Board qualifying

Question 1

What is the ossification (in years) for a talonavicular coalition?

Answer 1

3-5 y/o

Question 2

What is the ossification (in years) for a calcaneonavicular coalition?

Answer 2

8-12 y/o

Question 3

What is the ossification (in years) for a talocalcaneal coalition?

Answer 3

12-16 y/o

Question 4

List in order of ossification the common coalitions from youngest to oldest age groups

Answer 4

talonavicular (3-5 y/o)
calcaneonavicular (8-12 y/o)
talocalcaneal (12-16 y/o)

Question 5

which radiographic view do you see a talonavicular coalition best in?

Answer 5

AP view

Question 6

which radiographic view do you see a calcaneonavicular coaliton best in?

Answer 6

medial oblique view (and lateral view)

Question 7

which radiographic view do you see a talocalcaneal coaliton best in?

Answer 7

Harris- beath view

Question 8

How do you position for a Harris- beath view?

Answer 8

patient is erect;

• sole of the foot is flat on the cassette;
• central beam angled 45 deg toward the midline of the heel;
• 35 or 55 deg is used to better visualize other facets of sub-talar joint;

*demonstrates the body of the calcaneus, middle facet of the sub-talar Joint and the sustenaculum tali the best

Question 9

What are isherwood projections good at visualizing?

Answer 9

subtalar joint

• the MO axial view –> middle/ posterior facets
• the lateral oblique axial –> posterior facet
• olibque plantar dorsal –> anterior facet

Question 10

List the ASA classifications.

Answer 10

ASA 1- normal, healthy patient
ASA 2- mild, systemic dz (controlled HTN, DM)
ASA 3- severe systemic dz (uncontrolled DM)
ASA 4- critical condition constant threat to life
ASA 5- moribound, unexpected survival w/o sx
ASA 6- brain dead
*E- denotes emergency

Question 11

What are the pre-op guidelines for aspirin?

Answer 11

hold 7-10 days prior to sx

due to irreversible COX inhibition activity

Question 12

What are the pre-op guidelines for NSAIDs?

Answer 12

hold 3 days prior to sx

due to reversible COX inhibition activity

Question 13

what are the preop guidelines for plavix (clopidogrel)?

Answer 13

hold 7-10 days prior to sx

due to irreversible anti-platelets

Question 14

what are the pre-op guidelines for beta-blockers?

Answer 14

CONTINUE up to and including day of sx

Question 15

what are the pre-op guidelines for Calcium channel-blockers?

Answer 15

CONTINUE up to and including day of sx

Question 16

what are the pre-op guidelines for ACEi, diuretics, and ARBs?

Answer 16

HOLD morning of sx

increased risk of hypotension in sx

Question 17

what are the pre-op guidelines for statins?

Answer 17

hold one day prior (risk of rhabdo/myositis)

Question 18

what is the medial legal term for which a “doctor may be held responsible for nurse’s negligence”?

Answer 18

respondeat superior

Question 19

what is the medical legal term for which “the court follows its previous decision based on similar facts”?

Answer 19

stare decisis

Question 20

what is the medical legal term for which “describes the selection and questioning of jurors”?

Answer 20

voir dire

Question 21

what is the medical legal term for which “is the basis of malpractice based on negligence”? (i.e. private wrong NOT based on contract)

Answer 21

tort

Question 22

what is the medical legal term for which “the thing speaks for itself” (shows breach of care without direct evidence)?

Answer 22

res ipsa loquitor

Question 23

Which part of Medicare provides hospital coverage (as well as SNF, and home health)?

Answer 23

medicare part A

Question 24

Which part of Medicare provides prescription drug coverage?

Answer 24

Medicare part D

Question 25

Which part of medicare provides medical coverage (doctor/ lab services/ outpatient and preventative care/ pT/OT)

Answer 25

medicare part b

Question 26

What is Medicare part C?

Answer 26

(A+B) plans = Medicare advantage

Ex. HMO, PPO

Question 27

What is the anti-kickback law?

Answer 27

criminal statute that prohibits the exchange of anything of value in an effort to induce the referral of federal healthcare program

Question 28

what is the stark law?

Answer 28

prohibits physician self-referral to an entity if the physician has financial gain

Question 29

what 4 elements are required to prove negligence?

Answer 29

duty, breach, causation, damage

Question 30

Define how to calculate incidence.

Answer 30

NEW cases within a time frame/ population at risk

Question 31

Define how to calculate prevalence.

Answer 31

TOTAL # cases within a specific time frame/ population at risk

Question 32

Define how to calculate sensitivity.

Answer 32

TP / (TP + FN)

Question 33

Define how to calculate specificity.

Answer 33

TN/ (FP+ TN)

Question 34

Define how to calculate PPV.

Answer 34

TP/ (TP + FP)

Question 35

Define how to calculate NPV.

Answer 35

TN/ (TN + FN)

Question 36

List the Hawkins classification for talar neck fractures and their associated incidence of AVN.

Answer 36

Hawkins type 1- nondisplaced talar neck fx (rare to see AVN)
Hawkins type 2- talar neck fx with mild displacement; subluxing of STJ (AVN 16-75%)
Hawkins type 3- talar neck fx with moderate displacement; subluxing of AJ (AVN 35-75%)
Hawkins type 4- talar neck fx with severe displacement, subluxing of STJ, AJ, AND TNJ

Question 37

how much skin lengthening do you get with a 30 deg Z-plasty?

Answer 37

25%

Question 38

how much skin lengthening do you get with a 45 deg Z-plasty?

Answer 38

50%

Question 39

how much skin lengthening do you get with a 60 deg Z-plasty?

Answer 39

75%

Question 40

What is Barlow’s test for?

Answer 40

developmental hip dysplasia - hip pops out of the acetabulum with this maneuver
*mnemonic- BARlow’s test- “we’re going out tonight!”

Question 41

What is Ortolani’s test?

Answer 41

The femoral head is reduced back into the acetabulum with this maneuver
*mnemonic- Ortolani’s test-“o” for out; “once we have been out, it’s time to go home”