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A - MB Exam Buzzwords > 2MBChB Rheumatology + Orthopaedics > Flashcards

2MBChB Rheumatology + Orthopaedics Flashcards

1
Q

Most common bone tumour?

A

Osteosarcoma

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2
Q

A painful arc suggests damage to which rotator cuff muscle?

A

Supraspinatus

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3
Q

Nerve supply to trapezius?

A

Spinal accessory nerve

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4
Q

What is used to treat shaft of femur fractures?

A

Thomas splint

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5
Q

Which biologic causes reactivation of latent TB?

A

Infliximab

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6
Q

Tingling in ring + pinky finger suggests what?

A

Cubital tunnel syndrome

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7
Q

What is 1st line treatment of necrotising fasciitis?

A

Surgical debridement

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8
Q

Which rheumatoid drug causes black, tarry stool?

A

NSAID

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9
Q

Which rheumatoid drugs are nephrotoxic?

A

Gold

Penicilliamine

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10
Q

Visual loss, mouth and genital ulcers suggests what disease? In a Turkish guy perhaps?

A

Behcet’s syndrome

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11
Q

Which fracture typically produces a dinner fork deformity?

A

Colles fracture

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12
Q

Which structures may be damaged in Colles fracture?

A

Median nerve
Extensor pollicis longus
Carpal bones

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13
Q

Which fingers feel ‘funny’ in carpal tunnel syndrome?

A

Thumb
Index finger
Middle finger
Half of ring finger

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14
Q

How many XRAY views are taken for scaphoid fracture?

A

Two obliques
AP
Lateral

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15
Q

A patient presents with bone pain, deformity and deafness. What’s the likely differential?

A

Paget’s disease

chronic bone remodelling disease where new bone is constantly made

bisphosphonate is first line treatment - reduce osteoclast turnover and reduce ALP level

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16
Q

Side effects of methotrexate?

A

Bone marrow suppression
Liver cirrhosis
Pneumonitis
Contraindicated in pregnancy

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17
Q

Side effects of sulfasalazine?

A

Rash
Oligospermia

is pregnancy safe

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18
Q

Side effects of hydroxychloroquine?

A

Retinopathy

Corneal deposits

19
Q

Side effects of prednisolone?

A

Cushing’s syndrome
Osteoporosis
Impaired glucose tolerance
Cataracts

20
Q

Side effect of gold and penicillamine?

A

Proteinuria/nephropathy

21
Q

Pencil in cup XR

A

Psoriatic arthritis

22
Q

Wrist drop

A

Radial nerve palsy

23
Q

Arthritis + uveitis + urethritis

A

Reiter’s syndrome

24
Q

Foot drop

A

Common fibular/peroneal nerve

25
Q

Intracapsular hip fracture Rx

A

Hemiarthroplasty

26
Q

Sagging rope sign

A

Avascular necrosis (AVN) of bone - usually hip

27
Q

Onion-peel sign

A

Ewing sarcoma

28
Q

Sunray spiculation

A

Osteosarcoma

29
Q

Popcorn calcification

A

Chondrosarcoma

30
Q

Soap bubble XR

A

Giant cell tumour

31
Q

Rosary bead sign

A

Polyarteritis nodosa

32
Q

Shepherd’s crook deformity

A

Fibrous dysplasia

33
Q

investigation for giant cell arteritis?

A

Temporal artery biopsy - GCA is a sight threatening condition

34
Q

80 year old man with acute sudden onset unilateral headache and scalp tenderness. Pain in his jaw when eating with a background of 2-month history of pain and stiffness of the shoulder girdle.

what should you rule out? how?

A

Giant cell arteritis

perform temporal artery biopsy

35
Q

80 year old healthy woman on no medications, presents acutely with a hot, swollen right knee. Previously had mild knee pain on descending stairs. No other joints are involved. Struggling to weight bear on knee.

What is the most likely diagnosis? management?

A

pseudogout - common in knee and presents as acute painful swelling

Colchicine may be given if recurring

36
Q

A 30 year old Asian computer programmer presents to his GP with widespread muscle pain and weakness as well as difficulty rising from his chair. His alkaline phosphatase is elevated at 2000 and serum calcium is just below the reference range.

Which tests would be diagnostic for the underlying cause of his problems? why?

A

Vitamin D status (checking for osteopsorosis)

risk factors = asian, computer programmer (indoors)

key words = alkaline phosphate elevated, serum calcium low

37
Q

A 27 year old student sees his GP with a several years
of history back pain and stiffness. Pain is worse at night, first thing in the morning and when sitting for long periods studying. He is otherwise well apart from a previous episode of a red, painful eye for which he received some steroid eye drops. On examination he has a reduced Schober’s test and is tender over his right sacroiliac joint.

Which investigation would be most helpful in reaching a diagnosis? what is suspected?

A

ankalosing spondylitis - reduced schober’s test, uveitis, sacroiliac joint, pain worse at rest

MRI whole spine

38
Q

A 70 year old female patient presents with a 3 month history of proximal weakness of upper and lower limbs. She struggles to lift her arms above the shoulder level and cannot stand from sitting unaided.
Her blood results shoe elevated ESR at 80 and raised creatine kinase 5 times the upper limit of normal range.

What is the most likely diagnosis? initial management?

A

polymyosistis

corticosteroids - prednisolone should be given first line

39
Q

what is the most important muscle providing plantar flexion of the foot?

A

gastrocnemious

40
Q

A 37 year old woman attends her GP complaining of shooting pains in the 3rd web space of her foot made worse by wearing high heeled shoes.

what is suspected?
Which clinical sign would be consistent with the diagnosis? what wouldn’t?

A

Mortons neuroma

A positive Mulder’s click and reduced sensation in 3rd webspace - consistent with diagnosis

capillary return of 4 seconds in foot - inconsistent

41
Q

A 55 year old diabetic woman presents with a painful clicking sensation at the volar aspect of her ring ringer when flexing the digit. There has been no traumatic episode.

What is the most likely diagnosis?

A

trigger finger - painful clicking sensation on volar aspect

42
Q

waiters tip

A

Erbs palsy - caused by falling on arm C5, C6 roots affected

43
Q

claw hand

A

klumpke’s palsy - C8, T1 affected usually during breech delivery

affects intrinsic muscles of hand and flexors of wrists and fingers

A - MB Exam Buzzwords (15 decks)

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