MSK 1

Question 1

Down syndrome comorbidities: Rheumatology →

Answer 1

Atlantoaxial instability

Question 2

Atlantoaxial instability is due to___________

Answer 2

Excessive laxity in the posterior transverse ligament increases mobility between the atlas (C1) and the axis (C2).

Question 3

Diagnosis of Atlantoaxial instability is confirmed with

Answer 3

lateral x-rays of the cervical spine in flexion, extension, and in a neutral position. Open-mouth x-rays can also be helpful in visualizing the odontoid.

Question 4

Treatment of Atlantoaxial instability is

Answer 4

surgical fusion of C1 to C2.

Question 5

Burning, numbness & aching of the distal plantar surface of the foot/toes:

Answer 5

Tarsal tunnel syndrome

due to Compression of the tibial nerve at the ankle

Question 6

Morton neuroma presentation

Answer 6

○ Numbness or pain between the 3rd & 4th toes

○ Clicking sensation when palpating space between 3rd & 4th toes while squeezing the metatarsal joints

Question 7

Achilles tendinopathy presentation

Answer 7

Burning pain or stiffness 2-6 cm above the posterior calcaneus

Question 8

Plantar fasciitis presentation

Answer 8

• Plantar surface of the heel
• It usually worsens with the first steps in the morning, decreases with activity during the day, and often worsens again later in the day with prolonged weight bearing.

Question 9

Complications of giant cell arteritis:

Answer 9

Blindness

Aortic aneurysm

Question 10

Children should engage in _________ moderate to vigorous physical activity.

Answer 10

≥1 hour of daily

Question 11

Isolated ↑ALP is seen in:

Answer 11

Paget disease

Question 12

Polyarticular juvenile idiopathic arthritis (JIA) __________ is the first-line treatment.

Answer 12

Nonsteroidal anti-inflammatory drugs (eg, naproxen)

Question 13

The treatment of choice for uncomplicated Polymyalgia rheumatica PMR is

Answer 13

low-dose prednisone 10-20 mg daily

Question 14

Complications of Ankylosing spondylitis

Answer 14

Osteoporosis/vertebral fractures
Aortic regurgitation
Cauda equina syndrome

Question 15

Tethered cord syndrome is commonly associated with __________

Answer 15

spina bifida

Question 16

MANAGEMENT OF
Subacute pain (4-12 weeks)

Chronic pain (>12 weeks)

Answer 16

• Intermittent use of NSAIDs or acetaminophen
• Exercise therapy (stretching/strengthening, aerobic)
• Consider: tricyclic antidepressants, duloxetine

Question 17

MANAGEMENT OF
Acute pain (<4 weeks)

Answer 17

○ Maintain moderate activity
○ NSAIDs or acetaminophen
○ Consider: muscle relaxants, spinal manipulation

Question 18

Growing pains are bilateral, lower-extremity pains that occur at ______ in children age ______.

Answer 18

night

2-12 years

Question 19

Treatment of Growing pains consists of _________

Answer 19

observation, parental reassurance, massage, and over-the-counter pain medications.

Question 20

Decreased passive & active range of motion

Answer 20

Adhesive capsulitis (frozen shoulder)

Question 21

Hydroxychloroquine

Mechanism

Adverse effects

Answer 21

TNF & IL-1 suppressor

Retinopathy

Question 22

Sulfasalazine

Mechanism

Adverse effects

Answer 22

TNF & IL-1 suppressor

Hepatotoxicity
Stomatitis
Hemolytic anemia

Question 23

Paget disease mechanism

Answer 23

osteoclast dysfunction