Musculoskeletal

Question 0

Give the dexa score for osteopenia? Osteoporosis?

Answer 0

Osteopenia = 1 to 2.4 standard deviations, osteoporosis = 2.5 standard deviations or greater.

Question 1

At what age should you begin ordering dexa scans for male patients? What about female patients?

Answer 1

70 for males, 65 for females

Question 2

Check L5 nerve root for:

Answer 2

• decreased ankle strength
• decreased strength of great toe dorsiflexion
• numbness of the medial foot and the webspace between the 1st and 2nd toe

Question 3

Check S1 nerve root for:

Answer 3

• Numbness of posterior calf or lateral foot
• weakness of plantar flexion
• achilles reflex

Question 4

Ankylosing spondylitis

Answer 4

• Schober’s test
• bamboo spine
• elevated C-reactive protein & sed rate
• HLA-B27

Question 5

What ligament is most commonly injured in an ankle sprain?

Answer 5

Anterior talofibular ligament

Question 6

MC primary malignant bone tumor?

Answer 6

Multiple myeloma

Question 7

MC primary malignancies which metastasize to the bone?

Answer 7

Prostate, breast and lung

Question 8

Sunburst lesion on x-ray =

Answer 8

Osteosarcoma or ewings sarcoma

Question 9

MC pathogen osteomyelitis?

Answer 9

Staph aureus

Question 10

MC cause of osteomyelitis in a sickle cell patient?

Answer 10

Salmonella

Question 11

Vasculitis with a hepatitis B history should make you think of what diagnosis?

Answer 11

Polyarteritis Nododa

Question 12

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

Answer 12

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

Question 13

What fracture is the #1 cause of compartment syndrome?

Answer 13

Tibial shaft fracture

Question 14

A pathology report comes back with positive birefringent crystals. What is the most likely diagnosis?

Answer 14

Pseudogout

Question 15

A new mother presents with pain over the radial wrist. She has a positive Finkelstein’s test. What is the most likely diagnosis?

Answer 15

de Quervain’s tenosynovitis

Question 16

A patient’s labwork shows positive Smith antibody and positive double-stranded DNA antibodies. What is the most likely diagnosis?

Answer 16

Lupus

Question 17

What is the medical term for tennis elbow?

Answer 17

Lateral epicondylitis

Question 18

What major characteristic is used to identify a lower motor neuron lesion?

Answer 18

Flaccid paralysis or weakness in contrast to an upper motor neuron lesion which presents with spastic paralysis (paralysis accompanied by hypertonia)

Question 19

Anti jo antibodies should make you think of what diagnosis?

Answer 19

Polymyositis

Question 20

What is the most common knee injury?

Answer 20

Medial meniscal tear

Question 21

What test do you do for Sjogren’s syndrome?

Answer 21

Schirmer test

Question 22

What medication is used for patients with lupus?

Answer 22

Systemic steroids

Question 23

Where are Heberden’s nodes found?

Answer 23

DIP (OA)

Question 24

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

Answer 24

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

Question 25

Patient presents with conjunctivitis, urethritis, arthritis and oral lesions. What is the most likely diagnosis? What other lab might you expect to be positive?

Answer 25

Reactive arthritis, HLA B-27

Question 26

What is the most common fracture in children?

Answer 26

Clavicle

Question 27

A positive Hawkins test indicates what diagnosis?

Answer 27

Rotator cuff impingement

Question 28

List three medication that may cause lupus.

Answer 28

Procainamide, isoniazid and quinidine