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Musculoskeletal Diseases > Prodigy- Musculoskeletal > Flashcards

Prodigy- Musculoskeletal Flashcards

1
Q

Excessive posterior curvature of the spine that usually occurs in the thoracic region…..

scoliosis, kyphosis, lordosis, kyphoscoliosis

A

Kyphosis

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2
Q

Which one of the following durgs used in the treatment of RA can prolong the duration of sux?

A. Etanercept
B. Adimumab
C. Cycloophosphamide
D. Corticosteroids

A

C. Cyclophosphamide

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3
Q

Which of the following are reduced in patients with severe kyphoscoliosis? (select 2):

A. FEV1/FVC
B. Physiologic shunt
C. Residual Volume
D. Vital capacity

A

RV & VC

Hines & Stoeltings

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4
Q

Scoliosis caused by CP or syringomyelia is catagorized as:

A. Congential scoliosis
B. Neuropathic scoliosis
C. Myopathic scoliosis
d. Idopathic scoliosis

A

B. Neuropathic (and polio)

nagelhout

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5
Q

What preoperative diagnostic tests would be most accurate in predicting the need for postoperative ventilatory support in patients undergoing correction of severe scoliosis?

a. PFTs
b. Sputum C&S
c. CXR
d. ABG

A

A. PFTs - VC < 40% = likelyhood of postop vent support

Barash

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6
Q

Which of the following pathologies are closely associated with kyphoscoliosis? (select two)

A. Central sleep apnea
B. Pulmonary HTN
C. Increased VC
D. Restrictive Lung disease

A

B & D

Hines - Stoeltings

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7
Q

Rheumatoid arthritis typically:
A. occurs unilaterally
B. affects the lumbar and thoracic spine
C. affects weight-bearing joints
D. affects distal interphalangeal joints first

A

C. Affects weight bearing joings and PROXIMAL interphalangeal and metacarpophalangeal joints.

Typically worse in the morning

Hines- Stoeltings

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8
Q

All of the following are potential systemic manifestations of rheumatoid arthritis except:

A. Aortic regurgitation
B. Pleural effusion
C. Coronary arteritis
D. Catecholamine excess

A

D.

Catacholamine depletion results from chronic corticosteroid therapy

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9
Q

What are the EKG changes typically associated with musuclar dystrophy?

A. Short PR Interval
B. Tall R waves in the inferior leads
C. Q waves in the chest leads
D. Sinus bradycardia
A

A. Short PR

-tall R waves in V1
-deep Q in limb leads
-sinus tach

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10
Q

MS vs MG, which one is exacerbated by pregnancy

A

MG

MS is at risk postpartum

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11
Q

The initial signs and symptoms of Duchenne muscular dystrophy are due to the effect of the disease on
A. cardiac smooth muscle
B. proximal skeletal muscle groups
C. distal lower extremity muscle groups
D. gastrointestinal smooth muscle

A

B. PROXIMAL skeletal muscle groups

manifest as: alteration in gait, difficutly climbing stairs, frequent falls

Hines- Stoeltings

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12
Q

Which is a sensitive diagnostic tool for multiple sclerosis (MS) and provides direct evidence of the location of demyelinated plaques in the CNS?

A. CT scan
B. Magnetic resonance imaging
C. Lumbar punctures
D. Evoked potentials

A

MRI

Barash

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13
Q

Which of the following is NOT associated with Duchenne muscular dystrophy?

A. Loss of reflexes
B. Symmetric skeletal muscle wasting
C. Mitral regurgitation
D. Recurrent pneumonia

A

A.

There is no denervation of skeletal tissue, meaning that sensation and relfexes are intact

Hines - Stoeltings

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14
Q

MS is associated with which of the following?

A. Prolonged latency of evoked potentials
B. Excessive accumulation of myelin on the axon
C. Neuropathy due to demyelination of the peripheral nerves
D. Rapid progression in patients diagnosed after 35 years of age

A

A. Prolonged latency of evoked potentials

due to slowed nerve conduction from demylination of the central nerves

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15
Q

MS is characterized by a (slow/fast) progression when the onset occurs after 35yo

A

Slow

hines- stoeltings

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16
Q

What is the most significant anesthetic concern for the patient with Huntington’s chorea?

A. risks associated with aortic stenosis
B. aspiration pneumonia
C. resistance to succinylcholine
D. strict avoidance of phenothiazines

A

B. aspiration pneumonia

17
Q

All of the following are known contributors to the development of aspiration pneumonia in patients with muscular dystrophy except:

A. Impaired swallowing mechanism
B. Intestinal hypomobility
C. Increased acidity of gastric contents
D. Delayed gastric emptying

A

C.

18
Q

GBS and:

pain-
sensation-
reflexes-

A

pain usually
sensation - no
relfexes- no

19
Q

Select two non-depolarizing muscle relaxants useful for patients with Guillain-Barre syndrome:

A. Pancuronium
B. Rocuronium
C. Cisatracurium
D. Pipecuronium
A

Roc & Cist

short acting with minimal CV effects

20
Q

Which of the following factors is associated with an increased risk for postoperative ventilation following general anesthesia in patients with myasthenia gravis? (select two)

A. Daily pyridostigmine dose greater than 75 mg/day
B. Disease duration greater than 6 years
C. Vital capacity less than 3.2 L
D. A negative inspiratory pressure less than -25 cm H2O

A

B & D

-daily dose > 750mg
-disease duration > 6yrs
COPD
neg inspiratory pressure < -25cm H20
-Vital capacity < 2.9L

21
Q

increased risk for postop ventilation in pts with MG:

Daily dose pyridostigmine >
Disease duration >
negative inspiratory pressure less than
VC <

A

Daily dose > 750mg
Disease duration > 6 yrs
NIP < -25cm H20
VC < 2.9 L

+COPD

22
Q

T/F: COPD is considered a risk factor for postop ventilation for pts with MG

A

True

23
Q

T/F: Duchenne’s is an autosomal recessive disorder

A

False - X-Linked recessive disorder

glad I don’t know the difference between autosomal recessive and X-Linked recessive

24
Q

T/F: the response to NDMR’s is normal in pts with Duchenne’s

A

True

Hines- Stoeltings

25
Q

Which muscle most closely resembles the response of the diaphragm to muscle relaxants and should be monitored to avoid and inadvertent persistent NMB in pts with MG

A

Obicularis oculi

26
Q

What % of pts with GBS will require mechanical ventilation

A

25%

27
Q

Which antibiotic class is associated with aggravation of muscle weakness in patients with myasthenia gravis?

A. Carbapenems
B. Cephalosporins
C. Macrolides
D. Aminoglycosides

A

D. Aminoglycosides

28
Q

Which of the following would be the most appropriate anesthetic technique for a patient with multiple sclerosis?

A. General anesthesia with succinylcholine
B. Epidural anesthesia with bupivacaine
C. Spinal anesthesia with ropivacaine
D. Spinal anesthesia with tetracaine

A

B. Epidural Anesthesia

29
Q

Pt’s with Lupus often exhibit:

A. an obstructive respiratory defect
B. a restrictive respiratory defect
C. a combined obstructive/restrictive respiratory defect
D. no alteration in respiratory function

A

B. Restrictive defect

-prone to pleural effusions, pneumonitis, alveolar hemorrhage, and pulmonary HTN

Barash

30
Q

What endocrine disorder is closely associated with myasthenia gravis?

A. Hyperthyroidism
B. Adrenal insufficiency
C. Diabetes mellitus
D. Pheochromocytoma

A

A. Hyperthyroidism

-seen in about 10% of pts with MG
-also increased r isk for RA, SLE, and pernicious anemia

31
Q

The most common cause of death in patients with systemic lupus erythematosus is:

A. pericardial tamponade
B. cerebrovascular accident
C. myocardial infarction
D. renal disease

A

D. Renal Disease

32
Q

Which of the following symptoms would you expect to be consistent in a patient with systemic lupus erythematosus (SLE)? (select two):

A. Nephritis
B. Thrombocytosis
C. Cognitive dysfunction
D. Spinal arthralgias with limited range of motion

A

Nephritis & Cognitive dysfunction

Hines- Stoeltings

33
Q

What syndrome is a form of pericarditis following MI?

A

Dressler syndrome

Musculoskeletal Diseases (2 decks)

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