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Boards/Interviews > Pimp Interview Questions > Flashcards

Pimp Interview Questions Flashcards

1
Q

Fowler Phillip Angle (normal vs abnormal to ID what pathology)

A
  • ID Haglund’s Deformity
  • normal: 45-70 deg
  • Haglunds > 75 deg
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2
Q

Another name for “Total Angle”

A

Total angle “OF RUCH”

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3
Q

Total Angle (abnormal to ID what pathology)

A
  • ID Haglund’s Deformity

> 90 = pathologic

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4
Q

What is “Peak of Lampiere”

A

1st met-cuneiform exostosis

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5
Q

Another term for “Peak of Lampiere”

A

tarsal bossing

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6
Q

What are 3 angles you want to examine for haglund’s deformity

A
  1. Fowler-Phillip Angle
  2. Total Angle (of Ruch)
  3. Parallel Pitch Lines
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7
Q

How much cartilage should be intact to 1st MTPJ for decision justified to do joint salvage px for hallux lim

A

> 50%

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8
Q

For surgical correction of Haglunds deformity… you should consider using fixation (e.g., bone anchor) to secure it back in place if you have to resect what % of tendon?

A

50%

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9
Q

Difference b/w Bruit and Thrill

A
  • bruit : hear

- thrill: feel

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10
Q

Allen Test

A
  • performed in hand – test for radial or ulnar artery occlusion
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11
Q

Pallor with Elevation, Rubor with Dependency – how long does it take normally for color to return? abnormal/diseased?

A

10 seconds = normal return

45-60 seconds = abnormal

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12
Q

ABI necessary for healing?

A

DM: 0.45

Non-DM: 0.35

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13
Q

When is TBI indicated?

A
  • when ABI > 1.3

- i.e., when calcification of the vessels prohibits accurate ABI (doesn’t effect TBI b/c calcification rarely in digits)

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14
Q

What TBI value is consistent with LEAD

A
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15
Q

Toe pressure

A

TBI

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16
Q

Interpretation of Segmental Pressures

A
  • same leg: occlusion proximal if 30 mmHg decrease b/w 2 segments
  • CL leg: occlusion on one limb if 20-30 mmHg difference from other side (occlusion in lower read)
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17
Q

Transcutaneous Oxygen Pressure: when is it useful?

A
  • useful when ABI and TBI do not provide useful information (i.e., compressible vessels and toes amputated)
  • additional support for re-vasc sx
  • indicate amputation level
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18
Q

Interpretation of TcPO2

A

> 30 mmHg - normal (predictive of healing)

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19
Q

When is Skin Perfusion Pressure Test done (SPP)

A

when there is excessive local edema/anemia (TcPO2 can give false reading)

> 30 mmHg - likely to heal wound

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20
Q

IV contrast used in MRA

A

gadolinium

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21
Q

Contraindications to MRA

A
  • pacemaker
  • implanted defibrillators
  • other implanted electronic devices (cochlear implants)
  • aneurysm clips
  • pregnancy

relative contraindications: orthopedic hardware (creates artifacts on films), claustrophobia

22
Q

IV contrast used for CTA

A

iodinated contrast

23
Q

CTA vs MRA

A
  • CTA: more image detail, useful in pts with CI to MRA
    • however, less accurate in extensive vessel occlusion, ionizing radiation +
  • MRA: no ionizing radiation, more accurate with extensive vessel occlusion
    • however, many CI’s, less image detail, and pts may be claustrophobic b/c takes longer
24
Q

Foam Cells

A

lipid-laden macrophages

25
Q

Senile Medial Calcinosis

A

Monckeberg’s Sclerosis

26
Q

Extensive skin necrosis following limb ischemia occurs within what amount of time

A

6 hrs

27
Q

Causes of Hypercoaguable State

A
  • Protein C or S deficiency
  • Antithrombin III deficiency
  • Factor V Leiden deficiency
  • Antiphospholipid syndrome (associated with SLE)
28
Q

CAVEMAN common etiologies for embolic source

A 
Cardiac catheterization - iatrogenic
A. Fib
Valve Dz
Endocarditis
Myocardial Infarct/Mural Thrombus
Aneurysm
Nothing
29
Q

Virchow’s Triad

A
  • venous stasis
  • hypercoaguable state
  • endothelial damage
30
Q

R/o Test for DVT

A

d-dimer (fibrin degradation product)

31
Q

Tests for PE

A
  • CT pulmonary angiography (gold standard) – rule in
  • V/Q Scan
  • D-dimer (rule out)
32
Q

Pratts sign vs Pratts Test

A

Pratts sign: dilated pre-tibial vessels

Pratts test: compressing popliteal veins; calf squeeze

33
Q

Reversal agent Heparin

A

protamine sulfate

34
Q

Reversal agent Coumadin

A

Vit K or FFP (faster)

35
Q

Heparin Induced Thrombocytopenia – why is it bad?

A

antibodies activate platelets and cause arterial / venous thrombosis

36
Q

How to tx pt with HIT:

A
  1. stop heparin
  2. need anticoagulants due to incr risk of thrombosis
  3. begin non-heparin anti-coagulant (e.g., argatroban - direct thrombin inhibitor, fondaparinux, apixiban, rivaroxiban) -ban’s = Xa inhibitors

** don’t use lovenox as supplement

37
Q

Pharmacologic Tx of DVT

A
  1. initial (first 5 days):
    - Lovenox (1 mg/kg q 12 hrs = therapeutic dose)
    - Heparin so that PTT is 1.5 x normal
    - Apixiban or Rivaroxiban
  2. Long Term (Start initially but not therapeutic at the onset)
    - Warfarin (Coumadin) INR 2-3
  3. Other agents
    - Factor Xa inhibitors (Rivaroxaban, Apixaban, Edoxaban)
    - Direct Thrombin Inhibitors (Dabigatran, Argatroban)
38
Q

myxedema - what is it and what is it hallmark for?

A
  • mucopolysaccharide deposition in the dermis

- grave’s disease

39
Q

+ stemmer sign

A

thickened skin fold at the base of the second toe or second finger that is a diagnostic sign for lymphedema. Stemmer Sign is positive when this tissue cannot be lifted but can only be grasped as a lump of tissue; it is negative when it is possible to lift the tissue normally.

40
Q

Atrophie Blanch

A

sign of impending ulceration w/ venous insufficiency

41
Q

Lipodermatosclerosis

A

sclerotic hardening of the underlying fat

42
Q

Contraindications to using TQ:

A
  • PVD (h/o re-vasc px)
  • Traumatized limb
  • Severe infection in limb
  • DVT in limb
  • Peripheral neuropathy
  • Poor Skin Condition
  • AV fistula

Relative CI: sickle cell disease

43
Q

Examples of Large vessel vasculitis

A
  • giant cell (temporal) arteritis

- takayasu arteritis

44
Q

Examples of Medium Vessel Vasculitis

A
  • Polyarteritis nodosa

- Kawasaki Dz

45
Q

Examples of Small Vessel Vasculitis

A
  • Churg Strauss Syndrome (anti-neutrophil cytoplasmic Ab)
  • Wegener’s Granulomatosis (anti-neutrophil cytoplasmic Ab)
  • Henoch-Schonlein Purpura (mostly in kids following strep pharyngitis)
46
Q

How to diagnose Compartment Syndrome

A

Wick/Stryker Catheter (>30 mmHg comp pressure)

  • note: normal Compartment Pressures: 0-5… capillary blood flow compromised at 10-30 mmHg… and pain develops when tissue pressures reach 20-30 mmHg
47
Q

most common cause endocarditis

A

S. viridans

48
Q

cause of endocarditis due to IVDA

A

s. aureus

49
Q

Haglund’s DISEASE

A

osteochondrosis of accessory navicular

50
Q

Other names for Subtendinous/Retrocalcaneal Bursitis

A
  • Achillodynia
  • Albert’s disease
  • Anterior Achilles Bursitis
51
Q

Name for 1st TMTJ arthritis/exostosis

A
  • Tarsometatarsal “Bossing”

- “Peak of Lampiere”

Boards/Interviews (10 decks)

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