Musculoskeletal

Question 1

Back Pain that is exacerbated by standing and walking and relieved with Sitting and hyperflexion of the hips

Answer 1

Spinal Stenosis

Question 2

Joints in the hand affected in rheumatoid arthritis

Answer 2

MCP and PIP

DIP joints are SPARED

Question 3

Joint pain and stiffness that worsen over the course of the day and relieved by rest

Answer 3

Osteoarthritis

Question 4

Genetic disorder assocatied with multiple fractures and commonly mistaken for child abuse

Answer 4

Osteogenesis imperfecta

Question 5

Hip and back pain along with stiffness that improves with activity over the course of the day and worsens at rest

Diagnostic test?

Answer 5

Suspect ankylosing spondylitis

Check HLA-B27

Question 6

Arthritis, Conjunctivitis, and urethritis in young men.

Associated organisms?

Answer 6

Reactive (Reiter’s) arthritis.

Associated with Campylobacter,
Shingella
Calmonella
Chlamydia
Ureaplasma

Question 7

55 year old man has sudden excruciating first MTP joint pain after a night of drinking red wine.

Diagnosis?
Workup
Chronic TX?

Answer 7

Gout
Needles Shaped, negatively birefringent crystals

Chronic Tx- Allopurinol or Probenecid

Question 8

Rhomboid-shaped, positively birefrindent crystals on joint fluid aspirate

Answer 8

Pseudogout

Question 9

Elderly women presents with pain and stiffness of the shoulders and hips; she can’t lift arms above her head. Lab shows Anemia and increase ESR

Answer 9

Polymyalgia Rheumatica

Question 10

Active 13 year old boy has anterior knee pain

Dx?

Answer 10

Osgood-schlatter disease

Question 11

Bone is fractured in a fall on an outstretched hand

Answer 11

Distal Radius (Colles’ fracture)

Question 12

Complication of scaphoid fracture

Answer 12

Avascular necrosis

Question 13

Signs suggesting radial nerve damage with humeral fracture

Answer 13

Wrist Drop

Loss of thumb abduction

Question 14

Young Child rpesents with proximal muscle weakness, waddling gait, and pronounced calf muscles

Answer 14

Duchenne Muscular Dystrophy

Question 15

1st born female who was born in breech position is found to have asymmetric skin folds on her newborn exam

Dx

Tx

Answer 15

Developmental dysplasia of the hip

If severe, consider a Pavlik harness to maintain abduction

Question 16

11 y/o obese AA boy presents with sudden onset of limp.

Dx

Workup

Answer 16

Slipped capital femoral Epiphysis

AP and Frog leg lateral view

Question 17

Most common 1 malignant tumor of bone

Answer 17

Multiple Myeloma