MSK

Question 1

What is the maximum dose of acetaminophen?

Answer 1

4g/day

Question 2

What antibody is associated with limited cutaneous systemic sclerosis (CREST)?

Answer 2

anti-centromere Ab

Question 3

What antibody is associated with diffuse cutaneous systemic sclerosis?

Answer 3

anti-scl 70 Ab (anti-DNA topoisomerase Ab)

Question 4

What antibody is associated with mixed connective tissue disease?

Answer 4

anti-U1-RNP Ab

Question 5

What antibody is associated with Rheumatoid arthritis?

Answer 5

ACPA, RF=anti-IgG

Question 6

What antibody is associated with Polymyalgia Rheumatica?

Answer 6

None. Pt will have a very elevated ESR though

Question 7

What antibody is associated with polymyositis and dermatomyositis?

Answer 7

anti-jo 1 Ab (anti-synthase Ab)

Question 8

What antibody is associated with sjogrens?

Answer 8

anti-Ro Ab (anti-SSA Ab) and anti-La Ab (anti-SSB Ab)

Question 9

What antibody is associated with SLE?

Answer 9

anti-dsDNA Ab, anti-Sm Ab, ANA

Question 10

What antibody is associated with drug induced lupus?

Answer 10

anti-histone Ab

Question 11

What are the 4 seronegative spondylarthropathies?

Answer 11

PAIR

• Psoriatic arthritis
• Ankylosing spondylitis
• IBD arthritis
• Reactive arthritis

Question 12

Needle-shaped negatively birefringent crystals?

Answer 12

Gout

yellow=parallel, blue=perpendicular

Question 13

Rhomboid-shaped, positively birefringent crystals?

Answer 13

Pseudogout

Question 14

Drugs associated with drug-induced lupus? What is the antibody?

Answer 14

• SHIPP
• Sulfonamides, Hydralazine, Isoniazid, Phenytoin, Procainamide

-Anti-histone Ab

Question 15

Rheum disorder with shoulder/hip joint pain and stiffness? What is this associated with? Tx?

Answer 15

Polymyalgia rheumatica

• associated with Giant Cell arteritis
• low-dose glucocorticoids

Question 16

Labs to check in suspected polymyositis?

Answer 16

Labs: CK, ALT, AST, aldolase

Question 17

Xerophthalmia and xerostomia are associated with what condition?

Answer 17

(dry eyes and dry mouth)

-Sjogren’s

Question 18

Proximal muscle weakness and a facial rash?

Answer 18

Dermatomyositis

Question 19

Arthritis + oral ulcers + proteinuria

Answer 19

SLE

Question 20

What rheum disorder is associated with anti-citrullinated protein antibodies (ACPA)?

Answer 20

Rheumatoid arthritis

Question 21

Hand x-ray showing “pencil-in-a-cup”?

Answer 21

Psoriatic arthritis

Question 22

Arthritis affecting the DIPs and PIPs?

Answer 22

Osteoarthritis (DIP=Heberden’s nodes, PIPs=Bouchard’s nodes)

Question 23

Most common overall cause of osteomyelitis? What to consider in sickle cell? IVDA? In Diabetics?

Answer 23

• overall=s.aureus
• sickle cell=salmonella
• IVDA andDM=pseudomonas

Question 24

Cause of bilateral Bell’s Palsy?

Answer 24

Lyme

Question 25

What cancers like to metastasize to bone?

Answer 25

"Permanently Relocated Tumors Like Bones" - Prostate (blastic) - Renal cell carcinoma - Testes and Thyroid - Lung (lytic) - Breast

Question 26

X-ray showing Codman's triangle and sunburst pattern?

Answer 26

Osteosarcoma

Question 27

X-ray showing "onion skinning"?

Answer 27

Ewing sarcoma

Question 28

X-ray with "soap bubble" appearance?

Answer 28

Giant cell tumor (osteoclastoma) | Clast=clean

Question 29

Old man with bowed out legs, hearing loss, increase in hat size? Most sensitive test?

Answer 29

Paget's disease | -Nuclear bone scan for hot spots

Question 30

What type of shoulder dislocation will the arm be held in external rotation and slight abduction? What is a potential complication?

Answer 30

- Anterior dislocation | - Axillary N injury

Question 31

What type of shoulder dislocation is associated with an adducted and internally rotated arm? When do these normally occur?

Answer 31

- Posterior | - seizures and electrocution

Question 32

Nerve at risk with a fracture of the shaft of the humerus? Consequence?

Answer 32

Radial Nerve | -wrist drop

Question 33

Nerve at risk with a fracture of the surgical neck of the humerus? Consequence?

Answer 33

Axillary nerve | -loss of shoulder abduction

Question 34

Nerve at risk with a supracondylar humerus fracture? consequence?

Answer 34

Median N | -"pope's blessing"--> loss of flexion of the 2nd and 3rd digits.

Question 35

Name for a distal radius +/- distal ulna fracture with a posteriorly displaced radius?

Answer 35

Colles fracture

Question 36

Name for a distal radius fracture with a ANTERIORLY displaced radius?

Answer 36

Smith fracture

Question 37

Proximal ulnar fracture with dislocation of the radial head?

Answer 37

Monteggia fracture

Question 38

Fracture of the distal radius with dislocation of the distal radial ulna joint?

Answer 38

Galeazzi fracture

Question 39

Low back pain with radiation that is worse with standing and walking and better with leaning forward?

Answer 39

Spinal stenosis

Question 40

Injury causing arm extension and adduction with forearm pronation?

Answer 40

Erb-duchenne palsy (waiter's tip) -superior trunk injury (common in birth trauma)

Question 41

Injury causing forearm supination and wrist and finger flexion? How does this commonly happen?

Answer 41

Klumpke palsy (inferior trunk injury) -"klumpke the monkey hung from a tree"--> when falling and grab something it pulls that inferior trunk

Question 42

What is injured in the "unhappy triad"?

Answer 42

- ACL, MCL and medial meniscus | - normally occurs with a medially directed blow to the lateral side of the knee

Question 43

Middle aged man with bilateral calcification of articular cartilage on x-ray. Cause? tx?

Answer 43

Chondrocalcinosis 2/2 psudogout tx: NSAIDS or colchicine