1- Wrist/Hand

Question 1

Bouchard nodes are what joints?

Answer 1

PIP

Question 2

Heberden nodes are what joints?

Answer 2

DIP

Question 3

Carpal tunnel syndrome is caused by compression of what nerve?

Answer 3

median nerve

Question 4

The hallmark presentation of this syndrome is paresthesia in median nerve distribution.

Answer 4

carpal tunnel syndrome

Question 5

What are the 2 special tests to diagnose carpal tunnel syndrome?

Answer 5

• Phalen’s test

- Tinel’s sign (tap over nerve)

Question 6

If surgical treatment for carpal tunnel syndrome is being considered what do you need to get first?

Answer 6

electrodiagnostic studies

Question 7

Which of the following is NOT a good non-surgical option for carpal tunnel syndrome?

a. wrist splint
b. corticosteroid injection
c. yoga
d. NSAIDs
e. oral steroids

Answer 7

d. NSAIDs

Question 8

What is the most effective treatment option for carpal tunnel syndrome?

a. wrist splint
b. corticosteroid injection
c. yoga
d. NSAIDs
e. oral steroids
f. surgical decompression

Answer 8

f. surgical decompression

Question 9

De Quervain’s tenosynovitis involves inflammation of the tendon sheath that involves what 2 muscles?

Answer 9

• extensor pollicis brevis (EPB)

- abductor pollicis longus (APL)

Question 10

What special test is used to assess for De Quervain’s tenosynovitis?

Answer 10

Finklestein test

Question 11

Pain over the radial side of the wrist exacerbated by thumb and wrist movement, and difficulty holding or gripping subjects is consistent with what diagnosis?

Answer 11

De Quervain’s tenosynovitis

Question 12

What splint is used for De Quervain’s tenosynovitis?

Answer 12

thumb spica splint

Question 13

This is defined as a slow, progressive fibrosis of the PALMAR FASCIA which results in a flexion contracture of fingers.

Answer 13

Dupuytren’s contracture

Question 14

what is the treatment of choice for Dupuytren’s contracture?

Answer 14

open fasciotomy with transection of cords

Question 15

Stenosing flexor tenosynovitis (“trigger finger”) is caused by disparity in the size of the flexor tendons and the surrounding pulley system at which pulley?

Answer 15

first annular (A1) pulley

Question 16

Snapping, catching, locking of a finger during flexion should have you concerned for which diagnoses?

Answer 16

stenosing flexor tenosynovitis (“trigger finger”)

Question 17

Where is the most common site of a ganglion cyst on the wrist/hand?

Answer 17

dorsal wrist

Question 18

A painless, smooth, rubbery lump over the dorsal wrist is consistent with what diagnoses?

Answer 18

ganglion cyst of wrist and hand

Question 19

What is the most effective treatment for a ganglion cyst?

Observation
Needle aspiration
Corticosteroid injection
Surgical excision
Strike it with a book

Answer 19

Surgical excision

Question 20

What is the most likely organism in a human bite?

Answer 20

eikinella

Question 21

What is the most likely organism in a dog/cat bite?

Answer 21

pasteurella

Question 22

What is the most likely organism due to a cat scratch?

Answer 22

Bartonella

Question 23

which of the following is NOT a part of management of a human bite?

a. wound care
b. plain film
c. wound closure
d. tetanus
e. antibiotics
f. surgery for wash out

Answer 23

c. wound closure

Question 24

What antibiotic do you want to give for a human or dog bite?

Answer 24

augmentin PO

If they need IV = Unasyn

Question 25

What antibiotic do you want to give for a cat SCRATCH?

Answer 25

azithromycin

Question 26

what is a classic pathognomonic sign of rabies?

Answer 26

hydrophobia

Question 27

What is the most common bacteria causing paronychia?

Answer 27

staph aureus

Question 28

what is the recommended management for paronychia?

Answer 28

1. topical antibiotics and warm water soaks 2. oral antibiotics = keflex - if abscess is present = I/D

Question 29

what is the recommended antibiotic for paronychia if you are concerned for MRSA?

Answer 29

- bactrim

Question 30

This is defined as an infection/abscess in the pad of the finger that is associated with severe, throbbing pain.

Answer 30

felon

Question 31

Which of the following is helpful for treating herpetic whitlow? a. antibiotics b. I&D c. acyclovir

Answer 31

c. acyclovir

Question 32

This is defined as an infection within the flexor synovial sheath.

Answer 32

infectious flexor tenosynovitis *CANT MISS DIAGNOSIS*

Question 33

What are the 4 "Kanavel Signs" for infectious flexor tenosynovitis?

Answer 33

- tenderness along flexor tendon sheath - pain with passive extension of the digit - fusiform swelling of digit (sausage digit) - finger slightly flexed due to swelling

Question 34

What is the treatment for infectious flexor tenosynovitis?

Answer 34

IV antibiotics and often surgery ("wash out")

Question 35

If a patient has infectious flexor tenosynovitis d/t IVDU what 2 antibiotics would you give IV?

Answer 35

- Vancomycin + Ceftriaxone