Orthobullets OLD Flashcards
Anti CCP antibodies are detected in what disease?
RA
Protein C Deficiency causes a _ coagulable state
hyper
Most common radiographic finding of RSD about the knee?
patella osteopenia
Rate of fracture of strut allograft
25%
Rituximab is an antibody against what for RA?
CD20
periarticular erosions are seen in _
Gout
Rivoraxaban is a selective _ inhibitor
10A
Heparin is a _ inhibitor
non specific
Warfarin inhibits _
2,7,9,10
Juvenile RA is associated strongly with…
Uveitis
Mechanism of action for Vancomycion
Inhibition of cell wall synthesis
Protamine reverses the effects of what anti coagulant?
heparin
Medical tx for bone pain from fibrous dysplasia
Bisphosphonates
Binds presynaptic calcium channels to prevent release of neurotrans
gabapentin
Zone of polarizing activity controls what part of limb development
medial to lateral
apical ectodermal ridge controls what part of limb development?
proximal to distal
inhibits prostoglandin formation through IL-1B for pain relief
acetaminophen
Alteration in BMP-4 signaling is associated with _
fibrousdysplasia ossificans progressiva (FOP) - Stone man disease
Bending rigidity proportional to?
r^4
Sports hernias caused by activities that rely upon what hip position?
Hip extension and abduction
Most lethal condition associated with absent Radius
Fanconi’s anemia (aplastic anemia)
Tenotomy of Iliopsoas tendon from medial approach can injure what vessel?
Medial femoral circumflex
Excision of the lateral process of talus for non union leads to incompetence of what ligament
lateral talocalcaneal
Ewing’s is associated with what translocation and what fusion protein?
t(11:22), EWS-FL1
Pareosteal osteosarcoma is treated with?
wide excision alone; no chemo/xrt
Single bundle PCL recon should be tightened at what degree of knee flexion
90
What direction are CMC dislocations usually and what ligament is torn?
dorsal; dorsoradial ligament
What classification system correlates with the apex of curve progression in AIS
Turner-Whitehouse
Highest risk of blood born transmission from transfusion
Hep B
MOA non nitrogen Bisphosphonates
Toxic ATP analog
MOA nitrogen containing bisphosphonates
inhibits farnesyl disphosphate synthase
Position to avoid after remplissage
FF, adduction
primary blood supply to flexor tendons within the sheath?
synovial fluid, not veniculae
Fibular Hemimelia is associated with what ankle/hindfoot abnormalities?
ball and socket ankle, tarsal coalition
Driving reaction time returns to normal after THA at _ weeks
4-6
Type of collagen in Annulus fibrosis
1
Type of collagen in nucleus pulposus
2
During open chain knee extension, max tension on ACL is during _
0-30 extension
During open chain knee extension, max tension on PCL is during _
Deep flexion
BKA amputation with fibula strut is called
Ertl
Traditional long posterior flap BKA called
modified Burgess
Osteotomy for closed triradiates and incongruent joint
Chiari
Osteotomy for closed triradiate and congruent joint?
PAO
Dega osteotomy hinges through
open triradiate
Salter osteotomy hinges through
flexible pubis
Max amount of lateral uncoverage for THA cup
30%
A poly wear rate of greater than 0._mm/yr has increased risk of osteolysis
0.1
What Bone stimulating medication is contraindicated in Paget’s?
Teriparatide (Forteo)
Anterior or posterior ICBG has higher complication rate, duration of pain, and gait abnormalities?
Anterior
lead toxicity affects which growth factor?
PTHrP
hitchhikers thumb, cauliflower ears, severe clubfeet
diastrophic dwarfism
Gene and what it encodes for diastrophic dwarfism?
DTD, sulfate transport protein
Partial tears of the biceps insertion occur in what part of the tendon?
radial aspect
Articular cartilage cells are present in what zone of cartilage?
surface zone
Tumor suppressor gene inactivated in Li-Fraumeni Syndrome?
p53
pediatric trigger thumb will no longer resolve with conservative tx after what age?
2 years
Peroneal tendon injuries are a result of what mechanism?
Dorsiflexion and inversion
Peroneal tendon subluxation occurs in what position?
dorsiflexion and eversion
ligament tears occur through which zone?
sharpy’s fibers
What is the biggest risk factor for complication in adult deformity surgery?
Age > 60
In finger digital artery sits _ relative to nerve
dorsal
Elevated N-telopeptides, alpha-C-telopeptides, and urinary hydroxyproline levels are all consistent with
paget’s
Giant cell tumor of the tendon sheath is treated with _
marginal excision
Giant cell tumor of tendon sheath resembles _ on histology
PVNS
tardy ulnar nerve palsy is associated with _
lateral condyle fractures
Chronic PCL instability leads to DJD in what two compartments
PFJ, Medial
Medial opening wedge osteotomy has this effect compared to lateral closing
increases tibial slope, helpful with PCL incompentency
An abducens palsy after halo placement is caused by injury to what cranial nerve
VI
What percentage of flexor tendon laceration warrants repair?
>60%
Rupture of the 2nd MTP plantar plate can lead to _
2nd crossover toe
Absolute contraindication to meniscal transplant (medical condition)
inflammatory arthritis
type of autograft for scaphoid non union with prox pole AVN?
vascularized
In renal osteodystrophy what is the pathophysiological step that is responsible for his osteomalacia
uremia related phosphate retention
SMA is caused by a deficiency in _
survival motor protein
most common solid malignant tumor in children?
neuroblastoma
MOA of TXA
competitive inhibition of plasminogen activation
Muscles deforming rolando or Bennet fractures (2)
APL, adductor pollicis
Normal range for base deficit
2 to -2
Normal value for lactate?
<5
histologic finding of lateral epixondylitis
angiofibrotic dysplasia
Most common complication from endoscopic anterior thoracic spine surgery?
intercostal neuralgia
Fibular hemimelia associated with what 2 hind foot disorders?
tarsal coalition, ball and socket ankle
Predictors for ulcer not healing: ABI < _, Toe pressure < _, Albumin < _
0.45, 30-40 (varies), 3.0
Arterial supply for medial gastroc flap?
sural artery
What enzyme has increased activity in osteoid osteomas?
Cyclooxygenase
Most common nerve injury with flexion SCH
Ulnar
pseudo gout crystals are _ and _ birefringent
calcium pyrophosphate dehydrate; positive
gout crystals are _ and _ birefringent
monosodium urate; negative
Most important deciding factor between reconstruction and ablation for hypo plastic thumb?
CMC joint stability
Primary blood supply to humeral head (GT, and LT too)
anterolateral branch of anterior circumflex humeral artery
Displacement in which direction has the highest non union rate for odontoid fractures?
posterior displacement
Board answer to THA dislocation direction in patients with ankylosing spondylitis
Anterior due to loss of lumbar lordosis
4 most common locations of giant cell tumor from most to least common
distal femur, prox tibia, distal radius, sacral ala
Order of things to release in pediatric trigger finger (not thumb)
A1, A3, 1 slip of FDS
largest size of defect for Moberg advancement flap
2cm
What has been shown to be increased in subacromial bursitis
metalloproteases
Sites of ulnar nerve compression
arcade of Struthers, medial intermuscular septum, medial epicondyle, cubital tunnel (MCL and Osborne’s ligament), and deep flexor pronator aponeurosis (Two heads of FCU)
ligament of struthers can cause compression of what nerve?
median
Are facets a part of PLC
No, just their capsule
Tx for jones fx in older patients?
cast
With anabolic steroid use HDL _ and LDL _
decreases, increases
Classic location for juvenile OCD lesion in knee
lateral aspect of MFC
Position for ankle arthrodesis
plantigrade, 10 ER, 5 valgus, 5mm posterior translated
Deep muscular interval for medial inside out meniscus repair
joint capsule and medial head of gastroc
Best shoulder XR view for identifying hill Sachs lesion
stryker notch
Responsiveness is best measured using what type of graph
receiver operating characteristic curve (ROC);
children with lysosomal storage disorders have increased rate of _
Carpal tunnel syndrome
Treatment for early stage DJD of ankle in young person
supramalleolar osteotomy to correct varus or valgus, whichever is present
Hand deformity associated with Poland Syndrome
Symbrachydactyly
Relative contraindication to metaphyseal sleeve usage
uncontained metaphyseal defect
Pain with pushup from chair indicative of injury to _ of elbow
lateral ulnar colateral ligament
Small Blue Cell Tumors
LERNM Lympohoma ewings rhabdomyosarcoma neuroblastoma myeloma
Sarcomas that metastasize to lymph nodes
CARES Clear cell angiosarcoma rhabdomyosarcoma epithelioid sarcoma synovial sarcoma
Translocation associated with rhabdomyosarcoma?
t(2;13)
Hip Approach with highest risk of femur fracture during femoral implant placement
lateral
anteromedial bundle of ACL tight in?
flexion
posterolateral bundle of ACL tight in?
extension (PaLE)
T/F: indomethacin for HO ppx leads to increased femoral shaft non unions
True
Muscle that also originates from common extensor organ besides ECRL, ECRB, EDC, ECU
anconeus
Use of fracture table for antegrade nails has higher risk of _ deformity
internal rotation
Position for hip fusion
5 ER, 5 adduction, 20 flexion
What age cutoff for perthes pushes to surgical intervention?
8
The teardrop is composed of what structures?
cotyloid fossa, quadrilateral surface
peak bone mass in men and women is linked to what hormone?
estrogen
Besides less knee pain, supra patellar nailing is associated with _ for distal third tibia fractures
improved alignment
most common neurologic deficit in lumbar stenosis?
none
molecule formed by macrophages for osteolysis reaction?
IL-1
Primarily knee ligament responsible for rotational stability (out of ACL/PCL)
posterolateral band of ACL
Time since seen in your practice for it to be “new patient:
3 years
Mangled extremity scoring system takes into account what 4 factors?
Soft tissue injury, limb ischemia, shock, age
When plating proximal radius fractures, forearm should be in what position for plating?
neutral to assure you are on the extra artic portion of radial head
giant cell tumor of the tendon sheath is treated with ?
marginal excision
Vertical or horizontal mattress repair for meniscus?
vertical
In ACL deficient knee what is thought to be the highest risk factor for development of future DJD?
Meniscus tear
Secondary stabilizer of anterior tibia translation without ACL?
posterior horn of medial meniscus
What factor is most linked to poor outcomes from adult spinal deformity surgery?
obesity
TLICS
