MSK/Rheum

Question 1

How does an ankylosing spondylitis patient typically present?

Answer 1

Present with low back pain and stiffness, patient is usually a young male in his 20s

Question 2

What is the “buzzword” for Ankylosis spondylitis?

Answer 2

“bamboo sign” on x-ray

Question 3

In order to diagnose someone with kyphosis, the Cobb angle must be greater than what?

Answer 3

45 degrees. Angle of 20 to 45 is normal.

Question 4

If someone has kyphosis, you brace them if the angle is between ______ and ______. and you do surgery if the angle is greater than _______.

Answer 4

50 and 70.

70.

Question 5

This presents with radiculopathy or neurogenic claudication with exercise. Pain is relieved with forward bending “shopping cart sign”.

Answer 5

Spinal stenosis

Question 6

Where is the most common place to have a herniated nucleus pulpous?

Answer 6

L5-S1

Question 7

How do we treat spinal stenosis?

Answer 7

NSAIDs, short course of steroids, epidural injection, and surgery

Question 8

what is the appropriate management for scoliosis?

Answer 8

Observation

if cobb angle is greater than 30, brace.

If angle is greater than 50, surgery.

Question 9

What is the name of the test when you ask the patient to bend over and look for scoliosis?

Answer 9

Adams test

Question 10

What are some “red flag symptoms” if someone presents with low back pain?

Answer 10

weight loss, age over 50, history of cancer, night time pain, and fever.

Question 11

What is a good test to do on PE if you suspect sciatica?

Answer 11

Straight leg raise

Question 12

True or False, Bouchard nodes affect the PIPs and are a sign of osteoarthritis.

Answer 12

True.

Bouchard affect PIPs and Herberden nodes affect the DIPs

Question 13

When should we start screening women for DEXA scans? and how often should we repeat them?

Answer 13

65

at least 2 years before repeating

Question 14

Osteopenia is defined as a t-score of what? what about osteoporosis?

Answer 14

Osteopenia: t score between 1-2.5
Osteoporosis: t score greater than 2.5

Question 15

How do we treat osteomyelitis?

Answer 15

6 weeks of IV antibiotics – vanco

Question 16

Osteosarcoma presents with what type of pattern on x-ray?

Answer 16

Sunburst

Question 17

What is chondrosarcoma?

Answer 17

Tumor in the cartilage – usually older adults

Question 18

Ewing sarcoma presents with what type of pattern on x-ray?

Answer 18

onion peel

Question 19

What are the four muscles of the rotator cuff?

Answer 19

SITS muscles

Supraspinatus, infraspinantus, teres minor, subscapularis

Question 20

What are some tests you can do to look for impingement syndrome?

Answer 20

Hawkins test, drop arm test, Neers test

Question 21

Lateral epicondylitis (tennis elbow) is due to what?

Answer 21

excessive pronation and wrist extension

Question 22

Medial epicondylitis (golfer’s elbow) is due to what?

Answer 22

repetitive wrist felxion

Question 23

What presents with pain at the radial wrist, radiates to forearm, especially with thumb extension and gripping. Also has a positive Finkelstein’s test.

Answer 23

DeQuervian’s

Question 24

How do we treat carpal tunnel?

Answer 24

Wrist immobilization at night – if not improved can do surgery.

Question 25

What are the two PE tests to look for carpal tunnel?

Answer 25

Phalen’s and Tinel’s

Question 26

Gamekeeper’s thumb is due to a _____________ injury.

Answer 26

hyperabduction

Question 27

MCL strain is caused by a ______ force.

LCL strain is caused by a _____ force.

Answer 27

Valgus

Varus

Question 28

Anterior drawer and Lachman’s test, look for?

Answer 28

ACL injury

Question 29

How do people typically tear their PCL?

Answer 29

dashboard injury or fall on flexed knee

Question 30

Locking, popping, giving way are common symptoms of what knee injury?

Answer 30

Meniscal injuries

Question 31

Meniscus tears may present with a positive ______ sign.

Answer 31

McMurray’s

Question 32

What is the name of the disease that is caused by osteochondritis of the patellar tendon at the tibial tuberosity?

Answer 32

Osgood Schlatter’s

Question 33

Slipped capital femoral epiphysis is due to the femoral head slipping _______ and ______ at the growth plate.

Answer 33

Posterior and inferior

Question 34

How do you treat SCFE?

Answer 34

ORIF and crutches

Question 35

What are the names of the test to look for developmental dysplasia?

Answer 35

Ortolani (abd and anterior pull) and Barlow (add + post push)

Question 36

Male with an inflamed/tender toe, think of?

Answer 36

Gout

Question 37

How do we treat gout in both the acute and chronic setting?

Answer 37

Acute: 1. NSAIDS 2. colchicine 3. corticosteroids
Chronic: Allopurinol + lifestyle modifications (avoid seafood, red meats, EtOH)

Question 38

Can you start allopurinol during an acute attack of gout?

Answer 38

No

Question 39

What presents with fatigue, arthritis, malar rash (cheeks and nose), discoid rash (scaling rash), and photosensitivity?

Answer 39

Systemic Lupus Erythematous

Question 40

How do you diagnose SLE?

Answer 40

ANA (1:160) and DS DNA anti-smith antibodies

Question 41

What is Reiter’s syndrome?

Answer 41

Reactive arthritis.

Infection, then weeks later joint pain.