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Muskuloskeletal
Question | Answer |
---|---|
Clinical manifestations of a fracture? | Generalized swelling, pain/ tenderness, deformity, diminished functional use of affected limb/ digit, bruising, severe muscular rigidity and crepitus. |
Treatment for a fracture? | Analgesics. Splinted/ casted. Traction. Surgical intervention. |
What is compartment syndrome? | Serious complication that results from compression of nerves, blood vessels and muscles inside a closed space. |
6 P's to assess extent of injury? | 1. Pain 2. Pulselessness 3. Pallor 4. Paresthesia 5. Paralysis 6. Pressure |
5 different types of expected findings for clubfoot? | 1. Talipes varus- bending inward 2. Talipes valgus- bending outward 3. Talipes calcaneus- toes are higher than heel 4. Talipes equinus- toes lower than heel 5. Talipes equinovarus- toes facing inward and lower than heel |
Procedures to correct clubfoot? | Castings (series), weekly physical therapy, specialized shoes. |
Risk factors for developmental dysplasia of the hip (DDH)? | Birth order, female gender, family history, breech intrauterine position, delivery type and joint stability. |
Clinical manifestations of DDH in infants? | Asymmetry of gluteal/ thigh folds, limited hip abduction, shortening of the femur, widened perineum, positive Ortolani test and positive Barlow test |
Clinical manifestations of DDH in children? | One leg shorter than other, positive Trendelenburg sign, walking on toes on one foot and walking with a limp. |
What is osteogenesis imperfecta (OI)? | Gentic disorder resulting in bone fractures and deformity along with restricted growth. Most cases- rare autosomal recessive. Defects in COL1A1 or COL1A2 genes. |
Treatmeant for OI? | Bisphosphonate therapy with IV pamidronate (to promote increased bone density and prevent fractures. Less effective for long bones). Lightweight braces and splints and physical therapy. Surgery to prevent/ correct deformities. |
What is scoliosis? | Complex deformity of the spine that can also effect the ribs. |
Risk factors for scoliosis? | Genetic tendency, gender (more common in girls) and age (highest incidence between 8 to 15 years old). |
Clinical manifestations of juvenile idiopathic arthritis (JIA)? | Joint swelling, stiffness, redness and warmth that can be worse in the morning. Mobility limitations, fever, rash, limp in the morning and delay in growth. |
Labs associated with JIA? | Elevated C-reactive protein. Elevated ESR and WBCs. |
Medications to treat JIA? | NSAIDs, methotrexate, corticosteroids and etanercept. |
Clinical manifestations of lupus? | Fever, fatigue, weight loss, "butterfly rash" over bridge of nose, photosensitivity, alopecia, myalgia, headache, seizure, chorea, stroke, peripheral neuropathy, pleuritis, atelectasis, pericarditis, abdonminal pain, nausea, vomiting, colitis, anemia and |
Lupus goal of treatment? | Balancing medications to avoid exacerbation/ complications while preventing/ minimizing treatment associated morbidity. |
Lupus patients must avoid? | Exposure to the sun and UVB light. |
Clinical manifestations of oseomyelitis? | Fever, fussiness/ irritability, fatigue, lethargy, pain, warmth, tenderness, decreased ROM. |
Diagnosing oseomyelitis includes...? | Organism identification/ antibiotic susceptibility. Cultures of purulent drainage, blood, joint fluid and infected skin samples. Bone biopsy. Labs- ESR, CRP. Radiographic signs. Technetium bone scan. CT and MRI. |
Treatment of oseomyelitis? | IV antibiotic therapy- nafcillin/ clindamycin. MRSA- vancomycin. Surgery if no response to antibiotic treatment. |