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103 Cards in this Set
- Front
- Back
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where does compartment syndrome most often occur?
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anterior compartment of the lower leg and forearm
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pressures in compartment syndrome
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usually >30
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bowel-bladder dysfunction, impotence, saddle-area anesthesia
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cauda equina syndrome
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sudden onset of severe, electricity-like low back pain, usually preceded by several months of aching pain
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disk herniation
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nerve root for foot dorsiflexion
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L4
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nerve root for patellar reflex
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L4
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nerve root for big toe dorsiflexion
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L5
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nerve root for plantar flexion and hip extension
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S1
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back pain that improves with hip flexion
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spinal stenosis
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characteristics of back pain in ankylosing spondylitis
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worse with inactivity and in morning
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positive Schober test
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decreased spine flexion; consistent with ankylosing spondylitis
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cardiac condition associated with ankylosing spondylitis
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third degree heart block
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Reiter's syndrome usually follows infections with what organisms?
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campylobacter, shigella, salmonella, chlamydia, ureaplasma
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which joints does psoriatic arthritis affect?
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DIP
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sausage-shaped digits
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psoriatic arthritis
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bamboo spine and fused SI joints
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ankylosing spondylitis
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negative dystrophin immunostain, increased CK
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duchenne muscular dystrophy
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what does EMG show in Duchenne muscular dystrophy
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polyphasic potentials and increased recruitment
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normal dystrophin levels but abnormal protein
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Becker muscular dystrophy
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which is worse: duchenne or becker
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duchenne - life expectancy in teens
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MR associated with which muscular dystrophy
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duchenne
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what does muscle biopsy show in duchennes
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degeneration and variation in fiber size with fibrosis
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treatment for fibromyalgia
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antidepressants, stretching, heat, etc.
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presence of <11-18 tender points or non-fibromyalgia tender points
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myofascial pain syndrome
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what does gout result from?
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intra-articular depostition of monosodium urate crystals
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what does joint aspirate show in gout?
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needle-shaped, negatively birefringent crystals
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punched-out erosions with overhanging cortical bone (rat-bite)
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seen in advanced gout
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treatment for acute gout attack
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high dose NSAID (indomethacin), colchicine, and/or steroids
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gout maintenance therapy
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allopurinol for overproducers, probenecid for undersecretors
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rhomboid, positively birefringent crystals
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pseudogout
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crepitus, decreased ROM, pain that worsens with activity and improves with rest
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osteoarthritis
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joint space narrowing, osteophytes, subchondral sclerosis/bone cysts on XR
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osteoarthritis
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symmetric, progressive, proximal muscle weakness, pain, difficulty breathing or swallowing
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polymyositis
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heliotrope rash, shawl sign
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dermatomyositis
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Gottron's papules
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papular rash with scales located on dorsa of hands over bony prominences, associated with dermatomyositis
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what does EMG show in dermatomyositis/polymyositis?
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fibrillations
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elevated labs in dermatomyositis/polymyositis
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CK, aldolase, CPK
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what does muscle biopsy show in polymyositis
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inflammation and muscle fibers in varying stages of necrosis and regeneration
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treatment for polymyositis/dermatomyositis?
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high-dose corticosteroids with eventual taper
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what HLA type is associated with RA?
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HLA-DR4
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insidious onset of morning stiffnes for >1 hour and painful warm swelling of multiple symmetric joints (wrists, MCP, PIP, ankles, knees, etc.) for >6 wks
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rheumatoid arthritis
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ulnar deviation with MCP joint hypertrophy
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RA
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swan-neck, buotonniere deformities, Baker's cysts
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RA
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RA, splenomegaly, neutropenia
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Felty's syndrome
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what does synovial fluid show in RA
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trubid fluid, decreased velocity, and increased white cell count (3-50K)
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treatment for RA
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NSDAIDs adn methotrexate, hydroxychloroquine, TNF inhibitors
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pauciarticular juvenile RA is associated with an increased risk of what?
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iridocyclitis
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evanescent, salmon-colored rash in which type of JRA?
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acute febrile (least common)
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diagnostic test for JRA
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none; +RF in 15%, ANA+ esp in pauciarticular subtype
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CREST syndrome
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calcinosis, raynaud's, esophageal dysmotility, sclerodactyly, telangiectasias
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what lab test is specific for CREST syndrome?
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anticentromere antibodies
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what antibodies are associated with a poor prognosis in CREST syndrome?
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anti-scl-70
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excessive deposition of collagen
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scleroderma
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treatment for raynaud's
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ca2+ channel blockers
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treatment for scleroderma
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steroids; penicillamine for skin changes
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positive antihistone antibodies
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drug-induced lupus
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specific antibodies in SLE
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anti-dsDNA and anti-Sm
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positive anti-Ro antibodies
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neonatal SLE
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drugs that can cause lupus syndrome
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chlorpromazine, hydralazine, INH, methyldopa, penicillamine, procainamide, quinidine
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treatment for temporal arteritis
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high-dose prednisone
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most feared complication of temporal arteritis
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occlusion of the cntral retinal artery (branch of internal carotid)
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what other disease affects almost half of patients with temporal arteritis?
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polymyalgia rheumatica
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pain and stiffness of shoulder and pelvic girdle muscles with difficulty getting out of a chair or lifting arms above head
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polymyalgia rheumatica
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labs in polymyalgia rheumatica
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markedly increased ESR, often associated with anemia
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treatment for polymyalgia rheumatica
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low-dose prednisone
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in what kids is developmental dysplasia of the hip most often seen?
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first-born females born in breech position
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barlow's maneuver
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pressure placed on inner aspect of abducted thigh and hip is then abducted -> posterior dislocation
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ortolani's maneuver
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thighs gently abducted with anterior pressure on greater trochanter; soft click signifies reduction of femoral head into acetabulum
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allis'/galeazzi's sign
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knees are at unequal heights wehn hips and knees are flexed
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treatment of developmental hip dysplasia at <6 mos
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pavlik harness
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treatment of developmental hip dysplasia at 6-15 mos
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spica cast
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treatment of developmental hip dysplasia at 15-24 mos
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open reduction
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avascular necrosis of femoral head of unknown etiology
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legg-calve-perthes disease
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findings in legg-calve-perthes disease
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limited abduction and internal rotation; atrophy of affected leg
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separation of the proximal femoral epiphysis through the growth plate -> medial and posterior displacement of femoral head
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slipped capital femoral epiphysis
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how does slipped capital femoral epiphysis present?
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acute or insidious thigh or knee pain and painful limp; acute: restricted ROM, inability to bear weight
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what do radiographs show in slipped capital femoral epiphysis?
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posterior and medial displacement of femoral head
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where does osteosarcoma tend to occur?
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metaphyseal regions of the distal femur, proximal tibi, and proximal humerus
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codman's triangle
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periosteal new bone formation at diaphyseal end of lesion (osteosarcoma)
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sunburst pattern
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osteosarcoma
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onion skinning
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ewing sarcoma
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pitting nails and arthritis
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psoriatic arthritis
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pain, swelling, vasomotor instability
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reflex sympathetic dystrophy
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migratory superficial thrombophlebitis in young male smoker
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buerger's
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lifestyle changes for gout
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decrease alcool, purines, diuretics/pyrazinamide
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what complication is giant cell arteritis associated with?
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aortic aneurysm
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labs to check in fibromyalgia
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CBC, ESR, TFTs, CK
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complications associated with cyclophosphamide
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hemorrhagic cystitis, bladder CA
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class of drugs that can cause AVN of the hip
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corticosteroids
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chronic neck pain, limited ROM, bony spurs, sclerotic facet joints
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cervical spondylosis
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skin finding associated with Reiter's syndrome
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keratoderma blennorrhagicum
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xray findings in OA
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joint space narrowing, osteophytes
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where does tennis elbow occur
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(lateral epicondylitis) at origin of extensors from lateral epicondyle
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arthritis affecting DIP, PIP
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OA
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arthritis afecting PIP, MCP, wrist
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RA
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visible and palpable DIPs
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Heberden's nodes
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PIP osteophytes
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Bouchard's nodes
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articular inflammation that looks like granulation tissue due to chronic inflammation
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pannus (RA)
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what is a charcot joint?
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lack of sensation causes pt to overuse or misuse joints, which become deformed and painful
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what infection is polyarteritis nodosa classically associated with?
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HBV
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lab findings in polyarteritis nodosa
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elevated ESR, CRP, leukocytosis, anemia, hematuria, proteinuria, positive ANCA
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vasculitis that affects young asian women
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takayasu's
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young men in 20s with painful oral and genital ulcers; uveitis, arthritis, erythema nodosum
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Behcet's syndrome
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