Musculolskeletal

Question 1

At what age should you begin ordering dexa scans on male patients? female patients ?

Answer 1

70 males, 65 females

Question 2

Give the Dexa score for osteopenia and osteoporosis?

Answer 2

1-2.4 SD - osteopenia

>= 2.4 SD for osteoporosis

Question 3

What fracture is the #1 cause of compartment syndrome?

Answer 3

tibia shaft fracture

Question 4

A patient’s lab work shows + Smith antibody and + double stranded DNA antibiotidies. What is the most likely diagnosis>

Answer 4

Lupus

Question 5

Where are Bouchard’s nodes found?

Answer 5

PIP

Question 6

What will an Xray show in acute osteomyelitis?

Answer 6

Nothing - it will show destruction in chronic osetomyelitis

Question 7

What is the best imaging to diagnosis osteomyelitis?

Answer 7

Bone scan or MRI

Question 8

A 22 yo male patient present with what is clearly a septic knee. You also notice lesions on his hands and feet - what is the most likely causative agent?

Answer 8

Neiserria gonorrhea

Question 9

What would you expect the WBC count to be in a septic knee?

Answer 9

> 50,000 at minimum - maybe higher

Question 10

A patient present with a painless mass in her right wrist - what is the most likely diagnosis?

Answer 10

ganglion

Question 11

What is the age range for osteosarcoma?? where ar they typically found in the body?

Answer 11

15-25 you males

most are found around the knee

Question 12

You think a patient may have an osteoid osteoma due to his complaints of severe night pain. =You set I’m up for and Xray but in the meantime what medication do you start him on?

Answer 12

IBU. (if it is truly an osteoid sarcoma)

Question 13

Clicking or licking of the knee indicates what diagnose

Answer 13

Meniscal tear

Question 14

A 65 yo presents complaining of severe pain in the great toe that began when he woke up this am. It is swollen red and very tender. What is the most likely diagnosis?

Answer 14

Gout most likely due to locations - may also be infection.

Question 15

What uric acid level helps to confirm diagnosis of gout?

Answer 15

> 7.5

Question 16

What is the medical treatment for gout?

Answer 16

Allopurinol, colchicine

Question 17

Apathology report comes back whit + birefringent crystals. What is the most leaky diagnosis?

Answer 17

Pseudogout

Question 18

A patine tiwh a history of hepatitis B present complaining of bilateral knee pain., fever and weight loss. what is the most likely diagnosis?

Answer 18

Polyarteririts nodosa

Question 19

You suspect a patient has polyarteritis nodes. What is the test for a definitive diagnosis and what is the treatment?

Answer 19

Biopsy and high dose steriods

Question 20

On physical exam, you notice ulnar deviations and swan neck deformities. what is the most likely diagnosis?

Answer 20

Rheumatoid arthritis

Question 21

A positive Need sign indicates…

Answer 21

a rotator cuff inpingment.

Question 22

List 3 medications that may cause lupus

Answer 22

Procainaminde
INH(isoniazid)
Quinidine

Question 23

What test do you do for Sjorgen’s syndrome?

Answer 23

Schirmer test

Question 24

A patient with rheumatoid arthritis is heading to the OR for and open reduction and internal fixation of the ankle. In addition to ankle films - what other X-rays should be obtained

Answer 24

C-spine - for anesthesia - to concerns about instability at C1 and C2

Question 25

Which carpal bone has a high rate of nonunion and occult fracture?

Answer 25

scaphoid

Question 26

what medication is used for patients with lupus?

Answer 26

systemic steroids?

Question 27

Scleroderma limited version has 5 main characteristics for which the CREST acronym is often used. what are this 5 things?

Answer 27

``` Calcinosis Raynauds esophagal dysmotility Sclerodactyly Telengectasia ```

Question 28

There is a sunburst appearance on Xray. What is the most likely diagnosis?

Answer 28

Osteosarcoma

Question 29

Anatomically - where are 80% of clavicle fractures located?

Answer 29

middle third.

Question 30

A pathology report come back showing negatively birefringent crystals. What is the most likely diagnosis

Answer 30

Gout

Question 31

What are the 4 muscles of the rotator cuff?

Answer 31

Supraspinatus Infraspinatus Teres Minor Subscapularis

Question 32

Describe the characteristics of a lytic lesion on Xray

Answer 32

Spiculated, elevated periosteum, bone destruction (bad bad things)

Question 33

What ligament is the most commonly injured in and ankle sprain?

Answer 33

Anterior talolfibular ligament (AFTL)

Question 34

Vasculaitis with a hepatitis B history should make you think of what diagnosis?

Answer 34

Polyarteritis nodosa

Question 35

What is the most common fracture in children?

Answer 35

Clavicle

Question 36

A fat pad sign on a lateral Xray of the elbow has what significance?

Answer 36

It is blood in the joint indicating a fracture even if the fracture line cannot be easily seen.

Question 37

A patient present with progressive neck and proximal muscle weakness. On physical exam you see a reddish purple maculopapaular rash. He labs work shows an anti-Jo-1 antibody. What is the most likely diagnosis?

Answer 37

Polymyositis

Question 38

Which way does a Colles fracture angulate - dorsal or volar? what a bout a smith fracture?

Answer 38

``` Colles = Dorsal angulation Smith = volar angulation ```

Question 39

Tenderness over the anatomic snuffbox is indicative of what type of fracture?

Answer 39

Scaphoid

Question 40

What is the most common fracture in a patient with osteoporosis?

Answer 40

A compression fracture of a vertebral body | then a hip fracture

Question 41

A 15 yo boy presents complaining of night pain in the pelvis. Since you have no idea what to do, you order awn Xray. The report comes back with a description of a mass with an onion skin apprearance" what is the most likely diagnosis

Answer 41

Ewing Sarcoma

Question 42

What is the name for the 4th and 5th metacarpal fractures resulting from throwing a punch?

Answer 42

Boxer's fracture

Question 43

A new mother presents with pain over the radial wrist. She has a + fincklestein's test; What is the most likely diagnosis?

Answer 43

deQuervains tenosyovitis

Question 44

A + McMurray indicates what diagnosis?

Answer 44

meniscal tear

Question 45

What is the first line treatment for carpal tunnel?

Answer 45

wrist night splints

Question 46

What is the most common cause of C-spine fractures?

Answer 46

MVC accidents

Question 47

What is the medical term for "hunchback"

Answer 47

kyphosis

Question 48

What is another tern for podagra?

Answer 48

Gout

Question 49

A patient presents to the ED with saddle anesthesia and lowss of bowel and bladder function. What is th e most likely diagnosis?

Answer 49

Cauda Equina syndrome

Question 50

A patient with HIV present with severe groin pain. What is the most likely dignosis?

Answer 50

AVN of the femoral head. Antiretroviral meds put patients at an increase risk of AVN.

Question 51

A 95 yo female presents to the ER after a fall in her home. Her left leg is shortened and eternally rotated. What is the most likely diagnosis?

Answer 51

Hip fracture

Question 52

You recommend bisphosonates for a patient with osteoporosis. What instruction do you give her for immediately after taking the medication?

Answer 52

Remain upright for 30 minutes

Question 53

What is the most common cause of a hip dislocation? is it usually anterior or posterior?

Answer 53

MVC, posterior

Question 54

Which rotator cuff muscle is the most commonly injured?

Answer 54

supraspinatus?

Question 55

What is the first line treatment of Rheumatoid arthritis?

Answer 55

methotrexate

Question 56

A patient presents to the ED after taking a baseball bat to the knee. He is unable to actively extend his knee. What is the most likely diagnosis?

Answer 56

patella fracture.

Question 57

Are most shoulder dislocations anterior or posterior?

Answer 57

anterior

Question 58

What is the most useful physical exam test for diagnosing and ACL tear?

Answer 58

Lachman's followed by anterior drawer

Question 59

What is the most common knee injury?

Answer 59

meniscal tear

Question 60

Where are HErbendens nodes found>

Answer 60

DIP

Question 61

A patient presents withe knee pain following a soccer game 2 days ago. HE has joint line tenderness medially and feels a locking sensation in the knee from time to time. What 2 physical exam tests should you do?

Answer 61

McMurray and Apply tests are appropriate

Question 62

A patient presents with conjunctivitis, urethritis and oral lesions. Wha tis the most likely diagnosis?What test might you expect to be positive?

Answer 62

reactive arthritis | HLA - B27`

Question 63

a 46 yo make comes into the ED limping a little on the right. he states that it feels as though he was kicked in the back of the leg during a soccer game but clearly no-one was behind him. What is the most likely diagnosis?

Answer 63

achilles tendon rupture.

Question 64

Anti-Jo1 antibodies should make you think of what diagnosis?

Answer 64

Polymyositis

Question 65

A positive crossover test indicates what diagnosis

Answer 65

AC joint injury

Question 66

A positive Hawkins indicates what diagnosis?>

Answer 66

Rotator cuff impingement

Question 67

A bamboo spine indicates what diagnosis?

Answer 67

Anklyloising spondylitis

Question 68

a postive SLR test indicates what diagnosis?

Answer 68

lumbar disc herniation

Question 69

An African American female present with malaria rash and positive double stranded DNA antibiotdy. What is the most likely diagnosis?

Answer 69

Lupus

Question 70

Caral tunnel effects that nerve and what parts of the hand?

Answer 70

thumb, pointer and ring. Thenar wasting is a sign of advanced disease

Question 71

A patient has a silver fork deformity on Xray - what is the most likely diagnosis?

Answer 71

colles fracture

Question 72

A postive Apley test indicates what diagnosis?

Answer 72

meniscal tear.

Question 73

What is the most commonly herniated disc?

Answer 73

L4-5 followed by L5-S1