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Cam's Cards > ToL EM Ortho/Rheum > Flashcards

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
Q

What artery supplies the majority of blood to the femoral head?

A

The medial circumflex artery

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26
Q

What is the classic positioning of a hip/leg after a hip dislocation?

A

Leg shortened, internally rotated/ and adducted

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27
Q

What imaging should be ordered after a knee dislocation to rule out popliteal artery injury?

A

CTA

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28
Q

How can you check the peroneal nerve for function after a severe knee injury?

A

Check for foot drop

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29
Q

A knee XR with joint space narrowing, osteophytes, and subchondral sclerosis is suggestive of ______.

A

Osteoarthritis

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30
Q

List 4 physical exam findings that warrant an ankle XR after ankle/foot injury.

A

Pain along lateral malleolus
Pain along medial malleolus
Midfoot pain
Unable to walk >4 steps in exam room

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31
Q

What is the most common presentation of gout?

A

Men >30 with asymmetric great toe pain, swelling, and redness.

32
Q

What does joint aspiration analysis reveal in cases of gout?

A

Rod shaped negatively birefringent crystals

33
Q

What does joint aspiration analysis reveal in pseudogout?

A

Rhomboid shaped calcium pyrophosphad crystals, positively birefringent

34
Q

What is the treatment for gout flares?

35
Q

What are the options for gout prophylaxis?

A

Allupurinol, cholchicine, probenecid

36
Q

What is the most common pathogen seen in osteomyelitis?

A

Staph aureus

37
Q

What is Potts disease?

A

Osteomyelitis of vertebrae caused by TB

38
Q

What is the triad of XR findings seen in osteomyelitis?

A

Demineralization, periosteal reaction, and bone destruction

39
Q

What are the most common joints involved in septic arthritis?

A

Knee and hip

40
Q

What is the most common pathogen in septic arthritis?

A

Staph aureus

41
Q

What pathogen do you consider in septic arthritis in sexually active young adults?

42
Q

What pathogen is commonly seen in septic arthritis in IVDU?

A

Pseudomonas

43
Q

Is joint fluid aspirate with WBCs of 1200 diagnostic of septic arthritis?

A

Yes if it is a prosthetic joint. WBC count only needs to be higher than 1000.

44
Q

In a non-prosthetic joint, what WBC count in joint fluid aspirate is diagnostic of a septic joint?

A

> 50k primarily PMNs

45
Q

What is the treatment of a septic joint caused by staph aureus?

A

Vanco/nafcillin

46
Q

What is the treatment for suspected gonococcal septic arthritis?

A

Ceftriaxone

47
Q

What is the treatment for a septic joint in an IVDU?

A

Cirpi/levaquin + arthrotomy with joint drainage

48
Q

What type of epicondylitis is known as tennis elbow?

A

Lateral epicondylitis

49
Q

At what point do patients with medial or lateral epicondylitis qualify for surgery?

A

Patients who have failed steroid injections and 4-6 months of PT

50
Q

Where do paresthesias and pain localize in cubital/ulnar tunnel syndrome vs. carpal tunnel syndrome?

A

Cubital/ulnar tunnel - unlar half of 4th finger and ulnar dorsum of hand

Carpal tunnel - first 3 digits and radial half of 4th

51
Q

What special physical exam tests will be positive in carpal tunnel syndrome?

A

Phalen and tinel

52
Q

What is the treatment for ulnar/cubital tunnel syndrome and carpal tunnel syndrome?

A

NSAIDs, nighttime bracing, activity mediation

53
Q

What is the definitive treatment for cubital/ulnar tunnel syndrome?

A

Ulnar nerve decompression

54
Q

What physical exam finding is positive in De Quervain’s tenosynovitis?

A

Finkelstein’s

55
Q

What is the treatment for De Quervain’s tenosynovitis?

A

Thumb spica splint x 3 weeks, NSAIDs x10-14 days

56
Q

Dupuytren contracture is associated with what medical condition?

A

Alcoholic cirrhosis

57
Q

Avulsion of the extensor tendon at the DIP leading to forced flexion is known as?

A

Mallet finger

58
Q

What is the treatment for mallet finger?

A

DIP Extension splint x 6 weeks

59
Q

Describe a boutonniere deformity?

A

PIP flexion and DIP hyperextension

60
Q

What is the mechanism of injury for a boutonniere deformity?

A

Jammed finger

61
Q

A skin infection caused by HSV is called _______.

A

Herpetic whitlow

62
Q

What is the name for an abscess in the tip of the finger?

63
Q

What injury leads to a step off deformity or squaring of the shoulder?

A

AC joint separation

64
Q

What is a speeds test evaluating for?

A

A SLAP lesion (Superior labrum anterior to posterior

65
Q

What is the most commonly injured rotator cuff muscle?

A

Supraspinatus

66
Q

What physical exam special tests evaluate for a supraspinatus injury?

A

Empty can test
Drop arm test
Full can test

67
Q

What physical exam special tests evaluate for a subscapularis injury?

A

Lift off test

68
Q

What is the treatment for adhesive capsulitis?

A

NSAIDs, PT, steroid injection

69
Q

What physical exam special tests evaluate for subacromial impingement syndrome?

A

Neer test
Hawkins test
Drop arm

70
Q

What is the most sensitive physical exam test for an ACL tear?

A

Lachman’s

71
Q

What ligament injury would you suspect most after a valgus stress injury?

A

MCL tear - valgus stress is applied from the outside

72
Q

What ligament injury would you suspect most from a varus stress injury?

A

LCL - varus stress is from the inside

73
Q

What physical exam test evaluates for a meniscal tear?

A

McMurray test

74
Q

What is the mechanism of injury for PCL tears?

A

Blow to the knee while flexed

75
Q

What ligament is most commonly injured in rolled ankles?

76
Q

Why are ankle inversion injuries much more common than ankle eversion injuries?

A

The deltoid ligament is very strong and prevents ankle eversion in most cases

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