16

Question 1

key symptoms of rheumatoid arthritis

Answer 1

• joint pain
• relapsing remitting
• stiffness
• immobility
• poor function
• fatigue
• weight loss
• anaemia

Question 2

describe a ‘bulge’ lumbar disc prolapse

Answer 2

• majority asymptomatic

- just nucleus squished a bit

Question 3

metatarsalgia

Answer 3

pain in ball of foot

Question 4

management mortons neuroma

Answer 4

• injections for small lesions

- excision of lesions including section of normal nerve

Question 5

how is osteoporosis characterised

Answer 5

low bone mass
microarchitectural deterioration of bone tissue
bone fragility
increases in fracture risk

Question 6

how to manage internal tibial torsion

Answer 6

90% respond spontaneously

Question 7

motor presentation of nerve injury

Answer 7

altered;

• movement
• reflex
• strength
• paralysis
• dry skin
• loss of tactile adherence

Question 8

describe polymyalgia rheumatica

Answer 8

inflammatory disease causing widespread muscle pain and stiffness, especially around the shoulders and hips. Most people who develop PMR are in their 60s or 70s. PMR is closely linked with giant cell arteritis (GCA)

Question 9

Pagets disease signs

Answer 9

• isolated elevation of serum alkaline phosphatase
• bone pain
• local heat
• hearing loss

Question 10

child presentation acute septic arthritis

Answer 10

• unwell
• not willing to move joint at all
• pyrexial
• tachycardic
• acute pain @ single large joint

Question 11

paraplegia investigations

Answer 11

• MRI spine
• CT head
• x-rays

Question 12

causes of paraplegia

Answer 12

thoracic/ lumbar fractures

chest/ abdo injuries

Question 13

causes JIA

Answer 13

• genetics
• FH
• autoimmune
• immunological
• environmental

Question 14

surgical management of osteogenesis imperfecta

Answer 14

rods along long bones for support - they can grow with a child

Question 15

signs of excessive knee extension

Answer 15

loss of normal knee flexion during stance phase

hyperextension

Question 16

uveitis

Answer 16

inflammation of the middle layer of the eyeball, which consists of the iris, ciliary, body and choroid

Question 17

treatment of uveitis

Answer 17

topical/ intraocular/ systemic steroids

methotrexate

cyclosporin

anti-TNF

MMF

Question 18

dactylitis

Answer 18

diffuse painful swelling of an entire finger or toe

Question 19

function hypoxanthine-guanine phosphoribosyl transferase

Answer 19

recycling of purine bases, hypoxanthine and guanine

Question 20

describe a trendelenburg gate

Answer 20

unilateral lateral trunk tilt

Question 21

management options for requiring hyperuricaemia

Answer 21

xanthine oxidase inhibitors e.g. allopurinol

Question 22

warning signs non-accidental injury

Answer 22

• unusual locations (forearms, ribs, neck, humeral)
• old uninvestigated fractures
• incongruent history
• bruising pattern
• burns
• repeated incidences
• multiple fractures
• multiple stages of healing