PACES - Musc Flashcards

1
Q
A

Gottron’s Papules

Dermatomyositis

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2
Q
A

Nail Telangiectasia

Systemis Sclerosis

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3
Q
A

Onycholysis

PA

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4
Q
A

Pitting

PA

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5
Q
A

Longitudinal Ridging

PA

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6
Q
A

Nail Fold Infarct

Vasculitis

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7
Q
A

Subcutaenous Deposits

CREST

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8
Q
A

Dactylitis

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9
Q

DX?

A

PA with dactylitis

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10
Q
A

Heberden’s Nodes

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11
Q
A

Bouchard Nodes

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12
Q

How to conclude a hand exam

A

I would like to..
Examine other joints
Resp exam (fibrosis)
Abdo if RA (Felty’s Syndrome, splenomegaly)

Investigations:
FBC primarily to check for anaemia
U&Es, Vasculitic renal impairment and for drug dosing
LFT, baseline for meds
ESR/CRP, correlate with disease activity
TFT, Autoimmune concern

Immuno tests (Antibodies related to symptoms/signs identified)

Hand XR

Aspirate if effusion

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13
Q

What is a trendelenburg gait?

A

Waddling, body swings side to side due to hip abductor weakness, forcing the pt to use trunk muscles to lift the hip high enough to walk

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14
Q

What is an antalgic gait?

A

Hip pain = short stance phase on the painful side

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15
Q

How would you perform the trendelenburg test?

A

Ask the patient to stand facing you with hands out palms on top of yours

Stand on one leg then the other.

+ve test if pressure on contralateral palm, due to hip abductor weakness.

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16
Q

What is the modified thomas’s test

A

Hand under lumbar spine, ask pt to bring both knees up to chest

Passively push each hip into further flexion whilst watching pt’s face.

Ask pt to hold affected hip flexed whilst extending the other leg. Pressure should be felt on the examiner’s hand. Repeat on the other side whilst watching pt’s face. Fixed flexion deformity if pressure off hand lessens due to extension of lumbar spine as compensation.

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17
Q

What is reduced internal rotation of the hip a sign of?

A

Early OA

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18
Q
A

FAbER test

Hip pain & movement restriction = intraarticular dysfunction such as OA

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19
Q
A

FAdIR test

Femoroacetabular Impingement Syndrome
Anterior Labral Tear

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20
Q

How would you perform a hip exam

A

Intro

Inspect

Gait

Feel (Temperature, pulses,greater trochanter, leg length)

Move - Active hip flexion/extension with hand under lumbar spine
Passive extension, flexion, IR, ER, abduction, adduction

Special - Thomas’
Trendelenburg’s

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21
Q

How would you perform a knee exam?

A

Intro

Inspection

Gait

Feel - Temperature, measure quads size, palpate extended knee (joint lines, patella, offer patellar apprehension test, effusion, patellar tap), Palpate flexed knee and popilteal fossa

Move - Active flexion extension
Passive flexion extension

Posterior Sag
Anterior Drawer
Posterior Draw
LCL
MCL
McMurray’s

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22
Q

Hand exam

A

Intro

Inspection

Feel - temperature, radial/ulnar pulse,

Palms up - thenar/hypothenar bulk, palmar thickening,

Palms down - Radial Nerve (first dorsal webspace), bimanual joint palpation, snuffbox

Wrist palpation

Elbow - elbow palpation along ulnar

Active movement - Splay fingers
Make fist
Palms together and extend wrists
Back of hands together and flex wrists

Passive movement

Motor ->
Wrist/finger extension
Index finger abduction
Thumb abduction

Squeeze fingers, squeeze finger between thumb and index finger
Pick up coin

Tinel’s (Tap over the carpal tunnel)
Phalen’s (Hold wrist in maximum forced flexion for 60s, sx?)

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23
Q

What are the main principles of trauma management?

A

ATLS
Reduce Close -> Open
Repair
Rehab

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24
Q
A

Normal
Varus
Valgus

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25
Q
A

L = Volar
R = Dorsal

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26
Q
A
27
Q

What are the main complications of fractures?

A

Pain, bleeding, infection
Compartment syndrome, fat embolus syndrome, DVT

28
Q
A

Hip Arthroplasty Scar

29
Q
A

Gluteal Wasting

30
Q
A

Leg shortened and externally rotated

31
Q
A

Quadriceps wasting

32
Q
A

Trendelenburg test
Sound side sags

OA, Superior gluteal injury
DDH

33
Q

Apparent shortening of leg?

A

Scoliosis

34
Q

True shortening of the leg?

A

NOF
Hip dislocation

35
Q

OA Hip Signs/Mx

A

Loss of IR first, loss of other movements later

Arthroscopic washout
Realignment OSteotomy

36
Q

Complications of hip arthroplasty

A

Nerve Injury
Fracture

DVT
Dislocation

37
Q

Which x ray views do you need to examine a knee?

A

Skyline
Lateral
Medial

38
Q
A

Lap ports knee

39
Q
A

TKR scar

40
Q
A

Unicompartmental replacement scar

41
Q
A

ACL repair scar with graft harvest scar

42
Q
A

Open Menisciotomy

43
Q
A

Baker’s Cyst

44
Q
A

Varus Thrust
MCL Instability

45
Q
A

Valgus Thrust
LCL Instability

46
Q

Complications of TKR

A

Immediate- Fracture, Nerve Injury

Early - DVT, Infection

Late - Loosening, Reduced ROM

47
Q
A

Gouty Tophi

48
Q
A

CREST

49
Q
A

Trigger Finger
Stenosing Tenosynovitis

50
Q
A

Ulnar Claw, T1+C8

51
Q
A

RA Hands

Ulnar deviation of MCPs
Boutonniere of thumb (PIP flexion, DIP hyperextension)
Swan Neck deformity (hyperextended PIP, flexed DIP)

52
Q
A
53
Q
A

Squaring of thumb - OA

54
Q
A

Dupuytren’s

Idiopathic, Chronic liver disease

55
Q
A

Thenar Wasting (median nerve)

56
Q
A

Hypothenar wasting

Ulnar

57
Q

Monteggia vs galeazzi?

A

MU
MonteggiA A is proximal

GR
GaleaZzi
Z is distal

58
Q
A

Deltoid Atrophy

59
Q

Kennedy HAwkins test?

A

Impingement

60
Q

Jobe’s Empty can test?

A

Supraspinatus damage

61
Q

Belly Press

A

Subscapularis

62
Q
A

Winging of the scapula
Axillary surgery
Upper brachial plexus injury

Test by getting pt to press against the wall

63
Q

Scarf Test?

A

Push medially

ACJ OA