Flashcards in Musculoskeletal/BW Deck (75):
What is the most common cause of C-spine fx?
What is the medical term for hunchback?
What is another term for podagra?
A patient presents to the the ER with saddle anesthesia and loss of bowel and bladder function. What is the most likely Dx?
Cauda equina Syndrome
A patient with HIV presents with sever groin pain. What is the most likely Dx?
Avascular Necrosis of the femoral head. Antiretroviral meds put patients at an increased risk of AVN
A 95 yr old female presents to the ER after a fall in her home. Her left leg is shortened and externally rotated. What is the most likely Dx?
You recommend bisphosphonates for a patient with osteoporosis. What instruction do you give her for immediately after taking the medication?
Remain upright for 30mins
What is the mcc of hip dislocation? Is it normally anterior or posterior dislocation?
Which of the four rotator cuff muscles is most commonly injured?
What is the medical term for Tennis Elbow?
What is the first treatment for RA?
A patient presents to the ER 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 meniscus tear
Where are Heberden's nodes found?
Distal interphalangeal joint (DIP)
A patient presents with knee pain following a soccer game two days ago. He has joint line tenderness medially and feels a locking in the knee from time to time. What two physical exam tests should you do?
This is probably a medial meniscus tear. Mcmurry and Apley tests will be appropriate.
A patient 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
A 46 yr old male comes to the ER limping a little on the right side. He said it felt as thought 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 diagnosis?
A positive cross over shoulder test confirms what Dx?
AC joint injury
A positive Hawkins's test indicates what Dx?
Rotator Cuff impingement
A positive Finkelstein's test indicates what Dx?
De Quervain's tenosynovitis
A positive Phalen and Tinel's sign indicates what Dx?
Carpel tunnel (median nerve)
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 part of the hand?
Median nerve, Thumb, pointer and ring fingers. Thenar wasting is a sign of advance dz state.
Patient has a silver fork deformity on X-ray. What is the most likely Dx?
A positive Apley indicates what Dx?
At what age should you begin ordering dexa scans for male patients? what about female patients?
70 for males, 65 for females
Give the dexa score for osteopenia? osteoporosis?
Osteopenia= 1 to 2.4 standard deviations
Osteoporosis= 2.5 standard deviations or greater
What fracture is the #1 cause of compartment syndrome
Tibial shaft fracture
A patient's lab work shows positive smith antibody and positive double stranded DNA antibodies. What is the most likely Dx
Where are Bouchard's nodes found?
What will an X-ray show in an acute osteomyelitis?
Nothing- it will show bone destruction in chronic osteomyelitis
What is the best imaging to Dx osteomyelitis?
Bone scan or MRI will provide the Dx.
A 22yr old male patient presents with what is clearly a septic knee. You also notice lesions on his hands and 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 patient 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?
Osteosarcoma usually occur in 15-25 year old males and are most commonly found around the knee.
ou think a patient may have an osteoid osteoma due to his complaints of severe night pain. You set him up for an x-ray, but in the meantime what medication do you start him on?
If it is truly an osteoid osteoma ibuprofen will resolve his pain.
Clicking or locking of the knee indicates what diagnosis?
A 65 year old presents complaint of 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 b/c of the location, but you might also think about an infection
What uric acid level helps to confirm the Dx of gout?
What is the medical treatment of Gout?
A pathology report comes back with positive birefringent crystals. What is the most likely Dx?
A patient with a history of Hep B presents complaining of bilateral knee pain, fever and weight loss. What is the most likely Dx?
You suspect a patient has polyarteritis nodosa. What is the test for a definitive Dx and what is the treatment?
Biopsy, High dose Steroids
On physical exam 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
List three medication that may cause Lupus.
Procainamide, Isoniazid and Quinidine.
What test do you do for Sjogren's Syndrome?
A patient with RA is heading to the OR for open reduction and internal fixation of the ankle. In addition to ankle films what other X-ray should you get?
C-spine, anesthesia will want them due to concerns about instability of C1&C2
What carpal bone has a high rate of nonunion and occult fracture?
What medication is used for patients with SLE?
Scleroderma limited version has five main characteristics for which the CREST acronym is often used. What are those five things
Calcinosis, Raynaud's, Esophageal motility, Sclerodactyly, Telangiectasia
There is a sunburst appearance on X-ray. What is the most likely Dx?
Anatomically where are 80% of clavicle fractures located?
A pathology report comes back showing negatively birefringement crystals. What is the most likely Dx?
What are the four muscles of the rotator cuff
Commonly known as the SITS muscles, they are Supraspinatus, Infraspinatus, Tere minor, and Subscapularis
Describe the character of a lytic lesion on X-ray
Spiculated, elevated periosteum, bone destruction (think bad, very bad things)
What ligament is most injured in an ankle sprain?
Anterior talofibular ligament (ATF)
Vasculitis with a Hep B history should make you think of what Dx?
What is the most common fracture in children?
A fat pad sign on lateral x-ray of elbow has what significance?
It is blood in the joint indicating a fracture even if the fracture line cannot be seen.
A patient presents with progressive neck and proximal muscle weakness. On physical exam you see a reddish purple maculopapular rash. Her lab work shows an anti Jo 1 antibodies. What is the most likely Dx?
Which way does a Colles fracture angulate dorsal or velar? What about a Smith fracture?
Colles= Dorsal, Smith= Volar
Tenderness over the anatomical snuffbox is indicative of what fracture.
What is the most common fracture in a patient with osteoporosis?
A compression fracture of a vertebral body followed by hip fractures.
A 15 yr old boy presents complaining of 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 a 4th and 5th metacarpal fractures that often result from throwing a punch?
A new mother presents with pain over the radial wrist. She has a positive Finkelstein's test. What is the most likely Dx?
De Quervain's tenosynovitis
A positive Mcmurry indicates what Dx?