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MSK > High Yield MSK Things > Flashcards

High Yield MSK Things Flashcards

1
Q

What nerve root would be affected if the bicep reflex is not present?

A

C5

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2
Q

What nerve root would be affected if the brachioradialis reflex is not present?

A

C6

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3
Q

What nerve root would be affected if the tricep reflex is not present?

A

C7

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4
Q

What nerve root would be affected if the achilles reflex is not present?

A

S1

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5
Q

What nerve root would be affected if the patellar reflex is not present?

A

L4

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6
Q

What nerve root would be affected if the bulbocavernosus reflex is not present?

A

S2-4

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7
Q

A patient is having trouble abducting their shoulder and flexing their elbow. What nerve root is this?

A

C5

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8
Q

A patient is having trouble flexing their elbow and extending their wrist what nerve root is this?

A

C6

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9
Q

A patient is having trouble extending their elbow and flexing their wrist and extending their fingers. What nerve root is this?

A

C7

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10
Q

A patient is having trouble with finger abduction, adduction, and flexion. What nerve root is this?

A

C8

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11
Q

A patient is having trouble with foot dorsiflexion. What nerve root is this?

A

L4

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12
Q

A patient is having trouble with big toe extension. What nerve root is this?

A

L5

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13
Q

A patient is having trouble with anal sphincter tone. What nerve root is this?

A

S2-4

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14
Q

What are the risk factors for osteoporosis?

A

Caucasian/asian-smaller bone structure
smoking
malnutrition
decreased physical activity

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15
Q

Which cancers metastasize to the bone?

A

Breast
Lung
Thyroid
Kidney
Prostate

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16
Q

How is dermatomyositis diagnosed?

A

(not specific labs): ESR elevated, aldolase, creatinine kinase
Anti-mi
Anti-Jo
Anti-SRP
MRI
EMG
Muscle biopsy can be helpful but is not necessary

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17
Q

What are the seronegative spondyloarthritis? (negative for RF)

A

ankylosing spondylitis
psoriatic arthritis
reactive arthritis
arthritis associated with IBD
undifferentiated spondyloarthropathy

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18
Q

key words for bone tumors

A

nidus <1.5 cm: osteoid osteoma but improves with NSAIDs, nidus >2 cm = osteoblastoma
osteochondroma = cartilage-capped projection
enchondroma = in bone marrow
chondroblastoma: well-defined with sclerotic border
fibrous dysplasia: ground glass appearance
ossifying fibroma: well-circumscribed intracortical
non-ossifying fibroma: small, well-defined, eccentric, lytic
unicameral bone cyst: fallen leaf
aneurysmal: eggshell or soap bubble
osteosarcoma: moth eaten
chondrosarcoma: endosteal scalloping
ewing: onion skin

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19
Q

SLE lab studies

A

anti-dsDNA and anti-Smith

(also anti-SSB and anti-SSA but shared with sjogren)

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20
Q

chondroblastoma mets

A

lungs (benign)

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21
Q

Work up for osteoblastoma

A

xray followed by CT to determine size and extent

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22
Q

management of torticollis

A

remove underlying etiology
conservative therapy with NSAIDs, benzos, or other muscle relaxants
botox injections if unresponsive to conservative
if failure of botox, surgical release of SCM, selective denervation, dorsal cord stimulation

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23
Q

OA does not cause an elevation in what?

A

ESR. It is not inflammatory

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24
Q

Diagnostic modality of choice for OA

A

Radiographs

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25
Q

Treatment of OA

A

assistive devices
exercise program
weight loss
acetaminophen
can use voltaren gel
meloxican
intra-articular steroids
surgery
hyaluronic acid

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26
Q

when would you treat gout

A

treat arthritis with NSAIDs and use colchicene when symptomatic

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27
Q

when would you use corticosteroids for gout?

A

acute attack
if contrainidcation to NSAIDs
can use intra-articular injection of triamcinolone

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28
Q

when would you use urate-lowering therapy for gout and what are the drugs

A

acute arthritis
tophaceous deposits
CKD
minimum below 6

allopurinol and uloric

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29
Q

when would you use probenacid for gout

A

when xanthine oxide inhibitor cannot be used or does not reach

don’t use if crcl <50 mL/min

Moa increase uric acid excretion by kidney

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30
Q

ra

A

inflammatory disease with synovitis of multiple joints

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31
Q

pathologic findings in RA

A

formation of a pannus

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32
Q

clinical presentation of RA

A

symmetrical swelling for 30 minutes in AM and may recur after inactivity

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33
Q

deformity in rheumatoid arthritis

A

boutonniere and swan neck

34
Q

clinical presentation of ra

A

nodules correlate with RF in serum
ocular dryness and mucous membranes ILD pericarditis flety and small vessel vasculitis

35
Q

most specific blood test for RA

A

anti-CCP

36
Q

earliest radiographic changes in RA

A

hands and feet and soft tissue swelling

37
Q

treatment of RA

A

DMARDs: methotrexate
sulfasalazine 2nd line
TNF i added if needed (mab and enbrel)

38
Q

types of jia

A

oligoarticular
polyarticular
systemic
enthesitis-associated

39
Q

mc type of jia

A

oligoarticular

40
Q

symmetric or asymmetric jia

A

asymmetric four or fewer joints –> leg length discrepancy

41
Q

symmetric five or more joints jia

A

polyarticular

42
Q

fever evanescent salmon pink macular rash jia

A

systemic jia

43
Q

inflammation of tendinous insertions in jia

A

enthesitis associated
also see low back pain and sacroilitis

44
Q

is jia inflammatory?

A

yep
rf small percentage
anti-CCP antibody
positive aNA in late onset HLA B27 enthesitis

45
Q

joint fluid for jia

A

elevated white cells and low glucose

46
Q

diagnosis of jia

A

radiographs initially mri shows joint damage

47
Q

treatment of jia

A

nsaids: naproxen, ibuprofen, meloxicam
dmards second line for failure of nsaids: methotrexate/tnf inhibitors if mtx not tolerated

48
Q

cs for jia

A

reserved for severe involvement
can inject local triamcinolone

49
Q

treatment of uveitis in jia

A

corticosteroid and dilating agents
methotrexate if treatment failure, cyclosporine, TNF i
rehab

50
Q

highest rate of jia remission

A

oligoarticular
rf positive often continues into adulthood

51
Q

seronegative spondyloarteritis associated with

A

HLA-B27

52
Q

s/s of ankylosing spondylitis

A

worse in morningn stiffness for hours
improves with activity
lumbar curve flattes and thoracic urve exaggerates
can see sausage swelling and enthesopathy in 50%
anterior uveitis
constitutional symptoms absent

53
Q

diagnostics of ankylosing spondylitis

A

elevated esr
rf and anti-ccp negative
hla-b27
anemai

54
Q

imaging of as

A

shiny corneer
bamboo spine
bilateral and symmmetric later

55
Q

treatment of as

A

nsaids
tnf i for nsaid resistant
don’t use corticosteroids!

56
Q

s/s psoriatic arthritis

A

RA symmetric
oligoarticular destruction
dip primarily affected
arthritis mutilans
spondylotic form hla b27 positive
nail pitting
sausage swelling

57
Q

labs for psoriatic arthriits

A

increased esr rf neg

58
Q

imaging of pa

A

sharpened pencil

59
Q

treatment of pa

A

nsaids
methotrexate if no response
tnf i if refractory

60
Q

reactive arthritis

A

urethritis
conjunctivitis
uveitis
mucocutaneous lesions
hlab27

61
Q

in reactive arhtiritis

A

asymmetric of large weight-bearing joints

62
Q

s/s reactive arthritis

A

stomatitis
keratoderma blennorhagicum

63
Q

diagnostic rea a

A

inflammatory sync=ovial fluid
radiographic permanent or progressive joint disease

64
Q

treatment of rea a

A

nsaids
prevent by treating std\
sulfasalazine, methotrexate if poor response
anti-tnf if refractory

65
Q

peripheral arthritis in ibd

A

parallels bowel disease

66
Q

spondylitis in ibd

A

independent of bowel disease

67
Q

treatibd arthritis

A

control ibd
nsaids for spondylitis
dmards
corticosteroids

68
Q

s/s gonococcal arthritis

A

migratory polyarthralgia
purulent monoarthritis
fever
ankles, feet, toes
few have GU symptoms

69
Q

diagnostic of gonococcal

A

wbc elevated
urethral, throat, cervical, and rectal cultures
plain radiographs normal

70
Q

treatment of gonococcal arhtritis

A

hospital admission with antibiotics ceftriazond and azithromycin

71
Q

anti-dsdna and anti-smith

A

sle

72
Q

anti-histone

A

drug induced

73
Q

anti-mi-2
anti-jo
anti-srp

A

derm
derm/poly
derm/poly

74
Q

anti-centromere

A

crestan

75
Q

anti-ssa/ssb

A

sle/sjogren

76
Q

anti-scl 70

A

systemic sclerosis

77
Q

p-anca

A

sle, sjogrens, polymyositis
c-anca wga eg

78
Q

procainamide and hydralazine increase risk for

A

sle`

79
Q

sle treatment med thats all over the place

A

sle

80
Q
A

MSK (11 decks)

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