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ER EOR > MSK geriatrics > Flashcards

MSK geriatrics Flashcards

1
Q

in what population is scoliosis most common

A

girls
FHx

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2
Q

more sensitive screening test for scoliosis

A

Adams forward bend test

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3
Q

XR scoliosis

A

Cobb’s angle >/= 10 degrees

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4
Q

tx scoliosis

A

Cobb angle < 25 - observe

surgery if > 40

can do bracing otherwise to stop progression

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5
Q

kyphosis vs lordosis

A

kyphosis - humpback
lordosis - swayback

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6
Q

normal curvatures of the spine

A

cervical - lordosis
thoracic - kyphosis
lumbar - lordosis

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7
Q

risks for ankylosis spondylitis

A

young males 15-30
HLA-b27

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8
Q

sx ankylosis spondylitis

A

low back pain and neck pain
decreased ROM in the night and morning, not improved with rest
improves with exercise and activity

dactylitis - uniform swelling of the fingers and toes (sausage digits)

may have anterior uveitis
!!!

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9
Q

dx ankylosis spondylitis

A

increased ESR, HLAB27 positivity

XR - bamboo spine - straightening of spine; loss of lordotic lumbar curvature + fusing of vertebrae

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10
Q

tx ankylosis spondylitis

A

NSAIDs first line

anti-TNF drugs if no response after 2 weeks

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11
Q

at what level is herniated disc MC

A

L5-S1

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12
Q

sx herniated disc

A

RADICULAR BACK PAIN!!!

POSITIVE SLR, crossover

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13
Q

dx herniated disc

A

XR
MRI

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14
Q

tx herniated disc

A

conservative

injections

laminectomy vs discectomy

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15
Q

MCC cauda equina

A

massive lumbar disc herniation

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16
Q

sx cauda equina

A

back pain
leg pain
saddle anesthesia
urinary or bowel dysfunction

DECREASED ANAL SPHINCTER TONE

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17
Q

dx cauda equina

A

MRI!!!!

18
Q

tx cauda equina

A

emergency decompression

19
Q

dx spinal stenosis

A

MRI preferred

20
Q

which hip fractures are associated with AVN

A

fractures of the femoral head and neck

21
Q

PE hip fracture

A

shortened, abducted, externally rotated (opposite for dislocation)

22
Q

dx hip fracture

A

XR - traction-internal rotation AP hip

23
Q

first line for osteoporosis

A

1200 Ca+
800 Vit D

24
Q

DEXA screening

A

65 F or older

25
Q

what is poly myalgia rheumatica associated with

A

giant cell arteritis

26
Q

sx polymyalgia rheumatica

A

pain and stiffness in the proximal joints and muscles - shoulder and hip girdles!!!

worse after inactivity (worse in the AM > 45 min)

27
Q

PE polymyalgia rheumatica

A

normal muscle strength
may have decreased ROM

28
Q

dx polymyalgia rheumatica

A

clinical
increased ESR and CRP

29
Q

tx polymyalgia rheumatica

A

low dose steroids is associated with rapid response!!!

30
Q

what is polymyositis

A

muscle inflammation due to CD8+ lymphocytes

31
Q

sx polymyositis

A

progressive symmetric proximal muscle weakness (shoulder, hips)

decreased muscle strength!!

32
Q

dx polymyositis

A

elevated muscle enzymes - CK, aldolase, AST, ALT, LDH

Anti-jo-1

anti-signal recognition protein

muscle biopsy - definitive

33
Q

tx polymyositis

A

high dose steroids

34
Q

sx RA

A

joint pain, stiffness, swelling
worse inn the morning with morning stiffness > 1 hour after initiating movement
improves later in the day

wrist, MCP, PIP

35
Q

PE RA

A

symmetric inflamed joints - warm, erythematous, soft “boggy”

ulnar deviation

36
Q

dx RA

A

RF - best initial
anti-CCP most specific
XR - symmetric joint narrowing, osteopenia, bone and joint erosions

C1-2 subluxation

37
Q

tx RA

A

DMARDs (methotrexate, leflunomide) + NSAIDs or steroids (for sx)

38
Q

most important modifiable RF for OA

A

obesity

39
Q

sx OA

A

usage-related joint pain, stiffness, restriction of movement

evening joint stiffness - worse throughout the day; morning stiffness is short in duration

40
Q

PE OA

A

asymmetric joint space narrowing
marginal osteophytes

41
Q

tx OA

A

acetaminophen, NSAIDs, steroids

42
Q
A

ER EOR (28 decks)

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