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Flashcards in Miscellaneous Deck (29):
1

What should you order if you suspect posterior shoulder dislocation?

Axillary or scapular shoulder radiographs

2

Best mgmt of clavicular fractures

Figure eight sling

3

Best mgmt of Colles fracture (distal radius)

Closed reduction and casting

4

Monteggia and Galeazzi fractures lead to to a fracture/dislocation combination. How are they managed?

Monteggia (ulnar fracture) and Galeazzi (radius fracture) will cause diaphyseal fracture and a dislocation. Open reduction and internal fixation for diaphyseal fracture and closed reduction for dislocation

5

Best mgmt of scaphoid fracture

Thumb spica case to prevent nonunion. Repear radiographs if uncertain

6

Best mgmt of trigger finger and/or De Quervain tenosynovitis

Steroid Injections

7

Best mgmt of Dupuytren contracture

Try collagenase and if fails then surgery

8

Best mgmt of posterior hip dislocation

Extra: How does the leg present?

Emergency reduction to prevent avascular necrosis

Internally rotated

9

Best mgmt of MCL/LCL injuries

Hint: depends on how many ligaments involved

Single ligament: Casting

Multiple ligaments: Surgical repair

10

Best mgmt of ACL/PCL injuries

Hint: depends on age

Young: arthroscopic repair

Old: immobilization and rehabilitation

11

Best mgmt of meniscal injury

Arthroscopic repair

12

Best mgmt of Achilles tendon rupture

Casting in equinus position or surgical repair

13

Best mgmt of tibial stress injury

Radiographs may be negative; cast, don't bear weight, and repeat radiographs in 2 weeks

14

What is a more specific test for CTS, Phelan's or Tinel's?

Tinel's (tapping on flexor retinaculum)

15

What nerve roots control cremasteric response?
Absence of cremasteric response suggests what urologic pathology?

L1-L2
Testicular torsion

16

How do you manage testicular torsion?

Don't have to wait on US if high suspicion, emergent surgery with bilateral orchiopexy

17

How is acute epidydimitis treated?

Hint: depends on age

35 (treat as UTI): Levofloxacin

18

Should urologic obstructions accompanied by fever be treated electively, urgently, or emergently?

How are they treated?

Emergently!

Need to relive the obstruction bc it can lead to kidney damage and sepsis soon. Place urethral stent or percutaneous nephrostomy. Also provide IV antibiotics

19

A 1 week old boy is having issues with voiding and has a distended abdomen. What do you suspect? How do you diagnose it? How do you treat it?

Posterior urethral valves
Voiding cystourethrogram
Catheterization

20

Should you circumcise a child with hypospadias?

No

21

What does a child with UTI have until proven otherwise? How are they treated?

Vesicoureteral reflux
Antibiotics until they "grow out of it"

22

A young girl presents with constant wetting into her vagina. What is the likely dx?

Low implantation of ureter

23

A teenager presents with colicky abdominal pain every time he shotguns 6 beers. What's going on?

Ureteropelvic junction obstruction which causes colicky pain whenever he drinks large volumes

24

How can you distinguish subclavian steal from thoracic outlet syndrome?

Subclavian steal causes neurologic and vascular symptoms

Thoracic outlet syndrome causes vascular symptoms only

25

How does subclavian steal present classically?

Atherosclerotic plaque of subclavian allows the arm to be capable of doing normal level of activity however when exercising it there is claudication symptoms of arm and also a "steal" of blood supply from vertebral arteries causing syncopal episodes

26

How is subclavian steal diagnosed and how is it treated?

Diagnose: Angiography
Treatment: Bypass surgery

27

How is AAA recommended to be screened for?

Men 65-75 who have ever smoked should have one time US

28

What is biggest RF for thoracic aortic aneurysm progression?

Poor BP control

29

Do you need to work-up claudication symptoms in patients where it doesn't affect their daily living?

No, just recommend to quit smoking and give cilostazol and aspirin