misc ortho

Question 1

worsens with use/am stiffness

Answer 1

OA

Question 2

improves with use/am stiffness after an hour

Answer 2

RA

Question 3

neg ANA, neg RF, recurrent high fever, hepatosplenomegaly, salmon rash in pm, koebner

Answer 3

stills d/s(systemic JRA)

Question 4

+ ANA, - RF, no systemic symptoms, uveitis common

Answer 4

pauciarticular JRA-most common; can lead to blindness, do slit lamp

Question 5

what is sensitive and specific in lupus

Answer 5

+ANA highly sensitive

antibodies to double stranded DNA and smith antigen is highly specific

Question 6

procainamide, hydralazine, INH, methyldopa, quinidine, chlorpromazine

Answer 6

can cause lupus like syndrome

Question 7

osteopenia on a DEXA

Answer 7

1-2.5; 2.5 is osteoporosis

Question 8

distribution of sciatic nerve

Answer 8

buttock , post thigh, posterolateral aspect of leg around lateral malleolus to lateral dorsum of foot and entire sole

Question 9

Motor/Reflex/sensory of L4

Answer 9

Motor: foot dorsiflexion(tibialis anterior)

reflex: patellar
sensory: medial aspect of lower leg

Question 10

Motor/Reflex/sensory of L5

Answer 10

Motor: big toe dorsiflexion(extensor hallucis longus); foot eversion(peroneus muscles)

reflex: none
sensory: dorsum of the foot and lateral aspect of lower leg

Question 11

Motor/Reflex/sensory of S1

Answer 11

Motor: plantar flexion(gastrocnemius/soleus), hip extension(gluteus maximus)

reflex: achilles
sensory: plantar and lateral aspects of the foot

Question 12

motor and sensory deficit for radial nerve

Answer 12

motor: wrist extension
sensory: dorsal forearm and hand(1st 3 fingers)

Question 13

motor and sensory deficit for median nerve

Answer 13

motor: forearm pronation, thumb opposition
sensory: palmar surface(1st 3 fingers) [cannot close]

Question 14

motor and sensory deficit for ulnar nerve

Answer 14

motor: finger ABDUCTION
sensory: palmar and dorsal surface (last 2 fingers)[cannot open]

Question 15

motor and sensory deficit for axillary nerve

Answer 15

motor: arm ABDUCTION
sensory: decreased sensation over the deltoid

Question 16

motor and sensory deficit for peroneal nerve

Answer 16

motor: dorsiflexion, eversion
sensory: dorsal foot and lateral leg

Question 17

What nerve is affected?

humeral fracture; prolonged compression at level of humerus

Answer 17

radial

Question 18

What nerve is affected?

wrist drop

Answer 18

radial

Question 19

What nerve is affected?

elbow dislocation

Answer 19

ulnar

Question 20

What nerve is affected?

anterior shoulder dislocation

Answer 20

axillary

Question 21

What nerve is affected?

weak wrist flexion and flat, thenar eminence

Answer 21

median

Question 22

What nerve is affected?
cannot open
and cannot close hand

Answer 22

cannot open: ulnar

cannot close: median

Question 23

overweight males with knee pain?
Anterior knee pain in a 13 year old soccer player. What is the most likely diagnosis?
If you can only choose one physical exam test to test for an ACL injury which should you choose?
Which fifth metatarsal fracture has a high rate of nonunion?

Answer 23

overweight males with knee pain? Slipped capitol femoral epiphysis
Anterior knee pain in a 13 year old soccer player. What is the most likely diagnosis? Osgood Schlatter
If you can only choose one physical exam test to test for an ACL injury which should you choose? Lachman
Which fifth metatarsal fracture has a high rate of nonunion? Jones fracture

Question 24

The shopping cart sign is a symptom of what disorder?
Numbness of the posterior calf may indicate a dysfunction of which nerve root?
Decreased strength of great toe dorsiflexion may indicate a dysfunction of which nerve root?
Saddle anesthesia should make you think of what diagnosis?
The term bamboo spine should make you think of what diagnosis?
What is the minimum you should wait to order imaging on a patient with generalized low back pain and no significant history?

Answer 24

The shopping cart sign is a symptom of what disorder? Spinal stenosis
Numbness of the posterior calf may indicate a dysfunction of which nerve root? S1
Decreased strength of great toe dorsiflexion may indicate a dysfunction of which nerve root? L5
Saddle anesthesia should make you think of what diagnosis? Cauda equina syndrome
The term bamboo spine should make you think of what diagnosis? Ankylosing spondylitis
What is the minimum you should wait to order imaging on a patient with generalized low back pain and no significant history? 4 weeks

Question 25

X-ray shows a silver fork deformity

Pain with palpation over the anatomical snuffbox

Lateral Epicondylitis

Medial Epicondylitis

A fracture of the neck of the 4th and often 5th metacarpal

Name the four rotator cuff muscles

Answer 25

X-ray shows a silver fork deformity= Colles fracture

Pain with palpation over the anatomical snuffbox = scaphoid fracture

Lateral Epicondylitis = Tennis Elbow

Medial Epicondylitis = Golfers Elbow

A fracture of the neck of the 4th and often 5th metacarpal = Boxer’s fracture

Name the four rotator cuff muscles

Supraspinatus

Infraspinatus

Teres minor

Subscapularis

Question 26

Describe Tinel’s sign =

Describe Phalen’s sign

What do Neer and Hawkins asses

Which fingers are affected in carpal tunnel

What does the crossover test evaluate

What is the most commonly injured rotator cuff muscles

What does a fat pad sign indicate?

Answer 26

Describe Tinel’s sign = Tapping

Describe Phalen’s sign = Wrist flexion

What do Neer and Hawkins asses – Rotator cuff impingement

Which fingers are affected in carpal tunnel – all but the pinky

What does the crossover test evaluate – AC joint

What is the most commonly injured rotator cuff muscles – Supraspinatus

What does a fat pad sign indicate? – occult elbow fracture

Question 27

which hip dislocation?

shortened, IR leg

Answer 27

posterior

Question 28

which hip dislocation?

lengthened, ER leg

Answer 28

anterior

Question 29

shortened, ER leg

Answer 29

hip fracture