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Year 2 > MSK > Flashcards

MSK Flashcards

1
Q

Which is more common? Malignant primary bone tumours or metastatic cancer affecting the bone?

A

metastatic cancer affecting bone

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2
Q

What is the commonest benign bone tumour and what are its characteristics?

A

Osteochondroma- produces a bony outgrowth on the external surface with a cartilaginous cap

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3
Q

True or false: an Osteochondroma is always benign?

A

False- there is a small risk of malignant transformation

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4
Q

What causes an Enchondroma?

A

failure of the normal enchondral ossification at the growth plate causing a metaphyseal cartilaginous tumour.

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5
Q

Where do enchondromas usually occur?

A

Femur, humerus, tibia and small bones of the hands and feet.

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6
Q

What is a simple bone cyst?

A

a single cavity benign fluid filled cyst in a bone.

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7
Q

What is the difference between aneurysmal bone cysts and simple bone cysts?

A

Simple bone cysts are just fluid filled sacs on the bone but aneurysmal bone cysts contain chambers that are filled with blood or serum.

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8
Q

Where to Giant cell tumours occur?

A

around the knee and in the distal radius but can also occur in the long bones, pelvis and the spine.

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9
Q

What is the appearance of giant cell tumours on x-ray?

A

soap bubble appearance

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10
Q

If giant cell tumours were to metastasise, where are they most likely to?

A

lung

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11
Q

What is the treatment for a giant cell tumour?

A

intralesional excision with use of phenol, bone cement or liquid nitrogen to destroy remaining tumour material.

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12
Q

What is fibrous dysplasia?

A

disease of the bone usually occuring in adolescence where a genetic mutation results in lesions of fibrous tissue and immature bone. The affected bone is wider with thinned cortices.

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13
Q

When would a shepards crook deformity occur?

A

When there is extensive involvement with the proximal femur in fibrous dysplasia.

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14
Q

What is the treatment for fibrous dysplasia?

A

bisphosphonates may reduce pain and pathologic fractures should be stabilised with internal fixation and cortical bone graphs used to improve strength.

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15
Q

Are giant cell tumours benign or malignant?

A

benign

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16
Q

What is an osteoid osteoma?

A

a small nidus of immature bone surrounded by a sclerotic halo. They are characterised by intense constant pain worse at night due to the inflammatory response.

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17
Q

What is the treatment for an osteoid osteoma?

A

NSAIDs help with the inflammatory process. The lesion may resolve spontaneously over time but some cases need CT guided radiofrequency ablation.

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18
Q

What are the benign one tumours?

A

Osteochondroma, enchondroma, giant cell tumour, fibrous dysplasia, osteoid osteoma, simple bone cyst & aneurysmal bone cyst.

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19
Q

What are the cancers most likely to metastasise to bone?

A 
Breast
Bronchus (lung)
prostate
thyroid
kidneys
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20
Q

What age groups are most commonly affected from metastatic bone tumours?

A

people under 20 and over 60.

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21
Q

What might be seen on x-ray in metastatic bone cancer?

A

cortical destruction, a periosteal reaction (raised periosteum producing bone), new bone formation and extension into the surrounding soft tissue envelope.

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22
Q

What is the most common form of primary bone tumour?

A

Osteosarcoma

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23
Q

Where do osteosarcomas usually present?

A

Around the knee, proximal femur, proximal humerus and pelvis.

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24
Q

What is the treatment for osteosarcomas?

A

they are not radiosensitive but adjuvant chemotherapy can prolong survival.

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25
Q

What is a chondrosarcoma?

A

A cartilage producing primary bone tumour and is less common and less aggressive than osteosarcoma.

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26
Q

Do chondrosarcomas metastasise?

A

yes

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27
Q

Where are chondrosarcomas usually found?

A

the pelvis or proximal femur.

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28
Q

What is a fibrosarcoma?

A

fibrous malignant primary bone tumours which tend to occur in abnormal bone e.g. fibrous dysplasia, post irradiation, Pagets disease.

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29
Q

What is Ewings Sarcoma?

A

malignant tumour of primitive cells in the marrow. it is the second most prevalent primary bone tumour.

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30
Q

How does Ewings Sarcoma present?

A

fever, raised inflammatory markers and a warm swelling- it may be misdiagnosed as osteomyelitis.

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31
Q

Which malignant bone tumour has the worst prognosis?

A

Ewings sarcoma

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32
Q

What is the treatment of primary bone tumours?

A

tends to involve surgery to remove the tumour and surrounding tissue to reduce the risk of recurrence. Adjuvant chemotherapy and radiotherapy are used if appropriate.

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33
Q

What is a lymphoma?

A

a cancer of round cells of the lymphocytic system. it can occur as a primary bone tumour (non-Hogekins) from the marrow or lymphoma and can metastasise to bone.

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34
Q

What is polymyalgia rheumatica?

A

inflammatory condition causing myalgia at the hip and shoulder girdles

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35
Q

Who does polymyalgia tend to affect?

A

women over 50

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36
Q

What would blood tests show?

A

Raised CRP/ESR/PV

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37
Q

What other condition is polymyalgia rheumatica related to?

A

Giant cell arteritis

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38
Q

What is the treatment for polymyalgia rheumatica?

A

15mg of prednisolone reduced over 18 months

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39
Q

What is the commonest form of systemic vasculitis?

A

Giant cell arteritis

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40
Q

What are the symptoms of GCA?

A

visual disturbances, headaches, jaw claudication, scalp tenderness, fatigue

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41
Q

What is the disease process in GCA?

A

transmural inflammation of the intima, media and adventitia. patchy infiltration of lymphocytes, macrophages and granulomas with vessel wall thickening leading to ischaemia.

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42
Q

What investigations would be done for GCA?

A

temporal artery biopsy & bloods (raised ESR/CRP/PV)

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43
Q

What is the treatment of GCA?

A

if visual impairment: 60mg of prednisolone, if no visual impairment: 40mg of prednisolone.

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44
Q

What is polymyositis?

A

idiopathic inflammatior myopathy that causes symmetrical proximal muscle weakness

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45
Q

What is the difference between polymyalgia rheumatica and polymyositis?

A

PR- muscle stiffness but no weakness.

Polymyositis: muscle weakness

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46
Q

What is the pathogenesis of polymyositis?

A

CD8 T cells and macrophages surround healthy tissue and initiate a cytotoxic response

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47
Q

What are the symptoms of polymyositis?

A

symmetrical proximal muscle weakness in the upper and lower limbs, myalgia, insidious onset, dysphagia, fever, weight loss, raynaud’s, polyarthritis, SOB, cough

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48
Q

What investigations would be done for polymyositis?

A

inflammatory markers, serum CK (often raised x10), auto-antibodies, muscle biopsy (shoes different stages of inflammation, necrosis and regeneration)

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49
Q

What antibodies are seen in polymyositis?

A

ANA, Anti-Jo-1 and Anti-SRP

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50
Q

What is the treatment for polymyositis?

A

40mg prednisolone or immunosuppressive drugs such as azathioprine or methotrexate

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51
Q

What is dermatomyositis?

A

similar to polymyositis with cutaneous manifestations

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52
Q

What are the symptoms of dermatomyositis?

A

V shaped rash over chest, gottrons papules (purple colouring over the skin over the MCP and PIP joints), heliotrope rash and myalgia/muscle weakness

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53
Q

Is there a risk of malignancy in those with dermatomyositis?

A 
Yes- found in 25% 5 years after diagnosis. increased risk of:
breast
ovarian
lung
colon
oesophageal
bladder
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54
Q

What is fibromyalgia?

A

muscle condition causing widespread muscle pain and fatigue

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55
Q

Who commonly suffers from fibromyalgia?

A

young and middle aged females

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56
Q

What are the symptoms of fibromyalgia?

A

persistent widespread pain >3months on both sides of the body, above and below the waist including the axial skeleton, anxiety, depression, IBS, migraines

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57
Q

What is the treatment for fibromyalgia?

A

education, analgesia

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58
Q

What are the symptoms of SLE?

A

weight loss, fever, fatigue, arthralgia, myalgia, inflammatory arthritis, avascular necrosis, malar rash, photosensitivity, discoid lupus, oral/nasal ulceration, raynauds, alopecia

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59
Q

What auto-antibody is most specific to SLE?

A

Anti-dsDNA

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60
Q

What are complement levels like when disease is active in SLE?

A

Complement levels (C3/C4) are low

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61
Q

What investigations can be done to look for organ involvement in SLE?

A

urinalysis, CT chest, MRI, echo

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62
Q

What is the treatment for SLE?

A

skin disease and arthralgia: Hydroxychloroquine, topical steroids, NSAIDs
inflammatory arthritis: azathioprine, corticosteroids
Severe organ involvement: cyclophosphamide & IV steroids

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63
Q

What is Sjogrens?

A

autoimmune condition characterised by lymphocyte infiltrates in exocrine organs

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64
Q

What are the symptoms of Sjogrens?

A

ocular dryness, mouth dryness, arthralgia, fatigue, vaginal dryness and parotid gland swelling

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65
Q

How is Sjogrens Diagnosed?

A

Ocular dryness via Schirmers test, antibodies.

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66
Q

What auto-antibodies are positive for Sjogrens?

A

Anti-Ro and Anti-La

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67
Q

What is the treatment for Sjogrens?

A

Lubricating eye drops, pilocarpine, hydroxychloroquine and immunosuppression

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68
Q

What is Pilocarpine?

A

it is a medication used to treat increased pressure in the eye and dry mouth.

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69
Q

What are the characteristics of systemic sclerosis?

A

Raynaud’s, fibrosis and atrophy of the skin, excessive collage deposition can cause skin and internal organ changes

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70
Q

What does limited systemic sclerosis involve?

A

skin involvement generally limited to face, hands and forearms. Organ involvment occurs later

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71
Q

What is the antibody present in limited systemic sclerosis?

A

anti-centromere antibody

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72
Q

What does diffuse systemic sclerosis involve?

A

skin changes come rapidly and tend to affect more areas including the trunk and arms. Significant early organ involvement.

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73
Q

What is the antibody present in diffuse systemic sclerosis?

A

Anti-Scl-70

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74
Q

What is the treatment for Raynauds?

A

calcium channel blockers, iloprost, bosentan and sildenophil

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75
Q

What is the antibody present in Mixed connective tissue disease?

A

Anti-RNP

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76
Q

What are the characteristics of Anti-phospholipid syndrome?

A

Recurrent venous or arterial thrombosis and fetal loss (after 10 weeks)

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77
Q

What are the complications of anti-phospholipid syndrome?

A

increased frequency of stroke and MI, pulmonary hypertension, organ failure, livedo reticularis

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78
Q

Which antibody is present in anti-phospholipid syndrome?

A

Anti-Cardiolipin

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79
Q

What is the treatment for anti-phospholipid syndrome?

A

Warfarin or LMWH for during pregnancy

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80
Q

What are the vessel changes that occur in vasculitis?

A

vessel wall thickening, vessel stenosis and occlusion of vessels with subsequent infarction

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81
Q

What are the 2 types of large vessel vasculitis?

A

GCA and Takayasu arteritis

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82
Q

What are the arteries affected in Takayasu arteritis?

A

Arteries off the branch of the aorta

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83
Q

What is the treatment for large cell arteritis?

A

40-60mg of prednisolone which is gradually reduced

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84
Q

What are the types of medium vessel vasculitis?

A

Kawasaki disease, polyarteritis nodosa and Buergers disease

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85
Q

What are the symptoms of Kawasaki disease?

A

conjunctivitis, rash over the body, adenopathy, strawberry tongue, hands and feet swelling

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86
Q

Which vasculitis can be seen on angiogram as a string of beads?

A

Polyarteritis nodosa

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87
Q

What are the types of small vessel vasculitis?

A

GPA, EGPA, MPA, HSP

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88
Q

What are the antibodies for Granulomatosis with polyangiitis?

A

cANCA +ve and anti-PR3

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89
Q

Where does GPA affect?

A

nasopharynx, lungs and kidneys causing sinusitis, bloody mucous, saddle nose deformities and difficulty breathing

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90
Q

What vasculitis causes saddle nose deformities?

A

GPA

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91
Q

What does microscopic polyangiitis cause?

A

glomerulonephritis

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92
Q

What are the antibodies present in MPA?

A

pANCA +ve

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93
Q

What antibodies are present in EGPA?

A

Anti-MPO and anti-PR3

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94
Q

How does Henloch schonlein purpura present?

A

with palpable purpura which is like little bruises due to fibrosis occuring in the affected vessel over the buttocks and lower legs. Also presents with abdo pain, vomiting and joint pain

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95
Q

Which forms of vasculitis are ANCA positive and how are they treated?

A

MPA and GPA which can be treated with IV steroids and cyclophosphamide

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96
Q

What is the disease mechanism in Henloch Schonlein purpura?

A

IgA targets endothelial cells via molecular mimicry

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97
Q

How does alcohol and steroid use cause avascular necrosis?

A

they alter fat metabolism causing mobilisation of fat in the circulation, capillary system sruggles to maintain normal flow. this promotes coagulation in prone areas of blood. increased fat content also compresses venous outflow causing stasis and ischaemia

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98
Q

Where are common sites for avascular necrosis/

A

femoral head, scaphoid bone, femoral condyles, head of humerus, capitellum, proximal part of tallus

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99
Q

Is there pain associated with AVN?

A

there is constant pain or when weight bearing

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100
Q

How does AVN look on imaging?

A

large wedge shaped area of discolouration & trabeculae without osteophytes in the lacunae.

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101
Q

what is the treatment of AVN?

A

if the articular surface has not collapsed then drilling under fluoroscopy to decompress the bone. if articular surface has collapsed then joint replacement or fusion is considered in the wrist or ankle bones

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102
Q

What is osteochondritis?

A

inflammation of bone and cartilage

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103
Q

Who does osteochondritis usually affect and why?

A

tends to affect children and young adults due to increased physical activity and increased body weight.

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104
Q

What is traction osteochondritis at the tibial tubercle also called?

A

Osgood Schlatters disease

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105
Q

What is osteochondritis dissecans?

A

Fragmentation with separation of bone and cartilage within a joint.

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106
Q

What is the treatment of osteochondritis?

A

damaged bone is replaced with osteotomy, large or unstable fragments of bone are pinned for repair and small fragments are removed arthroscopically

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107
Q

What is a giant cell tumour?

A

it is a firm small swelling arising from a synovial tendon sheath or joint

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108
Q

what do giant cell tumours look like?

A

pigmented multinucleated giant cells which have haemosiderin giving them a brown appearance

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109
Q

What is a pigmented villonodular synovitis?

A

giant cell tumour of tendon sheath occurring in the knee joint

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110
Q

What is a rhabdomyosarcoma?

A

malignant tumour of skeletal muscle

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111
Q

Where does a synovial sarcoma usually manifest?

A

around the knee

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112
Q

What is a ganglion cyst?

A

herniation of synovial fluid at a weak point in the joint capsule or tendon sheath. it is well defined and trans-illuminates

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113
Q

Where is a Bakers cyst found?

A

popliteal fossa

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114
Q

What type of crystals accumulate in gout?

A

urate crystals

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115
Q

What are causes of high uric acid?

A

increased protein intake, increased cell breakdown, renal underexcretion, diuretics, renal failure, excessive alcohol, diet

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116
Q

What is gouty trophi?

A

painless white accumulations of uric acid which can occur in soft tissues and occasionally erupt through the skin

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117
Q

What is needed for the diagnosis of gout?

A

joint aspiration for serum urate >7mg

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118
Q

Where is a common site for gout?

A

The 1st MTP joint

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119
Q

What is the treatment for acute attacks of gout?

A

NSAIDs (colchicine), coricosteroids, opiods analgesia

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120
Q

What is the treatment for chronic gout?

A

Allopurinol

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121
Q

What are the X-ray findings for osteoarthritis?

A

Loss of joint space
Osteophytes
Subchondral sclerosis
Subchondral cysts

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122
Q

Which joints are affected by osteoarthritis?

A

DIPs, large weight bearing joints, spinal cord

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123
Q

What is the treatment for osteoarthritis?

A

analgesia, NSAIDs, steroids, education, weight loss, physiotherapy

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124
Q

Which joints are affected in rheumatoid arthritis?

A

PIPs, MCPs and is symmetrical

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125
Q

What are the hallmarks of RA?

A

Synovitis, tenosynovitis, pannus formation (inflamed spongy synovium as a result of inflammation and hypertrophy) and bony erosions (increased osteoclast activity)

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126
Q

What is the most specific antibody to RA?

A

Anti-CCP

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127
Q

What is the management of rheumatoid arthritis?

A

methotrexate, sulfasalazine, biologics (if 2 DMARDs are unsuccessful) e.g. infliximab

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128
Q

What is the grading score for RA and what are the boundaries?

A

DAS28
<2.6: remission
>5.1: severe active RA

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129
Q

What is Osteoporosis?

A

increased bone porosity and decreased bone mineral density

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130
Q

What is the cause of osteoporosis?

A

increased osteoclastic response after the menopause or decreased oestrogen

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131
Q

What is a Colles fracture?

A

fracture involving the distal radius where the fractured bone is bent backwards

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132
Q

How is osteoporosis diagnosed?

A

DEXA scan

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133
Q

What is the treatment for osteoporosis?

A

calcium supplements, vitamin D, bisphosphonates

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134
Q

What is the mechanism of bisphosphonates?

A

reduce osteoclast activity. examples include alendronate, riseadronate, etc.

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135
Q

What is the mechanism of strontium?

A

increases osteoblast replication and decreases osteoclastic activity

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136
Q

What is osteomalacia?

A

abnormal softening of the bone due to deficient mineralisation of osteoid with decreased phosphate and calcium

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137
Q

What are the causes of osteomalacia?

A

insufficient calcium, deficiency or resistance to vitamin D, phosphate deficiency, long term anti-convulsant use, chronic kidney disease, inherited disease

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138
Q

What are the symptoms of osteomalacia?

A

bone pain, deformities from soft bones, pathological fractures, hypocalcaemia, pseudofractures

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139
Q

What is the biochemistry of osteomalacia?

A

decreased phosphate & calcium. increased ALP

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140
Q

What is the treatment for osteomalacia?

A

Vitamin D therapy, calcium supplementation and phosphate supplementation

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141
Q

What is hyperparathyroidism?

A

overactivity of parathyroid glands resulting in increased PTH

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142
Q

What is the cause of hyperparathyroidism?

A

benign adenoma, hypocalcaemia, decreased phosphate

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143
Q

What is Paget’s disease?

A

chronic disease of bone causing thickened, brittle and misshaped bone

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144
Q

What causes pagets disease?

A

viral infection with paramyxoviruses and genetic defects

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145
Q

What is the disease mechanism in Paget’s disease?

A

potentially due to an exaggerated vitamin D response, there is an increased osteoclast activity which causes osteoblasts to become more active. There is new bone formed but it is brittle

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146
Q

How does Paget’s disease appear on x-ray?

A

Enlarged bone, thickened cortices, thickened and coarse trabeculae and mixed areas of lysis and sclerosis

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147
Q

What is the biochemistry of Pagets disease?

A

Raised ALP, normal calcium and normal phosphate

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148
Q

What is the treatment for Paget’s disease?

A

Bisphosphonates, calcitronin, joint replacement and stabilisation of femoral fractures with long intramedullary nails

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149
Q

What is osteogenesis imperfecta?

A

it is an autosomal dominant condition causing brittle bone disease via a defect in the maturation and organisation of type 1 collagen in bone

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150
Q

What is the presentation of osteogenesis imperfecta?

A

multiple fragility fractures, short stature, multiple deformities, BLUE SCLERAE, loss of hearing

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151
Q

What do bones look like in osteogenesis imperfecta?

A

thin and gracile, thin cortices, osteopenia and fractures heal poorly with poor quality callus

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152
Q

What kind of inheritance is Marfans?

A

autosomal dominant- mutation or defect in fibrillin gene causing tall stature with disproportionately long limbs and ligamentous laxity

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153
Q

What are the features of Marfan’s?

A

high arched palate, scoliosis, pectus excavatum, eye problems, aortic aneurysm, cardiac valve incompetence, spontaneous pneumothorax, long limbs

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154
Q

What is Skeletal dysplasia?

A

Dwarfism

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155
Q

What is the most common form of skeletal dysplasia?

A

achondroplasia- it is disproportionate

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156
Q

What is the mode of inheritance of achondroplasia?

A

Autosomal dominant

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157
Q

What is the mode of inheritance of duchenne muscular dystrophy?

A

X-linked recessive

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158
Q

What is Gower’s sign and what is it associated with?

A

it is a sign of muscle weakness in young boys with duchenne muscular dystrophy where the patient gets on all 4’s and progresses to put hands on knees before standing up

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159
Q

How is Duchenne Muscular dystrophy diagnosed?

A

By a raised serum CK and abnormalities on biopsy

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160
Q

What is Beckers muscular dystrophy?

A

a milder version of duchennes

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161
Q

What mode of inheritance is Ehlers-Danlos syndrome?

A

Autosomal dominant

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162
Q

How does Ehlers Danlos syndrome present?

A

joint hypermobilty, vascular fragility and scoliosis

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163
Q

What is cerebral palsy?

A

neuromuscular disorder caused by an insult to the immature brain before, during or after birth

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164
Q

What is the most common form of cerebral palsy?

A

spastic

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165
Q

In Ataxic cerebral palsy, where is the insult in the brain?

A

The cerebellum

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166
Q

What is Spina Bifida?

A

congenital disorder where 2 halves of the verterbal arch fail to join

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167
Q

What is the mildest form of Spina Bifida and how does it present?

A

Spina bifida occulta. Spinal cord and roots may tether to vertebral defects causing pes cavus and clawing of the toes. hair may be over the defect.

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168
Q

What is the severe form of spina bifida?

A

Spina Bifida cystica- contents of vertebral canal herniate through the defect- can be the meninges alone or the spina cord and cauda equina

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169
Q

How is Spina Bifida treated?

A

defect closed within 48 hours of birth

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170
Q

What is Syndactyly?

A

fusion of 2 digits

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171
Q

What is polydactyl?

A

extra digits

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172
Q

What is Fibular Hemimelia?

A

partial or complete absence of the fibula

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173
Q

What are the causes of brachial plexus injury?

A

large baby, twin delivery, shoulder dystocia

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174
Q

What is Erbs Palsy?

A

Injury to C5 and C6 roots

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175
Q

What are the characteristics of Erbs palsy?

A

Waiters tip posture because there is loss of innervation to all other rotator cuff muscles except subscapularis.

176
Q

What is Talipes equinovarus?

A

club foot- a congential deformity of the foot due to in utero abnormal aligment of the joints between the talus, calcaneus and navicular.

177
Q

What is the treatment for Talipes Equinovarus?

A

Ponseti technique: held in plaster cast for 6 weeks and then changed

178
Q

What is Hallux Valgus

A

Valgus of the 1st MTP with lateral deviation

179
Q

What is Scoliosis?

A

Lateral curvature of the spine

180
Q

What is spondylolisthesis?

A

slippage of one vertebrae over another

181
Q

What are the symptoms of spondylolisthesis?

A

lower back pain, radiculopathy (severe slippage), flat back and waddling.

182
Q

What is radiculopathy?

A

a pinched nerve

183
Q

Where does osgood schlatters disease occur?

A

the patellar tendon attaching to the tibial tubercle

184
Q

What are risk factors for patello-femoral dysfunction?

A

female, muscle imbalance, ligamentous laxity, genu varum, wide hips, femoral neck anteversion

185
Q

What is the most common type of meniscal tear?

A

bucket handle

186
Q

What is characteristic of meniscal tear

A

knee locking

187
Q

What gene are spondyloarthropathies usually linked with?

A

HLA-B27

188
Q

What is enthesis?

A

inflammation at insertion of tendons onto bones

189
Q

What joints does ankylosing spondylitis usually involve?

A

sacroiliac involvement

190
Q

What other conditions are associated with ankylosing spondylitis?

A

All the A’s:

Anterior uveitis, aortic valve, apical pulmonary fibrosis, amyloidosis, achilles tendonitis, atlanto-axial subluxation

191
Q

What tests confirm diagnosis?

A

Schober’s, bamboo spine on x-ray

192
Q

what is the most common fracture in kids?

A

Bucket fracture

193
Q

What is the mechanism of action of bisphosphonates?

A

inhibit osteoclasts by reducing recruitment and promoting apoptosis

194
Q

What are the adverse effects of bisphosphonates?

A

oesophageal reactions, osteonecrosis of the jaw, increased risk of atypical stress factor

195
Q

How should bisphosphonates be taken?

A

should be swallowed with plenty of water on an empty stomach at least 30 minutes before breakfast with the patient standing or sitting up

196
Q

What nerve can be compressed to cause referred lumbar pain?

A

Femoral

197
Q

What kind of epicondylitis is Tennis and Golfers elbow?

A

Lateral- Tennis, Medial- Golf

198
Q

What are the symptoms of lateral epicondylitis?

A

pain and tenderness on wrist extension against resistance with the elbow extended or supination of the forearm with the elbow extended

199
Q

What is the typical age group affected by ankylosing spondylitis?

A

20-30

200
Q

What is the commonest cause of hip pain in children?

A

Transient synovitis- it is an acute hip pain associated with viral infection

201
Q

What tests are positive in developmental displasia of the hip?

A

Barlows and Ortolanis

202
Q

What are the features of perthes disease?

A

hip pain that is getting progressively worse over a few weeks, limp, stiffness and reduced range of hip movement.

203
Q

What are the causes of Perthes disease?

A

Avascular necrosis of the femoral head

204
Q

What x-ray changes would be seen for perthes disease?

A

Widening of the joint space, decreased femoral head size/flattening

205
Q

Is Perthes disease more common in males or females?

A

Males- 5x more common

206
Q

What kind of hip pain does obese children usually present with?

A

Slipper upper femoral epiphysis

207
Q

What are the features of SUFE?

A

displacement of the femoral head epiphysis postero-inferiorly causing knee or distal thigh pain and loss of internal rotation of the leg in flexion

208
Q

What is Juvenile idiopathic arthritis?

A

arthritis occuring in someone who is less than 16 years old that lasts for more than 3 months

209
Q

What are the features of juvenile idiopathic arthritis?

A

joint pain and swelling in the knees, ankles or elbows, limp and ANA may be positive

210
Q

What is the most common organism involved in septic arthritis?

A

Staphylococcus aureus, in young adults who are sexually active, consider Neisseria gonorrhoea

211
Q

What is the first line investigation that should be done before starting treatment in septic arthritis?

A

Synovial fluid should be aspirated

212
Q

What is the treatment for septic arthritis?

A

Flucloxacillin (to cover gram negatives) or clindamycin if penicillin allergic

213
Q

What kind of drug is colchicine

A

NSAID

214
Q

What are the Ottawa rules for X-raying an ankle?

A

bony tenderness at the lateral & medial malleolar zone

unable to weight bear or walk 4 steps

215
Q

What is chondroclacinosis and in what condition is it seen?

A

linear calcification of the articular cartilage and distinguishes pseudogout from gout

216
Q

What is the most appropriate investigation for suspected achilles tendon rupture?

A

Ultrasound of the ankle

217
Q

What is a risk factor of quinolones (ciprofloxacin)?

A

tendon disorders

218
Q

What are the features of achilles tendonitis?

A

gradual onset of posterior heel pain that is worse following activity, morning pain and stiffness

219
Q

What is the management of achilles tendinopathy?

A

supportive: analgesia and reduction in activities

220
Q

What are the features of achilles tendon rupture?

A

an audible pop in the ankle, sudden onset significant pain in the calf or ankle or the inability to walk

221
Q

What is osteomalacia?

A

Normal bony tissue but decreased mineral content.

222
Q

What is Rickets?

A

osteomalacia in the young

223
Q

What is the biochemistry of osteomalacia?

A

Low calcium, low phosphate, low vitamin D3 and raised ALP and PTH

224
Q

What is the treatment of osteomalacia?

A

Vitamin D replacement

225
Q

what are the features of avascular necrosis?

A

Symptoms may be gradual or sudden onset and may follow high dose steroid therapy or previous hip fracture

226
Q

What rotations are affected in adhesive capsulitis?

A

External rotations is more affected than others

227
Q

What are the 2 signs that are positive in carpal tunnel?

A

Tinel’s and phalens
Tinel’s: tapping causes paraesthesia
Phalens: flexion of the wrist causes symptoms

228
Q

What is first line treatment for lower back pain?

A

NSAIDs- naproxen

229
Q

What does a positive simmonds sign mean?

A

Achilles tendon rupture

230
Q

What antibiotic has to be avoided with use of methotrexate due to the risk of bone marrow suppresion?

A

Trimethoprim

231
Q

What are the featuers of a Galeazzi fracture?

A

It is a radial fracture with ulnar displacement

232
Q

A fall on an outstretched hand with pain at the lateral side of the elbow during pronation and suppination is likely to be?

A

fracture of the radial head

233
Q

When are scaphoid fractures likely to occur

A

a direct blow to the palm

234
Q

What is a Colles fracture?

A

fall onto an extended outstretched hand and is described as a dinner fork deformity. Transverse fracture of the radius with dorsal displascement and angulation

235
Q

What is the opposite of a colles fracture?

A

Smiths fracture- caused by falling backwards

236
Q

What is the most common causative organism in psoas abscess?

A

Staph aureus

237
Q

What is a psoas abscess?

A

Causes lumbar pain and all the other systemic signs of infection- patients may favour a particular side to lie on

238
Q

what is a Greenstick fracture?

A

a fracture of the bone, occurring in children in which one side is broken and the other only bent

239
Q

What is a buckle fracture?

A

when one part of the bone fractures but the other side is undisrupted. It is an incomplete fracture

240
Q

What are the Salter Harris fractures?

A

They are fractures of the growth plate.
type I: through the physis
Type II: through physis and metaphysis
Type III: through the physis and epiphysis
Type IV: through the physis, epiphysis and metaphysis
Type V: crush involving the physis

241
Q

What is the most common type of intracapsular hip fracture?

A

Subcapital fracture

242
Q

What is the treatment for intracapsular hip fractures?

A

Undisplaced: internal fixation or hemi if unfit
Displaced: reduction and internal fixation if young, Hemi or THR if old

243
Q

What is the treatment for extracapsular hip fracture?

A

dynamic hip screw or if oblique, transverse or subtrochanteric then intramedullary nail

244
Q

What are the features of SLE?

A 
General:
fatigue, fever, mouth ulcers, lymphadenopathy
Skin:
Malar rash, discoid rash, photosensitivity, raynauds, livedo reticularis, alopecia
MSK:
arthralgia, arthritis
CVS:
pericarditis, myocarditis
Respiratory:
pleurisy, fibrosing alveolitis
Renal:
proteinuria, glomerulonephritis
Neuro:
anxiety, depression, psychosis, seizures
245
Q

What are the features of anti-phospholipid syndrome?

A

venous and arterial thromboses, recurrent fetal loss and thrombocytopenia

246
Q

What is the antibody for limited systemic sclerosis?

A

anti-centromere

247
Q

What is the antibody for diffuse systemic sclerosis?

A

Anti-Scl-70

248
Q

What are the features of limited cutaneous systemic sclerosis?

A

Raynauds, scleroderma affecting face and distal limbs, CREST syndrome (calcinosis, raynauds, oesophageal dysmotility, sclerodactyly, telangiectasia)

249
Q

What are the features of diffuse systemic sclerosis?

A

scleroderma, respiratory involvement, renal disease and hypertension

250
Q

What causes painful arc of abduction?

A

subacromial impingement

251
Q

What is the key investigation of temporal arteritis?

A

Vision testing

252
Q

What is the treatment for temporal arteritis?

A

prednisolone- there will be a dramatic response

253
Q

What are the likely blood test results in osteoporosis?

A

All normal!

254
Q

What are you likely to see in the blood tests in Paget’ disease?

A

Raised ALP alone

255
Q

What are the risk factors for osteoporosis?

A

corticosteroids use, smoking, alcohol, low BMI, family history

256
Q

What is first line treatment for osteoporosis?

A

Alendronate

257
Q

What is Feltys syndrome?

A

RA, splenomegaly and a low WCC

258
Q

What is McMurrays test used for?

A

Meniscal tears

259
Q

What usually causes meniscal tears?

A

Twisting of the knee

260
Q

What causes an ACL tear?

A

may be caused by twisting of the knee and with a popping noise. Rapid onset of knee effusion

261
Q

What causes a PCL tear?

A

anterior force applied to the proximal tibia

262
Q

What type of hypersensitivity reaction is involved in SLE?

A

Type 3

263
Q

What is the most common cardiac complication of Ehler-Danlos syndrome?

A

Aortic regurgitation

264
Q

What kind of collagen is affected in Ehler-Danlos syndrome?

A

III

265
Q

What are the features of Ehler-Danlos syndrome?

A 
elastic, fragile skin
joint hypermobility
easy bruising
aortic regurgitation
subarachnoid haemorrhage
retinal streaks
266
Q

What is the mutation in marfans syndrome?

A

Fibrillin

267
Q

What is De Quervains tenosynovitis?

A

It is when the sheath containing the extensor pollicis brevis and abductor pollicis longus tendons is inflamed

268
Q

What is the most common complication of posterior hip dislocation?

A

Sciatic nerve injury

269
Q

Which nerve innervates the anterior compartment of the lower leg?

A

Deep peroneal nerve

270
Q

What nerve innervates the peroneal compartment of the lower limb?

A

Superficial peroneal nerve

271
Q

Which nerve innervates the superficial posterior compartment of the lower limb?

A

tibial nerve

272
Q

Which nerve innervates the deep posterior compartment of the lower limb?

A

Tibial nerve

273
Q

What are the muscles that flex the toes?

A

Flexor digitorum longus: flexes the lateral four toes

Flexor hallucis longus: flexes the great toe

274
Q

What would a shortened, internally rotated leg suggest?

A

Dislocation of the hip

275
Q

What would suggest a shortened externally rotated leg?

A

Neck of the femur fracture

276
Q

What are the features of a fat embolism?

A

fever, breathlessness, confusion and retinal haemorrhages which can occur up to 3 days after trauma. a petechial rash on the back may be present

277
Q

What causes rupture to the MCL?

A

leg forced into valgus via force outside the leg

278
Q

What is the most common causative organism in osteomyelitis?

A

staph aureus

279
Q

What is the treatment for osteomyelitis?

A

Flucloxacillin for 6 weeks. if penicillin allergic then clindamycin

280
Q

what is the treatment for Raynauds?

A

Nifedipine

281
Q

What is a classic side effect of colchicine

A

Diarrhoea

282
Q

What is the treatment for pseudogout?

A

NSAIDs and colchicine

283
Q

What is a Bennett’s fracture?

A

intra-articular fracture of the first carpometacarpal joint- caused by fist fights

284
Q

What is a smiths fracture?

A

Volar angulation of distal radius fragment- caused by falling backwards onto the palm of an outstretched hand or falling with wrists flexed

285
Q

What is a Monteggia fracture?

A

dislocation of the proximal radioulnar joint in associated with an ulnar fracture. MURD- ulnar fracture with radial deviation

286
Q

What is a Galeazzi fracture?

A

radial shaft fracture with associated dislocation of the distal radioulnar joint- GRUD- radial fracture with ulnar deviation

287
Q

What is a Pott’s fracture?

A

bimalleolar ankle fracture.

288
Q

What is a Bartons’s fracture?

A

distal radius fracture (Colles/smiths) with associated radiocarpal dislocation- fall onto extended wrist

289
Q

What is pANCA associated with?

A

Churg-Strauss- eGPA

290
Q

What is cANCA associated with?

A

GPA

291
Q

What is Reiters syndrome?

A

Triad of urethritis, conjunctivitis and arthritis

292
Q

What is a trigger finger?

A

condition associated with abnormal flexion of the digits. it is thought to be caused by a disparity between the size of the tendon and pulleys through which they pass.

293
Q

When is a trigger finger likely to occur?

A

More common in women and can happen in RA and DM

294
Q

What is the treatment of osteoarthritis?

A

paracetamol and topical NSAIDs if knee/hand

295
Q

What group of patients typically get a psoas abscess?

A

PWID

296
Q

What is the most common rotator cuff tear?

A

Supraspinatus

297
Q

What is the most appropriate management of diagnosing meniscal tears?

A

MRI

298
Q

What is divided in surgical management of carpal tunnel syndrome?

A

Flexor retinaculum

299
Q

What joints are affected by psoriatic arthritis?

A

DIPs

300
Q

What is seen on x-ray for psoriatic arthritis?

A

Pencil in cup appearance

301
Q

What are common causative infections for reactive arthritis?

A

Urogential and enterogenic e.g. chylamydia, salmonella, shigella

302
Q

What is circinate balanitis?

A

dermatitis of glans penis

303
Q

Is reactive arthritis one of the seronegative arthritis’?

A

Yes- it has raised HLA-B27

304
Q

What nerve is responisible for foot drop?

A

Common fibular/peroneal

305
Q

What nerve is responsible for wrist drop?

A

Radial

306
Q

What type of inflammatory arthritis is associated with IBD?

A

Enteropathic

307
Q

What dermatomes are responsible for hip flexion?

A

L1/2

308
Q

What dermatoses are responsible for knee extension?

A

L3/4

309
Q

What dermatome is responsible for foot dorsiflexion

A

L5

310
Q

What dermatomes are responsible for ankle plantarflexion?

A

S1/2

311
Q

What nerve roots are disturbed in sciatica?

A

L4/5/S1

312
Q

How can osteoarthritis cause sciatica?

A

Oateophytes can impinge on nerve roots causing sciatica

313
Q

What symptoms accompany L3/L4 prolapse?

A

pain down medial ankle, loss of quadriceps power, reduction in knee jerk

314
Q

What symptoms accompany a L4/L5 prolapse?

A

pain down to foot dorsum and loss of power to extensor hallicus longus and tibialis anterior

315
Q

What are the characteristics of a prolapsed disc?

A

neuralgic burning or severe tingling pain which radiates to the back of the thigh below the knee

316
Q

What is spondylosis?

A

Intervertebral discs lose water content with age which causes less cushioning and secondary OA due to increased facet joint pressure

317
Q

What is Spinal Stenosis?

A

Narrowing of the spinal canal due to a bulging ligamentum flavum, osteophytes, bulging disc etc

318
Q

What movement does supraspinatus do?

A

Initiation of abduction

319
Q

What movement does infraspinatus and Teres minor do?

A

external rotation

320
Q

What movement does subscapularis do?

A

Internally rotates the shoulder

321
Q

Where do the rotator cuff muscles insert?

A

Supra/infra/teres minor- insert into the greater tuberosity of the humerus
Sub- inserts into the lesser tuberosity

322
Q

What causes impingement?

A

pain due to the tendons of the rotator cuff muscles caused by compression in the subacromial space during movement

323
Q

What is Biceps tendonitis?

A

anterior shoulder pain on resisted biceps contraction and popeye deformity

324
Q

What nerve is compressed in carpal tunnel syndrome?

A

Median

325
Q

What fingers go numb in carpal tunnel syndrome?

A

thumb and radial 2 1/2 fingers

326
Q

What is Tinel’s test?

A

percussion over the median nerve

327
Q

What is Phalen’s test?

A

holding the wrists hyperflexed

328
Q

What is the treatment of carpal tunnel syndrome?

A

Wrist splints, injection of corticosteroids, carpal tunnel decompression, division of transverse carpal ligament

329
Q

what nerve is compressed in cubital tunnel syndrome?

A

ulnar nerve

330
Q

What is the humero-ulnar joint responsible for?

A

flexion/extension

331
Q

What is the radio-capitellar joint responsible for?

A

supination/pronation

332
Q

What are the muscles of the upper arm and what do they do?

A

BBC:
Brachialis- powers flexion
Biceps Brachii- powers flexion
Coracobrachialis

333
Q

What joints in the hands are affected in osteoarthritis?

A

DIP joints and carpo-metacarpal joints

334
Q

How does RA present in the hands?

A

Synovitis & tenosynovitis
erosions of the joints- inflammatory pannus
joint instability and tendon rupture- subluxations and chronic tenosynovitis may cause extensor tendon ruptures

335
Q

What is a swan neck deformity?

A

hyperextension at PIPs with flexion at DIPs

336
Q

What are the characteristics of meniscal injuries?

A

localised pain to the joint line, effusion the following day, catching or locking sensation, feeling of the knee giving way

337
Q

In an ACL, where would you expect the tibia to translate to on drawer test?

A

anteriorly

338
Q

What test is positive in meniscal tears?

A

Steinmann’s

339
Q

What is patellofemoral dysfunction?

A

anterior knee pain with grinding or clicking and pseudolocking

340
Q

Where does the patella tend to dislocated to?

A

Lateral

341
Q

What is developmental dysplasia of the hip?

A

dislocation or subluxation of the femoral head in the perinatal period which affects joint development

342
Q

What are the signs of developmental dysplasia of the hip?

A

asymmetry, clicking/clunking when moving affected hip joint on Barlow’s/Ortlani’s test, decreased leg length

343
Q

What is Ortlani’s test?

A

reducing a dislocated hip with abduction and anterior displacement

344
Q

What is Barlow’s test?

A

Dislocatable hip with flexion/adduction and posterior displacement

345
Q

What is the treatment for Developmental dysplasia of the hip?

A

Pavlick harness for 6 weeks at a time

346
Q

What is the treatment for late developmental dysplasia of the hip?

A

combined femoral and acetabular surgery

347
Q

What is the commonest cause of hip pain in children?

A

transient synovitis

348
Q

What is the treatment of transient synovitis?

A

rest and NSAIDs

349
Q

What is Perthes?

A

idiopathic osteochondritis of the femoral head leading to AVN

350
Q

What is the pulley usually involved un trigger finger?

A

A1

351
Q

What are the patterns of pelvic injury?

A

lateral- half of pelvis is displaced medially
vertical sheer- causes superior displacement which causes leg on affected side to be shorter
Anteroposterior- open back pelvic fracture

352
Q

How do you treat c-spine fractures?

A

Stable: firm cervical collar
Unstable: halovest

353
Q

What is the commonest injury pattern in the spine?

A

central cord syndrome- caused by hyperextension injury in cervical spine

354
Q

How do you treat intra-articular distal humeral fractures?

A

ORIF

355
Q

What is the treatment of radial head and neck fractures?

A

Undisplaced: sling & early elbow exercises to minimise stiffness
Displaced: ORIF

356
Q

What is a Bankart lesion?

A

injury of the anterior glenoid capsule of the shoulder due to anterior shoulder dislocation

357
Q

When would you see a light bulb sign on x-ray?

A

Shoulder dislocation

358
Q

Which nerve is at risk in a shoulder dislocation?

A

axillary nerve

359
Q

What is the treatment for intracapsular hip fractures?

A

Hemi or THR

360
Q

What is the treatment of extracapsular hip fractures?

A

internal fixation via dynamic hip screw or intramedullary nail

361
Q

How would you treat a subtrochanteric fracture?

A

intramedullary nail

362
Q

How would you treat a trochanteric fracture?

A

Dynamic hip screw

363
Q

Where does pain from SUFE present?

A

knee

364
Q

How does avascular necrosis look on x-ray?

A

patchy sclerosis of weight bearing area. lytic zone underneath patchy sclerosis which causes classical sagging rope sign

365
Q

What is the treatment of AVN?

A

pre-collase: drill holes in femoral neck into the diseased region to decompress, promote healing and prevent collapse
Collapsed: THR

366
Q

What is a nightstick fracture?

A

fracture of the ulnar shaft

367
Q

What is the treatment of both forearm bones?

A

ORIF with plates and screws

368
Q

What is the treatment for Monteggia and Galeazzi fractures?

A

ORIF

369
Q

What are the features of a Colles Fracture?

A

extra-articular fracture of the distal radius within an inch of the articular surface and dorsal displacement. it is associated with median nerve compression and can damage the extensor pollicus longus

370
Q

What is abnormal Genu varum?

A

> 16 degrees from mean, short stature and painful

371
Q

Is flat foot normal?

A

it is normal in the young and then the medial arch develops as the posterior tibialis strenghtens

372
Q

What is the treatment of Raynauds?

A

Calcium channel blockers

373
Q

What is the first line treatment of arthritis?

A

Methotrexate. NSAIDs are given for flares

374
Q

Why are frequent blood tests taken when a patient is taking methotrexate or other DMARDs?

A

due to the risk of leucopenia, thrombocytopaenia, hepatitis and cirrhosis

375
Q

What are the side effects of DMARDs?

A

leukopaenia, low sperm count, hepatitis, cirrhosis, nausea, diarrhoea, rash, ulcers, temporary hair loss

376
Q

What is 2nd line treatment for arthritis?

A

Methotrexate and sulfasalazine

377
Q

What is the treatment of gout?

A

Colchicine- acute

Allopurinol- chronic.

378
Q

What is the treatment of stable ankle fractures?

A

walking cast or splint for 6 weeks

379
Q

What is the treatment for an unstable ankle fracture?

A

ORIF with plates and screws

380
Q

Where does a stress fracture normally occur?

A

The 2nd metatarsal- it is not visible on x-ray until healing has begun

381
Q

What are the characteristics of claw toes?

A

Hyperextension at the MTP joints and hyperflexion at the PIP and DIP joints

382
Q

What are the characteristics of hammer toes?

A

hyperextension at the MTP joints, hyperflexion at the PIP joints, hyperextension at DIP joints

383
Q

Is age of first dislocation proportional to risk of recurrent shoulder dislocation?

A

Yes- the younger the first dislocation, the increased chance of recurrence

384
Q

Is the periosteum of children’s long bones thicker than adult bones?

A

Yes

385
Q

What is the treatment of septic arthritis?

A

urgent orthopaedic review and debridement of the joint

386
Q

Which deformity is not well tolerated in a boxers fracture and requires fixation and manipulation?

A

Rotational deformity- treatment is by neighbour strapping of the affected digit

387
Q

What bones make up the ankle bone?

A

Talus, tibia and fibula

388
Q

Do wedge fractures require surgical inervention?

A

no, they are stable fractures in the anterior column of the spinal vertebrae

389
Q

What nerve is most at risk in a displaced Colles fracture?

A

Median nerve

390
Q

What is a Colles fracture?

A

Extra-articular fracture of the distal radius within an inch of the articular surface and with dorsal displacement or angulation.

391
Q

A GCS of what implies loss of airway control?

A

8

392
Q

What nerve is most at risk from a blow to the lateral aspect of the knee?

A

Common peroneal nerve

393
Q

What nerve is most as risk due to a posterior dislocation of the hip?

A

Sciatic nerve

394
Q

What nerve is most at risk due to a supracondylar fracture of the distal humerus

A

median nerve

395
Q

What are the classificiations of the Salter-Harris fractures?

A

I: pure physeal separation, best prognosis
II: physeal with a small metaphyseal fragment
III: intra-articular and with the fracture splitting the physis
IV:same as above
V: compression injury to the physis with subsequent growth arrest
SALTER:
I: Straight across
II: Above
III: Lower
IV: Through Everything
V: cRush

396
Q

What is Chronic regional pain syndrome?

A

heightened chronic pain response following trauma.

397
Q

Which vessel is at risk in a shoulder dislocation?

A

Axillary artery

398
Q

Which vessel is at risk in a knee dislocation?

A

Popliteal artery

399
Q

Which vessel is at risk in a paediatric supracondylar fracture/

A

Brachial artery

400
Q

in spinal stenosis, when is pain worst?

A

when walking downhill, it is better when sitting forward

401
Q

In peripheral artery disease, when is pain worse on walking?

A

uphill- the muscles in the legs must work harder, the oxygen and blood supply demand is greater and therefore the claudication is exacerbated quicker

402
Q

in which condition whould you see a shepherds crook deformity?

A

fibrous dysplasia

403
Q

What would show up on x-ray as a soap bubble?

A

giant cell tumour

404
Q

What histological features are present in cortical bone?

A

osteons, volkmann canals and haversian canals

405
Q

What compartment of the knee will be affected by varus malalignment?

A

median

406
Q

Where is pain localised in plantar fasciitis?

A

calcaneal tuberosity

407
Q

which principal clinical sign on examination is indicative of adhesive capsulitis?

A

external rotation

408
Q

Which bone is the slowest healer?

A

Scaphoid and tibia

409
Q

Which is he most common type of shoulder dislocation?

A

Anterior

410
Q

What are common side effects of NSAIDs?

A

renal impairment, dyspepsia, wheeze, increased CVS

411
Q

What type of splint is used for the temporary splintage of femoral shaft fractures?

A

Thomas splint

412
Q

What is impinged in hip impingement?

A

acetabular labrum

413
Q

What are the features of an aneurysmal bone cyst?

A

a lucent multi-lobulated cyst found within the medulla of many different bones often with associated cortical expansion

414
Q

What is osteochondritis?

A

fragmentation with separation of bone and cartilage within a joint

415
Q

What are the commonly affected sites in osteochondritis?

A

medial femoral condyle of the knee, femoral head and talar dome

416
Q

Where would you see Bouchard’s nodes?

A

PIP joints- RA

417
Q

Where would you see Heberden’s nodes?

A

DIP joints- OA

418
Q

What type of collagen is produced in Dupuytren’s contracture?

A

Type III

419
Q

What is Klumpke’s palsy?

A

it is a rare lower brachial plexus injury (C8 and T1) where there is paralysis of the intrinsic hand muscles

420
Q

What would an abnormal straight leg raise be indicative of?

A

prolapsed disc

421
Q

Old man, bone pain, isolated raised ALP

A

Pagets disease

422
Q

How do posterior hip disloactions present?

A

shortened and internally rotated leg

423
Q

How would a neck of the femur fracture present?

A

shortened, externally rotated leg

424
Q

What are the abnormal curvatures of the back in ankylosing spondylitis?

A

Thoracic Kyphosis

425
Q

What is the Barlow testing?

A

abducting and applying pressure to try to dislocate the hips

426
Q

What is the Ortlani test?

A

It adducts and flexes the hips and puts pressure on the greater trochanter to cause posterior dislocation

427
Q

What is the most common cause of hip pain in children?

A

Transient synovitis

428
Q

What is idiopathic osteochondritis of the femoral head?

A

Perthes

429
Q

What is Blounts disease?

A

Pathological cause of genu varum

430
Q

Injury to which nerve might prevent plantarflexion and inversion of the foot?

A

Tibial nerve

431
Q

Injury to which nerve causes claw hand?

A

Ulnar nerve

432
Q

Injury to which nerve causes a winged scapula?

A

Long thoracic nerve

433
Q

Which nerve is usually injured in humerus fractures?

A

Axillary nerve

434
Q

A positive trendelenburg test is indicative of injury to which nerve?

A

Superior gluteal nerve

435
Q

Which nerve is most likely to be injured in a THR?

A

Obturator

Year 2 (10 decks)

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