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Msk Flashcards

1
Q

Compartment syndrome is due to what physiologically?

A

Soft tissue swelling

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2
Q

Can compartment syndrome follow a lower extremity embolectomy

A

Yes. It is a form of ischemia-reperfusion syndrome

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3
Q

Anterior shoulder dislocation increases risk of injury to what nerve

A

Axillary

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4
Q

___ nerve palsy may lead to wrist drop and loss of thumb extension

A

Radial

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5
Q

Humerus fracture may lead to __ nerve palsy

A

Radial

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6
Q

Weak wrist flexion and flat thenar eminence is due to injury of what nerve

A

Median

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7
Q

Claw hand is due to injury of what nerve

A

Ulnar

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8
Q

Decreased sensation over deltoid is due to what nerve injury

A

Axillary

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9
Q

Foot drop is due to damage of which nerve

A

Peroneal

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10
Q

___ nerve injury leads to benediction sign due to an inability to close first through third digits

A

Median

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11
Q

When is intrabursal corticosteroid injection contraindicated for bursitis

A

When septic bursitis is suspected

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12
Q

Volkmans contracture Of wrist and fingers is caused by ___ associated with —— fractures

A

Compartment syndrome

Supracondylar humerus fractures

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13
Q

____ epicondylitis worsens with resisted extension of the wrist, and __ epicondylitis worsens with resisted flexion If wrist

A

Lateral

Medial

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14
Q

Passive and crossed straight leg raise can ___ pain in herniated disc

A

Increase

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15
Q

In lumbar stenosis, leg cramping is ___ with standing and walking and ___ with flexion at the hips

A

Worse

Better

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16
Q

Tx of refractory spinal stenosis

A

Surgical laminectomy (though often have recurrence of sx)

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17
Q

What nerve root controls foot dorsiflexion

A

L4

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18
Q

What nerve root controls patellar reflex

A

L4

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19
Q

What nerve root controls sensory input to medial aspect of lower leg

A

L4

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20
Q

What nerve root controls foot eversion and big toe dorsiflexion

A

L5

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21
Q

What nerve root controls sensory input to dorsum of foot and lateral aspect of lower leg

A

L5

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22
Q

What nerve root controls plantar flexion and hip extension

A

S1

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23
Q

What nerve root controls Achilles reflex

A

S1

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24
Q

What nerve root controls sensory input to plantar and lateral aspects of the foot

A

S1

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25
Q

Bowel or bladder dysfunction, impotence and saddle area anesthesia are consistent with

A

Cauda equina syndrome

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26
Q

Where does osteosarcoma tend to occur

A

Metaphyseal regions of distal femur, proximal tibia and proximal humerus

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27
Q

Pain worsens at night in what bone cancer

A

Osteosarcoma

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28
Q

Link these terms to appropriate bone cancer:

  1. Sunburst pattern
  2. Onion skinning
  3. Soap bubble
A
  1. Osteosarcoma
  2. Ewing sarcoma
  3. Giant cell tumor
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29
Q

Most common benign bone tumor

A

Osteochondroma

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30
Q

First step in relieving spinal cord pressure in suspected metastasis (as you go to mri?)

A

Steroids

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31
Q

Describe osteoma

A

Benign bone forming tumor characterized by prostaglandin formation

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32
Q

Relief of pain with osteoma

A

NSAIDs

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33
Q

Wbc on septic arthritis is

A

> 80,000

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34
Q

Empirically treat septic arthritis with

A

Ceftriaxone and vanc

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35
Q

Other than abx how do you tx septic arthritis

A

Surgical debridement or serial aspirations

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36
Q

Pmn % on synovial fluid analysis in inflamed joint will be

A

> 50

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37
Q

Pmn % on synovial fluid analysis in septic joint will be

A

> 75

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38
Q

Glucose on synovial fluid analysis in septic joint will be

A

<25

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39
Q

Pmn % on synovial fluid analysis in inflammatory joint will be

A

> 25

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40
Q

Where does Ewing sarcoma usually present

A

Diaphyseal regions of the femur

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41
Q

Giant cell tumor of the bone usually presents in what demographic

A

Women aged 20-40

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42
Q

What antibodies do you find on synovial fluid analysis in ra

A

Anti ccp antibodies

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43
Q

In a child with gout and inexplicable injuries consider

A

Lesch-nyhan syndrome

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44
Q

How does colchicine work

A

Inhibits neutrophil chemotaxis

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45
Q

Side effects of colchicine

A

Diarrhea and bone marrow suppression

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46
Q

How do you choose between allopurinol and probenecid for maintenance therapy for gout

A

Allopurinol for overproducers

Probenecid for under secreters

47
Q

Hla dr4 is a rf for

A

Ra

48
Q

In gout, crystals are ___ shaped and ___ bifereringent

A

Needle

Negatively

49
Q

In pseudogout, crystals are ___ shaped and ___ bifereringent

A

Rhomboid

Positively

50
Q

In pseudogout what joints are affected

A

Wrists and knees

51
Q

Dx of ra

A

Increased rf or presence of anti-ccp antibodies

52
Q

Anklyosing spondylitis is associated with hla-

A

B27

53
Q

Typical age of onset of anklyosing spondylitis

A

Late teens and early 20s

54
Q

Pain in anklyosing spondylitis ___ with inactivity and in mornings

A

Worsens

55
Q

Two complications of anklyosing spondylitis

A

Uveitis and heart block

56
Q

Radiographs of anklyosing spondylitis May show ___ SI joints and ___ spine

A

Fused

Bamboo

57
Q

Tx of anklyosing spondylitis

A

NSAIDs and tnf inhibitors for refractory cases

58
Q

Heliotrope rash (periorbital) is associated with what msk dz

A

Dermatomyositis

59
Q

___ syndrome is characterized by ra, splenomegaly, neutropenia

A

Felty

60
Q

Hydroxychloroquine causes ___ toxicity

A

Retinal

61
Q

Disease associated with this antibody: ana

A

Sle

62
Q

Disease associated with this antibody: anti-ccp

A

Ra

63
Q

Disease associated with this antibody: anticentromere

A

Crest syndrome

64
Q

Disease associated with this antibody: anti dsdna

A

Sle

65
Q

Disease associated with this antibody: antihistone

A

Drug induced sle

66
Q

Disease associated with this antibody: anti jo 1

A

Polymyositis/dermatomyositis

67
Q

Disease associated with this antibody: antimitochondrial

A

Primary biliary cirrhosis

68
Q

Disease associated with this antibody: anti scl-70

A

Systemic sclerosis

69
Q

Disease associated with this antibody: anti sm

A

Sle

70
Q

Disease associated with this antibody: anti smooth muscle

A

Autoimmune hepatitis

71
Q

Disease associated with this antibody: antitopoisomerase

A

Systemic sclerosis

72
Q

Disease associated with this antibody: anti tshr

A

Graves

73
Q

Disease associated with this antibody: c anca

A

Vasculitis esp wegner

74
Q

Disease associated with this antibody: p anca

A

Vasculitis esp microscopic polyangiitis

75
Q

Disease associated with this antibody: rf

A

Ra

76
Q

Disease associated with this antibody: u1rnp antibody

A

Mixed connective tissue disease

77
Q

Why should you discontinue aspirin in acute gout attack

A

Aspirin can decrease excretion of uric acid

78
Q

Antihistone antibodies are seen in what kind of lupus

A

Drug induced

79
Q

Tx of acute sle exacerbation

A

Steroids

80
Q

Tx for isolated skin and joint involvement in sle

A

Hydroxychloroquine

81
Q

Severe cases of lupus nephritis can be treated with ___. Be sure to get ___.

A

Cyclophosphamide

Renal biopsy

82
Q

Monocular amaurosis fugax is associated with __. How to dx?

A

Giant cell (temporal artery) arteritis

Dx with temporal artery biopsy

83
Q

In Giant cell (temporal artery) arteritis, esr is

A

Elevated over 50

84
Q

Most commonly involved metatarsal in stress fractures

A

Second metarsal

85
Q

Tx of stress fracture of 2nd, 3rd and 4th metarsals

A

Rest and analgesics

86
Q

Burns in a child that spare flexor surfaces are concerning for

A

Child abuse by deliberate immersion injury

87
Q

Arc of ecchymosis distal to the medial malleolus (crescent sign) is associated with

A

Ruptured popliteal cyst

88
Q

Most common asymptomatic elevation of alk phos in an elderly pt is due to

A

Paget dz of the bone

89
Q

X-ray of paget dz of the bone will show

A

Osteolytic or mixed lytic-sclerotic lesions

90
Q

What happens to head in Paget’s disease of the bone

A

It grows

91
Q

Tx of paget’s dz of the bone

A

Bisphosphates

92
Q

Are thiazides a rf for gout flare

A

Yes

93
Q

Etiology of paget dz of bone

A

Abnormal osteoclastic activity leading to increased bone turnover and disordered bone remodeling

94
Q

Why can you get hearing loss with paget dz of the bone

A

Due to enlargement of the temporal bone

95
Q

Tx of sciatica due to herniated disc

A

NSAIDs

96
Q

Do you need to do an mri of herniated disc

A

No unless there are progressive nerve deficits

97
Q

Most common complication of supracondylar fractures of the humerus

A

Entrapment of the brachial artery or median nerve

98
Q

To dx ra sx have to be present for over

A

Six weeks

99
Q

Sjogrens is most common in what demographic

A

Middle Aged women

100
Q

Can sjogrens cause dysphasia

A

Yes

101
Q

Which are associated with hemathrosis, acl or mcl

A

Acl

102
Q

Low grade fever, bilateral periorbital edema, headache, papilledema, cranial nerve deficits. What am I?

A

Cavernous sinus thrombosis

103
Q

Symmetric asymmetric muscle weakness and absent deep tendon reflexes after recent infection

A

Guillain barre syndrome

104
Q

Is guillain barre associated with severe pain in back or extremities

A

Yes

105
Q

Lp for guillain barre shows

A

Elevated csf protein with normal white blood cell count

106
Q

Tx of Giullain barre

A

Supportive and ivig

107
Q

Tx of myasthenia gravis

A

Cyclosporine and pyridostigmine

108
Q

What degenerative joint disease can cause groin pain

A

Oa of the hip

109
Q

Duchenne muscular dystrophy is transmitted via what gene thing

A

X linked recessive

110
Q

dx of duchene muscular dystrophy

A

Deletion of dystrophin gene on xp21

111
Q

Muscle biopsy in duchenne muscular dystrophy will show

A

Fibrosis and fatty infiltration

112
Q

Triad of fat embolism syndrome

A

Resp distress, neuro dysfunction, petechial rash

113
Q

Rule of 9s

A

Body surface area in adults

Head and each arm=9%
Back and chest each=18%
Each leg=18%
Perineum=1%
Palm=1%
114
Q

Tenosynovitis largely affects which extremities

A

Hands and wrists

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