MSK

Question 1

Big risk factor for osteoporosis:

Answer 1

Smoking

Question 2

Diagnosis of osteoporosis?

Answer 2

DEXA scan with t-score less than -2.5

Question 3

What medication should be used in a patient with osteoporosis and HTN?

Answer 3

Thiazides bc they stimulate osteoblasts and decrease Ca excretion.

Question 4

First line treatment for RA?

Answer 4

DMARDS- methotrexate and plaquenil- slow the progression on RA.

Question 5

Risk associated with DMARDS?

Answer 5

Suppression of immune function

Question 6

What does methotrexate deplete?

Answer 6

Folic acid so patient must supplement

Question 7

This presents as joint pain and AM stiffness that resolved in less than 1 hour.

Answer 7

OA

Question 8

What will patient with OA present with?

Answer 8

Heberden and Bouchard’s nodes.

Question 9

Where are Heberden nodes located?

Answer 9

DIP and only in OA

Question 10

Where are Bouchard’s node located?

Answer 10

PIP- both RA and OA

Question 11

What would an X-ray show in a patient with OA?

Answer 11

Joint space narrowing

Question 12

What is treatment for OA?

Answer 12

Tylenol and exercise

Question 13

This is a systemic issue that presents with bouchards nodes, warm, tender and swollen fingers (sausage fingers), boutonniere deformity, and swan neck deformity.

Answer 13

RA

Question 14

This is Hyper-extension of the DIP and flexion of the PIP?

Answer 14

Boutonniere’s deformity

Question 15

This is flexion of the DIP and hyper-extension of the PIP?

Answer 15

Swan neck deformity

Question 16

Another type of arthritis that typically begins in the lower back and works it way to upper back. It is autoimmune and a chronic inflammatory condition.

Answer 16

Ankylosing Spondylitis

Question 17

How do we diagnose ankylosing spondylitis?

Answer 17

X-ray first then MRI

Question 18

This presents with snuff box tenderness and patient may say “ I fell with arms out to catch me”.

Answer 18

Scaphoid fracture

Question 19

How do we treat scaphoid fracture?

Answer 19

Thumb spica cast because this does not show up immediately on X-ray.

Question 20

This is backward prayer hands to diagnose carpal tunnel?

Answer 20

Phalen’s

Question 21

This is we you tap on the inner wrist to diagnose carpal tunnel?

Answer 21

Tinnel’s

Question 22

This is caused by a thickening of the tissue around the nerve leading to the toes that is common in females that wear heals and patient may say “it feels like a pebble is in my shoe”.

Answer 22

Morton’s neuroma

Question 23

McMurray tests for:

Answer 23

Meniscal injury

Question 24

Lachman tests for:

Answer 24

ACL injury

Question 25

Valgus tests for:

Answer 25

Ligaments

Question 26

This is knock knees?

Answer 26

Gene Valgum

Question 27

This is Row legged/bow legged?

Answer 27

Gene varum

Question 28

When is the pain relieved with a herniated disk/spinal stenosis?

Answer 28

When sitting

Question 29

What test do we use to evaluate sciatica?

Answer 29

Straight leg test

Question 30

Describe the straight leg test:

Answer 30

This is positive when reproduction of symptoms occur between 30-70 degrees of elevation.

Question 31

Sciatica pain is worsen when?

Answer 31

Sitting

Question 32

Which nerve is the root of the patient's sciatica when they have a diminished knee jerk with squat and rise exam?

Answer 32

L4

Question 33

Which nerve is the root of the patient's sciatica when they have a numbness at the great toe with the heel walking test?

Answer 33

L5

Question 34

Which nerve is the root of the patient's sciatica when they have a diminished or absent ankle jerk when walking on toes?

Answer 34

S1

Question 35

What tests can be used to test for a rotator cuff injury?

Answer 35

Drop arm, empty can test, and apprehension test

Question 36

The apprehension test may also show?

Answer 36

Posterior impingement of rotator cuff

Question 37

What would diagnose a distal biceps tendon rupture?

Answer 37

Hook test- use the index finger to hook the biceps tendon from the lateral side of the elbow.

Question 38

Gout prevention?

Answer 38

Allopurinol and lifestyle modifications

Question 39

Side effect of Allopurinol?

Answer 39

Bone marrow suppression

Question 40

Lifestyle modifications of gout?

Answer 40

Low purine diet, no alcohol, avoiding diuretics, no thiazide

Question 41

How do we diagnose Gout?

Answer 41

Uric acid greater then 6.5

Question 42

Treatment of acute gout attack?

Answer 42

Potent NSAIDs such as Indomethacin or steroids if severe colchicine

Question 43

This is when the ball at the head of the femur slips off the neck of the bone in a backwards directions. The patient will walk with a limp and there will be a dip in the hip (positive trendelenburg). Seen in adolescents.

Answer 43

SCFE

Question 44

This is lack of blood supply to the femur head that is seen in babies?

Answer 44

Legg-Calves-Perthes disease