Clinical medicine, Radiology, Ethics Review Q's Flashcards
1. Introduction to MSK history & Physical Examination (1-16) 1. Synovial Fluid Chemistry- Review Session (17-53)
Patient with pain and stiffness in the mornings that gets better after exercise. What type of pain is this?
A. inflammatory
B. mechanical
a. inflammatory
Patient with pain in the knees, she says it hurts and makes sounds as she walks. What type of pain is this?
A. inflammatory
B. mechanical
b. mechanical
Delusional patient comes in claiming their magic knees control the weather. What type of pain is this?
A. inflammatory
B. mechanical
C. magical
a. inflammatory
Which muscles are responsible for lateral (external) rotation?
- Supraspinatus
- Infraspinatous
- Teres Minor
- Posterior fibers of deltoid
Which muscles are responsible for medial (internal) rotation?
- Subscapularis
- Pec major
- Teres major
- Latissimus dorsi
- Anterior fibers of deltoid
A person dislocated his shoulder previously. Which structure is responsible for the resulting instability?
ligaments
Which abduction angles does painful arch syndrome affect?
60-120
What causes painful arch syndrome?
Supraspinatus tendinitis
In which deformity does the proximal IP joint flex while the distal IP joint extended?
A. swan neck
B. mallet finger
C. boutonniere
C. boutonniere
In which deformity does the distal IP joint flex?
A. swan neck
B. mallet finger
C. boutonniere
b. mallet finger (also called baseball finger)
You perform a knee ligament test where you push the leg laterally while pushing the knee medially. Whats the name of this test?
A. Varus test
B. Valgus test
b. Valgus test
In which deformity does the distal IP joint flex while the PIP does hyperextension?
A. swan neck
B. mallet finger
C. boutonniere
a. swan neck
Which of the following ligaments does anterior drawer test, test?
A. ACL
B. PCL
C. MCL
D. LCL
A. ACL
Which of the following ligaments does varus test, test?
A. ACL
B. PCL
C. MCL
D. LCL
D. LCL
Which of the following ligaments does posterior drawer test, test?
A. ACL
B. PCL
C. MCL
D. LCL
B. PCL
What does the mcMurrey test, test?
the meniscus
T/F: the articulating surface of the synovial membrane is smooth
false, its irregular
What does the name synovium mean?
egg white
Which of the following synovial cells produce hyaluronan and mucin?
A. type A cells
B. type B cells
b. type B cells
Which of the following synovial cells clean the debris?
A. type A cells
B. type B cells
a. type A cells
What’s true about synovial fluid?
A. it has more electrolytes than plasma
B. it has more glucose than plasma
C. it has more calcium than plasma
c. it has more calcium than plasma
T/F: the more viscous the synovial fluid, the more lubricative it is
false
Which of the following synovial cells are also referred to as fibroblasts?
A. type A cells
B. type B cells
b. type B cells
What is reptate diffusion?
a diffusion path resembles a wiggling snake; the movement was termed reptation, which is the latin word for creeping
Why does the synovial fluid will flow in a snake-like motion?
due to the irregularities of the articulating surface of synovial joint
What can cross the synovial surface? a. big proteins b. water c. hyaluronan
b. water
What makes synovial fluid viscous?
hyaluronan
What makes synovial fluid lubricative?
lubricin
Which is used to collect synovial fluid for a Cell Count?
A. Plain tube
B. Heparinized tube
C. Sterile container
D. EDTA
b. Heparinized tube
Which is used to collect synovial fluid for Chemistry & Immunology tests?
A. Plain tube
B. Heparinized tube
C. Sterile container
D. EDTA
a. Plain tube
Consuming powdered anticoagulants before a synovial fluid test interferes with which test?
A. crystal analysis
B. glucose measurement
C. immunology
a. crystal analysis
Consuming food 6 hours before a synovial fluid test interferes with which test?
A. crystal analysis
B. glucose measurement
C. immunology
b. glucose measurement
Which is used to collect synovial fluid for microbiology tests?
A. Plain tube
B. Heparinized tube
C. Sterile container
D. EDTA
c. Sterile container
Which is used to collect synovial fluid for hematology tests?
A. Plain tube
B. Heparinized tube
C. Sterile container
D. EDTA
d. EDTA
Lab technician preforms wet preparation on synovial fluid, which test is he going to go on the specimen?
cystal study (it requires wet preparation; this was said in class)
Rice bodies are often an indicator of which disease?
RA
What are Rice bodies made out of?
infarcts of the joint synovium encased in layers of fibrin
What are ochronotic shards are made out of?
joint prosthesis debris. they look pepper-like
Which of the following tests viscosity? (aka hyaluronan)
A. ropes test
B. string test
C. thread test
b. string test
Which of the following tests requires the addition of acetic acid?
A. ropes test
B. string test
C. thread test
a. ropes test
Crystal examination showed calcium oxalate crystals that are positively birefringent with a bipyramidal shape. What’s the diagnosis?
A. gout
B. pseudogout
C. long term renal dialysis
D. acute arthritis
E. tuberculosis arthritis
F. rheumatoid arthritis
c. long term renal dialysis (Calcium oxalate crystals are the most common cause of kidney stones)
Which of the following tests hyaluronic acid-mucin protein complex?
A. ropes test
B. string test
C. thread test
a. ropes test
Crystal examination showed monosodium urate crystals that are negatively birefringent with a needle shape. What’s the diagnosis?
A. gout
B. pseudogout
C. long term renal dialysis
D. acute arthritis
E. tuberculosis arthritis
F. rheumatoid arthritis
a. gout
Appears blue when perpendicular to compensator.
A. negative birefringence
B. positive birefringence
a. negative birefringence
Crystals of which disease look yellow when aligned (parallel) with the compensator filter?
A. gout
B. pseudogout
a. gout (monosodium urate crystals)
Crystal examination showed calcium lipid crystals that are positively birefringent and have a maltase cross appearance. What’s the diagnosis?
A. gout
B. pseudogout
C. long term renal dialysis
D. acute arthritis
E. tuberculosis arthritis
F. rheumatoid arthritis
d. acute arthritis
Crystals of which disease look blue when aligned (parallel) with the compensator filter?
A. gout
B. pseudogout
b. pseudogout (calcium pyrophosphate dihydrate crystals)
Which type of arthritis causes a high number of monocyte cells?
A. rheumatoid arthritis
B. crystal induced arthritis
C. septic arthritis
b. crystal induced arthritis
Crystals are seen in a rhombic shape and a notched corner. They appear to adhere together. What are the crystals made out of?
cholesterol (may indicate RA or Tuberculosis artheritis)
Appears yellow when perpendicular to compensator.
A. negative birefringence
B. positive birefringence
b. positive birefringence
Which type of arthritis causes a high number of lymphocyte cells?
A. rheumatoid arthritis
B. crystal induced arthritis
C. septic arthritis
a. rheumatoid arthritis
Crystal examination showed calcium pyrophosphate dihydrate crystals that are rhomboid/square shape. What’s the diagnosis?
A. gout
B. pseudogout
C. long term renal dialysis
D. acute arthritis
E. tuberculosis arthritis
F. rheumatoid arthritis
b. pseudogout
Which type of arthritis causes a high number of neutrophils cells?
A. rheumatoid arthritis
B. crystal induced arthritis
C. septic arthritis
c. septic arthritis
Whats the most common place affected by OA?
A. hips
B. knees
C. hands
D. elbowz
b. knees
Which is more true?
A. OA starts with the degeneration then the inflammation
D. OA starts with the inflammation then the degeneration
a. OA starts with the degeneration then the inflammation
Knock knee is also known as
A. Varus deformity
B. Valgus deformity
b. Valgus deformity
Radiology of bone for OA is used to
A. screen
B. confirm
b. confirm (and to rule out other things)
Bow leg is also known as:
A. Varus deformity
B. Valgus deformity
a. Varus deformity
What are the most common causes of lower back pain?
lumbar sprain and strain
Lower back pain with unexplained weight loss might indicate
A. neurological problems
B. infection
C. malignancies
D. rheumatic disease
c. malignancies
Lower back pain with bladder/bowl problems might indicate
A. neurological problems
B. infection
C. malignancies
D. rheumatic disease
a. neurological problems
Medially wedged insoles are used for
A. Varus deformity
B. Valgus deformity
b. Valgus deformity
How does medically directed patellar taping help OA patients?
It changes the patella location to improve symptoms
Subtalar Strapped lateral insoles are used for
A. Varus deformity
B. Valgus deformity
a. Varus deformity
What’s the primary protection against malpractice lawsuits?
patient preference
T/F: informed consent is a paper the patient must sign
false, informed consent PROCESS
You look at an Xray and notice the dens in the middle of the vertebra. Which vertebra is this?
C2, axis
You look at an Xray and notice the foramen transversarium. Which vertebra is this?
C1, atlas
Who is most commonly affected by discitis?
patients with low immunity or those with a recent spinal procedure
What can you conclude when one nucleus pulposus appears more opaque than the others in an Xray?
its dehydrated
What type of fracture occurs if a patient takes a long fall on the feet?
burst fracture
Which most commonly affects the spinal canal?
A. dorsal spine fracture
B. wedges fracture
b. wedges fracture (it’s mostly wedged posteriorly)
Which stage of avascular necrosis is a patient with a regular acetabulum contour (but a collapsed femur) in?
A. stage 0
B. stage 1
C. stage 2
D. stage 3
E. stage 4
c. stage 2
Which stage of avascular necrosis is a patient with a regular contour of the femoral head in spite of dead bone tissue in?
A. stage 0
B. stage 1
C. stage 2
D. stage 3
E. stage 4
b. stage 1
What three bones have an easily compromised blood supply?
femoral head scaphoid talus
Which stage of avascular necrosis is a patient with a complete collapse of femoral head in?
A. stage 0
B. stage 1
C. stage 2
D. stage 3
E. stage 4
e. stage 4
What makes up the conjoined tendon of the knee?
The lateral collateral ligament and biceps femoris tendon
Which of the following can distinguish a clavicle fracture from inflammatory disease of subclavius?
A. Presence of crepitus
B. Limited range of motion
C. Morning pain
A. Presence of crepitus
What test is used to assess for shoulder impingement syndrome?
A. Painful arc test
B. Empty cup test
C. Speeds biceps test
D. External rotation against resistance
A. Painful arc test
What is the purpose of the patellar tap test?
A. Detect fluid accumulation posterior to patella
B. Detect patellar dislocation
C. Detect for patellar instability
A. Detect fluid accumulation posterior to patella
Upon patient examination, a doctor was able to push the patient’s right tibia posteriorly. The same could not be done for his left tibia. What structure is injured?
A. Anterior cruciate ligament
B. Posterior cruciate ligament
C. Lateral collateral ligament
D. Medial collateral ligament
B. Posterior cruciate ligament
A 14-year-old girl came into the doctor’s office with her mother. Her mother explained how she noticed that the girl’s shoulders were uneven and that her pelvis was tilted. What would be the next step taken by the doctor?
A. Reassure mother
B. Full spine x-ray
C. X-ray of shoulders and pelvis
D. MRI of spine and pelvis
B. Full spine x-ray
A 65-year-old woman with osteoarthritis of the knees complains of pain and swelling of gradual onset in both knees over a period of 5 years. Which of the following statements is true about her condition?
A. Her metacarpophalangeal joints are also likely to be involved
B. She’s likely to complain from prolonged morning stiffness
C. Increased weight can worsen the symptoms
D. Her pain is likely to improve with activity
E. Her ESR (erythrocyte sedimentation rate) is likely to be elevated
C. Increased weight can worsen the symptoms
A young male presented with low back pain for more than 6weeks. Which of the following is most likely related to this case of spondyloarthritis (inflammatory pain)?
A. Negative family history
B. Morning stiffness
C. Lumbar lordosis
B. Morning stiffness
What test is used to assess for shoulder impingement syndrome?
A. Painful arc test
B. Empty cup test
C. Speeds biceps test
D. External rotation against resistance
A. Painful arc test
What is the purpose of the patellar tap test?
A. Detect fluid accumulation posterior to patella
B. Detect patellar dislocation
C. Detect for patellar instability
A. Detect fluid accumulation posterior to patella
Upon patient examination, a doctor was able to push the patient’s right tibia posteriorly. The same could not be done for his left tibia. What structure is injured?
A. Anterior cruciate ligament
B. Posterior cruciate ligament
C. Lateral collateral ligament
D. Medial collateral ligament
B. Posterior cruciate ligament
A 14-year-old girl came into the doctor’s office with her mother. Her mother explained how she noticed that the girl’s shoulders were uneven and that her pelvis was tilted. What would be the next step taken by the doctor?
A. Reassure mother
B. Full spine x-ray
C. X-ray of shoulders and pelvis
D. MRI of spine and pelvis
B. Full spine x-ray
A 65-year-old woman with osteoarthritis of the knees complains of pain and swelling of gradual onset in both knees over a period of 5 years. Which of the following statements is true about her condition?
A. Her metacarpophalangeal joints are also likely to be involved
B. She’s likely to complain from prolonged morning stiffness
C. Increased weight can worsen the symptoms
D. Her pain is likely to improve with activity
E. Her ESR (erythrocyte sedimentation rate) is likely to be elevated
C. Increased weight can worsen the symptoms
A young male presented with low back pain for more than 6weeks. Which of the following is most likely related to this case of spondyloarthritis (inflammatory pain)?
A. Negative family history
B. Morning stiffness
C. Lumbar lordosis
B. Morning stiffness
Which tendon is stretched when eliciting patellar reflex?
A. Quadriceps femoris
B. Biceps femoris
C. Sartorius
D. Pectineus
E. Quadratus femoris
A. Quadriceps femoris