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Flashcards in Integrative MSK Deck (48)
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1
Q

MA woman, progressive weakness

problems rising from chair
dec strength in proximal LE bilateerally

CK is elevated

dx is ___/____
mechanism is ___ inflammation of muscle

A

polymyositis/dermatomyositis

immune mediated

2
Q

elderly woman, progressive bilateral knee pain

no redness/swelling

hypertrophy over DIP/PIP, crepitus

dx is ___

A

osteoporosis

3
Q

YAW, pain/swelling in wrists/knuckles/fingers

worse in AM
swelling in multiple joints

lump on extensor surfaces
no rash/ulcers

dx is ____
early antibody is ____

A

RA

anti-CCP

4
Q

MA woman, dysphagia of solids/liquids

skin on hands/fingers is tighter, sensitive to cold weather

nodules on forearms

dx is ____
antibody is ____

A

CREST

anti-centromere

5
Q

YA woman, diffuse joint pain, fatigue/myalgia, fever

rash on face, pleurisy

dx is ____

antibodies include __/___

A

SLE

ANA/ani DS DNA

6
Q

MA woman w weakness, rash on eyelids, difficulty swallowing

dec strength in proximal muscles, purple rash on eyelids/knuckles

CK is inc

dx is ___
antibodies include /__/

A

dermatomyositis

anti-Jo1/anti SRP/anti Mi2

7
Q

ma woman w dry, itchy eyes, dry mouth, ulcerated corneas

dx is ___
ab present ____

A

sjogrens

anti-Ro./La

8
Q

elderly man, fatigue and low grade fevers

hip/shoulder pain, tenderness over trapezius/deltoid/trochanter

strength is ___
___is inc

dx is _____

A

normal
ESR

polymyalgia rheumatica

9
Q

Arthralgia, photosensitivity, serositis, rash, cytopenias

dx is ____
sensitive Ab ___
specific ab for lupus nephritis __/___

A

SLE
ANA
anti-DS DNA, anti-Smith ab

10
Q

AM stiffness, symmetric, small joints of hand/feet, sub q nodules, joint erosions

dx is ___

A

RA

11
Q

dry eyes/mouth

dx is ___

ab nclude __/___

may be positive for __/___

A

sjogrens

anti SSA (Ro) or anti SSb (la)

ANA, RF

12
Q

YA male, low back pain, worse in AM

bilateral, forward bend, tender in SI joints, cannot touch toes
erosions in SI joint

dx is ___

A

AS

13
Q

painful, swollen, knee

high fever, effusion, red

inc WBC in arthrocentesis, no crystals

dx is _____
causative org is probably __
do __ to dx

A

septic arthritis
staph aureus
arthrocentesis

14
Q

YA woman, wrist/knee swelling, migratory pains

effusion in knee, papules on lower extremities

scant mucoid discharge from pelvis

dx is ____
causative organism is ___

A

gonococcal arhritis

n gonorhea

15
Q

MA man, swelling in ankle

red, warm, swollen, negatively birefringent crystals

dx is ___

A

gout

16
Q

Elderly male, knee pain/sweling

xray shows chondrocalcinosis

dx is ____
may be associated w __/__
crystals are __
___ birefringent, __ in parallel

A

pseudogout

Hemochromatosis, hyperPTH
rhomboid
+, blue

17
Q

tx acute gout w __ or __

chronic w ___ such as __

A

NSAIDs, colchicine

XO inhibitor, allopurinol

18
Q

conjunctivitis, urethritis, uveitis

dx is ___

causative orgs
S
Y
C
C
S
A

reactive arthritis

shigella
yersinia
campyl
chlamydia
salmonella
19
Q

sausage shaped digits, arthritis, scaly rash on limbs

dx is __

A

psoriatic arthritis

20
Q

popping sensation in knee, improved w ice/NSAIDs

medial joint line is tender
positive ___

dx is ___

A

McMurray

meniscal tear

21
Q

MA man, shoulder pain, worse when lifting arm overhead

TTP, pain w abduction, can lower arm smoothly

dx is ____
if could not lower arm slowly, dx is ___

A

rotator cuff tendonitis

rotator cuff tear

22
Q

immediate knee swelling, excess medial rotation to planted foot

dx is ____

A

ACL tear

23
Q

valgus stresss

__ injury

varus stress

__ injury

A

MCL

LCL

24
Q

hyperextension w knee pain

dx is ___

A

pcl tear

25
Q

younger than 45, knee pain walking down steps

pain at rest when knee flexed

dx is ____

A

patellofemoral pain syndrome

26
Q

teenage, ___ tenderness

dx is ___
aka

A

tibial tuberosity

Osgood schlatter
tibial tubercle apophysitis

27
Q

roll ankle, damage to ___

A

anterior talofibular ligament

28
Q

pain over distal radial styloid w repetitive use of thumb

dx is ____

swelling/stenosis of ___ and ___ tendon sheaths at wrist

A

De quervian tenosynovitis

abductor pollicus longus
extensor polllicus brevis

29
Q

punch a wall w hand pain

dx is ___
fracture of ____

A

boxer fracture

metacarpal

30
Q

forced dorsiflexion in elderly

fx is ___
avulsion of ___ from shaft of ___

A

colles fx

styloid process, radius

31
Q

hand/wrist fracture, w ulnar nerve involvement

fx to __

A

hamate

32
Q

fall on outstretched hand, pain in anatomic snuff box

dx is ___

A

scaphoid fracture

33
Q

distal humerus injury

affects __

A

ulnar nerve

34
Q

young boy, leg pain

family hx of retinoblastoma

elevation of periosteum

dx is ___

A

osteosarcoma

35
Q

young boy, trauma to arm

good grow, poor dentition, skeletal fractures

blue discoloration to sclera

dx is ____
defect in ___

A

OI

type 1 collagen

36
Q

young boy, post URI

resists RoM to hip
labs are normal
dx is ____

A

transient synovitis

37
Q

young boy w limp for month

limited internal rotation of hip, antalgic gait

dx is ___

aka ___

tend to have ___
pain over __/___
dec hip __/___

A

legg calve perthe dx

idiopathic avascular necrosis of femoral head

short stature
anterior thigh/knee
internal rotation/abduction

38
Q

SCFE
displaced ___ anteriorly

usually seen in ___

assc w ___ or ___ or ___

insidious hx of ___, localized to ___

no/minimal ____

A

femoral head

obese, adolescent male

hypoT, pseudohypoPTH, GH deficiency

dull pain, anterior hip

trauma

39
Q

baby, dec hip abduction

clunk on exam

dx is ___

A

DDH

40
Q

YA male, muscle aches/fever, ab pain, rash

numbness over fingers, foot drop

Hep B positive, inc creatinine, ESR

dx is ____

A

polyarteritis nodosa

41
Q

old man, dffuse bony pain

worse in clavicles, legs bowed

worse hearing

ALP is inc, others normal

dx is ___
disorganized ___

A

paget dz of bone

bony matrix

42
Q

comp of bisphosphonate therapy

A

osteonecrosis of the jaw

43
Q

young boy, weak pelvic girld, Gower’s sign, prominent calves

dx is __ w deleted dystrophin gene

dx is ___ w mutated dystrophin gene
usually presents ___/__

A

duchenne

becker
older/milder

44
Q

young boy, tumor in diaphysis of long bones/pelvis/scapula/rib

dx is ____
hisotology shows ___
xray w ___

translocation

A

ewing sarcoma
blue cells
onion skin

11, 22
EWS-FLI1

45
Q

side effect of NSAID

__ via ___
A
U

A

AKI, constriction of AA
AIN
ulcer

46
Q

SE of aspirin
T
H leading to ___ w anion gap ___

A

tinnitus

hyperventilation, RA, MA

47
Q

muscle change w exercise

type 1 is __, __ fibers
abundant in __/___
used for ___

type 2 is __/__ fibers
used for __/___
inc anaeorbic ___

A

slow, red
mito/myoglobin
endurance

fast, white
strnegth/speed
glycolytic capacity

48
Q

endurance athlete

__ to __ transition
resistance recruits/hypertrophies ____ fibers

A

fast, slow

type 2