1- Wrist/Hand Flashcards
Bouchard nodes are what joints?
PIP
Heberden nodes are what joints?
DIP
Carpal tunnel syndrome is caused by compression of what nerve?
median nerve
The hallmark presentation of this syndrome is paresthesia in median nerve distribution.
carpal tunnel syndrome
What are the 2 special tests to diagnose carpal tunnel syndrome?
- Phalen’s test
- Tinel’s sign (tap over nerve)
If surgical treatment for carpal tunnel syndrome is being considered what do you need to get first?
electrodiagnostic studies
Which of the following is NOT a good non-surgical option for carpal tunnel syndrome?
a. wrist splint
b. corticosteroid injection
c. yoga
d. NSAIDs
e. oral steroids
d. NSAIDs
What is the most effective treatment option for carpal tunnel syndrome?
a. wrist splint
b. corticosteroid injection
c. yoga
d. NSAIDs
e. oral steroids
f. surgical decompression
f. surgical decompression
De Quervain’s tenosynovitis involves inflammation of the tendon sheath that involves what 2 muscles?
- extensor pollicis brevis (EPB)
- abductor pollicis longus (APL)
What special test is used to assess for De Quervain’s tenosynovitis?
Finklestein test
Pain over the radial side of the wrist exacerbated by thumb and wrist movement, and difficulty holding or gripping subjects is consistent with what diagnosis?
De Quervain’s tenosynovitis
What splint is used for De Quervain’s tenosynovitis?
thumb spica splint
This is defined as a slow, progressive fibrosis of the PALMAR FASCIA which results in a flexion contracture of fingers.
Dupuytren’s contracture
what is the treatment of choice for Dupuytren’s contracture?
open fasciotomy with transection of cords
Stenosing flexor tenosynovitis (“trigger finger”) is caused by disparity in the size of the flexor tendons and the surrounding pulley system at which pulley?
first annular (A1) pulley
Snapping, catching, locking of a finger during flexion should have you concerned for which diagnoses?
stenosing flexor tenosynovitis (“trigger finger”)
Where is the most common site of a ganglion cyst on the wrist/hand?
dorsal wrist
A painless, smooth, rubbery lump over the dorsal wrist is consistent with what diagnoses?
ganglion cyst of wrist and hand
What is the most effective treatment for a ganglion cyst?
Observation Needle aspiration Corticosteroid injection Surgical excision Strike it with a book
Surgical excision
What is the most likely organism in a human bite?
eikinella
What is the most likely organism in a dog/cat bite?
pasteurella
What is the most likely organism due to a cat scratch?
Bartonella
which of the following is NOT a part of management of a human bite?
a. wound care
b. plain film
c. wound closure
d. tetanus
e. antibiotics
f. surgery for wash out
c. wound closure
What antibiotic do you want to give for a human or dog bite?
augmentin PO
If they need IV = Unasyn
What antibiotic do you want to give for a cat SCRATCH?
azithromycin
what is a classic pathognomonic sign of rabies?
hydrophobia
What is the most common bacteria causing paronychia?
staph aureus
what is the recommended management for paronychia?
- topical antibiotics and warm water soaks
- oral antibiotics = keflex
- if abscess is present = I/D
what is the recommended antibiotic for paronychia if you are concerned for MRSA?
- bactrim
This is defined as an infection/abscess in the pad of the finger that is associated with severe, throbbing pain.
felon
Which of the following is helpful for treating herpetic whitlow?
a. antibiotics
b. I&D
c. acyclovir
c. acyclovir
This is defined as an infection within the flexor synovial sheath.
infectious flexor tenosynovitis
CANT MISS DIAGNOSIS
What are the 4 “Kanavel Signs” for infectious flexor tenosynovitis?
- tenderness along flexor tendon sheath
- pain with passive extension of the digit
- fusiform swelling of digit (sausage digit)
- finger slightly flexed due to swelling
What is the treatment for infectious flexor tenosynovitis?
IV antibiotics and often surgery (“wash out”)
If a patient has infectious flexor tenosynovitis d/t IVDU what 2 antibiotics would you give IV?
- Vancomycin + Ceftriaxone
