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MK Flashcards

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1
Q

What is sciatica?

A

Pain radiating along the sciatic nerve, traveling from the lower back to the hips/buttocks and down each leg. Typically presents unilaterally.

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2
Q

What are the key findings for sciatica?

A

High sensitivity to low lumbar disc herniation, including L3 straight leg test, L4 diminished knee jerk, L5 numbness at big toe, and S1 absent ankle jerk.

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3
Q

What is spinal stenosis?

A

Narrowing of the spinal canal that can compress spinal nerves.

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4
Q

What are the symptoms of spinal stenosis?

A

Dull, aching low back pain that is relieved by sitting, commonly occurs in patients 50+ in the lumbar and cervical regions.

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5
Q

What are the signs/symptoms of discitis?

A

Pain that remains when supine, aching pain that disturbs sleep, and may also have systemic symptoms such as fever.

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6
Q

What is ankylosing spondylitis?

A

A chronic inflammatory disease and autoimmune arthritis.

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7
Q

What are the signs/symptoms of ankylosing spondylitis?

A

Intense neck pain that extends down the spine with limited range of motion and a hunched back, more common in males than females.

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8
Q

What are the test tips for ankylosing spondylitis?

A

Patient has no history of trauma, often seen with ulcerative colitis, and X-ray findings include ‘bamboo spine’ with continuous spine lesions and stenosis.

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9
Q

What is cauda equina syndrome?

A

Compression of the nerve roots of cauda equina causing motor and sensory dysfunction.

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10
Q

What are the common causes of cauda equina syndrome?

A

Ruptured lumbar disc leading to severe lower back pain with ‘saddle anesthesia.’

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11
Q

What are the signs/symptoms of cauda equina syndrome?

A

Numbness and tingling in lower extremities with new-onset incontinence. Refer to ED immediately.

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12
Q

What are stress fractures?

A

Lower extremity injuries caused by overuse, leading to micro-tears and inflammation of muscles, tendons, and bone tissue.

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13
Q

What are common symptoms of stress fractures?

A

“Shin splints” - common in runners and strenuous exercise athletes.

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14
Q

How are stress fractures diagnosed?

A

Not visible on X-rays; need MRI or bone scan to confirm.

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15
Q

What is the treatment for stress fractures?

A

R.I.C.E. (Rest, Ice, Compression, Elevation) and low-impact exercises.

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16
Q

What is the ‘Female Athlete Triad’?

A

A condition at increased risk for female athletes, characterized by eating disorders, amenorrhea (ceased periods), and osteoporosis.

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17
Q

What is gout?

A

A form of arthritis characterized by severe joint tenderness and redness, usually affecting one joint at a time (often the big toe joint “podagra”).

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18
Q

What causes gout?

A

Uric acid crystals.

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19
Q

How is gout diagnosed?

A

Uric acid levels (>7) via aspiration of joint synovial fluid; levels are not always elevated during acute attacks.

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20
Q

What lifestyle modifications are recommended for gout?

A

Low purine diet, avoid diuretics (HCTZ’s in hypertension) and alcohol.

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21
Q

What is the prevention medication for gout?

A

Allopurinol, which helps lower uric acid levels; do not start during an acute attack.

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22
Q

What are common treatments for acute gout attacks?

A

NSAIDs, corticosteroids, colchicine (start if many joints affected or if NSAIDs ineffective).

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23
Q

What are common NSAIDs used for musculoskeletal complaints?

A

Ketorolac (Toradol), Diclofenac (Voltaren), Naproxen (Aleve), Celecoxib (Celebrex), Meloxicam (Mobic), and Indomethacin (Indocin).

Avoid in CHF patients; Naproxen has the fewest cardiovascular effects.

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24
Q

What are anti-platelet medications?

A

Medications that prevent platelet clumping, including Aspirin (ASA), Clopidogrel, and Ticagrelor.

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25
What precautions should be taken with anti-platelet medications?
Stop if pregnant, 7-10 days before surgery, and avoid within 1-2 hours of consuming alcohol.
26
What are the signs and symptoms of fibromyalgia?
Widespread pain, overall sensitivity, and fatigue.
27
How is fibromyalgia diagnosed?
Widespread Pain Index (WPI >7), 11/18 tender points, and cognitive issues for more than 3 months that cannot be explained by any other diagnosis.
28
What are the treatment options for fibromyalgia?
Lyrica, Cymbalta (SNRI), Elavil (TCA), Flexeril, with a huge emphasis on exercise.
29
What are the risk factors for osteoporosis?
Family history, females > males, anorexia (low body weight), early menopause (<45 years old), long-term use of medications (Depo-Provera, steroids, PPI), smoking.
30
How is osteoporosis diagnosed?
Through a DEXA scan with T-scores below -2.5.
31
What is osteopenia?
A condition of low bone mass.
32
What is the treatment for osteoporosis?
Bisphosphonates (e.g., Risedronate, Alendronate) ## Footnote Sit upright for 30 minutes post-meals to prevent esophageal irritation.
33
What are the prevention strategies for osteoporosis?
Calcium and vitamin D supplements, weight-bearing exercises (walking > swimming).
34
What is the recommended diet for osteoporosis?
Yogurt, cereals, dark leafy greens, canned salmon, sardines, soy products.
35
What is kyphosis?
A late sign of osteoporosis characterized by excessive curvature of the thoracic spine.
36
What are the signs and symptoms of osteoporosis?
Impaired pulmonary function, decreased physical function, increased vertebral fractures, increased mortality.
37
What is rheumatoid arthritis?
An inflammatory autoimmune disorder that can occur at any age, with faster, acute onset and bilateral presentation.
38
What are the systemic symptoms of rheumatoid arthritis?
Fever, body aches, generalized joint pain.
39
What laboratory findings are associated with rheumatoid arthritis?
Elevated ESR and positive rheumatoid factor.
40
What is the treatment for rheumatoid arthritis?
DMARDs (e.g., Methotrexate) ## Footnote Contraindicated in pregnancy.
41
What is osteoarthritis?
A degenerative joint disease that occurs as patients age, with slower, gradual onset and unilateral presentation.
42
What are the characteristics of morning stiffness in osteoarthritis?
Lasts less than 1 hour.
43
What are the treatment options for osteoarthritis?
NSAIDs, regular exercise, smoking cessation, glucosamine supplements.
44
What are common deformities in rheumatoid arthritis?
Boutonniere deformity, Swan-neck deformity.
45
What are Heberden's nodes?
Bony outgrowths on distal interphalangeal (DIP) joints, common in osteoarthritis.
46
What are Bouchard's nodes?
Bony outgrowths on proximal interphalangeal (PIP) joints, seen in both rheumatoid arthritis and osteoarthritis.
47
What are common causes of meniscus injuries?
Twisting, cutting, or pivoting movements.
48
What are the signs and symptoms of meniscus injuries?
Catching, locking or clicking sounds, inability to flex or fully extend the knee, delayed and mild-moderate swelling.
49
What are the three must-know clinical exam findings for meniscus injuries?
1. McMurray's Test (patient lays supine) 2. Apley's Test 3. Ege's Test (patient weight-bearing).
50
What is McMurray's Test used for?
To assess for medial meniscus injuries by pressing and rotating the ankle in the opposite direction of the knee.
51
What does Apley's Test assess?
Meniscus injuries, but is not as frequently tested.
52
What does Ege's Test assess?
Meniscus injuries while the patient is weight-bearing.
53
What is the Valgus Test used for?
To test the MCL (medial collateral ligament).
54
What is the Varus Test used for?
To test the LCL (lateral collateral ligament).
55
What are the signs of medial cruciate ligament injuries?
Immediate and significant swelling.
56
What is Lachman's Test used for?
To assess the ACL (anterior cruciate ligament).
57
What do the Anterior and Posterior Drawer Tests assess?
ACL and PCL Bend knee 90 degree
58
What is the knee position for the Lachman’s test?
Bend the knee 15-30 degrees. ACL
59
What is the condition characterized by thickening of the tissue around a nerve leading to the toes?
Morton's Neuroma ## Footnote Signs/Symptoms: Sharp burning pains; described as feeling a 'pebble' between 3rd & 4th toes with numbness & tingling.
60
Who are high-risk patients for Morton's Neuroma?
Dancers, runners, and patients who wear high heels.
61
What is the referral for Morton's Neuroma?
Podiatry.
62
What is Hallux Valgus commonly known as?
Bunion.
63
What is a bunion?
A bony bump that forms on the 1st metatarsal phalangeal joint at the base of the big toe.
64
What are common causes of Hallux Valgus?
Tight shoes, foot stress, and arthritis.
65
How is Hallux Valgus diagnosed?
X-ray imaging. ## Footnote Positive diagnosis if angle of joint >15 degrees (>45 severe).
66
What are the treatment options for Hallux Valgus?
Foot padding, braces, or surgery.
67
What is Plantar Fasciitis?
Micro-tears in plantar fascia due to tightness of the Achilles tendon, causing increased stretching & irritation.
68
What are the signs/symptoms of Plantar Fasciitis?
Significant pain in heels that often occurs first thing in the morning, then resolves throughout the day.
69
Who are high-risk patients for Plantar Fasciitis?
Nurses, runners, or those who spend long hours on feet.
70
What are the treatment options for Plantar Fasciitis?
NSAIDs, cold therapy, rolling and stretching out plantar fascia (bottom of foot).
71
What is the Ottawa Ankle Rule?
Determines who needs an ankle X-ray.
72
What are the severity classifications in the Ottawa Ankle Rule?
Mild: Can bear weight & ambulate. Moderate: Bruising, swelling & pain with ambulation. Severe: Inability to bear weight or ambulate four steps with tenderness over posterior edge of lateral & medial malleolus.
73
What is the recommendation if an X-ray is needed according to the Ottawa Ankle Rule?
Immediate referral for X-ray if fracture likely.
74
What is Lateral Epicondylitis commonly known as?
Tennis Elbow ## Footnote Pain outside of elbow, radiates to forearms, worsens with twisting & grasping movements.
75
What is Medial Epicondylitis commonly known as?
Golfer's Elbow ## Footnote Pain inside of elbow, common in baseball, bowlers & golfers.
76
What is a risk associated with Medial Epicondylitis?
Ulnar nerve deformity or 'claw hand'.
77
What is a common chief complaint for Scaphoid fractures?
'Fall landing on outstretched arm'.
78
What diagnostics are used for Scaphoid fractures?
Watson's test or Snuffbox tenderness. ## Footnote Appears on X-ray imaging 2 weeks after initial injury.
79
What is the treatment for Scaphoid fractures?
Thumb spica cast, even if initial X-ray imaging is negative. ## Footnote Risks include wrist osteonecrosis if not treated.
80
What tests are used to diagnose Carpal Tunnel Syndrome?
Phalen's test and Tinel's test.
81
What are findings from Phalen’s test
Paresthesia within 60 seconds to palmar side of digits 1-3 and half of 4th.
82
What is the treatment for Carpal Tunnel Syndrome?
Splinting, braces, rest & steroids.
83
What does the Drop Arm Test indicate?
Supraspinatus tear.
84
What does the Jobe 'Empty Can' Test assess?
Supraspinatus weakness or tear.
85
What is De Quervain's Tenosynovitis?
Swelling of radial wrist tendons from overuse or rheumatoid arthritis.
86
What are the signs/symptoms of De Quervain's Tenosynovitis?
Lower thumb & wrist pain that worsens with grasping or turning motions.
87
What diagnosis test is used for De Quervain's Tenosynovitis?
Positive Finkelstein test (ulnar deviation). ## Footnote Stretching of inflamed tendon causes pain.
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