OITE 2020 Flashcards
Myxoid liposarc
- Met pattern
- Translocation
- Trt
Atypical met pattern: lungs, bone (spine), retroperitoneum
t(12;16)
Rad + surg
Synovial sarcoma
- Fusion protein
- Translocation
- XR findings
- Trt
SYT/SSX fusion protein
t(X;18)
Ca deposits on imaging
Chemo!!! + rads + surg
Pl insertion
Medial cuneiform + base 1st MT
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
Advantage of Lis Franc fusion > ORIF
Less reop (less prominent hardware w/ fusion)
No diff outcomes, patient satisfaction, complications
Achilles treatment by defect size
<2cm - direct repair
2-5cm - V-Y advancement
>5cm - turndown +/- allograft recon
Name the tumor:
+CD19/20
Small round blue cell
Lymphoma
Name the tumor/treatment:
- Snake swallowing egg on MRI
- Antoni A/B histo
Schwannoma - benign
Marginal resection
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
Name the tumor:
- CSF1 mutation
PVNS
Only use CSF1 inhibitor therapy for recurrent or unresectable disease
+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)
What effect does growing rods have on the pulmonary parameters of kids with early onset scoli?
Increase FVC only
What is the posterior lever push test?
IR + post translation so you can see SS insertion during a scope
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
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
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
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)
Treat subungual hematoma w/o frx
Trephine the nailbed to release hematoma
No need to remove nail without nailbed lac
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)
Main medial knee stabilizer in full extension
Post oblique ligament
dMCL Xs rotatory stress
sMCL Xs valgus (esp in flexion)
Treat Candida PJI
IV fluconazole»_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
