RCVS Statutory Membership Examination Veterinary Orthopaedics & Lameness: practice questions

1 · Fractures · medium

A 5-month-old Labrador has a displaced fracture that passes through the distal femoral epiphysis into the stifle joint and continues across the physis and metaphysis. What is the most appropriate management principle?

1. A modified Robert Jones bandage for four weeks, because physeal fractures in young dogs always heal quickly
2. Anatomical reduction and rigid internal fixation, as it is an articular Salter-Harris type IV fracture
3. Cage rest and analgesia only, because the remaining growth will remodel the joint surface in time
4. A single intramedullary pin alone, because it controls rotation and collapse in the distal femur

2 · Fractures · medium

A cat hit by a car has a mid-shaft femoral fracture. Which temporary support is most appropriate while it is stabilised for surgery?

1. A modified Robert Jones bandage from the toes to mid-thigh to immobilise the femur
2. A short distal limb cast ending just below the stifle to rest the limb in partial extension
3. Strict cage rest with analgesia, because a distal limb bandage cannot immobilise the femur
4. A spica splint over the shoulder with the forelimb strapped to the body wall

3 · Fracture fixation · medium

Why are positive-profile threaded pins preferred to smooth pins in external skeletal fixators?

1. They can be placed without pre-drilling in hard diaphyseal cortex
2. They allow the pin to slide so that the fracture compresses itself
3. They resist pin loosening and pull-out at the bone-pin interface
4. They avoid the need for connecting bars on the outside of the limb

4 · Joint diseases · hard

During examination under sedation, a 6-month-old dog's hip is pushed dorsally with the limb adducted, then abducted, and a clunk is felt as the femoral head drops into the acetabulum. This finding is:

1. A positive cranial drawer sign of the stifle
2. A normal finding in a puppy with tight hips
3. A positive Ortolani sign, indicating hip laxity
4. A craniodorsal hip luxation needing a sling

5 · Tendon and ligament injuries · easy

Which test detects cranial cruciate ligament insufficiency in a dog by flexing the hock while holding the stifle at a standing angle?

1. Ortolani test
2. Cranial drawer of the hock
3. Patellar push test
4. Tibial compression test

6 · Tendon and ligament injuries · hard

Which combination of procedures is commonly used to correct grade III medial patellar luxation in a small dog?

1. Medial transposition of the tibial tuberosity, medial imbrication and lateral release
2. Extracapsular lateral suture of the stifle combined with femoral head and neck excision of the hip
3. Trochleoplasty, lateral tibial tuberosity transposition, lateral imbrication and medial release
4. Medial patellar desmotomy under local anaesthesia with the dog standing

7 · Bovine lameness examination · hard

Using a 0 to 3 mobility score in a 200-cow herd, 30 cows score 2 and 10 score 3. What proportion of the herd is lame (score 2 or 3), and which cows need urgent attention?

1. 15 per cent; only cows scoring 2 need any treatment
2. 20 per cent; the 10 cows scoring 3 need urgent treatment
3. 5 per cent; only cows scoring 3 count as lame at all
4. 40 per cent; all cows scoring 1 or more need urgent treatment

8 · Hoof and claw disorders · medium

What is the purpose of step three of the Dutch five-step method, dishing out the sole?

1. To make the dorsal wall of each claw exactly the same angle
2. To remove all the horn of the sole down to the corium
3. To move load from the typical sole ulcer site to the wall and heel
4. To lower the heel of the healthy claw so the cow tips forward

9 · Hoof and claw disorders · easy

Which form of equine laminitis is now considered the most common?

1. Endocrinopathic laminitis associated with insulin dysregulation or PPID
2. Supporting-limb laminitis following a fracture of the opposite limb
3. Laminitis caused by walking on hard roads after a long journey
4. Laminitis caused by retained fetal membranes in mares after foaling

10 · Physiotherapy and rehabilitation · medium

After TPLO in a dog, which instruction is most appropriate in the first weeks?

1. Unrestricted off-lead exercise from the day after surgery to strengthen the quadriceps quickly
2. Complete immobilisation of the limb in a full-length cast for eight weeks after the osteotomy
3. No weight bearing on the limb at all until the implant is removed after six months
4. Short controlled lead walks and home exercises; no off-lead running until the bone has healed