Adult - Musculoskeletal

Question 1

connecting bone to bone

Answer 1

ligament

Question 2

connecting muscle to bone

Answer 2

tendon

Question 3

dense connective tissue with no blood supply

Answer 3

cartilage

Question 4

contusion

Answer 4

bruise

Question 5

hematoma

Answer 5

bruise you can feel

Question 6

strain has to do with -

Answer 6

muscle and associated tendon

Question 7

sprain has to do with -

Answer 7

joint

Question 8

Non-pharm management for acute musculoskeletal injury

Answer 8

RICE

rest - ice - compression - elevation

Question 9

Pharm management of acute musculoskeletal injury

Answer 9

3 to 4 rule -
3 to 4 ibuprofen
3 to 4 times a day
3 to 4 days

Question 10

What lab should be checked before high dose NSAID?

Answer 10

BUN and especially creatinine

Question 11

celecoxib (Celebrex)
class?
caution?

Answer 11

COX-2
not used much
cousin Vioxx caused valve problems

Question 12

What is naproxen typically used for?

Answer 12

more chronic pain

Question 13

metaxalone (Skelaxin)

class?

Answer 13

muscle relaxant

Question 14

Ultram
what is generic?
class?

Answer 14

tramadol

narcotic

Question 15

Vicodin / Lortab / Lorcet
what is generic?
class?

Answer 15

hydrocodone + acetaminophen

narcotic

Question 16

Tylenol #3
what is generic?
class?

Answer 16

acetaminophen + codeine

narcotic

Question 17

Percocet / Tylox
what is generic?
class?

Answer 17

acetaminophen + oxycodone

narcotic

Question 18

Typical meniscal tear presentation?

Answer 18

“locking”

immediate and significant swelling after injury (grapefruit within 30 minutes)

Question 19

McMurray’s test

Answer 19

patient recumbent, audible/palpable click when, with foot externally rotated, knee is flexed and then extended with one hand on the joint line

+ for medial meniscal tear

MMM - mcmurray - medial meniscal

Question 20

Lachman’s test

Answer 20

otherwise known as drawer test

knee at 20-30` put anterior force to proximal tibia

graded 1+ to 3+

assessing anterior and posterior cruciate ligament (ACL-PCL)

LL - lachman - ligament

Question 21

Apley’s grind test

Answer 21

patient PRONE
knee 90` rotate lower leg internally and externally

pain or click = + for medial or lateral collateral ligament
damage and/or meniscal injury

Question 22

Which type of arthritis can be assessed with bloodwork?

Answer 22

rheumatoid

Question 23

Diagnostics for knee pain -

Answer 23

bloodwork only if RA is suspected
Xray to evaluate joint
MRI only if really needed and after Xray

Question 24

Ankle sprain involves what type of structure?

Answer 24

ligaments - stretched, partially torn, or completely ruptured

Question 25

How are ankle sprains classified?

Answer 25

Grade 1 - 2 - 3

Question 26

What level of mobility impairment is present with each of the grades of ankle sprain?

Answer 26

grade 1 - no impairment
grade 2 - difficulty walking
grade 3 - impossible to ambulate

Question 27

Diagnostics for ankle sprain

Answer 27

consider X-ray to rule out fracture

MRI if unresolved in a few days and after X-ray

Question 28

What is a common cause of muscle strain?

Answer 28

repetitive movement resulting in inflammation

Question 29

Signs and symptoms of muscle strain

Answer 29

pain during ROM
edema
ecchymosis

Question 30

Definition of bursitis

Answer 30

inflammation of the small fluid filled cushion in a joint

Question 31

Olecranon bursitis affects the –

Answer 31

elbow

Question 32

Subdeltoid/subacromial bursitis affects the –

Answer 32

shoulder

Question 33

Ischial bursitis affects the –

Answer 33

ischial tuberosity at the base of the pelvis

Question 34

Prepatellar bursitis affects the –

Answer 34

front of the knee cap

Question 35

What is the characteristic pain found with bursitis?

Answer 35

pain with MOVEMENT

Question 36

What diagnostics are considered if infection is a concern with bursitis?

Answer 36

o aspiration - with gram stain and C & S

o WBC

Question 37

What is the management of bursitis?

Answer 37

o  splinting
o  RICE 
o  heat x 30 min TID
o  NSAIDS
o  steroid injection

Question 38

What is the total number of steroid injections, for all sites total, that a patient should have? Why?

Answer 38

3 total per year

o can break down joint surface
o can trigger Addisonian crisis