Orthobullets New Flashcards
1
Q
Time for return to preop braking reaction time after THA
A
4-6 weeks
2
Q
retrograde drilling in ankle arthroscopy is useful for what?
A
OCD lesion with a cartilage cap
3
Q
buerger’s diseases is painful or painless?
A
painful
4
Q
Random contraindication to TTC nail?
A
severe peripheral vascular disease
5
Q
ACL Recon technical error that leads to loss of terminal extension?
A
tibia tunnel too anterior causing graft impingement on notch
6
Q
Undifferentiated pleomorphic soft tissue sarcomas are treated with?
A
Wide excision and XRT
7
Q
Metaphyseal Diaphyseal Angle (MDA) cutoff for surgical intervention?
A
16
8
Q
Bracing is effective first line treatment for infantile blounts until what age?
A
3
9
Q
bisphosphonates binds what particle that leads to them being detectable for years?
A
calcium hydroxyappetite
10
Q
Humeral head version is?
A
20 retro
11
Q
Degrees of extensor lag for every 2mm of shortening of metacarpal
A
7 degrees
12
Q
Cricoid cartilage is what level
A
C6
13
Q
Hyoid cartilage is what level
A
C3
14
Q
Upper thyroid cartilage is what level
A
C4
15
Q
Lower thyroid cartilage is what level
A
C5
16
Q
only effect of FHL transfer for achilles
A
decreased pressure under hallux
17
Q
In cavovarus foot what muscle is “Strong” and what is “weak”
A
Peroneus longus, tib ant
18
Q
Position of tibia tunnel relative to PCL for ACL graft
A
10mm anterior to anterior border
19
Q
carotid tubercle is at what level?
A
c6
20
Q
Foot deformity associated with posteromedial bowing?
A
calcaneovalgus
21
Q
MOA heparin
A
binds and enhances antithrombin III to inhibit factors III, IIA, XA
22
Q
MOA Wafarin
A
Inhibits synth of vit K dependent II, VII, IX, X, Proteins c&S
23
Q
MOA enoxoparin
A
enhances antithrombin III to inhibit factors IIA, XA
24
Q
Freidberg’s Infarction is _
A
infarct to second MT head
25
Nerve that can be injured during anterior exposure to c2-3
hypoglossal nerve exits are C2
26
Nonoperative management of mid clavicle fx associated with what at 1 year?
decreased shoulder strength and endurance
27
Type X collagen significant in what part of physis
zone of hypertrophy
28
Kerboul angle is used to measure what?
Area of AVN in femoral head on coronal and axial images summed together; predictor of risk of collapse
29
Extraabdominal Desmond tumors are positive for what hormone receptor?
estrogen receptor
30
Patellar reflex nerve root
L4
31
Achilles reflex nerve root
S1
32
primary blood supply to ACL
middle genicular
33
Congenital hand disorder rare in caucasians, common in blacks
postaxial poly dactyly
34
Overpowering and weak muscle that lead to dorsal bunion after posteromedial clubfoot release
Strong = tib ant, weak = peroneus longus (may be inadvertently cut or lengthened at time of release)
35
biggest risk factor for not healing rotator cuff repair
age
36
"Critical canal stenosis" defined as:
AP diameter < 10mm
37
Viniculae disrupted when FDP tendon retracts to level of A2?
Brevia
38
Viniculae disrupted when fdp tendon retracts to palm
brevia and longa
39
Posteroinferior glenoide a potential pain generator for what athlete
baseball pitcher; repetitive stress on posterior capsule during deceleration; can get ossified and called a Bennet's lesion
40
increased IL-6 in trauma patients associated with _
increased mortality
41
Highest level LE amputation a child can get and still walk at normal speed c/t peers without increased energy?
through knee
42
When do most children with SCH achieve normal ROM after crpp?
6 months
43
Is UKA contraindicated in osteonecrosis of femoral condyle?
no
44
Flexion contracture greater than_ is contraindication to UKA
10
45
What preop CTS finding is associated with worse outcomes?
Severe EMG changes
46
Minimum follow up to be a level I study?
80%
47
Hypophosphotasia is a defect in the production of?
alkaline phosphatase
48
3.0T MRI is what factor of higher proton energy c/t 1.5?
9
49
DISH is highly correlated with what other diseases?
DM
50
PS TKA with increased posterior offset and small patellar component can lead to ?
patellar clunk syndrome
51
Achondroplasia is a defect in what enzyme and affects what part of the physis?
fgf3, zone of proliferation
52
"pencil in a cup" IP joint destruction associated with?
psoriatic arthritis
53
At what age is pavlik not the tx for femur fx?
6 months
54
Parts of knee with DJD in PCL deficiency?
medial and PFJ
55
CMT is caused by a mutation of what protein on what chromosome?
PMP, 17
56
What LE amputation has the worst outcomes in adults?
through knee (decreased prosthesis use, worse outcomes)
57
Liposarcoma associated with amplication of what gene?
MDM2
58
Thickness of cartilage cap on osteochondroma is useful for what?
in adults a thin cap (<2cm) is associated with malignant transformation; no use in kids
59
Most common reason for revision of charnley THA
acetabular component failure
60
Juvenile RA is diagnosed by serologic tests?
False, typically seronegative
61
Triad for Hand Schuler Christian disease?
Lytic skull lesions, diabetes insipidus, and exophtalmos. Basically this is Disseminated LCH
62
Anterior approach for ASD is associated with _ c/t posterior
higher rate of pseudarthrosis
63
fibula in the incisura most unstable in which plane
anterior posterior
64
Does irradiation lead to decreased immune response to allografts?
no. it sterilizes it
65
Antibiotic choice for psuedomonas osteo?
fluoroquinolone; except in kids ceftazidime or cefepime
66
maximum medial pool dye thickness after closed reduction of DDH for successful outcome
<5-7. Higher likely means reduction blocked by something, less chance of success
67
centigray of radiation for the following: HO ppx, soft tissue sarcoma, Bone mets
6, 60, 30
68
Fibrous dysplasia associated with what syndrome?
McCune Albright
69
Triad for McCune Albright
Fibrous dysplasia, precocious puberty, cafe au lait spots
70
Mutation in McCune Albright
activating mutation of the G(s) alpha gene
71
Levels of PTH, Phos, Ca in renal osteodystrophy
High, High, Low
72
only orthothotic effective for plantar fasciitis?
Nighttime dorsiflexion splint
73
Patellar tendonitis associated with _
muscle inflexibility (quads or hamstrings)
74
Spinal muscle atrophy associated with what cellular changes?
progressive loss of alpha motor neurons in anterior horn of spinal cord
75
Nuclei shape on eosinophilic granuloma?
bilobed Coffee bean nuclei
76
histologic appears of LCH
Langherhan cells (bilobed nuclei) surrounded by eosinophils
77
Virchow's triad
hypercoagubility, venous stasis, endothelial injury
78
Factor most associated with poor outcome after pilon fx with successful union?
lower education level
79
Camptodactyly is _
non traumatic flexion deformity to PIP joint. Treated with stretching first prior to any surgery consideration
80
Apert syndrome is comprised by _ and caused by what mutation?
Facial dysmorphism and severe hand syndactyly
81
Metal hypersensitivity is what type of hypersensitivity?
IV (DELAYED, cell mediated, not antibody mediated)
82
Frostbite demarcation can take how long?
1-3 months
83
Two herbal supplements that interfere with platelet function?
ginkgo and ginseng
84
Release of popliteus tendon is useful for what issue inTKA?
Valgus deformity, tight in flexion
85
Release of IT tendon is useful for what issue in TKA?
valgus deformity tight in extension
86
Apert's syndrome is a mutation of?
FGFR2.
87
Long term basal joint DJD leads to what hand deformity?
first webspace contracture
88
Oiller's disease has what chance of malignancy?
~25%
89
Bisphosphate tx has what effect on psif spine surgery in the postop period?
decreased fusion rates (in rats, no human clinical recs currently available)
90
Most common reason for late TKA revision?
aseptic loosening
91
Biggest risk factor for poor outcome after combined acetabular fx and hip dislocation?
Age > 55. time to reduction > 12 hrs
92
Rheumatoid factor is an auto antibody of what type against what type of host antibody?
IgM, IgG
93
Stenner lesion in UCL injury of thumb is caused by what muscle which blocks reduction of the ligament?
adductor policus, ulnar nerve
94
Tissue from groin flap has what NV supply?
superficial circumflex iliac a., LFCN
95
SSEMs or MEPs are more sensitive to the effect of anesthesia?
MEPs
96
After ceramic head fracture and revision, what can be a late complication?
3rd body wear from retained ceramic pieces
97
For cortical bone, as strain rate increases this has what effect on modulus and ultimate strength?
both increase
98
Largest negative predictor for good outcome in laborers with chronic MSK pain?
High initial VAS scores
99
IV Pain dosage for morbidly obese patients should be based on?
ideal body weight, not actual
100
Type of bone Metastatic lesion that has worst survival?
lung
101
Myxoid liposarcoma translocation
t(12,16)
102
In adult ASD surgery, extending fusion to sacrum or pelvis has what advantage?
improved correction and maintenance of sagittal balance
103
Reduction maneuver for nursemaid's elbow?
flexion and supination
104
Psych drug with increased risk for osteoporosis and fx?
phenytoin
105
Morquio's syndrome has what laboratory finding and what spine finding?
increased urine keratin sulfate, OA dissociation
106
Hemophilia A is deficiency in what factor?
VIII
107
Hemophilia B is deficiency in what factor?
IX
108
Gene mutation in Fibrodysplasia ossificans progressiva?
ACVR1
109
What is the worst indicator for prognosis of chondrosarcoma?
pelvis location
110
Larsen's syndrome is composed of:
multiple joint dislocations, scoliosis, potentially lethal cervical kyphosis
111
Gait abnormality seen in kids with spondylolisthesis?
shorten strides, flexion of hips/knees
112
Surgical delay leading to worse outcomes in acetabulum fx?
3 weeks
113
BMP-2 is approved for acute open tibias treated with what implant?
IMN
114
BMP-2 is approved for what spine indication?
Lumbar ALIFs
115
ECRB origin and insertion
lateral epicondyle, 3rd MC base
116
Most common sarcoma of the foot?
Synovial
117
Other msk finding associated with CMT besides cavovarus foot?
DDH
118
intermalleolar distance should be less than?
8cm
119
Smaller pedicle diameter, T12 or L1?
L1
120
Fracture table for femur fx associated with what deformity?
IR
121
What antibiotic improves the effect of methotrexate compared to methotrexate alone?
Doxycycline
122
Extensile lateral approach to distal femur fx has what complication c/t submuscular?
increased non union
123
In addition to RANKL, what else is increased with osteolysis?
VEGF
124
Is child bearing age a contraindication to metal on metal THA
Yes
125
Displacement/angulation for extra artic glenoid fx to be operative?
1cm, 40 degree
126
What percent of people have a posterior dominant biceps insertion to glenoid?
70%
127
What sacral fracture factor can lead too increased implant breakage?
vertical fracture line
128
Sever's disease is _
calcanea apophysitis
129
Osteopenia has what effect on the strength of the bone-cement interface in comparison to normal bone?
increased strenght
130
The use of EPO preop has had what complication?
Increased thrombotic risk
131
Treatment for periosteal chondroma is?
Marginal with excision of underlying cortex
132
Pronation abduction ankle fracture pattern
comminuted fibula fracture, horizontal medial mal
133
Pronation external rotation ankle fracture pattern
oblique fibula fracture above syndesmosis
134
Supination adduction ankle fracture pattern
transverse fibula, vertical medial mal
135
In children multi organ failure occurs _ and affects what organ system first?
shortly after admission, all systems simultaneously
136
In adults multi organ failure occurs _ and affects what organ system first?
48 hours after admission, lungs first
137
Urinary _ is a breakdown product of type I collagen and a marker of increased bone turnover
N-telopeptide
138
Most common site of boney mestasis?
spine
139
Most common site for path fx from met lesion?
prox femur
140
At what age is open reduction preferred for DDH?
18 months
141
What is the max amount of hip abduction to maintain hip reduction to continue with closed reduction only?
60
142
t(2, 13)
alveolar rhabdomyosarcoma
143
slip progression of spondy in kids associated with what parameter?
pelvic incidence
144
males or females have higher risk of non union of mid clavicle fx?
females
145
central cord syndrome now thought to be injury to what tract?
lateral corticospinal tract
146
What percent chance of hip fracture over ten years warrants bisphosphonate therapy?
3%
147
enteracept binds what molecule
tnf alpha
148
Anakinra binds what molecule?
IL-1
149
most water in cartilage is located in what layer?
superficial
150
water content in cartilage _ with DJD
increases
151
Water content in cartilage _ with age
decreases
152
Signs of preganglionic obstetric brachial plexus palsy?
winged scapula (long thoracic), absent rhomboids (dorsal scapular), Horner's syndrome, elevated hemidiaphragm
153
Age at which to perform nerve transfers for preganglionic obstetric brachial plexus palsy?
< 3 months
154
Compared with CSI, PT has _ effect in tennis elbow?
improved
155
Bands seen near physics in OI patients is associated with what?
Bisphosphonate use
156
TLIFs with PSIF are associated with?
increased cost only, no improvement in outcome or fusion rates
157
T/F: inflammatory arthritis associated with increased THA dislocations?
true
158
T/F: post traumatic arthritis associated with increased THA dislocations?
false
159
Collagen orientation in the superficial zone?
parallel to tidemark
160
Dominant collagen in cartilage in superficial and intermediate zone?
II
161
Collagen orientation in the intermediate zone?
oblique
162
translocation in clear cell sarcoma?
t(12,22)
163
translocation in myxoid liposarcoma?
t(12,16)
164
translocation in chondrosarcoma?
t(9,22)
165
Lateral mass overhang over what represents disrupted transverse ligament?
7mm
166
Viruses screened for in allografts
Hep B/C, HIV, Syphillis
167
According to SPORT, failure to improve with conservative management for lumbar disc herniation for what period of time pushes to surgery?
6 weeks
168
major side effect of doxorubicin?
cardiac
169
earliest radiographic finding seen in bed osteodiscitis of lumbar spine?
loss of lordosis
170
dega and salter osteotomies performed with _ triradiate
open
171
PAO requires _
congruent joint
172
Chiari osteotomy used for _
non congruent joint, closed triradiate
173
metastatic lesion that is often osteoblastic?
prostate
174
Endothelin is a molecule involved in?
osteoblastic metastasis
175
Benefits of vertebroplasty in RCT?
none, equal to sham procedure at all times
176
rivaroxaban is a _ inhibitor
Xa
177
Are hangman fx associated with vert art injuries?
no
178
At what age cutoff are you pushed towards surgery for perthes?
>8
179
anterolateral bowing of tibia associated with
NF-1
180
CD20 and CD45 markers are associated with
lymphoma
181
Unique part of Ewing's workup c/t osteosarcoma?
bone marrow biopsy
182
varus malunion of talar neck decreases what motion?
subtler eversion
183
Diplegia CP has
Affects lower more than upper extremity, mild spasiticity in UE
184
Paraplegia CP has
abnormal LE, sparring of UE
185
Pneumatic compression devices decrease risk of clot through what mechanism?
increased venous blood flow
186
Asia score level is based on
last normal level
187
X linked hypophosphatemic rickets is X linked _
dominant
188
Fibrous dysplasia is caused by a gene mutation involved in what signaling?
G protein involved in cAMP signalling
189
Name of law that forbids referral of patients to facilities the doctor has ownership in?
Stark
190
Morquio's is caused by _
lysomal storage disorder causing increased keratin sulfate
191
With aging there is greater mechanical strength loss to cortical or trabecular bone?
trabecular
192
What muscles are paralyzed in Erb's
Deltoid, and biceps (does not affect hand for true Waiter's tip, that is a Type II, which is less common)
193
Marker for angiosarcoma?
CD31
194
T/F: Radial head resection is contraindication to TEA?
False, worse outcomes, but not contraindication
195
What artery is encountered between IT band and biceps femoris in posterolateral approach to knee?
inf lat genicular artery
196
What head of pec is normally torn?
Sternocostal, not clavicular
197
Inheritance pattern of NF1
autosomal dominant
198
Marfan's is AD with defective _ gene
fibrillin
199
lisch nodules associated with
NF-1
200
ERLENMeyer flask femurs are seen in pediatric
osteopetrosis
201
tumoral calcinosis is seen in
hyperphosphatasia
202
T/F: Ewing's can be treated with XRT in situation where resection is risky
True
203
Most common origin of bony met when CT C/A/P is negative?
lung
