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Rosh Review > Musculoskeletal Disorders > Flashcards

Musculoskeletal Disorders Flashcards

1
Q

What is a complication of plantar fasciitis?

A

Plantar fascial rupture, which occurs during push-off phase of gait

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2
Q

Best type of I&D for felon infection

A

Single lateral incision along ulnar aspect of digits 2-4 and radial aspect of digits 1 and 5

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3
Q

Complications of felon infections

A
  • Ischemic necrosis
  • Osteomyelitis
  • Flexor tenosynovitis
  • Septic arthritis
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4
Q

Most commonly injured ligament of the knee?

A

ACL

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5
Q

Most likely cause of disk herniation symptoms?

A

Repetitive flexion

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6
Q

Difference between herniated vs. bulging disk?

A

Herniated disk - rupture of nucleus pulposus beyond annulus fibrosus of the vertebral body

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7
Q

Symptoms suggesting meniscal tear

A
  • Joint line pain
  • Joint effusion
  • Locking
  • Giving way of knee
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8
Q

Most common injury associated with traumatic hemarthrosis of knee joint?

A

ACL rupture

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9
Q

Maneuvers to test for meniscal tear

A
  • McMurray test
  • Thessaly test
  • Apley test
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10
Q

McMurray Test

A

lateral meniscus: knee fully flexed, rotate tibia medially and bring knee into extension

medial meniscus: knee fully flexed rotate tibia laterally and bring knee into extension

Positive = clicking, locking, pain

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11
Q

Apley test

A

Patient in prone position
Bring knee into 90 degree
Lateral and medial rotation of tibia

Excessive rotation or discomfort as compared with other side - ligamentous

Repeat procedure while pressing down on heel - decreased rotation or discomfort - meniscal damage

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12
Q

Thessaly Test

A

Most accurate for meniscal tests

Patient stand on injured leg flexed at 20 degrees
Rotate over tibia 3x on each side
Positive if patient complains of pain in joint line

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13
Q

Most serious complication associated with juvenile idiopathic arthritis, particularly during initiation of treatment

A

Macrophage activation syndrome

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14
Q

Presentation of juvenile idiopathic arthritis

A
  • High fevers for minimum of 2 weeks
  • Polyarticular arthritis
  • Erythematous, macular rash involving trunk, palms, and soles
  • May develop hepatosplenomegaly, lymphadenopathy, pleuritis, or pericarditis
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15
Q

Complications of juvenile idiopathic arthritis

A
  • Interstitial lung disease
  • Pulmonary hypertension
  • Lipoid pneumonia
  • Macrophage activation syndrome
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16
Q

What is macrophage activation syndrome

A
  • Massive T-cell up-regulation
  • Increased macrophage function
  • Release of proinflammatory cytokines
  • Hemophagocytosis
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17
Q

Clinical picture of macrophage activation syndrome

A
  • High fever
  • Hepatosplenomegaly
  • Lymphadenopathy
  • Pancytopenia
  • Liver dysfunction
  • DIC
  • Low ESR
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18
Q

Tx of macrophage activation syndrome

A

High-dose glucocorticoids

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19
Q

What treatments besides disease-modifying antirheumatic drugs have helped decrease incidence of growth retardation and osteoporosis in patients with juvenile idiopathic arthritis?

A

Recombinant growth hormone and vitamin supplementation, particularly with calcium

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20
Q

Which imaging modality may be an effective tool in the diagnosis of tendinopathy?

A

Ultrasound

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21
Q

The shoulder is most vulnerable to an anterior glenohumeral dislocation in which of the following positions?

A

Abduction and external rotation

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22
Q

What is the most common type of major joint dislocation?

A

Glenohumeral joint

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23
Q

What is most sensitive for the diagnosis of cauda equina?

A

Urinary retention (90%)

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24
Q

What is the tx for cauda equina syndrome 2/2 malignancy?

A

Emergent radiation therapy

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25
Q

What organism makes up majority of septic bursitis cases?

A

Staph aureus (80%)

26
Q

Mechanism of infection in septic bursitis

A

Percutaneous inoculation of skin organisms from trauma, prolonged pressure on the elbow such as from leaning on a hard surface, or from an overlying cellulitis

27
Q

What is a Pott puffy tumor?

A

Subperiosteal abscess or osteomyelitis of the frontal bone that results from contiguous spread of frontal sinusitis

  • tender, boggy protuberance overlying the frontal bone and frontal sinus
  • rare, most often presents in children and adolescents
28
Q

Presentation of a Pott puffy tumor

A
  • Fever
  • Headache
  • Photophobia
  • Vomiting
  • AMS/lethargy
  • Periorbital or forehead swelling
  • Purulent rhinorrhea
  • Meningismus
  • Cranial nerve deficits
29
Q

Complications of a Pott puffy tumor

A
  • Cerebral abscess
  • Meningitis
  • Cavernous sinus or dural venous thrombosis
  • Epidural abscess
30
Q

What organisms are most responsible for a Pott puffy tumor?

A

Staphylococcus, Streptococcus, and anaerobes

31
Q

Physical exam maneuvers that aid in diagnosing rotator cuff injury

A
  1. Painful arc test: patient abducts arm and if pain beyond 90 degrees = positive
  2. Empty can test: downward pressure on arm while patient abducts to 90 degrees and internally rotates arm pointing thumbs down
  3. Drop arm test: patient slowly lowers arm to side after abducting 90 degrees
  4. Weakness with external rotation
32
Q

Rotator cuff muscles and their movements

A 
Supraspinatus (abduction)
Infraspinatus (external rotation)
Teres minor (external rotation)
Subscapularis (internal rotation)
33
Q

What is Hawkins test?

A

Pain in shoulder with forced internal rotation with the arm parallel to the floor and elbow flexed at 90 degrees
-> shoulder impingement syndrome (sort of rotator cuff)

34
Q

What is Neer’s test

A

Pain with passive elevation of arm above the head

-> shoulder impingement syndrome (sort of rotator cuff too)

35
Q

Most common organism of felon

A

Staph aureus

36
Q

Pressures indicative of compartment syndrome

A

Compartment pressure >30-40mm Hg

Delta pressure = diastolic blood pressure - direct pressure <30 (more reliable than direct pressures)

37
Q

Compartments of forearm and legs

A

Look this up***

38
Q

Drugs that can increase urate levels

A

Low-dose Aspirin
Diuretic
Cyclosporine
Tacrolimus

39
Q

Upper Extremity Dermatomes

A

Q571252

40
Q

What is a Segond fracture?

A

Avulsion injury of lateral tibial plateau

41
Q

What ligamentous injury is highly associated with Segond fracture?

A

ACL

42
Q

Most common ligamentous injury of the knee?

A

ACL

43
Q

Most sensitive test for ACL tear

A

Lachman’s

44
Q

What is a gamekeeper’s/skier’s thumb injury?

A

Acute forced abduction of the thumb at the MCP joint causing Ulnar collateral ligament injury

Weak pincer grasp

45
Q

Tx for gamekeeper’s/skier’s thumb?

A

Thumb spica splint; could require operative repair

46
Q

What is more common, injury to ulnar or radial collateral ligament?

A

Ulnar is 10x more common

47
Q

Radiculopathies

A

Q138263

48
Q

What is the most common bony tumor in children?

A

Osteosarcoma

49
Q

Most common sites of involvement with osteosarcoma

A
  1. Distal femur
  2. Proximal tibia
  3. Proximal humerus
  4. Middle and proximal femur
50
Q

Radiographical finding of osteosarcoma

A 
Sunburst pattern (periosteal reaction)
Codman triangle
51
Q

Radiographical and path finding of Ewing Sarcoma

A

Onion skinning periosteal reaction

Blue cell tumor

52
Q

Which tends to have systemic symptoms, osteosarcoma or ewing sarcoma?

A

Ewing sarcoma

53
Q

Kanavel Criteria for Flexor Tenosynovitis

A
  1. Tenderness along course of flexor tendon
  2. Fusiform or symmetrical swelling of the finger
  3. Pain with passive extension (often first finding)
  4. Finger held in flexed posture
54
Q

Causes of rhabdomyolysis

A
  1. Trauma
  2. Infection
  3. Drugs
  4. Medications
  5. Heat
  6. Exercise
  7. NMS
55
Q

Electrolyte abnormalities in rhabdomyolysis

A

Early: hypocalcemia (results from deposition of calcium salts in necrotic muscle, binding with phosphorus, and sequestration by the sarcoplasmic reticulum)
Others: hyperkalemia, hyperphosphatemia

56
Q

Most common extra-articular manifestation of ankylosing spondylitis?

A

Uveitis

57
Q

What is first-line pharmacologic tx of ankylosing spondylitis?

A

NSAIDs

58
Q

Ottawa ankle rules

A

Pain in malleolar region with any of the following:

  • Bone tenderness at posterior edge of distal 6cm or the tip of lateral malleolus
  • Bone tenderness at posterior edge of the distal 6cm or the tip of medial malleolus
  • Inability to bear weight for at least 4 steps both immediately after injury and at time of evaluation
59
Q

When to add a foot x-ray when evaluating ankle injury

A

Pain in midfoot region and one of the following:

  • Bone tenderness at navicular bone
  • Bone tenderness at base of fifth metatarsal
  • Inability to bear weight for at least 4 steps both immediately after injury and at time of evaluation
60
Q

What fracture of proximal fibula is associated with a medial ankle disruption

A

Maisonneuve fracture

Rosh Review (22 decks)

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