MSK

Question 1

DeQuervain’s tenosynovitis –> what tendons are affected?

Answer 1

• abductor pollicis longus

- extensor pollicis brevis

Question 2

Ca: normal
Phos: normal
alk phos: normal
PTH: normal

what condition?

Answer 2

• normal

- osteoporosis

Question 3

Ca: normal
Phos: normal
alk phos: elevated
PTH: normal

what condition?

Answer 3

• osteopetrosis

- Paget’s disease

Question 4

Ca: decreased
Phos: decreased
alk phos: normal
PTH: increased

what condition?

Answer 4

• osteomalacia

- rickets

Question 5

Ca: elevated
Phos: decreased
alk phos: elevated
PTH: elevated

what condition?

Answer 5

• osteitis fibrosis cystica

- parathyroidism

Question 6

osteomalacia –> pathophys

Answer 6

inadeq Ca and phos –> defective bone mineralization –> bones soften –> bow

Question 7

osteomalacia –> MCC

Answer 7

vitD3 def –> decreased Ca absorption

Question 8

osteomalacia –> pathognomonic finding on imaging

Answer 8

pseudofractures (aka Looser’s zone, milkman’s fx)

Question 9

Paget’s dz –> pathognomonic finding on imaging

Answer 9

“mosaic” lamellar bone pattern

Question 10

Paget’s dz –> increased risk for what conditoin?

Answer 10

osteosarcoma

Question 11

hyperPTH –> presentation

Answer 11

• stones
• bones
• abd groans
• psych overtones

Question 12

slipped capital femoral epiphysis –> emergent consult to ortho is necessary

T/F

Answer 12

T

Question 13

slipped capital femoral epiphysis –> emergent consult to ortho is necessary –> why?

Answer 13

75% risk of avascular necrosis of femoral head after 48hr

ortho –> emergent fixation of slipped femoral head –> dramatically decrease risk of necrosis

Question 14

Bench pressing  feel “pop” in anterior shoulder  what 2 tendons attach to anterior shoulder that could have been injured?

Answer 14

• Biceps

- Pectoralis major

Question 15

Bench pressing  feel “pop” in anterior shoulder  what muscle was injured?

Answer 15

Pectoralis major

Question 16

Bench pressing  feel “pop” in anterior shoulder  injured pectoralis major muscle  at what stage of bench press is pec major tendon at greatest risk of rupture?

Answer 16

During downward motion toward chest

Question 17

Bench pressing  feel “pop” in anterior shoulder  injured pectoralis major muscle  during downward motion toward chest

What kind of contraction? Why?

Answer 17

Eccentric: muscle lengthen under tension

Bc force of weight is greater than force generated by muscle

Question 18

cannot spread fingers, atrophy of hypothenar eminence

condition?

Answer 18

ulnar nerve entrapment at Guyon’s canal (wrist)

Question 19

cannot spread fingers, atrophy of hypothenar eminence, impaired 4th-5th digit flexion

condition?

Answer 19

ulnar entrapment at cubital tunnel (elbow)

Question 20

differentiate: nutritional rickets vs X-linked hypophosphatemic rickets

Answer 20

nutritional rickets:
- elevated PTH

hypophosphatemic rickets:
- normal PTH

Question 21

nutritional rickets: lab findings

• Ca
• Phos
• Alk Phos
• PTH

Answer 21

• Ca: decreased-normal
• Phos: decreased-normal
• Alk Phos: mild-mod increase
• PTH: increase

Question 22

what is Thompson test (Simmond’s test)

Answer 22

test for rupture of achilles tendon

normal:
prone –> squeeze calf –> foot should plantarflex

Question 23

10M –> c/o LBP for months –> MRI shows thoracic kyphosis

dx?

Answer 23

Scheuermann’s disease (juvenile kyphosis)

Question 24

LE dermatomes

Answer 24

L3: knee
L4: medial leg
L5: big toe
S1: lat leg

Question 25

UE dermatomes

Answer 25

``` C4: shoulder C5: dorsal arm C6: thumb C7: middle C8: pinkie ```

Question 26

femoral neck fracture --> what blood vessel supplies this area?

Answer 26

medial & lateral femoral circumflex artery

Question 27

dorsiflex foot --> calf pain what test? indicates what?

Answer 27

Homan's sign DVT

Question 28

arm flex 90 --> forcible internal rotate what test? indicates what?

Answer 28

Hawkin's test - subacromial impingement - rotator cuff tendinitis

Question 29

stabilize scapula --> int rot so thumb points down --> flex arm what test? indicates what?

Answer 29

Neer's test - subacromial impingement

Question 30

flex shoulder, extend elbow, supinate --> flex shoulder against resistance what test? indicates what?

Answer 30

Speed's test bicipital tendinitis

Question 31

flex elbow to 90 --> physician pull down elbow, supinate --> patient resist supination what test? indicates what?

Answer 31

Yergason's test bicipital tendinitis

Question 32

differentiate: Boston brace vs Milwaukee brace

Answer 32

Boston brace: - for lower dysfx: thoraco-lumbar-sacral - sits under axilla Milwaukee brace: - for higher dysfx: cervico-thoraco-lumbar - goes from skull to sacrum

Question 33

biceps --> N

Answer 33

musculocutaneous N

Question 34

elbow pain --> worse w resisted wrist extension dx?

Answer 34

lateral epicondylitis

Question 35

olecranon bursitis --> pain where?

Answer 35

posterior elbow

Question 36

lateral epicondylitis --> injury to what muscle/tendon?

Answer 36

extensor carpi radialis brevis

Question 37

supraspinatus --> nerve?

Answer 37

suprascapular N

Question 38

what is cozen's sign? indicates what?

Answer 38

ulnar deviate --> difficulty w wrist extension ==> lateral epicondylitis