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Quick Facts > Maine Question Bank > Flashcards

Maine Question Bank Flashcards

1
Q

What tumors frequently metastasize to lymph nodes?

A

“SCARE”
1. synovial sarcoma
2. clear cell sarcoma
3. angiosarcoma
4. rhabdomyosarcoma
5. epithelioid sarcoma

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2
Q

anterolateral bundle of the PCL is tight in _______

A

mid flexion

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3
Q

posteromedial bundle of the pcl is tight in _____

A

both middle and high flexion

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4
Q

what is at risk with bicortical C1 lateral mass screws?

A

ICA

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5
Q

what is at risk with C1 pars screws?

A

vertebral a

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6
Q

Anteromedial bundle of the ACL is tight in _______

A

the anteromedial bundle of the ACL is tight in both flexion AND extension

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7
Q

Posterolateral Bundle of the ACL is tight in ________

A

posterolateral bundle of the ACL is TIGHT in extension and LOOSE in flexion

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8
Q

indications for static spacer in revision tka rather than dynamic spacer

A

uncontrolled infections
ligamentous laxity
extensor mechanism compromise/disruption
poor soft-tissue coverage or severe bone loss.

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9
Q

what size particles stimulate osteolysis

A

sub-micron - that is 0.1 - 1um diameter particles

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10
Q

what factors increase a patients risk of MRSA colonization

A

male
younger age
african american > caucasian

urban environments do not influence rates of colonization

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11
Q

how does biofilm allow the bacteria to evade antibiotics?

A

protective scaffolding formation

Following initial adherence and colonization, bacteria are thought to form a complex matrix of an extracellular polymetric substance, serving as a protective scaffold in which they can survive despite the competence of the host’s immune system or the presence of antimicrobial agents

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12
Q

nutritional markers for wound healing after arthroplasty

A
  • transferrin <200
  • neutrophil count <1500
  • albumin <3.5g/ml
  • zinc <95
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13
Q

what are the most common complications of tka (in order of frequency of occurrence)?

A

periprosthetic joint infection
aseptic loosening
instability
polyethylene wear
arthrofibrosis
malalignment

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14
Q

allograft should be added to distal biceps repair if the native tendon cannot reach the tuberosity in what degree of flexion?

A

90 degrees

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15
Q

what is the primary restraint to valgus stress at the knee in full extension?

A

posteromedial corner

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16
Q

what is the primary restraint to valgus stress at the knee in 30degrees flexion

A

superficial MCL

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17
Q

most common iatrogenic nerve injury during latarjet?

A

Axillary then musculocutaneous

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18
Q

what is an absolute contraindication to lumbar disc replaccement?

A

osteoporosis - need to get a DEXA scan prior to surgery

19
Q

where is the physis affected in gymnasts wrist?

A

Zone of provisional calcification
- repeated loading decreases vascularity -> diminished calcification

*** this is different from a salter harris fracture which occurs at the zone of hypertrophy

20
Q

What proteinaceous compound binds to hyaluronic acid to function as an effective boundary molecular layer in articular cartilage?

A

Hyaluronic acid binds to LUBRICIN
lubricin acts to reduce the coefficient of friction in the joint

21
Q

what mechanism is associated with metal on metal hips in pseudotumor formation

A

edge loading and associated loss of fluid film lubrication
while it is a lymphocyte driven reaction, it is not actually lymphocytes reacting to nickel, cobalt, or chrome molecules

22
Q

what human bone disease would result from loss of OPG protein?

A

osteoporosis
- OPG INHIBITS osteoclast activation (osteoclasts resorb bone)
- no opg -> no turning off osteoclasts -> unchecked bony resorption -> osteoporosis

23
Q

what is the most common soft tissue sarcoma of the foot?

A

synovial sarcoma
young adult males 15-40yo
t(x,18) -> SYT-SSX1, or SYT-SSX2 gene

24
Q

what orthopedic tumor are ring chromosomes associated with?

A

parosteal osteosarcoma

25
Q

what tissue factor is associated with muscle fibrosis during healing?

A

TGFB1

26
Q

hemophilia A - genetics and functional defect?

A

X-linked disorder
Factor VIII deficiency
recurrent spontaneous hemarthroses

27
Q

what is the mechanism of action of calcitonin

A

reduces serum calcium concentration by directly interfering with osteoclast maturation via receptors
- inhibits phosphate reabsorption and decreses calcium reabsorption in the kidneys

28
Q

when does adhesive wear most commonly occur

A

well placed THA

29
Q

when does abrasive wear occur

A
  1. damages surface - eg a femoral head scratched on implantation
  2. third body wear - eg cement in tka
30
Q

when does delamination occur?

A

with oxidized poly (eg irradiated in air)
tkas in high contact stresses

31
Q

Characteristics of healed ligament one year later

A
  1. increase in proportion of type III colagen early (returns to normal at 1 yer)
  2. increased absolute number of collagen fibers
  3. decreased number of collagen cross links (45% of predicted values)
  4. decrease in the mass and diameter of the collagen fibers
32
Q

perichondral ring of lacroiz

A

fibrocartilaginous ring surrounding the physis that provides 50% of resistance to shear stress

33
Q

how does physeal arrest occur following physeal fracture?

A

vascular invasion across the physis

34
Q

how do thiazolidenedione antihyperglycemics increase the risk of fracture?

A

suppress osteoblastic transcription factors
they activate peroxisome proliferator activated receptor gamma (PPARy)

35
Q

extrinsic tendon healing

A

occurs in synovial shathed tendons
faster healing
increased tendon scarring

36
Q

intrinsic tendon healing

A

relies on proliferation and migration of cells within an injured tendon
slower healing
no adhesion formation

37
Q

antibiotic spacer peak drug elution occurs when? how long can concentrations remain bacteriocidal?

A

24 hours; 4 months

38
Q

when do bmp concentrations peak during masquelet technique? when do they return to baseline?

A

4 weeks - peak
6 months - return to baseline

39
Q

A lateral wall thickness less than what threshold has been associated with secondary lateral wall fracture during the treatment of intertrochanteric femur fractures using a compression hip screw?

A

20.5mm

40
Q

outcomes of surgically managed elderly distal radius fracture at 1 year

A
  • surgically treated patients have better wrist ROM at 6 months, but at one year only grip strength has been shown to be significantly better
41
Q

most important ligament in the lis franc complex?

A

oblique interosseous ligament (aka the lis franc ligament)

42
Q

what are the three ligaments of the lis franc complex and which is the most important?

A
  1. oblique interosseous ligament (most important)
  2. plantar oblique ligament
  3. dorsal oblique ligament (dorsal ligaments are the weakest)
43
Q

Charcot marie tooth genetic mutation

A

Autosomal DOminant
duplication of the peripheral myelin protein (PMP) on chromosome 17

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