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ACS > Mosby 21 > Flashcards

Mosby 21 Flashcards

1
Q

Ankylosing Spondylitits

What is it?

Results?

Steps

Population

X-ray

Presentation

A

Chronic degenerative inflammatory arthritis primarily affecting the spine and sacroiliac joints

Fusion and deformity

Synovitis -> Bone destruction -> Fusion

Male 20-40yo

Bamboo spine

Uveitis (blurry vision/potential blindness)
Aortitis (aortic aneursym/aortic root dilation)
Decreased chest expansion

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2
Q

Lumbosacral Radiculopathy (Herniated Disk)

Cause

Population

Most coomon roots

Subjective

Objective

Test

A

Degeneration and tears in annulus fibrosis

30-50yo men

L4, L5, S1

When lifting heavey objectButtock ben and posterior thigh, relieved by lying down

Paraspinal muscle sensitivity, difficulty walking in heel/toes

Straight leg test

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3
Q

Lumbar Stenosis

Cause

Subjective

Objective

A

Hypertrophy of ligamentum flavum and facets joints resulting in narrowing of the spinal canal

Pain with walking especially downhill (relieved by uphill), pain often in buttons and legs

Focla weakness and sensory loss, neurological usually normal in early stages

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4
Q

Carpal Tunnel Syndrome

Cause

Association

Subjective

Objective

A

Compression of medial nerve

TAPRHOD , gout, acromegaly, hypothyroid, and pregnancy

Numbness, tingling, burning in 3 1/2 digits often worse at night (rotation can make it worse, may radiate to arms)

+Tinel +Phalen

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5
Q

Gout

Cause

Subjective

Location

Objective

A

Elevation of serum uric acid level, monosodium urate crystal deposition in tissues

Warm/hot swolleng joints, limited ROM

Great phalanx

Sking over the join may be shiny/purple/red and swollen

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6
Q

Lyme Disease

Cause

Subjective

Objective

Treatment

A

Tick bite –

Borrelia burgdorferi

fatigue, anorexia, headache, joints

Erythema migrans rash, neurological symptoms bell’s palsy, meningitis, encephalitis)

Doxycycline

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7
Q

Temporo Mandibular

Joint Syndrome

Cause

Subjective

Objective

A

Painful jaw movement often caused by congenital anomalies, malocclussion, trauma, arthritis, and other joint diseases.

unilateral facial pain that may worsen with joint movement. May refer to any point on the face/neck

muscle spasm, clicking, popping, crepitus in the affected joint

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8
Q

Osteomyelitis

Cause

Subjective

Objective

Treatment

A

Bone infection; open wounds, necrosis

dull pain develops and progresses over days to weeks

Looks limp or decreased movement in infants/children

fever, diabetetes/vascular disease

Debrideent, amputation

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9
Q

Paget Disease (of Bone)

Population

Cause

Subjective

Objective

A

>45 yo

Ill Bone turnover

increasing hat size, vertigo, headaches, deafness (CNVIII) or involvement of the ossicles

bowed tibias, misshapen pelvis, prominent forehead (Look for a history of frequent fractures due to poor bone formation)

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10
Q

Fibromyalgia

What is it

Population

Subjective

A

painful, nonarticular condition that leads to diffuse musculoskeletal discomfort

Women +40yo

widespread pain and aching, persistent fatigue, generalized morning stiffness, may also have headaches, sleep problems, and dysmenorrhea, may change with weather (?)

multiple tender points (>11) at nine bilateral sites

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11
Q

Osteo Arthiritis vs. Rheymatoid Arthritis

Onset

Duration

Progression during day

PE

LABS

A

Many years / gradual or suddent

<30min / >30min

Stays similar / gets worse

OA PE: reduced ROM, joint mal-alignment; joint crepitus

RA PE: synovitis; symmetrical joint; joint destruction;

OA LAB: osteophytes, space narrowing, clear fluid

RA PE: ESR; CCP

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12
Q

Fracture

What is it

Subjective

Objective

A

Partia. or complete break

Acute trauma more often in people with disorders e.g. OI

Deformity, edema, pain, loss of function, parasthesias

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13
Q

Tenosynovitis

Cause

Subjective

Objective

A

inflammation of the synovium-lined sheath around a tendon (repetitive action in occupational or sports activties)

Pain with movements at joints

Point tenderness if common, pain with movements, limitation of ROM

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14
Q

Rotator Cuff Tear

what is it

subjective

objective

tests

Treatment

A

Microtrauma and tering of rotator cuff muscles (most often supraspinatus) - repeatred lifting and compression under acromiom, also acutre from outstreched arm

pain in shoulder, can awake at night

Inability to maintain lateral arm raise against resistance, tenderness over AC joint, crepitus, weakness

Neer (hold scapula)

Hawkins test (flex rotate)

Empty Can test (thumb down pressure)

Surgery or supportive depending on patient

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15
Q

Ankle Injury

Test

Rules of this test

Importance

Absolute criteria exclusion

A

Ottwawa Ankle

Malleolar zone + one of the following

Pain in distal fibula

Pain in distal tibia

Inability to bear weight

High sensitivity

age <18, intoxication, multiple painful injuries, pregnancy, head injury, and neurologic deficit

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16
Q

Knee Injuries

Cause

Subjective

ACL/PCL tears vs. Meniscous tear

A

Injuries

Hyperextension / Pop

ACL/PCL swell faster

17
Q

Knee Injuries

tests

A

Anterior/Posterior Drawer Test - ACL/PCL

Lachman Test - ACL

McMurray Test - Medial lateral meniscus

18
Q

PEDIATRIC Clubfoot

Cause

Subjective

Objective

A

Fixed congenital defect of the ankles and foot

Demormity at birth

Inversion of the foot at ankle and plantar flexion

19
Q

PEDIATRIC Legg-Calvé-Perthes

Cause

Population

Subjective

DDx from Slipped capital femoral epiphysis (SCFE)

Objective

A

Decreased blood supply to femoral head, avacular aseptic necrosis

Boys 3-11 yo

Pain referred to knee, groin, or medial thigh

Limph that may be painless or antalgic (shortened extremity/painful limp); loss of internal rotation, abduction, and decreased ROM; muscle weakness

20
Q

PEDIATRIC Osgood-Schlatter Disease

What is it

Association

Population

Subjective

Objective

A

Inflammation of anterior aspect of tibial tubercle

Inflammation of anterior patellar tendom

9-15 boys (and self limited)

Liming and pain over tibial tubercle that worsens with activity

Knee swelling aggrevated by strenous activity esp. using quad muscles

21
Q

PEDIATRIC Slipped Capital Femoral Epiphysis (SCFE)

What is it

Population

Subjective

Objective

A

Disorder in which the capital femoral epiphysis slips over the neck of the femur

8-16 boys overweight

Kneee and limping

Taller, obsese, reduced internal hip rotation, XRAY with slippage of head

22
Q

PEDIATRIC Muscular dystrophy

Cause

Types

Subjective

Objective

A

Dysrophin gene causing muscular degeneration. Progressive symmetric symptoms or pseudohypertrophy. Skel and Cardiac muscle affected.

Becker / Duchenne

Clumsiness, difficulty standing, frequent falls

Positive Gower, muscle atrophy, waddling gait

23
Q

Barlow-Ortolani Maneuvers

Purpose

Symptom for dislocation sublaxation

A

Exam for newborns to assess hip dislocation or subluxation

palpable clunk

24
Q

Scoliosis

What is it

Shapes of vertebra

Cause

Population

Sujbective

Objective

A

Deformity lateral rotation of thoracic spine

Anterior concave and posterior convex

Unknown

Girls during early adolescene

Back discomfort, leg length discrepancy

Unevern shoulder, hip, spine, chest

25
Q

Radial Head Subluxation

Cause

Popuation

Subjective

Objective

A

Often jerking child’s arm

1-4 year old often after swinging

Pain in elbow

Pronation and flexion of arm

26
Q

OLDER: Osteoporosis

Cause

Population

Subjective

Most common fracture sites

Objective

A

Absorption/Deposition of bone imbalance causing fragile bone

Post menopausal women

Loss of height or an acute painful fracture

Hip, vertebra, wrist

Loss of height, decreased abdominothoracic space, kyphosis, scoliosis

27
Q

Dupuytren Contracture

Cause

Subjective

Objective

Population

A

Contractures involving the flexor hand tendons (unknown cause)

Flexion contractures develop insidiously

4th and 5th digit, tendons palpable

Men 40+ yo

28
Q

Sports Injuries

Always assess what?

Unusuall findings?

A

Neurovascular

Color – pallor or cyanosis

Temperature – cool/cold

Cap refill - > 4 seconds

Swelling – significantly swollen

Pain – presence of moderate to severe pain

Sensation – numbness, tingling, pins and needles feeling

Movement – decreased or no movement

29
Q

Meds given for skeletal injury

A

Medications (analgesics/anti-inflammatory drugs)

30
Q

Meds given for back pain

A

Medications (muscle relaxants, narcotics, analgesics, anti-inflammatory)

31
Q

RICE

A

rest, ice, compression, elevation

32
Q

Assessing Muscle Strength

Scale

A

No evidence of movement – 0

Trace of movement – 1

FROM, not against gravity – 2

FROM against gravity and some weak resistance – 3

FROM against gravity, full resistance – 4

33
Q

Muscle Strain

What is it

Cause

Symptoms

Treatment

A

: excessive stretching or forceful contraction beyond the muscle’s functional capacity

poor warm up, fatigue, and previous injry

temporary weakness, spasm, pain, and contusion

RICE

ACS (7 decks)

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