Hand

Question 1

What is paronychia

Answer 1

A soft tissue infection of the proximal or lateral nail fold

Question 2

Risk factors for paronychia

Answer 2

Acute: Trauma
Chronic: Job involving constant water+ irritant exposure, DM, psoriasis, steroid use, retroviral therapy

Question 3

Management of paronychia

Answer 3

Warm soaks and oral anibiotics / antifungals + Incision and drainage if fluctuance around nail is present

Question 4

AMPLE history

Answer 4

Allergies
Medications
Past history
Last Meal
Event

Question 5

Time cutoff for warm ischemia reperfusion

Answer 5

6hrs

Question 6

Reason why not all amputations are reperfused

Answer 6

Risk of reperfusion injury from muscle breakdown, releasing toxins into systemic circ.

Question 7

Tests for de quervains tenosynovitis

Answer 7

Finkelstein and Hitchhiker

Question 8

Risk Factors for trigger finger

Answer 8

Age 50-60
Female
DM
RA
Amyloidosis
Gout
CKD

Question 9

Risk Factors for trigger finger

Answer 9

Age 50-60
Female
repetitive movements
DM
RA
Amyloidosis
Gout
CKD

Question 10

Risk Factors for trigger finger

Answer 10

Age 50-60
Female
repetitive movements
DM
RA
Amyloidosis
Gout
CKD

Question 11

Pulley affected by trigger finger

Answer 11

A1

Question 12

Classification of trigger finger

Answer 12

Green’s

1) Pain and a bump
2) Catching
3a) Needs passive extension
3b) Needs passive flexion
4) Fixed Flexion Deformity

Question 13

Definitive surgical mx of trigger finger

Answer 13

Division of A1 pulley

Question 14

6 extensor compartments of hand

Answer 14

1st: APL,RPB
2nd: ECRL, ECRB
3rd: EPL
4th: EDC, EIP
5th: EDM
6th: ECU

Question 15

Pathognomonic signs for Duprytrens contracture

Answer 15

Pit and nodule

Question 16

Pathophysiology of Duprytrens contracture

Answer 16

Fibrosis of deep palmar fascia

Question 17

Risk factors for Duprytren contracture

Answer 17

Alcoholism
Smoking
DM
Endocrinopathy
Anti epileptics
HIV
FHx

Question 18

Mx of Duprytren contracture

Answer 18

Conservative:
1.Orthosis eg gloves
2. Injection of H&L /collagenase
Surgical
1. Fasciectomy(high recurrence rate)

Question 19

Main complication of H&L injection for trigger finger

Answer 19

1. Tendon rupture
2. Steroid flare
3. Infection
4. Fat atrophy
   Hypopigmentation

Question 20

Max number of H&L injections for trigger finger

Answer 20

2x , 6 months apart

Question 21

What is de quervains tenosynovitis

Answer 21

Stenosing tenosynovitis of the 1st dorsal/extensor compartment

Question 22

Signs of severe cubital tunnel syndrome

Answer 22

1. Wasting of intrinsic muscles of hand
2. weakness of?
3. Tinel’s sign
4. Froment’s sign
5. Wartenberg sign
6. Ulnar claw hand

Question 23

associations with Duprytren’s contracture

Answer 23

1. Alcoholism
2. DM
3. Use of anti epileptics
4. Hereditary
5. Plantar fibromatosis

Question 24

Surgical management of Duprytren’s contracture

Answer 24

Segmental or partial palmar fasciectomy