Monica book

Question 1

Triad of urethritis, conjunctivitis, arthritis Associated lesions include circinate balanitis
Keratoderma blenorrhagica
Mouth ulcers

Answer 1

Reiter’s syndrome

Question 2

Seronegative arthropathies

Answer 2

Reiter’s syndrome
Ankylosing spondylitis
Psoriatic arthritis
Enteropathic arthopathy

Question 3

4 A’s associations of ankylosing spondylitis

Answer 3

Arthritis
Anterior uveitis
Apical lung fibrosis
Aortic regurgitation

Question 4

What does the arthritis in UC/Crohn’s usually look like?

Answer 4

Asymmetrical, mainly affects lower limbs

Question 5

More common in Turkish, Iranian patients
Orogenital ulceration, uveitis, arthritis
Pathergy reaction is pathognomonic

Answer 5

Behcets

Question 6

Proximal muscle weakness, pain and tenderness

↑serum CK (creatine kinase)

Answer 6

Polymyositis

Question 7

Granulomas in respiratory tract, generalized vasculitis

Classic anti-neutrophil cytoplasmic antibody (cANCA), anti-PR3 positive

Answer 7

Wegeners

Question 8

Usually elderly patient with headache Scalp tenderness, jaw claudication very suggestive Amaurosis fugax, sudden unilateral blindness can occur associated with polymyalgia rheumatica

Answer 8

Temporal/giant cell arteritis

Question 9

Usually child (particularly under age 5) 
Purpuric rash over buttocks,
extensor surfaces
Associated with arthritis, abdominal
pain, nephritis

Answer 9

Henoch-Schonlein purpura

Question 10

Usually middle-aged male

Asthma, rhinitis and systemic vasculitis

Answer 10

Churg-Strauss syndrome

Question 11

Usually under 5 years:
Main features are:
– protracted fever (over 5 days)
– acute cervical lymphadenopathy
– bilateral non-purulent conjunctivitis
– dry, cracked, fissured lips
– redness, oedema of palms and soles Platelets, CRP (C-reactive protein) usually ↑↑

Answer 11

Kawasaki’s disease

Question 12

Painful shoulder following seizure

Answer 12

Posterior dislocation

Question 13

Failure to abduct shoulder after dislocation

Answer 13

Axillary nerve injury

Question 14

Winged scapular

Answer 14

Damage to the long thoracic nerve

Question 15

Dinner fork deformity

Answer 15

Colles fracture

Question 16

Forced adduction and flexion of thumb elicits pain on radial side of wrist

Answer 16

De Quervain’s syndrome

Question 17

Which movements will elicit pain in DeQuervains?

Answer 17

Forced adduction and flexion of thumb

Question 18

Flexed, adducted and externally rotated leg

Answer 18

Femoral shaft fracture

Question 19

Locked knee, positive McMurray’s test?

Answer 19

Meniscal tear

Question 20

Drop foot after hip replacement

Answer 20

Sciatic nerve injury

Question 21

Drop foot after knee injury

Answer 21

Common peroneal nerve injury

Question 22

Excessive anterior glide on femur

Answer 22

ACL tear

Question 23

Excessive posterior glide tibia on femur

Answer 23

PCL tear

Question 24

Prominent tender tibial tubercle

Answer 24

Osgood-schlatter disease

Question 25

Localized enlargement of bone with deformity (e.g. enlarged skull, bowed tibia)§

Answer 25

Paget's disease

Question 26

RA on x-ray

Answer 26

Loss of joint space Juxta-articular osteoporosis Erosions, subluxation joints

Question 27

Onion peel sign on x-ray

Answer 27

Ewing's sarcoma

Question 28

"Sunray spiculation" on x-ray

Answer 28

Osteosarcoma

Question 29

Hallmark sign of osteosarcoma

Answer 29

Osteoid production

Question 30

Side effects of ciclosporin

Answer 30

Gum hypertrophy Nephrotoxicity Hyperkalaemia

Question 31

Drugs which can cause big gums

Answer 31

Ciclosporin Phenytoin CCBs

Question 32

Intramuscular DMARD which can cause el massive rash all over your body

Answer 32

Gold

Question 33

Treatment for gout

Answer 33

Acute: colchicine Prophylaxis: allopurinol

Question 34

Question mark posture

Answer 34

Ankylosing spondylitis

Question 35

Most common cause of posterior shoulder dislocation

Answer 35

Epileptic fit

Question 36

Anterior shoulder dislocation might damage which nerve

Answer 36

Axillary

Question 37

Which nerve might be damaged in a humeral shaft fracture

Answer 37

Radial nerve

Question 38

Pre-patellar bursitis

Answer 38

Housemaids knee

Question 39

This nerve supplies the extensors of the wrist

Answer 39

Radial nerve

Question 40

Look for damage of this artery if you have supracondylar fracture

Answer 40

Brachial artery

Question 41

Pott's disease

Answer 41

Tuberculous spndylitis | -fever, weight loss, back pain

Question 42

Biochem findings in myeloma

Answer 42

High calcium | High ESR

Question 43

Which type of radiograph do you need in SUFE?

Answer 43

Lateral radiograph!

Question 44

Adducted Externally rotated Shortened

Answer 44

Fractured NOF

Question 45

Risk factors for pseudogout

Answer 45

Hypovolaemia, hyperparathyroidism, diabetes, haemochromatosis, acromegaly, arthritis