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CK_MSK > DIT > Flashcards

DIT Flashcards

1
Q

hematologic manifestations SLE

A

PANcytopenia

anemia (hemolytic), thrombocytopenia, leukopenia

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2
Q

SOAP BRAIN MD

A

serositis (pericardial, pleuritis, pleural effusion)
oral ulcers
arthralgia
photosensitivity
blood (pancytopenia)
renal (proteinuria, renal failure, glomeruloneph)
ANA
immunologic (anti dsDNA, anti Smith, antiphospholipid)
neurologic (personality change, seizures, psychosis, neuropathy)
malar rash
discoid rash

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3
Q

rheum markers for SLE

A

anti dsDNA, anti Smith, antiphos

ANA

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4
Q

anti histone

A

drug induced lupus
“SHIPP”
sulfonamides, hydra lazine, isoniazid, procainamide, phenytoin)

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5
Q

drugs that cause drug induced lupus (anti histone)

A 
SHIPP
sulfonamides
hydralazine
isoniazid
procainamide
phenytoin
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6
Q

patient with headaches, jaw claudication has shoulder and hip pain

A

Polymyalgia rheumatica

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7
Q

rheum markers for PMR

A

NONE!!!!!

check for elevated ESR

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8
Q

anti Jo 1 abs

A

polymotsitis/dermatomyositis

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9
Q

patient can’t comb hair, get out of chair, climb stairs, elevated aldolase, CK, AST, ALT

A

polymyositis

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10
Q

low fecal elastase

A

chronic pancreatitis (most sensitive test)

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11
Q

elevated lab markers for polymyositis/dermatomyositis

A

ALDOLASE

CK, AST, ALT, anti Jo 1 (antisynthetase)

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12
Q

complication polymer/dermatomyositis

A

increased malignancy risk

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13
Q

rx polymyositis/dermato

A

steroids

methotrexate, azothioprine

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14
Q

rx SLE

A

hydroxycholorquine
NSAIDS, steroids
avoid direct sunlight

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15
Q

lab/rheum markers for fibromyalgia

A

NOTHING!!!!!!!!

only pain points, no lab or pathologic cause

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16
Q

anti-scl 70/anti RNA polymerase

A

diffuse cutaneous systemic sclerosis

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17
Q

anti centromere`

A

limited cutaneous systemic sclerosis

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18
Q

limited cutaneous systemic sclerosis a/w what?

A 
CREST syndrome
Calcinosis (deep layers skin, fingers)
Raynaud phenomenon
Esophageal dysmotility
sclerodactyli (tight fingers, no dactylitis/sausage)
Telangiectasia (lips/hands/face)
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19
Q

patient with conjunctivitis, sand in eyes, dysphagia, dental caries

A

Srogen syndrome

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20
Q

Anti SSb

Anti SSA abs

A

aka Anti-Ro, Anti LA

SJROGEN

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21
Q

anti u1 RNP antibodies

A

mixed connective tissue disorder

overlap of SLE, polymyositis, systemic sclerosis)

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22
Q

joint pain worsens with use, DIP (heberden) PIP Bouchards

A

OA

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23
Q

risk factors OA

A

aging
obesity
previous joint injury

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24
Q

X-ray finding OA

A

osteophytes, joint space narrowing

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25
Q

rx OA

A

NSAIDs, celecoxib, acetominophen
steroid/hyaluronic acid joint injection
joint replacement
WEIGHT LOSS/REST

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26
Q

RF what kind of hypersensitivity

A

type III

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27
Q

swan neck deformities, ulnar deviation

A

RA

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28
Q

morning stiffness, improves with use

A

RA

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29
Q

lab and rheum marker RA (3)

A

anti IgG/rheumatoid factor
anti citrullinated protein antibodies (ACPA)
elevated ESR/CRP

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30
Q

ESR in OA

A

normal

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31
Q

ACPA (anti citrullinated protein antibodies)

A

RA

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32
Q

rx RA (4)

A

hydroxychloroquine
methotrexate
TNFa inhibitors (-zumabs, ertanercept)
leuflonomide

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33
Q

name some TNFa inhibitors

A

adalimumab
golimumab
infliximab
etanercept

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34
Q

rheum markers psoriatic arthritis

A

ANA and RF NEGATIVE

HLA-B27 positive

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35
Q

pencil in cup deformities of finger

A

psoriatic arthritis

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36
Q

common eye finding for all HLA-B27

A

anterior uveitis

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37
Q

joints involved ankylosing spondylitis

A

spine and SACROILIAC JOINTS

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38
Q

low back pain worse with inactivity, better with exercise

A

ankylosing spondylitis

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39
Q

bamboo spine

A

ankylosing spondylitis

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40
Q

rx ankylosing spondylitis (2 pharm, 2 conservative)

A

PT/exercise
NSAID/ celecoxib
TNFa inhibitors

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41
Q

HLA B 27 seronegative spondylarthropathies

A 
"PAIR"
psoriatic arthritis
ankylosing spondylitis
IBD arthritis
reactive arthritis (uveitis, urethritis, arthritis)
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42
Q

medications that lead to decreased uric acid excretion

A

loop diuretics

thiazides

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43
Q

synovial fluid of gout vs pseudogout

A

gout - YELLOW, NEEDLE, NEGATIVELY birefringent

pseudo gout - BLUE, RHOMBOID, POSITIVELY birefringent

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44
Q

rx acute gout

A

NSAIDs
glucocorticoids
colchicine

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45
Q

rx chronic gout

A

allopurinol (inhibits uric acid production; xanthine oxidase inhibitor)
probenecid (prevents uric acid reabsorption)

46
Q

risk factors pseudogout

A

hypercalcemia, hyperparathyroidism

47
Q

Most common affected joint in gout vs pseudogout

A

gout - first big toe (podagra)

pseudo gout - KNEE, elbow, feet

48
Q

MCC septic arthritis overall

A

staph aureus

49
Q

young, sexually active patient with septic arthritis, pustules/papules on skin

A

gonococcus

50
Q

lab findings septic arthritis

A

elevated ESR CRP
synovial fluid >50,000 WBC
luekocytosis

51
Q

rx septic arthritis

A

immediate surgical drainage/irrigaiton

culture and empiric antibiotics (vanc, ceftriaxone)

52
Q

How long does tick need to stay on skin to transmit Lyme dx

A

2-3 days

53
Q

early localized lyme disease (1-2 weeks)

A

erythema migrans

constitutional symptoms

54
Q

early disseminated Lyme disease (weeks to months)

A

facial nerve/BELLS PALSY
lymphocytic meningitis
peripheral neuropathy/radiculopathy
carditis (AV heart block, myocarditis)

55
Q

late Lyme disease (months to years)

A

arthritis

mild encephalopathy

56
Q

1st line rx lyme disease

A

doxy

DO NOT GIVE TO PREGNANT PATIENT

57
Q

rx Lyme disease pregnant patient

A

amoxicillin

cefuroxime

58
Q

x-ray finding pseudogout

A

calcification of articular cartilage (chonedrocalcinosis)

VERY HIGH YIELD

59
Q

pseudo gout involves deposition of what…

A

calcium pyrophosphate dihydrate crystals

60
Q

Ca, PTH, phosphate, alk phos value in osteoporosis

A

NORMAL

61
Q

T score values for dx osteoporosis

A

> -1 normal
-1 - -2.5 osteopenia
< - 2.5 osteoporosis

62
Q

pharm rx for osteoporosis

A

bisphosphonates
denosumab (RANKL inhibitor)
teriparatide (recombinant PTH, stimulates osteoblasts)

63
Q

pancytopenia (increased infections), hearing loss, fractures, increased skull circumference, normal bone labs, flared ends Xrays

A

osteopetrosis (impaired osteoclasts, abnormally dense bone)

genetic, rare

64
Q

patient arthritis, bored tibias, hearing loss, can’t fit hats, normal bone labs except alk phos

A

Paget disease (osteoclast overactivity -> osteoblast overactivity, unorganized bone)

65
Q

how to dx paget’s

A 
bone labs (elevated alk phos), osteolytic lesions on xray
hot spots on radio bone scan
66
Q

paget’s increases risk for….

A

osteosarcoma (lots of unorganized bone metabolism)

67
Q

osteomyelitis in sickle cell patient

A

salmonella

68
Q

osteomyelitis in IV drug user

A

pseudomonas

69
Q

osteomyelitis in person with prostheses

A

staph epidermidis

70
Q

MCC osteomyelitis

A

staph aureus

71
Q

osteomyelitis in diabetic foot ulcer

A

pseudomonas

72
Q

most helpful tests for osteomyelitis

A

MRI

also do bone biopsy and culture
can also see elevated ESR/CRP, bone erosion on Xray

73
Q

what cancers like to met to bone?

A 
"Permanently Relocated Tumors Like Bones"
prostate
renal
testicular/thyroid
lung
breast
74
Q

Rb gene mutation

A

osteosarcoma

75
Q

11;22 translocation, young boy, bone tumor

A

Ewing

76
Q

“soap bubble” bone appearance

A

giant cell tumor

77
Q

painless bone mass, benign, male <25, “chunk” of bone with cartilage cap

A

osteochondroma

78
Q

multinucleate giant cells, distal femur, proximal tibia, benign but destructive

A

giant cell tumor

79
Q

elevation of periosteum on bone xray

sunburst pattern

A

osteosarcoma

80
Q

onion skin appearance of bone on xray

A

Ewing

“wings and onion rings”

81
Q

60 year old man, bowed out legs kyphosis, hearing loss, hat can’t fit

A

Paget’s disease

more common than osteopetrosis

82
Q

carpal tunnel syndrome is injury of what nerve

A

median

numbness in palmar 1,2,3rd and half of ring finger

83
Q

patient has blow to extended arm, arm is in external rotation and slight abduction

A

anterior shoulder dislocation

AXILLARY NERVE commonly affected

84
Q

patient with seizure/electrocuted comes in with shoulder internally rotated and adducted, cannot externally rotate

A

posterior shoulder dislocaiton

rare

85
Q

patient has hyperextension of 4’th and 5th MCPs, and flexed IPs, apparent when patient tries to extend fingers

A

ulnar claw (ulnar nerve injury)

86
Q

patient can’t flex first and 2nd digits when asked to make fist

A

median nerve injury farther up arm

87
Q

patient has thenar muscle atrophy and cannot abduct thumb

A

median nerve injury at elbow

88
Q

patient develops wrist drop and cannot extend wrist

A

radial nerve injury

89
Q

radical nerve compression against spiral groove of humerus

A

Saturday night palsy

90
Q

scapular winging

A

long thoracic nerve

91
Q

unable to wipe bottom

A

thoracodorsal

92
Q

loss of shoulder abduction

A

axillary nerve

93
Q

loss of elbow flexion and forearm supination

A

musculocutaneous

94
Q

trouble initiating shoulder abduction

A

suprascapular

95
Q

trouble abducting arm beyond 10 degrees

A

axillary

96
Q

unable to raise arm above horizontal

A

long thoracic, spinal accessory

97
Q

fracture of shaft of humerus

A

radial nerve

98
Q

fracture of surgical neck of humerus

A

axillary

99
Q

supracondylar humerus fracture

A

median nerve

100
Q

fracture of medial epicondyle

A

ulnar nerve

101
Q

fall on outstretched hand, fracture of distal radius, posterior displaced
dx and rx

A

colle’s fracture

long arm cast

102
Q

fall on a flexed wrist, distal radius fracture, anterior displaced (more rare)

A

smith fracture

casting

103
Q

fall on outstretched hand, tenderness at anatomical snuff box
rx and mangement

A

scaphoid fracture

thumb spica and serial imaging (initial imaging may be negative)

104
Q

complication scaphoid fracture (2)

A

nonunion

avascular necrosis

105
Q

patient gets into a fight, fractures neck of 5th metacarpal

rx and potential complication

A

boxer’s fracture

watch out for infection from bite

106
Q

complication of femur fracture

A

fat embolus

107
Q

elderly woman after fall with shortened and external rotated leg

A

hip fracture (watch out for femoral neck avascular necrosis)

108
Q

rx carpal tunnel conservative

A

wrist splinting

activity mofidifaciton

109
Q

pharm treatment for carpal of conservative fails

A

NSAIDs
glucocorticoids (injected or PO)
surgial decompression

110
Q

how does ankylosing spond pain change throughout day

A

improves with exercise

worse in the morning

111
Q

younger patient symmetric polyarticular arthritis self limited course

A

viral arthritis usually due to parvovirus b19

CK_MSK (2 decks)

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