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Differential Diagnosis > Final > Flashcards

Final Flashcards

1
Q

Red flags thoracic

A 
CA
Steroid
Trauma
Infection
Drug/alcohol abuse
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2
Q

Adams test

A

Structural vs functional scoliosis

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3
Q

High scapula

A

Sprengels deformity

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4
Q

Buffalo hump

A

Fat buildup with Cushing or long term steroid use

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5
Q

Dowagers hump

A

Compression fracture

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6
Q

Hyperkyphosis in adolescents

A

Scheuermanns

Postural problems

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7
Q

What specific ROM does facet syndrome interfere with

A

Hyper extension

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8
Q

What tests are done for facet syndrome

A

Hyperextension

Kemps

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9
Q

Scheuermanns disease

A

Increased kyphosis
Anterior wedging greater than 5 degrees in 3 consecutive vertebra
Decreased disc height and end plate irregularity

Prone extension test

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10
Q

Prone extension test

A

For scheuermanns

Of persistence of kyphosis then structural

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11
Q

Osteoid osteoma MC found where

A

Metaphyseal region of long bones

On concave side

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12
Q

DDX of osteoid osteoma

A 
Osteoblastoma
ABC
Facet arthrosis
Missing pedicle
Contralateral pars defect
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13
Q

Missing pedicel ddx

A 
Congential
Destructive 
   1. Tumor (lytic mets MC or ABC/osteoblastoma)
   2. ST tumor (neurofibromas)
   3. Infection
Surgical
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14
Q

Reasons for decreased disc height

A

Joint disease
Metabolic
Developmental
Infection

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15
Q

Hypokyphosis assocaite with what and hyper with what

A

Hypo: scoliosis
Hyper: scheuermanns

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16
Q

What is used to determine rotation in curvature in scoliosis

A

Nash moe method

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17
Q

MRI and old vs new compression fracture

A

Dark T1, bright T2

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18
Q

What angle is used to measure scoliosis

A

Cobb angle

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19
Q

Spontaneous pneumothorax

A

Usually in young patient under 35
Vesicle visceral pleura
Radiolucent compared to other lung

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20
Q

What is the most sensitive indicator of cauda equine

A

Urinary retention

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21
Q

What is the best indicator of whether it is a disc or referred pain

A

Pain below knee is likely disc

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22
Q

L5 NR lesion s/s

A

Weakness of dorsiflexion of great toe and numbness on lateral side of lower leg
Difficulty toe walking

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23
Q

Absent Achilles reflex

A

S1 NR

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24
Q

Weakness on dorsiflexion of big toe

A

L5 NR

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25
Q

Weakness if plantarflexion NOF big toe

A

S1 NR

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26
Q

Midline/parade trail disc herniation s vs foraminal herniations lumbar

A

Midline: compress NR below
L5-S1 hernation compress S1 NR (traversing)

Foraminal: involve NR at same level
L5/S1 disc compress L5 disc

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27
Q

Toe walking

A

S1 NR

L5/S1 disc

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28
Q

Heel walking

A

L5 NR

L4/L5 disc

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29
Q

Patellar reflex

A

L4 NR

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30
Q

Hadley S curve

A

Facet imbrication

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31
Q

Normal canal size for lumbar and stenosis measurements

A

Normal: 15mm
12 relative
10 absolute stenosis

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32
Q

Isn’t ic spondy

A

MC at L5
Young
Stress fracture at pars

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33
Q

Degenerative spondy

A

L4

Older

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34
Q

Send out AAA larger than

A

3.5cm

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35
Q

Tumors that expand neural arch

A

ABC

Osteoblastoma

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36
Q

Rugger jersey

A

HPT

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37
Q

Common referral places from c2/3 and c5/6

A

Head and neck

Shoulder pain

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38
Q

Tests for meningitis

A

Kernigs

Brudzinskis

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39
Q

ULTT for?

A

Rule out cervical radiculopathy

+ when reproduced with s/s on side contralateral to cervical bending

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40
Q

C6

A

Brachioradialis

Wrist extension

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41
Q

C7

A

Triceps
Finger extension
Wrist flexion

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42
Q

C8

A

Finger flexors

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43
Q

Lhermittes

A

Spinal cord involvement

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44
Q

Canal in cervical

A

Less than 13= concern

11: stenosis

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45
Q

Radiographic features of a sever sprain

A

Interspinous distance widening
Loss of parallelism between facets
Horizontal displacement more than 3.5mm

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46
Q

Tietze’s syndrome

A

Female 50+
Moderate to severe pain in chest (2-3 costochondral junction)

Inflammatory reaction

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47
Q

Meniscus sign

A

Pleurisy

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48
Q

Ddx for hilar enlargement

A

Infection
Tumor
Vascular
Sarcoidosis (non-infection)

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49
Q

Air bronchogram sign

A

Airspace pathology

Usually pneumonia or pulmonary edema

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50
Q

S sign of golden

A

Collapse of RUL and superior migration of horizontal fissure MC due to hilar mass

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51
Q

Silhouette sign and determining if touching heart or not

A

Loss of boarder of heart

If touching—will obliterate that boarder on xray

Not touching—can see boarder

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52
Q

Consolidation

A

Anything that fills alveoli with substance

ill-defined homogenous opacity obscuring vessels
Air bronchogram sign

Pneumonia

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53
Q

Interstitial

A

Involvement of supporting tissue of lung parenchyma

Fine or course reticular opacities or small nodules

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54
Q

Four types of interstitial lung patterns

A

Linear
Reticular (mesh-like)
Modular
Reticulonodular

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55
Q

Kerley lines

A

Linear interstitial pattern
Thickening of interlobular septa

MC cause= pulmonary edema

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56
Q

What are most SPN

A

Granulomas
Lung CA
Hamartomas

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57
Q

MC location for SPN

A

RUL

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58
Q

Reasons for granuloma

A

TB
Histoplasmosis
Coccidioidomycosis
Sarcoidosis

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59
Q

What type of pneumonia usually presents with more wheezing

A

Viral

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60
Q

Lobar pneumonia uncommon in what

A

Viral

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61
Q

Ranke complex

A

TB
Ghon lesion: calcified parenchyma tuberculoma
With ipsilateral calcified hilar node

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62
Q

Bronchiogenic carcinoma categories

A

NSCLC (80%)

  • squamous cell
  • adenocardinoma
  • large cell carcinoma

SCLC (20%)

  • MC to cause SVC obstruction
  • oat cell carcinoma
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63
Q

Blue bloaters

A

C. Bronchitis

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64
Q

Pink puffers

A

Emphysema

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65
Q

Xray of emphysema

A 
Flattened hemidiaphragm
Lung hyperinflation
Small heart
Barrett chest 
Saber-sheath trachea (coronal narrowing of intrathoracic trachea)
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66
Q

Horner;s syndrome

A

Mitosis
Anhydrous is (lack of sweating)
Ptosis

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67
Q

Where are the 3 common sites of compression for TOS

A

Scalene triangle
Costoclavicular space
Subpectoral space (pec minor and coracoid)

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68
Q

When are HA a red flag

A

Onset 50+ years

Temporal arteritis or a mass lesion

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69
Q

HA associated with exertion…

A

Underlying tumor or vascular weakness

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70
Q

Food triggers for migraines

A 
Chocolate
Caffeine
Nitrates
Cheese
Nuts
Wine
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71
Q

HA that has a band distribution

A

Tension

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72
Q

HA that often has decreased ROM to one side

A

Cervicogenic

73
Q

5D and 3N

A 
Dizziness
Diplopia
Drop attach
Dysarthria
Dysphasia
Ataxia
Numbness
Nausea
Nystagmus
74
Q

Stroke vs Bells Palsy: can raise both eyebrows

A

Facial nerve in tact and stroke consideration

75
Q

Papilledema

A

Optic disc swelling secondary to intracranial pressure

76
Q

What intracranial structures are sensitive to pain

A 
Meningeal arteries
Prox. Part of cerebral artery
Dura at base of brain
Venous sinuous
Cranial N 5,7,9,10, 1,2,3
77
Q

Altered perception of touch or pressure, arm or leg weakness on one side of body, or confusion with left and right sides of body are linked to a tumor where

A

Frontal or parietal lobe

78
Q

Inability to look upward associated with tumor where

A

Pineal gland

79
Q

Lactation and altered periods and growth in hands nad feet tumor where

80
Q

MC brain tumor types in adults

A

Gliomas

Meningiomas

81
Q

Mc tumor in children

A

Astrocytoma
Medulloblastoma
Ependymoma

82
Q

Normal size of sella

A 
16x12mm across x deptth
Empty
Tumor
Normal 
Aneurysm
83
Q

Progressively worsening Ha which seems worse in the morning. Also complains of gradual but progressive vision loss. Primary concern?

A

Mass lesion

84
Q

Increased heel pad thickness seen with what

A

Acromegaly

85
Q

Mc skull fracture

86
Q

What motion associated with medial and lateral epicondylitis

A

Medial: flexion
Lateral: extension

87
Q

Locking or crepitus in young patient elbow suggestive of. Old?

A

osteochondritis desiccans

Older: degenerative

88
Q

Muscles involved in lateral epicondylitis

A

Extensor carpi radialis brevis
Extensor digitorum communis
Extensor carpi radialis longus

89
Q

Sail sign

A

Supracondylar fracture of humerus

90
Q

Monteggia fx

A

Ulnar shaft fracture with proximal dislocated radius

91
Q

Galeazzi fracture

A

Fracture of distal radius and dislocated distal radial ulnar articulation

92
Q

Colles fracture

A

Distal radius fracture with dorsal and radial angulation

93
Q

Smith fracture

A

Fracture of distal radius with volar/palmer/anteriorly angulation

94
Q

Keinbocks disease

A

AVN of lunate

95
Q

Aka for AVN of lunate

A

Keinbocks

Collapse of lunate on xray

96
Q

Terry Thomas sign

A

Increase space between lunate and scaphoid

97
Q

Scapholunate disassociation

A

Terry Thomas sign (increased space between lunate and scaphoid)
Signet ring sign

98
Q

Signet ring sign

A

Scapholunate disassociation

99
Q

Scapholunate instability vs instability with rotatory subluxation

A

Instability only: terry Thomas sign

Subluxation too: signet ring and terry Thomas sign

100
Q

Posterior perilunate dislocation

A

Lunate in tact—rest of the carpals posteriorly shifted

101
Q

Anterior lunate dislocation

A

Lunate anterior—carpals intact

Pie sign

102
Q

Pie sign

A

Anterior lunate dislocation

103
Q

De quervians muscles

A

EB and AL
Extensor pollicis brevis
Abductor pollicis longus

104
Q

Median nerve entrapment

A

CTS

Pronator syndrome

105
Q

Ulnar nerve entrapment

A

Cubital tunnel

Tunnel of guyon

106
Q

Radial nerve entrapment

A

Radial tunnel syndrome

107
Q

Flick sign

A

CTS

Done when s/s are at their worst

108
Q

Pronator syndrome/median nerve entrapment

A

Complain of volar forearm pain
Repetitive wrist flexion

Provocation: elbow extended, wrist flexed and resisted pronation

Compressed/entrapped MC btwn two heads

109
Q

Ulnar nerve entrapment

A

Cubital tunnel syndrome
Complain of medial forearm pain

May be compressed in tunnel of guyon

110
Q

Mallet finger/baseball finger

A

Avulsion of base of distal phalanx

111
Q

Bennetts fracture

A

Oblique intra-articular fracture at base of thumb with radial deviation of distal fragment

112
Q

Rolandos fracture

A

Comminuted Bennett’s fracture

Fracture at the base of the 1st metacarpal

113
Q

Gamekeepers thumb

A

Avulsion at base of proximal phalanx of 1st digit

Aka skier’s thumb

114
Q

Psoriatic arthritis

A 
Seronegative 
DIP*** and PIP
Tuft erosions 
Mouse ears 
Sausage digit 
Mimics RA but less symmetrical
115
Q

Mouse ears

A

Psoriatic

-

116
Q

Bare area erosions

117
Q

Haygarths nodes

A

ST swelling at MCP

RA

118
Q

Rat bite or marginal erosions

119
Q

OA vs RA

A

OA distal to prox

RA: prox to distal

120
Q

Anterior shoulder pain ddx

A 
Fracture
Dislocation
Subacromial bursitis
Capsular sprain
Rupture of long head of biceps
Labrum tear

Impingement
Subcoracoid impingement
Biceps tendonitis
Subscapularis tendinitis

121
Q

Lateral shoulder pain ddx

A

Contusion
Supraspinatus rupture
Referral from C or BP

Impingement
Deltoid strain
Supraspinatus tear/rupture

122
Q

Super shoulder pain

A

AC joint separation
Distal clavicular fracture
Shoulder pointer

OA
Osteolysis of distal clavicle

123
Q

Posterior shoulder pain ddx

A

Scap fx
Post dislocation

Posterior impingement
Infraspinatous/teres minor strain/tendonitis
Posterior deltoid staring
Triceps strain
Suprascapular nerve entrapment
124
Q

Tests for impingement shoulder

A

Neer: passive forward flexion end rage pain
Hawkins-Kennedy: internal rotation
Painful arc: increase pain 60-120

Pain worse with overhead activities

125
Q

Xray of chronic rotator cuff arthropathy with shoulder impingement

A 
Elevation of humerus
Erosion of inferior aspect of a Romain
Sclerosis
Osteophytes
Cystic changes
126
Q

Normal subacromial space height

127
Q

Empty can test

A

Suprascapular

128
Q

Lift off test

A

Subscapularis

129
Q

External rotation test

A

Infraspinatous strength test

Tendinopathy or tear

130
Q

Lag sign

A

Infraspinatous/teres minor

131
Q

Subdeltoid bursitis test

A

Tenderness found anterior to AC joint on passive extension of shoulder

132
Q

Calcification over humeral head/bursa

133
Q

Linear ca++ paralleling humeral head-thing

A

Chondrocalcinosis

MC due to CPPD

134
Q

Many densities in shoulder girdle

135
Q

Tests for glenoid labrum

A

Crank test and O’Brien sign (arm internally rotated and brough 15 degrees midline with pressure downward) again supinated. Pain felt in first position and no pain second

136
Q

Normal AC width

A

x<5mm

<2-3mm bilateral diff

137
Q

Normal distance between coracoid and clavicle

A

11-13mm

<5mm bilateral diff

138
Q

Grade 2 AC separation

A

AC ligament torn

Coracoclavicular lig intact

139
Q

MOI of anterior shoulder dislocation

A

Abducted and externally rotated

95%

140
Q

Bankart lesion

A

Osseous fragment at inferior aspect of glenoid fossa

141
Q

Hill Sachs

A

Impaction fracture at superior lateral humeral head

142
Q

Labral tears tests

A

Crank test
O’Brien’s test
Biceps load 2 test

143
Q

Rotator cuff tests

A 
Empty can
Lift off
Lag
Infraspinatous muscle test
Drop arm
Hawkins
144
Q

Widening of AC joint with destructive change of clavicle but no elevation

A

Post traumatic osteolysis

145
Q

MOI of ACL and PCL

A

ACL: hyperextension
PCL: hyperflexion

146
Q

Ottawa rules for acute trauma LE

A

55+
Tender at patella or fibula head
Unable to flex knee 90
Unable to bear weight immediately after

147
Q

O-donoghues triad

A

Rotatory component

ACL, medial meniscus and MCL

148
Q

Segonds fracture

A

Fragment on lateral margin of lateral tibial plateau

149
Q

Pain location in neurogenic vs vascular claudication

A

Neurogenic: back, thigh, claves, RARE BUTT

Vascular: BUTT, thigh, calves

150
Q

Salter type 1

A

Shear across GP

151
Q

Salter type 2

A

Physis and metaphysis

152
Q

Salter type 3

A

Epiphysis and physis

153
Q

Eversion injury

A

Oblique fracture fibular

Avulsion of medial malleolus

154
Q

MOI transverse lateral malleolar fracture

155
Q

Jones/dancer fracture vs normal

A

Jones: transverse fracture
Normal: vertical

156
Q

Sunburst periosteal reaction

Diametaphyseal

A

Osteosarcoma

157
Q

Is DJD in patellofemoral joint normal? Cause?

158
Q

Ca++ of medial collateral ligament

A

Pellegrini stieda

HADD

159
Q

Onions skin

A

Ewing sarcoma

160
Q

Brim sign

161
Q

MC hip fracture

A

Intra-capsular

Worse

162
Q

Putt is triad

A

Small absent epiphysis
Lateral displacement of femur
Increased inclination of acetabular roof

163
Q

Hilgenreiner’s line at birth

A

Less than 28

164
Q

Perkins line

A

Epiphysis should be seen in inferiomedial quadrant

165
Q

Small epiphysis

A

Developmental dysplasia
SCFE
AVN

166
Q

MC hip dislocation

A

Posterior

Flexed abducted hip

Xray: superior to acetabulum

167
Q

Xray of anterior hip dislocation

A

Anterior and medial to acetabulum

168
Q

Kleins line

A

SCFE

If line ok and small epiphysis —AVN

169
Q

femoral acetabular impingment syndrome

A

Sharp deep pain
Pain anteriorly

Flexion and internal rotation limited
C-sign (gripping)

170
Q

Pincer impingment

A

Middle aged women

Excessive coverage by anterior acetabular rim

171
Q

Cam impingment

A

Young men avg 32 years

Abnormalities of the femur/bony protrusion

172
Q

Femoral neck buttressing

173
Q

Cam deformity aka

A

Pistol grip

174
Q

Kohlers line

A

Acetabular protrusion

175
Q

Rind sign

A

Fibrous dysplasia

176
Q

ASIS Avulsion

A

Sartorious

177
Q

AIIS avulsion

A

Rectus femoris

178
Q

Lesser trochanter avulsion

179
Q

Normal TDD

A

9-11
<2mm bilateral diff
Septic arthritis

Differential Diagnosis (2 decks)

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