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PANRE > Musculolskeletal > Flashcards

Musculolskeletal Flashcards

1
Q

At what age should you begin ordering dexa scans on male patients? female patients ?

A

70 males, 65 females

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2
Q

Give the Dexa score for osteopenia and osteoporosis?

A

1-2.4 SD - osteopenia

>= 2.4 SD for osteoporosis

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3
Q

What fracture is the #1 cause of compartment syndrome?

A

tibia shaft fracture

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4
Q

A patient’s lab work shows + Smith antibody and + double stranded DNA antibiotidies. What is the most likely diagnosis>

A

Lupus

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5
Q

Where are Bouchard’s nodes found?

A

PIP

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6
Q

What will an Xray show in acute osteomyelitis?

A

Nothing - it will show destruction in chronic osetomyelitis

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7
Q

What is the best imaging to diagnosis osteomyelitis?

A

Bone scan or MRI

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8
Q

A 22 yo male patient present with what is clearly a septic knee. You also notice lesions on his hands and feet - what is the most likely causative agent?

A

Neiserria gonorrhea

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9
Q

What would you expect the WBC count to be in a septic knee?

A

> 50,000 at minimum - maybe higher

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10
Q

A patient present with a painless mass in her right wrist - what is the most likely diagnosis?

A

ganglion

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11
Q

What is the age range for osteosarcoma?? where ar they typically found in the body?

A

15-25 you males

most are found around the knee

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12
Q

You think a patient may have an osteoid osteoma due to his complaints of severe night pain. =You set I’m up for and Xray but in the meantime what medication do you start him on?

A

IBU. (if it is truly an osteoid sarcoma)

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13
Q

Clicking or licking of the knee indicates what diagnose

A

Meniscal tear

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14
Q

A 65 yo presents complaining of severe pain in the great toe that began when he woke up this am. It is swollen red and very tender. What is the most likely diagnosis?

A

Gout most likely due to locations - may also be infection.

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15
Q

What uric acid level helps to confirm diagnosis of gout?

A

> 7.5

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16
Q

What is the medical treatment for gout?

A

Allopurinol, colchicine

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17
Q

Apathology report comes back whit + birefringent crystals. What is the most leaky diagnosis?

A

Pseudogout

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18
Q

A patine tiwh a history of hepatitis B present complaining of bilateral knee pain., fever and weight loss. what is the most likely diagnosis?

A

Polyarteririts nodosa

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19
Q

You suspect a patient has polyarteritis nodes. What is the test for a definitive diagnosis and what is the treatment?

A

Biopsy and high dose steriods

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20
Q

On physical exam, you notice ulnar deviations and swan neck deformities. what is the most likely diagnosis?

A

Rheumatoid arthritis

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21
Q

A positive Need sign indicates…

A

a rotator cuff inpingment.

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22
Q

List 3 medications that may cause lupus

A

Procainaminde
INH(isoniazid)
Quinidine

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23
Q

What test do you do for Sjorgen’s syndrome?

A

Schirmer test

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24
Q

A patient with rheumatoid arthritis is heading to the OR for and open reduction and internal fixation of the ankle. In addition to ankle films - what other X-rays should be obtained

A

C-spine - for anesthesia - to concerns about instability at C1 and C2

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25
Q

Which carpal bone has a high rate of nonunion and occult fracture?

A

scaphoid

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26
Q

what medication is used for patients with lupus?

A

systemic steroids?

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27
Q

Scleroderma limited version has 5 main characteristics for which the CREST acronym is often used. what are this 5 things?

A 
Calcinosis
Raynauds
esophagal dysmotility
Sclerodactyly
Telengectasia
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28
Q

There is a sunburst appearance on Xray. What is the most likely diagnosis?

A

Osteosarcoma

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29
Q

Anatomically - where are 80% of clavicle fractures located?

A

middle third.

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30
Q

A pathology report come back showing negatively birefringent crystals. What is the most likely diagnosis

A

Gout

31
Q

What are the 4 muscles of the rotator cuff?

A

Supraspinatus
Infraspinatus
Teres Minor
Subscapularis

32
Q

Describe the characteristics of a lytic lesion on Xray

A

Spiculated,
elevated periosteum,
bone destruction
(bad bad things)

33
Q

What ligament is the most commonly injured in and ankle sprain?

A

Anterior talolfibular ligament (AFTL)

34
Q

Vasculaitis with a hepatitis B history should make you think of what diagnosis?

A

Polyarteritis nodosa

35
Q

What is the most common fracture in children?

A

Clavicle

36
Q

A fat pad sign on a lateral Xray of the elbow has what significance?

A

It is blood in the joint indicating a fracture even if the fracture line cannot be easily seen.

37
Q

A patient present with progressive neck and proximal muscle weakness. On physical exam you see a reddish purple maculopapaular rash. He labs work shows an anti-Jo-1 antibody. What is the most likely diagnosis?

A

Polymyositis

38
Q

Which way does a Colles fracture angulate - dorsal or volar? what a bout a smith fracture?

A 
Colles = Dorsal angulation
Smith = volar angulation
39
Q

Tenderness over the anatomic snuffbox is indicative of what type of fracture?

A

Scaphoid

40
Q

What is the most common fracture in a patient with osteoporosis?

A

A compression fracture of a vertebral body

then a hip fracture

41
Q

A 15 yo boy presents complaining of night pain in the pelvis. Since you have no idea what to do, you order awn Xray. The report comes back with a description of a mass with an onion skin apprearance” what is the most likely diagnosis

A

Ewing Sarcoma

42
Q

What is the name for the 4th and 5th metacarpal fractures resulting from throwing a punch?

A

Boxer’s fracture

43
Q

A new mother presents with pain over the radial wrist. She has a + fincklestein’s test; What is the most likely diagnosis?

A

deQuervains tenosyovitis

44
Q

A + McMurray indicates what diagnosis?

A

meniscal tear

45
Q

What is the first line treatment for carpal tunnel?

A

wrist night splints

46
Q

What is the most common cause of C-spine fractures?

A

MVC accidents

47
Q

What is the medical term for “hunchback”

A

kyphosis

48
Q

What is another tern for podagra?

A

Gout

49
Q

A patient presents to the ED with saddle anesthesia and lowss of bowel and bladder function. What is th e most likely diagnosis?

A

Cauda Equina syndrome

50
Q

A patient with HIV present with severe groin pain. What is the most likely dignosis?

A

AVN of the femoral head. Antiretroviral meds put patients at an increase risk of AVN.

51
Q

A 95 yo female presents to the ER after a fall in her home. Her left leg is shortened and eternally rotated. What is the most likely diagnosis?

A

Hip fracture

52
Q

You recommend bisphosonates for a patient with osteoporosis. What instruction do you give her for immediately after taking the medication?

A

Remain upright for 30 minutes

53
Q

What is the most common cause of a hip dislocation? is it usually anterior or posterior?

A

MVC, posterior

54
Q

Which rotator cuff muscle is the most commonly injured?

A

supraspinatus?

55
Q

What is the first line treatment of Rheumatoid arthritis?

A

methotrexate

56
Q

A patient presents to the ED after taking a baseball bat to the knee. He is unable to actively extend his knee. What is the most likely diagnosis?

A

patella fracture.

57
Q

Are most shoulder dislocations anterior or posterior?

A

anterior

58
Q

What is the most useful physical exam test for diagnosing and ACL tear?

A

Lachman’s followed by anterior drawer

59
Q

What is the most common knee injury?

A

meniscal tear

60
Q

Where are HErbendens nodes found>

A

DIP

61
Q

A patient presents withe knee pain following a soccer game 2 days ago. HE has joint line tenderness medially and feels a locking sensation in the knee from time to time. What 2 physical exam tests should you do?

A

McMurray and Apply tests are appropriate

62
Q

A patient presents with conjunctivitis, urethritis and oral lesions. Wha tis the most likely diagnosis?What test might you expect to be positive?

A

reactive arthritis

HLA - B27`

63
Q

a 46 yo make comes into the ED limping a little on the right. he states that it feels as though he was kicked in the back of the leg during a soccer game but clearly no-one was behind him. What is the most likely diagnosis?

A

achilles tendon rupture.

64
Q

Anti-Jo1 antibodies should make you think of what diagnosis?

A

Polymyositis

65
Q

A positive crossover test indicates what diagnosis

A

AC joint injury

66
Q

A positive Hawkins indicates what diagnosis?>

A

Rotator cuff impingement

67
Q

A bamboo spine indicates what diagnosis?

A

Anklyloising spondylitis

68
Q

a postive SLR test indicates what diagnosis?

A

lumbar disc herniation

69
Q

An African American female present with malaria rash and positive double stranded DNA antibiotdy. What is the most likely diagnosis?

A

Lupus

70
Q

Caral tunnel effects that nerve and what parts of the hand?

A

thumb, pointer and ring. Thenar wasting is a sign of advanced disease

71
Q

A patient has a silver fork deformity on Xray - what is the most likely diagnosis?

A

colles fracture

72
Q

A postive Apley test indicates what diagnosis?

A

meniscal tear.

73
Q

What is the most commonly herniated disc?

A

L4-5 followed by L5-S1

PANRE (12 decks)

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