Cram the PANCE MSK

Question 1

How to tell the difference between hip dislocation and hip fracture on physical exam

Answer 1

Question 2

what is the MC hip dislocation

Answer 2

posterior

Question 3

what does slipped capital femoral epiphyhsis show on xray

Answer 3

ice cream falling off cone

Question 4

is legg calve perthes disease painful or painless?

Answer 4

Question 5

what is the treatment for legg-calve-perthes disease

Answer 5

observation

Question 6

what are the key differnces between slipped capital femoral epiphysis and legg-calve-perthes disease

Answer 6

Question 7

where is the tenderness in osgood-schlatter disease

Answer 7

tibial tubercle

Question 8

tx of osgood schlatter

Answer 8

conservative (NSAID’s and PT)

Question 9

lachman test is for what injury

Answer 9

ACL because “LAChman”

Question 10

what physical exam findings are found in a meniscal inury

Answer 10

• joint line tenderness
• mcmurays test

Question 11

what is a complication that should be watched for in patients with knee dislocation

Answer 11

• popliteal artery (vascular compromise)
• peroneal nerve (neuro compromise)

Question 12

what is the MC population for patellofemoral syndrome

Answer 12

female runners

Question 13

what is the MC ligament injured in ankle sprains

Answer 13

anterior talofibular ligament

Question 14

what are the ottawa ankle rules

Answer 14

• walk after injury
• not tender in malleoli
• not tender in mid foot (base of 5th metatarsal or navicular bone)

Question 15

what is the thompson test

Answer 15

plantar flexion of the foot while squeezing the thigh

tests for achilles tendon rupture

Question 16

heel pain that is worse with first steps or after inactivity is suggestive of what diagnosis

Answer 16

plantar fasciitis

Question 17

burning pain in the mid foot area is suggestive of what diagnosis

Answer 17

interdigital (morton’s) neuroma

Question 18

who is mortons neuroma MC in

Answer 18

Women who wear high heels

Question 19

What is a jones fracture

Answer 19

Fracture of 5th metatarsal

can remember 5th because jones has 5 letters

Question 21

Mechanism of injury for antertior shoulder dislocation

Answer 21

blow to abducted externally rotated and extended arm

blocking basketball or volleyball.

Question 22

presentation of anterior shoulder dislocation

Answer 22

abducted and externally rotated

Question 23

Answer 23

bank on a hill: bankart and hill sachs lesion
ax: axillary lesion
antonio: anterior dislocatio
arms up and out: abducted and externally rotated.

Question 24

what is the MCC of posterior dislocation

Answer 24

seizures/electricution that causes convulsions and muscle tension

Question 25

physical exam for posterior dislocation

Answer 25

adduted and internally rotated shoulder

Question 26

what is the posterior shoulder dislocation picmonic

Answer 26

holding a posterboard: posterior dislocation ADD: adduction INTO: internal rotation lightbulb: lightbulb sign on xray shocked: shock and seizure for MOA

Question 27

tests for shoulder impingement

Answer 27

Hawkins test and neers

Question 28

odd risk factors for frozen shoulder

Answer 28

diabetes thyroid disorders (mostly hypo) | typical is just females and age.

Question 29

tx for frozen shoulder

Answer 29

PT steroid injections NSAIDs

Question 30

is anterior or posterior humral fat pads on xray more indicative of fracture

Answer 30

posterior!! posterior is problematic anterior is A-ok!

Question 31

what is a nightstick fracture

Answer 31

ulnar shaft fracture (occurs when someone has a direct blow to the forearm. think of someone blocking a blow from a stick at night"

Question 32

what is the moteggia fracture

Answer 32

proximal ulnar fracture, radial head dislocation

Question 33

what is galeazzi fracture

Answer 33

radial midshaft fracture with dislocation of distal radioulnar joint.

Question 34

What is nursemaids elbow

Answer 34

radial head subluxation | annular ligament involvement.

Question 35

tx of nursemaids elbow

Answer 35

hyperpronation or supination and flexion.

Question 36

what is tennis elbow

Answer 36

lateral epicondylitis

Question 37

what is the movement involeved with lateral epicondylitis

Answer 37

EXTENSION (tennis elbow) | tennis has an E in it but golf does not

Question 38

what is golf elbow

Answer 38

medial epiocondylitis

Question 39

what is the movement invoved in golf elbow

Answer 39

FLEXION

Question 40

what part of the hand will experience paresthesia in cubital tunnel syndrome

Answer 40

half of fourth and fifth finger and lateral portion of hand.

Question 41

how to differentiate carpal tunnel vs cubital tunnel

Answer 41

CUBital = bear cub = little finger cUbital = ULNAR nerve

Question 42

odd risk factors for carpal tunnel

Answer 42

pregnancy diabetes hypothyroidism

Question 43

what is the MC carpal fracture

Answer 43

scaphoid (navicular) fracture

Question 44

what physical exam finding is seen in scaphoid fractures

Answer 44

snuffbox tenderness

Question 45

tx for scaphoid fracture

Answer 45

thumb spica

Question 46

presentation of colles fracture

Answer 46

dorsal displacement of distal radius fracture i eat my collard greens w a fork

Question 47

presentation of smiths fracture

Answer 47

volar discplaement of distal radius fragment

Question 48

which hand fracture is MC to develop avascular necrosis

Answer 48

lunate fracture

Question 49

what is boxers fracture

Answer 49

5th metacarpal neck fracture

Question 50

gout arthrocentesis

Answer 50

negatively befringent needle shaped crystals

Question 51

Pseudogout arthrocentesis

Answer 51

positively birefringent rhomboid shaped crystals | P - P

Question 52

what are key points for polyarteritis nodosa

Answer 52

causes neuro, derm, renal and bp probs but spares the lungs. ANCA negative

Question 53

what is the progression of muscle weakness in polymyositis and dermatomyositis

Answer 53

proximal, progressive, symmetric muscle weakness.

Question 54

in addition to muscle weakness, what clinical manifestations does dermatomyositis have

Answer 54

* gottron papules (crusty rash on hands) * heliotrope rash (rash around eyes) * photodistributed poikiloderma (shawl sign/ Vsign) PERMatomyositis | VERY IMPORTANT

Question 55

what antibodies are present in polymyositis?

Answer 55

Anti-jo-1 and Anti-Mi-2 remember: Poly-MI-JO-sitis

Question 56

what antibodies are present in dermatomyositis?

Answer 56

Anti-jo-1 and Anti-Mi-2 remember: dermato-MI-JO-sitis ## Footnote anti-mi-2 is very specific for dermato more so than poly

Question 57

treatment for polymyositis and dermatomyositis

Answer 57

steroids

Question 58

what kind of infection preceeds reactive arthritis

Answer 58

GI or GU infection | chlamydia super common

Question 59

presentation of reactive arthritis

Answer 59

Cant see, cant pee, cant climb a tree * peripheral arthritis (asymmetric) * ocular symptoms (conjunctivitis) * GU symptoms (urethritis)

Question 60

what is the positive marker for reactive arthritis

Answer 60

HLA-B27

Question 61

treatment for reactive arthritis

Answer 61

* tx underlying cause * NSAIDs

Question 62

what are the clinical manifestations of RA

Answer 62

7 S's 1. symmetric 2. swollen 3. soft (boggy) 4. small joints (hands/wrist/feet) 5. spares DIP 6. Sixty minutes or more (morning stiffness) 7. Swan neck deformity`

Question 63

what markers will be elevated for RA

Answer 63

* Rheumatoid factor * Anti-CCP (most speCifiC test - CCP) | if ccp is positive = def RA

Question 64

tx for rheumatoid arthritis

Answer 64

* NSAIDs * Methotrexate | both, always unless contraindication

Question 65

what is sjogrens syndrome

Answer 65

autoimmune disease infiltrating EXORINE organs. | i just think this one really helps to know underlying

Question 66

clinical manifestations of sjogrens disease

Answer 66

* dry eyes * dry mouth * parotid swelling

Question 67

what markers are positive for sjogrens disase

Answer 67

* anti-Ro * SSA * Anti-La

Question 68

what diagnostic tool is used to diagnose sjogrens

Answer 68

schirmer test | measures tears basically

Question 69

tx for sjogrens syndrome

Answer 69

* pilocarpine * cevimeline | these are muscarinic agonists

Question 70

what is the clinical prsentation of systemic sclerosis (scleroderma)

Answer 70

CREST Calcinosis cutis Raynauds phenomenon Esophageal Dysmotility Sclerodactyly Telangiectasia DIFFUSE disease will also involve more widespread like organ involvement

Question 71

What is the marker for scleroderma

Answer 71

Anti-centromere - limited disease Antitopoisomerase - diffuse disease think of it as "anti-CRESTromere" and "antipoisonerase = diffuse scleroderma"

Question 72

diagnostic markers for SLE

Answer 72

* Anti-dsDNA * anti-smith

Question 73

tx for lupus

Answer 73

hydroxychloroquine

Question 74

which meds cause gout flares

Answer 74

Question 75

what is the presentation of osteosarcoma on xray

Answer 75

sunburst!!! S S S