MSK

Question 1

Mcmurray test

Answer 1

Meniscal tear

Question 2

Talar test

Answer 2

Ankle instability

Question 3

Tinels sign

Answer 3

Carpal tunnel syndrome

Question 4

Spurling

Answer 4

Cervical nerve root compression

Question 5

Lachman test

Answer 5

Anterior cruciate ligament tear

Question 6

Straight leg raising lift

Answer 6

Lumbar nerve root compression

Question 7

Drop arm test

Answer 7

Rotator cuff evaluation

Question 8

Finkelstein test

Answer 8

De Quervain’s tenosynovitis

Question 9

Osgood Schlatter disease

Answer 9

Patellar swelling and pain.

Usually during a period of growth spurt (tanner 3) and adolescents who play or participate in sports involving running or jumping.
Repeated stress causes inflammation below the patellar tendon where it attaches to the tibia.
New bone growth can occur where the tendon pulled away from the tibia resulting in a bony lump.

Treatment:
Reduce pain and swelling with mild pain relievers (NSAIDS)
physical therapy
Avoid heavy quadriceps loading or deep knee bending. Light weight training and exercise can help symptoms.

Question 10

Reactive

Answer 10

Multi organ system inflammatory condition. Usually caused by STI. Gonorrhea or chlamydia.

Can’t Pee (Urethritis)
Can see (conjunctivitis)
Can’t climb a tree (knee or ankle involvement)

Treatment:
Treat underlying cause (abx)
Steroids
NSAIDs

Question 11

Differences between LS strain and radiculopathy

Answer 11

LS caused by irritation of the spine and supporting muscles most common reason for low back pain. There are no neurological abnormalities in LS strain.

LS radiculopathy is caused by neural structure damage. Pt will have altered neurological exam including abnormal straight leg raising sensory loss or alter deep tendon reflexes.

Treatment of strain: analgesics, physical therapy, heat and ice, muscle relaxers.

Treatment for radiculopathy: SAME as above. Specialty evaluation if persistent neuro deficit without resolution after 4-6 weeks of conservative therapy.

Question 12

Heberden nodes

Answer 12

DISTAL joints of hands with osteoarthritic nodes

Question 13

Bouchards nodes

Answer 13

PROXIMAL joints of hands have osteoarthritic nodes

Question 14

Osteoarthritis

Answer 14

Assessment: pain, tenderness, stiffness predominately in the morning. Your strange emotion crepitus. Erythema and warmth is usually absent.

X-ray to distinguish between type of arthritis. Imaging will show narrowing of joints base changes in the bone and the presence of bone spurs or osteophytes.

Conservative treatment is recommended strengthening low impact aerobic exercises. Weight loss. NSAIDS. Intraartricular corticosteroid injection possibly.

Question 15

Grade 1 sprain

Answer 15

Mild stretching up with microscopic tears. No joint instability on exam, can bear weight with mild pain

Question 16

Grade 2 sprain

Answer 16

In complete tear of ligament. Mild to moderate joint instability, decreased range of motion, weight-bearing and ambulation is painful. Mild to moderate pain, swelling, tenderness and ecchymosis.

Refer to ortho for grade 2/3 sprain

Question 17

Grade 3 sprain

Answer 17

Complete tear of ligament. Pain, swelling, tenderness, Ecchymosis. Loss of function and motion. Unable to bear weight and ambulate.

Refer to ortho for grade 2/3 sprain.

Question 18

Treatment of acute gouty arthritis attack

Answer 18

Treatment should start within 24 hours of onset.

NSAIDs, corticosteroids, and oral colchicine are first line options

Question 19

Prevention of acute gouty arthritis attack

Answer 19

Allopurinol or febuxostat - xanthine oxidase inhibitors- 1st line in urate lowering therapy.

Colchicine is appropriate as first line therapy with appropriate dose adjustment in CKD.

If allopurinol intolerant - a 24 hour urine collection for uric acid level would be helpful. If a patient turned out to be an under-excretor, Probenecid would be the right approach for prophylactic treatment.