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Another Deck Flashcards

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1
Q

Time of presentatoin and resolution of femoral ante version

A

Presents age 4-6

Resolves 10-13

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2
Q

Lateral talus OCDs are:

A

Less common than medial
Typically traumatic
Less likely to respond to non op management
Shallower than medial lesions

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3
Q

Extra abdominal Desmoid tumors

A

Wide resectoin
Does not metastasize
Estrogen receptor Beta positive
High association with FAP syndrome

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4
Q

RUNX2 is also known as

A

CBFA1

Gene mutatoin in cleidocranial dysplasia

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5
Q

If you see a locked plate on long bone with long working length think this type of bone healing

A

Endochondral
Indirect
Flexible and strong construct

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6
Q

BMPS signal through which molecules

A

SMADS

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7
Q

BMP target cells

A

Undifferentiated perivascular mesenchymal cells

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8
Q

This BMP is associated with fibrodysplasia ossificans progressiva

A

Bmp4

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9
Q

These things inhibit fracture healing

A

Nicotine
Quinolone
Cortisone
NSAIDs

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10
Q

Do you need to tissue Match osteochondral allografts?

A

Yes, cartilage is highly immunogenicity, so tissue matching is necessary

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11
Q

The major antigen in allograft is

A

Cell surface glycoproteins

T lymphocyte response
Cellular response, not humoral
Marrow cells incite the greatest response

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12
Q

Is DBM osteoinductive?

A

Yes but minimally

BMPS are preservered

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13
Q

What bone formation type happens in distraction osteogenesis

A

Endochondral occurs if low stability

If optimal stability, will be intramembranous

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14
Q

Optimal prophylactic radiation dose for HO preventoin

A

Single dose

600-700 rad

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15
Q

Recommended vitamin d dose for children

A

600mg/day

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16
Q

Recommended D dose for adults

A

750mg/day

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17
Q

Recommended D dose for adults over 50

A

1200-1500mg

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18
Q

Cancer risk of teriparatide

A

Increased sarcoma risk

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19
Q

Functions of PTH

A
  • activates osteoblasts
    Increases renal phosphate filtration
    Jansen metaphyseal displasia
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20
Q

Dilantin effects on bone metabolism

A

Inhibits vitamin D metabolism

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21
Q

Fungal. Nail infections are associated with

A

Hypocalcemia

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22
Q

Pseudohyperparathyroidism

A

GNAS mtuatoin
Cellular response to PTH is defective
Defect in CAMP system

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23
Q

Amy.oidosis

A 
Beta microglobulin
Carpal tunnel syndrome
Arthropathy
Pathological fractures 
Congo red stain
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24
Q

Physis zone affected by rickets

A

Provisional calficication

Disoriented and widened

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25
Mutations in Hereditary vitamin D dependent rickets
Type 1: defect in renal 25 hydroxylase Type 2: defect in receptor for 1,25D Autosomal recessive
26
Familial hypophosphatemic rickets
``` X linked Phosphate wasting proximal renal tubular defect Normal calcium Low phos Low D3 Elevated alk phos ``` Treatment is phosphate supplementation and high dose D3
27
Elevated urinary phosphoethanolamine is diagnostic of
Hypophosphatasia
28
Methotrexate
Folate analog Inhibits purine metabolism Me Alon ate pathway
29
Leflunomide
Inhibits pyrimidine synthesis | Stop for surgery
30
Hydroxxychloroquine (plaquenil)
Inhibits toll like receptor TLR9 | Need ophthalmology evaluation annually
31
Anakinra
Anti-IL1 antibody
32
Diagnostic criteria JIA
6 weeks joint swelling in someone younger than 16 years
33
Felty syndrome
RA, SPOENOMEGALY, NEUTROPENIA
34
A kid with JIA always needs:
Eye screening for iridocyclitis and uveitis
35
SLE is what type of hypersensitivity reaction
Type 3
36
Schober test
A line10cm from the base of lumbar spine should increase at least 4-5 cm with flexing If <4cm increase test is positive and dx of AS is made
37
Organisms that cause Reiter syndrome
Chlamydia Shigella Yersinia Salmonella All are intracellular organisms
38
If inflammatory arthritis and DIP JOINT involved think
Psoriatic arthritis
39
Upper limit size for use of nerve tubes for reconstruction?
2-3cm nerve defect is max | greater than this, use autograft
40
Treatment of Hip Dysplasia/subluxation >18 months
- preferred open reduction +/- femoral or pelvic osteotomies | - definitely open if excessive abduction (>60) required to get closed reduced
41
Most beneficial tendon transfer for a PIN Palsy is:
FCR to finger extensors | PL to the EPL
42
TO increase fusion rates in lumbar spine, smoking cessation should be employed for at least:
6 months (Glassman et al)
43
Keller arthroplasty
resection of the proximal aspect of the middle phalanx of great toe for hallux rigidus in low demand elderly patient and your'e trying to avoid fusion
44
What is the heritability of post axial polydactyly
Autosomal dominant, more common in African Americans
45
Risk factors for pseudoarthrosis in scoliosis fusion:
- anterior thoracolumbar approaches - age >55 - SVA >5cm -
46
Indications for resecting talocalcaneal coalition?
- <50% subtalar joint involved | - no significant subtalar joint deformity
47
What is Denosumab
anti-RANKL Monoclonal antibody | - competitive receptor
48
What tumor is Denosumab useful for?
giant cell tumor of bone | - these are known to express RANKL and cause significant bony lysis
49
Thromboplastin
"tissue factor" - released during surgical dissectoin - activates factor VII - VII activates X - X activates II (thrombin) - clot formation this is the extrinsic pathway
50
Macrolide antibiotics work by:
50S ribosomal subunit - affects protein synthesis
51
Aminoglycosides work by:
30S ribosomal subunit
52
Beta lactams wokr by:
inhibiting transpeptidase enzymes | - prevents bacterial cell wall formation
53
compnents of the TFCC:
ECU subsheath meniscal homolog dorsal/ulnar radioulnar ligaments
54
Most common proteoglycan in tendons:
decorin
55
Collagen composition of tendons
95% type I | <5% type III, V, VI
56
Chronic perilunate, treat with a :
PRC
57
Heredity of Tumoral calcinosis?
inherited phosphate metabolism error
58
most frequent complication of TKA in patients with Paget's disease?
Malalignment
59
When should you operate on brachial plexus injuries?
2-3 months if no return of function | - waiting longer than 20 months risks destruction of the motor endplates
60
Unicortical locked plate compared with bicortical unlocked plate
decreased torsional stability with unicortical locked, but increased axial stability
61
Which medicines in conjunction with methotrexate do better for RA than mtx alone?
tetracyclines | - doxycycline specifically
62
Waht is the effect of fusing to the sacrum for long scoliosis constructs?
- increases pseudoarthrosis rate | - improves sagittal correction and maintenance
63
Wnt protein
- binds LRP5/6, activates intracellular beta-catenin pathway | - generates osteoblast differentiation from mesenchymal precursors
64
Intrinsic toughness
the amount of energy a material can absorb before it breaks
65
Yield stress
the amount of energy a material can absorb before it plastically deforms
66
Time to appropriate braking after tibia or ankle fractures?
- 9 weeks from injury | - 6 weeks from initiation of weight bearing
67
A northern blot detects:
DNA
68
A southern blot detects
RNA (by hybridization)
69
A western blot detects
Protein by SDS-PAGE
70
PCR amplification detects
DNA sequence isolated by restriction enzymes and PCR amplification of that sequence
71
Type 1 Hypersensitvity Reaction
IgE mediated histamine response vasodilatation
72
Type IV Hypersensitivity
cell mediated (T cells) activate cytotoxic cells and macrophages - 2-3 days to develop - type 1 diabetes - PPD - multiple sclerosis - allergy to orthopaedic metal hardware
73
Type II Hypersensitivity
Mediated by IgM or IgG - rheumatic fever - myasthenia gravis - HIT
74
Type III Hypersensitivity
Immune complex mediated - RA - SLE
75
Anti-Sm antibody
SLE
76
Anti-RNP antibody
mixed connective tissue disease
77
Anti-SCL70
scleroderma
78
Anti-ds-DNA
SLE
79
Anti-Histone
drug induced lupus
80
Anti-Ro and Anti-La
Sjogren syndrome
81
If you see radial club hand you need to think:
- VACTERL - Holt-Oram (cardiac abnormalities) - TAR (get bloodwork) - Fanconi anemia
82
Fanconi anemia
- autosomal recessive - treat with bone marrow transplant - dx with chromosomal breakage test

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