Orthopedic Certification Test 70 Questions with Verified Answers,100% CORRECT

Orthopedic Certification Test 70 Questions with Verified Answers Cartilage is made of - CORRECT ANSWER collagen and protein Joint Cartilage is made of - CORRECT ANSWER extracellular matrix and chondrocytes Extracellular matrix contains primarily - CORRECT ANSWER type 2, 4, and 6 collagens as well as aggrecan proteoglycans Type 2 collagen is responsible for - CORRECT ANSWER protecting the ends of bone within a joint Aggrecan proteoglycan is mainly responsible for - CORRECT ANSWER retaining water molecules, allowing resistance to affects of strenuous use of the joint Chondrocytes within joint cartilage is responsible for - CORRECT ANSWER the strength and resistance to loading What is the pathophysiology of osteoarthritis? - CORRECT ANSWER when cartilage becomes damaged it starts to lose elasticity, making it more susceptible to injury. With increasing stress and wear the bone starts to become affected causing thickening of bone and formation of bone spurs and osteophytes. Abnormal bone formations can break loose with cartilage fragments and float within joint space. Debris cause synovium to mount and inflammatory response to break down cartilaginous debris. What does the inflammatory response during degeneration of cartilage increase? - CORRECT ANSWER the breakdown of remaining healthy cartilage, leading to further degeneration Osteoarthritis symptoms: - CORRECT ANSWER pain that is exacerbated with activity and better with rest (early dz), stiffness, swelling, pain and stiffness worse in the morning (no more than 30 min), pain worse with prolong inactivity or weather changes Hip osteoarthritis symptoms: - CORRECT ANSWER pain in low back and groin, limping and knee pain from compensation Knee osteoarthritis symptoms: - CORRECT ANSWER locking, cracking, grinding, "give out" feeling, increasing pain with ascending and descending stairs Finger osteoarthritis symptoms: - CORRECT ANSWER swelling, nodules, stiffness, difficulty gripping What are causes of secondary osteoarthritis? - CORRECT ANSWER joint injury (fracture or sprain), chronic stress, joint instability, nervous system disorders (ex. charcot neuropathy), blood and endocrine disorders (diabetes, gout, thyroid disorders, osteoarthritis, growth hormone disorders), medications (oral steroids, meds for gout), inflammation (RA causing secondary osteoarthritis) What are diagnostic tests for osteoarthritis? - CORRECT ANSWER blood work to eliminate other disorders such as RA and to establish base line and possible secondary osteoarthritis diseases, X-rays, possible MRI, evaluation of synovial fluid What is the most common and cost-efficient diagnostic test for osteoarthritis? - CORRECT ANSWER x-ray What would an x-ray show to diagnose osteoarthritis? - CORRECT ANSWER joint space narrowing, bone spurs, osteophytes What does synovial fluid of osteoarthritis look like? - CORRECT ANSWER straw colored, no more than 2000 white blood cells, and synovial glucose should be equal to serum glucose What are alternative treatments for osteoarthritis? - CORRECT ANSWER glucosamine, SAM-e oral, copper and magnetic bracelets, acupuncture, tai chi, pilates, yoga, herbs, and supplements What is glucosamine? - CORRECT ANSWER helps to regenerate joint cartilage in osteoarthritis, some studies support reduce of pain and inflammation What is SAM-e oral? - CORRECT ANSWER thought to reduce osteoarthritis pain, studies vary What are copper and magnetic bracelets used for in osteoarthritis? - CORRECT ANSWER anecdotal reports only, studies don't support, no harmful effects What are herbs used to help with osteoarthritis? - CORRECT ANSWER garlic, echinacea, gingko, St. John's wort, ginger, turmeric, and cayenne. Ginger, turmeric, and cayenne have more supportive studies What is the number one modifiable risk factor for osteoarthritis? - CORRECT ANSWER weight What are key points to obtain in history of a patient with osteoarthritis? - CORRECT ANSWER pain (location, onset/duration, type), activity (response to pain, alleviating and exacerbating activities, fatiguability), effect on sleep, nutritional status, unintended weight gain/loss, caffeine consumption, affect on ADLs (self care, occupational, family roles), effect on sexual relations, self-concept and image, independence, hobbies, coping mechanisms, support system, knowledge of disorder, comorbidity, meds, compliance, and treatments tried, past medical history including family, social history (alcohol use, tobacco, drugs) What are side effects of acetaminophen use with osteoarthritis? - CORRECT ANSWER dose should be no larger than 4000 mg/day, liver toxicity (too much or alcohol) What are side effects of NSAIDs such as ibuprofen and naproxyn with osteoarthritis? - CORRECT ANSWER gastric ulceration and bleeding, renal impairment, newer COX-2 NSAIDs like celebrex reduce GI risks What are side effects of non-narcotic, centrally-acting analgesics such as tramadol with osteoarthritis? - CORRECT ANSWER vertigo, headache, nausea, constipation, habituation What are side effects of opioid (narcotic) analgesics such as codeine and propoxyphene with osteoarthritis? - CORRECT ANSWER constipation, disorientation, vertigo, high abuse potential, use with caution in elderly, can be safely used with NSAIDs but no more than 2 weeks at a time What is most successful in joints that demonstrate signs of inflammation and when other more conservative modalities fail? - CORRECT ANSWER injection of an osteoarthritic joint Injection with a glucocorticoid can provide what with osteoarthritis? - CORRECT ANSWER 3 to 4 weeks of relief How many injections can a single joint receive in a year? - CORRECT ANSWER no more than 3 What are some topical analgesics that are used in combo with other treatments? - CORRECT ANSWER capsaicin cream (most studied), aspercreme, bengay, icy hot, flexall Where should topical analgesics not be applied? - CORRECT ANSWER to a break in the skin or placed over a joint that is tightly occluded What is viscosupplementation that is used for osteoarthritis? - CORRECT ANSWER involve series of injections into joint over a weeks, reserved for cases where other treatments have failed What is viscosupplementation composed of? - CORRECT ANSWER hyaluronic acid, a substance found in the body that gives synovial fluid thickness and cushion What are the goals of viscosupplementation? - CORRECT ANSWER improbe lubrication of joints, decrease pain and allow for increase mobility and activity What side should a cane be used on? - CORRECT ANSWER opposite side of the affected hip How should someone with osteoarthritis go up the stairs? - CORRECT ANSWER lead with the good hip then bring the bad hip and cane up/down to the step the good foot is already on Modifiable risk factors for post op complications post total joint replacement are? - CORRECT ANSWER smoking, obesity, malnutrition, heath and conditioning pre surgery, not discontinuing meds meds pre surgery What comorbidities place patient at higher risk for operative complications with total joint? - CORRECT ANSWER diabetes, CAD, hypertension, congestive heart failure, COPD, asthma, autoimmune disease How does an abductor pillow keep the patients body? - CORRECT ANSWER hips in extension, legs in abduction and slight external rotation What are alternative therapies for chronic degenerative back pain? - CORRECT ANSWER spinal manipulation (best for newer pain), TENS (transcutaneous electric nerve stimulation) unit, acupuncture, biofeedback, massage When is spinal manipulation not recommended with degenerative back pain? - CORRECT ANSWER if there are radicular symptoms or signs of chronic neurological deficit or compression How long should ice be used for acute pain? - CORRECT ANSWER the first 48-72 hours and then heat after What are post-surgical hip precautions for anterior approach? - CORRECT ANSWER no external rotation of knees/ankles, no turning towards operative side with walking, no abduction of surgical hip and no crossing legs (ankle on knee or knee on knee), LESS PRECAUTIONS What are post-surgical hip precautions for posterior approach? - CORRECT ANSWER no bending at waist greater than 90 degrees, don't sit cross-legged, no internal rotation on surgical side, must sleep with pillow between knees and external rotation of legs Positioning for hip surgery with anterior approach means: - CORRECT ANSWER patient lying supine, hip extended and in external rotation, and knee flexed, can also be done with posterior approach positioning Positioning for hip surgery with posterior approach means: - CORRECT ANSWER patient lies on unaffected side, with affected hip in flexion, adduction and internal rotation Surgical positioning for thoracic spine surgery means: - CORRECT ANSWER prone position, elbows slightly flexed and be alert to pressure spots on face, same with lumbar spine procedures Surgical positioning for total knee replacement means: - CORRECT ANSWER supine position, with headrest to align cervical spine in comfortable and natural position, arms to side Surgical positioning for open hip reduction: - CORRECT ANSWER supine position Surgical positioning for shoulder replacement: - CORRECT ANSWER supine, reclined position with head secured Surgical positioning for knee scope: - CORRECT ANSWER supine with foot of bed lowered at knee level Surgical positioning for shoulder scope: - CORRECT ANSWER lateral position Osteoarthritis of shoulder is often caused by: - CORRECT ANSWER chronic rotator cuff tear When is a CPM machine applied? - CORRECT ANSWER within the first 24 hours, for max benefit apply at least 6 hours in a 24 hour period What is the purpose of a CPM machine? - CORRECT ANSWER reduce stiffness and aide in the return of ROM What is chondromalacia patellae? - CORRECT ANSWER seen in younger age groups, also known as patellofemoral syndrome, the underside of the kneecap is roughened causing pain with all movement and the kneecap moves over the femur What causes chrondromalacia patellae? - CORRECT ANSWER heavy joint use like marathon runner, also trauma and poorly developed thigh muscles or quads Who are candidates for shoulder fusion? - CORRECT ANSWER when shoulder osteoarthritis as failed at conservative treatments and shoulder pain and loss of ROM persist, good for patients 40 and have labor intensive occupations or participate in sports Who is shoulder fusion the best choice for? - CORRECT ANSWER patients who are non-complaint in post surgical rehab program What are bunions known as? - CORRECT ANSWER hallux valgus, lateral deviation of the metatarsal phalangeal joint of the greater toe What causes bunions? - CORRECT ANSWER the MTP joint degenerates over time due to poorly fitting footwear (narrow, tight-fitting, heels), or a birth deformity What are treatments for bunions? - CORRECT ANSWER wider fitting shoes, shoe inserts, NSAIDS, injections When is surgery an option for bunions? - CORRECT ANSWER only if 2nd-5th toes become affected and outward pointing and pain persists What is racemic epinephrine? - CORRECT ANSWER acts on adrenergic receptor sites causing reduction in airway inflammation and edema. What is racemic epinephrine commonly used for? - CORRECT ANSWER Croup and when stridor is present. What is Iprtropium and what is is used to treat? - CORRECT ANSWER Anticholinergic used to treat asthma and COPD. What is Sameterol and what is it used for? - CORRECT ANSWER Long acting beta agonisht used to treat asthma and COPD. What is Theophylline and what is it used for? - CORRECT ANSWER Xanthine derivative and is used to treat apnea of prematurit and sometimes COPD or asthma.