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Surg > Pestana2 Ortho (General) > Flashcards

Pestana2 Ortho (General) Flashcards

1
Q

Malignant bone tumors in adults what kind?

A

Metastatic

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2
Q

Origins of metastatic bone tumors in adults (by gender)

A
  • Women (breast; lytic lesions)

- Men (prostate: blastic lesions)

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3
Q

Malignant bone tumors in adults (dx)

A

XRAY < CT < MRI

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4
Q

Early symptom in adult bone tumors

A

Localized pain

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5
Q

Multiple myeloma (demographic)

A

Old men

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6
Q

Multiple myeloma (sxs 3)

A
  • Fatigue
  • Anemia
  • Localized pain
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7
Q

Multiple myeloma (dx 3)

A
  • XRAY: multiple punched-out lytic lesions
  • Urine: Bence-Jones proteins
  • Serum immunoelectrophoresis: abnl Ig
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8
Q

Multiple myeloma (tx)

A
  • Chemotherapy

- Thalidomide if chemo fails

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9
Q

Soft tissue sarcoma (dx 3)

A
  • Firm, fixed to surrounding tissue
  • MRI
  • Incisional biopsy
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10
Q

Soft tissue sarcoma (mets)

A

Lungs

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11
Q

Soft tissue sarcoma (tx 3)

A
  • Wide local excision
  • Chemo
  • Rad
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12
Q

XRAY views in suspected fx

A
  • AP and lateral

- Joints above and below fx

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13
Q

Closed reduction (def, guidelines 2)

A
  • Immobilization in cast or splint
  • Not badly displaced/angulated
  • Can be aligned by external manipulation
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14
Q

Clavicular fx (location)

A

Junction of middle and distal third

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15
Q

Clavicular fx (tx)

A

Arm in sling

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16
Q

MC shoulder dislocation

A

Anterior

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17
Q

Anterior shoulder dislocation (sxs 2, dx)

A
  • Close to body w/ external rotation
  • Possible numbness over deltoid (stretched axillary)
  • AP+Lateral xrays
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18
Q

Posterior shoulder dislocations (causes 2)

A

Massive uncoordinated muscle ctx:

  • Epileptic seizure
  • Electrical burn
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19
Q

Posterior shoulder dislocations (sx, dx)

A
  • Close to body w/ internal rotation

- Axillary view or scapular lateral view xrays

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20
Q

Colles fx (dem, injury)

A

Old osteoporotic woman falls on outstretched hand

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21
Q

Colles fx (lesion)

A
  • “Dinner fork”

- Dorsally displaced, dorsally angulated fx of distal radius

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22
Q

Colles fx (tx)

A

Closed reduction w/ long arm cast

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23
Q

Monteggia fx (injury)

A

-Direct blow to ulna (“nightstick” injury)

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24
Q

Monteggia fx (lesion)

A

-Fx of proximal ulna w/ resultant anterior dislocation of radial head

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25
Q

Galeazzi fx (lesion)

A

-Fx of distal radius w/ resultant dorsal dislocation of distal radioulnar joint

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26
Q

Monteggia and Galeazzi fx’s (tx)

A
  • Fx: ORIF

- Dislocation: closed reduction

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27
Q

Fx of scaphoid (dem, injury)

A

Young adult falls on outstretched hand

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28
Q

Scaphoid fx (sxs 2)

A
  • Wrist pain

- TTP over anatomical snuffbox

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29
Q

Scaphoid fx (dx)

A
  • H&P

- XRAY shows fx 3wks later

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30
Q

Scaphoid fx (mgmt)

A
  • Thumb spica cast

- If displacement/angulation on original xray, then ORIF

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31
Q

Scaphoid fx (complication)

A

Nonunion

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32
Q

Metacarpal neck fx (digit#)

A

4th/5th

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33
Q

Metacarpal neck fx (injury)

A

Closed fist hits a hard surface

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34
Q

Metacarpal neck fx (dx)

A

XRAYs

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35
Q

Metacarpal neck fx (mgmt)

A

Depends on severity

  • Mild: CR and ulnar gutter splint
  • Severe: Kirschner wire or plate fixation
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36
Q

Hip fx (dem, injury)

A

Old who sustain a fall

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37
Q

Hip fx (presentation 2)

A
  • Hip pain

- Affected leg is shorter and externally rotated

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38
Q

Femoral neck fx (complication)

A

AVN

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39
Q

Intertrochanteric fx (post-op complication)

A

DVT/PE 2/2 immobilization

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40
Q

Intertrochanteric fx (mgmt)

A
  • OR and pins

- Post-op anticoagulation

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41
Q

Femoral shaft fx (complications)

A
  • B/L and comminuted: shock

- Mulptiple: fat embolism syndrome

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42
Q

Femoral shaft fx (mgmt)

A

-Intramedullary rod fixation

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43
Q

When is a femoral shaft fx an emergency and what is the tx?

A
  • Open fx

- OR cleaning and closure w/in 6hrs

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44
Q

A highly sensitive sign of knee injury

A

Swelling

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45
Q

Collateral ligament injuries (force)

A
  • Medial blows: lateral ligaments

- Lateral blows: medial ligaments

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46
Q

Tests in collateral ligament injuries (x2)

A

Knee flexed at 30* (passive manipulation: pain and further displacement)

  • Valgus stress test: abduction: medial injury
  • Varus stress test: adduction: lateral injury
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47
Q

Collateral ligament injury (mgmt)

A
  • Isolated: hinged cast

- Multiple: surgical repair

48
Q

Which cruciate ligament injury is more common?

A

ACL

49
Q

Tests in cruciate ligament injuries (x2)

A
  • Drawer test (90* knee flexion)

- Lachman test (20* knee flexion)

50
Q

Cruciate ligament injuries (dx)

A

MRI

51
Q

Cruciate ligament injuries (mgmt 2)

A
  • Sedentary: immobilization and rehab

- Athletes: arthroscopic reconstruction

52
Q

Meniscal tear (dx)

A

MRI

53
Q

Meniscal tear (sxs 2)

A
  • Catching/locking that limit motion

- Click when knee is fully extended

54
Q

Meniscal tear (mgmt)

A

-Arthroscopic repair (preserve as much as possible)

[complete meniscectomy causes degenerative arthritis]

55
Q

Unhappy triad

A
  • Medial collateral
  • ACL
  • Medial meniscus
56
Q

Tibial stress fx (dem, injury)

A

Young men subjected to forced marches

57
Q

Tibial stress fx (dx)

A
  • TTP over a very specific point

- XRAY may be negative

58
Q

Tibial stress fx (mgmt)

A
  • Cast and f/u with xray in 2wks, or

- Crutches (non-weight bearing)

59
Q

Leg fx’s involving the tibia and fibula (injury)

A

Pedestrian hit by a car

60
Q

Leg fx’s involving the tibia and fibula (dx)

A

XRAYs

61
Q

Leg fx’s involving the tibia and fibula (mgmt)

A
  • Easily reducible: casting

- Can’t be aligned: intramedullary nailing

62
Q

Leg fx’s involving the tibia and fibula (complication)

A

Compartment syndrome

63
Q

Rupture of the Achilles tendon (dem, injury)

A

Out-of-shape middle-aged men subject themselves to severe strain (loud popping sound)

64
Q

Rupture of the Achilles tendon (mgmt)

A
  • Slow: casing in equinus position

- Fast: surgery

65
Q

Fx of the ankle (injury)

A

Falling on inverted/everted foot

66
Q

Fx of the ankle (lesion)

A

Both malleoli break

67
Q

Fx of the ankle (dx)

A

AP, lateral, mortise xrays

68
Q

Fx of the ankle (mgmt)

A

ORIF

69
Q

Compartment syndrome (PE)

A

Excruciating pain w/ passive extension

70
Q

Compartment syndrome (tx)

A

Emergency fasciotomy

71
Q

Pain under cast (mgmt)

A

Open and examine

72
Q

Open fx’s (mgmt)

A

Clean and reduce w/in 6hrs of injury

73
Q

Posterior dislocation of hip (presentation x3)

A
  • Shortened leg
  • Adducted
  • Internally rotated (vs externally in hip fx)
74
Q

Posterior dislocation of hip (complication)

A

AVN of femoral head

75
Q

Posterior dislocation of hip (mgmt)

A

Emergent reduction

76
Q

Gas gangrene (injury)

A

Deep, penetrating, dirty wound

77
Q

Gas gangrene (presentation x3)

A
  • Toxic pt
  • Tender, swollen, discolored wound
  • Crepitations
78
Q

Gas gangrene (mgmt x3)

A
  • IV penicillin
  • Surgical debridement
  • Hyperbaric oxygen
79
Q

Radial nerve (injured bone)

A

Mid to distal third humerus

80
Q

Radial nerve (sign)

A

Pt can’t dorsiflex/extend wrist

81
Q

Popliteal artery (injury)

A

Posterior dislocation of knee

82
Q

Popliteal artery injury (dx 3)

A
  • Pulses
  • Doppler
  • CT angio
83
Q

Popliteal artery injury (mgmt)

A

Prophylactic fasciotomy (w/ delayed restoration of flow)

84
Q

Falls from height (lesion location x4)

A
  • Foot, leg

- Thoracic, lumbar spine

85
Q

Head on auto collision (lesion location x4)

A
  • Face, head, torso

- Femoral head into pelvis or out of acetabulum

86
Q

What should be always evaluated in facial fx’s and closed head injuries?

A

Cervical spine

87
Q

Carpal tunnel syndrome (dem, injury)

A

Women who do repetitive hand work

88
Q

Carpal tunnel syndrome (sxs)

A

Numbness and tingling over radial 3.5 fingers (median n.)

89
Q

Carpal tunnel syndrome (dx)

A

Clinical (but xray recommended)

90
Q

Carpal tunnel syndrome (mgmt)

A
  • Splints

- Anti-inflammatory agents

91
Q

What should be performed if surgery for carpal tunnel syndrome is indicated?

A

Electromyography

92
Q

Trigger finger (presentation)

A

Acutely flexed finger w/ inability to extend

93
Q

Trigger finger (tx)

A

Steroid injections

94
Q

How can carpal tunnel syndrome sxs be reproduced?

A
  • Hang hand limply for a few min

- Tap/percuss over median nerve

95
Q

DeQuervain tenosynovitis (dem, injury)

A

Young mothers who hold babies w/ wrist flexion and thumb extension

96
Q

DeQuervain tenosynovitis (reproduce sxs)

A

Thumb in closed fist w/ ulnar deviation

97
Q

DeQuervain tenosynovitis (mgmt)

A
  • Splint

- Anti-inflammatory agents

98
Q

Dupuytren contracture (presentation x2)

A
  • Contracture of the hand

- Palmar fascial nodules can be felt

99
Q

Dupuytren contracture (tx)

A

Surgery

100
Q

Felon (definition, mgmt)

A
  • Abscess in pulp of finger

- I&D

101
Q

Gamekeeper thumb (injury)

A

Hyperextension of thumb

102
Q

Gamekeeper thumb (lesion)

A

Ulnar collateral ligament injury

103
Q

Gamekeeper thumb (mgmt)

A

Casting

104
Q

Jersey finger (injury)

A

Forceful extension of a flexed finger

105
Q

Jersey finger (lesion)

A

Flexor tendon injury

106
Q

Jersey finger (sign)

A

Injured finger doesn’t flex when making a fist

107
Q

Mallet finger (injury)

A

Forceful flexion of an extended finger

108
Q

Mallet finger (lesion)

A

Extensor tendon injury

109
Q

Mallet finger (sign)

A

Tip of injured finger remains flexed when hand is extended

110
Q

Jersey and Mallet finger (mgmt)

A

Splinting

111
Q

Traumatically amputated digit (mgmt x4)

A
  • Cleaned w/ sterile saline
  • Wrapped in saline-moistened gauze
  • Placed in sealed plastic bag
  • Bag on bed of ice
112
Q

Traumatically amputated digit (motor preservation procedure)

A

Electric nerve stimulation

113
Q

Marjolin ulcer (path)

A

Squamous cell carcinoma of skin developing in a chronic leg ulcer

114
Q

Marjolin ulcer (dx)

A

Biopsy

115
Q

Marjolin ulcer (mgmt)

A
  • Wide local excision

- Skin grafting

Surg (7 decks)

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