Week #3
1. Spindler KP, Wright RW. Anterior Cruciate Ligament Tear. NEJM 2008; 359:2135-42.
1. What is the most commonly injured ligament in the body?
2. What factors have been attributed to the increased incidence of ACL tears in female athletes?
3. Approximately how long does it take for osteoarthritis to set-in in patients who have had an ACL tear?
4. How often does an isolated tear of the ACL occur?
5. What other injuries are commonly associated with ACL tear?
6. What historical clues are important to diagnosing ACL tear?
7. What are the three physical exam maneuvers you can use to assess ACL tear (one of the exam maneuvers is not discussed in this article) and how do you do them?
8. Who should get surgery for an ACL tear?
9. How can you best prevent ACL tears, especially in female athletes?
2. Chou et al. Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from ACP and APS. Ann Intern Med 2007;147;478-491
1. What are the three broad categories of patients with low back pain?
2. When should physicians perform diagnostic imaging on patients with low back pain?
3. What nonpharmacologic therapy should be considered (besides self-care options)?
4. The symptoms and disability of most patients who seek out medical care improve significantly before how long?
5. What percent of patients who present to primary care physicians complaining of low back pain cannot reliably have their pain attributed to specific disease or abnormality?
6. For what neurologic problems should all patients be screened?
7. How does the posttest probability of cancer change in patients with back pain if they have a history of cancer?
8. What maneuvers should be included in a focused physical exam?
9. What is the difference between the straight-leg-raise test and crossed straight-leg-raise test? How are they performed and how should the results be interpreted?
10. What factors are stronger predictors of low back pain outcomes than physical examination or severity and duration of pain?
11. For patients with significant neurologic symptoms, which imaging modality is preferred for the spine, CT or MRI?
12. What is the value of the ESR in low back pain? When should it be ordered and with what other imaging tests?
13. What are the recommendations for self-care of patients with acute low back pain?
14. What are the pharmacologic options for low back pain and what are the benefits/risks of each?
15. When should opiods or tramadol be considered?
16. Are muscle relaxants helpful?
17. When should tricyclic antidepressants be considered?
18. What patients might benefit from gabapentin therapy?
19. When should physical therapy be recommended?
3. Brent GA. Graves’ Disease. NEJM 2008;358:2594-605
1. What percent of hyperthyroidism is Graves’ disease responsible?
2. What is the molecular etiology of Graves’ Disease?
3. What is the epidemiology of Graves’ Disease?
4. How do the clinical manifestations of older patients differ from younger patients?
5. Besides Graves’ disease, what are the common causes of hyperthyroidism?
6. Who should have a radioiodine uptake study?
7. How do thionamides work?
8. Why is methimazole used more often than propylthiouracil?
9. What are potential side effects of thionamides?
10. What are the other treatment options for Graves’ disease?
4. Le Cleach L, Chosidow O. Lichen Planus. NEJM 2012;366723-32
1. What is lichen planus?
2. What is the epidemiology of lichen planus?
3. What are the major clinical burdens of lichen planus?
4. What infection is commonly associated with lichen planus?
5. How is lichen planus diagnosed?
6. What is the role of phototherapy in cutaneous lichen planus?
7. What pharmacotherapy is used to treat cutaneous lichen planus?
8. When does oral lichen planus require treatment?
9. What is the treatment for oral lichen planus?
10. What are the goals in treating erosive anogenital lichen planus?
11. What are the treatments for anogenital erosive lichen planus, nail lichen planus, and scalp lichen planus?