05/03

Question 1

What joints are more commonly affected in pseudogout?

Answer 1

Knee
Wrist
Shoulder

Question 2

What are predisposing factors to pseudogout?

Answer 2

Haemochromatosis
Hyperparathyroidism
Low Mg
Low Phosphate
Acromegaly
Wilson disease

Question 3

What is management of reactive arthritis?

Answer 3

NSAIDs first line
Intra articular steroid injection
Oral steroids if multiple joints involved
Methotrexate or sulfalazine if resistant to treatment

Question 4

What are causes of avascular necrosis of the hip?

Answer 4

Steroid use
Alcohol excess
Chemotherapy
Trauma

Question 5

What is osteomalacia?

Answer 5

Softening of the bones due to Vit D deficiency

Question 6

What are features of osteomalacia?

Answer 6

Bone pain
Bone muscle/tenderness
Fractures- femoral neck
Proximal myopathy- can lead to waddling gait

Question 7

What is the most common site of a metatarsal stress fracture?

Answer 7

2nd metatarsal

Question 8

What are risk factors for bicep tendon rupture?

Answer 8

Steroid use
Overhead lifting
Smoking
Shoulder overuse or previous shoulder injuries

Question 9

What are features of bicep tendon rupture?

Answer 9

Popping sound followed by pain, swelling
‘Popeye’ deformity
Weakness of shoulder and elbow

Question 10

What are signs of L3 nerve root compression?

Answer 10

Loss of sensation over anterior thigh and knee
Absent knee reflex
Weak quadriceps
Positive femoral stretch test

Question 11

What are signs of L4 nerve root compression?

Answer 11

Loss of sensation over knee and medial aspect of calf
Decreased knee reflex
Positive femoral stretch test

Question 12

What are signs of L5 nerve root compression?

Answer 12

Loss of sensation over big toe and dorsum of foot
Decreased dorsiflexion and big toe resistance
Normal reflexes
Positive sciatic nerve stretch test

Question 13

What are signs of S1 nerve root compression?

Answer 13

Loss of sensation of lateral aspect of the calf
Reduced ankle reflex
Decreased plantarflexion against resistance
Foot drop
Positive sciatic nerve stretch test

Question 14

What are the features suggestive of compartment syndrome?

Answer 14

Severe pain that is uncontrolled by strong analgesia 
Paraesthesia 
Pallor
Paralysis
Pulses can be present

Question 15

What are key findings in chorndosarcoma?

Answer 15

Occurs in metaphysis region
Codman triangle
Sunburst appearance
History of retinoblastoma

Question 16

What are key findings of Ewing sarcoma?

Answer 16

Occurs in pelvis and long bones
Blue cell tumour
Onion skin appearance on XR

Question 17

What is first line treatment of septic arthritis?

Answer 17

IV flucloxacillin or clindamycin (if pen allergic)

Question 18

What is the lifelong management of APS?

Answer 18

Warfarin with target INR 2-3

If repeated clots then target INR should be 3-4