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GP > MSK Medicine > Flashcards

MSK Medicine Flashcards

1
Q

What is a screening assessment used for MSK presentation?

A

GALS screen
-Gait
-Arms
-Legs
-Spine

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2
Q

What is synovitis?

A

Inflammation of a synovial membrane

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3
Q

What are some common causes of synovitis?

A

RA
Gout
Sometimes OA when degeneration causes inflammation

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4
Q

How does synovitis present?

A

Swelling
Pain
Warmth

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5
Q

Define stiffness

A

Slowness or difficulty moving one or more joints

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6
Q

What conditions feature early morning stiffness?

A

Inflammatory arthritis:
-RA
-Psoriatic Arthritis
-Ankylosing spondylitis
-Gout and pseudogout

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7
Q

What problem is indicated when active movement is painful/limited but has full range of passive movement?

A

Problem with the muscles and tendons as they are functioning in active but not passive movement

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8
Q

What is the WHO pain ladder?

A

For acute pain
Stepwise approach to analgesia, NSAIDs and stronger analgesia

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9
Q

What is the problem with using WHO ladder for chronic MSK pain?

A

Risk of side effects with prolonged use
Risk of addiction
Risk of neglecting non-pharmacological options e.g. physiotherapy

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10
Q

What are ‘mechanical’ symptoms of the knee?

A

Locking or catching of the knee on movement

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11
Q

What is bursitis?

A

Inflammation of bursa (fluid filled sacs that surround joints to reduce friction)

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12
Q

What is a joint effusion?

A

Swelling due to excess synovial fluid in joint capsule

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13
Q

How can you differentiate between bursitis and a joint effusion?

A

In an effusion, fluid can be moved across joint but bursitis the swelling is localised to bursa affected

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14
Q

What is lateral hip pain suggestive of?

A

Trochanteric bursitis

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15
Q

What is anterior hip pain suggestive of?

A

‘true’ hip pain e.g. osteoarthritis

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16
Q

What is posterior/posterolateral hip pain suggestive of?

A

Lumbosacral spine or gluteal muscle issue

17
Q

What are some clinical features of plantar fasciitis?

A

-pain at insertion of plantar fascia into calcaneum
-occurs in people who spend lots of time on feet
-pain is marked with first few steps on getting out of bed
-worsens again at end of day

18
Q

What is metatarsalgia?

A

Pain in mid foot

One cause is Mortons neuroma - tenderness in inter-digital space where neuroma is located

19
Q

What is gout?

A

Form of inflammatory arthritis due to Uris acids crystal deposition in joint

20
Q

What joint is most commonly affected by gout?

A

Great toe

21
Q

How does gout present?

A

Rapid onset of severe pain, swelling and joint inflammation (warm)

22
Q

What treatment is used to prevent gout?

A

Allopurinol - lowers urate levels in blood

23
Q

How is acute gout managed?

A

-Analgesia
-NSAIDs
-Steriods if NSAIDs aren’t working
-rest

24
Q

What is radicular back pain?

A

Pain caused by irritation or impingement of a nerve root
Felt in a dermatomal pattern

Pain described as shooting or numb
May be other neurological symptoms e.g. weakness

25
Q

What is painful arc?

A

Pain in mid range (45-120degrees) of abduction of shoulder
Eases at greater range of abduction

26
Q

What does painful arc indicate?

A

Impingement do the shoulder in the sub-acromial space with movement
E.g. catching of rotator cuff tendons or shoulder bursae

Pain more pronounced on active movement

27
Q

What other conditions can present with shoulder pain?

A

-Referred pain from neck
-Cardiac -MI, angina
-Lung -Pancoast tumour
-Diaphragmatic pain - right shoulder pain from liver enlargement
-Polymyalgia rheumatica (bilateral)

28
Q

How does the appearance of OA and RA differ in the hands?

A

OA- heberdens nodes (distal IP joints), Bouchards nodes (proximal IP joints)

RA: acute- proximal IP, MCP and wrist affected
Chronic- ulnar deviation, swan neck and boutonnière deformity

29
Q

What is tennis Elbow?

A

Lateral epicondylitis
Pain in lateral elbow
Tenderness over common extensor origin

30
Q

What is golfers elbow?

A

Medial epicondylitis
Pain in medial elbow
Tenderness over common flexor origin

31
Q

What is olecranon bursitis?

A

Inflammation of olecranon bursae
Non painful swelling over olecranon process of elbow

GP (8 decks)

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