ABFAS FFA PRACTICE. TEST EXAM | QUESTIONS & ANSWERS (VERIFIED) | LATEST UPDATE | GRADED A+

1 ABFAS FFA PRACTICE. TEST EXAM | QUESTIONS & ANSWERS (VERIFIED) | LATEST UPDATE | GRADED A+ Two months status post plantar fibroma excision, the incision is healed but the three medial digits begin to hyperextend at the metatarsophalangeal joints. A possible cause would be the severance of which structure? Correct Answer: medial plantar nerve In which scenario should the patient's surgical intervention be canceled? a. MI in the past 6 months b. Glucose of 100 c. Female with HCG positive d. Correct Answer: Female with positive HCG A patient with a history of true penicillin allergy is scheduled for a total joint implant. Antibiotic prophylaxis would best be served with which of the following medications? 2 a. Ciprofloxacin b. Levofloxacin c. Cephalexin d. Vancomycin Correct Answer: Vancomycin When performing a Lapidus procedure for hallux abductovalgus, what structure should be avoided when exposing the first metatarsocuneiform articulation? Correct Answer: Deep perforating artery The radiograph shown below was taken 29 days postoperatively. Which treatment is appropriate? Correct Answer: remove pin; signs of healing Which of the following suture material is the LEAST reactive? Correct Answer: Monofilament wire When utilizing screw fixation for an osteotomy which of the following is the main reason for countersinking the screw based on AO principles? Correct Answer: Disperse compression force of screw head evenly. 3 A 65-year-old diabetic male presents to the emergency department with a longstanding heel ulcer. Assessment reveals he meets systemic inflammatory response syndrome (SIRS) criteria. What would be the most useful initial intervention? a. Culture wound b. Start fluid resuscitation and IV crystalloid c. Bedside I&D d. Gauze and tape Correct Answer: Start fluid resuscitation and IV crystalloid A 32-year-old female presents with a history of a slowly enlarging, subcutaneous, multinodular, painless mass beneath the flexor surface of the great toe. She denies any injury to the area. There is radiographic evidence of marginal bone erosion. Which of the following soft tissue masses is the most likely diagnosis? Correct Answer: Giant cell of tendon sheath Which complication is not associated with the Keller bunionectomy? A. Sesamoiditis b. Transfer stress fracture to 2nd digit c. Loss of hallux purchase d. Hallux malleus Correct Answer: Sesamoiditis 4 On a peripheral blood smear stained with hematoxylin and eosin, the presence of clusters of polynuclear leukocytes surrounding an extracellular hematoxylin body "rosettes" most likely indicates which of the following systemic disorders? Correct Answer: Systemic lupus What is the most appropriate suture needle tip for tendon repair? Correct Answer: Taper cutting Which of the following conditions is the rationale for holding a preoperative patient's metformin for 24 hours prior to surgical intervention? Correct Answer: Lactic acid A 60-year-old male develops an anaphylactic reaction secondary to a drug injection. Epinephrine (Adrenalin) 0.5 cc. is injected intramuscularly (IM) immediately. What is the purpose of administering this drug in this situation? Correct Answer: Dilate the bronchioles When performing a traditional chevron osteotomy to correct hallux abducto valgus with a hallux limitus component, how must the osteotomy be angulated to produce both shortening and plantarflexion of the capital fragment? Correct Answer: Dorsal distal medial to plantar proximal lateral 5 Which of the following treatment options would be the most appropriateto treat a calcaneonavicular coalition in a 20-year-old soft ball player with chronic foot pain? Correct Answer: Resection with muscle interposition Best test to order to determine sesamoiditis from sesamoid fx Correct Answer: MRI Which of the following anesthetic agents should be avoided in a patientwith an egg allergy? Correct Answer: Propofol Which of the following fixation techniques would be the most appropriate to repaira Jone's fifth metatarsal fracture? Correct Answer: Intramedullary screw Shortly after general anesthesia, a patient is nauseous and treatment is required. Which of the following would be the most appropriate treatment? Correct Answer: prochlorperazine (Compazine) 10 mg. intramuscularly (IM) In the early stages of superficial spreading malignant melanoma, which of the following conditions is not present? Correct Answer: Pain and bleeding 6 (it's a late sign, not an early sign) A 65-year-old patient in end stage renal disease with a glomerular filtration rate of nine is scheduled for an ankle arthrodesis. What laboratory values should be preoperatively evaluated? Correct Answer: Hb and electrolytes Kidney's are working, so make sure Hb and electrolytes are optimized prior to sx Which of the following surgical procedures would be most appropriateto correct a hallux abductus valgus deformity in a 25-year-old patient with a first inter metatarsal angle of 20 degrees, a negativemetatarsal protrusion distance and a rigid first ray? Correct Answer: Opening wedge osteotomy with graft. -shortened met, need to elongate Which is not an appropriate treatment of a dog bite on the foot which occurred eight hours ago? Correct Answer: debridement of wound and primary closure. Which of the the following surgical procedures would mostbeneficial in the repair of a stage four hallux limitus in an active patientwith a first inter metatarsal angle of 15 degrees? 7 Correct Answer: first metatarsophalangeal joint arthrodesis. The most probable etiology of heloma molle of the fourth interdigital space is pressure between which of the following structures? Correct Answer: head of the fifth proximal phalanx and the base of the fourth proximal phalanx. A 31-year-old female presents with a complaint of pain on the dorsal distal aspect of the hallux. She denies any injury. Radiographs reveal a radiolucent area at the distal phalanx with surrounding sclerosis. There is no sign of infection, no sinus tract, and no edema. Which of the following osseous tumors is the most likely clinical diagnosis? Correct Answer: Enchondroma In performing a McBride bunionectomy under local anesthesia, which of the following nerves does not need to be anesthetized? Correct Answer: Intermediate dorsal cutaneous nerve Which of the following statements is true with regards to performing a Z-plasty skin procedure? Correct Answer: make the central incision of the Z parallel to the contracted skin 8 Which of the following imaging modalities would be most helpful indiagnosing acute osteomyelits of the first metatarsal head in a Patient that is 3 weeks status post chevron osteotomy? Correct Answer: WBC scan Which of the following surgical procedures would be most appropriate to correct the deformity based on the given information? HA angle 25 degrees HAI angle 7 degrees PASA 10 DASA 8 1st IM angle 20 Correct Answer: Lapidus When utilizing the Ilizarov technique for repair of brachymetatarsiawhich of the following steps could cause inadequate lengthening to occur? Correct Answer: Too long of a latency Chronic treatment of which of the following medications has been found to result in osteonecrosis of the jaw? Correct Answer: Alendronate (fosamax) To derotate and correct an adductovarus fifth digit, which direction should the semielliptical incision be made? Correct Answer: Distal medial to proximal lateral 9 Three months after resecting a ganglion from the dorsum of the midfoot, a patient presents complaining of persistent numbness along the adjacent sides of the second and third digits. The most likely cause is an iatrogenic severance of which nerve? Correct Answer: Medial dorsal cutaneous nerve A patient presents with a transverse diaphyseal fracture of the second metatarsal. Which fixation device would be the least appropriate? A. Kirschner wire. B. external fixation. C. plate. D. cortical screw. Correct Answer: Cortical screw A patient presents 10 days status post a one stage fourth brachymetatarsia lengthening. The radiographic findings show bone resorption at the graft site. Based onthe radiographic findings, what should the next step be? A. take the patient back to the OR and replace graft. B. place a bone stimulator at the site of the graft. C. place the patient on anti-osteoporotic medications. D. continue with the current course of post-operative care. Correct Answer: Continue current course 10 A50-year-old male, with a 30 pack-year smoking history, presents with one block right calf claudication. Bilateral femoral pulses are palpable with no bruits. The left pedal pulse is present, but the right popliteal and pedal pulses are absent. What is the most likely level of arterial occlusion? Correct Answer: Right superficial femoral artery What should the postoperative care for a pan-metatarsal head resection consist of? A. strict non-weight bearing for four weeks. B. prevent range-of-motion for six weeks. C. allow weight bearing and range-of-motion as tolerated. D. below the knee cast and limit range-of-motion. Correct Answer: Allow WB and ROM as tolerated A65-year-old insulin dependent diabetic female arrives at the surgeon's office.While waiting she begins to feel faint and loses consciousness. What would bethe treatment of choice?A. administer phenytoin (Dilantin) 200 mg. intravenously (IV). B. administer epinephrine 0.5 cc. intramuscularly (IM). C. administer enoxaparin (Lovenox) 30 mg intramuscularly (IM). D. administer 25 cc. of 50 percent dextrose in water intravenously (IV) Correct Answer: administer 25 cc. of 50 percent dextrose in water intravenously (IV) Which benign soft-tissue lesion may be invasive into bone? A. lipoma. 11 B. histiocytoma. C. villonodular synovitis. D. neurilemmoma. Correct Answer: Villonodular synovitis A 40-year-old female presents with a ganglion at the base ofthe first metatarsal medially. After surgical excision of the ganglion, the patient complains of anesthesia along the medial aspect of the foot to thefirst metatarsal head. Which peripheral nerve was likely injured? Correct Answer: Saphenous Charcot joints are not commonly associated with which disease? (note negative format) A. syringomyelia. B. gout. C. diabetes mellitus. D. alcoholism. Correct Answer: Gout A 60-year-old diabetic male with history of gout, had a phenol and alcohol procedure of the lateral border of his hallux three weeks ago. He now presents with erythema, edema, increased warmth, and serous drainage. What is the most likely diagnosis from his history, clinical exam, and radiographic findings? Correct Answer: Osteomyelitis 12 A 25-year-old female has unremitting numbness in the lesser digits. The pain becomes more severe while walking and is difficult to relieve. Over the past several months, the pain has been sharp with radiating sensation in the arch. What is the most likely diagnosis? A. neuroma of the third intermetatarsal nerve. B. stress fracture. C. diabetes mellitus. D. compression of the posterior tibial nerve. Correct Answer: Compression of the posterior tibial n A patient presents to the emergency department after sustaining a through and through gunshot wound to the forefoot. Which fixation device would be the least appropriate? Correct Answer: Cerclage wire Which type of malignant melanoma is most commonly misdiagnosed as a pyogenic granuloma? A. superficialspreading. B. nodular. C. lentigomalignant. D. acral lentiginous. Correct Answer: Modular 13 Keratoses beneath the second metatarsal head are frequently observed in association with hallux valgus deformities. What is the most commoncause of these keratoses? A. hypermobilityof the first ray. B. shortsecond metatarsal bone. C. longfirst metatarsal bone. D. rigidplantarflexed first ray. Correct Answer: Hypermobile 1st ray Keratoses beneath the second metatarsal head are frequently observed in association with hallux valgus deformities. What is the most commoncause of these keratoses?A. hypermobilityof the first ray.B. shortsecond metatarsal bone.C. longfirst metatarsal bone.D. rigidplantarflexed first ray. Correct Answer: Arthrodesis of 3rd MTPJ How do you prevent floating toe of 5th digit after phalanx removal? Correct Answer: Syndactyly to 4th patient presents to the emergency department after a shower doorfell on her foot approximately 9 hours prior. The radiographic findings show a fracture at the head of the first metatarsal head and laceration dorsal midfoot. The most appropriate treatment would consist of the all the following,except: Correct Answer: Closing with interrupted sutures 14 you haven't fixed the fix, you wouldn't just close it A 55-year-old female is undergoing surgery and a thigh tourniquet has been inflated to 350mmHg for 120 minutes. The surgery is still not complete. What is the best protocol for use of the tourniquet for this patient? Correct Answer: Deflate and wait 15 min Four weeks following an excision of a neuroma in the third intermetatarsal space, the third digit drifts into an adducted position. Themost probable cause would be severance of which of the following anatomical structure? Correct Answer: 3rd dorsal interossei (abduction action gone.. you hurt DAB, now which one??) A 14-year-old female presents with dorsal foot pain for three months duration. There is no history of trauma or open wounds. After reviewing the history, radiographs, and magneticresonance imaging , what is the best treatment choice for this patient? Correct Answer: Bone biopsy Patient presents with a brachymetatarsia of the fourth. Which of the following isthe most appropriate callus distraction technique Correct Answer: the patient start turning the pin one full turn per day starting at day 7 post-operative. 15 Twenty-one hours after a bunionectomy under general anesthesia, the patient develops a temperature of 102 degrees Fahrenheit. Whatis the most likely cause? Correct Answer: pulmonaryatelectasis. What procedure most effectively transfers the action of theflexor digitorum longus to the metatarsophalangeal joint of the lesser digit? Correct Answer: arthrodesisof proximal and distal interphalangeal joints. Six weeks following resection of a soft tissue lesion from the 3rd interspace,the patient presents with lateral deviation of the 4th digit. Whatstructure was likely transected? Correct Answer: second plantar interossei. A 60-year-old male suddenly begins complaining of a "crushing" sensation in his chest. The episode lasts very briefly then subsides. It begins again and is more intense. What should you administer to this patient? Correct Answer: nitroglycerin (Nitrogard) 0.5 mg. When performing a first metatarsocuneiform joint fusion (Lapidus) on a short firstmetatarsal, the following techniques should be employed, except? Correct Answer: Translocationof the metatarsal dorsally. 16 When planning for a skin lengthening procedure,creating 60 degree angles on the "Z" would provide an increase of how many percent? Correct Answer: 75% 30 degrees: 25% 45 degrees: 50% 60 degrees: 75% Four weeks following a first metatarsocuneiform joint fusion (Lapidus), the patientpresents with persistent anesthesia at the medial aspect of the firstmetatarsal. Which nerve was likely injured during the procedure? Correct Answer: Saphenous A patient presents with painful hallux abducto valgusdeformity. There is pain-free range of motion of the first metatarsophalangealjoint. Radiographs reveal: hallux abductus angle: 35 degrees intermetatarsal angle: 16 degrees proximal articular set angle: 22 degrees distal articular set angle: four degrees metatarsus adductus angle: eight degrees What is the most appropriate procedure? Correct Answer: closing base wedge with Reverdin-Green. A 65-year-old female, with bodymass index of 35 and history of DVT, is undergoing a Lapidus bunionectomy. The surgeon's postoperative course is non-weight bearing until osseous healing. What is the best choice for DVT prophylaxis in this patient? 17 Correct Answer: low molecular weight heparin or oral equivalent until she is weightbearing. After performing a traditional Austin bunionectomy, the post-operative radiograph shows a significant shortening anda dorsiflexed first metatarsal. How was the axisguide placed during the procedure? Correct Answer: Dorsal proximal medial —> plantar distal lateral Five weeks status post a first metatarsocuneiform joint fusion(Lapidus) procedure, the patient presents with persistent paresthesia on thelateral aspect of the hallux. Which ofthe following nerve branch was most likely injured? Correct Answer: Deep peroneal A patienthas a history of hypertension which is controlled by furosemide (Lasix) 40 . What is the most frequentelectrolyte disturbance observed in this type of patient? Correct Answer: Hypokalemia A 35-year old female with a penicillin allergy is undergoing a bunionectomy and hammertoe repair. What is the antibiotic of choice for prophylaxis? Correct Answer: Vancomycin 18 A patient presents with an acute dorsal dislocation of the third digit at the metatarsophalangeal joint. Radiographs show no fractures andclosed reduction is performed under local anesthetic. What is the propersequence of maneuvers to reduce the dislocated third digit? Correct Answer: dorsiflexion,longitudinal traction, and plantarflexion of the digit.