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PANCE/EOC > MSK/Rheum #4 > Flashcards

MSK/Rheum #4 Flashcards

(54 cards)

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1
Q

Sjogren Syndrome is an autoimmune disease affecting what type of glands?

A

Exocrine glands

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2
Q

Symptoms of Sjogren Syndrome

A
  • Xerostomia (dry mouth)
  • Dry Eyes (Keratoconjunctivitis sicca)
  • Vaginal dryness (Dyspareunia)
  • Bilateral parotid gland enlargement
  • Dental Caries
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3
Q

Screening labs for Sjogren Syndrome

A

-AntiSS-A (Ro) and antiSS-B (La) best initial

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4
Q

Other diagnostics for Sjogren’s

A
  • Positive Schirmer Test: < 5 mm of tears production
  • Rose Bengal Stain: abnormal corneal epithelium
  • Definitive: Lip or parotid gland biopsy
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5
Q

Treatment for Sjogren’s Syndrome

A
  • Artificial tears, Increase fluid intake, Fluoride treatments
  • Cholinergic Drugs: Pilocarpine
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6
Q

With Sjogren’s, there is an increased risk of

A

Non-Hodgkin Lymphoma

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7
Q

Side effects of Pilocarpine

A

-Diaphoresis, flushing, sweating, bradycardia, diarrhea, nausea, vomiting, blurry vision

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8
Q

Describe the MC demographics and presentation of a patient with SCFE

A

13 year old African American athletic obese male with insidious hip/thigh/knee pain and a limp

-Externally rotated leg on affected side

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9
Q

What is seen on a radiograph of a patient with SCFE?

A

Posterior displacement of femoral epiphysis (ice cream slipping off cone)

-Best seen on frog leg lateral pelvis

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10
Q

Treatment for SCFE

A

Non-weightbearing with crutches followed by ORIF (increased risk of AVN)

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11
Q

Mechanism of action for a Smith and Colles Fracture

A

FOOSH

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12
Q

What is a Smith Fracture

A

Extra-articular distal radius fracture with ventral angulation of distal fragment

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13
Q

What is seen on physical exam for a smith fracture?

A

Garden spade deformity

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14
Q

Radiographs of a Smith Fracture show…

A

-Ventrally displaced or angulated fracture of the distal radius

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15
Q

Treatment for Smith Fracture

A

-Closed reduction followed by sugar tong splint or cast

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16
Q

What is spinal stenosis?

A

Narrowing of the spinal canal with impingement of the nerve roots

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17
Q

Symptoms of spinal stenosis

A
  • Back pain, numbness, paresthesias
  • Worse with extension
  • Better with flexion (shopping cart sign), walking uphill, cycling
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18
Q

Diagnostic of choice for spinal stenosis

A

MRI

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19
Q

Treatment for spinal stenosis

A
  • Conservative: Pain control, PT, injections

- Surgical: if refractory or no improvement

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20
Q

What is on history for a person with a synovial cyst?

A

MC in lumbar region of spine

  • Back/leg pain that is better when sitting
  • worse when standing/walking
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21
Q

Risk Factors for SLE

A
  • Young female
  • AA
  • Sun exposure
  • Estrogen (OCP
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22
Q

Clinical Manifestations of SLE

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A
  • Triad: Joint pain, fever, malaria rash
  • Fever, night sweats, fatigue
  • Oral ulcers, retinitis, alopecia, glomerulonephritis
23
Q

Diagnostics and antibodies for SLE

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A
  • ANA: screening (not specific)
  • Anti-double stranded DNA and Anti-Smith: specific for SLE
  • Depressed levels of serum complement (C3 and C4)
  • Antiphospholipid antibodies: increased risk of arterial and venous thrombosis
24
Q

Treatment for SLE

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A
  • Sunscreen and avoid sun exposure
  • Hydroxychloroquine for skin lesions
  • With or Without NSAIDs
  • For severe: high-dose glucocorticoids or intermittent IV pulses of Methylprednisone
25
what is the treatment for Torticollis
Conservative therapy
26
Torticollis can be congenital (_____) or acquired (____)
- Local trauma of soft tissues of neck during delivery | - Blunt trauma to head/neck, sleeping in awkward position, medications, infections, etc.
27
Transient Synovitis is the MC cause of acute hip pain in children aged 3-10 years old. What does it come after and what does it cause?
- Comes after recent URI, pharyngitis, bronchitis, or otitis media - Arthralgia, unilateral hip or groin pain
28
Treatment for traumatic soft tissue injury
RICE and NSAIDs
29
What are some etiologies of a vertebral compression fracture?
- Burst fractures occur in children jumping/fall from height | - Elderly, malignancy
30
Symptoms of vertebral compression fracture
-Localized back pain with focal midline tenderness at level of fracture
31
An xray for a vertebral compression fracture shoes
-Loss of vertebral height ( <20%)
32
When a patient has an open wound on the hand, what should you do?
- Thoroughly irrigate, check for bite wounds - ABX if bite wound - May leave open depending on location and risk of infection - Tetanus booster!
33
What organism is the most notable in all age groups for septic arthritis?
Staph Aureus
34
What other organism is prevalent in sexually active young adults for septic arthritis?
Neisseria Gonorrhea
35
Symptoms of septic arthritis
- Swollen warm, tender, painful joint with decreased ROM | - Fever, chills, myalgias, malaise
36
Best initial and most accurate test for septic arthritis
-Arthrocentesis: WBC > 50,000 (primarily neutrophils)
37
Treatment for Septic arthritis
- No organism seen (Empiric): Ceftriaxone + Vanco - Gram Positive Cocci: Vanco - Gram Negative Cocci/Gonorrhea: Ceftriaxone
38
Risk Factors for Developmental Dysplasia of the Hip
Breech presentation at delivery, first-born children, females, positive family history
39
Describe what Ortolani and Barlow Maneuvers do
Ortolani: reduces the hip joint Barlow: dislocates the hip joint
40
Treatment for Developmental Hip Dysplasia of the Hip
< 6 months: Pavlik Harness 6 months - 2 years: closed reduction in OR Routine hip radiographs until skeletally mature
41
Posterior hip dislocations are the MC Type of dislocation. What is seen on exam of a hip that is posteriorly dislocated?
Hip pain with leg shortened, internally rotated, and adducted
42
Treatment for posterior hip dislocation
Closed reduction under conscious sedation
43
Symptoms of osgood-Schlatter Disease
-Activity related anterior knee pain and swelling (swelling and tenderness to anterior tibial tubercle)
44
Risk Factors for Osgood-Schlatter Disease
- Males - 10-15 years old - During growth spurts - Athletes
45
What ligament is most commonly injured in a lateral ankle sprain?
ATFL (main stabilizer during inversion)
46
In a medial ankle sprain, what ligament is usually injured?
Deltoid ligament
47
Regarding the Ottawa Ankle Rules, when should you get ankle films?
- Inability to walk > 4 steps at time of injury in the ER - Pain along lateral malleolus - Pain along medial malleolus
48
According the Ottawa Ankle Rules, when should you get foot films?
- Inability to walk > 4 steps at time of injury in the ER - Navicular (mid foot) pain - 5th metatarsal pain
49
Symptoms and Risk factors for Achilles Tendon Rupture
- Sudden heel pain after push-off movement, pop, sudden sharp calf pain - Inability to bear weight - Positive Thompson Test - Weekend warrior athletes - Fluoroquinolone use, corticosteroid injections, 30-50 years old
50
Best test to assess for Achilles Tendon Rupture
MRI
51
Weber Ankle Fracture Classification
- Weber A: fibular fracture below syndesmosis - Weber B: fibular fracture at level of syndesmosis - Weber C: Fibular fracture above mortise (deltoid ligament damage)
52
Tarsal Tunnel Syndrome is compression of the ____ nerve
Posterior tibial nerve
53
Symptoms of Tarsal Tunnel Syndrome
- Pain and numbness in the medial malleolus, heel, and sole. - Pain increases throughout the day and does not improve with rest - Positive Tinel Sign (tap posterior medial malleolus)
54
What diagnostic confirms tarsal tunnel syndrome?
Electromyography

PANCE/EOC (63 decks)

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