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1.   Supracondylar # of the humerus :
A.    Most common in children
B.    Not cause compartment syndrome (forearm)
C.    Can coz cubitus valgus
D.    Vascular insufficiencyif brachial artery compressed
E.   Ant. displacement of distal part

2.     Colle’s #
A.   ‘ dinner fork’ deformity T
B.   Distal fragment show ulnar side displacement
C.   Elderly patient treat by internal fixation
D.   Coz stiffness if elderly patient afraid to move the joint
E.   Tear of flexor pollicis longus (FPL) a few weeks after #

3.     # femoral neck
A.   Common in elderly man
B.   Look distortion of Shenton”s line (x-ray)
C.   Garden stage 11 ( show complete & minimal displaces)
D.    Treat surgically
E.   Increase incidence of AVN

4. Compartment syndrome
A. bleeding and edema increase pressure of osteofacial compartment
B. can still be present in the presence of palpable distal pulse
C. complication of tight cast
D. treated with analgesic and elevated limb
E. cause little long term disability


5. Indication of internal fixation
A. when fracture is unstable and prone to displace
B. open fracture with gross contamination
C. polytrauma, when to minimize risk of acute respiratory distress syndrome
D. pathological fracture, whereby bone disease may prevent healing
E. shortage hospital bed

6. Causes of pathological fracture
A. repetitive stress
B. osteomyelitis
C. bone cyst
D. previous traumatic fracture
E. secondary to bone tumour

7.    The common sites of fractures in patients with osteoporosis are :
A.   Femoral neck
B.   Distal tibia
C.   Sacrum
D.   Distal radius
E. Vertebrae

8.   Traumatic anterior dislocation of the shoulder :
A.   Is caused by forced adduction and internal rotation
B.   Causes the head of the humerus to end up just below the coracoids process
C.   Is less common occurred as compare to posterior dislocation
D.   Would result in axillary nerve injury as a complication
E.   Would likely to become recurrent if occurred in younger patient

9 . Regarding fractured bone healing :
A. The process starts subsequently from inflammation stage,reparative stage and remodeling stage
B. Stabilization of the fracture ends is necessary for healing process to occur
C. Osteoprogenitor cells within the periosteum are mobilized
D. Healing is always associated with callus formation
E. Remodeling stage would take two weeks to complete the process

10. Factor associate in non-union fracture
A. Infection
B. Smoking
C. Splintage with POP
D. Interposition of periosteum between fragments
E. Excessive traction

11. Sports injuries of knee
A. Meniscus tear is most common
B. Haemarthrosis usually occur due to torn meniscus
C. Swelling of the knee for the next day commonly due to cruciate ligament tear
D. Positive posterior drawer test indicate anterior cruciate ligament tear
E. Lateral meniscus tear is more common rather than medial meniscus tear

12. Safety and road traffic accident :
A. Accident is misnomer term, because mostly accident caused by the negligence
B. Usage of technologies can cause the accident
C. Strict law totally abolish RTA
D. Accident can give give impact to economic growth and insurance
E. Road design itself can induce accident

13. TB spondylitis
A. Biopsy is a helpful diagnosis
B. Multiple drug regime is the treatment of choice for uncomplicated case
C. Destructive process caused by delayed hypersensitivity reaction

14. Spinal injury
A. Vertebral fracture commonly cause spinal cord injury
B. Neurovascular examination is performed to reveal the level of spinal cord injury
C. Resuscitation is the initial management of spinal cord injury

15. Hangman’s fracture
A.    Known as traumatic spondylolisthesis of c2
B.    First noted on crimal in death sentenced by hanging as post-mortem examination
C.    Symptom – pain radiating along the course of greater occipital nerve
D.   Initial management – immobilize with Philadelphia collar

16. In low back pain
A. Associated with cauda equine syndrome
B. Acute disc prolapsed can occur in patient between 40-50 years of age
C. Advice on care of the back is of great importance
D. Spinal claudication is typical of spondylolisthesis
E. X-ray of the spine do not usual show any abnormality in acute disc prolapsed

17. Loose body in the knee joint can be produced by
A. Synovial chondromatosis
B. Osteochondritis dissecans
C. Osteoarthritis
D. Pigmented villous nodular synovitis
E. Osteochondral fracture

18. The feature that should trigger more active investigation of TB of joint
A. A long history of joint swelling
B. Involvement of multiple joint
C. Marked synovial thickening
D. Periarticular osteoporosis
E. Marked muscle swelling

19. Factors/aetiology of DDD
A. Obesity
B. Genetic and hereditary
C. Frequent cracking the knuckles of finger
D. DM
E. Gout

20. Amputation
A. Diabetic gangrene of the foot require amputation at the distal tibia
B. Below knee amputation ,weight is taken on the stump
C. Above knee amputation,weight is taken on the ischial tuberosity
D. Elderly patient refuse to use above knee prostheses because of the high energy requirement
E. Pain due to neuroma formation is a complication

21. Bone tumour
A. Osteochondroma has tendency to develop into low grade chondrosarcoma
B. Giant cell tumor of bone will not metastases to the lung
C. Multiple echondromatosis also known as Ollier’s disease
D. Ewing’s tumor may associated with elevated ESR
E. Metastases tumor are the most common malignant tumor in elderly patient

24. The unfavourable long term prognostic indication for Perthes
A.   Early onset
B.   Premature closure of growth plate
C.   Persistent lateral uncovering of femoral head
D.   Deformed femoral head
E.   Limited extension

25. Regarding the clubfoot
A. Can occur in the association with arthrogryposis
B. Female is more predominant
C. 50% bilateral involvement
D. Deformity described as fixed equines,heel varus,fore foot and mid foot adduction
E. Surgical correction is gold standard

26. Imaging of osteomyelitis
A. Earliest changes include minimal periosteal destruction and thickening
B. Usefulness of radionuclide scanning limited by an overall lack of specificity and marginal sensitivity
C. MRI can also evaluate extents of infectious problems
D. CT scan distinguish between soft tissue and bone infections and aids in biopsy and aspiration site
(MRI)
E. Sclerotic changes and periosteal new bone formation suggest acute OM

27. Achilles tendon rupture
A. Common in people > 40 years old
B. Simmond’s test positive
C. Result in difficult to walk tip-toe
D. Cannot be treat non-operatively
E. Treatment via surgical reconstruction will result in wound dehiscence as

28. Adhesive capsulitis (frozen shoulder) :
A. Commonly occurs in patient aged 40-60 years old
B. Is presented with loss of shoulder movement in all directions
C. Is caused by a trauma to the shoulder
D. Is a self limiting disease
E. In association with diabetes mellitus would result in poor recovery

29. Pseudogout
A. Is presented as an acute attack of arthritis which is self limiting
B. Is due to deposition of monosodium urate crystal
C. Is demonstrated by positive birefringent in polarized light microscopy
D. Can result in the formation of thopus
E. Is shown as chondrocalcinosis on plain x-ray



30. Trendelenburg’s sign in hip examination results is positive when conducted on patient with :
A. Non-union femoral neck fracture
B. Poliomyelitis affecting hip abductor muscles
C. Chronic hip joint dislocation
D. Fracture of lesser trochanter of the femur
E. Ankylosed hip

31. Fractures:
A. When due to repetitive stress are called pathological fractures
B. When due to forcible traction by a tendon are referred to as avulsion fractures.
C. Are classified to as comminuted when there is more than 1 fragment.
D. Will usually unite even the bone ends lie side by side with fractures surfaces making no contact at al.
E. In adults when incomplete are referred to as greenstick fractures.

32. Factors associated with non union of fractures include:
A. Fracture angulation
B. Smoking
C. Splintage with Plaster of Paris
D. Interposition of periosteum between the fragments.
E. Osteoporosis

33. In Monteggia fractures:
A. The upper half of the ulnar is fractured
B. The upper half of the radius is fractured
C. The radial head is dislocated
D. The distal radioulnar joint is dislocated
E. Open reduction and internal fixation is done in adults because it is an unstable fracture

34. Compartment Syndrome:
A. Occur when bleeding or edema increases the pressure in one of the osteofascial compartment
beyond systemic blob pressure.
B. Is characterized by excruciating pain
C. Is a complication of a tight plaster cast
D. Is adequately treated by analgesics and elevating the limb.
E. Cause little long term disability in untreated condition.

35. Regarding traumatic paraplegia.
A. Complete paralysis and anaesthesia is a consequence of spinal shock.
B. Bladder training is required T
C. Flexion contracture cannot be avoided.
D. Bedsore developed after 2 day.
E. Emotional rehabilitation is not vital

36. Neck of femur fracture
A. Avascular necrosis is late complication
B. Occur commonly in older men
C. Occur commonly in osteoporotic
D. Surgery is not indicated if displaced fracture
E. Garden type II is complete with minimal displacement.

37. Sports injury:
A. Lateral meniscus is commonly affected
B.   Lateral collateral ligament injury is commonly cause bleeding.
C.   ACL tear does not require surgical treatment
D.   Cruciate ligament tear will cause joint swelling after 2 days.
E.   Posterior tibia sagging is a sign of PCL tear.

38. Osteosarcoma
A. Present most commonly in the 6th decade of life.
B. Typically affects the diaphysis.
C. Affects males and females equally.
D. Is a tumour arising from bone and producing bone.
E. Spreads mainly to the regional lymph nodes.

39. In Peripheral nerve lesion:
A. Neuropraxia is a permanent lesion
B. Neurotmesis occurs when the nerve is completely divided
C. Recovery is unlikely when axonotmesis occurs
D. Axonal regeneration proceeds at a rate of 1mm a day.
E. Associated with a closed fracture is usually an axonotmesis or neurapraxia.

40. Gout
A. Rarely seen in young women
B. Most commonly due to myeloproliferative disease
C. Diagnosis beyond doubt by finding birefringent crystal in synovial fluid.
D. Can be confused with septic arthritis in an acute attack
E. Treatment with allopurinol in acute stage.

41. Rheumatoid arthritis
A. ESR increase T
B. Positive rheumatoid factors makes diagnosis certain
C. Periarticular erosions on xrays are characteristic
D. Diseases show relentless progression in majority of cases
E. Splintage of inflamed joint is contraindicated as it causes stiffness.

42. Traumatic posterior dislocation of the hip joint
A. Occur following a dashboard injury
B. Cause the hip to be positioned into externally rotated and flexed
C. Will result in avascular necrosis of the femoral head as its late complication
D. Will be associated with femoral nerve injury
E. Require an urgent open reduction

43. In acute hematogenous osteomyelitis:
A. Adults are more commonly affected than children
B. Can result in septic arthritis if occur in young children
C. Plain x-rays changes are evident within 1 week
D. C-reactive protein will be positive
E. Emphirical antibiotic is given without knowing the causative organism

44. The axillary nerve injury
A.    associated with fracture of the humeral head
B.   Is a complication following traumatic shoulder dislocation
C.   Results in weakness in shoulder abduction
D.   Results in numbness over the proximal forearm
E.   Occur following a closed injury is often neupraxia

45. Prognostic features for Perthes disease in a child is based on:
A. Age
B. Sex
C. Degree of the head involvement
D. Duration of the hip pain
E. Present of Trendelenberg sign


46. Concerning limb amputation:
A. It is indicated in mangled limb.
B. In below knee amputations, the weight bearing is taken on the stump end.
C. The energy requirement to move the prosthesis is higher as the level of the amputation is more
   distal.
D. Formation of neuroma will occur if the nerve is severed near the stump end
E. Phantom limb is a known complication following amputation

47. Ganglion
A. Occurs most commonly on the anterior aspect of the wrist
B. Is due to cystic degeneration in the joint capsule or tendon sheath
C. Sometimes disappears after some months
D. Must be incised to prevent pressure necrosis of the underlying bone
E. On the dorsum of the hand is often tender

48. Injuries to the physis
A. Commonly occur along the germinal zone of the growth plate
B. Are classifieds as Salter Harris Type 2 when fracture occur through the physis and
metaphysic
C. Is associated with haemathrosis
D. Do not warrant treatment via open reduction and internal fixation
E. May result in premature fusion of the growth plate

49. Features suggesting tuberculosis of the joints include
A. Involvement of multiple joints
B. A short history
C. Marked synovial thickening
D. Marked muscle wasting
E. Periarticular osteoporosis on plain x-rays

50. In De Quervein’s disease
A. The sheath containing the extensor pollicis longus is inflamed and thickened
B. Tenderness is felt at the ulnar styloid
C. Abduction of the thumb againt resistant is painful
D. Passive abduction of the thumb cross the palm is painful
E. Resistant ……..surgical sitting of the thickened tendon sheath

51. Complication of plaster immobilization
A. Vascular compression
B. Pressure sores
C. Nonunion
D. Allergy
E. Skin abrasion or laceration

52. In injuries of the spine:
A. Fracture of the pedicle C1 is known as Hangman’s fracture
B. Anterior wedge compression fractures will affect the anterior, the middle, and posterior column of
the vertebra
C. Fracture dislocation are unstable
D. A fall from height landing on the feet is associated with fractures at the thoracolumbar junction
E. Neurological deficit occur in the majority of patient

53. Acute lumbar disc prolapse
A. Commonly occur at the level of L4/L5
B. At the level of L4/L5 will compress the L4 nerve
C. Can result in sciatica
D. Can be diagnosed through plain X-Rays
E. Is treated surgically in the presence of cauda equina.

54. Congenital Talipes Equino Varus (CTEV)
A. Is a polygenic inheritance
B. Occur more in female compare to male
C. Bilateral involvement is 1/3
D. Pathoanatomy talus is pointing upwards
E. Correction after 5 years old is difficult

55. Tredelenburg sign is positive in this condition
A. Femoral neck fracture
B. Poliomyelitis affecting abductor muscle
C. Dislocated hip
D. Fracture of lesser trochanter of femur
E. Synovitis of hip joint

56. Foot disorder in Diabetes mellitus
A. Clawing toes as result from intrinsic muscle imbalance
B. Dry gangrene of toes following angiopathy may need urgent amputation
C. Ulcer formation around pressure area suggestive of neuropathic complication
D. ABSI is useful parameter to assess peripheral angiopathy
E. Loss of proprioception may lead to charcot joint

57. Median nerve palsy
A. Thumb opposition weak
B.   Loss of sensation of ulnar three and a half fingers
C.   Low lesion due to carpal dislocation ?
D.   High lesion, long flexor of little finger is paralysed
E.   High lesion has pointing index sign when clinch the hand

58. Degenerative spine disease
A. Hyperthropied facet joint may cause nerve compression in lateral canal stenosis
B. Positive Babinski may be the only manifestation of cord myelopathy
C. Neurogenic claudication can be relieved by sitting or squatting down
D. Surgery is main choice of treatment
E. Osteophytic formation induced by vertebral instability

59. Indication of internal fixation
A. Gustilo type 3
B. Wound >5cm with massive tissues destruction
C. Unstable joint fracture with large articular surface involvement need accurate reduction
D. Polytrauma with comminuted fracture that need nursing care
E. Availability of surgeon expert in internal fixation

60. Compartment syndrome…
A. Bleeding and edema can increase at one of the osteofascial compartment
B. Can be present in the presence of pulse distal to the fracture site
C. The limb distal to the fracture became parasthesia
D. Can adequately treated by elevating the limb and antibiotics
E. Can lead to muscle contracture if not appropriately treated

61. Fracture of the forearm bones
A. Galleazi fracture is a fracture of the proximal ulna with dislocation of the radial head
B. Fracture neck of radius can cause posterior interosious nerve injury
C. Malunion of the Monteggia fracture can lead limitation of the supination and pronation.
D. Proximal forearm fracture usually leads to compartment syndrome
E. Displace fracture of the shaft of the radius need the ORIF

62. Colles fracture
A. Extraarticular fracture of the distal radius
B. The distal fragment will displace anteriorly
C. Most common type of all fractures in elderly
D. Need the ORIF
E. malunion can cause ‘gunstock’ deformity.

63. Regarding Tuberculosis, which statement is true:-
A.    Start as synovitis
B.    Pain at night is worse and is called as “nightmare cries”
C.    May result ankylosis
D.    Treat by Arthrotomy

64. Regarding ulnar Nerve:-
A. More clawed in higher lesion
B. Ulnar 3 fingers sensation is loss
C. Cause loss of adduction of thumb
D. Affect lumbrical which cause metacarpophalangeal extend
65. Ankylosing Sponylitits
A. Associated with HLABRA 7
B. Always associated with false positive rheumatoid factor
C. Common in Africans

66. In stenosing tenovaginitis (trigger finger):
A. The extensor tendon is commonly involved
B. The usual cause is thickening of the fibrous tendon sheath
C. The triggering occurs during flexion of the involved finger
D. A tender nodule can be felt in front of the affected area
F. The ring and middle fingers are most commonly affected

67. Gas gangrene:
A. Is caused by Streptococcus pyogenes infection
B. Is characterized by myonecrosis
C. Often manifests itself within 24 hours of injury
D. Causes little pyrexia but increases pulse rate
E. Is treated mainly by strong antibiotics

68. Rotator cuff tears:
A. May occur as a complication of chronic tendinitis
B. Is mostly presentable as limitation of glenohumeral joint movement in all directions
C. Is associated with ‘hook’ shaped acromion
D. Is commonly occur to supraspinatus tendon
E.Is ideally repair surgically in all elderly patients

69. Developmental dislocation of the hip
A. Can be demonstrated by Ortoloni test.
B. Trendelenburg test is positive in a child who is able to stand.
C. It is common in a child who presented with breech position during intrauterine.
D. Boys are more common than girls.
E. Increase acetabular angle in plain x-ray.

70. Regarding malignant bone tumours
A. Fibrosarcoma can arise from giant cell tumour
B. Ewing tumour presented with ‘onion peeling’ in plain x-ray.
C. Osteoblastic activity in prostate carcinoma

71. Management of diabetic foot ulcer (risk of amputation)
A. Superficial ulcer
B. Uncontrolled hyperglycaemia
C. Previous amputation
D. Uncontrolled infection
E. ABSI > 1.1
72. Radiological features of OA
A. Subchondral cyst
B. Osteophyte formation
C. Widening of joint space
D. Ankylosis
E. Periosteal osteoporosis

73. Ganglion cyst around wrist:
A. Common in male
B. Present as solitary nodule only
C. Mucoid degeneration of collagen and connective tissue
D. Contain mucin, albumin and globulin
E. Common in volar aspect of wrist

74. In crystal deposition disorder
A. Exclusively in gout
B. Gout can be diagnosed by characteristics of crystals in joint fluid
C. Intake of purine can diminish the symptom of gout
D. Pseudogout characterized by calcium pyrophosphate deposition
E. Acute symptom of gout can be treated by NSAIDs

75. Amputation
A. Diabetic gangrene of the foot require amputation at the distal tibia
B. Below knee amputation ,weight is taken on the stump
C. Above knee amputation,weight is taken on the ischial tuberosity
D. Elderly patient refuse to use above knee prostheses because of the high energy requirement
E. Pain due to neuroma formation is a complication

76. Regarding tenosynovitis:
A.       In the proliferative type, it starts within the synovial lining of tendon sheath or invades the
        tendon from involvement of a contagious joint.
B.       In crystalline type, precipitation of crystalline outside the confines of an enclosed space triggers
        fulminant inflammatory reaction.
C.       Calcium pyrophosphate deposition disease can cause acute inflammatory tenosynovitis within
        carpal tunnel.
D.       In stenosing tenovaginitis synovial proliferation is common
E.       De Quervain’s disease involves first compartment of the extensor part of the wirst.

77. Gene therapy:
A. Used to replace the non functional gene to become functional
B. RNA interference is used to activate a silent gene
C. Rota-viruses are used as carriers for the gene to be inserted into genome
D. Gene therapy is used to treat multifactorial gene problem
E. Gene therapy is used to produce bone growth.

78. Bone cells:
A.      Osteoblast is a polynucleated cell
B.      Osteocyte is a mature bone cell trapped in matrix
C.      Bone lining cells are immature cells
D.      Osteoclast is used for bone resorption
E.      Osteoclasts found in ‘ruffled border’

79. Rheumatoid Arthritis
A. Incidence is peak in 20-30 years of age
B. HLA-DR is occurs in 70% of people with RA
C. T-cell produced anti-IgG auto antibody, which is detected as Rheumatoid factor
D. Muscle weakness common present
E. In early stage, plain X-ray can show periarticular osteopenia

80. Charcoat joint caused by
A. Neurosyphilis
B. RA
C. Multiple myeloma
D. Peripheral neuritis
E. Gouty arthritis

81. DVT
A. Homan’s sign reliable clinical sign toward the diagnosis
B. Present with pain in calf region
C. Followed hip arthroplasty
D. Confirmed by Doppler ultrasound
E. LMW heparin are used as prophylaxis and treatment

82. In slipped capital femoral epiphysis
A. Affects girls more than boys
B. In 30% of acute slip with history of trauma
C. Slip occur in the proliferative zone of epiphysis plate
D. Confined to prepubertal growth age

83. in fracture of phalanges and metaphalanges
A. Undisplaced # of phalanges can be splinted to its neighbor
B. It is important to correct malrotation
C. Bernett # occur at the base of 5th metacarpal
D. Immobilization should be at least 6/52
E. Stiffness is the most important complication

84. Regarding CTEV
A. Hindfoot is dorsiflexed
B. Forefoot is internally rotated
C. Forefoot is everted
D. Calf muscle is underdeveloped
E. Treatment begin within 2-3 days after birth

85. Regarding Amputation
A. Diabetic gangrene of the foot require amputation at the distal tibia
B. Below knee amputation ,weight is taken on the stump
C. Above knee amputation, weight is taken on the ischial tuberosity
D. Elderly patient refuse to use above knee prostheses because of the high energy requirement
E. Pain due to neuroma formation is a complication

86. Fat embolism
A. Occurs after 3 days
B. Treatment mainly oxygen therapy
C. Shortness of breath, mild confusion and restlessness
D. Commonly seen in elderly patient followed minor trauma
E. Due to circulating fat globules

87. Archilles tendon rupture
A. Occurs in degenerate tendon

B.   Positive Simmon’s test
C.   Cannot be treated conservatively
D.   Patient have difficulty in walking tiptoe
E.   Complicated with wound dehiscence of surgical treatment

88. Carpal tunnel syndrome
A. More common in men than women
B. Caused hypothenar muscle wasting in late case
C. Happened in hypothyroid
D. Paraesthesia of fingers after fully palmarflexion in 1 minute
E. Treated surgically with incision of anterior carpal ligament

89. regarding examination of the knee
A. Anterior drawer test indicate PCL instability
B. Lachman tset is elicit in 90o flexion of knee
C. Q angle is required for patella subluxation
D. Positive patella tap indicate grossly knee effusion
E. Mc Murray classically for bucket handle tear of knee menisci

90. posterior hip dislocation
A. Less commonly than anterior dislocation
B. Lies in extension, abduction and externally rotated
C. Occur in dashboard injury
D. If involved with # of femoral head, closed reduction will be fail
E. Sciatic nerve injury is a complication

91. acute lumbar disc prolapsed
A. Common at L4 and L5
B. If occur at L4 & L5, L4 will be compressed
C. Plain xray is diagnostic
D. Sciatic nerve injury
E. Surgical intervention if involves cauda equine

92. spondylolisthesis
A.   Is forward shift displacement of vertebrae above on stable vertebrae below
B.   Common at L4,L5 and L5,S1
C.   Cannot occur in degenerative process
D.   In childhood is painful
E.   Operation is indicated in neurological deficit

93. multiple myeloma
A. Malignant B cell lymphoproliferative disorder of marrow
B. Sclerotic lesion is seen through out skeleton
C. Associated with increase blood viscosity
D. Bensen Jenssn protein in urine in 90% of patient
E. Sensitive to ankylating cytotoxic agents

94. bone healing
A. The process starts subsequently from inflammation stage,reparative stage and
     remodeling stage
B. Stabilization of the fracture ends is necessary for healing process to occur
C. Osteoprogenitor cells within the periosteum are mobilized
D. Healing is always associated with callus formation
E. Remodeling stage would take two weeks to complete the process

95. # in children
A. Rotational malalignment of # bone corrected by remodeling process
B. Metaphyseal alignment avulsion # lead to premature closure of adjacent growth plate
C. Apophysis injury lead to longitudinal growth arrest of bone
D. Salter Harris type IV treated by conservative treatment
E. Displaced supracondylar # of humerus treated by close reduction and percutaneous pin under image
intensifier

96. definite indication for internal fixation
A. When # is unstable and prone to displace after closed reduction
B. Open # with gross contamination
C. Polytrauma, afraid of ARDS
D. Pathological # which bone disease prevent healing process
E. Humeral # associate without radial nerve injury

97. frozen shoulder (shoulder tendinitis)
A. Commonly found in younger age
B. Restrict movement in forward flexion only
C. Cause by trauma to shoulder
D. Self limiting disease
E. Recover process is difficult in DM

98. Causes of pathological fracture
A. repetitive stress
B. osteoporosis
C. bone cyst
D. previous traumatic fracture
E. secondary to bone

99. anterior shoulder instability
A. Commonly occur in elderly men followed by an acute traumatic event
B. Can cause humeral head articular damage
C. Is associated with Bankart lesion
D. Positive Apprehension test
E. Mainly treated by conservative treatment

100. Late complications of fracture include
A. Non-union
B. Joint contracture
C. Osteomyelitis
D. Muscle atrophy
E. Bleeding

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Ganyang Ortho questions

  • 1. 1. Supracondylar # of the humerus : A. Most common in children B. Not cause compartment syndrome (forearm) C. Can coz cubitus valgus D. Vascular insufficiencyif brachial artery compressed E. Ant. displacement of distal part 2. Colle’s # A. ‘ dinner fork’ deformity T B. Distal fragment show ulnar side displacement C. Elderly patient treat by internal fixation D. Coz stiffness if elderly patient afraid to move the joint E. Tear of flexor pollicis longus (FPL) a few weeks after # 3. # femoral neck A. Common in elderly man B. Look distortion of Shenton”s line (x-ray) C. Garden stage 11 ( show complete & minimal displaces) D. Treat surgically E. Increase incidence of AVN 4. Compartment syndrome A. bleeding and edema increase pressure of osteofacial compartment B. can still be present in the presence of palpable distal pulse C. complication of tight cast D. treated with analgesic and elevated limb E. cause little long term disability 5. Indication of internal fixation A. when fracture is unstable and prone to displace B. open fracture with gross contamination C. polytrauma, when to minimize risk of acute respiratory distress syndrome D. pathological fracture, whereby bone disease may prevent healing E. shortage hospital bed 6. Causes of pathological fracture A. repetitive stress B. osteomyelitis C. bone cyst D. previous traumatic fracture E. secondary to bone tumour 7. The common sites of fractures in patients with osteoporosis are : A. Femoral neck B. Distal tibia C. Sacrum D. Distal radius
  • 2. E. Vertebrae 8. Traumatic anterior dislocation of the shoulder : A. Is caused by forced adduction and internal rotation B. Causes the head of the humerus to end up just below the coracoids process C. Is less common occurred as compare to posterior dislocation D. Would result in axillary nerve injury as a complication E. Would likely to become recurrent if occurred in younger patient 9 . Regarding fractured bone healing : A. The process starts subsequently from inflammation stage,reparative stage and remodeling stage B. Stabilization of the fracture ends is necessary for healing process to occur C. Osteoprogenitor cells within the periosteum are mobilized D. Healing is always associated with callus formation E. Remodeling stage would take two weeks to complete the process 10. Factor associate in non-union fracture A. Infection B. Smoking C. Splintage with POP D. Interposition of periosteum between fragments E. Excessive traction 11. Sports injuries of knee A. Meniscus tear is most common B. Haemarthrosis usually occur due to torn meniscus C. Swelling of the knee for the next day commonly due to cruciate ligament tear D. Positive posterior drawer test indicate anterior cruciate ligament tear E. Lateral meniscus tear is more common rather than medial meniscus tear 12. Safety and road traffic accident : A. Accident is misnomer term, because mostly accident caused by the negligence B. Usage of technologies can cause the accident C. Strict law totally abolish RTA D. Accident can give give impact to economic growth and insurance E. Road design itself can induce accident 13. TB spondylitis A. Biopsy is a helpful diagnosis B. Multiple drug regime is the treatment of choice for uncomplicated case C. Destructive process caused by delayed hypersensitivity reaction 14. Spinal injury A. Vertebral fracture commonly cause spinal cord injury B. Neurovascular examination is performed to reveal the level of spinal cord injury C. Resuscitation is the initial management of spinal cord injury 15. Hangman’s fracture
  • 3. A. Known as traumatic spondylolisthesis of c2 B. First noted on crimal in death sentenced by hanging as post-mortem examination C. Symptom – pain radiating along the course of greater occipital nerve D. Initial management – immobilize with Philadelphia collar 16. In low back pain A. Associated with cauda equine syndrome B. Acute disc prolapsed can occur in patient between 40-50 years of age C. Advice on care of the back is of great importance D. Spinal claudication is typical of spondylolisthesis E. X-ray of the spine do not usual show any abnormality in acute disc prolapsed 17. Loose body in the knee joint can be produced by A. Synovial chondromatosis B. Osteochondritis dissecans C. Osteoarthritis D. Pigmented villous nodular synovitis E. Osteochondral fracture 18. The feature that should trigger more active investigation of TB of joint A. A long history of joint swelling B. Involvement of multiple joint C. Marked synovial thickening D. Periarticular osteoporosis E. Marked muscle swelling 19. Factors/aetiology of DDD A. Obesity B. Genetic and hereditary C. Frequent cracking the knuckles of finger D. DM E. Gout 20. Amputation A. Diabetic gangrene of the foot require amputation at the distal tibia B. Below knee amputation ,weight is taken on the stump C. Above knee amputation,weight is taken on the ischial tuberosity D. Elderly patient refuse to use above knee prostheses because of the high energy requirement E. Pain due to neuroma formation is a complication 21. Bone tumour A. Osteochondroma has tendency to develop into low grade chondrosarcoma B. Giant cell tumor of bone will not metastases to the lung C. Multiple echondromatosis also known as Ollier’s disease D. Ewing’s tumor may associated with elevated ESR E. Metastases tumor are the most common malignant tumor in elderly patient 24. The unfavourable long term prognostic indication for Perthes
  • 4. A. Early onset B. Premature closure of growth plate C. Persistent lateral uncovering of femoral head D. Deformed femoral head E. Limited extension 25. Regarding the clubfoot A. Can occur in the association with arthrogryposis B. Female is more predominant C. 50% bilateral involvement D. Deformity described as fixed equines,heel varus,fore foot and mid foot adduction E. Surgical correction is gold standard 26. Imaging of osteomyelitis A. Earliest changes include minimal periosteal destruction and thickening B. Usefulness of radionuclide scanning limited by an overall lack of specificity and marginal sensitivity C. MRI can also evaluate extents of infectious problems D. CT scan distinguish between soft tissue and bone infections and aids in biopsy and aspiration site (MRI) E. Sclerotic changes and periosteal new bone formation suggest acute OM 27. Achilles tendon rupture A. Common in people > 40 years old B. Simmond’s test positive C. Result in difficult to walk tip-toe D. Cannot be treat non-operatively E. Treatment via surgical reconstruction will result in wound dehiscence as 28. Adhesive capsulitis (frozen shoulder) : A. Commonly occurs in patient aged 40-60 years old B. Is presented with loss of shoulder movement in all directions C. Is caused by a trauma to the shoulder D. Is a self limiting disease E. In association with diabetes mellitus would result in poor recovery 29. Pseudogout A. Is presented as an acute attack of arthritis which is self limiting B. Is due to deposition of monosodium urate crystal C. Is demonstrated by positive birefringent in polarized light microscopy D. Can result in the formation of thopus E. Is shown as chondrocalcinosis on plain x-ray 30. Trendelenburg’s sign in hip examination results is positive when conducted on patient with : A. Non-union femoral neck fracture B. Poliomyelitis affecting hip abductor muscles C. Chronic hip joint dislocation
  • 5. D. Fracture of lesser trochanter of the femur E. Ankylosed hip 31. Fractures: A. When due to repetitive stress are called pathological fractures B. When due to forcible traction by a tendon are referred to as avulsion fractures. C. Are classified to as comminuted when there is more than 1 fragment. D. Will usually unite even the bone ends lie side by side with fractures surfaces making no contact at al. E. In adults when incomplete are referred to as greenstick fractures. 32. Factors associated with non union of fractures include: A. Fracture angulation B. Smoking C. Splintage with Plaster of Paris D. Interposition of periosteum between the fragments. E. Osteoporosis 33. In Monteggia fractures: A. The upper half of the ulnar is fractured B. The upper half of the radius is fractured C. The radial head is dislocated D. The distal radioulnar joint is dislocated E. Open reduction and internal fixation is done in adults because it is an unstable fracture 34. Compartment Syndrome: A. Occur when bleeding or edema increases the pressure in one of the osteofascial compartment beyond systemic blob pressure. B. Is characterized by excruciating pain C. Is a complication of a tight plaster cast D. Is adequately treated by analgesics and elevating the limb. E. Cause little long term disability in untreated condition. 35. Regarding traumatic paraplegia. A. Complete paralysis and anaesthesia is a consequence of spinal shock. B. Bladder training is required T C. Flexion contracture cannot be avoided. D. Bedsore developed after 2 day. E. Emotional rehabilitation is not vital 36. Neck of femur fracture A. Avascular necrosis is late complication B. Occur commonly in older men C. Occur commonly in osteoporotic D. Surgery is not indicated if displaced fracture E. Garden type II is complete with minimal displacement. 37. Sports injury: A. Lateral meniscus is commonly affected
  • 6. B. Lateral collateral ligament injury is commonly cause bleeding. C. ACL tear does not require surgical treatment D. Cruciate ligament tear will cause joint swelling after 2 days. E. Posterior tibia sagging is a sign of PCL tear. 38. Osteosarcoma A. Present most commonly in the 6th decade of life. B. Typically affects the diaphysis. C. Affects males and females equally. D. Is a tumour arising from bone and producing bone. E. Spreads mainly to the regional lymph nodes. 39. In Peripheral nerve lesion: A. Neuropraxia is a permanent lesion B. Neurotmesis occurs when the nerve is completely divided C. Recovery is unlikely when axonotmesis occurs D. Axonal regeneration proceeds at a rate of 1mm a day. E. Associated with a closed fracture is usually an axonotmesis or neurapraxia. 40. Gout A. Rarely seen in young women B. Most commonly due to myeloproliferative disease C. Diagnosis beyond doubt by finding birefringent crystal in synovial fluid. D. Can be confused with septic arthritis in an acute attack E. Treatment with allopurinol in acute stage. 41. Rheumatoid arthritis A. ESR increase T B. Positive rheumatoid factors makes diagnosis certain C. Periarticular erosions on xrays are characteristic D. Diseases show relentless progression in majority of cases E. Splintage of inflamed joint is contraindicated as it causes stiffness. 42. Traumatic posterior dislocation of the hip joint A. Occur following a dashboard injury B. Cause the hip to be positioned into externally rotated and flexed C. Will result in avascular necrosis of the femoral head as its late complication D. Will be associated with femoral nerve injury E. Require an urgent open reduction 43. In acute hematogenous osteomyelitis: A. Adults are more commonly affected than children B. Can result in septic arthritis if occur in young children C. Plain x-rays changes are evident within 1 week D. C-reactive protein will be positive E. Emphirical antibiotic is given without knowing the causative organism 44. The axillary nerve injury
  • 7. A. associated with fracture of the humeral head B. Is a complication following traumatic shoulder dislocation C. Results in weakness in shoulder abduction D. Results in numbness over the proximal forearm E. Occur following a closed injury is often neupraxia 45. Prognostic features for Perthes disease in a child is based on: A. Age B. Sex C. Degree of the head involvement D. Duration of the hip pain E. Present of Trendelenberg sign 46. Concerning limb amputation: A. It is indicated in mangled limb. B. In below knee amputations, the weight bearing is taken on the stump end. C. The energy requirement to move the prosthesis is higher as the level of the amputation is more distal. D. Formation of neuroma will occur if the nerve is severed near the stump end E. Phantom limb is a known complication following amputation 47. Ganglion A. Occurs most commonly on the anterior aspect of the wrist B. Is due to cystic degeneration in the joint capsule or tendon sheath C. Sometimes disappears after some months D. Must be incised to prevent pressure necrosis of the underlying bone E. On the dorsum of the hand is often tender 48. Injuries to the physis A. Commonly occur along the germinal zone of the growth plate B. Are classifieds as Salter Harris Type 2 when fracture occur through the physis and metaphysic C. Is associated with haemathrosis D. Do not warrant treatment via open reduction and internal fixation E. May result in premature fusion of the growth plate 49. Features suggesting tuberculosis of the joints include A. Involvement of multiple joints B. A short history C. Marked synovial thickening D. Marked muscle wasting E. Periarticular osteoporosis on plain x-rays 50. In De Quervein’s disease A. The sheath containing the extensor pollicis longus is inflamed and thickened B. Tenderness is felt at the ulnar styloid C. Abduction of the thumb againt resistant is painful
  • 8. D. Passive abduction of the thumb cross the palm is painful E. Resistant ……..surgical sitting of the thickened tendon sheath 51. Complication of plaster immobilization A. Vascular compression B. Pressure sores C. Nonunion D. Allergy E. Skin abrasion or laceration 52. In injuries of the spine: A. Fracture of the pedicle C1 is known as Hangman’s fracture B. Anterior wedge compression fractures will affect the anterior, the middle, and posterior column of the vertebra C. Fracture dislocation are unstable D. A fall from height landing on the feet is associated with fractures at the thoracolumbar junction E. Neurological deficit occur in the majority of patient 53. Acute lumbar disc prolapse A. Commonly occur at the level of L4/L5 B. At the level of L4/L5 will compress the L4 nerve C. Can result in sciatica D. Can be diagnosed through plain X-Rays E. Is treated surgically in the presence of cauda equina. 54. Congenital Talipes Equino Varus (CTEV) A. Is a polygenic inheritance B. Occur more in female compare to male C. Bilateral involvement is 1/3 D. Pathoanatomy talus is pointing upwards E. Correction after 5 years old is difficult 55. Tredelenburg sign is positive in this condition A. Femoral neck fracture B. Poliomyelitis affecting abductor muscle C. Dislocated hip D. Fracture of lesser trochanter of femur E. Synovitis of hip joint 56. Foot disorder in Diabetes mellitus A. Clawing toes as result from intrinsic muscle imbalance B. Dry gangrene of toes following angiopathy may need urgent amputation C. Ulcer formation around pressure area suggestive of neuropathic complication D. ABSI is useful parameter to assess peripheral angiopathy E. Loss of proprioception may lead to charcot joint 57. Median nerve palsy A. Thumb opposition weak
  • 9. B. Loss of sensation of ulnar three and a half fingers C. Low lesion due to carpal dislocation ? D. High lesion, long flexor of little finger is paralysed E. High lesion has pointing index sign when clinch the hand 58. Degenerative spine disease A. Hyperthropied facet joint may cause nerve compression in lateral canal stenosis B. Positive Babinski may be the only manifestation of cord myelopathy C. Neurogenic claudication can be relieved by sitting or squatting down D. Surgery is main choice of treatment E. Osteophytic formation induced by vertebral instability 59. Indication of internal fixation A. Gustilo type 3 B. Wound >5cm with massive tissues destruction C. Unstable joint fracture with large articular surface involvement need accurate reduction D. Polytrauma with comminuted fracture that need nursing care E. Availability of surgeon expert in internal fixation 60. Compartment syndrome… A. Bleeding and edema can increase at one of the osteofascial compartment B. Can be present in the presence of pulse distal to the fracture site C. The limb distal to the fracture became parasthesia D. Can adequately treated by elevating the limb and antibiotics E. Can lead to muscle contracture if not appropriately treated 61. Fracture of the forearm bones A. Galleazi fracture is a fracture of the proximal ulna with dislocation of the radial head B. Fracture neck of radius can cause posterior interosious nerve injury C. Malunion of the Monteggia fracture can lead limitation of the supination and pronation. D. Proximal forearm fracture usually leads to compartment syndrome E. Displace fracture of the shaft of the radius need the ORIF 62. Colles fracture A. Extraarticular fracture of the distal radius B. The distal fragment will displace anteriorly C. Most common type of all fractures in elderly D. Need the ORIF E. malunion can cause ‘gunstock’ deformity. 63. Regarding Tuberculosis, which statement is true:- A. Start as synovitis B. Pain at night is worse and is called as “nightmare cries” C. May result ankylosis D. Treat by Arthrotomy 64. Regarding ulnar Nerve:- A. More clawed in higher lesion
  • 10. B. Ulnar 3 fingers sensation is loss C. Cause loss of adduction of thumb D. Affect lumbrical which cause metacarpophalangeal extend 65. Ankylosing Sponylitits A. Associated with HLABRA 7 B. Always associated with false positive rheumatoid factor C. Common in Africans 66. In stenosing tenovaginitis (trigger finger): A. The extensor tendon is commonly involved B. The usual cause is thickening of the fibrous tendon sheath C. The triggering occurs during flexion of the involved finger D. A tender nodule can be felt in front of the affected area F. The ring and middle fingers are most commonly affected 67. Gas gangrene: A. Is caused by Streptococcus pyogenes infection B. Is characterized by myonecrosis C. Often manifests itself within 24 hours of injury D. Causes little pyrexia but increases pulse rate E. Is treated mainly by strong antibiotics 68. Rotator cuff tears: A. May occur as a complication of chronic tendinitis B. Is mostly presentable as limitation of glenohumeral joint movement in all directions C. Is associated with ‘hook’ shaped acromion D. Is commonly occur to supraspinatus tendon E.Is ideally repair surgically in all elderly patients 69. Developmental dislocation of the hip A. Can be demonstrated by Ortoloni test. B. Trendelenburg test is positive in a child who is able to stand. C. It is common in a child who presented with breech position during intrauterine. D. Boys are more common than girls. E. Increase acetabular angle in plain x-ray. 70. Regarding malignant bone tumours A. Fibrosarcoma can arise from giant cell tumour B. Ewing tumour presented with ‘onion peeling’ in plain x-ray. C. Osteoblastic activity in prostate carcinoma 71. Management of diabetic foot ulcer (risk of amputation) A. Superficial ulcer B. Uncontrolled hyperglycaemia C. Previous amputation D. Uncontrolled infection E. ABSI > 1.1
  • 11. 72. Radiological features of OA A. Subchondral cyst B. Osteophyte formation C. Widening of joint space D. Ankylosis E. Periosteal osteoporosis 73. Ganglion cyst around wrist: A. Common in male B. Present as solitary nodule only C. Mucoid degeneration of collagen and connective tissue D. Contain mucin, albumin and globulin E. Common in volar aspect of wrist 74. In crystal deposition disorder A. Exclusively in gout B. Gout can be diagnosed by characteristics of crystals in joint fluid C. Intake of purine can diminish the symptom of gout D. Pseudogout characterized by calcium pyrophosphate deposition E. Acute symptom of gout can be treated by NSAIDs 75. Amputation A. Diabetic gangrene of the foot require amputation at the distal tibia B. Below knee amputation ,weight is taken on the stump C. Above knee amputation,weight is taken on the ischial tuberosity D. Elderly patient refuse to use above knee prostheses because of the high energy requirement E. Pain due to neuroma formation is a complication 76. Regarding tenosynovitis: A. In the proliferative type, it starts within the synovial lining of tendon sheath or invades the tendon from involvement of a contagious joint. B. In crystalline type, precipitation of crystalline outside the confines of an enclosed space triggers fulminant inflammatory reaction. C. Calcium pyrophosphate deposition disease can cause acute inflammatory tenosynovitis within carpal tunnel. D. In stenosing tenovaginitis synovial proliferation is common E. De Quervain’s disease involves first compartment of the extensor part of the wirst. 77. Gene therapy: A. Used to replace the non functional gene to become functional B. RNA interference is used to activate a silent gene C. Rota-viruses are used as carriers for the gene to be inserted into genome D. Gene therapy is used to treat multifactorial gene problem E. Gene therapy is used to produce bone growth. 78. Bone cells: A. Osteoblast is a polynucleated cell B. Osteocyte is a mature bone cell trapped in matrix
  • 12. C. Bone lining cells are immature cells D. Osteoclast is used for bone resorption E. Osteoclasts found in ‘ruffled border’ 79. Rheumatoid Arthritis A. Incidence is peak in 20-30 years of age B. HLA-DR is occurs in 70% of people with RA C. T-cell produced anti-IgG auto antibody, which is detected as Rheumatoid factor D. Muscle weakness common present E. In early stage, plain X-ray can show periarticular osteopenia 80. Charcoat joint caused by A. Neurosyphilis B. RA C. Multiple myeloma D. Peripheral neuritis E. Gouty arthritis 81. DVT A. Homan’s sign reliable clinical sign toward the diagnosis B. Present with pain in calf region C. Followed hip arthroplasty D. Confirmed by Doppler ultrasound E. LMW heparin are used as prophylaxis and treatment 82. In slipped capital femoral epiphysis A. Affects girls more than boys B. In 30% of acute slip with history of trauma C. Slip occur in the proliferative zone of epiphysis plate D. Confined to prepubertal growth age 83. in fracture of phalanges and metaphalanges A. Undisplaced # of phalanges can be splinted to its neighbor B. It is important to correct malrotation C. Bernett # occur at the base of 5th metacarpal D. Immobilization should be at least 6/52 E. Stiffness is the most important complication 84. Regarding CTEV A. Hindfoot is dorsiflexed B. Forefoot is internally rotated C. Forefoot is everted D. Calf muscle is underdeveloped E. Treatment begin within 2-3 days after birth 85. Regarding Amputation A. Diabetic gangrene of the foot require amputation at the distal tibia B. Below knee amputation ,weight is taken on the stump
  • 13. C. Above knee amputation, weight is taken on the ischial tuberosity D. Elderly patient refuse to use above knee prostheses because of the high energy requirement E. Pain due to neuroma formation is a complication 86. Fat embolism A. Occurs after 3 days B. Treatment mainly oxygen therapy C. Shortness of breath, mild confusion and restlessness D. Commonly seen in elderly patient followed minor trauma E. Due to circulating fat globules 87. Archilles tendon rupture A. Occurs in degenerate tendon B. Positive Simmon’s test C. Cannot be treated conservatively D. Patient have difficulty in walking tiptoe E. Complicated with wound dehiscence of surgical treatment 88. Carpal tunnel syndrome A. More common in men than women B. Caused hypothenar muscle wasting in late case C. Happened in hypothyroid D. Paraesthesia of fingers after fully palmarflexion in 1 minute E. Treated surgically with incision of anterior carpal ligament 89. regarding examination of the knee A. Anterior drawer test indicate PCL instability B. Lachman tset is elicit in 90o flexion of knee C. Q angle is required for patella subluxation D. Positive patella tap indicate grossly knee effusion E. Mc Murray classically for bucket handle tear of knee menisci 90. posterior hip dislocation A. Less commonly than anterior dislocation B. Lies in extension, abduction and externally rotated C. Occur in dashboard injury D. If involved with # of femoral head, closed reduction will be fail E. Sciatic nerve injury is a complication 91. acute lumbar disc prolapsed A. Common at L4 and L5 B. If occur at L4 & L5, L4 will be compressed C. Plain xray is diagnostic D. Sciatic nerve injury E. Surgical intervention if involves cauda equine 92. spondylolisthesis
  • 14. A. Is forward shift displacement of vertebrae above on stable vertebrae below B. Common at L4,L5 and L5,S1 C. Cannot occur in degenerative process D. In childhood is painful E. Operation is indicated in neurological deficit 93. multiple myeloma A. Malignant B cell lymphoproliferative disorder of marrow B. Sclerotic lesion is seen through out skeleton C. Associated with increase blood viscosity D. Bensen Jenssn protein in urine in 90% of patient E. Sensitive to ankylating cytotoxic agents 94. bone healing A. The process starts subsequently from inflammation stage,reparative stage and remodeling stage B. Stabilization of the fracture ends is necessary for healing process to occur C. Osteoprogenitor cells within the periosteum are mobilized D. Healing is always associated with callus formation E. Remodeling stage would take two weeks to complete the process 95. # in children A. Rotational malalignment of # bone corrected by remodeling process B. Metaphyseal alignment avulsion # lead to premature closure of adjacent growth plate C. Apophysis injury lead to longitudinal growth arrest of bone D. Salter Harris type IV treated by conservative treatment E. Displaced supracondylar # of humerus treated by close reduction and percutaneous pin under image intensifier 96. definite indication for internal fixation A. When # is unstable and prone to displace after closed reduction B. Open # with gross contamination C. Polytrauma, afraid of ARDS D. Pathological # which bone disease prevent healing process E. Humeral # associate without radial nerve injury 97. frozen shoulder (shoulder tendinitis) A. Commonly found in younger age B. Restrict movement in forward flexion only C. Cause by trauma to shoulder D. Self limiting disease E. Recover process is difficult in DM 98. Causes of pathological fracture A. repetitive stress B. osteoporosis C. bone cyst D. previous traumatic fracture
  • 15. E. secondary to bone 99. anterior shoulder instability A. Commonly occur in elderly men followed by an acute traumatic event B. Can cause humeral head articular damage C. Is associated with Bankart lesion D. Positive Apprehension test E. Mainly treated by conservative treatment 100. Late complications of fracture include A. Non-union B. Joint contracture C. Osteomyelitis D. Muscle atrophy E. Bleeding