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msk Flashcards

1
Q

features of L3 nerve root compression

A

Sensory loss over anterior thigh
Weak hip flexion, knee extension and hip adduction
Reduced knee reflex
Positive femoral stretch test

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2
Q

features of L4 nerve root compression

A

Sensory loss anterior aspect of knee and medial malleolus
Weak knee extension and hip adduction
Reduced knee reflex
Positive femoral stretch test

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3
Q

features of L5 nerve root compression

A

Sensory loss dorsum of foot
Weakness in foot and big toe dorsiflexion
Reflexes intact
Positive sciatic nerve stretch test

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4
Q

features of S1 nerve root compression

A

Sensory loss posterolateral aspect of leg and lateral aspect of foot
Weakness in plantar flexion of foot
Reduced ankle reflex
Positive sciatic nerve stretch test

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5
Q

drug induced lupus:
1. most common causes (2)
2. less common causes (3)

A
  1. procainamide (used to treat SVT)
    hydralazine

2.isoniazid
minocycline (a tetreacycline)
phenytoin

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6
Q

clinical features of drug induced lupus (4)

A

arthralgia
myalgia
skin (malar rash)
pulmonary involvement (e.g. pleurisy)

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7
Q

drug induced lupus antibodies:

A

ANA +ve in 100% (dsDNA -ve)
anti-histone antibodies are found in 80-90%
anti-Ro, anti-Smith positive in around 5%

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8
Q

RA poor prognostic features (7)

A

rheumatoid factor positive
anti-CCP antibodies
poor functional status at presentation
X-ray: early erosions (e.g. after < 2 years)
extra articular features e.g. nodules
HLA DR4
insidious onset

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9
Q

azathioprine

  1. test prior to starting
  2. adverse effects (4)
  3. drug interaction (1)
  4. is it pregnancy safe?
A
  1. TPMT (thiopurine methyltransferase)
  2. bone marrow supression (do FBC if pt develops infection/ bleeding)
    nausa & vomiting
    pancreatitits
    non-melanoma skin cancer
  3. allopurinol (use lower dose)
  4. yes
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10
Q

hip #mgt - intracapsular
i. undisplaced
ii. displaced

A

i. internal fixation or hemiarthoplasty if fit

ii. THR

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11
Q

hip #mgt - extracapsular

A

DHS (if stable intra-trochaneteric #)

im nail if oblique/ transverse/ subtrochanteric

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12
Q

nerve affected by meralgia paraesthetica

A

lateral cutaneous n. of thigh

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13
Q

osteomalacia bloods findings

i. calcium
ii. phosphate
iii. ALP
iv. PTH

A

i. calcium - low
ii. phosphate - low
iii. ALP - high
iv. PTH - high

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14
Q

primary hyperparathyroidism blood results:

i. calcium
ii. phosphate
iii. ALP
iv. PTH

A

i. calcium - high
ii. phosphate - low
iii. ALP - high
iv. PTH - high

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15
Q

CKD (secondary hyperparathyroidism) blood results:

i. calcium
ii. phosphate
iii. ALP
iv. PTH

A

i. calcium - low
ii. phosphate - high
iii. ALP - high
iv. PTH - high

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16
Q

antiphospholipid syndrome features: (3)

A
  • venous/arterial thrombosis
  • recurrent miscarriages
  • livedo reticularis

other features: pre-eclampsia, pulmonary hypertension

17
Q

antiphospholipid syndrome

i. antibodies (3)

ii. blood tests

A

i. anticardiolipin antibodies
anti-beta2 glycoprotein I (anti-beta2GPI) antibodies
lupus anticoagulant

ii. FBC - thrombocytopenia
clotting - prolonged APTT

18
Q

hydroxychloroquine

i. key adverse effect

ii. is it pregnancy safe?

A

i. bull’s eye retinopathy (can also get corneal deposits)

ii. yes

19
Q

reactive arthritis skin features (2) :

A

circinate balanitis (painless vesicles on the coronal margin of the prepuce)

keratoderma blenorrhagica (waxy yellow/brown papules on palms and soles)

20
Q

osteomyelitis:

  1. most common causative organism
  2. most common causative organism in sickle cell
A
  1. s. aureus
  2. non-typhi salmonella
21
Q

methotrexate SE (3)

A

Myelosuppression
Liver cirrhosis
Pneumonitis

22
Q

sulfasalazine SE (4)

A

Rashes
Oligospermia
Heinz body anaemia
Interstitial lung disease

23
Q

sulfasalazine cautions: (2)

pregnancy safe?

A

G6PD deficiency
aspirin/ sulphonamide allergy (cross sensitivity)

is pregnancy safe

24
Q

Leflunomide SE (3)

A

Liver impairment
Interstitial lung disease
Hypertension

25
Q

gold SE (1)

A

proteinuria

26
Q

penicillamine SE (2)

A

proteinuria
exacerbation of myaesthenia gravis

27
Q

entanercept SE (2)

A

demyelination
reactivation of TB

28
Q

infliximab and adalimumab SE

A

reactivation of TB

29
Q

drug causes of gout (5)

A

diuretics –> thiazides & furosemide
ciclosporin
alcohol
cytotoxic agents
pyrazinamide
aspirin

30
Q

ankylosing spondylitis examination features:

A

reduced:
- lateral flexion
- forwards flexion (Schober’s test)
- chest expansion

31
Q

ankylosing spondylitis other features “A” (8)

A

Apical fibrosis
Anterior uveitis
Aortic regurgitation
Achilles tendonitis
AV node block
Amyloidosis
cAuda equina syndrome
peripheral Arthritis (25%, more common if female)

32
Q

RA x-ray features: (5)

A

loss of joint space
juxta-articular osteoporosis
soft-tissue swelling
periarticular erosions
subluxation

MSRA (14 decks)

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