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Physician Assistant Exam > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

2
Q

You think a patient may have an osteoid osteoma due to his complaints of severe night pain. You set him up for an x-ray, but in the meantime what medication do you start him on?

A

Ibuprofen, if it is truly an osteoid osteoma ibuprofen will resolve his pain.

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3
Q

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

A

Biopsy, high dose steroids

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4
Q

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

A

Remain upright for 30 minutes

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5
Q

Which way does a Colles fracture angulate dorsal or volar? What about a Smith fracture?

A

Colles = Dorsal, Smith = Volar

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6
Q

Which type of arthritis RA or OA do patient complain about stiffness that improves as the day goes on?

A

Osteoarthritis

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7
Q

Which of the four rotator cuff muscles is most commonly injured?

A

Supraspinatus

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8
Q

Where are Heberden’s nodes found?

A

DIP joints

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9
Q

Where are Bouchard’s nodes found?

A

PIP joints

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10
Q

What would you expect the WBC count to be in the joint fluid of an infected knee?

A

> 50,000 at a minimum and probably much higher

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11
Q

What will an x-ray show in acute osteomyelitis?

A

Nothing - it will show bone destruction in chronic osteomyelitis

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12
Q

What uric acid level helps to confirm a diagnosis of gout?

A

7.5

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13
Q

What test do you do for Sjogren’s syndrome?

A

Schirmer test

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14
Q

What medication is used for patients with lupus?

A

Systemic steroids

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15
Q

What ligament is most commonly injured in an ankle sprain?

A

ATF

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16
Q

What is the treatment for gout?

A

Allopurinol, Colchicine

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17
Q

What is the name for a 4th and 5th metacarpal fractures that typically occur secondary to punching a wall.

A

Boxer’s fracture

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18
Q

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

A

Lachman’s, followed by anterior drawer

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19
Q

What is the most common knee injury?

A

Medial meniscal tear

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20
Q

What is the most common fracture in children?

A

Clavicle

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21
Q

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

A

Vertebral bodies, compression fracture followed by hip fracture

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22
Q

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

A

MVA

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23
Q

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

A

MVA, posterior

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24
Q

What is the medical term for tennis elbow?

A

Lateral epicondylitis

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25
Q

What is the medical term for hunchback?

A

Kyphosis

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26
Q

What is the medical term for golfer’s elbow?

A

Medial epicondylitis

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27
Q

What is the first line treatment for rheumatoid arthritis?

A

Methotrexate

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28
Q

What is the first line treatment for carpal tunnel?

A

Night splint

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29
Q

What is the best imaging to diagnose osteomyelitis?

A

Bone scan or MRI

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30
Q

What is the age range for osteosarcoma? Where are thy most typically found in the body?

A

15-25 year old males, most commonly found around the knee

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31
Q

What is another term for podagra?

A

Gout

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32
Q

What fracture is the #1 cause of compartment syndrome?

A

Tibial shaft fracture

33
Q

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

A

Scaphoid

34
Q

What are the Four muscles of the rotator cuff?

A

Commonly referred to as th SITS muscles they are Supraspinatus, Infraspinatus, Teres minor, Subscapularis

35
Q

Vasculitis related to hep B history

A

Polyarteritis Nodosa

36
Q

There is a sunburst appearance on x-ray. What diagnosis should you be thinking of?

A

Osteosarcoma

37
Q

Tenderness over the anatomical snuffbox is indicative of what fracture?

A

Scaphoid

38
Q

Scleroderma limited version has five main characteristics for which the CREST acronym is often used. What are those five things?

A

Calcinosis, Raynaud’s, Esophageal motility, Sclerodactyly, Telangiectasia

39
Q

Rheumatoid arthritis patient heading to the OR for open reduction and internal fixation of the ankle. In addition to ankle films what other x-rays should you get?

A

C-spine, anesthesia will want them due to concerns about instability of C1 & C2

40
Q

Patient with HIV presents with severe groin pain. What diagnosis should you be thinking of?

A

Avascular necrosis of the femoral head. Antiretroviral put patients at an increased risk of AVN.

41
Q

Patient with a history of hep B presents c/o of bilateral knee pain, fever and weight loss. What diagnosis should you be thinking of?

A

Polyarteritis Nodosa

42
Q

Patient presents with progressive neck and proximal muscle weakness. They also have a reddish purple maculopapular rash. It is also noted that she has anti Jo 1 antibodies. What diagnosis should you be thinking of?

A

Polymyositis

43
Q

Patient presents with painless mass in her right wrist. What diagnosis should you be thinking of?

A

Ganglion cyst

44
Q

Patient presents with knee pain following a soccer game two days ago. He has joint line tenderness medially and feels a locking in the knee from time to time. What two physical exam tests should you do?

A

This is probably a medial meniscal tear. Mcmurry and Apply tests would be appropriate.

45
Q

Patient presents with conjunctivitis, urethritis, arthritis and oral lesions. What diagnosis should you be thinking of? What other lab might you expect to be positive?

A

Reactive arthritis, HLA B-27

46
Q

Patient presents to the ER after taking a baseball bat to the knee. He is unable to actively extend his knee. What diagnosis should you be thinking of?

A

Patella fracture

47
Q

On physical exam you notice ulnar deviations and swan neck deformities. What diagnosis should you be thinking of?

A

Rheumatoid arthritis

48
Q

List three medication that may cause lupus.

A

Procainamide, Isoniazid, Quinidine

49
Q

Give the dexa score for osteopenia? Osteoporosis?

A

Osteopenia = 1 to 2.4 standard deviations, osteoporosis = 2.5 standard deviations

50
Q

Describe the characteristics of a lytic lesion on x-ray

A

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

51
Q

Clicking or locking of the knee indicates what diagnosis?

A

Meniscal tear

52
Q

Carpal tunnel affects what nerve and what parts of the hand?

A

Median nerve. Thumb, pointer and ring fingers. Thenar wasting is sign of advanced disease.

53
Q

At what age should you begin ordering dexa scans for male patients? Female patients?

A

70 for males, 65 for females

54
Q

Are most shoulder dislocations anterior or posterior?

A

Anterior

55
Q

Anti jo antibodies should make you think of what diagnosis?

A

Polymyositis

56
Q

Anatomically where are 80% of clavicle fractures located?

A

Middle third

57
Q

African American female presents with malar rash and a positive double stranded DNA antibody. What diagnosis should you be thinking of?

A

Lupus

58
Q

A positive straight leg test indicates what diagnosis?

A

Herniated disc

59
Q

A positive Phalen and Tinel’s sign indicates what diagnosis?

A

Carpal tunnel

60
Q

A positive Neer’s test indicates what diagnosis?

A

Rotator cuff tear

61
Q

A positive Mcmurry indicates what diagnosis?

A

Meniscal tear

62
Q

A positive Hawkin’s test indicates what diagnosis?

A

Rotator cuff tear

63
Q

A positive Finkelstein’s test indicates what diagnosis?

A

de Quervain’s tenosynovitis

64
Q

A positive cross over test indicates what diagnosis?

A

AC joint injury

65
Q

A positive Apley indicates what diagnosis?

A

Meniscal tear

66
Q

A patient’s lab work shows positive smith antibody and positive double stranded DNA antibodies. What diagnosis should you be thinking of?

A

Lupus

67
Q

A patient presents to the ER with saddle anesthesia and loss of bowel and bladder function. What diagnosis should you be thinking of?

A

Cauda equina

68
Q

A patient has a silver fork deformity on x-ray. What diagnosis should you be thinking of?

A

Colles fracture

69
Q

A pathology report comes back with positive birefringent crystals. What diagnosis should you be thinking of?

A

Pseudogout

70
Q

A pathology report comes back showing negatively birefringent crystals. What diagnosis should you be thinking of?

A

Gout

71
Q

A new mother presents with pain over the radial wrist. She has a positive Finkelstein’s test. What diagnosis should you be thinking of?

A

de Quervain’s tenosynovitis

72
Q

A fat pad sign on a lateral x-ray has what significance?

A

Blood in the joint indicating a fracture even if the fracture line cannot be seen.

73
Q

A bamboo spine indicates what diagnosis?

A

Ankylosing Spondylitis

74
Q

A 65 year old presents complaining of severe pain in his great toe. It is swollen, red and very tender. What diagnosis should you be thinking of?

A

Gout would be number one because of the location, but you might also think about an infection.

75
Q

95 year old female presents to ER after a fall in her home. Her left leg is shortened and externally rotated. What diagnosis should you be thinking of?

A

Hip fracture

76
Q

46 year old male comes into ER limping a little on the right side. He states that it felt as though he was kicked in the back of the leg during a soccer game, but clearly know one was behind him. What diagnosis should you be thinking of?

A

Achilles rupture

77
Q

22 year old male patient presents with what is clearly a septic knee. You also notice lesions on his hands and feet. What is the most likely pathogen?

A

Neisseria gonorrhoeae

78
Q

15 year old boy presents complaining of night pain in the pelvis. Since you have no idea what to do you order an x-ray. The report comes back with a description of a mass with “onion skin.” What diagnosis should you be thinking of?

A

Ewing Sarcoma

Physician Assistant Exam (14 decks)

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