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Intralesional glucocorticoid

 Intralesional glucocorticoid :

Used in Conditions like as follows : 

-Dupuytren Contracture

-Gout in Renal Failure


-Alopecia areata

Etiology and Association of Erythema Nodosum


Causes/association of E Nodosum?



Histoplasmosis, TB,

Streptococcal infections,

Leprosy, inflammatory bowel disease



......... commonly used to prevent ischemic hypoxia brain injury out of hospital cardiac arrest?

Therapeutic hypothermia

Brain tumor with estrogen receptors?


The hallmark of prolonged seizure and what the sequelae?

5 minutes...cortical laminar necrosis

Baby becomes floppy after family traveled to .............. or ................... or ......................? 

California, Utah, Pennsylvania have been reported

BB, Primidone, topiramate, Deep brain stimulation or thalamotomy if all else fails

those are Treat for what? 

essential tremor

1st line treatment in pseudotumor cerebri ?. 

Rx: Acetazolamide ----> 1st line---> inhibit choroid plexus carbonic anhydrase↓ CSF and IH. Add

furosemide in pts with continued symptoms

Symptoms refractory to medical therapy or those

with progressive vision loss----> surgical intervention with optic nerve sheath decompression or

lumboperitoneal shunting is recommended.

Short-term use of corticosteroids or serial lumbar

puncture (LP) can serve as bridging therapy for patients awaiting definitive surgical treatment ---> not

recommended as primary intervention due to side effects

Subjective restlessness in a patient on antipsychotics...dx and RX?


beta-blocker ,benzodiazepine

Which artery is affected by Wallenberg syndrome? 


We Add Dexamethasone in meningitis caused by what Bacterial infection?

Streptococcus pneumoniae and Haemophilus influenzae

MS symptoms last for how long Vs TIA symptoms?

For days and week vs less than 24 hours

In GBS what is the deep tendon reflex would be?

Dec or absent

Which Cranial nerve is responsible for Flavor perception?

cranial nerve VII

DTR that been seen in cyanide toxicity vs Magnesium Toxicity?

hyper vs hypo

Lyme meningitis is bacterial meningitis so what is WBC predominant?


we Dx brain death clinically what is the criteria to Dx it?

absent cortical and brain stem functions. but, the spinal cord may still be functioning; therefore, deep tendon reflexes may be present.

Pulsus Tardus Parvus where do you see them?


What is the BB that is CI in prolonged QT syndrome? 


MCC of erectile dysfunction post-infarction Patient ?


What causes the loss of the normal Right axis deviation in infants?

Tricuspid atresia

Quincke pulse where to see it ?


what is the EKG looks like in Cardiac tamponade?

electrical alternans

Rheumatology and Orthopedics USMLE Flashcards

1 - Exam that elicits pain for Tennis elbow?

Pain with resisted wrist extension and passive flexion

2 - Exam that elicits pain for Golfer's elbow?

Pain with resisted wrist flexion And with passive extension of the wrist

3 - Exam for De Quervain's tenosynovitis?

passive stretching of affected tendons ( passive ulnar deviation of the wrist ) by grasping flexed thumb into the palm with fingers elicits pain. (Finkelstein's test )

4 - Tendons affected in De Quervain's tenosynovitis?

Abductor Pollicious Longus and Extensor Pollicious Brevis

5 - Tendon affected/degenerated in tennis elbow?

Extensor Carpi Radialis Brevis

6 - What is Smith's Fx ? how did it happen?

Distal Radius Fx after falling on Flexed wrist, with anterior displacement of the distal part of the radius

7 - What is Colle's Fx? How did it happen?

distal radius Fx with posterior displacement of the distal part of radius and after fall on an outstretched hand

8 - Prophylaxis for Pseudo-gout ?


9 - MCC of Osteomyelitis in SCD pt?


10 - Give 2 Orthopedic Conditions that are Negative Initially on X-ray.?

Scaphoid Fx and AVN

11 - MC location of Osteomyetlis in adults vs. Children?

vertebral body in adults Vs metaphysis of long bones in children

12 - Indication for X-ray in Low Back Pain?

Osteoprosis / compression Fx

Suspect Malignancy

A Spondylitis ( i.e Insidious onset, nocturnal, Pain better with movement )

13 - Indication For MRI in Low Back Pain Pt?

Sensory/ motor deficits

Cauda equina syndrome " urine retention Saddle anesthesia" Suspected epidural abscess /infection (e.g fever IV abuse concurrent infection, hemodialysis )

Abnormal initial X-Ray too

14 - Indication for CT scan in Low Back Pt?

Same Indication For MRI if Pt not able to do MRI

15 - We check what before hydroxychloroquine sulfate? how often do we check that?

baseline ophthalmic exam @ time of start Rx, then annually after 5 years

16 - Pain of Trochanteric bursitis elicited by?

Sleeping / Pressure on the affected Lateral side and Ext rotation and Resisted abduction

17 - MCC of Back pain?

Lumbosacral muscle strain

18 - Confirmatory test for carpal tunnel syndrome?

Nerve conduction study

19 - Exam to Dx Cong Hip Dysplasia?

Barlow and Ortolani

ultrasound after 2 weeks (not before) till 6 months, after six months we can do Xray.

20 - What maneuver to do to treat dislocation of the radial head?

Supination with Flexion Or hyperpronation of the elbow joint

21 - What Joints Spared in Rheumatoid Arthritis?

DIP and Sacroiliac lumbar, thoracic vertebrae

22 - What is Pathergy where to see it?

pustular skin lesions secondary to minor trauma

Beh├žet disease, Crohn's disease

23 - Skin finding in Reactive Arthritis?

Keratoderma blennorrhagicum & Circinate balanitis

24 - Risk F for Pseudogout ( associated with what Diseases )?

hemochromatosis and hyperparathyroidism hypothyroidism and DM and Wilson

25 - Risk F for torticollis ?

Risk factors Related to crowding in the uterus :

Multiple gestations, breach Position Oligohydrominous

26 - What Conditions/disease Related to intrauterine Position?

Metatarsal Adductus, Congenital Muscular torticollis CHD, and Club foot

27 - Neer test for?

Rotator cuff tendinopathy

28 - Pseudothrombophlibitis has been seen in?

bakers cyst rupture

29 - Hypertension Treatment in Pt with gout?


30 - Which stress fracture needs to be treated with surgery?

Anterior tibial, 5th metatarsal

31 - Shin splints vs. tibial stress Fx?

shin splints are anterior leg pain in overweight pt who walk or run.


stress Fx is seen in underweight Pt and has localized pain.

32 - 2 cases we have to examine the neck before Anesthesia?

Rheumatoid Arthritis, Down Syndrome

33 - Rx of gout in Renal F Patient?

Intraarticular Steroid

34 - What is the most common stress fracture?

2nd metatarsal " March Fx "

35 - Which stress fracture needs to be treated with surgery?

Anterior tibial, 5th metatarsal

36 - Risk F for AVN?

Sickle cell

Caisson disease "decompression sickness"


SLE,, steroid, antiphospholipid Antibodies syndrome "APLAS", alcohol,

37 - Nerve compressed in CTS Vs TTS?

Median N Vs Tibila N

38 - Staph Aureus tend to Affect Epiphysis T/F?

F Metaphysis

39 - Osteosarcoma Vs Ewing sarcoma Arise from?

Metaphysis vs diaphysis

40 - MCC of Acute prepatellar bursitis is?

Staph Aureus

41 - Anterior Ischemic Optic Neuropathy seen As A SE of Viagra? T/F

F we see it in GCA

42 - Drugs to avoid in myasthenia vs drugs to avoid in gout?

Aminoglycosides, BBs, Azithromycin, quinolones,


Thiazides and Aspirin.

43 - What is the site where giant cell tumors in the bone arises from?


44 - What is Monteggia Fx ?

proximal 1/3 ulnar fracture with associated radial head dislocation/instability

45 - What is Galeazzi Fx ?

distal 1/3 radius shaft fx AND

associated distal radioulnar joint (DRUJ) injury

46 - What are the malignancy associated with dermatomyositis?

Ovarian, colon, pancreas lung stomach

47 - Medications Causing Drug-induced SLE with negative Anti histone?

Minocycline, Statin, Propylthiouracil

48 - What is the most accurate test to diagnose Sarcoidosis?

lymph node biopsy

49 - What is the treatment for renal osteodystrophy?

low phosphate diet, phosphate binders like sevelamer ( ca carbonate).Ca and vit D

50 - We provide CBT as Rx for Fibromyalgia T/F?


 1. Which one is not a clinical presentation in Guillain Barre Syndrome?

Ascending paralysis

Weakness and paresthesias

Descending paralysis

Autonomic dysregulation

- C

2. CSF with an increased level of proteins +/- pleocytosis, and diffuse demyelination in nerve conduction studies are seen in:

Multiple Sclerosis

Amyotrophic Lateral Sclerosis

Myasthenia Gravis

Guillain-Barre Syndrome

- D

3. 40 yo man comes to the ED with progressive weakness and paresthesias in his legs, later in his arms over the last few days. In the Physical Exam is seen: SO2 90% (FiO2 21%), slightly dyspneic, lungs clear to auscultation bilaterally, Strength 3/5 in LE bilateral, 4/5 UE bilateral, areflexia in LE bilateral. The patient refers to an episode of diarrhea 3 weeks ago. What is the best initial step?:

IVIG infusion


O2+ monitor Peak Inspiratory Pressure and Vital capacity 

Nerve conduction studies

- C

4. 60 yo man presents with progressive swallowing impairment over the last 15 days, associated with weight loss.  Also refers to weakness in his right hand later in his left hand that appeared 2 months ago. Denies pain, fever, night sweats, changes in bowel movements, urinary incontinence, paresthesias, tingling. PE fasciculations in tongue, weakness in UE and LE bilateral, atrophy in LE bilateral, Babinski + bilateral. Which of the following delay disease progression?





- D

5. In the previous case, this medical condition is characterized for the following, except:

It is a progressive degenerative disease of both upper and lower motor neurons.

Associated with recent Campylobacter jejuni infection.

Paresthesias and autonomic dysregulation

B and C

- D