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Step2CK > MSK rheum ortho Uworld > Flashcards

MSK rheum ortho Uworld Flashcards

1
Q

associated conditions with pyoderma gangrenosum

A

IBD
arthropathies
hematologic conditions

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2
Q

Tx pyoderma gangrenosum

A

local or systemic corticosteroids

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3
Q

Tx for non displaced scaphoid ractures

A

wrist immobilization for 6-10 weeks

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4
Q

rotator cuff tear

A

weakness with abduction and external rotation

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5
Q

young boy with single lytic lesion in humeral head

mild hypercalcemia

A

langerhans histiocytosis

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6
Q

solitary long bone lytic lesions

A

histiocytosis X or langerhans cell granulomatosis

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7
Q

Tx osgood schlatter

A

activity restriction, stretching and NSAIDs

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8
Q

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

A

SLE

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9
Q

lab abnomralities in SLE

A

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

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10
Q

peak incidence acute rheumatic fever

A

5-15

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11
Q

major criteria for acute rheumatic fever

A 
JONES
joints-migratory arthritis
carditis
nodules- subcutnaeous
erythema marginatum
syndeham chorea
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12
Q

Tx for Acute rheumatic fever

A

penicillin to prevent

during strep pyogenes GAS infection

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13
Q

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

A

spondylolithesis

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14
Q

triad of gonococcemia

A

polyarthralgia, tenosynobitis and painless vesiculopistular lesions

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15
Q

purulent arthritis in sexually active individual

A

gonococcal arthritis until proven otherwise

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16
Q

common complaint of sjogrens patients

A

dyspareunia

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17
Q

Osteogenesis imperfecta

A

CT disorder
auto dominant
COL1A1

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18
Q

manifestations OI

A

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

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19
Q

fever and acute monoarticular arthritis

next step

A

synovial fluid analysis to rule out septic arthritis

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20
Q

when is it not necessary to treat metatarsus adductus

A

when the feet overcorrect both passively and actively into abduction

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21
Q

morton neuroma

A

pain between 3rd and 4th toes

clicking sensation when palpating this space and squeezing the metatarsal joints

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22
Q

tarsal tunnel syndrome

A

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

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23
Q

violaceous slightly scaly papules over joints

A

gottrons papules- dermatomyositis

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24
Q

Ab with dermatomyositis

A

anti Jo 1 and ant Mi2- against helicase

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25
Q

high risk for what with dermatomyositis

A

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

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26
Q

acute monoarticular arthritis with chondrocalcinosis

A

pseudogout

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27
Q

if patient has pseudogout check for what else?

A

secondary cause
hyper PTH
hypothyroid
hemochromatosis

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28
Q

iron pannel in hemochromatosis

A

increased serum iron, ferritin and transferrin

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29
Q

Tx for herniated disk without neurologic Sx

A

early mobilization, muscle relaxants and NSAIDs

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30
Q

if have raynauds, order what

A

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

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31
Q

most common cause viral arthritis

A

parvo b19

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32
Q

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

A

excess alcohol intake

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33
Q

coagulation abrnoamlity in antiphospholipid syndrome

A

APTT prolongation not fixed by plasma mixing

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34
Q

Ab in antiphospholipid Ab syndrome

A

anticardiolipin

anti beta 2 glycoprotein I

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35
Q

next step if patient presents with sciatica

A

back XR and ESR

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36
Q

how to prevent gout

A 
weight loss
low fat diet
decreased seafood and red meat
protein from vegetables
avoidance organ rich foods like liver
avoid beer
avoid diuretics
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37
Q

Ab in systemic sclerosis

A

anti topoisomerase I

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38
Q

sequelae of systemic sclerosis

A

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

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39
Q

anti mitochondrial Ab

A

Primary biliary cirrhosis

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40
Q

supracondylar fracture of humerus at risk for

A

injury to brachial artery

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41
Q

causes of acquired torticolis

A

URI, minor trauma and cervical lymphadenitits

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42
Q

Dx for torticollis

A

XR of cervical spine

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43
Q

adverse effect hydroxychloroquine

A

retinopathy

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44
Q

adverse effects of MTX

A

hepatotoxicity
stomatitis
cytopenias

45
Q

side effects sulfasalazine

A

hepatotoxicity
stomatitis
hemolytic anemia

46
Q

complications of kawasaki

A

coronary artery aneurysms

MI and ischemia

47
Q

labs in pagets disease of bone

A

elevate alk phos

normal Ca and phosphorus

48
Q

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

A

pagets disease of bone

49
Q

common heart finding in ankylosing spondylitlis

A

aortic regurg

50
Q

what happens in systemic sclerosis that causes esophgeal dysmotility

A

smooth muscle atrophy and fibrosis

51
Q

Tx pagets disease of bone

A

alendronate

52
Q

what cause pagets

A

osteoclastic bone resorption

53
Q

how do bisphosphonates work

A

inhibit osteoclast

54
Q

which part of axial skeleton does RA affect

A

cervical spine

55
Q

pain of hip OA is where

A

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

56
Q

common XR findings in OA

A

loss of joint space, osteophytes and subchondral sclerosis

57
Q

long term glucocorticoids can cause hip pain how

A

osteonecrosis of hip

58
Q

bouchard and heberden nodules

A

OA

59
Q

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?

A

inflamed synovium

patient has RA

60
Q

Dx patellofemoral syndrome

A

patellofemoral compression test

61
Q

pain inferior to patellar

A

patellar tendonitis

62
Q

tenderness to gentle percussion over spine in IV drug user

A

vertebral osteomyelitis

63
Q

rachitic rosary

A

enlarged costochondral joints

rickets

64
Q

Tx for raynauds

A

CCB

65
Q

triggers for gout

A 
heavy alcohol consumption
intake of urate rich foods
trauma/surgery
dehydration
medications that raise uric acid like thiazide and cyclosporine
66
Q

what is reactive arthritis

A

from chlamydia

67
Q

Tx reactive arthritis

A

NSAIDs

68
Q

most important risk factor for osteoporosis

A 
post menopausal state
then
smoking, lack weight bearing
low BMI
heavy alcohol
low Ca and Vit D
corticosteroid use
69
Q

recommended screening for osteoporosis

A

DEXA for all women >65

70
Q

whipple disease presentation

A

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

71
Q

What causes whipples

A

gram + bacillus tropheryma whippelii

72
Q

Dx whipples

A

small intestine Bx and PCR

73
Q

Bx findings in whipples

A

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

74
Q

giant cell arteritis Sx

A

HA, jaw claudication, muscle fatigue, visual disturbance

75
Q

what is a complication of giant cell arteritis

A

aortic aneurysm– do serial CXR

76
Q

hypodense lesion on XR in long bone in adolescent

A

osteoid osteoma

77
Q

meniscal calcification occurs with what joint problem

A

pseudogout from more calcium pyrophosphate

78
Q

abnormal hip maneuvers in child under 6 months old

A

hip US

79
Q

abnomral hip maneuvers in child more than 6 mo old

A

hip XR

80
Q

Tx RA

A

DMARD ASAP like MTX

81
Q

before starting MTX check for

A

Hep B C and TB

82
Q

exam findings in ankylosing spondylitis

A

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

83
Q

viral arthritis

A

symmetric small joint inflammtory arthrits

84
Q

complication ankylosing spondylitis

A

anterior uveitis

85
Q

Tx radial head subluxation

A

hyperpronation

or supination with flexion at elbow

86
Q

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

A

ewings

87
Q

amyloidosis can be secondary to

A 
inflammatory arthritis
chronic infections
IBD
malignancy
vasculitis
88
Q

Tx for amyloidosis

A

cochicine

89
Q

nephrotic syndrome, hepatomegaly

ventricular hypertrophy and recurrent pulmonary infections

A

secondary amyloidosis

90
Q

what antibiotics cause serum sickness like reaction

A

antibiotics (beta lactams sulfa)

91
Q

clinical features serum sickness-like reactoin

A

fever, urticaria and polyarthralgia

HA edema, lymphadenopathy and splenomegaly

92
Q

complication of RA in women

A

generalized bone loss and osteoporosis/osteopenia

93
Q

what is dactylitis

A

sausage digit

psoriasis

94
Q

pulmonary involvement in systemic sclerosis

A

interstitial lung disease- pulm fibrosis

95
Q

next step after identifying hip fracture in elderly patient

A

EKG, cardiac markers and CXR

96
Q

antimetabolit drug in RA

A

MTX

97
Q

prolonged morning stiffness

A

RA

98
Q

macrocytic anemia from drug, which one

A

MTX because interferes with folic acid

99
Q

flexion helping with back pain

A

spinal stenosis

100
Q

imaging if suspect ankylosing spondylitis

A

XR SI joint

101
Q

clinical findings in behcet

A 
recurrent painful oral apthous ulcers
genital ulvers
eye lesions
skin lesions
thrombosis
102
Q

biopsy of behcet

A

nonspecific vasculitis of different sized vessels

103
Q

ethnicities with behcets

A

turkish, middle eastern, asian

104
Q

most common cause erythema nodosum

A

recent strep infection

105
Q

causes of erythema nodosum

A

sarcoid, TB, histo, IBD

106
Q

causes of gout

A

primary
myeloproliferative/lymphoproliferative
tymor lysis syndrome
leschnyhan

chronic kidney disease
thiazide/loop

107
Q

pruritis after hot bath

A

polycythemia vera

108
Q

neurogenic claudication

A

pain of spinal stenosis

worsens the narrowing of the canal when standing and walking

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