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Finals Revision > Ortho > Flashcards

Ortho Flashcards

1
Q

Conditions to inquire about in PMH? (AAA MR J DETHS)

A

Asthma, allergies, angina, MI, rheumatic heart disease, jaundice, diabetes, epilepsy, TB, HTN, Stroke

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2
Q

Causes of anything- TINCANBED

A

Trauma, infective, neoplastic, connective tissue, autoimmune, neurosis, blood, endo, drug/diet/deficiencies

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3
Q

Bone mets- 4 common locations

A

bronchus, breast, bowel, b-thyroid, prostate

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4
Q

What does management mean?

A

diagnosis and treatment

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5
Q

Treatment mnemonic CAGES

A

complications, age, general condition, aetiology, size/site/symptoms

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6
Q

What does the median nerve supply? LOAF

A

Lateral 2 lumbricals, Opponens pollicis, Abductor pollicis brevis, flexor pollicis brevis

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7
Q

How to categorise complications of surgery?

A

Immediate (within 24hrs), early (2 weeks), late (>2 weeks). Local vs systemic

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8
Q

Immediate local complication of surgery

A

Primary haemorrhage

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9
Q

Immediate systemic complication of surgery

A

Asphyxiation

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10
Q

Early local complication of surgery

A

Dehiscence (bursting/openign of wound), infection, secondary haemorrhage

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11
Q

Early systemic complication of surgery

A

atelectasis, LRTI, VTE, pseudomembranous colitis, constipation, acute urinary retention->UTI->sepsis

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12
Q

Late local complication of surgery

A

metal failure

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13
Q

Late systemic complication of surgery

A

CNS

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14
Q

Presenting pathology: Dressed in a surgeons gown a physician may make some progress

A

Definition, Incidence, Sex, Geography, Aetiology, pathogenesis, macroscopic pathology, microscopic pathology, symptoms, signs, prognosis

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15
Q

Presenting X-ray?

A

Name, Age, Date, What you can see (AP, lateral view of the right hip for example), most obvious abnormality

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16
Q

JOAST

A

Joint, outilne, attitude, soft tissue, texture

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17
Q

How can you tell apart bone and calcium on xrays?

A

Bone is trabeculated, calcium is homogenous- use this to tell apart avulsed piece of bone from soft tissue tendonitis

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18
Q

What is a stone of calcium in the pelvis called?

A

Phlebolith

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19
Q

Tendons of the pes anserinus? Say Grace before Tea

A

Tendons that insert on anterio-medial aspect of proximal tibia: Sartorius, gracilis, semiTendinosus

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20
Q

What is avascular necrosis of the lunate bone known as?

A

Kienbock disease

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21
Q

What kind of cartilage tops the femur and tibia?

A

hyaline

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22
Q

Where is the thickest hyaline cartilage in the body?

A

patella

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23
Q

What doe wearing down of cartilage in the knee lead to?

A

osteoarthritis

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24
Q

Which of the femur and tibia have round epicondyles?

A

Femur has rong, tibia has flat

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25
Q

What are the four heads of quadriceps?

A

rectus femoris, vastus lateralis, vastus intermedius, vastus medialis

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26
Q

What is the sesamoid bone of the knee called?

A

patella

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27
Q

What function does the patella have?

A

allows you to stand and walk

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28
Q

What structure in the knee joint helps reduce pressure travelling through the tibia?

A

menisci

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29
Q

What does removal of meniscus lead to?

A

100% get OA

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30
Q

Superficial to deep causes of knee pain?

A

Neuroma->vessels->bursae->tendonitis->patella->plical folds of capusle

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31
Q

What is Hoffa’s impingement?

A

Pinching of fat pad behind patella

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32
Q

What stops the patella dislocating?

A

vastus medialis, trochlear shorter on lateral side,

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33
Q

What is os trigonum?

A

An extra bone that develops behing the talus- can cause pain when wedge between the talus, calcaneus or tibia

34
Q

How does vitamin C treat osteoporosis?

A

increases bone density

35
Q

Symptoms of primary breast tumour?

A

lump, pain, discharge

36
Q

Signs of primary breast tumour?

A

inverted nipple, peau d’orange

37
Q

Investigations for primary breast tumour?

A

mammogram, FNA

38
Q

Symptoms of secondary breast tumour?

A

axillary lump, night bone pain, abdo pain, cough

39
Q

Signs of secondary breast tumour?

A

bony tenderness, axillary lymphadenopathy, oedema

40
Q

Investifations for secondary breast tumour?

A

CXR, FNA, biopsy, needle aspirate

41
Q

General effects of tumours- symptoms?

A

weight loss, fatigue, cachexia, night sweats

42
Q

General effects of tumours- signs?

A

weight los, anaemia

43
Q

Investigation of general effects of tumours?

A

FBC

44
Q

3 classic osteoporosis fractures?

A

NOF, Colle’s, vertebral wedge fractures

45
Q

Investigation of choice for osteoporotic fractures?

A

DEXA- x-ray only picks up if reduction in bone density is >25%

46
Q

What is a brown tumour?

A

a lytic lesion caused by increased PTH levels

47
Q

2 layers of periosteum?

A

fibrous (Very strong structural support), cambium (cellular- contains osteocytes which aid in fracture healing)

48
Q

4 stages of fracture healing?

A

haematoma->inflammatory->callus->remodelling

49
Q

Why avoid NSAIDs for fractures?

A

prevents inflammatory phase healing

50
Q

Which layer of periosteum lays down layers of callus as bone remodels?

A

cambium

51
Q

What kind of force causes a transverse fracture?

A

mid air horizontal force

52
Q

What kind of force causes an oblique fracture?

A

Force with load applied e.g. whilst standing

53
Q

What is atrophic non-union?

A

If a bone has not healed within 6 months

54
Q

What is a poor prognostic factor for fracture healing/

A

No periosteum on either side, increased age, smoking

55
Q

What can be used to determine when bone switches from callus to remodelling phase?

A

retrospective analysis- callus index= ration of bone:bone+callus

56
Q

What can the above be used for in terms of treatment?

A

Works out which treatment arms are superior to each other by working out the time to maximum callus index

57
Q

How can you classify fractures?

A

simple/comminuted, open (compound)/closed, pattern (transverse/oblique/spiral/butterfly), displaced/non-displaced, complicated/uncomplicated, Salter-Harris

58
Q

What could indicate a complicated fracture?

A

compartment syndrome, neurovascular syndrome

59
Q

Short term complication of Colles due to median nerve injury?

A

acute carpal tunnel syndrome

60
Q

Long term complication of Colles fracture?

A

rupture of extensor pollicus longus

61
Q

Who is Salter-Harris classification of fractures used for?

A

children

62
Q

Salter-Harris type 1?

A

through the physis (growth plate)

63
Q

Type 2?

A

Through the physes and metaphysis, sparing epiphysis

64
Q

Type 3?

A

Through the physis and epiphysis sparing the metaphysis

65
Q

Type 4?

A

Through the physis, metaphysis and epiphysis

66
Q

Type 5?

A

Compression fracture of the physis

67
Q

Basic treatment algorithm for fractures?

A

Complications?->type of fracture?->significant displacement->if displaced, how can it be reduced?->once reduced is it stable?->if unstable how will you immobilise->rehab

68
Q

What is displacement?

A

No longer in the plane of the closest joint- if it heals in this position it will cause significant debilitation

69
Q

4 methods od reducing fractures?

A

traction, gravity, manipulation under anaesthetic, open reduction

70
Q

Two types of traction?

A

skin or skeletal

71
Q

Example of gravity being used to heal?

A

collar and cuff

72
Q

5 methods of immoblising unstable fractures?

A

3 point moulding, splint, traction, operation (external fixation), internal fixation (nail/plate and screw)

73
Q

Rule of 2s?

A

2 views at 90 degrees, 2 dates, 2 sides, 2 joints to check above and below

74
Q

How are the 2 broad ways that antibiotics are used?

A

prophylactically or therapeutically

75
Q

What are the 2 broad ways you can categorise infections e.g. pneumonia vs empyema?

A

spreading vs localised

76
Q

How are the 2 above different categories managed?

A

excision/drainage/chest drain vs antibiotics

77
Q

Sepsis 6?

A

Oxygen, antibiotics, fluids, cultures, lactate, urine output

78
Q

3 reasons to give prophylactic antibiotics?

A

immunocompromise, high risk of infection, consequences of infection are serious

79
Q

Examples of immunocompromise?

A

old/young, diabetes, renal, immunosuppressed

80
Q

Patients with high risk of infection?

A

pre-existing infection e.g. appendix, gynae, large bowel surgery

81
Q

Situations where consequences of infection are serious?

A

joint replacement, heart valve, neurosurgery (VP shunt)

Finals Revision (9 decks)

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