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MSK > MSK MDT > Flashcards

MSK MDT Flashcards

1
Q

What is a major cause of chest pain in the ambulatory setting?

A

Costochondritis

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2
Q

Chest pain from costochondritis is said to be what?

A

Reproducible

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3
Q

What dx should you r/o before considering costochondritis

A

Myocardial ischemia
Infarction
Pulmonary embolism
Aortic dissection
Pneumothorax

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4
Q

Treatment for costochondritis

A

NSAIDS, HEP, Activity mods

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5
Q

Risk factors for osteoarthritis

A

Age: >50
Gender: greater risk in females
Joint injuries, chronic inflammation
Obesity, occupation
Heavy work load

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6
Q

What percentage of knee joints account for osteoarthritis cases

A

80%

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7
Q

Common sites of osteoarthritis

A

Hips, knees, spine and hands

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8
Q

Pt presents with:
-Pain exacerbated with use, alleviated with rest
-Pain is aching, deep in later stages
-Sharp pain in beginning stages

A

osteoarthritis

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9
Q

Rads for osteoarthritis

A

Plain films reveal: joint space narrowing, osteophytes, subchondral sclerosis, cysts

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10
Q

Treatment of osteoarthritis

A

Pain control
Activity/lifestyle modifications
Weight reduction

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11
Q

Examples of inflammatory arthroses

A

Rheumatoid arthritis, reactive arthritis, psoriatic arthritis, ankylosing spondylitis

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12
Q

Which joints are commonly effected by RA

A

Small and bilateral joints: hands, finger, wrists, feet, ankle

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13
Q

Pt presents with:

4 of 7 criteria
Morning stiffness
Arthritis
Swelling of hand joints
Symmetrical joint swelling
Rheumatoid nodules
Positive RF factor
Erosions or osteopenia in hand XR
Myelopathy with C1-C2

A

Rheumatoid arthritis

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14
Q

Labs for RA

A

RF
Antibody cyclic citrullinated peptide (anti-CCP)
C-reactive protein (CRP)
Erythrocyte sedimentation rate

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15
Q

Rads for RA

A

Plain films: may show osteopenia and mild soft tissue swelling along with erosions

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16
Q

Treatment for RA

A

MED ADVICE
NSAID/Tylenol
DMARD (Disease-modifying anti-rheumatic drug)
- Ab, etanercept, methotrexate, hydroxycholoquine, cyclosporine
PT/surgery

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17
Q

What causes reactive arthritis

A

UTI
Diarrheal
STI

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18
Q

Pt presents with:

-Acute onset of joint pain 1-4weeks after infection
-Sausage digits
-Lower back pain
-Nail changes, conjunctivitis, anterior uveitis, oral lesions

A

reactive arthritis

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19
Q

Treatment of reactive arthritis

A

Treat infection
Self limiting (may be up to 6 months)
NSAIDS for pain

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20
Q

What is psoriatic arthritis

A

Inflammatory arthritis associated with psoriasis

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21
Q

What is ankylosing spondylitis

A

Inflammatory arthritis of the spine

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22
Q

Sx of ankylosing spondylitis

A

“bamboo spine”

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23
Q

What is gout

A

Monosodium urate crystal deposition in joints and tissues

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24
Q

Common sites of gout

A

1st toe, ankle, wrist, fingers, elbow

25
Q

Labs for gout

A

Uric acid, chem panel, TSH, iron panel, WBC

26
Q

Rads for gout

A

Plain films: erosions and peripheral spurs, soft tissue swelling

27
Q

Treatment for gout

A

NSAID (indomethacin)
Colchicine
Steroids

28
Q

Prophylaxis of gout

A

Allopurinol (overproducer)
Probenecid (underexcreter)

29
Q

What should patients with gout avoid eating

A

Meat, seafood, alcohol, high fructose corn syrup

30
Q

How is pseudogout and gout differentiated

A

Labs

31
Q

What will uric acid levels be in pseudogout

A

Normal

32
Q

Pathophysiology of pseudogout is

A

Based on pyrophosphate deposition

33
Q

What is septic arthritis

A

Infection of joint space

34
Q

What is the most common cause of septic arthritis

A

Staphylococcus aureus

35
Q

Labs for septic arthritis

A

CBC, ESR, CRP

36
Q

Rads for septic arthritis

A

Plain films
MRI

37
Q

Treatment for septic arthritis

A

Supportive if having shock
IV antibiotics
MEDEVAC

38
Q

What is virchow’s triad

A

Hypercoagulability
Venous stasis
Endothelial damage

39
Q

DVT will often become what in most cases?

A

Pulmonary embolism

40
Q

Pt presents with:
-Pain in limb
-Edema (unilateral)
-Erythema

A

Deep vein thrombosis

41
Q

What is a special test for DVT?

A

Homan’s sign (pain w/dorsiflexion)

42
Q

What is a fracture

A

Disruption in the bone from repetitive or forceful trauma

43
Q

Pt presents with:
-Severe pain, swelling, decreased mobility
-Limited weight bearing
-Numbness, tingling, pallor, ecchymosis, deformity

A

Fracture

44
Q

What is the difference between an open and closed fracture

A

Open: bone through skin or break in skin
Closed: Intact skin

45
Q

What is a non-displaced fracture?

A

Anatomic alignment

46
Q

What is a displaced fracture?

A

Not in anatomic alignment, described as a percentage

47
Q

What is a bayonetted fracture?

A

Distal fragment overlaps proximal fragment

48
Q

What is a distracted fracture?

A

Fragments are separated

49
Q

What is angulation fracture?

A

Deviation at an angle

50
Q

Rads for fracture

A

Plain films (AP, lateral, oblique) above and below joint
Consider CT, MRI, US, bone scan

51
Q

Treatment for fractures

A

Recognition
Reduction
Retention of reduction
Rehabilitation

52
Q

What do you check before and after splinting

A

Pulses and sensations

53
Q

How do you splint femoral fractures

A

Traction

54
Q

How do you splint spine fractures

A

Spine board/C-collar

55
Q

How do you splint clavicular fractures

A

Sling

56
Q

How do you splint pelvic fractures

A

Pelvic binder

57
Q

What factors increase healing of fractures

A

Skeletal immaturity
Transverse fractures
Prescence of adjacent bone for support
Anatomic alignment

58
Q

Factors that decrease healing

A

Smoking
Skeletal maturity
Oblique/comminuted/segmental fractures
Marked displacement
Interarticular fracture

MSK (9 decks)

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