R2 LOCO3 Flashcards

1
Q

Which species of your normal skin flora:

Makes up 90% of the flora? [1]

Is found in nose, perineum, vulvar skin? [1]

Feeds off sebum and cellular debris and colonisation starts when sebaceous glands become more active?

A

Makes up 90% of the flora: Staphylococcus epidermidis

Is found in nose, perineum, vulvar skin: Staphylococcus aureus

Feeds off sebum and cellular debris and colonisation starts when sebaceous glands become more active: Propionibacterium acnes

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2
Q

Which pathogen causes hot tub folliculitis? [1]

A

Pseudomonas aeruginosa

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3
Q

Treatment for folliculitis? [3]

A

Oral antibiotic
Retinoic acid & Vit. A: reduces amount of sebum

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4
Q

Two primary pathogens that cause impetigo? [2]

A

Staphylococcus aureus or Streptococcus pyogenes

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5
Q

Tx of impetigo?:

Simple cases [1]
Severe cases? [1]
Most people? [1]

A

Oral or topical antibiotic for severe cases that have spread to other body areas

NICE recommends 1% hydrogen peroxide cream for simple cases

But most people will get better without treatment within 3 weeks

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6
Q

What is cellulitis in the face called? [1]

How does it differ to cellulitis in location? [1]

Most common pathogen? [1]

A

Erysipelas (cellulitis of the face) but just in the dermis and not in subcutaneous fat

Streptococcus pyogenes

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7
Q

What is this skin infection? [1]

Which pathogen causes this? [1]

A

Scalded skin syndrome:
Staphylococcus aureus

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8
Q

Describe the pathophysiology of scalded skin syndrome [2]

A

Exotoxins are proteases that destroy desmosomes holding keratinocytes in granulosum and spinosum layers together:

Causes widespread fluid filled blisters that easily break

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9
Q

Treatment of scalded skin syndrome? [2]

A

Treatment:
* Conservative: rehydration antipyretics
* Parenteral antibiotics

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10
Q

What is Nikolsky sign and what does it test? [1]

A

Nikolsky sign is a test of how weak the blister is.

Pencil eraser placed on top of blister and turned if blister ruptures the blister is intraepidermal. Or you turn the eraser on unblistered skin and new blister forms.

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11
Q

Therapy for Necrotising fascitis? [3]

A

Treatment:
* Surgical debridement
* Empiric antibiotics
* Hyperbaric oxygen (Add on therapy)

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12
Q

Describe pathophysiology of HPV causing warts and verrucas [3]

A

DNA virus
Infects basal cells of the epidermis
Lesions arise from proliferation of infected basal keratinocytes

Causes hyperkeratosis, acanthosis and hypergranulosis, rete ridge elongation and large blood vessels at dermoepidermal junction

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13
Q

Treatment for HPV: viral warts and veruccas? [5]

A

Topical salicylic acid
Fluorouracil cream
Cryosurgery
Surgical curettage
Laser treatment (CO2 laser 582nm)

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14
Q

Describe the pathophysiology of Pityriasis versicolour [1]

Which populations does it impact more? [1]

A

Overgrowth of commensal yeast Pityrosporum orbiculare; young adults, brown/pink scaly patches, hypopigmented if suntanned

Affects young adults and slightly more men than women:

It is not contagious infection is not due to poor hygiene usually occurs in warmer months white, salmon or light brown patches chest,back, arms and legs

More common in hot humid climates and only affects people that sweat heavily

Often clears during the winter months and reappears each summer

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15
Q

Treatment of Pityriasis versicolour (tinea versicolour)? [3]

A
  • Antifungal shampoo (ketoconazole)
  • Selenium sulphide (off-label)
  • For small areas antifungal creams
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16
Q

Describe what Postherpetic neuralgia (PHN) is [2]

A

Unpredictable complication of varicella zoster virus- (VZV-) induced herpes zoster (HZ) which often occurs in elderly and immunocompromised persons

The main symptom of post-herpetic neuralgia is intermittent or continuous nerve pain in an area of your skin previously affected by shingles.

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17
Q

Leprosy is caused by which pathogens? [2]

A

Mycobacterium leprae or mycobacterium lepromatosis

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18
Q

Treatment for leprosy? [3]

A

Rifampicin, dapsone and clofazimine

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19
Q

The femoral head recieves blood supply from which arteries? [3]

State the source of each of these arteries [2]

A

Medial and lateral circumflex arteries, from profunda femoris

Acetabular branch of obturator artery

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20
Q

Which type of prosthetic material has a narrower stem

Cemented
Uncemented

A

Cemented

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21
Q

Is nerve damage an intraoperative or postoperative complication?

A

postoperative complication

22
Q

Which ligament is removed in a total hip replacement? [1]

A

Acceptable responses: Ligamentum teres

23
Q

During a total knee replacement state what the femoral component [1] and tibial components [2] are made from

A

Femoral: Metal

Tibial: Metal tray that attaches directly to bone; plastic spacer that proves the bearing surface which replaces the mensici

24
Q

State 3 potential complications of using plaster of paris casts for fixation [3]

A

Muscle atrophy
DVT
Compartment syndrome

25
Q

State what type of internal fixation is present [1]

When would this type of internal fixation be used? [2]

A

Plates and screws

Used for :metaphyseal fractures of long bones and diaphyseal fractures of the radius and ulna

26
Q

Define the terms [3]

Isograft
Allograft
Alloplast

A

Isograft: A form of allograft. A graft between genetically identical individuals.

Alloplast: using an inert material to reconstruct a tissue

Allograft:A graft from person to another e.g using tendon or ligament or chondrocytes from a donor

27
Q

Which of the following best fits the description for:

Using an inert material to reconstruct a tissue

Allograft
Xenograft
Autograft
Alloplast
Isograft

A

Alloplast

28
Q

Name 2 sites of autografts commonly used for anterior cruciate ligament replacement [2]

A

Acceptable responses: Patella ligament, Semitendinosus, Semitendinosus tendon, Gracilis, Gracilis tendon

29
Q

Define arthrodesis

A

surgical fusion of a joint

30
Q

State two reasons why arthrodesis may be given [2]

A

Pain relief in a joint severely damaged.

Stabilisation of a joint which has lost stability from ligamentous damage or paralysis.

31
Q

Describe the mechanisms that arthrodesis may be given [2]

A

The joint may be fused by either clearing the articular cartilage and bringing the bone together and holding it in place until fusion occurs

Extra articular where fusion bypasses the joint.

32
Q

What form of management has been performed here? [1]

A

Arthrodesis of knee joint

33
Q

Which imaging technique is preferred in diagnosing DDH in young patients?

MRI
Ultrasound
X-ray
CT

A

Ultrasound

34
Q

A barlow test would is assessing which developmental problem? [1]

A

Developmental dysplasia of the hip (DDH)

35
Q

What is the name for this line? [1]

A

Hilgenreiner’s Line

This is a horizontal line along inferior aspect of triradiate cartilage.

36
Q

What is the name for this angle? [1]

Between which points is it measured between? [2]

A

Acetabular index

Hilgenreiner’s line and the acetabular index line

37
Q

State what the acetabular angle should be for each of the following ages?

0 - 1 year old < []
1 > 4 year old < []
> 4 year old < []

A

The acetabular angle should decrease with age:

0 - 1 year old < 34
1 > 4 year old < 28
> 4 year old < 25

38
Q

DDH:

What acetabular angles would correct with splintage [1] and would require surgery [1]

A

An angle of < 45 deg will spontaneously correct with splintage, whereas angle of > 60 deg will usually require surgery.

39
Q
A

On the left, the femoral head is located more laterally and the acetabulum appears underdeveloped.

40
Q

Describe how you would manage CDH in a

Newborn [1]

6-18 months [2]

A

Newborn
* Splintage in abduction (Pavlik harness, Von Rosen splint)

6 - 18 months
* Closed reduction – Traction, Splintage
* Open reduction and Splintage

41
Q

Describe the pathophysiology of Perthes disease [1]

A

Idiopathic avascular necrosis of the femoral head

42
Q
A
43
Q

What is the typical age of presentation for Perthes disease? [1]

A

4-10 yrs old

44
Q

Describe the pathophysiology of slipped upper femoral epiphysis [2]

A

Displacement of femoral epiphysis: predominately distal portion due to femoral neck roating externally off the head

45
Q

What is this line called? [1]

Which two parts is it from? [2[

A

Line of klein: line of Klein is drawn along the lateral most aspect of the femoral neck.

46
Q

What is the name of this deformity? [1]

A

Talipes Equinovarus (Clubfoot)

47
Q

What is the name of this deformity? [1]

A

Talipes Equinovarus (Clubfoot)

48
Q

Ankle arthrodesis is the fusion of the [] most commonly performed for end-stage arthritis of the joint.

A

Ankle arthrodesis is the fusion of the tibiotalar joint most commonly performed for end-stage arthritis of the joint.

49
Q

This line is:

Hilgenreiner’s Line
Shenton’s Line
Kline’s Line

A

Hilgenreiner’s Line

50
Q

State the effect of:

Barlow test [1]
Ortalini test [1]

What are positive results for each test? [2]

A

Barlow test:
* dislocates / subluxes the hip
* Positive if the hip can be popped out of the socket with this maneuver.

Ortalini test:
* if the hip was dislocated, a distinctive clunk will be heard as the hip relocates.

51
Q

Name this apparatus being used [1]

What pathology is it treating? [1]

What ages would this be used for? [1]

A

Pavlik harness: treats CDH for newborns - 6 months

52
Q

Name this apparatus being used [1]

What pathology is it treating? [1]

What ages would this be used for? [1]

A

Von Rosen splint: CDH between newborn - 6 months