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Alexey Ortho Flashcards > Basic Science > Flashcards

Basic Science Flashcards

1
Q

What are the 5 (or 7) layers of the growth plate

A 
Reserve Zone (near epiphysis)
Proliferative Zone
Hypertrophic Zone
- Maturation zone
- Degenerative zone
- Provisional zone (of calcification)

RPM DC
Reserve, Proliferative, Maturation, Degeneration, Calcification

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2
Q

What are the 3 stages of Endochondral fracture healing

A

Inflammation
Repair
Remodeling

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3
Q

What cell types are involved in the Inflammatory stage of Endochondral fracture healing?

A 
Macrophages
Neutrophils
Platelets
Fibroblasts
Mesenchymal cells
OsteoBlasts
FibroBlasts
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4
Q

Main collagen type for Ehlers Danlos, Dupuytrens, Bone, Cartilage

A

BCDE (minus 4)

Bone 1
Cartilage 2
Dupuytrens 3
Ehlers-Danlos 5 (classic type)

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5
Q

4 types of Necrotizing Fasciitis

A

MultiMicrobial
MonoMicrobial (Usually Group A strep)
Marine (Vibrio vulnificus
MRSA

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6
Q

Name a urine marker of bone turnover

A

N-telopeptide

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7
Q

What are 5 types of wear in bearing surfaces

A 
Adhesive
Abrasive
Volumetric
Linear
Third body
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8
Q

What blood test can be prognostic in Multiple Myeloma

A

Beta 2 Microglobulin

< 4 = median survival 43 months
> 4 = median survival 12 months

OR

< 3.5 = 62 months
< 5.5 = 44 months
> 5.5 = 29 months

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9
Q

Multiple Myeloma diagnostic criteria

A

CRAB and MDE (myeloma defining events)

CRAB:
hyperCalcaemia
Renal insufficiency
Anaemia
Bone lesions

MDE:
> 60% clonal cells on bone marrow
serum light chain ratio

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10
Q

What does OsteoProteGrin do and how

A

Inhibits Osteoclast activation and differentiation

Acts as a decoy receptor for RANK-L

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11
Q

What does Insulin-like Growth Factor - 2 do and how

A

Stimulates bone and cartilage formation

Acts through tyrosine kinase receptors on a variety of cells

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12
Q

What does Platelet Derived Growth Factor do and how

A

Signals Inflammatory cells to migrate to fracture site

Acts through tyrosine kinase receptors

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13
Q

What does Receptor Activated Nuclear Kappa Ligand do and how

A

Stimulates bone resorption

Acts through RANK receptors on osteoClasts

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14
Q

What does Bone Morphogenic Protein do and how

A

Stimulates proliferation and differentiation of pluripotent mesenchymal stem cells into bone forming cells
Acts through serine-threonine kinase receptors

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15
Q

Which bone graft substitute has the highest early compressive strength

A

Calcium Phosphate
CaPO

It is injected, then hardens into dahllite, which is 4 to 10 times harder than cancellous bone.

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16
Q

What is the name of the process by which primary bone healing occurs

A

Intramembranous bone healing occurs via Haversian remodelling with cutting cones
Strain <2 %

17
Q

What is the name of the process by which secondary bone healing occurs

A

Endochondral bone healing occurs via chondrocyte activity (callus formation)
Strain of 2 to 10 %

18
Q

Which BMPs are osteoinductive

A

BMP 2, 6 and 9 induce osteoblast differentiation

19
Q

Which BMP has no osteoinductive or osteogenic activity

A

BMP 3

20
Q

Demineralized Bone Matrix is Osteo(?inductive, ?conductive, ?genic)

A

Osteoconductive - contains collagen and calcium
Osteoinductive - contains BMPs and TGF-B

Has no stem cells and has no structural support

21
Q

6 factors that lead to Catastrophic wear in TKA

A 
Thickness of PE
Surface design
Kinematics
Sterilization of PE
Manufacturing of PE
Technique (tight flexion gap, tight PCL, anterior slope)
22
Q

6 factors that lead to Catastrophic wear in TKA

A 
Thickness of PE (< 8 mm)
Surface design
Kinematics (varus alignment)
Sterilization of PE
Manufacturing of PE
Technique (tight flexion gap, tight PCL, anterior slope)
23
Q

Synovial WBC values in infected TKA, THA, acute and chronic

A

Infected if:
1100 in TKA > 6 weeks
27800 in TKA < 6 weeks

3000 in THA > 6 weeks

4350 in MoM THA
1166 in THA antibiotic spacers

24
Q

Aminoglycosides - 1. Static or cidal, 2. type of bacteria, 3. mechanism

A

BacteriCidal
Aerobic
Gram -ve
30S ribosomal subunit

25
Q

Quinolones - 1. Static or cidal, 2. type of bacteria, 3. mechanism

A

Mostly BacteriStatic
Broad spectrum
interfere with bacterial topoisomerase IV and DNA gyrase

26
Q

Workup for Tuberculosis

A

Mycobacterium tuberculosis
Granulomatous infection

CXR
Mantoux
Quanterferon gold
Acid fast bacilli on cultures

Treat when RIPE

Rifampicin
Isoniazid
PyraZinaMide
Ethambutol

27
Q

CRPS major and minor criteria

A 
Major:
Intense and prolonged pain
Swelling
Stiffness
Discoloration
Minor:
Trophic changes
Osseous demineralization
Temperature changes
Palmar fibromatosis

Alexey Ortho Flashcards (21 decks)

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