Step 2 Dit: Msk/rheum 01

Front 1

Dx
elderly woman with a history of cholelithiasis and recurrent abdominal pain and vomiting

Back 1

gallstone ileus

Front 2

60 yo woman who leaks urine when laughing or coughing
what are her nonsurgical options

Back 2

Dx: stress incontinence

NONSURGICAL OPTIONS:
topical estrogen creams
kegel exercises
pessary

Front 3

what is the late, life-threatening complication of CML

Back 3

BLAST CRISIS
fever
bone pain
splenomegaly

Front 4

what are the classic symptoms of carpel tunnel

Back 4

WRIST PAIN
radiates up the arm
worsens with hand flexion/grasping

DECREASED HAND STRENGTH

NUMBNESS IN FIRST 3 1/2 DIGITS:
(i.e. thumb, index, middle & 1/2 of ring finger)

THENAR MUSCLE ATROPHY

TINNEL'S &/OR PHALEN'S SIGNS

Front 5

what scenarios favor an anterior shoulder dislocation

Back 5

blow to abducted, externally rotated, & extended arm (e.g. blocking a basketball shot)

Front 6

what scenarios favor a posterior shoulder dislocation

Back 6

blow to anterior shoulder

seizure --> fall & land on shoulder

electrocution

Front 7

what nerve is damaged:
claw hand

Back 7

ulnar

Front 8

what nerve is damaged:
ape hand

Back 8

median

Front 9

what nerve is damaged:
wrist drop

Back 9

radial

Front 10

what nerve is damaged:
scapular winging

Back 10

long thoracic

Front 11

what nerve is damaged:
unable to wipe bottom

Back 11

thoracodorsal

Front 12

what nerve is damaged:
loss of forearm pronation

Back 12

median

Front 13

what nerve is damaged:
cannot abduct or adduct fingers

Back 13

ulnar

Front 14

what nerve is damaged:
loss of shoulder abduction

Back 14

axillary

Front 15

what nerve is damaged:
weak external rotation of arm

Back 15

suprascapular/axillary

Front 16

what nerve is damaged:
loss of elbow flexion & forearm supinaiton

Back 16

musculocutaneous

Front 17

what nerve is damaged:
loss of wrist extension

Back 17

radial

Front 18

what nerve is damaged:
trouble initiating shoulder abduction

Back 18

suprascapular

Front 19

what nerve is damaged:
unable to abduct beyond 10 degrees

Back 19

axillary

Front 20

what nerve is damaged:
unable to abduct beyond horizontal

Back 20

long thoracic/ spinal accessory

Front 21

what nerve may be injured:
fracture of shaft of humerus

Back 21

radial

Front 22

what nerve may be injured:
fracture of surgical neck of humerus

Back 22

axillary

Front 23

what nerve may be injured:
supracondylar humerus fracture

Back 23

median

Front 24

nerve most likely injured:
fracture of medial epicondyle

Back 24

ulnar

Front 25

what nerve may be injured:
anterior shoulder dislocation

Back 25

axillary

Front 26

what nerve may be injured:
injury to carpel tunnel

Back 26

median

Front 27

what nerve may be injured:
injury to distal radius

Back 27

median

Front 28

Rx for scaphoid fracture

Back 28

THUMB SPICA SPLINT then CAST:
4-6 wks distal fxr
10-12 wks middle fxr
12-20 wks proximal fxr (highest risk of necrosis)

if displaced, OPEN-REDUCTION

Front 29

what fractures are a/w ruptured thoracic aorta

Back 29

RIB FRACTURES
(1st & 2nd ribs have high incidence of cervical spine & vascular injuries)

SCAPULAR FRACTURES

STERNAL FRACTURES

Front 30

what is the difference between monteggia fracture and galeazzi fracture

Back 30

MONTEGGIA
anterior dislocation of radial head with fracture of proximal ulnar diaphysis

GALEAZZIA
dislocation of distal radial-ulnar joint (DRUJ) with fracture of radial diaphysis

Front 31

complication a/w fracture/injury:
fall of outstretched hand --> snuffbox tenderness

Back 31

avascular necrosis (scaphoid fracture)

Front 32

complication a/w fracture/injury:
anterior shoulder dislocation

Back 32

axillary nerve and artery

Front 33

complication a/w fracture/injury:
fracture of 5th metacarpal neck

Back 33

abscess (i.e. "fight bite")

Front 34

complication a/w fracture/injury:
humerus fracture

Back 34

radial nerve

Front 35

complication a/w fracture/injury:
hip fracture

Back 35

DVT (short-term)

avascular necrosis (long-term)

Front 36

complication a/w fracture/injury:
femur fracture

Back 36

severe blood loss

fat emboli

Front 37

complication a/w fracture/injury:
tibial fracture

Back 37

compartment syndrome

Front 38

complication a/w fracture/injury:
pelvic fracture

Back 38

hypovolemic shock

Front 39

What is the appropriate antibiotic coverage of an open fracture

Back 39

GRADE I OR II:
Cefazolin (or other 1st gen Ceph's)

GRADE III (extensive soft tissue damage &/or high contamination):
Cefazolin + AMG

FARM INJURY:
Cefazolin + AMG + PCN (for anaerobic coverage)