Other / Misc

Question 1

This benign nodular tumor has a propensity for local recurrence in the volar aspect of the radial three digits

Answer 1

giant cell tumor of the tendon sheath (treat with marginal excision)

Question 2

What is the difference between pediatric and adult trauma populations in regards to the timeframe for developing multi-organ failure?

Answer 2

Adult trauma patients develop MOF 48hr after initial injury; with peds, MOF occurs early after admission during resuscitation

Question 3

Which nerve is commonly injured during repair of distal biceps rupture? And why?

Answer 3

LABCN (lateral antebrachial cutaneous nerve)
– ruptured biceps can displace the nerve further midline distorting its normal course
(usually emerges beneath lateral biceps tendon at level of interepicondylar line)

Question 4

Which artery has branches that run along the border of the piriformis tendon and can contributes to the femoral head blood supply?

Answer 4

the INFERIOR GLUTEAL artery

Question 5

TIBIAL deficiency is often associated with what other musculoskeletal conditions?

Answer 5

Hip dysplasia

Pre-axial polydactyly

Question 6

What are the two most common causes of neoplastic pathologic vertebral compression fracturs?

Answer 6

1) Multiple Myeloma

2) Plasmacytoma

Question 7

FIBULAR deficiency is often associated with what other musculoskeletal conditions?

Answer 7

absence of ACL
ball-and-socket ankle joint
tarsal coalition

Question 8

Most common cause of early limb loss after rotationplasty

Answer 8

Vascular compromise

– because both anastomosed and rotated vessels are at risk for thrombosis

Question 9

Which nerve is associated with entrapment at: the ligament of STRUTHERS

Answer 9

MEDIAN nerve entrapment

Question 10

What is the pathophysiology of repetitive loading injuries to growth plates in skeletally immature athletes?

Answer 10

repetitive overuse&raquo_space; metaphyseal perfusion disruption&raquo_space; inhibition of the ZONE OF PROVISIONAL CALCIFICATION&raquo_space; radiographic appearance of widened physis at hypertrophic zone (due to continued chondrocyte transition from germinal layer to proliferative zone)

Question 11

Which nerve is associated with entrapment at: the ARCADE of FROHSE

Answer 11

posterior interosseous nerve (PIN) – tendinous border of proximal supinator muscle

Question 12

What is the most common myopathy in adults older than 50?

Answer 12

Inclusion-Body Myositis

– affects wrist/finger flexors AND quads

Question 13

What differentiates the two types of CRPS?

Answer 13

Type I - no demonstrable nerve lesion

Type II - identifiable nerve damage, show minimal positive response to sympathetic blocks

Question 14

What is the most commonly injured nerve during arthroscopic Latarjet procedure?

Answer 14

musculocutaneous nerve injury

presents as weakness with elbow flexion LABCN sensory deficits

Question 15

What is considered to be a normal level of serum cobalt?

Answer 15

Less than 5 or 6 (ug/L) or >1 ppb

Question 16

signs/symptoms suggestive malignant transformation of an osteochondroma has ocurred

Answer 16

1. growth after skeletal maturity
2. cartilage cape >2cm thick
3. pain over previously painless area

Question 17

Name the two most common types of tarsal coalition

Answer 17

1) CALCaneoNAVICular

2) subtalar

Question 18

Nerve injury predictably causes a loss of distal function in what sequence?

Answer 18

(1) MOtor function, (2) PROprioception, (3) TOuch, (4) TEMPerature, (5) PAIN
[recovery occurs in reverse order]

Question 19

How do you treat Bupivicaine-related cardiac arrest?

Answer 19

“lipid resuscitation”

= IV 20% lipid emulsion +/- epinephrine

Question 20

Which RA meds should be held before an elective THA/TKA?

Answer 20

BIOLOGIC AGENTS should be held according to relative last dose – read: all of the monoclonal antibodies + etanercept + abatacept + anakinra + tofacitinib

**If a patient has severe lupus or organ transplant then it is okay to continue mycophenolate, azathioprine, cyclosporine, and tacrolimus (if not severe SLE, then it should be held 1 week prior to surgery)

Question 21

Order of transcortical motor evoked potentials…

Answer 21

Motor cortex to the CORTICOSPINAL tract
> spinal cord interneuron
>> anterior horn cells
>>> peripheral nerve
>>>> skeletal muscle
(EFFerent direction)

Question 22

Surgical approach for MEDIAL meniscus inside-out repair

Answer 22

posterior to MCL – interval is between postero-medial joint capsule and the medial head of the gastroc

Question 23

Which nerve is associated with entrapment at: the distal edge of the LACERTUS FIBROSIS?

Answer 23

anterior interosseous nerve (AIN) entrapment – at lacertus and deep head of pronator teres

Question 24

Surgical approach for LATERAL meniscus inside-out repair

Answer 24

posterior to the LCL and proximal to the biceps femoris – interval is between postero-lateral joint capsule and lateral head of the gastroc

Question 25

Predominant source of blood supply to the femoral head are the retinacular vessels, which are branches of the _____ artery.

Answer 25

MEDIAL femoral circumflex artery

Question 26

What are the 5 common DMARDs and should they be held pre-op for elective arthroplasty?

Answer 26

1) methotrexate 2) sulfasalazine 3) hydroxychloroquine 4) leflunomide 5) doxycycline

– NO, they should not be held pre-operatively

Question 27

Most appropriate candidate for a latissimus dorsi transfer is _____

Answer 27

young laborer with a massive RCT and supraspinatus atrophy with significant fatty infiltration