Past FRACS Orthopaedic Exams
Royal Australasian College of Surgeons
Part 2 Examination for Fellowship
Orthopaedic Surgery
MONDAY, 4 SEPTEMBER, 2000
SECOND PAPER - 2 hours
ALL questions must be answered - Question 3 (50%) & Questions 4 & 5 (25% )
Question (1 Hour)
A 43 year old male employed in a food processing factory presents to you complaining that for the past seven months he has had pain, numbness and tingling affecting his dominant right hand.
List your differential diagnosis in order of likelihood.(10%)
Consider the four most likely diagnoses and:
- Outline the clinical features of each (12.5% for each)
- Briefly describe any investigations you would utilise to assist in establishing a diagnosis (10%)
- Write notes on treatment options for each, noting expected outcomes, risks and complications (7.5% each)
Question 4. (30 minutes)
A 45 year old right handed accountant fell whilst cycling and sustained a four part fracture of the right proximal humerus. Discuss:
- Assessment (10%)
- Consent and counselling (10%)
- Operative management (40%)
- Rehabilitation (20%)
- Long term management (20%)
Question 5. (30 minutes)
A 70 year old male was playing bowls when his right leg suddenly collapsed under him when he stepped to deliver his bowl. He was unable to stand and had to be stretchered to the hospital in an ambulance. As part of his initial assessment a plain x-ray of the right hip was taken (Fig 1). An x-ray taken three months earlier was also available (Fig 2).
- List the differential diagnosis. Name your favoured diagnosis (20%)
- Write a brief outline of any investigations you would perform and why you would perform them. (40%)
- Write a brief outline of your proposed initial and subsequent management including any operative management (40%)
Fig 1 – Subtrochanteric fracture – irregular transverse 3cm distal to lesser troch
Fig 2 – 6cm long lytic lesion involving all of intramedullary canal and thinning medial and lateral cortexs
Figure 1.
Figure 2
