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STEP 2 AG > MSK/Rheum/Derm > Flashcards

MSK/Rheum/Derm Flashcards

1
Q

SLE

A

Sx: SEIZURES, autoimmune thrombocytopenia, anemia of chronic dz, CAN HAVE FEVER (no white count)
Dx: ANA (v sensitive) then anti-dsDNA, anti-Smith
Tx: hydroxychloroquine (retinopathy) cyclophosphamide (bladder cancer, MESNA)

***a/w avascular necrosis, mixed cryoglobulinemia, anti-phospholipid syndrome, splenic rupture

In pregnancy: AV block, flare can look like pre-e +MALAR RASH, ARTHRITIS, RBC CASTS, ANA, dec C3

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2
Q

Avascular necrosis

A

Sickle cell, steroids (SLE), infx, alcohol, renal tplant, gradual increasing pain, may not see on XR early, MRI more sens

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3
Q

Supracondylar fx

A

More common in kids, brachial artery/median nerve, compartment syndrome (swelling + intact pulse and neuro)

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4
Q

Systemic sclerosis

A

Diffuse (scl, topoisomerase, ILD, dysphagia smooth muscle atrophy fibrosis) vs cutaneous (CREST, centromere)

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5
Q

Atlantoaxial instability

A

Downs, upper motor signs, incontinence

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6
Q

Ringworm

A

Tinea corporis, topical clotrimazole or terbinafine, if doesn’t work can try PO (azole > griseofulvin side effects), can look worse in immunocomp pts DM HIV

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7
Q

Takayasu arteritis

A

Asian women 10-40 yo, aorta/big vessels, autoimmune, claudication, bruit, bp discrepancy, dx CT/MRI arterial wall thickening, Tx glucocorticoids

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8
Q

Allergic contact dermatitis

A

Vesicular rash exposed surfaces sometimes streaks type 4 hypersensitivity

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9
Q

Ankylosing spondylitis

A

Enthesitis early sign, Dx by XR, HLA-B27 is 90% sensitive but 5% specific cannot use to diagnose

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10
Q

Giant cell tumor

A

Young adult women, soap bubble lesions

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11
Q

Pemphigus vulgaris

A

desmosomes, IgG C3 intercellular deposits, tombstones, FLACCID bullae, Nikosky sign

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12
Q

Complex regional pain syndrome

A

After trauma/surgery, pain out of proportion, looks like an infection but nl inflammatory markers

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13
Q

When to XR an ankle

A

Point tenderness over malleolus, posterior, can’t bear weight >4 steps

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14
Q

Clavicle fracture

A

Middle 1/3 usually no surg but nd angiogram

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15
Q

Carpal tunnel

A

Diabetes!!, severe=loss of strength (sensation doesn’t count) or evidence on nerve imaging studies)–>surgery, otherwise try splint first

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16
Q

Amyloidosis

A

Can be 2/2 cancer/IBD/infx/arthritis/vasculitis, HEART STUFF, S4 pretty much every organ, dx abd fat pad aspiration bx, tx colchicine

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17
Q

Juvenile idiopathic arthritis

A

Non migratory, slower onset, can bear weight, maybe mild fever SEPTIC CANT BEAR WEIGHT

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18
Q

Osteoarthritis

A

MC, posture-dependent pain (if spine), tx quad strengthening

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19
Q

Rheumatoid arthritis

A

Periarticular erosions, RF, citrillunated protein, DMARDs folate inhibiting (methotrexate check LFTs hepatotoxic), tx ASAP
atlanto-axial, can have pleural exudative effusion

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20
Q

Squamous cell vs basal cell

A

SCC: sun-exposed surfaces, central ulceration, immunocomp, scarring, neuro sx (head&neck cervical LN referred otalgia)
BCC: skin-colored, telangiectasias, non-healing, crusting, much more common

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21
Q

Polymyalgia rheumatica

A

head, neck, shoulders, hip girdle, high ESR/CRP give low dose pred don’t need confirmatory testing, a/w GCA (aortic aneurysm)

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22
Q

Lichen planus

A

Hep C ACEi HCTZ, 5 p’s polygonal papules, plaques, pink/purple, pruritis flexural surfaces tx topical steroids

vag: fucked up red/inflamed ulcers white striae NOT Behcet, bx make sure it’s not cancer

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23
Q

Psoriatic arthritis

A

DIPs, nails, prednisone

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24
Q

Tophaceous gout

A

Looks like giant nodules

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25
Q

Transient sinovitis

A

Can bear weight!! Can see b/l effusion on US, preceding viral illness

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26
Q

Charcot joint

A

Denervation leads to altered mechanics and joint deformation

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27
Q

Behcet disease

A

Middle eastern Turkish Asian, ulcers (oral and genital), erythema nodosum, uveitis

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28
Q

Polymyositis/Dermatomyositis

A

Anti-Jo, Anti-Mi-2, prox muscle weakness w/o pain, dermatomyositis +heliotrope rash +Gottrons finger nodules +periorbital edema, dx Ab CK or muscle bx, tx pred, a/w cancer

29
Q

Quadriceps tendon rupture

A

Low patella (vs patellar tendon rupture patella will be high)

30
Q

Antiphospholipid syndrome

A

LONG PTT (lab artifact) Anti-cardiolipin, anti-beta2-glycoprotein, CVA/other thrombotic event/preg probs, ACs for lyfe, if SLE add hydroxychloroquine (side effect retinopathy) pos RPR

31
Q

Paget dz of bone

A

HA, may have no sx, Ca Phos nl, inc alk phos, inc urine hydroxyproline
LYTIC focal osteoClasts (MM systemic sx, osteomalacia diffuse)

32
Q

Molluscum contagiosum

A

POXVIRUS flesh colored umbilicated papules, 6-12 mo, worse in HIV

33
Q

SCFE

A

SURGICAL PINNING

34
Q

Kawasaki disease

A

tx aspirin & IVIG

35
Q

Myasthenia gravis vs LE

A

LE +autonomic sx (dry mouth), DECREASED DTRs, gets better w/ repetition, dx by repetitive nerve stimulation
MG nicotinic receptors, ptosis, ice pack test/edrophonium, get chest CT for thymoma, tx pyridostigmine, immunosuppresant
MYASTHENIC CRISIS acute resp failure tx plex or IVIG

36
Q

Actinic keratosis

A

white flaky sun-exposed, can do nothing or cryo or fluorouracil topical if really bad, can turn into SCC

37
Q

Secondary gout causes

A

PV or other myeloprolif disorder, Lesch-Nyhan, xanthine deficiency, CKD, thiazides

38
Q

meniscal tear

A

Click w/ McMurray, MRI, surg if impairing function or effusion >3w

39
Q

Felty syndrome

A

Untreated RA –> neutropenia<2,000, frequent sinus infx, splenomegaly

40
Q

Pseudogout

A

Hemochromatosis/hyperPTH/hypothyroid, Ca crystals rhomboid positively birefringent, usually the knee/monoarticular, trauma/overuse/surgery/illness, chondrocalcinosis

41
Q

Bullous pemphigoid

A

PD, MS, cancer pts, IgG C3 LINEAR along membrane, tx topical clobetasol

42
Q

Langerhans cell histiocytosis

A

bones, skin, LAD, HSM, central diabetes insipidus, benign but locally destructive, tx prednisone or curettage

43
Q

Epidermal inclusion cyst

A

comes and goes, can do nothing or I&D if infected

44
Q

Lyme dz

A

Months–can get arthritis

45
Q

Serum sickness-like reaction

A

1-2 w after penicillin, fever urticaria polyarthralgia kind of looks like ARF but in a pt who got tx

46
Q

Age-related sicca syndrome

A

dry eyes and mouth, dec exocrine fxn, eye drops

47
Q

Psoriasis

A

sudden onset severe HIV, can be exacerbated by contact irritation

48
Q

Ichthyosis vulgaris

A

Chronic genetic condition scaling

49
Q

Lumbar strain

A

NSAIDs, PT if persistent >6w

50
Q

Septic arthritis

A

vanc for MRSA coverage, gram neg (klebsiella) also common, add CTX if not getting better RA IS A RF

51
Q

Stress fracture

A

POINT TENDERNESS, skinny pt (shin splint will be diffusely tender, fat pt)

52
Q

Shingles

A

NSAIDs, >4mo gabapentin or TCA

53
Q

Henoch-Schonlein purpura

A

Abd pain, IgA, arthralgias, hematuria, INTUSSUSCEPTION

54
Q

Pressure ulcers

A

Pillows

55
Q

Midshaft humerus fx

A

Radial nerve

56
Q

Pyoderma gangrenosum

A

Crohns, UC, granulomatosis w/ polyangiitis

57
Q

Melanoma

A 
A - asymmetric
B - irregular borders
C - colors
D - diam>6mm
E - evolution
58
Q

Brown recluse spider bite

A

Ulcerated lesion–> eschar +/- debridement

59
Q

Gout tx

A

Acute indo COLCHICINE if CV risk pt

60
Q

Joint fluid analysis

A

nl: <200
OA: 200-2K
RA: 2-100K
Septic: 50-150K

61
Q

How to treat a sunburn

A

NSAIDs

62
Q

Iliotibial band syndrome

A

Lateral femoral epicondyle Noble test (pes anserina medial)

63
Q

Erythema multiforme

A

a/w HSV, mycoplasma (don’t get mixed up w/ Lyme, these are a LOT of lesions usually extremities Lyme more truncal)

64
Q

Acne step-up

A

Topical retinoids –> benzoyl peroxide –> (COMEDONAL salicylic acid) –> topical abx –> PO abx –> (CYSTIC PO istotretinoin)

65
Q

Shoulder dislocation

A

Posterior=seizure

66
Q

MCL tear

A

abduction (valgus) laxity NOT MENISCUS (meniscus has clicking Lachman’s test)

67
Q

Duchenne muscular dystrophy

A

GOLD STANDARD DX genetic testing

68
Q

Eczema herpeticum

A

HSV infx in pt w/ eczema (asthma/atopy on test), new lesions, ND ACYCLOVIR

STEP 2 AG (16 decks)

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