ABFM Musculoskeletal Exam Questions and Correct Answers Most effective medication for fibromyalgia? - Correct Answer TCAs Proper treatment for Boxer's fracture (fracture of 5th metacarpal head) - Correct Answer Ulnar gutter splint (immobilizes the wrist, hand and fourth/ fifth digits). Wrist is positioned in slight extension; x 3-
- weeks of continuous splinting.
If 5th metacarpal >40 degrees, refer for surgical intervention Goal for vertebral compression fractures? - Correct Answer early mobilization; no not need to keep recumbent in bed until back brace is made cubital tunnel syndrome risk factors - Correct Answer having elbow be bent for long periods of time (hairdresser) or having damage to elbow or "funny bone".Sx: similar to carpal tunnel but ulnar distribution, at worst, may start causing weakness of ring and little finger Cure rates for trigger finger after steroid injection: - Correct Answer 54-86% CURED after injection for this musculoskeletal condition Which solution for cleansing a pressure ulcer? - Correct Answer tap water saline (nothing else!!) which dressing for pressure ulcer? - Correct Answer non-adherent: hydrocolloid, foam or other non- adherent dressing which therapeutic modality is contraindicated for muscle injuries until growth plate is closed? - Correct Answer Therapeutic ultrasound is C/I on growth plate. Growth plate closes at age 15 First line for gout in patient with CKD IV? - Correct Answer Steroids only, Colchicine and NSAIDs not used if renal dysfunction 1 / 2
Which supplements to give at which age for breastfed babies? - Correct Answer - 400 IU of Vitamin D per day starting in the first few days of life. Do not need vit D supplementation when baby is comusming at least 500 cc of formula or milk with Vit D per day
- need to start iron supplementation at 4 months of age
- Shoulder OA steroid injection into the AC joint (intra-articular)
PCL tear symptoms - Correct Answer posterior knee pain and pain when kneeling; painful limitation of flexion and posterior drawer sign on exam Treatment for lateral patellar dislocation: - Correct Answer medial pressure to patella and then gently extend knee fully If patient presents after leg injury with exceptionally severe pain that is worse with stretching the calf muscles, think of ____. Which test to find out? - Correct Answer Compartment syndrome clinical presentation?Tests to confirm compartment syndrome are tissue pressure studies Where to give corticosteroid injection for rotator cuff tendonitis vs for shoulder osteoarthritis? - Correct Answer - Rotator cuff tendonitis steroid injection if pain interfering with sleep or function despite adequate analgesia, give injection into subacromial space
Mechanism of most common neurological deficit related to Paget's disease? - Correct Answer Most common deficit in Paget's disease is hearing loss. Not caused by CN 8 compression but is due to cochlear damage.Which herbal remedy helpful for joint pain? - Correct Answer SAMe most helpful (Glucosamine and chondroitin not as effective) Alpha lipoic acid and gamma linolenic acid are helpful for: - Correct Answer neuropathy symptoms helped with which herbal remedies?
Ottawa Ankle Rules - Correct Answer Includes:
The examiner should order x-rays when the patient has ankle (within 6 cm of distal, posterior tibia or fibula) or midfoot pain + (bone tenderness at the base of the 5th metatarsal OR pain in navicular bone (between heel and ankle) OR is unable to bear weight (for four steps) when examined)
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