Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Mahoney EBM > Mahoney case III > Flashcards

Mahoney case III Flashcards

1
Q

2 X-ray stress tests to specifically test Lisfranc’s

A
  • abduction stress test: step off of the 2nd met intermediate cuneiform joint
  • adduction stress test: 1st met-cuneiform and 2nd met cuneiform widen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is found with the adduction and abduction stress tests?

A
  • abduction stress test: step off of the 2nd met intermediate cuneiform joint
  • adduction stress test: 1st met-cuneiform and 2nd met cuneiform widen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Osteoporosis: imaging exams for diagnosis (4)

A
  • DXA
  • VFA
  • IFA
  • Quantitative Ultrasound scanner
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q 
Explain:
DXA-
VFA-
IFA
-Quantitative ultrasound scanner
A

DXA: dual photon X-ray absoptiometry. Gold standard to assess bone mineral density and detect early osteo.
—-2 energy X-rays shot at the bone and subtract the soft tissue component

VFA: x-ray taken of the spine, looking for an old fracture of the vertebra. Patient with the correct demographic features and positive VFA or IFA means positive for osteoporosis.

IFA: same as VFA

Quantitative Ultrasound scanner: popular prescreening tool to rule out osteoporosis. Need a DXA evaluation in order to rule in

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Definition of T-scores

A

Standard deviation that shows how much a patient’s bone density is higher or lower than the bone density of a healthy 30 year old adult

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Definition of Z- score

A

Standard deviation that compares patient bone density to what is normal in someone in their own age and body size.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

T-score: use in what patient population

A

T-score used in older adults such as postmenopausal women and men over 50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Z-score: use in what patient population

A

useful in children, teens, younger men and women still having periods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Normal T-score and Z-score

A

T-score: above -1 is normal

Z-score above -2 is normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

T-scores:

–normal value

– Low bone density (osteopenia)

–Osteoporosis

A
  • Normal bone density: -1 and above
  • Low bone density (osteopenia): between -1 and -2.5
  • Osteoporosis: below -2.5
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Non-pharmacological treatment options for osteoporosis (3)

A
  • behavioral modifications: stop tobacco, alcohol, and caffeine consumption
  • Balanced diet: adequate calcium and Vitamin D intake
  • Regulatory exercise program
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

MOA for estrogen

A

control activity of osteoblasts and osteoclasts. Will keep osteoclast numbers low and low activity as well

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

MOA calcium

A

increased bone mineralization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

MOA vitamin D

A

increases calcium absorption in the GI tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

MOA Calcitonin

A

hormone directly inhibits osteoclastic bone resorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

MOA bisphosphonates

A

bind permanently to mineralized bone surfaces and inhibit osteoclastic activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

MOA raloxifene

A

will inhibit trabecular and vertebral bone loss by blocking the activity of cytokines which stimulate bone resorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Definition of FRAX

A

can be used as an assessment modality for the prediction of fractures on the basis of clinical risk factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Wilson Katz: stress fracture Type I

-what will be seen on X-ray

A

fracture line with no evidence of endosteal callus or periosteal reaction

-will see a radiolucent line through bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Wilson Katz: stress fracture Type II

-what will be seen on X-ray

A

focal sclerosis and endosteal callus (occurs in cancellous bone)

-Will see a radiosclerotic at the metaphysis (in the metaphysis of the heads and bases)

21
Q

Wilson Katz: stress fracture type III

-What will be seen on X-ray

A

Periosteal reaction and external reaction. Will see this mainly on the shaft

-Will see a callus lump.

22
Q

Wilson Katz: stress fracture type IV

A

mixed combo of type 1,2,3

23
Q

Fundamentals of MRI physics.

TR and TE values for T1 and T2

A

T1: Short TR and short TE

T2:long TR and long TE

24
Q

What are the fat image and water image in MRI

A

Fat image is T1

Water image is T2

25
Q

Gadolinium and its use in MRI

A

it will identify acute inflammation and infection.

-Will improve visibility of inflammation, tumours, blood vessels and blood supply

26
Q

What disease will Gadolinium cause (2)

A
  • Nephrogenic systemic fibrosis

- Gadolinium retention (in the brain)

27
Q

What is the “magic angle effect”

A
  • An MRI artifact which occurs on sequences with a short TE.
  • It is confined to regions of tightly bound collagen at 54.74 degrees from the main magnetic field and appears hyperintense, thus potentially being mistaken for tendinopathy
28
Q

What are the 5 stages for hemorrhage

A
  • hyperacute
  • Acute(1-2days)
  • Early subacute (2-7days)
  • Late subacute (7-14days)
  • Chronic (14-28 days)
29
Q

What are the imaging characteristics of hyperacute stage

A
  • isointense on T1 and isointense to hyperintense on T2.

- Due to intracellular oxyhaemoglobin

30
Q

What are the imaging characteristics of acute stage

A
  • T2 signal intensity drops. T1 remains intermediate to low.
  • Due to intracellular deoxyhaemoglobin
31
Q

What are the imaging characteristics of early subacute stage

A
  • T1 signal gradually increases to become hyperintense.

- Due to intracellular methaemoglobin

32
Q

What are the imaging characteristics of late subacute stage

A

-extracellular methaemoglobin leads to increase in T2 signal

33
Q

What are the imaging characteristics of chronic stage

A
  • periphery is low on T1 + T2.

- Center is isointense on T1 and hyperintense on T2.

34
Q

Stages of bone healing and time line (5)

A

1) Inflammation (1-4days): hematoma formation
2) Induction(day 1-?)
3) Soft callus (4-4weeks)
4) Hard callus (4 weeks- 4months)
5) Remodeling(4 months-2 years)

35
Q

What effect does pH and O2 have on bone healing

A
  • pH: better when alkyline
  • High O2 better early on in bone healing
  • Low O2 better later on in bone healing
36
Q

Hardcastle classification for Lisfranc’s injuries

A

Type A: Total displacement

A1: Lateral displacement

A2: Dorsoplantar displacement

Type B: Partial displacement

B1: Medial dislocation 1st met

B2: Lateral dislocation lesser mets

Type C: Divergent (1st met medially while lesser mets go laterally)

C1: 1st met displaced medially with some lesser mets laterally displaced

C2: 1st met displaced medially with all lesser mets laterally displaced

37
Q

Myerson classification of Lisfranc’s injuries

A

Type A: Total displacement in any plane or direction

Type B1: Medial displacement of 1st met

Type B2: Lateral displacement of 1 or more lesser mets

Type C1: Partial displacement of 1st met medially and lesser mets laterally

Type C2: Total displacement with a divergent pattern with total incongruity

38
Q

AP X-ray findings for Lisfranc’s ligaments

A

flex sign: avulsion at base of 2nd met cuneiform

step off: widening of the 1st interweb space

39
Q

Oblique X-ray findings for Lisfranc’s ligaments

A

lateral margins of 2nd met-cuneiform and 3rd met-cuneiform should align

40
Q

Lateral X-ray findings for Lisfranc’s ligaments

A

will look for dorsoplantar subluxation or angulation and loss of medial plantar arch

  • medial plantar archis determined by medial cuneiform and 5th met
41
Q

Nunley Classification of Lisfranc’s injuries (3stages)

A

Stage I: pain at the Lisfranc complex and were nondisplaced radiographically, but demonstrates increased uptake on bone scan.
TX-nonoperative

Stage II: M1-M2 diastasis 1-5mm greater than the uninjured foot but no loss to arch height
TX- operative

Stage III: More than 5mm M1-M2 diastasis and arch height loss
TX- operative

42
Q

External bone growth stimulators (the two types)

A

Electrical stimulator and ultrasound stimulator

43
Q

Electrical bone stimulator details

A

to stimulate need to use negative electric current.

-to resorb need to use positive electric current.

44
Q

Ultrasonic osteogenesis stimulator detail

A

stimulates receptor of osteoblasts to start producing osteoprogenitor material

-not through the previously believed mechanism of mechanical stimulation

45
Q

Sudeck atrophy

A

metabolic bone changes that occur with CRPS

46
Q

Causes of Normocytic anemia (4)

A

Acute blood loss
Bone marrow failure
Chronic disease
Destruction (hemolysis)

47
Q

Causes of Macrocytic anemia (8)

A
  • Alcohol (liver disease)
  • B12 deficiency
  • Compensatory reticulocytosis
  • Drug/Dysplasia
  • Endocrine (hypothyroid)
  • Folate deficiency/Fetus
48
Q

Causes of Microcytic anemia (4)

A

Thalassemia
Iron deficiency
Chronic disease
Sideroblastic anemia

Mahoney EBM (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions