Trauma

Result from rotational forces that is perpendicular to the white matter of the brain
a. Epidural hematoma
b. Subdural hematoma
c. Diffuse axonal injury
d. Subarachnoid hemorrhage

c. Diffuse axonal injury

Sign/s of increasing intracranial pressure in patients with head injury
a. Deepening coma
b. Amnesia
c. Incoordination
d. Aphasia

a. Deepening coma

Tears from bridging veins after a minor head injury results to:
a. Acute subdural hematoma
b. Subacute subdural hematoma
c. Chronic subdural hematoma
d. Epidural hematoma

c. Chronic subdural hematoma

Traumatic cerebrospinal fluid leak typically stops:
a. 2 -3 days
b. 4 – 5 days
c. 7 – 10 days
d. 15 – 20 days

c. 7 – 10 days

This nerve arises from the posterior cord of the brachial plexus (C5, C6). It can be injured by the pressure of a badly adjusted crutch pressing upward into the armpit. Also seen on downward displacement of humeral head in shoulder dislocations or fractures of the surgical neck of humerus. Paralysis of the deltoid and teres minor muscles result to:
a. Radial nerve
b. Median nerve
c. Ulnar nerve
d. Axillary nerve

d. Axillary nerve

This type of hernia is most common in female and the neck of the sac is located below and lateral to pubic tubercle
a. Femoral hernia
b. Tibial hernia
c. Direct hernia
d. Rolling hernia

a. Femoral hernia

Upper lesion of the brachial plexus results in limb hanging or a waiter hinting for a tip and there’s a sensory loss down the lateral side of the arm. It is called:
a. Erb-Duchenne palsy (C5, C6 roots)
b. Klumpke palsy
c. Radial palsy
d. Axillary nerve palsy

a. Erb-Duchenne palsy (C5, C6 roots)

Wrist drop is due to nerve injury of
a. Radial nerve
b. Median nerve
c. Ulnar nerve
d. None of the above

a. Radial nerve

The femoral ring is bounded by the following except:
a. Femoral artery
b. Lacunar ligament
c. Inguinal ligament
d. Superior ramus of the pubis

a. Femoral artery

The inferior margin of the neck of femur form a smooth continuous curve with the superior margin of obturator foramen called
a. Bursa
b. Arch
c. Stability
d. Shenton’s line

d. Shenton’s line

The lymph drainage of the skin of the buttocks is into:
a. Internal iliac nodes
b. Popliteal nodes
c. Axillary nodes
d. Superior gluteal nodes

a. Internal iliac nodes

The skeletal muscle segmental innervation on plantar flexion of the ankle joint on tapping the Achilles tendon
a. S1 –S2
b. L2 – L4
c. S1 – S3
d. L1 – L2

a. S1 –S2

This nerve arises from the medial cord of the brachial plexus that gives off no cutaneous or motor branches in the axilla or in the arm. If the patient is asked to grip a piece of paper between the thumb and the index finger, he or she does so by strongly contracting the flexor pollicis longus and flexing the terminal phalanx or Froment’s sign. The nerve damaged is most likely:
a. Median nerve
b. Ulnar nerve
c. Radial nerve
d. Long thoracic nerve

b. Ulnar nerve

The avulsion of the insertion of one of the extensor tendons into the distal phalanges can occur if the distal phalanx is forcibly flexed when the tendon is taut. The last 20 degrees of active extension are lost, resulting in:
a. Mallet finger
b. Trigger finger deformity
c. Boutonniere
d. Felon

a. Mallet finger

The boundaries of the anatomical snuffbox, except:
a. Abductor pollicis brevis
b. Extensor pollicis longus
c. Extensor pollicis brevis
d. Abductor pollicis longus

a. Abductor pollicis brevis

The carpal bones are cartilaginous at birth, and the first carpal bone that ossifies is:
a. Capitate
b. Lunate
c. Trapezoid
d. Pisiform

a. Capitate

The clinical significance of the anatomic snuffbox
a. Scaphoid bone is easily palpated here, and the pulsations of the radial artery can be felt
b. Median nerve is restricted here
c. There is thickening of the fascia
d. Passage of the median nerve

a. Scaphoid bone is easily palpated here, and the pulsations of the radial artery can be felt

The fascial space in the forearm is called
a. Parona
b. Felon
c. Synovial sheath
d. Flexor sheath

a. Parona

Olaf came in after 7 days post injury and on physical examination it was noted that flexion of terminal phalanx of the thumb is lost. Thumb is laterally rotated and adducted. The hands look flattened and apelike. This is due to damage on
a. Median nerve
b. Ulnar nerve
c. Radial nerve
d. Long thoracic nerve

a. Median nerve

In long standing cases of nerve injury on ___, this assumes the characteristics of __ resulting in wasting of the paralyzed muscles, thus hypothenar eminences flattened and loss of convex curve to the medial border of the hand. On PE, the dorsum of the hand shows hollowing between the metacarpal bones caused by wasting of the dorsal interosseous muscles. The nerve damaged is most likely:
a. Median nerve
b. Ulnar nerve
c. Radial nerve
d. Long thoracic nerve

b. Ulnar nerve

The patient came into the ER and complained of pins and needle sensation on the hand. Most likely she is suffering from
a. Carpal tunnel syndrome
b. Tendinitis
c. Synovitis
d. Arthritis

a. Carpal tunnel syndrome

The patient sustained a stab wound along the thigh. Paralysis of quadriceps femoris was noted. The nerve injured is
a. Femoral nerve
b. Tibial nerve
c. Peroneal nerve
d. Sural nerve

a. Femoral nerve

Tendons of the following muscles forms the rotator cuff except
a. Teres major
b. Teres minor
c. Supraspinatus
d. Infraspinatus

a. Teres major

It refers to a ball and socket joint
a. Hip joint
b. Wrist joint
c. Elbow joint
d. Knee joint

a. Hip joint

It refers to an ellipsoid joint
a. Wrist joint
b. Shoulder joint – ball and socket
c. Hip joint
d. Elbow joint

a. Wrist joint

Jojo sustained a stab wound at the distal third forearm or just proximal to the flexor retinaculum. The nerve injury most likely:
a. Median nerve
b. Ulnar nerve
c. Radial nerve
d. Long thoracic nerve

a. Median nerve

Lower lesion of the brachial plexus are usually traction injuries caused by excessive abduction of the arm. It occurs in case of a person falling from height clutching at an object to save himself or herself
a. Erb-Duchenne palsy
b. Klumpke palsy
c. Radial palsy
d. Axillary nerve palsy

b. Klumpke palsy

Motor injury to this nerve results in calcaneovalgus
a. Tibial nerve
b. Obturator nerve
c. Common peroneal nerve
d. Femoral nerve

c. Common peroneal nerve

In the axilla, the nerve can be injured by the pressure of the upper end of a badly fitting crutch pressing up into the armpit or by a drunkard falling asleep with one arm over the back of the chair. It can be also damaged in the axilla by fractures and dislocations of the proximal end of the humerus where in the nerve is pulled downward, stretching the in the axilla excessively. The clinical findings are as follows except:
a. Wrist drop
b. Anesthesia at dorsal surface of the hand and the dorsal surface of the roots of the lateral three and a half fingers
c. Trophic changes are slight to absent
d. Claw hand deformity

d. Claw hand deformity

It is a fracture of the base of the metacarpal of the thumb caused by a violence applied along the long axis of the thumb or the thumb is forcefully abducted
a. Mallet finger
b. Trigger finger
c. Boutonniere deformity
d. Bennett’s fracture

d. Bennett’s fracture

It is a fracture of the distal end of the radius and occurs from a fall on the back of the hand. It is called:
a. Colles fracture
b. Galleazi fracture
c. Smith’s fracture
d. Montaggia’s fracture

a. Colles fracture

It is the largest bone of the foot and forms the prominence of the heel
a. Calcaneus
b. Talus
c. Cuneiform
d. Navicular

a. Calcaneus

It prevents the dislocation of femur backward
a. Anterior cruciate ligament
b. Posterior cruciate ligament
c. Lateral cruciate ligament
d. Medial cruciate ligament

b. Posterior cruciate ligament

Fracture of the distal end of radius resulting to a dinner fork deformity
a. Colles fracture
b. Galleazi fracture
c. Smith’s fracture
d. Montaggia’s fracture

a. Colles fracture

Henry sustained an injury in the elbow. On x-ray, a supracondylar fracture was noted on the PE flexion of the terminal phalanx of the thumb is lost because of the paralysis of the flexor pollicis longus. The nerve injury is most likely
a. Median nerve
b. Ulnar nerve
c. Radial nerve
d. Long thoracic nerve

a. Median nerve

If the proximal third of the radius is fractured and the distal end of the ulna is dislocated at the distal radioulnar joint, it is called:
a. Colles fracture
b. Galleazi fracture
c. Montaggia’s fracture
d. Smith’s fracture

b. Galleazi fracture

In adult, the chief arterial blood supply of the femur is:
a. Medial and lateral circumflex
b. Obturator artery
c. Superficial circumflex artery
d. Inferior gluteal artery

a. Medial and lateral circumflex

Injury to this nerve results in foot drop:
a. Sciatic nerve
b. Peroneal nerve
c. Sural nerve
d. Gluteal nerve

b. Peroneal nerve

A 65 year female after radical mastectomy complains of the inability to rotate the scapula during abduction of the arm above a right angle. On PE, it was noted that the vertebral border and inferior angle of the scapula is no longer kept closely applied to the chest wall and will protrude posteriorly known as winged scapula. The nerve involve is:
a. Ulnar nerve
b. Radial nerve
c. Median nerve
d. Long thoracic nerve

d. Long thoracic nerve

A 6 year old boy was brought to the emergency room. Radiologic findings noted ulnar shaft fracture and anterior dislocation of radial head with ruptured ulnar ligament. This type of fracture is called:
a. Colles fracture
b. Galleazi fracture
c. Smith’s fracture
d. Montaggia’s fracture

d. Montaggia’s fracture

Avulsion of the central slip of the extensor tendon proximal to its insertion into the base of the middle phalanx results from flexing of the proximal interphalangeal joint and hyperextension of the distal interphalangeal joint. This injury can result from direct end trauma to finger, direct trauma over the back of the proximal interphalangeal joint or laceration of the dorsum of the finger. This injury is called:
a. Mallet finger
b. Trigger finger
c. Boutonniere deformity
d. Felon

c. Boutonniere deformity

Distal row of carpal bones except
a. Lunate
b. Trapezoid
c. Capitate
d. Hamate

a. Lunate

Femoral artery has ____ branches
a. 5
b. 4
c. 3
d. 2

c. 5

A 24 year old male was brought to the ER. He sustained a stab wound at the right chest posterolateral at level of 7th ICS. He is not hypotensive and has no sign of peritoneal irritation. After an hour of observation, the patient became hypotensive, tachypneic, with distended neck veins, auscultation of the chest reveals decreased breath sounds with hyper resonance on percussion. The patient should immediately undergo:
a. Open thoracotomy
b. Tube thoracotomy insertion
c. Insertion of large bore needle at 2nd ICSMCL
d. Endotracheal insertion

c. Insertion of large bore needle at 2nd ICSMCL

The most likely diagnosis for this patient is:
a. Massive hemothorax
b. Cardiac tamponade
c. Flail chest
d. Tension pneumothorax

d. Tension pneumothorax

Glasgow coma scale of 7 or below in patient with head injury
a. Needs immediate intubation
b. Needs fluid resuscitation
c. Needs steroids
d. Needs no artificial support

a. Needs immediate intubation

Basal skull fractures at the anterior cranial fossa can be manifested by:
a. Blood or CSF from the nose
b. Lucid interval
c. Battle’s sign
d. Raccoon’s eye sign

a. Blood or CSF from the nose

Blunting of the costophrenic angle in chest x-ray of this patient indicates:
a. Pleural effusion
b. Cardiac tamponade
c. Pulmonary contusion
d. Hemothorax

a. Pleural effusion

Characterized by the reference of a lucid interval where the patient had loss of consciousness for several minutes, regains consciousness with mild signs and symptoms then again loss of consciousness:
a. Subarachnoid hematoma
b. Subdural hematoma
c. Sub pial hematoma
d. Epidural hematoma

d. Epidural hematoma

Classic triad seen in epidural hematoma includes the following except:
a. Coma
b. Amnesia
c. Fixed and dilated pupils
d. Decerebration

d. Decerebration

Clinical findings that can be observed in patient with injury to larynx and trachea
a. Respiratory distress
b. Hematemesis
c. Dysphagia
d. Paradoxical respiration

a. Respiratory distress

Clinical findings that can be observed in patient with injury to the cervical esophagus
a. Hematemesis
b. Respiratory distress
c. Hoarseness
d. Hemoptysis

c. Hoarseness

Diagnostic maneuvers that can be done in stable patient with neck injury, except:
a. Chest film
b. Esophagogram
c. CS Spine X-ray
d. Probing with hemostats

d. Probing with hemostats

Indication for doing thoracotomy in patient with hemothorax from a penetrating injury, except:
a. Initial drainage of more than 1 liter
b. Blunting of the costophrenic area – pleural effusion
c. Hypotension
d. Chest tube output of 100 ml/hr in the succeeding 3 hours

b. Blunting of the costophrenic area – pleural effusion

In epidural hematoma, the blood vessel commonly involved is the:
a. Venous sinuses
b. Carotid artery
c. Middle meningeal artery
d. Vertebral artery

c. Middle meningeal artery

Management of cerebral contusion includes the following, except:
a. Forced hyperventilation
b. Mannitol administration
c. Ventriculoperitoneal shunt
d. Dexamethasone

a. Forced hyperventilation

More than 90% of all trauma to the chest requiring surgical intervention would be adequately managed by:
a. Tube thoracostomy alone
b. Open thoracotomy
c. Insertion of large bore needle
d. Thoracentesis

a. Tube thoracostomy alone

Peri-auricular hematoma to fracture of the posterior cranial fossa is known as:
a. Lucid interval
b. Meningeal signs
c. Raccoon’s eye
d. Battle’s sign

d. Battle’s sign

Relative indication/s in doing neck exploration in penetrating neck injuries:
a. Expanding hematoma - absolute
b. Penetration of platysma
c. Subcutaneous emphysema - absolute
d. Sucking neck wound – absolute

b. Penetration of platysma