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Rheumatology & Othopaedics > Orthopaedics > Flashcards

Orthopaedics Flashcards

1
Q

How do you manage an open fracture?

A 
Take photo
Saline soaked gauze
IV Co-amox
Tetanus booster
Analgesia
IVI/tranfusion
XR
CTA/Doppler if arterial injury suspected
Pre-op bloods
Specialist- reduce and splint , debride, Gustilo and Anderson classification
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2
Q

Bloods to prep for theatre

A 
U&E
Group & save
FBC
Clotting
ECG/CXR
Cannula
Fluids O/N
Consented by reg
Neurovascular status
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3
Q

Shoulder fracture- which nerve affected and how do you test for it?

A

Axillary

Sensation on top of arm

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4
Q

How do you test ulnar nerve?

A

Hand sensation

Finger spread for motor

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5
Q

How do you damage the ulnar?

A

Elbow injury

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6
Q

What is colles?

A

Wrist fracture with dorsal angulation

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7
Q

How do you test motor radial?

A

Thumbs up

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8
Q

How do you test motor of median nerve

A

form a fist

and cross fingers over (interosseus)

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9
Q

What are criteria for a THR?

A

displaced, intracapsular NOF fracture and old, but

-able to mobilise with 1 stick or less outside, not cognitively impaired and medically well

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10
Q

What are criteria for hemiarthorplasty?

A

intracapsular and old

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11
Q

How to manage an intertrochanteric NOF?

A

Dynamic hip screw

MOST COMMON

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12
Q

How to manage a extracapsular NOF?

A

IM nail

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13
Q

Where do you press for ottawa ankle rules?

A

Midfoot zone, lateral and medial malleolus and 5th metatacal head

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14
Q

What criteria are used in deciding on cast and ops for ankles?

A

Webber criteria

Based on ligament placement- if below then stable so no cast (A), if aboce then C, least stable so pin

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15
Q

What investigations do you need to do in myeloma?

A 
IgG
RBC with film
U&E with calcium
Urinary bence jones
Xray any painful bones
Refer to radiology for myeloma screen
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16
Q

What fractures does osteomalacia present with?

A

Pseudo
Luscent lines on xray
Painful but not fracture as not displaced

17
Q

What is osteomalacia?

A

impaired bone mineralisation resulting in softening which deforms.

18
Q

How is osteomalacia manages?

A

Ca++ and vit D and monitor response with serium Ca++ and alkaline phos
OR PUT THEM OUTSIDE!

19
Q

What is Pagets?

A

Disregulation of osteoclasts and blasts forming large, new, weak bone quickly.
Focal disease of remodelling- mosaic of woven and lamellar bone

20
Q

How does Pagets present?

A

Bone pain in elderly
FH history
Isolated raised ALK PHOS, all other LFTs, GGT, calcium etc normal

21
Q

How is Pagets assessed?

A

Isotope bone scan to identify all affected
Radiographs for diagnosis
Serum alk phos for monitoring

22
Q

How is pagets Managed?

A

Bisphosphonates (zolendronate (IV)/ alendronate/ risedronate)
Give Ca and vit D too

23
Q

What are Pagets complications?

A

Deafness
Cord compression
nerve compression
Long bone weakness

24
Q

What cells are present in Pagets?

A

Giant multinucleate osteoclasts

25
Q

How do you diffentiate between mets and pagets lesions?

A

Mets- small areas on axial skeleton and tend to be symetrical
PAgets- unilateral lesions on mono/poly joints

26
Q

What are 3 signs of on xray?

A

white sclerotic patches
increased bone size
loss of trabecular acrhitecture

27
Q

What are red flags for back pain?

A 
Under 16 or over 65 new onset
Neurology
Night pain
pain at rest/unrelenting
Immunocompromised
Long term steroid use
Malignancy history
Weight loss
concurrent illness
28
Q

What are symptoms of cauda equina?

A 
Asymmetrical
Flaccid
Decreased reflexes
Bladder and bowel present late
LMN
(PR needed)
29
Q

What are symptoms of spinal cord compression?

A

Symmetrical
UMN
Perianal numbness
Urinary retention, foecal incontinence

30
Q

What is the criteria to decide between NOF treatments called?

A

Garden criteria

31
Q

What nerve is affected in humerus breaks?

A

Radial

32
Q

What nerve is affected in wrist fractures?

A

Median

33
Q

What nerve is affected in proximal fibular fractures?

A

Common peroneal

Rheumatology & Othopaedics (7 decks)

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