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musculoskeletal Flashcards

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Dermatology Board Prep flashcards
1
Q

Acute

A

defined as <6 weeks

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2
Q

Chronic

A

pain lasting > 6 weeks

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3
Q

Articular

A

internal/deep joint pain

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4
Q

nonarticular

A

soft tissue pain

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5
Q

Signs of Lupus

A

Fever with infection
fatigue
arthritis
Raynauds phenomenon
Butterfly rash over cheeks

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6
Q

Management of lupus

A

For mild symptoms
Bed rest
Midafternoon naps
Avoidance of fatigue
Sun protection
Topical glucocorticoid for isolated skin lesions
NSAIDS
Hydroxychloroquine—ANTIMALARIAL
Glucocorticoids

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7
Q

P in PRICE

A

Protect

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8
Q

R IN PRICE

A

Rest

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9
Q

I in PRICE

A

ICE

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10
Q

C in PRICE

A

Compression

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11
Q

E in PRICE

A

Eleveation

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12
Q

Empty can test

A

to test for rotator cuff tear
thumb up rotation down against resistance. You can write a positive empty can test indicating rotator cuff tendonitis if there is pain or unable to tolerate resistance

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13
Q

Red flags

A

radicular symptoms >4–6 weeks
increasing symptoms
Osteomyelitis
Cauda equina
herniation of disc
epidural abscess
fevers

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14
Q

Contraindications to joint injection

A

cellulitis or overlying skin ulceration
severe primary coagulopathy
anticoagulant therapy
previously replaced joint
purulent fluid aspiration

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15
Q

shoulder pain diagnosis

A

Trauma
Fracture of proximal humorous, greater tuberosity, clavicle, scapula
Rotator cuff strain, tear
Dislocation
Acromioclavicular separation
Sternoclavicular injury

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16
Q

shoulder pain diagnosis

A

Inflammatory Conditions
Bursitis
Rotator cuff tendonitis
Rheumatoid arthritis
Impingement syndrome

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17
Q

shoulder pain diagnosis

A

Degenerative conditions
Osteoarthritis

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18
Q

shoulder pain diagnosis

A

Miscellaneous
Chronic instability
Adhesive capsulitis—also called frozen shoulder

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19
Q

Plain film x-rays

A

7-10 days after suspected fx without initial evidence as “callus formation” will be evident

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20
Q

Ultrasound

A

soft tissue injury, r/o vascular source of swelling

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21
Q

CT/MRI

A

compression fractures
fractures not picked up in regular plain film
stress fracture

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22
Q

bone scan

A

anyone with a history of cancer think:
Metastasis, osteomyelitis, stress fractures.
Every 2 years

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23
Q

Arc sign

A

Inability to raise arm over head  Begins as gradual anterio-lateral pain with overhead reaching;
Inability to sleep on affected side  pain at night especially if trying to lay on affected side
Weakness or inability to externally rotate shoulder
Limited abduction, forward flexion of shoulder.
For rotator cuff injury

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24
Q

Positive sulcus sign

A

space under acromion on shoulder dislocation. Always check distal pulses

25
Q

positive apprehension test

A
26
Q

adhesive capsulitis

A

frozen shoulder

27
Q

Meniscus tear

A

preceded by trauma
Severe knee pain
Pain getting out of the car
Knee feels like its giving out
Positive mcmurray test

28
Q

Meniscus tear assessment

A

Pain with twisting of the knee (getting in and out of car)
Sense of locking or giving way
More difficult going downstairs than going up
Edema
Tenderness over medial or lateral tibial joint line
Positive McMurray test

29
Q

corticosteroid shots frequency

A

no more often than 3 months

30
Q

complications of MK injections

A

although rare can lead to transient hyperglycemia. The clinician must keep this in mind when treating diabetic patients and advise to monitor and treat accordingly. Blood increase levels can last up to 5 days.

31
Q

Lachman test

A

to test for ACL injury
Examiner grasps upper calf with the dominant hand, thumb over the anterior joint line. The other hand stabilizes the distal femur. Examiner pulls the tibia anteriorly in a sudden firm formation

32
Q

Anterior cruciate ligament (ACL) injury

A

Pain and almost immediate edema following sudden deceleration, jumping
Weight-bearing difficult because of sense of knee instability
Effusion
Hemarthrosis
Pain or tenderness in posterolateral joint
Positive anterior drawer test
Positive Lachman test

33
Q

Medial Collateral ligament injury (MCL)

A

Sudden Valgus stress on knee
May report “pop”
Medial knee pain
Localized edema over 1-4 hours
Tenderness over medial aspect

34
Q

Lateral collateral tear

A

Direct blow to medial aspect of knee
Similar to MCL but lateral
Tenderness with palpation over lateral aspect
Varying degree of joint laxity

35
Q

Meniscus tear

A

positive mcmurray test

36
Q

posterior cruciate ligament injury

A

Forces hyperextension of the knee
Direct blow to anterior proximal knee while knee is flexed and foot planted
Mild to moderate effusion
Positive posterior drawer test
Positive Godfrey’s test

37
Q

valgus stress tests?

A

MCL

38
Q

Varus stress test

A

LCL

39
Q

Lachmen’s and anterior drawer test

A

ACL

40
Q

McMurrays

A

Meniscus tear

41
Q

CARPLE TUNNEL SYNDROME

A

INFLAMMATION OF THE TUNNEL THAT CAUSES WITH NUMBNESS AND TINGLING OF THE HANDS

42
Q

Phalen test

A

to test for carpal tunnel syndrom. If there is numbness and tingling it is positive

43
Q

Tinel test

A

tapping of the nerve and its positive if there is numbness and tingling in the fingers

44
Q

Osteoarthritis

A

wake up feeling well and will worsen as the day goes on.

45
Q

Rheumatoid arthritis

A

is worse when they awake and improves throughout the day

46
Q

cervical stenosis

A

Compression of cervical spine. Vertebrate is stenosed, decreases in height, and causes numbness in the hand. Radiculopathy to the hand.

47
Q

4 signs of infection

A

Edema
warmth
redness
pain

48
Q

Gout

A

Initial uric acid is normal
If it looks like gout, warm, and swollen join just treat
Colchicine 0.6mg #3 (three)
Sig: Take two now, then one in an hour

Prednisone 20mg #10 (ten)
Sig: Take two tabs daily for 5 days

49
Q

how to diagnose fibromyalgia

A

diagnosis of exclusion
everything else has been excluded

50
Q

The greatest pain of gout

A

First Metatarsophalangeal (MTP) joint is most susceptible which is the medial aspect of the foot

51
Q

pharmacological management of osteoporosis

A

calcium and vit-d, weight-bearing exercise and Fosamax
Miacalcin – inhibits bone resorptive process

Bisphosphonates - antiresorptive medicines, which means they slow or stop the natural process that dissolves bone tissue, resulting in maintained or increased bone density and strength

SERM – Evista (Raloxifene) prevents and treats osteoporosis by mimicking the effects of estrogen to increase the density of bone.

52
Q

tophi

A

non tender soft tissue from chronic gout

53
Q

gout Acute Attack management

A

NSAIDS drug of choice
Indomethacin most frequently used but others just as good
COX2 inhibitor for those at high risk Gi bleed
Colchicine effective
Less frequently used 2/2 GI side effects
Should be given within the first few hours of symptom onset
Corticosteroids
For those who cannot take NSAIDS
Bed rest for 24 hours after acute attack

54
Q

gout Chronic Management

A

Chronic Management
Weight loss
Decrease purines in diet
Moderate alcohol use
Increase fluids: maintain 2L urine output per day- Need lots of fluids to flush crystals out
Colchicine may reduce number of acute attacks
Pharmacological blockade of renal absorption of uric acid
Allopurinol
Probenecid
Rarely requires hospital admission
Consult rheumatology for recurrent gouty attacks

55
Q

ACCESS leads to osteoporosis

A

Alcohol use
Corticosteroid use
Calcium low
Estrogen low
Smoking
Sedentary lifestyle

56
Q

sarcoidosis

A

Autoimmune, where the lungs are mostly affected.
pt presents with sob, needs a lung X-ray and see all puffy areas, pulmonology needs to be consulted for biopsy

57
Q

amyloidosis

A

is most common on people with kidney failure waiting on dialysis

58
Q

scleroderma symptoms referred to as CREST

A

Calcinosis-calcium deposits in the skin
Raynauds phenomenon- spasm of blood vessels in response to cold or stress
Esophageal dysfunction–acid reflux and decrease motility
Sclerodactyly- thickening and tightening of the skin on the fingers and hands
Telangiectasias–dilation of capillaries causing red marks on thespian

59
Q

lupus

A

rhemautologic work up–ANA + in 95% of patients
Antiphospholipid antibodies
Anti-ds/DNA
Anti-sm
CBC
Anemia
Leukopenia
thrombocytopenia

Derm (2 decks)

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