Orthopedic Surgery

Question 0

What is Legg-Calve-Perthes disease

Answer 0

Avascular necrosis of the capital femoral epiphysis

Question 1

Tx for developmental dysplasia of hip

Answer 1

Abduction splinting with Pavlik harness for 6 months

Question 2

Signs of SCFE on physical exam

Answer 2

External rotation on hip flexion without ability to internally rotate

Question 3

Tx for club foot (talipes equinovarus)

Answer 3

Serial plaster casting
Achilles tenotomy, braces
Surgery between 9 and 12 months

Question 4

Which fractures are especially concerning in children

Answer 4

Supracondylar fracture of the humerus

Fractures involving the growth plate

Question 5

Tx if growth plate is displaced but in one piece

Answer 5

Closed reduction

Question 6

Tx if growth plate is in two pieces

Answer 6

Open reduction

Internal fixation

Question 7

Most common primary malignant bone tumor
Around knee
Sunburst pattern on Xray

Answer 7

Osteogenic sarcoma

Question 8

Second most common primary malignant bone tumor
Diaphysis of long bones
Onion skinning on Xray

Answer 8

Ewing sarcoma

Question 9

Where do bone tumors in adults mostly arise

Answer 9

Breast in women - lytic

Prostate in men - blastic

Question 10

Punched out lytic bone lesions
Bence Jones proteins in urine
Abnormal Ig’s

Answer 10

Multiple myeloma

Question 11

Which type of shoulder dislocation is rare but can occur in epileptic seizures or electrical burns

Answer 11

Posterior dislocations

Question 12

Diaphyseal fracture of proximal ulna

Dislocation of radial head

Answer 12

Monteggia fracture

Question 13

Distal 1/3 radius fracture

Dorsal dislocation of distal radioulnar joint

Answer 13

Galeazzi fracture

Question 14

Fall on outstretched hand
Tenderness in anatomic snuffbox
Positive Xray

Tx?

Answer 14

Scaphoid fractures

Requires open reduction and internal fixation

Question 15

Tx for metacarpal neck fracture that is angulated, displaced or rotatory malaligned

Answer 15

K wire or plate fixation

Question 16

Which intervention for displaced femoral neck fractures allows faster healing and ambulation

Answer 16

Replacement of femoral head with a prosthesis

Question 17

Tx for intertrochanteric fracture

Answer 17

Open reduction, internal fixation

Question 18

Tx for femoral shaft fractures

What can kill these patients

Answer 18

Intramedullary rod fixation

Hemorrhagic shock, fat embolism

Question 19

Tx for isolated collateral ligament injuries

Answer 19

Hinged cast

Question 20

Tx for isolated cruciate ligament injuries

Answer 20

Immobilization, rehabilitation

Athletes require arthroscopic reconstruction

Question 21

Tx for meniscal tears

Complete meniscectomy leads to what

Answer 21

Open repair

Leads to degenerative arthritis

Question 22

Most common sites of compartment syndrome after fracture

Answer 22

Lower leg

Forearm

Question 23

Tx for achilles tendon rupture

Answer 23

Casting in equinus for several months

Surgery for quicker results.

Question 24

Tx for ankle fracture (malleoli)

Answer 24

Open reduction, internal fixation

Question 25

Tx for compartment syndrome Pulses?

Answer 25

Fasciotomy Pulses may be present

Question 26

Presentation of hip dislocation v hip fracture

Answer 26

Dislocation is internally rotated Fracture is externally rotated In both the leg is shortened

Question 27

Why is emergency reduction indicated in hip dislocation

Answer 27

To avoid avascular necrosis of femoral head

Question 28

Etiology of gas gangrene

Answer 28

Deep, penetrating, dirty wounds | I.e. dirty rusty nails

Question 29

Tx of gas gangrene

Answer 29

IV penicillin Extensive emergency debridement Hyperbaric oxygen

Question 30

Toxic appearing patient | Tender, swollen, discolored site of penetrating injury with crepitus

Answer 30

Gas gangrene

Question 31

Distal humerus fracture | Inability to extend the wrist

Answer 31

Radial nerve involvement Surgery required for entrapment if paralysis remains after reduction

Question 32

Posterior dislocation of knee No distal pulses If reduction is delayed, then what

Answer 32

Popliteal artery involvement Delayed reduction requires prophylactic fasciotomy

Question 33

Injury incurred when knees hit dashboard in head on mva

Answer 33

Posterior dislocation of hip

Question 34

Initial tx of carpal tunnel What is needed before surgery

Answer 34

Splints, anti-inflammatories EMG before surgery

Question 35

Initial tx of trigger finger

Answer 35

Steroid injection

Question 36

What is felon and its tx

Answer 36

Abscess in pulp of fingertip | I&D

Question 37

Ulnar collateral ligament injury caused by forced hyperextension of thumb Tx?

Answer 37

Gamekeeper's thumb Casting

Question 38

Injury to flexor tendon when flexed finger is forcefully extended Tx?

Answer 38

Jersey finger Splinting

Question 39

Extended finger is forcefully flexed Tx?

Answer 39

Mallet finger Splinting

Question 40

Distended bladder Flaccid rectal sphincter Perineal saddle anesthesia Tx?

Answer 40

Cauda equina syndrome Emergency surgical decompression

Question 41

Tx for lumbar disc herniation

Answer 41

Bed rest for 3 weeks Pain control with nerve blocks Surgery when neurologic deficits progress Cauda equina syndrome is a surgical emergency

Question 42

Progressive back pain unrelieved by rest or position changes in elderly Weight loss

Answer 42

Metastatic malignancy

Question 43

Squamous cell carcinoma of the skin developing in a chronic leg ulcer

Answer 43

Marjolin ulcer

Question 44

Common digital nerve inflammation between third and fourth toes

Answer 44

Morton neuroma

Question 45

Tx for acute gout Chronic gout?

Answer 45

Acute: indomethacin, colchicine Chronic: allopurinol, probenicid