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ABOS Step 1 Prep > General > Flashcards

General Flashcards

1
Q

What to avoid when treating fibrous dysplasia lesion?

A

Autograft - quickly turns into FD

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2
Q

Soft tissue sarcoma that metastasizes to the retroperitoneum?

A

Liposarcoma (order CT abd/pelvis in addition to chest)

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3
Q

MC Sarcoma of the hand/wrist?

A

Epithelioid

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4
Q

4 negative prognostic factors for soft tissue sarcoma?

A

High grade, mets, > 5 cm, deep

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5
Q

Most locally aggressive of all benign soft tissue tumors?

A

Extra-abdominal desmoid

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6
Q

Immunohistological marker for desmoid tumor?

A

Estrogen receptor beta

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7
Q

MC location of alveolar cell sarcoma?

A

Anterior thigh

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8
Q

Key difference b/t hematoma and spontaneous bleeding from sarcoma?

A

Lack of fascial plane tracking and subQ ecchymosis with sarcoma due to pseudocapsule

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9
Q

Origin of chordoma?

A

Notochord tissue

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10
Q

MC location of hemangioma involving bone?

A

Vertebral body

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11
Q

What is POEMS syndrome

A

Polyneuropathy, Organomegaly, Endocrinopathy, M-protein, and Skin changes

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12
Q

Classic triad of Hand-Schuller-Christian Disease?

A

Exophthalmos, DI, and Lytic skull lesions

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13
Q

5 MC carcinomas that metastasize to bone?

A

BLT and a Kosher Pickle (in order)

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14
Q

2 types of tissue found in periosteal osteosarcoma?

A

Cartilage and bone

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15
Q

Key features of Mafucci syndrome?

A

Soft tissue angiomas and enchondromas

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16
Q

2 benign bone tumors that metastasize to lung?

A

GCT and chondroblastoma

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17
Q

Substance produced by clear cell sarcoma cells?

A

Melanin

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18
Q

MC epiphyseal lesion in immature pt?

A

Infection (not neoplasm)

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19
Q

Immunohistochemical stain for benign and malignant vascular tumors?

A

CD34 and CD 31

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20
Q

5 parts of stance phase?

A

Initial contact, loading response, midstance, terminal stance, and preswing

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21
Q

Classic gait pattern for ACL deficient knee?

A

Quad avoidance gait

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22
Q

Gait pattern in pts with hemiplegia?

A

Prolongation of stance and double limb support

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23
Q

Problem with too soft prosthetic heel?

A

Excessive knee extension

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24
Q

Time for maximal spontaneous recovery from stroke? TBI?

A

6 mos.; 12-18 mos.

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25
Q

Amount of gait cycle spent in double stance phase?

A

12%

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26
Q

Amount of body’s center of gravity displaced during gait?

A

5 cm vertical, 6 cm lateral

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27
Q

Last functional level in which tetraplegic pts can function independently?

A

C6

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28
Q

This functional level allows community ambulation with AFO?

A

L3

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29
Q

Axes for plotting ROC curve?

A

X=1-specificity, Y=Sensitivity

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30
Q

Definition of discrete data? Categorical data?

A

Infinite # of poss. values (e.g height, time, etc.); finite # poss. values (e.g. male/female)

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31
Q

Transcription factor that directs mesenchymal cells to osteoblasts?

A

Runx2

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32
Q

Wolff’s Law?

A

Remodeling of bone occurs in response to stress (e.g. space travel)

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33
Q

Heuter-Volkman Law?

A

Remodeling occurs in small packets of cells - compression inhibits growth, tension stimulates it

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34
Q

What % of cardiac output goes to bone?

A

5-10%

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35
Q

Major source of nutrition of the growth plate?

A

Perichondral artery

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36
Q

3 types of bone formation and example of disease associated with each?

A

Enchondral - achondroplasia; Intramembranous - cleidocranial dysostosis; Appositional - Paget’s dz

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37
Q

Primary mechanism of rejection to allograft bone?

A

Cellular

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38
Q

Signal via serine-threonine kinase receptors?

A

BMP, TGF-B

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39
Q

Signal through tyrosine kinase receptors?

A

IGF-II, PDGF

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40
Q

Optimal radiation dose to prevent HO s/p THA?

A

600-700 rad/5 Gy

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41
Q

Typical radiation dose for treatment of STS?

A

60-70 Gy

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42
Q

Definition of + likelihood ratio?

A

Sensitivity/1-specificity

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43
Q

Definition of - likelihood ratio?

A

1-sensitivity/specificity

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44
Q

Study design for determining RR? OR?

A

Cohort; case-control

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45
Q

Definition of NNT?

A

1/ARR

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46
Q

What is clubbing a sign of?

A

Metastatic bone cancer

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47
Q

Size cut-off for staging STS according to AJCC? Bone tumors?

A

5 cm; 8 cm

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48
Q

3 soft tissue sarcomas that can show calcification?

A

Synovial cell, liposarcoma, and angiosarcoma

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49
Q

Causes of vertebra plana?

A

MELT: mets/myeloma, EG/Ewings, leukemia/lympohoma, trauma/TB

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50
Q

2 bone dysplasias associated with retinal detachment?

A

Kneist syndrome and SED

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51
Q

2 bone dysplasias that are AR?

A

Diastrophic dysplasia and McKusick

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52
Q

2 bone dysplasias assoc. with C1-2 instability?

A

McKusick and Morquio syndrome

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53
Q

Dysplasia assoc. with dumbbell-shaped bones and joint contractures?

A

Kneist syndrome

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54
Q

Key difference b/t Turner and Noonan syndrome?

A

Noonan - normal gonadal development, MR, and more severe scoliosis

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55
Q

2 causes of biconcave “fish” vertebrae?

A

Sickle cell anemia and OI

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56
Q

2 causes of Erlenmeyer flask deformity?

A

Gaucher’s disease and osteopetrosis

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57
Q

Poor prognostic factors for return of function after brachial plexus injury?

A

No biceps after 6 mos and horner’s syndrome

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58
Q

Highly prognostic of ability to walk in pts with cp?

A

Ability to sit independently by age 2

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59
Q

Key functional level in spina bifida that allows independent ambulation?

A

L4 (quad)

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60
Q

Has been shown to prevent scoliosis and prolong walking in pts with DMD?

A

High-dose steroids

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61
Q

Key distinguishing feature b/t limb girdle and fascioscapulohumeral muscular dystrophy?

A

Normal creatine phosphokinase in FSCH, increased in LGD

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62
Q

What must screen for in pt with hemi-hypertrophy?

A

Wilm’s tumor (up to age 5)

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63
Q

Definition of a structural curve?

A

Largest curve + additional curves that fail to bend to < 25 deg

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64
Q

Rib vertebral angle cutoff for determining progression?

A

< 20 deg = low risk, > 20 = high risk

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65
Q

Key prognostic factor for impending rapid progression of spinal deformity in pts with NF?

A

Penciling 3 or more ribs

66
Q

Where to stop fusion for Schuermann’s kyphosis (distally)?

A

1st lordotic disc/vertebra touched by sacral vertical line (vertical line extending from posterior body of S1)

67
Q

Classic triad for Klippel-feil Syndrome?

A

Low hairline, webbed neck, and dec cervical ROM

68
Q

Normal alpha angle?

A

60 deg (on coronal view), femoral head is bisected by line drawn down ilium

69
Q

What other test must be considered in pt with H. influenza septic joint?

A

Lumbar puncture due to increased risk of meningitis

70
Q

When genu varum naturally turns to genu valgum?

A

By 2.5 yrs

71
Q

MC cause of bilateral genu valgum?

A

Renal osteodystrophy

72
Q

Only inheritable long bone deficiency?

A

Tibial hemimelia (AD)

73
Q

4 conditions assoc. with ball-and-socket ankle?

A

Tarsal coalition, absence of lateral rays, fibular deficiency, and leg length discrepancy

74
Q

Most anterior structure on the anterior fibular head?

A

LCL

75
Q

LCL origin relative to the popliteus insertion?

A

Superior and posterior

76
Q

Order of insertion of structures on the proximal fibula (anterior to posterior)?

A

LCL, popliteofemoral ligament, biceps

77
Q

Contraindication for distal patellar realignment?

A

Proximal arthrosis of the medial patellar facet

78
Q

Contents of the rotator interval (4)?

A

Biceps, SGHL, caracohumeral ligament, and joint capsule

79
Q

When to fix partial cuff tears (e.g. PASTA)?

A

> 7 mm exposed bone lateral to the articular surface

80
Q

Objective test to help Dx CRPS?

A

3 phase bone scan

81
Q

Leddy classification of Jersey finger?

A

I-retraction into palm, II-retraction to PIPJ, III-large bony fragment with little retraction

82
Q

When to obtain CT scan in pt with concussion?

A

LOC > 5 min

83
Q

2 key differences b/t SED and MED?

A

No spine involvement and disproportionate dwarfism with MED

84
Q

MC cause of amenorrhea in female athletes?

A

Insufficient caloric intake

85
Q

Mediates proximal to distal growth in the limb bud?

A

AER (FGF)

86
Q

2 genetic conditions assoc. with syndactyly?

A

Poland and Apert syndromes

87
Q

2 key feature of Poland syndrome?

A

Unilateral chest wall hypoplasia and sprengel’s deformity

88
Q

MC type of thumb duplication?

A

Type IV - duplicated proximal phalanx

89
Q

Ortho condition most likely to result in malpractice claim?

A

Femur fx (esp. in kids)

90
Q

Mediates radial-ulnar growth in limb bud? Dorso-ventral axis?

A

ZPA (SHH); Wnt

91
Q

Statute of limitations for most states?

A

2 years

92
Q

Relationship of Ra (surface roughness) to fixation strength?

A

Linear

93
Q

Torsional stiffness of an IMN? Bending stiffness?

A

R4; R3 if hollow, R4 if solid

94
Q

Normal Bauman angle?

A

9-25 deg

95
Q

Last ossification center to fuse in elbow?

A

Medial epicondyle

96
Q

Tx of radial head/neck fxs?

A

60deg - ORIF

97
Q

Power’s radio?

A

BC/AD

98
Q

Primary shoulder restraint to inferior translation?

A

Coracohumeral ligament

99
Q

Optimum crystallinity of PE?

A

45-65%

100
Q

Maximal joint line elevation in TKA?

A

8 mm

101
Q

Best way to Dx hypersensitivity rxn following THA?

A

Serum lymphocyte T-cell proliferation test (LTT)

102
Q

Minimal PE thickness to prevent catastrophic wear?

A

8 mm

103
Q

How to avoid damaging the saphenous n. when dissecting on the medial side of the knee?

A

Keep dissection anterior to sartorius

104
Q

Indications for tibial tubercle transfer?

A

TT-TG > 20 mm

105
Q

Primary stabilizer of the foot longitudinal arch?

A

Interosseus ligaments (not plantar fascia)

106
Q

3 subtypes of Stage II PTTD?

A

IIA - hindfoot valgus without significant forefoot abduction; IIB - HF valgus with >40% talar uncovering; IIC - Fixed forefoot supination in addition HF valgus

107
Q

Main blood supply to the talar head?

A

Artery of the tarsal canal

108
Q

Most frequent fx in the body?

A

MC and phalanx

109
Q

Amount of lengthening achieved with 30, 45, and 60 degree Z-plasties

A

25%, 50%, and 75%

110
Q

2 key clinical signs of decreased digit perfusion after re-implantation?

A

Dec temp > 2 deg in 1 hour or temp < 30 deg

111
Q

Factor most predictive of digit survival after replant?

A

Mechanism of injury

112
Q

First sensation to be lost in compression neuropathy of UE?

A

Light touch with SW monofilament

113
Q

Most important prognostic factor for nerve recovery after injury?

A

Age

114
Q

Indicates expectant full recovery of obstetric brachial plexus plexopathy?

A

Biceps and deltoid muscle contraction by 2 mos of age

115
Q

Key difference b/t JRA and RA with respect to hand PE?

A

Radial deviation of MCPJs in JRA

116
Q

Oberlin’s transfer?

A

Transfer of ulnar n. fascicle of FCU to MC n. to help restore elbow flexion

117
Q

Smith 3-5-7 rule?

A

Estimates excursion of wrist flex/ext (3cm), MCP ext (5cm), and FDP (7cm)

118
Q

Indication for Brand tendon trx? What transferred?

A

High radial n. palsy; PT to ECRB, FCR to EDC, and PL to EPL.

119
Q

N. transfer for high radial n. lesion?

A

Median branch of FDS to radial branch of ECRB and median branch of FCR to PIN

120
Q

N. transfer for ulnar n. lesion?

A

AIN branch of PQ to deep motor branch of ulnar n.

121
Q

Ranawat classification of neurologic impairment for RA pts?

A

I-subjective paraesthesias/pain, II-subjective weakness/UMN, III-objective weakness/UMN (A=amb, B=nonamb)

122
Q

PADI that requires surgical stabilization in RA pts

A

<14 mm

123
Q

Normal soft tissue shadows on C-spine XR?

A

6 mm at C2, 20 mm at C6

124
Q

Indications for repair of pars defect?

A

Young pts with slippage < 10% and defect at L4 or above

125
Q

Adult scoliotic curves at highest risk of progression?

A

R thoracic curves > 50 degrees

126
Q

Which metatstatic tumors to the spine are radiosensitive?

A

Prostate, lymphoid, and breast (70%)

127
Q

Normal distance b/t basion and dens in adults? Kids?

A

4-5 mm; 10 mm

128
Q

Normal talocrural angle?

A

83 +/- 4 deg

129
Q

Amount of blood loss required before see a drop in blood pressure?

A

15-30%

130
Q

1st muscles to return after radial n. palsy? Last to return?

A

BR and ECRL; EPL and EIP

131
Q

MC involved condyle with Hoffa fx fragment?

A

LFC

132
Q

Which motion is not controlled by a Halo vest?

A

Axial distraction

133
Q

3 structures that insert distal to the coranoid tip?

A

Capsule (5 mm), brachialis (11 mm), anterior band MCL (18 mm)

134
Q

Last muscle to return after alleviation of PIN n. palsy?

A

EIP

135
Q

Order of ossification of carpal bones?

A

Capitate (at 1 y/o) then progress clockwise on PA view of right hand (hamate, triquetrum, lunate, scaphoid, trapezium, trapezoid, and pisiform)

136
Q

2 structures that attach to the scaphoid tubercle?

A

TCL and APB

137
Q

2 nn. that leave the greater sciatic foramen and re-enter the pelvis through the lesser sciatic foramen?

A

Pudendal and n. to obturator internus

138
Q

Mneumonic for nn. that leave the greater sciatic notch inferior to the piriformis (lateral to medial)?

A

POP’S IQ (Pudendal, Obturator internus, Posterior femoral cutaneous, Sciatic, Inferior gluteal, Quadratus femoris

139
Q

Origin of the a. to the ligamentum teres?

A

Obturator a.

140
Q

What makes up the floor of the popliteal fossa?

A

Plantaris

141
Q

Relationship of lumbricals and IO to transverse MT ligament in the foot?

A

Lumbricals plantar, IO dorsal

142
Q

What 2 aa. form the plantar arch in the foot?

A

Deep plantar a. (branch of DP) and lateral plantar a. (branch of PT)

143
Q

Artery MC embolized for pelvic fx with hemodynamic instability?

A

Superior gluteal a. (branch of internal iliac)

144
Q

Innervation of the SemiT?

A

L5 (tibial branch of the sciatic)

145
Q

Immunostain for Langerhans Cell histiocytosis?

A

S100, CD1A

146
Q

Immunostain for lymphoma?

A

CD20

147
Q

Immunostain for chordoma?

A

Keratin, S100

148
Q

Immunostain for myeloma?

A

CD138

149
Q

Immunostain for adamantinoma?

A

Keratin

150
Q

DDx for posterior spine lesions?

A

ABC, osteoid osteoma, and osteoblastoma

151
Q

4 negative prognostic factors for osteosarcoma s/p treatment with chemo?

A

Expression of P-glycoprotein, high serum alk phos, high LDH, and absence of anti-shock protein 90 Abs

152
Q

Innervation of the plantaris?

A

Tibial branch of sciatic

153
Q

Key lab test for hypophosphatemic rickets?

A

Increased urinary phosphoethanolamine

154
Q

% elongation of a nerve that leads to decreased microcirculation? Disruption of axons?

A

8%; 15%

155
Q

2 x-linked dominant disorders?

A

X-linked hypophosphatemic (vitamin-D resistant) rickets and Leri-Weill dyschondrosteosis

156
Q

Key difference b/t acute and subacute osteo?

A

Subacute osteo can cross the physis

157
Q

3 EKG changes that can be seen with PE?

A

RBBB, right axis deviation, and T-wave inversion

158
Q

Best physical measure of nutritional status?

A

Arm circumference

159
Q

Definition of visco-elastic behavior?

A

Stress-strain behavior is time- and rate-dependent (modulus increases as strain rate increases)

160
Q

Believed to be the glue that hold the collagen network together?

A

Type IX collagen

ABOS Step 1 Prep (1 decks)

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