Phys

Question 1

60 Yo Gradual onset of knee pain (L) No other symptoms - Morning stiffness < 30, increases with movment?

Answer 1

OsteoArthritis

Question 2

60 Yo Gradual onset of knee pain (L) No other symptoms - Morning stiffness < 30, increases with movment, decreases with rest- No fever heart problems, X-ray findings?

Answer 2

Degenerative changes (Narrowing spaces. Osteophyte Formation)

Question 3

To acheive a treatment effect that reduces eccessive neural tone.. Osteo should work ?

Answer 3

Inhibitory way

Question 4

70 Yo Sudden onset R eye vision lost- Consistent head ache (Temples), Jaw pain while eating, low grade fever, Wt loss/ Low apetitie.. Exam - Temp arteries tense and prominent, Scalp tenderness- Labs Elevated ESR and CRP… ?

Answer 4

Giant Cell arthritis

Question 5

70 Yo Sudden onset R eye vision loss, Fatig/ Difficulty movment- Symptoms in Shoulders, and Hips Bilaterally, Difficulty raising arm to brush hair, and teeth.. Temporal arteries are pulsatile, levated ESR and CRP… ?

Answer 5

Polymyalgia rheumatica

Question 6

28 Yo F. Fatiguability, Low mood, Symptoms started 1 year ago… Stiffness and pain in multiple areas … Exam = Multple tender points

Answer 6

Fibromyalgia

Question 7

27 Yo F. –> ER 1st trimester abortion.. Previously had 3, that all occured in 1st tri. History - significant for recurrent clots in legs, Migrains… Blood - low platlets, neutrophils, hemolytic anemia… Which Serological marker is here?

Answer 7

Anti-Cardiolipin Antibodies (ACA)

Question 8

23 Yo F–> Dr… Bilateral hand pain and swelling. Joint stiffness in the morning lasts longer than 1 hour.. Ulnar deviation present, both hands and wrists. Hand joint swollen and palpable nodules.. X-ray shows multiple erosions and joint space narrowing… probible diagnosis?

Answer 8

RA

Question 9

27 Yo F. –> ER 1st trimester abortion.. Previously had 3, that all occured in 1st tri. History - significant for recurrent clots in legs, Migrains… Blood - low platlets… Diagnosis ?

Answer 9

Antiphospholipid Syndromw (APS)

Question 10

50 YO Man… Diagnosis reactve arthritis.. What are 3 characteristic features?

Answer 10

Urethritis, Arthritis, Conjuntivitis

Question 11

29 Y0, m. Low backpaom fpr 6 months, fatigued, restricted ROM lower back, redness of eye.. Exam = decreased flexion, reduced chest expansion… Which is not a chracteristic of Ankylosing spondylitis

Answer 11

Ulnar deviation.. Small joint in hand

Question 12

Autonomic Dysreflexia, is related to ____: Whereas parkinsons is related to_____.

Answer 12

SCI above T6, Dopamine NT deficency

Question 13

29 Y0, m. Low back pain for 6 months, fatigued, restricted ROM lower back, redness of eye.. Exam = decreased flexion, reduced chest expansion… Whats happening cardio whise?

Answer 13

Aortic Regurgitation

Question 14

40- Yo, f. ER with 1st MTP joint pain, restricted ROM. Diet = Red meat, 3/4 Servings of alcohol daily..

Answer 14

Gout

Question 15

29 Yo, M. R ankle pain @ achilies Insertion.. 2 weeks of Gastoenterisits.. He has had Hyperkeratotic skin lesions on the palms .. Condition

Answer 15

Shigella infection, or shigellosis

Question 16

40 Yo, F. ER.. 1 MTP joint pain, restriced ROM.. Patients Diet - Meat, and 3/4 alcoholic Bev’s/ day… What chemicals contrute to dysfunction?

Answer 16

Uric Acid

Question 17

65 Yo, M. Actue/ R knee P, Swollen, ROM restriction, Low grade fever. X-ray = Chondrocalconosis, joint aspiration shows + Birefringence crystals of Ca+ Phospate…. Diagnosis?

Answer 17

Psudo Gout

Question 18

18 Yo, F… MOI - Ski (3 Months ago), Fell, L arm Frature, X-RAY = radioulnar shaft fracture…

Healed well… But reports pain, Burning/throbbing in L arm.

Dr. Notices Redness in forearm, Skin = tight and shiny… Diagnosis?

Answer 18

Complex Regional Pain Syndrome

Question 19

26 Yo, M. Humeral Shaft fracture. ER = Casts R.Arm.

after wearing it for sometime= pain, tingling… Meds don’t improve pain

Delayed Capillary refil… Diagnosis ?

Answer 19

Compartment Syndrome

Question 20

80 Yo, F. Slipped. R hand in dorsal angulation, and radial deviation.. Swelling and ecchymoses at dorsal aspec of wrist, and radial shortning.

Answer 20

Colles Fracture
Carpel Tunnel Syndrome

Question 21

26 Yo, M. Ski/ Fell. Humeral Shaft fracture…
After casted. removed and unable to raise arm laterally above 100. What is the patients most probable injury?

Answer 21

Deltoid Muscle damage (Axillary)

Question 22

28 Yo, M. Fell.. ER–> L/ arm deformality. X-ray.. to look for a fracture. What is not considered a good standard of practice?

Answer 22

Focusing on Fracture ONLY

Question 23

Rapid HR Seen in Heart failure ? Whats its purpose?

Answer 23

Compensate for weakened strength

Question 24

PCOS may occur with Wt gain b/c?

Answer 24

Adipose tissue Generates estrogen and an excess = stress on body

Question 25

27 Yo, M. Impact from object falling. R. Shoulder and clavicle pain.. Tenting right upper chest (Near neck), patient holds arm tight to body, difficulty breathing.. X-ray = air in chest --> Pushing lungs in opposite directions?

Answer 25

Pnuemothorax

Question 26

80 Yo, F. Slipped. R hand in dorsal angulation, and radial deviation.. Swelling and ecchymoses at dorsal aspec of wrist, and radial shortning.

Answer 26

Colles Fracture - Median N

Question 27

Anticardiolipin antibodies are associated with an increased risk of

Answer 27

blood clots (thrombosis), recurrent pregnancy loss, and thrombocytopenia (low platelet count).

Question 28

What is not a sign of mechanical joint damage? - Loss of Motion - Stability - Deformity - Crepidus

Answer 28

Stability

Question 29

What is interstitial fibrosis?

Answer 29

scarring and thickening of the lung's interstitial tissue, which is the tissue and space around the air sacs (alveoli)

Question 30

What is Scleritis

Answer 30

Painful inflammatory condition of the sclera ssociated with RA, SLE

Question 31

What antibody is associated with RA? a) Anti-CCP b) Anti- CCD c) Anti- ABC d) Anti- PCC

Answer 31

Anti-CCP cyclic citrullinated peptides --> diagnose and assess the severity of rheumatoid arthritis (RA).

Question 32

What is not a type of inflammatory myopathy? a) Polymyositis b) polyuria c) Dermatomyositis d) Immune-mediated necrotizing myopathy e) none of the above

Answer 32

B

Question 33

What is Polymyositis

Answer 33

inflammation and progressive weakness in muscles closest to the trunk of the body, such as the shoulders, hips, and neck.

Question 34

What is Polyuria?

Answer 34

Piss Alot

Question 35

What is Immune-mediated necrotizing myopathy?

Answer 35

Severe, symmetrical muscle weakness due to muscle cell death (necrosis). It is a form of inflammatory myopathy characterized by high levels of the enzyme creatine kinase (CK)

Question 36

Blood vessel disease characterized by inflammation of small and medium-sized arteries (vasculitis), preventing them from bringing oxygen and food to organs . No kidney and lung involvement. a) dermatomyositis b) polyarteritis nodosa c) raynauds d) systemic lupus erthematosus e) all of the above

Answer 36

B

Question 37

What is Polyarteritis nodosa?

Answer 37

form of vasculitis where inflammation damages and weakens medium-sized arteries, potentially leading to organ and tissue damage.

Question 38

What is raynauds?

Answer 38

Condition where blood vessels in the fingers and toes spasm in response to cold or stress, causing reduced blood flow.

Question 39

What type of low back pain might you find pseudoclaudication and elevation of ESR?

Answer 39

Spinal Stenosis- narrowing of SC

Question 40

Patellar reflex tests dorsiflexion, what level of spinal cord?

Answer 40

L4

Question 41

What 3 things does the 'barrier' consist of?

Answer 41

Contracting muscle, contractured muscle (fibrosis) and fluid

Question 42

Sally has worked in a silica factory for 30 years. The skin on her hands and feet have thickened and digits have started to painfully curl. Lab test was high for HLA-DR1

Answer 42

Scerloderma Silica exposure is a well-known environmental trigger for systemic sclerosis (scleroderma). Skin thickening of hands and feet = sclerodactyly, a hallmark of scleroderma. Painful curling of digits = progression of skin fibrosis + possible digital contractures. HLA-DR1 is associated with autoimmune connective-tissue diseases, including systemic sclerosis.

Question 43

Which disease is/ are not a large artery vasculitis? A) Giant cell arteritis B) Takayasu's arteritis C) Behcet arteritis D) Kawasaki's disease E) Granulamotisis with polyangiitis

Answer 43

Breakdown: A) Giant cell arteritis → Large artery vasculitis ✔ B) Takayasu’s arteritis → Large artery vasculitis ✔ The rest are not large-artery: - C) Behçet → variable-vessel vasculitis - D) Kawasaki → medium-vessel vasculitis - E) Granulomatosis with polyangiitis (GPA) → small-vessel vasculitis

Question 44

In what joints is OA typically NOT found? A) cervical and lumbar joints B) shoulders, ankles and elbow joints C) PIP's and DIP's D) hips and knees

Answer 44

shoulders, ankles and elbow joints

Question 45

Bob hurt his knee playing football, he heard a 'pop' sound, immediate swelling and had difficulty /pain with the 'push off' and going downstairs. Which ligament might be torn? A) ACL B) PCL C) MCL D) LCL

Answer 45

ACL

Question 46

Bob is laying supine, with his hips and legs flexed, feet on the table and you notice that his right tibial tuberosity appears concave and inferior to where it normally should be. What is this called and which ligament may be affected?

Answer 46

Posterior Sag Sign.--> Posterior cruciate ligament (PCL).

Question 47

The main intracapsular ligaments of the knee are the

Answer 47

ACL, PCL

Question 48

The main Extracapsular ligaments of the knee are

Answer 48

MCL, LCL

Question 49

Condition where the cartilage on the under surface of the patella (kneecap) deteriorates and softens, AKA as 'runners knee'

Answer 49

Chondromalacia patellae or Patellofemoral syndrome; *swelling is rare

Question 50

Which statement is NOT true A) Young woman more likely for patellar fracture B) Bow legged more likely for patellar fracture C) Q-angle is from ASIS to midpoint of patella & from tibial tubercle to midpoint of patella D) patella fracture more likely with a MCL injury

Answer 50

Bow legged more likely for patellar fracture- NO its knock-kneed more likely

Question 51

Bow-legged = Is called? and associated with ____loading, not ______.

Answer 51

Genu varum Medial compartment loading Not patellar instability.

Question 52

Which ligament of the ankle joint acts to resist over-inversion and is most likely injured?

Answer 52

anterior talofibular ligament (ATFL)

Question 53

What statement is NOT true about the Talus A) fractures more likely to occur in dorsiflexion B) the talus has very little articular cartilage on it C) high incidence of AVN with talar fractures

Answer 53

Fractures more likely to occur in dorsiflexion — TRUE B) The talus has very little articular cartilage — NOT TRUE C) High incidence of AVN with talar fractures — TRUE Especially with talar neck fractures (Hawkins classification), AVN risk can be 20–90% depending on displacement.

Question 54

The Talar neck is most vulnerable in ??? when it is compressed against the?

Answer 54

Dorsiflexion Compressed against the anterior tibia

Question 55

Why is the talus at a high AVN risk.? (avascular necrosis)

Answer 55

Mostly covered in articular cartilage= limited blood supply, contributing to high AVN risk.

Question 56

Displaying a varus heel. What possible type of fracture?

Answer 56

calcaneal (heel bone) fracture

Question 57

Calcaneal tendon rupture is the same as an Achilles tendon rupture... Is caused by?

Answer 57

Sudden, forceful movement during sports or activities like jumping, running, or pivoting quickly. It can also result from a traumatic event, such as a fall or tripping, or from factors like overuse, certain medications (steroids, fluoroquinolone antibiotics)

Question 58

What is Legg-Calve-Perthes disease?

Answer 58

Childhood hip disorder where the ball-shaped head of the thighbone (femoral head) temporarily loses its blood supply

Question 59

STARTSS-HOTT is a mnemonic for differential diganosis for limps. What is each letter?

Answer 59

Septic Joint Tumour Avn Trauma Ra /JRA Tb Sickle cell SCFE Henoch-Schonleon Osteomyelitis Trauma Toxic /transient synovitis

Question 60

Which LIMP disease may be due to an imbalance between growth hormone and sex hormones.

Answer 60

Slipped Capital Femoral Epiphysis (SCFE): 1. Rapid growth → physis (growth plate) thickens - growth hormone and IGF-1 surge, causing the growth plate to widen and become more cartilaginous. -A thicker, weaker physis is more vulnerable to shear stress, especially in overweight adolescents. 2. Sex hormones have not yet stabilized the physis - Estrogen (in both sexes) strengthens, matures, and eventually closes the growth plate.

Question 61

Which is the most common malignant tumor of bone?

Answer 61

Osteosarcoma

Question 62

Chronic Venus Insufficiency (CVI) is regurgitation from the ______ veins to the _____ veins

Answer 62

deep to superficial Bot normal- should be other way around; walls and valves become defective

Question 63

34 year old man is working in a factory while lifting a heavy metal sheet, patient develops sudden low back pain which radiates down to his leg. On examination his patellar reflex (knee reflex) is diminished. The MRI is shown as below: On comparing the MRI findings and examination (absent knee reflex), where is the lesion? a) L3&L4

Answer 63

The patellar (knee) reflex = L3–L4, primarily L4.

Question 64

Enteropathic arthritis is characterized by ?

Answer 64

Joint inflammation that is linked to inflammatory bowel disease (IBD) Pain, stiffness, and swelling in joints, particularly the lower limbs and spine. GI symptoms such as abdominal pain, diarrhea, and weight loss

Question 65

Which are characteristic of enteropathic arthritis? a. Symmetric arthritis b. Uveitis c. Hypertrophic osteoarthropathy d. Spondylitis

Answer 65

Symmetric arthritis Symmetric arthritis: While the oligoarticular form is typically asymmetric, a type of chronic polyarticular involvement can be symmetric. Uveitis: Eye inflammation (uveitis or iritis) is a known extra-articular manifestation of enteropathic arthritis and the broader group of spondyloarthropathies. Spondylitis: Involvement of the spine (spondylitis) and sacroiliac joints (sacroiliitis) is a major feature of enteropathic arthritis, which falls under the umbrella of spondyloarthropathies.