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Casey: Panre > Musculoskeletal > Flashcards

Flashcards in Musculoskeletal Deck (75):
1

At what age should you begin ordering DEXA scans for male pts? For female patients?

70 for males, 65 for females

2

Give the DEXA score for osteopenia and osteoporosis

Penia 1-2.4 standard deviations
Porosis 2.5 SD or greater

3

#1 cause of compartment syndrome

Tibial shaft fracture

4

Pt's lab work shows positive Smith antibodies and positive double-stranded DNA antibodies. What is most likely dx?

Lupus

5

Where are Bouchard's nodes found?

Proximal interphalangeal joint (PIP)--RA

6

What will an X-ray show in acute osteomyelitis?

Nothing. It will show bone destruction in chronic osteomyelitis.

7

What is the best imaging to dx osteomyelitis?

Either a bone scan or MRI

8

22yo male pt presents with what is clearly a septic knee. You also notice lesions on his hands & feet. What is the most likely pathogen?

Neisseria gonorrhoeae

9

What would you expect the WBC count to be in the joint fluid of an infected knee?

>50,000 at a minimum and probably much higher

10

A pt presents with a painless mass in her right wrist. What is the most likely dx?

Ganglion cyst

11

What is the age range for osteosarcoma ? Where are they most typically found in the body?

Usu occur in 15-25yo males
Most commonly found in knee

12

You think a pt may have an osteoid due to his complaints of severe night pain. You set him up for an X-ray; but in the meantime what med do you start him on?

Ibuprofen will resolve his pain if it is truly an osteoid osteoma.

13

Clicking or locking of the knee indicates what dx

Meniscal tear

14

A 65 yo presents c/o severe pain in his great toe that began when he woke up this morning. It is swollen, red and very tender. What is the most likely dx?

Gout would be number one because of the location, but you might also think about an infection.

15

What Uric acid level helps to confirm a diagnosis of gout?

>7.5

16

What is the medical tx for gout?

Allopurinol
Colchicine

17

A path report comes back w/ positive birefringent crystals. What is the most likely dx?

Pseudogout

18

Pt w/ a hx of hep B presents c/o bilateral knee pain, fever & wt loss. What is most likely dx?

Polyarteritis nodosa

19

You suspect a pt has polyarteritis nodosa. What is the test for a definitive dx and what is the tx?

Biopsy
High dose steroids

20

On PE you notice ulnar deviations and swan neck deformities. What is the most likely dx?

Rheumatoid arthritis

21

A positive Neer's test indicates what dx

Rotator cuff impingement

22

3 meds that may cause lupus

Procainamide
Isoniazid
Quinidine

23

What test do you do for Sjögren's syndrome

Schrimer test

24

A pt w/ RA is heading to the OR for open reduction & internal fixation of the ankle. In addition to ankle films, what other X-rays should you get?

C-spine: anesthesia will want them due to concerns about instability of C1&C2.

25

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

Scaphoid

26

What medication is used for patients with systemic lupus?

Systemic steroids

27

Scleroderma limited version has five main characteristics for which the CREST acronym is used. What are they?

Calcinosis
Raynaud's
Esophageal dysmotility
Sclerodactyly
Telangiectasis

28

There is a sunburst appearance on X-ray. What is most likely dx?

Osteosarcoma

29

Anatomically where are 80% of clavicle fractures located?

Middle third

30

A path report comes back showing negatively birefringent crystals. What is most likely dx?

Gout

31

What are the 4 muscles of the rotator cuff?

Supraspinatus
Infraspinatus
Teres minor
Subscapularis

32

Describe the characteristics of a lytic lesion on X-ray

Spiculated
Elevated periosteum
Bone destruction (think bad, very bad things)

33

What ligament is most commonly injured in an ankle sprain

Anterior talofibular ligament (ATFL)

34

Vasculitis w/ a hx of hep B should make you think of what dx

Polyarteritis nodosa

35

What is the most common fx in children

Clavicle

36

A fat pad sign on a lateral X-ray of the elbow has what sig?

It is blood in the joint indicating a fx even if the fx line cannot be seen

37

A pt presents w/ progressive neck and proximal muscle weakness. On PE, you see a reddish purple maculopapular rash. Her lab work shows anti-Jo-1 antibodies. What is the most likely dx?

Polymyositis

38

Which way does a Cooles fx angulate dorsal or volar? What about a Smith fx?

Colles= dorsal
Smith= volar

39

Tenderness over the anatomical snuffbox is indicative of what fx?

Scaphoid

40

What is the most common fx in a pt w/ osteoporosis?

A compression fx of a vertebral body followed by hip fx.

41

A 15yo boy presents c/o night pain in the pelvis. Since you have no idea what to do, you order an X-ray. The report comes back with a description of a mass with an "onion skin appearance." What is the most likely dx?

Ewing sarcoma

42

What is the name for the 4th and 5th metacarpal fxs that often result from throwing a punch?

Boxer's fx

43

A new mom presents with pain over the radial wrist. She has a positive Finklestein's test. What is the most likely dx?

de Quervain's tenosynovitis

44

A positive McMurry indicates what dx?

Meniscal tear

45

First line tx for carpal tunnel

Night splint

46

Most common cause of C-spine fractures

MVA

47

Medical term for hunchback

Kyphosis

48

Another term for podagra

Gout

49

A pt presents to ED with saddle anesthesia and loss of bowel & bladder fxn. What is most likely dx?

Cauda equina

50

A pt with HIV presents with severe groin pain. What is the most likely dx?

AVN
Antiretroviral meds put pts at an increased risk of AVN

51

A 95y female presents to the ED after a fall in her home. Her left leg is shortened and externally rotated. What is the most likely dx?

Hip fx

52

You recommend biphosphonates for a pt c osteoporosis. What instruction do you give her for immediately after taking the med?

Remain upright for :30

53

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

MVA, posterior

54

Which of the 4 rotator cuff muscles is most commonly injured?

Supraspinatus

55

What is the medical term for tennis elbow?

Lateral epicondylitis

56

What is the first line tx for rheumatoid arthritis?

Methotrexate

57

A pt 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 dx?

Patella fx

58

Are most shoulder dislocations anterior or posterior?

Anterior

59

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

Lachman's, followed by anterior drawer

60

What is the most common knee injury?

Medial meniscal tear

61

Where are Heberden's nodes found?

DIP

62

A pt presents with knee pain following a soccer game 2 days ago. He has joint Line tenderness medially and feels a locking in the knee from time to time. What 2 PE tests should you do?

Probably a medial meniscal tear. Mcmurry & apply tests would be appropriate.

63

A pt presents with conjunctivitis, urethritis, arthritis and oral lesions. What is the most likely dx? What other lab might you expect to be positive?

Reactive arthritis
HLA B-27

64

A 46 yo male comes into the ED limping a little on the right side. He states that it felt 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 dx?

Achilles' tendon rupture

65

Anti-Jo antibodies should make you think of what dx?

Polymyositis

66

A positive crossover test indicates what dx?

Acromioclavicular joint injury (AC joint)

67

A positive Hawkins test indicates what dx?

Rotator cuff impingement

68

A positive Finklestein's test indicates what dx?

de Quervain's tenosynovitis

69

A positive Phalen and Tinel's sign indicates what dx?

Carpal tunnel

70

A bamboo spine indicates what dx?

Ankylosing spondylitis

71

A positive straight leg test indicates what dx?

Herniated disc

72

An African American female presents with malar rash and a positive double-stranded DNA antibody. What is the most likely dx?

Lupus

73

Carpal tunnel affects what nerve and what parts of the hand?

Median nerve. Thumb, pointer and ring fingers. Thenar wasting is sign of advanced disease.

74

A pt has a silver fork deformity on X-ray. What is the most likely dx?

Colles fx

75

A positive Apley indicates what dx

Meniscal tear