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MSK Flashcards

1
Q

Marker of muscle injury

A

Creatine kinase

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2
Q

Grade 2 Ankle SPRAIN Tx

A
  • RICE + PT

- G3 may require surgery

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3
Q

Fracture at base of 2nd metatarsal pathognomonic. Dx?

A

Lisfranc Injury

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4
Q

Tx for Achilles Tendon Rupture

A
  • Posterior splint in plantarflexion

- Ortho consult

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5
Q

Tx for Slipped Capital Femoral Epiphysis (SCFE)

A
  • Non-weight bearing

- ER ortho (prompt operative stabilization)

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6
Q

Tx for Pseudogout (chondrocalcinosis)

A
  • 1st line: aspiration or steroid inj.
  • NSAIDs
  • CI (PUD): Colchicine
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7
Q

Most sensitive for ACL tear:

A

Lachman’s Test

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8
Q

Low back pain and stiffness when walking but relieved when leaning forward. Dx?

A

Spinal Stenosis

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9
Q

Tx for Raynaud’s phenomenon

A

CCB

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10
Q

Tx for de Quervain Tenosynovitis

A

Thumb spica splint + NSAIDs

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11
Q

Tx for Spinal Stenosis

A
  • PT, pain meds, lose wt.

- Surgery

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12
Q

TOC Cauda Equina Syndrome

A

MRI or CT Myelogram

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13
Q

PE of transillumination is found in:

A

Ganglion Cyst

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14
Q

Patellofemoral Pain Syndrome x-ray finding

A

Axial → patella sits in femoral trochlear groove AKA “sunrise view”

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15
Q

Scaphoid articulates ____ bone.

A

Radial

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16
Q

Myofascial Pain Tx

A
  • PT
  • CBT
  • Muscle relaxants (Cyclobenzaprine)
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17
Q

Synovial fluid: PMN >75% and WBC >50 K

A

Infectious arthritis

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18
Q

Diseases associated with HLA-B27

A

PAIR:

  • Psoriatic arthritis
  • Ankylosing spondylitis
  • Inflammatory bowel disease
  • Reactive arthritis
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19
Q

What Dx presents with low back pain worse at night, BETTER WITH EXERCISE and recurrent acute uveitis, psoriasis, aortic regurgitation, restrictive airway disease and IBD.

A

Ankylosing Spondylitis

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20
Q

PE test for de Quervain Tenosynovitis

A

Finkelstein’s test

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21
Q

MC issue that causes Cauda Equina Syndrome

A

Herniated disc

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22
Q

Patellofemoral Pain Syndrome Tx

A
  • Strengthen medial quadriceps

- NSAIDs

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23
Q

MCC Septic Arthritis < 35yo

A

N. gonorrhea

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24
Q

Abduction of hip while applying anterior force on femur to REDUCE hip joint.

A

Ortolani

“Call Dr. O to fix it!”

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25
Q

MC injured ligament in an ankle sprain

A

Anterior talofibular ligament (ATFL)

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26
Q

Pain on ulnar wrist deviation with thumb in fist. Test?

A

Finkelstein’s test

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27
Q

Grade 1 Ankle SPRAIN Tx

A

RICE

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28
Q

Achilles tendon rupture risk increases when using what meds?

A
  • FQs

- Chronic steroid usage

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29
Q

Tx for Ganglion Cyst

A

1st: Observe
2nd: Aspirate

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30
Q

MC patho seen in Flexor Tenosynovitis

A

S. aureus

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31
Q

MC fracture seen in Osteoporosis

A

Vertebrae compression (also in MEN)

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32
Q

Osteoporosis Vit. D and Calcium required

A
  • Vitamin D 800-1200 IU/day

- Calcium 1200 mg/day

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33
Q

Long-term steroid use can lead to:

A

Osteoporosis

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34
Q

Arm fully pronated (thumb’s down) with pain during forward flexion (shoulders held down by
PA). Test and what does it mean?

A
  • Neer

- Rotator cuff injury

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35
Q

Test: Shoulder in 90 deg. of forward flexion with the elbow extended. The arm is adducted 10 deg. The patient internally rotates arm, pointing thumb to the floor. Pt. hold arm in this position against resistance while PA pushes arm towards the floor. PA then applies the same force with the patient’s arm externally rotated. (+) with pain or popping in internally rotated position → pain gone with external rotation. Dx?

A
  • Active Compression Test - O’Brien

- SLAP (superior labral tear from anterior to posterior) lesion seen in Glenohumeral Tear

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36
Q

Light tap on volar surface of the wrist over the median nerve. Test and what does it help Dx?

A
  • Tinel’s sign

- Carpal Tunnel

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37
Q

Which bursa communicates with the knee joint?

What can happen with fluid?

A

Suprapatellar bursa
-Largest of the bursae but isn’t a true bursa, rather an extension of the knee joint capsule. Thus free fluid can travel into it.

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38
Q

What is needed with tenderness to the POSTERIOR edge of the LATERAL malleolus?

A

X-ray

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39
Q

MC bone fracture causing Compartment Syndrome

A

Tibia fracture

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40
Q

What is needed with tenderness to the base of 5th metatarsal?

A

X-ray

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41
Q

(+) Straight leg test. Dx and MC site:

A
  • Sciatica (disk herniation)
  • L4 to L5
  • L5 to S1
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42
Q

MC nerve compressed in Carpal Tunnel Syndrome

A

Median

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43
Q

MCC Septic Arthritis > 35yo

A

S. aureus

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44
Q

Pain with passive ROM and flexed posture of finger. Dx?

A

Flexor Tenosynovitis

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45
Q

Tx for Ankylosing Spondylitis

A

NSAIDs, PT

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46
Q

MCC Osteomyelitis

A

S. aureus

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47
Q

MCC Osteomyelitis with dog/cat bite

A

Pasteurella multocida

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48
Q

Tx for Rheumatoid Arthritis (RA)

A

Methotrexate

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49
Q

Reproduction of Sxs with both wrists hyperflexed (pushed together) and hands face the floor. Test?

A

Phalen’s test

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50
Q

Ankle sprain: Mod. tenderness and swell, ↓ ROM, ~instability. Grade?

A

2

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51
Q

Phalen’s sign is seen in:

A

Carpal Tunnel Syndrome

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52
Q

What antibody is seen in Rheumatoid Arthritis (RA)?

A

Anti-Cyclic Citrullinated Peptide Ab

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53
Q

Adduction of hip while applying force downwards on knee to promote dislocation. Test?

A

Barlow

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54
Q

Mgmt for 50% subungal hematoma (or smaller with pain). Abx needed?

A

Trephination, Splinting, F/U

→ NO Abx

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55
Q

Hx of recent GI or Chlamydia infxn + conjunctivitis, arthritis, urethritis. Dx?

A

Reactive Arthritis

56
Q

TOC Herniated Disk Pulposus (Sciatica)

57
Q

Flex infant hips and knees showing uneven knee heights. Test?

58
Q

MCC Osteomyelitis in SCD

A

Salmonella

59
Q

Synovial fluid: PMN >50% and WBC <50 K

A

Inflammatory Arthritis

60
Q

Progressive shoulder and pelvic girdle WEAKNESS. Dx?

A

Polymyositis

61
Q

What Dx presents with low back pain worse at night, BETTER WITH EXERCISE?

A

Ankylosing Spondylitis

62
Q

With athletes that suffer multiple stress fractures, what Dx should be checked for?

A

Osteoporosis (especially women)

63
Q

Loss of shoulder mobility D/T prolonged immobility from another shoulder injury.

A
  • Adhesive capsulitis

- Frozen shoulder

64
Q

Tx for Polymyositis

65
Q

Commonly injured nerve with fibula injury:

66
Q

Another name for pain in the 1st MTP (Gout)

67
Q

High ankle sprains involve partial tear of which ligament?

A

Syndesmosis

68
Q

Fusiform (taper @ both ends) or symmetrical swelling of the finger seen in:

A

Flexor Tenosynovitis

69
Q

14 yo basketball player presents with gradual increase in anterior knee pain. PE reveals tenderness over the patellar tendon. Dx?

A

Osgood-Schlatter Disease

70
Q

What meds can trigger Gout?

71
Q

Acute onset of lower back pain with weakness and NUMBness. Dx?

A

Cauda Equina Syndrome

72
Q

5 lab findings seen in Polymyositis

A 
(+) Anti-Jo
(+) Anti-SRP
(+) Anti-Mi-2
↑ Aldolase
↑ Creatine kinase
73
Q

Protuberance of the tibial tuberosity. Dx?

A

Osgood-Schlatter Disease

74
Q

Evening stiffness or morning stiffness <60 min. Dx?

A

Osteoarthritis

75
Q

Fast rise in body temp and severe muscle contractions when given general anesthesia. Dx?

A

Malignant Hyperthermia

76
Q

Mild to severe back pain with radicular symptoms of sensory loss and weakness throughout the lower extremities. Dx?

A

Herniated Disk Pulposus

77
Q

Tx for Baker’s (Popliteal Synovial) Cyst

78
Q

Spinal Epidural Abscess lab finding and MC patho

A
  • ↑ ESR

- S. aureus

79
Q

LP findings in Guillain-Barre Syndrome

A

+ regular WBC (known as albuminocytological).
-Normal Glu

80
Q

2 methods for fixing Nursemaids Elbow (Radial Head Subluxation)

A
  • Pressure to radial head and hyperpronating the forearm

- Simultaneous supinate + elbow flex

81
Q

MOI radial head subluxation

A

Longitudinal traction, pronated forearm + elbow extended

82
Q

1st line Tx Osteoarthritis elderly c bleed risk

A

Acetaminophen

83
Q

Osteonecrosis of proximal femoral head and limp. Dx?

A

Legg-Calve-Perthes Disease

84
Q

Asymmetric bone-on-bone joint narrowing and osteophytes. Dx?

A

Osteoarthritis

85
Q

Dx for Spinal Stenosis

86
Q

Osteoarthritis Tx

A

1st: exercise
2nd: acetaminophen or NSAIDs

87
Q

How long do Sxs have to be present for to Dx Rheumatoid Arthritis? Why?

A
  • At least 6 wks

- 5th Disease can mimic RA

88
Q

What DTR nerve is responsible for knee jerk (patellar) reflex?

89
Q

How to remember Salter Harris

A 
S: straight across
A: above 
L: lower
TE: through everything
R: cRush
90
Q

Female Athlete Triad

A
  • Disordered eating
  • Amenorrhea
  • Osteopenia
91
Q

Tx for Malignant Hyperthermia

A

Dantrolene

92
Q

Mgmt steps for Subungual Hematoma with injury

A

1st: X-ray (with injury)
2nd: Trephination

93
Q

With >50% subungal hematoma, what is the next best step?

A

Remove fingernail

94
Q

What is the initial and BEST test for SLU (lupus)?

A

Initial: ANA
BEST: Anti-DNA and Smith Ab

95
Q

Lisfranc Injury Tx

A
  • Open reduction and internal fixation (ORIF)

- Then non-wt. bear and cast for 12wks.

96
Q

Weak, absent plantar flexion when gastrocnemius (calf) is squeezed.

A

Thompson test

97
Q

Dx for Sjogren Syndrome

A

(+) Schirmer test

98
Q

Transverse fracture at 5th metatarsal base

A

Jones Fracture

99
Q

Lateral epicondylitis involves inflammation at which muscle?

A

Extensor carpi radialis brevis

100
Q

GOLD Dx for ACL injury

101
Q

Dx for Rhabdomyolysis

A

↑ CPK > 5x UNL

102
Q

Flexor digitorum superficialis (FDS) tendon provides flexion at what joints?

103
Q

Pain getting out of bed improved with walking or stretching the calf but then worsens again after periods of inactivity. Dx?

A

Plantar Fasciitis

104
Q

MC tendon injured with rotator cuff injury

A

Supraspinatus

105
Q

With any fracture, what is important to check?

A

Neurovascular supply

106
Q

What type of crystals are seen in Pseudogout (chondrocalcinosis)?

A

Calcium Pyrophosphate

107
Q

MC patho in septic arthritis

A

Staph aureus

108
Q

Tx for Osgood-Schlatter Disease

A
  • Ice
  • NSAIDs
  • Quad stretching
109
Q

What 2 (artery/nerve) are most at risk with Knee Dislocation?

A
  • Popliteal artery

- Peroneal nerve

110
Q

Tx for Gout in a pt. with renal issues

111
Q

Labs seen in Sjogren Syndrome

A
  • SSA (anti-Ro)

- SSB (anti-La)

112
Q

8-12 yo with gradual posterior heel pain. PE: Pain with medial-lateral compression of the calcaneus. Dx?

A

Sever Disease

113
Q

Excessive convex curvature of the thoracic spine. Dx?

114
Q

MOI for anterior glenohumeral dislocation

A

Abducted and externally rotated

115
Q

What DTR nerve is responsible for ankle jerk reflex (Achilles)?

116
Q

1st line Tx Osteoarthritis mild-moderate disease and NO bleed risk

117
Q

With NSAIDs failure in Ankylosing Spondylitis, what med helps with QOL?

A

Infliximab

118
Q

Med that aids with dry mouth in Sjogren’s syndrome

A

Pilocarpine

119
Q

Standing pt lifts 1 leg up at a time. When pt stands on affected side, pelvis droops on the unaffected side D/T weakened gluteal muscles. What sign is this?

A

Trendelenburg’s sign

120
Q

40yo DM pt presents with nodule, band, and slight contracture on the palm proximal to the finger. Dx?

A

Dupuytren’s contracture

121
Q

What condition is associated with Polymyalgia rheumatica?

A

Amaurosis fugax in Giant Cell Arteritis

122
Q

What is likely on PE with S1 radiculopathy?

A

Weak plantarflexion of foot

123
Q

In what Dx do we find Heberden nodes?

A

Osteoarthritis

124
Q

In an elderly pt. with gradual muscle weakness, what age-related body composition change is the likely Dx?

A

Myofibrosis

125
Q

What is a distracting injury per NEXUS criteria?

A

Any injury thought to have the potential to impair the patient’s ability to appreciate other injuries.

126
Q

At what age do Osteoporosis screenings start?

A

> 65 yo no history

127
Q

Pain worse at night, unrelated to activity and relieved by aspirin or NSAIDs. Slight limp. X-ray: small, round lucency (nidus) with a sclerotic margin. Dx?

A

Osteoid Osteoma

128
Q

A quick stop of movement and change of direction while running can lead to:

129
Q

What RF is the most predictive for the development of osteoarthritis?

130
Q

A patient complains of loss of sensation at the level of the umbilicus. Which of the following dermatomes is affected?

131
Q

Tx for Colle’s 2 fracture

A

In this order:

  • Stable: closed reduction, sugar tong
  • Unstable/comminuted: referral for ORIF
132
Q

13 yo presents with distal ulnar and radial fractures. She had sugar tong and had it removed d/t pain and pale limb. She has swelling and slightly decreased pulses. What could have cause this?

A

Vascular compromise or compartment syndrome

133
Q

Nursemaids Elbow is AKA:

A

Radial Head Subluxation

134
Q

MOI most commonly associated with meniscal tears

A

Axial loading and rotation

135
Q

Tx for Osteomyelitis D/T plantar puncture

A

Vanco (or Nafcillin) + FQ

136
Q

DM pt. presents with cellulitis (or any wound infection). What imagining would you like to do?

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