Austin Block 4

1

X-Ray of the left forearm of a 75 year old woman reveals an undisplaced fracture of the distal radius (a Colle's fracture). A forearm plaster is applied. She returns the following day complaining of increased pain. Her fingers.are cyanosed and cold with reduced sensation. The most likely diagnosis is:


  median nerve compression

  ulnar nerve compression

  rhabdomyolysis

  the plaster cast is too tight

  carpal tunnel syndrome

2

Which of the following statements about rheumatoid arthritis is true?


  Cox-2 selective NSAIDS (eg celecoxib) prevent disease progression

  radial deviation at the metacarpo-phalangeal joints is a characteristic deformity

  the distal interphalangeal joints are more commonly affected than the proximal interphalangeal joints

  the upper cervical vertebrae are more commonly affected than the lower cervical vertebrae

  a pleural effusion is most likely to be a transudate.

3

A 65 year old woman presents to the Emergency Department after a fall complaining of a painful left shoulder. X-Ray reveals a subcapital fracture of the humerus. She should be treated by:


  full length arm plaster for 8 weeks

  insertion of a nail into the shaft of the humerus

  excision of the head of the humerus

  collar and cuff for pain relief followed by early mobilization

  open reduction and stabilization by plate and pins

4

Which of the following fractures is most commonly associated with a significant vascular complication:


  Fracture of mid-shaft of femur

  Fracture of distal radius

  Fracture of lower end of tibia

  Supracondylar fracture of the humerus

  Subcapital fracture of humerus

5

Tenderness in the anatomical snuff box of the wrist suggests:


  Colle's fracture

  Smith's fracture

  Dislocated wrist

  Fractured scaphoid

  Fractured first metacarpal

6

The commonest malignant tumour of bone is:


  Secondary sarcoma

  Secondary carcinoma

  Secondary melanoma

  Lymphoma

  Osteosarcoma

7

Spontaneous (pathological) fractures occur in all of the following except:


  Secondary carcinoma

  Osteoporosis

  Osteomalacia

  Solitary bone cysts

  Acute osteomyelitis

8

In the history of a patient with a suspected tear of a meniscus you would expect all of the following, except:


  Giving way

  "Locking"

  A swollen knee

  That the patient was able to continue the activity during which the injury occurred

  Pain

9

The most frequent complication of Colle's fracture in a woman of 70 is:


  carpal tunnel syndrome

  stiffness of wrist and fingers

  ischaemic necrosis of distal fragment

  delayed union of fracture

  radial nerve injury

10

Which of the following is least likely to be involved in rheumatoid arthritis?


  elbows

  wrists

  metacarpophalangeal joints

  metatarsophalangeal joints

  C6-C7 intervertebral joint

11

A popliteal (Baker's) cyst of the knee is associated with:


  rheumatoid arthritis

  osteoarthritis

  internal disruption

  a normal joint

  all of the above

12

The clinical feature unique to a fracture is:


  Pain

  Swelling

  Bruising

  Crepitus

  Deformity