Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

IPAP > PPP ROSH- MSK/GI > Flashcards

PPP ROSH- MSK/GI Flashcards

1
Q

Components of CREST Syndrome

What two PE findings may be seen w/ this condition

? monitoring is needed for Pts on DMARD therapy

A

Calcinosis Raynauds Esophageal dysmotility Sclerodactyly Telangiectasias

Madonna finger- distal finger tapering
Rat bit necrosis- distal ulcers

CBC- s/e of marrow suppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Ottawa Ankle Rules

Define Maisonneuve Fx

MC soft tissue tumor of the hand

A

Bone pain posterior to distal 6cm of Lat/Med Malleolus
Inability to bear weight x 4 steps at evaluation
Navicular pain
Pain at base of fifth metatarsal

Spiral Fx of proximal 1/3 of fibula w/ tibiofibular syndesmosis and interosseous membrane tear

Ganglion- MC d/t repetitive movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Define Myofascial Pain Syndrome

How are Pts Tx

Rotator impingements are associated w/ ? two positive PE findings

A

Trigger points w/ painful spots in palpable taut bands of muscle

Cyclobenzaprine- muscle relaxer

Hawkins, Neers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the muscles and movements of the rotator cuff

Pseudogout lab results

What x-ray finding is associated w/ this Dx

A

Supraspinatus- abduction
Ingraspinatus- external rotation
Teres minor- external rotation
Subscapularis- internal rotation

Pos birefringent Ca pyrophosphate dihydrate rhomboids

Chondrocalcinosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Anti-SSA/Ro is associated w/ ? conditions

Anti-La/SS-B is associated w/ ? condition

Anticentromere is associated w/ ? condition

A

Lupus Sjogrens Neonate heart block

Sjogrens

CREST syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Anti-dsDNA is associated w/ ? condition

Anit-Jo1 is associated w/ ? condition

Anti-Smith is associated w/ ? condition

A

Lupus

Inflammatory myopathy

Lupus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Antitopoisomerase SCL-70 is associated w/ ? condition

Antihistone is associated w/ ? conditions

What are the two ANCA autoantibodies associated w/

A

Systemic sclerosis

Drug induced lupus

cANCA- granulomatosis
pANCA- micro/eosinophilic polyangitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Rheumatoid factor is associated w/ ? conditions

Anti-smooth muscle Ab is associated w/ ? condition

Antimitochondrial antibody is associated w/ ? condition

A

RA, Mixed CT d/o, Sjogrens

Chronic immune hepatitis

Primary biliary cholangitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the three classifications of osteoporosis

What causes mallet finger

What condition occurs if this goes untreated

A

1: post-menopause d/t lack of estrogen
2: Age >75y/o, Loss Zinc/Ca
Secondary: chronic dz/meds (type seen in men)

Force DIP flexion rupturing extensor tendon at insertion on distal phalanx

Swan neck- PIP hyperextension, DIP flexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Best initial screening test for SLE

What markers are Dx

What med is the best management for SLE

A

ANA

Anti-double strand DNA and Anti-Smith

Hydroxychloroquine- s/e retinal toxicity= annual Opto

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What medication is used for active lupus nephritis

What marker is MC elevated w/ this form of lupus

S/Sxs of patellofemoral pain syndrome

A

Cyclophosphamide

Anti-double stranded DNA

Pain worse w/ loaded flexion: stair, jump, theater sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Next step of knee OA after PO meds fail to control Sxs

First choice for mild-mod back pain

What is used for pain refractory to first choice

A

Intra-articular cortisone and lidocaine injections

NSAIDs

Muscle relaxors: Cyclobenzaprine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

? Ab triad is seen w/ scleroderma

What are the three urate lowering meds for gout

What two meds are c/i during Tx

A

ANA w/ Anticentromere (limited) and Anti-SCL 70 (progressive)

Allopurinol/Febuxostat: dec production
Probenacid: inc excretion
Pegloticase: converts uric acid to allantoin

ASA, Loops, Thiazides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

MOA of Colchicine during gout Tx

MCC of acute compartment syndrome and where is the MC location

Dx criteria for Compartment Syndrome

A

Inhibits microtubule formation for neutrophil migration

Fxs- anterior leg, Volar forearm

30-40mmHg (norm: 0-10)
Delta: DBP - Compartment pressure= ≤30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the 6 Ps of Compartment Syndrome

How is Pseudogout Tx

How can Meniscus injury be detected on PE and what image is preferred

A

Paresthesia Pallor Pulse Poikilothermia Paralysis PooP
Pain Color Sensation Pulse Temp Paralyzed

NSAID (Colchicine if c/i)

+Thesally, pain on medial joint line; MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the “Unhappy Triad”

Suspected Ca mets to bone is imaged w/ ?

? type of c/c is common in autoimmune mediated inflammation

A

Medial meniscus, ACL, MCL

MRI > CT myelography

Pain worse w/ rest, improved w/ movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

EMED recs

A 
Know when to intubate
GCS- calculate
Sickle cell chest pain/occlusive crisis w/ dec Hgb
EENT
Anterior should dislocation- nerve damaged?
When to do Ex-Lap 
Dental emergency
Ectopic pregnancy
Spont abortion/Placenta preva
Emergency before/after 20wks gestation
Consults- OB GenSurg
Disposition- admit, IV ABX, serial exams
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Define Dimple Sign

Why are these a surgical emergency

How are they Tx

A

Transverse groove at medial joint line indicating posterolateral knee dislocation

Irreducable w/ manual reducation: medial femoral condyle button holed through medial capsule, MC invaginated in joint

Surgical emergency: open reduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

? nerve/artery is MC damaged w/ tibiofemoral dislocations

Define Saturday Night Palsy

What sensory deficit is associated w/ this condition

A

N: Common Peronial/Fibular nerve
A: Popliteal artery

Prolonged external compression w/ wrist flexion causing inability to extend wrist against resistance

Superficial branch numbness: dorsal first web space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

? nerve is responsible for pinching movement between thumb and index finger

What is the function of the peroneal nerve

Anterior/Posterior hip dislocation presentations

A

Anterior Interosseous branch of median nerve

Superficial branch: Foot eversion
Deep branch: foot dorsiflexion, toe extension

P: internal rotation w/ shortening
A: external rotation w/ lengthening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Polymyalgia Rheumatica presentation

? other Dx is commonly co-existant

How are PR Pts Tx

A

Morning stiffness w/ shoulder/hip weakness and ESR >50

CGA

CCS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Best PE test for assessing ACL stability

Colchicine needs to be avoided in ? gout Pts

How is olecranon bursitis Tx

A

Lachman- bend 20-30*, pull tibia aneriorly

Dec GFR/renal failure

Compression, Ice, NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How can olecranon bursitis be differed from a joint effusion on PE

How is osteomyelitis and septic arthritis differed on PE

What imaging modality is preferred to Dx osteomyelitis

A

Effusion: pain w/ full extension
Bursitis: normal PROM

Preserved ROM

MRI- shows defect 2wks prior to x-rays

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

MC microbe involed in cat bites

What ABX is used for Tx

? microbes MC lead to Reactive Arthritis

A

Pasteurella multocida

Amp-Sulbactam

Campylobacter, Shigella, Salmonella, Yersinia, Chlamydia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How are stable ankle Fxs Tx

What causes Cauda Equina to occur

What is the most sensitive clinic sign for this condition

A

Weight bearing cast x 4-6wks

Compression of conus medullaris

Urine retention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How many pressure points for Fibromyalgia Dx

Function of Flexor Digitorum Superficialis

Function of Flexor Pollicus Longus

A

11 of 18

Medial humoral epicondyle to PIP/MCP for flexion

Thumb flexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Function of Palmaris Longus

Function of Flexor Carpi Ulnaris

Function of Flexor Digitorum Profundus

A

Wrist flexion

Hand adduction

DIP flexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Function of Flexor Carpi Radialis

What nerve innervates the FDS

Bicep reflex nerve

A

Flexion and hand abduction

Median

C5/6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Tricep reflex nerve

Brachioradialis reflex nerve

Patellar reflex nerve

A

C7

C6

L4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Dorsal web of first/second toe innervated by ?

Achilles reflex nerve

What muscles insert at the Pes Anserinus

A

L5

S1

Goose foot: gracilus, sartorius, semitendinous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Gracilis origin, insertion, innervation

What other knee injury needs to be r/o in a Pes Anserinus injury

O’Brien test is AKA ? and tests for ?

A

Inferior ramus, Medial tibial shaft, L2-4 via obturator nerve

MCL- insertion site near bursa

Active Compression- SLAP/glenohumeral joint tears

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

? nutritional deficiency presents w/ malar rash like SLE

What PE test is used to assess for Achilles rupture

How are Pt managed prior to surgery

A

Pellagra- B3 deficiency

Thompson squeeze- most reliable indicator

Splint in plantar flexion w/ non-weight bearing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Lisfranc is ? type of injury

How are these isolated for Dx on PE

What type of mechanisms leads to this injury

A

Tarsometatarsal joint Fx/dislocation from cuneiform

Stabilize hindfoot, forefoot rotation

Plantar flexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

MCC of acute hemarthroses in sport injuries

Joint aspirate w/ ? WBC levels indicate septic or inflammatory

How does glucose content help differ

A

ACL tear

Inflammation: 2-50K; Septic: >50K

Inflammation: >25; Septic <25

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What Dx causes tender, nodular lesions in starburst pattern w/ erythema on shins

What types of plaques can Pt develop

What is the preferred Tx for Polymyositis

A

Polyarteritis Nodosa: necrotizing vasculitis of small/medium arteries

Livedo reticularis- starburst and pathognemonic

Pred

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What type of Ca is associated w/ dermatomysoitis in women

How is Osgood-Schlatter Tx

What causes Bankart Lesion

A

Ovarian

Tylenol and activity as tolerated

Posterior humeral head hitting anterior gleniod rim w/ arm abducted and externally rotated causing Fx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

? biomarker is most specific for RA

What 3 infections can present w/ elevated RF

? is the MC hand infection

A

Anti-cyclic citrullinated peptide Abs

Hep C Malaria Rubella

Paronychia- infection of lateral nail fold

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What are two possible complications from paronychias

Dx test for Sjogrens

What lab markers may be positive in these pts

A

Progression to felon, Osteomyelitis of distal phalynx

Schirmer

Anti-Ro/La and RF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is used to measure spinal deformities

What test is used to r/o SLE

Define De Quervain Tendinopathy

A

Cobb angle: top of first vertebrae involved, bottom of last vertebrae involved, >10*= Dx

ANA

Abductor pollicis longus/Extensor pollicis brevis inflammation d/t overuse/post-partum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

? test is used for De Quervains Tendinopathy Dx

How are Pts Tx

What nerve innervates the ligaments involved

A

Finkelstein

NSAIDs, thumb spica spint, steroid injections

Deep branch of radial nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Kanavel Criteria for Flexor Tenosynovitis

Triad characteristics of septic arthritis

? derm manifestation of reactive arthritis may be seen on PE

A

Tenderness along flexor tendon
Finger swelling
Pain w/ passive extension
Flexed posture

Pain Swelling Fever

Brown/Red papules that become hyperkeratotic and crusted over on palm/soles after Chlamydia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

? PE finding is a c/i to manually reduce a tibiofemoral dislocation

? lab marker is used as a marker of muscle injury during Rhabdo and used for Dx

? is the MC non-spine complication or Ankylosing Spondlyitis

A

Dimple sign

Creatine kinase (CK-MB is more specific to cardiac muscle)

Anterior Uveitis- unilateral pain, photophobia, blurred vision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

How is Bipartite Patella differed from Patella Fx on x-ray

? body position leads to the MC type of shoulder dislocation

? nerve is MC injured during shoulder dislocations

A

Bipartitie- rounded/smooth edges

Anterior: abducted, externally rotated, extended

Axillary- lateral sensation, deltoid contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

? two PE tests suggest rotator cuff injury

? TB med can induce Lupus-like syndrome

? drugs are used for the Tx of osteoporosis by slowing bone loss

A

Drop arm, Empty can

Isoniazid

BisPhos: -dronates
Calcitonin
SERM: Raloxifene
Monoclonal: Denosumab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

? med is used for osteoporosis Tx to reduce bone formation

After initiating BisPhos therapy, when is the next f/u DEXA scan done

Dupuytren contracture is associated w/ ? Dx

A

Teriparatide (PTH)

2yrs

DM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Define Syndesmotic Ankle Sprain

What is seen on x-ray

How are these Tx

A

High ankle sprain: pain w/ external rotation and dorsiflexion (Kleger test) w/ partial syndesmosis tear

Diastasis between tib/fib

Grade 1: immobilize, non-weight bearing
2/3: surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

MC microbe seen w/ nail puncture induced osteomyelitis and how is it Tx

Normally what is the MC microbe of osteomyelitis

How is Lumbago Tx

A

Pseudomonas- Cipro

Staph A

Activity within pain limitations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Define Boutonniere deformity

Ankle sprain classifications by grade

? ABX is used for human bite infection prophylaxis

A

PIP flexion, DIP hyperextension

1: tender swelling, micro tears of colagen
2: dec ROM, possible instability; immobilize and PT
3: swelling, tenderness w/ instability e/ complete tear/rupture

Augmentin

49
Q

The MC microbes seen w/ dog bites

? medication is used for systemic stimulation in Pts w/ Sjogrens

Two DDx for non-traumatic subungual hematomas

A

Staph A, Pasteurella multocida, Strep viridian

Pilocarpine

Melanoma, Kaposi

50
Q

Define HSP

What are Pts at risk for

What lab result aids w/ Dx

A

MC vasculitis of child hood; IgA mediated lower extremity palpable purpura, arthritis, abdominal pain and renal involvement

Intussusception > Nephrotic syndrome

Normal platelet count

51
Q

Landmarks above/below snuff box

Pos snuff box tenderness w/ negative x-ray needs w/ d/c education

Scaphoid Fx are more likely to necrose w/ ? fx location

A

EPL/EPB/APL

Repeat x-ray 10-14d, remain in thumb-spica splint

Proximal, inc likelihood d/t blood supply via distal pole

52
Q

What RA presentation differs it from OA

RA induced effusions will have ? results

What is needed to confirm a Dx of scoliosis

A

Constitutional Sxs

Low glucose, low pH, high LDH

Radiographs to measure Cobb angle

53
Q

? lab result will be almost universally elevated in Pts w/ osteomyelitis

What radiographic finding indicates this Dx

MC Fx carpal bone

A

Inc ESR

Periosteal elevation w/ inflammation

Scaphoid

54
Q

? joints of the hand are spared w/ RA

Define Colles Fx

Plantar fasciitis is common w/ ? foot abnormality

A

DIP spared

Distal radial Fx from FOOWrist

Cavus foot

55
Q

Define Tarsal Tunnel Syndrome

What lab results will be seen in UA during rhabdo

What two carpals bone articulate w/ radius

A

Posterior tibial nerve entrapment under flexor retinaculum

Inc K, Ph; Dec Ca- MC

Scaphoid, Lunate

56
Q

If Pt presents w/ L4-L5 herniation, what nerve root is compressed

? hyperlipid medicine can exacerbate gout

This med is also an exacerbation to ? population Dx

A

One above- L4

Niacin

DM- hyperglycemia

57
Q

Lab results seen after muscle biopsy to Dx polymyositis

How are Frozen Shoulder’s Tx

Urate crystals are the product of ? metabolism

A

Inc aldolase and Creatine Kinase

PT, NSAID, injections

Purines

58
Q

MC cause of hip disability in adolescents

What c/c can Pts present w/

What PE finding will be seen

A

SCFE M: 12-16y/o F: 10-14y/o

Hip pain referred to thigh/knee

Dec internal rotation

59
Q

Name of x-ray line used for Dx SCFE

Fasciotomy’s are most effective if done w/in ? time frame

First step in ganglion cyst management

A

Klein line

<6hrs from injury

Aspiration

60
Q

? drug is safe for RA Tx during pregnancy

MC presenting complaint for men w/ osteoporosis

Pos anterior drawer test after ankle injury means ?

A

Hydroxychloroquine

Vertebral compression Fx

Grade 3: tear of anterior talofibular ligament

61
Q

Chronic use of ? meds place Pts at risk for vertebral compression Fxs outside of a Dx of osteoporosis

What is the straight leg raise test AKA ?

? PE test assesses the meniscus of the knee

A

CCS

Lasegue sign

McMurray

62
Q

How are Pts w/ Greater Trochanteric Pain Syndrome Tx in sequence

Pts w/ this condition who do not respond to conservative Tx need to have ? Dx r/o

What causes GTP Syndrome

A

1st: NSAIDs, PT
2nd: CCS injection to bursa

Medial glute tear

Overloading of glute medius/minimus

63
Q

Scleroderma Pts will most likely test positive for ? biomarker

MC joint for septic arthritis

Lab results seen w/ this Dx

A

+ ANA

Knee

WBC >50K, low glucose

64
Q

What PE finding aids w/ Dx of Ankylosing Spondylitis

Medical Tx options for Raynauds

Allopurinol can be used to avoid acute gout attacks except for ? type

A

Tenderness over spine/SI joint

CCBs Sildenafil Fluoxetine

Diuretic induced gout

65
Q

Mainstay of Tx for Reactive Arthritis

Three PE findings associated w/ Dermatomyositis

How are Pts Tx

A

High dose NSAIDs

Heliotrop rash: violet erythema around eyes
Gottron papules: thickened knuckle skin
Shawl sign

Pred, Methotrexate, Cyclophosphamide

66
Q

Joint aspiration WBC results for Normal, Non-Inflamm, Inflamm, Septic and Hemorrhagic

Red flags of back pain

A 
N: <150
Non-In: <3K
Inflamm: >3K
Septic: >50K
Hemorrhagic; n/a
IVDA
F/C/S- infection
AM tenderness >30min- seroneg spondyl
Retention/Anesthesia- cauda equina
Tenderness- Fx
Night pain/Weight loss- tumor
ImmDef- infection
Coagulopathy- hematoma
Extremes of age
Recent instrumentation- hematoma/abscess
67
Q

? x-ray view should be ordered for patellofemoral instability w/ catching

Frog leg view is used to view ?

Grashey view is used to view ?

A

Axial/sunrise

Hip

Glenohumeral joint

68
Q

Swimmers view x-ray is used to view ?

Most sensitive imaging for radiculopathy

What does xanthochromia indicate in CSF

A

Cervicothoracic junction

MRI > CT w/ contrast

RBCs in subarachnoid space

69
Q

? underlying condition is commonly associated w/ fibromyalgia Sxs in males

What are the MC positive autoantibodies for myositis

What other two results will can also be positive

A

OSA

Anti-Jo 1

ANA, RF

70
Q

Ottawa Ankle Rules apply to injuries that occurred ? long ago

? is the MC sprained ankle ligament

What are the Sxs associated w/ Sjogrens called and how are they Tx

A

<48hrs

Anterior talofibular

Sicca Sxs: pilocarpine

71
Q

Non-puncture foot osteomyelitis is MCC by ? microbes and Tx w/ ?

Criteria for adolescent scoliosis

How are Pts managed

A

Staph/Strep: Clinda/Cephalexin

Cobb angle ≥10* and onset ≥10y/o

10-19: observed w/ f/u q6-9mon until skeletal maturity
20-29: possible brace
30-39: brace
≥40: surgery

72
Q

What is the name of the grading system for assessing skeletal maturity

? two PE tests are done for suspected carpal tunnel

MC radiograph finding for Salter-Harris type 5

A

Risser classificaiton

Most sensitive: median compression test
Tinel tap test, Phalen compression x 60sec

Normal

73
Q

Legg Calve Pertheses Dz ages compared to SCFE ages

Define Colchicine toxicity

? DMARD is preferred for Ankylosing non-responsive to NSAIDs

A

LCPD: 4-10, SCFE: 12-16

Automn crocus/Glory lily alkaoids- severe GI upset w/in first 24hrs of use

Infliximab

74
Q

Define Sever Dz

Tx of choice for disseminated N gonorrhoeae septic arthritis

What are the main Sxs of bone maligancy

A

Calcaneal apophysitis- inflammed calcaneal growth plate causing pos compression test after cleat-wearing sport participation, self resolves

Ceftriaxone

Constant, deep ache at night unrelieved by rest

75
Q

Primary bone tumors of 20-30y/o

Primary bone tumors of 30-50y/o

Primary bone tumors of >50y/o

A 
Osteo-chondroma/sarcoma
Osteoid osteoma
Adamantinoma
Giant cell
Enchodondroma

Chondrosarcoma
Fibrosarcoma
Malignant histiocytoma
Lymphoma

MMyeloma

76
Q

What is the next step needed for Pts w/ proximal humerus Fxs

What 3 rotator muscle insert on the greater tuberosity

When is it appropriate to refer spinal claudication/stenosis to Ortho

A

Distal neurovascular supply assessment

Supraspinatus Infraspinatus Teres

Neuroclaudication >12wks

77
Q

What two PE tests are positive if ankle instability is present

Straight leg raise tests for radiculopathy at ? level

How is this test done

A

Anterior Drawer, Talar tilt

L5-S1

Sx leg raised straight; Pos= pain in back radiating past knee when raised 30-70*

78
Q

Reverse straight leg raise tests for radiculopathy at ? level

How is this test done

Pos Galeazzi test indicates ? issue

A

L3-L4

Passive extension of hip w/ Pt prone

Development hip dysplasia d/t femoral shortening

79
Q

Developmental dysplasia of the hips is more common in Pts w/ ? cervical condition

Involvement of ? structure indicates inoperable gastric Ca

Three PE signs of gastric Ca mets

A

Congenital torticollis, “wry neck”

Hepatic artery encasement

Virchow node
Iris node- L axillary node
Sister Mary Joseph- periumbilicular

80
Q

MCC of infectious diarrhea in AIDS Pts

Primary anal fissure location and causes

Secondary anal fissure location and causes

A

Crypto when CD4 <100

Posterior midline:
Trauma Constipation/Diarrhea Delivery

Lateral midline:
Crohns Malignancy Communicable/Granulomatous dz

81
Q

Marker of Hepatic Encephalopathy

How is this Tx

MC type of pancreatic Ca

A

Ammonia

Laculose, Rifaximin

Adenomacarcinoma- worst prognosis

82
Q

How do pancreatic Cas present

What serum marker is associated w/ this

MCC of intestinal obstruction in Pts <2y/o

A

Painless jaundice
Courvoisier sign
Trousseau syndrome- hypercoagulability seen as migratory thrombophlebitis

19-9

Inussusception- cyclic cramping pain w/ vomiting and bloody stool w/ palpable mass

83
Q

MC type of colorectal Ca

MC type of Ca and MCC of death in M/W

A

Adenocarcinoma- ab pain, bowel changes, weight loss, dec appetite and hematochezia

Men MC: Prostate Lung Colorectal
Men MC death: Lung Prostate Colorectal

Women MC: Breast Lung Colorectal
Women MC death: Lung Breast Colorectal

84
Q

MC emergent surgery in pregnancy

How is pancreatitis Dx

How are esophageal varices Tx

A

Appendicitis

Lipase inc 3x- most specific
US to evaluate for biliary etiology

Ligation Banding Sclerotherapy

85
Q

? infectious Dz can cause esophageal varices

When does candidiasis induced esophagitis occur and how is it Tx

Female athlete triad

A

Schistosomiasis (trematode)

CD4 <200; First line: fluconazole

D/o eating Amenorrhea Osteopenia

86
Q

Small intestine infarctions MC occurs d/t ?

If surgical intervention is performed on the left lower quadrant, ? was the issue

Shigella infections can cause ? Dx and ? extraintestinal manifestation

A

Superior mesenteric artery emoli

Inferior mesenteric artery

Dysentery: Reactive arthritis, Seizure, Hallucinations

87
Q

Lactose intolerance is d/t ?

What lab results may be seen

What causes achalasia

A

No lactase- glucose to galactose

Stool osmotic gap >125, pH <6

Degeneration of ganglion cells in the myenteric plexus of esophagus wall

88
Q

MCC of upper GI bleeds

MCC of lower GI bleeds

Define Hamman Sign

A

PUDz

Diverticulosis- painless rectal bleeding

Crunching on chest auscultation d/t esophageal perf

89
Q

? microbe causes ileocecitis

What is the Dx AKA ?

What post-infectious issues can develop

A

Yersinia enterocolitica from pigs

Pseudoappendicitis

Erythema nodosum, Reactive arthritis

90
Q

Most effective Tx of esophageal strictures

What type of laxative is first line Tx for chronic constipation

Phenyketonuria needs life long diet of ?

A

Dilation and PPIs

Bulks- psyllium, methylcellulose

High veggie, low meat/starch- inability to convert phyalanine to tyrosine

91
Q

What sweetner is avoided during PKU

Heinz bodies is associated w/ ? micro/macrocytic anemias

What lab result would show Heinz bodies

A

Aspartame

Micro: A-thalassemia
macro: G6PD deficiency- no glutathione (radical destroyer)

Neg Coombs test- non-immune

92
Q

Define Cholecystitis

Gold standard to Dx PUD

Ascending Cholangitis Sxs

A

Infected gallbladder d/t stones obstructing the cystic duct

Endoscopy

Charcots: RUQ pain, Jaundice, Fever
Reynolds: +shock and AMS

93
Q

Four classifications of hemorrhoid

Diverticulitis out-Pt Tx ABX

Viral hepatitis lab results

A

1: no protrusion
2: spontaneous reduction
3: manual reduction
4: non-reduceable, possible strangulation

Cipro w/ Metronidazole/TMP-SMX

ALT>AST

94
Q

Acute Hep B infection characterized by ?

Immunization is noted by ? result

A

Anti-HBc-IgM

Anti-HBsAg IgG

95
Q

Bulk laxative

Stool softener laxatives

Stimulant laxatives

A

Psyllium, Methylcellulose

Docusate

Senna Bisacodyl Castor oil

96
Q

? lab result are most significant for re-feeding syndrome

Complication that can arise from UC

How is this complication Tx

A

Hypo-phosphatemia HypoK Thiamine deficieny and CHF

Toxic megacolon

Bowel rest and NG tube

97
Q

MC type of gastric Ca and Dx method

What is the MC RF

What tumor marker will be inc in 50% of Pts w/ gastric Ca

A

Adenocarcinoma Dx w/ EGD

H pylori

Carcinoembryonic Ag (CEA)

98
Q

Define Mallory Weiss

What is a pre-disposing RF

Define Positive Dance Sign

A

Longitudinal tear in distal esophagus mucosal layer

Hiatal hernia

Empty RLQ in US significant for intussusception

99
Q

What causes intussusception in adults

How is ascites 2/2 P-HTN/cirrhosis Tx

What causes un/conjugated bili to rise

A

Malignancy

Spironolactone (reverses Na retention, conserves K and diuresis fluid), then Furosemide, then centesis

Un: hemolysis, liver dz, Con: biliary obstruction

100
Q

MCC of acute gastritis

What heme abnormality may be seen

What can/not be eaten w/ Celiac dz

A

H pylori

Pernicious anemia d/t parietal cell destruction, IF destruction

Can: rice, corn, potato, soybeans
No: wheat, barley, rye

101
Q

? GI med decreases Ca absorption

How is a Dx of lactose intolerance confirmed

Recommended Ca per day

A

PPIs

Lactose hydrogen breath test

1200mg/day

102
Q

EGD needs to be done on all Pts w/ dyspepsia over ? age

MCC of VGE

? population has a high mortality rate d/t Hep E

A

≥60

Norwalk virus from cruise ships

Pregnancy 2-3rd trimester

103
Q

How is cholelithiasis Tx during pregnancy

Zollinger Ellison is associated w/ ? genetic syndrome

MC PE finding for PUDz and what is the MC complication to arise from this Dz

A

Pain control, support

MEN-1

Epigastric tenderness; GI bleeds

104
Q

Colon Ca bleeding comes from ? side while diverticulitis comes from ? side

Acute management for variceal bleeds

Chronic management includes ?

A

Ca: R, Diver: L

Octreotide, Banding/Sclerotherapy, Ceftriax

BB, ligation

105
Q

Crohns biomarkers

Crohns derm manifestation

Crohns is AKA ?

A

ANCA, ASCA

Erythema nodosum- tender, erythematous nodules on bilateral shins

Regional enteritis

106
Q

PE finding suggesting B12/Cobalamin deficiency

What lab results will be pos

How are UTIs in G6PD Pts Tx

A

Enlarged, red tongue

Inc methylmalonic acid and homocysteine

Cephalexin

107
Q

What is seen on smears of G6PD blood

What tropical dz are they protected from

MCCs of SCC/Adeno Ca in esophagus

A

Heinz bodies, Bite cells

Malaria

SCC: Smoking, Alcohol, Adeno: Barrets

108
Q

Vit A toxicity

What is the result of this toxicity

Post-hernia surgery w/ beltline numbness is d/t ? nerve

A

Inc ICP, Oily skin, Alopecia, Dec appetite/weight loss

Suppress osteoblast, Stims osteoclast

Iliohypogastric

109
Q

What is a neuro complication arising form thiamine deficiency

How is this Tx/prevented

Ranson Criteria

A

Wernicke Korsakoff Syndrome- Encephalopathy Ocular dysfunction Ataxia

Thiamine before glucose

GA LAW: Glucose>200 AST>250 LDH>350 Age>55y/o WBC>16K
CHOBBS: Ca<8 Hct dec >10% O2<60 Base deficit >4 BUN inc >5 Sequesters fluid >6L

110
Q

What E+ needs to be monitored after admission for pancreatitis

Triad of Disulfuram Reaction

Perforation of ? GI structure has the highest mortality and MC d/t ?

A

Ca

Flushing Tachycardia HOTN

Esophagus MC d/t iatrogenic cause

111
Q

4Hs of Scurvy

Define IgA Vasculitits presentation

What will be seen on lab results

A

Hemorrhage- gum/petechiea
Hperkeratosis- rough skin, loose teeth
Hypochondriasis- irritable emotional changes
Heme abnormals- easy bruising

AKA Henoch Schonlen purpua- arthritis/arthralgia and palpable but non-blanching red/purple macules w/ abdominal cramps and bloody stools

Guiac pos stool, proteinuria, inc BUN/Cr

112
Q

Histopathologic term for gastric malignancy cells

Borders of inguinal hernias

Celiac Dz can cause Pts to become ? deficient

A

Signet ring cell

Hesselbach Triangle: abdominus rectus, inguinal ligament, epigastric vessels

Fe

113
Q

Nexus criteria

MC presentation for acute small bowel obstruction

How does the presentation of an ileus or pseudo-obstruction present differ

A 
Neuro deficit, no focal deficit
Spinal tenderness, midline
AMS, normal
Intoxicated
Distracting injury

Colicky pain w/ distension and emesis;

No colicky pain or N/V

114
Q

? vitamin deficiency presents w/ dermatitis, diarrhea and dementia?

MCC of esophageal varices in USA

How is H Pylori Tx

A

Niacin, Pellagra

Cirrhosis

Triple: Clarithromycin Amox (or Metro) and PPI
Quad: Bismuth Metro Tetracycline PPI

115
Q

INH Tx leads to ? deficiency

Folic acid production depends on ? vitamin

First line Tx for Crohns

A

B6- pyridoxine

B9- folate

Mesalamine (ileitis) or Sulfasalazine (ileocolitis, colitis)

116
Q

What lab results are seen w/ pyloris stenosis

Indications for H Pylori quad therapy

Lab results seen w/ Rickets

A

HypoCl/K w/ metabolic alkalosis

Recent macrolide use, Area w/ clarithromycin resistance, Triple therapy eradication ≤85%

Inc AlkPhos, low phosphorus/Ca

117
Q

3 MCC of small bowel obstructions in order

Define Ogilvie Syndrome

How is this Tx

A

Adhesion, Ca, Incarcerated hernia

Pseudo-obstruction w/ dilated colon d/t autonomic dysfunction

Cecal diameter >12cm: Neostigmine- aetylcholinesterase inhibitor
Opioid induced: methylnaltrexone

118
Q

S/e of using neostigmine for Tx of Ogilvie Syndrome

Hallmark histology result for celiac dz

? med is c/i in Pts w/ NSAID induced ulces

A

Bradycardia, Asystole

Villous atrophy

Misoprostol

119
Q

? acid base d/o does salicylate toxicity cause

What medication is used to trap the aspirin and promote excretion

External PE finding suggesting IBDz

A

Metabolic acidosis, Resp alkalosis

Na bicarbonate

Anal skin tags

IPAP (212 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions