MSK Flashcards
Which bone CA starts off in childrens pelvis or spine?
ewing’s sarcoma
Osteosarcoma starts in what age?
second decade-20s
Patient is 22yo with worsening bone pain at night, starburst on xray?
osteosarcoma
What bone CA is common in >50yo?
chondrosarcoma
What type of fracture increases risk for fat embolism?
long bone
What is pathognomic for fat embolism?
petechial rash after long bone fx
What does positive mcmurrays test mean?
menisceal tear
What does positive lachman test mean?
ACL tear
Best imaging test for congenital hip dysplasia?
US
Best imaging test for avascular necrosis?
MRI
Persistent hip pain after trauma, pain starts at groin and radiates to thigh?
avascular necrosis
How to tell diff between claudication and pseudoclaudication?
claudication has PAD invovled; pseudoclaudication has nerve compression causing sx of claudicaiton
What can be related to ankloysing spondylitis?
uvitis, cardiac abnormalitis, interstitial lung disease, IgA neph
Oblique view of spine shows scottie dog with collar?
spondlylosis
Back pain with positive leg raise?
herniated lumbar nucleus disk
Vertebral body slips anteriorly?
spondylolithesis
Nerve root that tests for ankle reflex?
S1
Motor root for the big toe?
L5
Clay shovler’s fx stable or unstable?
stable
Fractures in anterior and posterior arches of C1?
jefferson’s fracture
What type of trauma is associated with hangman fx?
hyperextension and compression of cervical
What type of fracture occurs with fractures of the pedicles of C2 and anterior slip of C2 on C3?
hangman’s
Preferred tx for dupuytren contracture?
surgery
What tx is recommend for scaphoid fx?
thumb spica
What bone does both colles and smiths fx have?
distal radial
What type of fx is likely with blow to the back of the wrist?
colle
Numbness in 4th and 5th fingers?
cubital tunnel sx
What metabolic dz are linked with carpal tunnel sx?
DM, TSH, pregnancy, ETOH
What does fat pad sign on elbow xray indicate?
elbow fx
Baseball pitcher with medial elbow pain d/t repetitive valgus stress?
medial collateral ligament strain
What are the 4types of humerus fx?
proximal, distal, supracondylar, shaft
Xray shows glenohumeral joint narrowing with spurring and flattening of the humeral head?
gleno-humeral joint osteoarthritis
Pain at groove of humerus and worse with arm movements?
bicep tendonitis
What are the 4 muscles involved in RTC?
supraspinatus, infraspinatus, teres minor, subscapularis
20yo with hip pain worse at night, xray shows codmans triangle?
osteosarcoma
17yo male with palpable mass on spine with hx of chemo and radiation, likely dx?
ewing sarcoma
67yo diabetic male with discoloration of his toenails and kertinaous growth, how to confirm dx?
KOH prep
Patient is on terbinafine for onychomycosis, what lab to keep an eye on?
LFT: AST and ALT
DM patient has elevated WBC and fever, 3cm x 2cm ulcer on foot, what is suspected?
osteomylitis
How to differentiate between PE and fat embolism?
fat embolism has petechial rash and altered mental status
What grade level is for complete tearing of the ankle ligaments?
level 3
Which ankle fracture is semi-emergent surgerical condition and tenous blood supply?
talus fx
What is the knee injury if the knee locks, knee effusion, and positive mcmurray test?
meniscal tear
Loud pop in knee with immediate swelling?
ACL injury
Which of the knee ligaments rarely need surgical treatment?
PCL
Patient complains of “glass in knee” when kneeling, xray shows egg shaped swelling over patella?
pre patellar bursitis
What abx is recommended for patient with pre patellar bursitis with cellulitis on knee?
clindamycin
What type of hip fracture has higher risk for avascular necrosis?
femoral neck fractures
PE for hip fracture?
external rotation and leg shortening
2yo has positive ortolani and barlows test, how to treat?
open reduction with internal fixation, cast
Avacular necorsis in children called?
legg-calve
Patients with spinal stenosis and PAD can have claudication but which one will not have pain with riding a bike?
spinal stenosis
What is the most common extra pulmonary site for manifestation with TB?
kyphosis
Where is pain and temp lost in brown sequard sx?
pain and temp is lost on opposite side; vibration, sensation, is on the same side
How to test for spondylosis?
stork test
58yo male has lower back pain when he sneezes and better when he leans?
slipped disk
What xray view is recommended with suspected neck fracture to see bilateral offset of C1 and C2?
open mouth odontoid view
45yo male presents with decreased sensation, weakness, and positive spurling test?
herniated disk
Anterior sublux of C1 and C2 from hyperextension can cause what fracture?
dens fracture
Abscess at the tip of finger is at high risk for what complication?
osteomylitis
Dupuytrens contracture is associated with what fingers?
4 and 5
What is peyronie disease associated with in the hand?
dupuytren contracture
Patient with de quervain tenosynovitis has swelling and tenderness over tendon, pain with passive extension, what to suspect?
infxn
18yo has a wrist pain, xray show ‘garden spade’ deformity?
smith fracture
Diabetic patient has tender, swollen, warm shoulder, what to do next?
aspiration and fluid analysis
Snowboarder comes to ED and has a elevated distal clavicle, what to suspect?
AC joint seperation
55yo female s/p shoulder fx cannot perform apleys test and decreased ROM, what to suspect?
adhesive capsulitis
How to tx patient with dry eyes form sjogren sx?
cyclosporine
What dz is associated with raynuad sx?
scleroderma
Anti-Ro (SSA) and anti-la (SSB) AB?
sjogren sx
What dz dose schirmers test help dx?
sjogren sx
Anticentromere AB?
scleroderma
20yo female with pericarditis and rash?
SLE
Anti-smith AB?
SLE
Causes of Reiter sx?
chlymadia, salmonella, C diff, camplylobacter jejuni
What dz is associated with polymyalgia rheumatica?
giant cell
Tx used for pseudogout?
aspiration and steroids
Anti-jo1 AB?
polymyositis
Where does pseudogout attack vs gout?
pseudogout: knee, gout: 1st MTP
How many trigger points are required to dx fibromyalgia?
11/18
Tx for fibromyalgia?
tricyclics
Swan deformity and ulnar deviation?
RA
Boutonniere deformity?
RA
Bouchard nodules?
osteoarthritis on DIP
Heberdens nodules?
osteoarthritis on PIP
Two common complication of sjgrens sx?
non hodgkin lymphoma and primary biliary cirrohosis
How to tx sjogren sx?
hydroxychloroquine
Scleroderma patient has difficulty swallow liquid, solid, both?
both
How to tx SLE?
corticosteroids and immune modulators
What is the diagnostic test for dermatomyositis?
muscle bx
50yo male has a purple mottled skin on torso, muscle pain, extermity weakness, HTN?
polyarteritis nodosa
What is the age onset for psoaritic arthritis?
30-50yo
What is the age cut off for juvenile arthritis?
16
What HTN meds can cause gout attacks?
hydrochlorothiazide
Positive C ANCA?
wegners
Positive P ANCA?
churg strauss and ulcertive colitis
Anti-CCP is accurate for what dx?
RA
Positive ASCA?
crohn
Positive anti-basement membrane?
good pasture