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Intro to Pod > Final Exam > Flashcards

Final Exam Flashcards

1
Q

What are the cardinal signs of infection?

A
  • Redness
  • Erythema
  • Increase in pain
  • Odor
  • Increase in warmth
  • Purulence of staph
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2
Q

Purulence of staph

A
  • Consistency is whitish-yellow and chalky

- Classic of staph aureus

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3
Q

Pseudonomas

A
  • Greenish discoloration
  • Another common bacteria that affects the foot, especially in diabetic patients
  • Much longer incubation period (usually 7 days or more for a good response)
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4
Q

Osteomyelitis

A
  • Bacteria begins to effect bone

- Diagnosed with an x-ray

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5
Q

Classic infection signs of bone (osteomyelitis)

A
  • Erosion

- Osteolucent/osteolytic types of irregularities in the bone

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6
Q

How do diagnose osteomyelitis on x-ray

A
  • Subjective findings
  • Typically includes osteolytic appearance or erosion of bone
  • Takes about 2-3 weeks for you to be able to see osteolytic erosions on an x-ray
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7
Q

Perinicea

A
  • Infection of soft tissue surrounding ingrown toenail
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8
Q

Treatment of perinicea

A
  • Put patients on Keflex or BSI and pain does not get better
  • If toenail is not removed, it will not resolve
  • If infection gets worse, it can seed the bone underneath the toe (phalanx)
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9
Q

Ingrown toenails often have _____

A
  • Associated infection with it
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10
Q

Ingrown toenail infection usually results from _____

A
  • Chronic irritation of impinged nail plate that causes localized redness, pain, etc.
  • Not necessarily true infection
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11
Q

For ingrown toenail infection to resolve itself _____

A
  • Ingrown toenail must be removed
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12
Q

What is the most common puncture wound?

A
  • Staph aureus

- Staph organism enters the body, then enough to cause infection can spread

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13
Q

Staph aureus typically requires an incubation period of _____

A
  • 3 days/72 hours
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14
Q

If a patient is going to develop an infection from a staph organism _____

A
  • It will typically begin to show cardinal signs of infection
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15
Q

One of the immediate things to do for staph infection that allows bacteria to escape is _____

A
  • Incision and drainage
  • Flush it out, then decrease bacteria count to a number in which body can fight effectively
  • Augment fighting with oral antibiotics
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16
Q

Drug of choice/oral antibiotic for staph

A
  • 1st generation cephalosporin like Keflex
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17
Q

Diabetic patients (immune compromised) cannot _____

A
  • Fight infection without antibiotic
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18
Q

Culturing bacteria determines _____

A
  • How antibiotic inhibits future growth
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19
Q

Strong bacterial killing agent may effect culture, so you must _____

A
  • Rinse with saline to get rid of surface contamination
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20
Q

Nail puncture wounds _____

A
  • May lead to septic arthritis (3 days)

- Superficial, visible entry site

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21
Q

If an infection is in the joint, it can be devastating to _____

A
  • Cartilage of the joint
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22
Q

Catrilage is avascular, so it _____

A
  • Does not respond well to oral or IV antibiotics
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23
Q

Infections in joints are considered _____

A
  • Surgical emergencies

- Requires aggressive incision and drainage to ensure joint is not damaged to the point of non-functional

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24
Q

Gout tophi may result from _____

A
  • Patients that have long-term untreated gout
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25
Q

Gout tophi characteristics

A
  • Crystals that deposit themselves not just in joint, but soft tissue around joint
  • Fill these masses called tophi
  • X-ray may even look like a bone tumor
  • Can be surgically resected
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26
Q

A non resolving scrape on the skin may be a result of _____

A
  • High BSL
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27
Q

Unresolved wounds may create _____

A
  • Infections
  • May lead to non-healing wound and continued spread of infection
  • May lead to amputation later (especially if patient has poor circulation)
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28
Q

Important notes for patients with wounds

A
  • Make sure they are metabolically optimized to heal from that wound
  • Requires normal blood sugar and good circulation
  • Patient requires treatment with primary care, endocrinologist, vascular surgeon, etc.
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29
Q

Many studies show presence/development of bunions are a result of these aggravating factors

A
  • Shoes

- High heels/shoes putting pressure on forefoot area will more commonly come in complaining of a bunion deformity

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30
Q

Bunion deformities develop from _____

A
  • The way we walk
  • Inherited biomechanical function creates these deformities, and they develop over time
  • Pronation causes this biomechanical fault
31
Q

What is the most common etiology of bunions and hammertoes?

A
  • Abnormal excessive pronation

- Try to correct with orthotics before surgery

32
Q

Two very common types of ulcers that are vascular related are those that form because of _____

A
  • Venous incompetency

- Arterial insufficiency

33
Q

Ulcer located proximal to medial malleolus (on the inside) typically is a _____

A
  • Venous ulcer
  • Usually not painful
  • Red and healthy looking tissue (granulation tissue)
34
Q

Ulcer located lateral to medial malleolus usually indicates _____

A
  • Arterial ulcer
  • Usually excruciatingly painful
  • Very necrotic in appearance
35
Q

A uniform border usually indicates _____ ulcer

A
  • Arterial ulcer
36
Q

Patients with arterial ulcers need _____

A
  • Vascular intervention
  • Need to reestablish blood flow to the extremity before any attempts at debridement
  • Then debridement is done every day in office with 15 blade or tissue nipper
37
Q

_____ is typically the antibiotic of choice for injuries obtained from salt water because of the pathogens that tend to grow in there

A
  • Augmentin
38
Q

Jellyfish stings typically require _____

A
  • Supportive treatment

- Want to minimize the effects of the toxin

39
Q

Typical medications effective in reducing effects of jellyfish toxin

A
  • Nitroglycerin patch
  • Topical steroid
  • Oral analgesics
  • Oral steroids
40
Q

Neurofibroma (neurofibromatosis)

A
  • Soft tissue pathology

- May be related to other issues

41
Q

Most common tumor in the body

A
  • Lipoma
42
Q

Characteristics of Lipomas

A
  • Benign mass, soft tissue growth
  • Common in lower extremity
  • Tumors tend to be very well encapsulated and vascularized
  • Classic signs of benign soft tissue mass
43
Q

Malignant melanoma

A
  • Very fast-growing soft tissue tumor
  • Invading of surrounding tissues and very destructive
  • Can be life-threatening
44
Q

Calcification in a soft tissue mass requires _____

A
  • Surgical resection with biopsy

- It is a potential malignant marker

45
Q

Liposarcoma

A
  • Fast growth and out grows its blood supply
  • Necrotic
  • Has same stem cells as lipoma, but unlike lipoma is highly malignant
46
Q

Characteristics of Liposarcomas

A
  • Lobulated
  • Not well encapsulated
  • No apparent supporting vascular structure
47
Q

Cavus foot, CMTD

A
  • Genetic disorder (result of neurological condition)
  • Commonly develop high arched foot
  • Many ways to surgically stabilize to create better weight bearing status
  • Least common type of foot pathology
48
Q

Treatment for cavus foot

A
  • Typically combination of osteotomies, fusions, and tendon transfers performed to address deformity
  • Staging can be used
  • Tendon transfers first to rebalance, then more bony procedures to address bony pathology
49
Q

2nd toe very often involved with pathology of _____

A
  • Bunions

- As patients develop bunions, first metatarsal will deviate from natural position

50
Q

When first metatarsal deviates (in multiple planes/transvers and frontal plane rotation) it puts a lot of stress underneath _____

A
  • 2nd metatarsal

- Complain about pain under 2nd metatarsal, not bunion

51
Q

Bunion/toe correction must be addressed in a specific order

A
  • Cannot put toe in correct position until bunion deformity is addressed first
  • Bunion > corrective position > then 2nd toe into stable position
  • Needs soft tissue work to re-stabilize structures so toe does not continue to dislocate post-operatively
52
Q

_____ makes the repair site heal more efficiently in an achilles tendon rupture

A
  • Augmentation of tendon with collagen graft
53
Q

Calcaneal fracture contour plates are utilized to _____

A
  • Reconstruct calcaneal fracture
  • Calcaneal fractures usually show multiple fragments, so plates are needed to get bones back together
  • Bone replacement products may be used with bone deficit
54
Q

Calcaneal fractures are typically _____

A
  • Interarticular

- Results in arthritis post-operatively

55
Q

Developing arthritis following calcaneal fracture reconstruction is often seen developing in _____

A
  • Subtalar joint

- Usually will need secondary surgery for arthritic complications

56
Q

Flatfoot/Charcot joint mid-food collapse

A
  • Common diabetic complication
  • Patients that are neuropathic may commonly undergo this bone-breakdown process in the foot
  • Seen most commonly in diabetics
  • Midfoot looks like it fuses into one block of bone
57
Q

Diabetic Charcot joint usually results from/in

A
  • No traumatic injury
  • Foot gets red, hot and swollen
  • Continues to walk on it (bones are very brittle during this acute charcot)
  • Bones begin to break down
58
Q

What foot type do diabetics with Charcot develop?

A
  • Rocker bottom foot
59
Q

Common issues associated with rocker bottom foot

A
  • Cannot feel bottom of foot
  • Do not adjust to pressures
  • Constantly come down on foot, creating ulcers/soft tissue ulceration
  • Ulcers commonly infected and lead to osteomyelitis
60
Q

Brachymetatarsia is _____

A
  • Early growth plate closure, most commonly the 4th metatarsal
  • No known etiology as to why this has happened
61
Q

Osteotomy

A
  • Create a cut in the bone in an area of high cell turnover
62
Q

_____ area of bone has the best vascularity compared to the _____ area of bone

A
  • Metaphyseal
  • Diaphyseal
  • Better vascularity means better healing potential
63
Q

Callous distraction lengthening

A
  • Cut bone
  • Insert external fixator
  • Place pins
  • Patient turns periodically
64
Q

Bandage scissors

A
  • Flat part against the patient’s skin

* You need to wash and clean the bandage scissors with disinfectant every time you use it*

65
Q

Two most common people you are cutting bandages off are _____

A
  • Post-ops

- Wound care

66
Q

Stethoscope

A
  • Single barrel stethoscope with one large aperture

- Smaller one and bigger one (smaller for pediatric patients)

67
Q

Auscultate lungs at _____

A
  • 10th Thoracic Vertebra
68
Q

Heart Sounds during auscultation

A
  • Lub (blood moves from atria to ventricles)

- Dub (ventricles expel blood from the heart)

69
Q

Blood Pressure Cuff/Sphygmomanometer

A
  • Also use stethoscope when taking blood pressure
  • Listening to brachial artery
  • Pump cuff above 120 (because 120 is normal)
  • First sound is the shutting off of the artery (gives first number)
  • Second noise is when you release the cuff, and start to hear blood flow again (gives second number, 80 is normal)
  • Systole over diastole
70
Q

Petechiae

A
  • Little red splotches if cuff is not released or left on for too long
71
Q

Systole/Diastole

A
  • Systole (ventricular shortening and emptying)
  • Diastole (ventricular elongation and filling)
  • 120/80 mm Hg within normal limits
72
Q

Goniometer or Tractograph used most often in

A
  • Biomechanics
73
Q

One of the angles to look at when evaluating for a bunion repair is the _____

A
  • Intermetatarsal angle

- Angle between the two metatarsals

74
Q

Goniometer or Tractograph used may also commonly be used in

A
  • Physical therapy
  • Tendon surgery
  • Shows the degree of flexion that you can get after the surgery

Intro to Pod (1 decks)

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