Ortho

Question 1

What nerve is at risk during a hip replacement and what would this result in?

Answer 1

Sciatic nerve

Foot drop

Question 2

Causes of venous ulcers

Answer 2

Venous HTN secondary to chronic venous insufficiency
Calf muscle pump dysfunction
Neurological disorders

Question 3

Features of venous insufficiency

Answer 3

Oedema
Brown pigmentation
Lipadermatosclerosis
Eczema

Question 4

Where do you get venous ulcers?

Answer 4

Above the ankle

Question 5

Do you get pain in venous ulcers?

Answer 5

Painless

Question 6

What is deep venous insufficiency related to?

Answer 6

Previous DVT

Question 7

What is superficial venous insufficiency related to?

Answer 7

Varicose veins

Question 8

What does doppler USS look at?

Answer 8

Presence of reflux

Question 9

What does duplex USS look at?

Answer 9

Anatomy / flow of the vein

Question 10

Management of venous ulcer

Answer 10

4 layer compression banding after exclusion of arterial disease
Surgery

Question 11

When may skin grafting be needed for a venous ulcer?

Answer 11

Fail to heal after 12 weeks

> 10cm2

Question 12

What is a majolins ulcer?

Answer 12

SCC

Question 13

Where does majolins ulcer occur?

Answer 13

At sites of chronic inflammation e.g. burns, osteomyelitis after 10 - 20 years

Question 14

Where do majolins ulcers mainly occur?

Answer 14

Lower limb

Question 15

Where do arterial ulcers occur?

Answer 15

Toe

Heel

Question 16

Are arterial ulcers painful?

Answer 16

Yes

Question 17

What may there be areas of in arterial ulcers?

Answer 17

Gangrene

Question 18

Features of arterial ulcers

Answer 18

Painful
Cold with no palpable pulses
Low ABPI measurements

Question 19

Where do you commonly get neuropathic ulcers?

Answer 19

Plantar surface of metatarsal head

Plantar surface of hallux

Question 20

What are neuropathic ulcers due to?

Answer 20

Pressure

Question 21

What is pyoderma gangrenosum related to?

Answer 21

IBD / RA

Question 22

Where can pyoderma gangrenosum occur at?

Answer 22

Stoma sites

Question 23

Presentation of pyoderma gangrenosum

Answer 23

Erythematous nodules or pustules which can ulcerate

Question 24

For total replacement of hip, what do NICE recommend in respect to LWMH?

Answer 24

Should be initiated 6 - 12 hours after surgery

Question 25

What drugs will slow bone healing?

Answer 25

NSAIDs
Steriods
Immunosuppressants
Anti-neoplastic drugs

Question 26

Where is intraosseous most commonly obtained?

Answer 26

Proximal tibia

Question 27

When can intraosseous access be used in a paediatric case?

Answer 27

After 2 failed attempts of peripheral intravenous line

Question 28

Where can be used for intraosseous access?

Answer 28

Proximal tibia
Distal femur
Humeral head