MSK and Rheumatology

Question 1

What is the appropriate timing for hip fracture surgery?

Answer 1

Generally within 24 hours of the injury and not longer than 72 hours

Question 2

What should be given prior to surgery for femoral neck fractures?

Answer 2

Single dose of IV prophylactic antibiotics - usually cefazolin

Question 3

What are the four muscles of the rotator cuff?

Answer 3

Supraspinatus
Infraspinatus
Teres minor
Subscapularis

Question 4

A patient presents with conjunctivitis, urethritis, and arthritis. What diagnosis do you suspect?

Answer 4

Reactive arthritis

Question 5

What is the intitial treatment for a Jones fracture?

Answer 5

Spinting and non-weightbearing

Question 6

What is the most common age range for osteosarcoma?

Answer 6

15-25 years old, males

Question 7

Anti-Jo-1 antibodies should make you think of what diagnosis?

Answer 7

Polymyositis

Question 8

What is the name for the 4th and 5th metacarpal fractures that often result from throwing a punch?

Answer 8

Boxer Fracture

Question 9

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

Answer 9

Biopsy, high dose steroids

Question 10

What is the most useful physical exam test for diagnosing an ACL tear?

Answer 10

Lachman’s followed by anterior drawer

Question 11

What ligament is most commonly injured in an ankle sprain?

Answer 11

Anterior talofibular ligament (ATFL)

Question 12

A positive straight leg test indicates what diagnosis?

Answer 12

Herniated disc

Question 13

What vessel is at risk of being injured with a patellar dislocation?

Answer 13

Popliteal artery

Question 14

What fracture is the most common cause of compartment syndrome?

Answer 14

Tibial shaft fracture

Question 15

What is the first line treatment for rheumatoid arthritis?

Answer 15

Methotrexate

Question 16

There is a sunburst appearance on x-ray. What is the most likely diagnosis?

Answer 16

Osteosarcoma

Question 17

A positive Apley test indicates what diagnosis?

Answer 17

Meniscal tear

Question 18

Where are Herberden’s nodes found?

Answer 18

Distal interphalangeal joint (DIP)

Question 19

What is the most common radiculopathy?

Answer 19

L5

Question 20

“onion skin” appearance on x-ray should make you think of what diagnosis?

Answer 20

Ewing sarcoma

Question 21

Which deep tendon reflexes are affected in cauda equina syndrome?

Answer 21

Patellar (knee) and Achilles (ankle) reflexes

Question 22

What is the most commonly fractured carpal bone?

Answer 22

Scaphoid

Question 23

What are the risk factors for reactive arthritis?

Answer 23

• HLA-B27
• Male sex
• History of recent GI or chlamydia infection

Question 24

In addition to acutely managing compartment syndrome, what other organ system should be evaluated?

Answer 24

Renal - need to evaluate for rhabdomyolysis with labs including creatinine kinase, renal function, urine analysis, and urine myoglobin

Question 25

What organism causes cat scratch fever? | How does it classically present?

Answer 25

Bartonella henselae, a gram negative bacillus | Tender regional lymphadenopathy, low grade fever

Question 26

In a 12-year old presenting with a longitudinal fracture of the distal radius through the physis what is the recommended treatment? | What type of Salter-Harris is being described?

Answer 26

Orthopedic evaluation for open reduction and internal fixation | Salter-Harris Type IV

Question 27

What is the most specific test in detecting the presence of SLE?

Answer 27

Anti-double stranded DNA and Anti-Smith

Question 28

When should bracing for scoliosis be considered? | What defines scoliosis?

Answer 28

A Cobb angle between 20-40 degrees | Cobb Angle > 10 degrees

Question 29

Pulmonary function tests are recommended in patients with scoliosis. What will be found on PFT's if scoliosis is affecting breathing?

Answer 29

Restrictive pattern

Question 30

What is the recommended follow-up for a patient with a Cobb Angle of 18 degrees? | When is surgery indicated?

Answer 30

Serial AP radiographic follow-up every 3-4 months | Cobb Angle > 40 degrees

Question 31

What is the most common mechanism of injury for a radial head fracture? | What will be seen on x-ray?

Answer 31

Fall on an outstretched hand | Posterior Fat pad sign (Sail Sign)

Question 32

What are the side effects of estrogen therapy in osteoporosis?

Answer 32

Increased risk of breast or endometrial cancer