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Lower Extremity Disorders

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Quiz for Clinical Medicine block 2A
Derek Trautwein
Quiz by Derek Trautwein, updated more than 1 year ago
Derek Trautwein
Created by Derek Trautwein about 9 years ago
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Resource summary

Question 1

Question
Techniques of arthrocentesis includes skin prepping/draping, using a 30 mL syringe, and:
Answer
  • Lateral approach
  • Hemarthrosis
  • Corticosteroid therapy
  • 22-24 gauge needle

Question 2

Question
In order to obtain a diagnostic radiograph, what angle would you ideally want an x-ray? 1. Anterior Posterior 2. Oblique 3. Transverse 4. Posterior Anterior
Answer
  • 1 and 3
  • 2 and 4
  • 1, 2, 3
  • 4 only
  • All of the above

Question 3

Question
A 55 year old patient complains of acute knee pain w/o trauma localized over the patella and is unable to bear his own weight. What would this be an indication of and how would you proceed with treatment?
Answer
  • Positive Ottowa criteria; perform radiological exam
  • Patellar dislocation; perform reduction
  • ACL injury; perform arthrocentesis
  • Positive McMurray test; perform x-ray

Question 4

Question
While performing an arthrocentesis, you begin to draw blood into the syringe. What should you strongly suspect?
Answer
  • ACL tear
  • Chondromalacia patella
  • Patellar fracture
  • Femoral head fracture

Question 5

Question
Identify what test you would use to diagnose a meniscal tear: 1. Thessaly 2. Apley Distraction 3. McMurray 4. Straight leg raise
Answer
  • 1 and 3
  • 2 and 4
  • 1, 2, 3
  • 4 only
  • All of the above

Question 6

Question
A history of malalignment of the knee and increased Q-angle is needed in order to diagnose Chondromalacia patella.
Answer
  • True
  • False

Question 7

Question
A young female is more likely to be treated for what condition? 1. Bi-partite patella 2. Patellar dislocation 3. Pelvic fracture 4. Chondromalacia patella
Answer
  • 1 and 3
  • 2 and 4
  • 1, 2, 3
  • 4 only
  • All of the above

Question 8

Question
A 34 year old female presents with knee inflammation and pain localized over her left lateral femoral epicondyle while training for a marathon. What is the most likely injury?
Answer
  • Iliotibial band syndrome (ITBS)
  • Shin splints
  • Medial collateral ligament (MCL) injury
  • Chondromalacia patella

Question 9

Question
A 15 year old male complains of pain while walking and his knee periodically "locking up". You notice the patient has an altered gait due to external rotation in his right lower leg. What are these signs consistent with?
Answer
  • Osteochondritis dessicans (OCD)
  • Osgood Schlatter's disease (OSD)
  • Meniscal tear
  • Baker cyst

Question 10

Question
Subchondral bone necrosis of the femoral condyle indicates:
Answer
  • Osteochondritis dessicans (OCD)
  • Osgood Schlatter's disease (OSD)
  • Chondromalacia patella
  • Iliotibial band syndrome (ITBS)

Question 11

Question
Osteochondritis dessicans (OCD) may take several days to weeks to heal.
Answer
  • True
  • False

Question 12

Question
Possible secondary injury associated with an anterior cruciate ligament (ACL) injury: 1. Gapping >10 millimeters 2. Avulsion of tibial spine 3. Aponeurosis tear 4. Segond fracture
Answer
  • 1 and 3
  • 2 and 4
  • 1, 2, 3
  • 4 only
  • All of the above

Question 13

Question
In relation to the distal femur, an anterior cruciate ligament (ACL) injury would displace the tibia anteriorly.
Answer
  • True
  • False

Question 14

Question
Collateral ligament tears present with effusion.
Answer
  • True
  • False

Question 15

Question
Upon performing varus/valgus stress testing in a patient with suspected lateral cruciate ligament (LCL) tear, you record a gapping of the joint line is 11 millimeters. What would you classify this as?
Answer
  • Grade III tear
  • Grade I tear
  • Grade II tear
  • Grade IV tear

Question 16

Question
Posterior patellar surface inflammation secondary to abnormal mechanical wear and often maltracking of the patella indicates:
Answer
  • Chondromalacia patella
  • Patellar dislocation
  • Meniscal tear
  • Bursitis

Question 17

Question
What is the appropriate test to confirm an ACL injury? 1. Lachman 2. McMurray 3. Anterior drawer 4. Apley distraction
Answer
  • 1 and 3
  • 2 and 4
  • 1,2,3
  • 4 only
  • All of the above

Question 18

Question
A PCL injury would most likely present with:
Answer
  • Subtle effusion
  • Difficult with ambulation
  • Joint line tenderness
  • Anterior instability

Question 19

Question
The mechanism of injury for a MCL tear is valgus and rotary stress.
Answer
  • True
  • False

Question 20

Question
What injury would you be looking for if a patient's MOI is knee flexion with rotational stress while bearing weight?
Answer
  • Meniscal tear
  • PCL tear
  • Patellar subluxation
  • Tendonitis

Question 21

Question
A common MOI for an ACL injury is rotational twist with a flexed knee.
Answer
  • True
  • False

Question 22

Question
Blunt trauma to the anterior tibia would present a positive history MOI for what injury?
Answer
  • PCL injury
  • Meniscal tear
  • Osteochondritis dessicans (OCD)
  • LCL tear

Question 23

Question
When would you classify an injury as a knee dislocation? 1. ACL tear 2. Collateral ligament tear 3. PCL tear 4. Bi-partite patella
Answer
  • 1 and 3
  • 2 and 4
  • 1,2,3
  • 4 only
  • All of the above

Question 24

Question
The dangerous complication of a knee dislocation which requires immediate reduction is: 1. Popliteal artery damage 2. Tibial nerve injury 3. Severed peroneal nerve 4. Vascular compromise
Answer
  • 1 and 3
  • 2 and 4
  • 1,2,3
  • 4 only
  • All of the above

Question 25

Question
Visible deformity and instability secondary to ischemia is indicative of Osgood Schlatter's disease (OCD)
Answer
  • True
  • False

Question 26

Question
You can treat tendonitis with all of the following EXCEPT:
Answer
  • Corticosteroidal injection
  • APAP
  • NSAIDs
  • RICE

Question 27

Question
Tendonitis is an overuse injury, leading to micro tears.
Answer
  • True
  • False

Question 28

Question
A 12 year old male complains of pain at the site of patellar tendon insertion on the proximal tibia while playing basketball. What should you suspect based on patient history and presentation? 1. Osteochondritis dessicans 2. Tibial tubercle apophysitis 3. ACL injury 4. Osgood Schlatter's disease (OSD)
Answer
  • 1 and 3
  • 2 and 4
  • 1, 2, 3
  • 4 only
  • All of the above

Question 29

Question
What treatment is appropriate for Iliotibial band syndrome (ITBS)? 1. Corticosteroidal injection 2. Eversion orthotics 3. Ice 4. NSAIDs
Answer
  • 1 and 3
  • 2 and 4
  • 1, 2, 3
  • 4 only
  • All of the above

Question 30

Question
What statement is NOT true in regards to shin splints versus tibial stress fractures?
Answer
  • Shin splints presents as linear tenderness or pain
  • Tibial stress fracture pain is localized along short band
  • Tibial stress fracture is more common in females
  • Shin splints causes severe nocturnal pain

Question 31

Question
Prepatellar bursitis (housemaid's knee) is the most common synovial disorder.
Answer
  • True
  • False

Question 32

Question
What is indicated in bursitis management? 1. Compression wrap 2. Aspiration 3. Corticosteroidal injection 4. VMO strengthening
Answer
  • 1 and 3
  • 2 and 4
  • 1, 2, 3
  • 4 only
  • All of the above

Question 33

Question
Synovial disorder in the popliteal fossa that presents as a synovial lined sac: 1. Bursitis 2. Popliteal cyst 3. Prepatellar bursitis 4. Baker cyst
Answer
  • 1 and 3
  • 2 and 4
  • 1, 2, 3
  • 4 only
  • All of the above

Question 34

Question
Baker cysts develops secondary to intra-articular disorder in children.
Answer
  • True
  • False

Question 35

Question
While treating a femur fracture, the patient has sudden onset dyspnea prior to losing consciousness and you notice a patch of small lesions develop. What should you immediately suspect?
Answer
  • Fat embolus
  • Compartment syndrome
  • Apophysitis
  • Posterolateral dislocation

Question 36

Question
What would you expect to see in early compartment syndrome? 1. Disproportionate pain during muscle stretch 2. Absent pulses 3. Parasthesia 4. Dyspnea
Answer
  • 1 and 3
  • 2 and 4
  • 1, 2, 3
  • 4 only
  • All of the above

Question 37

Question
Distal pulses may be intact during late stage compartment syndrome.
Answer
  • True
  • False

Question 38

Question
34 year old patient complains of lower leg pain after a fall. Upon inspection, you notice severe edema in distal tibia and ankle with pallor and varying temperatures of the foot. What is your treatment for this patient?
Answer
  • Immediate fasciotomy
  • Arthrocentesis
  • Immediate reduction
  • Corticosteroidal injection
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