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PrepU Questions > Ortho > Flashcards

Ortho Flashcards

1
Q

What are features of SCFE

A

Adolescent 10-14 years, obese, minority boys
Present with painful limp, referred pain to thigh or knee
Limited internal rotation
Xray frog leg view are diagnositc

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2
Q

What are features of Carpal Tunnel Syndrome

A

Numbess and Paresthesia of palmar aspect of thumb and first 2 fingers
Pain may awaken person at night
Then eminence atrophy
Positive Phalen test (wrist flexed 90 degrees)
Positive Tinel Sign (wrist percussion)

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3
Q

What causes Scapular Winging

A

Injury to Long Thoracic Nerve and secondary Serratus Anterior

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4
Q

What does the Lachman Test look for

How does it work

A

Anterior Cruciate Ligament
Knee flexed at 20-30 degrees with patient supine. Examiner places one hand behind tibia and grasps patient’s thigh. Tibia is pulled forward to assess anterior motion of tibia in comparison to femur.

Lots of laxity indicates ACL injury

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5
Q

What does the Apley’s Test look for

How does it work

A

Meniscus
Patient lies prone and flexes knee to 90 degrees. Examiner places hand across posterior aspect of patient’s thigh between posterior knee. Tibia is compressed onto knee joint while externally rotated.

Pain, clicking or popping indicates damaged meniscus

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6
Q

What does the McMurray test look for

How does it work

A

Meniscus
Patient lies supine. Knee is flexed to 90 degrees. Examiner places one hand on heel, the other hand on knee joint line. Passive external rotation is done by stabilizing knee joint while externally rotating from the heel/ankle, introduces valgus force (this tests medial meniscus). Do the same but with internal rotation, introducing varus force (this tests lateralmeniscus)

Pain, popping, or clicking indicates positive test, and meniscus tear.

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7
Q

What does Thompson’s Test look for

How does it work

A

Achille’s Tendon Rupture
Patient lies prone with feet hanging off bed. Normally, foot does plantar flexion in this position and calf muscles are engaged.

No plantar flexion indicates Achille’s Tendon Rupture

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8
Q

What do the following T-scores with DEXA scan indicate
T Score 0 to -1.0
T score -1.0 to -2.5
T Score -2.5 or less

A

T Score 0 to -1.0 = Normal
T score -1.0 to -2.5 = Osteopenia
T Score -2.5 or less = Osteoperosis

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9
Q

What is the number 1 treatment for Osteoperosis

What drugs are used for Osteopenia

A

Bisphosphonates like Alendronate

For Osteopenia use Calcium, Estrogen, or SSRI (Raloxifene)

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10
Q

What is Phalen Sign
What is Tinnel Sign
How do they work

A

Test for Carpal Tunnel
Phalen: Flex wrist at 90 degrees, produces pain
Tinnel: Tap the Median nerve, produces pain

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11
Q

What should you think of when you hear Heberden Nodes and Bouchard Nodes

A

Osteoarthritis

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12
Q

What are features of Gamekeeper’s Thumb

Tx

A

Ulnar Collateral Ligament of MCP joint is injured
Usually occurs in skiers
Results in poor pinching and thumb to finger opposition
Tx is immobilzation with thumb spica split

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13
Q

What are the 6 P’s of Compartment Syndrome

A 
Pallor
Paresthesia
Pulselessness
Pain
paralysis
Poikilothermy (cold)
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14
Q

What should you think of if a child comes in post-Upper Respiratory Infection with painful limp and mild thigh pain

A

Transient Synovitis

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15
Q

What are features of a Mallet Finger

Tx

A

Inability to extend fingers at DIP joint
Usually results from trauma to extended finger with forced flexion
Tx: Splint DIP with uninterrupted extension for 6 weeks

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16
Q

What is the forward slipping of the vertebrae on the other
Sx
Tx

A

Spondylolisthesis
Sx: Lower back pain, sciatica sx, may cause bowel and bladder dysfunction
Tx: Modification of activities

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17
Q

What is a defect in the pars interarticulars from stress fracture
Sx
Tx

A

Spondylolysis
Usually due to repetitive hyperextension trauma (football players, gymnasts)
Sx: Lower back pain with sciatica symptoms
Dx: Can bee seen on Xray
Tx: Sx relief, activity restriction, physical therapy, bracing

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18
Q

What do the following nerves do
Radial Nerve
Ulnar Nerve
Median Nerve

A

Radial nerve: Extends wrist and forearm
Ulnar Nerve: Flexes and Adducts Wrist (ulnar deviation)
Median Nerve: Opponens Pollicus, Abductor Pollicis Brevis, Flexor Pollicis Brevis
Axillary Nerve: Deltoid Muscles

19
Q

Medial Right Elbow Pain

Pain with resisted wrist flexion

A

Medial Epicondylitis

20
Q

Lateral right elbow pain

Pain with resisted wrist extension

A

Lateral Epicondylitis

21
Q

Knee pain for 3 weeks
Mass is felt on posterior aspect of femur
Xray shows lytic lesions and soft tissue involvement

A

Osteosarcoma

22
Q

Pain over anatomical snuffbox

Wrist pain and swelling

A

Scaphoid Fracture

23
Q

How should you perform an xray when Acromioclavicular separation is suspected

A

Weight bearing AC joint views

24
Q

Intermittent numbness in fifth finger
Person grips a lot in day-to-day
What is it and what test reproduces sx?

A

Ulnar Nerve Entrapment

Guyon’s Canal: apply pressure over Guyon’s canal through which ulnar nreve runs

25
Q

What is considered a positive straight leg raise

What is it assessing

A

Pain radiating along sciatic nerve at 60 degrees of PASSIVE elevation of ipsilateral leg
Testing for Disk Disease/Disk Herniation

26
Q

Asymmetric Polyarticular joint pain in knees, hands, elbows
Morning stiffness for 30 minutes
Bilateral dactylitis, nail pitting, scaly plaques on elbows
Pencil-in-Cup Deformity on Xray
HLA-B27

A

Psoriatic Arthritis

27
Q

Young male with diffuse low back pain, morning stiffness that lasts for hours, activity makes it better
Positive HLA-B27, Elevated ESR
What is it and what is tx

A

Ankylosing Spondylitis

NSAIDS

28
Q

What foods should be avoided in Gout

A

Purine rich foods

Organ meats, sardines, mussels, liver, trout, alcohol and beer can elevate uric acid levels

29
Q

What drugs have been known to induce lupus

A

Procainamide, Hydralazine, Isoniazid, Methyldopa, Chlorpromazine, Minocycline

30
Q

Scleroderma is positive for what

A

ANA

31
Q

1st line treatment for Raynaud’s

A

CCB

32
Q

1st line treatment for Rheumatoid Arthritis

A

DMARDS ASAP, NSAIDS for relief

33
Q

Periarticular pain and stiffness in several joints
Pain is worse in morning and lasts >60min
Ulnar Deviation, DIP spared, Swan Neck Deformity
Positive Anti-CCP
What is it and what is Tx

A

Rheumatoid Arthritis

DMARDS right away

34
Q

Rheumatoid Arthritis is positive for what

A

Anti-CCP

35
Q

Systemic Lupus is positive for what

A

ANA
Anti-Smith Antibodies (more specific)
Anti-Single Stranded DNA (Anti-ssDNA)

36
Q

What crystals are noted with Gout vs. Pseudogout

A

Gout: Uric Acid (negatively birefringent needle shaped crystals)
Pseudogout: Calcium Pyrophosphate (positively birefringent rhomboid crystals)

37
Q

What are features of Polymositis vs. Polymalgia Rheumatics

A

Both cause symmetric issues in proximal muscle groups
Polymyositis is WEAKNESS
Polymalgia is PAIN and STIFFNESS

38
Q 
Fever, Malaise, weight loss in 5 months
Pain at extremities, particularly calves
Right foot drop and ulcers at bilateral malleloi
New onset HTN
Livedo Reticularis
What is it
A

Polyarteritis Nodosa

39
Q

What are ways the Systemic Lupus can present

A 
General Malaise, Fever, Anorexia, Weight Loss
Malar Rash, Discoid Rash, Photosensitivity
Oral Ulcers
Arthritis, SErositis
Kidney Disease, Neurologic disease
Hematologic Disorders (thrombocytopenia)
Immunologic Abnormalities
Positive ANA
40
Q

1st line treatment for Polymalgia Rheumatica

A

Steroids

41
Q

What is the most important complication that can occur with Temporal Arteritis. What is it associated with

A

Vision Loss

Polymalgia Rheumatica

42
Q

What Cardiac Condition is often found in a person with Marfan’s

A

Mitral Valve Prolapse

Aortic Aneurysm

43
Q

What should you think of when you see Chondrocalcinosis on an Xray

A

Pseudogout which indicates calcium pyrophosphate deposition

44
Q

What is Hydroxychloroquine used for

What are side effects/complications and therefore what should be monitored

A

An antimalarial drug used for Systemic Lupus Erythematosus

Retinal exams needed due to increased retinal toxicity risk, baseline exam needed then yearly

PrepU Questions (7 decks)

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