History and examination of the hand and wrist including special clinical tests

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QUESTION 1 OF 3

A 29-year-old butcher presents after sustaining a palmar knife laceration over the proximal phalanx. He is unable to flex his non-dominant index finger. Neurovascular examination is unremarkable.
What is the most appropriate management plan?

QUESTION ID: 1071

1. A. Four-strand core suture repair with early active mobilisation
2. B. Four-strand core suture repair with position of safe immobilisation (POSI) for 2 weeks
3. C. Monofilament core suture repair with 5mm tendon purchase
4. D. Two-strand core suture repair of FDS and FDP with early active mobilisation
5. E. Urgent ultrasound
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QUESTION 2 OF 3

A 45-year-old female patient presents with a recent history of pain at the tip of her right middle finger. She also complains of hypersensitivity to cold stimulus at the tip of the finger. On examination, a small mass lesion is palpated in the tip and there is slight discolouration of the nailbed.
What is the most likely diagnosis?

QUESTION ID: 1079

1. A. Glomus tumour
2. B. Malignant melanoma of the nail bed
3. C. Mucous cyst
4. D. Osteoid osteoma
5. E. Pulp abscess
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QUESTION 3 OF 3

76.A 40-year-old gardener undergoes repair of a lacerated FDP tendon in the mid-palm of his hand, just distal to the flexor retinaculum,  affecting his middle finger. He develops post-operative scarring.
Which of the following clinical findings is most likely to be present?

QUESTION ID: 2235

1. Full ROM as he has had physiotherapy
2. Loss of flexion and extension of his middle finger
3. Loss of flexion of all four fingers
4. Loss of flexion of only his middle finger
5. Paradoxical extension of the PIPJ on attempting to flex at the MCPJ
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