Orthopedics/Rheum

Question 1

What is injured in a humeral shaft fracture with wrist drop?

Answer 1

radial n

Question 2

What type of clavicle fracture do you need an ortho consult?

Answer 2

proximal

Question 3

Galeazzi and monteggia are stable or unstable?

Answer 3

unstable

Question 4

An elbow dislocation needs what?

Answer 4

emergent reduction

Question 5

A “spilled teacup” refers to what wrist injury?

Answer 5

lunate dislocation

also called “piece of the pie”

Question 6

In a hip dislocation what does the leg look like?

Answer 6

shortened

internally rotated

Question 7

A hip fracture makes the leg look like what?

Answer 7

shortened

externally rotated

Question 8

How do you reduce a tibial- femoral dislocation?

Answer 8

longitudinal traction

Question 9

What blood level is a good indicator of osteomyelitis?

Answer 9

ESR

Question 10

What is the MC route of osteomyelitis in kids?

Answer 10

hematogenous

Question 11

MC cause of acute of osteomyelitis in kids?

Answer 11

staph aureus

Question 12

What can differentiate costochondritis from and MI?

Answer 12

pain is worse with inspiration

Question 13

What type of jones fracture has delayed healing?

Answer 13

type II (classic jones)

Question 14

what is the main medical management of fibromyalgia?

Answer 14

TCAs

Question 15

what does the biopsy of a muscle of fibromyalgia show?

Answer 15

moth eaten appearance

Question 16

what meds can cause gout?

Answer 16

thiazides
loops
ACEI
pyrazinamide-TB
ethambutol- TB
aspirin
ARBS

Question 17

athrocentesis shows what for gout?

Answer 17

negatively birefringent needle-shaped urate crystals

Question 18

where is pseudogout MC?

Answer 18

knee

Question 19

1st line tx for pseudogout?

Answer 19

intraarticular corticosteroids

Question 20

what is polyarteritis nodosa

Answer 20

necrotizing inflammatory lesions of the small/medium arteries

microaneurysms form along vessel making it look like a string with knots on it

has renal (HTN), constitutional (fever, arthritis, fever), CNS, and dermatologic (livedo reticularis) manifestations (some of the MC)

Question 21

what labs give an indication of polyarteritis nodosa? what is its ANCA status?

Answer 21

increased ESR

usually ANCA negative

Question 22

first line tx for polyarteritis nodosa?

Answer 22

corticosteroids

Question 23

what is polymyalgia rheumatica?

Answer 23

pain, stiffness of neck, shoulders, and pelvis

associated with Giant cell arteritis

no muscle weakness, just pain (polymyositis has muscle weakness)

Question 24

tx for polymyalgia rheumatica?

Answer 24

low dose corticosteroids

Question 25

what is polymyositis?

Answer 25

inflammatory muscle disease progressive muscle weakness no pain (polymyalgia rheumatica has pain) can have rashes has abnormal EMG, increased aldolase, and CK

Question 26

tx for polymyositis

Answer 26

high dose steroids

Question 27

mc cause of reactive arthritis

Answer 27

chlamydia

Question 28

first line tx for reactive arthritis?

Answer 28

NSAIDs

Question 29

what is felty's syndrome?

Answer 29

RA + splenomegaly + decreased WBC/repeated infections

Question 30

what hand joints does RA affect?

Answer 30

MCP, PIP

Question 31

best screening test for RA?

Answer 31

RFactor

Question 32

most specific test for RA?

Answer 32

anti-CCP

Question 33

the incidence of what cancer is increased with sjogren's?

Answer 33

non-hodgkin lymphoma

Question 34

dx of sjogren's?

Answer 34

ANA: anti-SS-A and antiSS-B +RF decreased tears (Schirmer)

Question 35

tx of sjogren's?

Answer 35

pilocarpine (SLUD SE) | cevimeline

Question 36

clinical manifestations of SLE?

Answer 36

``` malar rash arthritis fever serositis (pericarditis, pleuritis) erythematous patches of face/scalp glomerulonephritis retinitis oral ulcers alopecia ```

Question 37

most specific test for SLE?

Answer 37

anti-DS DNA | anti-smith ab

Question 38

best initial test if suspecting SLE?

Answer 38

ana

Question 39

dx systemic sclerosis (scleroderma)?

Answer 39

anti-centromere antibodies- limited (CREST) | anti-SCL-70 ab- diffuse