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Fennel the Cat Step 2 > Step 2 MSK > Flashcards

Step 2 MSK Flashcards

1
Q

Back pain exacerbated by standing and walking and relieved with sitting and hyperflexion of hips

A

Spinal stenosis

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2
Q

Joints in the hand affected by RA

A

MCP and PIPs

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3
Q

Joint pain and stiffness that worsens over course of day and is relieved by rest

A

OA

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4
Q

Genetic disorder characterized by multiple fractures & blue sclera

A

OI

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5
Q

Hip & back pain + stiffness that improves w activity and worsens w rest. Diagnostic test?

A

Ankylosing spondylitis. check HLA-B27

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6
Q

Arthritis, conjunctivits, and urethritis in young men. Assc’d bugs?

A

Reactive arthridis. Most commonly assc’d w Chlamydia, Campylobacter, Shigella, Salmonella, and Ureaplasma

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7
Q

55 yo w sudden, excruciating first MTP joint pain after a night of drinking wine. Dx, w/up and acute/chronic tx?

A

Gout. Needle-shaped negatively birefringent crystals are seen on joint fluid aspirate. Acute tx: NSAIDS #1, colchicine or steroids. Chronic treatment w allopurinol or prebenecid.

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8
Q

Elder w stiff shoulders and hips a dn pain. Cannot lift her arms above her head. Labs show anemia and elevated ESR.

A

Polymyalgia rheumatica

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9
Q

Bone fractured due to fall on outstreched hand. What bone?

A

Distal radius/Colles fx.

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10
Q

Complication of scaphoid fx

A

AVN

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11
Q

Signs suggesting radial nerve dmg w humerus fx

A

Wrist drop. Loss of thumb ABduction.

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12
Q

Most common primary malignant tumor or bone?

A

Multiple myeloma

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13
Q

HA, soreness in jaw, pain on scalp, transient monocular blindness?

A

Giant cell arteritis

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14
Q

Anterior shoulder dislocation. Presentation and treatment?

A

Most common type of shoulder dislocation. Patients hold arm in slight abduction and external rotation. Risk of axillary nerve injury. Tx: reduction followed by sling and swath. Recurrent dislocations may need surg.

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15
Q

Posterior shoulder dislocation. Presentation and treatment?

A

Rare. Assc’d w seizure and electrocution. Patients hold arm in adduction and internal rotation. Tx: reduction followed by sling and swath.

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16
Q

Humerus fx. Presentation and treatment?

A

Direct trauma. Risk of radial nerve palsy which may lead to wrist drop and loss of thumb extension/abduction. Tx: hanging-arm cast vs. coaptation splint and sling. Functional bracing.

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17
Q

“Nightstick fracture” / Ulnar fracture. Presentation and treatment?

A

P: Direct trauma often self defense. T: ORIF if significantly displaced

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18
Q

Monteggia fracture. Presentation and treatment?

A

Diaphyseal fracture of proximal ulna with subluxation of the radial head. Results from fall on pronated and outstretched arm. T: ORIF of the shaft and closed reduction of the radial head

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19
Q

Galeazzi fracture. Presentation and treatment?

A

Diaphyseal fx of the radius with dislocation of the distal radioulnar joint. Results from direct blow to radius. T: ORIF of the radius and casting of the fractured forearm in supination to reduce the distal radioulnar joint

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20
Q

Colles fracture involves distal ??? Presentation and treatment?

A

Distal radius. Dorsally displaced, dorsally angulated fracture. Commonly seen in kids and old folx. Tx: Closed reduction followed by long arm cast. ORIF if intra-articular fx.

21
Q

Most commonly fractured carpal bone?

A

Scaphoid. Results from fall on outstretched hand . May take 2 weeks for XR to show FX. Assume fx if tenderness in anatomic snuffbox w axial loading. Tx: Thumb spica cast. If displacement or scaphoid nonunion is present, treat with open reduction. With proximal-third fx, AVN is a risk.

22
Q

Boxers Fx? Presentation and treatment?

A

Fx of fifth metacarpal neck. Closed reduction and ulnar gutter splint. Percutaenous pins if fx is excessively angulated

23
Q

What is the unhappy triad knee injury?

A

MCL, ACL, and medial meniscus.

24
Q

Median nerve injury results from what classic sign? what can the patient not do?

A

Median nerve injury leads to “benediction sign” where patient cannot close the first-third digits.

25
Q

Ulnar nerve injury causes inability to do what with fingers?

A

Ulnar nerve injury prevents patient from opening the 4th and 5th digits “claw hand”

26
Q

RED flags for LBP

A

age >50, >=6 weeks of pain, previous cancer history, severe pain, consititutional sx, neurologic deficits, loss of anal sphincter tone.

27
Q

L4 nerve root motor sensory and reflex innervation

A

Motor: foot dorsiflexion

reflex: patellar
sensory: : medial aspect of lower leg

28
Q

L5 nerve root motor sensory and reflex innervation

A

Motor: big toe dorsiflexion (extensor hallucis longus), foot eversion (peroneus muscles)
Reflex: nonte
Sensory: dorsum of foot and lateral aspect of lower leg

29
Q

S1 nerve root motor sensory and reflex innervation

A

Motor: plantar flexion (gastrocnemus and soleus), hip extension (gluteus max)
Reflex: achilles
Sensory: plantar and lateral aspects of the foot

30
Q

Joint aspirate with WBC 500: inflammatory or noninflammatory?

A

inflammatory starts @ WBC of 1000.

31
Q

30 yo woman w knee pain and mass, with “soap bubble” appearance along eipphyseal/metaphyseal region of long bone. Dx?

A

giant cell tumor

32
Q

labs for RA?

A

RF & anti-CCP

33
Q

Causes of hyperuricemia?

A 
Increased cell turnover (as in hemolysis, blast crisis, tumor lysis, myelodysplasia, psoriais)
cyclosporine
dehydration
DI
increased meat and alchol
Diuretics
lead poisoning
lesch-Nyhan
Salicyalates
starvation
34
Q

Gout: acute tx and chronic maintenance?

A

Acute: high-dose NSAIDS (indomethacin) Colchicine (which inhibits neutrophil chemcotaxis and is most effective when used early in flare, can also cause diarrhea and neutropenia)

Cx:Allopurinol for overproducers or those with contraindications to probenecid (tophi, renal stones, CKD).
Probenecid for under-secreters

35
Q

Compare polymyositis and dermatomyositis

A

Polymyositis: symmetric, progressive proximal muscle weakness and/or pain. Difficulty breathing or swallowing in severe disease. Anti-Jo Ab. Increased serum CK

Dermatomyositis: Sx as above + rash. Heliotrope, shawl rash or gottron papules. Anti-Jo Ab. Increased serum CK

36
Q

Anti-centromere Ab +. Dx?

A

CREST: Calcinosis, Raynaud, Esophageal dysmotility, Sclerodactyly, Telanciectasias

37
Q

Anti-dsDNA Ab +. Dx?

A

SLE

38
Q

Anti-histone Ab +. Dx?

A

Drug-induced SLE

39
Q

Antimitochondrial Ab +. Dx?

A

primary biliary cirrhosis

40
Q

Anti-Scl-70 Ab +. Dx?

A

Systemic sclerosis

41
Q

Anti-Sm Ab +. Dx?

A

SLE

42
Q

Anti-smooth muscle Ab +. Dx?

A

Autoimmune hepatitis

43
Q

Antitopoisomerase I Ab +. Dx?

A

Systemic sclerosis

44
Q

Anti-TSH-R Ab +. Dx?

A

Graves Dz

45
Q

c-ANCA Ab +. Dx?

A

vasculitis, esp. granulomatosis w polyangitis

46
Q

p-ANCA Ab +. Dx?

A

vasculitis, esp. microscopic polyangitis

47
Q

U1RNP Ab +. Dx?

A

Mixed connective tissue dz

48
Q

Criteria for SLE: DOPAMINE RASH

A 
Discoid rash
Oral ulcers
Photosensitivity
Arthritis
Malar rash
Immunologic criteria: anti-dsDNA, anti-Sm, anti-phospholipids
Neurologic sx (lupus cerebritis
ESR (elevated)
Renal dz
ANA
Serositis: pleural or pericardial effusions
Hematologic abnormalities
49
Q

numbness in pinky and 1/2 ring finger. Dx?

A

Numbness of the pinkie and half of the ring finger is ulnar entrapment (cubital tunnel syndrome, which happens at the elbow)

Fennel the Cat Step 2 (15 decks)

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