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5 Cards in this Set

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  • Back
Which of the following patients with Dupuytren's contracture would benefit the most from dermatofasciectomy and full-thickness skin grafting opposed to traditional fasciectomy? 
1.  70-year-old sedentary male with small finger involvement isolate...
Which of the following patients with Dupuytren's contracture would benefit the most from dermatofasciectomy and full-thickness skin grafting opposed to traditional fasciectomy?
1. 70-year-old sedentary male with small finger involvement isolated to the MCP joint
2. 50-year-old male systems analyst with ring and small finger involvement limited to the MCP joints
3. 65-year-old female golfer with ring and small finger involvement including MCP and PIP joints
4. 40-year-old female stenographer with middle, ring, and small finger involvement including MCP and PIP joints with 50 and 55 degree contractures of ring and small finger MCP joints, respectively
5. None of the above as no difference in outcome has been demonstrated between the two procedures
Dermatofasciectomy and full-thickness grafting has not demonstrated superior finger range of motion, recurrence rate, or patient satisfaction in comparison with traditional fasciectomy.Ans5
Dermatofasciectomy and full-thickness grafting has not demonstrated superior finger range of motion, recurrence rate, or patient satisfaction in comparison with traditional fasciectomy.Ans5
All of the following have been implicated in the pathogenesis of Duputryen's contracture EXCEPT
1.  Fibroblast growth factor (FGF) 
2.  Transforming growth factor- beta (TGF-beta) 
3.  Myofibroblasts 
4.  Platelet-derived growth facture (PDGF)...
All of the following have been implicated in the pathogenesis of Duputryen's contracture EXCEPT
1. Fibroblast growth factor (FGF)
2. Transforming growth factor- beta (TGF-beta)
3. Myofibroblasts
4. Platelet-derived growth facture (PDGF)
5. CBFA-1
Dupuytren contracture, a disease of the palmar fascia, results in the thickening and shortening of fibrous bands in the hands and fingers. The offending cells are thought to be myofibroblasts and fibroblasts. Growth factors such as basic fibroblas...
Dupuytren contracture, a disease of the palmar fascia, results in the thickening and shortening of fibrous bands in the hands and fingers. The offending cells are thought to be myofibroblasts and fibroblasts. Growth factors such as basic fibroblast growth factor (FGF), platelet-derived growth factor (PDGF), and transforming growth factor-beta (TGF-beta) may signal the overproduction of the myofibroblasts and/or myofibroblastic activity of the fibroblasts. In addition, high levels of TGF-Beta may hinder apoptosis of the active myofibroblasts, unlike normal tissue healing. Core-binding factor alpha(1) (Cbfa1) is an essential transcription factor for osteoblastic differentiation and osteogenesis. Ans 5
What is the name of the pathologic structure, identified by the white arrow in Figure A, that displaces the digital neurovascular bundle and places it at risk during during surgical treatment of Dupuytren's disease? 
1.  Pretendinous cord 
2.  P...
What is the name of the pathologic structure, identified by the white arrow in Figure A, that displaces the digital neurovascular bundle and places it at risk during during surgical treatment of Dupuytren's disease?
1. Pretendinous cord
2. Pretendinous band
3. Spiral cord
4. Spiral band
5. Natatory cord
The spiral cord, shown by the white arrow in Figure A, can displace the neurvascular bundle (blue arrow) and places it at risk during surgical resection. Dupuytren's contracture is a rare and progressive condition characterized by contractures of ...
The spiral cord, shown by the white arrow in Figure A, can displace the neurvascular bundle (blue arrow) and places it at risk during surgical resection. Dupuytren's contracture is a rare and progressive condition characterized by contractures of the fascia of the hand as seen in Illustration A. The fascial components involved in the disease include the pretendinous bands, spiral bands, natatory bands, lateral digital sheets, and Grayson's ligament. The offending cell is the myofibroblast which causes the normal structures to become fibrosed. Once these normal bands become pathologically involved in the disease process, they are termed cords. An easy way to remember this is that bands are normal, and cords are abnormal. The spiral cord travels dorsal to the NVB and displaces it volarly, placing it at risk during surgical resection.Ans3
Hx:54yo F presents w/ a hand deformity. A surgical procedure is being considered that relocates the lateral bands dorsally to counteract the pathophysiology of the deformity. Which of the following deformities does this patient most likely have? 
...
Hx:54yo F presents w/ a hand deformity. A surgical procedure is being considered that relocates the lateral bands dorsally to counteract the pathophysiology of the deformity. Which of the following deformities does this patient most likely have?
1. Boutonneire finger deformity
2. Lumbrical plus finger deformity
3. Mallet finger deformity
4. Jersey finger deformity
5. Swan neck finger defomity
Boutonniere deformity is characterized with the PIP in flexion and the DIP in hyperextension as shown in Illustration A. It is caused by central slip rupture or attenuation (secondary to capsular distention, e.g., rheumatoid arthritis), laceration...
Boutonniere deformity is characterized with the PIP in flexion and the DIP in hyperextension as shown in Illustration A. It is caused by central slip rupture or attenuation (secondary to capsular distention, e.g., rheumatoid arthritis), laceration, or traumatic disruption. Volar subluxation of the lateral bands due to incompetence or disruption of the triangular ligaments leads to increased deformity as the lateral bands become flexors of the PIP. Relocation of the lateral bands to their original dorsal position to counteract the pathophysiology of the deformity is an option for patients that have an approximately 40 degree active flexion contracture but full passive extension.Ans1
Figure A depicts a child with a congenital abnormality. Which of the following is true regarding this condition?  
1.  Circumferential trunk involvement is more common than distal extremities involvement 
2.  Risk factors include late gestation ...
Figure A depicts a child with a congenital abnormality. Which of the following is true regarding this condition?
1. Circumferential trunk involvement is more common than distal extremities involvement
2. Risk factors include late gestation (>44 weeks) and high birth weight (>3500g)
3. Incomplete circumferential bands not directly interfering with lymphatic circulation should be resected
4. There is a strong correlation with anterolateral tibial bowing
5. Complete circumferential bands that interfere with lymphatic drainage can be treated with band excision and z-plasty.
constriction band syndrome (CBS). In the case of lymphatic obstruction or vascular compromise, the treatment of CBS is band excision. There are many terms used to describe this phenomenon. However, the etiology is the entanglement of fetal parts i...
constriction band syndrome (CBS). In the case of lymphatic obstruction or vascular compromise, the treatment of CBS is band excision. There are many terms used to describe this phenomenon. However, the etiology is the entanglement of fetal parts in the amniotic membrane. Kawakura et al reviewed the intrinsic and extrinsic theories of (CBS). The most common manifestations are distal extremity involvement, intrauterine amputations and acrosyndactyly. Excision of bands and mobilization of subcutaneous adipose tissue as described by Upton is seen in Illustration A.Ans5