MSK Flashcards
Sudden death in Marfan’s syndrome is due to
Aortic dissection
Treatment of plantar fasciitis
Treatment
• non-operative
■ pain control and stretching programs are first-line
■ rest, ice, NSAIDs, steroid injection
■ physiotherapy: Achilles tendon and plantar fascia stretching, extracorporeal shockwave therapy
■ orthotics with heel cup – to counteract pronation and disperse heel strike forces
• operative
■ very rarely indicated
■ when performed, includes endoscopic release of fascia
Extension of wrist lost in accident
Which fracture?
Fracture of mid shaft Humerus
The most common (80%) cause of vision loss in patients with GCA is ?
anterior ischemic optic neuropathy (due to occlusion of the posterior ciliary artery)
A rotator cuff injury typically occurs due to injury to the ______and presents with weakness and pain upon abduction of the arm.
Supraspinatus muscle
Septic arthritis initial step of management?
The best initial step in management is aspiration of the joint for diagnosis (often preceded by radiography), followed by broad spectrum antibiotics and surgical drainage.
Patellofemoral syndrome
Young and athlete ?
Patellofemoral pain syndrome classically presents with diffuse anterior knee pain after overuse or prolonged sitting; compression of the patella during knee extension will reproduce the pain.
Dequervain’s sinuvitis
Tx
De Quervain’s tenosynovitis is initially treated with conservative measures such as rest and NSAIDs.
Occur after pregnancy , with hypothyroidism
Pelvic fracture first step in Mx
Pelvic binder
Non displaced fracture of clavicle tx?
Conservative, heals on its own
Morton’s neuroma
presenting with pain upon palpation of the space between her third and fourth toes with an audible click upon palpation suggesting a diagnosis of an intermetatarsal plantar nerve neuroma (Morton’s neuroma).
Murmur of marfan’s syndrome
Patients with Marfan syndrome have an increased risk of both aortic regurgitation (diastolic murmur at the right second intercostal space) and mitral valve prolapse (late systolic murmur with mid-systolic click).
Renal dysfunction and gout
Low dose allopurinol and monitor Creatinine.
Worst hip pain
Anterior hip pain
Lateral hip pain
Sport injury
Or
fracture
Pelvic trauma
Bleeding doesn’t stop with pelvic binder
Next step?
vessel embolization
Drug causing drug induced lupus
mnemonic: Cute CHIMPPP)
quinidine chlorpromazine hydralazine isoniazid methyldopa primaquine, penicillamine, and procainamide
Sjogren bio markers
anti-Ro (anti-SSA) and anti-La (anti-SSB). Anti-nuclear antibodies (ANA) and rheumatoid factor (RF) may also be positive
AS treatment
Non pharma :
Exercise
Postural and deep breathing
PT
Smoking cessation
Pharma
nsaids
Glucocorticoids
DMARDS
ANTI TNF
SURGERY
hip replacement and vertebral osteotomy
Seronegative Spondyloarthropathies
Ankylosing spondylitis
Reactive arthritis (formerly known as Reiter syndrome)
Psoriatic arthritis
Juvenile rheumatoid arthritis
Extra-Articular Manifestations of AS
6 As
Atlanto-axial subluxation Anterior uveitis Apical lung fibrosis Aortic incompetence Amyloidosis (kidneys) Autoimmune bowel disease (ulcerative colitis)
Reactive arthritis tx
NSAIDS
Intra articular steroids
Rheumatoid arthritis criteria for diagnosis
RA is defined as having 4 or more of the following present for diagnosis:
7 Rheumatology
Morning stiffness lasting more than 1 hour
Positive rheumatoid factor or anti-CCP
C-reactive protein (CRP) or ESR
Inflammatory arthritis of 3 or more joints—the more joints involved, the
more likely the diagnosis. The proximal interphalangeal (PIP) and
metacarpophalangeal (MCP) joints are frequently involved.
Duration of symptoms: more than 6 weeks
Felty syndrome triad
Rheumatoid arthritis
Splenomegaly
Neutropenia
