Clinical Medicine

Question 1

When should one ask for joint aspiration?

Answer 1

When signs of effusion and inflammation is seen

Question 2

3 most important differential in mono articular ?

Answer 2

Trauma
Infection
Crystalline induced

Question 3

Why does most of the herniations happen at l4/5 l5/s1 ?

Answer 3

Because the posterior longitudinal ligament thins inferiorly from L1 to S1

Question 4

How to differentiate between real claudication and pseudo claudication?

Answer 4

Pseudoclaudication stays for 10-15 minutes

Relieved by spinal flexion and leaning forward? Increase diameter of spinal column reducing tension

Question 5

Major difference between pseudo claudication and herniated disc ?

Answer 5

Herniated disc symptoms exaggerated by sitting while pseudo is relieved by sitting!

Question 6

Typical history of a pseudo patient

Answer 6

No pain uphill but pain when downhill

Question 7

Major differentiating factors between inflammatory and non inflammatory arthritis

Answer 7

Non inflammatory
No sign of synovitis/arthritis
No effusion (usually)
Less than 30 min stiffness
No systemic extra articular manifestion
Pain is better with rest

Question 8

Socandary causes is osteoarthritis ?

Answer 8

Traumatic
Endocrine - hyper parathyroid
Hypo/hyper thyroid
Rheumatologic

Question 9

What does ostephytes and subchondral sclerosis represent?

Answer 9

Repair activity by new bone formation

Question 10

What does joint space narrowing indicates?

Answer 10

Cartilage thinning

Question 11

Pseudocyst formation results from

Answer 11

Focal bone necrosis