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MSK 4 (OA, Neoplasm)

Step-2

QuestionAnswer
What are the signs suggesting radial nerve damage with a humeral fracture? wrist drop and loss of thumb abduction
A pt presents to the clinic for f/u and is found to have BP of 150/85. You note in the chart that his last visit 1 mo ago, he had a BP of 145/90. What is the next step? Recheck BP in 2-4 weeks
What is the mc testicular cancer seminoma
What is the classic presentation of lyme disease in early localized dz? erythema chronicum migrans usually occurs within 1 month(bulls eye rash with central clearing that expands over days to weeks). +/-constitutional sx
What is the presentation of lyme disease in a pt with early disseminated dz? This happens in weeks to months after the tick bite. May get meningitis(lymphocytic), unilateral or bl cranial n palsies, radulopathy, peripheral neuropathy, carditis
What is the presentation of lyme disease in a pt with late manifestations of the dz? This occurs from months to years after infection onset. Arthritis(esp in knee) and subacute encephalitis
What is the treatment for Lyme dz? Early: give doxy, amoxicillin or cefuroxime. Late: ceftriaxone for 2-4 weeks.
What is the tx for Rocky Mountain Spotted Fever? Doxy or chloramphenicol
In case of unhelpful xray and unavailable MRI, what 3 studies can be used to make the diagnosis of osteomyelitis? CT scan, Bone scan, tagged WBC scan
What is the empiric tx for septic arthritis? IV vanco (for MRSA coverage), IV ceftriaxone and doxycycline
What are the mcc of bony metz? breast CA, Lung CA, prostate CA, RCC, Thyroid CA, lymphoma
What is the classic radiological appearance of osteosarcoma? sunburst pattern +/- codman's triangle.
What is the classic radiological appearance of Ewing Sarcoma? large destructive lesion with periosteal rxn (onion skinning) + codman's triangle.
A patient presents with bone tenderness, and found to have elevated WBC count, CRP, ESR. What is the most likely dx? osteomyelitis
What is the mc organism in osteomyelitis overall? Staph aureus
What organism should also be kept in mind for patients with osteomyelitis and sickle cell dz? salmonella
What organism should also be kept in mind for IV drug users who present with osteomyelitis? pseudomonas
__________ is one of the mcc of septic arthritis in young sexually active adults. N. gonorrhoeae
T/F It is common for patients with septic arthritis 2/2 N. gonorrhoeae to need I&D of the affected joint? False, because the inflammatory respose to n. gonorrhoeae is not as severe as that for other bacteria, I&D no required for tx
Aspirate from a septic joint will have ________/mm3 >50,000
Aspirate from an OA joint will have _________mm3 <2,000
OA is typically _________(symmetric/Asymmetric) and may only affect one joint. ____&____joints are frequently involved in the hands. DIP and PIP joints
Which nodules will be found in the DIP joints in patients with OA? Heberden nodes
Which nodules will be found in the PIP joints in patients with OA? Bouchard nodes
What are the classic radiological findings in patients with OA? osteophyte formation, joint space narrowing, subchondral bone sclerosis, and subchondral bone cyst formation.
Which joints are spared in RA? DIP joints
What type of hypersensitivity reaction is involved in RA? type III with autoimmune complexes deposited in tissues.
Created by: shelybel
 

 



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