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103 Cards in this Set

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