MSK

Question 1

most common cancers to metastasise to bone? list 10

Answer 1

breast
prostate
lung
colon
rectal
bladder
uterine
gastric
thyroid
kidney

NOT pancreatic or cervical or ovarian

Question 2

Features of ank spondylitis - the As

Answer 2

Ant uveitis
Apical fibrosis
Aortic regurgitation
AV node block
Achilles tendonitis
Amyloidosis

Question 3

3 clinical criterion of ank spon?

Answer 3

Chronic lower back pain improved on exercise and worse at rest
Reduced spinal mobility
Reduce chest expansion

Question 4

IN spinal stenosis:
what is the classical presentation?
what position alleviates the pain?

Answer 4

Neurogenic claudication
- burning pain in both legs on movement
- pain better on leaning forwards

Question 5

Vitamin D deficiency
- how does this affect Ca, Phosphate and PTH

Answer 5

reduced vit D –> less calcitriol–>

low Ca
low phosphate
secondary hyperparathyroidism
raised ALP

Question 6

What is a mortons neuroma? where is it most commonly?

Answer 6

inflammation of interdigital nerve
commonly between 3rd and 4th MT heads

Question 7

Bilateral plantar fasciitis?

Answer 7

consider inflammatory causes eg psoriatic and reactive arthritis

Question 8

What is Freibergs disease?
What population does it tend to affect?

Answer 8

avascular necrosis of metatarsal heads
teenage girls

Question 9

Pathognomic sign for calcaneal fracture?

Answer 9

bruising on sole of the foot tracking distally

Question 10

Ottawa rules for knee xr

Answer 10

• unable to weight bear at time of injury + 4 steps in ED
• > 55yo
• isolated patellar tenderness
• fibular head tenderness
• unable to flex knee to 90 degrees

Question 11

Gamekeepers thumb

Answer 11

thumb’s ulnar collateral ligament tear
from chronic wear and tear

Question 12

Bartons fracture?

Answer 12

INTRAARTICULAR distal radius fracture + radiocarpal dislocation

Question 13

most common part of the clavicle that is fractured?

Answer 13

junction of middle and outer 3rd of clavicle

Question 14

apperance on AP view of anterior shoulder dislocation?

Answer 14

humeral head lies inferior to coracoid process

Question 15

3 hallmark features of back pain indicating an inflammatory arthritis?

Answer 15

insidious onset
worse in the morning, better on exercise

Question 16

Bloods tests to do in first instance if you suspect fibromyalgia?

Answer 16

FBE
ESR
CK
TFTs
rheumatoid factor
autoantibodies

Question 17

commonest site of stress fracture in the foot?

Answer 17

2nd MT

Question 18

flexor digitorum profundus - what movement does this facilitate?

Answer 18

DIP

Question 19

flexor digitorum superficialis - what movement does this facilitate?

Answer 19

PIP

Question 20

which nerve is at risk of damage in anterior shoulder dislocation?

Answer 20

axillary nerve

Question 21

Features of crest syndrome

Answer 21

Calcinosis
Raynauds
Oesophageal dysmotility
Sclerodactyly
Telangiectasia

Question 22

limited vs diffuse systemic sclerosis?

Answer 22

Limited - crest syndrome
Diffuse - solid organ effects:
- pulmonary fibrosis
- glomerulonephritis

Question 23

antibodies in systemic sclerosis?

Answer 23

anticentromere
anti-scl70

Question 24

tennis elbow signs and symptoms

Answer 24

lateral epicondyle pain
worse on supination and extension

Question 25

key examination finding in SUFE?

Answer 25

on passive hip flexion, pt tries to externally rotate the hip also

Question 26

what is anterior cord syndrome
what are the classical symptoms?
what is the most common cause

Answer 26

• affects spinothalamic and corticospinal tract
  –> loss of pain and temperature sensation + motor
• common cause - anterior spinal artery thrombosis

Question 27

When to avoid giving colchicine for gout

Answer 27

renal impairment
taking CYPinhibitor - as colchicine toxicity is baaaaad. eg macrolides, antifungals

Question 28

Maisonneuve fracture

Answer 28

medial malleolus + proximal fibula fracture

Question 29

Mallet finger

Answer 29

damage to extensor tendon of finger

Question 30

U1RNP antibodies

Answer 30

mixed conn tissue disease

Question 31

initial mx of ank spon?

Answer 31

exercise
nsaids