From the Guidelines
The most appropriate management for patients with chronic non-bacterial osteitis (CNO) involves a multidisciplinary approach, including patient education, lifestyle modifications, and pharmacological interventions, with the goal of relieving symptoms, maintaining functional capacity, reducing inflammation, and preventing structural damage, as recommended by expert consensus guidelines 1.
Here are 10 multiple-choice questions with answers and explanations for orthopedic recertification exams based on content typically found in orthopedic knowledge resources:
- Question 1: A 35-year-old male presents with chronic hip pain and radiographs showing evidence of osteonecrosis. Which of the following is the most appropriate initial management?
- A) Core decompression
- B) Total hip arthroplasty
- C) Non-operative management with pain control and activity modification
- D) Bone grafting Answer: C. Non-operative management with pain control and activity modification is the most appropriate initial management for osteonecrosis, as it can help alleviate symptoms and slow disease progression, as suggested by studies on osteonecrosis management 1.
- Question 2: A 50-year-old female presents with knee pain and radiographs showing medial compartment osteoarthritis. Which of the following is the most appropriate next step in management?
- A) Unicompartmental knee arthroplasty
- B) Total knee arthroplasty
- C) High tibial osteotomy
- D) Weight loss and continued non-operative management Answer: D. Weight loss and continued non-operative management is the most appropriate next step, as weight loss can reduce stress on the affected joint and improve symptoms, as recommended by guidelines for osteoarthritis management 1.
- Question 3: A 20-year-old male presents with anterior shoulder instability following a traumatic dislocation. Which of the following factors is associated with the highest risk of recurrent instability?
- A) Age under 30 years
- B) Female gender
- C) First-time dislocation
- D) Participation in non-contact sports Answer: A. Age under 30 years is associated with the highest risk of recurrent instability, as young patients are more likely to experience recurrent dislocations due to higher activity levels and greater tissue elasticity, as noted in studies on shoulder instability 1.
- Question 4: A 75-year-old female sustains an intertrochanteric hip fracture after a fall. Which of the following is the most appropriate surgical management?
- A) Total hip arthroplasty
- B) Hemiarthroplasty
- C) Dynamic hip screw
- D) Cephalomedullary nail Answer: D. Cephalomedullary nail is the most appropriate surgical management for intertrochanteric fractures, as it provides superior biomechanical stability and allows for early weight-bearing, as recommended by guidelines for hip fracture management 1.
- Question 5: A 15-year-old male presents with knee pain and limping. Radiographs show widening of the growth plate and posterior displacement of the femoral epiphysis. What is the most likely diagnosis?
- A) Osgood-Schlatter disease
- B) Slipped capital femoral epiphysis
- C) Legg-Calvé-Perthes disease
- D) Osteochondritis dissecans Answer: B. Slipped capital femoral epiphysis is the most likely diagnosis, as it typically affects adolescents during periods of rapid growth and involves displacement of the femoral head relative to the femoral neck, as described in studies on pediatric orthopedic conditions 1.
- Question 6: A 40-year-old construction worker presents with low back pain radiating to the lateral aspect of the right leg and foot with associated numbness. MRI shows a right-sided L5-S1 disc herniation compressing the S1 nerve root. What is the most appropriate next step?
- A) Lumbar fusion
- B) Microdiscectomy
- C) Epidural steroid injection
- D) Continued physical therapy Answer: C. Epidural steroid injection is the most appropriate next step, as it can provide diagnostic confirmation and therapeutic benefit for persistent radicular symptoms, as recommended by guidelines for low back pain management 1.
- Question 7: A 60-year-old female presents with hip pain and radiographs showing evidence of osteoarthritis. Which of the following is the most appropriate initial management?
- A) Total hip arthroplasty
- B) Hemiarthroplasty
- C) Non-operative management with pain control and activity modification
- D) Hip resurfacing Answer: C. Non-operative management with pain control and activity modification is the most appropriate initial management for osteoarthritis, as it can help alleviate symptoms and slow disease progression, as suggested by studies on osteoarthritis management 1.
- Question 8: A 25-year-old male presents with knee pain and radiographs showing evidence of osteochondritis dissecans. Which of the following is the most appropriate initial management?
- A) Arthroscopic debridement
- B) Open reduction and internal fixation
- C) Non-operative management with pain control and activity modification
- D) Bone grafting Answer: C. Non-operative management with pain control and activity modification is the most appropriate initial management for osteochondritis dissecans, as it can help alleviate symptoms and promote healing, as recommended by guidelines for osteochondritis dissecans management 1.
- Question 9: A 50-year-old male presents with shoulder pain and radiographs showing evidence of rotator cuff tear. Which of the following is the most appropriate initial management?
- A) Arthroscopic repair
- B) Open repair
- C) Non-operative management with pain control and physical therapy
- D) Shoulder replacement Answer: C. Non-operative management with pain control and physical therapy is the most appropriate initial management for rotator cuff tears, as it can help alleviate symptoms and improve function, as suggested by studies on rotator cuff tear management 1.
- Question 10: A 70-year-old female presents with hip pain and radiographs showing evidence of osteoporosis. Which of the following is the most appropriate initial management?
- A) Bisphosphonate therapy
- B) Hormone replacement therapy
- C) Non-operative management with pain control and activity modification
- D) Hip replacement Answer: A. Bisphosphonate therapy is the most appropriate initial management for osteoporosis, as it can help reduce the risk of fractures and improve bone density, as recommended by guidelines for osteoporosis management 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Orthopedic Recertification Exam Questions
The following multiple-choice questions are designed to assist in preparing for orthopedic recertification exams, based on the structure and content of OKU14, AAOS, and ABOS resources.
- Question 1: What is the primary goal of surgical interventions for femoral neck fractures in elderly patients?
- Question 2: Which classification systems are commonly used to characterize femoral neck fractures?
- A) Garden and Pauwels
- B) AO and OTA
- C) Neer and Judet
- D) None of the above Answer: A) Garden and Pauwels 2
- Question 3: What is the recommended treatment for elderly patients with displaced femoral neck fractures who are unfit for surgery?
- A) Non-operative treatment with close nursing care, physiotherapy, and pain management
- B) Operative treatment with in situ fixation
- C) Operative treatment with hemiarthroplasty
- D) Operative treatment with total hip arthroplasty Answer: A) Non-operative treatment with close nursing care, physiotherapy, and pain management 3
- Question 4: What is the purpose of the Orthopaedic In-Training Examination (OITE)?
- A) To assess a resident's knowledge of orthopedic surgery core principles
- B) To predict a resident's likelihood of passing the American Board of Orthopaedic Surgery Part 1 examination
- C) To provide a standardized, national test for orthopedic residents
- D) All of the above Answer: D) All of the above 5, 6
- Question 5: How can residents prepare for the OITE?
- A) By starting preparation early
- B) By practicing with old OITE or self-assessment examination questions
- C) By focusing on comprehension over memorization
- D) All of the above Answer: D) All of the above 5
- Question 6: What is the recommended fixation method for femoral neck fractures?
- A) Closed reduction with percutaneous cannulated screw instrumentation
- B) Open reduction and internal fixation
- C) Hemiarthroplasty
- D) Total hip arthroplasty Answer: A) Closed reduction with percutaneous cannulated screw instrumentation 4
- Question 7: What is the benefit of using biologic bone augmentation cement in the treatment of femoral neck fractures?
- A) It decreases postoperative fracture collapse
- B) It increases the risk of infection
- C) It has no effect on the outcome of the treatment
- D) It is not recommended for use in femoral neck fractures Answer: A) It decreases postoperative fracture collapse 4
- Question 8: What is the recommended treatment for active elderly patients with acetabular disease or severely displaced fractures?
- A) Unipolar arthroplasty
- B) Bipolar arthroplasty
- C) Primary total hip arthroplasty
- D) None of the above Answer: C) Primary total hip arthroplasty 4
- Question 9: What is the purpose of the Orthobullets PASS curriculum?
- A) To provide a review curriculum for OITE preparation
- B) To assess a resident's knowledge of orthopedic surgery core principles
- C) To predict a resident's likelihood of passing the American Board of Orthopaedic Surgery Part 1 examination
- D) None of the above Answer: A) To provide a review curriculum for OITE preparation 6
- Question 10: What is the benefit of using the Orthobullets PASS curriculum for OITE preparation?
- A) It increases the resident's score on the OITE
- B) It decreases the resident's score on the OITE
- C) It has no effect on the resident's score on the OITE
- D) It is not recommended for use in OITE preparation Answer: A) It increases the resident's score on the OITE 6