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Misc Boards Review > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

1
Q

Neer test also called what?
Tests for what?

A

Painful arc test
Shoulder impingement

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2
Q

Hawkins test - for what?

A

Shoulder impingement

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3
Q

How much calcium should post menopausal women take?

A

1200mg daily

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4
Q

Apley scratch test

A

Reach hand behind to opposing shoulder blade
Positive with pain indicating rotator cuff issue

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5
Q

T score indicative of OP
Osteopenia?
Normal?

A
  • -2.5 and below (-3, -4)
  • -1 to -2.5
  • Normal: -1 and higher
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6
Q

Who gets a DEXA scan?

A
  • All women 65+
  • Younger patients with low trauma fractures
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7
Q

Drugs that increase risk for OP? (3)

A
  • Steroids
  • PPI
  • Depo
    *Think OP = SPD
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8
Q

Biggest risk factor for OP?

A
  • Smoking
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9
Q

Common first symptom of OP?

A

Fracture

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10
Q

What do DEXA scans specifically look at? (3)

A
  • Hip, femoral neck, lumbar spine
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11
Q

HTN med great for OP?
DM med that’s helpful?
Psych med that’s helpful?

A
  • Thiazides
  • GLP 1
  • Wellbutrin
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12
Q

How do bisphosphonates work?

A
  • Inhibits reabsorption of bone by osteoclasts
  • Increases bone density
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13
Q

How to take bisphosphonates?

A
  • Upright 30 min to avoid serious erosion
  • Take alone with full glass of water
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14
Q

Long term risk factors of bisphosphonates?
How long should we take these?

A
  • Femur fracture
  • Osteonecrosis of the jaw
  • 3-5 years
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15
Q

Morning Stiffness in RA vs. OA

A
  • OA: goes away within an hour
  • RA: doesn’t go away
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16
Q

Pain in RA vs. OA

A
  • RA: not relived with rest
  • OA: worse with activity, better with rest
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17
Q

Where are the Bouchard’s nodes?
Where are the Heberden’s nodes?

A
  • Bouchard’s: PIP
  • Heberden’s: DIP
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18
Q

What do you see on XRs in OA? (2)
Typical sites? (5)

A
  • Joint space narrowing, bone spurs
  • Hand
  • Spine
  • Hip, Knee, Foot
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19
Q

Risk factors for OA? (4)

A
  • Age
  • Trauma
  • Obesity
  • Overuse
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20
Q

Tx for OA? (3)

A
  • NSAIDs
  • Tylenol
  • Exercise – non-weightbearing
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21
Q

What is a FRAX score?
Need treatment when what?

A
  • Likelihood of a patient to experience a fracture
  • FRAX > 7.5% or osteopenia
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22
Q

How to DMARDs work in RA?
May use what until the DMARDs kick in?

A
  • Slow the disease process and preserve joint function
  • Steroids
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23
Q

Side effect of methotrexate? (2)

A
  • Immunosuppression
  • Folic Acid deficiency
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24
Q

Risk factors for OP (5)

Race?

A
  • Smoking
  • Low body weight
  • Anorexia
  • Alcohol
  • Early menopause
  • White and Asian
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25
Q

OA vs. RA
Which one is bilateral?
Which one has warmth and redness?

A
  • RA
  • RA
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26
Q

OA vs. RA – which one has a slow onset?
Which one has weight loss?

A
  • Slow: OA
  • Weight loss: RA
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27
Q

What lab is most specific to RA?
Other labs?

A
  • Anti CCP antibodies 98% specific
  • RF factor
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28
Q

ESR in RA vs. OA

A
    • RA
    • OA
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29
Q

What is the max dose of Tylenol?

A

3g

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30
Q

What is indomethacin good for?
What is Celebrex good for?

A
  • Indomethacin: Gout
  • Celebrex: Bursitis
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31
Q

Contraindications to NSAIDs (6)

A
  • Heart failure, HTN
  • Ulcers, GI bleed
  • On blood thinners
  • Pregnancy
  • Renal issues
  • Steroids
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32
Q

What is Ankylosing Spondylitis?
XR findings?

A
  • Autoimmune and chronic inflammatory disease that starts in the lower back and creeps up the spine
  • Bamboo spine on spinal/sacroiliac XR
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33
Q

How to diagnose Ankylosing Spondylitis?
Key symptoms? (2)
Commonly occurs with what?

A
  • sacroiliac XR first, then MRI
  • Loss of ROM, lordosis
  • Uveitis
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34
Q

Management for ankylosing spondylitis? (2)
Meds? (2)

A
  • Refer to rheumatology
  • Postural training
  • NSAIDs or DMARDs
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35
Q

Treatment of navicular/scaphoid fx?

A
  • Thumb spica cast
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36
Q

What is DeQuervain’s Tenosynovitis?

A
  • Pain in the lower thumb and wrist
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37
Q

Test for DeQuervain’s Tenosynovitis
How to do it?

A
  • Finkelstein’s test
  • Patient grabs thumb and preforms ulnar deviation
  • Positive if pain
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38
Q

How is carpal tunnel treated?

A
  • Splint or brace
  • Sometimes steroids
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39
Q

Symptoms of ulnar nerve palsy?
Test?

A
  • Numbness in fingers 4&5
  • Froment’s sign – thumb is bent when holding paper
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40
Q

Symptoms of Morton’s neuroma

A
  • Feels like a pebble in their shoe between toes 3&4
  • Numbness and tingling
  • Positive Mulder’s Sign
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41
Q

What is metatarsalgia?

A
  • pain on the ball of the foot
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42
Q

Where does a ganglion cyst occur?

A
  • Over a joint (not a space)
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43
Q

What is metatarsal phalangeal (MTP) joint synovitis?

A
  • Pain and swelling on both the dorsal and plantar parts of the foot
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44
Q

Symptoms of epicondylitis? (2)

A
  • Burning pain worsened with activity
  • Pain with palpation
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45
Q

Other names for lateral epicondylitis vs. medial epicondylitis?

A
  • Lateral: tennis elbow
  • Medial: Golfers elbow
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46
Q

What is a test for lateral epicondylitis?

A

Cozen test - Extend wrist against resistance

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47
Q

Treatment for epicondylitis? (3)

A
  • RICE
  • NSAIDs
  • Possible PT
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48
Q

Causes of Gout (5)

A
  • Diuretics (dehydration, avoid thiazides)
  • Renal issues
  • Obesity
  • ETOH*
  • Purine foods
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49
Q

Foods high in purines?

A
  • Alcohol, liver
  • Red meat, shellfish,
  • High fructose corn syrup
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50
Q

Foods low in purine?

A
  • Coffee, milk, vitamin C
51
Q

Med to avoid in gout?

A
  • Aspirin
  • HCTZ
52
Q

How to diagnose gout flare?

A
  • Aspiration of synovial fluid to see crystals
53
Q

What are tophi?

A
  • Stone-like deposits in the joints
  • Look like a bulge
54
Q

Is uric acid always high during a flare?
What is high during an attack?

A
  • No
  • ESR/CRP, WBC
55
Q

Go to treatment for gout flat? (2)
Not working? (1)

A
  • Indomethacin
  • Steroids
  • Severe: Colchicine
56
Q

Side effects of colchicine?

A
  • N/V/D, cramping
  • Take at onset of symptoms
57
Q

Side effect of allopurinol
What labs to monitor?

A
  • Bone marrow suppression
  • Monitor CBC, LFTs, RFP
58
Q

More expensive options for gout prevention

A
  • Colchicine
  • Probalan
  • Uloric
59
Q

What is gout of the big toe called?

A
  • Podogra
60
Q

Typical scenario of meniscus injury?
During injury?

A
  • Twisting maneuvers – can finish game
  • Pop then lock
  • Painful extension
61
Q

Swelling ACL vs. Meniscus

A
  • Meniscus: up to 24hr
  • ACL: immediate < 1 hr
62
Q

Most sensitive test for meniscus injury?

A
  • Thessaly test
63
Q

How to diagnose meniscus injury?

A

MRI

64
Q

Treatment for meniscus injury

A
  • RICE, NSAIDs
  • Refer to ortho
65
Q

Meniscus tests?
Positive with what?

A
  • Apleys
  • McMurrays
  • Clicking or pain
66
Q

Typical scenario of ACL injury?
Characteristics?

A
  • Pivoting, not contact
  • Sudden pop and knee gave way
67
Q

How to perform Lachmans?
Less specific test?

A
  • Supine, bend knee 20 degrees, pull calf to you
  • Too much ROM
  • Anterior drawer
68
Q

Treatment for ACL injury?

A
  • Refer to ortho
  • NSAIDs, RICE, PT
69
Q

MCL injury
Pain is where?
Feels like what?

A
  • Medial side of knee pain
  • Feels like it’s giving out
70
Q

MCL injury test

A
  • Valgus
  • *Think push knees to middle like Gum to the Middle
71
Q

LCL pain is where?

A
  • Lateral side of knee
72
Q

LCL test?

A
  • Varus
  • Think vaRus – lateral
73
Q

Symptoms of fibromyalgia (5)

A
  • Widespread pain
  • Tenderness
  • Overall sensitivity
  • Fatigue
  • Cognitive problems
74
Q

Population commonly affected by fibro?

A
  • Middle aged women
75
Q

Diagnostic criteria for Fibro? (4)
3 months or more of what?

A
  • > /= 3 months of
  • Fatigue
  • Waking up not feeling refreshed
  • Pain -WPI >/= 7 out of 19
  • Cognitive problems
76
Q

What are we no longer looking at to diagnose fibro?

A
  • Tender points
77
Q

First line treatment for fibro?

A
  • Regular exercise
78
Q

What is the name for bunion?
How to diagnose?
Treatment?

A
  • Hallux valgus
  • > 20 degree curve on XR
  • Braces or surgery
79
Q

Risk factors for plantar fasciitis?
Common symptom?

A
  • Runners
  • Sharp heel pain worse in the morning
80
Q

Plantar fasciitis treatment? (5)

A
  • NSAIDs, rest ice
  • Stretch arches
  • Supportive shoes
  • Changing sports
81
Q

Symptoms of bursitis

A
  • Generalized pain and swelling over the whole joint
82
Q

Treatment of bursitis?

A
  • Celebrex
  • Rest, ice
  • Injections to hip/shoulder, not elbows
83
Q

What is Wadells sign?

A
  • Eval for psychogenic LOW back pain
84
Q

What is another name for empty can test?
What does it test for?

A
  • Jobe test
  • supraspinatous tear
85
Q

Which tests are for shoulder impingement?

A
  • Hawkins and Neer (painful arc)
86
Q

Test for sciatica? (3)

A
  • Straight leg raise
  • Yeoman - prone
  • piriformis test
87
Q

L4 nerve root

A
  • Squat and rise
  • Diminished knee jerk
  • Think L4 squat on the floor
88
Q

L5 nerve root

A
  • Heel walking
  • Numbness on big toe
  • Think5/5 numbness on big toes
89
Q

S1 nerve root

A
  • Walk on toes
  • Diminished or absent ankle jerk and weakness with walking
90
Q

What is the speed test?

A
  • Evals for SLAP superior labrum tear
91
Q

What is the hook test?
What to do if positive?

A
  • Eval for bicep tear/rupture
  • Send to ortho
92
Q

How to diagnose rotator cuff tear?

A

MRI

93
Q

Most common mechanism of a sprain?

A
  • Ankle inversion
94
Q

What is Ottawa rule?

A
  • Determine if patient needs radiographs of ankle
95
Q

Grade 1 sprain

A
  • Mild
  • Can bear weight and ambulate
96
Q

Grade 2 sprain

A
  • Partial tearing of ligament
  • Bruising, swelling, pain with palpation
  • Painful to bear weight
  • Consider XR
97
Q

Grade 3 sprain

A
  • Complete rupture of ligaments
  • Can’t bear weight or walk 4 steps
  • Refer to ED
98
Q

How to diagnose shin splints?

A

MRI

99
Q

Bursitis behind the knee
Called what?

A
  • Baker’s cyst
  • Ball behind knee
100
Q

Name for shin splints?
Classic case (4)

A
  • Medial tibial stress syndrome
  • Pain on inner edge of tibia
  • Worse with exercise
  • Anterior aspect of shin
  • May develop into stress fx
101
Q

Shin splints tx? (3)

A
  • Stop and rest for several weeks
  • Cold packs BID 24-48hr
  • When pain is gone, wait 2 weeks after to resume exercise
102
Q

Gold standard test for any joint damage

A

MRI

103
Q

What do NSAIDs increase? (3)

A
  • Heart disease
  • Kidney problems
  • GI bleeding
104
Q

What may help diagnose ankylosing spondylitis?

A
  • Dramatic response to NSAIDs
105
Q

Which NSAID has the least cardiovascular effects?

A
  • Naproxen
106
Q

Rotator cuff injuries that need surgical intervention? (4)

A
  • Full thickness in young patients
  • > 50% partial with significant pain
  • Full thickness not responding to non-op measures
  • Any degree that results in loss of function
107
Q

What is the lever test?
What does it test for?

A
  • Thumb arthritis
  • Grasping base of thumb and moving it radially and ulnarly
108
Q

What does the O’Brien test test for?

A
  • Superior labrum tears following dislocation
109
Q

What is the apprehension test?

A
  • Used to assess pain and instability after shoulder dislocation
110
Q

First line meds for RLS (3)

A
  • Pramipexole
  • Requip
  • Rotigotine
111
Q

First line treatment for paronychia without abscess?
Symptoms not improved?

A
  • CHG soaks and Bactroban
  • Augmentin
112
Q

What does the Watson test look at?
Other name?

A
  • Wrist instability
  • Scaphoid shift test
113
Q

What does the Ege test look at?

A
  • Meniscus injuries
114
Q

What is the Fajersztajn test?

A
  • Straight leg raise with contralateral leg of symptoms
115
Q

Test most specific for rotator cuff test?

A

Drop arm test

116
Q

What condition involves weakness in the femoral growth plate allowing the femoral head to “slip” or move out of place in relation to the rest of the femur?

A

Slipped capital femoral epiphysis (SCFE)

117
Q

Risk Factors for SCFE

A

Adolescent males

Growth spurts, trauma, obesity

118
Q

Symptoms of SCFE

A

Hip stiffness/pain, limp, difficulty bearing weight, unequal leg lengths

119
Q

Positive test in SCFE?

Management?

A

Positive trendelenburg sign
Refer to ortho

120
Q

What is Legg Calve Perthes disease?

A

Temporary loss of blood supply to the femoral head causing necrosis and loss of bone mineral density in the hip joint

121
Q

Who is affected by legg calve perthes disease?

A

It’s a pediatric condition, commonly affecting ages 4-9 years

122
Q

Symptoms of Legg Calve perthes disease

A

Hip pain, joint pain, limited range of motion, and walking with a limp

123
Q

How dot diagnose Legg calve perthes

A

XR of hip

124
Q

What curve in scoliosis warrants referral to ortho?

A

> 20%

Misc Boards Review (19 decks)

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