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Internal medicine > Musculosckeletal > Flashcards

Musculosckeletal Flashcards

0
Q

Presentation of hip fracture

A

Shortened and externally rotated leg

also seen with femoral fracture

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1
Q

Treatment of Hip fracture

A

Open reduction and internal fixation with parallel pinning of the femoral neck

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2
Q

how do fat emboli present and what causes them

A

Caused by femoral fracture

presentation: fever, AMS, dyspnea, hypoxia, PETECHIA, THROMBOCYTOPENIA

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3
Q

Presentation of anterior and posterior shoulder dislocation

A

anterior dislocation= Axillary artery and nerve: ABduction and external rotation of arm

posterior dislocation= Radial artery and nerve: ADDuction and internal rotaion

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4
Q

colle’s fracture

A

Fall on an outstretched hand.
involves the distal radius
Tx: closed reduction + long arm cast

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5
Q

Scaphoid fracture

A

tenderness in the anatomical snuff box

Tx: thumb spica cast/ open reduction

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6
Q

Boxers fracture

A

fifth metacarpal neck injury

closed reduction + ulnar gutter splint

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7
Q

humerus fracture

A

radian nerve injury: wrist drop and loss of thumb abduction

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8
Q

achilles tendon rupture presentation and physical exam

A

sudden “pop” like a rifle shot

exam shows: limited plantar flexion

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9
Q

treatment of Achilles tendon rupture

A

treat surgically followed by long leg cast for six weeks

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10
Q

femoral fracture: treament

A 
primary arthroplasty (due to increased risk of AVN)
open reduction and internal fixation
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11
Q

bursitis: presentation and treatment

A

presents with localized tenderness, decreased ROM, edema and erythema

Tx: rest, heat and ice, NSAIDs and steroid injections

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12
Q

tendinitis presentation

A

presents with swelling and impaired function, pain and the site of insertion.

worse with repetitive stress and resisted strength testing of the affected muscle group.

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13
Q

tendinitis: most common location

A

supraspinatus, Biceps, wrist extensors, patella, achilles tendons

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14
Q

tendinitis: treatment

A

rest, NSAIDs, ice

splinting or immobilization

if no improvement: steroid/lidocaine injections

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15
Q

Antibiotics that cause tendinitis and tendon rupture

A

Fluoroquinolones

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16
Q

herniated disk diagnosis

A

positive straight leg test

MRI used for confirmation

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17
Q

spinal stenosis presentation

A

neck and back pain that radiates to the buttocks and legs
+ leg numbness and weakness
worse with sitting, standing and walking uphill

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18
Q

spinal stenosis: diagnosis

A

MRI/ CT of spinal cord

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19
Q

spinal stenosis treatment

A

NSAIDs and abdominal muscle strengthening
Epidural corticosteroid injections
surgical laminectomy

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20
Q

most common site of osteosarcoma

A

distal femur and proximal tibia

21
Q

osteosarcoma is a risk factor for what disease?

A

Paget’s Disease

22
Q

diagnosis of osteosarcoma

A

Codman’s triangle

sunburst pattern

23
Q

what is the most common benign bone tumor?

A

osteochondroma

24
Q

radiographic findings in OA

A

joint space narrowing
osteophytes
subchondral sclerosis
subchondeal bone cyst

25
Q

duchenne muscular dystrophy: diadnosis

A

negative dystrophin immunostain and increased CK level

EMG: polyphasic potentials

most accurate: muscle biopsy (necrotic muscle fibers)

26
Q

duchenne muscular dystrophy: treatment

A

PT

Tendon release surgery

27
Q

complications of duchenne muscular dystrophy

A

Pulmonary congestion
high output cardiac failure
cardiac fibrosis = arrhythmias

28
Q

nursmaids elbow presentation

A

pain with flexion

radial head subluxation

29
Q

nursemaid’s elbow treatment

A

Manual reduction by supination of the elbow at 90 deg of flexion

30
Q

supracondylar humerus fracture: treatment

A

cast immobilization and closed reduction

31
Q

Diagnosis of developmental dysplasia of the hip

A

mostly through PE

Ultrasound may be helpful

32
Q

developmental dysplasia of the hip: treament

A

<6months: splint with a pelvic harness (maintain hip flexed and abducted)

6-15months: Spica cast

15-24months: open reduction followed by spica cast

33
Q

complications of developmental dysplasia of the hip

A

joint contractures and AVN of the femoral head

34
Q

what is Legg-calve-Perthes Disease

A

AVN of the femoral head

35
Q

H/P of legg-calve-perthes disease

A
  • painless limp
  • if pain in present: usually in the grin and anterior thigh
  • limited abduction and internal rotation
36
Q

treatment of leg-calve-perthes disease

A

usually self limited (observation)

racing if there is decreased ROM

37
Q

differential diagnosis of pediatric limp (STARTSS HOTT)

A 
septic joint
tumor
Legg-calve-perthes
RA/JRA
tuberculsis
sicke cell disease
slipped capital femoral epiphysis
Henoch-Schonlein purpura
osteomyelitis
trauma
toxic synovitis
38
Q

what is slipped capital femoral epiphysis (SCFE)?

A

medial and posterior displacement of the femoral head

due to imbalance between GH and sex hormones

39
Q

risk factors for SCFE

A

obesity
age 11-13
male ender
African american

40
Q

what disorder is SCFE associated with?

A

Hypothyroidism

41
Q

H/P: SCFE

A
  • acute thigh and knee pain and PAINFUL limp
  • restricted ROm and inability to bear weight
  • BILATERAL in 40-50%
  • limited internal rotation and abduction of the hip
42
Q

diagnosis of SCFE

A

Radiographs: posterior and medial displacement of the femoral head

NEED TO R/O HYPOTHYROIDISM WITH TSH

43
Q

SCFE: treatment

A

no weight bearing

closed reduction

44
Q

scoliosis: treatment

A

curvature:

50 degees: surgical correction

45
Q

complication of scoliosis

A

restrictive lung disease

46
Q

risk factors for baker’s cyst

A

osteoarthritis and RA

47
Q

presentation of Baker’s cyst

A

swollen calf

palpated cyst behind the knee

48
Q

Baker’s cyst treatment

A

NSAIDs and steroid injections

49
Q

4 muscles involved in rotator cuff injury

A

Suprapinatus (highest risk of being injured)
infraspinatus- injury causes loss of external rotation
teres minor- injury causes loss of external rotation
subscapularis

50
Q

presentation of rotator cuff injury

A

difficulty abducting arm between 60-120 degrees

positive drop test

Internal medicine (8 decks)

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