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Musculoskeletal Flashcards

1
Q

Most likely presentation for gout

A

redness at first metatarsophalangeal joint

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2
Q

How would you tx a gout attack

A

intraarticular corticosteroid injection
naproxen
colchicine

allopurinol and febuxostate for prevention not tx of attack

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3
Q

potential triggers for gout

A

thiazide diuretic
sardines and anchovies
alcohol

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4
Q

etiology of gout

A

can be from an overproduction of uric acid, but an urate under-excretion is more common

made worse by renal insufficiency, alcohol, diuretics, aspirin and purine rich foods

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5
Q

purine rich foods

A

organ meats
seafood
spinach
oatmeal

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6
Q

Test used for meniscal tear

A

McMurray test

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7
Q

Test used for ankle instability

A

Talar tilt

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8
Q

Test used for Carpal tunnel

A

Tinel’s sign

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9
Q

Test used to eval ACL tear

A

Lachman test

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10
Q

Test for lumbar nerve root compression

A

Straight leg raising test

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11
Q

Test for rotator cuff tear

A

Drop arm test

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12
Q

Test for De Quervain’s tenosynovitis

A

Finkelstein test

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13
Q

What are some system signs of musculoskeletal issues

A 
fever
weight loss
anemia
rash
joint swelling
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14
Q

woman complains of fatigue and aching of her hips and shoulders x 2 months and struggles to get dressed. Her grip strength is normal but decreased active range of motion. Her joints are cool and smooth. Has a Hgb of 10.8 and increased set rate. What is her dx?

A

Polymyalgia rheumatica

She has anemia of chronic disease as well which helps you rule out fibromyalgia and osteoarthritis

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15
Q

Tx for polymyalgia rheumatica

A

corticosteroids

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16
Q

Expected findings with lumbar stenosis

A

back pain worse with standing (psudoclaudication)
bilateral leg numbness
pain improvement with flexion forward
age >50

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17
Q

Dx for lumbar stenosis

A

MRI or EMG if symptoms last longer than 1 month

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18
Q

Tx lumbar stenosis

A

PT
NSAIDS
epidural
surgery

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19
Q

Reiter’s syndrome presentation

A

can’t see
can’t pee
can’t climb a tree

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20
Q

Test if you suspect reiter’s syndrome

A

Urinary test for gonorrhoeae and trachomatis

21
Q

Clinical presentation of Osgood-Schlatter disease

A

anterior knee pain worse with squatting and walking up or down stairs and better with rest.

tender swollen tibial tuberosity

22
Q

Tx for Osgood Schlatter

A

rest

23
Q

Appropriate sport for someone with bleeding disorder

A

swimming

24
Q

Lumbar sacral strain

A

most common reason for low back pain
it can spasm, ache, stiffness
may have paraspinal muscle tenderness but normal neuro

25
Q

Lumbar rediculopathy

A

irritation or damage of the neural structures
L4-L5, L5-S1 most common
sharp, burn worse with increased pressure from sneezing or coughing

abnormal straight let raise and altered DTRs
try conservative therapy first

26
Q

Motor testing for L4 nerve root

A

Foot dorsiflexion

27
Q

Reflex testing for L4 nerve root

A

knee jerk

28
Q

Sensory area for L4 nerve root

A

medial calf

29
Q

Motor testing for L5 nerve root

A

great toe dorsiflexion

30
Q

Reflex testing for L5 nerve root

A

none

31
Q

sensory area for L5 nerve root

A

medial foot

32
Q

Motor testing for S1 nerve root

A

foot eversion

33
Q

Reflex testing for S1 nerve root

A

ankle jerk

34
Q

Sensory area for S1 nerve root

A

lateral foot

35
Q

When is imaging indicated for low back pain

A

after 2 months of conservative therapy and signs of radicular pain that persists

36
Q

What areas does a Dexa scan look at

A

spine
hip
forearm

37
Q

Normal bone mineral density

A

BMD within 1 SD of a younger normal adults

T score at -1.0 or greater

38
Q

osteopenia defined

A

BMD between 1.0 and 2.5 SD below that of normal

T score between -1.0 and -2.5

39
Q

osteoporosis defined

A

BMD 2.5 or more SD below normal

T score > -2.5

40
Q

Who should have BMD testing

A

women 65 and older
men 70 and older
younger postmenomausal women
anyone older than 50 who has broken a bone
taking meds that can cause bone loss (steroids)

41
Q

Risk factors for osteoporosis and fractures

A 
limited physical activity
alcohol
low calcium
cystic fibrosis
hyperprolactinemia
celiac disease
inflammatory bowel disease
myeloma
lupus 
RA
epilepsy
AIDS/HIV
42
Q

Meds to tx osteoporosis

A

bisphosphonates: alendronate, ibandronate, zoledronic acit

Vit D 800-1000 u/day
Calcium intake 1200mg/d

43
Q

What can be found with rheumatoid arthritis

A

anemia

elevated C-reactive protein

44
Q

What can be found with systemic lupus erythematosus

A

positive antinuclear antibody titer
anemia
elevated C-reactive protein

45
Q

What can be found with Osteoarthritis

A

joint space narrowing

no increase in CRP or set rate

46
Q

Where are Heberden’s nodes located

A

Distal phalangeal joints

47
Q

Where are Bouchard’s nodes located

A

medial phalangeal joints

48
Q

characteristics of osteoarthritis

A

more you use the worse it gets

49
Q

what could help symptomatic osteoarthritis of knee

A

strengthening and low impact aerobic exercise
weight loss
corticosteroids

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