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Step 2 DIT 😱 > 3, 4, 5 Star topics 3 > Flashcards

3, 4, 5 Star topics 3 Flashcards

1
Q

Sx of carpal tunnel syndrome (4)

A

Wrist pain that radiates up arm and worsens w/ flexion and grasping
Numbness/tingling in thumb, index, middle and radial side of 4th finger
Decreased grasp strength
Thenar atrophy long term

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2
Q

Signs of carpal tunnel syndrome (4)

A

Tinel and Phalen signs

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3
Q

Treatment carpal tunnel syndrome (4)

A

Activity modification, wrist splints
NSAIDs, steroid injections
Surgical release of ligament

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4
Q

Nerve affected in carpal tunnel syndrome (4)

A

Median nerve

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5
Q

MC shoulder dislocation (3.5)

A

Anterior

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6
Q

MC hip dislocation (3.5)

A

Posterior

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7
Q

Shoulder dislocation w/ external rotation and slight abduction (3.5)

A

Anterior

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8
Q

Shoulder dislocation w/ internal rotation (unable to externally rotate) and adduction (3.5)

A

Posterior

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9
Q

Shoulder rotation w/ possible axillary nerve damage (3.5)

A

Anterior

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10
Q

Nerve damage w/ claw hand (3)

A

Ulnar

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11
Q

Nerve damage w/ ape hand (3)

A

Median

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12
Q

Nerve damage w/ wrist drop (3)

A

Radial

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13
Q

Nerve damage w/ scapular winging (3)

A

Long thoracic

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14
Q

Nerve damage w/ inability to wipe bottom (3)

A

Thoracodorsal

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15
Q

Nerve damage w/ loss of forearm pronation (3)

A

Median

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16
Q

Nerve damage w/ inability to abduct or adduct fingers (3)

A

Ulnar

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17
Q

Nerve damage w/ loss of shoulder abduction (3)

A

Axillary

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18
Q

Nerve damage w/ weak external rotation of arm (3)

A

Suprascapular / Axillary

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19
Q

Nerve damage w/ loss of elbow flexion and forearm supination (3)

A

Musculocutaneous

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20
Q

Nerve damage w/ loss of wrist extension (3)

A

Radial

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21
Q

Nerve damage w/ trouble initiating shoulder abduction (3)

A

Suprascapular

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22
Q

Nerve damage w/ inability to abduct arm >10 degrees (3)

A

Axillary

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23
Q

Nerve damage w/ inability to raise arm above horizontal (3)

A

Long thoracic, spinal accessory

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24
Q

Nerve damage w/ fx of shaft of humerus (3)

A

Radial

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25
Q

Nerve damage w/ fx of surgical neck of humerus (3)

A

Axillary

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26
Q

Nerve damage w/ supracondylar humerus fx (3)

A

Median

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27
Q

Nerve damage w/ fx of medial epicondyle (3)

A

Ulnar

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28
Q

Nerve damage w/ anterior shoulder dislocation (3)

A

Axillary

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29
Q

Nerve damage w/ carpal tunnel injury (3)

A

Median

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30
Q

Back pain w/ radiation to epigastrum (5)

A

PUD, GERD, gastritis
Pancreatitis
AAA

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31
Q

Back pain w/ radiation to pelvis (5)

A

Nephrolithiasis, pyelonephritis

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32
Q

Back pain along paraspinal area only (5)

A

Muscle strain

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33
Q

Back pain w/ osteoporotic patient (5)

A

Compression fx

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34
Q

Back pain w/ back asymmetry (5)

A

Scoliosis

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35
Q

Back pain w/ abnormal gait (knees/hips flexed) (5)

A

Spondylolisthesis

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36
Q

Back pain w/ systemic symptoms (5)

A

Meningitis, discitis, osteomyelitis

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37
Q

Back pain worse w/ exertion, +straight leg raise (5)

A

Disk herniation

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38
Q

Back pain w/ walking, standing, better in supermarket (5)

A

Spinal stenosis

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39
Q

Back pain worse at rest, better w/ activity (5)

A

Ankylosing spondylitis (esp 20-30 yo men)

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40
Q

Back pain 24 hrs including night or at rest (5)

A

R/o cancer

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41
Q

Back pain w/ bowel or bladder dysfunction (5)

A

Cauda equina

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42
Q

Back pain w/ saddle anesthesia (5)

A

Cauda equina

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43
Q

Treatment spinal stenosis (4)

A

Analgesics (NSAIDs), PT, epidural injections

Surgical decompression

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44
Q

Treatment cauda equina syndrome (3.5)

A

Emergency surgical decomression

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45
Q

Waiter’s tip (3.5)

A

Erb-Duchenne palsy (superior trunk)

46
Q

Deltoid paralysis (3.5)

A

Axillary nerve damage (assoc w/ anterior shoulder dislocation)

47
Q

Claw hand + thenar/hypothenar eminence + possible Horner’s syndrome (3.5)

A

Klumpke palsy (C8-T1)

48
Q

Paget disease of bone s/sx (3.5)

A

Possibly asymptomatic
“Hat no longer fits,” bone pain, increased fx, tibial bowing, deafness, kyphosis
Increased alk phos, normal other labs

49
Q

Paget disease of bone diagnostic radiology (3.5)

A

Bone scan for “hot spots”

50
Q

Paget disease of bone treatment (3.5)

A

Bisphosphonates
Calcitonin (SC)
No treatment if asymptomatic

51
Q

Asymmetric arthritis (possibly only one joint) w/ PIP, DIP involvement (3)

A

Osteoarthritis

52
Q

Symmetric arthritis w/ DIP sparing w/ PIP, MCP (3)

A

Rheumatoid arthritis

53
Q

Insidious joint stiffness and pain that worsens w/ activity and weight bearing and is relieved by rest (3)

A

Osteoarthritis

54
Q

Pannus formation (3)

A

Rheumatoid arthritis

55
Q

Swan neck, boutonniere deformities; ulnar deviation of fingers (3)

A

Rheumatoid arthritis (S = flexed DIP, B = flexed PIP)

56
Q

Insidious joint stiffness and pain w/ 30+ min morning stiffness, worse w/ rest, better w/ activity (3)

A

Rheumatoid arthritis

57
Q

Rheumatoid arthritis treatment (3)

A

Start DMARDs early (sulfasalazine, hydroxychloroquine, MTX for moderate)
Also anti-TNFa
Steroids, NSAIDs as adjuncts

58
Q

Drug induced lupus causes (3)

A 
SHIPP
Sulfa drugs (esp sulfasalazine)
Hydralazine
Isoniazid
Phenytoin
Procainamide
(Methyldopa, quinidine, chlorpromazine)
59
Q

Skin symptoms of SLE (3)

A

Malar rash
Discoid rash
Photosensitivity
Painless oral ulcers

60
Q

Inflammatory symptoms of SLE (3)

A

Arthritis (symmetric, non-erosive, 2+ joints)
serositis (pleuritis, pneumonitis, pericarditis)
++ANA

61
Q

Organ system symptoms of SLE (3)

A

Renal
Neurologic (seizures, psychosis, stroke, neuropathy)
Hematologic
Immunologic (dsDNA, Smith, phospholipid Abs)

62
Q

Major causes of death of SLE (3)

A

Renal disease

Infection

63
Q

Treatment of SLE (3)

A

Avoid sun
NSAIDs, steroids
Hydroxychloroquine
Anticoagulation if needed

64
Q

Proximal muscle weakness (legs first) (3)

A

Polymyositis

65
Q

Proximal muscle weakness + rash (3)

A

Dermatomyositis

66
Q

Dermatomyositis skin signs (3)

A

Purple/red heliotropic rash (periorbital)
Shawl sign
Gottron’s papules
Mechanic’s hands

67
Q

Pain and stiffness in hips and shoulders (trouble raising arms and getting out of bed) with NO weakness (3)

A

Polymyalgia rheumatica

68
Q

PMR patients should be worked up for what? (3)

A

Temporal arteritis

69
Q

Muscle pain and tenderness in multiple distinct locations (trigger points) (3)

A

Fibromyalgia

70
Q

Young man w/ low back pain that is worse in morning and improves w/ exercise (3)

A

Ankylosing spondylitis

71
Q

Pencil-in-cup deformities of PIP and DIP joints (3)

A

Psoriatic arthritis

72
Q

Bamboo spine on x-ray (3)

A

Ankylosing spondylitis

73
Q

Asymmetric arthritis worse in morning, improves w/ activity (3)

A

Psoriatic arthritis

74
Q

CREST scleroderma (3)

A

Calcinosis cutis (SQ calcifications, often in fingers)
Raynaud phenomenon
Esophageal dysmotility
Sclerodactyly (skin thickening of fingers, hands, face)
Telangectasias (lip, hand, face)

75
Q

Dry eyes, dry mouth, arthritis (3)

A

Sjogren syndrome

76
Q

Adolescent, obese male w/ thigh/knee/hip pain (4)

A

Slipped capital femoral epiphysis (SCFE)

77
Q

SCFE treatment (4)

A

Surgical pinning, weight-bearing restriction

78
Q

SCFE complications (4)

A

AVN, premature OA

79
Q

AVN of capital femoral epiphysis btwn 3-8 years old (4)

A

Legg-Calve-Perthe’s disease

80
Q

Legg-Calve-Perthe’s disease treatment (4)

A

Non-weight bearing
Observation or bracing, Petrie cast, osteotomy
Surgical correction rare
50% untreated cases recover fully

81
Q

Pediatric limp + x-ray shows femoral head sclerosis (4)

A

Legg-Calve-Perthe’s disease

82
Q

Pediatric limp + x-ray shows “ice cream scoop falling off cone” (4)

A

SCFE

83
Q

Pediatric limp + acute onset tibial pain, fever, malaise, elevated ESR, no joint pain (4)

A

Osteomyelitis

84
Q

Pediatric limp + acute onset knee pain, fever, elevated ESR, +WBC (4)

A

Septic arthritis

85
Q

Pediatric limp + obese, male adolescent with dull hip pain and inability to bear weight (4)

A

SCFE

86
Q

Pediatric limp + 7 yr old with growth delay and inner thigh pain (4)

A

Legg-Calve-Perthe’s disease

87
Q

Pediatric limp + 13 yr old boy w/ pain and swelling at tibial tuberosity (4)

A

Osgood-Schlatter

88
Q

Erythematous papule w/ rough, yellow-brown scales, <5 mm in diameter, in sun-exposed area (4)

A

Actinic keratosis (pre-SCC)

89
Q

Painless, erythematous, irregular-looking papule w/ scaling or keratinized growths in sun-exposed areas; may become painful, bleed, or ulcerate (4)

A

Squamous cell carcinoma

90
Q

Pearly papule w/ telangiectasias or rolled edges around ulceration (4)

A

Basal cell carcinoma

91
Q

Irregular borders, multiple colors, large or rapidly growing moles (4)

A

Melanoma

92
Q

Metastatic risk of skin cancers (4)

A

BCC <0.1%
SCC 5-10%
Melanoma MC

93
Q

MCC skin cancer (4)

A

BCC

94
Q

Most important prognostic factor for melanoma (4)

A

Thickness (always need punch or excisional biopsy)

>0.76 mm associated w/ increased risk metastasis

95
Q

Follow what characteristics of moles? (4)

A 
ABCDE
Asymmetry
Border (irregular)
Color (variable)
Diameter (>6 mm)
Enlargement
96
Q

MC type of melanoma (4)

A

Superficial spreading

97
Q

Non-pigmented melanoma (4)

A

Amelanotic

98
Q

Dark papule on legs or trunk that bleeds w/ minor trauma, melanoma type (4)

A

Nodular (only grows vertically, rapidly invasive)

99
Q

occurs on palms, soles or beneath nail plate in patients w/ dark skin, melanoma type (4)

A

Acral lentiginous

100
Q

Dark lesion larger than 6 mm w/ irregular, asymmetric borders (4)

A

Superficial spreading melanoma

101
Q

Long-lasting in situ melanoma before vertical growth (4)

A

Lentigo maligma

102
Q

Treatment of actinic keratosis (4)

A

Topical 5-fluorouracil or imiquimod, cryotherapy

103
Q

Treatment of squamous cell carcinoma (4)

A

Surgical/Mohs excision, radiation for large lesions

104
Q

Treatment of basal cell carcinoma (4)

A

Surgical/Mohs excition, radiation or cryotherapy

105
Q

Treatment of melanoma (4)

A

Surgical excision w/ 0.5 cm margin (in situ), 1 cm margin (2 mm thick)
Possible LN dissection
Chemo and radiation if metastatic

106
Q

Purple-red lesion on face that does not regress with age (3)

A

Port-wine stain (Sturge Weber syndrome if in ophthalamic area)

107
Q

Infant w/ bright-red lesion that regresses over months-years (3)

A

Strawberry hemangioma

108
Q

Benign, small red papule that appears on skin w/ age (3)

A

Cherry hemangioma

109
Q

Bright red papule w/ radiating blanching vessels (3)

A

Spider hemangioma (assoc w/ liver disease)

110
Q

Blue or red compressible mass that does not regress (3)

A

Cavernous hemangioma

111
Q

Red-pink nodule on a child often confused w/ melanoma (3)

A

Spitz nevus

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