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Musculoskeletal Flashcards

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1
Q

how do you definitively scan for osteoporosis?

A

DEXA
-2.5 or less

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2
Q

What meds to treat osteoporosis?

A

Bisphosphonates
-Fosamax

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3
Q

What med should we use to tx htn in those that have osteoporosis?

A

HCTZ
thiazides

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4
Q

What meds are you going to prescribe for rheumatoid arthritis?

A

DMARDS
-Methotrexate

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5
Q

What deficiency is methotrexate notorious for?

A

Folic acid deficiency

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6
Q

When would we see bouchard’s nodes?
Where are they?

A

B=both
RA and osteo

PIP

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7
Q

When would you see Heberden’s nodes?
Where are they?

A

osteoarthritis
DIP

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8
Q

What might you see on exam with Rheumatoid arthritis?

A

Boutonniere
swan neck deformity

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9
Q

Where does the pain start in ankylosing spondylitis?

A

lower back
then works its way up to the nect

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10
Q

What diagnostic test for ankylosing spondylitis?

A

xray “bamboo spine”

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11
Q

When does a navicular/scaphoid fx usually show up on xray?

A

2 weeks later

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12
Q

Why is it important to treat a navicular/scaphoid fx?

A

prevent osteonecrosis in the wrist

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13
Q

What are 2 signs of carpel tunnel syndrome and describe

A

Phalen’s = backwards prayer hands

Tinels = tap median nerve on inner wrist “tinel tap”

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14
Q

What tests do you use to evaluate the meniscus?

A

mcmurray
Apley test

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15
Q

What does the valgus maneuver look at?

A

ligaments

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16
Q

When we have continued popping of hte knee…what type of injury is that?

A

Meniscal

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17
Q

What maneuver determines if it’s the L4 that’s causing sciatica?

A

squat and rise
diminished knee jerk

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18
Q

what maneuver if it’s the L5 causing sciatica?

A

heel walking = numbness at great toe

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19
Q

what manuever if it’s S1 causing sciatica?

A

walk on toes
dim or absent ankle jerk

20
Q

What is the drop arm test?

A

abduct arm away from body then lower back down to the waist slowly
…if there is a rotator cuff tear the arm will suddenly drop to the side

21
Q

how do you assess a supraspinatus tear?

A

empty can test

22
Q

What medication can be used as prevention to decrease uric acid levels?

A

allopurinol

23
Q

What’s a big side effect of allopurinol?
What do we want to monitor?

A

bone marrow suppression

CBC

24
Q

What is a treatment for a gout attack?
what about a severe attack?

A

NSAID ex Indocin
Steroids

Colcrys

25
Q

Diagnosis criteria for fibromyalgia

A

pain
fatigue
wake up feeling unrefreshed
cognitive problems
…for 3+ months
…and symptoms can’t be explained for any other reason

26
Q

Fibromyalgia treatment?

A

Cymbalta
Elavil
Lyrica
Flexeril
Regular exercise

27
Q

What is hallux valgus?
What joint is affected?
Dx?
Tx

A

bunion
1st metatarsal phalangeal joint
dx: Xray
tx: braces
-if severe, refer surgery

28
Q

What is De Quervain’s tenosynovitis?
Dx

A

pain in lower thumb/wrist

dx: Finkelstein test

29
Q

What is the finkelstein test

A

tests for De Quervain’s tenosynovitis

grab thumb and perform ulnar deviation…positive test if pain occurs

30
Q

What labs are going to be elevated for gout

A

ESR
CRP
WBC

31
Q

What are you going to prescribe during a gout attack?

A

NSAID: Indocin
steroids
Severe: Colchicine

32
Q

What lab do you want to monitor for a patient on Allopurinol?

A

CBC

look for bone marrow suppression

33
Q

What is the main drug tx for osteoporosis?

A

bisphosphonates…“-dronate”

34
Q

How do you take bisphosphonates?

why?

A

Need to be taken alone before food

need to remain upright for 30 mins to minimize acid reflux

35
Q

What are signs someone has an ACL injury

A

sudden POP with PIVOTing and IMMEDIATE swelling

36
Q

If someone has a positive Lachman or anterior drawer test…what do you do next?

A

refer to ortho

37
Q

What are some distinguishing features of a meniscal injury?

how to tx

A

maybe feel a pop then joint “locks up”
going to still be able to finish the game
DELAYED swelling

McMurray’s test shows “clicking” or pain

RICE and refer to ortho

38
Q

osteoarthritis symptoms 3

A

pain worse with activity but relieved with rest

morning stiffness <1hr

asymmetrical
no warmth or redness

39
Q

what deficiency can DMARDs (methotrexate) cause?

A

folic acid deficiency

40
Q

What are treatment options for fibromyalgia

A

1st line: physical exercise
2nd:
Duloxetine (Cymbalta) SSNRI
Amitriptyline (Elavil)
Flexeril
Pregabalin (Lyrica) GABA analogue

41
Q

What is the Hep B vaccination series?

A

24 hours after birth
1 month after 1st dose
6 months

42
Q

What is Hep B treatment for:

post exposure prophylaxis in unvaccinated?

post exposure prophylaxis vaccinated previouslyl?

A

unvaccinated: hep B vaccine AND hep B immunoglobulin within 24 hours

vaccinated:
hep b immunoglobulin within 24 hours

43
Q

What are the 3 main stages of HIV?

A

1st: flu symptoms for 1st week
2nd: viral load decreases = latency stage lasts for years
3rd: return of symptoms

44
Q

How do you diagnose HIV?

A

HIV1/HIV2 antigen/antibody immunoassay

it can detect acute infection and previous infection during latent phase

45
Q

What CD4 count to do we want to start antiretroviral drug therapy?

A

CD4 <350

46
Q

How should patients take their iron supplement?

A

with an acidic drink and on an empty stomach

47
Q

What exists in the stomach and small intestine to help absorb vitamin b12?

A

intrinsic factor

Brain Dump (22 decks)

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