Orthopedics/Rheumatology Flashcards
Tests that assess shoulder impigmengement (subscapular nerve, supraspinatus)
Hawkins, Drop Arm, Neer
Most common fracture in children?
Clavice (middle 1/3rd)
What must you be concerned about with parasthesias of ulnar aspect of hand, forearm, arm
Thoracic outlet syndrome
Child falls, onto arm, complains of elbow pain. X-ray shows anterior humeral line or anterior fat pad. Diagnosis?
Supracondylar fracture
Mid-distal radial shaft fracture with dislocation of distal radio ulnar joint
Galeazzi fracture
High rate of non-union on outstretched hand, anatatomical snuffbox tenderness
Scaphoid fracture
Complication with Colles fracture
EPL rupture
Garden slade deformity on x-ray
Smiths fracture
Lunate fracture
Most serious carpal fracture, piece of pie sign, emergent (AVN- Kienbocks dz))
Boutonniere deformity
Flexion at PIP, Extension at DIP
Intraarticular fracture of base of 1st MC
Bennetts fracture (comminuted= Rolands)
Women presents with hip pain, shortened leg, internally rotated and adducted with hip/knee flexed. Dx?
Hip dislocation
Women presents with hip pain, shortened leg, externally rotated and abducted. Dx?
Hip fracture
4 year old presents with painless limping for weeks on right side. X-ray reveals crescent sign. Dx?
Legg-Calve-Perthes Dz (idiopathic AVN)
10 year old obese male presents with hip and thigh pain with limp, externally rotated right leg. Dx? Tx?
SCFE; ORIF
Greenstick fracture
Bowing (convex side)
Torus (buckle) Fracture
Wrinkling or bump
Which ligament is associated with valgus stress?
MCL
Which ligament is associated with varus stress?
LCL
Tests for ACL tear?
Lachmans**, anterior drawer
Dashboard injury associated with?
PCL tear; pivot shift test
Test for MCL injury
McMurrays
Best view for patellar fracture
Sunrise view
Popliteal artery rupture associated with which dislocation
Knee (Tibial/femoral); emergency!
Positive Obers tests seen in?
IT band syndrome
Most common injured ligament in ankle sprain?
ATF
Spiral fibular fracture d/t rupture distal talofib syndesmosis
Maisonneuve Fracture
numbness/pain medial malleolus, heel that worsens throughout the day
tarsal tunnel syndrome
Transverse fracture of diaphysis 5th Metatarsal
Jones fracture
Transverse avulsion fracture at base of 5th Metatarsal
Pseudojones fracture
Fracture at base of 2nd metatarsal
Lisfranc fracture (Fleck sign)
Posterior leg/calf, plantar surface of foot; loss of plantar flexion, ankle jerk. Which nerve is affected?
S1
Back pain worse with extension
Spinal stenosis
Most sensitive test for assessing scoliosis?
Adams forward bending test
Most common form of back pain in children/adoloscents
Spondylolysis (defect in pars interarticularis)
Most common cause of osteomyelitis in sickle cell patients?Tx?
Salmonella; 3rd gen Cef or FQ
28 y/o sexually active patient with suspected septic arthritis has arthrocentesis. Likely gram stain and tx?
G - Cocci (gonorrhea); ceftriaxone
Fracture of femur; persistent deep burning, tense extremities. Pain with passive stretching. Dx?
Compartment syndrome
17 year old with persistent bone pain of leg. X-ray shows sunburst appearance, periosteal reaction. Likely Dx?
Osteosarcoma
5 year old with femur pain. X-ray reaveals layeared periosteal reaction (onion peel). Dx?
Ewings sarcoma
Matrix punctate or ring/arc appearance on x-ray
chondrosarcoma
17 year old with knee pain. X-ray reveals pedunculated lesion, growing away from growth plate. Dx?
Osteochondroma
Increased osteoclast bone resorption, abnormal trabecular bone formation, large and weak compact bones. Elevated ALP. Treatment?
Bisphosphonates and calcitonin (Pagets Dz)
Meds that can cause lupus like reaction?
procainamide, hydralazine, INH, quinidine (anti-histone bodies)
Best test to confirm SLE?
anti DS DNA, anti-smith ab
Anticardiolipin ab is associated with which disease?
Antiphospholipid ab syndrome
Anti-centromere Ab is associated with which disease?
Scleroderma (specfically CREST syndrome)
Anti SS Ab, Anti SS B and HLADR52 associated with which disease?
Sjogrens Syndrome
Treatment for sjogrens syndrome?
Pilocarpine, cevimeline (cholinergics)
Bilateral proximal joint pain/stiffness; elevated ESR, anemia
PMR
Progressive symmetric muscle weakness of proximal limbs, neck, pharynx
Polymyositis
Which disease is associated wth anti-Jo1 ab, anti-SRP ab?
Polymyositis
Heliotrope and gottron papules associated with?
Dermatomyositis
Negative birefringent crystals on arthrocentesis; Acute Tx?
Gout; NSAIDs
Positive birefringent crystals on arthrocentesis; Acute Tx?
Pseudogout; Steroids
Morning stiffness in wrists, PIP, MCP that gets better throughout the day
RA
Pain that worsens throughout the day in DIP, Thumb
OA
Anti-CCP is specific for which disease?
RA
Feltys Syndrome
RA + splenomegaly + leukopenia
Lab findings in rhabdomyolysis
Elevated CPK, LDH, ALT, K
Decrease in Ca
Myoglobinuria (Heme)
Asymmetric joint pain, conjunctivitis, urethritis in 27 year old. Cause?
Chlamydia (Reactive arthritis)
Chronic low back pain and morning stiffness in 25 year old with positive HLAB27
Ankylosing spondylitis
Papable purpura, arthritis, abdominal pain, hematuria in a child makes you think of? Dx?
Henoch-Scholein Purpura; kidney biopsy showing igA deposition
URI symtoms with dyspnea, glomerulonephritis, positive C-ANCA
Wegeners granulomatosis
Treatment for Kawasaki’s disease
IVIG + high dose ASA
Takayasu arteritis affects which vessels?
Aorta, aortic arch, pulmonary artery (large vessels); diagnosed with angiography
Eosinophilia with allergies, asthma, significant purpuric rash on legs
Churg-strauss
Which vasculitis is assocaited with capillaries, glomerulonephritis and P-ANCA?
microscopic polyangiitis
Vasculitis assocaited with Hepatitis B and C, renovascular HTN, livedo reticularis?
Polyarteritis nodosa
