Ankle
T/F: In ankle sprains, delaying ankle exam until 4-7 days postinjury yields the most reliable clinical findings
What is True?
Definition of neutropenia in adults and children >1 year old
What is absolute neutrophil count <1500 per microliter
Screening for cervical cancer stops at age ___ in people with recent test in 3-5 years, 3 consecutive negative cytology results, 2 consecutive negative HPV tests
What is 65 years?
This exam should not be performed unless the placenta is known to not be previa.
A cause of posterior heel pain that is common in adolescents, worsens with increased activity or during growth spurt. On exam there is tenderness at Achilles insertion and pain with passive dorsiflexion and mediolateral calcaneal compression
What is calcaneal apophysitis (Sever disease)?
In an acute ankle injury, if a patient has one of these exam findings, the Ottawa Ankle Rules support obtaining radiography.
What is: inability to bear weight immediately and at time of medical evaluation (4 steps), bony tenderness to palpation at the posterior edge or tip of either the malleoli, navicular or base of the fifth metatarsal?
Definition of febrile neutropenia
What is single oral temperature of 101F or greater or a temperature of 100.4F or greater sustained for 1 hour with ANC <500 per microliter?
Definition of heat stroke
What is core temperature greater than 104F with central nervous system dysfunction (encephalopathy, seizures, or coma)?
List 4 causes of emergent late pregnancy bleeding
What are placenta previa, vasa previa, placental abruption, uterine rupture?
List 3 initial treatments for plantar fasciitis
What is rest, ice massage, stretching and strengthening exercises, activity modification, NSAIDs, orthotics, night splints, walking program
How to manage acute ankle sprains? List at least 3
Rest, ice, compression, elevation. Pain control, joint protection with limited mobility for 5-10 days, early functional activity and targeted rehabilitation exercises.
In a patient with a known malignancy, antibiotics should be initiated within _____ of diagnosing febrile neutropenia.
What is 1 hour?
In patients with heat stroke, what is the target temperature to cool to? (Ok to just say a number, instead of a range)
What is 101F to 101.8F?
List 4 gynecologic causes of late pregnancy bleeding
What are cervical cancer, cervical polyp, cervicitis, genital herpes, postcoital bleeding, syphilis chancre, trauma, vaginitis, varices?
Preferred test for diagnosis and prognosis of calcaneal stress injury, especially within the first few weeks postinjury
What is MRI?
Recommendations to help patients recover from ankle sprain and prevent future sprain?
Ankle range of motion and resistance strengthening can be started 1-3 days postinjury. Consider continuous use of brace 4-6 weeks after initial injury, then external support (bracing > tape) up to 12 months in sporting activities.
The primary prophylaxis in patients with a solid tumor or lymphoma who are starting chemotherapy if they have a 20% or greater risk of febrile neutropenia, or as secondary prophylaxis if they have a history of a neutropenic complication from prior treatment.
What is G-CSF?
First line for treatment for heat stroke
What is whole body ice water immersion?
Order this test in patients who are Rh-negative with suspected placental abruption
What is Kleihauer-Betke test?
List 2 risk factors for peroneal tendon injury
What are corticosteroid injections into the peroneal sheath, use of fluoroquinolones, those with rheumatoid arthritis, hyperparathyroidism, and diabetes?
List at least 3 other conditions to consider if pain and disability persist after initial management of lateral ankle sprain.
Syndesmotic ankle sprains, talar fractures, peroneal tendon instability, chronic ankle instability with osteochrondral lesions, deltoid ligament injury or occult fracture
Cyclic neutropenia-this is an autosomal dominant disorder defined by periodic neutropenia for ___ days, with a nadir ANC < 200 per microliter. The interval varies but is typically ___ days.
What is periodic neutropenia for 3-6 days? What is interval 21 days? Diagnosis is made obtaining CBC 2x/week for at least 6 weeks to document 2 nadirs with return-to-normal ANC counts to establish a cyclic pattern.
Differentiate between Lewy body dementia from Parkinson disease dementia
What is symptom onset timing? Lewy body dementia typically starts within 1 year of parkinsonian symptoms, whereas Parkinson disease dementia is preceded by parkinsonian symptoms by more than 1 year
List 5 signs of uterine rupture
What are abdominal pain, FHR abnormalities with recurrent decelerations or bradycardia, loss of fetal station, palpable fetal parts, vaginal bleeding, peritoneal signs, hemodynamic instability, abnormal contraction patterns with tachysystole and increasing resting tone followed by cessation of contractions?
The maneuver to test for tarsal tunnel syndrome
What is triple compression test?