Buzzwords Flashcards

1
Q

narrowing of spinal canal

A

spinal stenosis

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2
Q

numbness/paresthesias radiating to bilateral buttocks and thighs

A

spinal stenosis

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3
Q

pain worse with extension

A

spinal stenosis

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4
Q

pain better with flexion

A

spinal stenosis

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5
Q

HLA-B27 positive

A

Akylosing Spondylitis
Reactive Arthritis aka Reiters syndrome
Psoriatic arthritis
IBD assoc arthritis

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6
Q

back pain/stiffness worse in AM

A

ankylosing spondylitis

polymyalgia rheumatica

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7
Q

back pain worse with rest

A

ankylosing spondylitis

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8
Q

uveitis

A

ankylosing spondylitis

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9
Q

increased ESR

A

ankylosing spondylitis

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10
Q

Xray shows sacroiliitis

A

ankylosing spondylitis

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11
Q

bamboo spine

A

ankylosing spondylitis

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12
Q

xray shows loss of normal lumbar curvature + squaring and fusion of the vertebrae

A

ankylosing spondylitis

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13
Q

unilateral radicular back pain radiating down leg in dermatomal pattern

A

Herniated disc

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14
Q

back pain increasing with coughing

A

herniated disc

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15
Q

back pain increasing with straining

A

herniated disc

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16
Q

back pain increasing with bending

A

herniated disc

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17
Q

back pain increasing with sitting

A

herniated disc

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18
Q

back pain increasing with valsalva

A

herniated disc

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19
Q

+ straight leg raise

A

herniated disc

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20
Q

xray of spine shows loss of disc height

A

herniated disc

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21
Q

anterior thigh pain

A

L4 herniated disc

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22
Q

weak ankle dorsiflexion

A

L4 herniated disc

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23
Q

loss of knee jerk + weak knee extension

A

L4 herniated disc

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24
Q

Lateral thigh/leg hip groin paresthesias + pain

A

L5 herniated disc

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25
Q

weakness in big toe extension aka big toe dorsiflexion

A

L5 hern disc

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26
Q

walking on heels more diff than walking on toes

A

L5 hern disc

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27
Q

posterior leg/calf and gluteus pain + Plantar surfaces of foot

A

S1 disc hern

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28
Q

weakness in plantar flexion

A

S1 disc herniation

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29
Q

walking on the toes is more difficult than walking on heels

A

S1 disc hern

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30
Q

Loss of ankle jerk

A

S1 disc hern

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31
Q

pain + numbness + weakness + swelling of arm/shoulder

A

thoracic outlet syndrome

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32
Q

(+) adson sign

A

thoracic outlet syndrome

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33
Q

goose egg

A

olecranon bursitis

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34
Q

snuffbox tenderness

A

scaphoid or navicular fx

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35
Q

DIP in flexion

A

mallet finger

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36
Q

PIP in flexion and DIP in hyperextension

A

Boutonniere deformity

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37
Q

PIP in hyperextension and DIP in flexion

A

swan neck deformity

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38
Q

inability to fully extend elbow

A
olecranon fx 
or 
elbow dislocation
or 
radial head fx
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39
Q

MC sequelae of elbow dislocation

A

lost of terminal extension

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40
Q

neuro testing maneuvers

*peace sign against resistance

A

ulnar nerve

**elbow dislocation to check ulnar nerve

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41
Q

neuro testing maneuvers

*hitchhiker/thumbs up

A

radial nerve

**elbow dislocation to check radial nerve

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42
Q

neuro testing maneuvers

*power to the people aka closed fist

A

median nerve

**elbow dislocation to check median nerve

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43
Q

neuro testing maneuvers

*OK sign

A

Median nerve—anterior interosseous

**elbow dislocation to check median nerve

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44
Q

+ posterior fat pad sign

A

radial head fx

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45
Q

+ displaced anterior fat pad sign

A

radial head fx

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46
Q

mid-distal radial shaft fx with dislocation of the distal radioulnar joint

A

Galeazzi fx

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47
Q

Fx to proximal 1/3 of ulnar shaft + dislocation of radial head

A

Monteggia fx

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48
Q

MUGR

A

MU= monteggia fx is ULNA fx
GR=galeazzi RADIUS fx

MonteggiA (ENDS IN A)… A is proximal: bones affected proximally

GaleaZZi=Z is distal–bones affected distally

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49
Q

extensor carpi radialis brevis muscle inflammation

A

tennis elbow aka lateral epicondylitis

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50
Q

pain with wrist extension against resistance

A

tennis elbow aka lateral epicondylitis

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51
Q

pain with wrist flexion against resistance with elbow flexion

A

medial epicondylitis aka golfers elbow

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52
Q

pronator teres-flexor carpi radialis muscle inflamm

A

medial epicondylitis aka golfers elbow

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53
Q

+ tinel sign

A
  1. cubital tunnel syndrome

2. Tarsal tunnel syndrome

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54
Q

Paresthesia and pain along the ulnar nerve distribution

-worse with elbow flexion

A

cubital tunnel syndrome

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55
Q

+) Froment sign

A

cubital tunnel syndrome

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56
Q

FOOSH with extended wrist

A

scaphoid (navicular) fx

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57
Q

MC fx carpal bone

A

scaphoid/navicular

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58
Q

anatomical snuffbox tenderness

A

scaphoid/navicular fx

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59
Q

distal radius fx with dorsal angulation

A

colles fx

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60
Q

dinner fork deformity

A

colles fx

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61
Q

XR shows dorsally displaced or angulated fx on distal radius

A

colles fx

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62
Q

MC complication from colles fx

A

extensor pollicis longus tendon rupture

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63
Q

distal radius fx with ventral angulation of distal fragment

A

smith’s fx

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64
Q

FOOSH with wrist flexed

A

smith’s fx

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65
Q

garden spade deformity

A

smith’s fx

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66
Q

wrist pain worse with passive motion

A

smith’s fx
and
colles fx

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67
Q

“piece of pie” sign

A

lunate dislocation

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68
Q

“spilled teacup” sign

A

lunate dislocation

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69
Q

whats the most serious carpal fx and why

A

lunate fx

-occupies 2/3 of radial articular surface

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70
Q

lateral angle

A

scoliosis

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71
Q

posterior and anterior angles

A

kyphosis and lordosis

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72
Q

hump back

A

kyphosis

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73
Q

indentation on lower back

A

lordosis

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74
Q

back pain not assoc with radiation to leg or neuro symps

A

lumbosacral sprain or strain

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75
Q

when you see a compression fx– what must you r/o

A

CA *!! esp if pt is elderly

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76
Q

localized back pain

A

compression fx

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77
Q

xray shows loss of vertebral height

A

compression fx

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78
Q

pars interarticular defect

A

spondylolysis

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79
Q

MC at L5-S1

A

spondylolysis

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80
Q

scotty dog

A

spondylolysis

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81
Q

lateral radiolucent defect in pars

A

spondylolysis

scotty dog

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82
Q

MC at L4-L5

A

Spondylolisthesis

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83
Q

forward slipping of a vertebra on xray

A

spondylothisthesis

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84
Q

anterolisthesis of L5 over S1 with associated spondylolysis at that level

A

spondylolisthesis

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85
Q

bad thing we must always r/o with back pain

A

cauda equina

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86
Q

back pain + decr sensation to buttocks, perineum and inner surfaces of thigh

A

cauda equina syndrome

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87
Q

back pain + new onset urinary bowel retention or incontinence

A

cauda equina syndrome

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88
Q

back pain + bilat leg radiation of pain

A

cauda equina syndrome

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89
Q

fever + spinal pain + neuro deficits

A

spinal infection

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90
Q

RF for spinal infection

A

> 50 YO
IVDU
immunodef
recent instrument/procedure—EX: LP

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91
Q

what lab test determines early diagnosis of RA

A

Anti-citrullinated protein antibody (ACPA)

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92
Q

what lab test diagnoses RA

A

Rheumatoid factor

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93
Q

aggravation of pain with prolonged rest— morning stiffness and improves with use

A
  • inflammatory arthritis—–RA, polyarthritis
  • polymyalgia rheumatica
  • ankylosing spondylitis
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94
Q

aggrivated by motion and relieved with rest

A

non-inflammatory arthritis

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95
Q

pain, limitation of motion, swelling and/or tenderness at a joint

A

arthritis in general

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96
Q

arthritis affecting single joint

A

monoarticular

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97
Q

arthritis affected several joints

A

oligoarticular

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98
Q

arthritis affecting many joints

A

polyarticular

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99
Q

rheum dz with age of onset 20-40 YO and is MC in W>M

A

RA

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100
Q

subcutaneous rheumatoid nodule over extensor surfaces

A

RA

extensor surfaces—lungs, pleura, pericardum**

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101
Q

symmetrical involvement of the joints of hands/feet

A

RA–typical presentation

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102
Q

HLA-DRA 1 & 4

A

RF for RA

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103
Q

Boutonniere deformities of PIP

A

RA

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104
Q

Swan-neck contractures of fingers

A

RA

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105
Q

ulnar deviation of metacarpophalangeal joints

A

RA

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106
Q
  • elevated RF
  • (+) Anticitrullinated peptide/protein antibodies
  • elevated ESR
  • elevated CRP
A

RA

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107
Q

which DMARD requires eye exam every 6 MO and why

A

hydroxychloroquine

*risk of visual loss due to retinopahty

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108
Q

what must you give with methotrexate

A

folic acid

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109
Q

DIP joint affected

A

osteoarthritis

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110
Q

MCP and PIP joints affected

A

RA (spares DIP)

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111
Q

conjunctivitis + urethritis + arthritis

A

reactive arthritis

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112
Q

cant see cant pee cant climb a tree

A

Reactive arthritis

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113
Q

arthritis + conjunctivitis + urethritis after an infection

A

reactive arthritis

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114
Q

hyperkeratinized lesions on palms and soles

A

keratoderma blennorrhagicum

finding in reactive arthritis

115
Q

arthritis involves larger joints— esp knee

A

reactive arthritis

116
Q

increased assoc with chronic hep B and C

A

Polyarteritis Nodosa

117
Q

MC seen in men 40-60 YO

A

PAN

118
Q

abd pain worse when eating

A

PAN— GI ischema

119
Q

skin appears mottled/purplish

A

livdeo reticularis–seen with PAN

120
Q

rosary sign on angiography

A

PAN

121
Q

microaneurysms with abrupt cut off of small arteries

A

PAN

122
Q

assoc with giant cell arteritis

A

Polymyalgia Rheumatica

123
Q

sudden onset of bilateral hip and shoulder girdle ache +stiffness and fatigue in PT >50 YO

A

Polymyalgia Rheumatica

124
Q

difficulty combing hair

A

polymyalgia rheumatica

polymyositis

125
Q

difficulty getting up from chair

A

polymyalgia rheumatica

polymyositis

126
Q

pain on movement and stiffness with periods of inactivity

A

Polymyalgia rheumatica

127
Q

muscle inflammation of pharynx, limbs and neck

A

polymyositis

128
Q

+ anti-signal recognition protein

A

most specific lab finding for polymyositis

129
Q

what has a 25% association with CA

A

dermatomyositis

130
Q

Anti-Jo 1 antibodies

A

Polymyositis

Dermatomyositis

131
Q

Anti-Mi 2

A

Dermatomyositis

132
Q

blue-purple discoloration of upper eyelid

A

pathognomonic for dermatomyositis (heliotrope rash)

133
Q

raised violaceous scaly knuckle eruptions

A

pathognomonic for dermatomyositis (gottron’s papules)

134
Q

MC in women 20-55 YO

A

Fibromyalgia

135
Q

pain is worse in the cold or by weather changes

A

fibromyalgia

136
Q

pain is allevaited with rest, warmth and mild exercise

A

fibromyalgia

137
Q

pain is worse with sleep deprivation and worse in am

A

fibromyalgia

138
Q

HLDA-DR52

A

Sjogren syndrome

139
Q

assoc with other autoimmune dz—Hashimoto, SLE or RA

A

Secondary Sjogren syndrome

140
Q

exocrine glands

A

Sjogren syndrome

141
Q

associated with incr risk of non-Hodgkin lymphoma

A

Sjogren syndrome

142
Q

anti-centromere antibodies

A

Systemic sclerosis— limited type (CREST)

143
Q

anti-SCL-70 antibodies

A

systemic sclerosis–diffuse type–multiple organ involvement
*poor prognosis

144
Q

proximal muscle weakness often painless + dermatologic manifestations

A

Dermatomyositis

145
Q

proximal muscle weakness often painless

A

polymyositis

146
Q

thickened skin + raynauds

A

scleroderma (CREST)

147
Q

dry eyes dry mouth

A

Sjogren

148
Q

malar rash
photosensitivity
fever

A

SLE

149
Q

type III hypersensitivity

A

SLE

PAN

150
Q

joint pain + fever + malar rash

A

SLE

151
Q

anti-double stranded DNA

A

SLE

152
Q

anti-Smith antibodies

A

SLE

153
Q

antiphospholipid antibodies

A

SLE

*means incr risk of arterial and venous thrombosis

154
Q

recurrent DVT or PE

A

Antiphospholipid syndrome

-can be assocc with SLE

155
Q

recurrent miscarriages

A

antiphospholipid syndrome–can be assoc with SLE

156
Q

anticardiolipin antibodies

A

antiphospholipid syndrome–can be assoc with SLE

**also assoc with false-positive testing for syphilis

157
Q

+ lupus anticoagulant

A

Antiphospholipid syndrome
=incr PTT
*****positivty assoc with hypercoaguability

158
Q

daily high fever + arthritis pain + salmon colored pink rash + lymphadenopathy in kid <16 YO

A

Jeuvenille RA— Systemic or Still’s DZ

159
Q

<16 YO patient

  • uveitis
  • knee and/or ankle arthritis pain
A

Jeuvenille RA— Pauci (oligo) articular

160
Q

<16 YO PT:
*small joints affected– many
*uveitis
+morning stiffness

A

Jeuvenille RA—polyarticular

***worse prognosis

161
Q

which Jeuvenille (idiopathic) Rheumatoid Arthritis is assoc with (-) RF and ANA

A

Still’z dz

162
Q

which Jeuvenille (idiopathic) Rheumatoid Arthritis is assoc with (+) ANA

A

oligoarticular

163
Q

Skin thickening that begins as swelling of the fingers and hands associated with telangiectasia, dysphasia, and hypomotility of the GI tract is most likely…..

A

scleroderma

164
Q

(+) ANA

A
SLE 
scleroderma 
RA 
Sjogrens 
dermatomyositis 
polymyositis
165
Q

affected limb is ADDucted, internally rotated and shortened

A

hip dislocation posterior

166
Q

affected limb is ABDucted, externally rotated and shortened

A

anterior hip dislocation

**hip fracture*

167
Q

MC affeected nerve and artery in anterior hip dislocation

A

femoral

168
Q

SCFE in kid before puberty what do you suspect

A

hormonal or systemic disorders— hypothyroidism**

169
Q

14 YO obese male with hip/groin/thigh pain and painful limp worse with activity

A

SCFE

  • obese
  • male
  • 8-16YO
170
Q

ice cream cone fell off the cone

A

SCFE

171
Q

frog leg lateral view

A

SCFE

172
Q

child with PAINFUL limp

A

SCFE

173
Q

child with painless limp

A

leg-calve-perthes dz

174
Q

(+) crescent sign on xray

A

advanced Leg-calve-perthes dz

175
Q

widening of cartilage space on xray with incr density of femoral epiphysis

A

early leg-calve-perthe dz

176
Q

MC long bone fx?

A

tibial and fibular fx

177
Q

what is the biggest and most stressed joint in the body

A

knee

178
Q

Sudden and severe knee pain with hx of trauma sugests?

A

disruption of a ligament, meniscus or osseous structure

179
Q

chronic knee pain suggests

A

degenerative condition

180
Q

knee pain that is worse with weight bearing suggests

A

mechanical pathologies–>meniscus tear, ligament tear, fx

181
Q

knee night pain + stiffness suggest

A

inflammatory pathology

182
Q

hip and lumbar pathologies can cause ?

A

diffuse and poorly localized knee pain

183
Q

Pain in the front of knee suggests

A

Chrondromalacia
patella tracking
bursitis
arthritis

184
Q

pain above the knee suggests

A

quads tendon swelling

185
Q

pain below the knee suggests

A

osgood schlatter

186
Q

pain on inside or outside parts of knee suggest

A

meniscus or collateral ligament tears

arthritis

187
Q

pain behind the knee

A

bakers cyst

188
Q

child with quadricep atrophy suggests

A

legg calve perthes dz

189
Q

list all the tests for ACL injury

A

Lachman test
Anterior drawer test
pivot shift test

190
Q

pain behind knee

A

DVT

bakers cyst

191
Q

noncontact injury to knee–what is MC affected

A

only ACL torn

192
Q

lateral trauma to knee

A

MCL tear

aka valgus stress

193
Q

MC knee ligament injury?

A

ACL

194
Q

MOA is noncontact pivoting injury during sports

A

ACL

195
Q

MVA + dashboard injury

A

PCL injury

196
Q

Fall on flexed knee

A

PCL

Patellar fx

197
Q

Direct blow to the knee

A

PCL

198
Q

contact injuries to the knee MC affect which ligament

A

PCL

NOT ACL— most commonly non-contact pivoting injuries

199
Q

popping of knee during ambulation

A

Mensical tear

200
Q

cyclists or runners

A

Patellofemoral syndrome– chondromalacia

201
Q

(+) apprehension sign

A
Patellofemoral syndrome (chondromalacia)
Patellar dislocation
202
Q

valgus stress after twisting injury, direct blow

A

patellar dislocation

203
Q

(+) hemarthrosis of knee joint in context of trauma suggests

A

patellar fx

204
Q

(+) drop foot finding on PE

A
  • **peroneal nerve injury
  • Femoral condyle fx
  • tibial platea fx
  • tibial/femoral dislocation if peroneal nerve injury present
205
Q

this injury is MC seen in kids in MVAs

A

Tibial Plateau fx

206
Q

MC complication from tibial plateau fx

A

soft tissue injury— MC lateral meniscal tears

207
Q

what is a severe limb-threatenign emergency

A

knee (tibial/femoral) dislocations

208
Q

MC in males 10-15 YO during ovruse activites

A

osgood-schlatter dz

209
Q

prominence swelling and tenderness to anterior tibial tubercle

A

Osgood Schlatter

210
Q

MC sprained ankle ligament

A

ATFL
anterior talofibular ligament
LATERAL LIGAMENT

211
Q

mc tx for ankle sprain

A

Rest
Ice
Compression
Elevation

212
Q

episodic atheletes

A

achilles tendon rupture

213
Q

Fluoroquinolone (ex Cipro) use

A

achilles tendon rupture

214
Q

(+) Thompson test

A

achilles tendon rupture

215
Q

what drug has a BBW for achilles tendon rupture

A

Ciprofloxacin

216
Q

what type of fx would be result of jumping out of a window

A

Pilon fx aka Plafond fx—- ankle fx— central portion of tibia fx

217
Q

commonly missed ankle fx?

A

Maisonneue fx —– always alays alawys examine joints ABOVE AND BELOW injury

218
Q

proximal fibula fx— what else do we want to look at?

A

Ankle xray— to r/o or r/i Maisonneuve fx

219
Q

exam of which structure is imp to any suspected ankle fx or injury?

A

Fibular and lateral. malleolus

***maisonneuve fracture

220
Q

localized tenderness at third metatarsal

A

march fx

221
Q

foot pain incrs with dorsiflexion of toes

A

plantar fasciitis

222
Q

pain incrs during the day–worse at night– and does not improve with rest

A

Tarsal Tunnel Syndrome

223
Q

hx of wearing tight, pointed shoes

A
hallux valgus (bunion) (more so the pointed shoes) 
hammer toe (more so high heels) 
Morton's neuroma (more so high heels)
224
Q

pain over great toe at MTP joint w/ a lateral deformty

A

Hallux Valgus

225
Q

patient has 2nd toe (or 3rd or 4th) longer than the first

A

hammer toe

226
Q

deformity of the PIP joint–>flexion of PIP joint w/ hyperextension of MTP and DIP joint

A

hammer toe

227
Q

tertiary syphilis

A

Neuropathic (charcot) arthropathy

228
Q

burning/lancinating foot pain

A

Morton’s neuroma

229
Q

pain on 5th metatarsal

A

jones fx

230
Q

(+) Fleck Sign

A

Lisfranc Injury

fx at the base of the second metatarsal pathognomonic for disruption of ligaments

231
Q

xray shows irregularity and fragmentation of the joint space

A

avasc necrosis— can be assoc with legg-calve-perthes dz

232
Q

blow to an abducted, externally rotated and extended shoulder causes

A

anterior shoulder dislocation

233
Q

groove fx of shoulder

A

hill sachs lesions (ant dislocation)

234
Q

Glenoid rim fx

A

bankart lesion– ant disloction

235
Q

neurovascular compromise more common in ant or post shoulder dislocaiton
-which nerve

A

anterior— axillary nerve (runs in deltoid) MC nerve

236
Q

this injury is assoc with seizures and electric shocks

A

post shoulder dislocation

237
Q

shoulder has decr ROM esp with external rotation and pt has pain worse at night

A

adhesive capsulitis frozen shoulder

238
Q

passive ROM of shoulder restricted

A

frozen shoulder

239
Q

passive ROM greater than active in shoulder

A

rotator cuff tear

240
Q

PE tests for rotator cuff injury

A
  1. Hawkins
  2. drop arm
  3. neer test
  4. supraspinatus strength test aka empty can test
241
Q

which PE test do to to check for supraspinatus involvement

A

empty can test

242
Q

common site for pathologic fxs in met BCA

A

proximal humerus—- humereal head fx

243
Q

mets of BCA

A

patholgic fxs of humeral head

244
Q

(+) wrist drop

A

radial nerve damage—- can be from humeral shaft fx

245
Q

which nerve do we worry about with:

  1. humeral head fx
  2. humeral shaft fx
A

head=brachial plexus

shaft=radial nerve

246
Q

severe vit D deficiency can cause

aka rickets

A

osteomalacia

247
Q

blue tinted sclerae

A

Osteogenesis imperfecta

248
Q

associated with deafness

A

osteogenesis imperfecta

249
Q

puncture wound through shoe

A

osteomyelitis via pseudomonas aeruginosa

250
Q

type of arthritis mc in weight bearing joints (knees, hips, spine, wrists)

A

OA

251
Q

short (<60 mins) of morning stiffness

A

OA

RA is longer period of morning stiffness

252
Q

Asymmetric joint narrowing
Marginal osteophytes
Subchondral bone sclerosis
Bone cysts

A

OA

253
Q

Symmetric joint narrowing
Osteopenia, bone and joint erosions
Ulnar deviation in severe case

A

RA

254
Q

OA is a ___ dz and RA is a ____ dz

A

OA=degenerative

RA=autoimmune

255
Q

morning stiffness <30-60 mins

A

OA

256
Q

morning stiffness >60 mins

A

RA

257
Q

pain out of proportion to injury

A

comp syndrome

258
Q

MC site for avasc necrosis

A

femoral head

259
Q

pain starts in groin—>thigh—>buttock

A

avasc necrosis in femoral head

260
Q

Avascular necrosis is a complication of which traumatic hip injuries?

A

hip dislocation or femoral neck fx

261
Q

pt is on statin tx

A

RHABDO

262
Q

muscle pain + weakness + dark tea colored urine

A

RHABDO

263
Q

hyperuricemia

A

hallmark of gout—– but does not itself indicate gout

264
Q

MC benign bone tumor

A

Osteochondroma

265
Q

MC bone tumor in kids

A

osteochondroma

266
Q

Xray shows pedunculated stalk that grows away from growth plate

A

Osteochondroma

267
Q

nidus produces prostaglandins

A

osteoid osteoma

268
Q

MC primary bone malignancy in kids + young adults

A

Osteosaroma

269
Q

Second MC primary bone malignancy in kids + young adults

A

ewing’s sarcoa

270
Q

onion skin apperance on xray

A

ewings

271
Q

lytic lesions with moth eaten apperaence on xray

A

ewings

272
Q

“hair on end” or “sunburst” apperance

A

osteosarcoma

273
Q

xray shows lytic mass with a multi-laminated periosteal reaction involving the proximal anterior tibia (or another long bone)

A

ewing

**onoin skoin

274
Q

xray shows round lucency surrounded by sclerotic bone

A

osteoid osteomao

275
Q

opioid receptors

A

δ [delta],andκ [kappa

276
Q

Leukocytosis and a low synovial glucose are indicative of

A

septic arthritis

277
Q

best screening test to evaluate for SLE?

A

ANA

278
Q

Cervical spondylosis occurs with

A

OA

279
Q

associated with C1-C2 subluxation

A

RA

280
Q

Hydroxychloroquine is associated with

A

macular damage—night vision impaired
rash
diarrhea

281
Q

FOOSH then–>

  • pain on the dorsal radial side of the wrist with minimal swelling
  • pain is incr with dorsiflexion
  • click with wrist movement
A

scapholunate dissociation

282
Q

high energy injuries while the wrist is extended and ulnarly deviated

A

lunate dislocation

283
Q

tenderness to palpation in shallow indentation on the mid-dorsum of the wrist

A

lunate fx