MS

Question 1

tx boxer’s fx

Answer 1

ulnar gutter splint

Question 2

monteggia vs galeazzi

Answer 2

MUGR
monteggia = proximal ULNA
galeazzi = distal radius
tx: ORIF + casting in supination

Question 3

risk w/ hip dislocation

Answer 3

sciatic nerve injury, AVN

tx: reduction + abduction bracing

Question 4

anterior dislocation shoulder

Answer 4

pt holds arm slightly abducted + externally rotated

Question 5

risk w femoral fx

Answer 5

fat emboli = fever + change mental status + dyspnea

Question 6

clicking or locking
joint line tenderness
mcMurray +

Answer 6

meniscal tear

can be conservative tx

Question 7

radial N injury

Answer 7

sensation: dorsal forearm and 1st 3 fingers
MCC: humeral fx
“wrist drop”

Question 8

median N injury

Answer 8

sensation: palmar surface 1st 3 fingers
MCC: carpal tunnel
weak wrist + flat thenar eminence

Question 9

ulnar N injury

Answer 9

sensation: palmar + dorsal last 2 fingers
elbow dislocation
claw hand

Question 10

axillary N

Answer 10

sensation: lateral shoulder

ANTERIOR humeral dislocation

Question 11

peroneal N

Answer 11

sensation: dorsal foot and lateral leg
MCC: knee dislocation
foot drop

Question 12

compartment syndrome

Answer 12

pain, paresthesia, poikilothermia, pulselessness, pallor, paralysis
pressure > 30

Question 13

pain worse w/ repetitive stress and resisted strength testing

Answer 13

tendinitis

Question 14

“soap bubble”

F 20-40, knee pain

Answer 14

giant cell tumor

Question 15

“onion skinning”

kid 10-20, femur

Answer 15

Ewing sarcoma

Question 16

MC benign bone tumor

Answer 16

osteochondroma

Question 17

Codman’s triangle - ne bone formation at diphyseal end

Sunburst pattern

Answer 17

osteosarcoma

tx: surgery

Question 18

tx septic arthritis

Answer 18

joint aspiration = WBC > 80K
MC staph, strep, and gram- rod
tx: rocephin + vanc until cultures come back

Question 19

abnormal Schober test

Answer 19

< 5cm distance change w/ forward bend = ank spond

Question 20

immune-mediated muscle inflammation
F, 50-70, AA
symmetric proximal muscle weakness/pain + difficulty swallowing/breathing

Answer 20

Polymyositis
high CK and anti-Jo-1
muscle bx = fibers in varying stages of necrosis and regeneration
tx: high dose steroids 4-6wk

Question 21

heliotrope rash - violet perioorbital rash
shawl sign
Gottron’s papuls - papular rash + scale on hands

Answer 21

dermatomyositis
high CK and anti-Jo-1
tx: high dose steroid 4-6wk

Question 22

risk factor RA

Answer 22

female
age 35-50
HLADR4

Question 23

anti-CCP

Answer 23

RA

tx: NSAID, DMARDS (methotrexate)

Question 24

common complication scleroderma

Answer 24

pulmonary fiborisis
core pulmonale
renal failure
malignant HTN

Question 25

tx scleroderma

Answer 25

steroids

Question 26

tests for SLE: sensitive vs specific?
ANA?
anti-dsDNA?
anti-Sm?

Answer 26

sensitive - ANA

specific - dsDNA, Sm

Question 27

non-infectious vegetations on mitral valve?

Answer 27

Libman-Sacks endocarditis assoc w/ SLE

Question 28

pain/stiff shoulders and pelvis + high ESR + anemia

Answer 28

poly rheumatica

tx: low dose prednisone

Question 29

painless limp, possible knee pain

limited abduction and internal rotation

Answer 29

LCP

tx: Petrie cast for hip abduction

Question 30

F < 16y

fever + nodules + red rash + pericarditis + fatigue

Answer 30

Juvenile RA
no dx test
tx: NSAID (methotrexate 2nd)

Question 31

Kanavel + (pain w/ attempting to straighten finger)
fusiform swelling
finger in slight flexion

Answer 31

flexor tenosynovitis

tx: OR

Question 32

AVN lunate

Answer 32

Keinbock’s disease

Question 33

ulnar+ sign (ulna longer than radius)

worse w/ twisting wrist

Answer 33

tirangular fibrocartilage complex tear
MRI
tx: volar splint

Question 34

mallet finger vs boutonniere vs swan neck deformities vs jersey finger

Answer 34

mallet - terminal externosor tendon
boutonniere - central slip rupture
swan neck - lateral bands
jersey finger - flexor digitorum profundus

Question 35

tx colle’s fx

Answer 35

sugar tong splint then long arm cast

Question 36

bennet fx

Answer 36

abductor pollicus longus

tx: thumb spica

Question 37

fx pars interarticularis from repeated stress from hyperextension of L spine

Answer 37

spondylolysis
XR - get oblique view!
tx: bracing, PT

Question 38

anterior slippage vertebra

Answer 38

sponylolisthesis

tx: rest, NSAID, surgery

Question 39

bankart lesion

Answer 39

injury or inferior labrum from shoulder dislocation

Question 40

Hill Sachs lesion

Answer 40

chuck out of back of humeral head from scraping against anterior glenoid upon anterior shoulder dislocation

Question 41

pain w/ catching, popping/locking w/ overhead activity

Answer 41

SLAP tear

O’Brien - pain w/ thumb down and no pain palm up

Question 42

lateral epicondylitis vs medial epicondylitis

Answer 42

lateral = ERCB (extensor carpi radialis brevis)
medial = flexor carpi radialis + pronator teres

Question 43

nursemaid elbow

Answer 43

anular ligament

Question 44

Mulder’s sign

Answer 44

squeezing toes will exacerbate sx of morton’s neuroma

tx rest, weight loss, proper shoes, steroid injection, surgery

Question 45

spain of ulnar collateral ligament thumb

Answer 45

gamekeeper’s thum

Question 46

cup and sauce of proximal phalanx

Answer 46

psoriatic arthritis