Flashcards in Musculoskeletal Deck (75):
At what age should you begin ordering DEXA scans for male pts? For female patients?
70 for males, 65 for females
Give the DEXA score for osteopenia and osteoporosis
Penia 1-2.4 standard deviations
Porosis 2.5 SD or greater
#1 cause of compartment syndrome
Tibial shaft fracture
Pt's lab work shows positive Smith antibodies and positive double-stranded DNA antibodies. What is most likely dx?
Where are Bouchard's nodes found?
Proximal interphalangeal joint (PIP)--RA
What will an X-ray show in acute osteomyelitis?
Nothing. It will show bone destruction in chronic osteomyelitis.
What is the best imaging to dx osteomyelitis?
Either a bone scan or MRI
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?
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
A pt presents with a painless mass in her right wrist. What is the most likely dx?
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
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.
Clicking or locking of the knee indicates what dx
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.
What Uric acid level helps to confirm a diagnosis of gout?
What is the medical tx for gout?
A path report comes back w/ positive birefringent crystals. What is the most likely dx?
Pt w/ a hx of hep B presents c/o bilateral knee pain, fever & wt loss. What is most likely dx?
You suspect a pt has polyarteritis nodosa. What is the test for a definitive dx and what is the tx?
High dose steroids
On PE you notice ulnar deviations and swan neck deformities. What is the most likely dx?
A positive Neer's test indicates what dx
Rotator cuff impingement
3 meds that may cause lupus
What test do you do for Sjögren's syndrome
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.
Which carpal bone has a high rate of nonunion and occult fracture?
What medication is used for patients with systemic lupus?
Scleroderma limited version has five main characteristics for which the CREST acronym is used. What are they?
There is a sunburst appearance on X-ray. What is most likely dx?
Anatomically where are 80% of clavicle fractures located?
A path report comes back showing negatively birefringent crystals. What is most likely dx?
What are the 4 muscles of the rotator cuff?
Describe the characteristics of a lytic lesion on X-ray
Bone destruction (think bad, very bad things)
What ligament is most commonly injured in an ankle sprain
Anterior talofibular ligament (ATFL)
Vasculitis w/ a hx of hep B should make you think of what dx
What is the most common fx in children
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
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?
Which way does a Cooles fx angulate dorsal or volar? What about a Smith fx?
Tenderness over the anatomical snuffbox is indicative of what fx?
What is the most common fx in a pt w/ osteoporosis?
A compression fx of a vertebral body followed by hip fx.
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?
What is the name for the 4th and 5th metacarpal fxs that often result from throwing a punch?
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
A positive McMurry indicates what dx?
First line tx for carpal tunnel
Most common cause of C-spine fractures
Medical term for hunchback
Another term for podagra
A pt presents to ED with saddle anesthesia and loss of bowel & bladder fxn. What is most likely dx?
A pt with HIV presents with severe groin pain. What is the most likely dx?
Antiretroviral meds put pts at an increased risk of AVN
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?
You recommend biphosphonates for a pt c osteoporosis. What instruction do you give her for immediately after taking the med?
Remain upright for :30
What is the most common cause of a hip dislocation? Is it usually anterior or posterior?
Which of the 4 rotator cuff muscles is most commonly injured?
What is the medical term for tennis elbow?
What is the first line tx for rheumatoid arthritis?
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?
Are most shoulder dislocations anterior or posterior?
What is the most useful physical exam test for diagnosing an ACL tear?
Lachman's, followed by anterior drawer
What is the most common knee injury?
Medial meniscal tear
Where are Heberden's nodes found?
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.
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?
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
Anti-Jo antibodies should make you think of what dx?
A positive crossover test indicates what dx?
Acromioclavicular joint injury (AC joint)
A positive Hawkins test indicates what dx?
Rotator cuff impingement
A positive Finklestein's test indicates what dx?
de Quervain's tenosynovitis
A positive Phalen and Tinel's sign indicates what dx?
A bamboo spine indicates what dx?
A positive straight leg test indicates what dx?
An African American female presents with malar rash and a positive double-stranded DNA antibody. What is the most likely dx?
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.
A pt has a silver fork deformity on X-ray. What is the most likely dx?