Subspecialty Flashcards
(102 cards)
1
Q
Avulsion
A
flap of skin
2
Q
abrasion
A
superficial loss of dermis with lower components intact
3
Q
What imaging is done for a fracture?
A
two X-rays perpendicular to each other
4
Q
What are treatment options for fracture?
A
- Open reduction internal fixation: if fracture is open, angular, or comminuted
- casting if fracture is closed and approximated
- Open fracture means emergency washout
5
Q
What can cause anteiror dislocation of shoulder?
A
any trauma (FOOSH, anteiror trauma)
6
Q
What is the appearance of an anterior shoulder dislocation?
A
Abduction externally “shaking hands”
7
Q
What nerve damage can occur in anterior shoulder dislocation?
A
- axillary artery and axillary nerve (C5,C6)(37%) results in a weakened or paralyzed deltoid muscle and as the deltoid atrophies unilaterally, the normal rounded contour of the shoulder is lost. difficulty abducting greater than 15 degrees.
- suprascapular nerve (29%)
- radial nerve (22%)
8
Q
What can cause a posterior shoulder dislocation?
A
Massive trauma: seizures, lightning, electric shock
9
Q
what is the appearance of a posterior shoulder dislocation?
A
Adducted and internally rotated, like arm is hurt. anterior shoulder is flattened with prominent coracoid process.
10
Q
Imaging for dislocated shoulder?
A
X-ray
11
Q
Treatment for anterior/posterior shoulder dislocaitons?
A
Relocate, sling. X-ray can confirm reduction
12
Q
What is a Colle’s fracture?
A
-a fracture of the distal radius in the forearm with dorsal (posterior) and radial displacement of the wrist and hand
13
Q
Who typically gets Colle’s fractures?
A
Old woman with osetoporosis who falls
14
Q
Management for Colle’s?
A
X-ray, treat
15
Q
What is a Monetggia fracture?
A
- fracture of the proximal third of the ulna with dislocation of the head of the radius.
- Caused by fall on outstretch arm or a blow to outer arm (upward block)
- open reduction internal fixation is typically performed
16
Q
What is a Galeazzi fracture?
A
- a fracture of the radius with dislocation of the distal radioulnar joint.
- “downward block”
17
Q
susepcted scaphoid fracture management
A
X-ray, cast regardless, x-ray again in 7-10 days
18
Q
Boxer’s fx
A
Punch against wall, fourth, fifth digits break
19
Q
If the knee hurts and is not swollen, it’s probably the _____
A
hip (referred pain)
20
Q
Hip fracture characteristics
A
- Lots of trauma
- Leg is shortened an externally rotated
21
Q
Hip fracture management for varying locations
A
-Femoral head = prosthesis (poor vascular supply)
-Intratrochanteric fx = plates
-shaft = rods
open = emergency washout with traction to stop bones form sliding against each other
22
Q
posterior knee trauma
A
ACL tear with anteiror drawer sign
23
Q
Anterior knee trauma
A
PCL with posteiror drawer sign
24
Q
Cruciate ligamaent tear management
A
MRI
Surgery (athletes)
Casting (everybody else)
25
Valgus stress causes what tear?
vaLgus - Lateral - MCL tear
26
Vargus stress causes
medial - LCL tear
27
MCL/LCL management
MRI
Surgery (athletes)
Hinge cast
28
Meniscus signs
Knee pain and a click on extension
29
Meniscus management
MRI, arthroscopic surgery to remove torn portion.
30
Stress fx managmeent
Weekend warriors
X-ray:
Normal: cast anyway, redo in a few days. Crutches.
31
An ankle patient in ortho doesnt need n x-ray if ________
they can walk on it
32
Who gets carpal tunnel most often?
Those with hypothyroidism and diabetes
33
What is the pathology of Carpel tunnel syndrome?
Compression of median nerve, inflammatory
34
What is the progression of Carpel tunnel?
Pain ->parasthesias->paralysis of first three digits
35
Phalen test
Carpel tunnel: flexion of both hands
36
Tinel's test
Carpel tunnel: tap median nerve
37
What is a high yeild physical exam finding for carpel tunnel?
Thenar atrophy
38
Diagnosis of Carpel tunnel
EMG: decreased conduction through the median nerve.
An electromyograph detects the electric potential generated by muscle cellswhen these cells are electrically or neurologically activated.
39
Carpel Tunnel Treatment
1. Splinting _ NSAIDs
2. Steroids
3. Surgery
f/u: RA assessment
40
Jersey finger
- Tearing of flexor tendon when grabbing jersey
- patient cannot flex digit
- Clinical diagnosis
- Standard treatment
41
Mallet finger
Tearing of extensor tendon
- Cannot extend digit
- Clinical diagnosis
- Standard treatment
42
Trigger finger
- Stenosing tensynovitus of extensor
- cannot extend, when they do there is a pop
- treatment: standard
43
Dequervains tensynovitis
- Path: tendonitis of the tendons of extensor pollicis brevis and abductor pollicis longus muscles. CHRNOIC DEGENERATIVE, not inflammation.
- Seen in mother holding a baby or man doing overhead lifts.
- diagnosis: you know
- Tx: NSAIDs, splinting, No surgery
44
Who does Dupuytren's occur in typcially?
Alcoholics and scandinavian men
45
What are the characteristics of Dupuytren's
Fascia balls up in hand, causes inability to extend fingers, they are clawed.
findings:
-cannot extend fingers
-fascial nodules
Treatment: surgical, no NSAIDs (not inflammatory)
46
Felon
- Abscess of pulp of finger
- Pain, penetrating injury, fever, leukocytosis
- Dx: clinical
- Tx: I+D
47
In what age does developmental dysplasia of the hip occur?
Newborn
48
What is the PE finding of Developmental dysplasia of the hip?
Clicky hip
49
What is Tx for Developmental dysplasia of the hip?
Harness
50
In what age does Legg-Calve-Perthe disease occur?
6
51
What are the H&P/PE findings of Legg-Calve-Perthe disease?
- Insidious onset
| - antalagic gait
52
What is Dx for Legg-Calve-Perthe disease?
X-ray
53
What is Tx for Legg-Calve-Perthe disease?
Cast
54
What is age of slipped-capital femoral epiphysis?
13
55
What are findings for slipped-capital femoral epiphysis??
Fat kid
Growth spurt
nontraumatic
knee pain
56
What is Dx for slipped-capital femoral epiphysis?
Frog-leg X-ray
57
What is Tx for slipped-capital femoral epiphysis?
Surgery
58
What age does septic hip occur in?
any age
59
What are findings for septic hip
Fever+joint pain
60
What is diagnosis for spetic hip?
Arthrocentesis
61
What is treatment for septic hip?
I&D
62
What is the typcial presentation of Osgood-schlatter disease?
Teenage athlete
| Knee pain+swelling
63
What is the diagnosis of Osgood-schlatter disease?
clinical
64
What is the Tx of Osgood-schlatter disease?
1. Work through it which could result in palpable nodule that does not go away
2. Cast + rest, which is curative
65
Scoliosis is usually on the _______ side
right
66
What is scoliosis?
Deformity of spine
67
What patient is scoliosis seen in?
Teenage girl
moderate: cosmetic
Severe: SOB
68
What is the Diagnosis for scoliosis?
- Adam's (she bends forward, look at back)
| - X-ray
69
What is Tx for scoliosis?
Brace
70
Ewing sarcoma is translocation of ______
11,22 (11+22 was patrick ewings jersey)
71
Ewing sarcoma locaiton
midshaft
72
Appearance of Ewing's on X-ray?
-onion skinning
73
Osteosarcoma is associated with what gene?
retinoblastoma gene (people who had an eye taken out as a child)
74
Osteosarcoma x-ray appearance?
sunburst
75
Presentation of bone tumors
Bone pain, atraumatic focal pain with no other symptoms
76
Diagnosis of bone tumors
- X-ray
- MRI
- Biopsy
77
Tx of bone tumors
Resection
78
what do you do for a fracture in kids that involves the growth plate?
Open reduction with internal fixation (no involvement is standard care)
79
Aortic stenosis murmur
- Systolic crescendo-decrescendo murmur
| - left sternal border
80
Mitral regurgitation murmur
- holosystolic
- occludes S1 and S2
- cardiac apex radiate to axilla
81
Aortic insufficiency murmur
- High pitched, blowing
- decrescendo
- diastole at 4th intervostal space left sternal border
82
Mitral stenosis murmur
rumbling diastolic murmur with OPENING SNAP
83
Atrial myxoma murmur
-An atrial myxoma may create an extra heart sound, audible to auscultation just after S2 It is most seen on echocardiography
84
Elderly, dehydrated post-op patient with fever, leukocytosis, and parotid inflammation has....
- acute bacterial parotitis
- Staph aureus most ocmmon cause
- prevented by adequate hydration and oral hygiene
85
What is suggested by terminal hematuria?
- prostate bleeding
| - with clots, suggests urothelial cancer
86
urothelial cancer risk factors
- Age >40
- Smoke!
- Male sex
87
What do you evaluate urothelial cancer with?
Cystoscopy
88
Old Asian with bleeding from nose and EBV history
Nasopharyngeal carcinoma (NPC)
89
Nasopharyngeal carcinoma
- recurrent otitis media, epistaxis, nasal obstruction, asian, old, smoking, nitrosamine consumption (fish) EBV
- Track with EBV titer levels
90
Whistling in nose after rhinoplasty
nasal septal perforation
91
Causative organism of prosthetic joint infection
Staph aureus or pseudmonas in first 3 months (late is propionibacterium or coagulase negative staph like epididermis after 3 months)
92
PEEP is used for what?
Increase oxygenation
93
What do you do to a bleeding lung after stabilization?
CT +/- bronchoscopy
94
Cusingoid features + hypotension
Adrenal insufficiency from chronic cortisol suppresion
95
Treatment for adrenal crisis
hydrocortosone or dexamethasone with aggressive fluid support
96
diaphragmatic rupture after trauma management
X-ray -> CT+/- bronchoscopy
97
most effective postop pneumonia prophylaxis
incentive spirometry
98
What do you suspect in patient with reperfusion surgery?
```
Compartment syndrome (reperfusion syndrome)
-Pain out of proportion to injury
-PAIN INCREASE ON PASSIVE STRETCH
-Rapidly increasing and tense swelling
Parasthesia (early)
```
99
Difference between arterial embolus and arterial thrombosis
embolus is sudden, thrombosis is slow
100
Bilateral lower extremity edema and stasis dermatitis
Venous hypertension
101
AAA repair colonic complication?
Ischemia of the bowel
102
Fast MVA trauma increases risk for
aortic injury
