ABFM MUSCULOSKELETAL COMPREHENSIVE
ANSWERS AND QUESTIONS SET A+
✔✔Osgood Schlatter syndrome, where is knee pain? - ✔✔anterior knee pain over tibial
tuberosity
✔✔Physical exam test for deQuervian's tenosynovitis - ✔✔Finkelstein test (put thumb
inside fist and tilt fist down (ulnar deviation))... should cause pain down thumb to wrist
✔✔Bisphosphonates associated with which calcium abnormality? - ✔✔hypocalcemia
✔✔bisphosphonates associated with fracture of: - ✔✔which medicine is associated with
fracture of femoral shaft?
✔✔Patellofemoral pain syndrome - ✔✔-anterior knee pain with crepitus
-positive *Clarke's sign*
-abnormal bony contact between the laterally tracking patella and the femoral groove
-*can be caused by weak VMO/tightness in ITB*
-joint stiffness after sitting with the knee in a flexed position
The physical examination reveals isolated tenderness with palpation at the medial and
lateral aspects of the knee, and the grind test is also positive.
-postural alignment test
: *static*-> Q-angle: ASIS-midpoint of patella, tibial tubercle
*dynamic*-> Step-down test
✔✔meniscal tear, best long term treatment? - ✔✔physical therapy (meniscectomy vs
placebo surgery had similar outcomes)
✔✔how to treat cat bite vs cat scratch disease? - ✔✔Cat bite- augmentin
Cat scratch disease- azithromycin
, ✔✔If infection persists from cat bite after 10 days of augmentin, then what? - ✔✔- refer
to surgery- may need I and D + IV antibiotics
✔✔Where is pain located in Slipped capital femoral epiphysis vs in Legg Calve Perthes
disease? - ✔✔both located in anterior thigh/ hip and/or knee
✔✔What is sever's disease? - ✔✔a traction injury at the apophysis (where tendon
meets bone) of the calcaneus where the achilles tendon attaches
- overuse injury in (often athletic) children in the heel, no overlying deformity. Patient
has pain when you squeeze the heel.
✔✔Achilles tendinopathy- what is contraindicated? - ✔✔steroid injection because it can
cause tendon rupture.
✔✔achilles tendonopathy presents as: - ✔✔heel pain that is worse with walking,
tenderness along achilles tendon
✔✔Pain in lower back with spinal extension due to: - ✔✔spinal stenosis
✔✔groin pain with internal hip rotation is characteristic of: - ✔✔hip arthritis (PE
findings?)
✔✔acute lower back treatment (most proven): - ✔✔NSAIDs, Tylenol and muscle
relaxers are most effective treatment of:
- little to no evidence supporting acupuncture
✔✔Treatment of stress fracture - ✔✔Using a walker boot for tibial stress fractures
reduces the time to resumption of full activity.
✔✔SSRIs in fibromyalgia - ✔✔SSRIs have been studied in the treatment of these
symptoms, and while they have been shown to produce up to a 30% reduction in pain
scores in patients with fibromyalgia, they have not been shown to affect fatigue or
sleeping problems.
✔✔ulnar collateral ligament injury seen in athletes participating in sports that require
overhead throwing, such as baseball, javelin, and volleyball. Patients often report a pop
followed by immediate pain and bruising around the medial elbow. Testing? - ✔✔The
moving valgus stress test has 100% sensitivity and 75% specificity for diagnosing UCL
injuries.
✔✔______________ is the most frequent finding in cauda equina syndrome (90%
sensitivity) - ✔✔Urinary retention
ANSWERS AND QUESTIONS SET A+
✔✔Osgood Schlatter syndrome, where is knee pain? - ✔✔anterior knee pain over tibial
tuberosity
✔✔Physical exam test for deQuervian's tenosynovitis - ✔✔Finkelstein test (put thumb
inside fist and tilt fist down (ulnar deviation))... should cause pain down thumb to wrist
✔✔Bisphosphonates associated with which calcium abnormality? - ✔✔hypocalcemia
✔✔bisphosphonates associated with fracture of: - ✔✔which medicine is associated with
fracture of femoral shaft?
✔✔Patellofemoral pain syndrome - ✔✔-anterior knee pain with crepitus
-positive *Clarke's sign*
-abnormal bony contact between the laterally tracking patella and the femoral groove
-*can be caused by weak VMO/tightness in ITB*
-joint stiffness after sitting with the knee in a flexed position
The physical examination reveals isolated tenderness with palpation at the medial and
lateral aspects of the knee, and the grind test is also positive.
-postural alignment test
: *static*-> Q-angle: ASIS-midpoint of patella, tibial tubercle
*dynamic*-> Step-down test
✔✔meniscal tear, best long term treatment? - ✔✔physical therapy (meniscectomy vs
placebo surgery had similar outcomes)
✔✔how to treat cat bite vs cat scratch disease? - ✔✔Cat bite- augmentin
Cat scratch disease- azithromycin
, ✔✔If infection persists from cat bite after 10 days of augmentin, then what? - ✔✔- refer
to surgery- may need I and D + IV antibiotics
✔✔Where is pain located in Slipped capital femoral epiphysis vs in Legg Calve Perthes
disease? - ✔✔both located in anterior thigh/ hip and/or knee
✔✔What is sever's disease? - ✔✔a traction injury at the apophysis (where tendon
meets bone) of the calcaneus where the achilles tendon attaches
- overuse injury in (often athletic) children in the heel, no overlying deformity. Patient
has pain when you squeeze the heel.
✔✔Achilles tendinopathy- what is contraindicated? - ✔✔steroid injection because it can
cause tendon rupture.
✔✔achilles tendonopathy presents as: - ✔✔heel pain that is worse with walking,
tenderness along achilles tendon
✔✔Pain in lower back with spinal extension due to: - ✔✔spinal stenosis
✔✔groin pain with internal hip rotation is characteristic of: - ✔✔hip arthritis (PE
findings?)
✔✔acute lower back treatment (most proven): - ✔✔NSAIDs, Tylenol and muscle
relaxers are most effective treatment of:
- little to no evidence supporting acupuncture
✔✔Treatment of stress fracture - ✔✔Using a walker boot for tibial stress fractures
reduces the time to resumption of full activity.
✔✔SSRIs in fibromyalgia - ✔✔SSRIs have been studied in the treatment of these
symptoms, and while they have been shown to produce up to a 30% reduction in pain
scores in patients with fibromyalgia, they have not been shown to affect fatigue or
sleeping problems.
✔✔ulnar collateral ligament injury seen in athletes participating in sports that require
overhead throwing, such as baseball, javelin, and volleyball. Patients often report a pop
followed by immediate pain and bruising around the medial elbow. Testing? - ✔✔The
moving valgus stress test has 100% sensitivity and 75% specificity for diagnosing UCL
injuries.
✔✔______________ is the most frequent finding in cauda equina syndrome (90%
sensitivity) - ✔✔Urinary retention
