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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)

1
Q

Patient with pain and stiffness in the mornings that gets better after exercise. What type of pain is this?

A. inflammatory

B. mechanical

A

a. inflammatory

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2
Q

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

A

b. mechanical

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3
Q

Delusional patient comes in claiming their magic knees control the weather. What type of pain is this?

A. inflammatory

B. mechanical

C. magical

A

a. inflammatory

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4
Q

Which muscles are responsible for lateral (external) rotation?

A
  1. Supraspinatus
  2. Infraspinatous
  3. Teres Minor
  4. Posterior fibers of deltoid
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5
Q

Which muscles are responsible for medial (internal) rotation?

A
  1. Subscapularis
  2. Pec major
  3. Teres major
  4. Latissimus dorsi
  5. Anterior fibers of deltoid
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6
Q

A person dislocated his shoulder previously. Which structure is responsible for the resulting instability?

A

ligaments

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7
Q

Which abduction angles does painful arch syndrome affect?

A

60-120

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8
Q

What causes painful arch syndrome?

A

Supraspinatus tendinitis

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9
Q

In which deformity does the proximal IP joint flex while the distal IP joint extended?

A. swan neck

B. mallet finger

C. boutonniere

A

C. boutonniere

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10
Q

In which deformity does the distal IP joint flex?

A. swan neck

B. mallet finger

C. boutonniere

A

b. mallet finger (also called baseball finger)

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11
Q

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

A

b. Valgus test

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12
Q

In which deformity does the distal IP joint flex while the PIP does hyperextension?

A. swan neck

B. mallet finger

C. boutonniere

A

a. swan neck

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13
Q

Which of the following ligaments does anterior drawer test, test?

A. ACL

B. PCL

C. MCL

D. LCL

A

A. ACL

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14
Q

Which of the following ligaments does varus test, test?

A. ACL

B. PCL

C. MCL

D. LCL

A

D. LCL

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15
Q

Which of the following ligaments does posterior drawer test, test?

A. ACL

B. PCL

C. MCL

D. LCL

A

B. PCL

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16
Q

What does the mcMurrey test, test?

A

the meniscus

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17
Q

T/F: the articulating surface of the synovial membrane is smooth

A

false, its irregular

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18
Q

What does the name synovium mean?

A

egg white

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19
Q

Which of the following synovial cells produce hyaluronan and mucin?

A. type A cells

B. type B cells

A

b. type B cells

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20
Q

Which of the following synovial cells clean the debris?

A. type A cells

B. type B cells

A

a. type A cells

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21
Q

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

A

c. it has more calcium than plasma

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22
Q

T/F: the more viscous the synovial fluid, the more lubricative it is

A

false

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23
Q

Which of the following synovial cells are also referred to as fibroblasts?

A. type A cells

B. type B cells

A

b. type B cells

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24
Q

What is reptate diffusion?

A

a diffusion path resembles a wiggling snake; the movement was termed reptation, which is the latin word for creeping

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25
Q

Why does the synovial fluid will flow in a snake-like motion?

A

due to the irregularities of the articulating surface of synovial joint

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26
Q

What can cross the synovial surface? a. big proteins b. water c. hyaluronan

A

b. water

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27
Q

What makes synovial fluid viscous?

A

hyaluronan

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28
Q

What makes synovial fluid lubricative?

A

lubricin

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29
Q

Which is used to collect synovial fluid for a Cell Count?

A. Plain tube

B. Heparinized tube

C. Sterile container

D. EDTA

A

b. Heparinized tube

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30
Q

Which is used to collect synovial fluid for Chemistry & Immunology tests?

A. Plain tube

B. Heparinized tube

C. Sterile container

D. EDTA

A

a. Plain tube

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31
Q

Consuming powdered anticoagulants before a synovial fluid test interferes with which test?

A. crystal analysis

B. glucose measurement

C. immunology

A

a. crystal analysis

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32
Q

Consuming food 6 hours before a synovial fluid test interferes with which test?

A. crystal analysis

B. glucose measurement

C. immunology

A

b. glucose measurement

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33
Q

Which is used to collect synovial fluid for microbiology tests?

A. Plain tube

B. Heparinized tube

C. Sterile container

D. EDTA

A

c. Sterile container

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34
Q

Which is used to collect synovial fluid for hematology tests?

A. Plain tube

B. Heparinized tube

C. Sterile container

D. EDTA

A

d. EDTA

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35
Q

Lab technician preforms wet preparation on synovial fluid, which test is he going to go on the specimen?

A

cystal study (it requires wet preparation; this was said in class)

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36
Q

Rice bodies are often an indicator of which disease?

A

RA

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37
Q

What are Rice bodies made out of?

A

infarcts of the joint synovium encased in layers of fibrin

38
Q

What are ochronotic shards are made out of?

A

joint prosthesis debris. they look pepper-like

39
Q

Which of the following tests viscosity? (aka hyaluronan)

A. ropes test

B. string test

C. thread test

A

b. string test

40
Q

Which of the following tests requires the addition of acetic acid?

A. ropes test

B. string test

C. thread test

A

a. ropes test

41
Q

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

A

c. long term renal dialysis (Calcium oxalate crystals are the most common cause of kidney stones)

42
Q

Which of the following tests hyaluronic acid-mucin protein complex?

A. ropes test

B. string test

C. thread test

A

a. ropes test

43
Q

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

44
Q

Appears blue when perpendicular to compensator.

A. negative birefringence

B. positive birefringence

A

a. negative birefringence

45
Q

Crystals of which disease look yellow when aligned (parallel) with the compensator filter?

A. gout

B. pseudogout

A

a. gout (monosodium urate crystals)

46
Q

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

A

d. acute arthritis

47
Q

Crystals of which disease look blue when aligned (parallel) with the compensator filter?

A. gout

B. pseudogout

A

b. pseudogout (calcium pyrophosphate dihydrate crystals)

48
Q

Which type of arthritis causes a high number of monocyte cells?

A. rheumatoid arthritis

B. crystal induced arthritis

C. septic arthritis

A

b. crystal induced arthritis

49
Q

Crystals are seen in a rhombic shape and a notched corner. They appear to adhere together. What are the crystals made out of?

A

cholesterol (may indicate RA or Tuberculosis artheritis)

50
Q

Appears yellow when perpendicular to compensator.

A. negative birefringence

B. positive birefringence

A

b. positive birefringence

51
Q

Which type of arthritis causes a high number of lymphocyte cells?

A. rheumatoid arthritis

B. crystal induced arthritis

C. septic arthritis

A

a. rheumatoid arthritis

52
Q

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

A

b. pseudogout

53
Q

Which type of arthritis causes a high number of neutrophils cells?

A. rheumatoid arthritis

B. crystal induced arthritis

C. septic arthritis

A

c. septic arthritis

54
Q

Whats the most common place affected by OA?

A. hips

B. knees

C. hands

D. elbowz

55
Q

Which is more true?

A. OA starts with the degeneration then the inflammation

D. OA starts with the inflammation then the degeneration

A

a. OA starts with the degeneration then the inflammation

56
Q

Knock knee is also known as

A. Varus deformity

B. Valgus deformity

A

b. Valgus deformity

57
Q

Radiology of bone for OA is used to

A. screen

B. confirm

A

b. confirm (and to rule out other things)

58
Q

Bow leg is also known as:

A. Varus deformity

B. Valgus deformity

A

a. Varus deformity

59
Q

What are the most common causes of lower back pain?

A

lumbar sprain and strain

60
Q

Lower back pain with unexplained weight loss might indicate

A. neurological problems

B. infection

C. malignancies

D. rheumatic disease

A

c. malignancies

61
Q

Lower back pain with bladder/bowl problems might indicate

A. neurological problems

B. infection

C. malignancies

D. rheumatic disease

A

a. neurological problems

62
Q

Medially wedged insoles are used for

A. Varus deformity

B. Valgus deformity

A

b. Valgus deformity

63
Q

How does medically directed patellar taping help OA patients?

A

It changes the patella location to improve symptoms

64
Q

Subtalar Strapped lateral insoles are used for

A. Varus deformity

B. Valgus deformity

A

a. Varus deformity

65
Q

What’s the primary protection against malpractice lawsuits?

A

patient preference

66
Q

T/F: informed consent is a paper the patient must sign

A

false, informed consent PROCESS

67
Q

You look at an Xray and notice the dens in the middle of the vertebra. Which vertebra is this?

68
Q

You look at an Xray and notice the foramen transversarium. Which vertebra is this?

69
Q

Who is most commonly affected by discitis?

A

patients with low immunity or those with a recent spinal procedure

70
Q

What can you conclude when one nucleus pulposus appears more opaque than the others in an Xray?

A

its dehydrated

71
Q

What type of fracture occurs if a patient takes a long fall on the feet?

A

burst fracture

72
Q

Which most commonly affects the spinal canal?

A. dorsal spine fracture

B. wedges fracture

A

b. wedges fracture (it’s mostly wedged posteriorly)

73
Q

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

A

c. stage 2

74
Q

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

A

b. stage 1

75
Q

What three bones have an easily compromised blood supply?

A

femoral head scaphoid talus

76
Q

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

A

e. stage 4

77
Q

What makes up the conjoined tendon of the knee?

A

The lateral collateral ligament and biceps femoris tendon

78
Q

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

A. Presence of crepitus

79
Q

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

A. Painful arc test

80
Q

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

A. Detect fluid accumulation posterior to patella

81
Q

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

A

B. Posterior cruciate ligament

82
Q

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

A

B. Full spine x-ray

83
Q

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

A

C. Increased weight can worsen the symptoms

84
Q

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

A

B. Morning stiffness

85
Q

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

A. Painful arc test

86
Q

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

A. Detect fluid accumulation posterior to patella

87
Q

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

A

B. Posterior cruciate ligament

88
Q

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

A

B. Full spine x-ray

89
Q

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

A

C. Increased weight can worsen the symptoms

90
Q

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

A

B. Morning stiffness

91
Q

Which tendon is stretched when eliciting patellar reflex?

A. Quadriceps femoris

B. Biceps femoris

C. Sartorius

D. Pectineus

E. Quadratus femoris

A

A. Quadriceps femoris

MSK (16 decks)

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