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PANCE Questions combined > Orthopedics PANCE > Flashcards

Orthopedics PANCE Flashcards

1
Q

At what age should you begin ordering DEXA scan’s for male patients? What about female patients?

A

70 for males, 65 for females

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2
Q

Give the DEXA score for osteopenia and osteoporosis

A

Osteopenia 1 to 2.4

Osteoporosis 2.5 or greater

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3
Q

What fracture is the number one cause of compartment syndrome

A

Tibial shaft fracture

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4
Q

A patient’s lab work shows positive Smith anti-body and positive double-stranded DNA anti-bodies. What is the most likely diagnosis

A

Lupus

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5
Q

Where are Bouchard’s nodes found

A

Proximal interphalangeus joint (PIP)

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6
Q

What will an x-ray show in acute osteomyelitis

A

Nothing. It will show bone destruction in chronic osteomyelitis

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7
Q

What is the best imaging to diagnose osteomyelitis

A

Either a bone scan or an MRI will provide the diagnosis

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8
Q

A 22-year-old male patient presents with what is clearly a septic knee. You noticed lesions on his hands and feet what is the most likely pathogen?

A

Neisseria gonorrhea

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9
Q

What would you expect the WBC count to be in the joint fluid of an infected knee

A

Greater than 50,000 at a minimum and probably much higher

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10
Q

A patient presents with a painless mass in her right wrist. What is the most likely diagnosis

A

Ganglion cyst

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11
Q

What is the age range for osteosarcoma? Where are the most typically found in the body

A

Osteosarcoma usually occur in 15 to 25-year-old males and are most commonly found around the knee

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12
Q

You think a patient may have an odteiod osteoma due to his complaints of severe night pain. You set him up for an x-ray but in the meantime what medication do you start him on?

A

If it is truly an osteoid osteoma ibuprofen will resolve this pain

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13
Q

Clicking or locking of the knee indicates what diagnosis

A

Minuscule tear

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14
Q

A 65-year-old presents complaining of severe pain in his great toe that began when he woke up this morning. It is swollen, red, and very tender. What is the most likely diagnosis

A

Gout would be the number one but you also need to consider an infection

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15
Q

What uric acid level helps to confirm a diagnosis of gout

A

Greater than 7.5

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16
Q

What is the medical treatment for gout

A

Allopurinol and Colochicine

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17
Q

A pathology report comes back with positive birefringment crystals. What is the most likely diagnosis

A

Pseudogout

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18
Q

A patient with a history of hepatitis B presents complaining of bilateral knee pain, fever and weight loss. What is the most likely diagnosis

A

Polyarteritis nodosa

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19
Q

You suspect the patient has polyarteritis nodosa. What is the test for a definitive diagnosis and what is the treatment

A

Biopsy, high-dose steroids

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20
Q

On physical exam, you notice ulnar deviation and swan neck deformities. What is the most likely diagnosis

A

Rheumatoid arthritis

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21
Q

A positive neers test indicates which diagnosis

A

Rotator cuff impingement

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22
Q

List three medications that may cause lupus

A

Procainamide, isoniazid and Quinidine

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23
Q

What test do you do for sjogren syndrome

A

Schirmer test

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24
Q

A patient with rheumatoid arthritis is heading to the OR for an open reduction and internal fixation of the ankle. In addition to ankle films, what other x-ray should you get

A

C-spine, anesthesia will want them due to concerns about instability of C1 and C2

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25
Q

Which carpal bone has a higher rate of non-union in occult fracture

A

Scaphoid

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26
Q

What medication is used for patients with lupus

A

Systemic steroids

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27
Q

Scleroderma limited version has five main characteristics for which the crest acronym is often use. What are those five things

A

Calcinosis, Reynards, Esophageal dysmotility, Sclerodactyly, telangiectasia

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28
Q

There is a Sunburst appearance on x-ray. What is the most likely diagnosis

A

Osteosarcoma

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29
Q

Anatomically where are 80% of clavicle fractures located

A

Middle third

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30
Q

A pathology report comes back showing negatively birefringment crystals. What is the most likely diagnosis

A

Gout

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31
Q

What are the four muscles of the rotator cuff

A

Supraspinatus
Infraspinatus
Teres minor
Subscapularis

32
Q

Describe the characteristics of a lytic lesion on x-ray

A

Spiculated, elevated periosteum, bone destruction

33
Q

What ligament is most commonly injured in an ankle sprain?

A

Anterior talofibular ligament (ATFL)

34
Q

What is the most common cause of C-spine fracture’s

A

Motor vehicle accidents

35
Q

What is the medical term for hunchback

A

Kyphosis

36
Q

What is another term for podagra

A

Gout

37
Q

A patient presents to the ER with saddle anesthesia and loss of bowel and bladder function. What is the most likely diagnosis

A

Cauda equina

38
Q

A patient with HIV presents with severe groin pain. What is the most likely diagnosis

A

Avascular necrosis of the formoral head. Antiretroviral medications patient at increased risk of AVN

39
Q

A 95-year-old female presents to the ER after a fall in her home. Her left leg is shortened in externally rotated what is the most likely diagnosis

A

Hip fracture

40
Q

You recommend bisphosphonate for a patient with osteoporosis. What instruction do you give her for immediately after taking the medication

A

Remain upright for 30 minutes

41
Q

What is the most common cause of a hip dislocation? Is it usually anterior or posterior

A

MVA, posterior

42
Q

Which of the four rotator cuff muscles is most commonly injured

A

Supraspinatus

43
Q

What is the medical term for tennis elbow

A

Lateral epicondylitis

44
Q

What is a first-line treatment for rheumatoid arthritis

A

Methotrexate

45
Q

The patient presents to the ER after taking a baseball bat to the knee. He is unable to actively extend his knee. What is the most likely diagnosis

A

Patella fracture

46
Q

Are most shoulder dislocations anterior posterior

A

Anterior

47
Q

What is the most useful physical exam test for diagnosing an ACL tear

A

Lachmans followed by anterior drawer

48
Q

What is the most common knee injury

A

Medial meniscus injury

49
Q

Where are herbeidens nodes found

A

Distal interphalangeal joint (DIP)

50
Q

The patient presents with knee pain following a soccer game two days ago. He has joint line tenderness medially and feels a locking in the knee from time to time. What two physical exam test should you do

A

Most likely a medial meniscus injury. McMurray and apply test would be appropriate

51
Q

A patient presents with conjunctivitis, urethritis, arthritis and oral lesions. What is the most likely diagnosis? What other lab might you expect to be positive

A

Reactive arthritis, HLA B-27

52
Q

A 46-year-old male comes into the ER limping a little on the right side. He states that it felt as though he was kicked in the back of the leg during a soccer game, but clearly no one was behind him what is the most likely diagnosis

A

Achilles tendon rupture

53
Q

Anti-Joe one antibodies should make you think of what diagnosis

A

Polymyositis

54
Q

A positive crossover test indicates what diagnosis

A

Acromioclavicular joint injury (AC joint)

55
Q

A positive Hawkins test indicates what diagnosis

A

Rotator cuff impingement

56
Q

A positive Finkelstein’s test indicates what diagnosis

A

Dequiverians tenosynovitis

57
Q

A positive Phalen’s and tinels sign indicates what diagnosis

A

Carpal tunnel

58
Q

Vasculitis with a hepatitis B history should make you think of what diagnosis

A

Polyarteritis nodosa

59
Q

What is the most common fracture in children

A

Clavicle

60
Q

A fat pad sign on a lateral x-ray of the elbow has what significance

A

It is blood in the joint indicating a fracture even if the fracture line cannot be seen

61
Q

A patient presents with progressive neck and proximal muscle weakness. On physical exam, you see a reddish purple maculopapular rash. Her lab work shows an anti-jo 1 antibody. What is the most likely diagnosis

A

Polymyositis

62
Q

Which way does a collies fracture angulate: dorsal or volar. What about a smith fracture

A

Collies is dorsal, Smith is volar

63
Q

Tenderness over the anatomical snuffbox is indicative of what fracture

A

Scaphoid

64
Q

What is the most common fracture in a patient with osteoporosis

A

A compression fracture of a vertebral body followed by hip fractures

65
Q

A 15-year-old boy presents complaining of night pain in the pelvis. Since you have no idea what to do you order an x-ray. The report comes back with the description of a mass with in “onionskin appearance” what is the most likely diagnosis

A

Ewing sarcoma

66
Q

What is the name for the fourth and fifth metacarpal fracture that often result from throwing a punch

A

Boxers fracture

67
Q

A new mother presents with pain over the radio rest. She has a positive Finkelstein’s test. What is the most likely diagnosis

A

Dequiverians tenosynovitis

68
Q

A positive McMurray indicate what diagnosis

A

Meniscus tear

69
Q

What is the first line treatment for carpal tunnel

A

Night splint

70
Q

A bamboo spine indicates what diagnosis

A

Ankylosing spondylitis

71
Q

A positive straight leg test indicates what diagnosis

A

Herniated disc

72
Q

An African-American female presents with Malor rash and a positive double-stranded DNA antibody. What is the most likely diagnosis

A

Lupus

73
Q

Carpal tunnel effect what nerve and what parts of the hand?

A

Median nerve. Thumb, pointer, ring fingers. The bar atrophy is a sign of advanced disease

74
Q

A patient has a silver fork deformity on x-ray. What is the most likely diagnosis

A

Collies fracture

75
Q

A positive apply indicates what diagnosis

A

Meniscus tear

PANCE Questions combined (7 decks)

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