Term
What nerve is compressed in carpal tunnel syndrome?
What is it compressed by? |
|
Definition
Median nerve
Transverse carpal ligament |
|
|
Term
Name 3 risk factors for getting carpal tunnel |
|
Definition
Pregnancy, overuse, diabetes |
|
|
Term
What are the symptoms of carpal tunnel syndrome? |
|
Definition
Wrist pain that radiates up the arm |
|
|
Term
Name 2 ways that posterior shoulder dyslocations happen |
|
Definition
Electrical shock
seizures |
|
|
Term
How do you treat a dislocated shoulder? |
|
Definition
| Closed reduction and sling |
|
|
Term
What nerve can be injured in shoulder dislocation?
How do you tell? |
|
Definition
Axillary nerve
loss of sensation and deltoid paralysis |
|
|
Term
What is the most common type of hip dyslocation? |
|
Definition
| Posterior (dashboard injury) |
|
|
Term
Define sprain
How do you treat it? |
|
Definition
Injury to ligaments and soft tissue surrounding a joint
RICE: rest, ice, compression, elevation |
|
|
Term
What are the difference in symptoms in a sprain versus a ligamental tear? |
|
Definition
Sprain: pain with weightbearing or movement but stable
Tear: Instability on stress testing |
|
|
Term
What kind of imaging do you order to look at bones?
What about to look at soft tissues around bones? |
|
Definition
Bones: CT
Soft tissue: MRI |
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|
Term
Name the 3 injuries you get with a lateral trauma to the knee. |
|
Definition
ACL tear
MCL tear
Medial meniscal tear |
|
|
Term
What is the pathophysiology of compartment syndrome? |
|
Definition
| Trauma-->reperfusion injury-->swelling within a defined fascial compartment-->compression of neurovascular structures leading to ischemia |
|
|
Term
What are the 6 P's of compartment syndrome? |
|
Definition
| Pain, pallor, pulselessness, paresthesia, paralysis, poikilothermia (can't regulate temperature) |
|
|
Term
True or False: there can still be a pulse in compartment syndrome? |
|
Definition
|
|
Term
How do you treat compartment syndrome? |
|
Definition
Emergency fasciotomy! Otherwise you can have permanent damage! |
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|
Term
[image]
What kind of fracture is this?
Describe what happened. |
|
Definition
Colles fracture: "dinner fork" fracture
Distal radius (and ulna) from fall onto an outstretched hand.
|
|
|
Term
[image]
What is broken?
How did this happen? |
|
Definition
Scaphoid fracture
Fall onto outstretched, medially rotated hand |
|
|
Term
When will you see a scaphoid fracture on imaging? |
|
Definition
| Not for 1-2 weeks after injury |
|
|
Term
[image]
What is this called?
How does it happen? |
|
Definition
Boxer's fracture
Punching something hard
|
|
|
Term
When does a Boxer's fracture require surgery? |
|
Definition
| "fight bite" to debride wound, look for tendon involvement. |
|
|
Term
What nerve injury do you care about in humeral fractures?
How do you tell? |
|
Definition
Radial nerve injury
Wrist drop, weak thumb abduction |
|
|
Term
[image]
What kind of injury is this?
How is it treated?
|
|
Definition
Monteggia fracture: radial dislocation, ulnar fracture
Rx: surgery on ulna, reduce radial dislocation |
|
|
Term
[image]
What kind of fracture is this? |
|
Definition
| Galeazzi: radial-ulnar dislocation, radial fracture |
|
|
Term
What are 2 risks that you worry about in hip fracture? |
|
Definition
| Avascular necrosis and DVT |
|
|
Term
What is a complication you worry about in femoral fractures? |
|
Definition
|
|
Term
What is the problem with pelvic fractures? |
|
Definition
Risk to lose a lot of blood! |
|
|
Term
C5 compression
Reflex?
Motor?
Sensory? |
|
Definition
Biceps reflex
Deltoids and biceps
Anterior shoulder |
|
|
Term
C6 compression
Reflex?
Motor?
Sensory? |
|
Definition
Brachioradialis
Biceps and wrist extension
Lateral forearm |
|
|
Term
C7 Compression
Reflex?
Motor?
Sensory? |
|
Definition
Triceps
Triceps and finger extensors
Posterior forearm |
|
|
Term
C8 compression
Reflex?
motor?
Sensory? |
|
Definition
No reflex
Finger flexors
Medial forearm, 4th/5th fingers |
|
|
Term
L4 compression
Reflex?
Motor?
Sensory? |
|
Definition
Patellar reflex
Foot dorsiflexion
Medial leg |
|
|
Term
L5 compression
Reflex?
Motor?
Sensory? |
|
Definition
No reflex
great toe dorsiflexion
first web space of toes |
|
|
Term
S1 compression
Reflex?
Motor?
Sensory? |
|
Definition
Achilles
plantar flexion
lateral foot |
|
|
Term
What is spinal stenosis?
What are the symptoms? |
|
Definition
Narrowing of bony spaces in the spine caused by old age
Radiating pain that's worse with walking |
|
|
Term
Name 3 symptoms of cauda equina syndrome |
|
Definition
| urinary retention, saddle anesthesia, decreased rectal tone |
|
|
Term
How do you treat cauda equina syndrome? |
|
Definition
| Emergency surgical decompression |
|
|
Term
Name 2 medications for osteoporosis |
|
Definition
Bisphosphonates
Raloxifene (SERM) |
|
|
Term
What kind of crystals do you see in gout? |
|
Definition
Sodium urate crystals
needles, (-) birefringent |
|
|
Term
How do you treat acute gout?
Chronic gout? |
|
Definition
Acute: indomethicin and colchicine
Chronic: allopurinol, Probenecid |
|
|
Term
What are pseudogout cyrstals made of? |
|
Definition
Calcium pyrophosphate dihydrate (CPP)
Rhomboid, (+) birefringent |
|
|
Term
Name 2 exam signs of Paget's disease |
|
Definition
| Increased head size, tibial bowing |
|
|
Term
How do you treat Paget's disease (2 drugs)? |
|
Definition
Bisphosphonates
Calcitonin |
|
|
Term
What bone disease can lead to deafness? |
|
Definition
|
|
Term
Waiter's tip palsy
AKA?
Site of injury?
Main cause? |
|
Definition
Erb-Duchenne palsy
Superior trunk
birth trauma |
|
|
Term
What nerve is injured in claw hand palsy? |
|
Definition
|
|
Term
How do you get wrist drop? |
|
Definition
| Posterior cord or radial nerve injury |
|
|
Term
Name 2 common causes of septic arthritis |
|
Definition
#1: Staph aureus
2: Neisseria gonorrhoae (sexually active) |
|
|
Term
| What can be the infectious agent of septic arthritis in a patient with DM or cancer? |
|
Definition
|
|
Term
How do you treat staph aureus septic arthritis?
N. gonorrhea?
Gram negative rod? |
|
Definition
Staph: Surgical I+D, oxacillin
Gonorrhea: abx only (cef and doxy)
Gram neg rod: aminoglycocide, surgical I+D |
|
|
Term
What are the 2 most common causes of osteromyelitis? |
|
Definition
| Staph aureus, Pseudomonas |
|
|
Term
Osteomyelitis...
in sickle cell?
in IVDU? |
|
Definition
Salmonella
Pseudomonas
**Staph is still #1 in these patients! |
|
|
Term
| What is the rash you see in early localized lyme disease? |
|
Definition
| Erythema chronicum migrans |
|
|
Term
| Name 3 complications of early disseminated lyme disease |
|
Definition
Bell's palsy
Myocarditis
Aseptic meningitis |
|
|
Term
| When do you get arthritis with lyme disease infection? |
|
Definition
| months ot years after infection |
|
|
Term
| What are 4 signs of osteoarthritis on X-ray? |
|
Definition
Joint space narrowing
subchondral sclerosis
subchondral cysts
osteophyte formation |
|
|
Term
What kind of arthritis is ASYMMETRIC? |
|
Definition
|
|
Term
| What happens in rheumatoid arthritis? |
|
Definition
| Synovial hypertrophy, granulation tissue on cartilage-->pannus formation |
|
|
Term
What are enlarged PIP joints called and where do you see them> |
|
Definition
Bouchard nodes
Rheumatoid arthritis |
|
|
Term
| Name 4 immunologic markers associated with RA |
|
Definition
HLA DR4
ANA (<50%)
RF (75%)
AntiCCP |
|
|
Term
|
Definition
NSAIDS
Sulfasalazine
Hydroxychloroquine
Infliximab (anti-TNF)
Mtx |
|
|
Term
| Name 4 immunologic markers of SLE |
|
Definition
ANA (95%)
Anti-dsDNA
Anti-Smith
False + RPR |
|
|
Term
| Name the MD SOAP CHAIR symptoms of SLE |
|
Definition
Malar Rash
Discoid Rash
Serositis
Oral ulcers
Arthritis
Photosensitive
CNS
Heart and heme
ANA
Immunologic issues
Renal |
|
|
Term
| What are the symptoms of polymyositis? |
|
Definition
| Proximal muscle weakness (+/-) skin rash (dermatomyositis) |
|
|
Term
| What antibody is present as a sign of interstitial lung disease in polymyositis? |
|
Definition
|
|
Term
How does PMR differ from polymyositis?
What other rheumatic disease is associated with PMR? |
|
Definition
There is muscle soreness but no weakness in PMR.
Temporal arteritis
|
|
|
Term
| How does Fibromyalgia differ from PMR or polymyositis? |
|
Definition
| Chronic pain WITHOUT inflammation! |
|
|
Term
| True or false: most patients with psoriasis get psoriatic arthritis? |
|
Definition
|
|
Term
| What are the immunologic markers of psoriatic arthritis? |
|
Definition
|
|
Term
| What antibodies are associated with scleroderma and CREST? |
|
Definition
Scleroderma: Anti Scl70
CREST: anticentromere |
|
|
Term
| Name 3 organ systems other than skin affected by scleroderma |
|
Definition
pulmonary fibrosis
heart failure
renal failure |
|
|
Term
| Mixed Connective Tissue disease is a mix of what 3 rheumatologic diseases? |
|
Definition
| SLE, Scleroderma, Polymyositis |
|
|
Term
| What is the definitition of Sjogren's syndrome and how does it differ from Sicca syndrome? |
|
Definition
Autoimmune disease with lymphocytic infiltration of exocrine glands leading to dry eyes/mouth.
Sjogren's is always associated with another autoimmune disease. If there is no other autoimmune disease, it's just sicca syndrome |
|
|
Term
| Name 2 antibodies associated with Sjogren's |
|
Definition
|
|
Term
Name 3 risk factors of osteosarcoma |
|
Definition
Paget's disease
Familial retinoblastoma
radiation exposure |
|
|
Term
[image]
What is the diagnosis?
What are 2 x-ray findings associated with this diagnosis? |
|
Definition
Osteosarcoma
Sunburst pattern
Codman's triangle |
|
|
Term
| Name 6 common cancers that metastasize to bones |
|
Definition
Renal
Lymphoma
Lung
Prostate
Breast
Thyroid |
|
|
Term
What bone cancer to kids get?
What does it look like on XR?
|
|
Definition
Ewing sarcoma
Onion skinning |
|
|
Term
| Bone cancer in teenage boy |
|
Definition
| Either Ewings OR Osteosarcoma! |
|
|
Term
How do you treat developmental dysplasia of the hip in...
kids <6 months
Kids 6mo-2yrs
>2 years
>8 years |
|
Definition
<6 months: Pavlik harness
6mo-2 years: surgery and spica cast
>2: surgery
>8 years: nothing! |
|
|
Term
| What are the risks of slipped capital femoral epiphysis? |
|
Definition
Avascular necrosis
premature osteoarthritis |
|
|
Term
| What are 2 causes of rickets? |
|
Definition
1) decreased Vit D intake (hypocalcemia)
2) impaired phosphate absorption (hypophosphatemia) |
|
|
Term
| How do you treat rickets due to malabsorption? |
|
Definition
Phosphorus suppplementation
1,25 dihydroxycholecalciferol supplementation |
|
|
Term
| What area is affected in Osgood-Schlatter disease |
|
Definition
|
|
Term
What is the most common fracture of childhood and how is it usually obtained? |
|
Definition
Clavicular fracture
Fall or birth trauma |
|
|
Term
[image]
What is this?
How is it treated? |
|
Definition
Legg-Calve-Perthes disease
Avascular necrosis of the femoral epiphysis
Rx: 50% resolve spontaneously, also bracing or surgery |
|
|
Term
| What due patients with Duchenne Muscular dystrophy die from? |
|
Definition
| Respiratory muscle malfunction |
|
|
Term
| Define epiphysis, Metaphysis, Diaphysis |
|
Definition
Epiphysis: end of bone
Metaphysis: growth plate
Diaphysis: shaft of bone |
|
|
Term
| What kind of arthritis has morning stiffness of >1 hours? |
|
Definition
|
|
Term
| What antibody is more specific and sensitive than RF in diagnosing Rheumatoid arthritis? |
|
Definition
|
|
Term
| How does colchicine work? |
|
Definition
| Inhibits microtubule polymerization and prevents PMN chemotaxis. |
|
|
Term
| Do Ankylosing Spondylitis symptoms improve or get worse with activity? |
|
Definition
| Improve with activity and hot shower. |
|
|
Term
What is the Reiter's syndrome Triad?
Name 4 bacterial causes
|
|
Definition
Seronegative arthritis, urethritis, conjunctivitis
Chlamydia, ureaplasma, salmonella, campylobacter |
|
|
Term
| What is the difference between localized sclerdoerm and systemic sclerosis? |
|
Definition
localized: just skin
Systemic: organ involvement - several different types of SSc |
|
|
Term
Other than fragile bones, name 3 signs associated with Osteogenesis imperfecta |
|
Definition
Teeth issues
hyperlaxity in joints
Hearing loss |
|
|
Term
Describe how patients with Ankylosing Spondylitis may have lung disease.
What do PFTs look like? |
|
Definition
Restrictive lung disease: From restricted chest wall motion
decreased FEV and FVC (ratio is normal) |
|
|
Term
| What other joint is affected in ankylosing spondylitis (other than the spinal column)? |
|
Definition
|
|
Term
What eye problem can people with ankylosing spondylitis get? |
|
Definition
|
|
Term
List 4 signs and symptoms associated with sarcoidosis |
|
Definition
Dry cough
hilar adenopathy
Anterior uveitis
Arthritis |
|
|
Term
What endocrine abnormalities can present with proximal muscle weakness?
|
|
Definition
|
|
Term
Name 4 symptoms of Behcet's syndrome
What is it and who gets it? |
|
Definition
Multisystem vasculitis - turkish people.
Oral ulcers
Genital ulcers
uveitis
Erythema nodosum |
|
|
Term
| What kind of arthritis has sausage fingers? |
|
Definition
|
|
Term
| What is step 1 in patients with Lupus Nephritis? |
|
Definition
|
|
Term
What kind of arthritis leads to Baker's cysts? |
|
Definition
|
|
Term
| What kind of arthritis can patients with hyperparathyroidism get? |
|
Definition
|
|
Term
| Name 3 side effects of Methotrexate |
|
Definition
Oral Ulcers
Hepatotoxicity
Anemia |
|
|
Term
Name 4 symptoms of Kawasaki disease
How do you treat it? |
|
Definition
Conjunctivitis
High Fever
Rash
Oral changes
Aspirin, IVIG |
|
|
Term
What is the scariest complication of untreated Kawasaki disease? |
|
Definition
|
|
Term
What is the worrisome side effect of hydroxychloroquine and how do you monitor for it? |
|
Definition
| Retinopathy, eye exams q6 months |
|
|
Term
| What kind of cancer metastasizes to the brain (even if the primary tumor was removed a long time ago)? |
|
Definition
|
|
Term
| What kind of cancer presents with SIADH? |
|
Definition
|
|
Term
| What is the pathophysiology of B12 deficiency anemia? |
|
Definition
| without B12 you can't make purines and then can't make DNA |
|
|
Term
| What kind of anemia presents with multisegmented neutrophils? |
|
Definition
|
|
Term
What substance is elevated in both B12 and folate deficiency?
In what kind of anemia is MMA elevated? |
|
Definition
Homocystine is elevatedin b12 and folate deficiency
MMA is only elevated in B12 deficiency
|
|
|
Term
|
Definition
| It binds to free hemoglobin in the serum and aids in its removal. |
|
|
Term
[image]
What is that blue dot called?
What does it mean? |
|
Definition
Howell Jolly Body
Sign of asplenia (functional or from surgery) |
|
|
