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MSK 4 (OA, Neoplasm)
Step-2
| Question | Answer |
|---|---|
| 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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