Step 2 Dit: Msk-Rheum (Combined)

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)

Front 40

infection a/w cold agglutinins

Back 40

mycoplasma pneumonia

infectious mononucleosis (EBV)

Front 41

cause of HTN a/w:
HTN in the arms; hypotension in the legs

Back 41

coarctation of aorta

Front 42

cause of HTN a/w:
proteinuria

Back 42

renal disease

Front 43

cause of HTN a/w:
hypokalemia

Back 43

hyperaldosteronism

Front 44

cause of HTN a/w:
tachycardia, diarrhea, heat intolerance

Back 44

hyperthyroidism

Front 45

cause of HTN a/w:
hyperkalemia

Back 45

renal failure

Front 46

cause of HTN a/w:
episodic sweating and tachycardia

Back 46

pheochromocytoma

Front 47

what is the cause of erythroblastosis fetalis

Back 47

maternal antibodies against fetal Rh+ RBC's

Front 48

what is grading system for sprained ankles

Back 48

GRADE I:
overstretching of ankle muscles
microscopic tears
able to bear wt

GRADE II:
incomplete tear
painful to bear wt
swelling/tenderness/ecchymosis

GRADE III:
complete tear
significant joint instability
loss of function & motion
unable to bear wt

Front 49

initial Rx for sprained ankle

Back 49

RICE
rest
ice
compress
elevate

NSAIDS

ROM EXERCISES

Front 50

knee injury a/w:
MC'ly injured knee ligament

Back 50

MCL

Front 51

knee injury a/w:
positive lachman test (i.e. anterior drawer sign)

Back 51

ACL

Front 52

knee injury a/w:
positive mcmurray test

Back 52

meniscal tear

Front 53

knee injury a/w:
dashboard knee injury in MVA
(i.e. positive drawer sign)

Back 53

PCL

Front 54

what is the earliest sign of compartment syndrome

Back 54

pain in excess of what is expected

pain even with passive motion

Front 55

what are the 6 Ps of compartment syndorme

Back 55

pain
pallor
poikilothermia
pulselessness
parasthesia
paralysis

Front 56

how is compartment syndrome dx'd & what is criteria for dx

Back 56

dx'c test = needle manometry

dx'c criteria: pressures >/= 30 mmHg

Front 57

Rx for compartment syndrome

Back 57

emergent fasciotomy of ALL compartments of affected PORTION OF EXTREMITY
(NOT just the affected compartment)

Front 58

MC compartments affected in compartment syndrome

Back 58

volar compartment of forearm**

anterior compartment of leg

**FYI: "volar" means "relating to the palm of the hand or sole of the foot"....palm of the forearm, in this case

Front 59

what study is used for ligamental tears

Back 59

MRI

Front 60

best imaging test for spinal cord compression

Back 60

CT

Front 61

best imaging test for spinal cord lesions (e.g. MS)

Back 61

MRI

Front 62

best imaging test for spinal disc herniation

Back 62

MRI

Front 63

imaging study used to visualise the brachial plexus

Back 63

MRI

Front 64

lower back pain a/w:
pain increases with passive straight leg raise

Back 64

herniated disk

Front 65

lower back pain a/w:
pain lessens with flexion of the hips
(e.g. bend over a shopping cart)

Back 65

spinal stenosis

Front 66

lower back pain a/w:
elderly, weight loss, pain that is worse when supine

Back 66

spinal tumor

Front 67

lower back pain a/w:
pain made worse by walking or standing
(aka pseudoclaudication)

Back 67

lumbar spinal stenosis

Front 68

lower back pain a/w:
loss of foot dorsiflexion and pain on crossed straight leg raise

Back 68

disc herniation

Front 69

lower back pain a/w:
pain limited to the paraspinal region

Back 69

paraspinal muscle strain

Front 70

lower back pain a/w:
acute urinary retention

Back 70

cauda equine syndrome

Front 71

what nerve root is lesioned:
parasthesia of lateral foot

Back 71

S1

Front 72

what nerve root is lesioned:
loss of foot dorsiflexion

Back 72

L4

Front 73

what nerve root is lesioned:
anterior shoulder numbness

Back 73

C5

Front 74

what nerve root is lesioned:
loss of ability to spread fingers

Back 74

T1

Front 75

parasthesia to posterior forearm

Back 75

C7

Front 76

type of vasculitis a/w
infants & young children involving the coronary arteries

Back 76

kawasaki's

Front 77

type of vasculitis a/w
MC type of vasculitis

Back 77

temporal arteritis

Front 78

type of vasculitis a/w
a/w hep B infection

Back 78

Polyarteritis Nodosa (PAN)

Front 79

type of vasculitis a/w
opthlamic artery occlusion, can lead to blindness

Back 79

temporal arteritis

Front 80

type of vasculitis a/w
perforation of nasal septum

Back 80

wegeners

Front 81

type of vasculitis a/w
unilateral headache and jaw claudication

Back 81

temporal arteritis

Front 82

5 main causes of microcytic anemia

Back 82

"A-LIST"

Anemia of chronic disease
lead poisoning
iron def
sideroblastic
thalassemia

Front 83

metabolic etiologies of osteoporosis

Back 83

hyperthyroidism
hyperparathyroidism
hypercortisolism
hypogonadism (low E2 or low T)

Front 84

change in Ca2+, Phos, Alk Phos, & PTH:
pagets

Back 84

Ca2+: normal
Phos: normal
Alk Phos: incr'd
PTH: normal

Front 85

change in Ca2+, Phos, Alk Phos, & PTH:
osteomalacia/rickets

Back 85

Ca2+: decr'd
Phos: decr'd
Alk Phos: nl/incr'd
PTH: incr'd

Front 86

change in Ca2+, Phos, Alk Phos, & PTH:
chronic renal failure

Back 86

Ca2+: decr'd
Phos: incr'd
Alk Phos: nl/incr'd
PTH: incr'd

Front 87

change in Ca2+, Phos, Alk Phos, & PTH::
osteoporosis

Back 87

Ca2+: normal
Phos: normal
Alk Phos: normal
PTH: normal

Front 88

change in Ca2+, Phos, Alk Phos, & PTH:
osteopetrosis

Back 88

Ca2+: normal
Phos: normal
Alk Phos: normal
PTH: normal

Front 89

change in Ca2+, Phos, Alk Phos, & PTH:
primary hyperPTH

Back 89

Ca2+: incr'd
Phos: decr'd
Alk Phos: incr'd
PTH: incr'd

Front 90

change in Ca2+, Phos, Alk Phos, & PTH:
hypoPTH

Back 90

Ca2+: decr'd
Phos: incr'd
Alk Phos: normal
PTH: decr'd

Front 91

change in Ca2+, Phos, Alk Phos, & PTH:
pseudohypoPTH

Back 91

Ca2+: decr'd
Phos: incr'd
Alk Phos: normal
PTH: incr'd

Front 92

disease a/w:
knee x ray shows calcification of meniscus

Back 92

pseudogout

Front 93

disease a/w:
rhomboid-shaped, positive biferingent crystals

Back 93

pseudogout

Front 94

disease a/w:
need-shaped negative birefringent crystals

Back 94

gout

Front 95

disease a/w:
child with low trauma fracture

Back 95

osteogenesis imperfecta

Front 96

disease a/w:
narrow BM cavity results in low H&H

Back 96

osteopetrosis

Front 97

disease a/w:
55 yo woman who falls and fractures her distal radius

Back 97

osteoporosis

Front 98

Rx for gout

Back 98

ACUTELY:
NSAIDS (e.g. indomethacin)
colchicine
steroids

CHRONICALLY:
allopurinol
probenicid

Front 99

what is rx for ostegenesis imperfecta

Back 99

bisphosphonates

Front 100

Rx for osteoporosis

Back 100

bisphosphonates
Ca2+ & Vit D supplementation
exercise
pulsatile PTH

Front 101

what imaging study is most sensitive for pagets

Back 101

radionuclide bone scan

Front 102

signs sugestive of radial nerve lesion

Back 102

wrist drop

loss of thumb abduction

Front 103

MCC testicular cancer

Back 103

seminoma

Front 104

what are sx's of early stage Lyme's

Back 104

erythema chronicum migrans

+/- constitutional sx's
(fatigue, HA, myalgias, arthralgias, etc)

Front 105

Rx for early stage Lyme's disease

Back 105

doxycycline

amoxicillin

cefuroxime

Front 106

what are sx's of late stage Lyme's

Back 106

carditis

encephalitis

arthritis

Front 107

Rx for late stage Lyme's disease

Back 107

ceftriaxone IV x 2-4 wks

Front 108

Rx for rocky mountain spotted fever

Back 108

doxycycline
chloramphenicol

Front 109

emperic Rx for septic arthritis

Back 109

IV vancomyocin (MRSA coverage)

IV ceftriaxone + doxycycline (Neisseria coverage)

Front 110

radiologic appearance of osteosarcoma

Back 110

sunbursts

+/- codman's triangle

Front 111

radiologic appearance of ewings

Back 111

onion skinning

+/- codman's triangle

Front 112

Dx
px with bone tenderness, elevated WBC, CRP, ESR

Back 112

osteomyelitis

Front 113

MCC of osteomyelitis

Back 113

S. Aureas

Front 114

MCC's of osteomyelitis in SS pt

Back 114

S. Aureus (#1)

Salmonella (#2)

Front 115

MCC's of osteomyelitis in IVDA

Back 115

S. Aureus (#1)

Pseudomonas (#2)

Front 116

what are the MCC's of bony mets

Back 116

prostate (typically blastic)
lung (typically lytic)
breast (blastic or lytic)
renal (RCC)
thyroid
lymphoma

(THINK: anything in "two's" --> 2 balls, 2 breasts, 2 lungs, 2 kidneys)

Front 117

glomerular disease a/w:
MC nephrotic in children

Back 117

minimal change disease

Front 118

glomerular disease a/w:
MC nephrotic in adults

Back 118

focal segmental glomerular sclerosis

Front 119

glomerular disease a/w:
kimmestiel wilson lesion
(i.e. nodular glomerulosclerosis)

Back 119

diabetic nephropathy

Front 120

glomerular disease a/w:
LM: crescentic formations

Back 120

rapidly progressive glomerulonephritis

Front 121

glomerular disease a/w:
LM: segmental sclerosis & hyalinosis

Back 121

focal segmental glomerular sclerosis

Front 122

glomerular disease a/w:
anti-GBM antibodies, hematuria, hemoptysis

Back 122

Goodpasture's

Front 123

glomerular disease a/w:
nephrotic syndrome a/w hep B

Back 123

membranoproloferative glomerulonephritis

Front 124

glomerular disease a/w:
nephrotic syndrome a/w HIV

Back 124

focal segmental glomerular sclerosis

Front 125

positive pANCA is a/w

Back 125

microscopic polyangitis
PAN
pauci-immune glomerulonephritis
churg-strauss
ulcerative colitis

Front 126

disease a/w:
DIP and PIP involvement

Back 126

osteoarthritis

Front 127

disease a/w:
PIP and MCP involvement (but not DIP)

Back 127

RA

Front 128

disease a/w:
isolated MCP joint (squared off bone ends and hook-like osteophytes of the MCP's)

Back 128

hemochromatosis

Front 129

deformaties a/w RA

Back 129

swan neck

boutonniere

ulnar deviation

MCP hypertrophy

Front 130

compare provocative/palliative features of RA vs OA

Back 130

RHEUMATOID ARTHRITIS:
provocative: disuse
palliative: use/mvmt

OSTEOARTHRITIS:
provocative: use
palliative: rest

Front 131

disease a/w antibodies against:
anti-histone

Back 131

drug-induced lupus

Front 132

disease a/w antibodies against:
rheumatoid factor

Back 132

RA

Front 133

disease a/w antibodies against:
anti-dsDNA

Back 133

lupus nephropathy

Front 134

disease a/w antibodies against:
anti-smith

Back 134

SLE

Front 135

disease a/w antibodies against:
HLA-DR4

Back 135

RA

Front 136

disease a/w antibodies against:
anti-mitochondria

Back 136

PBC

Front 137

4 skin findings a/w lupus

Back 137

malar rash

discoid rash

photosensitivity

painless oral ulcers

Front 138

7 diagnostic criteria for lupus

Back 138

arthritis

serositis

positive ANA

renal disease

neuro problems

hematologic problems

immunologic problems

Front 139

rx for RA

Back 139

NSAIDS (sx'c relief)

TYLENOL/ULTRAM/OPIATES (pain relief)

DMARDS (slow/stop progression)
sulfasalazine
hydroxychloroquin
methotrexate
a-TNF agents (e.g. infliximab, entanercept)
cyclosporine
azothioprine

Front 140

what test should be done before starting a-TNF agents & why

Back 140

PPD

a-TNF agents can reactivate TB

Front 141

platelet count, BT, PT, PTT in:
HUS/TTP

Back 141

plt's: decr'd
BT: incr'd
PT: normal
PTT: normal

Front 142

platelet count, BT, PT, PTT in:
hemophilia A or B

Back 142

plt's: normal
BT: normal
PT: normal
PTT: incr'd

Front 143

platelet count, BT, PT, PTT in:
vWD

Back 143

plt's: normal
BT: incr'd
PT: normal
PTT: incr'd

Front 144

platelet count, BT, PT, PTT in:
DIC

Back 144

plt's: decr'd
BT: incr'd
PT: incr'd
PTT: incr'd

Front 145

platelet count, BT, PT, PTT in:
warfarin

Back 145

plt's: normal
BT: normal
PT: incr'd
PTT: incr'd

Front 146

platelet count, BT, PT, PTT in:
end stage liver disease

Back 146

plt's: nl/decr'd
BT: nl/incr'd
PT: incr'd
PTT: incr'd

Front 147

platelet count, BT, PT, PTT in:
aspirin

Back 147

plt's: normal
BT: incr'd
PT: normal
PTT: normal

Front 148

type of renal failure in px with FENa <1%

Back 148

prerenal

Front 149

dx & initial lab w/u:
65 yo african americam female with weakness in her lower extremities, both are equally weak, rash on her chest

Back 149

dx: dermatomyositis

Abnormal labs:
CK
aldolase
AST/ALT
LDH
ANA
anti-Jo-1
BMP, CBC

Front 150

rash a/w dermatomyositis

Back 150

HELIOTROPIC (periorbital) red-purple rash

SHAWL SIGN (shoulders, upper chest, & back)

GOTTRON'S PAPULES
(papular rash with scales on dorsum of hands at bony prominences; often mistaken for psoriasis)

MALAR RASH

MECHANIC'S HANDS
(roughened, cracking skin on the tips & lateral aspects of the fingers)

Front 151

Dx and Rx
67 yo woman with pain in the extremities especially shoulders and hips, hard for her to get out of bed, elevated ESR

Back 151

dx: PMR

rx: low-dose steroids

Front 152

what other disease should you look for in a px with PMR

Back 152

temporal arteritis

Front 153

rheumatologic disease a/w:
proximal muscle weakness and facial rash

Back 153

dermatomyositis

Front 154

rheumatologic disease a/w:
pain and stiffness in the hips and shoulders

Back 154

PMR

Front 155

rheumatologic disease a/w:
muscle pain and tenderness in multiple distinct locations

Back 155

fibromyalgia

Front 156

rheumatologic disease a/w:
man in 20s with lower back pain that betters with exercise

Back 156

ankylosing spondylitis

Front 157

rheumatologic disease a/w:
jaw claudication and difficulty standing from chair

Back 157

PMR & temporal arteritis

Front 158

rheumatologic disease a/w:
pencil in cup deformity of the DIP and PIP joint

Back 158

psoriatic arthritis

Front 159

rheumatologic disease a/w:
bamboo spine

Back 159

ankylosing spondylitis

Front 160

rheumatologic disease a/w:
arthritis, oral ulcers, proteinuria

Back 160

SLE

Front 161

Rx for fibromyalgia

Back 161

amitriptyline/nortriptylline
Tylenol
pregabalin
duloxetine
fluoxetine
milnacipran

Front 162

disease a/w:
anti ro and la

Back 162

sjogrens

Front 163

disease a/w:
anti histone

Back 163

drug indiced lupus

Front 164

disease a/w:
anti jo 1

Back 164

dermato/polymyositis

Front 165

disease a/w:
anti RNP

Back 165

mixed connective tissue disease

Front 166

what are the autoimmune antibodies a/w CREST scleroderma (aka limited cutaneous systemic sclerosis)

Back 166

anti-Scl-70
anti-RNA
anti-UI RNP
anti-centromere

Front 167

features a/w CREST scleroderma

Back 167

"CREST"
Calcinosis cutis
Raynoud's phenomenon
Esophageal dysmotility
Sclerodactyly
Telangiectasias

Front 168

what labs, when increased, point to muscle inflammation

Back 168

CPK
aldolase
AST/ALT
LDH

Front 169

what are the seronegative HLA-B27 spondyloarthropathies

Back 169

"PAIR"

Psoriatic arthritis
Ankylosing spondylitis
IBD (enteropathic arthritis)
Reactive arthritis

Front 170

what are the 4 K+ sparing diuretics

Back 170

"SEAT"
spironolactone
eplerenone
amiloride
triamterine

Front 171

Dx
low urine specific gravity in the presence of high serum osmolarity

Back 171

Diabetes Insipidus

Front 172

Dx test for hereditary spherocytosis

Back 172

osmotic fragility test

Front 173

which infants should be screened for developmental dysplasia of the hip

Back 173

breached females

Fhx of developmental dysplasia of the hip

+/- breached males

Front 174

Rx for developmental dysplasia of hip in children

Back 174

< 6 MONTHS:
pavlik harness

6 MONTHS - 2 Y/O:
closed or open reduction + spica cast

2 Y/O - 8 Y/O:
open reduction

> 8 Y/O:
no correction (not found to be beneficial > 8 y/o)

Front 175

Rx for slipped capital femoral epiphysis

Back 175

AVOID WT-BEARING (bedrest, crutches, wheelchair)

PROMPT SURGICAL PINNING of the head of femur

Front 176

which infants should receive Vit D supplementation

Back 176

All children (including breastfed infants)

starting the 1st few days of life

(according to the American Academy of Pediatrics)

Front 177

Rx for juvenile idiopathic arthritis

Back 177

NSAID

2nd NSAID

MTX/corticosteroids

Front 178

characteristic feature of osgood schlatter disease

Back 178

ANTERIOR KNEE PAIN
increases over time
worsens with quadriceps flexion (running/jumping)

SIGNS AT TIBIAL TUBEROSITY:
soft tissue swelling
palpable bony mass
pain upon quadriceps flexion (running, jumping)

Front 179

Rx for osgood schlatter disease

Back 179

stretch hamstrings/quadriceps
strengthen quadriceps
ice
NSAIDS

Front 180

what should be done in a child born with a clavical fracture

Back 180

evaulate for brachial plexus injury

not necessary to immobilize by pinning the shirt

Front 181

Rx for mid-third clavical fracture in an adult

Back 181

figure-of-8 strap &/or sling

until fracture site & ROM are painless (~4-8 wks)

Front 182

Rx for legg calve perthes disease

Back 182

non-wt bearing on affected side
(for extended period of time)

surgical pinning

Front 183

classic presentation of childhood spondylolisthesis

Back 183

anterior slip of vertabrae that is palpable "step off" on PE

back pain exacerbated by hyperextending

knee-flexed, hip-flexed gait (hip extension impaired)

neurologic disfunction including urinary incontinence

Front 184

disease a/w with painful limp in a child and:
x ray shows femoral head sclerosis

Back 184

legg calve perthes disease

Front 185

disease a/w with painful limp in a child and:
x ray shows ice cream scoop falling off cone

Back 185

slipped capital femoral epiphysis

Front 186

disease a/w with painful limp in a child and:
obese male adolescent with dull hip pain and inability to bear weight

Back 186

slipped capital femoral epiphysis

Front 187

disease a/w with painful limp in a child and:
acute onset of tibial pain, fever, malaise, elevated ESR, no joint pain

Back 187

osteomyelitis

Front 188

disease a/w with painful limp in a child and:
acuet onset of knee pain, fever, increased ESR, leukocytosis

Back 188

septic arthritis

Front 189

disease a/w with painful limp in a child and:
7 yo with growth delay and inner thigh pain

Back 189

legg calve perthes disease

Front 190

disease a/w with painful limp in a child and:
13 yo boy with pain and swelling at the tibial tuberocity

Back 190

Osgood-schlatter disease

Front 191

Dx:
child presenting to the ER with parents is unable to bend his elbow after his father jerked him out of the steet an hour before presentation

Back 191

Nursemaid's elbow

Front 192

Rx for nursemaids elbow

Back 192

MANNUAL REDUCTION:
gentle supination of forearm
flexion of the elbow