Most Commons, Hallmark Signs and Symptoms Flashcards

1
Q

Most commonly fractured bone in the body

Where in the bone does the fracture usually occur?

A

Clavicle

At the junction of the medial two-thirds and lateral one-third

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2
Q

Common MOI of clavicular fracture

A

FOOSH (Fall on outstretched hand)
FOS (Fall on shoulder)
Medially directed blow to the shoulder

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3
Q

Most serious complication of a clavicular fracture

How does this occur?

A

Impingement of the Brachial plexus and Subclavian artery at the Costoclavicular space.

Occurs as the lateral fragment, having lost its axial connection, drops downward due to the pull of gravity, thereby compressing the structures underneath it

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4
Q

Lyme Disease

A

Erythema Migrans

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5
Q

Acute appendicitis

A

Pain over McBurney’s point, positive Rovsing’s sign (pain in the right lower quadrant during left-sided pressure), and/or referred rebound tenderness (right lower quadrant pain on quick withdrawal)

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6
Q

Acute cholecystitis or Acute polynephritis

A

Murphy’s sign (pain over the costovertebral angle with abrupt stopping of inspiratory effort)

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7
Q

Nagging, localized pain that is consistently present at night and worsens during activity; with swelling

A

Stress fracture

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8
Q

Nagging, localized pain that is consistently present and increases at night and worsens during activity; with swelling

A

Bone tumor (requires imaging)

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9
Q

Shin splints (medial tibial stress syndrome) is similar in presentation with stress fractures, except that there is lack of edema, and tenderness is _____?

A

Non-focal (diffuse along the mod-distal and posteromedial tibia)

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10
Q

Scotty dog - with collar

Bilateral pars interarticularis defect viewed in an oblique radiograph

A

Spondylolysis

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11
Q

Scotty dog - decapitated

Anterior displacement of a superior vertebra over an inferior vertebra

A

Spondylolisthesis

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12
Q

Scotty dog - decapitated

Posterior displacement of a superior vertebra over an inferior vertebra

A

Retrolisthesis

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13
Q

Most and second most commonly affected segment in spodylolysis and spondylolisthesis.

Why?

A

L5 over S1, and L4 over L5, respectively

L5 is the most weight-bearing segment, and experiences the greatest stresses

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14
Q

Ankylosing spondylitis

Eponyms of AS?

A

+Bamboo spine in radiographs

Von Beckterev’s disease
Marie-Strumpell disease

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15
Q

Rupture with volar slippage of the lateral bands

A

Boutonniere deformity

MCP and DIP in extension, PIP in flexion

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16
Q

Most injured ligament in inversion ankle sprains

A

ATFL

Anterior talofibular ligament (part of the lateral collateral ligaments of the ankle)

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17
Q

Chronic CHF (epidermal changes)

A

Digital clubbing and bluish-graying slate colored discoloration of the skin

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18
Q

Cherry red discoloration of the skin

A

Carbon monoxide poisoning

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19
Q

+Trendelenburg sign

Describe this sign

A

Weakness of the Gluteus medius

Contralateral pelvic drop (side opposite the stance LE)

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20
Q

Difference in the radiographic findings in Myositis Ossificans and Osteosarcoma.

A

Myositis ossificans: peripheral to central calcification, usually unanchored to bone

Osteosarcoma: central to peripheral calcification, usually attached to bone

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21
Q

Painful arc at last 30 degrees of shoulder abduction

A

Acromioclavicular joint sprain

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22
Q

Painful arc of Supraspinatus tendinitis and Subacromial bursitis

A

60-120 degrees of shoulder abduction

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23
Q

Early signs of CRPS

A

Hyperpathia, Allodynia, Hyperalgesia

Includes edema, sweating, and thin and shiny skin

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24
Q

LMNL hallmark sign

A

Fasciculations (visible contraction but no movement)

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25
Q

Theophylline toxicity

A

Feeling jittery, gastric upset, and irregular HR

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26
Q

Common symptoms of HIV encephalopathy

A

Disorientation, memory loss, confusion, unsteadiness while walking, clumsiness, shaky hands, personality changes, irritability, depression, apathy

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27
Q

Most common infection transmitted to healthcare workers.

A

Hepatitis B

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28
Q

Pattern of weakness in an Internal capsule stroke

A

Facial muscle weakness on the contralateral lower face (supranuclear palsy)

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29
Q

Most common cause of falls in the elderly

A

Turning while sitting down

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30
Q

Cardinal symptom of Addison’s disease

A

Asthenia

Other symptoms include: anorexia, weight loss, nausea, vomiting, abdominal pain, syncope

Addison’s disease is also known as adrenal insufficiency or hypocortisolism

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31
Q

Early signs of Cystic Fibrosis

A

Excessive appetite and weight loss

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32
Q

Spinal mobilization to improve rotation

A

Contralateral transverse process of the superior vertebra

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33
Q

Spinal mobilization to improve a closing restriction

A

Mobilization of the inferior vertebra, using central posteroanterior pressure oriented in the similar plane as the facet joints.

In a closing restriction, the inferior facets of the superior vertebra will not POSTERIORLY glide on the superior facets of the inferior vertebra.

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34
Q

Lateral pterygoid weakness presents as?

A

Deviation to the strong side on protrusion.

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35
Q

Most appropriate transfer for patients post-THA using a posterolateral approach.

A

Stand pivot on the sound side.

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36
Q

Describe the pain in Tic Douloureux.

A

Paroxysmal and severe, usually distributed to the maxillary and mandibular divisions

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37
Q

Barrel chest

A

Emphysema (COPD in general, where the AP diameter increases due to the lungs assuming an inspiratory state)

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38
Q

Mobilization of the rib head to improve inspiration and expiration.

A

Inspiration: inferior glide
Expiration: superior glide

Opposite motion; during inspiration, the ribs move superiorly, and the head moves inferiorly. The opposite happens with expiration.

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39
Q

Location of the stroke with loss of pain and temperature sense on one side of the face, and on the contralateral body.

A

Posterolateral medulla ipsilateral to the facial affectation.

Discriminative sensations are not affected, as the medial lemniscus is not involved.

Relevant anatomy: The tracts mediating sensory information only become completely contralateral after the medial lemniscal decussation at the upper medulla (this are the tracts for discriminative sensations; fasciculus cuneatus and gracilis).

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40
Q

Lesion to CN XI leads to what type of scapular winging?

A

Rotary winging.

May also be found in Serratus Anterior affectation

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41
Q

Kayser-Fleischer rings

A

Liver and metabolic diseases

These are rings that appear at the junction of the iris and the sclera of the eye. Depending on its color, the diseases may vary.

Golden-brown is indicative of Wilson’s disease (impaired copper metabolism)

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42
Q

Meige syndrome (Brueghel syndrome)

A

Combined oromandibular dystonia and blepharospasms.

Different from Meige disease, which is the familial variant of Primary Lymphedema Praecox, affecting adolescents to persons aged 35 years.

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43
Q

Hypopyon usually indicates? It is also known as?

A

Anterior Uveitis or Iritis

It is also known as sterile pus, in which its formation is due to the release of toxins, and not actual invasion of pathogens.

44
Q

Lack of AHF-A (Classic factor)

A

Hemophilia A (Classic Disease)

45
Q

Lack of AHF-B (Christmas factor)

A

Hemophilia B (Christmas Disease)

46
Q

Lack of AHF-C

A

Hemophilia C (Rosenthal Syndrome)

47
Q

Lack of AHF-D (Hageman factor)

A

Hageman factor deficiency

48
Q

Lack of clotting factor V

A

Owren’s disease

49
Q

Von Willebrand Disease

A

Lack of Von Willebrand factor, coded at the short arm of chromosome 21 (p21)

50
Q

Porphyria

A

Lack in the enzymes responsible for forming heme. Usually genetic, but a specific kind - Porphyria Cutanea Tarda (affecting the skin) - is acquired.

51
Q

Most common tube for feeding

A

NGT (Nasogastric tube)

52
Q

Rate pressure product is a reflection of? It is obtained how?

A

Myocardial oxygen consumption.

It is obtained by multiplying the HR with the SBP.

53
Q

Charcot’s foot

A

Diabetic neuropathy resulting in altered sensation.

Charcot’s foot can lead to a rockerbottom deformity and cause ulceration; it is more associated with pes planus.

54
Q

Finger position in splinting following a mallet finger.

What if the patient has swan neck deformity?

A

Mallet finger refers to a hyperflexion injury at the DIP.

Splinting is done with the DIP in hyperextension.

If the patient has swan neck deformity (DIP flexion), the PIP is placed in slight flexion (to accommodate the lateral slips), before placing the DIP in hyper extension.

55
Q

In Anemia, which is remains the same, SBP or DBP?

A

SBP is usually unaffacted.

DBP decreases.

56
Q

Following a burn, hematocrit rises or decreases?

A

Initially rises, then gradually decreases as fluid is replaced.

57
Q

Pattern of contraction in ankle strategy.

A

Distal to proximal.

58
Q

Pattern of contraction in hip strategy.

A

Proximal to distal.

59
Q

Most sensitive mechanoreceptor

A

Meissner’s corpuscles

Used for detecting light touch and vibrations less than 50Hz.

60
Q

The treatment area in US is usually _____ times the head of the ultrasound, and is treated for _____ minutes.

A

Treatment area: 2-3x the ERA (around 2x the transducer face)

Treatment time: 5 mins (assuming standard treatment area)

61
Q

Most common bacterial agent in gastric ulcers?

A

Helicobacter pylori

62
Q

Most common bacterial agent in tetanus?

A

Clostridium tetani

63
Q

Most common bacterial agent in pneumonia?

A

Streptococcus pneumonia

64
Q

Most common bacterial agent in meningitis?

A

Neisseria meningitidis

65
Q

Heart palpitations and shortness of breath

vs.

Dizziness, headaches, and blurred vision

A

Anemia; Hypertension

66
Q

Kleine-Levin syndrome

A

Sleeping beauty syndrome

Associated with lesions to the hypothalamus and diencephalon. Usually presents with hypersomnolence, hyperphagia and hypersexuality.

67
Q

Balint syndrome

A
Optic ataxia (hand-eye coordination problems)
Oculomotor apraxia (problems with fixation and tracking)
Visual simultagnosia (inability to see the "whole" object)

Associated with lesions to the bilateral parietal lobes

68
Q

Common prescribed positioning for patients with PD and hip flexion contractures in addition to posturing.

A

Prone-lying

69
Q

Pusher syndrome

A

Lateral deviation to the affected side while in sitting.

70
Q

Cross-over concept in metabolism.

A

Carbohydrates are used more in exercise intensities above 70% or the maximum oxygen consumption.

If the exercise is prolonged and is below 70%, fats are used more.

As exercise progresses, proteins are then used.

71
Q

Hoffman’s Reflex

A

Tapping of the nail of the middle finger causes flexion of the index finger and thumb.

Indicative of UMNL

72
Q

Common complication of modified radical mastectomy, where the skin is discolored, tender to palpation. and warm to touch.

A

Cellulitis.

Dermatitis is usually not warm to touch.
Erysipelas, a specific form of cellulitis caused by Streptococcal bacteria, has much more defined borders.

73
Q

Most common complication following and MI.

A

Arrythmias.

The four major complications following an MI are: Arrhythmias, heart structural damage, thrombus formation (mural and venous), and heart failure. Arrhythmias are the most common, occurring in about 90% of individuals.

74
Q

Waddell’s signs

A

Similar reactions to SLR in sitting and supine (normally different)

Stocking sensory loss (normally dermatomal)

Complaints of pain with simultaneous acetabular and glenohumeral rotation (normally no pain as rotation occurs at the joints and not at the low back)

Localized tenderness upon low back palpation (usually tenderness is deep and is felt over a wide area)

75
Q

True or false.

Waddell’s signs are diagnostic of malingering.

A

False. Positive Waddell’s signs are only indicative of a behavioral aspect to pain, and not necessarily malingering.

Giles B-133

76
Q

Ideal management for equinus gait pattern

A

Backward stepping

77
Q

Uncomplicated recovery permits patients to return to a functional level usually based on?

A

Their previous functional level

78
Q

Most oblique rib

A

9th rib

79
Q

Total ROM of knee axial rotation

A

40 degrees (20 IR, 20 ER)

80
Q

Calorie cost of walking is lowest at?

A

2 mph (anything lower will increase calorie demand)

81
Q

Vertebral discs are located only at segments _____.

A

C2 to S1

82
Q

Smallest carpal bone next to the pisiform.

A

Trapezoid

83
Q

Strongest hand prehension pattern.

A

Cylindrical

84
Q

Positive finding in a graded exercise test

A

ST segment depression, greater than or equal to 1 mm

Other findings, such as arrythmias and dysrhythmias, while critical to assess, are not positive indicators.

85
Q

Pain on the knee joint line usually indicates?

A

Meniscal injury

86
Q

Hemodynamics in renal failure.

A
Hypocalcemia
Hyperkalemia
Increased BUN
Increased Creatinine
Increased Magnesium
Increased Uric Acid
87
Q

Posterior alignment of the wheel axle in a wheelchair results in?

A

Increased energy expenditure during propulsion.

Rolling resistance increases
A wheelie becomes more difficult to perform.
The turning radius increases, hence maneuverability decreases.

88
Q

Normal measure of exercise intensity.

A

THR

89
Q

Measure of exercise intensity in cardiac patients.

A

RPE

90
Q

Measure used to select specific activities for patients.

A

METs

91
Q

Most common disease of the blood.

A

Anemia

92
Q

A limit of graded exercise testing is exercising up to volitional fatigue. A maximal performance is characterized by?

A

The HR does not rise, even with a further increase in intensity.

93
Q

Polyphasic potentials

A

Denervated motor unit (5 or more phases)

May indicate regeneration

94
Q

Electrical silence

A

Normally innervated muscle, may have insertional activity

95
Q

Positive sharp waves and spontaneous potentials

A

Acutely denervated muscle

Indicates spontaneous discharge of a single muscle fiber.

96
Q

Iliolumbar syndrome

A

Iliac crest pain syndrome.

Due to inflammation or tear of the iliolumbar ligament. Causes referred pain to the pelvis or groin.

97
Q

Most common site of osteosarcoma.

A

Distal femur

Followed by proximal tibia, then the proximal humerus

98
Q

Difference of an osteosarcoma and an Ewing’s sarcoma

A

An Ewing’s sarcoma can be found in long bones, flat bones, and soft tissues.

Osteosarcomas often occur in long bones, especially during periods of rapid bone growth.

Both are malignant growths, unlike osteochondromas, osteoblastomas, and osteoid sarcomas, which are benign tumors.

99
Q

Most important factor in determining equipment calibration frequency

A

Frequency of use

100
Q

Normal PR interval

A

0.12-0.2 ms

101
Q

Stretching of a joint facet

A

Flexion and contralateral rotation or contralateral side flexion

102
Q

One of the most common causes of miscommunication

A

Language barriers

103
Q

Decreased fremitus and decreased breath sounds

A

Pleural effusion

104
Q

Decreased breath sounds, increased fremitus

A

Atelectasis, Consolidation, Pulmonary edema

105
Q

Most affected muscle groups following immobilization

A

Lower extremity extensors

Bed rest for 30 days decreases muscle strength by 20% following decreased mass and cross sectional area

106
Q

Tetanic contraction of muscles occur if calcium ion concentraction increase or decrease?

A

Decrease by 1/2

Due to spontaneous generation of nerve impulses.