kanis

Question 1

Duchenne muscular dystrophy

Answer 1

• Physical features are present at BIRTH
• frequent falls and cant keep up with friends
• APPARENT 3-5 YEARS OLD
• GOWERS SIGN AROUND AGE 3-5 YEARS OLD
  
  • patient uses hands to climb up himself when getting up from floor

Question 2

Dermatomyositis

Answer 2

• SUBACUTE Progressive proximal muscle weakness with a skin rash (rash may precede weakness)
  
  • Heliotrope rash
• Patients present earlier b/c present with RASH
• INCREASED ASSOCIATION WITH MALIGNANCY
  
  • Ovarian cancer, breast cancer, melanoma, colon cancer, non-hodgkin lymphoma
  • IMPORTANT TO GET ALL SCREENING EXAMS FOR CANCER

Question 3

Statins and Fibrates

Answer 3

Cause TOXIC MYOPATHIES

• Myalgia, malaise and muscle tenderness
• muscle necrosis
• May be related to exercise
• Elevated CK is indication of toxicity
• STOP THE DRUG if they patient develop MYALGIA, MUSCLE TENDERNESS

Question 4

L4 nerve root

Answer 4

• tested by the quadricep or knee reflex

Question 5

S1 nerve roots***

Answer 5

• Tested by Gastrocnemius/soleus (ankle) reflex

Question 6

what are 4 indications for intervertebral disk surgery***

Answer 6

• Progressive motor weakness from nerve root injury demonstrated on clinical exam or EMG
• Bowel or bladder disturbances or other signs of spinal cord compression
• Incapacitating nerve root pain despite conservative tx for at least 4 weeks
• recurrent incapacitatin pain despite conservative tx

Question 7

Differential diagnosis of radicular back pain

Answer 7

• Herniated disk or disk disease
• spinal stenosis
• herpes zoster
• facet hypertrophy