Buzzwords Flashcards by Caroline Bouillon

narrowing of spinal canal

spinal stenosis

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numbness/paresthesias radiating to bilateral buttocks and thighs

spinal stenosis

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pain worse with extension

spinal stenosis

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pain better with flexion

spinal stenosis

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HLA-B27 positive

Akylosing Spondylitis
Reactive Arthritis aka Reiters syndrome
Psoriatic arthritis
IBD assoc arthritis

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back pain/stiffness worse in AM

ankylosing spondylitis

polymyalgia rheumatica

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back pain worse with rest

ankylosing spondylitis

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uveitis

ankylosing spondylitis

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increased ESR

ankylosing spondylitis

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Xray shows sacroiliitis

ankylosing spondylitis

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bamboo spine

ankylosing spondylitis

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xray shows loss of normal lumbar curvature + squaring and fusion of the vertebrae

ankylosing spondylitis

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unilateral radicular back pain radiating down leg in dermatomal pattern

Herniated disc

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back pain increasing with coughing

herniated disc

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back pain increasing with straining

herniated disc

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back pain increasing with bending

herniated disc

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back pain increasing with sitting

herniated disc

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back pain increasing with valsalva

herniated disc

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+ straight leg raise

herniated disc

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xray of spine shows loss of disc height

herniated disc

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anterior thigh pain

L4 herniated disc

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weak ankle dorsiflexion

L4 herniated disc

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loss of knee jerk + weak knee extension

L4 herniated disc

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Lateral thigh/leg hip groin paresthesias + pain

L5 herniated disc

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weakness in big toe extension aka big toe dorsiflexion

L5 hern disc

walking on heels more diff than walking on toes

L5 hern disc

posterior leg/calf and gluteus pain + Plantar surfaces of foot

S1 disc hern

weakness in plantar flexion

S1 disc herniation

walking on the toes is more difficult than walking on heels

S1 disc hern

Loss of ankle jerk

S1 disc hern

pain + numbness + weakness + swelling of arm/shoulder

thoracic outlet syndrome

(+) adson sign

thoracic outlet syndrome

goose egg

olecranon bursitis

snuffbox tenderness

scaphoid or navicular fx

DIP in flexion

mallet finger

PIP in flexion and DIP in hyperextension

Boutonniere deformity

PIP in hyperextension and DIP in flexion

swan neck deformity

inability to fully extend elbow

``` olecranon fx or elbow dislocation or radial head fx ```

MC sequelae of elbow dislocation

lost of terminal extension

neuro testing maneuvers | *peace sign against resistance

ulnar nerve | **elbow dislocation to check ulnar nerve

neuro testing maneuvers | *hitchhiker/thumbs up

radial nerve | **elbow dislocation to check radial nerve

neuro testing maneuvers | *power to the people aka closed fist

median nerve | **elbow dislocation to check median nerve

neuro testing maneuvers | *OK sign

Median nerve---anterior interosseous | **elbow dislocation to check median nerve

+ posterior fat pad sign

radial head fx

+ displaced anterior fat pad sign

radial head fx

mid-distal radial shaft fx with dislocation of the distal radioulnar joint

Galeazzi fx

Fx to proximal 1/3 of ulnar shaft + dislocation of radial head

Monteggia fx

MUGR

MU= monteggia fx is ULNA fx GR=galeazzi RADIUS fx MonteggiA (ENDS IN A)... A is proximal: bones affected proximally GaleaZZi=Z is distal--bones affected distally

extensor carpi radialis brevis muscle inflammation

tennis elbow aka lateral epicondylitis

pain with wrist extension against resistance

tennis elbow aka lateral epicondylitis

pain with wrist flexion against resistance with elbow flexion

medial epicondylitis aka golfers elbow

pronator teres-flexor carpi radialis muscle inflamm

medial epicondylitis aka golfers elbow

+ tinel sign

1. cubital tunnel syndrome | 2. Tarsal tunnel syndrome

Paresthesia and pain along the ulnar nerve distribution | -worse with elbow flexion

cubital tunnel syndrome

+) Froment sign

cubital tunnel syndrome

FOOSH with extended wrist

scaphoid (navicular) fx

MC fx carpal bone

scaphoid/navicular

anatomical snuffbox tenderness

scaphoid/navicular fx

distal radius fx with dorsal angulation

colles fx

dinner fork deformity

colles fx

XR shows dorsally displaced or angulated fx on distal radius

colles fx

MC complication from colles fx

extensor pollicis longus tendon rupture

distal radius fx with ventral angulation of distal fragment

smith's fx

FOOSH with wrist flexed

smith's fx

garden spade deformity

smith's fx

wrist pain worse with passive motion

smith's fx and colles fx

"piece of pie" sign

lunate dislocation

"spilled teacup" sign

lunate dislocation

whats the most serious carpal fx and why

lunate fx | -occupies 2/3 of radial articular surface

lateral angle

scoliosis

posterior and anterior angles

kyphosis and lordosis

hump back

kyphosis

indentation on lower back

lordosis

back pain not assoc with radiation to leg or neuro symps

lumbosacral sprain or strain

when you see a compression fx-- what must you r/o

CA *!! esp if pt is elderly

localized back pain

compression fx

xray shows loss of vertebral height

compression fx

pars interarticular defect

spondylolysis

MC at L5-S1

spondylolysis

scotty dog

spondylolysis

lateral radiolucent defect in pars

spondylolysis | **scotty dog**

MC at L4-L5

Spondylolisthesis

forward slipping of a vertebra on xray

spondylothisthesis

anterolisthesis of L5 over S1 with associated spondylolysis at that level

spondylolisthesis

bad thing we must always r/o with back pain

cauda equina

back pain + decr sensation to buttocks, perineum and inner surfaces of thigh

cauda equina syndrome

back pain + new onset urinary bowel retention or incontinence

cauda equina syndrome

back pain + bilat leg radiation of pain

cauda equina syndrome

fever + spinal pain + neuro deficits

spinal infection

RF for spinal infection

>50 YO IVDU immunodef recent instrument/procedure---EX: LP

what lab test determines early diagnosis of RA

Anti-citrullinated protein antibody (ACPA)

what lab test diagnoses RA

Rheumatoid factor

aggravation of pain with prolonged rest--- morning stiffness and improves with use

* inflammatory arthritis-----RA, polyarthritis * polymyalgia rheumatica * ankylosing spondylitis

aggrivated by motion and relieved with rest

non-inflammatory arthritis

pain, limitation of motion, swelling and/or tenderness at a joint

arthritis in general

arthritis affecting single joint

monoarticular

arthritis affected several joints

oligoarticular

arthritis affecting many joints

polyarticular

rheum dz with age of onset 20-40 YO and is MC in W>M

subcutaneous rheumatoid nodule over extensor surfaces

RA | extensor surfaces---lungs, pleura, pericardum****

symmetrical involvement of the joints of hands/feet

RA--typical presentation

HLA-DRA 1 & 4

RF for RA

Boutonniere deformities of PIP

Swan-neck contractures of fingers

ulnar deviation of metacarpophalangeal joints

* elevated RF * (+) Anticitrullinated peptide/protein antibodies * elevated ESR * elevated CRP

which DMARD requires eye exam every 6 MO and why

hydroxychloroquine | *risk of visual loss due to retinopahty

what must you give with methotrexate

folic acid

DIP joint affected

osteoarthritis

MCP and PIP joints affected

RA (spares DIP)

conjunctivitis + urethritis + arthritis

reactive arthritis

cant see cant pee cant climb a tree

Reactive arthritis

arthritis + conjunctivitis + urethritis after an infection

reactive arthritis

hyperkeratinized lesions on palms and soles

**keratoderma blennorrhagicum** | finding in reactive arthritis

arthritis involves larger joints--- esp knee

reactive arthritis

increased assoc with chronic hep B and C

Polyarteritis Nodosa

MC seen in men 40-60 YO

PAN

abd pain worse when eating

PAN--- GI ischema

skin appears mottled/purplish

livdeo reticularis--seen with PAN

rosary sign on angiography

PAN

microaneurysms with abrupt cut off of small arteries

PAN

assoc with giant cell arteritis

Polymyalgia Rheumatica

sudden onset of bilateral hip and shoulder girdle ache +stiffness and fatigue in PT >50 YO

Polymyalgia Rheumatica

difficulty combing hair

polymyalgia rheumatica | polymyositis

difficulty getting up from chair

polymyalgia rheumatica | polymyositis

pain on movement and stiffness with periods of inactivity

Polymyalgia rheumatica

muscle inflammation of pharynx, limbs and neck

polymyositis

+ anti-signal recognition protein

most specific lab finding for polymyositis

what has a 25% association with CA

dermatomyositis

Anti-Jo 1 antibodies

Polymyositis | Dermatomyositis

Anti-Mi 2

Dermatomyositis

blue-purple discoloration of upper eyelid

pathognomonic for dermatomyositis (heliotrope rash)

raised violaceous scaly knuckle eruptions

pathognomonic for dermatomyositis (gottron's papules)

MC in women 20-55 YO

Fibromyalgia

pain is worse in the cold or by weather changes

fibromyalgia

pain is allevaited with rest, warmth and mild exercise

fibromyalgia

pain is worse with sleep deprivation and worse in am

fibromyalgia

HLDA-DR52

Sjogren syndrome

assoc with other autoimmune dz---Hashimoto, SLE or RA

Secondary Sjogren syndrome

exocrine glands

Sjogren syndrome

associated with incr risk of non-Hodgkin lymphoma

Sjogren syndrome

anti-centromere antibodies

Systemic sclerosis--- limited type (CREST)

anti-SCL-70 antibodies

systemic sclerosis--diffuse type--multiple organ involvement *poor prognosis

proximal muscle weakness often painless + dermatologic manifestations

Dermatomyositis

proximal muscle weakness often painless

polymyositis

thickened skin + raynauds

scleroderma (CREST)

dry eyes dry mouth

Sjogren

malar rash photosensitivity fever

SLE

type III hypersensitivity

SLE | PAN

joint pain + fever + malar rash

SLE

anti-double stranded DNA

SLE

anti-Smith antibodies

SLE

antiphospholipid antibodies

SLE | *means incr risk of arterial and venous thrombosis

recurrent DVT or PE

Antiphospholipid syndrome | -can be assocc with SLE

recurrent miscarriages

antiphospholipid syndrome--can be assoc with SLE

anticardiolipin antibodies

antiphospholipid syndrome--can be assoc with SLE | ****also assoc with false-positive testing for syphilis

+ lupus anticoagulant

Antiphospholipid syndrome =incr PTT *****positivty assoc with hypercoaguability

daily high fever + arthritis pain + salmon colored pink rash + lymphadenopathy in kid <16 YO

Jeuvenille RA--- Systemic or Still's DZ

<16 YO patient * uveitis * knee and/or ankle arthritis pain

Jeuvenille RA--- Pauci (oligo) articular

<16 YO PT: *small joints affected-- many *uveitis +morning stiffness

Jeuvenille RA---polyarticular | ***worse prognosis

which Jeuvenille (idiopathic) Rheumatoid Arthritis is assoc with (-) RF and ANA

Still'z dz

which Jeuvenille (idiopathic) Rheumatoid Arthritis is assoc with (+) ANA

oligoarticular

Skin thickening that begins as swelling of the fingers and hands associated with telangiectasia, dysphasia, and hypomotility of the GI tract is most likely…..

scleroderma

(+) ANA

``` SLE scleroderma RA Sjogrens dermatomyositis polymyositis ```

affected limb is ADDucted, internally rotated and shortened

hip dislocation posterior

affected limb is ABDucted, externally rotated and shortened

anterior hip dislocation | ******hip fracture*****

MC affeected nerve and artery in anterior hip dislocation

femoral

SCFE in kid before puberty what do you suspect

hormonal or systemic disorders--- hypothyroidism****

14 YO obese male with hip/groin/thigh pain and painful limp worse with activity

SCFE * obese * male * 8-16YO

ice cream cone fell off the cone

SCFE

frog leg lateral view

SCFE

child with PAINFUL limp

SCFE

child with painless limp

leg-calve-perthes dz

(+) crescent sign on xray

advanced Leg-calve-perthes dz

widening of cartilage space on xray with incr density of femoral epiphysis

early leg-calve-perthe dz

MC long bone fx?

tibial and fibular fx

what is the biggest and most stressed joint in the body

knee

Sudden and severe knee pain with hx of trauma sugests?

disruption of a ligament, meniscus or osseous structure

chronic knee pain suggests

degenerative condition

knee pain that is worse with weight bearing suggests

mechanical pathologies-->meniscus tear, ligament tear, fx

knee night pain + stiffness suggest

inflammatory pathology

hip and lumbar pathologies can cause ?

diffuse and poorly localized knee pain

Pain in the front of knee suggests

Chrondromalacia patella tracking bursitis arthritis

pain above the knee suggests

quads tendon swelling

pain below the knee suggests

osgood schlatter

pain on inside or outside parts of knee suggest

meniscus or collateral ligament tears | arthritis

pain behind the knee

bakers cyst

child with quadricep atrophy suggests

legg calve perthes dz

list all the tests for ACL injury

Lachman test Anterior drawer test pivot shift test

pain behind knee

DVT | bakers cyst

noncontact injury to knee--what is MC affected

only ACL torn

lateral trauma to knee

MCL tear | aka valgus stress

MC knee ligament injury?

ACL

MOA is noncontact pivoting injury during sports

ACL

MVA + dashboard injury

PCL injury

Fall on flexed knee

PCL | Patellar fx

Direct blow to the knee

PCL

contact injuries to the knee MC affect which ligament

PCL | NOT ACL--- most commonly non-contact pivoting injuries

popping of knee during ambulation

Mensical tear

cyclists or runners

Patellofemoral syndrome-- chondromalacia

(+) apprehension sign

``` Patellofemoral syndrome (chondromalacia) Patellar dislocation ```

valgus stress after twisting injury, direct blow

patellar dislocation

(+) hemarthrosis of knee joint in context of trauma suggests

patellar fx

(+) drop foot finding on PE

* *****peroneal nerve injury*** - Femoral condyle fx - tibial platea fx - tibial/femoral dislocation if peroneal nerve injury present

this injury is MC seen in kids in MVAs

Tibial Plateau fx

MC complication from tibial plateau fx

soft tissue injury--- MC lateral meniscal tears

what is a severe limb-threatenign emergency

knee (tibial/femoral) dislocations

MC in males 10-15 YO during ovruse activites

osgood-schlatter dz

prominence swelling and tenderness to anterior tibial tubercle

Osgood Schlatter

MC sprained ankle ligament

ATFL anterior talofibular ligament ***LATERAL LIGAMENT***

mc tx for ankle sprain

Rest Ice Compression Elevation

episodic atheletes

achilles tendon rupture

Fluoroquinolone (ex Cipro) use

achilles tendon rupture

(+) Thompson test

achilles tendon rupture

what drug has a BBW for achilles tendon rupture

Ciprofloxacin

what type of fx would be result of jumping out of a window

Pilon fx aka Plafond fx---- ankle fx--- central portion of tibia fx

commonly missed ankle fx?

Maisonneue fx ----- always alays alawys examine joints ABOVE AND BELOW injury

proximal fibula fx--- what else do we want to look at?

Ankle xray--- to r/o or r/i Maisonneuve fx

exam of which structure is imp to any suspected ankle fx or injury?

Fibular and lateral. malleolus | ***maisonneuve fracture

localized tenderness at third metatarsal

march fx

foot pain incrs with dorsiflexion of toes

plantar fasciitis

pain incrs during the day--worse at night-- and does not improve with rest

Tarsal Tunnel Syndrome

hx of wearing tight, pointed shoes

``` hallux valgus (bunion) (more so the pointed shoes) hammer toe (more so high heels) Morton's neuroma (more so high heels) ```

pain over great toe at MTP joint w/ a lateral deformty

Hallux Valgus

patient has 2nd toe (or 3rd or 4th) longer than the first

hammer toe

deformity of the PIP joint-->flexion of PIP joint w/ hyperextension of MTP and DIP joint

hammer toe

tertiary syphilis

Neuropathic (charcot) arthropathy

burning/lancinating foot pain

Morton's neuroma

pain on 5th metatarsal

jones fx

(+) Fleck Sign

Lisfranc Injury | fx at the base of the second metatarsal pathognomonic for disruption of ligaments

xray shows irregularity and fragmentation of the joint space

avasc necrosis--- can be assoc with legg-calve-perthes dz

blow to an abducted, externally rotated and extended shoulder causes

anterior shoulder dislocation

groove fx of shoulder

hill sachs lesions (ant dislocation)

Glenoid rim fx

bankart lesion-- ant disloction

neurovascular compromise more common in ant or post shoulder dislocaiton -which nerve

anterior--- axillary nerve (runs in deltoid) MC nerve

this injury is assoc with seizures and electric shocks

post shoulder dislocation

shoulder has decr ROM esp with external rotation and pt has pain worse at night

adhesive capsulitis frozen shoulder

passive ROM of shoulder restricted

frozen shoulder

passive ROM greater than active in shoulder

rotator cuff tear

PE tests for rotator cuff injury

1. Hawkins 2. drop arm 3. neer test 4. supraspinatus strength test aka empty can test

which PE test do to to check for supraspinatus involvement

empty can test

common site for pathologic fxs in met BCA

proximal humerus---- humereal head fx

mets of BCA

patholgic fxs of humeral head

(+) wrist drop

radial nerve damage---- can be from humeral shaft fx

which nerve do we worry about with: 1. humeral head fx 2. humeral shaft fx

head=brachial plexus | shaft=radial nerve

severe vit D deficiency can cause | aka rickets

osteomalacia

blue tinted sclerae

Osteogenesis imperfecta

associated with deafness

osteogenesis imperfecta

puncture wound through shoe

osteomyelitis via pseudomonas aeruginosa

type of arthritis mc in weight bearing joints (knees, hips, spine, wrists)

short (<60 mins) of morning stiffness

OA RA is longer period of morning stiffness

Asymmetric joint narrowing Marginal osteophytes Subchondral bone sclerosis Bone cysts

Symmetric joint narrowing Osteopenia, bone and joint erosions Ulnar deviation in severe case

OA is a ___ dz and RA is a ____ dz

OA=degenerative | RA=autoimmune

morning stiffness <30-60 mins

morning stiffness >60 mins

pain out of proportion to injury

comp syndrome

MC site for avasc necrosis

femoral head

pain starts in groin--->thigh--->buttock

avasc necrosis in femoral head

Avascular necrosis is a complication of which traumatic hip injuries?

hip dislocation or femoral neck fx

pt is on statin tx

RHABDO

muscle pain + weakness + dark tea colored urine

RHABDO

hyperuricemia

hallmark of gout----- but does not itself indicate gout

MC benign bone tumor

Osteochondroma

MC bone tumor in kids

osteochondroma

Xray shows pedunculated stalk that grows away from growth plate

Osteochondroma

nidus produces prostaglandins

osteoid osteoma

MC primary bone malignancy in kids + young adults

Osteosaroma

Second MC primary bone malignancy in kids + young adults

ewing's sarcoa

onion skin apperance on xray

ewings

lytic lesions with moth eaten apperaence on xray

ewings

"hair on end" or "sunburst" apperance

osteosarcoma

xray shows lytic mass with a multi-laminated periosteal reaction involving the proximal anterior tibia (or another long bone)

ewing | **onoin skoin

xray shows round lucency surrounded by sclerotic bone

osteoid osteomao

opioid receptors

δ [delta], and κ [kappa

Leukocytosis and a low synovial glucose are indicative of

septic arthritis

best screening test to evaluate for SLE?

ANA

Cervical spondylosis occurs with

associated with C1-C2 subluxation

Hydroxychloroquine is associated with

macular damage---night vision impaired rash diarrhea

FOOSH then--> * pain on the dorsal radial side of the wrist with minimal swelling * pain is incr with dorsiflexion * click with wrist movement

scapholunate dissociation

high energy injuries while the wrist is extended and ulnarly deviated

lunate dislocation

tenderness to palpation in shallow indentation on the mid-dorsum of the wrist

lunate fx

Buzzwords Flashcards

(283 cards)