Prodigy- Musculoskeletal Flashcards
Excessive posterior curvature of the spine that usually occurs in the thoracic region…..
scoliosis, kyphosis, lordosis, kyphoscoliosis
Kyphosis
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
C. Cyclophosphamide
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
RV & VC
Hines & Stoeltings
Scoliosis caused by CP or syringomyelia is catagorized as:
A. Congential scoliosis
B. Neuropathic scoliosis
C. Myopathic scoliosis
d. Idopathic scoliosis
B. Neuropathic (and polio)
nagelhout
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. PFTs - VC < 40% = likelyhood of postop vent support
Barash
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
B & D
Hines - Stoeltings
Rheumatoid arthritis typically:
A. occurs unilaterally
B. affects the lumbar and thoracic spine
C. affects weight-bearing joints
D. affects distal interphalangeal joints first
C. Affects weight bearing joings and PROXIMAL interphalangeal and metacarpophalangeal joints.
Typically worse in the morning
Hines- Stoeltings
All of the following are potential systemic manifestations of rheumatoid arthritis except:
A. Aortic regurgitation
B. Pleural effusion
C. Coronary arteritis
D. Catecholamine excess
D.
Catacholamine depletion results from chronic corticosteroid therapy
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. Short PR
-tall R waves in V1
-deep Q in limb leads
-sinus tach
MS vs MG, which one is exacerbated by pregnancy
MG
MS is at risk postpartum
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
B. PROXIMAL skeletal muscle groups
manifest as: alteration in gait, difficutly climbing stairs, frequent falls
Hines- Stoeltings
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
MRI
Barash
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.
There is no denervation of skeletal tissue, meaning that sensation and relfexes are intact
Hines - Stoeltings
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. Prolonged latency of evoked potentials
due to slowed nerve conduction from demylination of the central nerves
MS is characterized by a (slow/fast) progression when the onset occurs after 35yo
Slow
hines- stoeltings
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
B. aspiration pneumonia
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
C.
GBS and:
pain-
sensation-
reflexes-
pain usually
sensation - no
relfexes- no
Select two non-depolarizing muscle relaxants useful for patients with Guillain-Barre syndrome:
A. Pancuronium B. Rocuronium C. Cisatracurium D. Pipecuronium
Roc & Cist
short acting with minimal CV effects
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
B & D
-daily dose > 750mg
-disease duration > 6yrs
COPD
neg inspiratory pressure < -25cm H20
-Vital capacity < 2.9L
increased risk for postop ventilation in pts with MG:
Daily dose pyridostigmine >
Disease duration >
negative inspiratory pressure less than
VC <
Daily dose > 750mg
Disease duration > 6 yrs
NIP < -25cm H20
VC < 2.9 L
+COPD
T/F: COPD is considered a risk factor for postop ventilation for pts with MG
True
T/F: Duchenne’s is an autosomal recessive disorder
False - X-Linked recessive disorder
glad I don’t know the difference between autosomal recessive and X-Linked recessive
T/F: the response to NDMR’s is normal in pts with Duchenne’s
True
Hines- Stoeltings
