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My notes - med > Ortho > Flashcards

Ortho Flashcards

1
Q

Discitis ft

A 
back pain
pyrexia
rigors
sepsis
changing lower limb neuro if epidural abscess
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2
Q

Fat embolism triad

A

respiratory (tachycardia, tachypnea, dyspnea, hypoxia, pyrexia)
neuro (confusion. retinal hemorrhages)
petechial rash

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3
Q

C8 radiculopathy

A

tingling on ulnar border hand+forearm, weak flexion of all digits

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4
Q

Salter harris 1

A

through physis only (across the base) - growth plate

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5
Q

Salter harris 2

A

physis and metaphysis (across base and up into bone)

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6
Q

Salter harris 3

A

physis and epiphysis to include joint (across base and down to bottom)

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7
Q

salter harris 4

A

physis, metaphysis, epiphysis (bottom up into bone)

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8
Q

salter harris 5

A

crush (across base and smooshed together)

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9
Q

Cauda Equina Sx

A 
low back pain
bilateral sciatica (50%)
reduced sensation/pins in perianal
decreased anal tone
urinary dysfunction
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10
Q

Fibular # distal to syndesmosis TX

A

below knee plaster to include midfoot

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11
Q

Fibular # at level of syndesmosis tx

A

below knee plaster case to include midfoot

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12
Q

Spiral # of fibula and widening of ankle mortisse tx

A

Surgical fixation

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13
Q

Ottawa ankle rules for xray

A

Pain in malleolar zone and any one of:
cant weight bear for 4 steps
tenderness over distal tibia
bone tenderness over distal fibula

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14
Q

Weber Class A

A

Inversion injury

below syndesmosis

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15
Q

Weber type B

A

Eversion injury

start at level of tibial plafond and extend proximally to involve syndesmosis

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16
Q

Weber C

A

force pushing medial to lateral

above syndesmosis which may itself be damamged

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17
Q

Maisonneuve #

A

spiral fibular # that leads to disruption of syndesmosis w widening of joint –> surgery

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18
Q

Facet joint pain

A

acute or chronic
worse in AM and when standing
pain over facets on exam
pain worse on extension

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19
Q

Spinal stenosis ft

A

grasual onset
uni or bi-lateral leg pain/numbness/weakness worse on walking…resolves when sitting down
“Aching” “crawling” pain
relieved by sitting, crouching, leaning forward
MRI to confirm

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20
Q

Ankylosing spondylitis ft

A

young man w low back pain + stiffness
worse in AM, improve w activity
peripheral arthritis

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21
Q

PAD feat

A

pain on walking, relieved by rest
absent/weak foot pulses
signs of limb ischemia
hx smoking, vascular dx

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22
Q

Anterior shoulder disloc ft

A

external rot and abd
35-40% recurr
assoc w greater tuberosity #, Bankart lesion, Hill-Sachs defect

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23
Q

Painful arc 90-120 ABduction

A

subacromial impingement

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24
Q

acromioclavicular degeneration

A

popping, swelling, clicking, grinding and positive scarf test

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25
Q

Cacific tendinopathy of shoulder

A

extreme pain, significant tenderness

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26
Q

Pain in 0-60 ABduction

A

rotator cuff tear

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27
Q

Achilles tendon rupture test

A

Simmonds triad (absence of plantar flexion on squeezing of calf, palpation for gap in tendon, examine angle of declination at rest)

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28
Q

monteggia #

A

dislocation of proximal radial head with proximal ulnar fracture - name
Monteggia Ulna (Man U)
(FOOSH w forced pronation)

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29
Q

Galeazzi #

A 
# of distal radius with dislocation of distal radioulnar joint
(FOOSH w rotational force)
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30
Q

Colles #

A

distal radius w dorsal displacement

FOOSH

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31
Q

Smiths #

A

distal radius with volar displacement

fall back on outstretched hand or fall on flexed wrist

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32
Q

Bennett’s #

A

base of 1st (thumb) metacarpal that extends into carpometacarpal joint
(fist fights)

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33
Q

Scaphoid #

A

Anatomical snuffbox pain
XRay in AP w ulnar deviation
FOOSH

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34
Q

Shortened, adducted, internally rotated leg

A

posterior hip dislocation

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35
Q

Leg abducted and externally rotated

A

anterior hip dislocation

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36
Q

Back pain analgesia

A

pracetamol and codeine

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37
Q

Hematogenous osteomyelitis

A

from bacteremia, usually monomicrobial
Most common form in kids
vertebral osteo is most common in adults

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38
Q

hematogenous osteomyelitis RF

A

sickle cell anemia
IVDU
Immunisuppression
Infective endocarditis

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39
Q

Non hematogenous osteomyelitis

A

contagious spread of infx from adjacent soft tissue to the bone or direct injury/trauma to bone
Polymicrobial
Most common in adults

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40
Q

Non hematogenous osteomyelitis RF

A

diabetic foot ulcers/pressure sores
DM
PAD

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41
Q

Most common osteomyelitis microbe

A

Staph aureus

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42
Q

Osteomyelitis tx

A

Fluclox 6w

Clindamycin if pen allergy

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43
Q

Femoral nerve damage

A

weak knee extension
loss of patellar reflex
numbness of thigh

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44
Q

Lumbosacral nerve damage

A

weak ankle dorsiflexion

numb calf and foot

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45
Q

Sciatic nerve damage

A

weak knee flexion and foot movements

pain and numbness from glutes to ankle

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46
Q

Obturator nerve damage

A

weak hip aDDuction

numb medial thigh

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47
Q

Femoral nerve motor

A

knee extension

thigh flexion

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48
Q

Femoral nerve sensory

A

anterior and medial aspect of thigh and lower leg

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49
Q

Common femoral nerve injuries

A

hip/pelvic #

stab/gunshot wound

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50
Q

Obturator n. motor

A

thigh adduction

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51
Q

Obturator n. sensory

A

medial thigh

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52
Q

Obturator n. injury mechanism

A

anterior hip dislocation

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53
Q

Lateral cutaneous n. motor

A

NONE

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54
Q

Lateral cutaneous n. sensory

A

later and posterior thigh

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55
Q

Lateral cutaneous n. injury mech

A

compression of nerve near ASIS - meralgia parasthetica

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56
Q

Tibial n. motor

A

foot plantarflexion and inversion

57
Q

Tibial n. sensory

A

sole of foot

58
Q

Tibial n. mech injury

A

popliteal lacerations

posterior knee dislocation

59
Q

Common peroneal n. motor

A

foot dorsiflexion and eversion

Extensor hallucis longus

60
Q

Common peoneal n. sensory

A

dorsum of foot

lower part of lateral leg

61
Q

Common peoneal n. mech injury

A

neck of fibula injury
tight lower limb cast
**DROP FOOT

62
Q

Superior gluteal n. motor

A

hip aBduction

63
Q

Superior gluteal n. sensory

A

NONE

64
Q

Superior gluteal n. mech injury

A 
misplaced IM injection
HIp surgery
Pelvic #
posterior hip dislocation
**Positive trendelenberg sign
65
Q

Inferior gluteal n. motor

A

hip extension and lateral rotation

66
Q

Inferior gluteal n. sensory

A

none

67
Q

Inferior gluteal n. injury mech

A

sciatic nerve associated

Hard to stand from seated, can’t jump, can’t climb stairs

68
Q

wrist drop after humeral midshaft fracture

A

radial nerve

69
Q

tingling in thumb and first finger

A

median nerve

70
Q

axillary n.

A

abduct arm

71
Q

waiters tip

A

Brachial plexus C5C6

72
Q

ACL injury

A

twisting

73
Q

MCL injury

A

valgus stretch, skiing

74
Q

meniscus sx

A

locking, giving way

75
Q

4yo limp and pain in hip following URTI

A

transient synovitis

76
Q

6yo progressive hip pain, limp

A

Perthes

77
Q

Obese child w hip pain and pain in distal thigh. Loss of internal rotation

A

slipped upper femoral epiphysis

78
Q

claw hand

A

lower trunk brachial plexus C8T1

79
Q

most common osteomyelitis microbe in sickle cell

A

salmonella

80
Q

Grade 1-2 AC joint injury repair

A

conservative mgmt w sling and immobilisation

81
Q

high twisting force applied to bent knee

A

ACL

82
Q

knee loud crack, pain and rapid swelling

A

ACL

83
Q

hyperextension of knee

A

PCL

84
Q

leg forced into valgus via force outside the leg

A

MCL

85
Q

rotating sport injury, delayed swelling, joint locking, pain and effusions recurring

A

meniscal tear

86
Q

teenage girl, knee injury, pain going down stairs + rest, tender, quads wasting

A

choncromalacia patella

87
Q

most common metatarsal stress #

A

2nd MTT shaft

88
Q

pain on radial wrist over styloid process, Finkelstein’s test

A

De Quervain’s tenosynovitis

89
Q

swelling of sheath containing extensor pollicis brevis and abductor pollicis longus tendons

A

De Quervain’s tenosynovitis

90
Q

OA hand joints

A

osteophytes at carpometacarpal and DIP

91
Q

RA hand joints

A

PIP + joint effusions

92
Q

Pencil in cup deformity

A

RA

93
Q

Brief morning stiffness, stiffness after long inactivity

A

OA

94
Q

DIP nodes OA

A

Heberden’s

95
Q

PIP nodes OA

A

Bouchards

96
Q

First line for back pain

A

NSAIDs

97
Q

Second line for back pain

A

Codeine +/- paracetamol

98
Q

Allopurinol + ? = bone marrow suppression

A

Azathioprine

99
Q

Azathioprine SE

A

Bone marrow suppression
N/V
pancreatitis
increased risk non-melanoma skin cancer

100
Q

Azathioprine use

A

Crohns

Safe in preg

101
Q

Inflammatory arthritis @ DIPs, dactylitis

A

psoriatic arthritis

102
Q

Psoriatic arthritis ft

A

Asymmetrical
PIP and DIP
Psoriasis

103
Q

RA ft

A

Small joints of hands and feet

Spares DIP

104
Q

OA ft

A

CMC, PIP, DIP

105
Q

Gout Ft

A

1st MTP
Knee
Wrist
One joint at a time

106
Q

Heel pain worse on tip toes

A

Plantar fascitis

107
Q

S1 radiculopathy pattern

A

sensory loss on lateral aspect of foot, reduced dorsiflexion

108
Q

Morton’s neuroma

A

thickening of tissue around nerve between 3rd and 4th toes, pain on ball of foot

109
Q

Syndesmophytes

A

Ank Spond

110
Q

Ank spond marker

A

HLA B27

111
Q

Ank spond radiology

A

Sacroiliitis - subchondral erosions, sclerosis
Squaring of lumbar vertebrae
Bamboo spine
Syndesmophytes (ossification of outer fibers of annulus fibrosus)
CXR: apical fibrosis

112
Q

Undisplaced scaphoid # mgmt

A

Cast 6-8w

113
Q

Scaphoid # suspected but not seen mgmt

A

cast and re image in 2w

114
Q

Nerve innervating Triceps (reflex)

A

C7 - Radial

115
Q

C7 nerve

A

Radial, triceps reflex

116
Q

Musculocutaneous nerve

A

C5-7

117
Q

Axillary nerve

A

C5-6

118
Q

Radial nerve

A

C5-8

119
Q

Median nerve

A

C6, C8, T1

120
Q

Ulnar nerve

A

C8, T1

121
Q

Long thoracic nerve

A

C5-7

122
Q

Musculocutanous nerve sensory

A

lateral forearm

123
Q

Musculocutanous nerve motor

A

elbow flexion and supination (biceps brachii)

124
Q

Axillary nerve sensory

A

inferior region of deltoid

125
Q

Axillary n motor

A 
shoulder abduction (deltoid)
(injured in humercal neck #/disloc)
126
Q

Radial n sensory

A

back of 1st and 2nd MCP

127
Q

Radial n motor

A

extension (forearm, wrist, fingers,thumb)

128
Q

Median n sensory

A

palmar lateral 3.5 fingers

129
Q

Median n motor

A

Lesion @ wrist (carbal tunnel) - paralysis of thenar muscles, opponens pollicis

Lesion @ elbow: loss of pronation of forearm and weak wrist flexion

LOAF muscles:

  • lateral two lumbricals
  • opponens pollis
  • abductor pollic brevis
  • flexor pollis brevis
130
Q

Ulnar n sensory

A

medial 1.5 fingers

131
Q

Ulnar n motor

A

intrinsic hand muscles but not LOAF
Wrist flexion

Medial epicondyle fracture - claw hand

132
Q

LT n motor

A

serratus anterior - winged scapula

133
Q

Erbs

A

Waiters tip

Dmg C5/6 upper trunk

134
Q

Klumpkes

A

C8T1 lower trunk
Assoc w horners
Arm being pulled up
Claw hand w forearm supinated, wrist and fingers hyperextended w flexion at

135
Q

NSAIDs on warfarin

A

NO - GI bleed

136
Q

Steroids with DM

A

NO - upset DM control

137
Q

Gout tx

A

Colchicine

138
Q

Gout prophylaxis

A

Allopurinol 10mg OD until serum uric acid of <300micromol

139
Q

McMurray test +ve

A

Meniscal tear

My notes - med (14 decks)

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