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Adult Health > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

1
Q

How often does lower back pain resolve?

A

90% in 6-12 weeks

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2
Q

DD for lower back pain?

A

Lumbar strain, disc buldge, Degenerative disc disease, spinal stenosis, spondyloarthropathy, spondylosis, sacroiliac dysfunction

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3
Q

What do you do to test for spondylosis?

A

HLA-B27

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4
Q

When do you do radiographic tests?

A

Hx trauma, 55 years with persistent pain, noted spinal deformity, S&S of spondyloarthropathy, suspicion for tumor or infection, failure of conservative treatment after 6 weeks.

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5
Q

When is lower back pain an emergency?

A

Cauda Equina syndrome

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6
Q

Treatment for lower back pain?

A

NSAIDs, steroids, non-narcotics, muscle relaxers, narcotics rarely indicated, Physcial terapy, surgery

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7
Q

What is herniated disc?

A

Nucleus pulpus is forced through a weakened part of the disc;

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8
Q

Symptoms of herniated disc

A

Low back pain with associated leg symptoms

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9
Q

How successful is conservative treatment with herniated disc?

A

90% symptom management with non operative management

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10
Q

What is a tendon?

A

Attach muscle to bone

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11
Q

Common sites of tendonitis?

A

Rotator cuff, insertion of wrist extensors and flexors at elbow, tibial tenon at leg, patellar and poplital, illiotibial, achilles tendons

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12
Q

Symptoms of Tendonitis?

A

Pain under pressure, restricted movement, burning sensation, swollen, red, warm

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13
Q

Treatment of tendonitis?

A

Radiology is rarely indicated, PRICE, brace area, anti-inflammatory agents

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14
Q

Treatment for DeQuervian’s Tendonitis?

A

Base of thumb, occurs over snuff box, point for 3-6 weeks, NSAIDS for two weeks

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15
Q

What is bursitis?

A

Painful inflammation of bursa

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16
Q

Risk factors for bursitis?

A

Over use, not stretching, rheumatoid disease, staphylococcal or other bacterial infections

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17
Q

Symptoms of bursitis

A

Pain that increases with movement of joint, joint tenderness, with swelling and redness in affected area

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18
Q

Treatment of bursitis?

A

Anti-inflammatory drugs, injection of corticosteroids, may need surgical intervention

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19
Q

Three types of femoral neck fractures?

A

Femoral neck (high risk for avascular necrosis), intertrochanteric, and subtrocanteric

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20
Q

Diagnosis and S&S of hip fracture?

A

Pain, inability to bear weight, shortened leg, externally rotated, tenderness over groin, hip motion painful, XR of hip. If negative, do MRI

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21
Q

What is carpel tunnel syndrome?

A

repetitive stress injury due to inflammation of the tissues around the median nerve

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22
Q

S&S of Carpal tunnel?

A

Pain in wrist and hand, nubness, pain that wakes you up at night, all but pinky and side of ring fever

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23
Q

DD of carpel tunnel syndrome?

A

Arthritis, cervical radiculopahty, (C6 thumb and index finger only), DM with neuropathy, cubism, wrist arthritis

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24
Q

Exam for carpel tunnel?

A

Tunnel’s sign, phalen’s sign, hypothenar atrophy

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25
Q

Diagnostic test for carpel tunnel?

A

Electromyography, XR to r/o fractured bones

26
Q

Conservative tx for carpel tunnel?

A

RICE, NSAIDs, srugery, B6, acupuncture, electromagnetic fields

27
Q

When do you refer for carpel tunnel?

A

Thenar atrophy or failure of conventional treatment

28
Q

What is plantar fasciitis?

A

Inflammation of plantar fascial tissue, adjacent to its insertion into heel.

29
Q

Etiology of plantar fasciitis?

A

strucutral abnormlaitis, flat foot, high arch, runners

30
Q

Symptoms of plantar fasciitis?

A

Foot pain with worst pain in morning, sharp, dull,

31
Q

Treatment for Plantar Fasciitis?

A

NSAIDs, night splints, ice the sore area, supporting splints, weight loss

32
Q

Lumbar stenosis pathology

A

Narrowing of the canal with compression of the nerve roots

33
Q

Symptoms of lumbar stenosis?

A

Pseudoclaudication causing radiuclar complaints, unlike claudication, does not get better with rest. May bend over to reduce pain, may have atrophy, incontenence

34
Q

Treatment of lumbar stenosis?

A

PT, NSAIDS, injections, refer to neurosurgery for bad pain

35
Q

What about Paget’s disease?

A

Second most common disease after osteoarthritis, leading to weaker bones

36
Q

When does pain occur with paget’s disease?

A

Occurs at night

37
Q

Test for Paget’s disease?

A

Radionucleotide test

38
Q

Differential diagnosis for Paget’s disease?

A

Cancer/ metastasis

39
Q

Treatment for Paget’s disease?

A

Biphosphinates, calcitonin for patients that can’t handle biphosphanates

40
Q

Path of multiple sclerosis?

A

Demyelinating disease of CNS and usually begins in young adulthood and frequently associated with vision changes, weakness, numbness, loss of balance

41
Q

Four types of multiple sclerosis?

A
  1. Replasing remitting
  2. Primary Progressive
  3. Secondary Progressive
  4. Progressive relpasing
42
Q

Subjective complaints of MS?

A

Sensory disturbances, spasticity, ataxic gait, paresthesias, fatigue, optic neuritis, trigeminal neuralgia

43
Q

Diagnosis of MS?

A

Done by neurologist, two or more parts of the CNS must be involved

44
Q

Treatment of MS?

A

Glucocorticoids are mainstay of treatment, with new medications prescribed by neurologist. May need plasma exchange for patients refractory to glucocorticoids

45
Q

Symptoms of polymyalgia rheumatica

A

usually older than 50 y.o., involves shoulders, hip girdle, neck, and torso, decreased ROM, subjective weakness

46
Q

Other condition that occurs with polymyalgia rheumatica?

A

Occurs with GCA- jaw claudication, new headache, scalp tenderness.

47
Q

Diagnosis of PM?

A

ESR >40, the rest of the labs should be normal for rheumatoid diseases. Should resolve quickly with steroids

48
Q

Differential diagnosis for PM?

A

rheumatoid arthritis, bone disease, drug induced myalgia, inflammatory myopathy, fibromyalgia

49
Q

Fibromyalgia symptoms and chronic fatigue syndrome?

A

Post exercise malaise, fatigue, multiple joint pains, headaches, impaired memory and concentration, depressed mood, cognitive disturbances, sore throat, restless and disordered sleep, vague symptoms

50
Q

What should you rule out for fibromyalgia symptoms?

A

sleep apnea

51
Q

Objective assessment for FM?

A

Widespread apin, at least 11/18 trigger points.

52
Q

Treatment for FM?

A

CBT and graded exercise has best outcomes. May use amitriptyline, lyrics, and SSRI.

53
Q

What two diseases are associated with carpel tunnel syndrome?

A

Hypothyroidism and pregnancy because of swelling

54
Q

Most common cause of bursitis?

A

Joint overuse

55
Q

Most symptoms of low back pain are caused by?

A

Muscle or ligamentous strain.

56
Q

Primary prevention for CTS includes?

A

Stretching and toning exercises

57
Q

Straight leg tests compression of which roots?

A

L5 S1

58
Q

First line bursitis treatment includes?

A

NSAIDS

59
Q

Red Flags for back pain?

A

Unexplained fever or wt loss, immunospression, >70 y.o., osteoporosis, duration >6 weeks, indwelling catheter, recent UTI or cellulitis, bowel/bladder incontenece, trauma/heavy lifting > 50 y.o., Hx malignancy or IVDU, prolonged steroid use, focal neuro deficit, new back pain >50 y.o., pain at night, urinary retention.

60
Q

Four muscles of the rotator cuff?

A

1 supraspinatus
2 infraspinatus
3 teres minor
4 subscapularis

Adult Health (21 decks)

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