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Ortho Flashcards

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1
Q

Conditions to inquire about in PMH? (AAA MR J DETHS)

A

Asthma, allergies, angina, MI, rheumatic heart disease, jaundice, diabetes, epilepsy, TB, HTN, Stroke

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2
Q

Causes of anything- TINCANBED

A

Trauma, infective, neoplastic, connective tissue, autoimmune, neurosis, blood, endo, drug/diet/deficiencies

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3
Q

Bone mets- 4 common locations

A

bronchus, breast, bowel, b-thyroid, prostate

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4
Q

What does management mean?

A

diagnosis and treatment

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5
Q

Treatment mnemonic CAGES

A

complications, age, general condition, aetiology, size/site/symptoms

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6
Q

What does the median nerve supply? LOAF

A

Lateral 2 lumbricals, Opponens pollicis, Abductor pollicis brevis, flexor pollicis brevis

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7
Q

How to categorise complications of surgery?

A

Immediate (within 24hrs), early (2 weeks), late (>2 weeks). Local vs systemic

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8
Q

Immediate local complication of surgery

A

Primary haemorrhage

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9
Q

Immediate systemic complication of surgery

A

Asphyxiation

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10
Q

Early local complication of surgery

A

Dehiscence (bursting/openign of wound), infection, secondary haemorrhage

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11
Q

Early systemic complication of surgery

A

atelectasis, LRTI, VTE, pseudomembranous colitis, constipation, acute urinary retention->UTI->sepsis

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12
Q

Late local complication of surgery

A

metal failure

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13
Q

Late systemic complication of surgery

A

CNS

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14
Q

Presenting pathology: Dressed in a surgeons gown a physician may make some progress

A

Definition, Incidence, Sex, Geography, Aetiology, pathogenesis, macroscopic pathology, microscopic pathology, symptoms, signs, prognosis

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15
Q

Presenting X-ray?

A

Name, Age, Date, What you can see (AP, lateral view of the right hip for example), most obvious abnormality

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16
Q

JOAST

A

Joint, outilne, attitude, soft tissue, texture

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17
Q

How can you tell apart bone and calcium on xrays?

A

Bone is trabeculated, calcium is homogenous- use this to tell apart avulsed piece of bone from soft tissue tendonitis

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18
Q

What is a stone of calcium in the pelvis called?

A

Phlebolith

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19
Q

Tendons of the pes anserinus? Say Grace before Tea

A

Tendons that insert on anterio-medial aspect of proximal tibia: Sartorius, gracilis, semiTendinosus

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20
Q

What is avascular necrosis of the lunate bone known as?

A

Kienbock disease

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21
Q

What kind of cartilage tops the femur and tibia?

A

hyaline

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22
Q

Where is the thickest hyaline cartilage in the body?

A

patella

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23
Q

What doe wearing down of cartilage in the knee lead to?

A

osteoarthritis

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24
Q

Which of the femur and tibia have round epicondyles?

A

Femur has rong, tibia has flat

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25
What are the four heads of quadriceps?
rectus femoris, vastus lateralis, vastus intermedius, vastus medialis
26
What is the sesamoid bone of the knee called?
patella
27
What function does the patella have?
allows you to stand and walk
28
What structure in the knee joint helps reduce pressure travelling through the tibia?
menisci
29
What does removal of meniscus lead to?
100% get OA
30
Superficial to deep causes of knee pain?
Neuroma-\>vessels-\>bursae-\>tendonitis-\>patella-\>plical folds of capusle
31
What is Hoffa's impingement?
Pinching of fat pad behind patella
32
What stops the patella dislocating?
vastus medialis, trochlear shorter on lateral side,
33
What is os trigonum?
An extra bone that develops behing the talus- can cause pain when wedge between the talus, calcaneus or tibia
34
How does vitamin C treat osteoporosis?
increases bone density
35
Symptoms of primary breast tumour?
lump, pain, discharge
36
Signs of primary breast tumour?
inverted nipple, peau d'orange
37
Investigations for primary breast tumour?
mammogram, FNA
38
Symptoms of secondary breast tumour?
axillary lump, night bone pain, abdo pain, cough
39
Signs of secondary breast tumour?
bony tenderness, axillary lymphadenopathy, oedema
40
Investifations for secondary breast tumour?
CXR, FNA, biopsy, needle aspirate
41
General effects of tumours- symptoms?
weight loss, fatigue, cachexia, night sweats
42
General effects of tumours- signs?
weight los, anaemia
43
Investigation of general effects of tumours?
FBC
44
3 classic osteoporosis fractures?
NOF, Colle's, vertebral wedge fractures
45
Investigation of choice for osteoporotic fractures?
DEXA- x-ray only picks up if reduction in bone density is \>25%
46
What is a brown tumour?
a lytic lesion caused by increased PTH levels
47
2 layers of periosteum?
fibrous (Very strong structural support), cambium (cellular- contains osteocytes which aid in fracture healing)
48
4 stages of fracture healing?
haematoma-\>inflammatory-\>callus-\>remodelling
49
Why avoid NSAIDs for fractures?
prevents inflammatory phase healing
50
Which layer of periosteum lays down layers of callus as bone remodels?
cambium
51
What kind of force causes a transverse fracture?
mid air horizontal force
52
What kind of force causes an oblique fracture?
Force with load applied e.g. whilst standing
53
What is atrophic non-union?
If a bone has not healed within 6 months
54
What is a poor prognostic factor for fracture healing/
No periosteum on either side, increased age, smoking
55
What can be used to determine when bone switches from callus to remodelling phase?
retrospective analysis- callus index= ration of bone:bone+callus
56
What can the above be used for in terms of treatment?
Works out which treatment arms are superior to each other by working out the time to maximum callus index
57
How can you classify fractures?
simple/comminuted, open (compound)/closed, pattern (transverse/oblique/spiral/butterfly), displaced/non-displaced, complicated/uncomplicated, Salter-Harris
58
What could indicate a complicated fracture?
compartment syndrome, neurovascular syndrome
59
Short term complication of Colles due to median nerve injury?
acute carpal tunnel syndrome
60
Long term complication of Colles fracture?
rupture of extensor pollicus longus
61
Who is Salter-Harris classification of fractures used for?
children
62
Salter-Harris type 1?
through the physis (growth plate)
63
Type 2?
Through the physes and metaphysis, sparing epiphysis
64
Type 3?
Through the physis and epiphysis sparing the metaphysis
65
Type 4?
Through the physis, metaphysis and epiphysis
66
Type 5?
Compression fracture of the physis
67
Basic treatment algorithm for fractures?
Complications?-\>type of fracture?-\>significant displacement-\>if displaced, how can it be reduced?-\>once reduced is it stable?-\>if unstable how will you immobilise-\>rehab
68
What is displacement?
No longer in the plane of the closest joint- if it heals in this position it will cause significant debilitation
69
4 methods od reducing fractures?
traction, gravity, manipulation under anaesthetic, open reduction
70
Two types of traction?
skin or skeletal
71
Example of gravity being used to heal?
collar and cuff
72
5 methods of immoblising unstable fractures?
3 point moulding, splint, traction, operation (external fixation), internal fixation (nail/plate and screw)
73
Rule of 2s?
2 views at 90 degrees, 2 dates, 2 sides, 2 joints to check above and below
74
How are the 2 broad ways that antibiotics are used?
prophylactically or therapeutically
75
What are the 2 broad ways you can categorise infections e.g. pneumonia vs empyema?
spreading vs localised
76
How are the 2 above different categories managed?
excision/drainage/chest drain vs antibiotics
77
Sepsis 6?
Oxygen, antibiotics, fluids, cultures, lactate, urine output
78
3 reasons to give prophylactic antibiotics?
immunocompromise, high risk of infection, consequences of infection are serious
79
Examples of immunocompromise?
old/young, diabetes, renal, immunosuppressed
80
Patients with high risk of infection?
pre-existing infection e.g. appendix, gynae, large bowel surgery
81
Situations where consequences of infection are serious?
joint replacement, heart valve, neurosurgery (VP shunt)

Finals Revision (9 decks)

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