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PCE > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

1
Q

Paget’s disease of bone labs

A

Urine hydroxy-proline UP
Blood alkaline phosphatase UP
Calcium NORMAL
Phosphate NORMAL

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2
Q

Fibromyalgia treatment

A

TCA 1st line

SNRI 2nd line

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3
Q

Rotator cuff impingement tests

A

Neer and Hawkins

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4
Q

Giant cell arteritis

A

Also called temporal arteritis
Highly associated with polymyalgia rheumatica
Predominantly whites women in 80s

Segmental involvement so could have negative artery biopsy
Blindness caused by ischemic optic beuritis

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5
Q

Gout attack characteristics

A

Can cause low grade fever

Typically have abrupt onset hitting max at 12-24 hrs

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6
Q

Ankylosing spondylitis exam findings

A 
Dactylitis
Uveitis
Sacroiliitis
Enthesitis
Reduced spinal mobility
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7
Q

Subacute pain reproduced by stretching the wrist extensors

A

Lateral epicondylitis (tennis elbow)

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8
Q

Dermatomyositis can be paraneoplastic

A

Gottron papules and heliotrope rash

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9
Q

Lambert Eaton myasthenic syndrome (LEMS)

A 
proximal muscle weakness
autonomic dysfunction (erectile, dry mouth)
loss of deep tendon reflexes (that return with repeated use of muscle groups)
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10
Q

most common cause of back pain after lifting

A

lumbosacral strain

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11
Q

Pseudogout association

A

hemochromatosis

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12
Q

de quervain tenosynovitis

A

classically affects new mothers
inflammation of the abductor pollicis longus and extensor pollicis brevis
Finkelstein test positive (grasping flexed thumb into fingers produces the pain)

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13
Q

scaphoid fracture

A

usually occurs due to FOOSH

pain localized to the anatomical snuff box

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14
Q

trigger thumb

A

pain at thumb MCP, causing thumb to be locked in flexion

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15
Q

osteoarthritis knee exam

A

crepitus
some swelling and warmth
new bony growths
baker cysts (highly associated)

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16
Q

pes anserinus syndrome

A

anteromedial tibia pain

highly associated with female and diabetics

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17
Q

causes of chronic low back pain

A

1) mechanical
2) cancer
3) infection
4) inflammation
5) radicular
6) stenosis (relieved by leaning forward)
>12 weeks *encourage PT
<12 weeks *use NSAIDs and tylenol

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18
Q

atlanto-axial dislocation

A

often trauma or RA

can cause quadriplegia

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19
Q

Spondylolysis

A

genetics or gymnasts
Usually L5 pain
Can progress to spondylolithesis and dislocation
Best seen on lateral film

20
Q

Pain from ankylosing spondylitis

A

Stiffness

Pain that CAN awaken from sleep

21
Q

Humerus greater tuberosity fracture

A

Rotator cuff tendon injury

supraspinatus (most common), infraspinatus, teres minor, subscapularis

22
Q

Humerus surgical neck fracture

A

axillary nerve damage

23
Q

Humerus shaft fracture

A

Radial nerve damage (radial spiral groove)

24
Q

Humerus supracondylar fracture (just above the elbow)

A 
median nerve and brachial artery
Volkmann's ischemic contracture
(damage and flexion of the arm and hands)
1) no flexion of digits 1-3
2) no wrist flexion
3) no pronation 
makes "hand of benediction"
25
Q

humerus medial epicondylar fracture

A 
ulnar nerve damage
1) no flexion of digits 4-5
2) no wrist flexion on ulnar side
3) no interosseos
"claw hand deformity"
CAN ALSO OCCUR WITH FRACTURE AT HOOK OF HAMATE
26
Q

Distal radius fracture (Colles)

A

Occurs after FOOSH
Often has ulnar styloid process fracture as well
Dinner fork deformity

27
Q

Scaphoid fracture

A

Pain localized to the anatomical snuffbox
Often missed on XRAY
Can lead to avascular necrosis
Repeat Xray in 10 days to see

28
Q

Femoral neck fracture

A

mostly in women with osteoporosis
Can damage medial circumflex femoral artery
Leads to avascular necrosis
Leg shorter and turned out

29
Q

Pott fracture

A

extreme foot eversion

Medial ligament very strong so pulls off piece of malleolus

30
Q

Fracture of the fifth metatarsal

A

Extreme foot inversion

Breaks lateral malleolus and fibular head

31
Q

Legg-Calve-Perthes disease

A

Avascular necrosis of the capital femoral epiphysis
Usually in male children 3-12 yo
Self resolving but can lead to OA

32
Q

How to reduce radial head subluxation

A

elbow flexed -> supination

33
Q

lateral impact force on the knee

A

Injury to medial collateral ligament

BUT ALSO medial meniscus because of attachment to MCL

34
Q

ACL course

A

anterior tibia to postero-lateral femur

35
Q

Gluteal muscle innervation and functions

A

Glut maximus - inferior gluteal nerve - abduct
Glut medius - superior gluteal - abduct and medially rotate
Glut minimus - superior gluteal - abduct and medially rotate
Other butt muscles laterally rotate

36
Q

anterior compartment of forearm function

A

wrist flexion AND arm pronation

37
Q

Piriformis syndrome

A

sciatic nerve usually comes out under piriformis
If comes out through it, then hypertrophy of muscle will cause pain
Common in bikers, climbers, skaters

38
Q

Sign of damaged superior gluteal nerve

A

Trendelenburg sign

Lift left leg up, if hip drops to left, then right is damage

39
Q

Common fibular (peroneal) nerve damage

A

takes out anterior and lateral compartment

Cannot dorsiflex foot, or evert

40
Q

Innervation for diaphragm

A

C3-4-5

41
Q

Cancers that met to bone

A 
BLT w/ Cool Kosher Pickle
Breast
Lung
Thyroid
Colon
Kidney
Prostate
Preferred site is vertebrae, proximal femur, pelvis
42
Q

predisposition for osteoma

A

FAP

43
Q

predisposition to osteosarcoma

A

Pagets
Radiation
Familial retinoblastoma

44
Q

Enchondroma

A

usually in small bones of hands
Can be multiple
looks like popcorn with calcified stippling

45
Q

reactive bone in OA

A

Subchondral sclerosis (eburnation)

46
Q

RA vs OA

A 
OA also morning stiffness but resolves in <30 min
RA usually >60 min
OA affects C/T/L spine; RA only C spine
RA associated with HLA-DR4
OA gives bone cysts
RA gives baker cysts
RA gives pannus (thickened synovium)
RA can lead to other serositis like pleural or carditis

PCE (15 decks)

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