MSK

Question 1

At what age should you begin ordering dexa scans for male patients? What about female patients?

Answer 1

70 for males, 65 for females

Question 2

Give the DEXA score for osteopenia and osteoporosis

Answer 2

Osteopenia equals 1 to 2.4 standard deviation’s, osteoporosis equals 2.5 standard deviation or greater

Question 3

What fracture is the number one cause of compartment syndrome?

Answer 3

Tibial shaft fracture

Question 4

A patient’s lab work shows positive Smith antibody and positive double-stranded DNA antibodies. What is the most likely diagnosis?

Answer 4

Lupus

Question 5

Where are Bouchard’s nodes found?

Answer 5

Proximal interphalangeal joint (PRP)

Question 6

What will an x-ray show in acute osteomyelitis?

Answer 6

Nothing-It will show bone destruction in chronic osteomyelitis.

Question 7

What is the best imaging to diagnose osteomyelitis?

Answer 7

Ether a bone scan or an MRI will provide the diagnosis.

Question 8

A 22-year-old male patient presents with what is clearly a septic knee. You also noticed lesions on his hands and feet. What is the most likely pathogen?

Answer 8

Neisseria gonorrhoeae

Question 9

What would you expect the WBC count to be in the joint fluid of an infected knee?

Answer 9

> 50,000 at a minimum and probably much higher.

Question 10

A patient presents with a painless mass in her right wrist. What is the most likely diagnosis?

Answer 10

Ganglion cyst

Question 11

What is the age range for osteosarcoma? Where are the most typically found in the body?

Answer 11

Osteosarcoma usually occur in 15 to 25-year-old males and are most commonly found around the knee.

Question 12

You think a patient may have an osteoid osteoma due to his complaints of severe night pain. You set him up for an x-ray; but int he meantime what medication do you start him on?

Answer 12

If it is truly an osteoid osteoma ibuprofen will resolve his pain.

Question 13

Clicking or locking of me indicates what diagnosis?

Answer 13

Meniscal tear

Question 14

A 65-year-old presents complaining of severe pain in his great toe that began when he woke up this morning. It is swollen, red, and very tender. What is the most likely diagnosis?

Answer 14

Gout would be number one because of the location, but you might also think about an infection.

Question 15

What you’re a gas it level helps to confirm a diagnosis of gout?

Answer 15

> 7.5

Question 16

What is the medical treatment for gout?

Answer 16

Allopurinol daily, for acute flares colchicine, systemic and intraarticular glucocorticoids, (NSAIDs), and biologic agents that inhibit the action of interleukin (IL)-1 beta

Question 17

What does the presence of tophi indicate in patients with gout?

Answer 17

The presence of tophi is an indication for the initiation of long-term urate-lowering pharmacotherapy either during or following resolution of a gout flare to prevent or reverse chronic gouty arthritis and joint damage.

Question 18

A pathology report comes back with positive birefringent crystals. What is the most likely diagnosis?

Answer 18

Psuedogout

Question 19

A patient with a history of hepatitis B presents complaining of bilateral knee pain, fever, and weight loss. What is the most likely diagnosis?

Answer 19

Polyarteritis nodosa

Question 20

You suspect a patient has polyarteritis nodosa. What is the test for definitive diagnosis and what is the treatment?

Answer 20

Biopsy, high dose steroids

Question 21

On physical exam, you notice ulnar deviations and swan neck deformities. What is the most likely diagnosis?

Answer 21

Rheumatoid arthritis