JB-Orthopaedics and Rheumatology

Question 1

Four key changes in OA

Answer 1

LOSS
Loss of joint space
Osteophytes (bone spurs)
Subarticular sclerosis (increased density of the bone along joint line)
Subchondral cysts (fluid filled holes)

Question 2

How do X-ray changes (?acronym) correlate to OA symptoms

Answer 2

Do not

LOSS

Question 3

Two nodes seen in OA in hand

Answer 3

Heberdens (DIP)
Bouchards (PIP)

Question 4

Diagnosis for OA

Answer 4

Can be made if: over 45, typical pain, no morning stiffness

Question 5

Most common organism in prosthetic joint infections

Answer 5

Staph A

Question 6

What is a Colles fracture

Answer 6

Transverse fracture of distal causing posterior displacement causing dinner fork deformity

Question 7

Common mechanism of Colles fracture

Answer 7

FOOSH

Question 8

Classification of ankle fractures that involve lateral malleolus

Answer 8

Webber classification

Question 9

Criteria to diagnose a fat embolism

Answer 9

Gurds

Respiratory distress, petechial rash, cerebral involvement + minor criteria

Question 10

Best blood test for RA

Answer 10

anti-cyclic citrullinated peptide

Question 11

Investigation for osteomyelitis

Answer 11

MRI

OsteoMRIlitis

Question 12

Treatment of choice for SLE

Answer 12

Hydroxychloroquine

Pred (or cyclo) if organ involvement

Question 13

Highly specific test for SLE

Answer 13

Anti-dsDNA

Question 14

Joint aspirate in RA

Answer 14

High WBC (mainly polymorphic neutrophils), yellow, no crystals

Septic arthritis usually cloudy, positive gram stain (staph a), mainly neutrophils

Question 15

Two key joints affected in AS

Answer 15

Vertebral column and sacroiliac

Question 16

X-ray changes in AS

Answer 16

Squaring of VBs
Subchondral sclerosis and erosions
Syndesmophytes (bone growth where ligaments insert onto bone)
Ossification of ligaments
Fusion of joints

Question 17

What does management of intracapsular hip fractures depend on

Answer 17

Undisplaced - Fixation

Displaced
Young - Reduction and fixation
Old
Low demand - hemi
High demand - THR

Question 18

What should disproportion pain on assessment of tone vs power raise suspicion of

Answer 18

Compartment syndrome

Question 19

Shoulder locked in internal rotation -> dx

Answer 19

Posterior shoulder dislocation

Question 20

What do all patients need after a diagnosis with dermatomyositis

Answer 20

Malignancy screen

Question 21

Most common joints in hand affected in OA

Answer 21

DIP and Carpometacarpal

Question 22

What should be co-prescribed with allopurinol

Answer 22

Colchicine or NSAIDs

Question 23

Second line urate lowering therapy

Answer 23

Febuxostat (xanthine oxidase inhibitor)

Question 24

How is weakness described in PMR

Answer 24

Weakness is not a symptom of PMR

Aching and morning stiffness in proximal muscles (ESR raised, CK normal)
Good response to pred

Question 25

Antibody associated with drug induced lupus

Answer 25

Anti-histone

Question 26

Reactive arthritis joint aspiration

Answer 26

Sterile synovial fluid with a high white blood cell count

Question 27

When should ?scaphoid fractures be seen in clinic/ have another x-ray

Answer 27

7-10 days

Question 28

How are aspirin and sulflasalazine linked

Answer 28

If allergic, most patients allergic to both

Question 29

Most common mechanism of ankle sprain

Answer 29

inversion

Question 30

Treatment for ank spond that is not responsive to NSAIDS

Answer 30

Must fail 2 types of NSAIDs and have active disease Anti-TNF Infliximab and etanercept