MSK

Question 1

Open fractures Tx

Answer 1

immediate wound debridement and application of external spanning device

definitive surgical fixation delayed until soft tissues have recovered

Question 2

Osteomyelitis most common affected area in children vs adults

Answer 2

children= metaphysis
adults= epiphysis

Question 3

Most common site of metatarsal stress fractures

Answer 3

2nd metatarsal

Question 4

Acromioclavicular joint injury management

Answer 4

Grade 1-2: managed conservatively including resting the joint using a sling.

Grade 4,5,6: surgical

Question 5

iliopsoas abscess

Answer 5

Patient in the supine position with the knee flexed and the hip mildly externally rotated

fever, back pain, limp

Question 6

Galeazzi fracture

Answer 6

dislocation of the distal radioulnar joint with an associated fracture of the radius

Question 7

Monteggia fracture

Answer 7

dislocation of the proximal radioulnar joint in association with an ulnar fracture

Question 8

Compartment syndrome is most commonly associated with

Answer 8

supracondylar and tibial shaft fractures

Question 9

Children and young people with unexplained bone swelling or pain:

Answer 9

consider very urgent direct access X-ray to assess for bone sarcoma

Question 10

osteomyelitis and SCA

Answer 10

salmonella

Question 11

Anterior vs posterior shoulder dislocation association

Answer 11

Anterior= FOOSH
posterior= seizures and electric shock

Question 12

Dupytren’s contracture causes

Answer 12

manual labour
phenytoin treatment
alcoholic liver disease
diabetes mellitus
trauma to the hand

Question 13

Salter Harris - paediatric fractures

Answer 13

SALTR

I: Slipped (either side of the growth plate slipping past each other)
II: Above growth plate
III: Lower than growth plate
IV: Through (fracture through both above and below the growth plate)
V: Rammed (a crush injury)

Question 14

Meralgia paraesthesia RF

Answer 14

Obesity
Pregnancy
Tense ascites
Trauma
iatrogenic -
various sports
idiopathic

Question 15

Fat embolism presentation

Answer 15

Respiratory
Neurological
Petechial rash (tends to occur after the first 2 symptoms)

Question 16

Avascular necrosis of femoral head XR findings:

Answer 16

osteopenia and microfractures may be seen early on

collapse of the articular surface may result in the crescent sign

Question 17

Subluxation of radial head:
signs
Tx

Answer 17

Signs include elbow pain and limited supination and extension of the elbow.

analgesia and passively supination of the elbow joint whilst the elbow is flexed to 90 degrees

Question 18

5th metatarsal fractures often follow

Answer 18

forced inversion of the foot and ankle

Question 19

Acetabular labral tears

Answer 19

hip/groin pain
snapping sensation around hip
there may occasionally be the sensation of locking

Question 20

avascular necrosis RF

Answer 20

long-term steroid use
chemotherapy
alcohol excess
trauma

Question 21

Leriche syndrome

Answer 21

1. Claudication of the buttocks and thighs
2. Atrophy of the musculature of the legs
3. Impotence (due to paralysis of the L1 nerve)

Question 22

Psoas abscess Ix

Answer 22

CT abdomen

Question 23

low back pain initial analgesia

Answer 23

oral NSAIDs

Question 24

L5 radiculopathy

Answer 24

Weakness of hip abduction and foot drop
no specific reflex lost
Sensory loss dorsum of foot
Positive sciatic nerve stretch test

Question 25

S1 radiculopathy

Answer 25

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

Question 26

L4 radiculopathy

Answer 26

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

Question 27

L3 radiculopathy

Answer 27

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

Question 28

dislocated patella

Answer 28

A patella dislocation is a common cause of haemarthrosis and many will spontaneously reduce when the leg is straightened.

Question 29

Posterior hip dislocations presentation

Answer 29

shortened and internally rotated leg

Question 30

Buckle fracture

Answer 30

Incomplete cortical disruption resulting in periosteal haematoma only

Question 31

Greenstick fracture

Answer 31

Unilateral cortical breach only

Question 32

Complications of total hip replacement

Answer 32

perioperative: venous thromboembolism intraoperative fracture nerve injury surgical site infection leg length discrepancy posterior dislocation asceptic loosening of joint (most common cause of revision) prosthetic joint infection

Question 33

femoral nerve injury

Answer 33

Weakness in knee extension, loss of the patella reflex, numbness of the thigh

Question 34

sciatic nerve injury

Answer 34

Weakness in knee flexion and foot movements, pain and numbness from gluteal region to ankle

Question 35

displaced hip fracture Tx

Answer 35

Hemiarthroplasty or total hip replacement

Question 36

A hemiarthroplasty is favoured over a total hip replacement if

Answer 36

frail, with a background of chronic health problems no history of hip osteoarthritis

Question 37

spinal stenosis Ix

Answer 37

MRI

Question 38

lower back pain red flags

Answer 38

age < 20 years or > 50 years history of previous malignancy night pain history of trauma systemically unwell e.g. weight loss, fever

Question 39

clubfoot

Answer 39

Inverted + plantar flexed foot which is not passively correctable.

Question 40

If evidence of neuromuscular compromise (prolonged CRT, paraesthesia, reduced sensation)

Answer 40

immediate reduction / stabilisation instead of XR

Question 41

anterior shoulder dislocation presentation

Answer 41

external rotation and abduction of the upper limb. Axillary nerve palsy can also occur --> weak deltoid muscle and sensory loss over the badge patch area.

Question 42

most common cause of heel pain in adults

Answer 42

plantar fasciitis worse on tip toes

Question 43

The nerve most likely to be injured during knee arthroplasty

Answer 43

common peroneal nerve--> foot drop

Question 44

subtrochanteric vs intertrochanteric fracture Tx

Answer 44

subtrochanteric= intramedullary nail intertrochanteric= dynamic hip screw