MSK and rheumatology Flashcards
1
Q
what is a common laboratory finding in Paget’s disease of the bone
A
Raised ALP
2
Q
give 4 features of ankylosing spondylitis on radiograph
A
Sacroilitis : subchondral erosions , sclerosis
squaring of lumbar vertebrae
bamboo spine
syndesmophytes : ossification of outer fibers of annulus fibrosus
3
Q
sign of Ankylosing spondylitis on chest xray
A
Apical fibrosis
4
Q
what’s the imaging of choice in Osteomyelitis ?
A
MRI of affected leg and hip
5
Q
most common cause of septic arthritis in sexually active adults
A
Neisseria Gonorrhoea
6
Q
first line investigation for suspected septic arthritis
A
Synovial fluid sampling
7
Q
what is an adverse effect of hydrochloroquine
A
Bulls eye retinopathy - leading to severe and permanent visual loss
8
Q
most common cause of discitis
A
Staph. Aureus
9
Q
how do Gottron’s papules present ? what condition is it present in ?
A
Roughened red papules over extensor surfaces of fingers. Dermatomyositis
10
Q
what is the key investigation in patients with suspected septic arthritis
A
Synovial fluid sampling
11
Q
what haematological findings are seen in APL
A
thrombocytopenia
prolonged APTT
12
Q
which antibody is +ve in APL
A
Anti cardiolipin antibody
13
Q
APL syndrome presents with which dermatological finding
A
Livedo Reticularis
14
Q
what type of reaction is anaphylaxis
A
Type 1
15
Q
how is Reactive arthritis managed ( 1st line and 2nd line)
A
Analgesia, NSAID’s , intra articular steroids
16
Q
which inflammatory marker is raised in Polymyalgia rheumatica
A
ESR
17
Q
what is the management of Polymyalgia Rheumatica
A
Prednisolone 15 mg / od
18
Q
what is the gold standard treatment of SLE
A
Hydroxychloroquine
19
Q
which condition is polymyalgia rheumatica associated with ?
A
Temporal arteritis
20
Q
what xray feature best supports the diagnosis of polymyalgia rheumatica
A
Sacro-ilitis on Pelvic xray
21
Q
what is the first line management of ankylosing spondylitis
A
exercise regimes and NSAID’s
22
Q
which antibody is specific and sensitive for Rheumatoid arthritis
A
Anti cyclic citrullinated peptide
23
Q
what is the first line management of Raynaud’s
A
Nifedipine
24
Q
give 5 early xray findings of RA
A
Loss of joint space
Juxta-articular osteoporosis
Soft tissue swelling
periarticular erosion
Subluxation
25
Achilles tendonitis can present with which condition
Ankylosing spondilytis
26
give 3 xray findings seen in ankylosing spondylitis
Subchondral erosions
sclerosis
squaring of vertebrae
27
which is the test for SLE with the highest sensitivity
ANA
28
which are tests for SLE that are highly specific
anti-dsDNA
Anti-smith
29
why is the use of methotrexate and trimethoprim together contraindicated
it can lead to bone marrow suppression and severe or fatal Ppancytopaenia
30
what is the management of methotrexate toxicity
folinic acid
31
what are the instructions for a patient on consuming bisphosphonates
swallow tablets with water while sitting / standing on empty stomach 30 mins before breakfast and stay upright for 30 mins
32
patients with Sjogren's syndrome have an increased risk of which malignancy
Lymphoid malignancy
33
what is the initial management regime for RA
DMARD monotherapy + short course of bridging prednisolone
34
how do you manage flares of RA
Corticosteroids ( oral /IM)
35
most common causes of drug induced SLE
procainamide
hydralazine
36
give 3 less common causes of drug induced SLE
Isoniazid
Minocycline
Phenytoin
37
which antibodies are positive in APL syndrome
anti-cardiolipin antibodies
38
T score, what is normal, osteopenia, osteoporosis
> -1 = normal
-1 to -2.5 = Osteopaenia
< - 2.5 = osteoporosis
39
what is the management when a diagnosis of temporal arteritis is suspected ?
urgent high dose glucocorticoids
40
what is the most common ocular complication of temporal arteritis
anterior ischaemic optic neuropathy
41
which tumour presents on radiograph with ''onion skin'' appearance ?
Ewing's sarcoma
42
which is the most common primary malignant bone tumour
Osteosarcoma
43
ewing's sarcoma most commonly affects which bones
pelvis + long bones
44
give 2 features seen on xray in Osteosarcoma
Codman triangle
sunburst pattern
45
how does giant cell tumour present on xray
double bubble / soap bubble
46
what is the most common benign bone tumour
Osteochondroma
47
which scoring system is used as a disease measure of RA
DAS28
48
''plantar spur'' and ''pencil in cup'' deformity are typical xray features seen in __________.
Psoriatic arthritis
49
is psoriatic arthritis symmetrical or asymmetrical ?
Asymmetrical
50
give 3 expected findings on examination of chest and spine in ankylosing spondylitis
reduced chest expansion
reduced lateral flexion
reduced forward flexion
51
is azathioprine safe to use in pregnancy
yes
52
which xray finding can be used to distinguish gout from pseudogout ?
pseudogout : chondrocalcinosis
gout : no chondrocalcinosis
53
how long do symptoms need to be present for a diagnosis of chronic fatigue syndrome to be made ?
3 months
54
give 3 features of inflammatory arthritis
pain in the morning
systemic features
raised inflammatory markers
55
_______ presents with pain and tenderness over the lateral side of the thigh
trochanteric bursitis
56
how does meralgia paraesthetica present
compression of lateral cutaneous nerve of thigh with a burning sensation of antero-lateral aspect of thigh
57
give 5 side effects of methotrexate
mucositis
myelosuppression
pneumonitis
pulmonary fibrosis
liver fibrosis
58
what is the drug given to manage methotrexate toxicity
Folinic acid
59
blue sclera is associated with _______
osteogenesis imperfecta
60
how does pseudogout present under the microscope ?
weakly +ve bi-fringent rhomboid shaped crystals
61
what is the imaging of choice for achilles tendon rupture
ultrasound
62
what are the red flag features of suggesting an alternative diagnosis to osteoarthritis
rest pain
night pain
morning stiffness >2 hours
63
which finger joints are more commonly affected in osteoarthritis
PIP
DIPJ
64
patients with ________ often get relief from shaking their hands
Carpal tunnel syndrome
65
what are the red flags for lower back pain
age < 20, >50
history of previous malignancy
night pain
history of trauma
systemically unwell ( weight loss and fever)
66
what is the most appropriate investigation to confirm the diagnosis of ACL injury
MRI
67
what is the most common PCL injury
Dashboard injury , occurs when knee is flexed
68
ACL injury caused by hyperextension / flexion ?
Hyperextension
69
what test can be performed to test for PCL damage
Posterior draw test
70
which structure is divided in surgical management of carpal tunnel syndrome
flexor retinaculum
71
prescribing folate with methotrexate reduces the risk of _________
Myelosuppression
72
what is the most common form of hip dislocation
Posterior dislocation
73
how does posterior dislocation of the hip present
affected leg is shortened, adducted and internally rotated
74
how does anterior dislocation of the hip present
affected leg is abducted and externally rotated ; no leg shortening
75
which type of back pain is a red flag symptom
thoracic back pain
76
what is the investigation of choice for Cauda Equina syndrome ?
MRI Spine
77
what is a late sign of cauda equina syndrome
Urinary incontinence
78
in how many hours should a patient with suspected cauda equina receive an MRI
6 hours
79
What type of injuries lead to meniscal tears?
Twisting injuries
80
what test can be used to check for a meniscal tear
Thessaly's test
81
which 2 arteries mainly supply the hip joint ?
medial and lateral circumflex femoral arteries
82
damage to the medial circumflex femoral artery can lead to __________
Avascular necrosis of the femoral head
83
which 3 nerves supply the hip joint
sciatic femoral and obturator nerves
84
what is the classical sign of a hip fracture
shortened and externally rotated leg
85
what is a key sign on x-ray of NOF Fracture
Shenton's line
86
Biceps rupture may lead to a ----------- deformity in the middle of the upper arm
Popeye
87
how are simple rib fractures managed ?
Conservative management with analgesia
88
what is a serious complication of rib fracture
Pneumothorax
89
what is the management of lumbar canal stenosis ?
Laminectomy
90
what is the management of a displaced intracapsular fracture ?
Hemiarthroplasty
91
cubital tunnel syndrome occurs due to the compression of which nerve ?
ulnar nerve
92
what is the key feature of cubital tunnel syndrome?
Tingling and numbness of 4th and 5th finger, starting off as intermittent and then becoming constant.
93
how does L5 disc prolapse present
loss of foot dorsiflexion and sensory loss on the dorsum of the foot
94
how does S1 nerve root compression present ?
sensory loss posterolateral aspect of leg and lateral aspect of foot
weakness in plantar flexion
reduced ankle reflex
95
What is the most common location for Ganglion ?
how does it present ?
Dorsal aspect of the wrist. Presents as a firm and well circumbscribed mass that trans-illuminates
96
how does a ganglion present
firm and well circumscribed mass that trans-illuminates
97
In a child with an asymptomatic, fluctuant swelling behind the knee the most likely diagnosis
Baker's cyst
98
which nerve is most likely to be injured during knee arthroplasty
common peroneal nerve
99
what is raloxifene used for ? what is its mechanism ?
selective oestrogen receptor modulator and mimics the effect of oestrogen on bone - used for management of post menopausal osteoporosis
inhibition of osteoclast activity
100
what are the symptoms seen in in Behcet's syndrome?
oral ulcers
genital ulcers
anterior uveitis
thrombophlebitis and DVT
erythema nodosum
101
what is Behcet's syndrome
It is a complex multisystem disorder associated with auto-immune mediated inflammation of arteries and veins
102
How does Olecranon bursitis present?
Swelling of the posterior aspect of the elbow with associated pain warmth and erythema.
Generally seen in middle aged male patients.
103
how does lateral epicondylitis present ? What is it commonly known as?
pain and tenderness on the lateral epicondyle worse on resisted wrist extension with elbow extended or supination of forearm with elbow extended.
tennis elbow
104
How does Medial epicondylitis present ? What is it commonly known as?
Pain and tenderness localised to the medial epicondyle.
aggravated by wrist flexion and pronation.
numbness and tingling in the 4th and 5th finger due to ulnar involvement
golfers elbow
105
what is radial tunnel syndrome caused by and what are its features?
Compression of the posterior interosseous branch of radial nerve.
Features include :
features of lateral epicondylitis
4-5 cm distal to lateral epicondyle
106
what is adhesive capsulitis commonly known as ? What condition is associated with? What are its features?
Frozen shoulder.
Associated with diabetes mellitus.
external rotation and active and passive movement affected.
107
what motion is a meniscal tear caused by? What test is used in its diagnosis?
Caused by twisting of the knee.
McMurray test positive
108
what motion is ACL tear caused by? what test confirms it ?
Twisting of the knee. Amplified with positive draw test.
109
what features of a humerus fracture would indicate an urgent need for surgery?
distal neurovascular deficit
110
what can the co-prescription of azathioprine and allopurinol cause?
Bone marrow suppression
111
what are the key features of polymyalgia rheumatica?
patients > 60
rapid onset
aching morning stiffness in proximal limb muscles - no weakness
112
what is the most common type of shoulder dislocation? What nerve is commonly injured?
Anterior shoulder dislocation
Axillary nerve affected
113
what antibodies are positive in Sjogren's syndrome?
RF
ANA
Anti Ro, Anti La
114
what are the key features of spinal stenosis ? How is the diagnosis confirmed?
gradual onset of unilateral or bilateral leg pain, numbness and weakness which is worse on walking and resolves on sitting.
Pain is also relieved by sitting down, leaning forwards and crouching down.
MRI is needed to confirm diagnosis.
115
what malignancies can dermatomyositis be associated with?
ovarian
breast
lung
116
what are the skin features of dermatomyositis?
Photosensitivity
Macular rash over the back and shoulder
Heliotrope rash in periorbital region
Gottron's papules : consisting of roughened red papules over the extensor surfaces of the fingers.
117
what antibodies are positive in dermatomyositis
ANA
Jo-1 - most specific
118
what are the Ottawa ankle rules?
ankle x-ray needed if :
Pain in malleolar zone and -
1. Inability to weight bear for 4 steps
2. Tenderness on distal tibia
3. Bone tenderness on distal fibula
119
what is the management of ankle fractures :
Prompt reduction of fracture to remove pressure on overlying skin and subsequent necrosis.
young patients usually require surgical repair with a compression plate
elderly patients generally require conservative management
120
how can you distinguish psoriatic arthritis from rheumatoid arthritis ?
Psoriatic arthritis presents with nail changes such as pitting and onycholysis
121
what is the first line management of lower back pain - mechanical?
NSAID's ( paracetamol monotherapy ineffective)
122
what is the most common mechanism of an ankle sprain?
Ankle inversion
123
What do the T-score and Z-score in a DEXA scan represent?
T-Score : based on bone mass of young reference population
Z-score : adjusted for age, gender and ethnic factors
124
how does paget's disease of the bone present on xray?
mixed lytic and sclerotic lesions
125
what are the features of Felty's syndrome?
splenomegaly
neutropenia
rheumatoid arthritis
126
where does osteosarcoma most commonly present?
Metaphyseal region of long bones prior to epiphyseal closure.
127
where does giant cell tumour most commonly occur?
Epiphyseas of long bones
128
which antibodies are diffuse cutaneous systemic sclerosis associated with?
anti scl-70 antibodies
129
what is a rheumatological drug that is safe to use in pregnancy?
Hydroxychloroquine
130
what are the causes of avascular necrosis of the hip?
Long term steroid use
chemotherapy
alcohol
trauma
131
what are the cautions for sulfasalazine use?
G6PD deficiency
allergy to aspirin / sulphonamides
132
what are the adverse effects related to sulfasalazine
oligospermia
Stevens Johnson syndrome
pneumonitis/ fibrosis
myelosuppression
133
What are the features of Still's disease?
arthralgia
elevate ferritin
salmon pink maculopapular rash
pyrexia
lymphadenopathy
134
What antibodies are present in Stills disease
RF, ANA
135
How is Still's disease managed?
NSAID's
steroids
136
what are the most common site for stress fractures? where do they most commonly occur?
Metatarsals
most commonly occur at the 2nd metatarsal shaft
137
what are the risk factors for pseudogout?
Hemochromatosis
Hyperparathyroidism
acromegaly, Wilson's disease
low magnesium, phosphate
138
what is Ehler-Danlos syndrome? What are it's features and complications?
autosomal dominant connective tissue disorder mainly affecting type III collagen.
Features include:
elastic, fragile skin
joint hypermobility and recurrent joint dislocation
easy bruising
complications include :
Aortic regurgitation
mitral valve prolapse
aortic regurgitation
SAH
139
how are flares of RA managed?
Corticosteroids - oral /IM
140
Children and young people with unexplained bone swelling or pain- ?
Very urgent direct access X-ray to assess for bone sarcoma
141
what features are seen with ankylosing spondylitis
A's
apical fibrosis
anterior fibrosis
aortic regurgitation
achilles tendonitis
AV node block
amyloidosis
142
what is the action of a statin ?
inhibition of HMG-CoA - rate limiting enzyme in hepatic chlolesterol control
143
what is the most common cause of heel pain seen in adults ? Where is the pain worse? How is it manahed
plantar fasciitis - around medial calcaneal tuberosity
management -
rest feet where possible
wear shoes with good support
insoles and heel pads
144
what is the first line medication for the management of Raynaud's
nifedipine
145
what test is used in the diagnosis of sjogren's syndrome
Schirmers
146
what type of medication is allopurinol
xanthine oxidase inhibitor
147
what is the most severe and dangerous form of Ehler's Danlos syndrome?
Vascular Ehlers Danlos syndrome
148
What syndrome, associated with Ehlers-Danlos syndrome, occurs as a result of autonomic dysfunction and causes significant tachycardia on sitting or standing along with presyncope or syncope
postural orthostatic tachycardia syndrome
149
describe swan neck and boutonniere's
swan neck - hyperextended PIP and flexed DIP
Boutonniere- hyperextended DIP and flexed PIP
150
What medical emergency causing severe hypertension and renal failure can be caused by diffuse cutaneous systemic sclerosis?
Scleroderma renal crisis
151
What condition typically causes self-limiting episodes of inflammatory arthritis, similar to rheumatoid arthritis, that last several days before completely resolving?
Palindromic rheumatism
152
What is the major complication of giant cell arteritis?
permanent vision loss
153
What test used in diagnosing Behçet's disease involves using a sterile needle to make multiple pricks on the forearm, then reviewed 24-48 hours later to look for erythema and induration?
pathergy test
154
What is the most common and least severe type of Ehlers-Danlos syndrome?
hypermobile ehlers danlos syndrome
155
What is the main presenting symptom of myositis?
gradual onset , symmetrical , proximal muscle weakness
156
give 2 dermatological side effects of hydroxychloroquine
blue grey skin
hair bleaching
157
What scoring system can be used to assess for hypermobility and support a diagnosis of hypermobile Ehlers-Danlos syndrome?
Beighton score
158
What skin changes are most associated with Kawasaki disease?
widespread erythematous maculopapular rash
desquamation ( skin peeling) of palms and soles
159
What term refers to inflammation of the points of insertion of tendons into bone, often seen in psoriatic arthritis?
enthesitis
160
What scoring system for calculating the risk of a major osteoporotic fracture or hip fracture is preferred in the NICE guidelines? (1)
What time frame does this score apply to? (1)
QFracture
10 years
161
Which DMARD notably causes peripheral neuropathy
leflunomide
162
What investigation is used to confirm a diagnosis of discoid lupus erythematosus? (1)
skin biopsy
163
What nail signs may be seen in psoriatic arthritis?
nail pitting
onycholysis - seperation of the nail from the nail bed
164
What tool is used to screen for psoriatic arthritis in patients with psoriasis?
psoriasis epidemiological screening tool
165
What rare bone-related side effects can occur with the use of bisphosphonates? (3)
atypical fractures- femoral
osteonecrosis of the jaw
osteonecrosis of the external auditory canal
166
What simple blood test is used in the diagnosis of myositis?
CK
167
What joint in the thumb is most often affected by osteoarthritis?
Carpometacarpal joint
168
what is the definition of accelerated progression of kidney disease
Sustained decline in the eGFR within 1 year of either 25% or 15 ml/ min / 1.73 m2
169
What oral medication may be used to stimulate tear and saliva production in patients with Sjögren's syndrome?
pilocarpine
170
What pattern of skin colour changes is characteristically seen in patients with Raynaud’s phenomenon when exposed to a cold trigger, and why do these changes occur?
white - due to vasoconstriction
then blue - cyanosis
red - reperfusion and hyperaemia
171
What are the characteristic presenting features of Behçet's disease?
recurrent oral ulcers
genital ulcers
172
What is the mechanism of action of adalimumab, infliximab and etanercept?
tumour necrosis factor inhibitors
173
What special technique can help distinguish between idiopathic Raynaud’s and Raynaud’s secondary to systemic sclerosis?
nailfold capillaroscopy
174
What class of medication often worsens the symptoms of Raynaud’s phenomenon?
beta blockers
175
What is the usual medical treatment for Kawasaki disease?
aspirin and IV immunoglobulins
176
explain t score
at the femoral neck
the number of standard deviations that the patients bone mineral density is from an average health adult
177
Which DMARD notably causes orange urine and a reduced sperm count?
sulfasalazine
178
Which DMARDs are most harmful in pregnancy?
methotrexate
leflunomide
179
What test assesses spinal mobility, particularly where ankylosing spondylitis is suspected? (1)
What reference points are marked in this test? (1)
What cutoff when bending forwards suggests restriction in lumbar movement? (1)
Schober's test
10 cm above and 5 m below the L5 vertebrae
less than 20 cm length between the reference marks suggests restriction
180
What unusual pathogens may cause infection in a transplant patient taking immunosuppressants?
PCP
CMV
TB
181
What gene is linked with Behçet's disease?
HLA B51
182
Which DMARD notably causes retinal toxicity?
Hydroxychloroquine
183
What are the key conditions associated with ankylosing spondylitis (5 As mnemonic)?
anterior uveitis
aortic regurgitation
av block
apical lung fibrosis
aocd
184
What is the medical term for a bunion?
hallux valgus
185
What term is used to describe the misaligned healing of a fracture?
malunion
186
What resisted movements can be used to establish a diagnosis of trochanteric bursitis?
external rotation
internal rotation
abduction
187
What are the three phases of frozen shoulder? (3)
How long does each phase last on average? (1)
painful, stiff, thawing
6 month each
188
Why would a bladder scan be indicated in a patient with back pain?
suspected cauda equina
189
what test assesses duputrens contracture
table top
190
What classification system can be used to describe fractures of the lateral malleolus of the ankle? (1)
What bone is affected? (1)
In relation to what important structure is the fracture described? (1)
What is the significance of this structure in relation to the fracture? (1)
weber
fibula
distal syndesmosis between tibia and fibula
fracture disprupts syndesmosis = surgery more liekly
191
What investigation can be used to measure the pressure in a compartment?
needle manometry
192
most common reason for total hip replacement revision.
Aseptic loosening - presenting with hip or groin region pain radiating down to the knee
193
how does posterior dislocation of the hip present ?
typically presents acutely with a 'clunk', pain and inability to weight bear
on examination there is internal rotation and shortening of the affected leg
194
what is a sign of scaphoid fracture
pain on longitudinal compression of thumb
195
where does the scaphoid get its blood supply from and what does interruption of this blood flow risk
dorsal carpal branch of the radial artery with disruption causing avascular necrosis of the scaphoid
196
what are the signs of a scaphoid fracture
point of maximal tenderness over anatomical snuffbox
pain elicited on longitudinal compression of the thumb
tenderness of scaphoid tubercle
pain on ulnar deviation of wrist
197
Ivx done for scaphoid injury
plain film radiographs in AP and lateral views
MRI definitive
198
how is a scaphoid fracture managed
immobilisation with a futuro splint or standard below backslab
199
how are undisplaced fractures of the scaphoid managed
cast for 6-8 weeks
200
how are displaced scaphoid fractures managed
surgical fixation
201
meniscal tear test
Thessaly's test - weight bearing at 20 degrees of knee flexion, patient supported by doctor, postive if pain on twisting knee
202
what investigation is essential prior to commencing biologics
chest xray
203
mx of scaphoid pole fractures
surgical fixation
204
how does compartment syndrome present renally
raised myoglobin
205
differentiate between direct and indirect injury of the patella
direct generally involves a blow or trauma to the front of the knee, generally an undisplaced crack
indirect injury is generally is when the quadriceps forcefully contracts against a block to knee extension ( like when catching foot against solid object)
206
investigations for patellar fracture
plain film radiograph generally AP anf lateral
207
management of patellar fracture
undisplaced - if they have intact extensor mechanism then hinged knee brace for 6 weeks
displaced - operative management with tension band wire, inter fragmentary screws etc
208
distinguish between galeazzi and monteggia fracture
monteggia - ulnar fracture, foosh
galaezzi - radial shaft fracture , reverse foosh
209
management of temporal arteritis
no visual loss - high dose pred
visual loss - IV methylpred
continue even if normal biopsy due to skip lesions
210
Osteochondritis dissecans
typically presents with knee pain after exercise, locking and 'clunking'
211
spinal stenosis diagnosis
MRI
212
feature suggesting primary raynaud's
young women
213
key features of APL
anticardiolipin
thrombocytopenia
prolonged APTT
214
causes of dupuytren's contracture
manual labour
phenytoin treatment
alcoholic liver disease
diabetes DM
215
tool used to assess hypermobility
Beighton score
216
what is visual loss in temporal arteritis caused by
anterior ischaemic optic neuropathy
217
how would you describe a club foot
inverted and plantar flexed foot which is not passively correctable
218
what are the features of fat embolism
respiratory distress, altered mental status, and a rash.
219
mx of fat embolism
fixation of long bone fractures
220
anterior vs posterior dislocation
posterior : leg is shortened, adducted and internally rotated
anterior : abducted and externally rotated with no leg shortening
221
which lung condition are persons with marfans most likely to develop
pneumothorax
222
which skin feature is behcets syndrome associated with
erythema nodosum
223
management of rib fractures
conservative management with analgesia
nerve block
surgical fixation if fracture has failed to heal following 12 weeks of conservative mx
224
how to distinguish between anterior cruciate ligament tear and medial meniscus tear
ACL = rapid joint swelling due to bleeding
meniscal tear= gradual swelling
225
Baker's cyst
develop in patients with arthritis or gout following minor trauma to the knee
226
which meds should be considered in all housebound patients
vitamin D
227
squaring of the thumb suggests ?
osteoarthritis
228
marfans is characterised by a deficiency of
fibrillin
229
how is APL managed
primary - low dose aspirin
secondary - lifelong warfarin
230
anterior and posterior shoulder dislocation
anterior - FOOSH
posterior - seizures and electrical shock
231
which is the main immunoglobulin found in breast milk
IgA
232
what is the management of subluxation of the radial head
analgesia
passive supination of the elbow joint while elbow is flexed up to 90 degrees
233
summary of osteogenesis imperfects
brittle bone disease
autosomal dominant
childhood- fractures following minor trauma, blue sclera, deafness and dental problems
calcium, phosphate , pth and alp generally normal
234
features of osteosarcoma
Codman's triangle
most common
sunburst pattern
235
management of shoulder dislocation
recent dislocation = attempt reduction without analgesia or sedation
236
Ant synthetase syndrome
Anti Jo1
myositis
ILD
thickened and cracked skin
Raynaud's
237
most common causes of drug induced SLE
procainamide
hydralazine
isoniazid
minocycline
phenytoin
238
C8 radiculopathy
weak flexion of all digits including the thumb
239
features of cauda equina
lower back pain
bilateral sciatica
decreased anal tone
240
Anterior ischemic optic neuropathy
swollen pale disc and blurred margins
241
virchows triad
stasis
hypercoagulability
endothelial damage
242
signs of central disc prolapse
weakness
urinary retention
incontinence
peri-anal sensory loss
reduced anal tone
243
HLA type associated with RA
HLA DR4/DR1
244
surgical management of carpal tunnel syndrome
decompression studies : division of the flexor retinaculum
245
ulnar nerve entrapment
Numbness and paraesthesia of the ulnar half of the ring finger and the little finger
246
survival rate of osteosarcoma
55% 5 year survival
247
froment's sign
Froment's sign - present in carpal tunnel syndrome : flexion of PIP while grasping a piece of paper between thumb and index
248
radiological signs of avascular necrosis of the femoral head
none initially
sclerosis and otolysis
fractures, flattening of femoral head
joint space narrowing
249
mx of hip dislocation
Reduction under general anaesthesia within 4 hours = reduces risk of avascular necrosis
250
ottawa knee rules
Age 55 / more
Patellar head tenderness
Fibular head tenderness
Can't flex knee
Can't weight bear
251
