A
What are the reversal agents for toxic doses of the ff:
a. Warfarin
b. Heparin
A. Warfarins: Vitamin K, Fresh Frozen Plasma
B. Heparin: Protamine Sulfate
A. Typically found on palms, Sole and nail folds…
B. Most common malignant skin cancer
C. Most common type of melanoma
A. Acral Lentiginous Melanoma
B. Nodular Melanoma
C. Superficial Spreading Melanoma
The middle and posterior facet are best seen by which radiographic view?
Harris Beath
What is the Simon Rule of 15?
TC angle < 15 degrees; Talo-1st metatarsal angle > 15 degree
For clubfoot, children < 3 years —> TN subluxation
How long should elective surgery be delayed following MI or CABG?
6 months
Which of the arthritides has the following attributes:
symmetric, progressive, polyarticular, degenerative inflammatory, swan neck, Butonniere deformity, marginal erosions, pannus formation, fibular deviation
Rheumatoid Arthritis
What vascular malignancy appears as red-blue plaques or nodules and has a high incidence in AIDs?
Kaposi Sarcoma
What is the most common complication of skin graft?
Seroma/Hematoma
What are the indications for the use of antibiotics?
Implant (Joint or Internal fixation)
Prolonged Surgery (> 2h)
Trauma surgery
Revisional Surgery
Immunocompromised patient
Intra-operative contamination
Extensive Dissection required
Endocarditis
What is the Lachman test?
Lachman test determines if a plantar plate is torn or ruptured.
While stabilizing the metatarsal, a dorsal translocation of the proximal phalanx > 2cm is suggestive of rupture.
Keratoderma Blenorrhagicum and Balanitis Circinata are clinical features of which arthritides?
Reiter Syndrome
17-year of male comes to clinic with complaints of Pain to the left foot. Patient states the pain started long ago but has suddenly become unbearable. Upon physical examination, there was limited range of motion of STJ and MTP and peroneal spasticity. What is your highest suspicion?
Tarsal coalision
Iatrogenic causes of Hallux varus?
MD’s FAIL
Medial capsulorrhaphy overcorrection
Dressings
Staking Head (Excessive removal of medial eminence)
Fibular sesamoidectomy
PASA overcorrection
IM angle overcorrection
Lateral
What is the purpose of tapping?
Creates a path for the screw head
What should be obtained prior to surgery on a patient with Rheumatoid Arthritis?
Cervical Spine X-ray
What conditions are associated with positive HLA-B27?
Psoriatic Arthritis
Enteropathic (Inflammatory Bowel Disese)
Ankylosing Spondylitis
Reiter’s Disease and Reactive Arthritis
What are the indications for ankle arthroscope?
Synovitis
Osteochondral lesion
Soft Tissue Impingement
Osteophytes
Loose bodies
What order do you resect and fixate the joints in a triple arthrodesis?
Resection order
Talo-navicular joint
Calcaneo-cuboid joint
Subtalar joint
Fixation Order: opposite of above
STJ
Midtarsal Joints (CCJ, TNJ)
What is the maximum tourniquet time for ankle and thigh?
Ankle: 90 minutes
Thigh: 120 minutes
After that, allow 5 minutes of perfusion for every half hour over.
What is the American Society of Anesthesia classification for general anesthesia?
Class I: Helathy
Class II: Mild Systemic Disease
Class III: Severely systemic disease
Class IV: Incapacitating systemic disease that is a constant threat to life
Class V: Moribund patient who isn’t expected to survive with or without surgery
Emergency to all class
Name the appropriate classification?
a. 1st MPJ
b. 5th Metatarsal
c. Lisfranc’s
d. Talar Dome
e. Epiphyseal Plate
f. Ankle Fractures
g. Pilon fracture
H. Achilles Rupture
I. Open Fracture
a. 1st MPJ JAHSS
b. 5th Metatarsal Stewart
c. Lisfranc’s Quenu & Kuss, Hardcastle
d. Talar Dome Berndt-Hardy
e. Epiphyseal Plate Salter-Harris
f. Ankle Fractures Laugh-Hansen
g. Pilon fracture Ruedi & Allgower;
Dias & Tachdjian
H. Achilles Rupture Kuwada
I. Open Fracture Gustillo-Anderson
Why do you countersink a screw?
Prevents stress risers and soft tissue irritation
Provides even compression from the screw head (land)
What should be done if the capital fragment falls on the floor?
1. Rinse with saline
2. Bacitracin soak for 15 minutes
3. Rinse with saline
4. Bacitracin soak for 15 minutes
5. Rinse with saline
6. Document and inform the patient
What is the difference between incisional and excisional biopsy?
Incision biopsy: only a portion of the lesion is removed
Excisional Biopsy: The entire lesion is removed
What is the status of the following medication prior or during surgery?
i. Methotrexate
ii. Aspirin
iii. Metoprolol, Atenolol
iv. ACE inhibitors, ARBs
v. Warfarin
i. Methotrexate ~ 14 days
ii. Aspirin ~ 7 days
iii. Metoprolol, Atenolol ~ continue on morning of surgery
iv. ACE inhibitors, ARBs ~ Discontinue on day of surgery
v. Clopidogrel; Warfarin ~ 5 days