SAQ 2011 Flashcards
1) What are 4 clinical features of Class IV shock?
1) sBP < 90
2) HR > 130
3) U/O – nil
4) Mentation - coma
2) What are 8 chest radiographic findings of aortic arch rupture?
1) Wideneed mediastinum
2) Obliteration of aortic knob
3) Apical cap
4) Depressed left hemidiaphragm
5) Right shift of trachea
6) Depressed left mainstem bronchus
7) Associated high rib fractures/scapula fractures
8) Right shift of esophagus/NG tube
3) What are 4 MRI findings of a patient with scoliosis and neurofibromatosis?
1) Paraspinal mass
2) Dumbell lesions
3) Dural ectasia
4) Vertebral body scalloping (>3mm thoracic, 4 lumbar)
5) TP spindling
6) intervertebral foraminal enlargement
4) What are 2 cervical spine findings in Down syndrome?
1) Atlantoaxial instability
2) C0-C1 instability
3) Scoliosis
4) Congenital Fusions
5) What are three conditions that have dural ectasia?
1) Marfans
2) Neurofibromatosis
3) Ehler’s Danlos
4) OI
5) Ank Spond
6) Given an xray of a varus malunited femoral neck fracture. List 4 clinical findings found on physical exam other than decreased ROM.
1) LLD
2) Abductor lurch
3) Trendelenburg sign
4) Prominent GT
7) List 4 relative contraindications to total joint arthroplasty.
1) Neurologic disorder
2) Previous infection (osteo)
3) Neuropathic
4) Poor medical status
5) Dementia
8) List 6 complications of a Malpositioned acetabular component.
1) Instability
2) Impingment
3) Increased wear
4) Component loosening
5) Squeaking if CoC
6) Pseudotumor if MoM
7) LLD
8) Decreased ROM
9) Psoas tendonitis
9) Given a picture of an AP pelvis with bilateral BHR (resurfacing). R BHR has femoral neck # / osteolysis. List 4 risk factors why this would happen.
1) Small head size
2) Varus component
3) AVN
4) Notching
5) Large head cysts
6) High activity level
7) Trauma
10) List 4 prognostic factors associated with poor prognosis in a patient with septic arthritis
a. Delayed presentation
b. Associated osteomyelitis
c. Hip
d. Neonates`
e. MRSA
11) List 4 long term complications of osteomyelitis in pediatric patient.
a. AVN
b. Physeal arrest
c. LLD
d. Decreased ROM
12) List 4 long term complications of radiation therapy for sarcoma treatment.
a. Arthrofibrosis
b. Fracture
c. Radiation induced sarcoma
d. Neuropathy
e. Physeal arrest in a pediatric
f. Wound Complications
13) List 3 advantages for coning an xray. (done with a collimeter)
a. Decreased exposure to patient
b. Decreased exposure to staff
c. Increased image quality
14) List 3 important radiographic relationships of a Lisfranc injury at the tarsometatrsal joint.
a. Fleck sign
b. Lateral 1st:Lat medial cuneiform
c. < 3 mm btw 1st and 2nd
d. medial 4th → medial cuboid
15) List 6 causes of acquired coxa vara. Lovell and Winter.
a. Infection
b. SCFE
c. Perthes
d. Trauma
e. Fibrous dysplasia
f. Rickets
16) List 4 reasons why you would percutaneously pin a displaced distal radius in a pediatric patient.
a. Ipsilateral Supracondylar
b. Compartment syndrome
c. SH 3 or 4
d. Unable to maintain closed reduction
17) Other than joint aspiration, list 4 clinical findings to differentiate septic arthritis from transient synovitis.
a. Fever > 38.5
b. WBC > 12
c. ESR > 40
d. Unable to WB
Please list the dermatomes for the following
a) medial knee
b) groin
c) medial calf
d) clavicle
a) medial knee L3
b) groin L1
c) medial calf L4
d) clavicle C4
In hypovolemic shock, the body relies on anaerobic metabolism. List what happens intracellularly to the following (decreased / increased / no change)
a) Na
b) K
c) Ca
d) Water
a) Na Increased
b) K Decreased
c) Ca Increased
d) Water Increased
21) List 3 anatomic landmarks for placing the femoral component in a TKA.
- Whitesides (90 to)
- Epicondylar axis
- Posterior condylar axias (ER 3 degrees)
22) List 4 complications of a radial head fracture.
- RC OA
- Instability
- Decreased ROM
- DRUJ instability
List four indications for a hemi-resection interpositional arthroplasty of the distal radioulnar joint of the wrist?
- DRUJ OA
- DR Malunion
- DRUJ painful instability
- Ulnocarpal Impaction
- RA DRUJ
24) List 3 xray findings of Madelung’s deformity.
- Pyramidilization of Carpus
- Increase Radial inclation
- Increased Volar tilt
25) List 6 risk factors of radioulnar synostosis that occurs after surgery.
- Single incision for both fractures
- Proximal 1/3 location
- Fracture at same level
- Comminution in IOM
- Hardware in IOM
- High energy with soft tissue stripping
26) List 3 predictors for unsuccessful treatment of UBC of the proximal humerus with methylprednisone.
- Large size
- Multi-loculated
- Active lesion
27) List 5 predictors of poor prognosis for Type II odontoid fractures.
- Initial displacement > 5mm
- Angulation > 10
- Gap > 2 mm
- Comminution
- Age > 50
28) What are two important considerations to take into account for placing C1-C2 trans-artricular screws.
- Reduction
- Vertebral Artery location
- Patient anatomy (no excessive CT kyphoisis)
29) List 3 complications of doing an ankle ORIF in a patient with DM.
- Loss of fixation
- Wound infection
- Non-union
- Amputation
30) List 3 complications of performing an open repair of an Achilles tendon rupture vs. closed treatment.
- Wound breakdown
- Infection
- Sural nerve injury
31) List 8 components of the pre-op checklist approved by WHO that will decrease patient morbidity and mortality.
- Allergies
- Expected blood loss
- Identify and mark leg
- Imaging on monitor
- Expected OR time
- Identify procedure
- Verify sterility
- Review implants needed
16 y/o F Jehovah witness trauma patient who has lost enough blood to require a blood transfusion. You explain her that she needs blood. She gets agitated when you say this and refuses. Although she is in shock, she seems competent. What ethical principles are in conflict with each other when dealing with this situation?
- Autonomy
- beneficience/non-malificience
33) What are 3 ways to decrease the rate of AVN when performing an antegrade femoral nailing in an adolescent patient.
- Lateral entry vs. Trochanteric
- Minimal passes with reamer
- Sharp reamers
- Small diameter nail
Give 2 advantages of doing a piriformis starting point vs. a trochanteric starting point for an antegrade femoral nail.
- Predictable alignment with femoral shaft in both planes to minimize varus malreduction
- Less disruption of gluteus medius insertion
35) Give the 4 types of SLAP tears.
- Type 1 Fraying of labrum
- Type 2 Labral Fraying with biceps offA
- Type 3 Bucket handle with biceps intact
- Type 4 Bucket handle with biceps off
36) Give the 4 stages of perilunate instability.
- Mayfield 1 Scapholunate dissociation 2 Capitolunate disruption 3 Lunotriquetral disruption 4 Lunate dislocation
37) A rheumatoid patient has a 2 week history of inability to extend D4 and D5. What are 3 most likely causes?
- Vaughn Jackson
- Sagittal band rupture with EDC subluxation
- MCP dislocation
38) List 3 anatomic causes of swan neck deformity in a RA patient as a result of synovitis.
- PIP volar plate rupture
- Triangular ligament rupture
- FDS rupture
39) What are two mechanisms of action of BMP?
- Activate mesenchymal cells to differentiate into osteoblasts and create bone
- Angiogenic
40) List 3 spine findings in Anchondroplasia.
- Forament magnum stenosis
- Thoracolumbar kyphosis
- Congenital short pedicles
41) DM is a common cause of Charcot arthropathy of the foot and ankle. List 3 other causes.
- Alcoholism
- Leprosy
- Syphillis
- Syrinx
42) List 3 relative indications to perform contralateral prophylactic pinning in a patient with SCFE.
- Obese males
- Age < 10 (or open triradiate)
- Endocrinopathy (eg. hypothyroidism)
43) List 4 extraosseous findings in fibrous dysplasia.
- Intramuscular myxomas (in Mazabraud syndrome)
- Café-au-lait spots in McCune Albright
- Endocrinopathy (precocious puberty in McCuneAlbright)
- Cherubism
44) Define the borders of the quadrangular space.
- Humerus
- Long head of triceps
- Teres minor
- Teres major
45) List 3 conditions that would result in a false +ve result using the Thessaly test.
- OA
- OC lesions
- ACL tear
46) List 4 sites of compression of the PIN
- Fibrous bands at RC Joint (bw brachialis and BR)
- Recurrent leash of Henry
- Leading edge of ECRB
- Arcade of Froshe
- Distal Supinator
47) List 3 ways to identify a spinal cord injury during spinal deformity correction.
- MEPS
- SSEP
- Wake up test
- Clonus
48) List 3 features of central cord syndrome.
- Distal > Proximal weakness
- UE > LE weakness
- Hyperextension injury in arthritic spine
- Recovery is good
49) List 3 predictors that contribute to poor prognosis for Perthes disease on initial presentation.
- Lateral Pillar C
- Age > 8 (bone age > 6)
- Female
- Decreased abduction
Factors to consider damage control ortho (8)
MAP less than 60 HR over 100 U/O less than 0.5-1 ml/kg/hr Lactate >2.5 IL-6 >800 pg/mL INR >1.5 Temperature less than 35 Platelets less than 100 Base excess over 6
