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Phase 3a > MSK > Flashcards

MSK Flashcards

1
Q

WHAT IS THE DEFINITION OF JIA

A

A CHRONIC INFLAMMATORY JOINT DISEASE

PERSISTENT JOINT SWELLING

IN ABSCENSE OF INFECTION OR OTHER DEFINED CAUSES

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2
Q

WHAT ARE THE SUBSTYPES OF JIA

A

OLIGOARTHRITIS

EXTENDED OLIGOATHRITIS

POLYARTHRITIS

SYSTEMIC

PSORIATIC

ENTHESITIS RELATED

UNDIFFERENTATED

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3
Q

A CHILD COMES IN WITH

  • MORNING STIFFNESS AND PAIN
  • STIFFNESS AFTER REST
  • INTERMITTENT LIMP
  • LOW MOOD
  • POOR BEHAVIOUS
  • JOINT SWELLING
  • +/- SALMON PINK RASH
A

JIA

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4
Q

WHAT ARE COMPLICATIONS OF JIA

A

CHRONIC ANTERIOR UVEITIS

FLEXION CONTRACTURES

GROWTH FAILURE

OSTEOPOROSIS

AMYLOIDOSIS

VALGUS DEFORMITY

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5
Q

HOW DO YOU MANAGE JIA

A

EDUCATION AND SUPPORT

PHYSIO

NSAID

JOINT INJECTIONS (IF OLIGOARTHRITIS)

METHOTREXATE (POLYARTHRITIS)

PULSED IV CORTICOSTERIOIDS

METHYLPREDNISOLONE FOR SYSTEMIC ARTHRITIS

BIOLOGICS

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6
Q

DESCRIBE THE ARTICULAR PATTERN OF EXTENDED OLIGOARTHRITIS

A

4< JOINT

AFTER 6M

ASSYMETRICAL JOINT DISTRIBUTION

ANA +VE

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7
Q

DESCRIBE THE ARTICULAR PATTERN + LAB RESULTS OF OLIGO ARTHRITIS

A

1-4 JOINTS

MOST COMMONLY KNEE, ANKLE, WRIST

+/-ANA +VE

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8
Q

DESCRIBE THE ARTICULAR PATTERN + LAB RESULTS POLYARTHRITS

A

SYMMETRICAL JOINTS DISTRIBUTION WITH HIGH FINGER INVOLVEMENT

1-6Y: RF -VE

10-16Y: RF +VE (POOR PROGNOSIS)

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9
Q

WHAT DOES AMYLIODOSIS CAUSE

A

PROTEINUREA

RENAL FAILURE

HIGH MORTALITY

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10
Q

WHY DOES OSTEOPOROSIS OCCUR IN JIA

A

REDUCED WEIGHT BARING

STEROIDS

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11
Q

WHAT IS THE TREATEMENT OF JIA OSTEOPOROSIS

A

CALCIUM

VIT D

WEIGHT BARING EXCERSISES

DECREASE STERIODS

BISPHOSPHONATES

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12
Q

WHY DO FLEXION CONTRACTURES OCCUR

A

FROM HOLDING THE JOINTS IN THE MOST COMFORTABLE POSITION

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13
Q

WHAT ARE THE COMMON COMPLICATONS IN JIA FLEXION CONTRACTURES

A

JOINT DESTRUCTION REQUIRING REPLACEMENT

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14
Q

HOW DO YOU TREAT CHRONIC ANTERIOR UVEITIS

A

CORTICOSTEROID EYEDROPS

MYCROLITIC EYE DROPS

CORTICOSTEROID INJECTION

SYSTEMIC CORTICOSTEROIDS

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15
Q

WHAT IS CHRONIC ANTERIOR UVEITIS

A

INFLAMMATION OF THE ANTERIOR PART OF THE EE

VERY COMMON COMPLICATION OF IBD AND ARTHRITIS THAT CAN LEAD TO VISUAL IMPAIREMENT

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16
Q

DESCRIBE THE ARTICUALR FINDINGS OF PSORIATIC ARTHRITIS

A

ASYMMETRICAL DISTRIBUTION

DACTYLISIS

PSORIASIS

NAIL PITTING

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17
Q

WHAT IS THE PRESENTATION OF SYSTEMIC ARTHRITS

AND LAB FINDINGS

A

OLIGOARTHRITIS/POLYARTHRITIS

PAIN IN MUSCLES

ACUTE ILLNESS

SALMON PINK RASH

RAISED WCC

RAISED PLATELETS

RAISED INFLAM MARKERS

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18
Q

WHAT ARE FEATURES ONLY FOUND IN POLYARTHRITIS FROM 10-16Y

A

RHEUMATOID NODULES

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19
Q

HOW DO YOU DIAGNOSE SEPTIC ARTHRITIS

A

BLOOD CULTURES

BLOODS

JOINT ASPIRATE

US

XRAY

BRI

BONE SCAN

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20
Q

HOW DOES THE PRESENTATION OF SEPTIC ARTHRITIS DIFFER IN INFANTS

A

PEUDOPARALYSIS

CRY IF JOINT IS MOVED

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21
Q

WHAT IS THE PRESENTATION OF SEPTIC ARTHRITISIN CHILDREN

A

ERYTHETEMATOUS

ACUTELY TENDER

REDUCED ROM

ACUTELY UNWELL AND FEBRILE CHILD

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22
Q

WHAT PATHOGENS COMMONLY CAUSE SEPTIC ARTHRITIS

A

STAPH. AUREUS

HiB

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23
Q

WHAT IS TRANSIENT SYNOVITIS

A

MOST COMMON CAUSE OF HIP PAIN IN CHILDREN OFTEN ACCOMPNIED BY A VIRAL INFECTION

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24
Q

WHAT IS THE PRESENTATION OF TRANSENT SYNOVITIS

A

SUDDEN ONSET OF PAIN

LIMP

DECREASED ROM

REFFERRED KNEE PAIN

AFEBRILE/LOW GRADE FEVER

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25
Q

WHAT INVESTIGATIONS WOULD YOU USE TO DIFFERENTIATE TRANSIENT SYNOVITIS FROM SEPTIC ARTHRITIS

A

BLOOD CULTURES

JOINT ASPIRATION

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26
Q

OUTLINE THE DIFFERENCES BETWEEN SEPTIC ARTHRITIS AND TRANSIENT SYNOVITIS

A
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27
Q

HOW DO YOU MANAGE TRANSIENT SYNOVITIS

A

BED REST +/- SKIN TRACTION

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28
Q

WHAT DSEASE CAN HAVE TRANSIENT SYNOVITIS AS A PRECURSER

A

PERTHES

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29
Q

WHAT IS SEPTIC ARTHRITIS

A

A SERIOUS INFECTION OF THE JOINT SPACE WHICH CAN LEAD TO BONE DESTRUCTION

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30
Q

HOW DO YOU TREAT SEPTIC ARTHRITIS

A

IV ABX > PO ABX

SURGIAL LAVAGE

IMMOBALIZATION OF JOINT

MOBALISATION

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31
Q

WHAT ABX WOULD YOU USE IN SEPTIC ARTHRITIS FOR S. AUREUS

A

FLUCLOXACILLIN

OR

CEPHALEXIN

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32
Q

WHAT ABX WOULD YOU USE IN SEPTIC ARTHRITIS FOR HiB

A

CEFTRIAXONE

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33
Q

WHAT IS HIP DISPLASIA

A

AN ABNORMALITY OF THE HIP JOINT WHERE THE SOCKET DOESNT FULLY COVER THE BALL

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34
Q

WHAT ARE THE RISK FACTORS WHICH PREDISPOSE YOU TO HIP DYSPLASIA

A

FAMILY HISTORY

SERTAIN SWADDLING TECHNIQUES

BREECH BIRTH

35
Q

WHAT IS THE PRESENTATION OF HIP DYSPLASIA

A

ASSYMPETRICAL LEG LENGTH AND SKIN FOLDS

LIMP

SENSATION OF INSTABILITY

GROIN/HIP PAIN

36
Q

HOW DO YOU DIAGNOSE HIP DYSPLASIA

A

NIPE EXAM

US

XR

37
Q

WHAT IS THE TREATEMENT OF HIP DISPLASIA

A

CAST +/- HI TRACTION

SURGERY

PHYSIO

MAY RESOLVE SPONTANEOUSLY

38
Q

WHAT IS THE DEFINITION OF OSTEOMYELITIS

A

AN INFECTION OF THE METAPHYSIS OF LONG BONES

39
Q

WHERE DOES OSTEOMYELITIS NORMALLY OCCUR

A

DISTAL FEMOUR

PROXIMAL TIBIA

40
Q

WHAT ARE COMMON PATHOGENS OF OSTEOMYELITIS

A

STAPH. AUREUS

STREP

HiB

SALMONELLA -SICKLE CELL

TB - IMMUNOCOMPRIMISED

41
Q

WHAT IS THE PRESENTATION OF OSTEOMYELITIS

A

PAIN

PSEUDOPARALYSIS

SWELLING AND TENDERNESS

ERYTHETEMATOUS

WARM

42
Q

HOW WOULD YOU INVESTIGATE OSTEOMYELITIS

A

BLOOD CULTURES

BLOODS: RAISED WCC, ESR, CRP

X RAYS

43
Q

WHAT RADIOLOGICAL FINDINGS WOULD YOU HAVE IN OSTEOMYELITIS

A

SOFT TISSUE SWELLING

SUBPERIOSTEAL NEW BONE FORMATION

44
Q

HOW WPULD YOU TREAT OSTEOMYELITIS

A

PARENTERAL ABX>IV>PO

SURGICAL DRAINIGE

LIMB IN SPLINT

EARLY MOBILISATION

45
Q

WHAT IS KÖHLER DISEASE

A

A RARE BONE DISEASE AFFECTING CHILDREN AGED 6-9Y

THERES NECROSIS OF THE NAVICULAR BONE DUE TO DECREASED BLOOD SUPPLY

46
Q

WHAT IS THE PRESENTATION OF KOHLER DISEASE

A

PAIN AND SWELLING AT MIDDLE PART OF FOOT

LIMP

TENDERNESS AT MIDDLE FOOT

47
Q

HOW WOULD OU INVESTIGATE KOHLER DISEASE

48
Q

HOW WOULD YOU TREAT KOHLER DISEASE

A

REST +/- CAST

ANALGESIA

50
Q

WHAT ARE DISCOID MENISCI

A

A RARE HUMAN ANATOMIC VARIENT

AFFECTS LATERAL MENISCI OF THE BONE

51
Q

DESCIBE THE WATANABE CLASSIFICTAIONS

A

INCOMPLETE - SLIGHTLY DEFORMED

COMPLETE - FULLY ROUNDED

WRISTBERG - LOCK OF POSERIOR MENISCI

52
Q

WHAT IS THE PRESENTATION OF DISCOID MENISCI

A

PAIN

CLICKING

MECHANICAL LOCKING

53
Q

WHEN DO DISCOID MENISCI PRESENT

A

ADOLESCENCE

54
Q

HOW DO YOU DIAGNOSE DISCOID MENISCI

55
Q

HOW WOULD YOU TREAT DISCOID MENISCI

A

SURGERY

PHYSIO

56
Q

WHAT IS OSGOOD SCHLATTERS

A

INFLAMMATION OF POSTERIAL LIGAMENT AT TIBIAL TUBEROSITY

57
Q

WHAT RF PREDISPOSE YOU TO OSGOOD

A

IMPACT SPORTS

OVERUSE

58
Q

WHAT IS THE PRESENTATION OF OSGOOD

A

PAIN IN FRONT LOWER PART OF KNEE

WORSE ON USE

59
Q

HOW WOULD YOU DIAGNOSE OSGOOD

A

SYMPTOMATICALLY

60
Q

HOW DO YOU TREAT OSGOOD

A

PHYSIO

BRACE

SURGERY

61
Q

WHAT IS SLIPPED CAPITAL FEMORAL EPIPHESIS

A

DISPLACEMENT OF EPIPHESIS OF FEMORAL HEAD POSTERIOINERIORLY

62
Q

WHAT CONDITIONS ARE ASSOCIATED WITH OSGOOD

A

HYPOTHYROIDISM

HYPOGONADISM

63
Q

WHAT IS THE PRESENTATION OF SLIPPED CAPITAL FEMORAL EPIPHESIS

A

LIMP

HIP PIAN

REFERRED KNEE PAIN

DECREASED ROM

64
Q

WHAT INVESTIGATIONS ARE REQUIRE FOR SLIPPED CAPITAL FEMORAL EPIPHESIS

65
Q

HOW WOULD YOU MANAGE SLIPPED CAPITAL FEMORAL EPIPHESIS

A

SURGICAL PIN FIXED IN SITU

66
Q

WHAT IS PETHES DISEASE

A

AVASULAR NECROSIS OF THE CAPITAL FEMORAL EPPHESIS

DUE TO AN INTERUPTED BLOOD SUPPLY

67
Q

DESCRIBE THE PHYSIOLOGICAL PATHWAY OF REVOVERY FROM PETHES DISEASE

A

NECROSIS

REVASULARISATION

REOSSIFICATION

68
Q

WHAT IS THE PRESENTATION OF PETHES DISEASE

A

HIP/KNEE PAIN

LIMP

SIMILAR TO TRANSIENT SYNOVITIS

69
Q

WHAT IS THE MANAGEMENT OF PERTHES

A

IF IDENTIFIED EARLY BED REST + TRACTION

OTHERWISE SURGERY

70
Q

WHAT IS A POSSIBLE CONSEQUENCE OF PETHES DISEASE

A

INCREASED RISKOF DEGENERATIVE ARTHRITIS

71
Q

WHAT IS OSTEOGENESIS IMPERFECTA

A

A GROUP OF DISORDERS OF COLLAGEN METABOLISM

CAUSING BONE FRAGILITY

CAUSING BOWING AND FREQUENT FRACTIONS

72
Q

WHAT ARE THE TWO TYPES OF OSTEOGENESIS IMPERFECTA

A

TYPE 1 - AUTOSOMAL DOMINANT

TYPE 2 - SEVERE AND LIFE THREATNING

73
Q

WHAT IS THE PRESENTATION OF T1 OSTEOGENESIS IMPERFECTA

A

CHILDHOOD FRACTURES

BLUE SCLERA

IN 50% HEARING LOSS

74
Q

WHAT IS THE PRESENTATION OF T2 OSTEOGENESIS IMPERFECTA

A

LETHAL IN PERINATAL PERIOD

FRACTURES PRESENT BEFORE DEATH

75
Q

HOW DO OU DIAGNOSE OSTEOGENESIS IMPERFECTA

A

X RAYS

DNA + COLLAGEN TESTING

US - FETAL PRESENTATION OFTEN IN T2

76
Q

WHAT IS THE THREATEMENT OF OSTEOGENESIS IMPERFECTA

A

PHYSIO

REHAB

BISPHOSPHONATES (PALANDOMIC ACID IV)

SURGERY

77
Q

WHAT IS RICKETS

A

A FAILURE IN MINERALISATION OF THE GROWING BONE (OSTEOID)

78
Q

WHAT IS OPTEOMALACIA

A

FAILURE TO MINERALISE MATURE BONE

79
Q

WHAT ARE THE TYPES OF RICKETS

A

NUTRITIONAL

VIT D DEPENDANT

VIT D RESISTANT

80
Q

WHAT NUTRITIONAL DEFICIENCIES CAN CAUSE RICKETS

A

VIT D

CALCIUM

PHOSPHURUS

81
Q

WHAT ARE THE TWO TYPES OF VITAMIN D RICKETS

A

TYPE 1: DECREASED VIT D HYDROXYLASE

TYPE 2: DEFECTIVE VIT D RECEPTOR AND PRODUCTION OF 1,25 DIHYDROXY VIT D

82
Q

WHAT ARE THE TWO TYPES OF VIT D RESISTENT RICKETS

A

X LINKED :

DECREASED RENALPHOSPHUSRUS TRANSPORT /ABSORBTION = HYPOPHOPHOATREMIC

HEREDIATRY :

DECREASED PHOSPHATE REABSORBTION WITH RAISED LEVELS OF CALCITOL = HYPOPHOPHOATREMIC + HYPERCALCEAMIC

83
Q

WHAT ARE CAUSES OF RICKETS

A

NORTHERN LATITUDES

DIETARY

MATERNAL VIT D DEFICIENCY

COELIAC

PANCREATIC INSIFFICIENCY

CHOLESTATIC LIVER DISEASE

CHRONIC LIVER DISEASE

HEREDITARY

X LINKED

FANCONI SYNDROME

Phase 3a (22 decks)

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