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Board Studying Notecards > Basic Science > Flashcards

Basic Science Flashcards

1
Q

Case series

A

retrospective analysis of a group of patients

no comparison group

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2
Q

Cross sectional study

A

single time frame sampling of a population

usually a survey

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3
Q

Case-control study

A

Retrospective comparison of a group of patients with similar conditions

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4
Q

What type of study allows for calculation of an odds ratio?

A

case-control

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5
Q

Cohort study

A

Prospective comparison of a group of patients with similar condition

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6
Q

What type of study allows for calculation of relative risk?

A

cohort

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7
Q

What type of study allows for calculation of incidence?

A

cohort (bc it is the only study that gathers data prospectively).

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8
Q

Phase 1 FDA

A

initial drug safety

dose finding

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9
Q

Phase 2 FDA

A

determine if a drug works

compare to other intervention

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10
Q

Phase 3 FDA

A

confirm efficacy with large trial

100s of subjects

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11
Q

Phase 4 FDA

A

long term safety (post-marketing)

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12
Q

What FDA Phase is most common for failure of a device/drug?

A

Phase 2

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13
Q

Level of Evidence based on study type

A

1: RCT or meta-analysis
2: cohort
3: case-control
4: case series, cross-sectional
5: expert opinion

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14
Q

Reasons for downgrade of a study (4)

A
  • heterogenous results
  • < 80% follow-up
  • no blinding
  • concerns about randomization
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15
Q

A funnel plot examines…

A

bias in the results of a meta-analysis.

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16
Q

Relative risk =

A

risk in exposed/risk in unexposed

measures the incidence

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17
Q

Odds ratio =

A

probability an event WILL occur/probability an event will NOT occur

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18
Q

What study measures prevalence?

A

cross-sectional

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19
Q

Channeling bias

A

subjects unequally given treatment based on their features

ex patients older than 40 having a higher rate of receiving allograft for ACL recon

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20
Q

citation bias

A

more likely to believe a study in a top journal

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21
Q

publication bias

A

positive results are more likely to be published

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22
Q

Categorical data

A

nominal or ordinal

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23
Q

Nominal data

A

can be labeled into exclusive categories within a variable that cannot be put into a specific order

(ex. blood type, eye color, gender)

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24
Q

Ordinal data

A

categories that can be ordered

ex. satisfaction level, pain level, SES status, educational status

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25
Q

Continuous data

A

interval or ratio

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26
Q

What type of statistical test to use for categorical data

A

Chi square test

or Fischer’s exact test for SMALL groups

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27
Q

How to know if data is normally distributed

A

either they show you a bell curve (or they tell you)

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28
Q

If there is abnormally distributed data, you will most likely perform a…

A

Mann-Whitney U test.

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29
Q

What to calculate if you need to determine relationship between 2 variables of continuous data?

A

pearson correlation coefficient

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30
Q

What to calculate if you want to predict outcomes from variables?

A

regression

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31
Q

Sensitivity represents…

A

the ability to detect disease

ability to detect true positives

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32
Q

Sensitivity =

A

TP/(TP + FN)

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33
Q

Specificity represents…

A

the ability to detect health

ability to detect true negatives

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34
Q

Specificity =

A

TN/(TN + FP)

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35
Q

PPV =

A

TP/(TP+FP)

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36
Q

NPV =

A

TN/(TN+FN)

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37
Q

Type I Error

A

false positive

incorrectly conclude that an association exists when it does NOT

only willing to accept this 5% of the time (p < .05)

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38
Q

Type II error

A

false negative

incorrectly conclude that an association does not exist when it DOES

willing to except this 20% of the time

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39
Q

A high NNT indicates…

A

low effectiveness.

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40
Q

Power is…

A

probability of finding a significant association if one truly exists.

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41
Q

5 things that affect power

A 
alpha
beta
effect size
variance
sample size
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42
Q

Moment is…

A

the rotational effect of a force.

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43
Q

Torque is…

A

the moment perpindicular to the long axis causing rotation.

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44
Q

Mass moment of inertia is…

A

resistance to rotation.

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45
Q

moment =

A

force x distance

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46
Q

Stress is…

A

the intensity of force acting on an object.

Stress = force/area

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47
Q

Strain is…

A

the deformation of an object due to stress.

Strain = change in height/original height

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48
Q

What are the units for strain?

A

no units

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49
Q

Hooke’s Law

A

when a material is loaded in the elastic zone, the stress is proportional to the strain

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50
Q

The yield point is…

A

the transition between elastic and plastic deformation.

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51
Q

Young’s modulus of elasticity is the ability to…

A

resist deformation in the elastic zone

represents stiffness

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52
Q

Ultimate strength is…

A

the maximum stress the material can sustain before breaking.

(BUT this is NOT the breaking point).

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53
Q

Necking represents…

A

the reduction of cross-sectional area. A local incresase in stress but overall decrease stress.

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54
Q

Necking begins after…

A

the ultimate strength.

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55
Q

Breaking point is…

A

the failure of the material.

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56
Q

Fatigue is…

A

failure of the material BELOW the ultimate strength owing to numerous loading cycles.

57
Q

Stiffness is…

A

resistance to change in shape.

Depends on elastic deformation and young’s modulus.

(a higher young’s modulus is a stiffer material)

58
Q

Strength is…

A

the load required to break a material

(depends on plastic deformation).

59
Q

Hardness is…

A

resistance to localized surface plastic deformation

scratch/dent

60
Q

Ductility is…

A

the amount of deformation a material undergoes before fracture.

61
Q

On the stress-strain curve, ductility is represented by…

A

the distance between the yield point and the fracture point. (the wider the distance, the more ductile)

62
Q

Toughness is…

A

the ability of material to absorb energy.

It is the area under the curve on a stress-strain curve.

63
Q

Creep

A

Increased load deformation over time with constant stress

shows increased strain

64
Q

Stress relaxation

A

Strain is held constant and stress decreases over time.

65
Q

Viscoelastic materials are typically stiffer, stronger and tougher when loaded…

A

over a short period of time.

66
Q

Hysteresis

A

ability of a viscoelastic material to dissipate energy between loading and unloading

(the dissipated energy is used to change the shape of the material - meniscus, discs can act as shock absorbers)

67
Q

Anisotropic

A

behave differently depending on the direction of force

68
Q

Pneumonic for Young’s Modulus of Materials

A

Ceramic CoST Could Cement Polly to Cancel her TeLephone Carrier

69
Q

What happens to strength and fatigue resistance as metal grain size decreases?

A

strength and fatigue resistance increase with decreasing grain size.

70
Q

Bacteria is most adherent to…

A

titanium alloy.

71
Q

Bacteria is least adherent to…

A

tantalum.

72
Q

Classic combination resulting in galvanic corrosion

A

stainless steel and cobalt-chrome

73
Q

Fretting corrosion

A

due to micromotion during loading of implants

modular THA at head-neck junction

74
Q

How to protect against corrosion

A
  • use similar metals
  • implant correctly
  • passivation by an adherent oxide layer
75
Q

Ceramics are…

A

compounds of metallic elements bound to non-metallic elements with ionic and covalent bonds

76
Q

3 key features of ceramics

A
  • brittle/stiff (sensitive to notches)
  • insoluble (great for biocompatibility)
  • low resistance to fx
77
Q

Conductivity of bioactive ceramics are improved by…

A

large pore sizes.

78
Q

What structures affect the mechanical properties of polymers?

A

structure of long chains

  • longer/linear are stronger
  • cross-linked are stiffer/harder/stronger
79
Q

Gamma-irradiation of PE acts to…

A

promote cross-linking and improves wear but decreases strength, etc.

80
Q

Heat generated from cement depends on…

A

thickness of cement mantle.

81
Q

Vacuum mixing of cement…

A

decreases porosity and increases strength.

82
Q

Dextro-lactide monomer is associated with…

A

more rapid degradation and potential for inflammatory response.

83
Q

What ceramic is responsible for the stiffness and strength of bone?

A

hydroxyapaptite

84
Q

What matrix component is responsible for the toe region of ligaments?

A

elastin

85
Q

What determines the stiffness of a screw?

A

core diameter

86
Q

What 3 features maximize screw pullout strength?

A

large outer diameter
small core diameter
fine pitch

87
Q

The stiffness of plates is proportional to…

A

the 3rd power.

88
Q

Stiffness of plates increases with…

A

increasing screws and with decreased working length.

89
Q

The stiffness of a nail is proportional to…

A

the 4th power.

90
Q

Reaming allows for…

A

increased torsional resistance.

91
Q

What form of lubrication is the mechanism for articular cartilage?

A

elastohydrodynamic lubrication

92
Q

The instant center of rotation of the ankle is…

A

the talus.

93
Q

What are the properties of the annulus fibrosus and nucleus pulposus?

A

AF: tensile
NP: compressive

94
Q

Osteoporosis of the spine involves…

A

loss of horizontal trabeculae with resulting loss of vertebral stiffness.

95
Q

Axis of rotation of the elbow

A

center of trochlea

96
Q

Instant center of motion of the wrist

A

head of the capitate

97
Q

Lead toxicity inhibits the effects of…

A

parathyroid hormone-related peptide (PTHrP) .

98
Q

What is the primary mode of bisphosphonate excretion?

A

renal

99
Q

Callus formation is biomechanically beneficial because it…

A

increases the outer diameter of bone, leading to increase in stiffness, torsional strength, moment of inertia, and decreases strain.

100
Q

Cells of the innate immune system

A
  • natural killer cells
  • mast cells
  • eosinophils
  • basophils
  • macrophages
  • neutrophils
  • dendritic cells
101
Q

Cells of the adaptive immune system

A
  • CD8+ T lymphocytes
  • T helper cells
  • B cells
  • plasma cells
102
Q

Orthopedic surgeons who are seropositive for which 3 pathogens need to inform patients prior to scheduling an exposure prone procedure?

A
  • HIV
  • Hep B
  • Hep C
103
Q

What part of the x-ray machine should be as close to the patient as possible to decrease scatter to personnel?

A

image intensifier receptor

104
Q

What percentage of RA patients test positive for RF?

A

80-90%

105
Q

The rank of ultimate strength (or tensile strength) from highest to lowest is:

A
  1. cobalt chrome
  2. titanium
  3. stainless steel
  4. cortical bone
106
Q

What percentage of bone weight is collagen?

A

20-25%

107
Q

What region of the physis does type X collagen play a prominent role?

A

zone of hypertrophy

108
Q

What dominant intracellular proteins become directly phosphorylated as a result of BMP binding to receptors?

A

SMADs

109
Q

Woven bone is seen in…

A

fracture callus or pathologic states (infxn, malignancy)

110
Q

Woven bone demonstrates…

A

random organization of osteocytes, not stress oriented, increased cellularity.

111
Q

Differentiation of osteoprogenitor cells depends on oxygen and strain:

A

High strain –> fibroblast
Medium strain, low O2 –> chondroblast
Low strain, high O2 –> osteoblast

112
Q

3 key transcription factors of osteoblast development

A
  • beta-catenin
  • runx2
  • osx
113
Q

In response to mechanical stress, osteoprogenitor cells release…

A

Wnt –> binds to receptors and cause production of beta-catenin

114
Q

Beta-catenin controls production of…

A

runX2 which then controls OSx for terminal differentiation to osteocytes.

115
Q

Osteocytes inhibit osteoblasts via…

A

sclerostin.

116
Q

Tartrate resistant acid phosphate (TART)

A

secreted by osteoclasts to lower the pH

117
Q

What is one of the major proteolytic enzymes that digests organic matrix at the ruffled border?

A

cathepsin K

118
Q

Cathepsin K mutation leads to…

A

pyknodysostosis.

119
Q

Calcitonin is produced by…

A

parafollicular cells of the thyroid.

It directly binds to osteoclast to slow bone resportion.

120
Q

Most abundant non-collagenous matrix protein

A

osteocalcin

121
Q

US can help to heal bone via…

A

producing nano motion.

122
Q

Electrical bone stimulator MOA

A

increase osteoblast activity by reducing O2 concentration and increasing local tissue pH.

123
Q

PTH normally acts to…

A

increase calcium and decrease phosphate.

124
Q

Calcintonin normally acts to…

A

decrease calcium.

125
Q

Vitamin D normally parallels the actionof…

A

PTH and increases reabsorption of calcium in the kidneys.

126
Q

Rickets occurs in which zone of the growth plate

A

zone of provisional calcification

127
Q

Dose of calcium and vitamin D for osteoporosis tx

A

Ca: 1200-1500 mg/day

Vit D: 800-1000 IU/day

128
Q

Raloxifence

A
  • estrogen based
  • reduces osteoclast activity
  • can be used for osteoporosis
129
Q

Romosozumab

A

sclerostin antibody

130
Q

thick sarcomere filaments

A

myosin

thick is the longer word

131
Q

thin filaments

A

actin

132
Q

Energy substrates for different exercise time

A

0-10 sec –> ATP and creatine phosphate
1-4 minutes –> glycogen and lactic acid
4+ minutes –> glycogen and fatty acids

133
Q

Spondyloepiphyseal Dysplasia - Congenita

A
  • short trunks/limbs
  • normal hands, head, mentation
  • type II collagen disorder
134
Q

TNF-alpha blockers

A

Etanercept (receptor fusion protein)
Infliximab (chimeric IgG antibody)
Adalimumab (monoclonal antibody)

135
Q

Tocilizumab

A

anti-human IL-6 receptor antibody

136
Q

What gene in staph aureus allows for adhesion to titanium?

A

fibronectin

137
Q

What antibiotic is not recommended for kids because it has been shown to cause arthropathy in animal models?>

A

ciprofloxacin

138
Q

A bone scan after well funcitoning TKA may demonstrate increased uptake for up to…

A

1 year.

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