Orthopedics and Rheumatology

Question 1

Which bony lesion has a “sunburst” appearance?

Answer 1

Osteogenic sarcoma OR osteosarcoma

Question 2

What is a periosteal elevation a sign of?

Answer 2

Osteogenic sarcoma

Question 3

What is the best determination of scoliosis on physical examination?

Answer 3

Asymmetric ribcage on bending forward

Question 4

What intervention worsens outcomes in Osgoode-Schlater’s disease?

Answer 4

Casting

Question 5

What is “onion-skinning” periosteal reaction a sign of?

Answer 5

Ewing Sarcoma

Question 6

Which tumor is usually in the metaphyses of long bones?

Answer 6

Osteosarcoma

Question 7

Which tumor is usually in diaphyses of long bones, flat bones?

Answer 7

Ewing Sarcoma

Question 8

What is the position of the septic hip?

Answer 8

Abducted and externally rotated

Question 9

What classical skin finding is associated with scarlet fever?

Answer 9

Sandpaper rash

Pastia’s lines

Question 10

What skin finding is classically associated with Lyme disease?

Answer 10

Erythema migrans

Question 11

What skin findings is classically associated with systemic JIA?

Answer 11

Evanescent non-fixed erythematous rash

Question 12

What is the alternative for IVIG in Kawasaki’s disease?

Answer 12

ASA and steroids

Question 13

What are the classical manifestations of DRESS?

Answer 13

1. Fever
2. Rash
3. Hepatitis

Question 14

Which condition is associated with pulmonary findings, eosinophilia, and mild hypercalcemia?

Answer 14

Sarcoidosis

Question 15

What is the most common childhood wrist fracture?

Answer 15

Greenstick fracture

Question 16

What are the guidelines for surgical management of scoliosis?

Answer 16

1. Skeletally mature patients with >50 degree curve

2. Skeletally immature patients with progressive curves >45 degree

Question 17

What patients should consider bracing for scoliosis?

Answer 17

Skeletally immature patients >20 degrees

Question 18

What laboratory finding is associated with Kawasaki’s disease?

Answer 18

Hypoalbuminemia

Question 19

What is the differential for extension low back pain with insidious onset?

Answer 19

Spondylolysis with positive bone scan

Posterior element overuse with negative bone scan

Question 20

What is a complication of oligoarticular JIA (esp. ANA positive)?

Answer 20

Uveitis

Question 21

What are complications of neonatal lupus?

Answer 21

1. Cytopenias
2. Neonatal rash
3. Heart block
4. Hepatitis

Question 22

What complication of HSP is most likely to cause long term morbidity?

Answer 22

Glomerulonephritis

Question 23

What are physical findings in OI Type 1?

Answer 23

1. Blue sclerae
2. Hyperextensible joints
3. Thin skin
4. Easy bruising
5. Scoliosis
6. Mild short stature

Question 24

What are physical findings in OI Type 2?

Answer 24

1. Relative macrocephaly
2. Triangular facies
3. Flaring of rib cage at the base
4. Scoliosis
5. Extreme short stature

Question 25

What organisms can cause Reiter syndrome?

Answer 25

1. Shigella 2. Campylobacter 3. Chlamydia 4. Gonorrhea 5. Salmonella 6. Yersinia