3.1 Flashcards

1
Q

Which is more infectious, chickenpox or shingles?

A

chickenpox

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2
Q

what cells do we see in shingles?

A

multinucleated giant cells

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3
Q

when shingles is reactivated, which way does it travel (anterogradely or retrogradely)

A

anterogradely

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4
Q

Does shingles rash cross the midline

A

no

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5
Q

Which roots are most commonly affected in shingles

A

thoracic
lumbar

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6
Q

when is a patient with shingles no longer infectious

A

7-10 days; after rash has healed over

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7
Q

What ganglion are activated in Ramsay Hunt

A

geniculate ganglion or dorsal root ganglion

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8
Q

What nerves are affected in Ramsay Hunt

A

CN7
Possible CN8

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9
Q

Will facial paralysis be contralateral or ipsilateral for shingles

A

Ipsilateral

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10
Q

what nerve roots are involved in herpes zoster ophthalmicus

A

trigeminal ganglion or dorsal root ganglion

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11
Q

what nerve is affected in herpes zoster ophthalmicus

A

ophthalmic division of trigeminal nerve

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12
Q

What sign is commonly seen in herpes zoster ophthalmicus

A

hutchinson’s sign

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13
Q

eye involvement in shingles indicates what other nerve could be involved

A

nasociliary nerve

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14
Q

sciatic nerve controls what dermatomes?

A

L4-S2

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15
Q

what is the most common cause of lower back pain

A

lumbar strain

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16
Q

what is lumbar strain

A

acute tear or stretch of paraspinal muscles

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17
Q

muscle spasms in lumbar strain are related to

A

activity; pain worsens with activity

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18
Q

do most herniations occur posteriorly or anteriorly? why?

A

posteriorly; posterior longitudinal ligament is much narrower

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19
Q

At what level is herniated disc most common

A

L5-S1

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20
Q

what is the most common organism is osteomyelitis

A

staph aureus

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21
Q

what bacteria is associated with osteomyelitis in someone after prosthetic joint placement

A

staph epidermis

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22
Q

what bacteria is associated with osteomyelitis in someone with SCD

A

salmonella

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23
Q

what bacteria is associated with osteomyelitis in neonates

A

Group B strep

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24
Q

what bacteria is associated with osteomyelitis in someone with puncture wounds through tennis shoes

A

pseudomonas

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25
Q

very common symptom of osteomyelitis

A

refusal to bear weight

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26
Q

Gold standard of diagnosis for osteomyelitis

A

bone aspiration (biopsy)

27
Q

does spinal epidural abscess most commonly occur anteriorly or posteriorly

A

posteriorly

28
Q

class triad in spinal epidural abscess

A

fever
spinal pain
progressive neurologic deficit

29
Q

test of choice for spinal epidural abscess

A

MRI with contrast (gadolinium)

30
Q

what type of lesion will you see in MRI with spinal epidural abscess

A

ring enhancing lesion

31
Q

what is the most common presenting symptom in amyotrophic lateral sclerosis

A

asymmetric limb weakness

32
Q

what is usually spared in ALS

A

sensation
voluntary eye movement
sphincter function (bowel and bladder)
sexual function
sensory exam is usually normal

33
Q

treatment option for ALS

A

Riluzone

34
Q

what is the most common cause of death in ALS

A

respiratory failure

35
Q

when is ALS typically fatal

A

usually 3-5 years after symptom onset

36
Q

what imaging method is best for herniated disc

A

MRI

37
Q

spinal column cancers are most commonly due to

A

metastases (70%)

38
Q

what is the most common primary bone malignancy in children and young adults

A

osteosarcoma

39
Q

Appearance on radiographs for osteosarcoma

A

sunburst or hair on end appearance

40
Q

is cauda equina a lower motor neuron issue or upper? why?

A

Lower motor neuron issue; spinal cord ends at conus medullaris

41
Q

most common cause of cauda equina syndrome

A

massive lumbar disc herniation

42
Q

will anal wink test be increased or decreased for cauda equina syndrome

A

decreased

43
Q

Imaging for cauda equina syndrome

A

immediate MRI

44
Q

treatment for cauda equina syndrome

A

emergent decompression
corticosteroids to reduce inflammation

45
Q

primary infection in adults with HSV1

A

tonsillopharyngitis

46
Q

primary infection in kids with HSV1

A

gingivostomatitis

47
Q

What type of smear used for HSV and varicella

A

Tzanck

48
Q

where do most cases of spondylolysis occur

A

L5-S1

49
Q

spondylolysis is due to what defect

A

pars articularis defect

50
Q

what will you see on radiographs for spondylolysis

A

scotty dog appearance

51
Q

at what grade do you do interventions for spondylolisthesis

A

Grade 3 and above (50%-75% for grade 3)

52
Q

what kind of gait do kids with spondylolisthesis tend to have

A

phalen-dickson gait

53
Q

burst (Jefferson) fracture of the atlas (C1)

A

bilateral fractures of both the anterior and posterior arches of C1

54
Q

odontoid process (dens) fractures

A

fracture of the dens (odontoid process) of the axis (C2)

55
Q

How is odontoid process fracture best seen on imaging

A

AP odontoid (open mouth) view

56
Q

hangman’s fracture (C2/axis pedicle)

A

traumatic bilateral fractures of the pedicles or pars interarticularis of the axis vertebra (C2)

57
Q

clay-shoveler’s fracture

A

spinous process avulsion fracture most common at the lower cervical vertebrae

58
Q

where does clay shoveler’s fracture most commonly occur

A

C7

59
Q

flexion teardrop fracture

A

anterior displacement of a wedge-shaped fracture fragment

60
Q

extension teardrop fracture

A

triangular shaped avulsion fracture of the antero-inferior corner of the vertebral body as a result of rupture of the anterior longitudinal ligament

61
Q

where are extension teardrop fractures most common

A

C2

62
Q

what type of fracture can result in anterior cervical cord syndrome

A

flexion teardrop fractures

63
Q

what type of fracture can result in central cord syndrome

A

extension teardrop fracture

64
Q

Burst fracture

A

due to nucleus pulpous of the intervertebral disc being forced into the vertebral body, causing it to burst outwards