Random
The patient was on antibiotics for cellulitis and got Diarrhhea and c. diff toxin was noted on assay. What abx can you place patient?
Flagyl or Oral vancomycin
How do you reverse local anesthesia toxicity?
List 3 amides, local anesthesia options
List 3 esthers, local anesthesia options
IV infusion of lipid emulsion
Esters- Benzocaine, Chloroprocaine, Cocaine, Procaine. Proparacaine, Tetracaine, Amylocaine, Oxybuprocaine.
Amides- Articaine, Bupivacaine,. Dibucaine, Etidocaine, Levobupivacaine, Lidocaine (also known as lignocaine), Mepivacaine. Prilocaine.
List the AO principles of internal fixation
1. Anatomic articular reduction, adequate shaft reduction (restoration of anatomy)
2. stable/biologic fixation
3. preservation of blood supply
4. Early ROM
After excision of tibial and fibular sesamoid, what deformity can come about of the hallux?
hallux malleus
When performing a Lapidus and you want to weight-bear the patient early, what type of fixation would you use?
Interfrag screw & plantar plate
What are the three stages of skin graft healing? and time frame of each
1. Imbibition (1-2 days)
2. Inosculation (2-3 days)
3. Revascularization (>72 hours)
What is the maximum allowable dose for Lidocaine and Bupivacaine with and without epi (mg/kg)? Then what is the equation to know the maximum allowable volume?
Lidocaine w/o epi= 4.5 mg/kg (300 mg)
Lidocaine w/ epi= 7.0 mg/kg (500mg)
Bupivacaine w/o epi = 2.5 mg/kg (175 mg)
Bupivacaine w/ epi = 3.0 mg/kg (225 mg)
Maximum allowable dose (mg/kg) x (weight in kg/10) x (1/concentration of local anesthetic) = mL
When dynamizing an external fixator what are you trying to accomplish?
Compreession
What can happen if you make the osteotomy for the Evans too proximal?
cut into the middle facet
Transverse fracture of the first metatarsal, how would you want to fixate?
1/3 tubular plate
What bone scan is used to differentiate between Charcot and osteomyelitis?
Indium and Tech 99
Which anesthetic can you use if a patient is allergic to lidocaine for hallux block?
-Sodium bicarbonate 0.8%
-Sodium metabasulfite
-1% diphenhydramine
1% diphhenyddramine
What is Vassal's principle
Adjacent fractures generally improve alignment after reduction of the initial fracture because soft tissue structures are returned to their normal position through traction.
What structure is at most risk when performing a calcaneal slide osteotomy and Evans ostoetomy?
Sural Nerve
When an os peroneum is being removed, what structure is at risk for damage and will need to repair?
Peroneus longus
What antibiotic is known to artificially rise creatinine levels?
Bactrim
If a patient has an egg allergy, what anesthetic should you be cautious of using?
Propofol
Goals for restoring a calcaneus fracture
1. Restore congruity of the sub-talar joint
2. Restore Bohler's angle (25-40) and calcaneal height
3. Restore Width
4. Correct varus malalignment
What is the most common angular deformity that is most often seen after a pilon tibial ankle fracture?
Ankle Varus
Patient had a complete partial 5th ray amputation, what is done to prevent an adductovarrus deformity from forming?
Peroneus brevis to cuboid
List 7 common antibiotics that cover MRSA
vancomycin, daptomycin, linezolid, Sulfamethoxazole and trimethoprim (TMP-SMZ/Bactrim), quinupristin-dalfopristin(Synercid), clindamycin and tigecycline
Which nerves block in a Mayo block?
What nerves blocked in an ankle block?
Mayo=1. Saphenous n
2. Deep peroneal n
3. Medial dorsal cutaneous n
4. Medial plantar n
Ankle= 1.Tibial n
2. Saphenous n
3. Medial dorsal cutaneous n
4. Intermediate dorsal cutaneous n
5. Deep peroneal n
6. Sural n
Ostegenic
Osteoconductive
Osteoinductive
Osteoconductive
Osteoinductive
What nerve is at most risk when placing a TTC nail?
Lateral plantar nerve
You do a TAR and make your cuts and now you take a look at your two resected bones. The resected talus appears to be in a bit of remaining varus, what can you do?
Peel/free the delotid ligament