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ToL EM Ortho/Rheum Flashcards

1
Q

A cervical neck sprain presents with paraspinal muscle tenderness and spasm and what positive special test?

A

Spurling test

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2
Q

What is a + spurling test?

A

Pain with axial loading of the cervical spine

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3
Q

What imaging is diagnostic for cauda equina syndrome?

A

MRI

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4
Q

What fracture location is the most common site of radial nerve injury?

A

Hummerus fracture

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5
Q

What signs seen on xray indicate a distal humerus fracture?

A

Posterior fat pad sign/sail sign

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6
Q

What is the appropriate splint for a distal humerus fracture?

A

sugar tong splint

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7
Q

What is the appropriate splint for a humeral shaft fracture?

A

Coaptation splint

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8
Q

What type of fracture do you suspect in a pediatric patient who fell on an outstretched arm, has elbow pain, and anterior fat pad sign is seen on XR?

A

Supracondylar fracture

Fun fact - it is the most common pediatric elbow fracture.

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9
Q

What fracture presents with pain and tenderness along the lateral aspect of the elbow, with particularly painful pronation/supination?

A

Radial head fracture

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10
Q

What are the two methods of reducing a nursemaids elbow?

A 
Supination flexion (preferred)
and hyperpronation
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11
Q

What bone is fractured in a nightstick fracture?

A

the ulna

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12
Q

A proximal ulnar shaft fracture with radial head dislocation is known as a ____ fracture.

A

Monteggia

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13
Q

What is a Galeazzi fracture?

A

a distal radial fracture with dislocation of the ulna

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14
Q

A distal radius fracture with dorsal angulation is known as a _____ fracture, while a distal radius fracture with ventral angulation is known as a _______ fracture.

A

Colles

Smith

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15
Q

A FOOSH injury with snuffbox tenderness should be treated as what type of fracture?

A

Scaphoid fracture

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16
Q

What is a severe complication of scaphoid fractures?

A

Avascular necrosis, most commonly of the proximal pole of the fractured bone.

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17
Q

What type of splint should be applied to a scaphoid fracture?

A

Thumb spica

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18
Q

What type of splint should be applied to a boxers fracture?

A

An ulnar gutter splint

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19
Q

What is the most common type of shoulder dislocation?

A

Anterior dislocation

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20
Q

What is the classic presentation of a patient with an anterior shoulder dislocation?

A

Arm abducted and externally rotated after a FOOSH injury

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21
Q

What is the classic patient presentation of a posterior shoulder dislocation?

A

Arm adducted and slightly internally rotated.

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22
Q

Where is a bankart lesion located?

A

The anterior inferior glenoid

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23
Q

Where is a hill-sachs lesion located?

A

Posterior superior humeral head

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24
Q

What is a severe complication of femoral neck fractures?

A

AVN of the femoral head

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25
What artery supplies the majority of blood to the femoral head?
The medial circumflex artery
26
What is the classic positioning of a hip/leg after a hip dislocation?
Leg shortened, internally rotated/ and adducted
27
What imaging should be ordered after a knee dislocation to rule out popliteal artery injury?
CTA
28
How can you check the peroneal nerve for function after a severe knee injury?
Check for foot drop
29
A knee XR with joint space narrowing, osteophytes, and subchondral sclerosis is suggestive of ______.
Osteoarthritis
30
List 4 physical exam findings that warrant an ankle XR after ankle/foot injury.
Pain along lateral malleolus Pain along medial malleolus Midfoot pain Unable to walk >4 steps in exam room
31
What is the most common presentation of gout?
Men >30 with asymmetric great toe pain, swelling, and redness.
32
What does joint aspiration analysis reveal in cases of gout?
Rod shaped negatively birefringent crystals
33
What does joint aspiration analysis reveal in pseudogout?
Rhomboid shaped calcium pyrophosphad crystals, positively birefringent
34
What is the treatment for gout flares?
NSAIDs
35
What are the options for gout prophylaxis?
Allupurinol, cholchicine, probenecid
36
What is the most common pathogen seen in osteomyelitis?
Staph aureus
37
What is Potts disease?
Osteomyelitis of vertebrae caused by TB
38
What is the triad of XR findings seen in osteomyelitis?
Demineralization, periosteal reaction, and bone destruction
39
What are the most common joints involved in septic arthritis?
Knee and hip
40
What is the most common pathogen in septic arthritis?
Staph aureus
41
What pathogen do you consider in septic arthritis in sexually active young adults?
Gonorrhea
42
What pathogen is commonly seen in septic arthritis in IVDU?
Pseudomonas
43
Is joint fluid aspirate with WBCs of 1200 diagnostic of septic arthritis?
Yes if it is a prosthetic joint. WBC count only needs to be higher than 1000.
44
In a non-prosthetic joint, what WBC count in joint fluid aspirate is diagnostic of a septic joint?
>50k primarily PMNs
45
What is the treatment of a septic joint caused by staph aureus?
Vanco/nafcillin
46
What is the treatment for suspected gonococcal septic arthritis?
Ceftriaxone
47
What is the treatment for a septic joint in an IVDU?
Cirpi/levaquin + arthrotomy with joint drainage
48
What type of epicondylitis is known as tennis elbow?
Lateral epicondylitis
49
At what point do patients with medial or lateral epicondylitis qualify for surgery?
Patients who have failed steroid injections and 4-6 months of PT
50
Where do paresthesias and pain localize in cubital/ulnar tunnel syndrome vs. carpal tunnel syndrome?
Cubital/ulnar tunnel - unlar half of 4th finger and ulnar dorsum of hand Carpal tunnel - first 3 digits and radial half of 4th
51
What special physical exam tests will be positive in carpal tunnel syndrome?
Phalen and tinel
52
What is the treatment for ulnar/cubital tunnel syndrome and carpal tunnel syndrome?
NSAIDs, nighttime bracing, activity mediation
53
What is the definitive treatment for cubital/ulnar tunnel syndrome?
Ulnar nerve decompression
54
What physical exam finding is positive in De Quervain's tenosynovitis?
Finkelstein's
55
What is the treatment for De Quervain's tenosynovitis?
Thumb spica splint x 3 weeks, NSAIDs x10-14 days
56
Dupuytren contracture is associated with what medical condition?
Alcoholic cirrhosis
57
Avulsion of the extensor tendon at the DIP leading to forced flexion is known as?
Mallet finger
58
What is the treatment for mallet finger?
DIP Extension splint x 6 weeks
59
Describe a boutonniere deformity?
PIP flexion and DIP hyperextension
60
What is the mechanism of injury for a boutonniere deformity?
Jammed finger
61
A skin infection caused by HSV is called _______.
Herpetic whitlow
62
What is the name for an abscess in the tip of the finger?
Felon
63
What injury leads to a step off deformity or squaring of the shoulder?
AC joint separation
64
What is a speeds test evaluating for?
A SLAP lesion (Superior labrum anterior to posterior
65
What is the most commonly injured rotator cuff muscle?
Supraspinatus
66
What physical exam special tests evaluate for a supraspinatus injury?
Empty can test Drop arm test Full can test
67
What physical exam special tests evaluate for a subscapularis injury?
Lift off test
68
What is the treatment for adhesive capsulitis?
NSAIDs, PT, steroid injection
69
What physical exam special tests evaluate for subacromial impingement syndrome?
Neer test Hawkins test Drop arm
70
What is the most sensitive physical exam test for an ACL tear?
Lachman's
71
What ligament injury would you suspect most after a valgus stress injury?
MCL tear - valgus stress is applied from the outside
72
What ligament injury would you suspect most from a varus stress injury?
LCL - varus stress is from the inside
73
What physical exam test evaluates for a meniscal tear?
McMurray test
74
What is the mechanism of injury for PCL tears?
Blow to the knee while flexed
75
What ligament is most commonly injured in rolled ankles?
ATFL
76
Why are ankle inversion injuries much more common than ankle eversion injuries?
The deltoid ligament is very strong and prevents ankle eversion in most cases

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