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1
Q

mc salter fx

A

salter 2- above

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2
Q

which slater have future growth impairment

A

4 and 5

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3
Q

central slip extensor hood disriptuon near PIP joint

A

bourtoneeiere - forced flexion at PIP- EXTENSOR INJURY - lateral components hold DIP in extension

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4
Q

abx for felon or paronychiia

A

felon

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5
Q

funal hand infection w skip lesions, rose gardner

A

sporotrichosis, Itraconazole

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6
Q

gamekeepers thumb, skiiers thumb,

A

UCL of thumb MCP- pincer and grasp fxn, avulsion fracture - thumb spica

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7
Q

jersey finger

A

ring finger usually, FDP avulsion fx- cant close finger all the way to fist

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8
Q

mallet finger-

A

extensor tendor disrution- DIP - forced flexion of DIP- ie bal - avulsion fx base of distal phalanx- splint

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9
Q

rotational displacement of metacarpal fx

A

unacceptable, index and middle toerate only 15 deg angulation- radial gutter, the 4th and 5th olerate 35-45, ulnar gutter splint

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10
Q

kanavels signs

A

diffuse fusiform swelling, pain on paation of proximal sheath, severe pain on extension, held in slightly flexed- Redness is not one sign

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11
Q

mc commplications colles fx

A

median n, mc fx adults

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12
Q

intraarticlar fx distal radius

A

bartons fx

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13
Q

dorsal chip fracture of wrist fall on outstretched hand

A

triquetral fracture- pain at dorsum and ulnar styloid, pain on flexion

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14
Q

ulnar n entretmanet injury - waht 2 associated bones

A

guyons canal - connceted to pisiform and hamar

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15
Q

mc ligamentous injury of hand

A

scapholunate dissociatd- 3 mm - foosh – thuumb spice

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16
Q

perilunate vs lunate dsilocation

A

forced hypertension, median n injury- PERILunATE -capitate is displaced, LUNATE - lunate is displaced

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17
Q

tenderness iin snuffbox, what is managmenet and complication

A

scaphoid - thumb spica if theyre tender- complication AVN- definitive imaging is mri

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18
Q

risk factors for carpal tunnel

A

pregancy hypothyroid DM RA

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19
Q

galeazzi

A

DRUJ dista radius GRUM- ulnar n affected

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20
Q

monteggia

A

proximal ulna– radial head dislocated- radial N injury

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21
Q

volkmans contracture cause

A

supracondlyfacture mc- inadequate circulation- patient with cast complaining of pain and numnbess - remove cast

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22
Q

injury w nursemaids

A

tear to anular ligament- radial head subluxed

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23
Q

which reduction can trap the artery and n in the joint

A

elbow

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24
Q

ralationship between capitellum, radius, huermus

A

anterior humeral thru middle third capetellim, middle radial thru capitelllum

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25
impingement vs rotator cuff
pain with passive vs active ROM against resistance
26
shoulder dislocationw tih notch on humeral head
hill sachs
27
shoulder dislocation with labral tear/anterior glenoid rx
bankart
28
light bulb sign, dumstick sign on shoulder xr
posterior dislocation
29
medial third clavicle fx
look for subclavian injuries
30
unable toe xternally rotate and abduct shoulder with force
rotator cuff injury - mc supraspinatus injury, needs MRI -
31
mcc hip pain in kids
transient synjovitis- recent viral - limp/cant brear weight, may have lo grade fever- r/o septic hip - do hip US - if effusion needs a tap
32
pain swelling eryteham over anterior tibial uberosity
patellar tendon apophysitis - NSAIDS
33
where does osterocondtiis dessicans occurs
media femoral condyle - locking knee
34
injures with posteior knee dislocation
peroneal N, popiltearl A, needs angio
35
abx with tendon rupture
fluoroquinolones - risk lasts for 1 year
36
OAR
cant bear with immedately and in ED, tenderness to posterior edge of medial or lateral mal, tenderness to base fo 5th mt, tenderness over navicular
37
maisoneeuve
external rotation of ankle, rupture of medial (deltoid) igament, proximal fibular fx- might miss on ankle xr- medial ankle tendernss and swelling consider maissonevue
38
neonataal joint and bone infxn
strep b strep
39
child with blue sclera, flaccid joints, frequent fractures -
osteogenesis imperfect, misdiagnoes as child abuse
40
reflex levels
c5 - bicceps c6 biceps brachip c7 triceps , l4 knee jerk s1 ankle
41
atlantoaxial disruption
c1/2 , RF RA, anklyosing spodlyitis, unstable
42
hangmans fracture
bilateral pedicle fx of c2 from forward displacement, extension-
43
jefferson
burst of c1- axial load
44
mc cervical fx kids
odontoid- atlanto dens interval 3mm in adults, 5mm in peds
45
teardrop fx
extreme flexion- ligamentous disruption- chipp on the front of vertebral body
46
posterior column function? lateral corticospinal (pyramidal)? anterior horn? anterior spinothalamaic
vibration and proprioception, upper MN, lower MN, pain and temp
47
motor paralysis below injury, loss of pain and temp, vibration and proprioception intact
anterior cord
48
brown sequard motor vs pain and temp?
motor out on upsilateral, contralateral loss of pain and temp
49
hyperexntion in elderly patiennt - what is cord / deficits
central cord, arms > leg weakness, rectal tone sparing, some distal paina nd temp loss
50
cord syndrome trauma, b12, tertiary syphillis
position and vibration
51
neurogenic shock vitals/treatment
70/70 - no sympathetic, dilated, not tachycardic, treatment fluid and pressors
52
spinal shock difference from neurogenic shock
neurogenic is an injury to level and unoppose dysmpathetic outflow, usually t1 and above, loss of reflexes, autonomic tone, warm, flushed, dry , SPINAL SHOCK is loss of sensation and motor paralysis and reflex- like a concussion- and it returns
53
torus vs greenstick fx
buckled in torus vs one cortex broken in greenstick
54
inflammatory condition of bones, raid resorption, enalrged weak bones, calcium normal, alk phos up
pagets- fx with minimal truauma- can cause neuro sxs in skul and vertbrae
55
who doesnt glucagon work well on
cirhotis, liver diseaase- live does not have glucose to release
56
hypoglycemia insulinoma vs munchausens
c peptide- exogenous insulin has no C -peptide
57
what treatment to avoid cerebral edema in kids with DKA
bicarb
58
alcoholic ketoacidosis what are labs for etoh levels and ketones
etoh leves are low, low bicarb, high anion gap, glucose can be low- urinary ketones can be weakly positive but BHB will be very positive-- tx d5NS
59
differences between DKA and NHSS
NHSS - no ketoacidosis, serum osm >350, higher mortality, longer onset, usually renal issues, dehydrated, aletered, 8-12 L deficit
60
graves disease what other manifestations
exopthalmos, pretibial myxedema, from TSH similar IG stimulatiing tissues
61
what manifestation is dx thyroid storm
AMS
62
5 step approach to thyroid storm
corticocostaroids- dec peripheral conversion- Propanolol also blocks t4 to t3- block thyroid hormone effects, PTU- block enzyme to make hormones and blocks t4 to t3, iodine- block thyroid hormone release
63
tx myxedema coma
t4 t3 and corticosteroids - concerned for concomitatn AI
64
waterhouse friderchens
biateral adrenal failure associated with meningococermia
65
primary ai vs 2nd teritary
primary- in the adrenals- inc ACTH/MSH made- 2nd- pituitary - cant make the ACTH - dx serum cortisol and give ACTH -s eei fthey respond- if it goes up adrneals are normal - if not then primary adrenal ----- teriaty is iatrogenic from prolonged steroids
66
low sodium hiigh potassium, eosinophilia
AI
67
concentrate urine w low serum osm and normovolemia
siadh

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