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Millers > OITE 2020 > Flashcards

OITE 2020 Flashcards

1
Q

Myxoid liposarc
- Met pattern
- Translocation
- Trt

A

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

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2
Q

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

A

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

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3
Q

Pl insertion

A

Medial cuneiform + base 1st MT

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4
Q

Anterior tarsal tunnel syndrome
- Nerve involved
- Trt

A

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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5
Q

Advantage of Lis Franc fusion > ORIF

A

Less reop (less prominent hardware w/ fusion)

No diff outcomes, patient satisfaction, complications

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6
Q

Achilles treatment by defect size

A

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

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7
Q

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

A

Lymphoma

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8
Q

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

A

Schwannoma - benign
Marginal resection

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9
Q

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

A

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

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10
Q

Name the tumor:
- CSF1 mutation

A

PVNS
Only use CSF1 inhibitor therapy for recurrent or unresectable disease

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11
Q

+Wartenburg sign is weakness of what muscle

A

3rd palmar interosseous (abductor)

Unopposed action of ext digit quinti (radial n)

Remember
Dorsal interossei are adductors (ulnar n)

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12
Q

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

A

Increase FVC only

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13
Q

What is the posterior lever push test?

A

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

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14
Q

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

A
  • 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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15
Q

What is blocking your Seymour fracture reduction?

A

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

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

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16
Q

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

A

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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17
Q

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

A

MM: Lowenstein Jensen 30C

MTB: LJ 37C (core body temp)

NG: Thayer Martin (no specific temp needed)

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18
Q

Treat subungual hematoma w/o frx

A

Trephine the nailbed to release hematoma

No need to remove nail without nailbed lac

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19
Q

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

A

SHS higher AVN

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

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20
Q

Main medial knee stabilizer in full extension

A

Post oblique ligament

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

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21
Q

Treat Candida PJI

A

IV fluconazole&raquo_space; voriconazole or ampho B

22
Q

Most frequent complication with open pantalar dislocation

A

AVN without collapse

Not post traumatic arthritis or infection

23
Q

Mutation, inheritance Juvenile Paget

A

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

24
Q

Tell the difference between osteofibrous dysplasia and adamantinoma

A

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)

25
Q

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

A

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

26
Q

What 2 tests are most predictive of PJI

A

Synovial alpha defensin
Leukocyte esterase reagent strips

27
Q

Benefit all poly tibia

A

Lower cost
Lower osteolysis
Survivorship equal to modular tibial trays

28
Q

Mechanism by which Ewing sarcoma increases risk of DVT

A

Tumor activation factor X -> Xa

29
Q

What does MDM2 gene amplification signify?

A

Atypical lipomatous mass, not lipoma

30
Q

Interval for a sports hernia

A

Rectus abd
Adductor longus

31
Q

What determines a talar body vs neck fracture?

A

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

32
Q

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

A

50-80yo
ASA 1
Prefracture indep
Nonsmoker

33
Q

What is return to braking time for ankle fractures?

A

6wks

34
Q

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

A

Acromial stress fracture - get a CT

35
Q

Why do you get an MRI for spine trauma

A

TLICS - determine the status of the posterior ligamentous complex

Intact 0 points
Indeterminate 2 points
Injured 3 points

36
Q

Bamboo spine
Bridging syndesmophytes
Painful

A

Ank spon

Inflam disease = painful
No ALL ossification (DISH)

37
Q

Congenital scoli
- Highest progression deformity
- Lowest

A

Highest: unilat bar, CL hemivert
Low: block

38
Q

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

A

Higher risk
1. Ant knee instability
2. Flexion deficits

39
Q

Tendon transfer for foot drop

A

PTT to cuneiform (medial or lateral)

40
Q

First test and confirmatory test for Lyme

A

1: ELISA
2: Western blot

41
Q

Brow Sequard syndrome

A

CL pain/temp/sens loss
Ipsi motor loss

42
Q

What innervates the lumbar disk?

A

Sinu vertebral nerve

43
Q

Where does the artery of Adamkiewicz arise?

A

Off LEFT intercostal arteries bet T9-L1

Occlusion = motor deficit only (anterior cord)

44
Q

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

A

Pins
- Decrease compression
- Increase shear

Pins are better for torsion and bending loads

Wires are better for compression and shear

45
Q

Rate of FNF w/ shaft

A

0-15%

46
Q

Type 2 dens displaced
- RF
- Trt

A

RF: males
Trt: surg bc lowers mortality

Outcomes in general:
30d mortality 15%
2.5 yr mortality 50%

47
Q

What is Klippel Feil syndrome

A

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

48
Q

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

A

Transverse post wall

L5 nerve root
CPN br of sciatic

49
Q

Most common part of spine for osteo

A

LUMBAR > T > C

50
Q

What is fretting corrosion

A

Micromotion bet 2 metals that are not loose

51
Q

What is galvanic corrosion

A

Dissimilar metals producing an electrochem circuit

52
Q

OI has what amino acid substitution

A

Glycine

Millers (29 decks)

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