3, 4, 5 Star topics 3 Flashcards
(111 cards)
1
Q
Sx of carpal tunnel syndrome (4)
A
Wrist pain that radiates up arm and worsens w/ flexion and grasping
Numbness/tingling in thumb, index, middle and radial side of 4th finger
Decreased grasp strength
Thenar atrophy long term
2
Q
Signs of carpal tunnel syndrome (4)
A
Tinel and Phalen signs
3
Q
Treatment carpal tunnel syndrome (4)
A
Activity modification, wrist splints
NSAIDs, steroid injections
Surgical release of ligament
4
Q
Nerve affected in carpal tunnel syndrome (4)
A
Median nerve
5
Q
MC shoulder dislocation (3.5)
A
Anterior
6
Q
MC hip dislocation (3.5)
A
Posterior
7
Q
Shoulder dislocation w/ external rotation and slight abduction (3.5)
A
Anterior
8
Q
Shoulder dislocation w/ internal rotation (unable to externally rotate) and adduction (3.5)
A
Posterior
9
Q
Shoulder rotation w/ possible axillary nerve damage (3.5)
A
Anterior
10
Q
Nerve damage w/ claw hand (3)
A
Ulnar
11
Q
Nerve damage w/ ape hand (3)
A
Median
12
Q
Nerve damage w/ wrist drop (3)
A
Radial
13
Q
Nerve damage w/ scapular winging (3)
A
Long thoracic
14
Q
Nerve damage w/ inability to wipe bottom (3)
A
Thoracodorsal
15
Q
Nerve damage w/ loss of forearm pronation (3)
A
Median
16
Q
Nerve damage w/ inability to abduct or adduct fingers (3)
A
Ulnar
17
Q
Nerve damage w/ loss of shoulder abduction (3)
A
Axillary
18
Q
Nerve damage w/ weak external rotation of arm (3)
A
Suprascapular / Axillary
19
Q
Nerve damage w/ loss of elbow flexion and forearm supination (3)
A
Musculocutaneous
20
Q
Nerve damage w/ loss of wrist extension (3)
A
Radial
21
Q
Nerve damage w/ trouble initiating shoulder abduction (3)
A
Suprascapular
22
Q
Nerve damage w/ inability to abduct arm >10 degrees (3)
A
Axillary
23
Q
Nerve damage w/ inability to raise arm above horizontal (3)
A
Long thoracic, spinal accessory
24
Q
Nerve damage w/ fx of shaft of humerus (3)
A
Radial
25
Nerve damage w/ fx of surgical neck of humerus (3)
Axillary
26
Nerve damage w/ supracondylar humerus fx (3)
Median
27
Nerve damage w/ fx of medial epicondyle (3)
Ulnar
28
Nerve damage w/ anterior shoulder dislocation (3)
Axillary
29
Nerve damage w/ carpal tunnel injury (3)
Median
30
Back pain w/ radiation to epigastrum (5)
PUD, GERD, gastritis
Pancreatitis
AAA
31
Back pain w/ radiation to pelvis (5)
Nephrolithiasis, pyelonephritis
32
Back pain along paraspinal area only (5)
Muscle strain
33
Back pain w/ osteoporotic patient (5)
Compression fx
34
Back pain w/ back asymmetry (5)
Scoliosis
35
Back pain w/ abnormal gait (knees/hips flexed) (5)
Spondylolisthesis
36
Back pain w/ systemic symptoms (5)
Meningitis, discitis, osteomyelitis
37
Back pain worse w/ exertion, +straight leg raise (5)
Disk herniation
38
Back pain w/ walking, standing, better in supermarket (5)
Spinal stenosis
39
Back pain worse at rest, better w/ activity (5)
Ankylosing spondylitis (esp 20-30 yo men)
40
Back pain 24 hrs including night or at rest (5)
R/o cancer
41
Back pain w/ bowel or bladder dysfunction (5)
Cauda equina
42
Back pain w/ saddle anesthesia (5)
Cauda equina
43
Treatment spinal stenosis (4)
Analgesics (NSAIDs), PT, epidural injections
| Surgical decompression
44
Treatment cauda equina syndrome (3.5)
Emergency surgical decomression
45
Waiter's tip (3.5)
Erb-Duchenne palsy (superior trunk)
46
Deltoid paralysis (3.5)
Axillary nerve damage (assoc w/ anterior shoulder dislocation)
47
Claw hand + thenar/hypothenar eminence + possible Horner's syndrome (3.5)
Klumpke palsy (C8-T1)
48
Paget disease of bone s/sx (3.5)
Possibly asymptomatic
"Hat no longer fits," bone pain, increased fx, tibial bowing, deafness, kyphosis
Increased alk phos, normal other labs
49
Paget disease of bone diagnostic radiology (3.5)
Bone scan for "hot spots"
50
Paget disease of bone treatment (3.5)
Bisphosphonates
Calcitonin (SC)
No treatment if asymptomatic
51
Asymmetric arthritis (possibly only one joint) w/ PIP, DIP involvement (3)
Osteoarthritis
52
Symmetric arthritis w/ DIP sparing w/ PIP, MCP (3)
Rheumatoid arthritis
53
Insidious joint stiffness and pain that worsens w/ activity and weight bearing and is relieved by rest (3)
Osteoarthritis
54
Pannus formation (3)
Rheumatoid arthritis
55
Swan neck, boutonniere deformities; ulnar deviation of fingers (3)
Rheumatoid arthritis (S = flexed DIP, B = flexed PIP)
56
Insidious joint stiffness and pain w/ 30+ min morning stiffness, worse w/ rest, better w/ activity (3)
Rheumatoid arthritis
57
Rheumatoid arthritis treatment (3)
Start DMARDs early (sulfasalazine, hydroxychloroquine, MTX for moderate)
Also anti-TNFa
Steroids, NSAIDs as adjuncts
58
Drug induced lupus causes (3)
```
SHIPP
Sulfa drugs (esp sulfasalazine)
Hydralazine
Isoniazid
Phenytoin
Procainamide
(Methyldopa, quinidine, chlorpromazine)
```
59
Skin symptoms of SLE (3)
Malar rash
Discoid rash
Photosensitivity
Painless oral ulcers
60
Inflammatory symptoms of SLE (3)
Arthritis (symmetric, non-erosive, 2+ joints)
serositis (pleuritis, pneumonitis, pericarditis)
++ANA
61
Organ system symptoms of SLE (3)
Renal
Neurologic (seizures, psychosis, stroke, neuropathy)
Hematologic
Immunologic (dsDNA, Smith, phospholipid Abs)
62
Major causes of death of SLE (3)
Renal disease
| Infection
63
Treatment of SLE (3)
Avoid sun
NSAIDs, steroids
Hydroxychloroquine
Anticoagulation if needed
64
Proximal muscle weakness (legs first) (3)
Polymyositis
65
Proximal muscle weakness + rash (3)
Dermatomyositis
66
Dermatomyositis skin signs (3)
Purple/red heliotropic rash (periorbital)
Shawl sign
Gottron's papules
Mechanic's hands
67
Pain and stiffness in hips and shoulders (trouble raising arms and getting out of bed) with NO weakness (3)
Polymyalgia rheumatica
68
PMR patients should be worked up for what? (3)
Temporal arteritis
69
Muscle pain and tenderness in multiple distinct locations (trigger points) (3)
Fibromyalgia
70
Young man w/ low back pain that is worse in morning and improves w/ exercise (3)
Ankylosing spondylitis
71
Pencil-in-cup deformities of PIP and DIP joints (3)
Psoriatic arthritis
72
Bamboo spine on x-ray (3)
Ankylosing spondylitis
73
Asymmetric arthritis worse in morning, improves w/ activity (3)
Psoriatic arthritis
74
CREST scleroderma (3)
Calcinosis cutis (SQ calcifications, often in fingers)
Raynaud phenomenon
Esophageal dysmotility
Sclerodactyly (skin thickening of fingers, hands, face)
Telangectasias (lip, hand, face)
75
Dry eyes, dry mouth, arthritis (3)
Sjogren syndrome
76
Adolescent, obese male w/ thigh/knee/hip pain (4)
Slipped capital femoral epiphysis (SCFE)
77
SCFE treatment (4)
Surgical pinning, weight-bearing restriction
78
SCFE complications (4)
AVN, premature OA
79
AVN of capital femoral epiphysis btwn 3-8 years old (4)
Legg-Calve-Perthe's disease
80
Legg-Calve-Perthe's disease treatment (4)
Non-weight bearing
Observation or bracing, Petrie cast, osteotomy
Surgical correction rare
50% untreated cases recover fully
81
Pediatric limp + x-ray shows femoral head sclerosis (4)
Legg-Calve-Perthe's disease
82
Pediatric limp + x-ray shows "ice cream scoop falling off cone" (4)
SCFE
83
Pediatric limp + acute onset tibial pain, fever, malaise, elevated ESR, no joint pain (4)
Osteomyelitis
84
Pediatric limp + acute onset knee pain, fever, elevated ESR, +WBC (4)
Septic arthritis
85
Pediatric limp + obese, male adolescent with dull hip pain and inability to bear weight (4)
SCFE
86
Pediatric limp + 7 yr old with growth delay and inner thigh pain (4)
Legg-Calve-Perthe's disease
87
Pediatric limp + 13 yr old boy w/ pain and swelling at tibial tuberosity (4)
Osgood-Schlatter
88
Erythematous papule w/ rough, yellow-brown scales, <5 mm in diameter, in sun-exposed area (4)
Actinic keratosis (pre-SCC)
89
Painless, erythematous, irregular-looking papule w/ scaling or keratinized growths in sun-exposed areas; may become painful, bleed, or ulcerate (4)
Squamous cell carcinoma
90
Pearly papule w/ telangiectasias or rolled edges around ulceration (4)
Basal cell carcinoma
91
Irregular borders, multiple colors, large or rapidly growing moles (4)
Melanoma
92
Metastatic risk of skin cancers (4)
BCC <0.1%
SCC 5-10%
Melanoma MC
93
MCC skin cancer (4)
BCC
94
Most important prognostic factor for melanoma (4)
Thickness (always need punch or excisional biopsy)
| >0.76 mm associated w/ increased risk metastasis
95
Follow what characteristics of moles? (4)
```
ABCDE
Asymmetry
Border (irregular)
Color (variable)
Diameter (>6 mm)
Enlargement
```
96
MC type of melanoma (4)
Superficial spreading
97
Non-pigmented melanoma (4)
Amelanotic
98
Dark papule on legs or trunk that bleeds w/ minor trauma, melanoma type (4)
Nodular (only grows vertically, rapidly invasive)
99
occurs on palms, soles or beneath nail plate in patients w/ dark skin, melanoma type (4)
Acral lentiginous
100
Dark lesion larger than 6 mm w/ irregular, asymmetric borders (4)
Superficial spreading melanoma
101
Long-lasting in situ melanoma before vertical growth (4)
Lentigo maligma
102
Treatment of actinic keratosis (4)
Topical 5-fluorouracil or imiquimod, cryotherapy
103
Treatment of squamous cell carcinoma (4)
Surgical/Mohs excision, radiation for large lesions
104
Treatment of basal cell carcinoma (4)
Surgical/Mohs excition, radiation or cryotherapy
105
Treatment of melanoma (4)
Surgical excision w/ 0.5 cm margin (in situ), 1 cm margin (2 mm thick)
Possible LN dissection
Chemo and radiation if metastatic
106
Purple-red lesion on face that does not regress with age (3)
Port-wine stain (Sturge Weber syndrome if in ophthalamic area)
107
Infant w/ bright-red lesion that regresses over months-years (3)
Strawberry hemangioma
108
Benign, small red papule that appears on skin w/ age (3)
Cherry hemangioma
109
Bright red papule w/ radiating blanching vessels (3)
Spider hemangioma (assoc w/ liver disease)
110
Blue or red compressible mass that does not regress (3)
Cavernous hemangioma
111
Red-pink nodule on a child often confused w/ melanoma (3)
Spitz nevus
