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PCM IV > Final: Orthopedic Procedures > Flashcards

Final: Orthopedic Procedures Flashcards

1
Q

Sprain or strain: ligamentous stretching that causes tearing; may feel or hear a pop

A

Sprain

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2
Q

Sprain or strain: occurs when muscle is stretching and contracting at same time; “grabbing sensation”

A

Strain

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3
Q

What’s an important physical exam habit when looking at an extremity issue?

A

Compare BILATERALLY

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4
Q

What are the Ottawa Ankle Rules for x-ray?

A

Bone tenderness of distal 6 cm of tib/fib or medial/lateral malleolus

Inability to bear weight for four steps BOTH immediately after and in ER/office

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5
Q

What are the Ottawa Foot Rules for x-ray?

A

Bone tenderness at base of 5th metatarsal or navicular bone

Inability to bear weight for four steps BOTH immediately after and in ER/office

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6
Q

What is the best treatment option for sprains?

A 
RICE
Rest
Ice
Compress
Elevate

Can add splint if necessary

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7
Q

How do you treat a third degree sprain?

A

Surgery

-complete tear that requires reattachment

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8
Q

Is an ACE bandage good for short or long term?

A

Short term only

Good for limited movement to remind pt to slow down

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9
Q

How do you apply an ACE bandage?

A

Start distally and move proximally w minimal stretching of bandage

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10
Q

When would you use the buddy taping method?

A

To stabilize non-displaced fractures of fingers and toes

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11
Q

What type of motion does an ankle stirrup still allow?

What type of injury is it good for?

A

Allows for flexion and extension; limits IR/ER

Good for mild to moderate ankle sprains

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12
Q

What type of injury is a posterior leg splint good for?

A

Foot and ankle fractures, or high grade sprains

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13
Q

What type of cast: fracture of carpal/metacarpal base

A

Short arm cast

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14
Q

What type of cast: fx of scaphoid, trapezium, 1st metacarpal

A

Short arm cast with thumb spica

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15
Q

What type of cast: fx of scaphoid, radius, or ulna; colles fracture

A

Long arm cast

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16
Q

What type of cast: fx of neck, shaft, or base of 4th/5th metacarpals

A

Ulnar gutter

17
Q

If a patient has large joint septic arthritis, with a warm distended joint capsule and systemic symptoms then what is the likely diagnosis?

A

Septic arthritis

-most likely gonococcal

18
Q

What are the therapeutic indications for joint arthrocentesis? (3)

A

Relieve pain
Improve diagnostic accuracy
Instill meds

19
Q

Are intraarticular antibiotics recommended for septic arthritis?

A

nah fam

20
Q

What are the diagnostic indications for joint arthrocentesis? (2)

A

Establish etiology of unknown joint effusion

Distinguish between infectious and non-infectious

21
Q

What are the two contraindications for joint arthrocentesis?

A

Overlying skin lesions/infections
Bacteremia
-can seed the joint

22
Q

Middle aged obese male; diet consists of meat and potatoes and drinks a six pack nightly comes in with intense pain in the big toe. Crystals are needly shaped negatively birefringent. Dx?

A

Gout

23
Q

Elderly male with intense pain in the knee region; crystals are rhomboid shaped and positively biferengent

A

Pseudogout

24
Q

Gout or pseudogout: has well-defined erosions with sclerotic margins

A

Gout

25
Q

Gout or pseudogout: Radiodense deposits within meniscus or hyaline cartilage (chondrocalcinosis)

A

Pseudogout

26
Q

OA or RA: asymmetric arthritis in weight bearing joints that is worse with use; DIP and PIP joints; eburnation

A

OA

27
Q

OA or RA: symmetric arthritis in small joints of hands and toes; better with use; PIP and MCP; boutonniere and swan neck

A

RA

28
Q

What landmarks do you use for shoulder arthrocentesis/injections?

A

Inferior and lateral to coracoid process, directed posterior towards joint space

29
Q

What landmarks do you use for knee arthrocentesis/injections?

A

1 cm medial or lateral to superior 1/3 of patella

30
Q

What is the appearance of normal synovial fluid?

A

Amber and transparent

31
Q

Regardless of the appearance of synovial fluid, what three tests should be ordered?

A

CBC w diff
Crystal analysis
Gram stain w culture and sensitivity

32
Q

Does a CBC w diff have any diagnostic value on its own?

A

NO

-simply tells you there is inflammatory process or not

33
Q

Should a chemical analysis of synovial fluid (glucose, LDH, protein) be routinely ordered?

A

Nope, little discriminitory value

34
Q

Does evaluation of serum uric acid level have any value for diagnosis of acute arthritis?

A

Nope

-can be normal or decreased in pt w gout

PCM IV (13 decks)

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