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Millers > OITE 2021 > Flashcards

OITE 2021 Flashcards

1
Q

Age + location chondroblastoma

A

KIDS
Epiphysis (and pelvis, talus, calc)
Lytic
Curretage + bone graft bc can erode articular cartilage untreated

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2
Q

The majority of enchondromas are what Enneking stage?

A

Enchondroma is a benign lesion = E st 1

Enneking of benign tumors
St 1 = indolent
St 2 = active
St 3 = aggressive

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3
Q

Treat enchondroma

A

If symptomatic: curettage

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4
Q

Sarcoma screening vs myxoid liposarcoma screening tests

A

Sarcoma: MRI field, CT chest
- Met to lungs

Myxoid liposarc: “ “ + CT abd/pel
- Mets to abd and retroperitoneum

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5
Q

The dorsomedial cutaneous nerve is the terminal branch of what nerve? (inner big toe)

A

SPN (cross from P to A 5cm above the ankle joint)
Commonly cut during hallux valgus

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6
Q

What is the common deformity when nailing prox 1/3 tibia?
Where do you place the blocking screw to prevent this?

A

Valgus + apex anterior
Screw in lateral + posterior proximal segment

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7
Q

What are the resus parameters for early total care?

A

One of the following:
Lactate <4
pH > 7.25
Base excess > -5.5

WBC not included

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8
Q

3 soft CI for hip scope

A

Cystic bone changes on MRI
>45yo
BMI >24

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9
Q

Which position of tab retractor placement is most likely to increase risk of femoral nerve injury?

A

Generally thinking direct anterior approach for THA - fem n + ext iliac art
Inf-med retractors
And penetrating IP muscle

Safest = 12 o’clock

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10
Q

Which structure provides the most valgus stability in extension: dMCL, sMCL or POL?

A

POL - most valgus stability in ext and IR

dMCL - stab ant translation, min valgus restraint at 60deg flex (2ary valgus stabilizer, does its most in extension)
sMCL - 1ary valgus restraint in flexion and IR

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11
Q

What is Grisel syndrome?
- Ddx
- Best diagnostic tests

A

Kid
Recent URI/head neck surg
SCM spasm -> acute head tilt/rotation bc general lig laxity in kids (AA rotatory subluxation)
Painful!

Ddx: congenital muscular torticollis (not painful)

Get XR: open mouth odontoid - see asymmetric C1 lateral masses
CT = gold standard

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12
Q

Treat Sever disease

A

Calc apophysitis

  1. Stretching
  2. SLC

Orthotics no benefit

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13
Q

Treat Lyme in kids

A

<8 = amoxicillin
>8 = doxy

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14
Q

Compare ORIF vs TEA for distal humerus frx in elderly patients

A

TEA
- Faster in OR
- Better Mayo elbow scores

ORIF
- Higher reop

Same post op ROM

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15
Q

SNAC wrist treatment tree (4 procedures)

A
  1. Distal pole excision (take out part thats causing arthritis w/ radial styloid)
    CI: arthritis, SL instability, midcarpal instability, midcarpal arthritis
    2/3. (retain wrist motion)
    Scaphoidectomy w/ 4 corner fusion (capitate, lunate, triquetrum, hamate aka ULNAR)
    Soft CI: smoker
    PRC
    CI: arthritis @ capitate head
  2. Wrist fusion
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16
Q

Gout
- RF
- Crystals

A

RF
- Purine rich diet
- Diuretics
- EtOH
- Obesity

Monosodium urate

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17
Q

Complication of P1 fractures

A

PIP flexion contracture

Bc apex volar deformity
- Prox frag flexes 2/2 lumbrical
- Distal frag extends 2/2 central slip
The bone becomes too short for the long extensor mechanism

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18
Q

RCL injury thumb
- Where does the lig tear
- Treat

A

Evenly distributed between prox/mid/distal ligament (vs UCL = distal)
Amenable to 1ary repair even when delayed

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19
Q

What is the intrinsic tightness test

A

MCP extended, see PIP flexion
If PIP flexion improves w/ MCP flexion, then you have intrinsic tightness

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20
Q

What is the treatment for intercarpal coalitions

A

Non-op 1st since generally incidental finding
Then fusion (not resection of coalition)

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21
Q

Mechanism TXA

A

Lysine analog
Binds lysine receptors on plasminogen
Blocks plasminogen -> plasmin (cannot breakdown clots)

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22
Q

What artery lives in the biciptial groove?

A

Ax art -> ant hum circhumflex -> arcuate
Arcuate = branch that runs up medial biceps groove

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23
Q

What is the innervation of the long vs short head biceps femoris

A

Short: CPN
Long: tibial n

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24
Q

What is the most common fracture for intimate partner violence

A

Nasal

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25
What foot injury has high correlation with amputation?
Frx all 5 MT
26
Do OATs procedures in the patellofem and tibfem joints do the same?
NO - patellofem 2x failure rate
27
What is the structure involved in the avulsion fracture of a "wrist sprain"?
Dorsal triquetral avulsion fracture - DRC - Dorsal intercarpal ligament
28
RF for DRUJ instab w/ DR frx
Ulnar styloid *base* frx (not tip) Open
29
Treat Kienbock disease
= AVN lunate Early = radial shortening osteotomy, core decompression distal radius Late + active = PRC Late + inactive = capitate resurfacing implant arthroplasty
30
What is likely happening if you have a irreducible volar PIP dislocation?
P1 head through lateral band + central slip (can get caught too) Closed reduction tightens these Dorsal - volar plate or flexor tendons
31
Thumb tip flap coverage
<2cm volar advancement flap >2cm FDMA Can do a NV island flap up to 4cm Dorsal thumb is FDMA all the way
32
What is happening with RA patients slowly lose the ability to extend their fingers
Progressive attritional rupture of extensor tendons Starts ulnar (small finger) As the wrist degenerates and falls into ulnar deviation, the subsequent tendons sublux ulnar and rupture over the ulnar head Painless Must resect ulnar head to treat + tendon transfers
33
How splint snapping ECU
Pronation + wrist ext + rad dev For acute ECU subsheath rupture If refractory to non-op, can do subsheath recon
34
Structure at risk with C1 lateral mass screws
Internal carotid art Why place screws 10deg med trajectory
35
SPORT outcomes
Spinal stenosis - surg > nonop
36
What are the 3 parameters for corrective surgery in adult spinal deformity What is the most common complication for adult spinal deformity surgery
1. TK + LL + PI <45deg 2. LL = PI (if mismatch, construct breaks) PT<25deg SVA<5cm 3. T1 pelvic angle <14deg Pseudarthrosis >> PJK
37
What are risk factors for progression of infantile scoliosis? Treat
Progression: - Cobb >25deg - RVAD 40deg - Worsening curve Trt: elongation derotation flexion cast
38
Genetics for tibial pseudarthrosis
NF1 chr 17 - spont mutation
39
What are the pulleys in the thumb Trt congenital trigger thumb
A1 oblique A2 (no cruciates in thumb) Stretching + obs NO role CSI Op release
40
What are the 3 diseases with radius deficiencies and how do you tell them apart
TAR - AR - Thumb *present* - Bilateral absent radii Holt Oram - AD - Cardiac defects Fanconi anemia - AR - Do chromosomal breakage test -> bone marrow transplant
41
What nerve can be injured during an inversion ankle sprain
SPN
42
What is the most reliable XR landmark for accurate reduction of the syndesmosis
Posterior overlap fib/tib on lateral XR
43
What is Freiberg's disease / 2 risk factors
2nd MT head AVN - looks like flattening on XRs RF - Long 2nd MT head (transfer loading) - GR contracture
44
What cytokines are elevated in pro-inflam conditions?
TNFa IL 1B NF kappa B
45
Atypical lipomatous tumor - 2 tumor markers - Problematic areas - Treat
MDM2, CDK4 Problematic in the retroperitoneum Trt: marginal resection (not wide excision since benign)
46
Treat sarcoma
Wide excision - need clear margins Pre vs post op rads (just different complications) EXCEPT rhabdomyosarcoma (chemo sensitive, no rads!, +/- surg)
47
For MTP fusion (hallux rigidus), where can you malposition the plate causing too much MTP dorsiflexion?
Too proximal!! 6mm proximal to ideal position = 8deg increased DF
48
Spring lig - What is the main lig + origin/insertion
#1 = supmed calc-navic lig = larger/more important arch stabilizer O: sustentaculum I: navicular Inf cal-navic lig O: between ant/mid calc facets
49
Treat interdigital neuroma
Resection is the only way!!!
50
CSI 2mo prior to RCR have been associated with:
High REVISION rate Tendon doesn't heal! NOT infection Avoid 6mo before RCR
51
What skin suture pattern has best mean incision perfusion?
Running subcuticular
52
A p value cutoff of 0.05, this indicates that there is a 5% chance that....
A positive result is not valid
53
If power is 0.9 rather than 0.8, the change in the interpretation is....
Increased confidence if a negative value is found Power = 1- type 2 error T2 error = negative result when a true difference exists 0.9 power = 10% probability of T2 error 0.8 power = 20% probability of T2 error Increase sample size to increase power
54
What is a significant change for the following during spine surgery: - Sensory change
Sensory change 50%+
55
What is Parsonage Tuner syndrome
Acute brachial neuritis Ex: acute onset shoulder pain, subsequent weakness MRI: diffuse T2 signal change Trt: obs only
56
Rate of NV injury w/ knee dislocation
Pop art 16% Pern nerve 25%
57
Insall Salvati index vs Caton Deschamps
IS = Patellar tendon length : patellar length Normal <1.2 CD = inf pat articular surface distance from plateau : pat articular surface length Normal <1.3
58
Describe the 3 MCL bundles elbow
Ant = tight ext, 1ary valgus restraint Post = tight flex, 2ary valgus restraint Transverse doesn't cross elbow joint so no stability
59
Test for non-continuous data (ordinal) between 2 groups
Mann Whitney
60
What is a Brodie abscess
Intraosseous abscess 2/2 chronic osteo Usually tibia in kids No fever Trt: OR + abx - leave the defect, will fill in with bone over time
61
Inheritance of post axial polydactyly of foot (aka extra pinky toe)
AD If well formed (with nail) - high penetrance If small or tag like - reduced penetrance
62
What does a 2:1 ratio of Co:Cr mean in a THA setting
Indicates trunnion as ion source Not modular neck-stem interface or bearing surface
63
What is the interval for direct anterior hip approach
2cm dis/lat to ASIS, over TFL muscle (lateral to sartorius) LCFN at risk (L2/3 roots)
64
Which meniscus is: More important to stability More mobile
Med more impt to stability - more attached to capsule / MCL Lat more more mobile
65
ALL insertion
Between Gerdy + fib head (Segond frx here) Xs tibial IR
66
Anatomic landmark for radial n
4cm prox to triceps aponeurosis (more helpful in trauma perhaps) Crosses posterior humerus 20cm prox med epicondyle / 14cm prox to lat epicondyle
67
Goal serum 25 vit D
32-250 ng/mL
68
RF that say you should treat FNF with SHS > cancellous screws
Females High BMI Displaced frx Smokers Have high rates revision surgery with screws - why do SHS
69
Trt osteosarc
Chemo + wide resection Chemo: MTX, adriamycin, cisplatin (MAP)
70
Blocking screws for distal femur frx
Lateral + anterior in distal segment
71
What are the osteotomies of a PAO
Sup pub rami Ilium Post col Ischium
72
Mayfield classification perilunate
1: SL lig disruption 2: lunocapitate disruption 3: LT lig disruption - carpus dislocates, lunate stays 4: lunate dislocates into carpal tunnel
73
Nerve roots for Erbs
C5-6 Watch for biceps function 6mo
74
SCFE blood vessel causing AVN
MFCa From postmed of deep fem art
75
DMD inheritance
X recessive
76
What factor determines if a selective thoracic fusion will be successful for AIS
Apical vertebral translation ratio > 1.2 Ratio = distance between C7 plumb line to apex of thoracic curve / distance bet center sacral vertical line + apex lumbar curve

Millers (29 decks)

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