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musculoskeletal Flashcards

(59 cards)

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1
Q

Acute

A

defined as <6 weeks

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2
Q

Chronic

A

pain lasting > 6 weeks

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3
Q

Articular

A

internal/deep joint pain

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4
Q

nonarticular

A

soft tissue pain

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5
Q

Signs of Lupus

A

Fever with infection
fatigue
arthritis
Raynauds phenomenon
Butterfly rash over cheeks

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6
Q

Management of lupus

A

For mild symptoms
Bed rest
Midafternoon naps
Avoidance of fatigue
Sun protection
Topical glucocorticoid for isolated skin lesions
NSAIDS
Hydroxychloroquine—ANTIMALARIAL
Glucocorticoids

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7
Q

P in PRICE

A

Protect

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8
Q

R IN PRICE

A

Rest

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9
Q

I in PRICE

A

ICE

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10
Q

C in PRICE

A

Compression

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11
Q

E in PRICE

A

Eleveation

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12
Q

Empty can test

A

to test for rotator cuff tear
thumb up rotation down against resistance. You can write a positive empty can test indicating rotator cuff tendonitis if there is pain or unable to tolerate resistance

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13
Q

Red flags

A

radicular symptoms >4–6 weeks
increasing symptoms
Osteomyelitis
Cauda equina
herniation of disc
epidural abscess
fevers

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14
Q

Contraindications to joint injection

A

cellulitis or overlying skin ulceration
severe primary coagulopathy
anticoagulant therapy
previously replaced joint
purulent fluid aspiration

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15
Q

shoulder pain diagnosis

A

Trauma
Fracture of proximal humorous, greater tuberosity, clavicle, scapula
Rotator cuff strain, tear
Dislocation
Acromioclavicular separation
Sternoclavicular injury

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16
Q

shoulder pain diagnosis

A

Inflammatory Conditions
Bursitis
Rotator cuff tendonitis
Rheumatoid arthritis
Impingement syndrome

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17
Q

shoulder pain diagnosis

A

Degenerative conditions
Osteoarthritis

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18
Q

shoulder pain diagnosis

A

Miscellaneous
Chronic instability
Adhesive capsulitis—also called frozen shoulder

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19
Q

Plain film x-rays

A

7-10 days after suspected fx without initial evidence as “callus formation” will be evident

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20
Q

Ultrasound

A

soft tissue injury, r/o vascular source of swelling

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21
Q

CT/MRI

A

compression fractures
fractures not picked up in regular plain film
stress fracture

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22
Q

bone scan

A

anyone with a history of cancer think:
Metastasis, osteomyelitis, stress fractures.
Every 2 years

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23
Q

Arc sign

A

Inability to raise arm over head  Begins as gradual anterio-lateral pain with overhead reaching;
Inability to sleep on affected side  pain at night especially if trying to lay on affected side
Weakness or inability to externally rotate shoulder
Limited abduction, forward flexion of shoulder.
For rotator cuff injury

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24
Q

Positive sulcus sign

Study These Flashcards
A

space under acromion on shoulder dislocation. Always check distal pulses

25
positive apprehension test
26
adhesive capsulitis
frozen shoulder
27
Meniscus tear
preceded by trauma Severe knee pain Pain getting out of the car Knee feels like its giving out Positive mcmurray test
28
Meniscus tear assessment
Pain with twisting of the knee (getting in and out of car) Sense of locking or giving way More difficult going downstairs than going up Edema Tenderness over medial or lateral tibial joint line Positive McMurray test
29
corticosteroid shots frequency
no more often than 3 months
30
complications of MK injections
although rare can lead to transient hyperglycemia. The clinician must keep this in mind when treating diabetic patients and advise to monitor and treat accordingly. Blood increase levels can last up to 5 days.
31
Lachman test
to test for ACL injury Examiner grasps upper calf with the dominant hand, thumb over the anterior joint line. The other hand stabilizes the distal femur. Examiner pulls the tibia anteriorly in a sudden firm formation
32
Anterior cruciate ligament (ACL) injury
Pain and almost immediate edema following sudden deceleration, jumping Weight-bearing difficult because of sense of knee instability Effusion Hemarthrosis Pain or tenderness in posterolateral joint Positive anterior drawer test Positive Lachman test
33
Medial Collateral ligament injury (MCL)
Sudden Valgus stress on knee May report “pop” Medial knee pain Localized edema over 1-4 hours Tenderness over medial aspect
34
Lateral collateral tear
Direct blow to medial aspect of knee Similar to MCL but lateral Tenderness with palpation over lateral aspect Varying degree of joint laxity
35
Meniscus tear
positive mcmurray test
36
posterior cruciate ligament injury
Forces hyperextension of the knee Direct blow to anterior proximal knee while knee is flexed and foot planted Mild to moderate effusion Positive posterior drawer test Positive Godfrey’s test
37
valgus stress tests?
MCL
38
Varus stress test
LCL
39
Lachmen's and anterior drawer test
ACL
40
McMurrays
Meniscus tear
41
CARPLE TUNNEL SYNDROME
INFLAMMATION OF THE TUNNEL THAT CAUSES WITH NUMBNESS AND TINGLING OF THE HANDS
42
Phalen test
to test for carpal tunnel syndrom. If there is numbness and tingling it is positive
43
Tinel test
tapping of the nerve and its positive if there is numbness and tingling in the fingers
44
Osteoarthritis
wake up feeling well and will worsen as the day goes on.
45
Rheumatoid arthritis
is worse when they awake and improves throughout the day
46
cervical stenosis
Compression of cervical spine. Vertebrate is stenosed, decreases in height, and causes numbness in the hand. Radiculopathy to the hand.
47
4 signs of infection
Edema warmth redness pain
48
Gout
Initial uric acid is normal If it looks like gout, warm, and swollen join just treat Colchicine 0.6mg #3 (three) Sig: Take two now, then one in an hour Prednisone 20mg #10 (ten) Sig: Take two tabs daily for 5 days
49
how to diagnose fibromyalgia
diagnosis of exclusion everything else has been excluded
50
The greatest pain of gout
First Metatarsophalangeal (MTP) joint is most susceptible which is the medial aspect of the foot
51
pharmacological management of osteoporosis
calcium and vit-d, weight-bearing exercise and Fosamax Miacalcin – inhibits bone resorptive process Bisphosphonates - antiresorptive medicines, which means they slow or stop the natural process that dissolves bone tissue, resulting in maintained or increased bone density and strength SERM – Evista (Raloxifene) prevents and treats osteoporosis by mimicking the effects of estrogen to increase the density of bone.
52
tophi
non tender soft tissue from chronic gout
53
gout Acute Attack management
NSAIDS drug of choice Indomethacin most frequently used but others just as good COX2 inhibitor for those at high risk Gi bleed Colchicine effective Less frequently used 2/2 GI side effects Should be given within the first few hours of symptom onset Corticosteroids For those who cannot take NSAIDS Bed rest for 24 hours after acute attack
54
gout Chronic Management
Chronic Management Weight loss Decrease purines in diet Moderate alcohol use Increase fluids: maintain 2L urine output per day- Need lots of fluids to flush crystals out Colchicine may reduce number of acute attacks Pharmacological blockade of renal absorption of uric acid Allopurinol Probenecid Rarely requires hospital admission Consult rheumatology for recurrent gouty attacks
55
ACCESS leads to osteoporosis
Alcohol use Corticosteroid use Calcium low Estrogen low Smoking Sedentary lifestyle
56
sarcoidosis
Autoimmune, where the lungs are mostly affected. pt presents with sob, needs a lung X-ray and see all puffy areas, pulmonology needs to be consulted for biopsy
57
amyloidosis
is most common on people with kidney failure waiting on dialysis
58
scleroderma symptoms referred to as CREST
Calcinosis-calcium deposits in the skin Raynauds phenomenon- spasm of blood vessels in response to cold or stress Esophageal dysfunction--acid reflux and decrease motility Sclerodactyly- thickening and tightening of the skin on the fingers and hands Telangiectasias--dilation of capillaries causing red marks on thespian
59
lupus
rhemautologic work up--ANA + in 95% of patients Antiphospholipid antibodies Anti-ds/DNA Anti-sm CBC Anemia Leukopenia thrombocytopenia

Derm (2 decks)

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