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Section 10. Multiple choice questions
Select the single best answer for each question:
1 With regard to injuries at the Lisfranc joint, which of the following is true?
A Arthrodesis is indicated for primarily ligamentous injuries
B Lisfranc’s ligament tethers the first and second metatarsal bases
C The navicular is dislocated
D The severity of the injury is less important than the final position
E The third metatarsal is the keystone
2 Which of the following is NOT a feature of Marfan’s syndrome?
A Aortic arch anomalies
B Brachydactyly
C Dislocation of the lens
D High arched palate
E Scoliosis
3 After a bite by a pit viper which of the following is most appropriate?
A Antivenom in the field
B Application of pressure immobilization
C Apply ice to the limb
D Electroshock therapy
E Sucking the wound
4 A middle-aged lady presents with left pes planovalgus. Examination reveals that she is unable to rise onto her toes on that side. After correction of her heel into neutral the forefoot remains rigidly supinated. Which would you treat her by?
A Pan-talar arthrodesis
B Tendon transfer and calcaneal osteotomy
C Tendon transfer, calcaneal osteotomy and medical cuneiform osteotomy
D Tenosynovectomy of tibialis posterior tendon
E Triple arthrodesis
5 A 20 year old suffers a Hawkins type III fracture of the talus. Which of the following is true?
A Regardless of the surgical treatment of this fracture, weight bearing should be delayed for 18 months to allow the talus to revascularize
B The subtalar joint is subluxed but the ankle joint normal
C There is a 90% rate of avascular necrosis of the body of the talus after this fracture
D There is a 90% rate of non-union of this fracture
E Those fractures treated conservatively tend to go into valgus
6 Which of the following is true with respect to calcaneal fracture?
A Approximately 60% are sustained in a fall from a height
B Böhler’s angle is increased to greater than 40°
C Greater than 50% of fractures are extra-articular in adults
D Reduced triceps surae power is a serious clinical problem
E Sustentaculum fracture rarely occurs as an isolated fracture
7 In poliomyelitis:
A Classically patients develop an equinovarus foot
B Feet affected by polio may be cold and blue
C Full leg braces are seldom required
D Heel varus is associated with forefoot valgus
E Muscle wasting only affects the foot extensors
8 In the treatment of an acute attack of gout:
A Prescribe allopurinol, building the dose up to 300 mg/day
B Prescribe colchicine in increasing dosage if renal function impaired
C Prescribe indomethacin and start allopurinol at high dose
D Prescribe probenecid and increase fluid intake
E Prescribe probenecid and reduce fluid intake
9 Regarding cartilaginous tumours in the foot:
A Chondrosarcomas are generally multiple
B Deep endosteal scalloping is characteristic of an enchondroma
C Lesions in the hindfoot are more likely to be malignant than those in the forefoot
D Malignant transformation from enchondroma is common
E The lesions are generally entirely radiolucent
10 A patient presents with a discolouration under her second toe nail. Would you?
A Amputate the digit immediately
B Arrange admission for excisional biopsy
C Assume that as there is no lymphadenopathy the lesion is benign
D Note with interest and arrange to review in 3 months
E Wedge resect the nail and shave the lesion
11 A child presents with metatarsus adductus.
A It is the most common cause of intoeing gait in children with diplegic cerebral palsy
B It will increase the first-second intermetatarsal angle (IMA) in patients with hallux valgus
C Long-term deformity is generally to be expected
D Split lateral anterior tibialis tendon transfer may be required to address muscle imbalance
E The majority of patients require surgical intervention
12 A 3-year-old presents with congenital curling of her third toe. Treatment should consist of:
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A A Girdlestone flexor digitorum longus to extensor digitorum transfer
B Excision of the PIP joint of the toe
C Lengthening of the extensor digitorum tendon and release of the dorsal joint capsule
D Stretching exercises and taping up of the digit
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