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107 Cards in this Set
- Front
- Back
Dx: adhesions and fibrosis in uterus causing secondary amenorrhea (does not respond to estrogen)
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Ashermans syndrome
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Dx: implantation of endometrial tissue in the myometrium, tender enlarged "boggy" uterus
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adenomyosis
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Diagnostic FSH value in menopause?
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<30
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Unopposed estrogen increases the risk of what?
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endometrial cancer
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Dx: firm enlarged irregular uterus, dysmenorrhea and abnormal menstrual bleeding
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Leiomyomata (fibroids)
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Meds which may reduce size of fibroids?
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GnRH agonists
mifepristone |
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What types of endometrial cancer are found in younger pts? Which type in older pts?
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Younger: estrogen dependent
Older: estrogen independent |
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Diagnosis that must be ruled out in post menopausal bleeding?
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endometrial cancer
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Dx: dysmenorrhea, dyspareunia, spotting, fixed uterus, associated with infertility?
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endometriosis
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Dx: amenorrhea, hirsutism, infertility, and insulin resistance
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polycystic ovary syndrome
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"String of pearls" seen on ultrasound?
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polycystic ovary syndrome
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HPV types associated with genital warts?
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6 and 11
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HPV types associated with cervical cancer?
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16 and 18
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Area involved in most cervical cancers?
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transformation zone
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Ductal carcinoma presenting with ezcematous lesion of nipple?
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pagets disease
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Gestational age when fundus reaches the umbilicus?
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20 wks
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Gestational age when fetal heart rate can be heard on doppler?
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10-12 wks
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Gestational age when quickening occurs?
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18-20 wks
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Blood levels in first trimester associated with increased risk of Trisomy 21?
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low PAPP-A
high free B-hCG |
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Bluish discoloration of vagina and cervix?
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chadwicks sign
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Softening between fundus and cervix?
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hagars sign
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Procedure used to test for neural tube defects?
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amniocentesis (15-18 wks)
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Maternal Blood levels associated with increased risk of trisomy 21 in 2nd trimester?
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low unconjugated estriol
low AFP high inhibin A |
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What maternal blood level is abnormally high in neural tube defects?
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AFP (2nd trimester)
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Medication used to treat most ectopic pregnancies?
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methotrexate
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Criteria for using methotrexate in an ectopic pregnancy?
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hCG < 5,000
ectopic mass < 3.5 cm hemodynamically stable patient with ability to follow up |
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Explain the 5 types of spontaneous abortions?
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threatened: vaginal bleeding, closed cervix, no products passed
inevitable: vaginal bleeding, open cervix, no products passed incomplete: vaginal bleeding, open cervix, some products passed complete: vaginal bleeding, open cervix, all products passed missed: no vaginal bleeding, closed cervix, no products passed but fetus dead |
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Findings on ultrasound with hydatiform moles?
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"grapelike vesicles"
"snowstorm pattern" |
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HcG levels seen with hydatiform mole?
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> 100,000
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Birth defects seen in gestational diabetes?
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macrosomia
prematurity fetal demise delated fetal lung maturity |
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What tocolytics are used in preterm labor?
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mag sulfate
Beta agonists: ridodrine, terbutaline CCB |
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Tests used to diagnose premature rupture of membranes?
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nitrazine paper
fern test |
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What med is administered in preterm labor < 34 wks to enhance fetal lung maturity?
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betamethasone
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Pregnancy induced hypertension presents when?
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> 20 wks
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Medication treatment of choice for severe pregnancy induced hypertension?
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Methyldopa
labetalol |
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Classic triad of preeclampsia?
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hypertension
edema proteinuria |
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What is HELLP syndrome?
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Hemolysis
Elevated Liver enzymes Low Platelets + severe preeclampsia |
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Proteinuria seen in mild and severe preeclampsia?
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mild: >300 mg /24 hr
severe: 5g in 24 hr |
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DIP and PIP joints associated with osteoarthritis?
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DIP: heberdens
PIP: Bouchards |
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Dx: Morning stiffness lasting >1 hr, symmetric arthritis with positive RF?
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rheumatoid arthritis
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Dx: polyarthralgias, salmon pink rash appearing daily in the evening associated with fever, <16 yo?
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Juvenile idiopathic arthritis
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Uveitis that may lead to blindness is associated with what positive lab value in juvenile idiopathic arthritis?
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ANA
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Most common bacteria involved in septic arthritis?
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staph aureus
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Sausage finger appearance is seen in what type of arthritis?
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psoriatic
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Xray findings of psoriatic arthritis?
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pencil in cup (proximal phalanx)
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Tetrad of conditions in reactive arthritis (reiters syndrome)?
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urethritis
conjunctivitis oligoarthritis (asymmetric) mucosal ulcers |
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Common causes of reactive arthritis?
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sexually transmitted infection
(chlamydia) gastroenteritis (shigella, salmonella, yersinia, campylobacter) |
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Common positive antigen blood level in reactive arthritis?
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HLA-B27 (50-80%)
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Name for first MTP joint, most common site of gout?
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podagra
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Deposits of urate crystals adjacent to joint, seen in chronic gout?
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tophi
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Gout findings on fluid aspiration?
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rod shaped negatively birefringent urate crystals
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Causes of hyperuremia?
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Primary: idiopathic overproduction or over excretion
Secondary: -Overproduction due to purine intake, myelo/lympho proliferative, drugs, hemolytic anemia |
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Tx of choice for acute gout?
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indomethacin 25-50mg TID
steroids if renal insufficiency |
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Side effects of colchicine?
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n/v, diarrhea
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What causes of pseudogout should be ruled out in younger patients?
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Hemochromatosis
Hypothyroidism Hyper parathyroidism |
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Joint aspiration findings in pseudogout?
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rhomboid calcium pyrophosphate crystals, positively birefringent
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Systemic sx and findings in lupus?
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malar rash
discoid rash photosensitivity oral ulcers arthritis serositis (heart lungs) renal disease Heme disorders Neuro disorders (seizures, psychosis) |
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Lab value that is very sensitive for SLE?
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ANA
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Besides ANA, what lab tests are very specific for SLE?
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Ro
La ds-DNA Smith histone (usually drug induced SLE) U1-RNP |
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What meds cause SLE?
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procainamide
hydralazine penicillamine minocycline INH methyldopa quinidine chlorpromazine diltiazem |
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Dx: inflammatory disease affecting proximal limb, neck and pharynx muscles
Sx: weakness, syphagia, poyarthralgias |
polymyositis
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Clinical findings in dermatomyositis?
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polymyositis +
malar (shawl sign) or heliotrope rash |
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What muscular inflammatory condition is associated with occult malignancy?
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polymyositis
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Scaly purple plaque found over finger/elbow joints in dermatomyositis?
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gottrons papules
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Elevated lab values in polymyositis?
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ANA
CPK aldolase anti Jo1 anti Mi2 |
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Dx: pain and stiffness in neck, shoulders, pelvic girdle. Accompanied by fever, fatigue, weight loss, depression
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polymyalgia rheumatica
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What condition is polymyalgia associated with?
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temporal arteritis
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Polyarteritis nodosa is associated with what infection?
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HepB
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Dx: vasculitis causing fever, wt loss, abd pain, neuropathy, arthralgias, arthritis, HTN , uremia
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polyarteritis nodosa
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Skin lesions seen in polyarteritis nodosa?
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livedo reticularis
palpable purpura |
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What is CREST syndrome?
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seen in limited scleroderma
Calcinosis Raynauds Esophageal dysfunction Sclerodactyly Telangiectasias |
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Lab value associated with Limited scleroderma?
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anticentromere antibody
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Lab value associated with Diffuse scleroderma?
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anti-Scl-70
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Dx: dry mouth, dry eyes, enlarged parotid glands
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sjogrens syndrome
(autoimmune destruction of salivary and lacrimal glands) |
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Test to evaluate tear secretions in sjogrens syndrome?
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schirmers test
(filter paper placed in lower eyelid) |
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Sickle cell patients are at risk for developing what kind of osteomyelitis?
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salmonella
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Sarcoma found in diaphyses of long bones/ribs/flat bones found in pts age 5-25?
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Ewings sarcoma
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Sarcoma found in metaphyseal area of long bones, ages 10-20?
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osteosarcoma
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Most common fracture sites in type 1 osteoporosis?
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vertebrae
hip distal radius |
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Classification system for childrens fractures involving the epiphyseal plate?
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salter harris
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Stretching or tearing of a ligament?
Injury to muscle near muscle-tendon junction? |
sprain
strain |
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Cause of rheumatoid arthritis?
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hyperplastic synovial tissue (pannus) erodes cartilage, bone, capsule and ligaments
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Hand findings in rheumatoid arthritis?
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ulnar deviation
subluxation of MCP joint swan-neck deformity (flexion of DIP, extension of PIP) boutonnieres deformity |
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Most common benign bone neoplasm of the hand?
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enchondroma
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Most common primary malignancy of bone?
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multiple myeloma
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Most common shoulder dislocation, fall on an outstretched arm?
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anterior glenohumoral
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2 Tests for shoulder impingement?
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1: Neers sign: flexion to fully overhead
2: Hawkins sign: passive abduction to 90 degrees then internal rotation |
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Exam tests for rotator cuff problems?
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apley scratch test (touch opposite scapula)
drop arm test empty can test (thumb pointing down, raises arm against force) |
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Xrays findings of calcium deposits under supraspinatus?
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calcific tendonitis
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Inflammation of joint after injury or idiopathically, common in diabetics, pain with restricted ROM
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Adhesive capsulitis
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Most common nerve injured in humeral shaft fracture?
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radial nerve
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Xray finding in supracondylar humerus fracture?
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fat pad sign (joint capsule distended with blood)
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Dx: subluxation of head of radius, usually child that was lifted at wrist
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nursemaids elbow
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Site of lateral epicondylitis (tennis elbow)?
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extensor carpi radialis brevis tendon
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Site of medial epicondylitis (golfers elbow)?
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flexor carpi radialis tendon
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Radial shaft Fracture associated with distal radioulnar dislocation?
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galeazzi
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Fracture of ulnar shaft associated with radial head subluxation?
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monteggia fracture
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Dx: fall on outstretched hand, diner fork deformity, dorsal displacement of wrist?
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colles fracture (distal radius fx)
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Dx: Tenosynovitis inhibiting flexion/extension of finger joint, thickening of A1 pulley?
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Trigger finger
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Dx: hyperabduction and radial deiation to 1st MCP joint?
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gamekeepers thumb
(skiers thumb) |
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Sign seen in flexor tenosynovitis:
-tendernes over sheath -symmetric enlargement of whole finger -pain on passive ROM -flexed rested position |
Kanavel's sign
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Dx: LE pain exacerbated with walking, relieved with bending forward
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neurogenic claudication (from spinal stenosis)
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Dx: young male with stiffness and back/hip pain which improves with activity, associated with uveitis
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ankylosing spondylitits
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Lumbar film findings in ankylosing spondylitis?
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bamboo spine (fusion of spine)
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Condition in children associated with avascular necrosis of the femoral head?
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legg-calve perthes disease
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Displacement of femoral neck caused by weakening of epiphyseal plate of femur?
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slipped capital femoral epiphysis
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MC nerve injury in humeral shaft fracture?
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radial nerve
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