1. This document provides 33 questions about various topics in podiatry and medicine. It tests knowledge of classifications of osteomyelitis, stages of wound healing, treatments for infections, radiographic patterns of bone destruction, and more. 2. Questions cover topics like the stages of syphilis, phases of bony healing, layers of skin, periosteal reactions seen on x-rays, and conditions like Felty's syndrome and CREST syndrome. 3. Tests are also included on laboratory values, medications, and clinical assessments - including peak and trough levels of antibiotics, disease-modifying drugs for rheumatoid arthritis, and neurological pathways for sensory perceptions.

1. PODIATRY TRIVIA
Part 1

2. 1. Name 3 classifications for
osteomyelitis

3. Waldvogel
Cierny – Mader
Buckholtz

4. 2. What are the 5 D’s for the treatment
of infection?

5. Debridement
Decompressions
Drainage
Dressings
Drugs

6. 3.What is the D-dimer assay used for?

7. This is a new way to detect PE and more
recently DVT. D-dimer is a fragment that is
specific for the degradation of fibrin. (Barbe
et al Am J Clin Path 1998)

8. 4. Name 5 causes for bilateral edema.

9. CHF
Protein deficiency
Prolonged standing
Chronic venous valve insufficiency
Myedema
Drugs (corticosteroids, NSAIDs, BCP, Abx with increased sodium)
Pregnancy

10. 5. Name 5 causes for unilateral edema.

11. - Venous obstruction (DVT, post phlebotic syndrome)
- Lymphatic obstruction
- Infection
- Trauma
- Tumor
- Previous surgery
- Popliteal aneruysm
- Charcot
- AV fistula
- Milroy’s disease (swelling secondary to lymphatic obstruction) Filariasis
- Baker’s cyst
- Retroperitoneal fibrosis

12. 6. Name the stages of wound healing.

13. Inflammatory: PMN predominate
Features – hemostasis, debridement, decontamination of the wound Day
3 – 4
Fibroblastic or Proliferative: macrophages predominate
Features – collagen synthesis, neovascular formation, re-epithelialization
Day 3 – 4 to day 14 – 21
Maturation or Remodelling:
Features – remodeling and reorganization of collagen bundles; wound
contraction, increase tensile strength
Week 3 post injury to 1 yr post injury

14. 7. What is Charnley’s description of
closed reduction?

15. 1. Recreate the deformity
2. Distract
3. Reduce the deformity and realign
4. Maintain correction with immobilization

16. 8. What disease is the CREST syndrome
associated with and what does it stand
for?

17. Associated with Scleroderma (systemic sclerosis); this syndrome
occurs in the limited form of the disease
C: calcinosis
R: raynaud’s phemenon
E: esophygeal dysmotility
S: sclerodactyly
T: telangectasia

18. 9. What are the phases of bony
healing?

19. Inflammatory Reparative Remodelling
Secondary bone healing has been said to heal in six
phases:
Hematoma formation
Hematoma organization
Fibrocartilagenous callus
Primary bone callus
Primary bone callus resorption
Remodelling (maturation)

20. 10. Name the layers of skin.

21. Stratum basale (germinativum)
Stratum spinosum
Stratus granulosum
Stratus lucidum
Stratus corneum

22. 11. What clinical conditions occur in
each stage of syphilis?

23. Primary: chancre
Secondary: skin lesions that resemble many other
diseases (the Great Masquerader)
Tertiary: tabes dorsalis, CNS effects,
neuropathy

24. 12. What is the Jarisch-Herxheimer
reaction?

25. This occurs when patients are being treated with antibiotics
(Lyme disease). During the initial 24 hours of therapy, the
patient becomes sicker with worsening of the symptoms. This
is due to the massive destruction of the bacteria and the
release of toxins into the blood as the bacteria dies.
This can also occur in any treponemal infection (Syphillis)

26. 13. Name 5 anaerobes.

27. Clostridium
Bacteroides
Peptostreptococcus
Peptococcus
Fusobacterium

28. 14. If a pt is taking Rifampin and notice
a red color in their urine, should they be
worried?

29. No, this is a normal side effect.
Rifampin may turn body fluids red

30. 15. Name 5 gas forming organisms.

31. Staph
Strep
Serratia
Peptococcus
Peptostrepococcus
Escherichia
Clostridium
Klebsiella
Bacteroides
Fusobacterium
SSSPPECK-BF

32. 16. Which side effect seen in
aminoglycoside therapy is reversible?

33. Kidney function

34. 17. What are the peaks and troughs for
gentamycin and vanco and what do
they tell you?

35. 17. What are the peaks and troughs for gentamycin and vanco and what do they tell you?
Gentamycin Trough – 2 Peak – 10
Vancomycin Trough – 10 Peak – 20
The peak gives information regarding the amount of the dosage
The trough gives information regarding the timing of the dose (frequency)
18. Name all of the beta-lactamase penicillins and their dosages
Augmentin (amoxicillin/clav) 250, 500, 875 mg PO (500 TID; 875 BID)
75 mg amoxicillin
125 mg clavulanic acid
Timentin (ticracillin/clav) 3.1 g IV q6-8h
3 g ticracillin
100 mg clavulanic acid
Unasyn (ampicillin/sulbactam) 1.5/3.0 g IV q6-8h
2:1 ratio

36. 18. Name all the beta-lactamase
penicillins

37. Augmentin (amoxicillin/clav)
Timentin (ticracillin/clav)
Unasyn (ampicillin/sulbactam)
Zosyn (pipercillin/tazobactam)

38. What is the dose of
Augmentin?

39. 250, 500, 875 mg PO (500 TID; 875 BID)
75 mg amoxicillin
125 mg clavulanic acid

40. What is the dose of
Timentin?

41. 3.1 g IV q6-8h
3 g ticracillin
100 mg clavulanic acid

42. What is the dose of
Unasyn?

43. 1.5/3.0 g IV q6-8h
2:1 ratio

44. What is the dose of
Zosyn?

45. 3.375 IV q6h –or—4.5 g IV q8h
Pipercillin 3g
Tazobactam 0.375g

46. 19. Name some treatments for MRSA
and VRE.

47. MRSA:
Vancomycin,
Zyvox,
Bactrim/Rifampin,
Cipro/Rifampin,
Minocycline
VRE:
Zyvox,
Syndercid,
Amp/Aminoglycoside

48. 20. What is the characteristic color
pattern in Raynaud’s phenomenon?

49. White-blue-red

50. 21. Explain the glucose tolerance test.

51. Pt ingests 75 g of oral glucose.
Blood sugar is tested at 0, .5, 1, 1.5 and 2 hours after ingesting.
If the reading at 2 hrs and 1 other measurement is >200mg/dl then
diabetes can be diagnosed.

52. 22. Name 5 Disease modifying anti-
Rheumatic drugs (DMARDS)

53. Methotrexate
Gold salts
Penicilliamine
Axathioprine
Sulfasalazine
Leflunonide

54. 23. What is the hallmark of ankylosing
spondylitis?

55. Bilateral sacro-illitis (bamboo spine)

56. 24. What is the half life of Tc-99, Gd and
Indium?

57. Tc 99 – 6 hours
Gd – 79 hours
Indium – 67 hours

58. 25. What is the major distinction
between Roussy-Levey Syndrome and
CMT?

59. Essential tremor expressed primarily in
the hands (RLS)

60. 26. What are the three stages of RSD?

61. 1. Acute: hyperemic; lasts 1 – 3 months
2. Dystrophic: ischemic; lasts 3 – 6 months
3. Atrophic: 6 – 9 months

62. 27. What are the three types of biopsy?

63. - Shave: not commonly done
- Incisional: usually a punch biopsy; done to
remove a section of the lesion; pick
the most aggressive appearing part of the lesion
- Excisional: removal of the entire lesion

64. 28. What are the four main types of
malignant melanoma?

65. - Superficial spreading: the most common type
- Lentigo: most commonly seen in older men
- Acral lentiginous: see Hutchinson’s sign (color
changes in the eponychium of subungual melanomas):
most common in non-caucasians
- Nodular: the most malignant type

66. 29. What are the three radiographic
patterns of bone destruction?

67. Geographic
Moth eaten
Permeative

68. 30. Name types of periosteal reaction.

69. Single layer
Onion skin
Codman’s triangle
Velvet
Sunburst
Perpendicular (hair on end)

70. 31. 5 D/Dx for chest pain.

71. MI
PE
Angina
Heartburn Pneumothorax Cardiac tamponade
Aortic dissection
Aortic aneurysm
Pericarditis
Herpes Zoster
Musculoskeletal pain

72. 32. What is Felty’s syndrome?

73. Rheumatoid Arthritis,
Splenomegaly,
Neutropenia

74. 33. Which specific ascending pathway is
responsible for vibratory, pressure, light
touch and conscious proprioception?

75. Dorsal column medial lemniscus

76. 34. What is responsible for pain, temp,
light touch and itch?

77. Anterolateral spinothalamic tract