MSK

Question 1

sulfasalazine
tx?
side effects?
monitoring?

Answer 1

IBD
RA + psoriatic arthritis
revesible male infertility
mouth ulcers, depression
bloods for hepatits and agranulocytosis

Question 2

vit D def
- adults
- children

Answer 2

adult - osteomalacia
child - rickets

Question 3

felty syndrome

Answer 3

RA, splenomegaly and neutropenia
complication of RA

Question 4

sjogrens

Answer 4

dry eyes and mouth +/- arthritis
anti ro + anti la
tx = tears and fluids
anti row = dry
anti la - llalala dry mouth

Question 5

antiphospholipid syndrome

Answer 5

ab?
anticardioplipin
VTE risk ++ and miscarriages

Question 6

diffiuse systemic sclerosis
ab

Answer 6

anti-scler
- skin changes affect whole body
- affect internal organs
- weight loss, fatigue, joint pain and stiffness

Question 7

LIMITed systemic sclerosis
aka
syx

Answer 7

CREST syndrome
anti-centromere
begin reynauds then develop
calcinosis
raynauds
esophageal dysmotility
sclerodactyly
telangectasia

Question 8

3 types systemic sclerosis

Answer 8

diffuse (Trunk, proximal limbs and often lungs ILD
limited (CREST)
scleroderma. (without internal organ)

Question 9

Ankylosis spodylitis
criteria?

Answer 9

modified new york criteria
- need radiological evidence of sacroiliitus
- lower back pain for 3+months relieved by exercise
- limitation spine movement
- limited chest expansion for age

Question 10

drug induced lupus

Answer 10

chlorpormazine
methydopa
hydralazine
isoniazid
d-penicillimine
myoclyline

Question 11

bone profile in…
(ALP, Calcium, Phosphate)
1) osteomalacia

2) osteoporosis

3) paegets

Answer 11

softened and fragile bones
low Calcium, raised ALP, low Phosphate

normal calcium, ALP + phosphate

normal Calcium, raised ALP, normal Phosphate

Question 12

post gout investigation?

Answer 12

blood test (Hba1c, renal + lipid)
serum urice acid +
BP

Question 13

SLE
systemic lupus erythematosus
tx?

Answer 13

1st line low dose steroids or nsaids
2nd line hydroxychorloquinine
= needs yearly eye tests

Question 14

achilles tendon rupture
good bedside test?

Answer 14

simmonds test
squeeze calf patient lying down and NO plantar flexion if ruptured

Question 15

beighton score

Answer 15

assess hypermobility

Question 16

caplan syndrome

Answer 16

pulmonary fibrosis cavitating lesions in patients with both coal / asbestos exposure AND Rheumatoid A

Question 17

Eosinophilic Granulomatosis with polyangitis
aka
triad
antibodies?

Answer 17

churg straus
asthma + worsening allergies
vasculitis (GI bleed, abdo pain, renal damage)
eosionophillia
PANCA

Question 18

GOUT

PSEUDOGOUT

Answer 18

NEGSTIVELY birofringent NEEDLE SHAPED crystals

RHOMBOID POSITIVELY BIROFRINGENT crystals
chondrocalcinosis

Question 19

barlow - age?
ortalleni
galezzi

Answer 19

barlow + ortalleni under 2 months
ortalleni OUT barlow back
galezzi 3 month + age
flexed knee one shorter

Question 20

perthes disease
age

Answer 20

ischaemia and necrosis femoral head
age 4-8, mostly boys

Question 21

slipper uper femoral epiphysis
age

Answer 21

10-14

Question 22

colles

smiths

Answer 22

DISTAL radius = posterior (foosh)

distal radius = anteriorally (fall back of hand)

Question 23

potts disease

Answer 23

TB of spine

Question 24

Ewing’s sarcoma x ray

Answer 24

‘onion skin’ appearance on x-ray.

Question 25

osteosarcoma,

Answer 25

this is the most common primary malignant bone tumour in children and adolescents
sunburst appearance

Question 26

chondrocalcinosis

Answer 26

pseudogout - deposition of calcium pyrophosphate dihydrate crystals in the synovium.
joint aspiration: weakly-positively birefringent rhomboid-shaped crystals

Question 27

cubital tunnel

Answer 27

cUbital Ulnar

Question 28

gout tx

Answer 28

when post gout attack eg 2 weeks post, start allopurinlol 100mg
++ NSAID cover / colchine cover

Question 29

treat acute flare RA?

Answer 29

IM / PO methyl pred