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Differential Dx > MSK chest, ribs, T-spine > Flashcards

MSK chest, ribs, T-spine Flashcards

1
Q

What is the pain pattern for cardiac involvement?

A
  • radiating to one or both UEs
  • precipitated by exertion
  • no TTP

Ease: supine

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2
Q

What is the pain pattern for pulmonary involvement?

A
  • exacerbation by deep breathing
  • no TTP

Ease: upright

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3
Q

What is the pain pattern for food?

A

pain after food

Ease: upright

30 mins: esophagus
30-90 mins: stomach
90-4 hours: Lower GI system

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4
Q

What are red flags for possible SC joint arthritis?

A
  • TTP at SC joint
  • limited shoulder movement
  • swelling
  • fever
  • insidious onset of chest pain localized to the SC joint

Patient interview: HX of IV drug use, DM, trauma, and infection

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5
Q

What is mastitis?

A

Inflammation/obstruction of the mammary duct

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6
Q

What is mastitis associated with in females?

A

lactation

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7
Q

What are s/s of mastitis?

A
  • red and warm
  • swollen
  • painful
  • fever and chills
  • flu-like s/s
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8
Q

What are risk factors for mastitis?

A
  • female
  • PMH of mastitis
  • stress
  • fatigue
  • trauma
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9
Q

(true/false) Males can get mastitis

A

true

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10
Q

What are cyclical breast cysts?

A

Cysts that are hormonally induced cysts that resolve within 2-3 menstrual cycles

Less common after menopause

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11
Q

What is a rare form of ductal carcinoma?

A

paget’s disease

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12
Q

What are the sxs of paget’s disease?

A
  • itching
  • redness
  • flaking skin
  • occasional bleeding
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13
Q

(true/false) Paget’s disease in the breast is the same as paget’s disease in the bone

A

FALSE

it is not

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14
Q

What is the 2nd most common site of cancer and cause of death in women?

A

breast cancer

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15
Q

What are risk factors for breast cancer?

A
  • PMH
  • white, 45-70 y/o
  • genetics
  • estrogen exposure
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16
Q

Where does breast cancer commonly occur?

A

upper outer segment of the breast

17
Q

What are signs of breast cancer?

A
  • Nipple discharge
  • nipple erosion
  • breast enlargement
  • breast shrinkage
  • orange peel appearance
    ~~~~~~~ “BREAST”
    Breast mass
    Retraction
    Edema
    Axillary mass
    Scaly Nipple
    Tender breast and breast pain
18
Q

What is mastodynia?

A

Irritation of the upper dorsal intercostal nerve causing chest pain

19
Q

What are s/s of mastodynia?

A
  • unilateral chest pain
  • becomes more persistent during menstrual cycle
20
Q

When does mastodynia occur initially?

definition: upper dorsal intercostal nerve irritation

A

Premenstrual period (ovulatory cycles)

21
Q

What is Tietze’s Syndrome?

A

Inflammation of a rib and its cartilage in those < 40 y/o WITH swelling

22
Q

What are the sxs of Tietze’s syndrome?

A
  • < 40 y/o
  • swelling
  • single site of involvement
  • pain worsened with sneezing, coughing, deep inspiration, trunk twisting, and horiz. ABD/ADD
23
Q

Where is Tietze’s syndrome commonly found in the rib cage?

A

2nd and 3rd costal cartilage

24
Q

What is costochondritis?

A

Inflammation of one or more costal cartilages…refers to pain the costochondral articulations without swelling in those > 40 y/o

25
Q

Where in the rib cage is costochondritis commonly found?

A

2nd to 5th costochondral joints

26
Q

What are the s/s of costochondritis?

A
  • Sharp pain along the sternal borders
  • burning breast pain
27
Q

What is the cause of Tietze’s syndrome?

A

Unknown

28
Q

What is the cause of costochondritis?

A

Trauma
surgery
sports
repetitive motion

29
Q

What is slipping rib syndrome?

“clicking rib syndrome” or “lower rib hypermobility”

A

Subluxation of the anterior rib’s costal cartilage tips due to rupture/inadequacy of interchondral fibrous attachments

Impinges the intercostal nerves

Common during mid-life

30
Q

What are the causes of intercostal neuritis?

A

Herpes Zoster (Shingles)

31
Q

What are s/s of herpes zoster?

A
  • Fever and chills
  • HA and malaise
  • pain
  • itching
  • hyperesthesias prior to lesions (1-2 days)
  • skin eruptions along the dermatome (4-5 days after other s/s)
32
Q

What portion of the spine are tumors commonly found?

A

lower T-spine

33
Q

What amount of displacement is seen with compression Fx in the T-spine?

A

> 3 mm

34
Q

What are Schmori’s nodes?

A

Protrusion of the the vertebral disc into the growth cartilage of the vertebrae above or below the disc

T-spine disc disease

35
Q

Compression Fx are commonly seen on the (anterior/posterior) vertebral bodies.

A

anterior vertebral bodies

36
Q

What are red flags for spinal fx?

A
  • midline TTP at level of fx
  • bruising
  • LE neuro deficits
  • Thoracic kyphosis

Interview red flags:
- fall or MVA
- > 70 y/o
- PMH of osteoporosis
- prolonged steroid use
- loss of function and/or mobility

37
Q

What medication type relieves GI pain?

A

antacids

Differential Dx (13 decks)

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