IV fluconazole >> voriconazole or ampho B

OITE 2020 Flashcards by Lo Kola

Myxoid liposarc
- Met pattern
- Translocation
- Trt

Atypical met pattern: lungs, bone (spine), retroperitoneum
t(12;16)
Rad + surg

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Synovial sarcoma
- Fusion protein
- Translocation
- XR findings
- Trt

SYT/SSX fusion protein
t(X;18)
Ca deposits on imaging
Chemo!!! + rads + surg

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Pl insertion

Medial cuneiform + base 1st MT

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Anterior tarsal tunnel syndrome
- Nerve involved
- Trt

Medial or lateral br DPN (either!)
1. Remove dorsal osteophytes
2. If evidence of decreased motion/joint space, fuse TN joint

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Advantage of Lis Franc fusion > ORIF

Less reop (less prominent hardware w/ fusion)

No diff outcomes, patient satisfaction, complications

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Achilles treatment by defect size

<2cm - direct repair
2-5cm - V-Y advancement
>5cm - turndown +/- allograft recon

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Name the tumor:
+CD19/20
Small round blue cell

Lymphoma

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Name the tumor/treatment:
- Snake swallowing egg on MRI
- Antoni A/B histo

Schwannoma - benign
Marginal resection

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Osteosarcoma
- Additional imaging
- What is Enneking stage if no mets
- Treat

CT chest - mets to chest
No mets = st 2B
Trt: chemo - surg (limb salvage) - chemo
Chemo: doxorubicin, cisplatin, MTX

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Name the tumor:
- CSF1 mutation

PVNS
Only use CSF1 inhibitor therapy for recurrent or unresectable disease

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+Wartenburg sign is weakness of what muscle

3rd palmar interosseous (abductor)

Unopposed action of ext digit quinti (radial n)

Remember
Dorsal interossei are adductors (ulnar n)

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What effect does growing rods have on the pulmonary parameters of kids with early onset scoli?

Increase FVC only

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What is the posterior lever push test?

IR + post translation so you can see SS insertion during a scope

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Name structures at risk for elbow portals:
- Prox ant-med
- Ant-med
- Prox ant-lat
- Ant-lat
- Prox post-lat

Prox ant-med : MABC / median
Ant-med: MABC / median
Prox ant-lat : radial/PABC
Ant-lat : PIN / PABC
Prox post-lat : M/PABC

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What is blocking your Seymour fracture reduction?

Displaced distal phalanx physeal frx (open!!)
Nail matrix blocks you

<24h - reduce + abx
>24h - OR I&D, nailbed repair, abx

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Whats the problem:
Can hold finger in extension after passive placement
Can’t actively extend MCP joint

Sagittal band insuff
Extensor subluxates to the side of the intact band
Passive extension centralizes the tendon - can hold extension (vs tendon rupture)
Acute: relative motion splint
Delay: repair vs recon

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Describe the medium for the following:
- Mycobacterium marinum
- Mycobaterium TB
- Neisseria gonorrhoeae

MM: Lowenstein Jensen 30C

MTB: LJ 37C (core body temp)

NG: Thayer Martin (no specific temp needed)

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Treat subungual hematoma w/o frx

Trephine the nailbed to release hematoma

No need to remove nail without nailbed lac

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FAITH trial: SHS has what higher complication than screws for displaced FNF

SHS higher AVN

SHS w/ smokers or basicervical frxs have lower reop rates w/ SHS (vs screws)

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Main medial knee stabilizer in full extension

Post oblique ligament

dMCL Xs rotatory stress
sMCL Xs valgus (esp in flexion)

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Treat Candida PJI

IV fluconazole&raquo_space; voriconazole or ampho B

Most frequent complication with open pantalar dislocation

AVN without collapse

Not post traumatic arthritis or infection

Mutation, inheritance Juvenile Paget

Hereditary hyperphosphatasia
AR
OPG inactivation
OPG is a RANLK decoy
So uninhibited RANKL - more bone turnover
High alk phos
+Bisphos

Tell the difference between osteofibrous dysplasia and adamantinoma

HISTO

OFD
- Anterior cortex tibia, painful
- Rimming osteoblasts
- Observation if no sx

Adaman
- Mixed lytic and blastic
- More aggressive on imaging + histo
- Histo: epithelial glands in bone (keratin+)
- Trt: wide resection + recon (malignant)

NF1 with an evolving mass - what tumor - Tumor marker - Trt

Malignant peripheral nerve sheath tumor (from a pre-existing NF) +S100 Trt: rads, surg w/ nerve resection

What 2 tests are most predictive of PJI

Synovial alpha defensin Leukocyte esterase reagent strips

Benefit all poly tibia

Lower cost Lower osteolysis Survivorship equal to modular tibial trays

Mechanism by which Ewing sarcoma increases risk of DVT

Tumor activation factor X -> Xa

What does MDM2 gene amplification signify?

Atypical lipomatous mass, not lipoma

Interval for a sports hernia

Rectus abd Adductor longus

What determines a talar body vs neck fracture?

Relationship to lateral process Posterior to lat process - body Anterior - neck

FAITH: 4 predictors of independent and ambulatory status living 1 year after FNF fixation

50-80yo ASA 1 Prefracture indep Nonsmoker

What is return to braking time for ankle fractures?

6wks

New onset pain in rTSA Infection negative What should you think of

Acromial stress fracture - get a CT

Why do you get an MRI for spine trauma

TLICS - determine the status of the posterior ligamentous complex Intact 0 points Indeterminate 2 points Injured 3 points

Bamboo spine Bridging syndesmophytes Painful

Ank spon Inflam disease = painful No ALL ossification (DISH)

Congenital scoli - Highest progression deformity - Lowest

Highest: unilat bar, CL hemivert Low: block

What are 2 reasons to delay recon of a knee dislocation (vs acute)

Higher risk 1. Ant knee instability 2. Flexion deficits

Tendon transfer for foot drop

PTT to cuneiform (medial or lateral)

First test and confirmatory test for Lyme

1: ELISA 2: Western blot

Brow Sequard syndrome

CL pain/temp/sens loss Ipsi motor loss

What innervates the lumbar disk?

Sinu vertebral nerve

Where does the artery of Adamkiewicz arise?

Off LEFT intercostal arteries bet T9-L1 Occlusion = motor deficit only (anterior cord)

What happens to axial compression and transverse shear with half pins (vs fine wires)

Pins - Decrease compression - Increase shear Pins are better for torsion and bending loads Wires are better for compression and shear

Rate of FNF w/ shaft

0-15%

Type 2 dens displaced - RF - Trt

RF: males Trt: surg bc lowers mortality Outcomes in general: 30d mortality 15% 2.5 yr mortality 50%

What is Klippel Feil syndrome

Block vertebrae Check for C spine instability with flex ex XRs (not C spine MR)

Tab fracture with highest rate of nerve injury What nerve root / peripheral nerve

Transverse post wall L5 nerve root CPN br of sciatic

Most common part of spine for osteo

LUMBAR > T > C

What is fretting corrosion

Micromotion bet 2 metals that are not loose

What is galvanic corrosion

Dissimilar metals producing an electrochem circuit

OI has what amino acid substitution

Glycine