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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
Cacific tendinopathy of shoulder
extreme pain, significant tenderness
26
Pain in 0-60 ABduction
rotator cuff tear
27
Achilles tendon rupture test
Simmonds triad (absence of plantar flexion on squeezing of calf, palpation for gap in tendon, examine angle of declination at rest)
28
monteggia #
dislocation of proximal radial head with proximal ulnar fracture - name Monteggia Ulna (Man U) (FOOSH w forced pronation)
29
Galeazzi #
``` # of distal radius with dislocation of distal radioulnar joint (FOOSH w rotational force) ```
30
Colles #
distal radius w dorsal displacement | FOOSH
31
Smiths #
distal radius with volar displacement | fall back on outstretched hand or fall on flexed wrist
32
Bennett's #
base of 1st (thumb) metacarpal that extends into carpometacarpal joint (fist fights)
33
Scaphoid #
Anatomical snuffbox pain XRay in AP w ulnar deviation FOOSH
34
Shortened, adducted, internally rotated leg
posterior hip dislocation
35
Leg abducted and externally rotated
anterior hip dislocation
36
Back pain analgesia
pracetamol and codeine
37
Hematogenous osteomyelitis
from bacteremia, usually monomicrobial Most common form in kids vertebral osteo is most common in adults
38
hematogenous osteomyelitis RF
sickle cell anemia IVDU Immunisuppression Infective endocarditis
39
Non hematogenous osteomyelitis
contagious spread of infx from adjacent soft tissue to the bone or direct injury/trauma to bone Polymicrobial Most common in adults
40
Non hematogenous osteomyelitis RF
diabetic foot ulcers/pressure sores DM PAD
41
Most common osteomyelitis microbe
Staph aureus
42
Osteomyelitis tx
Fluclox 6w | Clindamycin if pen allergy
43
Femoral nerve damage
weak knee extension loss of patellar reflex numbness of thigh
44
Lumbosacral nerve damage
weak ankle dorsiflexion | numb calf and foot
45
Sciatic nerve damage
weak knee flexion and foot movements | pain and numbness from glutes to ankle
46
Obturator nerve damage
weak hip aDDuction | numb medial thigh
47
Femoral nerve motor
knee extension | thigh flexion
48
Femoral nerve sensory
anterior and medial aspect of thigh and lower leg
49
Common femoral nerve injuries
hip/pelvic # | stab/gunshot wound
50
Obturator n. motor
thigh adduction
51
Obturator n. sensory
medial thigh
52
Obturator n. injury mechanism
anterior hip dislocation
53
Lateral cutaneous n. motor
NONE
54
Lateral cutaneous n. sensory
later and posterior thigh
55
Lateral cutaneous n. injury mech
compression of nerve near ASIS - meralgia parasthetica
56
Tibial n. motor
foot plantarflexion and inversion
57
Tibial n. sensory
sole of foot
58
Tibial n. mech injury
popliteal lacerations | posterior knee dislocation
59
Common peroneal n. motor
foot dorsiflexion and eversion | Extensor hallucis longus
60
Common peoneal n. sensory
dorsum of foot | lower part of lateral leg
61
Common peoneal n. mech injury
neck of fibula injury tight lower limb cast **DROP FOOT
62
Superior gluteal n. motor
hip aBduction
63
Superior gluteal n. sensory
NONE
64
Superior gluteal n. mech injury
``` misplaced IM injection HIp surgery Pelvic # posterior hip dislocation **Positive trendelenberg sign ```
65
Inferior gluteal n. motor
hip extension and lateral rotation
66
Inferior gluteal n. sensory
none
67
Inferior gluteal n. injury mech
sciatic nerve associated | Hard to stand from seated, can't jump, can't climb stairs
68
wrist drop after humeral midshaft fracture
radial nerve
69
tingling in thumb and first finger
median nerve
70
axillary n.
abduct arm
71
waiters tip
Brachial plexus C5C6
72
ACL injury
twisting
73
MCL injury
valgus stretch, skiing
74
meniscus sx
locking, giving way
75
4yo limp and pain in hip following URTI
transient synovitis
76
6yo progressive hip pain, limp
Perthes
77
Obese child w hip pain and pain in distal thigh. Loss of internal rotation
slipped upper femoral epiphysis
78
claw hand
lower trunk brachial plexus C8T1
79
most common osteomyelitis microbe in sickle cell
salmonella
80
Grade 1-2 AC joint injury repair
conservative mgmt w sling and immobilisation
81
high twisting force applied to bent knee
ACL
82
knee loud crack, pain and rapid swelling
ACL
83
hyperextension of knee
PCL
84
leg forced into valgus via force outside the leg
MCL
85
rotating sport injury, delayed swelling, joint locking, pain and effusions recurring
meniscal tear
86
teenage girl, knee injury, pain going down stairs + rest, tender, quads wasting
choncromalacia patella
87
most common metatarsal stress #
2nd MTT shaft
88
pain on radial wrist over styloid process, Finkelstein's test
De Quervain's tenosynovitis
89
swelling of sheath containing extensor pollicis brevis and abductor pollicis longus tendons
De Quervain's tenosynovitis
90
OA hand joints
osteophytes at carpometacarpal and DIP
91
RA hand joints
PIP + joint effusions
92
Pencil in cup deformity
RA
93
Brief morning stiffness, stiffness after long inactivity
OA
94
DIP nodes OA
Heberden's
95
PIP nodes OA
Bouchards
96
First line for back pain
NSAIDs
97
Second line for back pain
Codeine +/- paracetamol
98
Allopurinol + ? = bone marrow suppression
Azathioprine
99
Azathioprine SE
Bone marrow suppression N/V pancreatitis increased risk non-melanoma skin cancer
100
Azathioprine use
Crohns | Safe in preg
101
Inflammatory arthritis @ DIPs, dactylitis
psoriatic arthritis
102
Psoriatic arthritis ft
Asymmetrical PIP and DIP Psoriasis
103
RA ft
Small joints of hands and feet | Spares DIP
104
OA ft
CMC, PIP, DIP
105
Gout Ft
1st MTP Knee Wrist One joint at a time
106
Heel pain worse on tip toes
Plantar fascitis
107
S1 radiculopathy pattern
sensory loss on lateral aspect of foot, reduced dorsiflexion
108
Morton's neuroma
thickening of tissue around nerve between 3rd and 4th toes, pain on ball of foot
109
Syndesmophytes
Ank Spond
110
Ank spond marker
HLA B27
111
Ank spond radiology
Sacroiliitis - subchondral erosions, sclerosis Squaring of lumbar vertebrae Bamboo spine Syndesmophytes (ossification of outer fibers of annulus fibrosus) CXR: apical fibrosis
112
Undisplaced scaphoid # mgmt
Cast 6-8w
113
Scaphoid # suspected but not seen mgmt
cast and re image in 2w
114
Nerve innervating Triceps (reflex)
C7 - Radial
115
C7 nerve
Radial, triceps reflex
116
Musculocutaneous nerve
C5-7
117
Axillary nerve
C5-6
118
Radial nerve
C5-8
119
Median nerve
C6, C8, T1
120
Ulnar nerve
C8, T1
121
Long thoracic nerve
C5-7
122
Musculocutanous nerve sensory
lateral forearm
123
Musculocutanous nerve motor
elbow flexion and supination (biceps brachii)
124
Axillary nerve sensory
inferior region of deltoid
125
Axillary n motor
``` shoulder abduction (deltoid) (injured in humercal neck #/disloc) ```
126
Radial n sensory
back of 1st and 2nd MCP
127
Radial n motor
extension (forearm, wrist, fingers,thumb)
128
Median n sensory
palmar lateral 3.5 fingers
129
Median n motor
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
Ulnar n sensory
medial 1.5 fingers
131
Ulnar n motor
intrinsic hand muscles but not LOAF Wrist flexion Medial epicondyle fracture - claw hand
132
LT n motor
serratus anterior - winged scapula
133
Erbs
Waiters tip | Dmg C5/6 upper trunk
134
Klumpkes
C8T1 lower trunk Assoc w horners Arm being pulled up Claw hand w forearm supinated, wrist and fingers hyperextended w flexion at
135
NSAIDs on warfarin
NO - GI bleed
136
Steroids with DM
NO - upset DM control
137
Gout tx
Colchicine
138
Gout prophylaxis
Allopurinol 10mg OD until serum uric acid of <300micromol
139
McMurray test +ve
Meniscal tear

My notes - med (14 decks)

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