Ipapburke Ortho- Test 1

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A GROUP OF ONE OR MORE MUSCLES AND THEIR ASSOCIATED NERVES AND VESSELS SURROUNDED BY FASCIA THAT IS RELATIVELY UNYIELDING

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MUSCULAR COMPARTMENT

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TYPE OF COMPARTMENT SYNDROME THAT IS CONSIDERED A EMERGENT CLINICAL SITUATIION THAT USUALLY FOLLOWS TRAUMA

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ACUTE COMPARTMENT SYNDROME

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CAUSES OF ACUTE COMPARTMENT SYNDROME

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SEVERE CRUSH INJURIES, SYSTEMIC HYPOTENSION, DIRECT BLOWS, AND HEMORRHAGE

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WHAT IS THE END RESULT IN ACUTE COMPARTMENT SYNDROME?

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NECROSIS OF MUSCLE AND NERVE TISSUE THAT CAN OCCUR IN AS FEW AS 4 TO 8 HOURS

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ANOTHER NAME FOR CHRONIC COMPARTMENT SYNDROME

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EXERCISE INDUCED COMPARTMENT SYNDROME

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COMPARTMENTS MOST COMMONLY INVOLVED IN ACUTE COMPARTMENT SYNDROME

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ANTERIOR COMPARTMENT OF THE LEG AND THE VOLAR ASPECT OF THE FOREARM

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COMPARTMENTS MOST COMMONLY INVOLVED IN EXERCISE-INDUCED COMPARTMENT SYNDROME

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ANTERIOR AND LATERAL LEG COMPARTMENTS

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CHARACTERISTIC EARLY SYMPTOMS OF ACUTE COMPARTMENT SYNDROME

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PAIN OUT OF PROPORTION TO INJURY AND SENSORY HYPOESTHESIA DISTAL TO THE INVOLVED COMPARTMENT

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WHEN DO THE SYMPTOMS IN CHRONIC COMPARTMENT SYNDROME NORMALLY IMPROVE

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THE SYMPTOMS TEND TO IMPROVE WITH REST FOLLOWING EXERCISE

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MOST IMPORTANT PHYSICAL SIGN IN PE OF COMPARTMENT SYNDROME

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EXTREME PAIN ON STRETCHING OF THE LONG MUSCLES THAT PASS THROUGH THE COMPARTMENT

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WHY ARE PULSES TYPICALLY COMPLETELY NORMAL IN EARLY COMPARTMENT SYNDROME?

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THE INTRACOMPARTMENTAL PRESSURE DOES NOT EXCEED SYSTOLIC PRESSURE LEVELS

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WHAT DEVICE DO WE USE TO DIRECTLY MEASURE PRESSURE WITHIN COMPARTMENTS?

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NEEDLE PRESSURE DEVICE SUCH AS A STRYKER MONITOR

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TREATMENT FOR COMPARTMENT SYNDROME

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SURGICAL FASCIOTOMY; WOUND IS LEFT OPEN WITH DELAYED CLOSURE OR GRAFTING AFTER SWELLING SUBSIDES?

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IF DIASTOLIC PRESSURE MINUS THE INTERCOMPARTMENTAL PRESSURE IS LESS THAN OR EQUAL TO 30 MM HG, WHAT IS THE PRESUMPTION?

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ACUTE COMPARTMENT SYNDROME

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WHAT IS THE ABSOLUTE PRESSURE IN THE COMPARTMENT TO BE ASSURED OF ACUTE COMPARTMENT SYNDROME?

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ABOVE 40 MM HG

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ADVERSE OUTCOMES OF SURGERY FOR COMPARTMENT SYNDROME

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UNSIGHTLY SCAR AND INFECTION

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IF ACUTE COMPARTMENT SYNDROME IS NOT TREATED IMMEDIATELY, WHAT OCCURS?

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PERMANENT LOSS OF FUNCTION- MUSCLES DIE, SHORTEN, AND SCAR; FINGERS AND TOES BECOME CLAWED WITH LITTLE MOTION

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WHAT ARE THE TWO TYPES OF CRYSTALLINE DEPOSITION DISEASES?

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GOUT AND PSEUDOGOUT

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TYPE OF CRYSTAL IN GOUT

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MONOSODIUM URATE CRYSTALS

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TYPE OF CRYSTALS IN PSEUDOGOUT

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CALCIUM PYROPHOSPHATE CRYSTALS

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WHAT IS THE MOST FREQUENT MANIFESTATION OF GOUT?

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ARTHRITIS

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50% OF INITIAL EPISODES OF GOUTY ARTHRITIS ARE THIS?

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MTP JOINT OF THE GREAT TOE (PODAGRA)

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WHAT COULD YOU CONFUSE THE OVERLYING ERYTHEMA OF GOUT WITH?

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CELLULITIS OR SEPTIC JOINT

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SOFT TISSUE MASS RESULTING FROM URATE CRYSTAL DEPOSITION THAT ARE NOTED SEVERAL YEARS FOLLOWING ONSET OF GOUT

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TOPHI

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THIS IS AN IMPORTANT DIAGNOSTIC TEST FOR ACUTE ARTHRITIS

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JOINT ASPIRATION AND ANALYSIS OF SYNOVIAL FLUID- EXAMINE UNDER POLARIZED MICROSCOPE FOR NEGATIVELY BIREFRINGENT URATE CRYSTALS

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WHY DO YOU OBTAIN A GRAM STAIN AND CULTURE OF JOINT FLUID?

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BECAUSE SEPTIC ARTHRITIS IS A CONSIDERATION

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WHAT DO THE RADIOGRAPHS OF ACUTE GOUTY ARTHRITIS LOOK LIKE?

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THEY ARE NORMAL EXCEPT FOR SOFT TISSUE SWELLING AT THE ONSET OF ACUTE GOUT; PICTURES OF ESTABLISHED GOUT ARE CHARACTERIZED BY SUBCHONDRAL BONY EROSIONS AND AND PERIPHERAL ARTICULAR SPURS

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WHAT CAN CHRONIC HYPERURICEMIA CAUSE?

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NEPHROPATHY AND RENAL STONES

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ADVERSE OUTCOMES OF UNTREATED ACUTE GOUT

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TOPHI AND CHRONIC GOUTY ARTHRITIS

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WHAT SERUM AND URINE TESTS SHOULD BE DONE FOR PRESUMPTIVE GOUT?

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SERUM URIC ACID LEVELS, AND THEN A 24 HR URIC ACID EXCRETION TEST (90% OF PTS UNDERSECRETE URIC ACID)

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INDOMETHACIN (NSAID) AND COLCHICINE ARE FOR TREATMENT OF WHAT?

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ACUTE GOUT

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BESIDES MEDICATION, WHAT IS ANOTHER TREATMENT FOR GOUT?

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JOINT CAN ALSO BE ASPIRATED AND INJECTED WITH A CORTICOSTEROID

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COMMON LOCATIONS FOR TOPHI

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OLECRANON BURSA, EXTENSOR SURFACE OF FOREARM, ACHILLES TENDON, OR TENDON SHEATHS IN HAND

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BESIDES THE BIG TOE, WHAT ARE OTHER TYPICAL SITES OF GOUT?

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ANKLE, TARSAL JOINTS, AND THE KNEE

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ANTURANE AND PROBENECID ARE USED FOR WHAT?

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UNDEREXCRETORS OF URIC ACID

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WHAT JOINT DOES PSEUDOGOUT MOST NORMALLY AFFECT?

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KNEE (AROUND 50%)- ESP. MENISCUS

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BESIDES THE KNEE, COMMONLY AFFECTED , JOINTS FOR PSEUDOGOUT

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ELBOWS, WRISTS, ANKLES, HIPS, AND SHOULDERS

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PSEUDOGOUT IS THE MOST COMMON CAUSE OF ACUTE ARTHRITIS INVOLVING A SINGLE JOINT IN THIS POPULATION.

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THE ELDERLY

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CALCIFICATION OF ARTICULAR CARTILAGE OR MENISCUS, USUALLY AT THE PERIPHERY OF THE JOINT; MOST PEOPLE HAVE NO SYMPTOMS

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CHONDROCALCINOSIS

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CHONDROCALCINOSIS. PSEUDOGOUT, AND CHRONIC ARTHROHY ARE COMMON MANIFESTATIONS OF WHAT?

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CPPD (CALCIUM PYROPHOSPHATE DEPOSITION DISEASE)

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WITH THIS CONDITION, THE EXAMINATION OF JOINT FLUID UNDER POLARIZED MICROSCOPE REVEALS WEAKLY POSITIVE, BIREFRINGENT RHOMBOID SHAPED CALCIUM PYROPHOSPHATE CRYSTAL

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PSEUDOGOUT

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COMPARE PAIN IN PSEUDOGOUT TO GOUT;

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USUALLY MILD PAIN IN PSEUDOGOUT;MODERATE TO SEVERE PAIN IN GOUT

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TREATMENT FOR SYMPTOMATIC PSEUDOGOUT

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POSSIBLE ARTHROSCOPY FOR DEBRIDEMENT

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DIAGNOSTIC TEST FOR PSEUDOGOUT

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JOINT ASPIRATION

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DRUG USED FOR OVERPRODUCERS (GOUT)

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ALLOPURINOL

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WHAT MAY HELP TO LIMIT SYMPTOMS OF GOUT IF USED AT THE FIRST SIGN OF JOINT INFLAMMATION?

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SMALL DAILY DOSES OF COLCHOLINE OR EARLY USE OF INDOMETHACIN

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ACUTE GOUTY ARTHRITIS NORMALLY BEGINS IN A ___________ JOINT AND THE SYMPTOMS FIRST APPEAR AT ________.

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SINGLE; NIGHT

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WHAT WILL PHYSICAL EXAM OF A GOUT JOINT REVEAL?

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SWOLLEN, RED SKIN THAT MAY LOOK LIKE AN INFECTION; MAY HAVE LIMITED MOTION DUE TO PAIN

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THE CONDITION THAT OCCURS WHEN VASCULAR PERFUSION OF THE MUSCLE AND OTHER TISSUES WITHIN THE COMPARTMENT DECREASES TO A LEVEL THAT IS NOT ADEQUATE TO SUSTAIN VIABILITY OF TISSUES

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COMPARTMENT SYNDROME

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DESCRIBE WHAT HAPPENDS TO INTERCOMPARTMENTAL AND VENOUS PRESSURE W/ COMPARTMENT SYNDROME

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VENOUS PRESSURE ELEVATES AND OBSTRUCTS VENOUS FLOW; INTERCOMPARTMENTAL TISSUE PRESSURE ELEVATES; CAUSES CYCLE OF INCREASING PRESSURE IN COMPARTMENT AND DECREASE IN ARTERIAL FLOW- LEADS TO DEATH AND NECROSIS

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CHRONIC COMPARTMENT SYNDROME MAY DEVELOP IN WHAT POPULATIONS?

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LONG DISTANCE RUNNERS, NEW MILITARY RECRUITS, OR OTHERS INVOLVED IN MAJOR CHANGE IN ACTIVITY LEVEL

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THIS IS AN IDIOPATHIC TYPE OF OSTEOARTHRITIS CHARACTERIZED BY STRIKING OSTEOPHYTE FORMATION IN THE SPINE

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DIFFUSE IDIOPATHIC SKELETAL HYPEROSTOSIS

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PATIENTS WITH THIS CONDITION WILL HAVE OSSIFICATION SPANNING THREE OR MORE INTERVERTEBRAL DISCS

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DIFFUSE IDIOPATHIC SKELETAL HYPEROSTOSIS

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POPULATION THAT IS MOST AFFECTED BY DISC

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AFFECTS WHITE MEN; MALE TO FEMALE RATIO 2:1; AGES 60 PLUS

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PRINCIPAL SYMPTOM IN DISH

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STIFFNESS IN THE SPINE, ESP IN THE MORNING; SYMPTOMS HAVE BEEN THERE FOR MONTHS OR YEARS; MAY BE ASSYMPTOMATIC (INCIDENTAL FINDING)

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WHAT DO PE ON PT WITH DISH REVEAL?

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STIFFNESS IN THE SPINE ON FORWARD FLEXION AND ON EXTENSION

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WHAT ON XRAY WILL BE DIAGNOSTIC FOR DISH?

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OSSIFICATION SPANNING THE INTERVERTEBRAL DISKS OF AT LEAST 4 CONTINUOUS VERTEBRAE

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DISK _______ IS PRESERVED IN THE FUSED SEGMENTS IN DISH.

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HEIGHT

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WHAT ARE POSSIBLE ADVERSE AFFECTS OF DISH?

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SPINAL STIFFNESS, DYSPHAGIA, AND COMPRESSION OF THE SPINAL CORD

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WALKING AND EXERCISE PROGRAMS ARE THE MOST COMMON INITIAL TREATMENT FOR WHAT?

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DISH

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DIFFICULTY TALKING OR SWALLOWING

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DYSPHAGIA

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THIS OCCURS FIVE TIMES MORE OFTEN FOLLOWING HIP REPLACEMENT SURGERY IN DISH

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HETEROTOPIC OSSIFICATION

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HETEROTROPHIC OSSIFICATION

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AFTER SURGERY, BLOOD CALCIFIES INSTEAD OF BEING REABSORBED

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CHRONIC CONDITION CHARACTERIZED BY GENERALIZED PAIN, FATIGUE, AND TENDER AREAS IN SOFT TISSUES

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FIBROMYALGIA SYNDROME (FMS)

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POPULATION AT GREATEST RISK FOR FMS

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WOMEN BETWEEN 20 AND 60

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CLINICAL SYMPTOMS OF FMS

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WIDESPREAD PAIN PRESENT FOR 3 PLUS MONTHS; WIDESPREAD PAIN; AXIAL SKELETON PAIN; SLEEP DISTURBANCES, MUSCLE TISSUE, SHORT TERM MEMORY LOSS, FATIGUE, DEPRESSION AND ANXIETY

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DISEASE INVOLVING ONLY SOFT TISSUE, NO JOINT INVOLVEMENT

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FMS

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WHAT DOES PE REVEAL IN FMS?

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TENDERNESS TO PALPATION OVER AT LEAST 11 OF 18 TENDER POINT SITES; TENDER POINTS LIMITED TO SOFT TISSUE

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WHEN SHOULD FIBROMYALGIA BE CONSIDERED?

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IN ANY PATIENT WITH MUSCULOSKELETAL PAIN THAT IS UNRELATED TO A CLEARLY DEFINED ANATOMIC LESION

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FMS IS NOT A ____________ OR _____________ DISEASE.

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LIFE-THREATENING; PROGRESSIVE

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THESE MEDS ARE CONTRAINDICATED FOR FIBROMYALGIA

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CORTICOSTEROIDS AND NARCOTICS

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WHAT IS PROZAC (FLUOXETINE) USED FOR IN FMS?

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USEFUL TO REDUCE SEVERE DEPRESSION WHEN TAKEN IN THE MORNING

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DRUGS USED FOR TREATING PAIN IN FMS

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TRICYCLIC ANTIDEPRESSANTS (ELAVIL), CYCLOBENZAPRINE (FLEXERIL) AND NSAIDS

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TREATMENT FOR FMS

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EXERCISE AND STRETCHING; REFERRAL TO A DIETICIAN FOR WEIGHT LOSS; FMS SUPPORT GROUP; MULTIDISCIPLINARY APPROACH

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TOPICAL AGENTS LIKE CAPSAICAN CREAM APPLIED TO TENDER POINTS IS USEFUL IN THIS DISEASE

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FMS

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MULTISYSTEM ILLNESS WITH ACUTE AND CHRONIC MANIFESTATIONS CAUSED BY BORRELLIA BURGDORFERI BORNE BY THE DEER TICK IXODES DAMMINI

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LYME DISEASE

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MOST PREVALENT VECTOR BORNE ILLNESS IN THE US

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LYME DISEASE

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WHERE IS INCIDENCE OF LYME DISEASE MOST PREVALENT?

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NORTHEAST (MD TO MASS); UPPER MIDWEST (WISC AND MINN), AND CA AND OR.

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DISTINCTIVE LESION OF LYME DISEASE

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ERYTHEMA MIGRANS

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THE SUBACUTE OR INTERMEDIATE STAGE OF LYME DISEASE IS CHARACTERIZED BY WHAT?

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ARTHRALGIA AND ARTHRITIS (ESP OF KNEE)

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BELL PALSY

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PARALYSIS OF CN 7- FACIAL DROOPING

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WHEN DOES CHRONIC STAGE LYME DISEASE APPEAR?

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SEVERAL MONTHS TO EVEN YEARS; WILL HAVE CHRONIC ARTHRITIS AND RECURRENT PAINFUL JOINTS

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BESIDES JOINT ISSUES, WHAT ARE OTHER SYMPTOMS OF LYME DISEASE? RN

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CHRONIC FATIGUE, POLYRADICULOPATHY, ENCEPHALOPATHY WITH LOSS OF MEMORY AND INABILITY TO CONCENTRATE

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WHAT IS THE TREATMENT FOR LYME DISEASE?

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IF DIAGNOSED EARLY, TREATED EFFECTIVELY WITH ANTIBIOTICS; AMOXICILLLIN OR DOXYCYCLIN

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WHAT ARE NONORGANIC SYMPTOMS AND SIGNS?

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PATIENT RESPONSES OR SYMPTOMS THAT DO NOT FIT KNOWN PATTERNS OF ILLNESSES OR INJURY

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WHAT IS NON SEGMENTAL NUMBNESS MEAN?

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DOES NOT FIT A NERVE ROOT OR PERIPHERAL NERVE PATTERN

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WHAT IS NON ANATOMIC PAIN?

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PAIN OR SYMPTOMS THAT APPEAR TO TRAVEL FROM ONE SIDE OR AREA OF THE BODY TO ANOTHER IN A NONANATOMIC FASHION

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WHAT IS STOCKING OR NON ANATOMIC NUMBNESS?

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SOME PATIENTS REPORT HYPOESTHESIA THATAL AFFECTS THE EXTREMITY IN A CIRCUMFERENTIAL (STOCKING GLOVE) DISTRIBUTION OR COVERS NON ANATOMIC PATTERNS

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WHERE MIGHT STOCKING NUMBNESS BE NORMAL?

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PATIENTS WITH MS OR DIABETES

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WHAT ARE THE RADIOGRAPHIC FINDINGS IN TYPE I A-C INJURIES?

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TYPE I INJURIES ARE SPRAINS; THE RADIOGRAPH WILL APPEAR NORMAL

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WHAT ARE THE RADIOGRAPHIC FINDINGS IN TYPE II INJURIES?

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THERE WILL BE SOME AC JOINT WIDENING; THE DISTANCE BETWEEN THE CLAVICLE AND CORACOID (CC) SPACE WILL BE NORMAL THOUGH

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WHAT ARE THE RADIOGRAPHIC FINDINGS IN TYPE III AC INJURIES?

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SHOW COMPLETE DISPLACEMENT OF THE CLAVICLE ABOVE THE SUPERIOR BORDER OF THE ACROMION WITH A 30% TO 100% INCREASE IN THE CC INTERSPACE

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WHAT IS THE RADIOGRAPHIC FINDING ON A TYPE IV INJURY?

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MAY SHOW SUPERIOR DISPLACEMNT OF THE CLAVICLE ON AP RADIOGRAPHS, BUT AN AXILLARY LATERAL VIEW WILL CLEARLY SHOW THE PREDOMINANT POSTERIOR DISPLACEMENT

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WHAT IS THE RADIOGRAPHIC FINDING ON A TYPE V AC INJURY?

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SHOW THE CORACOCLAVICULAR INTERSPACE TO BE INCREASED OVER 100% OF THAT SEEN IN THE OPPOSITE SHOULDER

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WHAT IS THE RADIOGRAPHIC FINDING ON A TYPE VI A-C INJURY?

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SHOW THE DISTAL END OF THE CLAVICLE TO LIE EITHER IN THE SUBACROMIAL OR SUBCORACOID SPACE

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THIS IS A BENIGN TUMOR OF BONE ASSOCIATED WITH NIGHT PAIN AND RELIEVED WITH ASA

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OSTEOID OSTEOMA

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MOST COMMON CLAVICLE FRACTURE (80%)

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MIDDLE 1/3

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SECOND MOST COMMON CLAVICLE FRACTURE (15%)

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LATERAL 1/3

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HOW ARE CLAVICLE FRACTURES DIAGNOSED?

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AP RADIOGRAPH WITH OR WITHOUT WEIGHTS; REPEAT IN 6-8 WEEKS

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WHAT ARE NONORGANIC SYMPTOMS AND SIGNS?

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PATIENT RESPONSES OR SYMPTOMS THAT DO NOT FIT KNOWN PATTERN OF ILLNESSES OR INJURIES; PAIN OR SYMPTOM S THAT PPEAR TO "TRAVEL" FROM ONE SIDE OF THE BODY TO ANOTHER IN A NON-ANATOMIC FASHION AND AND GLOBAL PAIN ARE CHARACTERISTIC

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WHAT WILL BE THE FINDINGS IN A PE FOR NONORGANIC SYMPTOMS AND SIGNS?

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EXAGGERATED RESPONSES; LIGHT TOUCH CAUSES A JERK OR WITHDRAWAL; GRIMACING, GROANING, AND GRABBING THE AFFECTED EXTREMITY WHEN THERE IS NO OBVIOUS INJURY

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PROGRESSIVE, IRREVERSIBLE CONDITION INVOLVING LOSS OF ARTICULAR CARTILAGE THAT LEADS TO PAIN AND DEFORMITY

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OSTEOARTHRITIS

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MOST COMMON TYPE OF ARTHRITIS

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OSTEOARTHRITIS- EVERYONE GETS IT WITH VARYING SEVERITY

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ANOTHER NAME FOR OSTEOARTHRITIS

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DEGENERATIVE JOINT DISEASE

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COMMON SYMPTOMS OF OA

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STIFFNESS, PAIN, DEFORMITY; UNTIL LATER STAGES PAIN IS USUALLY RELIEVED BY REST; BONE SPURS MAY PHYSICALLY BLOCK MOTION IN LATE STAGES

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WHAT ARE THE RADIOGRAPHIC FINDINGS IN OA?

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FAIRBANKS SIGNS: LOSS OF JOINT SPACE, SCLEROSIS, SUBCHONDRAL CYSTS, AND SPURS AT THE JOINT MARGIN

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TREATMENT FOR OA

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WEIGHT LOSS ESP FOR LOWER EXTREMITY JOINTS, PAIN MANAGEMENT WITH ACETAMINOPHEN, NSAIDS, AND ASA; PHYSICAL THERAPY AND KEEPING ACTIVE; GLUCOSAMINE AND CHONDROITIN; BRACING-UNLOADER TO SHIFT WEIGHT TO NONARTHRITIC JOINT; INTRA-ARTICULAR CORTICOSTEROID INJECTIONS; SURGICAL ARTHROSCOPY- DEBRIDEMENT

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WHAT ARE SOME OF THE SURGICAL TREATMENT OPTIONS FOR OA?

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INTERPOSITIONAL GRAFT OR TRANSPLANT, JOINT REPLACEMENT WHEN PATIENTS HAVE PAIN AT REST, AT NIGHT, OR LOSS OF JOINT FUNCTION OUTSIDE OF NORMAL LIMITS, JOINT ARTHRODESIS OR FUSION

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WHAT IS THE UNLOADER BRACE?

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A BRACE USED IN A YOUNG PATIENT WHERE THE WEIHHT IS SHIFTED FROM ONE COMPARTMENT TO THE OTHER