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3rd year medicine > MSK guidelines > Flashcards

MSK guidelines Flashcards

1
Q

carpa tunnel syndrome Ix

A

nerve conduction studies show prolongation of APs both motor and sensory

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2
Q

carpal tunnel syndrome Mx

A

splinting, steroid injection, surgery

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3
Q

trigger finger 1st line and last line

A

steroids and surgery

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4
Q

dupuytrens indication for surgery

A

cannot place hand flat on table

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5
Q

de Quervains tenosynovitis test and 1st and 2nd line Mx

A

finklesteins
1st = immobilisation in spica splint +/- steroid
2nd = splitting tendon sheath surgically

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6
Q

mallet finger 1st and last line

A

6 weeks of splinting followed by surgery

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7
Q

Scaphoid fracture Ix and mx

A

AP and lateral xrays
If fracture, refer to ortho and POP
If no fracture, rexray in 2w with POP in meantime

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8
Q

olecranon bursitis 1st and 2nd line

A

RICE and NSAIDs

steroid injection

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9
Q

epicondylitis 1st and 2nd line

A

RICE

surgery to release extensor or flexor origins

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10
Q

ACJ injury Mx

A

grade 1-2 = conservative with sling
Grade 3 = unsure
grade 4-6 = surgery

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11
Q

Hip fractures

- Ix and definitive Ix

A

Xray, if negative and suspicious do MRI

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12
Q

Hip fractures

- admission and surgery target

A

admit to ortho in 4 hours, surgery in 36 hours

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13
Q

Hip fractures

- analgesia

A

iliofascial nerve block

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14
Q

Hip fractures

- garden 1 or 2

A

weight bearing = ORIF screw

non-weight bearing = hemi

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15
Q

Hip fractures

- garden 3 or 4

A

total if all good
hemi if dementia, comorbid, more than one stick
screw if young and roll the dice

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16
Q

Hip fractures

- intertrochanteric

A

DHS

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17
Q

Hip fractures

- subtrochanteric

A

IM nail

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18
Q

meniscal tear - 3 tests

A

McMurays, Apley, Thessaly

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19
Q

Meniscal tear/cruciate ligament definitive test

A

MRI

20
Q

Simmonds triad for achiles tendon

A

1) Simmonds tets positive
2) palpable gap in tendon
3) angle of the dangle

21
Q

best test for achiles rupture

A

USS

22
Q

Mx of achiles tear

A

always refer to ortho
old/comorbid = splint in equinus
young/normal = surgery

23
Q

ottowa ankle rule

A

do an xray if pain over malleolus + 1 of:

  • non weight bear for 4 steps
  • pain in distal fibula or tibia (6cm)
24
Q

ottowa foot rule

A

do an xray if pain in the midfoot + 1 of:

  • non weight bear for 4 steps
  • pain base 5th metatarsal
  • pain navicular
25
Q

weber a b c Mx

A 
a = boot or cast below knee
b = pop to midfott and below knee
c = ORIF
26
Q

DDH Ix and Mx

A

<4.5 month = USS and Pavlik

>4.5 month = xray and surgery

27
Q

1st line Ix for perthes. definitive?

A

Xray and MRI (but remember MRI is first for adult AVN)

28
Q

caterall staging

A 
for perthes
1 = symptmos only
2 = crescent sign only
3 = femoral head destruction
4 = also acetabulum destruction
29
Q

Mx of Perthes

A 
<6 = conservative
6+ = surgery
30
Q

clubfoot Mx

A

ponsetti method
85% need achiles tenotomy
night braces till 4yo

31
Q

kocher criteria

A

38.5
ESR
WCC
non weight bearing

32
Q

definitive Ix for septic arthritis

A

aspirate (NOT IF PROSTHETIC)

33
Q

usualy abx for septic arthritis

A

2w IV fluiclox and 4w oral fluclox

34
Q

SUFE Ix and Mx

A

frog leg and lateral xray

need surgery

35
Q

nursemaid elbow ix and mx

A

USS for annular ligament

manual reduction

36
Q

open fracture staging and Mx

A 
gustillo Anderson
1 = <1cm
2 = >1cm
3 = >1cm and severe soft tissue damamg
3c = vascularly impaired

need tetanus stuff, IV abx, debridement, ex-fix

37
Q

compartment syndrome Ix

A

intracompartmebtal pressure >40 is diagnostic >20 is abnormal
Xray is nothing

38
Q

discitis Ix and Mx

A

MRI and 6-8w IV Abx

39
Q

Iliopsoas abscess Ix and Mx

A

MRI and drainage+abx

40
Q

simple back pain Ix and Mx

A

No Ix. only do MRI if suspect other stuff

Mx = oral naproxen

41
Q

meralgia paraesthetica Ix and Mx

A 
Ix = push on ASIS, inject LA into nerve
Mx = neuropathic pain meds and conservative
42
Q

osteomyelitis Ix and Mx

A

MRI and IV abx fluclox

43
Q

Osteoporosis

- who do you screen

A

women >65
men >75
anyone else with a big RF (alchol >14U, BMI<18.5, steroid, smoking, history of falls or fractures)

44
Q

Osteoporosis

- who do you do straight dexa for and what result means you treat straight away

A

if about to start a med that will affect bones

if

45
Q

Osteoporosis

- DEXA results

A

-1 to -2.5 is osteopaenia

46
Q

Mx based on FRAX

A 
low = lifestyle 
medium = do DEXA
high = bone protection which is always alendronate PO OD

3rd year medicine (31 decks)

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