MS 3

Question 1

common site for herniated disc w/ symptoms is at what level of spine

Answer 1

L5-S1 (buttock/leg pain)

Question 2

best imaging for dx a herniated disc

Answer 2

MRI

Question 3

medial tibial stress syndrome MTSS aka

Answer 3

shin splints - microtears and inflammation of the muscles and tendons of the tibia

Question 4

shin splint - if stress fracture if suspected, order what imaging first

Answer 4

plain x ray

Question 5

steinman’s test is to

Answer 5

meniscus tear

Question 6

steinman’s test

Answer 6

flex the knee joint and palpate the joint line, pain over the posterior joint line w/ flexion is positive for meniscus tear

Question 7

apley’s test is to

Answer 7

meniscus tear

Question 8

apley’s test

Answer 8

supine, flex knee 90 degrees, press heel down + pain indicates meniscus tear

Question 9

meniscus tear tx plan
4

Answer 9

1. RICE
2. ice packs
3. when pain/swelling gone, start quad strengthening exercises
4. NSAIDs or tylenol for pain

Question 10

most sensitive dx imaging for meniscal tear

Answer 10

MRI

Question 11

morton’s neuroma

Answer 11

inflammation of the digital nerve of the foot between the third and fourth metatarsals

Question 12

inflammation of the digital nerve of the foot between the third and fourth metatarsals

Answer 12

morton’s neuroma

Question 13

morton’s neuroma - increased risk of getting with what?
5

Answer 13

high heeled shoes
tight shoes
obesity
dancers
runners

Question 14

morton’s neuroma test

Answer 14

Mulder test

Question 15

Mulder test is to

Answer 15

morton’s neuroma

Question 16

Mulder test

Answer 16

grasp the 1st and 5th metatarsals and squeeze together; positive is hearing a click along w/ a patient report of pain with compression

Question 17

morton’s neuroma tx plan
2

Answer 17

avoid tight shoes
refer to podiatry

Question 18

what two deformities are found in OA

Answer 18

Bouchard nodes
Heberden’s nodes

Question 19

Heberden’s nodes

Answer 19

OA - nodules on DIP joints

Question 20

Bouchard’s nodes

Answer 20

OA - nodules on PIP

Question 21

OA - tx plan, starts with

Answer 21

topical NSAIDs

Question 22

OA - oral NSAIDs are recommended in who

Answer 22

patients w/ inadequate relief w/ topical NSAIDs or those w/ symptomatic OA in multiple joints

Question 23

ketorolac/Toradol is limited to

Answer 23

5 days of use

Question 24

OA - recommended in pts for pain with contraindication of NSAID use and multiple joints involved

Answer 24

duloxetine

Question 25

OA - tylenol

Answer 25

no longer recommended

Question 26

OA - topical meds
2

Answer 26

diclofenac gel
capsaicin cream

Question 27

compression and irritation of the sciatic nerve in the buttock

Answer 27

piriformis syndrome

Question 28

which NSAID has fewest CV effects

Answer 28

naproxen

Question 29

popliteal/Baker’s cyst

Answer 29

type of bursitis that is located behind the knee (fluid filled synovial sac)

Question 30

ball like mass behind the knee that is soft and smooth

Answer 30

popliteal/baker’s cyst

Question 31

popliteal/baker’s cyst dx is made how

Answer 31

clinical presentation and history

Question 32

popliteal/baker’s cyst - if imaging is desired, or what

Answer 32

US and plain x ray