MSK Flashcards
What is the maximum dose of acetaminophen?
4g/day
What antibody is associated with limited cutaneous systemic sclerosis (CREST)?
anti-centromere Ab
What antibody is associated with diffuse cutaneous systemic sclerosis?
anti-scl 70 Ab (anti-DNA topoisomerase Ab)
What antibody is associated with mixed connective tissue disease?
anti-U1-RNP Ab
What antibody is associated with Rheumatoid arthritis?
ACPA, RF=anti-IgG
What antibody is associated with Polymyalgia Rheumatica?
None. Pt will have a very elevated ESR though
What antibody is associated with polymyositis and dermatomyositis?
anti-jo 1 Ab (anti-synthase Ab)
What antibody is associated with sjogrens?
anti-Ro Ab (anti-SSA Ab) and anti-La Ab (anti-SSB Ab)
What antibody is associated with SLE?
anti-dsDNA Ab, anti-Sm Ab, ANA
What antibody is associated with drug induced lupus?
anti-histone Ab
What are the 4 seronegative spondylarthropathies?
PAIR
- Psoriatic arthritis
- Ankylosing spondylitis
- IBD arthritis
- Reactive arthritis
Needle-shaped negatively birefringent crystals?
Gout
yellow=parallel, blue=perpendicular
Rhomboid-shaped, positively birefringent crystals?
Pseudogout
Drugs associated with drug-induced lupus? What is the antibody?
- SHIPP
- Sulfonamides, Hydralazine, Isoniazid, Phenytoin, Procainamide
-Anti-histone Ab
Rheum disorder with shoulder/hip joint pain and stiffness? What is this associated with? Tx?
Polymyalgia rheumatica
- associated with Giant Cell arteritis
- low-dose glucocorticoids
Labs to check in suspected polymyositis?
Labs: CK, ALT, AST, aldolase
Xerophthalmia and xerostomia are associated with what condition?
(dry eyes and dry mouth)
-Sjogren’s
Proximal muscle weakness and a facial rash?
Dermatomyositis
Arthritis + oral ulcers + proteinuria
SLE
What rheum disorder is associated with anti-citrullinated protein antibodies (ACPA)?
Rheumatoid arthritis
Hand x-ray showing “pencil-in-a-cup”?
Psoriatic arthritis
Arthritis affecting the DIPs and PIPs?
Osteoarthritis (DIP=Heberden’s nodes, PIPs=Bouchard’s nodes)
Most common overall cause of osteomyelitis? What to consider in sickle cell? IVDA? In Diabetics?
- overall=s.aureus
- sickle cell=salmonella
- IVDA andDM=pseudomonas
Cause of bilateral Bell’s Palsy?
Lyme
What cancers like to metastasize to bone?
“Permanently Relocated Tumors Like Bones”
- Prostate (blastic)
- Renal cell carcinoma
- Testes and Thyroid
- Lung (lytic)
- Breast
X-ray showing Codman’s triangle and sunburst pattern?
Osteosarcoma
X-ray showing “onion skinning”?
Ewing sarcoma
X-ray with “soap bubble” appearance?
Giant cell tumor (osteoclastoma)
Clast=clean
Old man with bowed out legs, hearing loss, increase in hat size? Most sensitive test?
Paget’s disease
-Nuclear bone scan for hot spots
What type of shoulder dislocation will the arm be held in external rotation and slight abduction? What is a potential complication?
- Anterior dislocation
- Axillary N injury
What type of shoulder dislocation is associated with an adducted and internally rotated arm? When do these normally occur?
- Posterior
- seizures and electrocution
Nerve at risk with a fracture of the shaft of the humerus? Consequence?
Radial Nerve
-wrist drop
Nerve at risk with a fracture of the surgical neck of the humerus? Consequence?
Axillary nerve
-loss of shoulder abduction
Nerve at risk with a supracondylar humerus fracture? consequence?
Median N
-“pope’s blessing”–> loss of flexion of the 2nd and 3rd digits.
Name for a distal radius +/- distal ulna fracture with a posteriorly displaced radius?
Colles fracture
Name for a distal radius fracture with a ANTERIORLY displaced radius?
Smith fracture
Proximal ulnar fracture with dislocation of the radial head?
Monteggia fracture
Fracture of the distal radius with dislocation of the distal radial ulna joint?
Galeazzi fracture
Low back pain with radiation that is worse with standing and walking and better with leaning forward?
Spinal stenosis
Injury causing arm extension and adduction with forearm pronation?
Erb-duchenne palsy (waiter’s tip)
-superior trunk injury (common in birth trauma)
Injury causing forearm supination and wrist and finger flexion? How does this commonly happen?
Klumpke palsy
(inferior trunk injury)
-“klumpke the monkey hung from a tree”–> when falling and grab something it pulls that inferior trunk
What is injured in the “unhappy triad”?
- ACL, MCL and medial meniscus
- normally occurs with a medially directed blow to the lateral side of the knee
Middle aged man with bilateral calcification of articular cartilage on x-ray. Cause? tx?
Chondrocalcinosis 2/2 psudogout
tx: NSAIDS or colchicine
