MSK Flashcards
What is the mechanism of a type I hypersensitivity reaction?
Antigen reacts with IgE bound to mast cells
Give 2 examples of a type I hypersensitivity reaction
- Anaphylaxis
- Atopy
What is the mechanism of a type II hypersensitivity reaction?
IgG or IgM binds to antigen on cell surface
Give 3 examples of a type II hypersensitivity reaction
- Autoimmune haemolytic anaemia
- ITP
- Goodpasture’s syndrome
- Pernicious anaemia
- Acute haemolytic transfusion reactions
- Rheumatic fever
- Pemphigus vulgaris / bullous pemphigoid
What is the mechanism of a type III hypersensitivity reaction?
Free antigen and antibody (IgG, IgA) combine
Give 3 examples of a type III hypersensitivity reaction
- Serum sickness
- Systemic lupus erythematosus
- Post-streptococcal glomerulonephritis
- Extrinsic allergic alveolitis (especially acute phase)
What is the mechanism of a type IV hypersensitivity reaction?
T-cell mediated
Give 3 examples of a type IV hypersensitivity reaction
- Tuberculosis / tuberculin skin reaction
- Graft versus host disease
- Allergic contact dermatitis
- Scabies
- Extrinsic allergic alveolitis (especially chronic phase)
- Multiple sclerosis
- Guillain-Barre syndrome
What is the most appropriate management for the following injury:
A 24-year-old man falls sustaining an inversion injury to his ankle. On examination he is tender over the lateral malleolus only. On x-ray there is a fibular fracture that is distal to the syndesmosis.
Application of below knee plaster cast to include the midfoot
What is the most appropriate management for the following injury:
An 86-year-old lady stumbles and falls whilst opening her front door. On examination her ankle is swollen with both medial and lateral tenderness. X rays demonstrate a fibular fracture at the level of the syndesmosis.
Application of below knee plaster cast to include the midfoot
What is the most appropriate management for the following injury:
A 25-year-old man suffers an injury whilst playing rugby involving a violent twist to his left lower leg. On examination both malleoli are tender and the ankle joint is very swollen. On x-ray there is a spiral fracture of the fibula and widening of the ankle mortise.
Surgical fixation
What is the most likely diagnosis:
- Most common primary malignant bone tumour in children
- Commonly affects the metaphyseal region of long bones
- Radiographs classically show Codman triangle (a triangular area of new subperiosteal bone)
Osteosarcoma
Describe the clinical presentation of psoriatic arthritis
- Asymmetrical polyarthritis with >30 minutes of morning stiffness
- Typically affects the hands and feet
- Sacroiliitis
- DIP joint disease and dactylitis
- Psoriatic skin lesions
Name the antibody associated with lung fibrosis in myositis
Anti-Jo1 antibodies
How would you manage a flare of gout in a patient who is already on prophylactic treatment?
Continue allopurinol and commence colchicine
(allopurinol should be continued during an acute attack in patients presenting with an acute flare of gout who are already established on treatment)
What is the most likely diagnosis in a patient presenting with bone pain, tenderness, and proximal myopathy (→ waddling gait)?
Osteomalacia
How long must the symptoms of chronic fatigue syndrome be present before making a diagnosis?
3 months
Name 3 adverse effects of bisphonates
- Oesophageal reactions
- Osteonecrosis of the jaw
- Increased risk of atypical stress fractures
Which patient group are more at risk of osteonecrosis of the jaw when taking bisphonates?
Greater risk for patients receiving IV bisphosphonates in the treatment of cancer
What is the first line treatment for SLE?
Hydroxychloroquine
True/false: creatine kinase levels are elevated in temporal arteritis
False
A 72-year-old man is brought to the Emergency Department after falling at his nursing home. On arrival he complains of pain in the left hip.
What is the diagnosis?
Left subcapital fracture
What patient factors are accounted for in a Z-score (DEXA scan)?
Age, gender, ethnicity
What is the most appropraite management for a non-displaced patella fracture with an entact extensor mechanism (can perform straight leg raise)?
Conservative management with knee immobilisation