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OITE Review Book > Practice Management > Flashcards

Practice Management Flashcards

1
Q

Need all of the following to bill for consultation

A
  1. requested by another physician
  2. request is documented
  3. patient’s visit and consultant’s opinions are documented
  4. opinion is communicated back to requesting physician
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2
Q

If already billed for fx care (whether reduction was done in clinic or OR), then all services related to tx within…

A

90 days is considered global fee –> cannot bill.

Exception: application of splint or cast during global period is billed separately

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3
Q

Modifier 25

A

significant, separately identifiable evaluation and management service by same physician on same day of procedure or other service

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4
Q

Modifier 58

A

appended to 2nd procedure (staged or related procedure) during global period

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5
Q

Physician Payments Sunshine Act

A

must report payments of > $10

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6
Q

4 legal elements of medical negligence

A
  1. duty
  2. breach of duty
  3. causation
  4. damages
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7
Q

Worker’s comp case can be settled once…

A

patient has reached maximum medical improvement.

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8
Q

Stark Law

A

prohibits any provider from referring medicare or medicaid patients to a facility in which the provider has a financial relationship with

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9
Q

A formal written complaint from a patient requires…

A

a formal written response from provider.

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10
Q

What is a physician’s obligations regarding another physician’s error?

A

ethically but NOT lawfully obligated to inform patient

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11
Q

The federal trade commission prohibits…

A

false advertising

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12
Q

IMN. with stainless steel is associated with…

A

increased risk for adverse events (nonunion, revision, fx of implant) because stainless steel causes more autodynamization (screw breakage).

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13
Q

What is the actual lifetime IPV among female patients and perceived IPV prevalence by surgeons?

A

40% and 10%

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14
Q

Predictor of IPV

A

repeated ED visits

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15
Q

Timed up and go test predicts…

A

functional outcome (need for walking aid) after hip hemi.

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16
Q

For occult hip fx, if CT is neg and unable to obtain MRI, then obtain…

A

bone scan 72 hrs after initial injury.

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17
Q

How to reverse bupivicaine-related cardiac arrest (asystole from injecting bupivicaine into femoral vein)

A

lipid (20%) fat emulsion

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18
Q

Sheathed tendons receive blood supply from…

A

vincula.

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19
Q

Tib ant rupture - treat with…

A

primary tendon repair and possible graft augmentation with EHL.

Also consider gastroc recession if there is contracture bc it can compromise repair.

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20
Q

Scapular injury is most commonly associated with concomitant…

A

chest injury.

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21
Q

Hip fracture mortality…

A

in hospital 6%
1 yr 30%

**better if operated on within 48 hours

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22
Q

Outpatient UE surgery should only go home with…

A

10 narcotic pills.

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23
Q

Compared to freeze-dried allograft, frozen allograft has…

A

greater torsional and bending strength.

24
Q

What allograft has the highest immunogenicity?

A

fresh

25
Q

What type of nerves are at bone-tendon junction?

A

free nerve endings –> nociception

26
Q

What metal has highest rate of bacterial adherence?

A

titanium

27
Q

adductor canal block blocks…

A

saphenous sensory but not femoral motor nerve.

28
Q

Best predictor of premature physeal closure in pediatric distal tibia fx

A

physeal gap > 3 mm

29
Q

Strongest risk factor for patellar tendonitis

A

hamstring/quad inflexibility

30
Q

osteoblasts regulate hematopoietic cells and immune response via…

A

PTH-Jagged1-Notch pathway.

31
Q

PTH induces Jagged1 on…

A

osteoblasts which stimulates notch receptors on hematopoietic stem cells leading to cell proliferation.

32
Q

ECD tendon laceration, after primary repair use…

A

a yoke splint (relative motion splint) that holds the MCP in slight extension but allows AROM of PIP and DIP.

33
Q

Tx of chronic SPN pain

A

neurotomy with transposition into bone

34
Q

During fx healing, MMP 13 acts to…

A

degrade cartilaginous ECM.

35
Q

Tooth avulsion

A

rinse in water or saline and place in milk, saliva, or sterile saline

36
Q

Pregnant patient, place in…

A

left lateral decubitus to minimize positional hypotension due to aortocaval compression.

37
Q

Malignant hyperthermia genetics

A

AD

38
Q

Hypersensitvity to implants is type…

A

IV (delayed, T-cell mediated)

39
Q

Osteopoikilosis

A

AD inheritance
hundreds of bone islands usually around joints
benign
usually asymptomatic –> observe

40
Q

After flexi nailing of femur or tibia, often need…

A

supplemental immobilization.

41
Q

D-zone test

A

determine whether S aureus infxn that is resistant to erythromycin is also resistant to clindamycin (inducible resistance).

42
Q

AVN of the talus that requires TTC is best approached via….

A

lateral transfibular approach which allows removal of the talus, preparation of the tibiotalar and subtalar joints, and bone grafting.

43
Q

Motor evoked potential

A

stimulation of the motor cortex to the corticospinal tract –> spinal cord interneurons –> anterior horn cells –> peripheral nerve –> skeletal muscle in an efferent direction.

44
Q

Sensory evoked potential

A

afferent direction; signal initiation in UE and LE –> transcranial recording of somatosensory cortex

45
Q

Groin flap has risk to…

A

LFCN.

46
Q

Treatment of osteoporosis resistant to long term bisphosphonates

A

add teriparatide (anabolic)

47
Q

Most doctors interrupt patients within…

A

23 seconds.

48
Q

Does hypothermia improve otucomes after SCI?

A

no

49
Q

Pressure =

A

force/area

50
Q

Contact pressure is decreased by…

A

decreasing joint reactive forces and increasing contact area.

51
Q

PROMIS

A

computer adaptive test that minimizes floor and ceiling effects

52
Q

For tibial shaft fractures, suprapatellar nailing improves…

A

alignment compared to infrapatellar nailing.

53
Q

Process improvement

A

retrospective review of cases for quality improvement (not considered research)

54
Q

Tx of non-op 5th MC fx

A

one visit to evaluate and manage w/ taping or splint and optional follow-up

55
Q

Distal radial physeal injury (gymnast’s wrist) involves the…

A

zone of provisional calcification.

56
Q

Bacteria to consider in fishing or water related injuries

A

Mycobacterium marinum

**incubation of culture at 2 temperatures (35 C and 28-32 C)

57
Q

A front passenger seat airbag should be turned off for….

A

children < 80 pounds.

OITE Review Book (10 decks)

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