MSK Cortext Mix

Question 1

between giant cell and Takayasu arteritis, which is more common in over 50s?

Answer 1

giant cell

Question 2

what forms the carpal tunnel?

Answer 2

carpal bones

flexor retinaculum

Question 3

what can cause carpal tunnel syndrome?

Answer 3

idiopathic
swelling in the carpal tunnel
- RA (synovitis)
fluid retention
- pregnancy
- diabetes
- chronic renal disease
- hypothyroidism
fracture
- e.g distal radius fracture

Question 4

what tests can confirm carpal tunnel syndrome?

Answer 4

tinels test (tapping over median nerve) and phalens test (holding wrists hyperflexed) can recreate symptoms
nerve conduction studies

Question 5

main sign of extensor mechanism rupture and how is this managed?

Answer 5

cant do straight leg raise

usually surgically managed

Question 6

WHO definition of osteoporosis?

Answer 6

reduced bone mineral density and increased porosity of bone

bone mineral density less than 2.5 standard deviations below mean peak value for young adults of same age race and sex

Question 7

what is osteopaenia?

Answer 7

intermediate stage before osteoporosis

bone mineral density between 1-2.5 standard deviations below mean peak value

Question 8

polymyalgia rheumatica vs polymyositis?

Answer 8

PR = significant pain and stiffness in proximal limb muscles, significantly raised inflammatory markers, improves with exercise
polymyositis = mainly weakness rather than pain, worsens with exercise

Question 9

describe scaphoid blood supply?

Answer 9

retrograde

Question 10

what can cause plantar fasciitis?

Answer 10

diabetes
obesity
walking on hard floors without cushioned soles

Question 11

how is plantar fasciitis managed?

Answer 11

gel heel cushions
achilles and plantar fascia stretching exercises
corticosteroid injections
avoid plantar fascia surgical release due to risk to plantar nerves

Question 12

modified new York criteria for diagnosis of ankylosing spondylitis?

Answer 12

pain for more than 3 months
worse at rest, relieved by movement
X ray changes of sacroiliitis

Question 13

visible line surrounding the osteon is called what?

Answer 13

cement line

Question 14

risk factors for DDH?

Answer 14

female
first born
breech presentation
left leg
down syndrome
family history of DDH
other congenital disorders (talipes etc)

Question 15

blood supply to femoral head?

Answer 15

medial and lateral circumflex artery branches of profundal femoris artery
small amount from obturator artery (goes directly to femoral head at the top)

Question 16

lightbulb sign?

Answer 16

posterior shoulder dislocation

Question 17

6 risk factors for osteoporosis?

Answer 17

female
inactivity
smoking
alcohol
reduced exposure to sunlight
diet

Question 18

boxers fracture can often be managed conservatively, what type of deformity cannot and must be fixed?

Answer 18

rotational

Question 19

A lucent, multi-loculated cyst found within the medulla of many different bones, often with associated cortical expansion?

Answer 19

aneurysmal bone cyst

Question 20

A mostly lucent lesion, with a patchy sclerosis, found within the metaphyseal region of long bones?

Answer 20

enchondroma

Question 21

klumpkes palsy is caused by damage to which nerve roots?

Answer 21

C8 and T1

Question 22

how does klumpkes palsy present?

Answer 22

paralysis of intrinsic hand muscles and finger/wrist flexors

fingers are typically flexed due to paralysis of interossei and lumbricals which assist in extension at PIPs

Question 23

4 risk factors for talipes equinovarus?

Answer 23

male
breech presentation
oligohydramnios
family history

Question 24

what is the target serum urate level?

Answer 24

<360

Question 25

management of acute gout?

Answer 25

colchicine and steroids
don’t start allopurinol until 2 weeks after flare up
if already on allopurinol, don’t stop it during an acute flare

Question 26

how does allopurinol work?

Answer 26

inhibits xanthine oxidase

Question 27

how does DMARD therapy affect immunisations?

Answer 27

cant have live vaccinations while taking DMARDs

must have influenza and pneumococcal vaccines before starting treatment

Question 28

describe ganglion cysts

Answer 28

smooth
firm
rubbery
transilluminate

Question 29

how is a ganglion cyst managed?

Answer 29

needle aspiration often not successful due to thick gelatinous material in cyst
whacking with a bible often has high recurrence as wall of cyst isn’t removed
surgical removal = definitive management

Question 30

what is peyronie’s disease?

Answer 30

fibromatosis (like dupytrens) of the penis

Question 31

what is ledderhose disease?

Answer 31

fibromatosis (like dupytrens) of the plantar aspect of the foot

Question 32

what is a greenstick fracture?

Answer 32

occurs in children

when the bone bends and the tension side (part being stretched) breaks while the side being compressed remains intact

Question 33

3 risk factors for dupytrens?

Answer 33

male
alcohol
diabetes

Question 34

MSK development stages from 6-9 months to 3 years?

Answer 34

6-9 months = sits alone, crawls
8-12 months = stands
14-17 months = walks
2 years = jumps
3 years = manages stairs alone

Question 35

where do stress fractures normally occur and how are they diagnosed?

Answer 35

2nd followed by 3rd metatarsal

not visible on X ray until 3 weeks after when callus forms

Question 36

how is a metatarsal stress fracture managed?

Answer 36

6-12 weeks rest in a rigid soled boot

Question 37

what are the 2 types of chronic regional pain syndrome?

Answer 37

type 1 = not caused by peripheral nerve injury

type 2 = caused by peripheral nerve injury

Question 38

how is chronic regional pain syndrome managed?

Answer 38

analgesics
antidepressants
anticonvulsants
steroids
sympathetic nerve blocking

Question 39

what are osteoprogenitor cells?

Answer 39

cells on surface of bone which serve as a reserve pool of osteoblasts

Question 40

what is osteochondritis dissecans?

Answer 40

fragmentation with separation of bone and cartilage within a joint

Question 41

what sites are particularly pre-disposed to osteochondritis?

Answer 41

lateral part of medial femoral condyle in the knee
anteromedial talar done
superomedial femoral head
humeral capitellum

Question 42

how might osteochondritis present?

Answer 42

pain
effusions
locking
giving way