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Misc. Notes Year 2 > MSK Cortext Documents > Flashcards

MSK Cortext Documents Flashcards

1
Q

Which pathology is also known as brittle bone disease

A

Osteogenesis Imperfecta

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2
Q

Which pathology causes gracile bones

A

Osteogenesis Imperfecta

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3
Q

What effect can Osteogenesis Imperfecta have on the eyes and ears

A

Blue Sclera

Hearing loss

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4
Q

What is the pathology in osteogeneis imperfecta

A

Defect in type 1 collagen

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5
Q

Where can aneurysms occur in someone with Marfan’s

A

Aorta

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6
Q

Which connective tissue disorder can cause scoliosis

A

Ehlers-Danlos

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7
Q

What is Babinski’s sign

A

extensor plantar response

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8
Q

What causes cerebral palsy

A

Insult to immature brain before, during or after birth

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9
Q

What are the 4 classifications of cerebral palsy to do with which limbs are involved

A

1 limb (monoplegic)
Ipsilateral limbs (hemiplegic)
Both legs only (diplegic)
Total body involvement

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10
Q

Which two foot pathologies can be a part of the presentation of spina bifida

A

High arched foot (pes cavus) Clawing of toes

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11
Q

What actually causes spina bifida

A

Two halves of posterior vertebral arch fail to fuse in first 6 weeks of gestation

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12
Q

What is Fibular hemimelia

A

Partial or complete absence of fibula often with absence of lateral foot rays

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13
Q

Are children born with straight legs

A

No, born with genu varus

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14
Q

Name some risk factors for DDH

A

Family history
Breech birth
First born

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15
Q

What special harness can be used in children with DDH

A

Pavlik harness

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16
Q

Who does transient synovitis most commonly affect

A

Commonly occurs after an URT infection typically in 2-10 year old boys

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17
Q

What is Perthe’s disease

A

An idiopathic osteochondritis of femoral head

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18
Q

Who does Perthe’s commonly affect

A

Short stature boys aged 4-9

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19
Q

What is the first clinical sign of Perthes

A

Loss of internal rotation
Loss of abduction
Positive Trendelenburg test

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20
Q

Who does Slipped Upper Femoral Epiphysis affect

A

Mainly affects overweight pre-pubescent boys where femoral head slips inferiorly in relation to femoral neck

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21
Q

What is chondromalacia patellae

A

Softening of hyaline cartilage in patella

Causing anterior knee pain

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22
Q

Which 3 deformities make up Talipes Equinovarus (clubfoot)

A

Ankle Equinus (plantarflexion)
Supination of Forefoot
Varus alignment of forefoot

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23
Q

What splintage technique is used to treat Clubfoot

A

Ponseti technique

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24
Q

Which part of the intervertebral disc is richly innervated

A

Periphery

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25
Q

Where is the most common site for disc material to impinge on a nerve root

A

L4/5

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26
Q

What is the insertion of the rotator cuff muscles

A

Supraspinatus, Teres minor, Infraspinatus all insert at greater tuberosity of humerus
Subscapularis inserts at lesser tuberosity of humerus

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27
Q

What is the popeye deformity seen in

A

Biceps tendon rupture

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28
Q

What is divided in carpal tunnel decompression surgery

A

The transverse carpal ligament

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29
Q

What is the name of the fascia which forms the roof of the cubital tunnel

A

Osborne’s fascia

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30
Q

What is the test done for cubital tunnel syndrome and what muscle does it use

A

Tinel’s test

Froment’s test (adductor pollicus)

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31
Q

Why can steroid injections not be given in golfer’s elbow

A

Risk of injury to ulnar nerve

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32
Q

How many degrees of flexion can be tolerated in Dupuytren’s before surgery is indicated

A

30 degrees

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33
Q

What hand pathology is characterised by multinucleate giant cells and haemosiderin staining

A

Giant cell tumours of tendon sheath

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34
Q

What are some early complications of a joint replacement

A

Infection, dislocation, nerve injury

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35
Q

What are some early systemic complications of a joint replacement

A

MI, Chest infection, UTI, P.E

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36
Q

What does the hanging rope sign suggest

A

Avascular necrosis

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37
Q

What are the treatment options for avascular necrosis of the hip and what do they depend on

A

Pre-collapse - decompression

Post- collapse - THR

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38
Q

What movement does the ACL resist

A

Abnormal internal rotation

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39
Q

What movement does the PCL resist

A

Hyperextension of knee

Anterior movement of femur

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40
Q

How do meniscal injuries often occur

A

Twisting force on a loaded knee

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41
Q

What kind of effusion is usually present with an ACL tear

A

Haemarthrosis

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42
Q

What is the principal complaint of ACL rupture

A

Rotatory instability

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43
Q

Name the extensor mechanism from superior to inferior

A 
Quadriceps muscles
Quadriceps tendon 
Patella 
Patellar tendon 
Tibial tuberosity
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44
Q

Which class of antibiotics can cause tendon rupture

A

Quinolones

ciprofloxacin

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45
Q

What is the gold standard treatment for hallux rigidus

A

Arthrodesis

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46
Q

Which toe pathology often accompanies pes cavus

A

Claw toes

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47
Q

What is a pseudotumour in terms of joint replacements

A

Metal particles cause an inflammatory granuloma

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48
Q

What can polyethylene particles cause in bones

A

Bone resorption (osteolysis)

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49
Q

Which technique uses a special external fixator to to lengthen short limbs

A

Lizarov technique

50
Q

What respiratory problem can scoliosis cause

A

Restrictive lung disease

51
Q

What is an involucrum

A

New bone will form around the area of necrosis in osteomyelitis

52
Q

What is a Brodie’s Abscess

A

When bone reacts by walling off the abscess with a thin rim of sclerotic bone - seen in osteomyelitis

53
Q

What does displacement mean when describing a fracture

A

The direct translation of the distal fragment

54
Q

What does angulation mean when describing a fracture

A

The direction in which the distal fragment points towards and the degree of this deformity

55
Q

What is a de-gloving injury

A

A shearing force on the skin which results in avulsion of the skin from its underlying blood vessels

56
Q

What are the two types of non-union

A

Hypertrophic

Atrophic

57
Q

What does hypertrophic non-union occur due to

A

Instability and excessive motion at the fracture site

58
Q

What does atrophic non-union occur due to

A

Rigid fixation with a fracture gap (lack of blood supply)

59
Q

What antibiotics are typically given to manage an open fracture and what cover do they provide

A

Flucloxacillin- gram positive Gentamicin- gram negatives Metronidazole- anaerobes

60
Q

What is the bulbocavernous reflex

A

Reflex contraction of the anal sphincter with either a squeeze of the glans penis, tapping the mons pubis or pulling on a urethral catheter

61
Q

what does absence of the bulbocavernous reflex indicate

A

Spinal shock

62
Q

What is spinal shock

A

Physiological response to injury with complete loss of sensation and motor function and loss of reflexes below the level of the injury

63
Q

What does sacral sparing indicate in terms of incomplete spinal injury

A

A better prognosis

64
Q

What is central cord syndrome

A

Paralysis of the arms more than the legs occurs due to corticospinal (motor) tracts of the upper limbs being more central than those of the lower limbs

65
Q

What is the difference between anterior cord syndrome and posterior cord syndrome

A

Proprioception, vibration and light touch senses are preserved in anterior cord syndrome but motor function is lost

66
Q

What is Brown-Sequard syndrome

A

Ipsilateral paralysis and loss of dorsal column sensation occurs with contralateral loss of pain, temperature and coarse touch

67
Q

What are the three types of pelvis fracture

A

Lateral compression
Vertical shear
Anteroposterior compression

68
Q

What is a Bankart lesion

A

Detachment of the anterior glenoid labrum and capsule

69
Q

What is a Hill‐Sachs lesion

A

Impaction fracture of posterior humeral head after impacting on anterior glenoid

70
Q

Where in the humeral shaft does the radial nerve sit

A

Spiral groove

71
Q

What is a Barton’s fracture

A

Intra‐articular fractures of the distal radius involving the dorsal or volar rim

72
Q

What is a volar Barton’s fracture also known as

A

An intra-articular Smith’s fracture

73
Q

What is a dorsal Barton’s fracture also known as

A

An intra-articular Colles’ fracture

74
Q

What is a Lisfranc fracture

A

Fracture of the base of the 1st/ 2nd metatarsal associated with dislocation of the other metatarsals

75
Q

What are calcium, phosphate, ALP & PTH levels like in osteoporosis

A

All normal

76
Q

What is osteomalacia

A

Softening of the bones, typically through a deficiency of vitamin D or calcium

77
Q

What are the levels of Ca, Phosphate, ALP & PTH like in osteomalacia

A

Decreased Calcium & phosphate

Increased ALP & PTH

78
Q

What are the levels of Ca, Phosphate, ALP & PTH like in primary hyperparathyroidism

A

Increased Ca & PTH
Increased ALP
Decreased Phosphate

79
Q

What are the levels of Ca, Phosphate, ALP & PTH like in chronic kidney disease

A

Decreased calcium
Increased Phosphate
Increased ALP & PTH

80
Q

What are the levels of Ca, Phosphate, ALP & PTH like in Paget’s disease

A

Increased ALP

Normal everything else

81
Q

What are the levels of Ca, Phosphate, ALP & PTH like in bone malignancy

A

High calcium
Very High ALP
PTH normal

82
Q

What is a Brown tumour

A

A bone lesion which arises in the setting of excess osteoclast activity e.g hyperparathyroidism

83
Q

What is osteochondritis dissecans (OCD)

A

an osteochondritis where a fragment of hyaline cartilage with a variable amount of bone fragments and breaks off the surface of the joint

84
Q

What test is used to differentiate between mobile and fixed flat foot

A

Jack’s test

85
Q

What is Jack’s test and what is it used for

A

A flattened medial arch forms with dorsiflexion of the great toe (Jack test) -> Mobile flat foot
Used to differentiate between mobile and fixed flat feet

86
Q

What are three possible causes of flexible flat feet

A

Ligamentous laxity
Familial
Idiopathic

87
Q

What does dynamic flat footedness mean

A

It is present on weight bearing only

88
Q

What is the most common cause of mobile/flexible flat feet in adults

A

Tibialis posterior dysfunction

89
Q

What is the most common cause of rigid flat feet

A

Tarsal coalition

90
Q

Asides from tarsal coalition, what else can cause rigid flat feet

A

Underlying inflammatory disorder

Neurological disorder

91
Q

What the three commonest primary tumours which metastasise to bone

A

Breast, Prostate, Lung

92
Q

What is Caisson’s disease

A

Decompression sickness

93
Q

Which joint pathology can Caisson’s disease lead to

A

Avascular necrosis

94
Q

What organism seen in the joint aspirate in reactive arthritis

A

No organism, usually sterile

95
Q

Which type of arthritis is associated with Z-shaped thumb

A

Rheumatoid Arthritis

96
Q

Which type of arthritis is associated with squaring of the base of the thumb

A

Osteoarthritis

97
Q

When is lifelong warfarin indicated in a patient with Anti-Phospholipid syndrome

A

After a thrombotic event

98
Q

Which joint pathology will cause thrombocytosis

A

Rheumatoid Arthritis

99
Q

What ANCA result do most large vessel vasculitis have

A

Usually ANCA negative

100
Q

Which classification is used for sorting vasculitis

A

Chapel-Hill classification

101
Q

Which antibody is associated with GPA (Wegener’s)

A

Anti-PR3

102
Q

Which antibody is associated with eGPA (Churg-Strauss) )

A

Anti-MPO ANCA

103
Q

What proportion of SUFE cases are bilateral

A

1/3rds

104
Q

Which congenital MSK condition is a hip pathology but can present with knee pain

A

SUFE

105
Q

Which movement is lost in SUFE

A

Internal rotation

106
Q

What actually is DDH

A

Dislocation/ Subluxation of the femoral head in the neonatal period

107
Q

Name 4 risk factors for DDH

A

Female sex
Breech birth
Down syndrome
A family history of DDH

108
Q

Which way does the patella usually dislocate

A

Laterally

109
Q

Which structure is torn when the patella laterally dislocates

A

Medial patellofemoral ligament

110
Q

Which knee examination test will be positive when examining a suspected patellar dislocation

A

Positive apprehension test

111
Q

Which investigation is done to diagnose DDH

A

Ultrasound

112
Q

What is the method of transmission of osteogenesis imperfect

A

Autosomal dominant & autosomal recessive

113
Q

What is Myositis Ossificans

A

heterotopic ossification (bone forming outside the skeleton) occurs in muscles usually after an injury

114
Q

Where can the ulnar nerve become trapped asides from within the cubital tunnel

A

Guyon’s canal

ulnar tunnel

115
Q

What is the minimum score someone can get on the Glasgow Coma Scale

A

3

116
Q

If Froment’s test is positive, which muscle supplied by which nerve will be weak and which muscle, supplied by which nerve, will be used to compensate

A

If Froment’s test positive
Adductor Pollicus is weak -> Ulnar nerve
Flexor Pollicus Longus compensates -> Median nerve

117
Q

What should you suspect if someone comes in with severe joint pain and systemic upset

A

Septic arthritis

118
Q

If there are clinical signs of a scaphoid fracture but it is not visible on X-Ray, what should you do

A

Review in 2 weeks

119
Q

Which part of the scaphoid is susceptible to Avascular Necrosis and why

A

Proximal end

because the blood supply is derived from the distal end via a branch of the radial artery

120
Q

What splint is used to temporarily immobilise a suspected scaphoid fracture

A

Discharge home with futura splint and fracture clinic appointment

Misc. Notes Year 2 (30 decks)

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