Musculoskeletal Flashcards
When determining the root cause of lumbar radiculopathy, or sciatica, if the patient has a positive squat and rise test and has a diminished knee jerk, then L4 (B) is likely the root cause of the sciatica. If the patient has numbness or weakness in the big toe with heel walking, L5 (C) is responsible. If S1 (D) is the cause, the patient will have a diminished or absent ankle jerk and weakness while walking on their toes
Patients with chronic kidney disease (CKD) should avoid ibuprofen (Motrin) and colchicine (Colcrys) if possible
The Finkelstein test (A) is used to diagnose De Quervain’s tenosynovitis, which is inflammation of the first dorsal tendon compartment, typically presenting as thumb or radial side hand pain.
The anti-cyclic citrullinated peptide (CCP) antibody test is highly specific to RA and will often be positive before the patient experiences clinical symptoms. Anti-CCP antibodies (A) are up to 98% specific to RA.
Polymyalgia rheumatica (PMR) is an inflammatory condition that affects patients who are 50 years and older. It causes symmetrical, aching pain and stiffness in the hips, shoulders, and neck. Symptoms are more severe in the morning. Physical examination can reveal a limited range of motion in affected joints. Initial treatment for PMR includes oral prednisone 12.5–25 mg daily, and symptoms should markedly improve within days. Prednisone should be tapered slowly every 2–4 weeks to avoid recurrent symptoms.
ESR and C-reactive protein (CRP) are acute phase reactants that indicate inflammation in the body and are elevated in polymyalgia rheumatica
Lateral ankle sprains, or inversion sprains (B), are most common
The Lachman test (B) is performed by the nurse practitioner placing one hand over the femur and the other over the tibia. If the tibia can be moved anteriorly, this indicates damage to the anterior cruciate ligament
The posterior drawer test (C) is used to assess for posterior cruciate ligament tears. It is performed by having the patient flex the knee to 90 degrees while lying supine and attempting to move the lower leg posteriorly.
The valgus stress test (D) is done to assess for a medial collateral ligament injury by placing one hand on the ankle and one over the femur while attempting to externally rotate the tibia.
