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MSK Flashcards

(86 cards)

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1
Q

Arm held in abduction and external rotation. Risk of? Tx?

A

Anterior shoulder dislocation is a risk of axillary nerve injury. Tx with reduction and sling

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2
Q

Humerus fracture risk for nerve damage to…

A

radial nerve that leads to wrist drop and loss of thumb extension

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3
Q

Anterior hip dislocation can injure what nerve

A

obturator

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4
Q

Shortened and externally rotated leg tx

A

hip fracture- anticoag to decreased likelihood of DVTs

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5
Q

Fat embolism presentation

A

fever, mental status, dyspnea, hypoxia and petechiae

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6
Q

6 P’s of compartment syndrome

A

Pain, parasthesias, pallor, poikilothermia, pulselessness, and paralysis (last two are late)

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7
Q

Diagnosis of compartment

A

history and exam plus delta pressure < 30 (diastolic pressure- compartment pressure)

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8
Q

Prophylaxis tx for open fractures

A

antibiotics and tetanus

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9
Q

wrist drop nerve

A

radial- prolonged compression at humerus

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10
Q

weak wrist flexion and flat thenar eminence

A

median- carpal tunner

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11
Q

claw hand- inability to open 4th and 5th digits

A

ulnar- elbow dislocation

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12
Q

decreased sensation over deltoid

A

axillary- ant shoulder dislocation

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13
Q

foot drop

A

peroneal- knee dislocation or trauma to fibula

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14
Q

confirmatory studies for carpel tunnel

A

nerve conduction or EMG

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15
Q

shortened leg that is internally rotated

A

posterior hip dislocation

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16
Q

lengthened and externally rotated leg

A

anterior hip dislocation

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17
Q

volkmann contracture

A

compartment syndrome associated with supracondylar humerus fractures

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18
Q

most common site site of herniated disc

A

L5-S1

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19
Q

Sudden onset severe, electricity like LBP usually preceded by several months of aching pain. tx

A

NSAIDS and continuation of regular activities; nerve block may benefit

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20
Q

Passive straight leg test

A

sensitive but not specific for herniated disc

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21
Q

Test if cauda equina suspected

A

MRI- also good in refractory cases or rapidly progressing neuro change

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22
Q

treatment for broken skin injury from human mouth

A

irrigation, debridement and IV abx

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23
Q

Cause of spinal stenosis

A

degenerative joint disease

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24
Q

back pain that radiates to arms or butt and leg numbness/weakness. Tx?

A

spinal stenosis- NSAIDS (mild to mod); epidural steroids (advanced)

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25
L4 nerve root compression
foot dorsiflexion, patellar reflex, and decreased sensation on medial aspect of lower leg
26
L5 nerve root compression
big toe dorsiflexion, and decreased sensation on dorsum of foot and lateral aspect of lower leg
27
S1 nerve root compression
plantar flexion and hip extension, achilles reflex, and decreased sensation on plantar and lateral aspect of foot
28
most common primary malignancy of bone in children
osteosarcoma
29
location of osteosarcome
metaphyseal region of distal femur, proximal tibia, proximal humerus
30
child, progressive pain in leg that is worse at night. Next step
Xray will show sunburst of osteosarcoma; confirm dx with biopsy, MRI/CT for staging
31
Tx osteosarcoma
limb sparing surgical procedures and chemo postop; amputation may be needed
32
15 yo upper thigh pain, XR shows small nidus of lucency; TX?
osteoid osteoma- pain relief with NSAIDS, may self resolve or require surgical removal
33
most common organisms in septic arthritis
staphylococcus, strep, and gram - rods
34
XR of joint shows osteophytes, subchondral sclerosis, and bone cysts
OA
35
DIP and PIP joints
OA
36
anti ccp sign of
RA
37
onion skinning on XR
ewing sarcoma
38
20-30 yo knee pain, soap bubble on XR
giant cell tumor of bone
39
child with gout and inexplicable injuries
Lesch nyhan
40
causes of hyperuricemia
increased cell turnover (hemolysis, blast crisis, tumor lysis), cyclosporine, dehydration, DI, increased meat or alcohol, diuretics, lead poisoning, Lesch-Nyan, salicylates, starvation
41
risk factors for gout
male, obese, postmen, binge drinking
42
tx acute gout attack
nsaids (indometh) 1st line; colchicine 2nd line; Steroids in renal disease or if NSAIDS dont work
43
maintenance therapy gout
allopurinol (producers) or probenecid (underexcretors)
44
associations with pseudogout
hemochromatosis and hyperparathyroidism
45
tx RA
DMARDS- methotrexate
46
cardiac association with ankylosing spondylitis
heart block
47
ank spond associated with what GI condition
IBD
48
malignancy associated with poly/dermatomyositis
lung and breast
49
anti- jo1 antibody
poly/dermatomyositis
50
RA, splenomegaly and neutropenia
felty syndrome
51
hydroxychloroquine SA
retinal toxicity
52
CREST
calcinosis, raynaud, esophageal dysmotility, sclerodactyly, telangiectasias
53
anticentromere antibody
CREST
54
antitopoisomerase
scleroderma
55
most common cause of mortality in scleroderma
pulm htc
56
new headache, scalp pain, temporal tenderness, and jaw claudication, fever, monocular blindness, wt loss, myalgias
giant cell arteritis
57
findings in temporal arteritis biopsy
necrosis of media, and lymphocytes plasma cells and giant cells
58
Tx giant cell arteritis
high dose prednisone immediately (save the eyes); do BEFORE biopsy for eye
59
Tx for skin involvement in SLE
hydroxychloroquine
60
Tx for lupus nephritis
cyclophosphamide
61
criteria for SLE (dopamine rash)
discoid rash, oral ulcers, photosensitivity, arthritis, malar rash, immuni (dsDNA, sm proteins), neurologic, elevated ESR, renal, ANA +, serosistis, hematologic abn
62
Causes of serum sickness
immune complex formation, Beta lactams and sulf drugs, and acute hep B
63
clinical features of serum sickness
1-2 weeks after exposure, fever rash polyarthralgia
64
tx serum sickness
remove offending agent and supportive care
65
rash of scarlet fever
sandpaper rash
66
supracondylar fracture of the humerus worry about damage to...
brachial artery and median nerve
67
proximal humerus fracture worry about damage to
axillary nerve
68
oral ulcers, genital ulcers, uveitis, erythema nodosum
behcets
69
malabsorptive diarrhea, wt loss, migratory arthritis, LAD and fever
Whipple disease caused by tropheryma whippelii
70
pain with abduction, external rotation of arm subacromial tenderness, normal range of motion with positive neer and hawkins test
rotator cuff impingement or tendinopathy
71
pain with abduction, external rotation of arm, weakness with external rotation age >40
rotator cuff tear
72
decreased passive and active range of motion of shoulder more stiff than pain
adhesive capsulitis (frozen shoulder)
73
anterior shoulder pain, pain with lifiting and carrying
biceps tendonopathy or rupture
74
acute back pain and point tenderness
vertebral compression fracture
75
lower back pain worse with mov't and typically in paraspinal area
ligamentous back sprain
76
acute swelling, tenderness, inability to extend knee, fall from height or blow
fracture of patella
77
episodic knee pain and tenderness at the inferior patella and tendon; usually seen in jumping sports or repetitive knee extension at work
patellar tendinitis
78
anterior knee pain more common in women, worse with activity or sitting; anterior knee pain that is reproduced by patellofemoral compression
patellofemoral pain syndrome
79
knee pain associated with kneeling, painful, swelling and erythema
preparellar bursitis commonoly d/t S auereus
80
chondrocalcinosis are pathonemonic for
CPPD but should look for secondary cause of CPPD including hyperpara, hypothyroid, or hemochromatosis
81
Non liver symptoms of hemochromatosis
bronze diabetes, arthralgia, hypogonadism, restrictive or dilated cardiomyopathy
82
lytic bone lesions, papules, LAD, HSM, central DI
langerhans cell histiocytosis Tx with chemo
83
Blue sclerae, diffuse cortical thinning, pathologic fractures
osteogenesis imperfecta
84
benign bone tumor in adolescent with pain, resolves with NSAIDS X ray would show
Small round hypodense area consistent with osteoid osteoma
85
adolescent or kid with poly or oligoarticular joint pain, elevated ESR, what are other lab findings
hyperferritinemia, hypergammaglobulinemia, thrombocytosis, and anemia associated with JIA
86
what is at risk of being injured with a clavicle injury in middle of bone
subclavian artery andbrachial plexus

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