MSK Flashcards
The most commonly fractured carpel bone? Dx?
Scaphiod
Dx: clinical, XR can take 2 weeks to show positive!
A guy presents with fracture of 5th metacarpal neck. What medication to give? Bug?
Abx for coverage of eikenella. Most likely from human mouth
Most common bone broken when defending yourself from cops?
Ulna (nightstick fracture)`
What is the unhappy triad?
Injury to ACL, MCL, and medial meniscus.
Lateral meniscus is more commonly seen in acute ACL injuries
Knee injury shows clicking and locking. Exam shows tenderness to joint line and a + Mcmurray’s test. Dx?
Meniscal tear
What will the compartment pressures look like in compartment syndrome?
> 30mmHg.
Delta pressure = diastolic pressure - compartment pressure. is + if it is
Lower back pain in middle aged man, made worse with coughing. Pain shoots down back of legs. Passive leg raise is +. Dz? What is the most common level?
Herniated disk. Most commonly at L5-S1
DO NOT STOP ACTIVITY, must keep moving. Take NSAIDs
What nerve root gives sensation to the:
medial aspect of lower leg?
dorsum of foot and lateral aspect of lower leg?
Plantar and lateral aspects of foot?
L4
L5
S1
Pt w/ lower bak pain complains of bowel/bladder dysfunction, impotence, saddle anesthesia. Dx?
Cauda Equina syndrome. emergency!
Lower back pain that radiates to buttocks and legs. Worse with standing and walking. Improves with flexion of hips and bending forward
Spinal Stenosis
Kid (10-20) with onion-skinning finding on xray in the diaphyseal region of the femur. Dx?
Ewings Sarcoma
Where are osteosarcomas located? Who gets them? Pathology? Where should I be concerned it metz to?
In the metaphyseal region of DISTAL FEMUR or PROXIMAL TIBIAL, aka around the knee.
Young people (men) 20-30
Path = codmans triangle (periosteal new bone at diaphyseal end of lesion) w/ a sunburst pattern
Commonly metz to the lungs
Where are giant cell tumors located?
Who gets them?
Pathology?
Epiphysieal/Metaphysieal region of long bones
people (females) 20-40
Path = soap bubble
How high is the WBC count in septic arthritis?
What do you tx with?
> 80k
empirically tx w/ cef and vanc until cultures of aspiration come back.
What does the synovial fluid analysis look like for RA?
Antic CCP Abs in the fluid
Child w/ gout and inexplicable injuries =
Lesch-Nyhan syndrome
What do gout crystals look like with condenser?
pseudogout?
needle shaped negative bifringence (yellow) w/ parallel light
rhomboid crystals with positive bifringence
What do lesions look like in bone with chronic gout?
Punched out lesions (rat bite erosions)
What is the MOA of Colchicine?
side effects?
it inhibits neutrophil chemotaxis, best used EARLY in gout flair
side effects = diarrhea and BM suppression (neutropenia)
Tx for an acute attack of gout?
maintenance therapy?
acute = NSAIDS (indomethacin) > colchicine > steroids (only use if other methods have failed or pt can’t take NSAIDs
maintenance = allopurinol (if pt is overproducer) or probenecid (if pt is underexcreter)
probenecid is contraindicated in pts with tophi, renal stones, or CKD!
Young man who complains of hip pain, LBP that worsens w/ inactivity and in the mornings. Dx?
What other (random) symptoms may occur?
What will xray look like?
Ankylosing Spondylitis
May also have uveitis and heart block!
xray = fused sacroiliac joints w/ bamboo spine
What will the xray of psoriatic arthritis look like?
“pencil in cup” deformity
Sx of polymyositis
Dermatomyositis?
Abs seen?
poly = symmetric, progressive proximal muscle weakness, pain, difficulty breathing/swallowing
dermato = same but with a heliotrope rash w/ “shawl sign” and gottron’s papules
Abs = serum CK and anti-Jo-1 Abs
What specific dz are antihistone Abs seen in?
anti-Ro abs?
Drug-induced SLE
Neonatal SLE