MSK rheum ortho Uworld Flashcards by Amanda Beach

associated conditions with pyoderma gangrenosum

IBD
arthropathies
hematologic conditions

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Tx pyoderma gangrenosum

local or systemic corticosteroids

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Tx for non displaced scaphoid ractures

wrist immobilization for 6-10 weeks

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rotator cuff tear

weakness with abduction and external rotation

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young boy with single lytic lesion in humeral head

mild hypercalcemia

langerhans histiocytosis

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solitary long bone lytic lesions

histiocytosis X or langerhans cell granulomatosis

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Tx osgood schlatter

activity restriction, stretching and NSAIDs

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young woman with fatigue weight loss, inflammatory arthritis and pericardial friction rub
also has edema and proteinuria

SLE

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lab abnomralities in SLE

anemia, leukopenia, thrombocytopenia
+ANA and + dsDNA and +ant Sm
low C’ and increased IC

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peak incidence acute rheumatic fever

5-15

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major criteria for acute rheumatic fever

JONES
joints-migratory arthritis
carditis
nodules- subcutnaeous
erythema marginatum
syndeham chorea

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Tx for Acute rheumatic fever

penicillin to prevent

during strep pyogenes GAS infection

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12 year old boy with low back pain and palpable step off

spondylolithesis

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triad of gonococcemia

polyarthralgia, tenosynobitis and painless vesiculopistular lesions

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purulent arthritis in sexually active individual

gonococcal arthritis until proven otherwise

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common complaint of sjogrens patients

dyspareunia

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Osteogenesis imperfecta

CT disorder
auto dominant
COL1A1

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manifestations OI

blue sclerae, osteopenia, hearing loss, hypotonia, easy bruising
dentinogenesis imperfecta- weak enamel

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fever and acute monoarticular arthritis

next step

synovial fluid analysis to rule out septic arthritis

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when is it not necessary to treat metatarsus adductus

when the feet overcorrect both passively and actively into abduction

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morton neuroma

pain between 3rd and 4th toes

clicking sensation when palpating this space and squeezing the metatarsal joints

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tarsal tunnel syndrome

compression of tibial nerve at ankle causing burning, numbness and aching of distal plantar surface of foot/toes

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violaceous slightly scaly papules over joints

gottrons papules- dermatomyositis

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Ab with dermatomyositis

anti Jo 1 and ant Mi2- against helicase

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high risk for what with dermatomyositis

internal malignancies ovarian, lung, pancreatic, stomach and colorectal ca non hodgkin lymphoma

acute monoarticular arthritis with chondrocalcinosis

pseudogout

if patient has pseudogout check for what else?

secondary cause hyper PTH hypothyroid hemochromatosis

iron pannel in hemochromatosis

increased serum iron, ferritin and transferrin

Tx for herniated disk without neurologic Sx

early mobilization, muscle relaxants and NSAIDs

if have raynauds, order what

CBC with CMP UA ANA and RF ESR and C' levels

most common cause viral arthritis

parvo b19

msot significant risk factor for developing osteoporosis in someone who exercises is overweight drinks plenty of milk and alcohol

excess alcohol intake

coagulation abrnoamlity in antiphospholipid syndrome

APTT prolongation not fixed by plasma mixing

Ab in antiphospholipid Ab syndrome

anticardiolipin | anti beta 2 glycoprotein I

next step if patient presents with sciatica

back XR and ESR

how to prevent gout

``` weight loss low fat diet decreased seafood and red meat protein from vegetables avoidance organ rich foods like liver avoid beer avoid diuretics ```

Ab in systemic sclerosis

anti topoisomerase I

sequelae of systemic sclerosis

HTN R heart failure from pulm arterial HTN esophageal and gastric dymotility

anti mitochondrial Ab

Primary biliary cirrhosis

supracondylar fracture of humerus at risk for

injury to brachial artery

causes of acquired torticolis

URI, minor trauma and cervical lymphadenitits

Dx for torticollis

XR of cervical spine

adverse effect hydroxychloroquine

retinopathy

adverse effects of MTX

hepatotoxicity stomatitis cytopenias

side effects sulfasalazine

hepatotoxicity stomatitis hemolytic anemia

complications of kawasaki

coronary artery aneurysms | MI and ischemia

labs in pagets disease of bone

elevate alk phos | normal Ca and phosphorus

most common cause of asymptomatic elevation of alk phosphatase in elderly patient

pagets disease of bone

common heart finding in ankylosing spondylitlis

aortic regurg

what happens in systemic sclerosis that causes esophgeal dysmotility

smooth muscle atrophy and fibrosis

Tx pagets disease of bone

alendronate

what cause pagets

osteoclastic bone resorption

how do bisphosphonates work

inhibit osteoclast

which part of axial skeleton does RA affect

cervical spine

pain of hip OA is where

groin, buttock or pelvis that can radiate to lower thigh or knee

common XR findings in OA

loss of joint space, osteophytes and subchondral sclerosis

long term glucocorticoids can cause hip pain how

osteonecrosis of hip

bouchard and heberden nodules

caucasian female with long Hx polyarthritis with fatigue, low grade fever, weakness weight loss MTX, naproxen, ranitidine deformed hand joints, soft tender mass in right popliteal fossa mass is what?

inflamed synovium | patient has RA

Dx patellofemoral syndrome

patellofemoral compression test

pain inferior to patellar

patellar tendonitis

tenderness to gentle percussion over spine in IV drug user

vertebral osteomyelitis

rachitic rosary

enlarged costochondral joints | rickets

Tx for raynauds

CCB

triggers for gout

``` heavy alcohol consumption intake of urate rich foods trauma/surgery dehydration medications that raise uric acid like thiazide and cyclosporine ```

what is reactive arthritis

from chlamydia

Tx reactive arthritis

NSAIDs

most important risk factor for osteoporosis

``` post menopausal state then smoking, lack weight bearing low BMI heavy alcohol low Ca and Vit D corticosteroid use ```

recommended screening for osteoporosis

DEXA for all women >65

whipple disease presentation

malabsorptive diarrhea, protein losing enteropaty weight loss migratory arthritis lymphadenopathy and low grade fever

What causes whipples

gram + bacillus tropheryma whippelii

Dx whipples

small intestine Bx and PCR

Bx findings in whipples

PAS+ macrophages in lamina propria with non acid fast gram + bacilli

giant cell arteritis Sx

HA, jaw claudication, muscle fatigue, visual disturbance

what is a complication of giant cell arteritis

aortic aneurysm-- do serial CXR

hypodense lesion on XR in long bone in adolescent

osteoid osteoma

meniscal calcification occurs with what joint problem

pseudogout from more calcium pyrophosphate

abnormal hip maneuvers in child under 6 months old

hip US

abnomral hip maneuvers in child more than 6 mo old

hip XR

Tx RA

DMARD ASAP like MTX

before starting MTX check for

Hep B C and TB

exam findings in ankylosing spondylitis

arthritis reduced chest expansion and spinal mobility enthesitis (tenderness at tendon insertion sites) dactylitis (swelling fingers and toes) uveitis

viral arthritis

symmetric small joint inflammtory arthrits

complication ankylosing spondylitis

anterior uveitis

Tx radial head subluxation

hyperpronation | or supination with flexion at elbow

distal femur has centraly lytic lesion with onion skinning and moth eaten appearance with extension into soft tissue

ewings

amyloidosis can be secondary to

``` inflammatory arthritis chronic infections IBD malignancy vasculitis ```

Tx for amyloidosis

cochicine

nephrotic syndrome, hepatomegaly | ventricular hypertrophy and recurrent pulmonary infections

secondary amyloidosis

what antibiotics cause serum sickness like reaction

antibiotics (beta lactams sulfa)

clinical features serum sickness-like reactoin

fever, urticaria and polyarthralgia | HA edema, lymphadenopathy and splenomegaly

complication of RA in women

generalized bone loss and osteoporosis/osteopenia

what is dactylitis

sausage digit | psoriasis

pulmonary involvement in systemic sclerosis

interstitial lung disease- pulm fibrosis

next step after identifying hip fracture in elderly patient

EKG, cardiac markers and CXR

antimetabolit drug in RA

MTX

prolonged morning stiffness

macrocytic anemia from drug, which one

MTX because interferes with folic acid

flexion helping with back pain

spinal stenosis

imaging if suspect ankylosing spondylitis

XR SI joint

clinical findings in behcet

``` recurrent painful oral apthous ulcers genital ulvers eye lesions skin lesions thrombosis ```

biopsy of behcet

nonspecific vasculitis of different sized vessels

ethnicities with behcets

turkish, middle eastern, asian

most common cause erythema nodosum

recent strep infection

causes of erythema nodosum

sarcoid, TB, histo, IBD

causes of gout

primary myeloproliferative/lymphoproliferative tymor lysis syndrome leschnyhan chronic kidney disease thiazide/loop

pruritis after hot bath

polycythemia vera

neurogenic claudication

pain of spinal stenosis | worsens the narrowing of the canal when standing and walking