MSK Flashcards
1
Q
Marker of muscle injury
A
Creatine kinase
2
Q
Grade 2 Ankle SPRAIN Tx
A
- RICE + PT
- G3 may require surgery
3
Q
Fracture at base of 2nd metatarsal pathognomonic. Dx?
A
Lisfranc Injury
4
Q
Tx for Achilles Tendon Rupture
A
- Posterior splint in plantarflexion
- Ortho consult
5
Q
Tx for Slipped Capital Femoral Epiphysis (SCFE)
A
- Non-weight bearing
- ER ortho (prompt operative stabilization)
6
Q
Tx for Pseudogout (chondrocalcinosis)
A
- 1st line: aspiration or steroid inj.
- NSAIDs
- CI (PUD): Colchicine
7
Q
Most sensitive for ACL tear:
A
Lachman’s Test
8
Q
Low back pain and stiffness when walking but relieved when leaning forward. Dx?
A
Spinal Stenosis
9
Q
Tx for Raynaud’s phenomenon
A
CCB
10
Q
Tx for de Quervain Tenosynovitis
A
Thumb spica splint + NSAIDs
11
Q
Tx for Spinal Stenosis
A
- PT, pain meds, lose wt.
- Surgery
12
Q
TOC Cauda Equina Syndrome
A
MRI or CT Myelogram
13
Q
PE of transillumination is found in:
A
Ganglion Cyst
14
Q
Patellofemoral Pain Syndrome x-ray finding
A
Axial → patella sits in femoral trochlear groove AKA “sunrise view”
15
Q
Scaphoid articulates ____ bone.
A
Radial
16
Q
Myofascial Pain Tx
A
- PT
- CBT
- Muscle relaxants (Cyclobenzaprine)
17
Q
Synovial fluid: PMN >75% and WBC >50 K
A
Infectious arthritis
18
Q
Diseases associated with HLA-B27
A
PAIR:
- Psoriatic arthritis
- Ankylosing spondylitis
- Inflammatory bowel disease
- Reactive arthritis
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
20
Q
PE test for de Quervain Tenosynovitis
A
Finkelstein’s test
21
Q
MC issue that causes Cauda Equina Syndrome
A
Herniated disc
22
Q
Patellofemoral Pain Syndrome Tx
A
- Strengthen medial quadriceps
- NSAIDs
23
Q
MCC Septic Arthritis < 35yo
A
N. gonorrhea
24
Q
Abduction of hip while applying anterior force on femur to REDUCE hip joint.
A
Ortolani
“Call Dr. O to fix it!”
25
MC injured ligament in an ankle sprain
Anterior talofibular ligament (ATFL)
26
Pain on ulnar wrist deviation with thumb in fist. Test?
Finkelstein's test
27
Grade 1 Ankle SPRAIN Tx
RICE
28
Achilles tendon rupture risk increases when using what meds?
- FQs
| - Chronic steroid usage
29
Tx for Ganglion Cyst
1st: Observe
2nd: Aspirate
30
MC patho seen in Flexor Tenosynovitis
S. aureus
31
MC fracture seen in Osteoporosis
Vertebrae compression (also in MEN)
32
Osteoporosis Vit. D and Calcium required
- Vitamin D 800-1200 IU/day
| - Calcium 1200 mg/day
33
Long-term steroid use can lead to:
Osteoporosis
34
Arm fully pronated (thumb's down) with pain during forward flexion (shoulders held down by
PA). Test and what does it mean?
- Neer
| - Rotator cuff injury
35
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?
- Active Compression Test - O'Brien
| - SLAP (superior labral tear from anterior to posterior) lesion seen in Glenohumeral Tear
36
Light tap on volar surface of the wrist over the median nerve. Test and what does it help Dx?
- Tinel's sign
| - Carpal Tunnel
37
Which bursa communicates with the knee joint?
| What can happen with fluid?
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.
38
What is needed with tenderness to the POSTERIOR edge of the LATERAL malleolus?
X-ray
39
MC bone fracture causing Compartment Syndrome
Tibia fracture
40
What is needed with tenderness to the base of 5th metatarsal?
X-ray
41
(+) Straight leg test. Dx and MC site:
- Sciatica (disk herniation)
- L4 to L5
- L5 to S1
42
MC nerve compressed in Carpal Tunnel Syndrome
Median
43
MCC Septic Arthritis > 35yo
S. aureus
44
Pain with passive ROM and flexed posture of finger. Dx?
Flexor Tenosynovitis
45
Tx for Ankylosing Spondylitis
NSAIDs, PT
46
MCC Osteomyelitis
S. aureus
47
MCC Osteomyelitis with dog/cat bite
Pasteurella multocida
48
Tx for Rheumatoid Arthritis (RA)
Methotrexate
49
Reproduction of Sxs with both wrists hyperflexed (pushed together) and hands face the floor. Test?
Phalen's test
50
Ankle sprain: Mod. tenderness and swell, ↓ ROM, ~instability. Grade?
2
51
Phalen's sign is seen in:
Carpal Tunnel Syndrome
52
What antibody is seen in Rheumatoid Arthritis (RA)?
Anti-Cyclic Citrullinated Peptide Ab
53
Adduction of hip while applying force downwards on knee to promote dislocation. Test?
Barlow
54
Mgmt for 50% subungal hematoma (or smaller with pain). Abx needed?
Trephination, Splinting, F/U
| → NO Abx
55
Hx of recent GI or Chlamydia infxn + conjunctivitis, arthritis, urethritis. Dx?
Reactive Arthritis
56
TOC Herniated Disk Pulposus (Sciatica)
MRI
57
Flex infant hips and knees showing uneven knee heights. Test?
Galeazzi
58
MCC Osteomyelitis in SCD
Salmonella
59
Synovial fluid: PMN >50% and WBC <50 K
Inflammatory Arthritis
60
Progressive shoulder and pelvic girdle WEAKNESS. Dx?
Polymyositis
61
What Dx presents with low back pain worse at night, BETTER WITH EXERCISE?
Ankylosing Spondylitis
62
With athletes that suffer multiple stress fractures, what Dx should be checked for?
Osteoporosis (especially women)
63
Loss of shoulder mobility D/T prolonged immobility from another shoulder injury.
- Adhesive capsulitis
| - Frozen shoulder
64
Tx for Polymyositis
Steroids
65
Commonly injured nerve with fibula injury:
Peroneal
66
Another name for pain in the 1st MTP (Gout)
Podagra
67
High ankle sprains involve partial tear of which ligament?
Syndesmosis
68
Fusiform (taper @ both ends) or symmetrical swelling of the finger seen in:
Flexor Tenosynovitis
69
14 yo basketball player presents with gradual increase in anterior knee pain. PE reveals tenderness over the patellar tendon. Dx?
Osgood-Schlatter Disease
70
What meds can trigger Gout?
Diuretics
71
Acute onset of lower back pain with weakness and NUMBness. Dx?
Cauda Equina Syndrome
72
5 lab findings seen in Polymyositis
```
(+) Anti-Jo
(+) Anti-SRP
(+) Anti-Mi-2
↑ Aldolase
↑ Creatine kinase
```
73
Protuberance of the tibial tuberosity. Dx?
Osgood-Schlatter Disease
74
Evening stiffness or morning stiffness <60 min. Dx?
Osteoarthritis
75
Fast rise in body temp and severe muscle contractions when given general anesthesia. Dx?
Malignant Hyperthermia
76
Mild to severe back pain with radicular symptoms of sensory loss and weakness throughout the lower extremities. Dx?
Herniated Disk Pulposus
77
Tx for Baker’s (Popliteal Synovial) Cyst
Observe
78
Spinal Epidural Abscess lab finding and MC patho
- ↑ ESR
| - S. aureus
79
LP findings in Guillain-Barre Syndrome
-↑ protein
----------------------------
+ regular WBC (known as albuminocytological).
-Normal Glu
80
2 methods for fixing Nursemaids Elbow (Radial Head Subluxation)
- Pressure to radial head and hyperpronating the forearm
| - Simultaneous supinate + elbow flex
81
MOI radial head subluxation
Longitudinal traction, pronated forearm + elbow extended
82
1st line Tx Osteoarthritis elderly c bleed risk
Acetaminophen
83
Osteonecrosis of proximal femoral head and limp. Dx?
Legg-Calve-Perthes Disease
84
Asymmetric bone-on-bone joint narrowing and osteophytes. Dx?
Osteoarthritis
85
Dx for Spinal Stenosis
MRI
86
Osteoarthritis Tx
1st: exercise
2nd: acetaminophen or NSAIDs
87
How long do Sxs have to be present for to Dx Rheumatoid Arthritis? Why?
- At least 6 wks
| - 5th Disease can mimic RA
88
What DTR nerve is responsible for knee jerk (patellar) reflex?
L4
89
How to remember Salter Harris
```
S: straight across
A: above
L: lower
TE: through everything
R: cRush
```
90
Female Athlete Triad
- Disordered eating
- Amenorrhea
- Osteopenia
91
Tx for Malignant Hyperthermia
Dantrolene
92
Mgmt steps for Subungual Hematoma with injury
1st: X-ray (with injury)
2nd: Trephination
93
With >50% subungal hematoma, what is the next best step?
Remove fingernail
94
What is the initial and BEST test for SLU (lupus)?
Initial: ANA
BEST: Anti-DNA and Smith Ab
95
Lisfranc Injury Tx
- Open reduction and internal fixation (ORIF)
| - Then non-wt. bear and cast for 12wks.
96
Weak, absent plantar flexion when gastrocnemius (calf) is squeezed.
Thompson test
97
Dx for Sjogren Syndrome
(+) Schirmer test
98
Transverse fracture at 5th metatarsal base
Jones Fracture
99
Lateral epicondylitis involves inflammation at which muscle?
Extensor carpi radialis brevis
100
GOLD Dx for ACL injury
MRI
101
Dx for Rhabdomyolysis
↑ CPK > 5x UNL
102
Flexor digitorum superficialis (FDS) tendon provides flexion at what joints?
- PIP
| - MCP
103
Pain getting out of bed improved with walking or stretching the calf but then worsens again after periods of inactivity. Dx?
Plantar Fasciitis
104
MC tendon injured with rotator cuff injury
Supraspinatus
105
With any fracture, what is important to check?
Neurovascular supply
106
What type of crystals are seen in Pseudogout (chondrocalcinosis)?
Calcium Pyrophosphate
107
MC patho in septic arthritis
Staph aureus
108
Tx for Osgood-Schlatter Disease
- Ice
- NSAIDs
- Quad stretching
109
What 2 (artery/nerve) are most at risk with Knee Dislocation?
- Popliteal artery
| - Peroneal nerve
110
Tx for Gout in a pt. with renal issues
Steroids
111
Labs seen in Sjogren Syndrome
- SSA (anti-Ro)
| - SSB (anti-La)
112
8-12 yo with gradual posterior heel pain. PE: Pain with medial-lateral compression of the calcaneus. Dx?
Sever Disease
113
Excessive convex curvature of the thoracic spine. Dx?
Kyphosis
114
MOI for anterior glenohumeral dislocation
Abducted and externally rotated
115
What DTR nerve is responsible for ankle jerk reflex (Achilles)?
S1
116
1st line Tx Osteoarthritis mild-moderate disease and NO bleed risk
NSAIDs
117
With NSAIDs failure in Ankylosing Spondylitis, what med helps with QOL?
Infliximab
118
Med that aids with dry mouth in Sjogren’s syndrome
Pilocarpine
119
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?
Trendelenburg’s sign
120
40yo DM pt presents with nodule, band, and slight contracture on the palm proximal to the finger. Dx?
Dupuytren’s contracture
121
What condition is associated with Polymyalgia rheumatica?
Amaurosis fugax in Giant Cell Arteritis
122
What is likely on PE with S1 radiculopathy?
Weak plantarflexion of foot
123
In what Dx do we find Heberden nodes?
Osteoarthritis
124
In an elderly pt. with gradual muscle weakness, what age-related body composition change is the likely Dx?
Myofibrosis
125
What is a distracting injury per NEXUS criteria?
Any injury thought to have the potential to impair the patient’s ability to appreciate other injuries.
126
At what age do Osteoporosis screenings start?
>65 yo no history
127
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?
Osteoid Osteoma
128
A quick stop of movement and change of direction while running can lead to:
ACL tear
129
What RF is the most predictive for the development of osteoarthritis?
Age
130
A patient complains of loss of sensation at the level of the umbilicus. Which of the following dermatomes is affected?
T10
131
Tx for Colle’s 2 fracture
In this order:
- Stable: closed reduction, sugar tong
- Unstable/comminuted: referral for ORIF
132
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?
Vascular compromise or compartment syndrome
133
Nursemaids Elbow is AKA:
Radial Head Subluxation
134
MOI most commonly associated with meniscal tears
Axial loading and rotation
135
Tx for Osteomyelitis D/T plantar puncture
Vanco (or Nafcillin) + FQ
136
DM pt. presents with cellulitis (or any wound infection). What imagining would you like to do?
MRI
