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USMLE Step Two > Musculoskeletal Disorders > Flashcards

Musculoskeletal Disorders Flashcards

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USMLE® Step 1 flashcards
1
Q

claw hand

A

ulnar nerve injury

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2
Q

ape hand

A

median nerve injury

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3
Q

wrist drop

A

radial nerve injury

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4
Q

scapular winging

A

long thoracic nerve injury

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5
Q

unable to wipe bottom

A

thoracodorsal nerve injury

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6
Q

loss of forearm pronation

A

median nerve injury

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7
Q

cannot abduct or adduct fingers

A

ulnar nerve injury

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8
Q

loss of arm abduction

A

axillary nerve injury

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9
Q

weak lateral rotation of arm

A

suprasacpular nerve or axillary nerve injury

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10
Q

loss of arm and forearm flexion

A

musculocutaneous nerve injury

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11
Q

loss of forearm extension

A

radial nerve injury

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12
Q

trouble iniating arm abduction

A

suprascapular nerve injury

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13
Q

unable to aduct arm beyond 10 degrees

A

axillary nerve injury

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14
Q

unable to raise arm above horizontal

A

long thoracic nerve and accessory nerve injury

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15
Q

what nerve is most at risk of injury with fracture of shaft of the humerus

A

radial nerve

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16
Q

what nerve is most at risk of injury with fracture of surgical neck of the humerus

A

axillary nerve

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17
Q

what nerve is most at risk of injury with fracture of supracondyle of the humerus

A

median nerve

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18
Q

what nerve is most at risk of injury with fracture of medial epicondyle

A

ulnar nerve

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19
Q

what nerve is most at risk of injury with fracture of anterior shoulder dislocation

A

axillary nerve

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20
Q

what nerve is most at risk of injury with injury to the carpal tunnel

A

median nerve

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21
Q

most commonly injured knee ligament

A

medial collateral ligament

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22
Q

positive lachman test

A

anterior cruciate ligament

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23
Q

positive mcmurray test aids in diagnosis

A

meniscal tear

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24
Q

common dashboard knee injury in an MVA

A

PCL tear

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25
Q

classic symptoms of carpal tunnel syndrome

A

weakness, tingling of thumb, index, and middle fingers, decreased 2-point discrimination, thenar atrophy, possible pain radiating to elbow

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26
Q

nerve injured in carpal tunnel syndrome

A

medial nerve

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27
Q

difference between monteggia’s fracture and galeazzi’s fracture

A

monteggia is dislocation of radial head with ulnar diaphyseal fracture and galeazzi is dislocation of distal radial ulnar joint with radial diaphyseal fracture

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28
Q

fall on outstretched arm with snuffbox tenderness

A

scaphoid fracture

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29
Q

anterior shoulder dislocation complication

A

axillary nerve/artery injury

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30
Q

fracture of fifth-metacarpal neck complication

A

irrigation and antibiotics (likely bite wound)

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31
Q

humerus fracture complication

A

radial nerve injury

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32
Q

hip fracture complication

A

DVT formation and avascular necrosis

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33
Q

femur fracture complication

A

fat embolism and excessive blood loss

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34
Q

tibial fracture complication

A

compartment syndrome

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35
Q

pelvic fracture complication

A

hemorrhagic shock

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36
Q

low back pain with pain increasing with passive straight leg raise

A

disc herniation

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37
Q

low back pain with pain lessening with flexion at the hips

A

spinal stenosis

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38
Q

low back pain with elderly, weight loss, pain constant but worse when supine

A

cancer

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39
Q

low back pain with acute urinary retention

A

cauda equina syndrome

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40
Q

low back pain made worse with walking and standing (AKA pseudoclaudication)

A

spinal stenosis

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41
Q

low back pain with loss of foot dorsiflexion and pain on crossed straight leg raise

A

disc herniation

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42
Q

low back pain with pain limited to the paraspinal region

A

muscle strain

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43
Q

nerve most at risk of injury with fracture of shaft of humerus

A

radial

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44
Q

nerve most at risk of injury with fracture of surgical neck of the humerus

A

axillary

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45
Q

nerve most at risk of injury with fracture of supracondyle of the humerus

A

median

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46
Q

nerve most at risk of injury with fracture of medial epicondyle

A

ulnar

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47
Q

nerve most at risk of injury with anterior shoulder dislocation

A

axillary

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48
Q

nerve most at risk of injury with injury to the carpal tunnel

A

median

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49
Q

scenarios favoring a posterior shoulder dislocation

A

seizures or electric shock

50
Q

treatment for compartment syndrome

A

emergent fasciotomy

51
Q

unhappy triad of the knee

A

ACL, MCL, and medial meniscal tears

52
Q

PTH, alkaline phosphatase, serum calcium, and serum phosphate in paget’s disease

A

PTH: normal
alk phos: increased
calcium: normal
phosphate: normal

53
Q

PTH, alkaline phosphatase, serum calcium, and serum phosphate in osteomalacia/rickets

A

PTH: increased
alk phos: normal or increased
calcium: decreased
phosphate: decreased (due to increased PTH)

54
Q

PTH, alkaline phosphatase, serum calcium, and serum phosphate in chronic renal failure

A

PTH: increased
alk phos: normal or increased
calcium: decreased
phosphate: increased (kidneys cannot excrete phosphate)

55
Q

PTH, alkaline phosphatase, serum calcium, and serum phosphate in osteoporosis

A

PTH: normal
alk phos: normal
calcium: normal
phosphate: normal

56
Q

PTH, alkaline phosphatase, serum calcium, and serum phosphate in osteopetrosis

A

PTH: normal
alk phos: normal
calcium: normal
phosphate: normal

57
Q

PTH, alkaline phosphatase, serum calcium, and serum phosphate in primary hyperparathyroidism

A

PTH: increased
alk phos: increased
calcium: increased
phosphate: decreased

58
Q

PTH, alkaline phosphatase, serum calcium, and serum phosphate in hypoparathyroidism

A

PTH: decreased
alk phos: normal
calcium: decreased
phosphate: increased

59
Q

PTH, alkaline phosphatase, serum calcium, and serum phosphate in pseudohypoparathyroidism

A

PTH: increased
alk phos: ?
calcium: decreased
phosphate: increased

60
Q

what 3 studies can be used to make the diagnosis of osteomyelitis

A

MRI, bone scan, tagged WBC scan

61
Q

what disease involves arthropathy of DIP and PIP

A

osteoarthritis

62
Q

what disease involves arthropathy of PIP and MCP

A

rheumatoid arthritis

63
Q

what disease involves arthropathy of isolated MCP (squared-off bone ends and hook-like osteophytes)

A

hemochromatosis

64
Q

most common causes of bony metastasis

A

prostate, lung, breast

65
Q

classic radiological appearance of osteosarcoma

A

sunburst pattern and codman’s triangle

66
Q

treatment for lyme disease

A

doxycycline, amoxicillin, or cephalosporin

67
Q

treatment for rocky mountain spotted fever

A

doxycycline or chloramphenicol

68
Q

medications used in treatment of acute gout

A

NSAIDs (ketorlac), colchicine, steroids

69
Q

medications used in treatment of pseudogout

A

NSAIDs, colchicine

70
Q

treatment options available to patients with osteoporosis

A

exercise, calcium, vitamin D, bisphosphonate. pulsatile PTH

71
Q

endocrine causes of osteoporosis

A

chronic steroid use, hyperthyroidism, hyperparathyroidism, hypogonadism

72
Q

diagnosis: knee x-ray reveals calcification of the menisci

A

pseudogout

73
Q

diagnosis: hats no longer fit, deafness

A

paget’s disease or osteopetrosis

74
Q

diagnosis: needle-shaped, negatively birefringent crystals

A

gout

75
Q

diagnosis: bone pain/tenderness with elevated WBC, CRP, and ESR

A

osteomyelitis

76
Q

diagnosis: child with low-trauma fractures

A

osteogenesis imperfecta

77
Q

diagnosis: narrowing of marrow cavity results in low H&H

A

osteopetrosis

78
Q

diagnosis: 55 year-old female trips and sustains a distal radius fracture

A

osteoporosis

79
Q

empiric treatment for septic arthritis

A

I&D + IV vancomycin

if suspect gonorrhea, no I&D, ceftriaxone + doxycycline

80
Q

painful limp in child: x-ray reveals femoral head sclerosis

A

legg-calve-perthes avascular necrosis of the femoral head

81
Q

painful limp in child: x-ray reveals ice-cream scoop (femoral head) falling off of cone (femur)

A

slipped capital femoral epiphysis

82
Q

painful limp in child: obese, male adolescent with dull hip pain and an inability to bear weight

A

slipped capital femoral epiphysis

83
Q

painful limp in child: acute onset of tibial pain, fever, malaise, elevated ESR, no joint pain

A

osteomyelitis

84
Q

painful limp in child: acute onset of knee pain, fever, elevated ESR, and leukocytosis

A

septic arthritis

85
Q

painful limp in child: 7-year-old with growth delay and inner thigh pain

A

legg-calve-perthes avascular necrosis of the femoral head

86
Q

painful limp in child: 6-year-old with unilateral hip pain for 5 days, low-grade fever, spontaneous resolution

A

transient synovitis

87
Q

painful limp in child: 13-year-old male with pain and swelling at the tibial tuberosity

A

osgood-schlatter

88
Q

treatment of nursemaid’s elbow

A

manual reduction with supination on flexion and elbow pressure

89
Q

treatment for slipped capital femoral epiphysis

A

no weight bearing and surgical pinning of leg and prophylactic pinning of contralateral leg

90
Q

treatment for juvenile rheumatoid arthritis

A

NSAIDs, second-line NSAIDs, methotrexate for more severe cases

91
Q

treatment for osgood-schlatter disease

A

rest, stretching, ice, NSAIDs

92
Q

treatment for developmental dysplasia of the hip in children younger than 6 months

A

pavlik harness

93
Q

treatment for developmental dysplasia of the hip in children 6 months - 2 years

A

closed or open reduction and spica casting

94
Q

treatment for developmental dysplasia of the hip in children older than 2 years

A

open reduction

95
Q

treatment for developmental dysplasia of the hip in children older than 8 years

A

correction may not be performed because of reduced benefit

96
Q

characteristic findings of CREST scleroderma

A

calcinosis, reynaud’s phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasias

97
Q

medications approved for treatment of fibromyalgia

A

pregabalin, duloxetine, milnacipran

98
Q

rash of dermatomyositis

A

heliotrope rash around eyes, shawl sign around shoulders and upper back, discoloration of eyelids, scaly patches over hand joints “mechanic hands”

99
Q

rheumatologic disease with proximal muscle weakness and facial rash

A

dermatomyositis

100
Q

rheumatologic disease with pain and stiffness in the hips and shoulders

A

polymyalgia rheumatica

101
Q

rheumatologic disease with muscle pain and tenderness in multiple distinct locations

A

fibromyalgia

102
Q

rheumatologic disease with male in his 20s with low back pain that improves with exercise

A

ankylosing spondylitis

103
Q

rheumatologic disease with jaw claudication and difficulty standing from a chair

A

polymyalgia rheumatica with temporal arteritis

104
Q

rheumatologic disease with pencil in cup deformities of the DIP and PIP joints

A

psoriatic arthritis

105
Q

rheumatologic disease with bamboo spine on x-ray

A

ankylosing spondylitis

106
Q

rheumatologic disease with arthritis, oral ulcers, and proteinuria

A

SLE

107
Q

rheumatologic disease with flexed DIP and hyperextended PIP

A

rheumatoid arthritis swan-neck deformity

108
Q

anti-histone antibodies

A

drug-induced lupus

109
Q

anti-dsDNA antibodies

A

renal disease in SLE

110
Q

anti-centromere antibodies

A

CREST scleroderma

111
Q

anti-RNP antibodies

A

mixed connective tissue disease

112
Q

treatment after initial gout attack

A

alcohol cessation and weight loss
pharmacologic therapy is only initiated after repeated attacks, tophi (indicative of chronic disease), or renal insufficiency

113
Q

pain between third and fourth toes reproducible with palpation, common in runners, often exhibits clicking sensation

A

motor neuroma

treatment: bilateral shoe inserts

114
Q

burning pain in plantar area of foot, made worse with walking

A

planter fasciitis

115
Q

sharp and localized pain over bony surface on foot that worsens with palpation

A

stress fracture

116
Q

treatment for nondisplaced scaphoid fracture

A

wrist immobilization

117
Q

treatment for displaced scaphoid fracture

A

open reduction and internal fixation

118
Q

treatment for slipped capital femoral epiphysis

A

surgical pinning of slipped epiphysis

119
Q

how to diagnose developmental dysplasia of the hips

A

< 4 months U/S

> 4 months X-ray (when bones have developed)

120
Q

limitation of internal rotation and abduction of the hip

A

legg-calve-perthes

USMLE Step Two (17 decks)

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