Ortho Mixed Bag Flashcards

1
Q

What are the Ottawa Ankle Rules for getting ankle films?

How about for getting foot films?

A

-Ankle Films
–Pain along lateral malleolus
–Pain along medial malleolus
–Unable to walk > 4 steps in ER

-Foot Films
–Navicular (mid foot) pain
–5th metatarsal pain
–Unable to walk > 4 steps in ER

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2
Q

Weber Ankle Fracture Classification
-What is a Weber A
-What is a Weber B
-What is a Weber C

A

-Weber A: fibular fracture BELOW syndesmosis. All ligaments intact. Stable.

-Weber B: fibular fracture AT LEVEL of syndesmosis. Can be stable or unstable. Tibiofibular ligament and deltoid ligament may be intact or mild tear.

-Weber C: fibular fracture ABOVE mortise. Tibiofibular ligament torn, widening of talofibular joint, deltoid ligament damage, medial malleolar fracture. Requires ORIF due to instability.

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3
Q

Septic Arthritis
-MC organism overall
-MC in neonates and infants < 3 months
-MC in sexually active young adults

A

Staph A MC overall

Strep Pneumo, Group B Strep in neonates

Neisseria Gonorrhea in sexually active young adults

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4
Q

What is the best initial and most accurate test for septic arthritis?

What is seen?

A

Arthrocentesis: WBC > 50,000 and primarily neutrophils

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5
Q

Septic Arthritis Treatments
-Empiric
-Gram Positive Cocci (Staph A)
-Gram Neg Cocci (Gonorrhea)
-Gram Neg Rods (Pseudomonas)

A

-Empiric: Ceftriaxone + Vanco
-Staph A: Vanco
-Gonorrhea: Ceftriaxone
-Pseudomonas: Ceftazidime + Gentamicin (Cipro for PCN allergy)

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6
Q

SALTER-HARRIS classification for growth (epiphyseal) plate fractures
-Explain SALTR in relation to the fractures

A

-Type I: Same (at growth plate only)
-Type II (MC): growth plate + fracture of metaphysis
-Type III: growth plate + fracture of epiphysis
-Type IV: fracture extending across teh metaphysis, growth plate, and epiphysis (NEEDS REDUCTION)
-Type V: growth plate compression injury.

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7
Q

MC location for a herniated disc and why?

Symptoms of a herniated disc

Best diagnostic test

A

-L5-S1 (this is the junction between mobile and non-mobile spine)

Radicular back pain, unilateral radiating down the leg in a dermatomal pattern.
-Positive Straight Leg Raise, crossover test

MRI is best imaging study

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8
Q

Herniated Disc Facts
-Location - Sensory - Weakness - Reflex Diminished

A
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9
Q

L4 (think A)

A

-Anterior thigh pain and sensory loss to medial ankle
-Ankle dorsiflexion weakness
-loss of knee jerk

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10
Q

L5 (think L)

A

-Lateral thigh/hip/groin pain and dorsum of foot
-Big toe extension/dorsiflexion weakness
-reflexes usually normal

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11
Q

S1 (think P)

A

-Posterior leg/calf pain and plantar surface of foot
-Plantar flexion weakness
-Loss of ankle jerk

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