1. Which of the following clinical signs of an ankle sprain would present most often?

  1. Tenderness palpated over the plantar fascia
  2. Pain on resisted motion
  3. Tenderness over the lateral talocalcaneal ligament
  4. Medial ankle edema

2. If a bull rider walks into your office and presents with lateral ankle pain, which he attributes to hitting his ankle on the gate while exiting the bucking chute at Madison Square Gardens, which diagnosis would be most likely. You did notice edema, bruising, and palpable pain over the lateral malleolus.

  1. Periosteal contusion
  2. Sprain
  3. Strain
  4. None of the above

3. How would you differentiate the Grade III from the Grade II strain of the achilles tendon?

  1. Palpable pain
  2. Loss of continuity of the achilles tendon
  3. Edema of the achilles tendon
  4. Increased temperature with crepitus over the back of the lower calf

4. Why would a patient complain of chronic ankle sprains?

  1. Alcoholic with unstable gait
  2. Laxity of ligaments due to prior sprain
  3. Unstable talus
  4. All of the above

5. Why would you consider tarsal tunnel syndrome rather than plantar fasciitis if the pain were not worse upon waking and standing?

  1. More likely with achilles tendonitis
  2. More likely with plantar fasciitis
  3. Compression with prolonged standing produces pain with tarsal tunnel syndrome
  4. None of the above

6. Which special orthopedic testing would produce paresthesias with tarsal tunnel syndrome?

  1. Tinel’s Sign
  2. Tapping of the posterior tibial nerve
  3. Tinel’s Foot Sign
  4. None of the above

7. Which special compression testing would produce pain and paresthesias in the foot and leg with a patient suffering with tarsal tunnel syndrome?

  1. Tourniquet Sign
  2. Tinel’s Foot Sign
  3. Thompson’s test
  4. Compression of the posterior tibial nerve

8. If a patient presents with severe posterior ankle pain, inability to stand on toes, posterior leg and heel edema and ecchymosis after diving into a pool, which loss of function in the lower extremity would you anticipate?

  1. Dorsiflexion of the foot
  2. Extension of the toes
  3. Bilateral raising onto toes
  4. Plantar flexion of affected foot

9. A patient presents with lateral ankle pain after turning the ankle while running in Seaside Park. You perform the anterior drawer testing and reveal excessive anterior displacement of the talus on the tibia. The presence of an anterior drawer sign indicates a sprain. Name the ______ligament most often sprained with an ankle sprain.

  1. Anterior talofibular
  2. Interosseous membrane
  3. Posterior talofibular
  4. Deltoid

10. This same patient with the lateral ankle sprain indicates in the history that she was unable to walk following the initial injury. How would you grade the sprain based upon the history?

  1. Grade one with stretch injury
  2. Grade two with incomplete tear of the ligament
  3. Grade two with stretch injury to three ligaments
  4. Grade three with rupture of ligament

11. Inversion stress testing of this patient’s ankle revealed excessive motion. Name the ligament that you suspect is ruptured.

  1. Anterior talofibular
  2. Calcaneofibular
  3. Posterior talofibular
  4. Deltoid

12. According to Wolfe and based upon the ______ankle and foot rules this patient with the lateral ankle injury should have the ankle examined with a radiographic study to determine the potential for an osseous fracture due to the inability to place weight on the foot following the injury and in the emergency room.

  1. St. Louis
  2. Albuquerque
  3. Ottawa
  4. New York

13. You notice that this same patient experiences severe pain in the ankle while crossing the affected leg onto the unaffected leg to put on the sock. You squeeze the tibia and fibula and the patient complains of increased pain. Now you are wondering if the patient might have injured the ______.

  1. Tibia
  2. Fibula
  3. Interosseous membrane
  4. All of the above

14. Your patient presents with pain in the back of the ankle above the heel following a dive into the swimming pool. Upon examination, you notice the patient experiences increased pain with percussion of the Achilles tendon. You squeeze the calf with the knee flexed in order to cause ______.

  1. Extension of the ankle
  2. Plantar flexion of the foot
  3. Inversion of the foot
  4. Eversion of the foot
  1. Name the test that involves squeezing of the calf with the knee flexed in order to determine the integrity of the Achilles tendon.

a. Babinski

  1. Lehman
  1. Thompson
  1. Evans

16. Your patient presents with pain over the dorsum of the foot and the metatarsal heads. He mentions that he has been increasing the amount of walking and running in order to lose weight. His athletic shoes appear to be well-worn. Upon squeezing the metatarsal heads, the patient complains of increased pain. Name two common conditions that must be differentiated prior to making a final diagnosis.

  1. Metatarsalgia and stress fracture of the calcaneous
  2. Metatarsalgia and medial plantar neuroma
  3. Metatarsalgia and plantar fasciitis
  4. Hallux valgus and hammertoes

17. A medial plantar neuroma is commonly known as ______.

  1. Episacral lipoma
  1. Morton’s neuroma
  1. Baker’s cyst
  1. Hallux neuroma
  1. A high ankle sprain is known as ______.
  1. Syndesmotic sprain
  2. Lateral ankle sprain
  3. Medial ankle sprain
  4. Posterior ankle sprain

19. Your patient presents with severe pain in the heel. She mentions that initially she experienced tightness in the back of her heel upon rising from bed to walk but now the main pain is a sharp pain in the heel and bottom of foot following long runs. Examination reveals severe pain with palpation of the plantar fascia with the most intense pain at the heel. Dorsi-flexion of the affected foot increases the pain. Name the conditions to differentiate.

  1. Achilles tendonitis and calcaneal fracture
  2. Achilles tendinopathy and plantar fasciitis
  3. Metatarsalgia and plantar fasciitis
  4. Achilles tendinopathy and metatarsalgia

20. Why should you consider the use of PRICE with the treatment of an acute lateral ankle sprain?

  1. Reduce pain
  2. Reduce edema
  3. Avoid re-injury
  4. All of the above