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finals > ortho > Flashcards

ortho Flashcards

1
Q

extracapsular hip fractures

A

trochanteric
subtrochanteric
intertrochanteric

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2
Q

intracapsular hip fractures

A

intracapsular

subcapital

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3
Q

mx of undisplaced intracapsular hip fracture

A

internal fixation

hemiarthroplasty if unfit

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4
Q

mx of displaced intracapsular hip fracture

A

arthroplasty - either THR or hemiarthroplasty (THR > hemiarthroplasty)

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5
Q

mx of extracapsular hip fractures

A

dynamic hip screw

intramedullary device if reverse, oblique, transverse or subtrochanteric

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6
Q

location of Bouchard’s and Heberden’s nodes

A

Bouchard’s - proximal IPJ

Heberden’s - distal IPJ

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7
Q

type of shoulder dislocation that results in loss of external rotation

A

posterior (nb they are much rarer than anterior)

common after seizures

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8
Q

features of adhesive capsulitis

A

active and passive movement limited

external rotation most affected

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9
Q

features of plantar fasciitis

A

heel pain that is worse around the medial calcaneal tuberosity
exacerbated by walking on tip toes

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10
Q

Salter Harris classification

A 
SALT-C
Straight across (physis)
Above (physis and metaphysis)
Lower (physis and epiphysis)
Through (physis, metaphysis and epiphysis)
Crush
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11
Q

mechanism of anterior shoulder dislocation

A

forced abduction, extension and external rotation of affected arm

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12
Q

which fractures is compartment syndrome most commonly associated with

A

supracondylar and tibial shaft fractures

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13
Q

mx for ganglion

A

reassurance and review if not setting, often disappear spontaneously

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14
Q

mx of children and young people with unexplained bone swelling or pain

A

urgent x-ray to assess for bone sarcoma

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15
Q

hand osteoarthritis x-ray changes

A

osteophytes at DIPs and base of thumb

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16
Q

hand rheumatoid arthritis x-ray changes

A

joint space narrowing at PIP with joint effusion

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17
Q

ix for osteoporotic vertebral fracture

A

whole spine x-ray

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18
Q

ix for hip fractures

A

x-ray

MRI if x-ray normal but hip fracture is suspected (e.g. patient in pain and unable to weight bear)

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19
Q

what is Colles’ fracture

A

transverse fracture of radius, 1 inch proximal to radio-carpal joint with dorsal displacement and angulation
classically follows FOOSH
‘dinner fork’ deformity

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20
Q

features of radial head fracture

A

common in young adults following FOOSH

marked local tenderness over radial head (proximal forearm) and restricted supination and pronation

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21
Q

causes of dupuytren’s contracture

A

manual labour
phenytoin treatment
alcoholic liver disease
diabetes mellitus

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22
Q

feature of epidural abscess

A

signs of systemic sepsis with neurological features, especially if changing LL neurology

23
Q

reasons for revision of THR

A

aseptic loosening - most common

pain, dislocation and infection

24
Q

features of meniscal tear

A

rotational sports injury
delayed knee swelling
joint locking

25
Q

causes of carpal tunnel syndrome

ARMPIT

A 
Acromegaly
Rheumatoid
Myxoedema (hypothyroid)
Pregnancy
Idiopathic
Trauma
26
Q

describe the ulnar nerve paradox

A

proximal ulnar nerve lesions produce a less prominent deformity (clawed hand) than distal lesions
therefore, clawing more likely with damage to ulnar nerve at elbow

27
Q

features of hand osteoarthritis

A

squaring of the thumb
episodic joint pain
stiffness

28
Q

a teenage girl with knee pain on walking downstairs or rising from prolonged sitting

A

chondromalacia patellae

29
Q

athletic teenagers with inflammation, pain and tenderness at tibial tuberosity

A

osgood-schlatter disease

30
Q

red flags suggesting an alternative dx in OA of the hip

A

rest pain
night pain
morning stiffness >2 hours

31
Q

mx of ankle fractures

A 
Weber A&B: cast/boot and weight bear as tolerated
Weber C (unstable): open reduction, internal fixation
32
Q

Weber classification

A

type A: below syndesmosis
type B: level of syndesmosis
type C: above syndesmosis, often unstable

33
Q

nerves and nerve roots tested in UL reflexes

A

biceps reflex - musculocutaneous nerve (C5-7)

triceps reflex - radial nerve (C7)

34
Q

features of Brown-Sequard syndrome

A

caused by hemisection of the spinal cord
ipsilateral paralysis and loss of proprioception and fine discrimination
contralateral loss of pain and temperature

35
Q

what does surgical decompression of carpal tunnel syndrome involve?

A

division of flexor retinaculum

36
Q

ix for achillies tendon rupture

A

USS

37
Q

features of osteochondritis dissecans

A

knee pain after exercise
locking
‘clunking’

38
Q

features of supraspinatous tendonitis

A

painful arc of abduction between 60-120 degrees

tenderness over anterior acromion

39
Q

features of complex regional pain syndrome

PORTS

A 
Pain
Oedema
Restriction of movement
Temperature/colour change
Stiffness
40
Q

what medication may precipitate Achilles’ tendon rupture

A

Ciprofloxacin

41
Q

features of ruptured ACL

A

twisting mechanism

loud crack, pain and rapid joint swelling

42
Q

mx of pain in OA

A
  1. paracetamol and/or topical NSAID
  2. oral NSAID, COX2 inhibitor or opiate
    NB if CKD avoid COX2 and NSAIDs
43
Q

mx of undisplaced scaphoid waist fracture

A

cast for 6-8 weeks

44
Q

what types of scaphoid fractures need surgical fixation

A

displaced scaphoid waist fracture

proximal scaphoid pole fractures

45
Q

medial vs lateral epicondylitis

A

medial - tenderness over medial epicondyle and medial wrist pain on resisted wrist pronation
lateral - tenderness over lateral epicondyle and lateral elbow pain on resisted wrist extension

46
Q

when to perform spinal x-ray in back pain

A

any red flag symptoms (e.g. being woken from sleep)
long duration of symptoms (i.e. months)
spinal tenderness

47
Q

most prominent sign of T1 nerve root lesions

A

intrinsic hand muscle wasting

48
Q

damage to which structures causes winged scapula

A

long thoracic nerve leading to serratus anterior being affected

49
Q

ix of tibial stress syndrome

A

radiographs of bilateral tibia and fibula to rule out stress fractures or periosteal exostoses

50
Q

crystals for pseudogout

A

weakly positively birefringement rhomboid-shaped crystals

51
Q

ABX for septic arthritis

A

flucloxacillin

clindamycin if penicillin allergic

52
Q

drug that can cause achilles tendon rupture

A

quinolone, e.g. Ciprofloxacin

53
Q

features of iliotibial band syndrome

A

common cause of lateral knee pain in runners

tenderness 2-3cm above joint line

finals (25 decks)

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