Sample Orthopaedic Surgery Questions （样例骨科手术的问题）.pdf

Sample Orthopaedic Questions Critiques Sample Orthopaedic Surgery Questions Critiques The sample NCCPA items and item critiques are provided to help PAs better understand how exam questions are developed and should be answered for NCCPA’s Orthopaedic Surgery CAQ exam. Question 1 A 25-year-old man comes to the orthopedic clinic because he has had pain in the ankle since he sustained an inversion injury 10 days ago. The patient is otherwise healthy. On physical examination, the skin is intact and mild edema is noted. Tenderness to palpation is noted over the distal fibula and anteromedial ankle. Neurovascular examination shows no abnormalities. X- ray study is shown. Which of the following is the most appropriate management? (A) Application of a long leg cast (B) Application of a short leg cast (C) Closed reduction and external fixation (D) Open reduction and internal fixation (E) Percutaneous pinning ©NCCPA. 2011-2015. All rights reserved Sample Orthopaedic Questions Critiques Content Area: Fractures/Dislocations (22%) Critique This question assesses the examinee’s ability to correctly interpret an x-ray study to determine the diagnosis and then select the most appropriate management. The correct answer is Option (D), open reduction and internal fixation. The x-ray study shows oblique fracture of the lateral malleolus, widening of the medial clear space, and lateral displacement of the talus. On the basis of these findings, the diagnosis is supination external rotation, type IV (Weber B2), which is an unstable injury to the ankle that requires operative intervention. Option (A), application of a long leg cast, is plausible but incorrect because closed reduction must be performed first . Additionally, even with adequate closed red