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Flashcards in Rapid fire stuff that you got wrong Deck (96)
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1
Q

What is the sign called when you cause bone bleeding?

A

Paprika sign

2
Q

Name the avascular non unions

A

Torsion wedge
Cominuted
Defect
Atrophic

3
Q

What is the name for the disease causing lymhadema in neonates?

A

Ven Watson syndrome

4
Q

How long does it take for vicryl to be absorbed?

A

56 days to 120 days

5
Q

What is ethibond made of?

A

Polyester

6
Q

What is fiberwire made of?

A

Polyethylene jacketed in polyester

7
Q

How many nerves cross the ankle joint?

A

6

8
Q

What does the coleman block test check?

A

Checks for rearfoot flexibility!

9
Q

What is the herx reaction

A

The dying off of bacteria secondary to antibiotic treatment.

Typically seen in the treatment of lymes disease

10
Q

What is the dose for oral lamasil?

A

250 mg daily for 3 months

Order LFT beforehand

11
Q

What is apligraft made of?

A

Neonatal foreskin

12
Q

Normal peak and trough for vancomycin?

A

30-40 for peak

10-20 for trough

Peak is dose dependent trough is interval dependent

13
Q

Clindamycin dose?

A

300 mg qid PO
or
900 mg IV

14
Q

Normal size for an ankle tourniquette?

A

18 inches

15
Q

When performing an austin, you determine the bone is too soft. What fixation should you use?

A

Crossing K-wires for static stability.

16
Q

How long must you wait for an MRI after a new tattoo?

A

6 months.

17
Q

What’s the score for newborn respirations?

A

APGAR

18
Q

Osteochondrosis of the proximal fibular head?

A

Ritters disease

19
Q

What is phlegmasia cerulea dolens?

A

venous gangrene common after DVT ischemic blockage

20
Q

At what stage of pregnancy is a woman most at risk for a DVT?

A

Third trimester as the placenta separates.

21
Q

What is the name for the RSD classigication?

A

Steinbroker

Acute, Dystrophic, Atrophic

22
Q

Low calcium has what effect on the QRS wave?

A

Widens the wave form!!

23
Q

Toxic dose of marcaine with and without epi

A

without 175

with 225

24
Q

Blake orthotic?

A

Inverted rear post for rearfoot varus

25
Q

How long can a ligament lengthen before being torn?

A

6-8%

26
Q

Multiple enchondroma with and without hemangiomas?

A

Maffuci syndrome (hemangiomas)

Vs

Olliers disease (without)

27
Q

What is Bowens disease?

A

squamous cell carcinoma in situ

28
Q

Name the neuromas in proper order

A
1 joplin
2 Housers
3 Heuters
4 Mortons
5 Iselens
29
Q

What genetic disease places a patient at risk for pseudomonal infection?

A

Cystic fibrosis

30
Q

What is a normal NCV test speed?

A

Normally >40 mps

31
Q

Immunosupressant drug used in transplant patients?

A

Tacrolimus

32
Q

What proteins are broken down with gout?

A

Purines

33
Q

What is used to test for Sjorgrens?

A

The Swermer test in which a piece of litmus paper is put into the eye to test for tears.

34
Q

A true Limb Length Discrepancy requires a __mm deficit to cause significant biomechanical problems

A

5mm

35
Q

What is the dose for oral vancomycin?

A

125 PO q6

36
Q

Dose for bactrim single strength vs double?

A

160 TMP single strength

800 TMP double strength

37
Q

What is the normal uric acid level?

A

2-7 in females

3-8 in males

38
Q

These oral hypoglycemic agents work on decreasing insulin resistance at the peripheral receptor site of insulin.

A

Thiaglitazones

39
Q
Give the dose of the following drugs
Fortaz –
Aztreonam – 
Timentin – 
Ciprofloxacin –
Aminoglycosides 
Gentamicin & Tobramycin: 
Amikacin: 
Imipenem –
Zosyn –
A
Fortaz – 2 g IV q12h
Aztreonam – 1 g IV q8h
Timentin – 3.1 g IV q4-6h
Ciprofloxacin – 400 mg IV q12h or 250-750 mg PO BID
Aminoglycosides 
Gentamicin & Tobramycin: 3-5 mg/kg q8h
Amikacin: 15 mg/kg q8h
Imipenem – 500 mg IV q8h
Zosyn – 4.5 g IV q8h
40
Q

Describe the resnik classification

A

I. Superficial/cutaneous, usually visible without signs of infection
II. Subcutaneous or articular without soi
IIIA. SubQ or articular with soi
IIIB. Bone penetration without soi
IV. Bone penetration with known osteomyelitis

41
Q

Give the Patzaki classification and its corresponding risks of infection

A

Zone 1: met necks and distal risk of OM: 50%
Zone 2: Met necks to TMTJ Risk of OM: 17%
Zone 3: Calcaneus Risk of OM: 33%

42
Q

What bar is used to correct club foot and what angle is it set at?

A

The dennis brown bare set at a 70 degree angle

43
Q

What are the indications for a TTC nail?

A
Talar AVN
STJ and Ankle arthritis 
Pantalar fusion 
Failed TAR
Trauma
44
Q

What is the working length of a TTC nail?

A

The working length of an IM nail is that length of the nail that transmits the loads from the proximal to the distal segments of the bone. In a locked nail, with no friction between the nail and the bone, the working length of the nail is the distance between the proximal and distal locking bolts.

45
Q

Classification for Friebergs Infarction?

A

Smilies
Stage 1: epiphyseal fracture that is typically not visualized on radiograph; with or without joint space widening
Stage 2: metatarsal head begins to flatten as the dorsal aspect of the joint continues to deteriorate. This is the hallmark characteristic of Freiberg’s which can be seen on x-ray.
Stage 3: structural compromise of the metatarsal head resulting in central joint depression from subchondral bone collapse.
Stage 4: loose bodies can be seen around the periphery of the joint; these represent the fracturing of the medial and lateral projections.
Stage 5: complete degeneration (arthrosis) of the MPTJ representing the end point of the condition

46
Q

What is Felty Syndrome?

A

A childhood form of severe rheumatoid arthritis, splenomegaly, and leukopenia

47
Q

What is mycosis fungiodes?

A

A cutaneous T cell lymphoma that resembles eczema or psoriasis

48
Q

DOC for human/dog/cat bites?

A

Augmentin

49
Q

Describe the treatment plans for a superficial infection
Mild
Moderate
Severe

A

Mild: >0.5cm but < 2cm of erythema very superficial treat with 2-4 weeks of oral abx

Moderate: >2cm of erythema and containing the subq layers. Treat with 2-4 weeks of oral abx

Severe: +2 signs of SIRS with a localized infection treat with 2-4 weeks of parenteral or oral abx.

50
Q

Describe the abx regimine IDSA for bone infections

A

No bony infection 4-6 days of PO abx

Mild bony infection 2-4 weeks PO or IV

Osteomyelitis with viable bone 2-4 weeks IV then switch to PO

Osteomyelitis with nonviable bone 4-6 weeks abx starting parenteral

51
Q

Brodsky classification with the most common form?

A

1: Lis franc variant most common 27-60% prevelance
2: Chopart 30-35% prevelant
3: Ankle joint 9% prevelance
4: Multiple combinations
Type 5: Forefoot

52
Q

Name some anaerobic bacteria

A

Clostridium
Peptostreptococcus
Bacteroides

53
Q

Antibiotic reccomendations for an IDSA mildly infected wound

A

Mild: 2+ manifestations of infx with >.5cm but <2cm of erythema.

Limited to skin and sub q
Treat with: oxacillin, nafcillin, clindamycin, keflex, bactrim, augmentin, levo

54
Q

Antibiotic treatment for a moderately IDSA infected wound

A

+2 signs of infection
>2cm of erythema or cellulitis involving the deep structures.

Bactrim, Augmentin, Levo, or levo/clinda
cephuroxime, zyvox + aztreoam, levo

55
Q

Antibiotic treatment for a severely infected wound IDSA

A
Patient with SIRS and infx site
Primaxin
Zosyn
Cipro+clinda
Vanco + fortaz
56
Q

Which three abx can be used to cover all bases?

A

Vanco
Aztreonam
Flagyl

57
Q

What type of bacillis is clostridium tetani?

A

A gram positive raquet shaped bacillus.

Releases exotoxin causing a pre-sympathetic blockade.

58
Q

Triad of tetanus?

A

Aphagia
Risus Sardonicus
Trismus

59
Q

Dose for the tetanus toxoid and immunoglobulin?

A

The toxoid is 0.5 mL

The immunoglobulin is 250-300 units

60
Q

What is the mangled extremity score based on?

A

Skeletal/Soft tissue injury
Shock
Limb ischemia
Age

If >7 then one must consider an increased likelihood of amputation.

61
Q

What’s the mechanism of action for a Stewart I injury?

A

Internal rotation of the forefoot while the fifth metatarsal remains on the ground.

Creates a fracture at the metataphyseal diaphyseal junction.

62
Q

What is the mechanism of injury for a Stewart 2 injury?

A

Internal rotation of the forefoot with a hypertonicity or flexure of the peroneus brevis resulting in an intrarticular avulsion fx.
ORIF if over 5 mm

63
Q

What is the normal Hibbs angle?

A

135-140 degrees

64
Q

What is the PO dose for vancomycin?

A

125 q6

65
Q

How do miglitol and acarbose work?

A

Prevent sugar uptake by competing with amylase in the pancrease.

66
Q

How do thiazolidenaids work?

A

These work by increasing peripheral sensitivity to insulin.

Known as rosaglitazone.

67
Q

What causes reiters syndrome?

A

Chlamydia!

68
Q

Most common causes of viral arthritis?

A

hepatitis B
Rubella
Mono

69
Q

Most common cause of a haglunds deformity?

A

Rearfoot varus

70
Q

This is a talonavicular wedge arthrodesis. The TA is routed under the navicular and attached to the spring ligament. Name

A

Lowman procedure

71
Q

What do you give a patient that is constipated?

A

Docolax, or Colase 50mg

72
Q

Mattles test

A

Foot should be plantarflexed with patient prone and knee at 90 degrees

73
Q

Simmonds test?

A

Foot should be plantarflexed with patient laying prone

74
Q

Toygars skin angle?

A

Normally should be 110-125 degrees.

Increases to 130-150 with a rupture.

75
Q

NAme the five augmented open repair types for achilles tendon ruptures

A

Lynn: Fanned out plantars
Silverskold: 1 strip of gastrocnemius aponeurosis brought down and rotated.
Lindholm: Two strips of gastroc brought down and rotated.
Bug and Boyd: Utilizes the fascia lata
V-Y lengthening of the gastroc with FHL reinforcement and possible graftjacket/pegasus.

76
Q

ADC VANDLMAX

A
Admission
Diagnosis
Condition
Vitals
Ambulatory Status
Nursing orders
Diet
Labs
Medications
Ancillary
X-ray/imaging.
77
Q

Normal BMP

A
Na: 135-145
Cl: 95-105
BUN:5-20
Glucose: 120
K: 3.5-5
CO: 28-32
Creat: .5-1.5

CMP adds ALT,AST, Calcium, procalcitonin,

78
Q

What needs to be taken into consideration when correcting hyper or hyponatremia?

A

Both of these conditions require care as rapid correction of either can lead to brain injury.

79
Q

How can one lower potassium levels?

A

May see peaked T waves on EKG with prolongation of the PR interval.

Increase the cellular uptake via:

  • Insulin 10-20 units + glucose 50g IV
  • IV sodium bicorbonate (3 ampules in 5% dextrose)
  • Albuterol (5-10mg nebulized over 30-60 minutes)

Increase potassium excretion:

  • Loop diuretics
  • Thiazide diuretics

Dialysis

Calcium gluconate

80
Q

What GFR indicates chronic kidney disease?

Which indicates failure?

A

GFR <60 is chronic kidney disease

GFR < 15 indicated kidney failure

81
Q

Which two bacteria can cause a fever shortly after surgery?

A

Group A strep

Clostridium

82
Q

Why must one be careful to diagnose fever in dialysis patients?

A

They tend to run one degrree cooler

A fever in them is 100.5 degrees instead of 101.5

83
Q

Diagnostic tests for DVT?

A

Duplex ultrasound
Contrast venography
D-dimer >500
Impedence plethesmography

84
Q

Dose for unfractionated heparin?

A

LAw of 80-18
80mg/kg bolus
18 mg/kg per hour until PTT is >45 <70
PTT q6h

85
Q

What is the dose for enoxaparin?

A

1mg/kg q12 subq

86
Q

What is the warfarin dose?

A

10mg or 7.5 mg PO q24h

INR 2.5 and maintain for 3-12 months following DVT.

87
Q

Diagnostic tests for PE?

A

Pulmonary angiography
Spiral CT
VQ scan
CXR

88
Q

Treatment for PE?

A

Urokinase 4,400 units/kg IV then 4,400 units/kg/hr for 12 hours.
Streptokinase 1.5 million units IV over 60 minutes.

89
Q

Tensile strength of vicryl at 14 days?

A

65%!

90
Q

What type of foot is related to edwards syndrome?

A

A flat foot

AKA pes planus

91
Q

What bacteria causes rheumatic fever?

A

Strep Pyogenes

Defined by the JONES criteria

92
Q

What type of hypersensitivity is RA related to?

A

A type III hypersensitivity

AKA an immune complex disorder

93
Q

Earliest sign of sepsis?

A

cutaneous vasodilation

94
Q

When would a bone scan be falsely positive?

A

In peripheral vascular disease

95
Q

strawberry allergies are most closley related to what drug?

A

Codeine

96
Q

Treatment mnemonic for acute MI

A
MONAB
Morphine
Oxygen
NO
Aspirin
Beta blockers