performed prior to realignment of bony fractures or dislocations.
Occult profound femurs injury can result in compartment syndrome and limb loss
Which of the following is a characteristic clinical sign of proximal rupture of the long head of m.biceps Brach? - Popeye deformation
Popeye deformation
Commonest dangerous complication of posterior dislocation of knee is: - Popliteal artery injury - Sciatic nerve injury - Ischemia of lower leg compartment - Femoral artery injury
Popliteal artery injury
Fractures involving both the malleoli is: - Cotton's fracture - Pott's fracture - Pirogoff's fracture - Dupuytren's fracture
Pott's fracture
Which of the following is the method of choice for osteoarthritis of the shoulder joint with massive rupture of the rotator cuff: - Reverse shoulder arthroplasty
Reverse shoulder arthroplasty
What is the most common concomitant injury in anterior dislocation of the shoulder over the age of 60? - Rupture of the rotator cuff
Rupture of the rotator cuff
Contraindications for intravenous urography include: - Pregnancy - History of allergy - Impaired renal function - a+b+c
a+b+c
Radionuclide imaging is use in urology for: - Determination of renal function- of each kidney separately - Studying preoperatively space-occupying in renal masses (e.g tumors) - Discovering bone metastases with skeletal scintigraphy - a+b+c - a+c
a+c
Intramedullary fixation is appropriate in a case with: - A transverse shaft fracture - A compound shaft fracture - Soft tissue interposition between the fracture ends - Femoral shaft fractures in children
A transverse shaft fracture
Whats the risk position of the upper limb for anterior dislocation of the shoulder joint? - Abduction and internal rotation - Adduction with internal rotation - Abduction and external rotation - Abduction only
Abduction and external rotation
Which of the following statements regarding the treatment of fractures are true? - Absolute stability is obtained by getting exact reduction and then compressing the fragments of the fracture together - All fractures should be reduced - All fractures should be stabilized - Reduction of a fracture means jamming the fragments together
Absolute stability is obtained by getting exact reduction and then compressing the fragments of the fracture together
Extracorporeal shock wave lithotripsy is contraindicated in case of: - All of the above (pregnancy , bleeding, UTI)
All of the above (pregnancy , bleeding, UTI)
Serum tumor markers for testicular cancer are: - Alpha-fetoprotein, hcG, LDH - LDH, PSA - LDH,hug, CA 125 - Alpha-fetoprotein, LDH, vanillylmandelic acid
Alpha-fetoprotein, hcG, LDH
A 32-year-old man comes to the clinic because he has had pain in the back for the past 24 hours. The patient says he first noticed the pain when he awoke in the morning and had difficulty getting out of bed. He had been playing flag football the day before the pain began but did not sustain any injuries during the game. Acetaminophen has provided only minimal relief of the patient's pain. On physical examination, pain is elicited on palpation of the back on the left, lateral to the region of L2-L5. Full range of motion is noted in vertebral flexion, extension, lateral rotation, and lateral bending, with some hesitancy because of pain on the left side. Which of the following is the most appropriate initial step? - Anti-inflammatory and muscle relaxant therapy - CT scan of the lumbar spine - Epidural injection of a corticosteroid - MRI of the lumbar spine - Strict bed rest and application of moist heat to the lower back
Anti-inflammatory and muscle relaxant therapy
A 35-year-old man comes to the primary care office because he has had pain and swelling of the right knee for the past three days. Also, for the past two days, he has felt feverish. The patient is able to ambulate, but walking exacerbates the pain in his knee. Temperature is 39.3°C (102.7°F). On physical examination, the right knee is red, warm to touch, and tender. A large effusion is noted. Which of the following diagnostic studies of the knee is the most appropriate initial step? - Arthrocentesis - Arthroscopy - Bone scan - CT scan - MRI
Arthrocentesis
A 63-year-old man is referred to the office by his primary care provider because he has pain in the right knee that has been worsening over the past two years. He usually plays tennis several times per week, but recently the pain has made it difficult for him to continue this routine. Conservative treatment measures such as courses of nonsteroidal anti-inflammatory drugs and injections of cortisone have failed to relieve the patient's pain. Current physical examination of the right knee shows moderate effusion and tenderness along the medial joint line. Result of McMurray test is positive. MRI of the knee shows a 3-cm defect of the articular cartilage of the medial femoral condyle. Weight-bearing x-ray studies of the right knee show no narrowing of the joint spaces. Which of the following is the most appropriate management? - Application of a medial unloader knee brace - Arthroscopy with microfracture of the articular cartilage defect - Osteochondral grafting of the articular cartilage defect - Total arthroplasty of the knee - Unicompartmental joint replacement
Arthroscopy with microfracture of the articular cartilage defect
The imaging modality of choice in hemodynamically stable patient with suspected renal trauma is: - CT-scan with contrast media - Ultrasound - Renal scintigraphy - Retrograde ureteropyelography
CT-scan with contrast media
In comorbid patients with supracondylar hip fracture, contra-indicated for operative treatment, immobilization can be by: - Kinesis tape - Circular leg cast - Boot cast sarmiento - Lower leg spica cast
Circular leg cast
A 19-year-old woman is brought to the emergency department by ambulance after she sustained an injury to the right knee while rollerblading. The patient says she felt sudden, severe pain in the knee when she turned a corner quickly. She fell to the ground and was unable to bear weight on the right leg. Physical examination shows swelling and deformity of the right knee as well as inability to fully extend and straighten the right lower extremity. X-ray studies show dislocation of the patella. In addition to administration of analgesics, which of the following is the most appropriate management? - Arthroscopic lateral release - Arthroscopic medial plication - Closed reduction of the patella - Open reduction of the patella - Tibial tubercle medialization
Closed reduction of the patella
A 72-year-old man comes to the office for follow-up examination eight weeks after he underwent total arthroplasty of the right hip. The patient's rehabilitation had been progressing fairly well until approximately five days ago, when worsening pain developed in the hip. The patient says the pain is aggravated by walking and persists during sleeping hours even after he takes acetaminophen. Infection of the prosthetic joint is suspected. Which of the following is the most likely causative organism? - Coagulase-negative staphylococcus - Escherichia coli - Group A beta-hemolytic streptococcus - Haemophilus influenzae - Pseudomonas aeruginosa
Coagulase-negative staphylococcus
A 20 - year - old college student receives a several blow on the inferolateral side of the left knee joint while playing football. Radiographic examination reveals a fracture of the head and neck of the fibula. Which of the following nerves is damaged: - Tibial - Sciatic - Common perineal - Superficial peroneal
Common perineal
In fibular neck fracture, the following nerve is involved: - Common peroneal nerve - Anterior tibial nerve - Posterior tibial nerve - Medial popliteal nerve
Common peroneal nerve
In fibular neck fracture, the following nerve is involved: - Common peroneal nerve - Anterior tibial nerve - Posterior tibial nerve - Medial popliteal nerve
Common peroneal nerve
Internal splints (plate) are used in all except: - Compound (open) fractures - Multiple fractures - Fractures in elderly patients - Fractures of acetabulum
Compound (open) fractures
A male neonate who was delivered vaginally at term one hour ago has a deformity of the right foot. On physical examination, plantar flexion of the ankle, inversion of the subtalar joint, andmedial subluxation of the talocalcaneal and calcaneocuboid joints are noted. The position of the foot cannot be passively corrected. Which of the following disorders is the most likely diagnosis? - Calcaneovalgus - Congenital clubfoot - Metatarsus adductus - Pes planus - Tarsal coalition
Congenital clubfoot
A late complication of an acetabular fracture is: - Hip dysplasia - Acetabular impingement - Flexor-adductor contracture - Coxarthrosis
Coxarthrosis
Whats the preferred diagnostic modality for suspected bladder injury in case of pelvic fracture: - Cystography - Cystoscopy - Ultrasound - MRI( magnetic resonance imaging)
Cystography
What is the most common nerve injury that accompanies dislocation of the shoulder joint: - Damage to n. axillaris - Damage to n. radials - Damage to n. ulnas - Damage to n. median
Damage to n. axillaris
What is a SLAP lesion? - Damage to the proximal insertion site of the short head pf M.biceps brachii - None of the above - Damage to the proximal insertion site of the long head of M.biceps brachii - Damage to the distal insertion site of m. biceps brachii
Damage to the proximal insertion site of the long head of M.biceps brachii
What are the main mechanisms of fractures of the femoral diaphysis? - Vertical stress and compression - Axial stress and compression - Direct mechanism and axial stress - Direct and indirect mechanism
Direct and indirect mechanism
Why pertrochancteric fractures are indicated for surgery? - Due to the need for early verticalisation and mobilization of the patient - For reduction of bone oxidative stress - Because of need of evacuation of the hematoma - Because.... adhesion???
Due to the need for early verticalisation and mobilization of the patient
Female, 78y, falls and injures her right hip, on the examination, a fracture of the femoral neck is detected,what are the most likely clinical symptoms? - Impaired arterial conduction of a. femoris - External rotation and symptoms of the "nailed heel" - Hematoma in the inguinal fold - Parenthesis along the anterior muscle group
External rotation and symptoms of the "nailed heel"
Fall on heel with fracture os calcis is associated with: - Fracture clavicle - Fracture vertebra - Fracture femur - Posterior dislocation of hip
Fracture vertebra
Compound (open) fracture is: - Fracture with artery involvement - Fracture with nerve involvement - Fracture with muscle involvement - Fracture with penetration through the skin
Fracture with penetration through the skin
Which of the following activities causes acute compartment syndrome most frequently: - Fractures - Post ischemic swelling - Exercise initiated syndrome - Soft tissue injuries
Fractures
Prostate cancer develops: - from the peripheral zone of the prostate - from the central zone of the prostate - in patients with not cured chronic prostatitis - in patients with preceding benign prostatic hyperplasia
From the peripheral zone of the prostate
A patient with an undisplaced acetabular fracture is indicated for: - Percutaneous fixation with screws - Gait with no-weight bearing on the limb for 8 weeks - Bed rest for 2 weeks - Direct skeletal extension for 30 days
Gait with no-weight bearing on the limb for 8 weeks
Where is the attachment of the proximal part of the long head of m. biceps brachii? - Glenoid labrum in the area of the tubercular supraglenoidale
Glenoid labrum in the area of the tubercular supraglenoidale
Male, 31 y, suffered a motor bike accident with severe pain and deformity in the supracondylar region of his left knee.A supracondylar hip fracture is detected on the X- ray , which are the most likely clinical symptoms ? - Hemarthrosis, limited mobility, pain, inability to move independently - External rotation and symptom of the "nailed heel" - Hemarthrosis ,limited mobility, pain, the possibility of self-movement - Internal rotation and abduction
Hemarthrosis , limited mobility , pain , inability to move independently
Extracorporeal shock wave lithotripsy is recommended for the treatment of: - Kidney stones smaller than 2 cm - Ureteral stones in pregnant women - Bladder stones in men with benign prostatic enlargement - Urethral stones
Kidney stones smaller than 2 cm
A 20-year-old man who plays baseball on his college team comes to the clinic because he has had pain in the right elbow for the past three weeks. The pain began approximately one week after the beginning of the baseball season. Physical examination of the elbow shows full range of motion in flexion, extension, supination, and pronation. No pain is elicited on varus or valgus stress of the elbow. Dorsiflexion of the right hand against resistance immediately elicits pain that is localized to the lateral aspect of the elbow. Which of the following is the most likely diagnosis? - Biceps tendinitis - Fracture of the radial head - Lateral epicondylitis - Olecranon bursitis - Sprain of the lateral collateral ligament
Lateral epicondylitis
Medial meniscus of the knee joint is injured more often than the lateral meniscus because the medial meniscus is relatively: - More mobile - Less mobile - Thinner - Attached lightly to femur
Less mobile
What is the most suitable osteosynthesis implant in adults with transverse fracture of the femoral diaphysis? - Semitubular plate - Locking hip nail - DHS - Elastic titanium nails
Locking hip nail
Pott's fracture is fracture of: - Lower end of tibia - Lower end of tibia + fibula - Lower end of tibia + calcaneum - Calcaneum + talus
Lower end of tibia + fibula
Which muscle is not involved in the composition of the rotator cuff of the shoulder joint? - M.suprapinatious - M.triceps brachii - M.subscapularis - M.teres minor
M.triceps brachii
A 49-year-old man comes to the sports medicine office because he has pain in the right hip and thigh that has been worsening since he fell while working in his yard two weeks ago. Physical examination shows a healing puncture wound over the proximal aspect of the thigh. Erythema and warmth are noted over the lateral aspect of the right hip and the proximal aspect of the right thigh. Full range of motion of the hip is noted, and distal sensation and pulses are intact. On laboratory studies, erythrocyte sedimentation rate is 30 mm/hr. Results of complete blood cell count are within normal limits. X-ray studies of the hip show a slightly raised periosteum in the proximal femoral shaft. Which of the following additional diagnostic studies is most appropriate? - CT scan - Indium 111 bone scan - MRI - Technetium 99m bone scan - Ultrasonography
MRI
A 6-year-old boy is brought to the office by his parents because he has had pain in the right hip with weight-bearing as well as obvious limping for the past week. The patient's parents say they have noticed the child favoring his right leg during the past few weeks. He has not had any recent illness or injury to the leg. Medical history includes no chronic disease conditions. Physical examination shows tenderness on passive internal rotation of the hip joint and mild diffuse atrophy of the right thigh musculature. X-ray studies of the hip and femur show no abnormalities. Which of the following studies is the most appropriate next step? - Aspiration of the hip - Bone scan - CT scan - MRI - Ultrasonography
MRI
For which kidney stones infection is the main etiological factor? - Magnesium ammonium phosphate stones
Magnesium ammonium phosphate stones
The preferred treatment for renal colic in man or non pregnant woman is : - Non steroidal anti inflammatory drugs (NSAIDs)
Non steroidal anti inflammatory drugs (NSAIDs)
Retroperitoneal lymph node dissection is a standard treatment for which type of testicular cancer? - Non-seminoma
Non-seminoma
Dislocated acetabular fracture is indicated primarily for: - Open reduction and fixation with locking nail - Open reduction and fixation with reconstructive plates - External fixation - Hip arthroplasty
Open reduction and fixation with reconstructive plates
A 25-year-old man comes to the orthopedic clinic because he has had pain in the ankle since he sustained an inversion injury 10 days ago. The patient is otherwise healthy. On physical examination, the skin is intact and mild edema is noted. Tenderness to palpation is noted over the distal fibula and anteromedial ankle. Neurovascular examination shows no abnormalities. X- ray study is shown. Which of the following is the most appropriate management? - Application of a long leg cast - Application of a short leg cast - Closed reduction and external fixation - Open reduction and internal fixation - Percutaneous pinning
Open reduction and internal fixation
A 19-year-old man who is a long-distance runner is referred to the office by his primary care provider because he has had dull, aching pain in his right thigh after running during the past nine months. Six months ago, the patient's primary care provider prescribed ibuprofen, which relieves the pain only temporarily. The patient has no history of specific injury. Physical examination shows no abnormalities of the right lower extremity. X-ray studies of the right femur show cortical thickening of the distal one-third of the shaft with a central nidus measuring approximately 8 mm in diameter. Which of the following is the most likely diagnosis? - Aneurysmal bone cyst - Enchondroma - Osteoblastoma - Osteochondroma - Osteoid osteoma
Osteoid osteoma
The commonest cause of pathological fracture is generally determined as a result of: - Malignant processes - Osteoporosis - Cyst - All of the above
Osteoporosis
A 47 year old man is undergoing a road traffic accident. A fracture of the femoral neck without dislocation is found on the examination. what is the most appropriate method of treatment? - Osteosynthesis with reconstructive plate - Conservative treatment - Endoprosthetics - Osteosynthesis with cannulated screws or DHS
Osteosynthesis with cannulated screws or DHS
A 16-year-old girl who plays tennis on her high school team is brought to the emergency department by her parents because she has had pain and worsening swelling of her right knee since she sustained an injury during a match four hours ago. The patient says she was playing on a hard court and fell directly onto her knee. She was able to complete the match. The pain is localized to the anterior aspect of the knee and is dull in nature. The patient rates the pain as 6 on a 10-point scale. Physical examination of the right knee shows a fluctuant mass (5×3 cm) over the patella. Full range of motion is noted, and muscle strength is 5/5. Result of apprehension test is negative. Which of the following is the most likely diagnosis? - Dislocation of the patella - Fracture of the patella - Patellar tendinitis - Prepatellar bursitis - Sprain of the patellar ligament
Prepatellar bursitis
A 40-year-old woman comes to the emergency department because she has pain in the right arm two hours after she fell in her home. Physical examination shows swelling and deformity of the right arm. The patient is unable to dorsiflex the wrist. X-ray studies show a spiral midshaft fracture of the humerus. Which of the following nerves is most likely affected by this fracture? - Axillary - Median - Musculocutaneous - Radial - Ulnar
Radial
The mechanism of injury in transverse fracture of medial malleolus is due to: - Abduction injury - Adduction injury - Rotation injury - Direct injury
Rotation injury
What is a bankart lesion? - Damage of the anchor of the long head of biceps brachii - Rupture of the posterior labrum - Impact fracture of the posterior upper part of the head of the humerus - Rupture of the anterior- inferior glenoid labrum together with the anterior capsule- ligament complex
Rupture of the anterior- inferior glenoid labrum together with the anterior capsule- ligament complex
Which of the following statements about growth plate injuries are true? - Salter-harris type 2 are the commonest and are rarely cause growth arrest
Salter-harris type 2 are the commonest and are rarely cause growth arrest
Late complication of acetabular fracture: - Avascular necrosis of femoral head - Avascular necrosis of iliac crest - Fixed deformity of the hip joint - Secondary osteoarthritis of hip joint
Secondary osteoarthritis of hip joint
What is March (Doichlender's) fracture? - Stress fracture of 2nd metatarsal - Fracture of 4th metatarsal - Fracture of cuboids - Fracture of tibia
Stress fracture of 2nd metatarsal
Femoral head avascular necrosis is common in one of the following fracture patterns? - Pertrochanteric - Subcapital - Sub—trochanteric - Diaphysis of the femur
Subcapital
In transverse fracture of the patella, the treatment is: - Excision of a small fragment - Wirefixation - Plaster cylinder - Patellectomy
Wirefixation
The best treatment for men with voiding symptoms and prostate bigger than 100ml is: - a and d (open and HolEP)
a and d (open and HolEP)
