Other Muskuloskeltal Conditions

Question 1

What is snuffbox tenderness and how it will a question on the exam usually present?

Answer 1

It’s a navicular fracture, scaphoid fracture
“The patient fell with hands brace to catch them “

Question 2

How do you diagnose, snuffbox tenderness?

Answer 2

First you give the patient a thumb spika cast to prevent osteosis of the wrist and then do an x-ray in two weeks.

Question 3

How do you assess for carpal tunnel syndrome?

Answer 3

Phalen sign and tinel sign

Question 4

What is phalen sign?

Answer 4

Backwards prayer hands

Question 5

What is tinel sign?

Answer 5

Tap the inner wrist, and then the symptoms will persist

Question 6

What is the treatment for carpal tunnel syndrome?

Answer 6

Splint, brace, steroids

Question 7

How will a patient with Morton neuroma usually present?

Answer 7

“Pebble in their shoe” between the third and fourth toe, numbness, and tingling

Question 8

What is lateral epicondylitis?

Answer 8

Also known as tennis, elbow.
Elbow pain worsens with activity, painful tendon, or outer part of the elbow.

Question 9

What is medial epicondylitis?

Answer 9

Golfers elbow, the tendon on the inner part of the elbow is inflamed.

Question 10

What is the treatment for lateral and medial epicondylitis?

Answer 10

RICE, NSAID’s, physical therapy

Question 11

How do you assess for a meniscus injury?

Answer 11

McMurray test and apley test

Question 12

What do you do for a McMurray test?

Answer 12

A “click” in early or mid extension while passively flexing and extending the knee.

Question 13

What do you do for the apley test?

Answer 13

Patient lies on their stomach with knees flex to 90 degrees, rotate leg away and then back towards body, then press down lightly

Question 14

How do you assess for an ACL injury?

Answer 14

Lachman and anterior drawer sign

Question 15

What do you do to perform a Lachman test?

Answer 15

Grasp upper calf, pull tibia anteriorly and then sudden firm forward motion.

Question 16

What does a positive valgus test mean?

Answer 16

MCL (medial collateral ligament)

Question 17

What does a positive Varus test mean?

Answer 17

LCL: lateral collateral ligament

Question 18

A lot of injuries with the knee will have a popping sound, but if a question presents with popping at the time of injury with continued popping even hours after what is most likely the injury that occurred?

Answer 18

Meniscal injury

Question 19

How do you assess for sciatica?

Answer 19

Straight leg test: it’s positive if reproduction of symptoms are at 30 to 70° of elevation

Question 20

How do you assess which nerve is causing sciatica? L4,L5,S1

Answer 20

L4: squat and rise exam, their knee-jerk will be diminished
L5: heel walking, numbness at the big toe
S1: walk on toes, absent ankle jerk

Question 21

How do you assess for a rotator cuff tear?

Answer 21

Drop arm test: abduct the arm away from the body, lower arm slowly, if rotator cuff terrace present then the arm almost suddenly dropped to the side

Question 22

How do you assess for supraspinous tear?

Answer 22

Empty can test

Question 23

What is the treatment to prevent gout?

Answer 23

Allopurinol

Question 24

What is the side effect with allopurinol?

Answer 24

Bone marrow suppression

Also do not start during an acute attack but the patient can continue taking it if they already were.

Question 25

What are lifestyle interventions for gout?

Answer 25

Low purine diet no alcohol avoid diuretics if possible Thiazide diuretics can specifically can increase uric acid level.

Question 26

What is the most common diagnostic test for gout? And what is the most sensitive for diagnosing gout?

Answer 26

Serum uric acid level Sometimes it will remain normal, even if they have a gout attack Serum uric acid level is most sensitive. This is not commonly done due to patient discomfort when the presentation is classic for gout, but it is the most sensitive.

Question 27

What is the treatment for an acute attack with gout?

Answer 27

Steroids NSAIDs: indomethacin Colcrys: if attack is severe and affecting multiple joints

Question 28

What are common symptoms of people who have fibromyalgia?

Answer 28

Pain, fatigue, waking up not feeling refreshed, cognitive problems all that lasts for three or more months. Also symptoms that can’t be explained from any other condition tend to be diagnosed with fibromyalgia

Question 29

What are medication’s and treatment for fibromyalgia?

Answer 29

Duloxetine (Cymbalta) Amitriptyline (Elavil) Lyrica Flexiril “Treat your CELF” Regular physical activity

Question 30

What is Hallux Valgus? How do you diagnose and treat?

Answer 30

Bunion Diagnose: Xray Treatment: surgery or braces

Question 31

What are symptoms of cauda equina syndrome? Treatment?

Answer 31

Saddle anesthesia (numbness and tingling around perineum), severe low back pain, incontinence Send to ED due to severe ruptured disc

Question 32

What is DeQuervain tenosynovitis? How do you diagnose and treat?

Answer 32

Inflammation of the tendon on the radial ( thumb side of the wrist), causes pain in lower thumb Finklestein test: grab thumb and have ulnar deviation Treatment: splinting and NSAIDs

Question 33

Bursitis

Answer 33

Bursa help cushion the joints. Olecronon bursitis: in elbow Treatment: RICE, NSAIDs, can aspirate the joint and do antibiotics if necessary

Question 34

What is De Quervain tenoshnovitis?

Answer 34

A painful condition affecting the tendons on the thumb side of the wrist. The patient will probably feel pain when they turn their wrist, grasp anything, or make a fist.

Question 35

Sprains are grades 1-3. What are the symptoms of each level?

Answer 35

Grade 1 sprain: mild sprain, can bear weight or partially bear weight on affected extremity , no joint instability Grade 2 sprain: moderate sprain, are able to bear weight but painful, joint instability present with ecchymosis and moderate to severe edema Grade 3: unable to bear weight on affected extremity. Refer to ortho.

Question 36

What does ankylosing spondylitis look like on an x-ray?

Answer 36

Also known as “Bamboo spine” continuous spine lesions, vertebral, squaring, joint spaced stenosis, sacrolilitis. The pain with ankylosing spondylitis often improves with movement and exercise and worsen with rest or inactivity. Pain is often described as nagging or deep ache.

Question 37

How do you perform an anterior drawer test?

Answer 37

Patient supine, with their knee pen at 90° in their foot on the exam table. The clinician sits on the patient’s foot while holding the lower leg with both hands and gently pulling it toward them. Anterior movement is considered positive. MRI is gold standard for diagnosis of ACL injury.

Question 38

What is the Romberg test used for?

Answer 38

To evaluate a clients sense of balance and is used when assessing neurological status.

Question 39

What is osgood-schlatter disease characterized by?

Answer 39

is common in active adolescents due to repetitive quadriceps contraction, and is characterized by worsening knee pain with activity. It occurs most frequently in participants of sports that involve running, cutting, and jumping, especially children and adolescents who have recently undergone a rapid growth spurt. It is a benign and self-limiting condition with a usual course of 6 to 18 months.

Question 40

Inversion ankle sprains most often injure the…?

Answer 40

anterior talofibular ligament

Question 41

What is genu varum? And when should is resolve by?

Answer 41

“Bow legs” occurs when childs knees stay apart despite child standing with their feet together. Usually self resolves by 2 years old.

Question 42

What is genu varum? And when should is resolve by?

Answer 42

“Bow legs” occurs when childs knees stay apart despite child standing with their feet together. Usually self resolves by 2 years old.