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MSK Flashcards

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1
Q

The shoulder is most vulnerable to an anterior glenohumeral dislocation in which of the following positions?

A

abduction and external rotation

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2
Q

How do you test the motor function of the median nerve?

A

OK sign (pincer function of the thumb and index finger) or oppose the thumb and fifth finger

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3
Q

How do you test sensation of the median nerve?

A

Sensation at the volar tip of the index finger confirms sensory function of the median nerve

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4
Q

There is a risk of injury to which artery during anterior shoulder dislocation reduction?

A

axillary artery

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5
Q

What is a common complication if an anterior shoulder dislocation is left untreated?

A

difficulty with shoulder aBduction

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6
Q

Which spinal levels, when injured, are associated with loss of respiratory drive?

A

C1–4. Lesions at this level require intubation.

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7
Q

What is the splint of choice for a stable, non displaced wrist fracture?

A

sugar tong splint

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8
Q

LE that appears shortened and externally rotated. What part of the femur?

A

neck fx or dislocation of the head of the femur

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9
Q

Bence Jones protein are associated with what condition?

A

multiple myeloma

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10
Q

What is the common presentation of a posterior hip dislocation?

A

internal rotation position and adducted, leg will be shortened

usually after MVA

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11
Q

Describe the Galeazzi test for developmental hip dysplasia

A
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12
Q

Which nerve root is affected in a patient with loss of the ankle jerk reflex?

A

S1

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13
Q

What test is the most SENSITIVE for carpal tunnel?

A

Phalen maneuver

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14
Q

What is the MC MOI for medial collateral ligament?

A

direct blow to the lateral aspect of the knee

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15
Q

What is the MC MOI for posterior cruciate ligament?

A

fall onto a flexed knee while the foot is plantarflexed

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16
Q

What is the MC MOI for medial or lateral meniscus injury?

A

twisting on a fixed foot

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17
Q

What is the MC MOI for anterior cruciate ligament?

A

Twisting while the knee is hyperextended

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18
Q

What is the greatest risk factor for adhesive capsulitis?

A

DM

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19
Q

What are 2 important SEs to remember about bisphosphonates?

A

pill esophagitis

osteonecrosis of the jaw

low calcium

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20
Q

What is the PE test used in thoracic outlet syndrome?

A

Physical examination may reproduce symptoms when the arms are raised in the goalpost position (90° abduction with external rotation).

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21
Q

What is considered a positive Adson test? What dx?

A

There may be a positive Adson test (decrease or loss of radial pulse by abducting the arm at the shoulder and rotating the head toward the affected side)

Thoracic outlet syndrome (TOS)

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22
Q

Which nerve roots does the brachial plexus originate from?

A

C5-T1

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23
Q

What are the main complications of a felon?

A

Tenosynovitis and osteomyelitis

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24
Q

What are the classic muscle biopsy results associated with polymyositis?

A

Large nuclei, fiber size variation, atrophy, and the simultaneous presence of necrotic and normal type I and type II fibers

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25
What is Sever Disease?
calcaneal apophysitis, is believed to be a traction apophysitis of the Achilles tendon at the calcaneal apophysis related to overuse. It is most commonly seen in children ages 8–12 years, and the pain is often associated with sports that use cleats.
26
What dx?
Sever Disease
27
What does the posterior "sail sign" demonstrate in kids?
supracondylar fracture in a child
28
What does the posterior "sail sign" demonstrate in adults?
radial head or proximal ulnar fracture in adults
29
What is the MC fx of the elbow in the pediatric population?
supracondylar fracture of the humerus that occurs at the distal portion of the humerus without involving the growth plate
30
What nerve innervates the diaphragm? What level does it exit the spinal cord?
phrenic nerve C3-5
31
What is the MC DISLOCATED (not fractured) carpal bone?
lunate
32
What is the Koebner phenomenon, which can be seen in juvenile idiopathic arthritis?
A rash that appears in the area of minor trauma to the skin.
33
What is a severe and potentially fatal complication of JIA?
macrophage activation syndrome (MAS), which causes pancytopenia, hepatitis, extreme hyperferritinemia, and coagulopathy. To prevent MAS, JIA should be recognized and treated expediently
34
What is the difference between spondylolisthesis and spondylolysis?
35
What vertebra is most commonly involved in spondylolysis? What movement tends to exacerbate pain?
L5 vertebra lumbar extension
36
What dx?
buckle fracture
37
What is another name for a buckle fracture?
torus fracture
38
______ is recommended in the initial treatment of patients with mild rheumatoid arthritis symptoms and is generally considered safe until the patient knows they are pregnant
Hydroxychloroquine
39
What is another name for a syndesmotic ankle sprain?
high ankle sprain
40
What is the MC mechanism for a high ankle sprain?
external rotation on a planted foot
41
What is pes anserinus pain syndrome?
It causes medial knee pain and tenderness at the upper medial tibia near the site of the insertion of the pes anserinus. three most suggestive clinical manifestations in the absence of alternative etiologies are medial knee pain, tenderness over the upper medial tibia, and the absence of local swelling.
42
What are 3 common historical findings associated with pes anserinus pain syndrome?
OA DM obesity
43
What is the leading cause of death for patients with scleroderma?
pulmonary disease
44
a pt tripped while running, PE reveals A key exam finding is pain with forefoot rotation against a stabilized hindfoot (calcaneus). What joint is most likely dislocated?
tarsometatarsal aka Lisfranc injury
45
Where is the pain usually located in a Lisfranc injury?
dorsum of the midfoot
46
What is the thessaly test? What dx?
This test is performed by having the patient stand on one leg and flex the knee to 20°, then internally and externally rotate the knee. meniscus tear
47
What biomarker is the most specific for RA?
anti-cyclic citriullinated peptide antibodies (anti-ccp)
48
What is the underlying cause of a bipartite patella? What pt population?
Bipartite patella results from a failure of secondary ossification at one or more poles of the patella, most often the superolateral aspect. Instead of bone, a fibrous synchondrosis forms, which may remain asymptomatic or become a pain generator if disrupted adolescent athletes
49
What is the underlying cause of sjogren syndrome?
Sjögren syndrome is an autoimmune disease characterized by lymphocytic infiltration of the exocrine glands.
50
The tendons of the _____, ______, and _______ muscles insert onto the medial tibia below the knee joint and overlie the pes anserinus (Latin for goose’s foot) bursa
gracilis sartorius semitendinosus
51
What is the double line sign? What dx?
The double line sign is specific for avascular necrosis of the hip and is seen as two hyperintense lines, with the first representing edema and the second showing the line between normal and ischemic bone marrow. avascular necrosis
52
Patients commonly present with pain on the radial surface of the wrist, which is increased with movement of the thumb or ulnar deviation at the wrist. What dx?
De Quervain tendinopathy
53
What PE finding is specific for an L5-S1 herniated nucleus pulposus?
weak plantar flexion of the foot
54
What dx? What is the tx?
osteochondromas reassurance and watchful waiting
55
Where is the MC location for an osteochondroma?
distal femur
56
What dx? What is super important risk factor?
osteosarcoma rapid bone growth during adolescence
57
What is the inititial treatment of a ganglion cyst?
observation or needle aspiration
58
What is another name for pseudogout?
acute calcium pyrophosphate crystal arthritis
59
Name this fracture. What was the most likely MOI? What direction is it displaced?
colles fracture fall on outstretched hand, dorsally displaced dinner fork deformity
60
What is a weird side effect of bisphonates?
osteonecrosis of the jaw
61
What level does the spinal cord terminate in adults?
L1-2
62
What type of injury? What nerve and artery are most likely to be damaged?
Anterior knee dislocation nerve: common peroneal nerve artery: popliteal artery
63
What dx? What is the tx plan?
lisfranc injury non-weight bearing cast for 12 weeks aka where disruption occurs between the articulation of the base of the 2nd metatarsal and the medial cuneiform
64
What is the fleck sign?
a fracture at the base of the 2nd metatarsal which is pathognomonic for the lisfranc injury
65
Adult, with +anterior and + posterior fat pads. What is the most likely dx?
radial head fracture
66
kid, with +anterior and + posterior fat pads. What is the most likely dx?
supracondylar fracture
67
sail sign, is it anterior or posterior fat pad?
anterior fat pad
68
What genetic inheritance pattern is associated with Paget disease of the bone?
Autosomal dominant with variable penetrance.
69
Pt presents with mild pain in his pelvis and low back for the past 6 months. He also mentions his hat is much tighter than before. What dx?
Paget disease of the bone
70
What additional finding will a Paget disease of the bone pt complain of? Why?
Bone pain is the MC symptom The involvement of the skull, particularly the temporal bone, can lead to compression of the cochlear or vestibulocochlear nerve or distortion of the ossicles in the middle ear, leading to **sensorineural hearing loss**
71
What is the MC dislocated joint in the body?
shoulder
72
What type of shoulder dislocation is MC?
anterior
73
How will an anterior shoulder dislocation present?
On examination, the arm is held in abduction and external rotation (down adjacent to the body)
74
How will a posterior shoulder dislocation present?
are much more uncommon and typically result from significant adduction and internal rotation caused by a fall on an outstretched arm, seizure, or direct blow to the anterior shoulder. The shoulder will be held in adduction and internal rotation (across the chest)
75
Classic "foot drop" is associated with damage to what nerve?
deep peroneal inability to dorsiflex and loss of sensation between the first and second toes
76
Which of the following diagnostic studies has the highest sensitivity to evaluate for acute radiculopathy?
MRI
77
What is a specific PE finding associated with an L5-S1 herniated disc?
Weak plantar flexion of the foot
78
What type of bone cancer, 50 year old male. Radiograph findings vary based on the subtype, but half are lytic lesions, often lobular, and nearly three-quarters are accompanied by ring-and-arc or punctate calcifications,
Chondrosarcoma
79
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