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High Yield MSK Things Flashcards

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1
Q

What nerve root would be affected if the bicep reflex is not present?

A

C5

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2
Q

What nerve root would be affected if the brachioradialis reflex is not present?

A

C6

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3
Q

What nerve root would be affected if the tricep reflex is not present?

A

C7

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4
Q

What nerve root would be affected if the achilles reflex is not present?

A

S1

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5
Q

What nerve root would be affected if the patellar reflex is not present?

A

L4

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6
Q

What nerve root would be affected if the bulbocavernosus reflex is not present?

A

S2-4

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7
Q

A patient is having trouble abducting their shoulder and flexing their elbow. What nerve root is this?

A

C5

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8
Q

A patient is having trouble flexing their elbow and extending their wrist what nerve root is this?

A

C6

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9
Q

A patient is having trouble extending their elbow and flexing their wrist and extending their fingers. What nerve root is this?

A

C7

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10
Q

A patient is having trouble with finger abduction, adduction, and flexion. What nerve root is this?

A

C8

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11
Q

A patient is having trouble with foot dorsiflexion. What nerve root is this?

A

L4

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12
Q

A patient is having trouble with big toe extension. What nerve root is this?

A

L5

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13
Q

A patient is having trouble with anal sphincter tone. What nerve root is this?

A

S2-4

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14
Q

What are the risk factors for osteoporosis?

A

Caucasian/asian-smaller bone structure
smoking
malnutrition
decreased physical activity

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15
Q

Which cancers metastasize to the bone?

A

Breast
Lung
Thyroid
Kidney
Prostate

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16
Q

How is dermatomyositis diagnosed?

A

(not specific labs): ESR elevated, aldolase, creatinine kinase
Anti-mi
Anti-Jo
Anti-SRP
MRI
EMG
Muscle biopsy can be helpful but is not necessary

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17
Q

What are the seronegative spondyloarthritis? (negative for RF)

A

ankylosing spondylitis
psoriatic arthritis
reactive arthritis
arthritis associated with IBD
undifferentiated spondyloarthropathy

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18
Q

key words for bone tumors

A

nidus <1.5 cm: osteoid osteoma but improves with NSAIDs, nidus >2 cm = osteoblastoma
osteochondroma = cartilage-capped projection
enchondroma = in bone marrow
chondroblastoma: well-defined with sclerotic border
fibrous dysplasia: ground glass appearance
ossifying fibroma: well-circumscribed intracortical
non-ossifying fibroma: small, well-defined, eccentric, lytic
unicameral bone cyst: fallen leaf
aneurysmal: eggshell or soap bubble
osteosarcoma: moth eaten
chondrosarcoma: endosteal scalloping
ewing: onion skin

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19
Q

SLE lab studies

A

anti-dsDNA and anti-Smith

(also anti-SSB and anti-SSA but shared with sjogren)

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20
Q

chondroblastoma mets

A

lungs (benign)

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21
Q

Work up for osteoblastoma

A

xray followed by CT to determine size and extent

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22
Q

management of torticollis

A

remove underlying etiology
conservative therapy with NSAIDs, benzos, or other muscle relaxants
botox injections if unresponsive to conservative
if failure of botox, surgical release of SCM, selective denervation, dorsal cord stimulation

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23
Q

OA does not cause an elevation in what?

A

ESR. It is not inflammatory

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24
Q

Diagnostic modality of choice for OA

A

Radiographs

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25
Treatment of OA
assistive devices exercise program weight loss acetaminophen can use voltaren gel meloxican intra-articular steroids surgery hyaluronic acid
26
when would you treat gout
treat arthritis with NSAIDs and use colchicene when symptomatic
27
when would you use corticosteroids for gout?
acute attack if contrainidcation to NSAIDs can use intra-articular injection of triamcinolone
28
when would you use urate-lowering therapy for gout and what are the drugs
acute arthritis tophaceous deposits CKD minimum below 6 allopurinol and uloric
29
when would you use probenacid for gout
when xanthine oxide inhibitor cannot be used or does not reach don't use if crcl <50 mL/min Moa increase uric acid excretion by kidney
30
ra
inflammatory disease with synovitis of multiple joints
31
pathologic findings in RA
formation of a pannus
32
clinical presentation of RA
symmetrical swelling for 30 minutes in AM and may recur after inactivity
33
deformity in rheumatoid arthritis
boutonniere and swan neck
34
clinical presentation of ra
nodules correlate with RF in serum ocular dryness and mucous membranes ILD pericarditis flety and small vessel vasculitis
35
most specific blood test for RA
anti-CCP
36
earliest radiographic changes in RA
hands and feet and soft tissue swelling
37
treatment of RA
DMARDs: methotrexate sulfasalazine 2nd line TNF i added if needed (mab and enbrel)
38
types of jia
oligoarticular polyarticular systemic enthesitis-associated
39
mc type of jia
oligoarticular
40
symmetric or asymmetric jia
asymmetric four or fewer joints --> leg length discrepancy
41
symmetric five or more joints jia
polyarticular
42
fever evanescent salmon pink macular rash jia
systemic jia
43
inflammation of tendinous insertions in jia
enthesitis associated also see low back pain and sacroilitis
44
is jia inflammatory?
yep rf small percentage anti-CCP antibody positive aNA in late onset HLA B27 enthesitis
45
joint fluid for jia
elevated white cells and low glucose
46
diagnosis of jia
radiographs initially mri shows joint damage
47
treatment of jia
nsaids: naproxen, ibuprofen, meloxicam dmards second line for failure of nsaids: methotrexate/tnf inhibitors if mtx not tolerated
48
cs for jia
reserved for severe involvement can inject local triamcinolone
49
treatment of uveitis in jia
corticosteroid and dilating agents methotrexate if treatment failure, cyclosporine, TNF i rehab
50
highest rate of jia remission
oligoarticular rf positive often continues into adulthood
51
seronegative spondyloarteritis associated with
HLA-B27
52
s/s of ankylosing spondylitis
worse in morningn stiffness for hours improves with activity lumbar curve flattes and thoracic urve exaggerates can see sausage swelling and enthesopathy in 50% anterior uveitis constitutional symptoms absent
53
diagnostics of ankylosing spondylitis
elevated esr rf and anti-ccp negative hla-b27 anemai
54
imaging of as
shiny corneer bamboo spine bilateral and symmmetric later
55
treatment of as
nsaids tnf i for nsaid resistant don't use corticosteroids!
56
s/s psoriatic arthritis
RA symmetric oligoarticular destruction dip primarily affected arthritis mutilans spondylotic form hla b27 positive nail pitting sausage swelling
57
labs for psoriatic arthriits
increased esr rf neg
58
imaging of pa
sharpened pencil
59
treatment of pa
nsaids methotrexate if no response tnf i if refractory
60
reactive arthritis
urethritis conjunctivitis uveitis mucocutaneous lesions hlab27
61
in reactive arhtiritis
asymmetric of large weight-bearing joints
62
s/s reactive arthritis
stomatitis keratoderma blennorhagicum
63
diagnostic rea a
inflammatory sync=ovial fluid radiographic permanent or progressive joint disease
64
treatment of rea a
nsaids prevent by treating std\ sulfasalazine, methotrexate if poor response anti-tnf if refractory
65
peripheral arthritis in ibd
parallels bowel disease
66
spondylitis in ibd
independent of bowel disease
67
treatibd arthritis
control ibd nsaids for spondylitis dmards corticosteroids
68
s/s gonococcal arthritis
migratory polyarthralgia purulent monoarthritis fever ankles, feet, toes few have GU symptoms
69
diagnostic of gonococcal
wbc elevated urethral, throat, cervical, and rectal cultures plain radiographs normal
70
treatment of gonococcal arhtritis
hospital admission with antibiotics ceftriazond and azithromycin
71
anti-dsdna and anti-smith
sle
72
anti-histone
drug induced
73
anti-mi-2 anti-jo anti-srp
derm derm/poly derm/poly
74
anti-centromere
crestan
75
anti-ssa/ssb
sle/sjogren
76
anti-scl 70
systemic sclerosis
77
p-anca
sle, sjogrens, polymyositis c-anca wga eg
78
procainamide and hydralazine increase risk for
sle`
79
sle treatment med thats all over the place
sle
80

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