MSK

Question 1

Polymyalgia Rheumatica

Answer 1

painful stiff shoulder & pelvic girdle
temporal arteritis
elevated ESR

Tx: Prednisone 10-20 mg/d

Question 2

Most sensitive test for acute ACL tear

Most appropriate tx. in young athlete

Answer 2

• Lachman Test (NOT Ant. Drawer)

- Bracing + mobilization + PT prior to ACL reconstruction

Question 3

Tx: Legg-Calve-Perthes (avascular necrosis of femoral head)

Answer 3

Bracing with Petrie Cast and use crutches

Question 4

Trigger finger description

Answer 4

Stenosing tenosynovitis common in DM pts. with a nodule in the MCP of the index/ring fingers that causes “catching” and locking in a flexed position.

Tx: stretching, splinting, ice, then steroids and surgery

Question 5

Relapsing polychondritis

Answer 5

Chondritis involving:

1. Bilateral auricles
2. Non-erosive inflammatory arthritis
3. Nasal cartilage
4. Conjunctivitis, keratitis, scleritis, uveitis
5. Larynx/trachea
6. Hearing loss/tinnitus/vertigo

Question 6

Differential diagnosis of saddle nose deformity

Answer 6

Wegeners
Leprosy
Syphilis
Relapsing polychondritis

Question 7

Tx. Relapsing polychondritis

Answer 7

Prednisone 40-60mg/d

Question 8

Dislocation due to electrocution or tonic clonic seizure

Answer 8

Posterior dislocation –> Internal rotation of arm

Question 9

Elderly pt. with externally rotated and shortened leg likely has?

Answer 9

Femoral neck fracture

(Anterior hip dislocation will also be ext.rot., but affected limb is usually LONGER, not shorter).

Question 10

Complex Regional Pain Syndrome

Answer 10

Unilateral limb pain
Cognitive neglect
Different skin temperatures
Autonomic dysregulation

Question 11

Osteosarcoma

Answer 11

@ Metaphysis of Long Bones
Codman’s Triangle (Elevation of Periosteum)
Often mets to lungs (DO a CHEST CT)

Question 12

Ewing Sarcoma

Answer 12

@ Diaphysis

Onion skin

Question 13

Osteomalacia

D/t?

Dx?

Tx?

Answer 13

Vit. D Deficiency leading to defective bone mineralization

Low Ca –> Inc. PTH –> Low PO4, Milkman’s Lines

Tx: Vit D

Question 14

Osteopetrosis (“Marble Bone Dz.”)

d/t

Dx?

Tx?

Answer 14

failure of bone resorption –> thick, dense bones prone to fx. d/t abnormal osteoclast function

Erlenmeyer Flask deformity, Normal Ca, PO4, ALKPHOS

Question 15

Labs in Paget’s disease

Tx?

Answer 15

Normal Ca, PO4
Inc. ALKPHOS

Tx: Bisphosphonates, Calcitonin

Question 16

Presence of girdle weakness, elevated troponins points toward a diagnosis of?

Answer 16

Myositis.

Question 17

Migraine Ppx? (in order of 1st line, 2nd line, etc.)

Answer 17

1. Topiramate; Metoprolol if comorbid HTN

2. Amitriptyline