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Musculoskeletal > Formative Assessments > Flashcards

Formative Assessments Flashcards

1
Q

Name 3 blood tests to Dx osteomyelitis

A 
FBC + diff WCC
ESR 
CRP 
Blood cultures x3 
U&E's
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2
Q

Name 3 types of imaging which can be used to Dx osteomyelitis

A 
X-ray 
USS 
Labelled white cell scan 
Aspiration 
MRI
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3
Q

Name 3 DDx of acute osteomyelitis

A

Acute septic arthritis
Trauma (fracture, dislocation)
Transient synovitis
Acute inflammatory arthritis

Soft tissue infection:
Cellulitis
Erysipelas
Necrotising Fasciits

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4
Q

Name 2 likeliest organisms responsible for acute osteomyelitis

A

Staph. aureus
Strep. Pyogenes
Haemophilus influenzar

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5
Q

Which organism would be suspected to cause acute osteomyelitis in sickle cell disease

A

Salmonella

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6
Q

Name 2 Rx for acute osteomyelitis

A 
Analgesia 
Rehydration 
Rest 
Spintage 
IV abx
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7
Q

Name 3 potential complications of acute osteomyelitis

A 
Pathological fracture 
Chronic osteomyelitis 
Septicaemia 
Death 
Metastatic infection 
Septic artritis 
Altered bone growth (esp since young)
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8
Q

True or false:

Congenital clubfoot is a rare birth defect

A

False

It is a common one

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9
Q

True or false:

Congenital clubfoot is caused by a single gene defect

A

Fale

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10
Q

True of false:

Congenital clubfoot the sole of the foot turns laterally and the foot is everted

A

False

Turned medially and is inverted

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11
Q

Name 3 different types of synovial joints and where they are found

A 
Plane (wrist)
Hinge (elbow, knee)
Condyloid/Ellipsoid
Picot (atlas and axis)
Saddle (thumb)
Ball and socket (hip and shoulder)
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12
Q

Name 3 components of synovial fluid

A

Lubricin
Hyaluronic acid
Fluid component

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13
Q

Name 1 function of synovial fluid

A

Lubrication
Nutrition of cartilage
Removal of waste products

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14
Q

Name 2 anatomical features that aid in the stability of a joint

A

Ligaments
Muscles
Shape of articulating surface
Capsule

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15
Q

Name 3 groups of individual involved in the management of OA

A 
GP 
Consultant 
Patient 
Physio 
OT
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16
Q

Name 2 non-pharmacological Rx for patients with OA

A

Thermotherapy
Electrotherapy
Manual therapy
Aids and devices

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17
Q

What non-pharmacological Rx do NICE NOT recommend for OA

A

Acupuncture

Nutraceuticals

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18
Q

Name 2 pharmacological Rx for OA

A 
Analgesia 
Paracetamol 
NSAIDS 
Topical NSAIDS (Capsaicin)
Steroid injections
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19
Q

Name 4 potential causes of a fracture slow healing

A 
Infection 
Age 
Steroid use 
Metabolic disorder 
Smoking 
Malnutrition 
Radiotherapy 
Warfarin 
Immune suppressants
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20
Q

Describe strength in UMN lesions

A

Decreased

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21
Q

Describe strength in LMN lesions

A

Decreased

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22
Q

Describe tone in UMN lesions

A

Increased/hypertonia

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23
Q

Describe tone in LMN Lesions

A

Decreased/hypotonia

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24
Q

Describe reflexes in UMN lesions

A

Increased/hyperreflexia

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25
Q

Describe reflexes in LMN lesins

A

Decreased/hyporeflexia

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26
Q

Describe clonus in UMN lesions

A

Present

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27
Q

Describe clonus in LMN lesons

A

Absent

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28
Q

Describe babinskis in UMN lesions

A

Present

29
Q

Describe Babinskis in LMN lesons

A

Absent

30
Q

Is atrophy present in UMN lesions

A

No

31
Q

Is atrophy present in LMN lesions

A

Yes

32
Q

50yr F presents with sensation of painful clicking in volar aspect of her ring finger when bending it. Most likely diagnosis?

a. OA of MCJ
b. Duputryens disease
c. Flexor ganglion
d. Trigger finger
e. Ruptures flexor tenson

A

d. Trigger Finger

33
Q

Name 4 muscles of the thenar eminence of the hand

A

Abductor pollicis brevis
Flexor pollivis brevis
Opponent pollicis
Adductor pollicis

34
Q

60yr F attends surgery complaining of pain at base of thumb when putting on clothes and using it. Suspect OA of thumb. Name 2 operative and non-operative management of this lady

A 
Non-operative:
Analgesia (NSAIDs)
Splinting 
Steroid injection 
Lifestyle modifications

Operative:
Fusion
Trapezioectomy
Replacement

35
Q

Name 3 non-operative managements for painful foot conditions

A 
Orthotics 
Weight loss 
Activity modification 
Footwear assessment/modification 
Physio
36
Q

40yr old woman complains of shooting pains in 3rd web space of her foot made worse by wearing high heels. You suspect Mortons Neuroma. Name 2 clinical signs you might elicit. Name 2 Rx for this condition?

A

Signs:
Mulder click
Altered sensation in 3rd webspace
Palpable swelling of the nerve

Rx:
Excision
Steroid injection

37
Q

50yr old DM attends clinical complaining of heel pain first thing in morning and on walking. You suspect plantar fasciitis. Give one differential diagnosis.

A

OA
Nerve entrapment syndrome
Calcaneal pathology

38
Q

Name 4 traditional treatments used to treat plantar fasciitis

A 
Weight loss 
Activity limitation 
Rest 
Steroid injections 
Stretching 
ICE 
NSAIDs
39
Q

Name2 newer/third line rx for plantar fasciitis

A 
Extracorpeal Shock Wave Therapy 
Nitric Oxide 
Platelet rich plasma
Topaz Plasma Coblation 
Endoscopic/Open surgery
40
Q

Name 3 muscles that attach to the clavicle

A 
Trapezius 
Sternocleidomastoid 
Omohyoid 
Deltoid 
Stenohyoid 
Subclavius 
Pectoralis major
41
Q

Name 3 directions in which the shoulder can dislocated

A

Anterior
Inferior
Posterior

42
Q

What is the most common direction of shoulder dislocation

A

Anterior

43
Q

Name 2 treatments for shoulder dislocation

A

Analgesia
Manipulation
Immobilisation
Physio.

44
Q

Name 2 injuries where the axillary nerve is at risk

A

Shoulder dislocation

Fracture of surgical neck of humerus

45
Q

What is the motor deficit of axillary nerve palsy

A

Loss of deltoid and trees minor

Cannot bend arm at elbow

46
Q

Sensory deficit of axillary nerve palsy

A

Lateral arm sensation loss

Regimental badge area

47
Q

Name 2 injuries where the radial nerve is at risk

A

Entrapment
Compression
Trauma

48
Q

What is the motor deficit of radial nerve palsy

A

Wrist drop

49
Q

Name 2 static constraints of the knee

A 
Collateral ligaments (medial and lateral)
Anterior cruciate ligament 
Posterior cruciate ligament
Capsule 
ITB 
Meniscii
50
Q

Name 2 dynamic constraints of the knee

A

Quadriceps
Hamsrings
Medial and lateral gastric.
Popliteus

51
Q

Name 2 flexors of the knee

A

Biceps femoris
Semimembranosus
Semitendinosis
Gastrocnemius

52
Q

Name 2 extensors of the knee

A

Rectus femoris
Vastus medialis
Vastus lateralis
Vastus intermedialis

53
Q

Name 3 causes of caudal equine syndrome

A 
Tumours 
Central lunar disc prolapse 
Trauma 
Infection 
Iatrogenic (spinal surgery or manipulation)
54
Q

Name 2 clinical features of caudal equine

A 
Bilateral sciatica 
Saddle anaesthesia 
Bladder incontinence 
Bowel incontinence 
Urinary retention
55
Q

What is the Rx for caudal equine

A

Urgent surgical decompression

56
Q

Name 3 types of blunt force injury

A

Contusions/Bruising
Abrasions
Lacerations

57
Q

Names 2 types of sharp force injury

A

Incision

Stab wounds

58
Q

What is the clinical term used for diffuse brain injury

A

Diffus axonal injury

59
Q

What is the pathological term used for diffuse brain injury

A

Traumatic Axonal Injury

60
Q

60yr M falls whilst working in his garden fracturing his left hip once he has recovered from the fracture which of the following would be the next step in his management?

a. Reassure him that it was simply bad luck as men of his age not at risk of osteoporosis
b. Commence him on bisphosphonate therapy
c. Refer for a bone density scan
d. Advise him to avoid working in the garden
e. Commence calcium and Vitamin D tablets

A

C. refer for a bone density scan

61
Q

75yr M presents acute onset unilateral headaches, scalp tenderness and pain in his jaw on eating on a background of 2 month history of pain and stiffness of the shoulder what is the next best investigation?

a. ESR
b. RF
c. CT head
d. Temporal artery biopsy
e. ANA

A

d. temporal artery biopsy

Suspected GCA

62
Q

50rs M attends GP complaining of swelling of his toes. He has just returned from a holiday. He has hypertension and his BMI is 32
What test wold be the most helpful to establish a Dx

A

Aspirate joint

63
Q

22yr F presents 3mnth history of stiffness of hand joints and new onset right sides sharp chest pain on inspiration. Urinanalysis shows microscopic haematuria and proteinuria
What is the suspected Dx?
Which antibody should be tested

A

Lupus

Anti double stranded DNA Ab (dsANA)

64
Q

Which cells are directly responsible for loss of articular cartilage

a. Macrophages
b. Synovial fibroblasts
c. T cells
d. B cells
e. Osteoclasts

A

Osteoclasts

65
Q

78yr healthy woman on no medications presents acutely with a hot swollen left knee. She was previously well with only mild knee pain on coming down the stairs no other joint involvement. She is struggling to weight bear on the knee. What is the most likely Dx?

a. RA
b. Psoriatic arthritis
c. Pseudogout
d. Trauma
e. OA

A

Pseudogout (knee is what gout is to the big toe)

66
Q

50yr lady attends GP concerned about osteoporosis as her mother had it. How should GP proceed

a. Perform a fracture risk assessment
b. Refer bone density scan
c. Explain she is too young and return in 5yrs time
d. Comment therapy HRT
e. Commence calcium and Vit D supplements

A

A. Perform a fracture risk assessment

67
Q

23yr student sees his GP with a several year history back pain and stiffness. Pain is worse at night, first thing in morning and if he has been sitting for long periods of time. Otherwise well apart from previous episode of red painful eye which he received steroid eye drops for. O/E reduced Schobers test and is tender over his right sacroiliac joint. Which Ix would be most helpful in reaching a Dx

CRP 
HLA-B27 
MRI whole spine 
Anti-CC antibody 
Trial of NSAIDs
A

c. MRI whole spine

Likely Dx = ankylosing spondylitis

HLA-B27 will be useful but not give whole Dx

68
Q

67yr F presents with 3mnth history of proximal weakness of the upper and lower limbs. She struggles to lift her arms above the shoulder level and to stand from sitting unaided. Her blood tests show ESR at 80 and creatinine kinase at 5x the upper limit of normal range. What is the most likely Dx?

A

Polymyositis

69
Q
  1. 30yr F newly diagnose with RA. 2yr old daughter currently trying for another baby. She has synovitis across the MCPs in both hands and has evidence of erosions and joint damage on x-ray
    Which Rx should she receive?

a. NSAIDs
b. Methotrexate
C. Sulfasalazine
d. Leflunomide
e. Paracetemol

A

Sulfasalazine

a. NSAIDS (not strong enough)
b. Methotrexate - Not safe for pregnancy
c. Sulfasalazine - Safe for pregnancy
d. Leflunomide- Not safe for pregnancy
e. Paracetemol - Does not treat the disease

Musculoskeletal (13 decks)

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