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Surgery > Subspecialties > Flashcards

Subspecialties Flashcards

1
Q

[Ortho]

____ fracture refers to bone broken into three or more fragment

A

comminuted fracture

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2
Q

[Ortho]

____ refers to an incomplete fracture in which the angulating force bends the cortex on the compression side and breaks it on the distraction side

A

Greenstick fracture

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3
Q

[Ortho]

refers to an abnormally slow fracture healing

A

delayed union

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4
Q

[Ortho]

refers to a fracture healing that stops short of firm union

A

non-union

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5
Q

[Ortho]

refers to fracture healing that takes place in unsatisfactory alignment

A

malunion

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6
Q

[Fracture or Dislocation]

deformity, angulation, shortening, rotation, loss of function, swelling

A

fracture

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7
Q

[Fracture or Dislocation]

Loss of normal joint contour and bony landmarks, loss of motion

A

dislocation

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8
Q

[Initial management of fractures]

this prevents further soft tissue injury, reduces pain, and facilitate transport

A

splinting

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9
Q

[Gustilo Classification]

What is the incidence of infection of Gustilo IIIB?

A

10-50%

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10
Q

[Gustilo Classification]

severe crushing of soft tissue with adequate coverage; bone comminution, soft tissue coverage of bone is possible

A

IIIA

7% incidence of infection

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11
Q

[Gustilo Classification]

severe loss of coverage which will require reconstruction for coverage of soft tissue

moderate to severe comminution of bone; poor soft tissue coverage

A

Type IIIB

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12
Q

What is the DOC for Gustilo Type 1?

A

1st generation cephalosporin (Cefazolin)

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13
Q

What is the DOC for Gustilo Type II?

A

1st generation cephalosporin (Cefazolin) PLUS

Aminoglycoside

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14
Q

What is the DOC for Gustilo Type III?

A

1st generation cephalosporin (Cefazolin) PLUS

Aminoglycoside PLUS

Penicillin or Metrondazole

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15
Q

What are the indications for immediate amputation

A
  1. Nonviable limb
  2. Limb remains severely damaged even after attempted revascularization
  3. Limb is a threat to patient’s life
  4. Severity of injury demands repeated surgical procedures that may not be compatible with patient’s goald
  5. Expected post salvage function will not justify salvaging the limb
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16
Q

What is the definition of a nonviable limb

A

irreparable vascular injury with warm ischemia time >8 hours

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17
Q

What is the most commonly dislocated joint?

A

Glenohumeral Joint

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18
Q

What is the most common type of glenohumeral joint dislocation? (anterior/posterior)

A

Anterior

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19
Q

What is the most common complication of glenohumeral joint dislocation?

A

Redislocation

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20
Q

What is the most important risk factor for the recurrence of glenohumeral joint dislocation?

A

Age

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21
Q

[PE for Developmental Dysplasia of the Hip]

Name this test:

A flexed calf and knee; hip is adducted slightly and gently pushed back posteriorly and laterally

A

Barlow’s Test

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22
Q

[PE for Developmental Dysplasia of the Hip]

Flexed calf and knee, hip is abducted while the femur is gently lifted with the fingers at the greater trochanger

A

Ortolani test

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23
Q

[PE for Developmental Dysplasia of the Hip]

Name this radiographic line

disruption of the obturator-coxofemoral line

A

Shenton line

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24
Q

[PE for Developmental Dysplasia of the Hip]

Name this radiographic line

capital epiphysis is displaced upward the horizontal line

A

Hilgenreiner line

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25
Q

[PE for Developmental Dysplasia of the Hip]

Name this radiographic line

capital epiphysis is displaced lateral to this vertical line

A

Perkin line

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26
Q

[Management of DDH]

<6 months old

A

Pavlik Harness

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27
Q

[Management of DDH]

6-15 months

A

Spica cast

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28
Q

[Management of DDH]

15 months to 2 years old

A

femoral osteotomy

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29
Q

[Management of DDH]

more than 2 years

A

Acetabular and femoral osteotomies

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30
Q

____ disease refers to (mostly idiopathic) avascular necrosis of the femoral head affecting children age 4 and 10 years of age

A

Legg-Calve-Perthes Disease or Coxa Plana

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31
Q

[LPCD Catterall Classification]

involvement of the anterior epiphyses only

A

Stage I

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32
Q

[LPCD Catterall Classification]

involvement of the anterior epiphysis with central sequestrum

A

Stage II

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33
Q

[LPCD Catterall Classification]

only to a small part of the epiphysis is not involved

A

Stage III

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34
Q

[LPCD Catterall Classification]

total head involvement

A

Stage IV

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35
Q

____ is the name of the disease of an adolescent characterized by displacement of the femoral head on the femoral neck

A

Slipped Capital Femoral Epiphyses (SFCE)

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36
Q

___ sign refers to a radiographic sign wherein the klein’s line does not intersect the lateral part of the superior femoral epiphysis on an AP radiograph of the pelvis

A

Trethowan’s Sign

321

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37
Q

What is the orthopedic management of SFCE?

A

Percutaneous pinning or screw fixation through the growth plate

38
Q

____ disease refers to ossification of the distal patellar tendon at the point of its tibial insertion; commonly seen in athletically among active adolescents

A

Osgood Schlatter Disease

39
Q

[Salter-Harris Classification]

Complete separation of epiphysis from shaft through calcified cartilage

A

Type I

40
Q

What is the most common type of fracture based on Salter-Harris classification?

A

Type II

41
Q

[Salter-Harris Classification]

line of separation extends partially across deep layer of growth plate and extends through metaphysis leaving triangular portion of metaphysis attached to epiphyseal fragment

A

Type II

42
Q

[Salter-Harris Classification]

intraarticular fracture through epiphysis, across deep zone of growth plate to periphery

A

Type III

43
Q

[Salter-Harris Classification]

Fracture line extends from articular surface through epiphysis, growth pate, and metaphysis; fractured segment not perfectly realigned with open reduction

A

Type IV

44
Q

[Salter-Harris Classification]

severe crushing force transmitted across epiphysis to portion of growth plate by abduction or adduction stress or axial load

A

Type V

45
Q

[Salter-Harris Classification]

portion of growth plate sheared or cut off

A

Type VI

46
Q

What are the tendons involved in De Quervain syndrome

A
  1. Extensor Pollicis Brevis Tendon

2. Abductor pollicis longus tendon

47
Q

[MSK Special Test]

Pain on flexion of the shoulder against resistance, while the elbow is extended, and the forearm is supinated

A

Speed Test

48
Q

[MSK Special Test]

pain and tenderness over the bicipital groove with forearm supination against resistance with elbow flexed and the shoulder adduction

A

Yergasons Test

49
Q

[MSK disease]

Fixed or flexible deformity of the DIP joint of the toe

A

Mallet Toe

50
Q

What is the most common deformity of the lesser toes?

A

Hammer toe

51
Q

[MSK disease]

flexion deformity of the PIP of the toe with hyperextension of the MTP and DIP joints

A

Hammer toe

52
Q

What is the most common cause of shoulder pain?

A

Supraspinatus Tendinitis

53
Q

[Pediatric Disease]

Slow progression, retraction, tachypnea, cyanosis, CNS changes

inability to pass catheter

A

Choanal Atresia

54
Q

[Pediatric Disease]

respiratory distress within minutes after delivery, tachypnea, tachycardia, intercostal retraction, absent breath sound

posterolateral defect, left

A

Bochdalek Hernia

55
Q

[Pediatric Disease]

respiratory distress within minutes after delivery, tachypnea, tachycardia, intercostal retraction, absent breath sound

anterior defect, left

A

Morgagni hernia

56
Q

[Pediatric Disease]

Early inspiratory stridor, diminished sounds when crying

A

Laryngomalacia

57
Q

[Pediatric Disease]

poor cry, wheezing, barking cough

A

Subglotting stenosis

58
Q

[Anterior abdominal wall defect]

right of umbilicus
Absent sac

A

Gastroschisis

59
Q

What are the associated anomalies in gastroschisis?

A
  1. Intestinal Atresia
  2. Undescended testis
  3. Malrotation
60
Q

[Anterior abdominal wall defect]

Umbilical ring
liver herniation present, intestine grossly normal

A

Omphalocele

61
Q

[Anterior abdominal wall defect]

below umbilicus

A

Bladder Extrophy

62
Q

When is the ideal time for definitive surgical management of bladder extrophy?

A

48 hours

63
Q

What is the cardinal sign of intestinal obstruction in the newborn?

A

Bilious emesis

64
Q

[Intestinal Obstruction]

Bilious emesis, down syndrome

AbXR: Double bubble sign

Mesentery is intact, there is a web formed by mucosa and submucosa

A

Duodenal atresia

Type I (Windsock deformity)

65
Q

[Intestinal Obstruction]

Bilious emesis, down syndrome

AbXR: Double bubble sign

Mesentery is intact, there is a fibrous cord in between

A

Duodenal atresia type II

66
Q

[Intestinal Obstruction]

Bilious emesis, down syndrome

AbXR: Double bubble sign

V-shaped mesentery, no connection between proximal and distal segments

A

Type III

67
Q

[Diagnose]

Excessive salivation of newborn, dysphagia, intermittent cyanosis and aspiration, maternal history of polyhydramnios

A

Esophageal Atresia

68
Q

[Intestinal Obstruction]

sudden pain, ineffective vomiting, acute gastric distention, inability to pass NGT

A

Gastric Volvulus

69
Q

[Intestinal Obstruction]

failure to pass meconium; meconium passage through vagina, cloaca or urinary tract

no anal opening

A

imperforate anys

70
Q

When will you do a definitive treatment for low type imperforate anus?

A

Neonatal period anoplasty

71
Q

What is the surgical method of choice for high type imperforate anus

A

Posterior Sagittal Anorectoplasty

72
Q

[Diagnose]

Intermittent vomiting, abdominal distention, tenderness, melena

AbXR: pigtail sign, loops spiraling about the axis

A

Malrotation

73
Q

What is the UGIS finding of malrotation

A

Abnormal C-loop for duodenum

74
Q

[Diagnose]

delayed passage of meconium more than 24 hours after birth, collapsed rectal ampulla with explosive discharge of liquid feces on rectal exam

intermittent obstruction relieved by suppositories or enemas

AbXR: presence of transition zone between distal nondilated bowel and proximal dilated bowel

A

Hirschsprung

75
Q

What are the findings needed to establish Hirschsprung disease on rectal biopsy?

A
  1. Absence of ganglion cells in the myenteric plexus
  2. Increased acetylcholinesterase positive nerve fibers
  3. Hypertrophied nerve bundles
76
Q

What are the surgical techniques used in single stage operation for Hirschsprung disease?

A
  1. Swenson
  2. Duhamel
  3. Soave
  4. Georgeson
77
Q

[Diagnose]

Intermittent, colicky abdominal pain, vomiting, lethargy, currant-jelly stools, sausage-shaped mass, hyperactive bowel sounds,

A

Intussusception

78
Q

What are the UTZ findings in Intussusception?

A
  1. Superimposed Hypoechoid and hyperechoic layers (Pseudokidney sign)
  2. Two rings of low echogenicity separated by a hyperechoic ring (Donut sign)
79
Q

[Diagnose]

Feeding intolerance, bilious emesis, family history of cystic fibrosis, abdominal distention

A

Meconium Ileus

80
Q

[Diagnose]

AbXR: soap bubble sign or ground glass appearance, gas filled loops

Barium enema: microcolon and inspissated meconium

A

Meconium ileus

81
Q

[Diagnose]

maternal DM, bilious emesis, abdominal distention

AbXR: Low intestinal obstruction

Barium: small colon with transition zone at splenic flexure

A

Meconium Plug Syndrome

82
Q

[Diagnose]

regurgitation of feedings, projectile non-bilious emesis, peristaltic gastric waves, olive-shaped mass in right upper epigastrium

hypokalemic hyperchloremic metabolic alkalosis

A

Pyloric Stenosis

83
Q

The double bubble sign is usually seen in

A

Duodenal obstruction

84
Q

The eggshell pattern in AbXR is usually seen in

A

Meconium ileus

85
Q

The microcolon in contrast enema suggests ___

A

meconium ileus

86
Q

What is the most common and lethal GI disorder affecting a preterm neonate?

A

Necrotizing Enterocolitis

87
Q

What is the most effective surgical treatment for biliary atresia?

A

Portoenterostomy (Kasai procedure)

88
Q

What is the most common type of choledochal cyst?

A

Fusiform dilatation of the bile duct

89
Q

What is the most common anomaly associated with gastroschisis?

A

intestinal atresia

90
Q

What are the components of the Pentalogy of Cantrell?

A

HOMES

  1. Heart anomalies
  2. Omphalocele
  3. Morgagnian hernia
  4. Ectopia cordis
  5. Sternal cleft
91
Q

Biopsy of an abdominal mass reads “small round blue cells’

A

neuroblastoma

Surgery (19 decks)

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