ortho

Question 1

which antibiotic is associated with tendon disorders

Answer 1

quinolones

Question 2

achilles tendonitis risk factors

Answer 2

quinolones
hypercholesteraemia

Question 3

achiles tendonitis mx

Answer 3

simple analgesia
calf muscle eccentric exercises

Question 4

simmonds triad

Answer 4

palpable gap
lack of plantarflexion on calf squeeze test
altered angle of declination

Question 5

AT ix

Answer 5

ultrasound

Question 6

what movement is most affected in adhesive capulitis

Answer 6

external rotation

Question 7

ottawa rule

Answer 7

xray indicated only if:

malleolar pain AND one of the following:
1. tenderness over lateral or medial malleolar zone
2. inability to nweight bear immediately after injury

Question 8

weber classification

Answer 8

type a = above syndesmosis
type b = at syndesmosis
type c = below syndesmosis

Question 9

Maisonneuve fracture

Answer 9

spiral fibular fracture that leads to disruption of the syndesmosis with widening of the ankle joint

Question 10

hopkin’s test

Answer 10

pain when the T and F are squeezed together

Question 11

avascular necrosis of the hip causes

Answer 11

steroids
chemotherapy
alcohol excess
trauma

Question 12

bicep tendons origin

Answer 12

long head - glenoid
short head - coracoid process

Question 13

bicep tendon insertion

Answer 13

radial tuberosity

Question 14

what medication weakens tendons

Answer 14

corticosteroids

Question 15

mechanism of bicep rupture:
proximal tendons
distal tendon

Answer 15

P = when biceps are lengthened and contracted and loads is applied
D = elbow flexed and quickly extends whilst bicep still contracted

Question 16

when should MRI be carried out for biceps rupture

Answer 16

distal ruptures - clinically harder to find

Question 17

buckle fracture

Answer 17

incomplete fractures along shaft of long bone that causes bulging of cortex
common in children

Question 18

carpal tunnel syndrome mx

Answer 18

mild-to-mod:
- 6 weeks of conservative mx (CS injections and wrist splint)

severe or persisting:
- flexor retinaculum division

Question 19

causes of carpal tunnel syndrome

Answer 19

idiopathic
rheumatoid
pregnancy
oedema
lunate fracture

Question 20

charcot joint

Answer 20

neuropathic joint

Question 21

colles’ fracture definition

Answer 21

distal radial fracture with dorsal displacement of fragments.
3 features
1. trransverse fracture of radius
2. 1 inch proximal to the RC joint
3. dorsal displacement

Question 22

colles’ cx

Answer 22

early:
- median nerve injury
- compartment syndrome
late:
- osteoarthritis

Question 23

finkelstein’s test

Answer 23

test for de querveins tenosynovitis:

examiner pulls thumb in ulnar deviation and longitudinal traction causing pain over radial styloid process

Question 24

de querveins tenosynovitis mx

Answer 24

analesgia
steroid injection

Question 25

discitis - most common cause?

Answer 25

staph aureus

Question 26

discitis mx

Answer 26

gold standard is 6-8 weeks of IV abx therapy

Question 27

when to consider surgery for dupuytrens contracture

Answer 27

cannot straight MCP joints so hand is flat on table

Question 28

lateral epicondylitis sx

Answer 28

pain and tenderness around region pain worse on wrist extension when elbow extended or supination of the forearm when elbow extended

Question 29

medial epicondylitis sx

Answer 29

pain worse on wrist flexion and pronation

Question 30

bennett's fracture

Answer 30

intra-articular fracture of the first CMC joint caused by impact of flexion of CMC (fist fight)

Question 31

monteggia's fracture

Answer 31

proximal radio-ulnar dislocation in association with an ulna fracture

Question 32

galeazzi fracture

Answer 32

radial shaft fracture associated with dislocation of distal radio-ulnar joint

Question 33

pott's fracture

Answer 33

bimalleolar fracture forces foot eversion

Question 34

fat embolus mx

Answer 34

prompt fixation of bone DVT prophylaxis

Question 35

hip dislocation - most common variant

Answer 35

posterior (90%) - leg shortened, adducted and internally rotated

Question 36

anterior hip dislocation features

Answer 36

leg abducted and externally rotated no leg shortening

Question 37

complications of hip dislocations

Answer 37

sciatic or remoral nerve injury avascular necrosis osteo recurrence

Question 38

intracapasular fractures

Answer 38

also known as subcapital - from edge of femoral head to insertion of capsule of the hip joint

Question 39

garden system

Answer 39

for hip fractures 1 = stable fracture with impaction in valgus 2 = complete fracture but undisplaced 3 = complete displaced fracture 4 = complete boney disruption difference between 3 and 4 is there is still boney contact in 3

Question 40

intracapsular fracture tx

Answer 40

undisplaced = INTERNAL FIXATION or hemiarthroplasty if unfit displaced = arthroplasty --> total over hemi if: 1. patient could walk independently outdoors w/out stick before injury 2. not cognitively impaired 3. are medically fit for anesthesia and procedure

Question 41

extracapsular fracture tx

Answer 41

stable intratrochanteric = DHS if reverse oblique, transverse or subtrochancteric = intramedullary device

Question 42

iliopsoas abscess: - most common cause - ix of choice - mx

Answer 42

- crohns - CT - percutaneous drainage and abx

Question 43

unhappy triad

Answer 43

damage to lateral knee causing damage to: 1. ACL 2. MCL 3. meniscus

Question 44

menisci injuries come from

Answer 44

twisting injuries locking and giving way are common sx

Question 45

MCL injuries

Answer 45

come from valgus stress

Question 46

ruptured PCL injuries

Answer 46

come from hyperextension

Question 47

tibial plateau fracture

Answer 47

typically older patients knee fractures before ligaments varus stress causes medial plateu injury

Question 48

L5 compression causes

Answer 48

sensory loss to dorsum of dfoot weakness in big toe dorsiflexion reflexes intact

Question 49

lumbar spinal stenosis cardinal sx

Answer 49

pt find it easier to walk uphill rather than downhill

Question 50

meralgia paresthetica nerve

Answer 50

lateraol femoral cutaneous nerve

Question 51

mangled extremity scoring system

Answer 51

scoring system to ascertain whether open fractures with arterial injury need amputation

Question 52

5th metatarsal fractures are associated with

Answer 52

lateral ankle sprain caused by inversion injuries

Question 53

surgery for osteoarthrtic hips

Answer 53

cemented THR

Question 54

scaphoid fractures tx

Answer 54

undsiplaced: cast for 6-8 weeks displaced: surgical fixation proximal scaphoid pole fractures: surgical fixation

Question 55

sublaxation of the raidal head: who does it affect more tx

Answer 55

1. children - weaker attachment of the annular ligament covering radial head 2. analgesia and passive supination of the elbow joint when the elbow flexed at 90 degrees

Question 56

SH type 2

Answer 56

fracture through physis and metaphysis

Question 57

SH type 3

Answer 57

fracture through physis and epiphysis to involve joint

Question 58

SH type 4

Answer 58

fracture through physis, metaphysis and epiphysis

Question 59

femoral nerve injury

Answer 59

weakness in knee extension loss of patella reflex numbness in thigh

Question 60

sciatic nerve injury

Answer 60

weakness in knee flexion weakness in foot movements

Question 61

metatarsal stress fracture commonest site

Answer 61

2nd metatarsal shaft