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Orthobullets Questions > Orthobullets Questions > Flashcards

Orthobullets Questions Flashcards

1
Q

The organism associated with use of penicillin for open fractures is what type of organism?

A

Clostridium botulinum:

Gram Positive Bacilli, obligate anaerobe, spore forming

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2
Q

When should a Moberg osteotomy be performed on great toe?

A

When cheilectomy fails to achieve at least 30 deg of dorsiflexion intraoperatively…especially in runners

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3
Q

How much malrotation after IM nailing of femur is acceptable?

A

Differences of <10 degrees between sides are considered normal. >15 deg usually require treatment

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4
Q

What is the most important Good prognostic indicator for Perthes?

A

Age 8 yrs (bone age of <6yrs) at presentation. ROM is the 2nd most

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5
Q

Where is the location of hip dysplasia in spastic CP?

A

Posterior Superior

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6
Q

Where is the location of dysplasia in DDH without spastic CP?

A

Anterior or anterolateral

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7
Q

Which joints have an intra-articular metaphysis?

A

SHEA: Shoulder, Hip, Elbow, Ankle….NOT KNEE

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8
Q

After THA, when are nearly all patients’ driving reaction times returned to their preoperative level

A

4-6 wks

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9
Q

What is the Bunnell test?

A

Test for Intrinsic tightness. It is positive if there is more passive PIP flexion with MP joints flexed than when MP joints are extended.

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10
Q

What ligament is the main restraint to ulnar translation of the carpus?

A

The volar radioscaphocapitate ligament. It must be preserved when doing PRC.

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11
Q

What structure is typically injured/pathologic in a boutonniere deformity?

A

Central slip

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12
Q

Where is the origin and insertion of the lumbrical muscles?

A

Originate on the FDP and insertion on the lateral bands

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13
Q

What are the lateral bands made of and where do they insert?

A

Lateral bands are formed from the deep head of the dorsal interossi combining with the volar interossi. Insert on the base of the distal phalanx to extend the DIP

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14
Q

Which FDP tendons share a common muscle belly?

A

Long, ring and small fingers

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15
Q

What is the optimal pore size for cement less porous implants to allow for optimal bony ingrowth?

A

50 - 400 microns (um) (50-150 ideal)

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16
Q

Metal on metal wear generates what type of cell reaction?

A

Lymphocytic

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17
Q

Poly wear generates what type of cell reaction?

A

Macrophage

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18
Q

What size particles are implicated in osteolysis?

A

<1 micron (submicron)

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19
Q

Which gender has a slightly higher revision rate after uni knee replacement?

A

females

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20
Q

What number of white cells do we use to diagnose PJI in knees and hips?

A

> 1,100 cells/ul for knees
3,000 for hips
This is for Chronic Infections

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21
Q

What number of PMNs do we use to diagnose PJI in hips and knees?

A

> 64% knees

>80% hips

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22
Q

When does CRP peak after surgery and when does it normalize?

A

Peaks 2-3 days after surgery

Normalizes at 21 days (3 wks)

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23
Q

What synovial WBC count <6wks after TKA is suggestive of infection?

A

27,800

24
Q

What are heat stable abx commonly used in cement spacers?

A

Vancomycin, Tobramycin and Gentamycin

25
Q

What hip approach is most likely to cause intraoperative fracture of femur?

A

Press fit femur through lateral approach, typically due to underreaming

26
Q

What type of medication is infliximab?

A

TNF inhibitor.

27
Q

What clinical finding is characteristic of involvement of the natatory ligament in Dupuytren’s disease?

A

Web space contracture

28
Q

What causes PIP and MCP contracture in dupuytren’s disease?

A

Spiral cord

29
Q

How does the spiral cord typically displace the neurovascular bundle?

A

Displaces it central and superficial

30
Q

What is the dominant pathologic cell type in dupuytren’s?

A

Myofibroblast

31
Q

What type of CT scan is used to evaluate healing of scaphoid fractures?

A

1mm fine cut CT scan in plane of the scaphoid axis

32
Q

What is the artery used when harvesting medial femoral condyle autograft for distal radius?

A

Descending genicular artery, from the superficial femoral artery.

33
Q

What is the single most important factor in the prognosis of nerve recovery?

A

Age

34
Q

What type of nerve injury has better prognosis for recover, proximal or distal injuries?

A

The more distal the injury, the more likely the recovery

35
Q

What type of in utero failure leads to proximal radio/ulnar synostosis?

A

Failure of Differentiation/Segmentation

36
Q

In a patient with radial clubland, what MUST you order in the workup?

A

CBC, Renal US, and echo to look for associated conditions. Especially Fanconi’s anemia. If Fanconi’s is expected, need to get chromosomal breakage study.

37
Q

What gene is thought to be associated with radial clubland?

A

Sonic Hedgehog

38
Q

What is a pre-requisite requirement for hand centralization procedure in radial clubhand?

A

Good elbow motion and intact biceps function

39
Q

What type of polydactyly is 10x more common in African Americans?

A

Post axial polydactyly (small finger). If found in caucasians, requires a full genetic workup

40
Q

Apert syndrome is associated with what gene abnormality?

A

FGFR2

41
Q

What is the gold standard to assess healing potential in diabetic foot ulcers?

A

Transcutaneous oxygen pressure. (TcpO2). > 30 mm Hg (or 40mmHg depending on review source cited) is a good sign of healing potential

42
Q

After treatment for a diabetic foot ulcer with total contact casting, if the ulcer recurs, when is it most likely to occur?

A

3-4 wks

43
Q

What is the triad of Hand Schuller Christian disease?

A

multiple lytic skull lesions, diabetes insipidus, exophthalmos.
(chronic, disseminated form with bone and visceral lesions. Also known as Langerhans cell histiocytosis with visceral involvement)

44
Q

What is the most common organism that causes OSTEOMYELITIS in the foot after a puncture wound?

A

Pseudomonas:

  • Gram neg rod
  • Produces exotoxin
  • Secretes pigment in vitro (a blue-green pigment and has a characteristic grape-like odor.)
  • Treat with fluoroquinolone
45
Q

What is the most common complication of surgical treatment of syndacytly?

A

Web creep, the most common complication of this procedure, is the distal migration of the web commissure seen in surgically corrected syndactyly patients. It is caused by abnormal scar tissue formation and increasing growth of underlying osseous structures. Informing parents of this complication preoperatively is advised

46
Q

What is the antagonist muscle to the ECRB?

A

ECRB is in the mobile wad compartment and its antagonist muscle is flexor carpi ulnaris

47
Q

What skin receptors are slowly adapting receptors that detect pressure, texture and low frequency vibration and best evaluated by 2 point discrimination?

A

Merkel’s receptor

48
Q

What is McCune albright syndrome and it’s orthopedic association?

A
  • Cafe au last spots in coast of Maine pattern
  • endocrine abnormalities (precocious puberty)
  • Unilateral Polyostotic Fibrous Dysplasia
    Obtain AP spine radiographs to look for scoliosis
49
Q

Shepard’s crook deformity and alphabet soup histology?

A

Fibrous Dysplasia

50
Q

Placing a retractor at what place risks the obturator artery doing THA?

A

Placing an inferior retractor under the transverse acetabular ligament (or placing a screw in the anterior-inferior quadrant)

51
Q

With a volar PIP dislocation, what structure is frequently injured and how should it be treated?

A

Central slip commonly torn. Should be treated with full time extension splinting for 6 weeks. If not, leads to boutinneire deformity.

52
Q

What disease process is caused by over-secretion of growth hormone and where does it affect the growth plate?

A

Gigantism. Affects the PROLIFERATIVE ZONE.

53
Q

What is the major transcription factor involved with the regulation of chondrocytes?

A

Sox-9

54
Q

What is the effect of PTHrP on chondrocytes?

A

delays the differentiation of chondrocytes in the zone of hypertrophy

55
Q

What is the groove of ranvier responsible for?

A

Appositional growth of the physis

Orthobullets Questions (1 decks)

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