Musculo- Lower extremites Flashcards

1
Q

Shortened limb in external rotation

A

Hip fracture

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2
Q

Shortened limb in internal rotation

A

Hip dislocation

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3
Q

anterior or posterior more common for hip dislocation

A

posterior

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4
Q

no blood flow to bone -> bone death -> bone collapse -> joint destruction

A

Avascular necrosis

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5
Q

Barlow test

A

<3 months old

Hip dislocation

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6
Q

Ortolani test

A

< 3 months old

Hip Reolcation

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7
Q

key terms- histoyr of breech dlivery, baby has uneven gluteal folds, unequal femur lenghts

A

Hip Dysplasia

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8
Q

Treatment for Hip Dysplasia

A

Pavlik Harness Tips

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9
Q

key terms- young boy groin/knee pain

painless limp, decrease hip ROM

A

Legg-Calve-Perthes disease

-AVN of hip

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10
Q

key terms- flattened & fragmented frog leg x-ray

A

Legg-Calve-Perthes disease

- AVN of hip

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11
Q

Key terms- young/teenage boy who is African american, Hispanic, obese, hip, thigh, knee pain, external rotation of leg, internal rotation is painful

A

Slipped Capital Femoral Epiphysis

- often BILATERAL !

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12
Q

Xray of hip shows abnormal Klein line

A

Slipped Capital Femoral Epiphysis

Klein line- is a line that your draw on top of femoral neck and should intersect epiphysis

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13
Q

Treatment for Slipped Capital Femoral Epiphysis

A

Emergent Surgery !

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14
Q

widen hips that cause abnormal patella tracking - increased Q angle

A

Patellofemoral syndrome

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15
Q

key terms- increased Q angle, pain with stair climbing, pain with patellar compression, tighten quadriceps

A

Patellofemoral syndrome

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16
Q

key terms- knee twist or squat, locking, McMurray, apley & Thessaly positive

A

Meniscus tear

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17
Q

Apley grind test

A

person is laying on their belly
lift leg up in 90 degree
and push on foot and gride it
pain = torn meniscus

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18
Q

Thessaly test

A

person holds on to the exam table and bens knees a little and twists back and forth
pain = torn meniscus

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19
Q

what is the best test for ACL tear

A

lachmans

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20
Q

Tibial tubercule apophysitis in teenage boy

A

Osgood schlatter disease

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21
Q

key terms- patient states that it feels full behind one knee, you palpate a mass

A

Baker - popliteal cyst

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22
Q

medial or lateral patella dislocation most common?

A

Lateral

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23
Q

what is the most common artery and the most common nerve to be damaged in Knee dislocation

A

Popliteal artery !!!

Peroneal nerve

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24
Q

what are important diangositics to get on knee dislocatoin

A

important to remember that the knee can spontaneosuly relocation

  • ankel-brachial index
  • arteriography **
  • ultra sounds
  • CT angiography
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25
Q

Thompson test

A

Achilles tendon tear

squeezing calf and no plantar flexion

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26
Q

what are the most common ligaments injured in Ankle sprain

A

Anterior talofibular ligament *
Calcanelofibular ligment
Posterior talofibular ligment

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27
Q

Ottawa ankle rules

A
  1. Medial malleolus - tip 6cm above
  2. Lateral malleolus- tip 6cm above
  3. navicular
  4. base 5th metatarsal
  5. walk 4 steps
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28
Q

What are the grades of Ankle sprain

A

Grade 1- stretch ligment
Grade 2- Partial tear
Grade 3- complete tear

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29
Q

What is a Weber classification

A

how to classify a angle fracture

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30
Q

Weber A fracture

A

Fracture of the ankle below the syndesmosis

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31
Q

Weber B fracture

A

At the syndesmosis

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32
Q

Weber C fracture

A

Fracture of the ankle

above the syndesmosis

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33
Q

what is the most common type of ankle fracture

A

weber type B

at the syndesmosis

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34
Q

Maisonneuve fracture

A

Proximal 1/3 fibula fracture PLUS
widened syndesmosis
PLUS
Medial malleolus fracture

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35
Q

Inflammation of the plantar aponeurosis at calcaneal orgin

A

Plantar fasciitis

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36
Q

Key terms- sharp heel pain in the morning

A

Plantar fasciitis

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37
Q

Perineural fibrosis of the interdigital nerve of the 3rd and 4th MT head

A

Morton Neuroma

  • buring pain
  • walking on a marble
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38
Q

Medial deviation of the 1st MT head

A

Hallux valgus - Bunion

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39
Q

key terms- Midfoot tendreness, xray shows diastatsis 1st -2nd joint

A

Lisfranc injury

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40
Q

what joint holds the midfoot to the forefoot

A

Lisfranc joint

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41
Q

Avulsion fracture of teh peroneus brevis at the base of the 5th MT

A

Dancer Fracture

-inversion-plantar flexion

42
Q

Transverse fracture of the proximal 5th MT at teh metaphyseal-diaphyseal junction

A

Jones Fracture

43
Q

Heberden nodes

A

DIP nodes in osteoarthritis

44
Q

Bouchard

A

PIP joint nodes in osteoarthritis

45
Q

at what age to start bone density scan ?

A

women >65

men >70

46
Q

What is a normal T score

A
  • 1 to 1

- 1 to -2.5 osteopenia

47
Q

Treatment for osteoprosis

A
  1. exercise
  2. vit D
  3. bisphosphonates
  4. Raloxifene
48
Q

Key terms- history of injury to limb, extereme pain, intense pressure, numbness/tingling, muscle weakness, palor, decrease pulse in affected limb

A

Compartment syndrome

49
Q

How do you diagnose compartment syndrome

A

measure the tissue pressure >30mmHg

50
Q

treatment for compartment syndrome

A

Fasciotomy

51
Q

Most common organism with Acute Osteomyelitis

A

Staph aureus

52
Q

Most common organism with Acute Osteomyelitis & sickle cell

A

Salmonella

53
Q

Most common organism with Nongonococcal Septic arthritis

A

Staph aureus

if fake joint * coagulase negative staph !
usually less red & creats a biofilm

54
Q

Benign cartilaginous bone tumor most commonly found around the knee

A

Osteochondroma

55
Q

what is the most common benign tumor

A

Osteochondroma

56
Q

fluid filled bone lesiosn usually found posterior humerus/femur in teenagers

A

Unicameral bone cyst

57
Q

Mesencyme derived bone cancer producing malignant ostoid usually in distal femur

A

Osteosarcoma

58
Q

key terms- bone pain for weeks/months, swelling near joint, pain waking them up at night

A

Osteosarcoma

59
Q

xray- sun burst

A

Osteosarcoma

60
Q

most common malignant tumor of bone

A
Metastatic disease! 
came from somewhere else!!! 
BREASTS * 
LUNG
PROSTATE
61
Q

What key lab finding will be elevated in Metatstic bone cancer

A

Alkaline phosphatase

62
Q

Lab values for Septic Arthtitis
wbc
neturophils

A

wbc 50,000

neturophils 75%

63
Q

key terms: kid, distal femur pain

A

Osteochondroma

looks like an extra piece of bone at the end of long bones

64
Q

most common bening bone tumor

A

osteochondroma

65
Q

mesynchyme derived bone tumor

A

osteosacroma

66
Q

what is the most common bone cancer

A
  1. multiple myloma

2. osteosacroma

67
Q

key terms- xray onion peel, sunburst, periosteal reaction

A

osteosacroma

68
Q

most common location for osteosacroma

A

end of long bone

distal femur

69
Q

most common malignant tumor of bone

A

metastatic disease

  • breast
  • lung
  • prostate
  • kidney
70
Q

what lab value is elevated in metastatic bone cancer

A

Alkalne phosphatase !!!

71
Q

rhomboid shaped crystal

A

pseudogout

72
Q

x-ray with condrocalcinosis

A

pseudogout

73
Q

key terms rash of levido reticulars

molding

A

polyartirits nodasa

74
Q

key terms: rash on legs, arthritis pain, kidneys will be affected, maybe hep B, ANCA +, intrarenal aneursm

A

polyarititis nodsa

PAN

75
Q

ANCA +

A

polyarititis nodsa

PAN

76
Q

intrarenal aneursm

A

polyarititis nodsa

PAN

77
Q

treatment for polyarititis nodsa

PAN

A

HIGH dose steroids

78
Q

key terms: proximal limb weakness, neck muscle weakness, +/- skin rash around eyes

A

polymyositis

if the skin is involved Polymyositis & Dermatomyositis

79
Q

best diagnostic tool for polymyositis

A

muscle biopsy

80
Q

Heliotroph rash
where is it located
what is the diagnsosi

A

around the eyes

Dermatomyositis

81
Q

Dermatomyositis has a very strong assocation with what?

EXAM !!!!!!!!!!!!!

A

CANCER

82
Q

polymyalgia rheumatic has a strong association with what

A

temporal artritis

83
Q

key terms- older female with chronic, pain in neck, and pelivs, fever, fatigue

A

polymyalgia rheumatic

84
Q

seronegative arthritis

A

reactive arthritis

85
Q

key terms- chronic joint pain, extra articular sysmptoms (eyes, lungs, heart) , DIP joints are spared, symmetric bony erosin

A

rhematoid arthritis

86
Q

Anti-CCP +

A

rhematoid arthritis

87
Q

Treatment for rhematoid arthritis

A

methotrxate

88
Q

what is still’s disease

A

Juvillne arthritits

89
Q

key terms- kid-teenager with salmon colored rash that gets worse at night, spiking fevers, joint pain
- pacuiarthicular, polyarthicular

A

Juvillne arthritits

90
Q

Treatment for Juvillne arthritits

A

NSAIDS and refer

most like resolve on own

91
Q

Anti-DNA +

A

Lupus
also
Anti-Smith

92
Q

Discoid rash

A

Lupus

93
Q

how many criteria need to be met before diagnosing lupus

A
4 
remember common ones 
rash sparing nasolabia folds -* malar rash 
discoid rash 
*kidney failure 
*oral ulcers 
seizures
94
Q

Treatment for Lupus

A

NSAIDS, steroids, Methotrexate

95
Q

deposition of collagin in tissues

A

scleroderma

96
Q

Anti-smith +

A

Lupus

also anti-DNA

97
Q

Scleroderma is associated with what ?

A

Pulmonary hypertension
High right sided heart pressures !
EXAM !!!

98
Q

what is CREST syndrome

A
Limited Scleroderma 
Calcinosis
Raynaud 
Esophageal dysmotility - GERD 
Sclerodactyly 
Telangiectasias
99
Q

what makes Scleroderma dissuse

A
slerotic skin on chest , abdomen, upper arms 
heart 
lungs 
GI tract 
Kidney
100
Q

Anti-centromere antibody +

A

Scleroderma

101
Q

Schmiers test

< 5 mm wetting

A

Sjogren syndrome

102
Q

Treatment for Sjogren syndrome

A

articifal tears
pilocarpine - muscarinic agonist
methotrexate - suppress the immune system