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Step 2 > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

1
Q

Injury to shoulder, holds arm in abducted, ext rotated: dx, tx, nerve injry

A

anterior dislocation, risk axillary nerve injury, reduction with sling

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2
Q

Post vs ant hip dislocation: nerve injury, tx

A

Ant: obturator
Post: sciatic nerve, AVN
Tx: closed reduction + abduction pillow
CT after reduction

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3
Q

Fall on outstretched hand leads to dorsally placed, dorsally angled fracture: dx, tx

A

Dx: colles fracture (distal radius
Tx: closed reduction + long arm cast (open if intra-articular fx)

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4
Q

Tenderness in anatomical snuff box: dx and tx

A

Scaphoid fracture

thumb spica cast; if displacement open reduction

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5
Q

Injury assoc with humerus fx

A

radial nerve palsy: wrist drop, loss of thumb extension

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6
Q

Tx of ulnar fx

A

ORIF if significantly displaced

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7
Q

Diaphyseal fx of proximal ulna with subluxation ulnar head: type and tx

A

monteggia’s fx

ORIF of shaft, closed reduction radial head

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8
Q

Galeazzi fx: diaphyseal fx of radius with dislocation distal radial-ulnar joint: cause and tx

A

direct blow to radius

ORIF of radius, casting with supination

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9
Q

Tx + complication of femoral fx

A

Fat emboli

intramedullary nailing, irrigate and debride if open

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10
Q

Common complication of tibila fx

A

compartment syndrome

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11
Q

limited plantar flexion and + Thompson test (pressure on gastrocnem absent foot plantar flexion): dx and tx

A

achilles tendon rupture

surgical + long leg cast for 6 weeks

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12
Q

herniate disc: common affected regions, tx

A

L5-S1

NSAID, PT, local heat, continue normal activity

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13
Q

neck pain, back pains that radiates to buttocks and legs, leg numbness/ weakness; leg cramping worsens with standing, improves with felxion at hips/ bending forward: dx and tx

A

spinal stenosis
NSAIDS/abd muscle strength
epidural corticosteroids (severe)
Laminectomy (refract)

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14
Q

“onion-skin” on diaphyseal region of femur

A

ewing sarcoma

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15
Q

soap bubble, on epiphyseal region long bones

A

giant cell tumor

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16
Q

progressive pain, worsen at night, sumburst pattern on xr: dx and common regions

A

osteosarcoma

distal femur, proximal tibia, proximal humerus

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17
Q

Empiric tx of septic arthritis

A

cetriaxone and vancomycin

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18
Q

anti-CCP antibodies

A

Rheumatoid arthritis

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19
Q

Joints affected: OA vs RA

A

OA: DIP (heberden) /PIP (Bouchard) / hips/ knees
RA: wrist, MCP, ankle, knee, shoulder, hip, elbo

20
Q

Rhomboid vs needle shaped crystals: joint pain

A

Rhomboid: psudogout, + birefring (calcium pyrophosphate)
Needle: gout, neg biref

21
Q

Acute and long term tx of gout

A

acute: NSAID > cochicine; steroids
Maintenance: allopurinol (overproducers); probenicid (undersecretors); weight loss + avoid ETOH

22
Q

Back pain with Decr spine flexion, loss lumbar lordosis, worse with morning: dx and other risks

A

Ankylosing spondylitis; HLA B27

anterior uveitis and heart block

23
Q

arthritis, uveitis, conjunctivits, urethritis in young man: dx and cause

A

reactive/ reiter arthritis

infx with campy, shigella, slamonella, chlamydia, ureaplasma

24
Q

sausage-shaped digits, DIP joint: dx

A

psoriatic arthritis

25
Q

asymmetric sacroilitis: dx and common assoc disease

A

enteropathic spondylitis, IBD

26
Q

Symmetric proximal muscle weakness, heliotrope rash: dx and tx

A

polymyoisits/ dermatomyositis
high dose corticosteroids 4-6 wks
azathioprine/ MTX

27
Q

Anticentromere Ab

A

CREST syndrome

28
Q

Antihistone Ab

A

Drug-induced SLE

29
Q

Antimitochondrial Ab

A

PBC

30
Q

Anti-smooth muscle B

A

Autoimmune hepatitis

31
Q

cANCA vs pANCA

A

cANCA: Wegener
pANCA: microscopic polyangitis

32
Q

U1RNP ab

A

mixed connective tissue disease

33
Q

RA, splenomegaly, neutropenia

A

Felty’s syndrome

34
Q

RA tx

A 
NSAIDs
Disease modifying (1st line): MTX, hydroxychloroquine, sulfasalzine
35
Q

symmetric thickening of skin of face or distal extr, pulm fibrosis: dx and tx

A 
scleroderma
Corticosteroids (acute)
Penicillamine (skin)
Ca Ch block (Raynaud's)
ACEI (renal)
36
Q

noninfectious vegetations on mitral valve: dx and assoc dis

A

Libman-sacks endocarditis; SLE and APLAS

37
Q

pain accompanied by loss of function and autonomic dysfunction after trauma: dx and tx

A

Complex regional pain syndrome
NSAIDS, corticosteroids, low-dose TCAs, gabapent
Chemical sympathetic block

38
Q

Fibromylagia vs polymyalgia rheumatica: joints involved and tx

A

Fibromylagia: various joints (>11 of 18, all 4 regions body); NSAIDs, Antidepr, rest, PT
Polymyalgia rheumatica: shoulder + pelvic girdle; low-dose prednisone

39
Q

Muscle Bx: necrotic muscle fibers, variation in fiber size with fibrosis: Dx and tx

A

Neg dystrophin
Duchenne
PT, use of tendon release to maintain mobility

40
Q

Cause of death: DMD

A

pulm congestion caused by high output cardiac failure

41
Q

Refusal to bend elbow after being lifted by arm: dx and tx

A 
nursemaid elbow (radial head subluxation)
manual reduction by gentle supination of elbow at 90deg fexion; no immobilization
42
Q

Supracondylar humerus fx: risk + tx

A

brachial artery entrapment, Volkmann contracture (compartment syndr)
cast immobilization

43
Q

hip dysplasia: tx by age

A
44
Q

Limited abduction and internal rotation, painless limp or groin pain: dx and tx

A

legg-calve-perthes
AVN femoral head
observation if nl ROM. pracing

45
Q

pediatric acute groin or knee pain, painful , inability to bare weight, limited internal rotation and abduction: dx and tx

A

AP and frog leg laterals, TSH
Slipped capital femoral epiphysis
percutaneous single-screw fixaiton, no weight bearing until surgery

46
Q

Arthritis, high-spiking fevers, maculopapular, evanescent salmon-colored rash (pediatric)

A

Still’s disease

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