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Crozer Flashcards

1
Q

What attaches periosteum to bone?

A

Sharpey fibers

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2
Q

Eponym for the anterior inferior tibiofibular ligament?

A

Bassett’s ligament

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3
Q

Sesamoid occasionally found in tendon of lateral grastroc head?

A

Fabella

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4
Q

Sources of blood supply to the talus?

A
  1. Artery of the Sinus Tarsi

2. Artery of the Tarsal Canal

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5
Q

What should the peaks and troughs be for Vancomycin?

A

Peak: 15-30 mg/mL
Trough: < 10 mg/mL

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6
Q

How do you treat Red Man Syndrome?

A

Antihistamines (e.g. Benadryl)

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7
Q

What can beta-lactams cause?

A

Leukopenia

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8
Q

What drug sensitivity do you look at to see if someone has MRSA?

A

Oxacillin

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9
Q

Difference between cellulitis and erysipelas?

A

Cellulitis-confined superficial infection

Erysipelas-superficial infection that spreads to lymphatics

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10
Q

What happens to WBC count after surgery?

A

May actually increase slightly post-op day 1 and 2.

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11
Q

Following PRBC transfusion, when will H/H changes be seen?

A

3 hours, thus order new labs to be drawn 4 hours after last unit given.

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12
Q

What should be given if Na is low?

A

NSS or regular salt

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13
Q

What should be given if K is low?

A

K-Dur and/or potassium rich foods

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14
Q

What should be given if K is high?

A

Calcium gluconate, sodium bicarbonate, dextrose with insulin, kayexalate

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15
Q

What’s more important, BUN or Cr?

A

Cr. BUN is influenced by hydration state. If BUN is high but Cr is normal, patient is probably dehydrated. If both are high, then it’s probably renal damage.

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16
Q

What can cause an elevated PT/INR?

A

Coumadin, Malnutrition, Alcoholism, Abx, Vitamin K disorders

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17
Q

What pathways do PTT/PT check?

A

PTT-Intrinsic (“PITT”)

PT-Extrinsic (“PET”)

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18
Q

What are the reasons for post-op fever?

A
  1. Wind (12-24 hrs)-atelectasis (tx with pulmonary toilet), pneumonia
  2. Water (24 hrs)-UTI
  3. Walk (48 hrs)-DVT, PE
  4. Wound (72 hrs)-post-op infection
  5. Wonder drug (anytime)-drug fever
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19
Q

When do fever peaks occur?

A

Between 4-8 PM.

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20
Q

What test can you look at if you suspect someone at risk for malignant hyperthermia?

A

CPK (elevated in 79% of pts with it)

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21
Q

What is the only local anesthetic with vasoconstriction?

A

Cocaine

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22
Q

What should be given for an indomethacin overdose?

A

Benadryl (reduces serotonin and histamine release)

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23
Q

Triad of pulmonary embolism?

A

Dyspnea, Chest pain, Hemoptysis (although tachycardia is more common)

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24
Q

Risk factors for DVT?

A 
"I AM CLOTTTED"
Immobilization
Arrhythmia
MI history
Coagulable state
Longevity (old age)
Obesity
Tumor
Trauma
Tobacco
Estrogen
DVT history
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25
Q

What can be ordered to diagnose DVT?

A

Doppler US
D-Dimer
Venogram

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26
Q

How do you reverse Lovenox?

A

Recombinant Factor VII

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27
Q

Signs of hypoglycemia?

A

Nervousness, tachycardia, diaphoresis, nausea, headache, confusion, tremor, seizure, coma

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28
Q

How much lengthening per day is typical for callus distraction?

A

1 mm per day

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29
Q

Phosphate versus acetate steroids?

A

Phosphate-soluble with shorter half-life

Acetate-insoluble with longer half-life

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30
Q

What is given for acetaminophen overdose?

A

Acetylcysteine

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31
Q

Most common clinical pattern of onychomycosis and it’s most common infecting organism?

A

Distal subungual onychomycosis; Trichophyton rubrum

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32
Q

When evaluating bunion, what does tibial sesamoid position tell you?

A

Abnormal effects of the adductor tendon and FHB.

33
Q

What x-ray measurements evaluate a haglund deformity?

A

Parallel pitch lines
Fowler & Philip Angle (44-69˚, > 75˚ is abnormal)
Total Angle of Ruch (

34
Q

What may falsely elevate an ABI?

A

Vessel calcification/non-compressible vessel

35
Q

Most common type of melanoma?

A

Superficial spreading melanoma

36
Q

What is the Badgley procedure?

A

Surgical resection of coalition or bar with interposition of muscle belly

37
Q

What is the technique for correction of clubfoot?

A

Ponseti technique

  • Serial casting
  • Correct FF and RF deformities first, then correct ankle equinus
38
Q

What are the types of bunions?

A

Positional: HA > PASA + DASA
Structural: HA

39
Q

Angles for assessing Tailor’s bunion?

A

Fallat & Buckholz IM angle: 6˚ (8.7˚ is pathologic)

Fallat & Buckholz Lateral Deviation angle: 2.64˚ (> 8˚ is pathologic)

40
Q

STJ Axis?

A

Frontal-48˚
Transverse-42˚
Sagittal-16˚

41
Q

Longitudinal MTJ Axis?

A

Frontal-75˚
Transverse-15˚
Sagittal-9˚

42
Q

Oblique MTJ Axis?

A

Frontal-38˚
Transverse-52˚
Sagittal-57˚

43
Q

What angles can be used to assess intra-articular calcaneal fractures?

A

Bohler’s Angle: 25-40˚ (decreases with fx)

Angle of Gissane: 125-140˚ (increases with fx)

44
Q

How to calculate daily fluid input requirement?

A

First 10 kg x 100 = 1000 mL/day
Second 10 kg x 50 = 500 mL/day
Remaining kg x 20 = _____

45
Q

How to calculate IV fluid input rate?

A

“421” rule
First 10 kg x 4 = 40 mL/hr
Second 10 kg x 2 = 20 mL/hr
Remaining kg x 1 = ____

46
Q

When should PRBC transfusion be given?

A

If Hbg < 8 or Hct is < 24.

47
Q

What type of screw has a fluted tip?

A

Self-tapping

48
Q

What is a Keith needle?

A

Straight needle

49
Q

Order of lateral release for a McBride?

A
  1. Extensor hood
  2. ADH tendon release
  3. Fib sesamoid lig
  4. Lat collateral lig
  5. FHB
  6. Fibular sesamoid excision (if performing)
50
Q

Difference between a Vogler, Kalish, and Youngswick?

A

Vogler-apex at metaph-diaph junction
Kalish-long-arm Austin with angle of 55˚
Youngswick-Austin with dorsal slice to decompress and plantarflex

51
Q

What are surgical procedures for pes planus and their plane of correction?

A

Transverse: Evans, Kidner, CC distraction arthrodesis
Sagittal: Cotton, Young, Lowman, Hoke, Miller, Cobb
Frontal: Koutsi, Dwyer, Chambers, Gleich, Baker-Hill, Lord

52
Q

What imaging study can distinguish between hypertrophic and atrophic non-unions?

53
Q

Best study for evaluating AVN?

A

MRI (decreased signal intensity on T1 and T2)

54
Q

ASA Classification

A

1-healthy pt
2-mild systemic disease
3-serious systemic disease
4-disease that is constant threat to life
5-patient not expected to survive w/o emergency treatment
6-pt for organ harvest

55
Q

How does bone stimulator work?

A

Piezoelectric principle-side under compression makes negative charge that leads to bone growth

56
Q

Sequence of release for hammertoe surgery?

A
  1. Arthroplasty PIPJ
  2. Extensor hood recession
  3. EDL/EDB tenotomy
  4. MPJ Capsulotomy
  5. Flexor plate release
  6. Flexor to extensor transfer
  7. MT osteotomy
57
Q

What is the lag time for presentation of osteomyelitis on x-ray?

A

10-14 days

58
Q

How do assess someone for trauma?

A 
"ABCDE"
Airway
Breathing
Circulation
Disability (neuro status)
Exposure of pt and environment control
59
Q

What is the Vassal principle?

A

Initial fixation of the primary fx will assist in stabilization of secondary fx

60
Q

Are dorsal or plantar Lisfranc dislocations more common?

A

Dorsal because plantar ligaments are stronger

61
Q

What are the fractures with the eponyms Tillaux-Chaput, Wagstaff, Volkman, Cedell, Foster, and Bosworth?

A

Tillaux-Chaput: avulsion of anterior-lateral tibia
Wagstaff: avulsion of anterior-medial fibula
Volkman: posterior mal fx
Cedell: posterior medial process fx
Foster: fx of entire posterior process
Bosworth: lateral mal fx with ankle displacement

62
Q

When should a posterior mal fx be fixated?

A

Fragment is > 25% of posterior mal

63
Q

Most common benign and malignant primary bone tumors?

A

Benign-Osteochondroma

Malignant-Multiple Myeloma

64
Q

What are the stages of wound healing?

A
  1. Inflammatory (lag) phase
  2. Proliferative (repair) phase
  3. Remodeling (maturation) phase
65
Q

What is Santyl?

A

Collagenase-enzymatic debrider that digests collagen (fibrotic tissue) in wounds

66
Q

What is minimum ABI necessary for wound healing?

A

Non-DM: 0.35

DM: 0.45

67
Q

What is Integra, Apligraf, and GraftJacket?

A

Integra: bilayer graft of bovine tendon collagen and a silicone layer to control moisture
Apligraf: bilayer graft from neonatal foreskin with dermal and epidermal layers
GraftJacket: extracellular matrix from human tissue with intravascular channels

68
Q

What are phases of a bone scan?

A
  1. Blood Flow (2-3 sec)
  2. Blood pool (2-3 min)
  3. Bony uptake (2-3 hrs)
  4. Delayed (24 hrs)
69
Q

What is Regranex?

A

PDGF-1 (Platelet derived growth factor)

70
Q

What is Integra?

A

Bilayer graft composed of bovine tendon collagen and a silicone layer to control moisture loss

71
Q

What is Oasis?

A

Extracellular graft matrix derived from porcine, small intestine submucosa

72
Q

What is Apligraft?

A

Bilayer graft derived from neonatal foreskin with dermal and epidermal layers

73
Q

What is GraftJacket?

A

Extracellular graft matrix derived from human tissue with intact vascular channels

74
Q

What is TissueMend?

A

Acellular collagen matrix derived from fetal bovine dermis

75
Q

What is Endoform?

A

Collagen ECM that’s bovine derived.

76
Q

What is Promogran?

A

55% collagen, 45% oxidized regenerated cellulose

77
Q

What is Repara?

A

Calcium alginate, contains silver; for draining infected wounds

78
Q

What is Iodosorb?

A

Cadexomer iodine; cleans by absorbing fluid, removing exudate, slough, and debris

79
Q

Sneppen Talar Body Classification

A 
Type 1: compressive fracture of talar dome
Type 2: shearing fx of talar body
-2A: coronal shearing force
-2B: sagittal shearing force
-2C: transverse shearing force
Type 3: fx of posterior tubercle
Type 4: fx of lateral process
Type 5: crush fx

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