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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
tx of dequervains tenosynovitis
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
26
when to image low back pain
concern for: - cauda equina - cancer (hx of cancer that mets to bone) - fracture - infection
27
HS can be associated with what GI condition
Chrons
28
dermatitis herpetiformis associated with what GI condition
Celiac disease (and maybe UC) pruritic grouped vesicles on knees and elbows
29
Fixed drug eruption
T cell mediated reaction to bactrim or anti-convulsant. Difference between that and EM is that EM presents as multiple lesions
30
OA hands vs RA hands
OA: Heberden/Bouchard nodes RA: MCPs/PIP, ulnar deviation, subcutaneous nodules
31
Apophysitis diseases
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
osteochondrosis disease
Legg calves perthes effects ossification of femoral head, should avoid weight bearing until heals
33
generalized hyperpigmentation with insideous onset with accompanying weakness, malaise, nasuea, tc
Addisons
34
1st and 2nd step for diagnosis of scoliosis in office
1: scoliometer with patient bent at 90 degree 2: if >7 degrees, do Cobb angle on radiograph with patient standing upright
35
management of NON-displaced radial head fractures
cast for 3 days and early return to ROM
36
axillary nerve injuries
presentation: shoulder dislocation, humeral neck fracture, crutches Dec sensation/pain over the lateral shoulder, weakness with shoulder external rotation, abduction, and extension.
37
first line for tinea versicolor
pityariasis antifungals like selenium sulfade or topical terbinafine
38
Ottawa knee rule
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
Pharm for CHRONIC low back pain
NSAIDS, tramadol, duloxetine Duloxetine= tramadol at 12 mo
40
Non-pharm tx chronic low back pain
mindfulness based stress reduction, excersice, etc
41
when to consider surgry for low back pain with radiculopathy
<6 weeks = conservative management >6 weeks can consider surgery Surgery has better outcomes in first 2 years, but equal after that
42
tx of lumbar spinal stenosis
Apap > Nsaids PT
43
associations with adhesive capsulitis
DM, parkinsons
44
tx of patellofemoral pain syndrome
acitivity modification and PT >>>> brace
45
Most sensitive test for capral tunnel
flick sign (assciations thyroid dz, diabetes, pregnancy, alcoholism, rheumatoid arthritis)
46
when to do surgery for carpal tunnel
>6 months of splinting
47
tarsal tunnel syndrome
-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
plantar fasciitis tx
night splint for 3 weeks or TC orthotics are best (PT, stretch, massage, steroid injc, etc)
49
highest rate of injury and knee injury in highschool sports
football
50
best test meniscal tear
thessaly
51
best test MCL
valgus stress
52
who is most at risk for ACL tar
females, neuromuscular training prevention program is effective
53
mgmt of ankle sprain
-early mobility is best -ankle bracing is both primary and secondary prevention -proprioceptive training is good
54
cubital tunnel vs guyon's canal
cubital= ulnar nerve, DORSAL, pitchers guyons= ulnar nerve, VOLAR, cyclists
55
xray is the first test but CT is better than MRI for....
tibial plateau displaced intraarticular distal radial head fracture
56
management by saltar harris
I + II = immobilization ***II= most common III= eval for ORIF IV+ V = surgery because growth arrest
57
Supracondylar fracture (peds FOOSH): pres, nerves, management
- cant fully extend elbow -anterior interossueous ("OK"), median, radial - long arm cast x3 weeks > xray >> surgery if still displaced
58
fat pad signs elbow
ant= probable fracture post= definite fracture
59
buckle fracture
- MOA= 50% of peds FOOSH - removable splint/brace for 3 weeks, ok if they don't follow up
60
evidence based approach for nurse maids
hyperpronation of forearm
61
when to refer clavicle fracture
-skin tenting - NV compromise - significant displacement - overriding by >2cm
62
nerve compromised in scaphoid/distal radius fracture
median nerve, "ok" sign (displaced ones should be surgically repaired because prone to non-union)
63
jersey finger
- avulsion of FDP from distal phalynx - can't flex DIP - needs surgery
64
boutonneire deformity
"jammed finger" splint PIP in extension for 6 weeks, then night splints 4-6 weeks
65
ottawak ankle
malleolar pain or navicular/5th met pain AND inability to take 4 steps
66
mgmt oof AC joint injury
I-III= non op in sling for comfort IV-VI= surgery

ABFM questions (11 decks)

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