Ortho

Question 1

best test for Acl

Answer 1

lachman
Lie the patient supine on the bed. Place the patient’s knee in about 20-30 degrees flexion. According to Bates’ Guide to Physical Examination, the leg should also be externally rotated slightly. The examiner should place one hand behind the tibia and the other on the patient’s thigh. It is important that the examiner’s thumb be on the tibial tuberosity. On pulling the tibia anteriorly, an intact ACL should prevent forward translational movement of the tibia on the femur (“firm end-feel”).

Question 2

best test for meniscus

Answer 2

McMurray

supine, knee flexed, ER and IR

Question 3

Ottowa ankle rules

Answer 3

bone tenderness at posterior edge of distal 6 cm or tip of medial/lateral malleolus
inability to bear weight for 4 steps

Question 4

Ottowa foot rules

Answer 4

bone tenderness at navicular bone/base of 5th metatarsal

inability to bear weight for 4 steps

Question 5

osteoperosis

Answer 5

T score less than -2.5
tx with bisphosphonates
MC fx is vertebral body compression fx

Question 6

RA

Answer 6

morning stiffness >30 min
symmetrical joint swelling, boutonierre/swan deformity
-+ RF, anti-cyclic citrullinated peptide antibodies

Question 7

gout

Answer 7

negative birefringent needle monosodium crystals

diuretics can make worse

Question 8

Polymyalgia Rheumatica

Answer 8

proximal muscle (shoulder, neck, hip girdle) stiffness and aching in the morning

• ESR >40
• associated with temporal arteritis
• tx w/prednisone (quick response seen)

Question 9

chondrosarcoma

Answer 9

30-50 YO

deep achey pain at night, popcorn calcifications

Question 10

flexor tenosynovitis

Answer 10

Kanavel criteria

1. tenderness along flexor tendon
2. symmetrical swelling of finger
3. pain wihth PROM
4. flexed posture of finger

Question 11

osteosarcoma

Answer 11

10-20 YO or >65
xray shows codman’s triangle, sunburst pattern
MC at the long bone metaphysis
MC malignant bone tumor

Question 12

mallet finger can result in

Answer 12

swan neck deformity

Question 13

hip dislocation

Answer 13

posterior

Question 14

when is spinal stenosis pain better?

Answer 14

when leaning forward pain is less

Question 15

TIA

Answer 15

transient episode of neurological disfunction caused by focal brain, spine, or retinal ischemia without infarct

Question 16

how to dx carcinoid

Answer 16

5-HIAA

Question 17

MS

Answer 17

CSF shows oligoclonal bands

MRI-multiple T2 hyperintensities

Question 18

Scleroderma

Answer 18

ANA
Anti centromere
Anti topoisomerase

Question 19

Anti Smith ab

Anti DS-DNA

Answer 19

SLE

Question 20

Citrullinated

Answer 20

rheumatoid

Question 21

Giant cell arteritis is a/w

Answer 21

polymyalgia rheumatica

Question 22

Lisfranc injury

Answer 22

tenderness to tarsometatarsal joint

Question 23

Tests for carpal tunnel

Answer 23

Phalen’s is best
Tinel
Nervw conduction confirms

Question 24

dequervains tenosynovitis

Answer 24

finklestein test

Question 25

Internal rotation hip pain

Answer 25

scfe

Question 26

Osgood schlatter tx

Answer 26

Tylenol and continue as tolerates

Question 27

Mc bone fx that causes compartment syndrome

Answer 27

tibia

Question 28

Pes anserine bursitis

Answer 28

Pain ober medial tibial condyle

Question 29

sprain

Answer 29

ligmaent

Question 30

strain

Answer 30

muscle, check for avulsion fx

Question 31

most shoulder dislocations are

Answer 31

anterior, externally rotated

may injure axillary nerve

Question 32

boxer fx

Answer 32

distal end of 5th metacarpal, gutter splint

Question 33

Galeazzi

Answer 33

radial fx middle to distal 1/3 and dislocation of distal radioulnar joint

Question 34

monteggia

Answer 34

ulna fx in proximal 1/3 and radial head dislocation

Question 35

Gamekeepers

Answer 35

ucl injury

Question 36

Duquervins

Answer 36

may have forearm pain as well, test with finkelstein

Question 37

lateral epicondylitis

Answer 37

tennis elbow

Question 38

kyphosis

Answer 38

thoracic spine curvature
may impact pulmonary function
scheurmans appears at puberty

Question 39

scoliosis

Answer 39

right thoracic curve is MC
screen with Adams
>40 refer to sx otherwise just f/u

Question 40

jefferson fx

Answer 40

C1, odontoid view

Question 41

hangman fx

Answer 41

C2

Question 42

Clay Shoverler

Answer 42

C6/C7

Question 43

spondylolithesis

Answer 43

scotty dog, ant slippage of vert body on inf counterpart, pars inticularis defect, oblique view**

Question 44

hip fx

Answer 44

leg is short held in ER

Question 45

hip dislocation

Answer 45

90% posterior, adducted in IR

Question 46

stress fx

Answer 46

3rd metatarsal

Question 47

what will be elevated in osteo

Answer 47

Sed rate

Question 48

who gets screened for osteoperosis

Answer 48

women 65+

Question 49

PAN

Answer 49

palpable purpura, P-ANCA

Question 50

anti-histone

Answer 50

drug induced lupus

Question 51

scleroderma

Answer 51

+ANA
anticentromere
anti SCL70

Question 52

osteosarcoma

Answer 52

10-14 YO, starburst/sunray, sx

typically effects knee

Question 53

ewing

Answer 53

moth eaten
onion skin
effects long bones

Question 54

nerve injury that produces foot drop

Answer 54

deep peroneal nerve

Question 55

what nerve injury results in scapular winging

Answer 55

long thoracic

Question 56

frozen shoulder

Answer 56

decreased PROM and AROM

Question 57

biceps tendiopathy

Answer 57

anterior shoulder pain

Question 58

MC hip fx location in older adults

Answer 58

femoral neck