Mehl. Peds MSK random Dx table

Question 1

Talipes equinovarus aka?

Answer 1

Aka clubbed foot.

Question 2

USMLE just wants you to know that this is treated initially with serial casting. What Dx?

Answer 2

Talipes equinovarus aka clubbed foot.

Question 3

Talipes equinovarus aka clubbed foot. Tx?

Answer 3

USMLE just wants you to know that this is treated initially with serial casting.

Question 4

Talipes equinovarus aka clubbed foot. Cause? in what syndrome can be seen?

Answer 4

Usually idiopathic; can be seen in Potter sequence.

Question 5

Talipes equinovarus aka clubbed foot.

!!Not the same as rocker-bottom foot (aka congenital vertical talus), seen in Edward syndrome.

Answer 5

.

Question 6

Arthrogryposis.

You just need to know this is fancy name for a child born with multiple joint contractures.

Answer 6

If they give you a child with not just a clubbed foot, but also knee and/or elbow contractures, etc., the answer is arthrogryposis.

Question 7

Tibia vara. Aka Blount disease.
CP?

Answer 7

Bowing of the tibias after the age of 2 years in a patient whom rickets has been ruled out.

Can be unilateral or bilateral.

Question 8

Tibia vara. Bowing of one or both tibias is sometimes normal until age 2 years.

Answer 8

.

Question 9

Tibia vara. Tx?

Answer 9

Treatment is surgery (osteotomy).

Question 10

Growing pains. No, this is not a joke. This is the answer straight-up on a 2CK NBME form.

Answer 10

.

Question 11

Vignette is healthy child age 3-12 who awakens from sleep with throbbing pain in the legs. Dx?

Answer 11

Growing pains

Question 12

Growing pains. Tx?

Answer 12

No treatment necessary. You just need to know this Dx is exists and isn’t a troll.

Question 13

The answer on USMLE if they give severe heel pain that is worst when first getting out of bed in the morning. Dx?

Answer 13

Plantar fasciitis

Question 14

Buzzy vignette is knee pain in fast-growing teenage male who plays soccer. Don’t pigeon-hole things, but that’s classic vignette. Dx?

Answer 14

Osgood-Schlatter disease

Question 15

Osgood-Schlatter disease. mechanism?

Answer 15

Inflammation of the patellar ligament at the tibial tuberosity.

Mechanism is repeated stress on the growth plate of the superior tibia.

Question 16

The answer on USMLE if they say lateral knee pain, usually in a runner. Dx?

Answer 16

Iliotibial band syndrome

Question 17

Iliotibial band syndrome. Anatomic location?

Answer 17

Iliotibial band runs from the hip to the knee. Pain may occur anywhere along the hip, lateral thigh, and lateral knee, but is worst in the latter.

Question 18

Iliotibial band syndrome. TX?

Answer 18

conservative with physiotherapy; NSAIDs for pain.

Question 19

“Unhappy triad” Refers to a trio injury of the ??

Answer 19

ACL, medial collateral ligament, and either the medial or lateral meniscus.

Question 20

“Unhappy triad”. Students are sometimes fanatical about this triad as though it has yieldness. USMLE doesn’t give a fuck. I cannot recall a single NBME question that has ever assessed this. This Dx primarily resides within the domain of Qbank, not the NBME

Answer 20

.

Question 21

Medial meniscal tear.

Answer 21

Medial knee pain where patient experiences “locking” or “catching” of the knee in partial flexion.

Question 22

….knee pain where patient experiences “locking” or “catching” of the knee in partial flexion. Dx?

Answer 22

Medial pain.

Medial meniscal tear.

Question 23

Medial meniscal tear Dx?

Answer 23

Diagnosed with McMurray test -> EXTERNAL rotation of leg with concurrent knee extension causes medial knee pain / “catching.”

Question 24

Diagnosed with McMurray test ???

Answer 24

Medial meniscal tear

Question 25

..... knee pain where patient experiences “locking” or “catching” of the knee in partial flexion. Dx?

Answer 25

Lateral meniscal tear

Question 26

Lateral meniscal tear Dx?

Answer 26

Diagnosed with McMurray test -> INTERNAL rotation of leg with concurrent knee INTERNAL causes ... knee pain / “catching.”

Question 27

Diagnosed with McMurray test -> internal rotation of leg with concurrent knee INTERNAL causes ...knee pain / “catching.”

Answer 27

Lateral meniscal tear

Question 28

...... is the answer if valgus test induces excessive medial motion of the knee compared to the unaffected side.

Answer 28

Medial collateral ligament injury.

Question 29

Valgus test = hand placed on lateral knee and pushing inward + other hand placed on medial ankle and pulling outward. Pathology?

Answer 29

Medial collateral ligament injury

Question 30

..... the answer if varus test induces excessive lateral motion of the knee compared to the unaffected side.

Answer 30

Lateral collateral ligament injury

Question 31

Varus test = hand placed on medial knee and pushing outward + other hand placed on lateral ankle and pushing inward. Pathology?

Answer 31

Lateral collateral ligament injury

Question 32

.... is answer if (+) anterior drawer test or Lachman test -> excessive anterior displacement of tibia relative to femur.

Answer 32

Anterior cruciate ligament injury

Question 33

Classically injured when knee is hyper-extended, or with a rotational force on a fixed, planted knee. Dx?

Answer 33

Anterior cruciate ligament injury

Question 34

.... is answer if (+) posterior drawer test -> excessive posterior displacement of tibia relative to femur.

Answer 34

Posterior cruciate ligament injury

Question 35

Classically injured when knee hits the dashboard in car accident

Answer 35

Posterior cruciate ligament injury

Question 36

Patellofemoral pain syndrome. Aka chondromalacia patellae; name implies softening of cartilage in the knee.

Answer 36

.

Question 37

The answer on NBME if they say pain that worsens when sitting for long periods of time, or when going up or down stairs.

Answer 37

Patellofemoral pain syndrome

Question 38

Classic in obesity or those who squat heavy weight (knees think you’re obese).???

Answer 38

Patellofemoral pain syndrome

Question 39

Patellofemoral pain syndrome. Tx?

Answer 39

Tx = quadriceps strengthening exercises.

Question 40

Lateral epicondylitis. Tennis elbow.

Answer 40

.

Question 41

pain worsened when patient extends wrist against resistance.???

Answer 41

Lateral elbow pain. Lateral epicondylitis

Question 42

NBME asks “extensor carpi radialis brevis” as answer for site of inflammation. Dx?

Answer 42

Lateral epicondylitis

Question 43

Medial/lateral epicondylitis. Tx = ?

Answer 43

"forearm strap” on 2CK FM forms

Question 44

Medial epicondylitis. Golfer elbow.

Answer 44

.

Question 45

.... pain worsened when patient flexes wrist against resistance.

Answer 45

Medial elbow

Question 46

Medial elbow, iflammation of what?

Answer 46

Inflammation at flexor carpi radialis and pronator teres.

Question 47

Radial head subluxation. “Nursemaid elbow”; HY for 2CK Peds.

Answer 47

.

Question 48

Child stops using arm + arm pronated and partially flexed.

Answer 48

Radial head subluxation.

Question 49

Hx of child having arm pulled/yanked, or child holding hands and running with older sibling + the child falls, resulting in elbow pull.

Answer 49

Radial head subluxation.

Question 50

Radial head subluxation. Tx?

Answer 50

Tx = hyper-pronation, OR supination when arm partially flexed. Either is correct. Both will not be listed at the same time as answers. nereikia daryt xray!!! buvau sita pazymejus

Question 51

Inflammation of patellar tendon.?

Answer 51

Patellar tendonitis (“Jumper’s knee”)

Question 52

The answer on USMLE if they describe anterior knee pain that initially occurs only after finishing sports (e.g., basketball game), then progresses to more chronic pain. Dx?

Answer 52

Patellar tendonitis (“Jumper’s knee”)

Question 53

Patellar tendonitis (“Jumper’s knee”), Tx?

Answer 53

“quadricep strengthening exercises.”

Question 54

Patellofemoral instability. Presentation is annoyingly similar to patellar tendonitis, but do not confuse.

Answer 54

.

Question 55

Patellofemoral instability is misalignment of the patella at the trochlear groove of the femur. Q can mention crepitus.

Answer 55

.

Question 56

Shows up on 2CK Peds CMS form 6 as teenage girl who has knee pain worse after jumping or running + has crepitus, answer=?

Answer 56

answer = “patellofemoral instability” (patellar tendonitis / “jumper’s knee” not listed as answer).