Mixed Deck — All ABFAS Topics Flashcards

Which tarsal bone serves as the keystone of the medial longitudinal arch?

Answer: Talus

The talus is considered the keystone of the medial longitudinal arch because it transmits body weight from the tibia to the foot.

Which gait phase is most critical to assess when evaluating a patient with a weak tibialis anterior muscle?

Answer: Loading response

During loading response, tibialis anterior eccentrically controls foot drop; weakness causes a characteristic foot slap or steppage gait.

A patient undergoing elective bunionectomy with spinal anesthesia develops sudden hypotension (BP 72/40 mmHg) and bradycardia (HR 42 bpm). This presentation is most consistent with:

Answer: High spinal block causing sympathectomy

High spinal block causing a sympathectomy produces hypotension from vasodilation and bradycardia from blockade of cardiac accelerator fibers (T1-T4).

What is the ethical obligation regarding continuing education?

Answer: Maintaining current knowledge and competence throughout ones career

Professionals have an ethical duty to maintain and update their knowledge and skills to provide competent service.

What happens if a surgeon fails to meet the requirements for the Maintenance of Certification (MOC) by the deadline?

Answer: The surgeon’s certification becomes inactive or suspended

Failing to meet the requirements for the Maintenance of Certification (MOC) by the deadline results in the surgeon's certification becoming inactive or suspended. This measure ensures that only those who continuously demonstrate their commitment to ongoing education and competency retain their board-certified status, protecting public trust and patient safety.

According to OSHA Bloodborne Pathogen Standards, when is double-gloving most strongly recommended in foot and ankle surgery?

Answer: During procedures with high risk of glove perforation such as bone work with wires

Double-gloving is recommended during high-risk procedures involving sharp instrumentation like K-wires to reduce bloodborne pathogen exposure.

What is the primary purpose of using a total contact cast (TCC) in diabetic foot postoperative care?

Answer: To redistribute plantar pressure and protect wound healing

Total contact casts distribute plantar pressure evenly across the entire foot surface, protecting wounds from repetitive mechanical stress and facilitating healing in diabetic patients.

A surgeon is explaining the risks of an elective hammertoe correction to a patient. Which approach best ensures true informed consent?

Answer: Explain risks in plain language, verify understanding using teach-back, then document the discussion

The teach-back method confirms comprehension rather than mere acknowledgment, which is the standard for genuine informed consent.

Under ABFAS standards, what is the minimum number of years a candidate must be in practice before applying for the Reconstructive Rearfoot/Ankle Surgery (RRAS) certification?

Answer: At least 6 months post-residency before submitting a case list

Candidates may begin compiling case lists shortly after residency, and ABFAS requires a defined post-residency case collection period before submission.

Which incision approach is preferred for open repair of an acute Achilles tendon rupture to minimize wound complications?

Answer: Posteromedial longitudinal

A posteromedial longitudinal incision avoids the sural nerve and lateral watershed skin zone, reducing risk of wound breakdown and infection.

A patient presents with sudden-onset lateral ankle pain after an inversion injury. Radiographs are negative. The Ottawa Ankle Rules indicate radiographs are warranted when bone tenderness is present at which location?

Answer: Posterior edge or tip of the lateral malleolus within 6 cm

Ottawa Ankle Rules require radiographs if tenderness exists at the posterior edge or tip of the lateral or medial malleolus within the distal 6 cm, to rule out fracture.

Which principle guides the selection of appropriate clinical interventions?

Answer: Evidence-based practice guidelines

Evidence-based practice integrates the best available research with clinical expertise and patient values to guide intervention selection.

ABFAS board certification requires candidates to demonstrate competency in which of the following ways beyond completing fellowship training?

Answer: Passing written and oral board examinations administered by ABFAS

In addition to fellowship training, ABFAS requires candidates to pass both a written (Part I) and oral (Part II) examination to achieve certification.

What is the most common early complication following foot and ankle surgery?

Answer: Surgical site infection

Surgical site infection is the most common early postoperative complication in foot and ankle surgery and requires prompt recognition and treatment.

Which of the following best explains why ABFAS uses a two-pathway certification model (Foot Surgery vs. Reconstructive Rearfoot/Ankle)?

Answer: To reflect distinct surgical skill sets and training emphases required for forefoot versus rearfoot/ankle procedures

The two pathways recognize that forefoot surgery and reconstructive rearfoot/ankle surgery involve substantially different technical skills and clinical knowledge bases.

During a postoperative appointment, a patient expresses anger about their slower-than-expected recovery after Achilles tendon repair. What is the best initial response?

Answer: Acknowledge the patient's frustration and ask them to describe their specific concerns

Acknowledging the patient's feelings and inviting them to share concerns builds trust and opens a productive dialogue.

The flexor hallucis longus tendon passes through which anatomical structure before entering the plantar foot?

Answer: Sustentaculum tali groove

The flexor hallucis longus tendon passes through a groove on the inferior surface of the sustentaculum tali before entering the plantar compartment.

Which of the following foot and ankle procedures is classified as 'clean-contaminated' (Class II)?

Answer: Total ankle arthroplasty through intact skin with no viscus entered

Clean-contaminated wounds involve controlled entry into a body cavity without unusual contamination, such as total ankle arthroplasty through intact non-infected skin.

A board-certified foot and ankle surgeon is asked to provide expert witness testimony in a malpractice case. Which ethical obligation applies?

Answer: Provide honest, objective testimony regardless of who retained them

Expert witnesses have an ethical duty to provide truthful, unbiased testimony based on evidence and professional standards.

Which phase I metabolic reaction is responsible for converting prodrugs such as codeine to their active form?

Answer: O-demethylation by CYP2D6

CYP2D6-mediated O-demethylation converts codeine to morphine; poor metabolizers receive no analgesic effect while ultra-rapid metabolizers risk toxicity.