Amboss 7/1 Flashcards
patellar dislocation with osteochondral fragment requires what
arthroscopic repair
what is first line therapy for hyperkalemia with signs of cardiac toxicity
calcium gluconate for cardiac membrane stability
what is expected in crush injuries
hyperkalemia, rhabdomyolysis
what is a common therapy for fibromyalgia
TCAs
what is the underlying pathophysiology of pagets disease
increased rate of bone remodeling, there is a hereditary component
what is the presentation of pagets
most people are asymptomatic. Bone pain characterizes the late stages of disease
The pelvis, skull, vertebral column, and long bones of the lower extremities are the most commonly affected sites .
what are the radiographic findings of pagets
While osteolytic bone lesions may be seen earlier in the course of the disease, late disease is dominated by sclerotic bone with cortical thickening, and microfissures and fractures are also common.
MIXED LYTIC AND SCLEROTIC LESIONS is the most likely finding
what are the labs for pagets
normal PTH, calcium and phosphate. elevated alk phos.
what neurological symptoms are found in pagets
sensorineural hearing loss
what are the labs for osteoporosis
mildly elevated alk phos. all other parameters normal
what is the cause of lateral epicondylitis
repetitive forearm supination/pronation with the elbow nearly fully extended. also repetitive wrist extension
what is the presentation of osteopetrosis
usually from birth with an age of onset from infancy to adulthood. elevated calcium and pancytopenia.
there is usually upward gaze palsy
what is first line treatment for osteoarthritis pain management
NSAIDs
symptoms characteristic of osteoarthritis (OA):
joint pain that worsens with ambulation/weight bearing, joint stiffness < 30 minutes after prolonged immobility, decreased range of motion (due to osteophytes), palpable crepitus of both knees, genu varum (due to medial cartilage loss), and nodules on the DIP (Heberden’s nodes) and PIP (Bouchard’s nodes).
what is first line therapy for rheumatoid arthritis
methotrexate is a DMARD and the first line longterm therapy for moderate to severe RA
should DMARDs be given early in disease
yes. because damage occurs early in RA.
what are the benefits of methotrexate for RA
it is cheap, highly effective and well-tolerated.
is methotrexate given during acute RA attacks
no. glucorticoids and NSAIDs are used as bridging therapy
what is the typical SE of methotrexate and what drug should be given to prevent it
myelosuppression.
leucovorin (folic acid)
what are some other features of RA
rheumatoid nodules which are subcutaneous nodules and felty syndrome
what is felty syndrome
hepatosplenomegaly with pancytopenia
what is the most specific lab test for RA
anti-CCP antibodies
what is the treatment for an acute RA flare
prednisone
what is one of the most common causes of bakers cyst
rheumatoid arthritis
what are the treatments of choice for ankylosing spondylitis
NSAIDs and TNF inhibitors such as etanerecept
X-ray findings of RA typically include
joint space narrowing, erosions of the cartilage and bone, and generalized demineralization.
what is the strongest predisposing factor for a bakers cyst
traumatic synovium or meniscal tear.
inflammation of the synovium stimulates synovial fluid generation
what nerve provides sensation to the medial thigh
obturator
what nerve provides sensation to the anteromedial thigh
femoral
what are anti-Jo-1
dermatomyositis and polymyositis
what are the antibodies found in dermatomyositis and polymyositis
anti-Jo-1; Anti-Mi-2;
what are anti-histone antibodies indicative of
drug induced lupus
what are anti-Ro and La antibodies indicative of
sjrogens
Anti-Scl-70 antibodies (anti-topoisomerase)
are associated with systemic sclerosis (SSc), especially with diffuse cutaneous systemic sclerosis.
what is the presentation of osteogenesis imperfecta
short stature, convexity of thoracic spine, curvature of the tibias, increased mobility of the joints, hearing loss, easy bruisability, blue sclera
what is one way to reduce gouty flares
reduce purine rich foods, such as fish
what is erbs palsy
damage to the upper truck of the brachial plexus and is the most common neonatal brachial plexus injury
