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ABOS PART I > Orthobullets New > Flashcards

Orthobullets New Flashcards

1
Q

Time for return to preop braking reaction time after THA

A

4-6 weeks

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2
Q

retrograde drilling in ankle arthroscopy is useful for what?

A

OCD lesion with a cartilage cap

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3
Q

buerger’s diseases is painful or painless?

A

painful

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4
Q

Random contraindication to TTC nail?

A

severe peripheral vascular disease

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5
Q

ACL Recon technical error that leads to loss of terminal extension?

A

tibia tunnel too anterior causing graft impingement on notch

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6
Q

Undifferentiated pleomorphic soft tissue sarcomas are treated with?

A

Wide excision and XRT

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7
Q

Metaphyseal Diaphyseal Angle (MDA) cutoff for surgical intervention?

A

16

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8
Q

Bracing is effective first line treatment for infantile blounts until what age?

A

3

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9
Q

bisphosphonates binds what particle that leads to them being detectable for years?

A

calcium hydroxyappetite

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10
Q

Humeral head version is?

A

20 retro

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11
Q

Degrees of extensor lag for every 2mm of shortening of metacarpal

A

7 degrees

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12
Q

Cricoid cartilage is what level

A

C6

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13
Q

Hyoid cartilage is what level

A

C3

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14
Q

Upper thyroid cartilage is what level

A

C4

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15
Q

Lower thyroid cartilage is what level

A

C5

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16
Q

only effect of FHL transfer for achilles

A

decreased pressure under hallux

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17
Q

In cavovarus foot what muscle is “Strong” and what is “weak”

A

Peroneus longus, tib ant

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18
Q

Position of tibia tunnel relative to PCL for ACL graft

A

10mm anterior to anterior border

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19
Q

carotid tubercle is at what level?

A

c6

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20
Q

Foot deformity associated with posteromedial bowing?

A

calcaneovalgus

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21
Q

MOA heparin

A

binds and enhances antithrombin III to inhibit factors III, IIA, XA

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22
Q

MOA Wafarin

A

Inhibits synth of vit K dependent II, VII, IX, X, Proteins c&S

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23
Q

MOA enoxoparin

A

enhances antithrombin III to inhibit factors IIA, XA

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24
Q

Freidberg’s Infarction is _

A

infarct to second MT head

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25
Q

Nerve that can be injured during anterior exposure to c2-3

A

hypoglossal nerve exits are C2

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26
Q

Nonoperative management of mid clavicle fx associated with what at 1 year?

A

decreased shoulder strength and endurance

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27
Q

Type X collagen significant in what part of physis

A

zone of hypertrophy

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28
Q

Kerboul angle is used to measure what?

A

Area of AVN in femoral head on coronal and axial images summed together; predictor of risk of collapse

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29
Q

Extraabdominal Desmond tumors are positive for what hormone receptor?

A

estrogen receptor

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30
Q

Patellar reflex nerve root

A

L4

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31
Q

Achilles reflex nerve root

A

S1

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32
Q

primary blood supply to ACL

A

middle genicular

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33
Q

Congenital hand disorder rare in caucasians, common in blacks

A

postaxial poly dactyly

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34
Q

Overpowering and weak muscle that lead to dorsal bunion after posteromedial clubfoot release

A

Strong = tib ant, weak = peroneus longus (may be inadvertently cut or lengthened at time of release)

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35
Q

biggest risk factor for not healing rotator cuff repair

A

age

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36
Q

“Critical canal stenosis” defined as:

A

AP diameter < 10mm

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37
Q

Viniculae disrupted when FDP tendon retracts to level of A2?

A

Brevia

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38
Q

Viniculae disrupted when fdp tendon retracts to palm

A

brevia and longa

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39
Q

Posteroinferior glenoide a potential pain generator for what athlete

A

baseball pitcher; repetitive stress on posterior capsule during deceleration; can get ossified and called a Bennet’s lesion

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40
Q

increased IL-6 in trauma patients associated with _

A

increased mortality

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41
Q

Highest level LE amputation a child can get and still walk at normal speed c/t peers without increased energy?

A

through knee

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42
Q

When do most children with SCH achieve normal ROM after crpp?

A

6 months

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43
Q

Is UKA contraindicated in osteonecrosis of femoral condyle?

A

no

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44
Q

Flexion contracture greater than_ is contraindication to UKA

A

10

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45
Q

What preop CTS finding is associated with worse outcomes?

A

Severe EMG changes

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46
Q

Minimum follow up to be a level I study?

A

80%

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47
Q

Hypophosphotasia is a defect in the production of?

A

alkaline phosphatase

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48
Q

3.0T MRI is what factor of higher proton energy c/t 1.5?

A

9

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49
Q

DISH is highly correlated with what other diseases?

A

DM

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50
Q

PS TKA with increased posterior offset and small patellar component can lead to ?

A

patellar clunk syndrome

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51
Q

Achondroplasia is a defect in what enzyme and affects what part of the physis?

A

fgf3, zone of proliferation

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52
Q

“pencil in a cup” IP joint destruction associated with?

A

psoriatic arthritis

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53
Q

At what age is pavlik not the tx for femur fx?

A

6 months

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54
Q

Parts of knee with DJD in PCL deficiency?

A

medial and PFJ

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55
Q

CMT is caused by a mutation of what protein on what chromosome?

A

PMP, 17

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56
Q

What LE amputation has the worst outcomes in adults?

A

through knee (decreased prosthesis use, worse outcomes)

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57
Q

Liposarcoma associated with amplication of what gene?

A

MDM2

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58
Q

Thickness of cartilage cap on osteochondroma is useful for what?

A

in adults a thin cap (<2cm) is associated with malignant transformation; no use in kids

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59
Q

Most common reason for revision of charnley THA

A

acetabular component failure

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60
Q

Juvenile RA is diagnosed by serologic tests?

A

False, typically seronegative

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61
Q

Triad for Hand Schuler Christian disease?

A

Lytic skull lesions, diabetes insipidus, and exophtalmos. Basically this is Disseminated LCH

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62
Q

Anterior approach for ASD is associated with _ c/t posterior

A

higher rate of pseudarthrosis

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63
Q

fibula in the incisura most unstable in which plane

A

anterior posterior

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64
Q

Does irradiation lead to decreased immune response to allografts?

A

no. it sterilizes it

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65
Q

Antibiotic choice for psuedomonas osteo?

A

fluoroquinolone; except in kids ceftazidime or cefepime

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66
Q

maximum medial pool dye thickness after closed reduction of DDH for successful outcome

A

<5-7. Higher likely means reduction blocked by something, less chance of success

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67
Q

centigray of radiation for the following: HO ppx, soft tissue sarcoma, Bone mets

A

6, 60, 30

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68
Q

Fibrous dysplasia associated with what syndrome?

A

McCune Albright

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69
Q

Triad for McCune Albright

A

Fibrous dysplasia, precocious puberty, cafe au lait spots

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70
Q

Mutation in McCune Albright

A

activating mutation of the G(s) alpha gene

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71
Q

Levels of PTH, Phos, Ca in renal osteodystrophy

A

High, High, Low

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72
Q

only orthothotic effective for plantar fasciitis?

A

Nighttime dorsiflexion splint

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73
Q

Patellar tendonitis associated with _

A

muscle inflexibility (quads or hamstrings)

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74
Q

Spinal muscle atrophy associated with what cellular changes?

A

progressive loss of alpha motor neurons in anterior horn of spinal cord

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75
Q

Nuclei shape on eosinophilic granuloma?

A

bilobed Coffee bean nuclei

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76
Q

histologic appears of LCH

A

Langherhan cells (bilobed nuclei) surrounded by eosinophils

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77
Q

Virchow’s triad

A

hypercoagubility, venous stasis, endothelial injury

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78
Q

Factor most associated with poor outcome after pilon fx with successful union?

A

lower education level

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79
Q

Camptodactyly is _

A

non traumatic flexion deformity to PIP joint. Treated with stretching first prior to any surgery consideration

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80
Q

Apert syndrome is comprised by _ and caused by what mutation?

A

Facial dysmorphism and severe hand syndactyly

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81
Q

Metal hypersensitivity is what type of hypersensitivity?

A

IV (DELAYED, cell mediated, not antibody mediated)

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82
Q

Frostbite demarcation can take how long?

A

1-3 months

83
Q

Two herbal supplements that interfere with platelet function?

A

ginkgo and ginseng

84
Q

Release of popliteus tendon is useful for what issue inTKA?

A

Valgus deformity, tight in flexion

85
Q

Release of IT tendon is useful for what issue in TKA?

A

valgus deformity tight in extension

86
Q

Apert’s syndrome is a mutation of?

A

FGFR2.

87
Q

Long term basal joint DJD leads to what hand deformity?

A

first webspace contracture

88
Q

Oiller’s disease has what chance of malignancy?

A

~25%

89
Q

Bisphosphate tx has what effect on psif spine surgery in the postop period?

A

decreased fusion rates (in rats, no human clinical recs currently available)

90
Q

Most common reason for late TKA revision?

A

aseptic loosening

91
Q

Biggest risk factor for poor outcome after combined acetabular fx and hip dislocation?

A

Age > 55. time to reduction > 12 hrs

92
Q

Rheumatoid factor is an auto antibody of what type against what type of host antibody?

A

IgM, IgG

93
Q

Stenner lesion in UCL injury of thumb is caused by what muscle which blocks reduction of the ligament?

A

adductor policus, ulnar nerve

94
Q

Tissue from groin flap has what NV supply?

A

superficial circumflex iliac a., LFCN

95
Q

SSEMs or MEPs are more sensitive to the effect of anesthesia?

A

MEPs

96
Q

After ceramic head fracture and revision, what can be a late complication?

A

3rd body wear from retained ceramic pieces

97
Q

For cortical bone, as strain rate increases this has what effect on modulus and ultimate strength?

A

both increase

98
Q

Largest negative predictor for good outcome in laborers with chronic MSK pain?

A

High initial VAS scores

99
Q

IV Pain dosage for morbidly obese patients should be based on?

A

ideal body weight, not actual

100
Q

Type of bone Metastatic lesion that has worst survival?

A

lung

101
Q

Myxoid liposarcoma translocation

A

t(12,16)

102
Q

In adult ASD surgery, extending fusion to sacrum or pelvis has what advantage?

A

improved correction and maintenance of sagittal balance

103
Q

Reduction maneuver for nursemaid’s elbow?

A

flexion and supination

104
Q

Psych drug with increased risk for osteoporosis and fx?

A

phenytoin

105
Q

Morquio’s syndrome has what laboratory finding and what spine finding?

A

increased urine keratin sulfate, OA dissociation

106
Q

Hemophilia A is deficiency in what factor?

A

VIII

107
Q

Hemophilia B is deficiency in what factor?

A

IX

108
Q

Gene mutation in Fibrodysplasia ossificans progressiva?

A

ACVR1

109
Q

What is the worst indicator for prognosis of chondrosarcoma?

A

pelvis location

110
Q

Larsen’s syndrome is composed of:

A

multiple joint dislocations, scoliosis, potentially lethal cervical kyphosis

111
Q

Gait abnormality seen in kids with spondylolisthesis?

A

shorten strides, flexion of hips/knees

112
Q

Surgical delay leading to worse outcomes in acetabulum fx?

A

3 weeks

113
Q

BMP-2 is approved for acute open tibias treated with what implant?

A

IMN

114
Q

BMP-2 is approved for what spine indication?

A

Lumbar ALIFs

115
Q

ECRB origin and insertion

A

lateral epicondyle, 3rd MC base

116
Q

Most common sarcoma of the foot?

A

Synovial

117
Q

Other msk finding associated with CMT besides cavovarus foot?

A

DDH

118
Q

intermalleolar distance should be less than?

A

8cm

119
Q

Smaller pedicle diameter, T12 or L1?

A

L1

120
Q

Fracture table for femur fx associated with what deformity?

A

IR

121
Q

What antibiotic improves the effect of methotrexate compared to methotrexate alone?

A

Doxycycline

122
Q

Extensile lateral approach to distal femur fx has what complication c/t submuscular?

A

increased non union

123
Q

In addition to RANKL, what else is increased with osteolysis?

A

VEGF

124
Q

Is child bearing age a contraindication to metal on metal THA

A

Yes

125
Q

Displacement/angulation for extra artic glenoid fx to be operative?

A

1cm, 40 degree

126
Q

What percent of people have a posterior dominant biceps insertion to glenoid?

A

70%

127
Q

What sacral fracture factor can lead too increased implant breakage?

A

vertical fracture line

128
Q

Sever’s disease is _

A

calcanea apophysitis

129
Q

Osteopenia has what effect on the strength of the bone-cement interface in comparison to normal bone?

A

increased strenght

130
Q

The use of EPO preop has had what complication?

A

Increased thrombotic risk

131
Q

Treatment for periosteal chondroma is?

A

Marginal with excision of underlying cortex

132
Q

Pronation abduction ankle fracture pattern

A

comminuted fibula fracture, horizontal medial mal

133
Q

Pronation external rotation ankle fracture pattern

A

oblique fibula fracture above syndesmosis

134
Q

Supination adduction ankle fracture pattern

A

transverse fibula, vertical medial mal

135
Q

In children multi organ failure occurs _ and affects what organ system first?

A

shortly after admission, all systems simultaneously

136
Q

In adults multi organ failure occurs _ and affects what organ system first?

A

48 hours after admission, lungs first

137
Q

Urinary _ is a breakdown product of type I collagen and a marker of increased bone turnover

A

N-telopeptide

138
Q

Most common site of boney mestasis?

A

spine

139
Q

Most common site for path fx from met lesion?

A

prox femur

140
Q

At what age is open reduction preferred for DDH?

A

18 months

141
Q

What is the max amount of hip abduction to maintain hip reduction to continue with closed reduction only?

A

60

142
Q

t(2, 13)

A

alveolar rhabdomyosarcoma

143
Q

slip progression of spondy in kids associated with what parameter?

A

pelvic incidence

144
Q

males or females have higher risk of non union of mid clavicle fx?

A

females

145
Q

central cord syndrome now thought to be injury to what tract?

A

lateral corticospinal tract

146
Q

What percent chance of hip fracture over ten years warrants bisphosphonate therapy?

A

3%

147
Q

enteracept binds what molecule

A

tnf alpha

148
Q

Anakinra binds what molecule?

A

IL-1

149
Q

most water in cartilage is located in what layer?

A

superficial

150
Q

water content in cartilage _ with DJD

A

increases

151
Q

Water content in cartilage _ with age

A

decreases

152
Q

Signs of preganglionic obstetric brachial plexus palsy?

A

winged scapula (long thoracic), absent rhomboids (dorsal scapular), Horner’s syndrome, elevated hemidiaphragm

153
Q

Age at which to perform nerve transfers for preganglionic obstetric brachial plexus palsy?

A

< 3 months

154
Q

Compared with CSI, PT has _ effect in tennis elbow?

A

improved

155
Q

Bands seen near physics in OI patients is associated with what?

A

Bisphosphonate use

156
Q

TLIFs with PSIF are associated with?

A

increased cost only, no improvement in outcome or fusion rates

157
Q

T/F: inflammatory arthritis associated with increased THA dislocations?

A

true

158
Q

T/F: post traumatic arthritis associated with increased THA dislocations?

A

false

159
Q

Collagen orientation in the superficial zone?

A

parallel to tidemark

160
Q

Dominant collagen in cartilage in superficial and intermediate zone?

A

II

161
Q

Collagen orientation in the intermediate zone?

A

oblique

162
Q

translocation in clear cell sarcoma?

A

t(12,22)

163
Q

translocation in myxoid liposarcoma?

A

t(12,16)

164
Q

translocation in chondrosarcoma?

A

t(9,22)

165
Q

Lateral mass overhang over what represents disrupted transverse ligament?

A

7mm

166
Q

Viruses screened for in allografts

A

Hep B/C, HIV, Syphillis

167
Q

According to SPORT, failure to improve with conservative management for lumbar disc herniation for what period of time pushes to surgery?

A

6 weeks

168
Q

major side effect of doxorubicin?

A

cardiac

169
Q

earliest radiographic finding seen in bed osteodiscitis of lumbar spine?

A

loss of lordosis

170
Q

dega and salter osteotomies performed with _ triradiate

A

open

171
Q

PAO requires _

A

congruent joint

172
Q

Chiari osteotomy used for _

A

non congruent joint, closed triradiate

173
Q

metastatic lesion that is often osteoblastic?

A

prostate

174
Q

Endothelin is a molecule involved in?

A

osteoblastic metastasis

175
Q

Benefits of vertebroplasty in RCT?

A

none, equal to sham procedure at all times

176
Q

rivaroxaban is a _ inhibitor

A

Xa

177
Q

Are hangman fx associated with vert art injuries?

A

no

178
Q

At what age cutoff are you pushed towards surgery for perthes?

A

> 8

179
Q

anterolateral bowing of tibia associated with

A

NF-1

180
Q

CD20 and CD45 markers are associated with

A

lymphoma

181
Q

Unique part of Ewing’s workup c/t osteosarcoma?

A

bone marrow biopsy

182
Q

varus malunion of talar neck decreases what motion?

A

subtler eversion

183
Q

Diplegia CP has

A

Affects lower more than upper extremity, mild spasiticity in UE

184
Q

Paraplegia CP has

A

abnormal LE, sparring of UE

185
Q

Pneumatic compression devices decrease risk of clot through what mechanism?

A

increased venous blood flow

186
Q

Asia score level is based on

A

last normal level

187
Q

X linked hypophosphatemic rickets is X linked _

A

dominant

188
Q

Fibrous dysplasia is caused by a gene mutation involved in what signaling?

A

G protein involved in cAMP signalling

189
Q

Name of law that forbids referral of patients to facilities the doctor has ownership in?

A

Stark

190
Q

Morquio’s is caused by _

A

lysomal storage disorder causing increased keratin sulfate

191
Q

With aging there is greater mechanical strength loss to cortical or trabecular bone?

A

trabecular

192
Q

What muscles are paralyzed in Erb’s

A

Deltoid, and biceps (does not affect hand for true Waiter’s tip, that is a Type II, which is less common)

193
Q

Marker for angiosarcoma?

A

CD31

194
Q

T/F: Radial head resection is contraindication to TEA?

A

False, worse outcomes, but not contraindication

195
Q

What artery is encountered between IT band and biceps femoris in posterolateral approach to knee?

A

inf lat genicular artery

196
Q

What head of pec is normally torn?

A

Sternocostal, not clavicular

197
Q

Inheritance pattern of NF1

A

autosomal dominant

198
Q

Marfan’s is AD with defective _ gene

A

fibrillin

199
Q

lisch nodules associated with

A

NF-1

200
Q

ERLENMeyer flask femurs are seen in pediatric

A

osteopetrosis

201
Q

tumoral calcinosis is seen in

A

hyperphosphatasia

202
Q

T/F: Ewing’s can be treated with XRT in situation where resection is risky

A

True

203
Q

Most common origin of bony met when CT C/A/P is negative?

A

lung

ABOS PART I (7 decks)

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