Muskuloskeletal

Question 1

management of pyogenic tenosynovitis

Answer 1

w/in 48 hrs: ATBs and splinting

later, more severe: ATBs and surgical drainage

Question 2

adolescent girl w/ anterior knee pain

Answer 2

patellofemoral pain syndrome

Question 3

sxs of patellofemoral pain syndrome

Answer 3

pain up and down stairs

difficulty abducting hip

Question 4

pain up and down stairs

difficulty abducting hip

Answer 4

patellofemoral pain syndrome

Question 5

1st step in evaluating stress fracture

Answer 5

x ray

Question 6

scaphoid fone fracture types and management

Answer 6

middle or distal 1/3: thumb spicca cast 10-12 weeks for union
proximal 1/3: send to ortho

Question 7

only meds that prevent hip fracture

Answer 7

alendronate
risendronate
zoledronic acid

Question 8

pain in lateral hip associated w/

Answer 8

tronchanteric bursitis

Question 9

hip pain w/ FADIR (flexion, adduction, internal rotation)

Answer 9

femoroacetabular impingement

Question 10

hip pain w/ FABER (flexion, abduction, external rotation)

Answer 10

osteoarthritis

Question 11

imaging for septic arthritis

Answer 11

ultrasound (to detect effusion)

Question 12

female athlete triad

Answer 12

amenorrhea
osteoporosis
disordered eating

Question 13

best imaging for osteomyelitis

Answer 13

MRI

Question 14

Ottawa ankle rules (when to order x rays)

Answer 14

maleolar pain
bone tenderness distal 6 cm of posterior edge or tip of med or lat malleolus
can’t bear wt for 4 steps immediately after or in ED
midfoot pain
bone tender 5th metatarsal or navicular

Question 15

lab to determine vit D deficiency

Answer 15

25-OH vit D

Question 16

absence of passive plantar flexion when calf squeezes

Answer 16

Achilles tendon rupture

Question 17

osteoporosis med that decr risk of BRCA

Answer 17

raloxifene (SERM)

Question 18

4th finger w/ pitting of skin and nodule

Answer 18

Dupuytren’s contracture

Question 19

burning pain in shoulder (dx and workup)

Answer 19

brachial neuritis –> do EMG

Question 20

frozen shoulder’s MCC risk factor

Answer 20

DM

Question 21

osteoporosis screening

Answer 21

females at least 65
males at least 70
50+ w/ risk factors

Question 22

disease that involves the medial part of the proximal tibia

Answer 22

Blount’s disease

Question 23

blood lvl of 25-OH vitamin D that signals deficiency

Question 24

limited internal rotation of flexed hip

Answer 24

SCFE

Question 25

most important thing to test in pt with rheumatoid arthritis pre op

Answer 25

cervical spine imaging (for atlantoaxial subluxation)

Question 26

overuse injuries cause

Answer 26

stress fractures

Question 27

what calcium supplement is favored if pt on PPIs

Answer 27

calcium citrate (better than calcium carbonate)

Question 28

shoulder pain and decr ROM - differential - management

Answer 28

adhesive capsulitis or degenerative rotator cuff tendinopathy NSAIDs, subacromial cortisone injections, physical therapy

Question 29

management of lateral epicondylitis

Answer 29

conservative management (resolves on own in 12-18 mod)

Question 30

lateral epicondylitis from what muscle

Answer 30

extensor carpi radialis

Question 31

flexed arm, then internally rotated shoulder - test name - dx

Answer 31

Hawkins impingement test | impingement / rotator cuff disorder

Question 32

extension of knee causes patella to deviate laterally - dx - tx

Answer 32

patellofemoral stress syndrome | PT

Question 33

Dupuytren's contracture associated w/

Answer 33

diabetes mellitus alcohol smoking

Question 34

when to do surgery for Dupuytren's contracture

Answer 34

30 degrees or more

Question 35

tx of volar angulation of 5th metacarpal

Answer 35

ulnar gutter splint

Question 36

risk factors for nonunion of mid clavicle fracture

Answer 36

``` female fracture comminution or displacement clavicle shortening advanced age greater extent of initial trauma ```

Question 37

tarsal tunnel syndrome entraps what nerve

Answer 37

posterior tibial

Question 38

tx of plantar fasciitis

Answer 38

stretching exercises for Achilles tendon

Question 39

differential for locking of knee

Answer 39

loose body | meniscal tear

Question 40

tx of acute rupture of major tendon

Answer 40

surgical repair within 6 weeks

Question 41

groin pain, limited hip flexion and internal rotation

Answer 41

stress fracture of femoral neck

Question 42

stinging pain of lateral femoral epicondyle

Answer 42

iliotibial band syndrome

Question 43

pain in ant pelvic area and tender symphysis pubis

Answer 43

osteitis pubis

Question 44

med that reduces both hip and vertebral fracture risk

Answer 44

zoledronic acid

Question 45

old pt with back pain that doesn't radiate - dx - testing - tx

Answer 45

osteoporotic vertebral compression fracture plain x ray SQ or intranasal calcitonin for pain relief

Question 46

heel pain in older person that worsens as the day progresses

Answer 46

fat pad atrophy