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Orthobullets Wrong > Wrong > Flashcards

Wrong Flashcards

1
Q

Halo treatment for preadolescent children typically requires use of…

A

8-12 pins with an insertional torque of 1 to 5 in-lb.

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2
Q

Rett syndrome

A
  • X-linked dominant
  • MECP2 mutation
  • developmental delay, seizures, GI issues
  • associated with C-shaped scoliosis
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3
Q

In patients with ankylosing spondylitis who undergo TKA, they are more likely to experience post-op…

A

stiffness and HO.

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4
Q

The best MUCL elbow reconstruction technique for return to play is…

A

docking technique with in situ ulnar nerve release (as long as there is no pre-op ulnar nerve symtpoms).

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5
Q

Following osteochondral autograft mosaicplasty, healing of the graft is…

A

initially decreased during the early healing phase and then increase with subchondral bone healing.

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6
Q

Humeral nailing has a higher…

A

rate of reoperation of ORIF.

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7
Q

The Grammont reverse total shoulder arthroplasty is designed to…

A

medialize the center of rotation, thereby increasing the deltoid moment arm and lengthening the deltoid.

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8
Q

Articular cartilage progenitor cells have been identified in…

A

the surface zone or superficial tangenetial zone of cartilage.

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9
Q

Brown-Sequard Syndrome

A

ipsilateral loss of motor function and proprioception, contralateral loss of pain/temperature

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10
Q

Which type of NF is scoliosis seen in?

A

Type I

*Nondystrophic mimics idiopathic
Dystrophic often has a very sharp, angular curve over 4-6 vertebrae.

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11
Q

Is previous spine surgery a risk factor for infection following spine surgery?

A

No

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12
Q

Metastatic tumors are throught to induce osteolysis by….

A

releasing osteoclastogenic inflammatory cytokines.

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13
Q

Best estimate for nonunion in closed, displaced middle third clavicle fractures

A

15%

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14
Q

Lubricin is a

A

hyaluronic acid-binding proteoglycan found in synovial fluid that reduces the coefficient of friction in a joint.

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15
Q

Sclerostin acts to…

A

impede osteoblast proliferation by inhibiting the Wnt signaling pathways and thus inbhitibs bone formation.

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16
Q

In an osteochondral autograft transfer (OAT), the characteristics of the graft are….

A

the chondrocytes remain viable, the transferred cartilage heals and the biopsy reveals articular cartilage primarily of type II collagen.

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17
Q

Posteromedial tibial bowing is associated with…

A

LLD in an older child and calcaneovalgus in a newbown. Bowing gradually resolves over time.

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18
Q

Anterolateral tibial bowing is associated with…

A

NF and congenital pseudoarthrosis.

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19
Q

Young’s modulus of elasticity of PMMA is between…

A

cortical and cancellous bone.

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20
Q

Hamstring injuries in adults most commonly occur at…

A

the myotendinous junction.

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21
Q

Microfracture heals with…

A

fibrocartilage which is mainly type I collagen.

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22
Q

Partial distal biceps tendon tears most commonly occur at…

A

the radial aspect of the radial tuberosity insertion.

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23
Q

The most common neurologic deficit associated with halo placement is…

A

cranial nerve VI palsy which results in paralysis of the lateral rectus causing a deficit in lateral eye movement.

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24
Q

Pivot shift test

A

The knee is internally rotated and a valgus force is applied and then the knee is flexed from extension. The IT band becomes a reducing force facilitating the reduction of the lateral tibial plateau under the femur ((posterior subluxation of the tibia on the femur).

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25
Q

3 stages of articular cartilage degeneration:

A
  1. water increases and proteoglycan aggregation/aggrecan concentration decreases
  2. chondrocytes detect tissue damage and release mediators to increase proliferation
  3. proliferative response and anabolic activity are decreased
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26
Q

Which element of tendon is most predominantly found in areas of tendon compression?

A

aggrecan

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27
Q

What is the only non-reversible effect of anabolic steroids?

A

alopecia

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28
Q

Expected blood loss in bilateral femur fractures

A

2000-3000 cc (1000-1500 in single femur fracture)

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29
Q

The anterior portal for hip arthroscopy is located…

A

approximately 6 cm distal to the ASIS, penetrating the muscle belly of the sartorius and the rectus femoris before entering the anterior capsule. The LFCN is at danger with this portal.

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30
Q

Intrinsic tougness is defined as…

A

the amount of energy per volume a material can absorb without breaking.

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31
Q

Physeal bridge excision is a recommended treatment for…

A

patients with at least 2 years or 2 cm of growth left and a physeal bridge that is less than 50% of the area.

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32
Q

Which medication has been shown to decrease the pain associated with skeletal lesions of fibrous dysplasia?

A

Bisphosphonates

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33
Q

What nerve lies on the anteromedial surface of the psoas muscle?

A

Genitofemoral

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34
Q

In congenital kyphosis, a block vertebrae is…

A

least likely to progress (compared to failure of formation and bar formation) and does not require early surgery.

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35
Q

The deep dissection in the medial approach to the hip takes place between…

A

the adductor brevis and adductor magnus.

(Superficial dissectoin is between gracilis and adductor longus).

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36
Q

Cleinocranial dysplasia inheritance pattern

A

Autosomal dominant

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37
Q

The superficial branch of the radial nerve travels…

A

with the radial artery along the dorsal side of the brachioradialis.

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38
Q

Best way to reduce pediatric hip fracture

A

closed reduction under general anesthesia with fluoroscopy

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39
Q

With regards to capillary afterload, VAC dressing allows…

A

a decrease in afterload which produces better inflow of blood.

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40
Q

Treatment and genetic basis for well-differentiated liposarcoma

A

MDM2 amplification and marginal resection w/o radiation

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41
Q

A distal scaphoid resection for treatment of STT arthritis has been shown to be a risk factor for…

A

increased scapholunate angle and subsequent DISI deformity.

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42
Q

Gene associated with ABC

A

USP6

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43
Q

Tibial attachment of anterolateral ligament

A

midway between Gerdy’s tubercle and fibular head

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44
Q

An arcuate complex avulsion is…

A

an avulsion fracture of the fibular styloid attachment of the arcuate complex.

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45
Q

When performing an iliopsoas tendon release via a medial approach, what structure is most at risk?

A

Medial femoral circumflex artery

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46
Q

What acetabular procedure for dysplasia does not require a concentric reduction?

A

Staheli shelf procedure - covers the head with fibrocartilage rather than hyaline cartilage

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47
Q

Teres major

A

internally rotates humerus, innervated by lower subscapularis nerve, attaches on medial lip of intertubercular groove

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48
Q

Retrograde trans calcaneal talartibial pins is a fixation adjunct that has been shown…

A

to increase fracture stability/union in the diabetic ankle fracture population.

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49
Q

Larsen’s syndrome

A

multiple dislocated joints (hip, knee, elbow/radial head), foot deformities, scoliosis and potentially lethal cervical kyphosis.

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50
Q

What is the function of Cbfa1/Runx2?

A

Key transcription factor associated with osteoblastic differentiation

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51
Q

For excision of a Morton’s neuroma, compared to the dorsal approach a planter approach is associated with

A

Increased likelihood of complete neuroma excision.

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52
Q

MRI studies Of the shoulder of people with long-term paraplegia Demonstrate

A

Increased rotator cuff tears

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53
Q

Combined laminoplasty and fusion for the treatment of cervical myelopathy as the benefit of…

A

Preserved paraspinal muscle attachments and decreased muscular atrophy.

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54
Q

The groove of Ranvier is responsible for…

A

appositional bone growth.

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55
Q

In the pre-pubescent athlete, anaerobic weight training has what effect?

A

It can increase efficiency of muscle action. It does not induce muscle hypertrophy.

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56
Q

Boutonniere deformity is treated with distal extensor tenotomy. What structures allow for active extension of the DIP joint after tenotomy?

A

Oblique retinacular ligament

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57
Q

An occurrence policy provides coverage for

A

all claims made during employment irrespective of when it is filed

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58
Q

Claims made policy only covers lawsuits…

A

For the time employed.

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59
Q

Parsonage turner syndrome is…

A

A disorder characterized by severe shoulder pain, muscle paralysis, sensory loss. The most common associated respecters viral illness. EMG will show positive sharp waves and fibrillation. Recovery is gradual but usually complete.

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60
Q

What approach to the acetabulum is most associated with HO development?

A

Kocher-Langenbeck

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61
Q

What risk factor leads to highest risk for loss of fixation of in unstable posterior pelvic ring injuries?

A

vertical sacral fracture

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62
Q

During the classic Henry approach to the proximal forearm, the radial artery is…

A

retracted medially, the supinator muscle is elevated laterally while the arm is supinated to protect the PIN.

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63
Q

What nerve is most at risk when applying external fixator pins through the AIIS?

A

LFCN

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64
Q

The most common soft tissue sarcoma in the hand is…

A

epithelioid sarcoma. Common in young adults. Biopsy typically reveals a nodular pattern with central necrosis

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65
Q

Commotio cordis is…

A

a rare condition resulting from a direct blow to the precordium during ventricular repolarization. Immediate defibrillation is linked to increased survival.

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66
Q

Electrodiagnostic studies of patients with radiculopathy will likely reveal..

A

fibrillations and positive sharp waves in the affected root distribution.

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67
Q

What is a contraindication to nerve transfer?

A

absent pre-op compound muscle action potentials

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68
Q

In the posterior knee, the order of structures from superficial to deep (and lateral to medial) is…

A

tibial nerve, popliteal vein, popliteal artery.

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69
Q

The radial forearm free flap is supplied by…

A

the radial artery which passes between the FCR and BR.

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70
Q

The interosseous arteries branch off of the…

A

ulnar artery.

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71
Q

Pre-operative superior glenoid erosion has been associated with…

A

scapular notching and this is correlated with decreased ROM, strength and constant scores.

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72
Q

What bleeding disorders are caused by an X-linked recessive mutation?

A

Hemophilia A (Factor VIII deficiency) and Hemophilia B (factor IX deficiency)

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73
Q

Ischemia after lunate dislocation is treated with…

A

observation as it is typically transient.

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74
Q

The anterior superior portion of the labrum has the most….

A

tenuous blood supply and thus is most susceptible to degenerative tears.

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75
Q

SLAP tears are most often associated with cysts in the…

A

spinoglenoid notch.

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76
Q

Post op protocol following a SLAP repair limits…

A

abduction and external rotation.

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77
Q

Treatment of low grade intramedullary osteogenic sarcoma

A

surgery only

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78
Q

Prior HTO is associated with…

A

patella baja.

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79
Q

Kienbock disease etiologies include…

A
  • ulnar negative variance
  • high interosseous pressure
  • underlying medical conditions
  • increased carpal height
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80
Q

In a pelvic injury, what is the best study to rule out a urethral injury.

A

retrograde urethrogram

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81
Q

What is fibrin?

A

Fibrin is the end product of the coagulation cascade that results from cleavage of fibrinogen by thrombin.

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82
Q

DVT is made up of…

A

RBCs and fibrin.

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83
Q

Surgical treatment of disc herniation includes…

A

laminotomy and limited diskectomy

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84
Q

What structure is most at risk with anterior penetration of C1 lateral mass screws?

A

Internal carotid artery

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85
Q

The first line prophylactic antibiotic while using leech therapy is…

A

ciprofloxacin (a fluoroquiolone) which acts by inhibition of DNA gyrase.

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86
Q

What is the expected life expectancy for a patient with primary lung carcinoma and metastatic bone disease?

A

7 months

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87
Q

During knee flexion, the tibia initially…

A

internally rotates and then maintains this position until flexion past 90 degrees when more IR occurs.

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88
Q

In phalanx fractures treated with plate, adhesions may develop between…

A

fx, HW and extensor tendon. Leads to decreased passive IP ROM with MP joint flexed.

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89
Q

What bone modulator utilizes adenylyl cyclase as a mediator for its cellular signaling within osteocytes?

A

PTH

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90
Q

What is the primary mechanism by which anabolic steroids increase muscle tissue?

A

increased production of mRNA

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91
Q

When performing ACDF, the following factors should be considered for elective intubation 1-3 days:

A
  • surgery > 5 hours
  • EBL > 300 cc
  • multilevel surgery or above C3-C4
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92
Q

The use of medial to lateral cortical bone trajectory screws in the single level lumbar spine interbody fusion has been associated with…

A

lower intra-op blood loss and decreased surgical incision length.

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93
Q

Duchenne’s muscular dystrophy genetic pattern

A

X-linked recessive

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94
Q

Arthrodesis of which joint eliminates almost all hindfoot motion?

A

Talonavicular

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95
Q

During repair of a distal biceps tendon, the most commonly injured sensory and motor nerves are…

A

lateral antebrachial cutaneous and PIN.

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96
Q

Posterolateral instability is caused by…

A

insufficiency of the LUCL. Sx include clicking, locking, difficulty getting out of a chair or triceps dip.

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97
Q

Where does the piriformis muscle originate?

A

Ventral surface of the sacrum

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98
Q

A periosteal desmoid lesion is characterized by…

A

bone irregularity along the posteromedial aspect of the distal femur at the insertion of the adductor magnus. Usually in patients 10-15. Lesions are treated with observation.

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99
Q

In which femur fracture types in children should submuscular plating be used over flexi nails?

A

Length unstable (comminuted or long oblique patterns)

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100
Q

In pediatric patients with DDH, pelvic osteotomies are considered for…

A

acetabular index > 28 after 4 years of age.

101
Q

When is a chiari (salvage type osteotomy) indicated?

A

patients without a concentrically reducible hip

102
Q

What is the most common cause of revision after spica casting?

A

loss of reduction

103
Q

Children > 12 months old with DDH and hip dislocation most often require…

A

open reduction rather than closed. Those older than 18 months may also require an osteotomy.

104
Q

Risk factors for DVT in children with osteomyelitis include…

A

surgical treatment, CRP > 6, MRSA and age > 8 years old.

105
Q

Predictive percentages for Kocher criteria

A 
0 - .2%
1 - 3%
2 -40 %
3 - 93.1%
4 - 99.6%
106
Q

The acetabular teardrop is comprised of the…

A

quadrilateral surface and the cotyloid fossa. In normal hips, all children develop the teardrop by 18 months of age.

107
Q

The dominant blood supply to the femoral head after the age of 4 is…

A

the medial circumflex artery.

108
Q

What is the biggest risk factor for DDH?

A

breech positioning

109
Q

What does a Morton’s extension orthosis limit?

A

1st MTP dorsiflexion

110
Q

What nerve root is at risk with reduction of a L5-S1 spondyloslisthesis?

A

L5

111
Q

Hypothenar hammer syndrome can be associated with…

A

aneurysm and is best treated with resection of the involved segment and repair/reconstruction.

112
Q

What ligament is the primary stabilizer of the wrist following a PRC?

A

radioschapocapitate

113
Q

Congenital vertical talus can be associated with….

A
  • arthrogryposis
  • SMA
  • hip dysplasia
  • chromosomal deletions
114
Q

action of the peroneus tertius

A

eversion and dorsiflexion

115
Q

Tumoral calcinosis is due to…

A

abnormal phosphate metabolism and is hereditary.

116
Q

An older patient with calcaneal enthesopathy who undergoes tendon debridement and osteotomy may take this long to recover….

A

1 year

117
Q

Partial distal bicep tendon tears most commonly occur at the…

A

radial aspect of the radial tuberosity insertion.

118
Q

Delayed onset muscle soreness is associated with…

A

eccentric exercise.

119
Q

When performing a psoas tendon release through a medial approach, what structure is most at risk?

A

medial femoral circumflex artery

120
Q

A spontaneous bleed into the iliopsoas sheath can cause…

A

a compartment like syndrome of the femoral nerve as it runs in the fascial sheath.

121
Q

The pencil in cup deformity see in DIP arthritis is a common manifestation of…

A

psoriatic arthritis.

122
Q

Leukocyte chromosomal abnormalities have been observed in patients with…

A

metal on metal THA.

123
Q

Scurvy leads to…

A

widening of the zone of provisional calcification which is demonstrated as a dense band at the growing metaphysis.

124
Q

Specificity is the probability that…

A

a test result will be negative in a patient without a disease. TN/(TN+FP)

125
Q

Sensitivity is the probability that…

A

a test result will be positive in patients with disease. TP/(TP+FN)

126
Q

For a CP patient who is toe-walking, treatment includes…

A

bracing, casting, botox injection. Do not perform surgery until patient is at least 6 years old to prevent recurrence.

127
Q

What structures may help maintain radial length after a radial head fracture?

A

TFCC and interosseous membrane

128
Q

In revision total knee for decreased ROM, the goal is…

A

to reach near full extension.

129
Q

The posterior approach to the shoulder utilizes the interval between…

A

the teres minor and the infraspinatus.

130
Q

Inheritance pattern of Ollier’s disease

A

no inheritance pattern

131
Q

what is the most common site for all bony metastasis?

A

spine

132
Q

what is the most common site for pathologic fracture 2/2 metastasis to the bone?

A

proximal femur

133
Q

Changes to the properties of UHMWPE with increasing irradiation include…

A

improved volumetric wear.

134
Q

Patients with a sagittal band injury typically present with…

A

an inability to actively extend the MCP joint but the ability to maintain MCP extension after passive extension.

135
Q

Elson’s test

A

rigidity of the DIP joint when the PIP is flexed 90 degrees over the edge of a table and the patient is asked to extend the digit (indicative of a central slip injury)

136
Q

What nerve is most likely to be injured during the extensile lateral approach to the calcaneus?

A

sural nerve

137
Q

Articular cartilage progenitor cells (chondrocyte stem cell population) have been identified in the…

A

surface zone (superficial tangential zone) of cartilage.

138
Q

With regards to basilar thumb arthritis, what are the advantages of LRTI over trapeziectomy alone?

A

None

139
Q

TEA for rheumatoid arthritis has been shown to have positive survival analysis for up to…

A

15 years.

140
Q

Stanozolol

A

sold under the name winstrol

is an anabolic steroid

141
Q

Compared to metal on PE, the particles created with metal on metal are….

A

smaller and more numerous.

142
Q

Risk factors for HO

A
  • prolonged ventilator time
  • brain injury
  • spinal cord injury
  • burns
  • neurologic compromise (GCS)
  • amputation thru the zone of injury
143
Q

Quadriga results from….

A

over-advancement (> 1 cm) of the FDP tendon during repair. (***FDP shares a muscle belly; FDS does not)

144
Q

What structure is most vulnerable during approach to the medial sesamoid?

A

plantar-medial cutaneous nerve of the hallux

145
Q

ATFL vs CFL testing

A

ATFL tear: 8-10 mm translation with drawer test in 10 degrees of plantarflexion

CFL tear: 8-10 mm translation with drawer test in 10 degrees of dorsiflexion

146
Q

With regard to cartilage stock, after a periord of off-loading, the off-loaded limb will experience…

A

cartilage thinning and the contralateral leg will not demonstrate any cartilage changes.

147
Q

What is the most common fracture associated with a lateral subtalar dislocation?

A

cuboid fracture

148
Q

What lateral structures of the knee provide the most rotational stability in knee flexion?

A

Popliteus and popliteofibular ligament

149
Q

What is the effect of shortening metacarpal fractures?

A

results in an average extensor lag of 7 degrees of every 2 mm of shortening

150
Q

The spiral cord is found predominantly at the…

A

palmodigital transition and causes contracture of the MCP. It displaces the bundle lateral and deep to the NV bundle.

151
Q

What nerve roots supply the lateral femoral cutaneous nerve?

A

L2-3

152
Q

Lateral scapular winging

A

Injury to spinal accessory nerve and resultant trapezius muscle palsy

153
Q

Medial scapular winging

A

Injury to the long thoracic nerve resulting in serratus anterior palsy

154
Q

When compared to IMN, perc plate of distal third tibial shaft fractures has been shown to have…

A

greater amounts of intra-op radiation exposure.

155
Q

What radiographic view should you obtain when evaluating for scapholunate ligament injury?

A

PA clenched fist

156
Q

With regards to drain placement after TKA, the AAOS clinical practice guidelines recommend…

A

against placement with strong evidence.

157
Q

During open surgical hip dislocation, during which part is the blood supply to the femoral head at the greatest risk?

A

release of the anteroinferior capsule

158
Q

What ligament attaches to the volar lunate facet?

A

short volar radiolunate ligament

159
Q

Bilateral femur fractures have not been shown to have increased rates of…

A

thoracic/chest wall injury.

They do have increased rates of hypotension, mortality, open skull fractures and pelvic fractures.

160
Q

What is the most common osseous injury associated with dorsal PIP dislocation?

A

middle phalanx palmar lip fracture

161
Q

What is the most common complication of TKA in patients with Pagets?

A

malalignment

162
Q

Most common complication of hip surgery in patients with Pagets

A

hemorrhage

163
Q

Periodontoid pannus resulting in cervical myelopathy can be safely treated with…

A

occipitocervical fusion alone (w/ or w/o posterior decompression)

164
Q

Patients over the age of 50 who undergo ACL reconstruction are at increased risk for…

A

developing post-traumatic arthritis.

165
Q

When performing extra-capsular tenotomy of the iliopsoas, the leg should be placed in…

A

external rotation to protect the femoral NV bundle.

166
Q

Where do the MFCA and first branch of the profunda femoris artery anastamose?

A

medial to the glut max insertion

167
Q

What is the most significant advantage of endoscopic release of the carpal tunnel?

A

decreased post-op pain and analgesic use

168
Q

For PCL deficiency, the tibial slope should be…

A

increased. (opposite for ACL)

169
Q

Isolated coronoid fractures are most likely related to what instability pattern?

A

varus posteromedial instability

170
Q

Rothmund-Thomson syndrome

A

growth retardation, thin brows/lashes, cataracts, sunlight sensitivity, hypogonadism, teeth abnormalities

*Increased risk for cancer including osteosarcoma

171
Q

What is the most common method of failure after unconstrained TEA?

A

instability

172
Q

Brown-Sequard syndrome

A

hemitransection of the cord leading to ipsilateral loss of motor function and proprioception and contralateral loss of pain/temperature

173
Q

The most common associated MRI finding in the setting of acute lateral ankle ligament injury is….

A

talar bone bruising.

174
Q

The presence of athetosis (slow, involuntary writhing movements of fingers, toes, hands and feet in CP) is a contraindication to…

A

selective dorsal rhizotomy.

175
Q

Unilateral limitation of hip abduction in an infant has shown to be…

A

very specific for hip dysplasia. Bilateral limitation in hip abduction is NOT.

176
Q

Vitamin B12 deficiency is a known cause of…

A

peripheral sensory neuropathy.

177
Q

Flexor tendons in zone 2 receive their nutritional supply from…

A

diffusion from the synovial sheath.

178
Q

What suture technique uses the least amount of suture necessary to prevent tendon gap formation > 2 mm?

A

epitendinous suture repair of the cut edges

179
Q

What is the arterial supply to the medial femoral condyle graft?

A

longitudinal branch of the descending geniculate artery

180
Q

Ochronosis

A

degenerative arthritis caused by alkaptonuria. rare AR defect of the homogentisic acid oxidase enzyme. Excess homogentisic acid deposits in joints leading to chondrocalcinosis and early arthritis as well as spondylitis.

181
Q

The ascending branch of the lateral femoral circumflex artery (seen during anterior approach to the hip) is a branch of…

A

the profunda femoris artery.

182
Q

Which immunoglobulin subtype does rheumatoid factor target?

A

IgG

183
Q

Which bundle of the MCL is isometric?

A

anterior

184
Q

The corona mortis is identified within…

A

the medial window of the ilioinguinal approach.

185
Q

The obturator internus projects…

A

posteriorly, banks 90 degrees around the ischium and then inserts on the posterior aspect of the proximal femur.

186
Q

Most prevalent noncollagenous protein in bone

A

osteocalcin

187
Q

Osteocalcin is expressed by…

A

mature osteoblasts and is a marker of osteoblast differentiation.

188
Q

Osteonectin

A

a glycoprotein that binds calcium

189
Q

What factor has been found to have the highest correlation with severe HO formation after knee dislocation?

A

ISS

190
Q

The annulus fibrosus is mostly composed of…

A

type 1 collagen.

191
Q

What nerve is most likely to be injured during the anterior exposure of C2-C3?

A

hypoglossal

192
Q

Charcot Marie Tooth initial presentation is highlighted by a weak…

A

tib ant and peroneus brevis that are overpowered by a stronger peroneus longus/posterior tibialis resulting in a plantar flexed 1st MT and pronated foot.

Hindfoot varus deformity develops secondarily.

193
Q

What percentage of asymptomatic osteonecrosis of the femoral head in patients with sickle cell will progress to collapse?

A

> 75%

194
Q

The primary blood supply to the adult femoral head is from the….

A

medial femoral circumflex artery.

195
Q

What effect does growing rod surgery have on the pulmonary parameters of children with early onset scoliosis?

A

improvement in forced vital capacity only

196
Q

Amniotic band syndrome can be associated with which other deformities?

A

clubfoot, cleft palate, acrosyndactyly

197
Q

What features in patient history/PE with discoid meniscus show the greatest sensitivity/specificity in predicting the presence of articular cartilage lesions?

A

duration of symptoms > 6 months and extension block

198
Q

What is the expected long term recovery after achilles tendon repair?

A

plantarflexion strength deficit of 12-18% at 14 yr follow-up

199
Q

In hyperacute phase (less than 24 hours), on MRI, a hematoma will appear as…

A

hypointense on T1 and hyperintense on T2 due to the oxyhemoglobin in freshly oxygenated blood.

200
Q

In the subacute phase (3 days to 2 weeks), on MRI, a hematoma will appear…

A

hyperintense on T1 due to deoxyhemoglobin converting to methemoglobin.

201
Q

In the acute stage (1-3 days) on MRI, a hematoma will appear…

A

isointense on T1 and hypointense on T2 due to intracellular deoxyhemoglobin.

202
Q

After 2 weeks of a hematoma (chronic), the extracellular methemoglobin will convert to…

A

hemosiderin and appear hypointense on both T1 and T2.

203
Q

What best describes the motion of the distal fibula within the incisura as the ankle moves into a dorsiflexed position?

A

external rotation, proximal translation

204
Q

What type of medial collateral ligament tear heals the most reliably?

A

proximal

205
Q

Nitrogen containing bisphosphonates exert their action by…

A

inhibiting farnesyl pyrophosphate synthase.

Ex: Alendronate, Riserdronate, Pamidronate, Zolendronate

206
Q

The inferior and superior gluteal nerves are designated such based on their relationship to….

A

the piriformis.

207
Q

Significant risk factors for HO after TKA are…

A
  • hypertrophic arthrosis (often seen with trauma)
  • male
  • obese
208
Q

What structure is most at risk for injury from a retractor against the tracheoesophageal junction during an anterior approach to the cervical spine?

A

recurrent laryneal nerve

209
Q

What imaging modality is most accurate in locating a toothpick in the foot?

A

ultrasound

210
Q

What is the most common proteoglycan found in tendon?

A

Decorin which regulates collgen fibril diameter

211
Q

Which system of lacunar networks is used among osteocytes to communicate?

A

canaliculi

212
Q

What ankle mechanism leads to peroneal tendon subluxation?

A

forced dorsiflexion and inversion

213
Q

By definition, open femur fractures are classified as…

A

at least Gustilo type III due to the amount of energy necessary to disrupt the soft tissue of the thigh.

214
Q

As you move from cranial to caudal in the tranpsoas approach to the spine, the safe zone…

A

decreases due to the lumbar plexus moving more ventral.

215
Q

In relation to the femoral insertion of the popliteus, the femoral attachment of the LCL is…

A

posterior and proximal.

216
Q

Duchenne’s muscular dystrophy is caued by…

A

absence of the dystrophin protein which is found on the Xp21 gene.

217
Q

The dominant arterial supply to the patella enters by which anatomical location?

A

distal pole.

218
Q

After getting through the interval between the medial border of the gastroc and the posterior border of the semimembranosus tendon, further exposure of the posteromedial tibia or PCL fossa requires….

A

dissection of the popliteus.

219
Q

What is the muscular imbalance in claw toe deformity?

A

EDL overpowering relatively weak intrinsics

220
Q

Peak bone mass attainment in both men and women is most dependent on which steroid?

A

estrogen

221
Q

Endothelin 1 is known to be involved in which of the following disease processes?

A

osteoblastic bone metastases

222
Q

Long term success after epidural steroid injection has been found to range from…

A

50-70%.

223
Q

Periosteal chondroma

A

rare, benign surface lesion composed of cartilage (look similar to osteochondroma but don’t have a stalk) - histology is chondroid matrix with multiple chondrocytes. tx is marginal excision including the underlying cortex

224
Q

Some metastatic cancers create lytic lesions because they….

A

directly produce RANKL.

225
Q

Cryotherapy has been demonstrated to achieve what effect after TKA?

A

Improved ROM at time of discharge. No long term differences.

226
Q

What is a Bennett’s lesion?

A

mineralization of the posterior-inferior glenoid observed in overhead athletes (baseball pitchers). It is a traction spur of the postero-inferior GH capsule.

227
Q

What percent of adult patients with RA test positive for rheumatoid factor?

A

80-90%

228
Q

Metal on metal disc arthroplasty release metal ions systemically at a concentration that is…

A

similar to that in metal on metal THA.

229
Q

Risk factors for IPV:

A
  • young age
  • short term relationship
  • lower SES
  • pregnancy
  • drugs/alcohol
  • female
  • cohabitation
230
Q

Synovial folds or plica are the result of…

A

incomplete or partial resolution of the synovial membranes during fetal development of the knee.

231
Q

What is the penetrance and transmission of MHE?

A

96% penetrance (from 1 study) and 50% transmission (bc it is AD).

232
Q

Injury to the popliteal artery during TKA is most likely to occur when placing a retractor…

A

posterolateral to the PCL.

233
Q

What is the nerve most at risk for transection during an anterior exposure of the ankle?

A

medial branch of the superficial peroneal nerve

234
Q

What naturally produced human hormone has chondroprotective and chondroregenerative properties?

A

PTH

235
Q

Cross-linking of polyethelene has concerns due to…

A

reduced ductility, tensile strength and fatigue resistance.

236
Q

Cryotherapy for oncologic lesions has know complication of…?

A

fracture

237
Q

Shortening of metacarpal fractures beyond 5 mm is limited primarily by…?

A

the deep transverse intermetacarpal ligament

238
Q

Does femoral head size affect wear rates?

A

no

239
Q

What acetabular fracture pattern is associated with the highest incidence of nerve injury?

A

transverse posterior wall

240
Q

What lab marker is highly sensitive and specific for determining the level of degenerative knee pathology?

A

serum stromelysin

241
Q

The pathophysiology of athletic pubalgia is due to injury to the…

A

common aponeurosis between the rectus abdominis and adductor longus.

242
Q

The sinus tarsi is…

A

a laterally based cone-shaped potential space that leads to the subtalar joint.

243
Q

Fractures of the talar body and neck are defined by…

A

their relationship to the lateral process of the talus.

244
Q

What are factors associated with a high risk of developing pseudotumor after metal on metal hip resurfacing?

A
  • female
  • age younger than 40
  • small components
  • dx of hip dysplasia
245
Q

Vertebral osteomyelitis/diskitis is most commonly located in what part of the spine?

A

lumbar

246
Q

What is clenched fist syndrome?

A

a factitious disorder in which a patient presents with flexion contractures of the hand without an organic etiology. Fingers typically remain flexed. Tx is aggresive rehab and psych support.

247
Q

What is the antibiogram?

A

the tabulation of prevalence of different bacteria in a specific setting or population

248
Q

The artery of Adamkiewicz most commonly arises from…

A

the left between T9 and L1.

249
Q

In clubfoot, abduction of the foot is incrementally increased until…

A

hypercorrection to 70 degrees.

Orthobullets Wrong (2 decks)

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