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Baloney > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

1
Q

Salter-Harris Fracture Type I?

A

When the physis is widened, distorted or displaced by traction or shear force

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2
Q

Salter-Harris Fracture Type II?

A

Metaphysis is fractured

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3
Q

Salter-Harris Fracture Type III?

A

Epiphysis is fractured

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4
Q

Salter-Harris Fracture Type IV?

A

Both metaphysis and epiphysis are fractured

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5
Q

Salter-Harris Fracture Type V?

A

Physis is compressed or crushed by axial compression

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6
Q

Which of the following is a benign bone cancer that presents as a normal bone exostosis on the skull?

  • Osteoma
  • Osteosarcoma
  • Chrondrosarcoma
  • Ewing’s Sarcoma
A

Osteoma

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7
Q

Which of the following is a malignant bone cancer that presents with viscous liquid like pus in marrow and sheets of round cells?

  • Osteoid osteoma
  • Osteosarcoma
  • Chrondrosarcoma
  • Ewing’s Sarcoma
A

Ewing’s Sarcoma

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8
Q

Ewing’s Sarcoma typically affects the ____?

  • Young
  • Middle aged
  • Elderly
A

Young

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9
Q

What is Jefferson’s Fracture?

A
  • Fracture caused by heavy object falling directly on head or hitting head while diving
  • Consists of at east 2 fractures of C1
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10
Q

What is Hangman’s Fracture?

A
  • Bilateral pedicle fracture with anterior displacement of C2
  • Associated with MVA and hangings
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11
Q

What is Clay Shoveler’s fracture?

A

Fracture resulting from flexion injury in lower cervical spine in which spinous process is broken or fractured

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12
Q

Which of the following is a malignant bone cancer?

  • Osteoma
  • Osteoid osteoma
  • Osteosarcoma
A

Osteosarcoma

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13
Q

Is Ewing’s sarcoma a malignant or benign bone tumor?

A

Ewing’s sarcoma is extremely malignant

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14
Q

What is a Chance fracture?

A

Horizontal fracture of a vertebra

Usually occurs during a MVA where the seat belt immobilizes the pelvis and the upper body is thrust forward

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15
Q

Which condition is characterized by progressive erosion of articular cartilage with subchondral cysts and osteophytes?

A

Osteoarthritis

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16
Q

What is a Burst / Compression fracture?

A

Collapse or compression of vertebral body, usually caused by fall from a height

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17
Q

What is spondylolysis?

A

Defect in pars interarticularis
Appears as a collar on the Scottie Dog
Best seen on oblique view

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18
Q

What is the most common primary malignant bone tumor?

A

Chondrosarcoma

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19
Q

What is a Bucket Handle fracture?

A

Fracture through ischiopubic rami on one side and fracture of SI joint on the other side

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20
Q

Which of the following is a malignant tumor of cartilage that typically affects middle aged men and presents as a painful, enlarging mass in their pelvis, shoulders and/or ribs?

  • Osteoid osteoma
  • Osteosarcoma
  • Chrondrosarcoma
  • Ewing’s Sarcoma
A

Chrondrosarcoma

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21
Q

Where in the clavicular bone is a fracture most likely to occur?

A

In the middle third of the bone

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22
Q

What is a Malgaine fracture?

A

Fracture through the ischiopubic rami and SI joint on the same side

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23
Q

An acute, painful, swollen single joint accompanied by fever suggests what diagnosis?

A

Infectious arthritis

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24
Q

What is an avulsion fracture?

A

A small piece of bone is separated from the origin or insertion site of a tendon

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25
Q

What signs do you look for to assess a radial head fracture?

A

Anterior and posterior fat pad signs

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26
Q

What is a Monteggia Fracture-Dislocation (night-stick)? What is it usually caused by?

A

Monteggia Fracture-Dislocation is Fracture of Ulna and dislocation of Radial Head

Caused by receiving a blow when protecting oneself

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27
Q

What is a Galeazzi Fracture-Dislocation? What is it usually caused by?

A

Galeazzi Fracture-Dislocation is a Fracture of the Distal Radius and dislocation of the distal Radio-Ulnar joint.

Caused by FOOSH

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28
Q

How does pseudo-Gout present? How is it distinguished from Gout?

A

Pseudo gout presents with joint pain but there is no increase in uric acid

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29
Q

What is a Colle’s fracture? What is it usually caused by?

A

Colle’s fracture is a distal radial fracture posteriorly displaced

Caused by FOOSH when the hand is outward (palmar aspect flat down on floor)

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30
Q

What is a Smith’s fracture? What is it usually caused by?

A

Smith’s fracture is a distal radial fracture anteriorly displaced

Caused by FOOSH when the hand inward (dorsal aspect flat down on floor)

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31
Q

What carpal bone is most commonly fractured? Where is the pain felt by the patient?

A

Scaphoid bone is most commonly fractured

Pain is felt in the anatomic snuffbox

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32
Q

What condition are you concerned about if the patient has a scaphoid fracture?

A

Avascular necrosis

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33
Q

What are common risk factors for Gouty arthritis?

A

Alcohol and red meat

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34
Q

What is Gamekeeper’s thumb or Skier’s thumb?

A

Fracture of base of proximal phalanx of thumb

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35
Q

What is Bennett’s fracture?

A

Fracture through base of first (thumb) metacarpal

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36
Q

Patient presents with CC of pain in first MTP and pain in elbow, knee, foot or ear in addition to history of significant alcohol use. What diagnosis is most likely?

A

Gout

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37
Q

What is Boxer’s fracture?

A

Fracture of the 5th (pinkie) metacarpal

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38
Q

Where is a Subcapital fracture located?

A

Fracture under the head of the femur

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39
Q

What is Bar Room / Brawler’s Fracture?

A

Fracture of the 3rd metacarpal

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40
Q

What labs / imaging are ordered to assess for Gout?

A

Synovial fluid aspiration - - Needle shaped negatively bifringent crystals

CBC - Increased WBC

Serum uric acid - Increased

X-ray - Punched out erosions (Rat bite) in advanced Gout

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41
Q

How does ankylosing spondylitis present?

A

Low back pain worse with activity, worse in morning
Loss of lumbar lordosis, increase in thoracic kyphosis
Hip pain
Decreased chest expansion
Anterior uveitis
Heart block
Severe spinal immobility
Bony alkalosis of SI and vertebral processes

42
Q

Is low back pain in ankylosing spondylitis better or worse with activity?

A

Worse with activity

43
Q

Is low back pain in ankylosing spondylitis better or worse in morning?

A

Worse in morning

44
Q

What is a concerning complication of Subcapital fracture?

A

Avascular necrosis

45
Q

What is Pannus as related to Rheumatoid arthritis?

A

Pannus is inflamed synovial tissue seen when layer of vascular fibrous tissue extends over surface of an organ or other specialized anatomical structure

46
Q

Which of the following bone cancers is typically destructive with mixed lytic and blastic presentation?

  • Osteoid osteoma
  • Osteosarcoma
  • Chondrosarcoma
  • Ewing’s Sarcoma
A

Osteosarcoma

47
Q

What position is associated with a hip dislocation sustained from an MVA?

A

Hip is flexed in a sitting position and impact to knee displaces femoral head posteriorly

48
Q

What labs / imaging are ordered if anykylosing spondylitis is suspected?

A

HLA-B27
RF
ANA
X-ray - fused joints with Bamboo Spine appearance

49
Q

Infectious arthritis is typically caused by organisms such as?

A

Gonococcus
Staph, Strep
TB
Lyme

50
Q

Are hip dislocations usually anterior or posterior displacements?

A

Posterior displacement in 90% of cases

51
Q

Where are spiral fractures commonly found?

A

Femur
Tibia
Fibula

52
Q

A tibial plateau fracture is most commonly caused by an impact from the medial or lateral side of the tibia?

A

Impact from the lateral side of the tibia results in tibial plateau fracture

53
Q

Stress on which metatarsal bones causes a March fracture?

A

Stress on 2nd or 3rd metatarsal bones causes March fracture

54
Q

Base of which metatarsal is fractured on Jones fracture?

A

Base of 5th metatarsal is fracture in Jones fracture

55
Q

What population is at high risk for Jones fracture?

A

Athletes are at high risk for Jones fracture

56
Q

Name three indications for a bone scan (with normal Lumbar Spine X-ray)

A

Osteomyelitis
Bony neoplasm / metastases
Occult vertebral fracture

57
Q

What is a Baker’s cyst?

A

Outpouching of synovium behind knee

58
Q

How does a bone scan work?

A
  • Radiographic tracer compounds taken up by new bone (Technetium Tc 99m Phosphate, Gallium 67 Citrate)
  • Incorporated into hydroxyapatite crystals
  • Increased uptake indicates areas of high bone turnover
59
Q

What are the advantages of a bone scan?

A

Bone scan is sensitive for bony neoplasm (sensitivity of 85% in spinal metastases) and sensitive for infection

60
Q

Rheumatoid arthritis typically affects ____ between the ages of ____ - ____.

A

Females between the ages of 25 - 50 yo

61
Q

What are the disadvantages of a bone scan?

A

Bone scan suffers from poor specificity

False positives of Osteoarthritis in 33% of older patients

False negatives in diffuse bony metastases, multiple myeloma

62
Q

Name three bone scan protocols?

A

Technetium Tc 99m Phosphate
Gallium 67 Citrate
Single-Photon Emission Computed Tomography (SPECT)

63
Q

Which condition is characterized by ulnar deviation with MCP joint hypertrophy, Baker’s cyst, Swan-neck deformity and Boutonniere deformity?

A

Rheumatoid arthritis

Boutonniere deformity in finger with flexed PIP and extended DIP

64
Q

What are the characteristics of Felty’s Syndrome?

A

Rheumatoid arthritis
Neutropenia
Splenomegaly
Deformity

65
Q

What is the most accurate imaging in infectious spondylitis?

A

Bone scan using Gallium 67 citrate (95% accurate)

66
Q

What is SPECT?

A

Single-Positron Emission Computed Tomography - 3D bone scan imaging

67
Q

You run a SPECT and find lesions of vertebral pedicles. What does this mean?

A

Malignancy

68
Q

Which of the following bone cancers are usually secondary to Paget’s disease in the elderly population?

  • Osteoid osteoma
  • Osteosarcoma
  • Chrondrosarcoma
  • Ewing’s Sarcoma
A

Osteosarcoma is usually secondary to Paget’s disease in the elderly

69
Q

Your patient is concerned that her hip pain has not improved at all even with chronic steroid therapy. What is the main DDx?

A

Avascular necrosis of the hip

70
Q

What is the most common MSK disease in children?

A

Duchenne’s Muscular Dystrophy

71
Q

What is the inheritance pattern of Duchenne’s Muscular Dystrophy?

A

Sex linked in males

72
Q

What is the general pathophysiology in Duchenne’s Muscular Dystrophy?

A

Muscle is replaced by fat causing pseudo-hypertrophy of the calves

73
Q

What is the name of the sign that is positive in patient’s with Duchenne’s Muscular Dystrophy?

A

Gower’s sign. The patient has to use his hands and arms to walk up his own body due to lack of hip and thigh muscle strength

74
Q

What is the prognosis for a patient with Duchenne’s Muscular Dystrophy?

A

Death usually by 20 years of age

75
Q

An adolescent male presents with bone pain his knee, hip, humerus and jaw. Which bone cancer is he likely to have?

  • Osteoid osteoma
  • Osteosarcoma
  • Chrondrosarcoma
  • Ewing’s Sarcoma
A

Osteosarcoma

76
Q

What is the most common MSK disease in adults?

A

Myotonic dystrophy

77
Q

Myotonic dystrophy onset usually occurs when?

A

Adolescence

78
Q

What is the most common presenting feature in myotonic dystrophy?

A

Facial atrophy

79
Q

Osteosarcoma typically spreads ________ to the ____, _____, and _____.

A

Osteosarcoma usually spreads hematogenously to the lungs, bone and brain.

80
Q

What is a Brodie’s abscess?

A

A walled off area of bacteria

81
Q

What microorganism usually causes Osteomyelitis?

A

Staph

82
Q

How is Osteomyelitis spread?

A

Hematogenously

83
Q

Which of the following is the second most common primary malignant bone cancer?

  • Osteoid osteoma
  • Osteosarcoma
  • Chondrosarcoma
  • Ewing’s Sarcoma
A

Osteosarcoma

84
Q

Tubercular osteomyelitis usually occurs in the _____ and _____ spine?

  • Cervical
  • Thoracic
  • Lumbar
  • Sacral
A

Tubercular osteomyelitis usually occurs in the Thoracic and Lumbar spine

85
Q

Rheumatoid arthritis, deformity, splenomegaly and neutropenia are characteristics of _______ syndrome:

  • CREST
  • Felty’s
  • Schwanman-Diamond
  • Fanconi
A

Felty’s syndrome

86
Q

Primary osteoporosis is a reduction of bone mass / matrix and demineralization commonly found in women with _____.

A

Primary osteoporosis is commonly seen in women with menopause.

87
Q

What two diseases result in secondary osteoporosis?

A

Advanced hyperthyroidism

Hyper Parathyroid hormone disease

88
Q

Define osteomalacia

A

Bone demineralization

89
Q

What is the most common benign bone tumor?

A

Chondrosarcoma

90
Q

A patient who has multiple lesions with osteochondroma is at risk for ______.

A

Chondrosarcoma

91
Q

Osteochondroma appears as _________ with _________ covering.

A

Osteochondroma appears as exostoses with cartilaginous covering.

92
Q

What organism causes Paget’s disease / Osteitis deformans?

A

Paramyxovirus

93
Q

A patient with Paget’s disease/Osteitis deformans has _______ of ______ bones and _______ of _______ bones.

A

A patient with Paget’s disease has bowing of long bones and thickening of flat bones.

94
Q

Paget’s disease/Osteitis deformans usually occurs on the ________ with _______-like symptoms.

A

Paget’s disease/Osteitis deformans usually occurs on the skull with osteoarthritis like symptoms.

95
Q

Gardener’s syndrome is characterized by ______ and ______.

A

Gardener’s syndrome is characterized by intestinal polyps and sarcomas.

96
Q

Which of the following is a benign tumor of osteoblasts in vertebrae and long bones and typically occurs in young adults?

  • Osteoid osteoma
  • Osteosarcoma
  • Chrondrosarcoma
  • Ewing’s Sarcoma
A

Osteoid osteoma

97
Q

Rheumatoid arthritis typically presents _______ with pain in ____ or more joints.

A

Rheumatoid arthritis typically presents symmetrically with pain in 3 or more joints.

98
Q

Heberden’s and Bouchard’s nodes are characteristic of

  • Osteoarthritis
  • Osteosarcoma
  • Osteoporosis
  • Osteomyelitis
A

Osteoarthritis

99
Q

Heberden’s nodes occur at the _____ joint.

  • PIP
  • DIP
  • MCP
A

DIP

think HD

100
Q

Bouchard’s nodes occur at the _____ joint.

  • PIP
  • DIP
  • MCP
A

PIP

think BP

101
Q

_______ cysts typically occur in areas that were injured over the years.

  • Baker’s cysts
  • Ovarian cysts
  • Subchondral cysts
  • Ganglion cysts
A

Subchondral cysts typically occur in areas that were injured over the years.

Baloney (37 decks)

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