MS 4

Question 1

two deformities associated with RA

Answer 1

Swan neck - DIP joint hyperextension
Boutonniere - hyperextension of DIP w/ flexion of the PIP joint

Question 2

RA - what meds are rec to be started ASAP

Answer 2

DMARDs

Question 3

RA - adjunct meds
2

Answer 3

NSAIDs
glucocorticoids

Question 4

when starting on hydroxychloroquin all patients must

Answer 4

have eye exam prior to starting and every 6 months while on to assess and prevent retinal damage

Question 5

lateral ankle sprain (most common) - caused by

Answer 5

injury is inversion of the plantar flexed foot

Question 6

medial ankle sprain

Answer 6

infrequent injury; forced eversion of the ankle

Question 7

Ottawa rules

Answer 7

used to determine whether a patient needs x ray of the injured ankle in the ED

Question 8

x ray of the ankle are only indicated if

Answer 8

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

Question 9

x ray of the foot is indicated if pain where

Answer 9

midfoot and fifth metatarsal or at the navicular

Question 10

grades of sprains
3

Answer 10

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

Question 11

which grade of sprains req immobilization

Answer 11

II and III - grade II may require brief periods of immobilization and non weight bearing

Question 12

lupus - what lab is positive in all patients

Answer 12

ANA

Question 13

painful arc test is to

Answer 13

rotator cuff tear

Question 14

jobe’s test is to

Answer 14

rotator cuff tear

Question 15

pain with shoulder ROM; >90 degrees of adduction or pain w/ internal rotation is suggestion of ___

Answer 15

rotator cuff tear - this is painful arc test

Question 16

instruct patient to straighten arm at 90 degrees of abduction w/ 30 degrees of forward flexion, resist when examiner attempts to adduct the arms

Answer 16

Jobe’s test for rotator cuff tear

Question 17

imaging for rotator cuff tear

Answer 17

MRI

Question 18

most commonly presents with buttock pain of gradual onset that increases with sitting

Answer 18

piriformis syndrome

Question 19

the predominant symptom in ____ is chronic back and neck pain and impaired spinal mobility

Answer 19

ankylosing spondylitis

Question 20

lachman test is used to evaluate injury to what

Answer 20

ACL

Question 21

test for assess for medial meniscus tear of the knee

Answer 21

flexion pinch

Question 22

the empty test can be used to assess what

Answer 22

supraspinatus function when performing a physical exam of the shoulder

Question 23

Ottawa ankle rules for imaging

Answer 23

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

Question 24

connects muscle to bone

Answer 24

tendon

Question 25

connects bone to bone

Answer 25

ligaments

Question 26

refers to a clicking sensation that occurs when palpating the involved interspace while simultaneously squeezing the metatarsal joints

Answer 26

Mulder’s sign

Question 27

which NSAID has the highest risk for CV events

Answer 27

diclofenac

Question 28

knee popping, locking, catching, or the knee giving out

Answer 28

meniscal injury

Question 29

meniscal injury - provocative maneuvers include
3

Answer 29

Thessaly test
McMurray test
Apley test

Question 30

NSAID best for increased risk factor of GI bleed

Answer 30

celecoxib

Question 31

cherries and gout

Answer 31

have been shown to be beneficial

Question 32

bones of the hands

Answer 32

metacarpals

Question 33

bones of the wrist

Answer 33

carpals

Question 34

bones of the feet

Answer 34

metatarsals

Question 35

fall on outstretched hand with wrist in dorsiflexion; snuff box pain

Answer 35

scaphoid fracture

Question 36

radial “dinner fork” deformity

Answer 36

Colles fracture