ortho6 Flashcards
(174 cards)
1
Q
MRI for AIS is indicated if red flags are present. These include atypical curve (***3), rapid progression, hyperkyphosis, structural abnormalities, neurologic symptoms or pain, foot deformities and asymmetric abdominal reflexes.
A
left thoracic, short angular curve, apical kyphosis
2
Q
MRI for AIS is indicated if red flags are present. These include atypical curve (left thoracic, short angular curve, apical kyphosis),***, hyperkyphosis, structural abnormalities, neurologic symptoms or pain, foot deformities and asymmetric abdominal reflexes.
A
rapid progression
3
Q
MRI for AIS is indicated if red flags are present. These include atypical curve (left thoracic, short angular curve, apical kyphosis), rapid progression, ***, structural abnormalities, neurologic symptoms or pain, foot deformities and asymmetric abdominal reflexes.
A
hyperkyphosis
4
Q
MRI for AIS is indicated if red flags are present. These include atypical curve (left thoracic, short angular curve, apical kyphosis), rapid progression, structural abnormalities, neurologic symptoms or pain, *** and asymmetric abdominal reflexes.
A
foot deformities
5
Q
MRI for AIS is indicated if red flags are present. These include atypical curve (left thoracic, short angular curve, apical kyphosis), rapid progression, structural abnormalities, neurologic symptoms or pain, foot deformities and ***.
A
asymmetric abdominal reflexes
6
Q
first bony goal in fixing tibial plateau fx?
A
fixing articular block
RG61_84 9/17/2020
7
Q
w/metaphyseal diaphyseal plateau fx, how deal with metaphyseal region?
A
span it w/plate
RG61_84 9/17/2020
8
Q
postop how restrict motion after plateau fx?
A
don’t
RG61_85 9/17/2020
9
Q
why avoid pins near knee for frame for tibial plateau fx?
A
risk of septic arthritis
RG61_87 9/17/2020
10
Q
SBQ12TR.28) After application of a unilateral tibial external fixator, it is observed that the frame does not provide sufficient rigidity acr`oss the fracture site. Altering the external fixator in which of the following ways will have the greatest impact on frame stiffness?
A
increasing pin diameter
11
Q
Nutritional deficiency rickets found to have low calcium, low phosphate, high alkaline phosphatase, and increased parathyroid hormone (PTH). The disease is characterized by physeal widening and osteopenia on imaging, which may manifest on physical exam with widened wrists and ankles, spinal kyphosis, and genu varum. A rachitic rosary may also be present with thickening of the costochondral junction of the anterior ribs.
A
low calcium
low phosphate
high alk phos
increase pth
12
Q
Nutritional deficiency rickets found to have low calcium, low phosphate, high alkaline phosphatase, and increased parathyroid hormone (PTH). The disease is characterized by *** which may manifest on physical exam with widened wrists and ankles, spinal kyphosis, and genu varum. A rachitic rosary may also be present with thickening of the costochondral junction of the anterior ribs.
A
physeal widening and osteopenia on imaging
13
Q
Nutritional deficiency rickets found to have low calcium, low phosphate, high alkaline phosphatase, and increased parathyroid hormone (PTH). The disease is characterized by physeal widening and osteopenia on imaging, which may manifest on physical exam with widened wrists and ankles, spinal kyphosis, and genu varum. A rachitic rosary may also be present with ***
A
thickening of the costochondral junction of the anterior ribs
14
Q
Preop things use to reduce complications for spine patients?
A
weight loss
smoking cessation
osteoporosis management
blood sugar control
rothman_7th ed chap 98 9/22/20
15
Q
what vascularcomplication postop keep in mind for someone after anterior lumbar surgery related to manipulation of iliac vv?
A
dvt
rothman_7th ed chap 98 9/22/20
16
Q
what is a surgical complication?
A
undesirable, unintended, and direct result of an operation affecting the patient that would not have occurred had the operation gone as well as could reasonably be hoped.
rothman_7th ed chap 98 9/22/20
17
Q
(OBQ18.99) A 72-year-old female with rheumatoid arthritis is scheduled to undergo total hip arthroplasty. She presents for her preoperative visit and asks about dosing of her antirheumatic medications. She currently takes etanercept weekly and hydroxychloroquine daily. Which of the following is the best dosing recommendation for her antirheumatic medications prior to surgery?
A
continue hydroxychloroquine
hold etanercept 2 weeks prior to surgery
18
Q
For PCL deficiency, the tibial slope should be ***
A
INCREASED
QID: 2848
19
Q
basic force generating event in skeletal mm?
A
cyclic formation of cross bridges bw actin and myosin
rothman_7th ed chap 3 9/23/2020
20
Q
three different types of skel mm architecture?
A
longitudinal
unipennate (fixed angle of fiber to force generating axis)
multipennate
rothman_7th ed chap 3 9/23/2020
21
Q
where do bisphosphonates bind?
A
calcium hydroxyapaptite
QID: 5899 9/25/2020
22
Q
contraindications to teriparatide use? 3
A
Osteosarcoma
cancer metastases to bone
Paget’s disease
QID: 5899 9/25/2020
23
Q
(SAE11OS.66) Figures 66a through 66d are the radiographs and CT scans of a 72-year-old woman with osteoporosis who sustained a fall from standing height (split depression tibial plateau fx). She has pain and is unable to bear weight on the right knee. Surgical management is considered. Which of the following best describes the preferred proximal screw fixation construct within a laterally applied buttress plate? Tested Concept
A
3.5-mm nonlocking screws followed by 3.5-mm locking screws
QID: 7654
9/25/2020
24
Q
US on infant hip alpha angle should be above what?
A
60 degree
OB?
9/25/2020
25
Why avoid too much abduction in pavlik harness for DDH?
Increase risk AVN
OB?
9/25/2020
26
PaO2, PaCO2 andA-A gradient aw PE?
Most patients are hypoxic (Pao2 < 80 mm Hg), hypocapnic (Paco2 < 35 mm Hg), and have a high A-a gradient (> 20 mm Hg).
OB?
9/26/2020
27
polypeptide hormone produced by parafollicular cells
Calcitonin
OB?
9/26/2020
28
wear associated with chronic PCL instability occurs most commonly in what knee compartments?
Patellofemoral
Medial
OB?
9/26/2020
29
A patient has a C6-7 herniated nucleus pulposus. What is the most likely distribution of symptoms?
C7 symptoms
Pain forearm/hand
Numb MF
Weak triceps
Weak finger extensors
OB?
9/26/2020
30
How does adult flatfoot affect Achilles’ tendon?
Contracture
OB?
9/26/2020
31
Recent studies have shown that cells of the intervertebral discs are biologically responsive and increase their production of matrix metalloproteinases, nitric oxide, interleukin-6, and prostaglandin E2 when stimulated by what molecule
Interleukin 1 beta
OB?
9/26/2020
32
SCFE in a child <10 years of age or with a weight <50th percentile merits an endocrine workup. Certain endocrine disorders have been associated with SCFE; these include***
hypothyroidism, renal osteodystrophy, growth hormone deficiency, and panhypopituitarism.
OB?
9/26/20202
33
65-year-old male who had a total knee arthroplasty 8 years ago comes into the office with worsening knee pain. The orthopaedic surgeon is concerned about infection and aspirates the knee. Which of the following are the lowest laboratory values from a synovial aspirate suggestive of infection?
Wbc 1500 cells/mL
PMN 70%
OB?
9/26/2020
34
Radiographic changes suggestive of osteopetrosis in children are a known complication of which of the following types of medications?
Bisphosphonates
OB?
9/26/2020
35
Findings suggestive of a pre-ganglionic injury would include
Horner Syndrome (due to disruption of the sympathetic chain),
MEDIAL scapular winging resulting from rhomboid and serratus anterior paralysis,
cervical paraspinal muscle weakness,
absent sensation, and
hemidiaphragmatic paralysis
OB?
9/26/2020
36
A cervical canal of less than *** is considered stenotic whereas a diameter of less than *** is considered absolute stenosis
13mm
10mm
OB?
9/27/2020
37
IL-6 is a proinflammatory cytokine that promotes osteolysis and is inhibited by***
tocilizumab
OB?
9/27/2020
38
A 28-year-old man sustains a distal forearm laceration. Surgical exploration reveals complete ulnar nerve transection but an intact median nerve. Motor examination reveals intact finger abduction and adduction. Why?
Martin gruber anastamosis
OB?
9/27/2020
39
Bilateral facial nerve palsy is associated with ***
Lyme disease
OB?
9/27/2020
40
what year hand dominance usually established by?
3
OB?
10/7/20
41
what cell type does bisphosphonate target?
osteoclast
OB?
10/7/20
42
(OBQ08.221) A 70-year-old female has persistent anterior knee pain and stiffness 10 months status-post total knee arthroplasty with associated lateral patellar release. Radiographs before and after surgery are shown in Figures A and B respectively. Pre-operatively, her Insall-Savati ratio is 0.95, compared to 0.76 post-operatively. Which of the following is the most likely cause of her radiographic abnormality and pain? Tested Concept
QID: 607
Excessive resection of the distal femur and lateral release of the patella
OB?
10/8/20
43
(SAE10BS.10) A patient has a C6-7 herniated nucleus pulposus. What is the most likely distribution of symptoms? Tested Concept
QID: 7098
Pain at the forearm and hand, numbness of the middle finger, weakness of the triceps and finger extensors
OB?
10/8/20
44
(OBQ11.67) Which of the following elbow apophyses is the last to fuse during growth?
QID: 3490
internal medial epicondyle
OB?
10/9/20
45
OBQ12.112) A 7-year-old patient presents with a fracture of her left supracondylar humerus and distal radius as evidenced in Figure A. She is neurovascularly intact and the skin shows no evidence of open wounds. Radiographs of the elbow show a displaced supracondylar fracture. Radiographs of the wrist show an extra-articular distal radius fracture with 25 degrees of dorsal angulation. This injury is most appropriately treated with which of the following?
QID: 4472
Closed reduction and pinning of both the supracondylar humerus fracture and distal radius fracture
OB?
10/9/20
46
A 9-year-old-female presents with her parents who have concerns regarding the appearance of her elbow (Figure A). Her past medical history is significant for a supracondylar fracture treated in a cast when as a younger child. She has no pain with motion and has 0 to 120 degrees range of motion. She does not have functional limitations but her parents would like to improve the appearance of her elbow. Which of the following procedures will correct the cubitus varus but may result in a lateral prominence?
lateral closing wedge osteotomy
OB?
QID: 3651
10/9/20
47
Gold standard bone graft for spine fusion?
iliac crest bone graft
rothman chap 65
10/10/20
48
if harvesting iliac crest BG for anterior spinal surgery where don't want the scar to sit?
right over bony prominence
rothman chap 65
10/10/20
49
where place incision to stay away from LFCN when harvesting anterior iliac crest bone graft?
2cm lateral to ASIS
rothman chap 65
10/10/20
50
A 65-year-old male who had a total knee arthroplasty 8 years ago comes into the office with worsening knee pain. The orthopaedic surgeon is concerned about infection and aspirates the knee. Which of the following are the lowest laboratory values from a synovial aspirate suggestive of infection?
1500 cells/mL
PMN 70%
OB?
10/10/20
51
What does cox2 produce?
PGE2
OB?
10/10/20
52
(SAE07PE.89) Where is the most common site for tuberculosis (TB) spondylitis in children? Tested Concept
QID: 6149
anterior aspect of the lower thoracic region
10/11/20
53
(OBQ12.243) What is the most common fracture in children younger than 16-years-old?
distal radius
OB?
10/17/20
54
(OBQ16.81) An 11-year-old male falls from his bike sustaining the injury seen in Figure A(radial neck fx). He underwent treatment as seen in Figure B(metaizeau). Which of the following factors is associated with unsuccessful outcomes, such as osteonecrosis or heterotopic ossification, after surgical treatment of these fracture types?
QID: 8843
age over 10
OB?
10/17/20
55
After how much angulation consider closed reduction for radial neck fx?
>30 degree
OB?
10/17/20
56
where is calcitonin produced?
parafollicular cells of thyroid gland
QID: 210166
10/17/20
57
the *** attachment of the MPFL is a common site of injury and avulsion.
Femoral
OB?
10/18/20
58
Semimembranosus inserts onto***
posterior surface of the medial tibial condyle
OB?
10/18/20
59
multilevel spondylolisthesis c spine think what?
RHeumatoid arthritis
OB?
10/18/20
60
Classically, in frozen shoulder the rotator interval is released to improve ***, while the posterior capsule is released to improve internal rotation and ***
ER
cross-body adduction.
OB?
10/18/20
61
distal physis humerus contributes ~***mm/yr of longitudinal humeral growth.
3
OB?
10/25/20
62
child should be able to sit by age ***months
9
OB?
10/25/20
63
*** attaches to the tibial sesamoid, adductor hallucis attaches to the fibular sesamoid, flexor hallucis brevis (FHB) attaches to both sesamoids, and flexor hallucis longus (FHL) runs between the sesamoids in the FHB hiatus.
Abductor hallucis brevis
QID: 4741
OB?
10/19/20
64
Abductor hallucis brevis attaches to the tibial sesamoid, adductor hallucis attaches to the fibular sesamoid, *** attaches to both sesamoids, and flexor hallucis longus (FHL) runs between the sesamoids in the FHB hiatus.
flexor hallucus brevis(fhb)
QID: 4741
OB?
10/19/20
65
Abductor hallucis brevis attaches to the tibial sesamoid, *** attaches to the fibular sesamoid, flexor hallucis brevis (FHB) attaches to both sesamoids, and flexor hallucis longus (FHL) runs between the sesamoids in the FHB hiatus.
adductor hallucis
QID: 4741
OB?
10/19/20
66
lab findings aw nutritional rickets?
low calcium, low phosphate, high alkaline phosphatase, and increased parathyroid hormone (PTH).
QID: 5319
OB?
10/19/20
67
(OBQ13.39) A 22 year-old college cross-country runner developed hip and groin pain that initially started while running, but is now painful when walking across campus. Radiographs show no evidence of a stress fracture, an alpha angle of 45 degrees, and a lateral center edge angle of 30 degrees. An MRI shows focal, intense marrow edema in the superior-lateral femoral neck. What is the most appropriate treatment?
operative treatment with percutaneous screw placement
OB?
10/19/20
68
(SAE10PE.25) You are asked to consult on a 4-day-old neonate admitted because of failure to thrive. She has swelling of her left shoulder. Examination reveals limited motion of her hips and left shoulder. Radiographs of the shoulder and pelvis are negative. Laboratory studies show a WBC count of 24,000/mm3, an erythrocyte sedimentation rate of 50/h, and C-reactive protein is 16.4. What is the next most appropriate step in management?
QID: 7213
ultrasound of the hip and shoulder
10/20/20
OB?
69
Proximal tibial shaft fractures treated with intramedullary nails are most commonly malreduced with ***.
QID: 3228
apex anterior and valgus deformities
10/20/20
OB?
70
Remember, the blocking screws should go in the ***, or where you don't want the nail to go.
QID: 3228
concavity of the deformity
10/20/20
OB?
71
Remember, the blocking screws should go in the concavity of the deformity, or ***.
QID: 3228
where you don't want the nail to go
10/20/20
OB?
72
(SBQ18BS.12) A 13-year-old girl with fevers, chills, and rigor for the last 2 weeks presents with the MRI findings shown in Figure A. She undergoes CT-guided biopsy and culture. Final cultures reveal methicillin-resistant staphylococcus aureus (MRSA). She becomes septic and is taken to the operating room for urgent surgical debridement. Which of the following is often associated with this diagnosis and requires close surveillance in the acute setting? Tested Concept
QID: 211233
DVT
OB?
10/24/2020
73
Ju et al describe a clinical prediction algorithm for distinguishing MRSA from MSSA osteomyelitis in children. They report 4 patient factors - ***
QID: 5031
temperature >38.0 C, WBC>12,000, Hct<34, and CRP>13
OB?
10/24/20
74
bacterial topoisomerase and DNA gyrase MOA for what abx class?
QID: 5031
Describes the mechanism of fluoroquinolone antibiotics.
OB?
10/24/20
75
Binding to 30S ribosomal proteins MOA of what abx class?
QID: 5031
aminoglycoside antibiotics
OB?
10/24/20
76
what ribosomal subunit clindamycin inhibit?
50s
OB?
10/24/20
QID: 5031
77
The differential diagnosis of an infectious presentation with NWB in a child should include: ***, sacroilitis, transient synovitis, septic hip, osteomyelitis, and Iliopsoas abscess
QID: 3357
discitis
OB?
10/28/20
78
The differential diagnosis of an infectious presentation with NWB in a child should include: discitis, ***, transient synovitis, septic hip, osteomyelitis, and Iliopsoas abscess
QID: 3357
sacroilitis
OB?
10/28/20
79
The differential diagnosis of an infectious presentation with NWB in a child should include: discitis, sacroilitis, ***, septic hip, osteomyelitis, and Iliopsoas abscess
QID: 3357
transient synovitis
OB?
10/28/20
80
The differential diagnosis of an infectious presentation with NWB in a child should include: discitis, sacroilitis, transient synovitis, ***, osteomyelitis, and Iliopsoas abscess
QID: 3357
septic hip
OB?
10/28/20
81
The differential diagnosis of an infectious presentation with NWB in a child should include: discitis, sacroilitis, transient synovitis, septic hip, ***, and Iliopsoas abscess
QID: 3357
osteomyelitis
OB?
10/28/20
82
The differential diagnosis of an infectious presentation with NWB in a child should include: discitis, sacroilitis, transient synovitis, septic hip, osteomyelitis, and ***
QID: 3357
iliopsoas abscess
OB?
10/28/20
83
The Kocher criteria for septic arthritis include (4)
QID: 3357
fever>38.5 degrees centigrade, inability to bear weight, ESR>40 mm/h, and WBC count>12,000/ul.
OB?
10/28/20
84
Transoral anterior odontoid resection is rarely required in the treatment of odontoid fractures and is only indicated
QID: 464
when there is posterior displacement of the dens leading to spinal cord compression, that can not be reduced by closed methods
OB?
10/28/20
85
How is disc space different bw AS and DISH?
QID: 3759
preserved in DISH, ossification of disc space in AS
OB?
10/28/20
86
OBQ09.183) On average, the radial nerve travels from the posterior compartment of the arm and enters the anterior compartment at which of the following sites? Tested Concept
QID: 2996
10 cm proximal to the radiocapitellar joint
OB?
10/28/20
87
(SBQ12SP.94) A 45-year-old man presents the emergency department after being stabbed in the upper back. His physical examination is consistent with an incomplete spinal cord injury caused by a complete hemitransection of the spinal cord. Which of the following is consistent with this patient's physical examination? Tested Concept
QID: 3792
Ipsilateral to injury loss of motor function and propriception, contralateral loss of pain/temperature sensation
OB?
10/29/20
88
Hardware placement in the *** is a risk-factor of disrupting the vascular supply following surgical management of a SCFE.
QID: 2231
posterosuperior femoral neck
OB?
11/3
89
Blount's disease is a *** growth disturbance leading to varus, flexion, and internal rotation deformity of the tibia
QID: 5347
posteromedial proximal tibial physeal
OB?
11/5
90
Blount's disease is a posteromedial proximal tibial physeal growth disturbance leading to *** deformity of the tibia
QID: 5347
varus, flexion, and internal rotation
OB?
11/5
91
If overlooked, HAGL lesions can cause a failure of *** repair
QID: 791
Bankart
OB?
11/5
92
Rules of osteotomy as outlined by Paley.
Rule 1:
Rule 2: If ACA passes through the CORA (ACA-CORA), but the osteotomy does NOT pass through the ACA-CORA, there will be angulation and translation of the bone ends at the osteotomy site. But the axis lines are collinear (no translation of axis).
Rule 3: If the osteotomy passes through the ACA, but the CORA is at a different level, there will be angulation but no translation of bone ends. The axis lines will be parallel, but translated.
QID: 5629
The axis of correction of angulation (ACA) can pass through the CORA (ACA-CORA).
If the osteotomy passes through the ACA-CORA, correction produces pure angulation at the osteotomy site (no translation).
OB?
11/6
93
Rules of osteotomy as outlined by Paley.
Rule 1: The axis of correction of angulation (ACA) can pass through the CORA (ACA-CORA).
If the osteotomy passes through the ACA-CORA, correction produces pure angulation at the osteotomy site (no translation).
Rule 2:
Rule 3: If the osteotomy passes through the ACA, but the CORA is at a different level, there will be angulation but no translation of bone ends. The axis lines will be parallel, but translated.
QID: 5629
If ACA passes through the CORA (ACA-CORA), but the osteotomy does NOT pass through the ACA-CORA, there will be angulation and translation of the bone ends at the osteotomy site. But the axis lines are collinear (no translation of axis).
OB?
11/6
94
Rules of osteotomy as outlined by Paley.
Rule 1: The axis of correction of angulation (ACA) can pass through the CORA (ACA-CORA).
If the osteotomy passes through the ACA-CORA, correction produces pure angulation at the osteotomy site (no translation).
Rule 2: If ACA passes through the CORA (ACA-CORA), but the osteotomy does NOT pass through the ACA-CORA, there will be angulation and translation of the bone ends at the osteotomy site. But the axis lines are collinear (no translation of axis).
Rule 3:
QID: 5629
If the osteotomy passes through the ACA, but the CORA is at a different level, there will be angulation but no translation of bone ends. The axis lines will be parallel, but translated.
OB?
11/6
95
By ***, physiologic varus should be resolved
QID: 5347
2.5 years of age
OB?
11/8
96
(SBQ12SP.94) A 45-year-old man presents the emergency department after being stabbed in the upper back. His physical examination is consistent with an incomplete spinal cord injury caused by a complete hemitransection of the spinal cord. Which of the following is consistent with this patient's physical examination?
QID: 3792
Ipsilateral to injury loss of motor function and propriception,
contralateral loss of pain/temperature sensation
OB?
11/8
97
The long thoracic nerve is the first nerve to branch off from the brachial plexus, taking contributions from nerve roots ***
QID: 8963
C5, C6 and C7
OB?
11/8
98
(SAE10SM.30) In the anterior cruciate ligament-deficient knee, what structure provides an important secondary restraint to anterior tibial translation? Tested Concept
QID: 7318
posterior horn of the medial meniscus
OB?
11/8
99
The patient's history and imaging are consistent with a femoral neck stress fracture. While most compression-sided fractures may be treated non-operatively with protected weightbearing, percutaneous screw fixation is indicated for *** and compression-sided fractures that extend greater than 50% of the way across the neck
QID: 1377
tension-sided fractures
OB?
11/10
100
The patient's history and imaging are consistent with a femoral neck stress fracture. While most compression-sided fractures may be treated non-operatively with protected weightbearing, percutaneous screw fixation is indicated for tension-sided fractures and ***
QID: 1377
compression-sided fractures that extend greater than 50% of the way across the neck
OB?
11/10
101
most reliable diagnostic test for RSD of the knee is ***
QID: 1296
symptom relief after sympathetic blockade.
OB?
11/11
102
which way does PaCo2 go with pulmonary embolism?
QID: 3282
hypocapnic
OB?
11/11
103
A distal humeral axial view is used aid in measuring the displacement in pediatric fractures of the
QID: 211370
medial epicondyle.
OB?
11/11
104
A West Point axillary view is an additional shoulder view that can identify
QID: 211370
a bony bankart and associated glenoid bone loss.
OB?
11/11
105
A Zanca view is an AP of the shoulder with 15 degrees cephalic tilt that is used in
QID: 211370
acromioclavicular joint pathology.
OB?
11/11
106
The *** coalition is most common
QID: 210273
calcaneonavicular
OB?
11/13
107
Normal strength mm in CMT at the foot?
QID: 211209
PL
PT
OB?
11/13
108
Weak mm in CMT disease?
QID: 211209
peroneus brevis
tibialis anterior
OB?
11/13
109
long thoracic nerve is the first nerve to branch off from the brachial plexus, taking contributions from nerve roots ***
QID: 8963
C5, C6 and C7
OB?
11/13
110
metaphyseal-diaphyseal angles (MDA) *** degrees are consistent with physiologic varus
QID: 5347
<9 degrees
OB?
11/13
111
In single lateral release of compartment syndrome, elevation of the *** off the posterior fibula ensures proper deep compartment release
QID: 917
soleus
OB?
11/13
112
what pE finding argue for repair of partial finger flexor laceration?
QID: 5713
triggering
OB?
11/15
113
(OBQ07.93) During head-on motor vehicle collisions occurring at highway speeds, airbag-protected individuals have a decreased rate (as compared to non-airbag protected individuals) of all of the following EXCEPT: Tested Concept
QID: 754
pelvic ring injuries
OB?
11/15
114
Vitamin D-resistant rickets is an example of a *** mutation
QID: 213145
x linked dominant
OB?
11/15
115
(OBQ17.25) A concerned mother brings in her 3-year-old son for consultation. Though he is currently asymptomatic, the mother is concerned as her brother had a "muscle disease that enlarged his calves and made his spine crooked." This condition led to an early death and she is concerned that her son may have the same disease. Which of the following diagnostic tests could be performed at this time to screen for the presence of disease? Tested Concept
QID: 210112
serum creatine kinase
OB?
11/18
116
Mutations in the DMPK gene or the CNBP gene cause ***
QID: 1528
myotonic dystrophy
OB?
11/18
117
A deletion of repeated elements of D4Z4 on chromosome 4q35 causes ***
QID: 1528
facioscapulohumeral muscular dystrophy
OB?
11/18
118
Thromboplastin is also known more commonly as *** which is involved in the Extrinsic Pathology of the coagulation cascade.
QID: 1058
tissue factor
OB?
11/20
119
Thromboplastin is also known more commonly as tissue factor which is involved in the *** of the coagulation cascade.
QID: 1058
extrinsic pathway
OB?
11/20
120
The mechanism of action of vancomycin is binding to ***moieties to inhibit bacterial cell wall synthesis.
QID: 5031
D-Ala-D-Ala
OB?
11/20
121
Binding to 30S ribosomal proteins a/w what abx class?
aminoglycoSide
OB?
11/20
QID: 5031
122
The primary elbow flexor is actually the ***
QID: 461
brachialis
OB?
11/22
123
(OBQ08.82) Which of the following best describes a patient's functional level with a wheelchair with a complete C5 spinal cord injury?
QID: 468
Electric wheelchair with hand control
"C5, 5 fingers on hand"
OB?
11/22
124
A coalition between the talus and calcaneus would demonstrate a ***
QID: 210273
"C" sign
OB?
11/24
125
Achondroplasia is caused by a mutation in the FGFR3 gene on chromosome 4 leading to enhanced *** activity.
QID: 5431
tyrosine kinase
OB?
11/25
126
Achondroplasia is caused by a mutation in the FGFR3 gene on chromosome ***
QID: 5431
4
OB?
11/25
127
*** is a known cause of sudden death in young children with achondroplasia, as it can result in central sleep apnea and cessation of breathing
QID: 214243
Foramen magnum stenosis
OB?
11/25
128
Cauliflower ear may occur patients with ***
QID: 214243
diastrophic dysplastic.
OB?
11/25
129
(OBQ08.263) An adolescent male with a known genetic mutation of COL1A1 presents to the emergency department with symptoms of unsteady gait and difficulty with buttoning his shirt. On physical exam, when the patient holds his fingers extended and adducted, the small finger spontaneously abducts. Snapping of the patient's distal phalanx of the middle finger leads to spontaneous flexion of the other fingers. What is the most likely cause of the patient's symptoms? Tested Concept
QID: 649
basilar invagination
OB?
11/25
130
When an incomplete cervical spinal cord lesion exists, * **and those with either a central cord or Brown-Sequard syndrome have a more favorable prognosis for recovery.
younger patients
OB?
11/25
131
When an incomplete cervical spinal cord lesion exists, younger patients and those with either a *** or Brown-Sequard syndrome have a more favorable prognosis for recovery.
central cord
OB?
11/25
132
When an incomplete cervical spinal cord lesion exists, younger patients and those with either a central cord or * ***syndrome have a more favorable prognosis for recovery.
brown sequard
OB?
11/25
133
No anterior external fixator, regardless of design or region of application, offers sufficient *** to serve as definitive treatment for vertically unstable pelvic fracture variants.
posterior stability
OB?
11/25
134
(SAE10SM.85) Kinematic testing of patellofemoral motion demonstrates that malalignment that produces increased Q angle causes a shift of the patella laterally in the trochlear groove and is most pronounced during what phase of the flexion arc? (degree range) Tested Concept
QID: 7373
40-90 degree
OB?
11/27
135
During the medial parapatellar approach to the knee, most of the arterial supply to the patella is divided. What artery is at risk if a lateral retinacular release is performed?
Lateral superior genicular artery
OB?
11/30
136
Someone with VCF, it is important to always rule out *** to the spine, specifically in fractures abover T5 or in younger patients.
Metastatic cancer
OB 12/2
QID 3375
137
A 28-year-old man sustains a distal forearm laceration. Surgical exploration reveals complete ulnar nerve transection but an intact median nerve. Motor examination reveals intact finger abduction and adduction.
How able to do this with their fingers? What is this called?
Median n connection to ulnar n(Martin Gruber anastamosis)
OB
12/5
138
Central slip (Zone *** extensor tendon) injury
III
OB 12/3
QID: 211644
139
impaired ability to perform rapid, alternating movement that can be seen in cervical myelopathy?
dysdiadochokinesia
OB 12/4
QID: 211839
140
Earliest sign of cervical myelopathy includes problem with what function?
hand dexterity
OB 12/8
QID: 211839
141
(SBQ18SP.55) A 43-year-old female undergoes posterior occipitocervical fusion due to significant instability secondary to Rheumatoid Arthritis. During placement of screws in C1 the drill penetrates through the anterior cortex, which places what structure at the greatest risk of injury?
internal carotid artery
OB 12/8
QID: 211707
142
A 27-year-old man falls on his hand at work. He notices an immediate deformity of his ring finger. Radiographs are provided in Figure A(Volar PIP dislocation). What is the most appropriate initial treatment?(2)
Closed reduction
Full-time extension splinting
OB ?
12/9/20
143
A normal popliteal angle is about ***degrees
25
OB 12/9/20
QID 9027
144
***is generally indicated only as a salvage procedure if a proximal row carpectomy is unsuccessful.
Wrist arthrodesis
OB 12/9/20
QID 7713
145
Which of the following is an appropriate treatment for vitamin D-resistant rickets?
Calcitriol
JBJS CC
12/11/20
146
A cross-finger flap would best cover a [location] fingertip wound.
Volar
OB?
12/14/20
147
*** hypoplasia is seen in Morquio's syndrome and pseudoachondroplasia.
odontoid
OB 12/11/20
QID: 5637
148
The sulcus sign provides information on the status of [this space]
rotator interval
OB 12/11/20
QID: 5637
149
Impingement on the L3 nerve root will lead to symptoms near the [bony landmark] of the femur. The skin over the medial malleolus is innervated by the L4 nerve root
medial epicondyle
OB 12/11/20
QID: 5890
150
Impingement on the L3 nerve root will lead to symptoms near the medial epicondyle of the femur. The skin over the [bony landmark] is innervated by the L4 nerve root
medial malleolus
OB 12/11/20
QID: 5890
151
Wet to dry dressing changes are most beneficial in the presence of an *** wound, as removal of the dressing when it dries removes drainage and debris
Open
OB?
12/14/20
152
Which substance is likely to cause the most soft-tissue damage in the long term if injected into a fingertip under high pressure?
Oil based paint
OB?
12/14/20
153
Impingement on the *** nerve root will lead to symptoms near the medial epicondyle of the femur.
L3
OB?
12/16
QID5890
154
The skin over the medial malleolus is innervated by the *** nerve root
L4
OB?
12/16/20
QID5890
155
The *** is a boundary between the calcified and uncalcified layers of articular cartilage.
tidemark
OB?
12/18/20
QID 7167
156
***Syndrome is compression of the superficial radial nerve
Wartenberg’s
OB?
12/19/20
7793
157
Wartenberg's syndrome, or compression of the sensory branch of the radial nerve, occurs in the interval between the *** and the extensor carpi radialis longus approximately 8 cm proximal to the radial styloid.
Brachioradialis
OB?
12/19/20
7793
158
Wartenberg's syndrome, or compression of the sensory branch of the radial nerve, occurs in the interval between the brachioradialis and the *** approximately 8 cm proximal to the radial styloid.
extensor carpi radialis longus
OB?
12/19/20
7793
159
***syndrome is caused by an anomalous tendinous connection between the flexor pollicis longus and the flexor digitorium profundus of the index finger
Limburg-Comstock
OB?
12/19/20
160
(OBQ08.61) What is a potential complication of an amputation at the level of the distal interphalangeal joint?
lumbrical plus finger
OB?
12/24/20
QID 447
161
A lumbrical plus finger is descibed as paradoxical *** while attempting to flex the fingers
extension of the IP joints
OB?
12/24/20
QID 447
162
A lumbrical plus finger is descibed as paradoxical extension of the IP joints while attempting to ***
flex the fingers
OB?
12/24/20
QID 447
163
Subscapularis is innervated by the ***(2) derived from the posterior cord of the brachial plexus
upper and lower subscapular nerves
OB?
12/24/20
QID: 4671
164
Subscapularis is innervated by the upper and lower subscapular nerves derived from the *** of the brachial plexus
posterior cord
OB?
12/24/20
QID: 4671
165
The saphenous nerve arises as a division of the *** nerve
Femoral
OB?
12/25
166
In SLAC wrist If *** arthritis exists, both PRC and 4CF are contraindicated
radiolunate
OB?
12/30/20
167
In basilar thumb arthritis, what ligament is attenuated?
anterior oblique ligament
OB?
12/30/20
QID: 211182
168
A polypeptide hormone produced by *** cells describes calcitonin. Calcitonin is produced by the thyroid and binds membrane receptors on osteoclasts to inhibit resorption. It is not anabolic.
parafollicular
OB?
12/30/20
QID: 210166
169
A polypeptide hormone produced by parafollicular cells describes ***. *** is produced by the thyroid and binds membrane receptors on osteoclasts to inhibit resorption. It is not anabolic.
calcitonin
OB?
12/30/20
QID: 210166
170
A polypeptide hormone produced by parafollicular cells describes calcitonin. Calcitonin is produced by the *** gland and binds membrane receptors on osteoclasts to inhibit resorption. It is not anabolic.
thyroid
OB?
12/30/20
QID: 210166
171
(OBQ10.38) During surgical treatment of an olecranon fracture with a tension band construct as seen in Figure A(don't need to see it), what nerve is at risk with over penetration of the proximal anterior cortex of the ulna with the Kirchner wire?
AIN
OB?
12/30/20
QID: 3126
172
Weakness to Hip Flexion would be caused by injury to the *** nerve root.
L2 and L3
OB?
12/30/20
QID: 3701
173
Which of the following medication classes has been shown to improve skeletal muscle regeneration and decrease fibrosis following muscle injury in an animal model?
angiotensin receptor II blocker
1/4/2021
OB?
QID: 5446
174
The best test to determine Vitamin D deficiency is the measurement of ***
25-hydroxycholecalciferol
1/8/2021
OB?
QID: 4653
