FCPS IMM Surgery Orthopaedics MCQs: High-Yield Practice Questions & Prep

Orthopaedics is one of the subject blocks in the FCPS IMM Surgery QBank. It covers fractures, dislocations, bone tumours, paediatric orthopaedics and nerve injuries. Below is a sample set in the style of the bank, with the reasoning after each answer.

Sample MCQs

1. A 60-year-old man has an acutely swollen red knee with synovial WBC above 50,000/mL. The diagnosis is:

• A) Osteoarthritis
• B) Septic arthritis ✅
• C) Gout
• D) Haemarthrosis

Why: High synovial leucocyte counts suggest bacterial infection; treat with drainage and antibiotics.

2. Absent biceps reflex with hyperreflexia of knee and ankle reflexes suggests a cord lesion at:

• A) L1-L3
• B) C5-C6 ✅
• C) C8-T1
• D) T8-T9

Why: The biceps reflex is C5-C6; lesion at that level causes LMN signs at the level and UMN signs below.

3. The earliest sign of TB hip in X-ray is:

• A) Narrow joint space
• B) Irregular moth-eaten femoral head
• C) Periarticular osteoporosis ✅
• D) Dislocation

Why: Periarticular osteoporosis is the earliest radiographic sign of TB hip.

4. Normal neck-shaft angle of femur is:

• A) 90 degrees
• B) 120 degrees ✅
• C) 150 degrees
• D) 170 degrees

Why: The normal neck-shaft angle is about 120-130 degrees.

5. The treatment of choice for non-union of extracapsular fracture neck femur

• A) Hip spica
• B) Intramedullary nailing
• C) Internal fixation ✅
• D) Compression plating

Why: Non-union of an extracapsular femoral neck fracture is treated by internal fixation with bone grafting.

6. Tenderness in the anatomical snuffbox after a fall on an outstretched hand suggests:

• A) Lunate dislocation
• B) Colles fracture
• C) Smith fracture
• D) Scaphoid fracture ✅

Why: Scaphoid fracture presents with snuffbox tenderness and risks avascular necrosis.

7. The first bone to ossify in foetal life is:

• A) Femur
• B) Tibia
• C) Clavicle ✅
• D) Sternum

Why: The clavicle is the first bone to ossify.

8. Thyroid carcinoma that commonly spreads hematogenously to bone and lung?

• A) Papillary
• B) Follicular carcinoma ✅
• C) Medullary
• D) Anaplastic

Why: Follicular carcinoma spreads via blood (bones, lungs); papillary spreads via lymphatics.

9. Commonest complication of extracapsular fracture of neck of femur is

• A) Non Union
• B) Iscnemic necrosis
• C) Maiunion ✅
• D) ATPuTmonary complications

Why: Malunion (coxa vara) is the commonest complication of extracapsular neck of femur fractures, whereas avascular necrosis is typical of intracapsular ones.

10. The initial management of a displaced Colles fracture is:

• A) Closed reduction and below-elbow cast ✅
• B) Open reduction in all cases
• C) Sling only
• D) Traction

Why: Closed reduction under haematoma block with immobilisation is standard.

How to Study This Block

• Learn fracture eponyms with their classic complication (for example the nerve at risk) as a pair.
• Know the Salter-Harris pattern and the management logic for paediatric fractures.
• Revise bone tumours by age, site and X-ray appearance.

Each subject in the QBank can be filtered on its own, so you can drill orthopaedics until your accuracy is stable. Confirm the exam format and syllabus against the current CPSP guidelines.

Frequently Asked Questions

How big is the orthopaedics block?

It is the largest subject in the bank, because orthopaedic and trauma questions are heavily represented in recalled IMM material.

Do these cover X-ray based questions?

The practice set here uses text-only questions; for radiograph recognition pair it with your own image practice.

Practise With the Full QBank

The FCPS IMM Surgery QBank has a free trial batch in Tutor mode, subject filters and Timed mode. Related: complete exam guide, how to use recalls.