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PANCE/EOC > MSK/Rheum #4 > Flashcards

MSK/Rheum #4 Flashcards

1
Q

Sjogren Syndrome is an autoimmune disease affecting what type of glands?

A

Exocrine glands

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2
Q

Symptoms of Sjogren Syndrome

A
  • Xerostomia (dry mouth)
  • Dry Eyes (Keratoconjunctivitis sicca)
  • Vaginal dryness (Dyspareunia)
  • Bilateral parotid gland enlargement
  • Dental Caries
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3
Q

Screening labs for Sjogren Syndrome

A

-AntiSS-A (Ro) and antiSS-B (La) best initial

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4
Q

Other diagnostics for Sjogren’s

A
  • Positive Schirmer Test: < 5 mm of tears production
  • Rose Bengal Stain: abnormal corneal epithelium
  • Definitive: Lip or parotid gland biopsy
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5
Q

Treatment for Sjogren’s Syndrome

A
  • Artificial tears, Increase fluid intake, Fluoride treatments
  • Cholinergic Drugs: Pilocarpine
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6
Q

With Sjogren’s, there is an increased risk of

A

Non-Hodgkin Lymphoma

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7
Q

Side effects of Pilocarpine

A

-Diaphoresis, flushing, sweating, bradycardia, diarrhea, nausea, vomiting, blurry vision

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8
Q

Describe the MC demographics and presentation of a patient with SCFE

A

13 year old African American athletic obese male with insidious hip/thigh/knee pain and a limp

-Externally rotated leg on affected side

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9
Q

What is seen on a radiograph of a patient with SCFE?

A

Posterior displacement of femoral epiphysis (ice cream slipping off cone)

-Best seen on frog leg lateral pelvis

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10
Q

Treatment for SCFE

A

Non-weightbearing with crutches followed by ORIF (increased risk of AVN)

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11
Q

Mechanism of action for a Smith and Colles Fracture

A

FOOSH

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12
Q

What is a Smith Fracture

A

Extra-articular distal radius fracture with ventral angulation of distal fragment

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13
Q

What is seen on physical exam for a smith fracture?

A

Garden spade deformity

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14
Q

Radiographs of a Smith Fracture show…

A

-Ventrally displaced or angulated fracture of the distal radius

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15
Q

Treatment for Smith Fracture

A

-Closed reduction followed by sugar tong splint or cast

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16
Q

What is spinal stenosis?

A

Narrowing of the spinal canal with impingement of the nerve roots

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17
Q

Symptoms of spinal stenosis

A
  • Back pain, numbness, paresthesias
  • Worse with extension
  • Better with flexion (shopping cart sign), walking uphill, cycling
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18
Q

Diagnostic of choice for spinal stenosis

A

MRI

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19
Q

Treatment for spinal stenosis

A
  • Conservative: Pain control, PT, injections

- Surgical: if refractory or no improvement

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20
Q

What is on history for a person with a synovial cyst?

A

MC in lumbar region of spine

  • Back/leg pain that is better when sitting
  • worse when standing/walking
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21
Q

Risk Factors for SLE

A
  • Young female
  • AA
  • Sun exposure
  • Estrogen (OCP
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22
Q

Clinical Manifestations of SLE

A
  • Triad: Joint pain, fever, malaria rash
  • Fever, night sweats, fatigue
  • Oral ulcers, retinitis, alopecia, glomerulonephritis
23
Q

Diagnostics and antibodies for SLE

A
  • ANA: screening (not specific)
  • Anti-double stranded DNA and Anti-Smith: specific for SLE
  • Depressed levels of serum complement (C3 and C4)
  • Antiphospholipid antibodies: increased risk of arterial and venous thrombosis
24
Q

Treatment for SLE

A
  • Sunscreen and avoid sun exposure
  • Hydroxychloroquine for skin lesions
  • With or Without NSAIDs
  • For severe: high-dose glucocorticoids or intermittent IV pulses of Methylprednisone
25
Q

what is the treatment for Torticollis

A

Conservative therapy

26
Q

Torticollis can be congenital (_____) or acquired (____)

A
  • Local trauma of soft tissues of neck during delivery

- Blunt trauma to head/neck, sleeping in awkward position, medications, infections, etc.

27
Q

Transient Synovitis is the MC cause of acute hip pain in children aged 3-10 years old. What does it come after and what does it cause?

A
  • Comes after recent URI, pharyngitis, bronchitis, or otitis media
  • Arthralgia, unilateral hip or groin pain
28
Q

Treatment for traumatic soft tissue injury

A

RICE and NSAIDs

29
Q

What are some etiologies of a vertebral compression fracture?

A
  • Burst fractures occur in children jumping/fall from height

- Elderly, malignancy

30
Q

Symptoms of vertebral compression fracture

A

-Localized back pain with focal midline tenderness at level of fracture

31
Q

An xray for a vertebral compression fracture shoes

A

-Loss of vertebral height ( <20%)

32
Q

When a patient has an open wound on the hand, what should you do?

A
  • Thoroughly irrigate, check for bite wounds
  • ABX if bite wound
  • May leave open depending on location and risk of infection
  • Tetanus booster!
33
Q

What organism is the most notable in all age groups for septic arthritis?

A

Staph Aureus

34
Q

What other organism is prevalent in sexually active young adults for septic arthritis?

A

Neisseria Gonorrhea

35
Q

Symptoms of septic arthritis

A
  • Swollen warm, tender, painful joint with decreased ROM

- Fever, chills, myalgias, malaise

36
Q

Best initial and most accurate test for septic arthritis

A

-Arthrocentesis: WBC > 50,000 (primarily neutrophils)

37
Q

Treatment for Septic arthritis

A
  • No organism seen (Empiric): Ceftriaxone + Vanco
  • Gram Positive Cocci: Vanco
  • Gram Negative Cocci/Gonorrhea: Ceftriaxone
38
Q

Risk Factors for Developmental Dysplasia of the Hip

A

Breech presentation at delivery, first-born children, females, positive family history

39
Q

Describe what Ortolani and Barlow Maneuvers do

A

Ortolani: reduces the hip joint
Barlow: dislocates the hip joint

40
Q

Treatment for Developmental Hip Dysplasia of the Hip

A

< 6 months: Pavlik Harness
6 months - 2 years: closed reduction in OR

Routine hip radiographs until skeletally mature

41
Q

Posterior hip dislocations are the MC Type of dislocation. What is seen on exam of a hip that is posteriorly dislocated?

A

Hip pain with leg shortened, internally rotated, and adducted

42
Q

Treatment for posterior hip dislocation

A

Closed reduction under conscious sedation

43
Q

Symptoms of osgood-Schlatter Disease

A

-Activity related anterior knee pain and swelling (swelling and tenderness to anterior tibial tubercle)

44
Q

Risk Factors for Osgood-Schlatter Disease

A
  • Males
  • 10-15 years old
  • During growth spurts
  • Athletes
45
Q

What ligament is most commonly injured in a lateral ankle sprain?

A

ATFL (main stabilizer during inversion)

46
Q

In a medial ankle sprain, what ligament is usually injured?

A

Deltoid ligament

47
Q

Regarding the Ottawa Ankle Rules, when should you get ankle films?

A
  • Inability to walk > 4 steps at time of injury in the ER
  • Pain along lateral malleolus
  • Pain along medial malleolus
48
Q

According the Ottawa Ankle Rules, when should you get foot films?

A
  • Inability to walk > 4 steps at time of injury in the ER
  • Navicular (mid foot) pain
  • 5th metatarsal pain
49
Q

Symptoms and Risk factors for Achilles Tendon Rupture

A
  • Sudden heel pain after push-off movement, pop, sudden sharp calf pain
  • Inability to bear weight
  • Positive Thompson Test
  • Weekend warrior athletes
  • Fluoroquinolone use, corticosteroid injections, 30-50 years old
50
Q

Best test to assess for Achilles Tendon Rupture

A

MRI

51
Q

Weber Ankle Fracture Classification

A
  • Weber A: fibular fracture below syndesmosis
  • Weber B: fibular fracture at level of syndesmosis
  • Weber C: Fibular fracture above mortise (deltoid ligament damage)
52
Q

Tarsal Tunnel Syndrome is compression of the ____ nerve

A

Posterior tibial nerve

53
Q

Symptoms of Tarsal Tunnel Syndrome

A
  • Pain and numbness in the medial malleolus, heel, and sole.
  • Pain increases throughout the day and does not improve with rest
  • Positive Tinel Sign (tap posterior medial malleolus)
54
Q

What diagnostic confirms tarsal tunnel syndrome?

A

Electromyography

PANCE/EOC (63 decks)

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