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Flashcards in MSK rheum ortho Uworld Deck (108):
1

associated conditions with pyoderma gangrenosum

IBD
arthropathies
hematologic conditions

2

Tx pyoderma gangrenosum

local or systemic corticosteroids

3

Tx for non displaced scaphoid ractures

wrist immobilization for 6-10 weeks

4

rotator cuff tear

weakness with abduction and external rotation

5

young boy with single lytic lesion in humeral head
mild hypercalcemia

langerhans histiocytosis

6

solitary long bone lytic lesions

histiocytosis X or langerhans cell granulomatosis

7

Tx osgood schlatter

activity restriction, stretching and NSAIDs

8

young woman with fatigue weight loss, inflammatory arthritis and pericardial friction rub
also has edema and proteinuria

SLE

9

lab abnomralities in SLE

anemia, leukopenia, thrombocytopenia
+ANA and + dsDNA and +ant Sm
low C' and increased IC

10

peak incidence acute rheumatic fever

5-15

11

major criteria for acute rheumatic fever

JONES
joints-migratory arthritis
carditis
nodules- subcutnaeous
erythema marginatum
syndeham chorea

12

Tx for Acute rheumatic fever

penicillin to prevent
during strep pyogenes GAS infection

13

12 year old boy with low back pain and palpable step off

spondylolithesis

14

triad of gonococcemia

polyarthralgia, tenosynobitis and painless vesiculopistular lesions

15

purulent arthritis in sexually active individual

gonococcal arthritis until proven otherwise

16

common complaint of sjogrens patients

dyspareunia

17

Osteogenesis imperfecta

CT disorder
auto dominant
COL1A1

18

manifestations OI

blue sclerae, osteopenia, hearing loss, hypotonia, easy bruising
dentinogenesis imperfecta- weak enamel

19

fever and acute monoarticular arthritis
next step

synovial fluid analysis to rule out septic arthritis

20

when is it not necessary to treat metatarsus adductus

when the feet overcorrect both passively and actively into abduction

21

morton neuroma

pain between 3rd and 4th toes
clicking sensation when palpating this space and squeezing the metatarsal joints

22

tarsal tunnel syndrome

compression of tibial nerve at ankle causing burning, numbness and aching of distal plantar surface of foot/toes

23

violaceous slightly scaly papules over joints

gottrons papules- dermatomyositis

24

Ab with dermatomyositis

anti Jo 1 and ant Mi2- against helicase

25

high risk for what with dermatomyositis

internal malignancies
ovarian, lung, pancreatic, stomach and colorectal ca
non hodgkin lymphoma

26

acute monoarticular arthritis with chondrocalcinosis

pseudogout

27

if patient has pseudogout check for what else?

secondary cause
hyper PTH
hypothyroid
hemochromatosis

28

iron pannel in hemochromatosis

increased serum iron, ferritin and transferrin

29

Tx for herniated disk without neurologic Sx

early mobilization, muscle relaxants and NSAIDs

30

if have raynauds, order what

CBC with CMP
UA
ANA and RF
ESR and C' levels

31

most common cause viral arthritis

parvo b19

32

msot significant risk factor for developing osteoporosis in someone who exercises is overweight drinks plenty of milk and alcohol

excess alcohol intake

33

coagulation abrnoamlity in antiphospholipid syndrome

APTT prolongation not fixed by plasma mixing

34

Ab in antiphospholipid Ab syndrome

anticardiolipin
anti beta 2 glycoprotein I

35

next step if patient presents with sciatica

back XR and ESR

36

how to prevent gout

weight loss
low fat diet
decreased seafood and red meat
protein from vegetables
avoidance organ rich foods like liver
avoid beer
avoid diuretics

37

Ab in systemic sclerosis

anti topoisomerase I

38

sequelae of systemic sclerosis

HTN
R heart failure from pulm arterial HTN
esophageal and gastric dymotility

39

anti mitochondrial Ab

Primary biliary cirrhosis

40

supracondylar fracture of humerus at risk for

injury to brachial artery

41

causes of acquired torticolis

URI, minor trauma and cervical lymphadenitits

42

Dx for torticollis

XR of cervical spine

43

adverse effect hydroxychloroquine

retinopathy

44

adverse effects of MTX

hepatotoxicity
stomatitis
cytopenias

45

side effects sulfasalazine

hepatotoxicity
stomatitis
hemolytic anemia

46

complications of kawasaki

coronary artery aneurysms
MI and ischemia

47

labs in pagets disease of bone

elevate alk phos
normal Ca and phosphorus

48

most common cause of asymptomatic elevation of alk phosphatase in elderly patient

pagets disease of bone

49

common heart finding in ankylosing spondylitlis

aortic regurg

50

what happens in systemic sclerosis that causes esophgeal dysmotility

smooth muscle atrophy and fibrosis

51

Tx pagets disease of bone

alendronate

52

what cause pagets

osteoclastic bone resorption

53

how do bisphosphonates work

inhibit osteoclast

54

which part of axial skeleton does RA affect

cervical spine

55

pain of hip OA is where

groin, buttock or pelvis that can radiate to lower thigh or knee

56

common XR findings in OA

loss of joint space, osteophytes and subchondral sclerosis

57

long term glucocorticoids can cause hip pain how

osteonecrosis of hip

58

bouchard and heberden nodules

OA

59

caucasian female with long Hx polyarthritis with fatigue, low grade fever, weakness weight loss
MTX, naproxen, ranitidine
deformed hand joints, soft tender mass in right popliteal fossa
mass is what?

inflamed synovium
patient has RA

60

Dx patellofemoral syndrome

patellofemoral compression test

61

pain inferior to patellar

patellar tendonitis

62

tenderness to gentle percussion over spine in IV drug user

vertebral osteomyelitis

63

rachitic rosary

enlarged costochondral joints
rickets

64

Tx for raynauds

CCB

65

triggers for gout

heavy alcohol consumption
intake of urate rich foods
trauma/surgery
dehydration
medications that raise uric acid like thiazide and cyclosporine

66

what is reactive arthritis

from chlamydia

67

Tx reactive arthritis

NSAIDs

68

most important risk factor for osteoporosis

post menopausal state
then
smoking, lack weight bearing
low BMI
heavy alcohol
low Ca and Vit D
corticosteroid use

69

recommended screening for osteoporosis

DEXA for all women >65

70

whipple disease presentation

malabsorptive diarrhea, protein losing enteropaty
weight loss
migratory arthritis
lymphadenopathy and low grade fever

71

What causes whipples

gram + bacillus tropheryma whippelii

72

Dx whipples

small intestine Bx and PCR

73

Bx findings in whipples

PAS+ macrophages in lamina propria with non acid fast gram + bacilli

74

giant cell arteritis Sx

HA, jaw claudication, muscle fatigue, visual disturbance

75

what is a complication of giant cell arteritis

aortic aneurysm-- do serial CXR

76

hypodense lesion on XR in long bone in adolescent

osteoid osteoma

77

meniscal calcification occurs with what joint problem

pseudogout from more calcium pyrophosphate

78

abnormal hip maneuvers in child under 6 months old

hip US

79

abnomral hip maneuvers in child more than 6 mo old

hip XR

80

Tx RA

DMARD ASAP like MTX

81

before starting MTX check for

Hep B C and TB

82

exam findings in ankylosing spondylitis

arthritis
reduced chest expansion and spinal mobility
enthesitis (tenderness at tendon insertion sites)
dactylitis (swelling fingers and toes)
uveitis

83

viral arthritis

symmetric small joint inflammtory arthrits

84

complication ankylosing spondylitis

anterior uveitis

85

Tx radial head subluxation

hyperpronation
or supination with flexion at elbow

86

distal femur has centraly lytic lesion with onion skinning and moth eaten appearance with extension into soft tissue

ewings

87

amyloidosis can be secondary to

inflammatory arthritis
chronic infections
IBD
malignancy
vasculitis

88

Tx for amyloidosis

cochicine

89

nephrotic syndrome, hepatomegaly
ventricular hypertrophy and recurrent pulmonary infections

secondary amyloidosis

90

what antibiotics cause serum sickness like reaction

antibiotics (beta lactams sulfa)

91

clinical features serum sickness-like reactoin

fever, urticaria and polyarthralgia
HA edema, lymphadenopathy and splenomegaly

92

complication of RA in women

generalized bone loss and osteoporosis/osteopenia

93

what is dactylitis

sausage digit
psoriasis

94

pulmonary involvement in systemic sclerosis

interstitial lung disease- pulm fibrosis

95

next step after identifying hip fracture in elderly patient

EKG, cardiac markers and CXR

96

antimetabolit drug in RA

MTX

97

prolonged morning stiffness

RA

98

macrocytic anemia from drug, which one

MTX because interferes with folic acid

99

flexion helping with back pain

spinal stenosis

100

imaging if suspect ankylosing spondylitis

XR SI joint

101

clinical findings in behcet

recurrent painful oral apthous ulcers
genital ulvers
eye lesions
skin lesions
thrombosis

102

biopsy of behcet

nonspecific vasculitis of different sized vessels

103

ethnicities with behcets

turkish, middle eastern, asian

104

most common cause erythema nodosum

recent strep infection

105

causes of erythema nodosum

sarcoid, TB, histo, IBD

106

causes of gout

primary
myeloproliferative/lymphoproliferative
tymor lysis syndrome
leschnyhan

chronic kidney disease
thiazide/loop

107

pruritis after hot bath

polycythemia vera

108

neurogenic claudication

pain of spinal stenosis
worsens the narrowing of the canal when standing and walking