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Pestana2 Ortho (General) Flashcards

(115 cards)

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1
Q

Malignant bone tumors in adults what kind?

A

Metastatic

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2
Q

Origins of metastatic bone tumors in adults (by gender)

A
  • Women (breast; lytic lesions)

- Men (prostate: blastic lesions)

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3
Q

Malignant bone tumors in adults (dx)

A

XRAY < CT < MRI

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4
Q

Early symptom in adult bone tumors

A

Localized pain

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5
Q

Multiple myeloma (demographic)

A

Old men

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6
Q

Multiple myeloma (sxs 3)

A
  • Fatigue
  • Anemia
  • Localized pain
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7
Q

Multiple myeloma (dx 3)

A
  • XRAY: multiple punched-out lytic lesions
  • Urine: Bence-Jones proteins
  • Serum immunoelectrophoresis: abnl Ig
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8
Q

Multiple myeloma (tx)

A
  • Chemotherapy

- Thalidomide if chemo fails

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9
Q

Soft tissue sarcoma (dx 3)

A
  • Firm, fixed to surrounding tissue
  • MRI
  • Incisional biopsy
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10
Q

Soft tissue sarcoma (mets)

A

Lungs

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11
Q

Soft tissue sarcoma (tx 3)

A
  • Wide local excision
  • Chemo
  • Rad
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12
Q

XRAY views in suspected fx

A
  • AP and lateral

- Joints above and below fx

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13
Q

Closed reduction (def, guidelines 2)

A
  • Immobilization in cast or splint
  • Not badly displaced/angulated
  • Can be aligned by external manipulation
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14
Q

Clavicular fx (location)

A

Junction of middle and distal third

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15
Q

Clavicular fx (tx)

A

Arm in sling

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16
Q

MC shoulder dislocation

A

Anterior

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17
Q

Anterior shoulder dislocation (sxs 2, dx)

A
  • Close to body w/ external rotation
  • Possible numbness over deltoid (stretched axillary)
  • AP+Lateral xrays
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18
Q

Posterior shoulder dislocations (causes 2)

A

Massive uncoordinated muscle ctx:

  • Epileptic seizure
  • Electrical burn
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19
Q

Posterior shoulder dislocations (sx, dx)

A
  • Close to body w/ internal rotation

- Axillary view or scapular lateral view xrays

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20
Q

Colles fx (dem, injury)

A

Old osteoporotic woman falls on outstretched hand

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21
Q

Colles fx (lesion)

A
  • “Dinner fork”

- Dorsally displaced, dorsally angulated fx of distal radius

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22
Q

Colles fx (tx)

A

Closed reduction w/ long arm cast

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23
Q

Monteggia fx (injury)

A

-Direct blow to ulna (“nightstick” injury)

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24
Q

Monteggia fx (lesion)

A

-Fx of proximal ulna w/ resultant anterior dislocation of radial head

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25
Galeazzi fx (lesion)
-Fx of distal radius w/ resultant dorsal dislocation of distal radioulnar joint
26
Monteggia and Galeazzi fx's (tx)
- Fx: ORIF | - Dislocation: closed reduction
27
Fx of scaphoid (dem, injury)
Young adult falls on outstretched hand
28
Scaphoid fx (sxs 2)
- Wrist pain | - TTP over anatomical snuffbox
29
Scaphoid fx (dx)
- H&P | - XRAY shows fx 3wks later
30
Scaphoid fx (mgmt)
- Thumb spica cast | - If displacement/angulation on original xray, then ORIF
31
Scaphoid fx (complication)
Nonunion
32
Metacarpal neck fx (digit#)
4th/5th
33
Metacarpal neck fx (injury)
Closed fist hits a hard surface
34
Metacarpal neck fx (dx)
XRAYs
35
Metacarpal neck fx (mgmt)
Depends on severity - Mild: CR and ulnar gutter splint - Severe: Kirschner wire or plate fixation
36
Hip fx (dem, injury)
Old who sustain a fall
37
Hip fx (presentation 2)
- Hip pain | - Affected leg is shorter and externally rotated
38
Femoral neck fx (complication)
AVN
39
Intertrochanteric fx (post-op complication)
DVT/PE 2/2 immobilization
40
Intertrochanteric fx (mgmt)
- OR and pins | - Post-op anticoagulation
41
Femoral shaft fx (complications)
- B/L and comminuted: shock | - Mulptiple: fat embolism syndrome
42
Femoral shaft fx (mgmt)
-Intramedullary rod fixation
43
When is a femoral shaft fx an emergency and what is the tx?
- Open fx | - OR cleaning and closure w/in 6hrs
44
A highly sensitive sign of knee injury
Swelling
45
Collateral ligament injuries (force)
- Medial blows: lateral ligaments | - Lateral blows: medial ligaments
46
Tests in collateral ligament injuries (x2)
Knee flexed at 30* (passive manipulation: pain and further displacement) - Valgus stress test: abduction: medial injury - Varus stress test: adduction: lateral injury
47
Collateral ligament injury (mgmt)
- Isolated: hinged cast | - Multiple: surgical repair
48
Which cruciate ligament injury is more common?
ACL
49
Tests in cruciate ligament injuries (x2)
- Drawer test (90* knee flexion) | - Lachman test (20* knee flexion)
50
Cruciate ligament injuries (dx)
MRI
51
Cruciate ligament injuries (mgmt 2)
- Sedentary: immobilization and rehab | - Athletes: arthroscopic reconstruction
52
Meniscal tear (dx)
MRI
53
Meniscal tear (sxs 2)
- Catching/locking that limit motion | - Click when knee is fully extended
54
Meniscal tear (mgmt)
-Arthroscopic repair (preserve as much as possible) | [complete meniscectomy causes degenerative arthritis]
55
Unhappy triad
- Medial collateral - ACL - Medial meniscus
56
Tibial stress fx (dem, injury)
Young men subjected to forced marches
57
Tibial stress fx (dx)
- TTP over a very specific point | - XRAY may be negative
58
Tibial stress fx (mgmt)
- Cast and f/u with xray in 2wks, or | - Crutches (non-weight bearing)
59
Leg fx's involving the tibia and fibula (injury)
Pedestrian hit by a car
60
Leg fx's involving the tibia and fibula (dx)
XRAYs
61
Leg fx's involving the tibia and fibula (mgmt)
- Easily reducible: casting | - Can't be aligned: intramedullary nailing
62
Leg fx's involving the tibia and fibula (complication)
Compartment syndrome
63
Rupture of the Achilles tendon (dem, injury)
Out-of-shape middle-aged men subject themselves to severe strain (loud popping sound)
64
Rupture of the Achilles tendon (mgmt)
- Slow: casing in equinus position | - Fast: surgery
65
Fx of the ankle (injury)
Falling on inverted/everted foot
66
Fx of the ankle (lesion)
Both malleoli break
67
Fx of the ankle (dx)
AP, lateral, mortise xrays
68
Fx of the ankle (mgmt)
ORIF
69
Compartment syndrome (PE)
Excruciating pain w/ passive extension
70
Compartment syndrome (tx)
Emergency fasciotomy
71
Pain under cast (mgmt)
Open and examine
72
Open fx's (mgmt)
Clean and reduce w/in 6hrs of injury
73
Posterior dislocation of hip (presentation x3)
- Shortened leg - Adducted - Internally rotated (vs externally in hip fx)
74
Posterior dislocation of hip (complication)
AVN of femoral head
75
Posterior dislocation of hip (mgmt)
Emergent reduction
76
Gas gangrene (injury)
Deep, penetrating, dirty wound
77
Gas gangrene (presentation x3)
- Toxic pt - Tender, swollen, discolored wound - Crepitations
78
Gas gangrene (mgmt x3)
- IV penicillin - Surgical debridement - Hyperbaric oxygen
79
Radial nerve (injured bone)
Mid to distal third humerus
80
Radial nerve (sign)
Pt can't dorsiflex/extend wrist
81
Popliteal artery (injury)
Posterior dislocation of knee
82
Popliteal artery injury (dx 3)
- Pulses - Doppler - CT angio
83
Popliteal artery injury (mgmt)
Prophylactic fasciotomy (w/ delayed restoration of flow)
84
Falls from height (lesion location x4)
- Foot, leg | - Thoracic, lumbar spine
85
Head on auto collision (lesion location x4)
- Face, head, torso | - Femoral head into pelvis or out of acetabulum
86
What should be always evaluated in facial fx's and closed head injuries?
Cervical spine
87
Carpal tunnel syndrome (dem, injury)
Women who do repetitive hand work
88
Carpal tunnel syndrome (sxs)
Numbness and tingling over radial 3.5 fingers (median n.)
89
Carpal tunnel syndrome (dx)
Clinical (but xray recommended)
90
Carpal tunnel syndrome (mgmt)
- Splints | - Anti-inflammatory agents
91
What should be performed if surgery for carpal tunnel syndrome is indicated?
Electromyography
92
Trigger finger (presentation)
Acutely flexed finger w/ inability to extend
93
Trigger finger (tx)
Steroid injections
94
How can carpal tunnel syndrome sxs be reproduced?
- Hang hand limply for a few min | - Tap/percuss over median nerve
95
DeQuervain tenosynovitis (dem, injury)
Young mothers who hold babies w/ wrist flexion and thumb extension
96
DeQuervain tenosynovitis (reproduce sxs)
Thumb in closed fist w/ ulnar deviation
97
DeQuervain tenosynovitis (mgmt)
- Splint | - Anti-inflammatory agents
98
Dupuytren contracture (presentation x2)
- Contracture of the hand | - Palmar fascial nodules can be felt
99
Dupuytren contracture (tx)
Surgery
100
Felon (definition, mgmt)
- Abscess in pulp of finger | - I&D
101
Gamekeeper thumb (injury)
Hyperextension of thumb
102
Gamekeeper thumb (lesion)
Ulnar collateral ligament injury
103
Gamekeeper thumb (mgmt)
Casting
104
Jersey finger (injury)
Forceful extension of a flexed finger
105
Jersey finger (lesion)
Flexor tendon injury
106
Jersey finger (sign)
Injured finger doesn't flex when making a fist
107
Mallet finger (injury)
Forceful flexion of an extended finger
108
Mallet finger (lesion)
Extensor tendon injury
109
Mallet finger (sign)
Tip of injured finger remains flexed when hand is extended
110
Jersey and Mallet finger (mgmt)
Splinting
111
Traumatically amputated digit (mgmt x4)
- Cleaned w/ sterile saline - Wrapped in saline-moistened gauze - Placed in sealed plastic bag - Bag on bed of ice
112
Traumatically amputated digit (motor preservation procedure)
Electric nerve stimulation
113
Marjolin ulcer (path)
Squamous cell carcinoma of skin developing in a chronic leg ulcer
114
Marjolin ulcer (dx)
Biopsy
115
Marjolin ulcer (mgmt)
- Wide local excision | - Skin grafting

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