MSK

Question 1

First line for oligoarticular JIA

Answer 1

NSAIDs + intra articular steroids

Question 2

JIA

Answer 2

joint inflammation >6/52
most common type oligoarticular

Question 3

Systemic onset JIA

Answer 3

salmon pink rash
intermittent fever
raised inflammatory markers

Question 4

management of polyarticular JIA

Answer 4

first line: NSAID
second: DMARD - methotrexate

5 or more joints affected

Question 5

Dermatomyositis

Answer 5

vasculitis of skin, muscles and internal organs

P/W proximal muscle weakness which can affect swallowing and speech
elevated CK, slightly elevated ESR
neg ANA/ dsDNA

Question 6

psoriatic arthritis

Answer 6

asymmetrical oligoarticular arthritis (<5 joins involved, typically large joints)
nail pitting
can occur with or without rash
dactylitis
FH of PA or psoriasis
F > M affected

Question 7

erbs palsy

Answer 7

C5, C6 root
extended arm adducted at the shoulder, fully flexed wrist

reduced sensation over post and lateral aspect of arm, thumb and index finger (branches of median nerve)

Question 8

Perthes’ disease

Answer 8

Boys 5x > girls
age 4-9
limp and reluctance to weight bear
avascular necrosis of femoral head
xray: flattened femoral head, can be normal at early stages

Question 9

which part of the bone does OM usually start in

Answer 9

Metaphysis

Question 10

what are kinins

Answer 10

proteins that attract phagocytes , promote vasodilation, increase permeability of blood vessels
work to increase migration of WBC

Question 11

DMD

Answer 11

X linked recessive
Dystrophin gene
proximal muscular dysthrophy
gowers sign
develops in all by age 3
raised serum CK
genetic analysis and muscle biopsy