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**FINAL REVIEW > *Practice Tests > Flashcards

*Practice Tests Flashcards

1
Q

role of pre-tibial muscles at the contact period of gait cycle includes:

A

(pre-tibial muscles = TA, EDL, EHL)

  1. absorb impact loads from the floor
  2. provide an unstable midtarsal joint for shock absorption and adaptation (mobile/unstable adaptor)
  3. decelerate pronation & provide even weight-bearing from the lateral to the medial side of the foot
  4. decelerate plantarflexion of the ankle
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2
Q

major clinical feature of:

primary adrenal insufficiency → adrenal crisis

A

major clinical features of adrenal crisis from primary adrenal insufficiency:

  • plasma volume depletion → increased serum urea
  • hypotension
  • hyponatremia - because of mineralocorticoid deficiency, and due to inappropriate secretion of ADH (vasopressin) that is caused by cortisol (NOT aldosterone) deficiency → urinary sodium loss
  • hyperkalemia -
  • (resulting mainly from mineralocorticoid deficiency)
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3
Q

major clinical features of:

secondary or tertiary adrenal insufficiency (isolated glucocorticoid deficiency) → adrenal crisis

A
  • decreases vascular tone → hypotension
  • increased blood volume
  • dilutional hyponatremia
  • less urinary sodium lsos
  • NO hyperkalemia

adrenal crisis is rarer in these patients, but can be triggered during acute stress, or with acute cortisol deficiency due to pituitary infarction or after surgical cure of Cushing’s syndrome

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4
Q

Congenital Vertical Talus

A
  • presents as the talus fixed in a vertical position with hypoplasia of the talar neck and head
  • navicular is dislocated and articulates with the dorsal aspect of the talar neck
  • the tibionavicular and dorsal talonavicular ligaments are contracted preventing reduction of the navicular.
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5
Q

what is a true Jones fracture?

A

Type I Stewart Classification:

supra-articular fracture occurring at the metaphyseal-diaphyseal junction

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6
Q

MOI: fracture of the styloid process of the fifth metatarsal?

A

(styloid process = avulsion fracture = Stewart Type II)

MOI: usually involves a strong force applied by peroneus brevis tendon

Recall: the peroneus brevis tendon inserts on the styloid process of the 5th met → can cause fracture of the process w/ excessive traction applied to the bone by tendon

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7
Q

hallmark of dominant sagittal plane pronatory compensation

A
  • The greater the angle formed between the axis and the plane of motion, the more motion is available in that plane.
  • As the calcaneal inclination angle decreases, the sagittal plane compensation becomes more significant.
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8
Q

State Practice Act

A

set of laws by the state legislature that determines the extent to which a podiatric physician can practice

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9
Q

best SERUM BLOOD test for detecting muscle disorders?

A

Creatine phosphokinase is an enzyme found in heart, brain, and skeletal muscle tissue

It is used to detect muscle disorders in serum blood testing.

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10
Q

what neurologic pathways carry the sensory nerve fibers for position, vibration, and proprioception?

A

posterior column of the spinal cord

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11
Q

what is the best casting technique to allow best visualization of the neutral STJ position and the forefoot-to-rearfoot relationship?

A

prone suspension technique

With the prone suspension technique, the forefoot-to- rearfoot relationship can be visualized from behind, allowing the subtalar joint to be manipulated through its range of motion to help determine the joint’s neutral position.

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12
Q

digitalis:

A

Digitalis toxicity (DT) occurs when you take too much digitalis (also known as digoxin or digitoxin), a medication used to treat heart conditions.

Signs of toxicity include arrythmias, nausea, vomiting, and an irregular heartbeat.

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13
Q

involucrum vs sequestrum

A
  • involucrum: new bone formed beneath an elevated periosteum surrounding necrotic bone in osteomyelitis
  • sequestrum: a piece of devitalized (dead) bone that has been separated from the surrounding bone during the process of necrosis.
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14
Q

cloaca

A

an opening in an involucrum which allows drainage of purulent and necrotic material out of the dead bone. If the tract extends to the skin surface, the portion extending beyond the involucrum to the skin surface is called a sinus tract

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15
Q

orientation of talus on lateral WB view

in flexible flatfoot

A

a plantarflexed attitude of the talus

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16
Q

purpose of ultrasound therapy

A

Ultrasound therapy is used to treat enthesopathy, which is inflammation at the site of attachment of muscle tendons and ligaments to bones or joint capsules.

Ultrasound therapy reduces tightness and spasms, decreases inflammation, and assists in healing.

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17
Q

how to calculate mortality rate:

e.g. infant mortality rate

A

Infant mortality rate in a population is defined as the:

  • # of deaths of children < 1 y/o during a year / divided by
  • # of live births that year.

The rate is expressed per 1,000 live births.

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18
Q

nail pathology associated with Lichen Planus?

A

Pterygium:

is a result of scarring of the nail unit and subsequent adherence of the proximal nail fold to the nail bed

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19
Q

Lichen Planus

A

band-like inflammation and destruction of keratinocytes at the dermoepidermal junction; associated w/ HEPATITIS C

  • pruritic, purple, polygonal, papules
  • coalescing into plaques
  • common on wrists and hands, or oral or genital mucosa

Tx: potent topical steroids, antihistamines, oral steroids, mucosal involvement is bad

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20
Q

to assess tibial varum, where should rearfoot be placed?

A

rearfoot should be in the neutral calcaneal stance position (NCSP)

to evaluate the inward angulation of the distal ⅓ of the shaft toward the midline int he frontal plane

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21
Q

what is Pentoxifylline used for?

A

tx of arterial insufficiency

22
Q

After surgery for a dislocated hammer toe, the digit is still slightly dorsiflexed at the metatarsophalangeal joint, despite the fact that
a complete sequential reduction was performed. At the time of surgery, the podiatric physician should have done which of the following?

A

A complete sequential reduction will reduce the deformity, but the position must be maintained with temporary fixation to prevent redislocation

for dislocated HT correction → stabilize the digit to the base of the proximal phalanx and across the MTPJ with a kirschner wire

23
Q

how does Lidocaine control premature ventricular contractions?

A

helps suppress ectopic ventricular rhythms by depressing automaticity which decreases the slope of phase IV depolarization

24
Q

McBride steps:

A

McBride procedure is an important historical procedure for hallux valgus correction in which the sequence of steps is:

  • medial capsulotomy,
  • exostectomy,
  • section of the deep transverse intermetatarsal ligament,
  • release of the conjoined adductor tendon, and
  • removal of the fibular sesamoid.
25
Q

what is Peroneal Muscular Atrophy better known as?

A
  • Charcot-Marie-Tooth disease is also known as peroneal muscle atrophy.
  • As the disease progresses, symmetrical muscular atrophy and weakness are apparent in peroneal muscles and toe extensors.
26
Q

early signs of sepsis in elderly patients

A
  • urinary incontinence, dehydration
  • agitation
  • nocturnal disorientation (“sundowning”)
  • increased respiration rate → respiratory alkalosis
27
Q

“sundowning”

A
  • a variety of behaviors, such as confusion, anxiety, aggression or ignoring directions
  • can also lead to pacing or wandering
  • a group of symptoms that occur at a specific time of the day that may affect people with dementia, such as Alzheimer’s disease.
28
Q

CMT causes what foot type?

A

Charcot-Marie-Tooth disease specifically increases the spasticity of the fibularis (peroneus) longus muscle, resulting in the supination of the entire foot around the subtalar joint, producing a pes cavus appearance of the foot.

29
Q

what are the characteristics of a:

closed-kinetic-chain subtalar joint pronation

A
  • increased talar declination angle
  • increased talocalcaneal angle
  • anterior break in the cyma lin
30
Q

“rail tracking” radiographic appearance:

what is it associated w/

A
  • Dual, curvilinear soft tissue calcifications that are
    parallel to one another and somewhat serpiginous
    in appearance
  • called “rail tracking” and described as a pipe stem pattern

Associated w/ Mönckeberg’s arteriosclerosis, which occurs in peripheral arteries of the lower limbs as calcification of the tunica media

31
Q

phleboliths

A
  • small blood clots in a vein that harden over time due to calcification.
  • vein stones, tend to be oval-shaped and less than 5 millimeters in diameter

They’re often found in the lower part of your pelvis and usually don’t cause any symptoms or other health problems

32
Q

decreased metatarsal girth is associated with?

A

Osteogenesis imperfecta is a genetic disease that results in weakness of the bones secondary to a malfunction of the body’s production of collagen.

Pedal manifestations include decreased metatarsal girth

33
Q

The most common cell types seen in cases of
immediate hypersensitivity are?

(Type I Hyersensitivity)

A

Immediate hypersensitivity is the result of antigen binding to IgE, which is attached to circulating tissue mast cells and basophils

associated w/ atopy (allergic reaction due to
inhaling of allergens), anaphylaxis (systemic reaction)

34
Q

Type 2 Hypersensitivity

A

mediated by soluble IgG and IgM antibodies to molecules on cells and tissues

Autoimmune diseases – autoimmune hemolytic anemia, Goodpasture’s syndrome –antibodies to glomerular BM, damage lining of lungs and kidney

35
Q

Type 3 Hypersensitivity

A

mediated by immune complexes from chronic exposure to antigens

e.g. arthrus reaction, serum sickness, rheumatic fever, SLE

36
Q

Type 4 Hypersensitivity

(Delayed Hypersensitivity)

A

delayed hypersensitivity (after 24-48 hours), mediated by immunocytes (Th1 cells)

Assoc. w/ contact dermatitis, tuberculin rxn (Tb skin test), leprosy, sarcoidosis, Crohn’s disease, Schistosomiasis

37
Q

serum sickness

A

associated with Type 3 Hypersensitivity rxn;

a reaction that is similar to an allergy. The immune system reacts to medicines that contain proteins used to treat immune conditions. It can also react to antiserum, the liquid part of blood that contains antibodies given to a person to help protect them against germs or poisonous substances

38
Q

what characterizes the second phase of wound healing?

(proliferative phase)

A

The second phase of wound healing is the proliferative phase, which is characterized by epithelialization, angiogenesis, granulation tissue formation, and collagen deposition

39
Q

Stabilization of toes at the metatarsophalangeal joint during midstance is aided by which muscles?

A

Stabilization of the toes in midstance is assisted by the plantar intrinsic musculature, which includes the quadratus plantae.

40
Q

Running in a shoe with a sole that is too rigid across the metatarsophalangeal joints increases a person’s risk of developing…?

A

A shoe that does not flex at the MTPJs has the effect of increasing the lever arm of GRF at the ankle.

The longer the lever arm of ground reactive force, the greater the tension on the Achilles tendon in plantarflexing the ankle.

This results in overuse of the tibialis anterior muscle as it attempts to counteract the resistance of the Achilles tendon, causing inflammation where the muscle of the tibialis anterior attaches to the anterior aspect of the tibia.

41
Q

hinge axis concept

A

Christensen and colleagues concluded that the major stabilizing factor of the first metatarsal base osteotomy is the medial cortical hinge.19 They found that osteotomies with an intact hinge exhibited superior stiffness in comparison to osteotomies without a hinge.

E.g. Maintaining hinge for metatarsal basilar (base) osteotomy is important for stabilization

42
Q

Capitation

A

a fixed periodic HMO payment calculated to cover the expected cost of providing services to patients over a period of time.

43
Q

sxs of iliac artery occlusion

A

include:

  • weak femoral pulses
  • sexual dysfunction (e.g. impotent)
  • buttock claudication (e.g. cramping pain in calf and buttock)
44
Q

Which of the following therapies is
recommended for initial treatment of an acute
asthmatic attack?

A

Inhaled beta-adrenergic agonists provide immediate relief of asthma symptoms by causing direct dilation of the constricted air passages.

45
Q

In civil court, the performance of a procedure on
a patient without the patient’s informed consent
could be considered

A

battery

46
Q

LMN lesions cause which gait pattern?

A

high steppage gait

Lower motor neuron lesions cause weakening of muscles and paralysis which leads to a steppage gait.

47
Q

In podiatric radiology, the standard anode-film
distance usually falls within a range of

A

The standard distance between the film and anode when a podiatric foot x-ray is performed is 24-30 inches.

48
Q
A
  • Ganglion cyst
  • Adamantinoma
  • Hemangioma

The T1 weighted image will have lowest signal intensity in tissues consisting primarily of water

49
Q

adamantinoma

A

a cancerous tumor that is capable of spreading and requires surgery to remove; consists mostly of water?

low signal on T1

50
Q

Which radiographic angles in a dorsoplantar view are most indicative of talipes equinovarus?

A

In talipes equinovarus:

  • increase in the talo-first metatarsal angle from the normal range of 0° to -20° is due to the adductus of the forefoot
  • decrease in the talocalcaneal angle from the normal range of 20° to 50° reflects the inversion (varus) of the heel.
51
Q

typical presentations of multiple myeloma may include:

A
  • Lytic lesions are frequently seen on bone scans as “cold” areas
  • Hypercalcemia is frequently seen due to increased bone destruction and release of calcium into the circulation.
  • Bone pain, Renal failure, Normocytic Anemia
    • (anemia of chronic disease)
52
Q

casting order for talipes equinovarus deformity:

A

correct the components in the following order:

  1. adduction
  2. inversion
  3. internal torsion at the tibia (varus)
  4. equinus

**FINAL REVIEW (13 decks)

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