294.A 22-year-old soccer player presents to the ED complaining of right
knee pain and swelling. He states that earlier in the day he was in a soccer
match and was running for the ball, but stopped abruptly and tried to run
in a new direction. Immediately thereafter, he felt intense pain in his knee
with instant swelling. Which of the following is the most commonly injured
major ligament of the knee?
a. Anterior cruciate ligament (ACL)
b. Posterior cruciate ligament (PCL)
c. Medial collateral ligament (MCL)
d. Lateral collateral ligament (LCL)
e. Patella ligament
295.A 45-year-old man is on his way to work and loses his footing while
walking up a flight of steps. He feels excruciating pain at the back of his
ankle and cannot ambulate. He arrives to the ED and states that he felt a
snap in his leg during the injury. He has a past medical history of hyper-
tension and hypercholesterolemia. He spends most of his free time in front
of the television watching horror movies. On examination, you note swelling
of the distal calf. Which of the following is likely to be positive in this
individual?
a. Homan sign
b. Lachman test
c. McMurray test
d. Ballotable patella
e. Thompson test
296.A 24-year-old competitive ice-skater is practicing for the Olympic
trials when she falls during one of her jumps and lands on her outstretched
hand. She is brought to the ED complaining of wrist pain. On examination,
you note tenderness at the anatomic snuffbox and pain with axial loading
of the thumb. You suspect she has a scaphoid fracture. In what part of a
fractured scaphoid is the incidence of avascular necrosis highest?
a. Proximal scaphoid.
b. Waist (middle third) of the scaphoid.
c. Distal scaphoid.
d. Tubercle of the scaphoid.
e. The scaphoid is not at risk for avascular necrosis.
318 Emergency Medicine