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ABFM questions > MSK/derm > Flashcards

MSK/derm Flashcards

1
Q

Rotator cuff muscle functions

A

Subscap- internal rotation
infraspinatus/teres minor- externatl rotation
supraspinatus/deltoid- abduction

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2
Q

Indication for surgical release of Dupuytren’s contracture

A

MCP contracture 30 deg –OR– any degree of contracture of PIP

**intralesional injection may reduce need for surgery in grade I disease

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3
Q

Best test for ACL tear

A

Lachman more sens/spec than ant drawer

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4
Q

management of achilles tendonopathy

A

eccentric calf strengthening

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5
Q

When to refer for scoliosis

A

Cobb angle >20
-potential for future growth, female sex are other considerations

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6
Q

nursemaids elbow

A

subluxation of head of radius from annular ligament

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7
Q

mgmt of 5th metatarsal fracture

A

non-displaced tuberosity – aircast, weight bare, exercises

avulsion fracture <3mm displaced – short boot

avulsion >3mm displaced – ortho ref

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8
Q

Dx SI joint dysfunction

A

+FABER w/ pain in SI joint, lumbar spine, post hip

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9
Q

Dx piriformis syndrome

A

+ log roll test (passive supine internal and external rotation)

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10
Q

Dx femoroacetabular impingement

A

+ faber with pain in GROIN

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11
Q

Injection location for rotoator cuff tendonitis

A

subacromial space– only if interferes with pain and function despite NSAIDs

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12
Q

scabies

A

likes folds of skin/web spaces eczematous

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13
Q

bed bugs

A

diffuse, areas oof body where you are not clothed like limbs

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14
Q

T/f steroids can be curative of trigger finger?

A

TRUE, but not always

not curative for long trm mgmt of other joints

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15
Q

Fibromyalgia tx

A

SSRI = tricyclics for pain

no effect on sleep or fatigue

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16
Q

cubital tunnel syndrome

A

peripheral ulnar neuropathy

Causes ulnar nerve dist parasthesias and intrinsic muscle weakness –> difficulty with coordination and weakness

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17
Q

Wartenberg’s syndrome

A

compression of superficial radial nerve

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18
Q

pronator syndrome

A

proximal median nerve neuropathy

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19
Q

mgmt of minimally displaced mid clavicular fracture

A

sling 2-6 weeks, passive ROM when no pain, PT at 4 weeks

**refer if significantly displaced

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20
Q

pharm treatment of ACUTE low back pain (evidence based)

A

Nsaids OR muscle relaxants (no benefit for both)

Or nonpharm tx- heat, acupuncture, massage, chiro

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21
Q

gottron’s sign

A

non-palpable macules over extensor surface of joints seen in DERMATOMYOSITIS

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22
Q

jones fx mgmgt

A

metadiaphyseal fracture of 5th metatarsel

-active patients have shorter healing time and return to activity with surgery
-if non op, then post splint 3-5 days, short walking cast 6 weeks, reimage

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23
Q

immobilization after shoulder dislocation?

A

3week <30

1 week>30

at risk for adhesive capsulitis

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24
Q

tx of shingles vs post herpetic neuralgia

A

singles = val/acyclovir

post herpetic neuralgia= gabapentin, can do nerve blocks if two weeks from rash

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25
Q

tx of dequervains tenosynovitis

A

NSAIDs and thumb spica for 1-4 weeks
- use injection if refractory to above
- pain CAN last up to one year if not tx’d early

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26
Q

when to image low back pain

A

concern for:
- cauda equina
- cancer (hx of cancer that mets to bone)
- fracture
- infection

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27
Q

HS can be associated with what GI condition

A

Chrons

28
Q

dermatitis herpetiformis associated with what GI condition

A

Celiac disease (and maybe UC)

pruritic grouped vesicles on knees and elbows

29
Q

Fixed drug eruption

A

T cell mediated reaction to bactrim or anti-convulsant.

Difference between that and EM is that EM presents as multiple lesions

30
Q

OA hands vs RA hands

A

OA: Heberden/Bouchard nodes

RA: MCPs/PIP, ulnar deviation, subcutaneous nodules

31
Q

Apophysitis diseases

A

Traction injury to the cartilage and bony attachments of tendons in growing children.

Osgood-Schlatter disease- ant tibial tubercle
Sever’s disease- heel
Sinding-Larsen-Johansson- patella

Tx: stretching, activity modification, icing, NSAIDs.

32
Q

osteochondrosis disease

A

Legg calves perthes

effects ossification of femoral head, should avoid weight bearing until heals

33
Q

generalized hyperpigmentation with insideous onset with accompanying weakness, malaise, nasuea, tc

A

Addisons

34
Q

1st and 2nd step for diagnosis of scoliosis in office

A

1: scoliometer with patient bent at 90 degree

2: if >7 degrees, do Cobb angle on radiograph with patient standing upright

35
Q

management of NON-displaced radial head fractures

A

cast for 3 days and early return to ROM

36
Q

axillary nerve injuries

A

presentation: shoulder dislocation, humeral neck fracture, crutches

Dec sensation/pain over the lateral shoulder, weakness with shoulder external rotation, abduction, and extension.

37
Q

first line for tinea versicolor

A

pityariasis antifungals like selenium sulfade or topical terbinafine

38
Q

Ottawa knee rule

A
  1. > 55
  2. <4 steps immediately after
  3. inability to flex to 90 deg
  4. pain of head of fibula
  5. isolated patellar tenderness
39
Q

Pharm for CHRONIC low back pain

A

NSAIDS, tramadol, duloxetine

Duloxetine= tramadol at 12 mo

40
Q

Non-pharm tx chronic low back pain

A

mindfulness based stress reduction, excersice, etc

41
Q

when to consider surgry for low back pain with radiculopathy

A

<6 weeks = conservative management

> 6 weeks can consider surgery

Surgery has better outcomes in first 2 years, but equal after that

42
Q

tx of lumbar spinal stenosis

A

Apap > Nsaids
PT

43
Q

associations with adhesive capsulitis

A

DM, parkinsons

44
Q

tx of patellofemoral pain syndrome

A

acitivity modification and PT&raquo_space;» brace

45
Q

Most sensitive test for capral tunnel

A

flick sign

(assciations thyroid dz, diabetes, pregnancy, alcoholism, rheumatoid arthritis)

46
Q

when to do surgery for carpal tunnel

A

> 6 months of splinting

47
Q

tarsal tunnel syndrome

A

-mimics plantar fascitis but no pain on physical exam
-entrapment of post tibial nerve at medial mall
- medial heel pain, burning
- provoked by subtalar pronation

48
Q

plantar fasciitis tx

A

night splint for 3 weeks or TC orthotics are best

(PT, stretch, massage, steroid injc, etc)

49
Q

highest rate of injury and knee injury in highschool sports

A

football

50
Q

best test meniscal tear

A

thessaly

51
Q

best test MCL

A

valgus stress

52
Q

who is most at risk for ACL tar

A

females, neuromuscular training prevention program is effective

53
Q

mgmt of ankle sprain

A

-early mobility is best
-ankle bracing is both primary and secondary prevention
-proprioceptive training is good

54
Q

cubital tunnel vs guyon’s canal

A

cubital= ulnar nerve, DORSAL, pitchers

guyons= ulnar nerve, VOLAR, cyclists

55
Q

xray is the first test but CT is better than MRI for….

A

tibial plateau
displaced intraarticular distal radial head fracture

56
Q

management by saltar harris

A

I + II = immobilization
***II= most common
III= eval for ORIF
IV+ V = surgery because growth arrest

57
Q

Supracondylar fracture (peds FOOSH): pres, nerves, management

A
  • cant fully extend elbow
    -anterior interossueous (“OK”), median, radial
  • long arm cast x3 weeks > xray&raquo_space; surgery if still displaced
58
Q

fat pad signs elbow

A

ant= probable fracture
post= definite fracture

59
Q

buckle fracture

A
  • MOA= 50% of peds FOOSH
  • removable splint/brace for 3 weeks, ok if they don’t follow up
60
Q

evidence based approach for nurse maids

A

hyperpronation of forearm

61
Q

when to refer clavicle fracture

A

-skin tenting
- NV compromise
- significant displacement
- overriding by >2cm

62
Q

nerve compromised in scaphoid/distal radius fracture

A

median nerve, “ok” sign

(displaced ones should be surgically repaired because prone to non-union)

63
Q

jersey finger

A
  • avulsion of FDP from distal phalynx
  • can’t flex DIP
  • needs surgery
64
Q

boutonneire deformity

A

“jammed finger”
splint PIP in extension for 6 weeks, then night splints 4-6 weeks

65
Q

ottawak ankle

A

malleolar pain or navicular/5th met pain

AND

inability to take 4 steps

66
Q

mgmt oof AC joint injury

A

I-III= non op in sling for comfort

IV-VI= surgery

ABFM questions (11 decks)

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