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11 Cards in this Set
- Front
- Back
Which skeletal dysplasias is caused by a sex linked mutation of the short stature homeobox (SHOX) gene?1-Cleidocranial dyplasia; 2-Leri-Weil dyschondrosteosis;; 3-Pseudoachondroplasia; 4-Ellis-van Creveld (EVC) syndrome; 5-Achondroplasia
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a skeletal dysplasia characterized by short stature and bilateral Madelung deformities of the wrist . Madelung deformity is result of disruption of the volar ulnar physis of the distal radius (leading to radial inclination and a radiopalmar tilt).Ans2
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Madelung's deformity of the distal radius is caused by which of the following? 1-Premature fusion of the distl radial ulnar jnt; 2-Physeal growth mismatch b/w the distal rad & ulna; 3-Nutritional deficncy affectg the physeal zone of provisional calcifictn;
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4-Impaired growth of the volar & ulnar aspect of the distal radial physis; 5-Unrecognized trauma::caused by impaired growth of the volar & ulnar aspect of the dist rads physis, bony lesion in the palmar/ulnar corner distl radl physis or an abn radial-carpal ligament (Vicker's ligament).Ans4
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1-Radial clubhand; 2-scaphoid fx; 3-hypoplastic thumb;
4-Gymnast’s wrist is a distal radius physeal injury due to repetitive axial loading; 5-keinbock's dz; which of the depicted conditions is temporary scaphotrapeziotrapezoidal pinning most indicated? |
Temporary scaphotrapeziotrapezoidal (STT) pinning is indicated for treatment of Kienbocks disease in adolescents as shown in Figure D. The radiograph shows increased density and slight lunate collapse.Ans5
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39yo M c/o longstandg R wrist pn, faild conservtv measures includg prolongd immobiliztn. fig A & B. What's tx? 1-Ulnar shortng osteotmy; 2-TFCC repair; 3-Radius core decomprssn; 4-Arthroscpc lunate chondrplsty & debrdmnt; 5-Scapholunate lig reconstrctn
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pt has Kienbock's dz. Tx options: a joint leveling procedure, or radius core decomprssn, which incite local vascular healg respnse in lunate; good results w/out complctns. Most pts improvmnt in pn & were able to retrn to wrk.Ans3
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32 yo carpenter c/o progressvly worsn'g wrist pn: 2 mths duration. denies hx trauma-> wrist/hand. MRI fig A. Which of the followg surgical interventions is thought to be effective for this condition by inciting a local vascular healing response?
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1-Wrist fusn; 2-Ulnar shorteng osteotmy; 3-Dis radius core decomprssn; 4-Prox row carpctmy; 5-Scapholunate lig recon::Kienbock's dz, avn lunate, in the pre-collapse stg. Core decomprsn of the distl radus prior to collapse & degenrtn lunate.Ans3
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30yo F gets scopy chronically painful R wrist, faild to improve w/ 4 mths of immobilization & NSAIDS. PE: pnt tendrns dorsally over the lunate but no tendrns elsewhere. The articular surface of the lunate is stable to probing. Fig B & C. What is next step in tx?
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1-Continu Immblztn & NSAIDS; 2-Radl shortng osteotmy; 3-Prox row carpctmy; 4- STT fusn; 5-Wrist fusn:::Stg 2 Kienbock's dz w/ neg ulnar variance. Radl shortng osteotmy. Stg 2 dz = lunate sclerosis w/out significant collapse.Ans2
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PE finding demonstrated on the patient's R hand is found with neuropathy of which of the followg nerves? 1-Musculocutaneous n; 2-AIN; 3-Radial n; 4-Ulnar n 5-Median n
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Froment's sign= (IP) flexion durg attempted key pinch. (+) pts w/ ulnar neuropthy-> cubital tunl S, Ulnar Tunl Syndm). bc/ add pollicis (ulnar n.) is deficient, & can NOT flex the MCP jnt give pinch strgth w/ extndd IP joint. thumb compnsts->FPL (median n.) flex the IP jnt ->give pinch strgth.Ans4
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Cubital tunl syndrm is caused by compression ulnar n b/w what 2 structrs as it passes post to the medial epicondyle? 1-Osbrne's lig & MCL; 2-MCL & Arcd of Struthrs; 3-Osbrne's lig & intramusclr septm; 4-MCL & medl head tricps; 5-Ulnr & hum heads FCU
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roof of the cubital tunl: is Osborne's ligament, & the floor: is MCL. These soft tissue structures can cause narrowing of the tunnel, especially with elbow flexion.Ans1
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1mnemonic for radial, ulnar median nerves?
2 name and describe the 4 test of the nerve in hand |
Dr. FCuMa; D-wrist drop;R- radial n
F-FrometsC-claw hand; U-ulnar . n M-median. n; A-ape hand FuJu WuMu- Ulner nerve out: Fromet's sign-compensatory AIN, Jeanne sign-compensatory radial n, Wartenberg sign, Masse sign |
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All are possible sites of compression for the ulnar n EXCEPT: 1-arcade of Struthers; 2-lig of Struthers; 3- FCU fascia; 4- medial intermsclr septm; 5-Osborne's lig
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5 sites of ulnar n entrapment @ elbow: 1 arcade of Struthrs, 2 med intermuscular septum, 3 med epicondyle, 4 cubital tunl, 5 deep flexor pronator aponeurosis.Ans2(congenital human anatomcl variation->median-n entrapment syndrm)
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50 yo M c/o numbns & tinglg along his R small fingr. PE in Fig A. Elbow flex reproduces numbness & tinglg. PT & splintg have failed. Which is the most appropriate surgical intervention & minimizg complctns?
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1-Simple ulnar n decomprsn @ cubital tunnl
2-Ulnar n decomprsn @ cubital tunl w/ ant submsculr transpstn; 3-Ulnar n decomprsn @ cubital tunl w/ ant subcut transpstn; 4-Open carpal tunl release; 5-Endoscopic carpal release::: meta-analysis b/w ant transpstn & simple decomprsn of the ulnar n. No difference found.Ans1 |