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MSK Flashcards

1
Q

What are the Ottawa rules?

A

Bony tenderness at the posterior tip of the mallelous
Unable to weight bear at time of injury AND when seen

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2
Q

What is osteomalacia?

A

Chronic low vit D in adults. Causes bony pain/ tenderness/ muscle weakness.

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3
Q

First line treatment of acute gout?

A

NSAIDS (or Colchicine)

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4
Q

What is the inheritance of Elhers Danos syndrome and what are the features?

A

Autosomal dominant
Hyperelastic skin and atrophic scars

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5
Q

Anti centromere is a/w?

A

Sclerosis

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6
Q

Drug induced lupus is caused by which drugs?

A

Chlorpromazine, Minocycline, Methyldopa, Hydralazine, Isoniazid, D-penicillamine.

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7
Q

What are some complications of Paget’s?

A

High output cardiac failure, deafness, bone sarcoma, skull thickening.

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8
Q

Calcium/ ALP/ Phosphate. What happens in Pagets/ Oestemalacia/ Osteoporosis?

A

Osteoporosis- normal bloods
Pagets- Raised ALP - (isolated)
Osteomalacia- Raised ALP. Low calcium/ low phosphate

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9
Q

What drug is used after initial therapy for Lupus?

A

Hydroxychloroquinine

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10
Q

What monitoring is required for hydroxychloroqunine?

A

Yearly eye check

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11
Q

What is the normal range for calcium (corrected)

A

2.2-2.7

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12
Q

What are the blood results for Osteomalacia and how does it present?
Treatment

A

Raised ALP
LOW calcium

Presents with bony pain/ potential for fractures (femoral)
Tx: high dose vitamin D

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13
Q

Median nerve supplies?

A

Thumb and first 2 fingers

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14
Q

Simmonds test - tests for?

A

Achilles tendon rupture.

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15
Q

What is Feltys syndrome?

A

RA/ Neutropenia/ Splenomegaly

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16
Q

What is Caplands syndrome?

A

RA and pulmonary fibrosis in coal miners

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17
Q

P-ANCA is positive in x2

A

Both small vessel vasculitis
1. Churg Strauss (EGPA)
2. Microscopic Polyangitis (MPA)

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18
Q

C- ANCA is positive in?

A

Wegners
Granulomatosis with polyangitis

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19
Q

How does eosinophilic granulomatosis with polyangiitis present? Classic triad
‘Churg Strauss’

A

Asthma
Vasculitis
Eosinophilia

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20
Q

What are the features of Polyarteritis Nodosa?

A

Aneurysm formation
Associated with Hep B
Constitutional symptoms/ Rash/ Renal failure

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21
Q

What is Galeazzis Test

A

Used to test for DDH when >3-4 months old.
Knees are a different height.

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22
Q

What is the most common bone tumour?

A

Osteosarcoma

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23
Q

How does Ewings Sarcoma present and what are the Xray findings?

A

Lots of pain
Long bones and pelvis
Children and adolescents
Xray- onion skin appearance.
(Small round blue tumour)

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24
Q

Wrist drop = palsy of which nerve?

A

Radial nerve palsy.
Associated with sensory loss over back of hand

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25
Q

High stepping gait indicates?

A

Foot drop
Foot drop= common peroneal nerve injury

26
Q

What does McMurrays test for?

A

Test for meniscal tears/ injuries

27
Q

Classical Perthes presentation?

A

PAIN
Boys aged 4-8
Progressivley painful limp over a couple of weeks

28
Q

What are the examination findings in SUFE?

A

Loss of internal rotation

29
Q

Colles vs Smiths fracture?

A

Colles= classic= FOOSH. Distal radius displaced dorsally

Smiths= falling on back of hand. Distal radius goes anterior.

30
Q

What is Potts disease?

A

TB of the spine and causes angular kyphosis. Treatment with TB medications.

31
Q

What is the presentation with a rotator cuff injury? AKA SUPRASPINATUS TENDONITIS

A

Painful arc of abduction.

32
Q

What is the examination findings for adhesive capsulitis?

A

Loss of external rotation.

33
Q

How to grade muscle power MRC rating 0-5

A

5= Normal power
4= Resistance
3= Gravity
2= Some active movement
1= Flicker of contraction
0= Nothing

33
Q

Shoulder dislocation
- What type is the most common and what is the presentation?
- Complications?

A

Anterior shoulder dislocation is the most common
Presents with the arm externally rotated

Complications include damage to axillary nerve. Regimental patch- sensory loss. AND weakness of deltoid muscle.

34
Q

What is the T value to diagnose osteoporosis?

A

Less than -2.5

35
Q

What do these antibodies indicate?
AMA
ANA
Anticentromere
Anti Ro, Anti LA

A

AMA = PBC
ANA= SLE
Anticentromere= CREST
Anti Ro/ Anti La= Sjogrens

36
Q

Boxers fracture is the most common type of fracture of which bone?

A

Most common metacarpal fracture

37
Q

Bartons fracture is a fracture where?

A

Distal radius but intra-articular (as opposed to Smiths or Colles)

38
Q

What investigations form part of the secondary survey in Trauma ?

A

CXR
Pelvic XR
Lateral Spine

39
Q

What are the associations with adhesive capsulitis? what people at risk?

A

Middle age females
Diabetics!!

Passive and active range of movement

40
Q

How does a Gastronemius muscle tear present?

A

Pop after sudden push off

41
Q

How may a patellar fracture present?

A

Compressive blow
In displaced transverse fractures= inability to straight leg raise.
Swelling

42
Q
A
42
Q

Tibial plateau fracture presents how?

A

Bumper fracture
Car into lateral side of knee
Swollen and deformed

43
Q

CREST syndrome is a/w which condition and which antibody?

A

Limited cutaneous systemic sclerosis
ANTI-CENTROMERE!

44
Q

How do stress fractures present?

A

Repetitive injury

45
Q

How would a supracondylar fracture present?

A

FOSH in children
Check for neurovascualar compromise!

46
Q

What are the Ottawa KNEE rules ?

A

Age > 55, Tenderness over patella, Tenderness at head of fibula, Inability to flex to 90 degrees

47
Q

What is the acute management of Gout?

A

NSAIDS! Naproxen!
Colchicine (main side effect is diarrhoea)

48
Q

Anticentromere antibody is a/w which disease?

A

Limited cutaneous systemic sclerosis

49
Q

What blood test is the most SPECIFIC to RA?

A

Anti CCP

50
Q

Regimental patch is supplied by which nerve and how could it be damaged?

A

Axillary nerve- damaged by dislocation of shoulder OR humeral fracture.

51
Q

Shoulder dislocation- what are some facts?

A

Fall on outstretched hand
Most common is ANTERIOR
Assess for axillary nerve damage- regimental patch
Presentation- elbow is flexed, arm in abduction

52
Q

Traumatic rotator cuff tear- presentation and management?

A

Trauma- eg traction injury/ shoulder is forcibly stretched
DROP ARM TEST! Pt cannot hold their arm up.
Management- needs referral to ortho.

53
Q

Patella dislocation- presents how?

A

Dislocation laterally
Twisting injury
Patella is displaced laterally
Knee is held in flexion

54
Q

McMurreys Test is used for?

A

To test for mensical TEARS

55
Q

What are the 2 risk scores for osteporosis fracture risk and when can they be used?

A

QFracture aged 30-84
FRAX - aged 40-90

56
Q

Drug induced lupus- what are the 2 common drugs?

A

procainamide
hydralazine

57
Q

What sign is pathognomonic of sarcoidosis?

A

lupus pernio- blue rash on tip of nose is characteristic of sarcoidosis

58
Q
A

MSRA- my cards (15 decks)

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