Brainscape's Knowledge GenomeTM

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


See full index

AA Y4 Finals cards NE > MSK - Passmed > Flashcards

MSK - Passmed Flashcards

1
Q

What 2 disease processes is trigger finger associated with?

A
  1. Diabetes

2. Rheumatoid arthritis

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

Name the 4 indications of Paget’s disease

A
  1. Bone pain
  2. Headaches
  3. Hearing loss
  4. Raised ALP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the main treatment for Paget’s disease? How do they work?

A

Biphosphonates

They inhibit osteoclastic activity

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

What is Paget’s disease

A

A condition of excessive bone remodelling by osteoclasts, followed by disordered formation of new bone

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

What is the most suitable form of thromboprophylaxis for a patient with anti-phospholipid syndrome who has no history of venous or arterial clots

A

Low dose aspirin

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

What is the most suitable form of thromboprophylaxis for a patient with anti-phospholipid syndrome who has a history of venous or arterial clots

A

Warfarin, INR target 2-3

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

Which antibiotic is used to treat osteomyelitis and also reactive arthritis? For how long?

What antibiotic is used if patient is penicillin-allergic?

A

Flucloxacillin for 6 weeks

Clindamycin if penicillin allergic

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

What feature helps to distinguish pseudogout from gout?

A

Pseudogout shows chondrocalcinosis on XR

Gout does not show calcification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What type of crystals are deposited in the synovium in pseudogout?

A

Calcium pyrophosphate dehydrate crystals

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

Which disease shows weakly positively bifringent rhomboid-shaped crystals on joint aspiration

A

Pseudogout

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

Bamboo sign on XR is pathognomic of which disease?

A

Ank Spon

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

Name the 3 features in Bechet’s disease?

A

Bechet’s triad:

  1. Uveitis
  2. Oral ulcers
  3. Genital ulcers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why is a Charcot joint also referred to as a neuropathic joint?

A

It describes a joint which has become badly damaged and disrupted secondary to a loss of sensation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What side effect of hydroxychloroquine must be closely monitored?

A

Visual acuity - Hydroxychloroquine may result in severe and permanent retinopathy

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

A FOOSH commonly results in what kind of fracture?

A

Colle’s fracture

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

Describe a Colle’s fracture

A

A fracture of the distal radius with dorsal displacement of fragments

No involvement of the articular cartilage

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

What are the 5 D’s of a Colle’s fracture?

A

Dorsally Displaced Distal radius –> Dinner fork deformity

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

Name the term used to describe a dislocation of the distal radioulnar joint with an associated fracture of the distal radius

A

Galeazzi fracture

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

What is the most appropriate treatment for a patient with renal complications secondary to systemic sclerosis

A

ACE inhibitors

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

What renal complications usually occur as a result of systemic sclerosis?

A
  1. Hypertension

2. AKI

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

Why are ACE inhibitors 1st line in renal complications due to systemic sclerosis?

A

The reduced kidney function results in constant activation of the RAAS system- this causes high blood pressure

Activation of the RAAS system can be stopped by an ACE inhibitor

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

Name the triad of symptoms seen in Reiter’s syndrome

A
  1. Conjunctivitis
  2. Urethritis
  3. Oligoarthritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

In young sexually active adults, what is the most common causative of reactive arthritis?

A

Neisseria gonorrhoea

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

Name the nerve root and innervation of the tricep reflex?

A

Radial nerve innervates the tricep muscle. Derived from the C7 root

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Name the motor supply to the extensor compartments of the upper arm?

A

Radial nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Which nerve supplies elbow flexion? What is the nerve root?

A

Musculocutaneous nerve

Supplied by C5-C7 nerve roots

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

Name 3 biphosphonates that are used in osteoporosis treatment?

A
  1. Alendronate (1st line)
  2. Risedronate
  3. Etidronate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the difference between limited and diffuse systemic sclerosis?

A

Limited SS- scleroderma affects trunk and distal limbs mostly
Anti-centromere antibody +ive

Diffuse SS - scleroderma affects trunk and proximal limbs mostly
Scl-70 antibody +ive

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

Describe the components of CREST syndrome?

A

Calcinosis, Raynaud’s phenomenon, oEsophageal dismotility, Sclerodactyl, Telangectasia

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

Describe the difference in presentations of neck of femur fractures and hip dislocations

A

Neck of femur fractures - present with shortened, EXTERNALLY rotated leg

Hip dislocations present with shortened, INTERNALLY rotated leg

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

Azathioprine + Allopurinol = ?

A

Bone marrow suppression and agranulocytosis!!

Cant give them both together

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

Is CREST syndrome a subtype of limited or diffuse cutaneous systemic sclerosis?

Which antibodies will therefore be present?

A

A subtype of limited (central) cutaneous systemic sclerosis

Anti-Centromere antibodies

(Central cutaneous systemic sclerosis = anti Centromere antibodies)

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

In limited cutaneous systemic sclerosis, where is the cutaneous sclerosis limited to?

A

Cutaneous sclerosis limited to below the elbow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Why must CXRs be performed prior to starting a biologic?

A

Got to look for TB prior to starting biologic - they can cause reactivation of latent TB

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

Which feature of psoriatic arthritis best differentiates it from rheumatoid arthritis?

A

Asymmetrical joint pains

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

When beginning urate lowering therapy in gout, what should be prescribed alongside allopurinol?

A

“colchine cover”

Colchine or an NSAID if colchine cannot be tolerated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Describe calcium, phosphate, ALP and PTH levels in a patient with osteomalacia?

A

Calcium and phosphate = LOW

ALP and PTH = RAISED

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

which nerve root is most likely to be affected if there is loss of foot dorsiflexion and sensory loss on the dorsal of the foot?

A

L5

S1 causes loss of plantar flexion and sensory loss on posterolateral aspect of leg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

what is an early feature of ank spond seen on spine XR?

A

syndesmophytes on XR

seen as ossifications inside spinal ligaments

bamboo spine is also seen, but presents much later

40
Q

what one feature is most commonly seen on initial XRs of early RA?

A

junta-articular osteopenia

peri-articular erosions and subchondral cysts are more likely seen in late stage RA

41
Q

which medication should methotrexate not be taken alongside?

A

trimethoprim and co-trimoxazole

concurrent use can cause bone marrow suppression and pancytopenia

42
Q

what is 1st line Tx for RA?

A

methotrexate + short course of oral prednisolone

43
Q

who do NICE recommend a total hip replacement or hemiarthroplasty to?

A

all patients with a displaced intracapsular hip fracture

44
Q

in cases of a displaced intracapsular hip fracture, when is a THR preferred to a hemiarthroplasty?

A

do a THR if:
-able to walk outside independently

  • not cognitively impaired
  • medically fit for procedure and anaesthesia
45
Q

at every followup appointment with a patient on methotrexate, what should be asked?
Why?

A

if they have any SOB, cough or fever

these can be signs of pneumonitis, which can be a S/Ex of methotrexate

if not caught early, can cause irreversible pulmonary fibrosis

46
Q

name 3 medications that can be used throughout pregancy to treat SLE?

A

azathioprine

hydroxychloroquine

steroids

47
Q

name 3 medications that can be used throughout pregancy to treat SLE?

A

azathioprine

hydroxychloroquine

steroids

48
Q

what anticoagulant is indicated for long term treatment of APS?

A

warfarin

LMWH is only used for short term episodes of thrombosis

49
Q

what symptom is virtually pathognomic for osteogenesis imperfecta?

A

blue sclera

50
Q

what ophthalmic side effect can hydroxychloroquine have?

A

“bullseye retinopathy”

patients complain about the loss of central vision

51
Q

name one very highly specific antibody test for SLE?

A

anti-dsDNA

52
Q

what is the investigation of choice for suspected psoas abscesses?

A

CT abdomen

53
Q

following a trial of NSAIDs in ank spond, what should be trialled 2nd line?

A

TNF-alpha blockers

eg- infliximab and etanercept

54
Q

in a suspected scaphoid fracture, how soon after 1st imaging should another XR be taken?

A

repeat imaging should be performed after 7 days

55
Q

in Mx of an acute flare up of gout, what medication should be given alongside allopurinol?

A

NSAID or colchine cover

allopurinol in itself can cause an acute flare up of gout

56
Q

which antibody is most associated with myositis?

A

anti-Jo1 antibodies

myositis + anti-jo1 antibodies can predispose to lung fibrosis

57
Q

compare which nerve root is responsible for plantar flexion and which is responsible for dorsiflexion?

A

L5 - dorsiflexion

S1: plantar flexion

58
Q

how can lumbar discitis be differentiated from a presentation of lumbar epidural abscess?

A

both cause lower limb neuropathy and possible systemic sepsis

discitis causes pain

epidural abscess does not cause pain

59
Q

what imaging method has the highest sensitivity for discitis?

A

MRI

60
Q

how can gout be differentiated from pseudogout on XR?

A

pseudogout presents with chonedrocalcinosis on XR

a visible calcification of cartilage

61
Q

what finding on XR best supports a diagnosis of ank spond?

A

sarcoiliitis

HLA-B27 isn’t as useful as it can be positive in patients without the disease

62
Q

what is used to manage acute flares of rheumatoid arthritis?

A

IM methylprednisolone acetate

can be delivered IM or intra-articularly

63
Q

name the triad of symptoms seen in a fat embolism?

A
  • respiratory (hypoxic, pyritic and tachycardic)
  • neurological (agitation and confusion)
  • petechial rash
64
Q

name 4 symtoms seen in osteomalacia?

A

bone pain

tenderness

proximal myopathy

waddling gait

65
Q

what is the primary management for osteomalacia?

A

vit D supplements

66
Q

what is the softening of the bones in osteomalacia a direct result of?

A

low vit D levels

in children, it is known as rickets

67
Q

how is pagets disease of the bone treated?

A

biphosphonates

aldendronate, risedronate

Pagets causes bone pain and an isolated rise in ALP

68
Q

how is ALP, calcium, phosphate and PTH affected by osteoporosis?

A

not affected: blood markers are normal

69
Q

what baseline investigation must be done before a patient starts taking hydroxychloroquine?

A

examination by ophthalmologist

Hydroxychloroquine can cause bulls eye retinopathy

70
Q

what is 1st line tx for lower back pain?

A

oral NSAIDs

71
Q

name the main neurovascular structure compromised in a scaphoid fracture?

A

dorsal carpal arch of the radial artery

72
Q

what is the most common reason THRs need to be revised?

A

aseptic loosening of the implant

73
Q

what is the 1st line management of a psoas abscess?

A

IV antibiotics and percutaneous drainage

74
Q

compare the symptoms seen in cANCA and pANCA associated vasculitis?

A

cANCA: renal impairment, respiratory, systemic and ENT symptoms

pANCA: asthma and eosinophilia

75
Q

in adhesive capsulitis, what movement is affected the most?

A

external rotation

both active and passive movement is affected

76
Q

what antibodies are associated with enteropathic arthritis?

A

HLA-B27

it is seronegative (RF negative)

77
Q

describe symptoms of dermatomyositis?

A

proximal muscle weakness

macular rash over back/shoulders

red papule over extensor surfaces of fingers

78
Q

name the antibody associated with dermatomyositis?

A

antinuclear antibodies (ANA)

79
Q

describe the bone mineral density profile of a patient with osteoporosis?

A

normal PTH, calcium and phosphate

osteoporotic patients have normal bone profiles

80
Q

what does “can’t pee, cant see, cant climb a tree” describe?
how can you treat it?

A

reactive arthritis

urethritis, uveitis, arthritis

Tx = 1st line: NSAIDs
2nd line: steroids

81
Q

which antibodies are associated with drug induced lupus?

A

anti-histone antibodies

82
Q

which drug used to treat TB is most likely to cause drug induced lupus?

A

isoniazid

83
Q

which drug class used in RA Mx may reactivate latent TB?

A

TNF-a inhibitors reactivate latent TB

etanercept, infliximab

84
Q

which 2 blood results would be elevated in polymyalgia rheumatica?

A

ESR and CRP raised

CK is normal in PMR

85
Q

compare blood results and presentation of PMR and polymyositis?

A

polymyositis: CK raised, more associated with muscle weakness

PMR: CK normal, muscle pain rather than muscle weakness

86
Q

name some symptoms in a headache history that may indicate raised ICP?

A 
focal signs: numbness, tingling, weakness, drowsiness 
neurological deficit 
worse in morning 
worse when lying down 
nausea and vomiting
87
Q

name some symptoms in a headache history that may indicate raised ICP?

A 
focal signs: numbness, tingling, weakness, drowsiness 
neurological deficit 
worse in morning 
worse when lying down 
nausea and vomiting
88
Q

what is the most important side effect of biphosphonates to warn patients about?

A

variety of oesophageal problems - ie- heartburn

89
Q

what is the initial tx for sciatica?

A

anti-neuropathic pain agent (gabapentin, pregablin or amitryptyline) + physio

refer routinely for spinal surgery once 4-6 weeks of conservative tx above has failed

90
Q

what is denosumab used for?

A

it is a monoclonal antibody that prevents the development of osteoclasts

it can be used to prevent pathological fractures in adults

it can be used to treat osteoporosis and is preferred to oral biphosphonates in patients with an eGFR<30

91
Q

which class of drug are associated with an increased risk of atypical stress fractures?

A

biphosphonates

92
Q

when would colchine be preferred to NSAIDs to treat acute gout?

A

if NSAIDs are contraindicated in the patient - ie- if they have peptic/duodenal ulcers

93
Q

what is the imaging modality of choice for osteomyelitis?

A

MRI

94
Q

what is the main immunoglobulin found in breast milk, passed from mother to baby?

A

IgA

95
Q

how does CKD cause secondary hyperparathyroidism?

A
  1. the CKD means the kidneys cannot activate vit D and excrete phosphate
  2. this leads to a reduction in calcium
  3. this low calcium causes increase in PTH, increasing osteoclastic activity
  4. increased osteoclastic activity increases ALP

therefore, overall blood results expected = raised phosphate, raised PTH and raised ALP

96
Q

compare the causatives of septic arthritis and reactive arthritis in a young, sexually active male?

A

septic arthritis: N. Gonorrhoea

reactive arthritis: chlamydia trachomatis

97
Q

compare the 1st line Tx for pseudogout and gout?

A

pseudogout: NSAIDs and colchine

Gout: acute = colchine and NSAIDs
prophylaxis= allopurinol

AA Y4 Finals cards NE (40 decks)

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