Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 5 notes > MSK and trauma > Flashcards

MSK and trauma Flashcards

1
Q

XR features in septic arthritis

A
  • may be normal initially or show only soft tissue swelling
  • later features - bone destruction, subluxation, narrowing of spaces, erosive changes
  • wide spaces suggests effusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Kocher criteria for septic arthritis

A
  • temp >38.5
  • increased ERSR
  • increased WCC
  • non-weight bearing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

antibiotic usually given in septic arthritis

A

flucloxacillin, clindamycin if allergic

given 6-12 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

which arteries are inflamed in GCA

A

posterior ciliary arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

why can GCA cause visual disturbances

A

secondary to anterior ischaemic optic neuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

when to consider Takayusu’s in GCA

A

if <55

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

investigations for GCA

A
  • ESR >50

- temporal artery biopsy (skip lesions?)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

retinal appearance in GCA

A
  • pale papilloedema
  • ischaemic disc is pale, waxy, elevated
  • splinter haemorrhages
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

at which level is a prolapsed disc most common

A

L4-5 or L5-S1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what to consider as a differential for spinal cord compression

A

if on steroids - may have caused some proximal myopathy

will have a normal neurological exam other than some wasting/maybe reduced hip flexion which is symmetrical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

neurological signs of spinal cord compression depending on level of lesion

A
  • lesions above L1 = UMN signs in legs

- lesions below L1 = LMN signs in legs and perianal numbness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

analgesia to use in osteoarthritis

A
  • topical NSAIDs + paracetamol

- if ineffective - oral NSAIDs + PPI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

most common sites of fragility fractures

A
  • vertebrae
  • hip (proximal femur)
  • wrist (distal radius)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

risk assessment to do in those on oral steroids over 3 months

A

FRAX tool for osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

first line bisphosphonate to use in osteoporosis

A

alendronate

review after 5 years (3 years for zolendronic acid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

drug to use for osteoporosis in severe osteoporosis in postmenopausal women and men at high risk of fracture

A

strontium ranelate - increases MI risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is palindromic RA

A

relapsing/remitting mono arthritis of different large joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is a poor prognostic factor in RA

A

positive rheumatoid factor (positive in 70% but can also be raised in Sjogren’s Felty’s SLE etc)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

more specific antibody in RA

A

anti-CCP antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

FBC findings in RA

A

normocytic, normochromic anaemia and reactive thrombocytosis

ESR and CRP may be increased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

DMARDs to use in RA

A
  • monotherapy +/- short course prednisolone

- give methotrexate, or sulfasalazine, hydroxychloroquine, leflunomide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

when to give TNF inhibitors in RA

A

if inadequate response to at least 2 DMARDs including methotrexate

E.g:

  • etanercept
  • adalimumab
  • infliximab
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

condition associated with GCA

A

polymyalgia rheumatica

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

bloods results in PMR

A
  • ESR >40
  • raised CRP
  • ALP raised in 30%
  • CK and EMG NORMAL
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

histology in PMR

A
  • vasculitis with giant cells
  • skip lesions
  • muscle bed arteries most affected
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

dose of prednisolone to give in PMR

A

15mg/d PO

reduce dose slowly
most need for >2 years (remember GI and bone protection)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

2nd line drugs for PMR after prednisolone

A
  • methotrexate

- tocilizumab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

drugs which can precipitate gout

A

diuretics

cytotoxic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is Lesch Nyhan syndrome

A

X-linked recessive disorder causing gout, renal failure, neurological deficits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

joint aspirate in gout

A

negatively birefringent crystals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

drugs to give in acute gout attack

A

NSAIDs + colchicine

if contraindicated - prednisolone 15mg/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what to give for gout remission if allopurinol contraindicated

A

febuxostat

aim for serum uric acid <300

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

risk factors for pseudogout

A
  • hyperparathyroidism
  • hypothyroidism
  • haemochromatosis
  • acromegaly
  • low magnesium, low phosphate
  • Wilson’s disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

joint aspirate in pseudogout

A

positively birefringent rhomboid shaped crystals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

XR finding in pseudogout

A

chonedrocalcinosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

investigation to diagnose spinal stenosis

A

MRI

37
Q

what does a straight leg raise test for

A

lumbar root irritation

38
Q

genes associated with ankylosing spondylitis and reactive arthritis

A

HLA-B27 (only positive in 10%)

seronegative

39
Q

XR changes in ankylosing spondylitis

A
  • normal in early disease
  • sacroiliitis: subchondral erosions, sclerosis
  • squaring of lumbar vertebrae
  • bamboo spine (late)
  • syndesmophytes - due to ossification of outer fibres of annulus fibrosis
40
Q

what might spirometry show in ankylosing spondylitis

A

restrictive defect due to:

  • pulmonary fibrosis
  • kyphosis
  • ankylosis of costovertebral joints
41
Q

6 As of ankylosing spondylitis

A
  • apical fibrosis (CXR)
  • anterior uveitis
  • aortic regurgitation
  • achilles tendonitis
  • AV node block
  • amyloidosis
42
Q

first line drugs for ankylosing spondylitis

A

NSAIDs

43
Q

when to use DMARDs in ankylosing spondylitis

A

only if peripheral joint involvement

44
Q

can’t see, pee or climb a tree

A

reactive arthritis - urethritis, conjunctivitis, arthritis

asymmetrical oligoarthritis of lower limbs

45
Q

usual organism causing reactive arthritis

A

chlamydia (do PCR) - develops within 4 weeks of initial infection

46
Q

2 fractures commonly causing compartment syndrome

A
  • supracondylar

- tibial shaft fractures

47
Q

why may arterial pulsation still be felt in compartment syndrome

A

necrosis occurs due to microvascular compromise

48
Q

investigations for compartment syndrome

A

measurement of intra-compartmental pressure:

  • > 20mmHg abnormal
  • > 40mmHg diagnostic
49
Q

why can renal failure occur after fasciotomy

A

myoglobinuria - need aggressive IV fluids

50
Q

what can cause chronic compartment syndrome

A

young athletes - excessive training

51
Q

ligaments involved in high ankle sprain

A

tibia and fibula syndesmosis (what binds them together)

52
Q

ligaments involved in low ankle sprain

A

lateral collateral ligaments

53
Q

most common ligament affected in low ankle sprain

A

inversion injury causing tear of ATFL

54
Q

what is Hopkin’s squeeze test

A

pain when tibia and fibula squeezed together at mid-calf

shows a high ankle sprain

55
Q

management of low ankle sprain

A

RICE

crutches etc.

56
Q

management of high ankle sprain

A

non-weight bearing orthosis

if widening of tibiofibular joint (diastasis) then operative fixation needed

57
Q

how does Colles’ fracture occur

A

FOOSH - dinner fork deformity

distal radius fracture with dorsal displacement of fragments

58
Q

nerve which can be damaged in Colles’ fracture

A

median or ulnar nerve

may experience acute carpal tunnel syndrome

59
Q

what is a Smith’s fracture

A

reverse Colles’ - anterior displacement of distal fragments - garden spade deformity

60
Q

type of hip fracture at risk of avascular necrosis

A

intracapsular

61
Q

what is broken in hip fractures

A

Shenton’s line

62
Q

classification of hip fractures I-IV

A

I = stable fracture with impaction in valgus, inferior cortex intact

II = complete fracture but undisplaced

II = displaced

IV = complete bony disruption

63
Q

management of intracapsular hip fractures

A

surgery within 24 hours

  • undisplayed = internal fixation with screws, hemiarthroplasty if unfit
  • displaced = young and fit then reduction and internal fixation, if older and reduced mobility then hemiarthroplasty/total hip replacement
64
Q

management of extra capsular hip fractures

A
  • dynamic hip screw

- if reverse oblique, transverse or subtrochanteric: intramedullary device

65
Q

cerebral perfusion pressure equation

A

CPP = MAP - ICP

66
Q

why can increased ICP result in ipsilateral pupillary dilatation

A

increased ICP = herniation of temporal lobe through tentorial hiatus = compresses oculomotor nerve

67
Q

what is Battle’s sign

A

bruising over mastoid process - sign of basal skull fracture but takes several days to appear

68
Q

what NOT to use in a basal skull fracture

A

nasopharyngeal airway

69
Q

when to do an immediate CT scan after head injury

A 
o GCS <13 initial assessment
o GCS <15 2 hours post injury
o Suspected open/depressed skull fracture o Any sign basal skull fracture
o Post traumatic seizure
o Focal neurological deficit
o >1 episode vomiting
70
Q

when to do a CT scan within 8 hours after head injury

A

if some LOC/amnesia and ANY of:

  • 65+
  • history bleeding/clotting problems
  • dangerous mechanism of injury - fall >1m, pedestrian struck by car etc.
  • > 30 min retrograde amnesia of events immediately before injury

if on warfarin

71
Q

score 1-4 in Eye on GCS

A

Eye opening:

  • spontaneous = 4
  • to speech = 3
  • to pain = 2
  • none = 1
72
Q

score 1-5 in verbal on GCS

A

Verbal response:

  • orientated = 5
  • confused = 4
  • inappropriate words = 3
  • sounds = 2
  • none = 1
73
Q

score 1-6 in motor on GCS

A

Best motor response:

  • obeys commands = 6
  • localises to pain = 5
  • normal flexion = 4
  • abnormal flexion = 3
  • extension = 2
  • none = 1
74
Q

what is the trauma triad of death

A

hypothermia
coagulopathy
acidosis

75
Q

ATOM FC for major thoracic injury

A

Airway obstruction
Tension pneumothorax
Open chest wound
Massive haemothorax

Flail chest (2+ ribs broken in 2+ places)
Cardiac tamponade
76
Q

type of shoulder dislocation associated with seizures

A

posterior dislocation (limited external rotation)

but rare type of dislocation

77
Q

triad of symptoms in reactive arthritis

A

urethritis
conjunctivitis
arthritis

78
Q

investigation results in reactive arthritis

A
  • ESR and CRP raised

- HLA-B27 positive in majority of those affected

79
Q

why do PCR in reactive arthritis

A

to test for chlamydia (because reactive arthritis is usually caused by chlamydia)

80
Q

management of reactive arthritis

A
  • analgesia, NSAIDs, intra-articular steroids if unresponsive to NSAIDs
  • antibiotics to treat causative organism
  • sulfasalazine and methotrexate if persistent disease
81
Q

extra-articular manifestations of seronegative arthritis

A
  • uveitis
  • pulmonary fibrosis (upper zone)
  • amyloidosis
  • aortic regurgitation
82
Q

examples of seronegative arthritis

A
  • ankylosing spondylitis
  • psoriatic arthritis
  • Reiter’s syndrome (reactive arthritis)
  • enteropathic arthritis (associated with IBD)
  • JIA (rare)
83
Q

causes of osteomalacia

A
  • vitamin D deficiency
  • renal failure
  • drugs
  • liver disease
84
Q

what does XR show in osteomalacia

A

translucent bands

85
Q

sclerotic bone tumour - likely primary?

A

prostate

86
Q

lytic bone tumour - likely primary?

A

breast, myeloma

87
Q

treatment of lupus nephritis, vasculitis and cerebral lupus

A

cyclophosphamide

88
Q

lung problems associated with scleroderma

A

ILD

pulmonary artery HTN

89
Q

CK levels in myositis

A

> 1000

Year 5 notes (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions