Biomechanics/Orthotics
Random
Pharmacology
Miscellaneous
Dermatology
100
A 37 year-old female presents with pain and swelling of her left ankle. Examination reveals instability on single heel raise and marked abduction of the forefoot in stance ("too many toes" sign). Radiographs reveal pes planus bilateral, worse on the left. Which of the following imaging studies is most likely to confirm the diagnosis? A. Axial CT B. Ultrasonography C. MRI scan D. Harris-Beath plain film radiograph views
MRI scan - posterior tibial tendon dysfunction/tendinitis (source- pathomechanic section ABPM)
100
A 52 year-old male presents with a severely painful ulcer on the lateral aspect of the left ankle that began as a painful small lump that "broke down". He denies any trauma to the area. Past medical history is remarkable for well controlled hypertension, and ulcerative colitis. Medications include verapamil (Covera HS) and sulfasalazine (Azulfidine). Arterial and venous studies are normal. See Figure 12. Which of the following is the most likely underlying diagnosis? A. Venous stasis B. Arterial ischemia C. Pyoderma gangrenosum D. Squamous cell carcinoma
C. Pyoderma gangrenosum
100
This medication is used for post-operative urinary retention which activates urinary bladder smooth muscle contraction and treat neurogenic ileus and myasthenia gravis and does not cross BBB. What medication?
Neostigmine
100
A 48 year-old male presents to the ED after a motorcycle collision with difficulty breathing and an ankle fracture. Radiograph is shown Figure 8. Which of the following is the correct radiographic impression? A. COPD B. Pneumonia C. Pneumothorax D. Rib fractures
C. Pneumothorax
100
A 55 year-old hypertensive diabetic male presents with lesion shown on his lower leg (Figure 10). He denies trauma or other cutaneous lesions. Which of the following is the most likely diagnosis? A. Kaposi's sarcoma B. Majocchi’s granuloma of tinea corporis C. Cutaneous lupus erythematosis D. Necrobiosis lipoidica diabeticorum
Necrobiosis lipoidica diabeticorum
200
A 1 year-old child presents with an adducted left foot during gait. The left patella faces straight ahead. Examination reveals a rectus foot and 2° of external malleolar position. Which of the following is the most likely etiology for the left foot position? A. Tight adductor muscles B. Tibial antetorsion C. Tight iliotibial band D. Genu varum E. Metatarsus adductus
B. Tibial antetorsion
200
This condition refers to the skin induration and hyperpigmentation of the legs that usually occur w/ patients who have chronic venous insufficiency. This condition is described as “reverse champagne bottle” or “stork leg”. What condition?
Lipodermatosclerosis.
200
On presentation for a matrixectomy a 35 year-old female with Type 2 DM and hypertension becomes diaphoretic and confused. A glucometer is unavailable. Which of the following is the most appropriate intervention? A. Administer metformin 250 mg B. Infuse dextrose 5% in water C. Give 20 Grams instant glucose tablets D. Inject 15 units of regular insulin
C. Give 20 Grams instant glucose tablets. Sweating, confused , increased HR, difficulty speaking, and weakness are signs of hypoglycemia
200
A 41 year-old male complains of itching, malaise and nausea, along with the eye changes shown, which developed 1 month after starting oral terbinafine. See his eyes in Figure 12. Which of the following is the most likely diagnosis? A. Reiter’s syndrome B. Iron deficiency anemia C. Hepatocellular disease D. Neutropenia
C. Hepatocellular disease
200
A 56 year-old male with Type 2 DM presents with a pruritic rash on the legs, arms and trunk of 48 hours duration (Figure 9). The face, palms and soles are spared. Past medical history includes controlled schizophrenia. BP is WNL. He denies difficulty breathing and any history of genital ulceration. Medications are metformin and amlodipine (Norvasc) which were initiated 10 days earlier. Which of the following is the most likely diagnosis?
D. Drug reaction. Amlodipine may cause pruritic erythematous maculopapular rash on lower extremity
300
Which of the following shoe modifications are most appropriate for augmentation of other therapies for countering excessive subtalar pronation? A. Thomas heel with medial stabilizer B. Heel to toe lateral sole wedge C. Reverse Thomas heel and lateral stabilizer D. Solid ankle cushion heel (SACH heel)
A. Thomas heel with medial stabilizer
300
IAMCLOTTED is an mneumonic is commonly associated with which condition? What are these abbreviation stands for?
DVT risk factor Immobility A. Fib MI Coaguability Longevity Tobacco Trauma Estrogen Hx DVT
300
35 year old male presents to the office with red, hot and swollen in his right big toe joint. The podiatrist decided to give him medrol dose pak. What is the standard dosage of medrol dosepak (total number of tablets and total number of days)?
Directions for Medrol Dosepak (21 tablets total) 1st day: 2 tablets before breakfast, 1 tablet after lunch and after supper, and 2 tablets at bedtime. 2nd day: 1 tablet before breakfast. 1 tablet after lunch and after supper, and 2 tablets at bedtime. 3rd day: 1 tablet before breakfast, after lunch, after supper and at bedtime. 4th day: 1 tablet before breakfast, after lunch and at bedtime. 5th day: 1 tablet before breakfast and at bedtime. 6th day: 1 tablet before breakfast.
300
Identify the instrument in Figure 2
Crego periosteal elevator -helps in periosteal reflection around curved surface such as the talar neck and posterior aspect of the calcaneus and is essential in performing triple arthrodesis
300
A 57 year-old male complains of incurvated toenails that he cannot care for himself. He states that his nails had started to change a few years ago. Examination reveals a similar appearance of his fingernails (shown Figure 7). Which of the following should be ruled out? A. Bronchogenic carcinoma B. Hyperparathyroidism C. Myeloma D. Grave’s disease
A. Bronchogenic carcinoma. Nail clubbing is most commonly associated with cardiopulmonary disorder. Schamroth's test Lovibond's angle
400
The 52 year-old male shown (Figure 5) presents with burning pain along his left medial ankle and plantar/medial heel. He denies trauma and states the burning pain has been getting worse over the past 3-4 years. He runs 10-12 miles per week and has worn the same pair of running shoes for the past 2 years. Which of the following is LEAST likely to be contributing to this patient's complaints? A. Limited ankle joint and first MTP joint dorsiflexion B. A high degree of tibial varum and supinatus C. Compression of the flexor retinaculum on the medial plantar nerve D. Charcot-Marie-Tooth disease
D. Charcot Marie-tooth disease
400
Name osteochondritis associated with apophysitis of the fifth metatarsal base
Iselin's disease
400
A 67 year-old male with Type 2 DM presents for a pre-scheduled pre-op discussion. The following is reported or noted on examination: Headache, Confusion, Fruity breath, Tachypnea and Tachycardia. The patient remains conscious throughout the visit. Which of the following should be administered at this time? A. 25 units of regular insulin B. 1 baby aspirin (81 mg.) C. 8 oz. of a glucose beverage D. Sublingual nitroglycerin
A. 25 units of regular insulin
400
Identify the instrument in Figure 1
Knot pusher suture passer (commonly used for Jones tenosuspension to pass the EHL through the hole in 1st metatarsal head) Alternate instrument is tendon passing forcep
400
A 28-year-old female college student returns from spring break complaining of a "weird rash" on her chest and an inability to acquire an even tan on her chest, despite laying out in the Caribbean sun for many hours. She has no other specific complaints and the rest of her past medical history is unremarkable. A picture of her chest is shown in Figure 4A. A skin scraping and KOH preparation is shown in Figure 4B. What diagnosis is responsible for this woman's condition and the name of the organism that is contributing to her skin problem?
This patient's presentation is consistent with tinea versicolor, a superficial fungal infection. Tinea versicolor is a common superficial fungal infection that classically presents with hypo- or hyperpigmented patchy macules on the chest and back. The causative agent is malassezia furfur, a lipid-dependent fungus. Diagnosis can be confirmed through microscopy with a KOH preparation, which should reveal hyphae and spores in a characteristic "spaghetti and meatballs" pattern.
500
In Figure 6, select the picture with the condition shown that is most appropriate to the shoe or shoe modification listed. Which foot would benefit most from a shoe with a reverse last? Item A Item B Item C Item D
C. Reverse last shoes is designed to correct extreme varus or adductus foot deformity such as metatarsus adductus or talipes equinovarus deformity
500
This condition is caused by abnormal lipid metabolism which results in an accumulation of phytanic acid in the serum which is up to 50% normal. It is associated with these findings: ichthyosis (scaling), night blindness and preceding febrile illness. This condition will cause patient to have peripheral muscle weakness, areflexia, dropfoot, pes cavus and claw toes. What condition?
Refsum's disease
500
A 45-year-old woman presents to the emergency room from her primary care physician’s office for high blood pressure unresponsive to therapy. She has a history of neurofibromatosis type 1, though without any neurological deficits. She has multiple café-au-lait spots on her body. She is found to be hypertensive to 154/121 mmHg. Her 24-hour urine metanephrines and VMA come back elevated. Her abdominal CT comes back with an adrenal mass. This condition is best managed by what medication?
She has a pheochromocytoma 1) Phenoxybenzamine (irreversible alpha 1 blocker) 2) Phentolamine (reversible alpha 1 blocker)
500
Arrange these words in the order from the inner structure to the outer structure: Pia Mater Subdural space white matter Arachnoid mater epidural space gray matter subarachnoid space dura mater
From inner to outer Gray matter, White matter, pia mater, subarachnoid space, arachnoid mater, subdural space, dura mater, epidural space
500
A 40 year-old female presents with non-pitting, brawny edema in both lower extremities which has an "orange rind" appearance. Vascular studies are normal. Laboratory studies show an elevated TSH (thyrotropin). See Figure 11. Which of the following is the most likely diagnosis? A. Thyrotoxicosis B. Contac dermatitis C. Erythema chronicum migrans D. Myxedema
D. Myxedema. Seen in patient withi hx of hyperthyroidism
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