Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Finals: Speciality Blocks > MSK > Flashcards

MSK Flashcards

1
Q

How is a diagnosis of medial meniscus confirmed

A

Hyperintense medial meniscus seen on MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

A positive McMurray test suggests what kind of MSK injury

A

Meniscus injury

McMurray tests - manoeuvre of passive external rotation of the patient’s tibia with valgus stress (for medial meniscus) or passive internal rotation of the patient’s tibia with varus stress (for lateral meniscus) while extending the knee. Positive if pain or audible pop/click sound is elicited on performing the manoeuvre.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How does meniscal tears present typically

A

Pain and swelling of the knee, and patients may complain of ‘locking’ or ‘buckling’ of the knee.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Most likely Dx

“dashboard” injury after RTA
Leg internally rotated, slightly flexed and adducted and the patient is not be able to bear weight due to severe pain.

A

Posterior hip dislocation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Most likely Dx

Leg is externally rotated leg, slightly flexed and abducted

A

Anterior hip dislocation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

A positive Lachman test is suggestive of which MSK injury

A

Anterior cruciate ligament (ACL) injury

Lachman test is the passive forward jerking of the proximal lower leg while the knee is flexed around 45 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

A positive anterior drawer test indicates the presence of which kind of injury?

A

Anterior cruciate ligament (ACL) injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which two examination tests can be performed to test for the presence of an anterior cruciate ligament (ACL) injury?

A
  1. Lachman test
  2. Anterior drawer test
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

A positive posterior drawer test indicates the presence of which kind of injury?

A

Posterior cruciate ligament (PCL) injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Pseudogout typically affects which joints?

A

Larger joints such as the knee joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Risk factors for Pseudogout

A

Increasing age
Haemochromatosis
Wilson’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Chondrocalcinosis is an XR feature of which MSK condition

A

Psuedogout
Chondrocalcinosis refers to calcification of the cartilage of the affected joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Lightbulb sign on XR of the shoulder is pathognomonic of which kind of injury?

A

Posterior shoulder dislocation

The lightbulb sign occurs when the head of the humerus is in the same axis as a shaft, producing a shape of a lightbulb on x-ray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

In posterior shoulder dislocation, typically the arm is held in which kind of position?

A

Internal rotation and adduction position

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the typical presentation of a patient with rotator cuff tear

A

Shoulder pain
Functional weakness
Night pain
Pain is aggravated by overhead activities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the definitive management a Bimalleolar fracture

A

Open reduction and internal fixation (ORIF)

Because it is an unstable fracture that requires strong fixation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is a Bimalleolar fracture

A

Fracture of the lateral and medial malleoli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the 4 characteristic features of osteoarthritis on an XR

A

Mnemonic LOSS:

Loss of joint space
Osteophytes
Subchondral cysts
Subarticular sclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the first-line analgesic therapy for knee osteoarthritis

A

Topical NSAID treatment.

Paracetamol is not routinely offered unlike in other osteoarthritis in which it is first line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the first line pharmacological treatment of Raynaud’s phenomenon

A

Calcium channel blockers usually Nifedipine

They act as vasodilators, improving blood flow to the digits
Can reduce both frequency and severity of attacks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which blood test is positive in around 90% of ankylosing spondylitis cases

A

Human Leukocyte Antigen B27 (HLA-B27)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Likely Dx

Inflammatory nature of the back pain (worse in the morning, better with exercise, prolonged morning stiffness) in a young male

A

Ankylosing spondylitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the 5 key diseases in the group of spondyloarthropathies

A

1) Ankylosing spondylitis
2) Reactive arthritis
3) Enteropathic arthritis
4) Psoriatic arthritis
5) Behcet’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Likely Dx:

Back pain with associated leg or buttock pain, often relieved with flexion e.g. leaning forward to sit, and worsened with extension e.g. climbing stairs

A

Spinal stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

CREST (Calcinosis, Raynaud’s phenomenon, oEsophageal dysmotility,
Sclerodactyly, Telangiectasia).

Are features of which rheumatoid condition?

A

Systemic sclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Which antibody is specific for limited cutaneous systemic sclerosis

A

Anti-centromere antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Which antibody is specific for diffuse systemic sclerosis

A

Anti-Scl-70 antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the three extra-articular features associated with ankylosing spondylitis

A

Anterior uveitis (most common)
Aortitis (which can lead to aortic regurgitation)
Apical pulmonary fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

X-Ray features of ankylosing spondylitis

A

Squaring of vertebral bodies
Syndesmophytes (bony bridges between adjacent vertebrae)
Sacroiliitis
Bamboo spine (late stage- complete fusion of the vertebral column)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the most sensitive investigation for sacroiliitis

A

MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the first line medication to manage ankylosing spondylitis

A

NSAIDs + PPI (proton pump inhibitor)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the investigation of choice to assess the size and location of the uterine fibroids

A

Trans-vaginal ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are the 5 Ps for the classic signs of compartment syndrome

A

Pain
Pallor
Paresthesia
Paralysis
Pulseness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Headache and unilateral visual loss in those over 55 years old is what condition until proven otherwise

A

Giant cell arteritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Falls onto his outstretched hand with pain in the anatomical snuffbox is pathognomonic of what condition

A

Scaphoid fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What antibodies are associated with anti-phospholipid syndrome

A

Anti-cardiolipin
Anti-beta2-GPI antibodies
Lupus anticoagulant assay

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Damage to what nerve causes a foot drop

A

Common peroneal nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Name the classification system used to grade intra-capsular fractures of the femoral neck

A

Garden classification - rated based on if complete or uncomplete fracture and how displaced it is

Grade 1 (best) -> 4 (worst)
Grade 1 and 2 fractures are often treated using a dynamic hip screw
Grade 3 and 4 fractures are treated using open reduction and internal fixation or a hip arthroplasty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Distal radial fracture with volar displacement of the distal bones is pathognomonic of what type of fracture

A

Smith fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Distal radial fracture with dorsal displacement of the distal bones is pathognomonic of what type of fracture

A

Colles fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Likely Dx:

Pain bilateral hips
No Hx of falls or trauma
Chronic steroid use
Tenderness and stiffness of the hips

A

Avascular necrosis of the femoral heads

Strongly associated with chronic steroid use

42
Q

What are the 3 characteristic features of Felty’s syndrome

A

Rheumatoid arthritis
Splenomegaly
Neutropenia

43
Q

What is the gold standard investigation to confirm giant cell arteritis

A

Temporal artery biopsy

A negative temporal artery biopsy does not exclude GCA due to the presence of skip lesions

44
Q

cANCA is an antibody specific to what condition

A

Granulomatosis with polyangiitis (formerly known as Wegner’s granulomatosis)

Type of small vessel vasculitis

45
Q

What drug should be co-prescribed with methotrexate

A

Folic acid

46
Q

pANCA is an antibody specific to what condition

A

Eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome)

47
Q

What are the two rheumatological conditions that are ANCA positive

A

Granulomatosis with polyangiitis (formerly known as Wegner’s granulomatosis)

Eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome)

48
Q

Achilles tendonitis is strongly associated with which rheumatoid condition

A

Ankylosing spondylitis

49
Q

Likely Dx:
Malar rash
Photosensitivity
Mucosal ulcers
Alopecia

A

SLE

50
Q

Before starting biologics, what condition do patients have to be screened for

A

Mycobacterium tuberculosis

51
Q

Pain during resisted flexion of the wrist and digits is characteristic of which type of epicondylitis

A

Medial epicondylitis

52
Q

Pain during resisted extension of the wrist and digits is characteristic of which type of epicondylitis

A

Lateral epicondylitis

53
Q

What serum enzymes are raised in polymyositis and dermatomyositis

A

DM and PM turn your muscles into CLAAA (clay)

Creatine kinase
Lactate
Aldolase
ALT
AST

54
Q

What is the classical triad of Sjogren syndrome

A

Dry mucosa (especially eye and mouth)
Fatigue
Joint pain

Schirmer’s test confirms the extent of the patient’s dry eyes

55
Q

What XR finding is characteristic of psoriatic arthropathy

A

Pencil in cup deformity

56
Q

What is the classical triad of Behcet’s disease

A

Recurrent ulcerations (oral and genital)
Uveitis
Erythema nodosum

57
Q

De Quervain’s tenosynovitis refers to inflammation of which two tendons?

A

Abductor pollcis longus tendon
Extensor pollcis brevis tendon

Inflammation at their distal insertion points at the wrist.

Patients experience pain at the base of the thumb which is exacerbated on abduction

58
Q

Pain at night and on both active and passive movement of the shoulder are highly suggestive of what condition?

A

Frozen shoulder

59
Q

What two antibodies are raised in Rheumatoid arthritis

A

Rheumatoid factor

Anti-CCP

60
Q

What does Schirmer’s test test for?

A

Used to test tear production

Useful to determine dry eyes, particularly in Sjogren syndrome

61
Q

Rheumatoid arthritis spares which joints in the fingers?

A

Distal interphalangeal joints (DIP)

RADS - RA DIP sparing

62
Q

What tunnel syndrome is caused by compression of the ulnar nerve and can present with tingling/numbness of the 4th and 5th finger

A

Cubital tunnel syndrome

63
Q

What is most common organism for Septic arthritis

A

Staphylococcus aureus

Septic Arthritis (SA) = Staph Aureus (SA)

64
Q

What is the most common reason total hip replacements need to be revised

A

Aseptic loosening

65
Q

What is the first line pharmacological agent for polymyalgia rheumatica

A

Oral prednisolone

66
Q

Anti-Jo-1 antibody is raised in what condition

A

Polymyositis

jO1 = pOIymyositis

67
Q

Proximal muscle weakness + raised CK + no rash is pathognomonic of what condition

A

Polymyositis

68
Q

What is the inheritance pattern for Marfan’s syndrome

A

Autosomal Dominant

Caused by mutation of Fibrillin-1 mutation on chromosome 15q21
Characterised by loss of elastic tissue, affecting the musculoskeletal, cardiovascular, neurological, respiratory systems, and the skin and eyes.

69
Q

Aspiration results of septic arthritis

A

Yellow in appearance
Raised white cell count ( >10,000/mm3)
High neutrophil count (> 90%)

70
Q

Management of supracondylar fracture of the humerus

A

Admit for neurovascular observation and closed reduction

The neurovascular integrity (particularly the ulner nerve and brachial artery) are at risk so needs to be carefully monitored.

Cast fixation is an option in partially displaced fracture, closed reduction reduces the risk of complications such as ischaemic contracture and malunion. Open reduction with internal fixation is used if the fracture is fully displaced

71
Q

What medication should be given in addition to high dose steroids in giant cell arteritis

A

Bisphosphonate

Usually, bone protection with Calcium, Vitamin D and bisphosphonate are required to prevent glucocorticoid associated bone loss

72
Q

What is the microscopic features of Staph aureus

A

Gram positive cocci in grape-like clusters

73
Q

What lung disorder is very common in

A

Pulmonary fibrosis

Occur in up to 80% of cases

74
Q

Anti-centromere antibodies are associated with what condition?

A

Systemic sclerosis (scleroderma)

75
Q

Anti Mi-2 antibodies are associated with what condition?

A

Dermatomyositis

76
Q

X-ray findings of the hip x-ray:
Inferior and medial translation of the left femoral epiphysis and Klein lines that do not intersect the epiphysis

This describes which condition?

A

Slipped upper femoral epiphysis (SUFE).

Seen commonly in obese adolescent boys

Due to weakening and widening of the physis due to factors like obesity and puberty

77
Q

X-ray findings of the hip x-ray:
Femoral head collapse and fragmentation suggestive of osteonecrosis

This describes which condition?

A

Perthes’ disease

Self-limiting disease of the femoral head comprising of necrosis, collapse, repair and re-modelling

78
Q

HLA-DR4 is strongly associated with which rheumatoid condition?

A

Felty syndrome (variety of RA)

79
Q

Colles fracture of the wrist is described as a fracture of the distal radius with what kind of angulation of the distal fracture fragments?

A

Dorsal

80
Q

dinner fork deformity is a pathognomonic XR feature of what kind of fracture

A

Colles Fracture

81
Q

Smiths fracture of the wrist is described as a fracture of the distal radius with what kind of angulation of the distal fracture fragments?

A

Volar angulation

82
Q

Fall onto a outstretch hand is a common mechanism for which of these fractures:
A) Colles
B) Smiths

A

A) Colles

83
Q

Fall onto a flexed wrist is a common mechanism for which of these fractures:
A) Colles
B) Smiths

A

B) Smiths

84
Q

What is the scoring classification tool used to classify lateral malleolar fractures related to the level of the fracture in relation to the ankle joint, specifically the distal tibiofibular syndesmosis

A

Weber

A->C

Weber A: fracture is below the level of the joint
Weber B: fracture is going through the joint level
Weber C: fracture is above i.e. proximal, to the joint

85
Q

What is the first choice of treatment for eosinophilic granulomatosis with polyangiitis (Churg-Strauss)

A

High dose corticosteroids

See vasculitis choose steroids

86
Q

What is the gold standard investigation for the definitive diagnosis of Osteomyelitis

A

Bone biopsy for pathology and culture

Osteomyelitis refers to infection of the bone (acute or chronic)

87
Q

What is the mainstay of treatment for chronic osteomyelitis

A

Surgical debridement

88
Q

What is the mainstay of treatment for acute osteomyelitis

A

Antibiotics + Surgical debridement

Most commonly IV flucloxacillin (as Staph aureus is most common causative agent)

89
Q

What type of embolism can develop after trauma presenting as shortness of breath, neurological symptoms (e.g. confusion, fatigue) and petechial rash

A

Fat embolism

90
Q

How is fat embolism (a complication of trauma surgery) managed

A

Conservatively with supportive measures

91
Q

The Ottawa ankle rules are a decision aid for use in the assessment of acute ankle injuries and the need for radiological imaging.

What are the 3 requirements for x-ray if there is malleolar pain

A

Ankle x-ray is required if any of the following are present:
- Bone tenderness at the posterior edge or tip of the lateral malleolus
- Bone tenderness at the posterior edge or tip of the medial malleolus
- Inability to bear weight both immediately and in emergency department for four steps.

92
Q

The Ottawa ankle rules are a decision aid for use in the assessment of acute ankle injuries and the need for radiological imaging.

What are the 3 requirements for x-ray if there is midfoot pain

A

Foot x-ray is required if any of the following are present:
- Bone tenderness at base of the fifth metatarsal
- Bone tenderness at navicular bone.
- Inability to bear weight both immediately and in emergency department for four steps.

93
Q

What are the XR features of gout

A

Normal joint space
Soft tissue swelling
Periarticular erosions

94
Q

First-line treatment for mild to moderate osteoarthritis

A

Paracetamol +/- topical NSAIDS (not oral, which is second line)

95
Q

What is the gold standard investigation for diagnosing calcaneal fractures

A

CT

96
Q

Likely Dx:

Hx of childhood fractures
Blue sclera
Dental abnormalities
Hearing defects

A

Osteogenesis imperfecta

Defect of type 1 collagen synthesis (Type I collagen is for bONE)

97
Q

What is a clay-shoveller fracture

A

Fracture of the spinous process and not the vertebral body

XR Feature:
An oblique lucency through the level of the spinous process seen on the lateral view

Associated with trauma such as injury from a road-traffic accident or a direct blow to the spine

98
Q

CREST syndrome is for what type of cutaneous systemic sclerosis:

A) Limited

B) Diffuse

A

A) Limited cutaneous systemic sclerosis

99
Q

Anti-double stranded DNA (dsDNA) autoantibodies are associated with what condition

A

SLE

dsDNA are a subgroup of anti-nuclear antibody (ANA)

100
Q

What joint is most likely the joint first affected by gout

A

Great toe metatarsalphalangeal joint

Finals: Speciality Blocks (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions