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Flashcards in Musculoskeletal Deck (46)
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1

Injury to shoulder, holds arm in abducted, ext rotated: dx, tx, nerve injry

anterior dislocation, risk axillary nerve injury, reduction with sling

2

Post vs ant hip dislocation: nerve injury, tx

Ant: obturator
Post: sciatic nerve, AVN
Tx: closed reduction + abduction pillow
CT after reduction

3

Fall on outstretched hand leads to dorsally placed, dorsally angled fracture: dx, tx

Dx: colles fracture (distal radius
Tx: closed reduction + long arm cast (open if intra-articular fx)

4

Tenderness in anatomical snuff box: dx and tx

Scaphoid fracture
thumb spica cast; if displacement open reduction

5

Injury assoc with humerus fx

radial nerve palsy: wrist drop, loss of thumb extension

6

Tx of ulnar fx

ORIF if significantly displaced

7

Diaphyseal fx of proximal ulna with subluxation ulnar head: type and tx

monteggia's fx
ORIF of shaft, closed reduction radial head

8

Galeazzi fx: diaphyseal fx of radius with dislocation distal radial-ulnar joint: cause and tx

direct blow to radius
ORIF of radius, casting with supination

9

Tx + complication of femoral fx

Fat emboli
intramedullary nailing, irrigate and debride if open

10

Common complication of tibila fx

compartment syndrome

11

limited plantar flexion and + Thompson test (pressure on gastrocnem absent foot plantar flexion): dx and tx

achilles tendon rupture
surgical + long leg cast for 6 weeks

12

herniate disc: common affected regions, tx

L5-S1
NSAID, PT, local heat, continue normal activity

13

neck pain, back pains that radiates to buttocks and legs, leg numbness/ weakness; leg cramping worsens with standing, improves with felxion at hips/ bending forward: dx and tx

spinal stenosis
NSAIDS/abd muscle strength
epidural corticosteroids (severe)
Laminectomy (refract)

14

"onion-skin" on diaphyseal region of femur

ewing sarcoma

15

soap bubble, on epiphyseal region long bones

giant cell tumor

16

progressive pain, worsen at night, sumburst pattern on xr: dx and common regions

osteosarcoma
distal femur, proximal tibia, proximal humerus

17

Empiric tx of septic arthritis

cetriaxone and vancomycin

18

anti-CCP antibodies

Rheumatoid arthritis

19

Joints affected: OA vs RA

OA: DIP (heberden) /PIP (Bouchard) / hips/ knees
RA: wrist, MCP, ankle, knee, shoulder, hip, elbo

20

Rhomboid vs needle shaped crystals: joint pain

Rhomboid: psudogout, + birefring (calcium pyrophosphate)
Needle: gout, neg biref

21

Acute and long term tx of gout

acute: NSAID > cochicine; steroids
Maintenance: allopurinol (overproducers); probenicid (undersecretors); weight loss + avoid ETOH

22

Back pain with Decr spine flexion, loss lumbar lordosis, worse with morning: dx and other risks

Ankylosing spondylitis; HLA B27
anterior uveitis and heart block

23

arthritis, uveitis, conjunctivits, urethritis in young man: dx and cause

reactive/ reiter arthritis
infx with campy, shigella, slamonella, chlamydia, ureaplasma

24

sausage-shaped digits, DIP joint: dx

psoriatic arthritis

25

asymmetric sacroilitis: dx and common assoc disease

enteropathic spondylitis, IBD

26

Symmetric proximal muscle weakness, heliotrope rash: dx and tx

polymyoisits/ dermatomyositis
high dose corticosteroids 4-6 wks
azathioprine/ MTX

27

Anticentromere Ab

CREST syndrome

28

Antihistone Ab

Drug-induced SLE

29

Antimitochondrial Ab

PBC

30

Anti-smooth muscle B

Autoimmune hepatitis

31

cANCA vs pANCA

cANCA: Wegener
pANCA: microscopic polyangitis

32

U1RNP ab

mixed connective tissue disease

33

RA, splenomegaly, neutropenia

Felty's syndrome

34

RA tx

NSAIDs
Disease modifying (1st line): MTX, hydroxychloroquine, sulfasalzine

35

symmetric thickening of skin of face or distal extr, pulm fibrosis: dx and tx

scleroderma
Corticosteroids (acute)
Penicillamine (skin)
Ca Ch block (Raynaud's)
ACEI (renal)

36

noninfectious vegetations on mitral valve: dx and assoc dis

Libman-sacks endocarditis; SLE and APLAS

37

pain accompanied by loss of function and autonomic dysfunction after trauma: dx and tx

Complex regional pain syndrome
NSAIDS, corticosteroids, low-dose TCAs, gabapent
Chemical sympathetic block

38

Fibromylagia vs polymyalgia rheumatica: joints involved and tx

Fibromylagia: various joints (>11 of 18, all 4 regions body); NSAIDs, Antidepr, rest, PT
Polymyalgia rheumatica: shoulder + pelvic girdle; low-dose prednisone

39

Muscle Bx: necrotic muscle fibers, variation in fiber size with fibrosis: Dx and tx

Neg dystrophin
Duchenne
PT, use of tendon release to maintain mobility

40

Cause of death: DMD

pulm congestion caused by high output cardiac failure

41

Refusal to bend elbow after being lifted by arm: dx and tx

nursemaid elbow (radial head subluxation)
manual reduction by gentle supination of elbow at 90deg fexion; no immobilization

42

Supracondylar humerus fx: risk + tx

brachial artery entrapment, Volkmann contracture (compartment syndr)
cast immobilization

43

hip dysplasia: tx by age

44

Limited abduction and internal rotation, painless limp or groin pain: dx and tx

legg-calve-perthes
AVN femoral head
observation if nl ROM. pracing

45

pediatric acute groin or knee pain, painful , inability to bare weight, limited internal rotation and abduction: dx and tx

AP and frog leg laterals, TSH
Slipped capital femoral epiphysis
percutaneous single-screw fixaiton, no weight bearing until surgery

46

Arthritis, high-spiking fevers, maculopapular, evanescent salmon-colored rash (pediatric)

Still's disease