Infectious Disease
Pharmacology
Podiatric medicine
Complications
Surgery
100
Odor, Color and Appearance as Clues to the Infecting Organism: Yellow pus White pus Green pus Dishwater pus Draining sinuses/granules
Yellow pus - Staph Aureus White pus - Staph Epidermidis Green pus - Pseudomonas Aeruginosas Dishwater pus - Group A Streptococcus (Necrotizing Fasciitis) Draining sinuses/granules - Actinomyces Mycetoma (Madura foot)
100
What side effect may occur if Bactrim is given to a patient who is taking Hydrochlorothiazide medication?
Pharmacologically similar to K spaing diuretics and decrease urinary K excretion by as much as 40%.. May cause serious Hyperkalemia if combined with ACE inhibitors, ARB’s or K spaing diuretics.
100
What antibiotic of choice is effective in treating necrotizing fasciitis
Clindamycin has been shown to suppress toxin production by Group A streptococci in Necrotizing fasciitis
100
A narrower cuff placement is associated with a greater risk of what complication?
A narrower cuff requires a much higher tourniquet  pressure to stop blood flow (higher limb occlusion pressure) and is associated with a greater risk of neurological injury. A wider cuff requires a lower tourniquet pressure.
100
Gelfoam is derived from what animal? Avitene?


Gelfoam - purified porcine skin, contraindicated in infected area

Surgicel - plant, bactericidal, thus may be left in  an infected area

Avitene - bovine collagen


200
Wood’s Light fluorescence color appearance: What organism? Coral red Green Red Yellow
Wood’s Light fluorescence Coral red C. minitissimum Green P. aeruginosa Red Bacteroides melaninogenicus Yellow Pityriasis versicolor
200
What lab must be monitored for a patient who is on Daptomycin?
CPK level. There has been a reports of skeletal muscle toxicity. Caution using Daptomycin with statin drugs because of the possibility of overlapping skeletal muscle toxicity
200

A 50-year-old obese man with past medical history of diabetes and hypertension presents with darkening and thickening of his neck skin. He states that sometimes, it is itchy and painless. On exam, there are hyperpigmented plaques in the neck fold region as shown in Figure 1. What is the diagnosis and what is the treatment?

Acanthosis Nigracans - most commonly caused by insulin resistance in obese. The most effective treatment is weight loss and exercise to correct the underlying endocrinologic abnormality. Obesity causes the insulin resistance, and weight loss can correct the problem

200
Injury to what structure will occurs if the tourniquet inflation time exceeded 2 hours and what should be done?

As tourniquet time increases, muscle cells are more susceptible to ischemia. To help avoid ischemic injury to muscle cells, perform “downtime” technique (release tourniquet for 20 minutes than re-inflate)

200
What is the recommended position for ankle arthrodesis? 
Foot is 90 degrees to the leg (sagittal)

5 to 10 degrees external rotation (transverse), the 2nd digit is aligned with the tibial tuberosity

0 to 5 degrees valgus (frontal plane)

Exception: 5 degrees equinus for quadriceps with knee instability or woman who wants to wear high heel after the surgery

300
A patient has a lower extremity life-threatening infection. A doctor decided to prescribes Primaxin (imipenem/cilistatin). What is the common side effect to watch out for?
Dose-related seizures
300
What antibiotic must be avoided to patient who is taking vancomycin since both antibiotics share a common staphylococcal binding site?
Daptomycin and vancomycin share a common staphylococcal binding site, therefore be cautious about using daptomycin for vancomycin treatment failures.
300

When is the plantar fasciitis surgery indicated? (Standard of care)

6 months of failed conservative therapy

300
What percent of avascular necrosis in type 1 Hawkins classification?
0-13%
300
Where is the exact location on the plantar heel when you place intramedullary rod for pan-talar fusion?

Intersection of the line drawn from the 2nd toe to the heel and between malleolus and anterior to heel wieghtbearing surface

400
Name 7 antibiotics that covers HA-MRSA
Linezolid (Zyvox) Vancomycin (vancocin) Doxycycline (Vibramycin), Minocycline (Minocin) - (CA-MRSA) Dalfopristin/Quinupristin (Synercid) Daptomycin (Cubicin) Tigecycline (tygacil) Bactrim (CA-MRSA) Dalbavancin (dalvance) Ortiavancin (orbactiv) Telavancin (vibrativ) Clindamycin - (CA-MRSA) Ceftaroline (Teflaro) Tedizolid (Sivextro) -oxazolidinone - 50% less myelosuppression than Linezolid
400
What antibiotic is given only 2 doses that covers MRSA?
Dalbavancin (Dalvance) - FDA approved in 2014 1st dose- give 1000 mg Dalvance IV infusion over 30 mins 2nd dose- 500 mg one week later
400

Cornyebacterium minitissimum causes what 2 conditions? 

Erythrasma and Pitted keratolysis

400

What is the most common complication seen after total plantar fasciotomy

Lateral column pain (cuboid syndrome)

400

With regards to screw technique fixation for Tibio-talar fusion, parallel screw gives superior rigidity in what movement and crossed screw gives superior rigidity in what movement?

According to Friedman in 1994, parallel screw gives superior rigidity in plantarflexion and inversion. Crossed screws gives superior rigidity in dorsiflexion and eversion

500
What organism is associated with the following: Florists/Rose bushes Gardens Nail salons Fish tanks, pools Salt /brackish water
Florists/Rose bushes Sporothrix schenkii Gardens Mycobacterium chelone Nail salons Mycobacterium fortuitum Fish tanks, pools Mycobacterium marinum Salt / brackish water Vibrio vulnificus
500
What are 3 antibiotics that belong to the class of Lipoglycopeptide?
Televancin (Vibrativ) - most common adverse effect is taste disturbance, nausea, vomiting and foamy urine Oritivancin (Orbactiv) - 1 dose of 1200 mg is equal to 7 days of vancomycin for MRSA Dalbavancin (Dalvance)
500
Identify Figure 2. What is the condition called?

Piezogenic papules

500
Which surgical approach/incision is the worst regarding the plantar fasciitis surgery?
Griffith - U -flap
500

According to McGlamry's, what are the main indications/criteria for Keck and Kelly procedure? (Be specific)

Keck and Kelly is to be performed when the presence of structural pes cavus with a high calcaneal inclination angle and normal posteriorsuperior prominence.

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