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Family Med > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

1
Q

What are the ottawa ankle rules for X-ray?

A
  • Bony tenderness on posterior edge of malleoli (laterally)
  • Navicular tenderness
  • 5th Metatarsal tenderness
  • Inability to bear weight for 4 steps in the ED
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2
Q

What is the squeeze test used to diagnose?

A

High ankle sprain – syndesmosis tear

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3
Q

How is the thompson test performed and test for?

A

Patient laying prone and feet extended over the edge of the table, squeeze the calf (gastrocnemius/soleus) are compressed flexing achilles – plantar flexion

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4
Q

What is the best test for ruling in/out an ACL tear?

A

Lachman Test – knee flexed to 30 degrees while supine

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5
Q

If a patient has a positive sag sign, what should you do and be suspicious of?

A

PCL tear, should perform posterior drawer test

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6
Q

What is the McMurray test used for in diagnosing?

A

Meniscal damage

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7
Q

What are the Ottawa knee rules for x-rays?

A
    • Age 55+
    • Tenderness over the proximal fibular head
    • Isolated patella tenderness
    • Inability to flex to 90
    • Inability to bear weight for 4 steps
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8
Q

What are the most effective treatment options for Degenerative joint disease?

A

– Glucosamine or Corticosteriod joint injections

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9
Q

What are the big differences between osteoarthritis and rheumatoid arthritis?

A

OA – M>F, chronic, includes DIP joints and big joints, stiffness only lasts short amount of time
RA – F»M, chronic flare ups, 40-60, inflammatory features, 45-1hr stiffness time

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10
Q

What is commonly associated with RA?

A
    • Other autoimmune disorders
    • Systemic symptoms
    • pulmonary nodules
    • fibrosis pericarditis
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11
Q

How can you test for and diagnose RA?

A
  • Arthritis in symmetric joints lasting 6weeks+
  • Positive Rheumatoid Factor
  • Radiologic damage of joints present
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12
Q

Does a high uric acid level in the blood correlate to acute exacerbation of gout?

A

False

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13
Q

What are the best medications for acute symptomatic relieve of gout pain?

A
    • NSAIDS
    • Intra-articular steroids
    • Colchicine
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14
Q

What should not be used in an acute gout attack?

A

ASA
Allopurinol
Febuxostat

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15
Q

What is the best treatment for chronic gout?

A

– Reduce red meat, beer/liquor, increase liquid intake (not soft drinks), Vitamin C, and take Allopurinol/Febuxostat

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16
Q

If a patient is an over producer of urate, what is the best pharmocologic agent?

A
  • Allopurinol

- Febuxostat

17
Q

If a patient is an under secretor of uric acid?

A

Probenecid – increase secretion

– contraindicated in nephrolithiasis

18
Q

What are the nerve root for knee extension?

A

L4

    • Medial Foot Sensation
    • if deficit unable to squat and rise
    • DEFECTIVE PETELLAR REFLEX
19
Q

If there is a lesion at L5, where would you find abnormalities?

A

Weakness in Dorsiflexion ankle/Great Toe
Dorsal Foot sensory loss
– Unable to Heel Walk
– No reflex changes

20
Q

If there is a herniated disc at S1, what might you expect to find?

A
    • Lateral Foot loss sensation/shooting pains
    • Weak/Loss Achilles relfex
    • Plantarflexion ankle/toes weakness
  • Unable to Walk on toes
21
Q

When is the only time you should get imaging of the spine?

A

Worried about fracture

22
Q

If a patient has dorsiflexion weakness, positive straight leg raise, and lower back pain. What is the most likely diagnosis?

A

Herniated Disc

23
Q

If a patient has improved pain with sitting down and pain in their legs when walking down stairs and when on feet for periods of time?

A

Spinal Stenosis

24
Q

What two exam tests can be performed to evaluate neck pain?

A
  • -Spurling Test – bend side to side toward painful side

- - Arm Abduction test – reduces pressure on nerve outlet

25
Q

When do you image a patient who is having neck pain?

A

When they have had unsuccessful treatment of their symptoms which involve neurologic syndrome, need to further eval for possible surgery.

26
Q

What muscles include the rotator cuff?

A

Supraspinatus
Infraspinatus
Teres Minor
Subscapularis

27
Q

If a patient has shoulder pain with “empty can” test?

A

Supraspinatus dysfunction

28
Q

If a patient has difficulty with external rotation of the shoulder, what does this indicate?

A

usually there might be a problem with the infraspinatus muscle

29
Q

What testing can you do, while looking for impingement of the rotator cuff?

A

Hawkins Impingement Test – arm in front bent at 90 degrees

30
Q

If a patient has a positive apprehension test, then what would you be worried about?

A

Dislocation

Family Med (9 decks)

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