MS 4 Flashcards
two deformities associated with RA
Swan neck - DIP joint hyperextension
Boutonniere - hyperextension of DIP w/ flexion of the PIP joint
RA - what meds are rec to be started ASAP
DMARDs
RA - adjunct meds
2
NSAIDs
glucocorticoids
when starting on hydroxychloroquin all patients must
have eye exam prior to starting and every 6 months while on to assess and prevent retinal damage
lateral ankle sprain (most common) - caused by
injury is inversion of the plantar flexed foot
medial ankle sprain
infrequent injury; forced eversion of the ankle
Ottawa rules
used to determine whether a patient needs x ray of the injured ankle in the ED
x ray of the ankle are only indicated if
there is pain in the malleolar zone AND bone tenderness over the posterior edge or tip of the medial or lateral malleolus OR inability to bear weight both immediately after the injury and for four steps into the office
x ray of the foot is indicated if pain where
midfoot and fifth metatarsal or at the navicular
grades of sprains
3
I - able to bear weight and ambulate; no joint instability
II - ecchymoses, mod swelling, pain; joint tenderness; ambulation but pain; mild to mod joint instability; consider x ray
III - severe pain, swelling, tenderness, significant loss of function
which grade of sprains req immobilization
II and III - grade II may require brief periods of immobilization and non weight bearing
lupus - what lab is positive in all patients
ANA
painful arc test is to
rotator cuff tear
jobe’s test is to
rotator cuff tear
pain with shoulder ROM; >90 degrees of adduction or pain w/ internal rotation is suggestion of ___
rotator cuff tear - this is painful arc test
instruct patient to straighten arm at 90 degrees of abduction w/ 30 degrees of forward flexion, resist when examiner attempts to adduct the arms
Jobe’s test for rotator cuff tear
imaging for rotator cuff tear
MRI
most commonly presents with buttock pain of gradual onset that increases with sitting
piriformis syndrome
the predominant symptom in ____ is chronic back and neck pain and impaired spinal mobility
ankylosing spondylitis
lachman test is used to evaluate injury to what
ACL
test for assess for medial meniscus tear of the knee
flexion pinch
the empty test can be used to assess what
supraspinatus function when performing a physical exam of the shoulder
Ottawa ankle rules for imaging
must have malleolar zone and bony tenderness over the posterior edge or tip of medial or lateral malleolus OR inability to bear with BOTH immediately after injury and for four steps into the ED office
connects muscle to bone
tendon
connects bone to bone
ligaments
refers to a clicking sensation that occurs when palpating the involved interspace while simultaneously squeezing the metatarsal joints
Mulder’s sign
which NSAID has the highest risk for CV events
diclofenac
knee popping, locking, catching, or the knee giving out
meniscal injury
meniscal injury - provocative maneuvers include
3
Thessaly test
McMurray test
Apley test
NSAID best for increased risk factor of GI bleed
celecoxib
cherries and gout
have been shown to be beneficial
bones of the hands
metacarpals
bones of the wrist
carpals
bones of the feet
metatarsals
fall on outstretched hand with wrist in dorsiflexion; snuff box pain
scaphoid fracture
radial “dinner fork” deformity
Colles fracture
