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44 Cards in this Set
- Front
- Back
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What nerve and artery are at risk with a anterior shoulder dislocation?
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Axillary artery and nerve
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What nerve is damaged when a patient presents with the following symptom (upper extremity)?
- Claw hand - Ape hand - Wrist drop - Scapular winging |
Claw hand
- Ulnar nerve Ape hand - Median nerve Wrist drop - Radial nerve Scapular winging - Long thoracic nerve |
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What nerve is damaged when a patient presents with the following symptom (upper extremity)?
- Unable to wipe bottom - Loss of forearm pronation - Cannot abduct or adduct fingers - Loss of arm abduction |
Unable to wipe bottom
- Thoracodorsal nerve Loss of forearm pronation - Median nerve Cannot abduct or adduct fingers - Ulnar nerve Loss of arm abduction - Axillary nerve |
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What nerve is damaged when a patient presents with the following symptom (upper extremity)?
- Weak lateral rotation of arm - Loss of arm and forearm pronation - Loss of forearm extension |
Weak lateral rotation of arm
- Suprascapular nerve, Axillary nerve Loss of arm and forearm pronation - Musculocutaneous nerve Loss of forearm extension - Radial nerve |
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What nerve is damaged when a patient presents with the following symptom (upper extremity)?
- Trouble initiating arm abduction - Unable to abduct arm beyond 10 degrees - Unable to raise arm above horizontal |
Trouble initiating arm abduction
- Suprascapular nerve Unable to abduct arm beyond 10 degrees - Axillary nerve Unable to raise arm above horizontal - Long thoracic nerve, Spinal accessory nerve |
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What nerve is most at risk of injury with the following types of fractures/injuries?
- Shaft of the humerus - Surgical neck of the humerus - Supracondyle of the humerus - Medial epicondyle - Anterior shoulder dislocation - Injury to the carpal tunnel |
Shaft of the humerus
- Radial nerve Surgical neck of the humerus - Axillary nerve Supracondyle of the humerus - Median nerve Medial epicondyle - Ulnar nerve Anterior shoulder dislocation - Axillary nerve Injury to the carpal tunnel - Median nerve |
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What type of fractures would prompt you to search for a ruptured thoracic aorta?
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1st and 2nd rib fractures
Scapular fractures Sternal fractures |
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What type of knee injury matches the following statement?
- Most commonly injured knee ligament - Positive Lachman test - Positive McMurray test - Common dashboard knee injury in an MVA |
Most commonly injured knee ligament
- Medial Collateral Ligament Positive Lachman test - ACL tear Positive McMurray test - Meniscus tear Common dashboard knee injury in an MVA - PCL tear |
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What are the 6 P's of compartment syndrome?
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Pain
Pallor Poikilothermia Pulselessness Paresthesia Paralysis |
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What imaging study is best for detecting spinal cord compression? Which is best for detecting spinal cord lesions as in multiple sclerosis?
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Spinal cord compression: CT scan
Spinal cord lesions (ie. MS): MRI |
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What is the best imaging study for visualizing the brachial plexus?
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MRI
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What are the classic symptoms carpal tunnel syndrome?
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- Wrist pain that radiates up arm and worsens with hand flexion and grasping
- Decreased hand strength, numbness in thumb, and in index and middle fingers - Tinel's sign - Phalen's sign - Thenar muscle atrophy |
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What nerve is injured in carpal tunnel syndrome?
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Median nerve
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What is the difference between a Monteggia's fracture and a Galeazzi's fracture?
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Monteggia's fracture:
Dislocation of radial head and ulnar diaphyseal fracture Galeazzi's fracture: Distal radial ulnar joint dislocation and radial diaphyseal fracture |
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What complication should you be looking for with the following type of fracture/injury?
- Fall on outstretched arm -> snuffbox tenderness - Anterior shoulder dislocation - Fracture on the fifth-metacarpal neck - Humerus fracture - Hip fracture - Femur fracture - Tibial fracture - Pelvic fracture |
Fall on outstretched arm -> snuffbox tenderness
- Scaphoid fracture: Risk of AVN Anterior shoulder dislocation - Axillary nerve injury Fracture on the fifth-metacarpal neck - Boxer's fracture: Bite wound Humerus fracture - Radial nerve injury Hip fracture - DVT formation, AVN Femur fracture - Fat embolism, severe blood loss Tibial fracture - Compartment syndrome Pelvic fracture - Hypovolemic shock from blood loss |
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What is the cause of low back pain given the following hints at presentation?
- Pain increases with passive straight leg raise - Pain lessens with flexion at the hips (eg. bending over shopping cart) - Elderly, weight loss, pain constant but worse when supine - Acute urinary retention - Pain made worse by walking and standing (AKA pseudoclaudication) - Loss of foot dorsiflexion and pain on crossed straight leg raise - Pain limited to the paraspinal region |
Pain increases with passive straight leg raise
- Disk herniation Pain lessens with flexion at the hips (eg. bending over shopping cart) - Spinal stenosis Elderly, weight loss, pain constant but worse when supine - Spinal tumor Acute urinary retention - Cauda equina syndrome Pain made worse by walking and standing (AKA pseudoclaudication) - Spinal stenosis Loss of foot dorsiflexion and pain on crossed straight leg raise - Disk herniation Pain limited to the paraspinal region - Muscular strain |
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What nerve is most at risk of injury with the following types of fractures/injuries
- Shaft of the humerus - Surgical neck of the humerus - Supracondyle of the humerus - Medial epicondyle - Anterior shoulder dislocation - Injury to the carpal tunnel |
Shaft of the humerus
- Radial nerve Surgical neck of the humerus - Axillary nerve Supracondyle of the humerus - Median nerve Medial epicondyle - Ulnar nerve Anterior shoulder dislocation - Axillary nerve Injury to the carpal tunnel - Median nerve |
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What scenarios favor a posterior shoulder dislocation?
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Seizures
Electrocution |
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What is the treatment for compartment syndrome?
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Emergent fasciotomy
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What is the unhappy triad of the knee?
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Medially directed blow to the lateral side of the knee:
Medial meniscus tear Medial collateral ligament tear Anterior cruciate ligament tear |
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Compare the PTH, Alk phos, serum Ca, and serum Phosphate levels i patients with the following diseases:
- Paget's disease - Osteomalacia/Rickets - Chronic renal failure - Osteoporosis - Osteopetrosis - Primary hyperparathyroidism - Hypoparathyroidism - Pseudohypoparathyroidism |
Paget's disease
- Normal PTH, High Alk Phos, Normal Ca, Normal PO4- Osteomalacia/Rickets - High PTH, High/Normal Alk Phos, Low Ca, Low PO4- Chronic renal failure - High PTH, High/Normal Alk Phos, Low Ca, High PO4- Osteoporosis - Normal PTH, Normal Alk Phos, Normal Ca, Normal PO4- Osteopetrosis - Normal PTH, Normal Alk Phos, Normal Ca, Normal PO4- Primary hyperparathyroidism - High PTH, High Alk Phos, High Ca, Low PO4- Hypoparathyroidism - Low PTH, Normal Alk Phos, Low Ca, High PO4- Pseudohypoparathyroidism - High PTH, Normal Alk Phos, Low Ca, High PO4- |
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What three studies can be used to make the diagnosis of osteomyelitis?
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MRI
Bone scan Tagged WBC scan |
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What diseases should you include in your differential with arthopathy of the following joints?
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DIP and PIP: Osteoarthritis
PIP and MCP (but not DIP): Rheumatoid arthritis Isolated MCP (squared-off bone ends and hook-like osteophytes of the MCPs): Hemochromatosis |
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What are the most common causes of bony metastasis?
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Lung, Breast, Prostate, Renal Cell, Thryoid, Lymphoma cancers
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What is the classic radiologic appearance of osteosarcoma? Ewing's sarcoma?
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Osteosarcoma: sunburst appearance +/- Codman's triangle
Ewing's sarcoma: Onion skinning |
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What is the treatment for Lyme disease? For Rocky Mountain Spotted Fever?
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Lyme disease: Doxycycline, Axomicillin, Cefuroxime
Rocky Mountain Spotted Fever: Doxycycline or Chloramphenicol |
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What medications are used in the treatment of acute gout? Pseudogout?
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Gout:
Colchicine NSAIDs Steroids Pseudogout: NSAIDs Colchicine |
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What treatment options are available to patients with osteoporosis?
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Weight-bearing exercise, walking
Bisphosphonates Calcium, Vit D Stop steroids Estrogen/testosterone replacement Pulsatile PTH |
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What are some of the endocrine causes of osteoporosis?
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Cushing's disease
Hyperthyroidism Hyperparathyroidism Hypogonadism (ie Menopause) |
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Which disease matches the following description?
- Knee x-ray reveals calcification of the menisci - Hats no longer fit + deafness - Needle-shaped, negatively birefringent crystals - Bone pain/tenderness with elevated WBC, CRP, and ESR - Child with low-trauma fractures - Narrowing of the marrow cavity results in low H&H - 55 year old female that trips and sustains a distal radius fracture |
Knee x-ray reveals calcification of the menisci
- Pseudogout Hats no longer fit + deafness - Osteopetrosis, Paget's disease Needle-shaped, negatively birefringent crystals - Gout Bone pain/tenderness with elevated WBC, CRP, and ESR - Osteomyelitis Child with low-trauma fractures - Osteogenesis imperfecta Narrowing of the marrow cavity results in low H&H - Osteopetrosis 55 year old female that trips and sustains a distal radius fracture - Osteoporosis |
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What is the empiric treatment for septic arthritis?
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IV Vancomycin (Staph Aureus)
Ceftriaxone + Doxycycline (Gonorrhea) |
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What medications are considered first-line treatment for rheumatoid arthritis?
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NSAIDs at full doses
Tylenol, Ultram, opiates Disease modifying antirheumatic drug - Sulfasalazine - Hydroxychloroquine - MTX - Lefluonomide - Cyclosporin - Anti-TNF agents - (azathiprine, penicillamine, gold less common) |
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Which infants should be screened for developmental dysplasia of the hip?
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Obtain hip sonogram at 6 weeks if:
- Female that is breech - Female with family history of DDH - Male that is breech (sometimes) |
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What disease is responsible for a painful limp in a child in each of the following scenarios?
- X-ray reveals femoral head sclerosis - X-ray reveals ice-cream scoop (femoral head) falling off of cone (femur) - obese, male adolescent with dull hip pain and an inability to bear weight - Acute onset of tibial pain, fever, malaise, elevated ESR, no joint pain - Acute onset of knee pain, fever, elevated ESR, leukocytosis - 7 year old with growth delay and inner thigh pain - 6 year old with unilateral hip pain for 5 days, low-grade fever, spontaneous resolution - 13 year old male with pain and swelling at the tibial tuberosity |
X-ray reveals femoral head sclerosis
- Avascular necrosis with Legg-Calve-Perthes X-ray reveals ice-cream scoop (femoral head) falling off of cone (femur) - Slipped capital femoral epiphysis Obese, male adolescent with dull hip pain and an inability to bear weight - Slipped capital femoral epiphysis Acute onset of tibial pain, fever, malaise, elevated ESR, no joint pain - Osteomyelitis Acute onset of knee pain, fever, elevated ESR, leukocytosis - Septic arthritis 7 year old with growth delay and inner thigh pain - Legg-Calve-Perthes disease 6 year old with unilateral hip pain for 5 days, low-grade fever, spontaneous resolution - Toxic synovitis 13 year old male with pain and swelling at the tibial tuberosity - Osgood-Schlatter disease |
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What is the treatment of Nursemaid's elbow?
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Supination and flexion
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What is the treatment for slipped capital femoral epiphysis?
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Non-weight bearing
Surgical pinning |
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What is the treatment for juvenile rheumatoid arthritis?
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1. NSAIDs
2. Different NSAIDs 3. Steroids or Methotrexate |
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What is the treatment for Osgood-Schlatter disease?
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Stretching, Ice, NSAIDs
Do not need to stop sports, do not need to immobilize |
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What is the treatment for developmental displasia of the hip in children younger than 6 months of age?
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Pavlik harness
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What are the characteristic findings of CREST scleroderma
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Calcinosis
Reynaud's phenomena Esophageal dysmotility Sclerodactyly Telangiectasia |
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Which medications are FDA approved for the treatment of fibromyalgia?
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Pregabalin
Duloxetine Milnacipran |
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Describe the rash of dermatomyositis
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- Heliotropic (periorbital) red-purple rash
- Shawl sign: Rash involving the shoulders, upper chest, and back that is worsened by UV light - Gottron's papules: papular rash with scales on the dorsum of the hands at the bony prominences - Erythroderma of the malar region and forehead - Mechanic's hands: roughened, cracking skin on the tips and lateral aspects of the fingers |
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Which rheumatological disease matches the following description?
- proximal muscle weakness and facial rash - pain and stiffness in the hips and shoulders - muscle pain and tenderness in multiple distinct locations - male in his 20s with low back pain that improves with exercise - jaw claudication and difficulty standing from a chair - pencil in cup deformities of the DIP and PIP joints - bamboo spine on xray - arthritis + oral ulcers + proteinuria - flexed DIP and hyperextended PIP |
proximal muscle weakness and facial rash
- Dermatomyositis pain and stiffness in the hips and shoulders - Polymyalgia rheumatica muscle pain and tenderness in multiple distinct locations - Fibromyalgia male in his 20s with low back pain that improves with exercise - Ankylosing spondylitis jaw claudication and difficulty standing from a chair - Polymyalgia rheumatica with Temporal arteritis pencil in cup deformities of the DIP and PIP joints - Psoriatic arthritis bamboo spine on xray - Ankylosing spondylitis arthritis + oral ulcers + proteinuria - Lupus flexed DIP and hyperextended PIP - Rheumatoid arthritis |
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Which disease is indicated by the following antibodies?
- Anti-histone - Anti-dsDNA - Anti-centromere - Anti-Ro - Anti-RNP |
Anti-histone
- Drug induced Lupus Anti-dsDNA - Lupus (With renal damage) Anti-centromere - CREST syndrome Anti-Ro - Sjogren's syndrome Anti-RNP - Mixed connective tissue disease (MCTD) |
