Derek Trautwein
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Clinical medicine study aid

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Derek Trautwein
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Hand and Wrist Disorders

Question 1 of 33

1

A ganglion cyst is a type of malignant tumor found in the hand.

Select one of the following:

  • True
  • False

Explanation

Question 2 of 33

1

27 year old patient presents with an infection in the closed tip of the anterior second phalanx. How would you present this to a medical officer?

Select one of the following:

  • Paronychia

  • Felon

  • Trigger finger

  • Mallet finger

Explanation

Question 3 of 33

1

Which is NOT a sign of septic tenosynovitis?

Select one of the following:

  • Finger resting in the flexed position

  • Fusiform swelling

  • Tendon sheath tenderness

  • Swan neck deformity

Explanation

Question 4 of 33

1

You would use Kanavel's cardinal signs in order to identify a septic tenosynovitis.

Select one of the following:

  • True
  • False

Explanation

Question 5 of 33

1

A patient is diagnosed with a felon. After incision and drainage, you would prescribe an antibiotic in order to combat what bacteria?

1. Streptococcus
2. MRSA
3. Rickettsia
4. Staphylococcus aureus

Select one of the following:

  • 1 and 3

  • 2 and 4

  • 1, 2, 3

  • 4 only

  • All of the above

Explanation

Question 6 of 33

1

"Trigger finger" is a non-acute, idiopathic condition in a phalanx in which a patient has extension but not flexion.

Select one of the following:

  • True
  • False

Explanation

Question 7 of 33

1

Carpal tunnel syndrome is an idiopathic condition that involves entrapment of the:

Select one of the following:

  • Median nerve

  • Ulnar nerve

  • Dorsal nerve

  • Radial nerve

Explanation

Question 8 of 33

1

26 year old male supply clerk (POG) complains of pain and numbness in his first (pollux), second, and third phalanxes. As a learned doctor, you suspect carpal tunnel syndrome due to his weak genes and excessive use of a computer. What would you do to confirm your diagnosis?

1. Finklestein
2. Tinel
3. Colle's
4. Phalen

Select one of the following:

  • 1 and 3

  • 2 and 4

  • 1, 2, 3

  • 4 only

  • All of the above

Explanation

Question 9 of 33

1

What kind of hand injury may look minor but requires immediate referral to a specialist for surgical intervention in order to avoid amputation or even death?

Select one of the following:

  • Injection injury

  • Nerve injury

  • Proximal interpharangeal joint dislocation

  • De Quervain's tenosynovitis

Explanation

Question 10 of 33

1

Common nerve injuries can include:

1. Radial nerve palsy
2. Ulnar nerve palsy
3. Median nerve palsy
4. Crutch palsy

Select one of the following:

  • 1 and 3

  • 2 and 4

  • 1, 2, 3

  • 4 only

  • All of the above

Explanation

Question 11 of 33

1

Delayed reporting and/or lying is a major problem when treating De Quervain's tenosynovitis.

Select one of the following:

  • True
  • False

Explanation

Question 12 of 33

1

21 year old male Marine complains of severe pain in a hand injury he suffered over the weekend in a bar brawl. You notice jagged soft tissue damage near his second metacarpophalangeal (MCP) joint and is holding his finger in extension. What condition is this most indicative of?

Select one of the following:

  • Septic tendonsynovitis

  • Trigger finger

  • Subungual hematoma

  • Boxer fracture

Explanation

Question 13 of 33

1

Enteral (oral) antibiotics is the gold standard treatment of septic tendonsynovitis.

Select one of the following:

  • True
  • False

Explanation

Question 14 of 33

1

De Quervain's tenosynovitis is a condition which involves the tendon of what muscle?

1. Abductor pollicus longus
2. Extensor carpi radialis longus
3. Extensor pollicus brevis
4. Flexor carpi ulnaris

Select one of the following:

  • 1 and 3

  • 2 and 4

  • 1, 2, 3

  • 4 only

  • All of the above

Explanation

Question 15 of 33

1

43 year old female patient presents with pain and tenderness that radiates up her forearm and down to her thumb. You perform and confirm a positive Finklestein test. What would you diagnose in this patient?

Select one of the following:

  • De Quervain's tenosynovitis

  • Volar plate fracture

  • Carpel tunnel syndrome

  • Wilson fracture

Explanation

Question 16 of 33

1

Dislocation of a metacarpophalangeal (MCP) joint usually requires surgery to properly treat.

Select one of the following:

  • True
  • False

Explanation

Question 17 of 33

1

Gamekeeper's thumb would be classified as what type of injury?

1. Scaphoid fracture
2. Chronic injury
3. "Silver fork" deformity
4. Ulnar collateral ligament (UCL) rupture

Select one of the following:

  • 1 and 3

  • 2 and 4

  • 1, 2, 3

  • 4 only

  • All of the above

Explanation

Question 18 of 33

1

Upon reviewing an MRI from a 34 year old patient with a traumatic hand injury, you discover a rupture of the ulnar collateral ligament. What could you also call this condition?

Select one of the following:

  • Skier's thumb

  • Crutch palsy

  • Volar plate fracture

  • Colle's deformity

Explanation

Question 19 of 33

1

The indicative treatment for an ulnar collateral ligament (UCL) rupture includes a thumb spica splint.

Select one of the following:

  • True
  • False

Explanation

Question 20 of 33

1

How would you anatomically describe a mallet finger?

Select one of the following:

  • Distal phalanx avulsion fracture

  • Distal metacarpal neck fracture of fifth phalanx

  • Subluxation of metacarpal joint

  • Flexion fracture with voller/palmer angulation

Explanation

Question 21 of 33

1

How would you properly treat an avulsion fracture of the distal phalanx?

1. Reduction to prevent compartment syndrome
2. Splint DIP in hyperextension for 6 weeks
3. Sugar tong splint for 2 weeks
4. Educate patient to leave splint on long enough

Select one of the following:

  • 1 and 3

  • 2 and 4

  • 1, 2, 3

  • 4 only

  • All of the above

Explanation

Question 22 of 33

1

What obvious visual sign would you expect to see in a patient with a volar plate fracture?

1. Swan-neck deformity
2. Hyperextended PIP
3. Flexed DIP
4. Volar angulation

Select one of the following:

  • 1 and 3

  • 2 and 4

  • 1, 2, 3

  • 4 only

  • All of the above

Explanation

Question 23 of 33

1

A Wilson fracture is a volar plate avulsion of the base of the middle phalanx.

Select one of the following:

  • True
  • False

Explanation

Question 24 of 33

1

The most common metacarpal fracture, also known as a "boxer fracture", will commonly present with what sign or symptom?

1. External rotation
2. Injury is usually to fifth phalanx
3. Fracture occurred in distal neck of the metacarpal
4. Volar angulation

Select one of the following:

  • 1 and 3

  • 2 and 4

  • 1, 2, 3

  • 4 only

  • All of the above

Explanation

Question 25 of 33

1

A boxer fracture is commonly treated with an ulnar gutter splint.

Select one of the following:

  • True
  • False

Explanation

Question 26 of 33

1

A 55 year old male presents with pain in his fourth phalanx. Using inspection, palpation, and radiography: you assess that there is a dislocation of the finger at the metacarpal joint. What is this commonly known as?

Select one of the following:

  • Bennett fracture

  • Rolando fracture

  • Colle's fracture

  • Smith's fracture

Explanation

Question 27 of 33

1

A Rolando fracture is simply a comminuted Bennett fracture.

Select one of the following:

  • True
  • False

Explanation

Question 28 of 33

1

Avascular necrosis secondary to trauma and a non or mal union is a very concerning sign most likely found in what hand injury?

Select one of the following:

  • Scaphoid fracture

  • Colle's fracture

  • Injection injury

  • Mallet finger

Explanation

Question 29 of 33

1

After properly diagnosing a wrist injury as a scaphoid fracture, what is the most appropriate treatment?

Select one of the following:

  • Sugar tong splint

  • Thumb spica cast/splint

  • Corticosteroidal injection

  • Parenteral antibiotics

Explanation

Question 30 of 33

1

You would repeat x-ray views in 10-14 days if they are negative for a scaphoid fracture.

Select one of the following:

  • True
  • False

Explanation

Question 31 of 33

1

A 104 year old man suffers a hand injury secondary to trauma while trying to catch himself during a fall. Upon inspection, you note a "silver-fork" deformity at the distal radius and dorsal angulation of the hand. These signs would lead you to believe the diagnosis of this patient would be:

Select one of the following:

  • Colle's fracture

  • Scaphoid fracture

  • Volar plate fracture

  • Smith's fracture

Explanation

Question 32 of 33

1

A forearm sugar tong splint is indicated in displaced fractures in regards to the treatment of injuries in the distal radius.

Select one of the following:

  • True
  • False

Explanation

Question 33 of 33

1

A 23 year old Airman complains of severe wrist pain after suffering a fall on the dorsum of his hand due to wine coolers and limp wrist syndrome. In addition to this classic MOI, you also discover voller (palmer) angulation. What would you diagnose this as?

Select one of the following:

  • Smith's fracture

  • Colle's fracture

  • Barton's fracture

  • Monteggia fracture

Explanation

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