Remediation:
A. Diabetes mellitus can increase the risk of infection by twofold.
B. Smoking was found to double the risk of infection in these injuries.
C. Hypertension was not identified as a risk factor for infection.
D. The risk of infection is increased in malnourished patients.
E. Osteoporosis has no effect on a patient's risk of infection.

Remediation:
A. The patient has radial tunnel syndrome. She has persistant pain with nonoperative management. The next best step is radial tunnel release.
B. The patient has had 90% relief of symptoms, and nonoperative treatment has failed. The next best step is to perform a radial tunnel release.
C. The patient has had 90% relief of symptoms, and nonoperative treatment should be continued at this time. Should nonoperative treatment fail, she may require radial tunnel release.
D. The patient has had 90% relief of symptoms, and nonoperative treatment should be continued at this time. Prolonged splinting in 90° of flexion is not recommended as it would cause an elbow contracture.

Remediation:
A. Conus medullaris syndrome typically causes mild bilateral lower-extremity weakness.
B. Conus medullaris syndrome typically causes mild bilateral lower-extremity pain.
C. Patients with conus medullaris syndrome typically have an absent Achilles reflex with intact patellar reflexes.
D. Patients with conus medullaris syndrome typically have an absent bulbocavernosus reflex.

Remediation:
A. Smoking can lead to weaker tendons in general, making them more prone to rupture.
B. Distal biceps ruptures can occur in middle-aged patients with a single traumatic episode of elbow flexion against resistance, but they are more likely to occur in young patients who are heavy lifters.
C. High BMI is not a risk factor for distal biceps rupture.
D. The distal biceps tendon attaches to the radial tuberosity, which is distal to the radial head. A fracture of the radial head does not increase the risk of distal biceps rupture.

Remediation:
A. The clinical scenario and radiograph suggest an acute unstable slipped capital femoral epiphysis. A limb-length discrepancy is possible after treatment, but the clinical significance is questionable as the actual magnitude of the discrepancy varies. Osteonecrosis occurs in 15% to 50% of patients and is a primary reason for total hip arthroplasty at a later age.
B. The clinical scenario and radiograph suggest an acute unstable slipped capital femoral epiphysis. Patients are typically left with loss of internal rotation after stabilization of this deformity.
C. The clinical scenario and radiograph suggest an acute unstable slipped capital femoral epiphysis. Osteonecrosis occurs in 15% to 50% of patients and is the most likely long-term complication.
D. The clinical scenario and radiograph suggest an acute unstable slipped capital femoral epiphysis (SCFE). The incidence of chondrolysis has decreased in SCFE over time with improved intra-operative imaging technology and is now relatively rare.
E. The clinical scenario and radiograph suggest an acute unstable slipped capital femoral epiphysis. The healed position of this deformity is a relative proximal femoral varus, not coxa valga.

Remediation:
A. For this patient, depending on the size of the mass, radiation therapy either before or after surgery would most likely be indicated. There are conflicting reports regarding the incidence of lymph node metastases for synovial sarcoma when compared to other soft-tissue sarcomas, and there is no clear benefit to routine lymph node dissection in these patients.
B. In the absence of neurovascular compromise, most patients with soft-tissue sarcoma of the extremity can be managed with limb salvage wide excision.
C. While radiation is often given, particularly for large high-grade soft-tissue sarcomas, and chemotherapy may be considered in a young patient with synovial sarcoma, wide surgical resection would be most appropriate in the management of localized soft-tissue sarcoma.
D. For large high-grade soft-tissue sarcomas of the extremity, the optimal treatment course typically involves wide excision and radiation therapy. In a young patient with synovial sarcoma, consideration may be given to chemotherapy, which most commonly involves doxorubicin and ifosfamide.

Remediation:
A. Subungual melanoma is an uncommon manifestation of cutaneous melanoma. Mean Breslow depth is >3 mm at diagnosis. The appropriate treatment is distal interphalangeal joint disarticulation.
B. Distal interphalangeal joint disarticulation and confirmation of negative margins is the preferred treatment of subungual melanoma.
C. Same as B
D. Same as B

Remediation:
A. A is labeling the talus.
B. B is labeling the flexor hallucis longus, which is the medial limit of posterior ankle arthroscopy.
C. C is labeling the postero-inferior tibiofibular ligament, also known as the tibial slip.
D. D is labeling the posterior talofibular ligament.

Remediation:
A. Oral TXA provides an equivalent reduction in blood loss at a lower cost and is easier to administer.
B. Same as A
C. Oral TXA tablets are large and may be difficult for some patients to swallow and tolerate
D. Oral TXA is less bioavailable than the IV form and therefore, the onset of action is delayed.

Remediation:

A. A 2013 study by Park et al. found that male sex was the largest predictor of blood loss during elective total hip arthroplasty. A Charlson Comorbidity Index score of >3, age, and body mass index (BMI) also increased intraoperative blood loss.
B. Same as A
C. Same as A
D. Same as A
E. Same as A