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Step 2 > Bone > Flashcards

Bone Flashcards

1
Q

Osteoma
Osteoid osteoma
Osteoblastoma

A

Osteoma - facial bones

osteoid osteoma - diaphysis - resolves w/ aspirin

osteoblastoma - vertebral - no relief w/ aspirin

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2
Q

Vit D, Ca, PTH, alk phosph findings

Osteoporosis

Osteomalacia

Achondroplasia

osteopetrosis

pagets

A

Osteoporosis - Normal Ca, P, PTH, alk phosph

Osteomalacia - Vit D def, INC PTH, INC alk phosph

Achondroplasia - AD - FBGFr - blocks chondrocytes. Normal longevity/fertility.

osteopetrosis - carbonic anhydrase - defective osteoclasts. pancytopenia. CN palsy. Thick bones prone to fracture.

Pagets - INC clasts/blasts. Ca, P, PTH normal, INC alk phosph! osteosarcomma risk! INC urine hydroxyproline

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3
Q

CLavicular fracture work up?

A

Neurovasc ular exam

Angiogram if bruit or concern

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4
Q

Subacrombial bursitis presentation

A

Pain on internal rotation/flexion. No atrophy of deltoild

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5
Q

Adhesive capsulitis

A

DEC active AND passive ROM

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6
Q

Rotator cuff

A

Difficulty Abduction and externally rotating.

Falling on outstretched hand>

Lidoshot helps with rotator tendonitis but not tear

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7
Q

Glenohumeral osteA

A

Trauma - gradual onset

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8
Q

Bicepts rutpure/tendiopathy

A

Anterior shoulder pain

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9
Q

Suprachondylar fracture

A

brachial - median nerve (an terior interosseous) - > ulnar

voklmnass contraction

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10
Q

Lateral epicondylitis

A

Tennis elbow - pain w/ finger erxtenosion. Point tenderness.

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11
Q

Lumbosacral strain

vertebral fracture

A

Both have point tenderness that is acute onset.

basically only difference is demographic, risk factors

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12
Q

Anklyosing spondylitis

A

Anterior uveitis, enthesitis (inflam of ligaments)

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13
Q

Legg Cave Perthe

slipped capital femoral epyphysis

A

LC- 5-7 y.o idiopathic

Slipped capital femoral - 12-14 overweight adolescent- URGENT SURGICAL

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14
Q

osgood Schattler

Patellofemoral syndrome - dx?

A

Osgood - patella ripped off

patellofemoral syndrome - women young, runners, hurts with going up stairs. Tx - stretch.

dx w/ knee extension while applying pressure

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15
Q

Ansernine bursitis

A

Anteriomedial tibila

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16
Q

PMR

Fibromyalgia

Dermatomyositis

polymyositi s

MCTD lab finding

A

PMR - no weakness, temporal artritis. INC ESR. lwo dose steroids

Fibromyalgia - no weakness, exercise, ssri. younger than PMR

Dermatomyositis - CD4, weakness, perimysial. Molar, grotton, heliotrope

polymyositis - CD8, weakness

Later two have INC CK, ANA

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17
Q

Bone tumors

for each region
E
M
D

A

E - Giant Cell

M - osteochondroma
osteosarcoma

D Ewings
chondrosarcoma

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18
Q

Epiphyseal tumors

A

Giant cell - locally aggressuive, non malignant. Multinucleated giant, soap bubble.

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19
Q

Metaphyseal tumors

A

Osteochondroma - males

Osteosarcoma . Codman sunburst aggressive en block resection pagets rb inc risk

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20
Q

Diaphyseal tumor

A

Ewings 11:22 - Boys less than 15. Onion skinning. Chemo response

Chondrosarcoma - rare, malignant, Males 30-60, glistening mas

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21
Q

Osteo A

RA - tx algorithm

A

OsteoA - osteophytes, boney crepitus, eburnation. DIP+PIP

RA - pannus, baker cyst, anticitrullinated peptide. 2nd amyloidosis. Tx METHOTREXATE asap. If fail 6 mo -> TNF inhibitors. CERVICAL spinal involvement most common

22
Q

Tx algorithsm - presentations
GOUT

Pseudogout

A

GOUT - monosodum urate - yellow in parallel light.
Punched out erosions.
Acute - NSAIDS, steroids, colchicine
Chronic - XO - allopurinol, febuxostat
Synovial fluid analysis shows WBC less than 50k.

Pseduo - CAPP, + birefriong. blue in parallel. Hemochromatosis. Chondrocalsinosis
Tx- Nsaids, steroids, colchicine.

23
Q

Neurogenic arthropathy “Charcot joint”

A

Longstanding DM, B12 def - sig deformatlies of joints, fractures, effusions, osteophytes.

24
Q

Infectious Arthritis

Seronegative

A

Infectious - S. Aureuas, Strep, GC, Migratory

Seronegative - Reactive (couple weeks after GI/viral/GU)
- conjuncitivits, urethritis, arthritis. Tx - NSAIDS (NOT ABX)

25
Q

Metatarsal hairline fracture -

Mortons Neuroma

A

Hairline factuer Rest, analgesics, hard soled shoe

Mortons Neuroma - click in metatarsals when squeezed. Padded shoe.

26
Q

Stress fracture

A

X ray may or may not show - Rest and heal. nsaids.

27
Q

Avascualr necorsis rpesentation/.

A

X ray may not pick up initially. May or may not see point tendrness, full ROM early on.

28
Q

Ankylosing spodnylitis - Inflam of what?

Dx?

A

Apophyseal joints (Facet joints). INC ESR, CRP.

Dx - Xray. B27 later.

29
Q

Myasthenia crisis - tx

A

Intubatge if needed.

Steroids + plasmap-hx or IVIG.

30
Q

Prostehsis infection - timecoruse bugs

A

Early onset - St. A> and GN anaerobes

3+ months - Staph Epi, propionibacterium, Enterococci

31
Q

Spinal crod compression tx alg

A

Immedaite IV steroids + MRI + surgery consutl

32
Q

Gout - what must you do?

A

Tap the joint to rule out infection.

33
Q

Preventative measure for gout in pt w/ renal diseasE?

A

Allopurinol. Also colchiscine.

Probenecisd, NSAID contraindicated.

34
Q

Lower back pain - Straight leg raise is positive. Is imaging needed?

A

If no sign neuro findings usually no.

SLR more specific than sensitive.

35
Q

Hydroxychloroquine tox?

A

Retinal toxicity - dialted eye exam.

Anotehr DMARD second line to Methotrexate .

36
Q

?APL sydrome - what should qualify for workup of in pregnant women ?

What tx to prevent this?

A

2 or more 1st trimester events, or A SINGLE SECOND TRIMESTESR EVENT.

Tx - heparin and aspirin

37
Q

Ab associated with crest?

Most specific test for CREST?

A

Anti centromere (less specific but more sensitive)

Most specific - SCL70 - anti topoisomerase.

38
Q

Sjogrens - best initial test. Most accurate test?

concerns?

A

Initial test - Schirmer test (filter paperagainst eye and look for tears)

Most accureate folowup - parotid/lip biopsy/.

Concerns- lymphoma

39
Q

Best test for Wegeners?

A

Lung biopsy!!!

Better than renal >sinus.

40
Q

Which complement is decreased in cryoglobulinemia

A

c4 (Hep C - 4 letters)

SLE (dec C3 - 3 letters)

41
Q

presntation
Anterior shoudler dislocation
Posterior shoulder dislocation

A

Anterior - most common - - abducted and externally rotated - same as rotator cuff tear presentation

Posterior - flattened deltoid - adducted and internally rotated -

42
Q

Otosclerosis - when deos this present? tx?

A

– common cause of conductive hearing loss in adults – esp in 20s and 30s. Female prepond. Tx – surgical stapedectomy or hearing amplification.

43
Q

Ank spond presentation

A

– BETTER WITH EXERICSE, no improvement with rest. (worse at night)

44
Q

Polymyosisit best way to diagnose?? Findings?

A

Muscle biopsy

DM - perimyseal cd4
Polymyositis - endomesial CD8

45
Q

Low Threshold for What therapy in RA?

A

Bisphosphonates to prevent osteoporosis

46
Q

Penetrating trauma vs blunt algorithm in unstable pt?

A

Penetrating with unstabl e-> lap. Blunt with inconclusive FAST and unstable vitals -> diagnostic peritoneal lavage.

47
Q

Kid with no fever, URI, and externally rotated hip with pain what to do –

A

transient synovitis if no fever, no white count, and low ESR/CRP. Analgesics and followup.

48
Q

Septic arthritis vs Osteomyelitis

A

septic is at JOINTS! Arthrocentesis. Whereas Osteo usu MRI?

49
Q

Inheritance of muscular dystrophies

A

Duchennes, Becker Xr. Myotonic Muscular Dystrophy is AD! Of trinucleotide.

50
Q

Asx pagets tx?

A

Bisphosphonates, NO OCTREOTIDE (that is acromegaly)

51
Q

2 blastic maglinancies

A

prostate , breast, pagets

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