Ortho

Question 1

Describe the Salter-Harris Pediatric Fxs.
Note: physis = growth plate
Epiphysis = end of the long bone: articulation with the joint
Metaphysis = spongy bone region

Answer 1

S(I): Slipped
A(II): Through the physis and above (metaphysis)
L(III): through physis and lower (epiphysis)
T(IV): through all–physis, metaphysis, epiphysis
R(V): rammed (crushed) physis

Question 2

What are the special tests for Rotator Cuff Impingement?

Answer 2

Hawkins Kennedy, Neer Test, Empty can

Question 3

What are the Ottawa Ankle Rules to determine if imaging is needed?

Answer 3

Bony tenderness at lateral malleolus or medial malleolus.
Inability to bear weight both immediately and in the ED.
Bony tenderness at base of 5th metatarsal or navicular mid foot zone.

Question 4

Neuro exam of Hand:
Where to check for the radial nerve?
Ulner nerve?
Median nerve?

Answer 4

1st dorsal web space (snuff box).
Volar pad pinky.
Volar pad index finger.

Question 5

Motor exam of hand:
Radial?
Ulnar?
Median?

Answer 5

Thumb up.
Hand intrinsics.
Thumb opposition: touching thumb to pinky.

Question 6

What are the findings of the synovial fluid analysis for gout?

Answer 6

Negative birefrigent urate crystals.

Question 7

When a knee is dislocated it is important to check what artery and nerve?

Answer 7

Popliteal artery and peroneal nerve

Question 8

What is the stiffness scenario for RA?

Answer 8

Morning stiffness >1 hr.

Question 9

Scleroderma- CREST syndrome is the 5 main features, what are they?

Answer 9

Calcinosis deposits
Raynauds
Esophageal dysmotility
Sclerodactyly
Telangiecatasias

Question 10

What is a late finding for Carpal Tunnel Syndrome?

Answer 10

Thenar atrophy: median nerve supplies innervation to the thenar compartment of the hand.

Question 11

What is the Jefferson’s Fx?

Answer 11

Fx of the C1 vertebrae

Question 12

What is the typical presentation of a hip fracture?

Answer 12

Groin pain and leg externally rotated.

Question 13

What bone condition does this describe: inadequate calcium or phosphate mineralization of the bone.

Answer 13

Osteomalacia

Question 14

What is the pathophysiology of osteoporosis when it comes to bone generation.

Answer 14

Bone formation is normal, but bone resorption is increased. (Usually normal calcium, phosphate, PTH levels)

Question 15

What does a wrist drop indicate with a humeral shaft fracture?

Answer 15

Radial nerve injury

Question 16

Appearance of a posterior fat pad sign on lateral view of elbow indicates what Fx in adults and what Fx in children?

Answer 16

Adults: occult Fx of radial head
Children: supracondylar humerus Fx; also can see this with anterior fat pad or both

Question 17

What is the special test called, “Thompson Test” used to diagnose?

Answer 17

Achilles Tendon Rupture.

Question 18

Falling on an outstretched hand–Name these fractures:

1. MC distal radius fx without dislocation
2. Fx of distal radius with dislocation of distal radioulnar joint
3. Fx of ulna shaft and dislocation or radial head

Answer 18

1. Colles Fx
2. Galeazzi Fx
3. Monteggia Fx

Question 19

What does this describe: fever, joint pain with decreased motion or limp and US showing joint effusion

Answer 19

Septic Arthritis, treat aggressively with abxs

Question 20

What are these deformities associated with?

Swan neck and Boutonnière

Answer 20

RA.