Basic science - SA

  1. List 3 non-skeletal findings in Marfan’s syndrome
    • Aortic dissection
    • Mitral valve prolapse
    • Superior lens dislocation
    • Spontaneous pneumo
    • Aortic regurg
    • Retinal detachment
  2. Hemophilia patient
    a. at what level does his factor have to be during surgery?
    b. for how long does his factor have to be at surgery levels?
    c. Is the long term outcome the same in hemophiliacs compared to non-hemophiliac patients?
    • a) 100%
    • b) 2 days ( 60-80 to day 4, 40-60 to day 6)
    • c) When infection excluded they have the same outcome
  3. In hypovolemic shock, the body relies on anaerobic metabolism. List what happens intracellularly to the following (decreased / increased / no change) a) Na b) K c) Ca d) water
    • Na: Increased
    • K: Decreased
    • Water: Increased
  4. What are 2 mechanisms of action of BMP?
    • DIfferentiation of MSC to osteoblast
    • Proliferation of MSC
  5. List 4 potential complications of using BMP-2 in spine surgery.
    • Vertebral osteolysis
    • Graft subsidence
    • Graft migration
    • Ectopic bone formation
  6. What are the 3 phases of muscle repair
    • Inflammatory
    • Reparative
    • Remodelling
  7. Give 4 changes in and around muscle with endurance training
    • INcreased resistance to fatigue
    • INcreased capillary density
    • Hypertrophy of slow twitch fibers
    • Improved lipid profile
  8. Give 5 principles of managing a medical error
    • Acknowledge error
    • Take responsibility
    • Offer emotional support
    • Prevent recurrence
    • Identify underlying cause
  9. Name the layers of cartilage (see picture)
    • Superficial zone: fibers parallel
    • Transitional zone: Random fibers
    • Deep zone
    • Tidemark
    • SUbchondral bone
  10. Name 5 ways to limit bias in a randomized controlled trial?
    • Centralized randomization
    • Blind: Assessor, investigator, participants
    • Stratification
    • Intention to treat analysis
    • Large sample size
  11. List the 7 CANMEDs domains
    • Communicator
    • Medical expert
    • Health advocate
    • Manager
    • Professional
    • Scholar
    • COllaborator
  12. List 4 principles of ethics
    • Beneficence
    • Non-maleficence
    • AUtonomy
    • Justice
  13. List 4 prognostic factors associated with poor prognosis in a patient with septic arthritis.
    • RA
    • Polyarticular
    • Delayed diagnosis
    • Extremes of age: <6 months/elderly
    • Immunosuppression
    • Location: Hip worse than knee
    • Osteomyelitis
  14. List 3 advantages for coning an xray.
    • Decreased radiation to patient
    • Decreased radiation to surgeon
    • Better quality picture
  15. List 8 components of the pre-op checklist approved by WHO that will decrease patient morbidity and mortality.
    • Patient ID, sitem procedure and consent
    • Mark surgical site
    • COnfirm allergies
    • COnfirm members have introduced themselves
    • Anesthesia safety check
    • Confrim antibiotics
    • Confirm imaging available
    • Risk of bleeding
    • Pulse oxymetry
  16. 16 y/o F Jehovah witness trauma patient who has lost enough blood to require a blood transfusion. You explain her that she needs blood. She gets agitated when you say this and refuses. Although she is in shock, she seems competent. What ethical principles are in conlict with each other when dealing with this situation?
    • Beneficency
    • Autonomy

    The others are: non maleficence and justice
  17. List 6 essential components of obtaining an informed consent.
    • Patient is competent
    • Patient must know/understand diagnosis
    • Procedure explained
    • ALternatives explained
    • All risks that a reasonable person would want to know explained
    • COnsent must be voluntary
  18. Name the Four components of the WOMAC
    • Pain
    • Stiffness
    • Physical function
    • SOcial function
    • Emotional function
  19. List 4 principles for establishing causality
    • Biologic plausibility
    • Consistency:Different places/times same result
    • Temporal relationship
    • Dose response
  20. A surgeon is called by the ER for a 40 y.o male with olecranon # who needs surgery. The surgeon is conducting a research trial that is comparing tension band wiring with pre-contoured locking plate fixation. The surgeon is currently busy performing another surgery in the OR but the OR would be ready to do the olecranon case right after the surgeon finishes with his first case. Since the surgeon is currently operating he sends his medical student, who is new on the service, to get verbal consent from the patient for the surgery and for participation in the research trial. List 3 problems with obtaining consent for the surgery and the research participation in this scenario.
    Medical expert: student may be unable to explain procedure and risks appropriately

    Professional: Surgeon not meeting patient

    Verbal consent only appropriate when written consent not possible

    Manager: surgeon not managing time appropriately
  21. List 5 non-medication related modifiable risk factors for osteoporosis
    • Low body weight
    • Low protein intake
    • Smoking
    • Heavy ETOH
    • Sedentary lifestyle
  22. Name the 5 terminal branches of the posterior cord
    • Axillary nerve
    • Radial
    • Thoracodorsal
    • Upper subscapular
    • Lower Subscapular
  23. Which 2 muscles are innervated by the lower subscapular nerve?
    • Subscapularis: lower part
    • Teres major
  24. Name 5 sites of compression of the ulnar nerve.
    • Intermuscular septum
    • Arcade of struthers
    • Medial epicondyle
    • Cubital tunnel: osborne ligament
    • BTW 2 heads of FCU: arcuate ligament
    • Guyons canal
  25. Name the 4 major seronegative spondylarthropathies
    • Ankylosing spondylitis
    • Psoriatic arthritis
    • Enteropathic arthropathy
    • Reactive arthritis
  26. Name 6 risk factors for opioid analgesic abuse
    • Previous substance abuse
    • HIstory of overdose
    • Mental health condition
    • Low income
    • Non medical use
    • History of chronic pain
  27. You are doing a case, which will likely require more than 2.5 hours of tourniquet time. Give 3 possible management methods to prevent tourniquet-related complications.
    • Apply ciff at proper locatiov
    • Pressure: 100-150 > systolic
    • Wider tourniquet
    • Contoured tourniquet
    • Use limb protection sleeve
  28. Shown a histologic picture of a physis. Name the layers.
    • Reserve
    • Proliferative
    • Hypertrophic: Maturation, degeneration, provisional calcification)
    • Primary spongiosa
    • Secondary spongiosa
Card Set
Basic science - SA
Basic science sa