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MEDICINE FINALS > MSK > Flashcards

MSK Flashcards

1
Q

What would the clinical picture be of someone with compression of L3 nerve root? (4)

A
  • sensory loss of anterior thigh
  • weak quads (knee extension)
  • reduced knee reflex
  • positive femoral stretch test
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2
Q

What would the clinical picture be of someone with compression of L4 nerve root? (4)

A
  • sensory loss anterior aspect of knee
  • weak quads (knee extension)
  • reduced knee reflex
  • positive femoral stretch test
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3
Q

What would the clinical picture be of someone with compression of L5 nerve root? (3)

A
  • sensory loss dorsum of foot
  • weakness in foot and big toe dorsiflexion
  • reflexes intact
  • positive sciatic nerve stretch test
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4
Q

What would the clinical picture be of someone with compression of S1 nerve root? (4)

A
  • weak foot plantarflexion and eversion
  • loss of ankle jerk
  • calf pain
  • decreased sensation sole of foot/back of calf
  • positive sciatic nerve stretch test
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5
Q

What is tennis elbow and how do you test for it?

A

Lateral epicondylitis

Pain worse on:
- wrist extension with elbow extended (shoo pigeons)
- supination of forearm with elbow extended

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6
Q

What is golfer’s elbow and how do you test for it?

A

Medial epicondylitis

Pain worse on:
- wrist flexion
- pronation
(elbow extended)

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7
Q

What is cubital tunnel syndrome?

A

Compression of ulnar nerve

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8
Q

What is olecranon bursitis?

A

swelling over posterior aspect of elbow
- hot, red, painful

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9
Q

What is radial tunnel syndrome?

A

Compression of radial nerve
- pain is 4-5cm distal to lateral epicondyle

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10
Q

What are the different patterns of systemic sclerosis?

A
  • limited cutaneous systemic sclerosis
  • diffuse cutaneous systemic sclerosis
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11
Q

What are features of limited cutaneous systemic sclerosis?

A

CREST syndrome
C – Calcinosis
R – Raynaud’s phenomenon
E – oEsophageal dysmotility
S – Sclerodactyly
T – Telangiectasia

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12
Q

What are features of diffuse cutaneous systemic sclerosis?

A

CREST + CVS/lung/kidney problems

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13
Q

Which antibodies would be present in diffuse/limited systemic sclerosis?

A

diffuse = anti-Scl 70
limited = anti centromere

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14
Q

What is pseudogout?

A

Microcrystal synovitis caused by deposition of calcium pyrophosphate dihydrate crystals in the synovium.

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15
Q

Which joints are most commonly affected in pseudogout?

A

knee, wrist, shoulders

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16
Q

What would you find on joint aspiration of someone with pseudogout?

A

weakly-positive birefringent rhomboid-shaped crystals

17
Q

What would you see on X-ray of someone with pseudogout?

A

chondrocalcinosis

18
Q

How would you manage someone with pseudogout?

A
  1. aspiration of joint fluid (rule out septic arthritis)
  2. NSAIDs or intraarticular steroids
19
Q

What is the most common cause of septic arthritis overall/in young people?

A

overall = staph aureus
young peeps = neisseria gonorrhoeae

20
Q

How could test whether hip pain is actually just referred lumbar spine pain?

A

femoral nerve stretch test would be positive (due to femoral nerve compression)

21
Q

Pain over lateral side of thigh in women aged 50-70 might point to which diagnosis?

A

trochanteric bursitis

22
Q

Burning sensation of antero-lateral aspect of thigh would point to which diagnosis?

A

meralgia paraesthetica

23
Q

Which antibodies would you find in someone with SLE?

A

99% are ANA positive
anti-dsDNA more specific

24
Q

What X ray findings would you see in someone with Ankylosing Spondylitis?

A
  • Sacroilitis
  • Subchondral erosions
  • Sclerosis
  • Squaring of lumbar vertebrae
25
Q

What is the management for someone with ankylosing spondylitis?

A
  1. NSAIDs
  2. physio
  3. DMARD (if peripheral joint involvement)
26
Q

Which organism is most often responsible for osteomyelitis?

A

Staph aureus

27
Q

What investigation would you carry out on someone with suspected osteomyelitis?

A

MRI

28
Q

Who should be assessed for osteoporosis?

A

women over 65
men over 75

younger people with
- prev fragility fracture
- low BMI
- high alcohol intake/smoking
- FH of hip fracture
- prolonged steroid use

29
Q

What is FRAX?

A

A scoring system used to estimate probability of fragility fracture in next 10 years

30
Q

What would you do if FRAX score was low/intermediate/high?

A

low - reassure and lifestyle
medium - Order DEXA scan
high - bone protection treatment

31
Q

When would you perform a DEXA scan?

A
  1. before starting treatment that may have a rapid adverse effect on BMD
  2. people <40 with major risk factor
32
Q

What is osteoporosis?

A

Condition where bone gradually decreases in bone mineral density, increasing likelihood of fragility fractures.

33
Q

Where is the most common site of fragility fracture?

A

Spine

34
Q

What is discitis and what is the most common causative organism ?

A

Infection in the intervertebral disc space
- staph aureus

35
Q

What scoring system is used to assess if an ankle injury needs an X-ray?

A

Ottawa ankle rules

36
Q

When should you order an X-ray for an ankle injury?

A

Pain in malleolar zone
AND
1. inability to weight bear for 4 steps
2. tenderness over distal tibia
3. bone tenderness over distal fibula

37
Q

What blood results would you expect to see in osteoporosis?

A
  • Alk Phos normal
  • calcium normal
38
Q

What blood results would you expect to see in someone with a secondary bone tumour?

A
  • raised serum calcium
  • raised Alk Phos

MEDICINE FINALS (19 decks)

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