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122 Cards in this Set
- Front
- Back
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back pain associated with high ESR, CPK and anemia
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ankylosis spondylitis
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back pain gets better bending forward
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ankylosis spondylitis or spinal stenosis
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causes of cauda equina syndrome (4)
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disk herniation
epidural abscess hematoma fx |
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diagnostic tests for cauda equina syndrome
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mri or myelogram
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most common sites of disk herniation
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L4-S1
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limited rom, pain at sciatic notch and positive straight leg raise test
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herniated disk
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another name for idiopathic nonflexible kyphosis
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scheuermann's
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screening test for scoliosis
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adam's bend forward test
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pt has trouble standing from a chair, knee reflexes are decreased. where's the herniation?
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L4
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Pt has trouble heel-walking. where's the herniation?
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L5
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pt has trouble walking on his/her toes, ankle reflexes diminished. where's the herniation?
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S1
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pt holds the arm in neutral position, positive apprehension test
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anterior shoulder dislocation
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Compression fracture of the posterior humeral head
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anterior shoulder dislocation
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positive drop arm test, CXR shows high riding humerus
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rotator cuff tear usually supraspinatus muscle
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most common shoulder dislocation
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anterior
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how to evaluate axillary nerve injury after shoulder dislocation?
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pt has difficulty abducting the arm
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x rays finding in anterior dislocation
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humerus displaced inferiorly and internally
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high riding humerus
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rotator cuff tear
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common fx associated with elbow dislocation in adults/children
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adults: radial head
children: medial epicondyle |
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pt is unable to flex the wrist and adduct fingers after dislocating elbow. what nerve is damaged?
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median nerve
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pt is unable to abduct fingers. what nerve is injured?
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ulnar
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what structures should assessed in an elbow dislocation?
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brachial artery
median and ulnar nerves |
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name for ulnar collateral ligament injury
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gamekeeper/skier's thumb
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tx for partial thumb ligament tears
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thumb spica splint/cast
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sublaxation of radial head common in children younger than 5
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nursemaid's elbow
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reduction of nursemaid's elbow
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placing thumb on radial head and supinating forearm
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common causes of carpal tunnel syndrome (5)
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1. trauma
2. tumors 3. thyroid dz 4. dm 5. pregnancy |
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pt cannot open jars, drops objects and wakes at night with pain and numbness in hand
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carpal tunnel syndrome
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flexing wrists to elicit numbness
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phalen test
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tapping over the median nerve on the hand elicits tingling
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+ tinel sign
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inflammation of the sheath around abductor pollicis longus and extensor pollicis brevis of the thumb
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de quervain's tenosynovitis
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positive finkelstein test
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de quervain's tenosynovitis
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mets that can cause low back pain
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thyroid
lung breast prostate |
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pt maintains straight spine with an elevated esr
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discitis
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common culprit of discitis and epidural abscess
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staph aureus
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decreased sensation on the deltoid, weakness on biceps and decreased bicep reflex. where's the herniation?
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c5
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decreased biceps reflex, weakness of biceps and wrist extensors and decreased sensation of dorsolateral aspect of thumb and index finger. where's the herniation?
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c6
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triceps weakness and decreased triceps reflex. where's the lesion?
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c7
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weakness flexing foot, decreased knee reflex. where's the lesion?
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l4
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decreased sensation on top of the foot, normal dtr. where's the lesion?
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l5
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calf weakness, decreased achilles reflex. where's the lesion?
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s1
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which claudication usually gets better sitting?
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neurogenic
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which claudication gets better standing?
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vascular
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common causes of hip osteonecrosis (3)
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1. trauma
2. drugs (etoh, steroids) 3. autoimmune (ra, sle) |
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pt presents with a limp, decreased rom. xr reveals flattened femoral head and joint space narrowing
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osteonecrosis of the hip
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most common hip dislocation
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posterior
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hip is flexed, adducted and internally rotated
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posterior hip dislocation
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on xr femoral head appears smaller than the opposite
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posterior hip dislocation
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prepatellar bursitis second to chronic kneeling
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housemaid's knee
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twisting tibia with pt in a prone position to check for meniscal tears
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appley's compression test
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positive anterior drawer test and lachman's
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anterior cruciate lig injury
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Oblique fracture through base of first metacarpal
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Bennett's fx
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Fracture neck of fourth and fifth metacarpal
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Boxer's fx
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Fracture of shaft of radius with dislocation of distal radioulnar joint
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Galeazzi's fx
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Fracture and dislocation of atlas and axis
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hangman's fx
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Stress fracture of the metatarsal
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march fx
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Fracture of the proximal and middle third of the ulna with anterior dislocation of the radial head
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monteggia's fx
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Fracture of ulna, radius, or both
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Nightstick fx
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fracture of distal radius with volar displacement of distal fragment.
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Smith's fx
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epiphyseal fx involving the epiphyseal plate only
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salter-harris type 1
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epiphyseal fx involving the epiphyseal plate and metaphysis
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salter-harris type 2
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epiphyseal fx involving the epiphyseal plate and the epiphysis
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salter-harris type 3
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epiphyseal fx involving the epiphyseal plate, metaphysis and epiphysis
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salter-harris type 4
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Crush injury of the epiphysis
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salter-harris type 5
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rules required to determine if ankle xr are needed
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ottawa ankle rules
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fracture of the distal radial metaphysis with dorsal displacement
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colle's fx
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dinner fork deformity of the wrist
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colle's fx
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tx for colle's fx
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reduction and sugar tong splinting with the wrist in flexion
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pain in snuffbox with normal xr. what's the best action
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repeat xr in 2 weeks
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fat pad associated with
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radial fx
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young pt presents w hip pain. xr show onion-skin appearance. dx?
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ewing's sarcoma
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most common site of bone ca due to mets
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spine
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drug that decreases uric acid excretion
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asa
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urosuric drugs that decrease tubular uric acid reabsorption (2)
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probenecid (benemid)
sulfinpyrazone (anturane) |
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side effects of allopurinol (2)
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renal function impairment
leukocytosis |
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disease that can result in pseudo-gout
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hyperparathyroidism
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calcium deposits in the tendons, ligaments and cartilage
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chondrocalcinosis second to pseudo-gout
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vasculitic dz of the medium sized arteries w/ palpable purpura, renal involment and neuropathy
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polyateritis nodosa
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proximal muscle weakness, photosensitive rash
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polymyositis
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more than 1 month hx of pain in neck, shoulder and hip w/ increased ESR
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polimyalgia rheumatica
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tx for raynaud's phenomenom (3)
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1. dress warmly
2. quit smoking 3. ccb |
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dmard medications that need baseline ppd
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etanercept
infliximab abatacept |
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difference on ct between pyogenic dikitis and pott's dz
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in pyogenic diskitis ct shows preservation of posterior elements of the spine (spinous processes, facets...), less common in pott's dz
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difference in t1 and t2 weighted mri's
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t1--> basic, fat brighter than water
t2--> basic, water brighter than fat (good to visualize edema) |
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child with irritability, sudden lower back pain and refusal to walk plus fever think...
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lumbar diskitis
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mechanism of injury in dequervain's tenosynovitis
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pts usually get it from lifting infants (mothers or daycare workers)
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tx for dequervain's tenosynovitis
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.5 xylocaine + .5 corticosteroid
in the tendon sheath |
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complication of tx in dequervain's tenosynovitis
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if sheath is missed can cause fat and dermal atrophy characterized by loss of pigmentation and hollowing of the skin
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rat-bite appearance on xray
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chronic gout
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most common causes of hangman's fx
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mva, fall
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Intra-articular fracture dislocation of the wrist
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barton's fx
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arm held externally rotated, positive jerk test
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posterior shoulder dislocation
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Most common progressive motor neuron disease
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Amyotrophic Lateral Sclerosis
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Asymmetric limb weakness, excess laughing or crying, stiff muscles
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Amyotrophic Lateral Sclerosis
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Symmetric proximal muscle weakness, hyperkeratotic eruptions on the fingers (Mechanic hands), increased CPK, anti-Jo antibodies
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POLYMYOSITIS
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Unilateral, proximal myalgia of the hip and shoulder, morning stiffness > 1 hr, associated with Temporal Arteritis, positive HLA-DR4,
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POLYMYALGIA RHEUMATICA
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Myopathy and heliotrope rash
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DERMATOMYOSITIS
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Hyperextension of the PIP joints with flexion of DIPs assoc. with RA
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SWAN NECK DEFORMITY
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Fixed flexion of the PIP joint with hyperextension of DIP
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BOUTONNIERE'S DEFORMITY
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Swelling of the PIPs in osteoarthritis
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BOUCHARD'S NODES
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Swelling of the DIPs in osteoarthritis
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HEBERDEN'S NODES
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Mollusk shell appearance papule on the penis assoc. with Reiter syndrome
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KERATODERMA BLENNORRHAGICUM
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Pt picks himself from the floor using his arms
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GOWER'S MANEUVER
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X linked disorder of calf hypertrophy with proximal weakness
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DUCHENNE MUSCULAR DYSTROPHY
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V shaped rash over shoulders and neck due to photosensitivity in dermatomyositis
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SHAWL SIGN
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Purple papules on DIP and MCPs
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GOTTRON'S PAPULES
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Mastoid hematoma
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BATTLE'S SIGN
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Pain elicited with forced elevation of the arm
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NEER'S SIGN
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Type of extracerebral hematoma where there a concave pattern w/o crossing suture lines
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EPIDURAL HEMATOMA
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Type of extracerebral hematoma where there's a convex or crescentic pattern w/ crossing of suture lines
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SUBDURAL HEMATOMA
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Burning pain on a extremity acompanied by changes in temp and color, also hypersensitivity. A past hx of injury is common. dx?
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Regional pain syndrome
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Condition where there are fever spikes throughout the day followed by a return to normal temps. Fevers are usually accompanied by a salmon-colored bumpy rash
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Adult Still's disease
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X-linked disorder similar to Duchenne Muscular Dystrophy but more rare where pts present with better prognosis, mental retardation not as common and heart failure can be a feature.
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BECKER MUSCULAR DYSTROPHY
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How to differentiate Duchenne's Muscular Dystrophy from Becker's Muscular Dystrophy
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PTS WITH BECKER'S MD WILL WALK BEYOND AGE 15, DUCHENNE'S MD PTS WILL BE WHEELCHAIR BOUND BY AGE 12
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Asian-Mediterranean pt with oral and genital ulcers, erythema nodosum-like lesions that ulcerate, polyarthritis, ocular disease (uveitis, retinal infarcts, hypopion..), HLA-B51 association and all types of blood vessels are affected. Dx?
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BEHCET'S DISEASE
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Medium-sized arteries vasculitis that presents in the form of arthralgias, lower extremity ulcerations near the malleoli, livedo reticularis, mononeuritis multiplex (foot drop most common) and renin mediated htn 2nd to vasculitis of renal arteries.
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POLYARTERITIS NODOSA
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Between NSAIDs and Tylenol, which is safer to use in a pt with hepatic disease?
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TYLENOL (ANTI-NFLAMMATORIES CAN CAUSE RENAL INSUFFICIENCY AND SODIOUM RETENTION IN THIS PTS)
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50+ female w/ a h/o temporal arteritis c/o muscle pain and stiffness in her arms and legs. She states she's weakness too but it doesn't bother her as much as the pain. She has lost weight and her sed rate is elevated. MLDx?
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POLYMYALGIA RHEUMATICA
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40sh female pt c/o weak legs and neck discomfort. She struggles to comb her hair and rise from a seated position. She also has trouble swallowing sometimes. Her CK is increased. MLDx?
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POLYMYOSITIS
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A V-shaped rash over the shoulders is termed..?
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SHAWL SIGN
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Which structures are involved in the "unhappy triad"
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(MAMy!)
M-MCL A-ACL M-MEDIAL MENISCUS |
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A Colle's Fx is likely to injure which nerve?
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MEDIAN
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