Prep q

quickster2008's version from 2016-01-26 19:48

Section 1

Question Answer
best closure for contaminated wound1)tape, 2) stapes
best suture f/contaiminated woundnylon or polypropylene
interns fxos trigonum
pirie's boneos supranaviculare
what passes plantar to DTILlumbricales
FDL passes thr what layer of the foot2nd
C/I to P & A matrixectomyinfection, vasc compromise, DM
why do you need a digital tourniquet with a P and Ab/c blood will dilute phenol
which matrixectomy allows removal of subungual exostosis d/t exposure?zadik total matrixectomy
most radical procedure for dystrophic nailsterminal syme total matrixectomy
PIPJ fusion..what size K-wire if crossing MPJ?.062(anything smaller would break)
where is the axis of the foot2nd MT
would you give a steroid injection for PDSno ligament is already weak
what signs do you see w/neuromasullivans, mulders, berkowsky
complication of osteotomy lengthening for brachymetatarsiaNV compromise with stretch
4 things you release in HAV lateral release and in order1.lateral capsule2. DTIL 3.addH 4) fibular sesamoid
neuroma is plantar or dorsal to DTILplantar
minimal distance b/w incisions on dorsum of foot to avoid skin necrosis2.7cm
what is the pirogoff amputationmodified prox symes-preserves calcaneus
what preserves more calcaneus, boyd or pirogoff amputationboyd
should you remove cartilage when amputatingyes, nidus for infection & uneven cartilage surface delays healing and can->pressure pts
how would you diagnose CMT dzmuscle biopsy
1 unit of blood raises your Hgb and Hct by how muchHgb by 1 Hct by 3

Section 2

Question Answer
What is blauth and olsson classificationfor polydactyly...based on position of duplication in longit and transv planes
Tx for PDSPIPJ fusion, Girdlestone* Weil
Peg in hole..what PP cortex is left intactDorsal
berkowsky sign isreproducible pain with lateral compression of FF(neuroma)
lachman testfor PDS, vertical stress/drawer test
what did DuVries believe was cause of tailors bunion?1. hypertrophy of ST 2. congenitally wide 5th MTH 3. lateral bowing of 5th MTH
what is the SHIP implantsgarlatto hammertoe implant prosthesis(total implant, no hinge)
c/I to hemi implantsuncontrolled pronation, arthritis both sides of jt
how do you treat brown recluse spider bitedapsone
3 most common causes of charcot1.DM 2)ETOH 3) leprosy
why are bunions more common in femalesligament weakening d/t hormones
what ligament is weaker in females causing more bunions in femalesmet-phalangeal ligament
why is demerol called the bear huggerits for shivering...raises your temperature
radiographic separation b/w implant and bone normal until3 months
what % of infections from implants occur w/in 1 mo to 2 yy p/op60%( or > than 50%)


Question Answer
medial plantar nerve supplies what muscles?AbdH m, FDB, 1st lumbricale, FHB
1 unit of insulin will lower your blood glucose how much?30(50 will also work based on sliding scale)
what NSAID is used to prevent heterotopic ossificaition following surgeryindomethacin
osteochondrosis of fibular head is known asritter's dz(reiter's?)
antidote to epiphentolamine
Epineurolysis=interdigital n. freed from surr s.t.s. w/o nerve excision
What is presenting symptom of MSoptic neuritis
RA pt, what 3 things you must do before surgeryC spine xray, cover for steroid suppresion, cervical collar
what is the radiographic difference/major distinguishing factor b/w PA and RAno osteoporosis w/PA
Pt allergic to amide and ester what would you usebenzoyl alcohol
Which NSAID causes dose related headachesindomethacin


Question Answer
1st ray-what is the cruciate anastomosis1. medial br of 1st plantar MT artery 2. lateral br of " " 3. hallucal br of medial plantar a 4. 1st PMA
describe how to perform a bicorrectional Austin2nd bone cut is made that extends 80% through the MT to remove a medial wedge of bone
what is the difference b/w kalish and offset Voffset V can swivel to correct PASA and the apex is a metaph-diaphyseal junction
what makes up the sagittal logrescinowaterman/waterman green + lambrindui
what is the name of the 1st MPJ arthrodesismckeever


Question Answer
how much of 1st MTH is excised in mayo procedure5mm
talo-navicular angle(AP) defines what relationshiprelationship b/w greater and lesser tarsal bones
what pedal angle is a good predictor of FF pathologytalo-cuboid angle
? is an angle of calcaneal structurebohlers angle
how do bohlers and gissanes values change with calcaneal fx?bohlers decreases, gissanes increases
name the 5 stages of bone graft healing1. vascular ingrowth 2. osteoblast proliferation 3. osteoinduction 4. osteoconduciton 5. graft remodeling
free vascularized bone grafts are indicated forlarge bony defects
what type of allograft promotes osteoinduction?demineralized (DBM) or decalcified bone graft
what is a common example of inlay bone graft technique?evans calcaneal osteotomy and bone graft procedure
what was the Papineau technique designed forrapid revascularization
list the DBM productsgrafton, dynagraft, osteofil, allomatrix
MC NM cause of cavus footCMT
anterior cavus is primarily what type of deformitysagittal plane
posterior cavus is what type of deformitySTJ deformity
when do u get a neuro consult on a cavus foot ptpt has 1.hyporeflexia 2. nystagmus


Question Answer
what is the only osteotomy for cavus foot that does Dot remove any bone Wedges?japas(displacement V shaped osteotomy)
Anterior tarsal tunnel syndrome is what nervedeep peroneal n(entrapment under inferior extensor retinaculum)
functional tarsal tunnel syndrome is d/t?pronation..internal rotation of leg tightens flexor retinaculum, also forced eversion of foot stretches n and compresses contents of TT
What order do you fuse jts in a triple arthrodesis?in order of stability 1. STJ 2. TNJ 3. CCJ
3 sources of blood supply to tendonM. belly, bone/periosteum, meso/paratenon
#1 complication of tendon transfersadhesions
what is the putti technique for PTTT?PTT is passed from proximal incision through interosseous membrane and transferred to LC (*ober technique=goes around medial mall)
What are the 2 procedures for PTTDcobb, FDL transfer
which procedures replace ATFL, CFL, and PTFLspotoff, rosendahl-jensen, both utilize fascia lata
chondromalacia-?arthritic change in articula
gold std for severe, painful AJ DJDankle fusion
how do you fix DF/PF/angular deformity of previously fused AJ?wedge resection of tibia
only FDA approved AJ implantAgility ankle
only AJ implant that can be used post failed AJ fusion and with AVN of talusbuechel-Pappas implant(fibula must be intact)
what angulation of a Z plast gives the greatest skin lengthening60 deg
Why are angles less than 45 or greater than 60 deg not acceptable for Z plasties(skin)?less than 45-> impaired blood flow, greater than 60-> severe tension


Question Answer
Stages of skin graft healing?1. plasmatic2. inoscultation3. reorganization 4. reinnervation stage
pinch testto determine RSTL...see a regularly shaped furrow
why do thicker skingrafts have a decreased chance of incorporationd/t greater tissue demands
full thickness skin grafts are indicated for...?coverage of WB areas or flexion points
What bugs do you need to worry about with skin graft infectionsstrep pyogenes, pseudomonas pyogenes
cutaneous flaps vs arterial flaps what is important for flap survivalcutaneous-pedicle must be wide enough to support flap, arterial-dependent on dimension of artery and length of artery territory not on pedicle width
first radiographic sign of osteonecrosissclerosis
what happens when you give an amide anesthetic to a pt w/liver problemsaccelerated action of anesthetic
MC tumor in epiphysischondroblastoma
IV drug for pt with NV?promethazine(phenergan)
where is common peroneal n block performed2 cm distal to fibular neck
pt with cavus foot and incr CPK..what dz?muscular dystrophy
turf toe is caused byhyperextension with compression
clinical findings with tuberous sclerosisperiungual fibroma, sebaceous adenoma, thickened skin
lidocaine toxicity affects what system firstCNS, CVS is affected 2nd
who originally described Morton's neuromadurlacher


Question Answer
Pt w/raynauds and calcinosis has ?CREST
MC location of osteoid osteoma?proximal tibia
what lab value is high w/bone tumor?alkaline phosphatase
MC fungal infection in immunosuppressedcandida
incr in calcaneal fat pad is seen w/what dzacromegaly
purpose of inserting an implant into 1st MPJ after perform Kelleracts as a spacer
can u give atropine to a pt w/glaucomano(give atropine w/glaucoma and you wont get a diploma)
STJ easiest to displace in what positioninversion
midtarsal break during gait is characterisitic ofequinus
first line of tx for RSDPT
blue discoloration in webspacecavernosa hemangioma
syndesmotic rupture seen with weber ?weber c-shouldnt it be b??
one of the diff diagnosis for kaposismalignant melanoma
sickle cell crisis txO2, narcotics, abx
incr in bone width seen withacromegaly, pagets
decr in bone width seen withosteogenesis imperfecta
hallmark of lisfranc's fxfleck fracture-off medial base of 2nd MT
Excise both sesamoids, what might resulthallux malleus..lose insertion of FHB
firm, non-mobile mass located on dorsum of foot; which of the following is it: ganglionic cyst, lipoma, granuloma, or fibroma?granuloma
6 cardinal signs of chronic osteomyelitis1. radiolucency-osteolysis, decr density, loss of trabeculation 2. sclerosis-dead bone or area of advanced bone repair 3. sequestra-island of dead bone 4. involucrum-area of new bone formation, incr density 5. cloaca-sinus tract in bone, decr density(outlet f/pus) 6. superiosteal calcification
Pt presents w/ h/o AJ sprains and ankle occasionally locks, what is the problemOCD talus
Avulsion fx of calc anterior process d/t?bifurcate ligament???(true?)
incision directly over tendon may result inadhesion
tx for RSDPT, TENS, bier block, psychotherapy
MC bone tumor in calcaneusUBC
abx for PCN allergic pt w/DM and liver dx w/cultures + for gram - rod?cipro
clinical hallmark of pityriasis roseaherald patch
male pt w/toes that turn blue, then redTAO
3 phases of wound repair1. substrate 2. proliferation 3. remodeling
toxic drug reaction to LA manifests how1. stimulation 2. convulsions 3. depression 4. death
volkmann's ischemiad/t direct pressure on arteries by severe edema
skin wedge must be placed how for skin plastiesperpendicular to axis of rotation of toe
what is simons angleline bisecting talar head and extends distally towards 1st MT(AP view), if it falls medial to 1st MT its neg(MA), if it falls lateral to 1st its TEV
what is Engles Anglesimplified MA angle, bisection 2nd MT and bisection IC (Approx 3 deg greater than MAA)
what is position of navicular in TEVmedially subluxed
ganley splint..where is bar placed for external rotation correctionFF(vs RF for internal rotation correction)
what MA device was designed as alternative to serial castingwheaton brace
after correction of MA is achieved, how long should casting continuefoot should be maintained in corrected position for at least as long as it took to correct MA
when can osseous correction of MA be performedonce pt is 6-8 yr or older
Modified Heyman, Herndon, and strong procedure: preserves plantar and lateral ligaments and uses 3 dorsal incisions (original HHS-one trasn incision and released all ligaments at LF jt)
Question Answer
list the osseous procedures for MABankart, peabody and muro, mcCormick and blount, fowler, steytler and Van Der Walt, Berman and Gartland, lepird, brink and levitsky
Which MA procedure is a Juvara w/cresentric osteotomies of lesser MTslepird
another name for steytler and Van der Waltmodified berman and gartland
difference btw intrinsic and extrinsic clubfootintrinsic(TEV) vs extrinsic(postural, intrinsic also has TNJ subluxation, lateral talar rotation in AJ mortise
MC pathologic, congenital foot deformityTEV(2.29/1000 births)
only tendons enlongated w/TEVperoneals
Simon's rule of 15 for TEVTNJ subluxation present if TCA<15, Mearys >15
TEV ST release..what is not releasedcircumferential release, all but anterior is released
Primary deforming structures in calcaneovalgustendons of antero-lateral ankle
CCV..location of navicularmedially subluxed(like in TEV)
AchT is stretched in which congenital deformityCCV
Major deforming F in vertical talusPF m=mjr deforming F w/increased pronatory potential
xray diagnosis of VTforced pF lateral view..TNJ dislocation not alleviated when foot is in stressed PF
how to differentiate CCV from VT clinically?VT-hollow anterior to lat malleolus
tx for anaphylaxis (and dose)0.3 ml epi 1:000 dilution IM
tx for CP of CV or respiratory originO2
tx of CP w/o shock or respir originD5W, morphine, labs
earliest sign of shocktachycardia(tachypnea is also an early sign)
when is drop in urinary output seen in shock ptsonly in severe shock states
what class of hemorrhage shows classic shock signsclass 3
what class of hemorrhage is life threateningclass 4
how much loss of blood results in LOC50% loss of blood
how much blood can you lose w/pelvic fx6 units(3000ml)...immediately life threatening
MC fx in FFhallux fx(usu DP)
Vascular supply to 5th MTextraosseous-DMA, PMA, fibular plantar marginal a, intraosseous-periost. plexus, nutrient a, metaph plexus
which is safer..ringers lactate or NSSringer lactate f/jts it is less damaging to chondrocytes and f/shock pts, NSS causes hypochloremic acidosis, ringers does not
what are the 5 D's of charcotdestruction, density, debris, disorganization, dislocation
dif in mech b/w jones and 5th MTB avulsion fxMOI f/avulsion=inversion injury vs jones-foot cannot invert