Musculoskeletal Flashcards

1
Q

which of following best describes dislocation?

a. it is the complete dissociation of joint surfaces
b. it always involves loss of blood and shock
c. it is unrelated to joint and joint surfaces

A

it is complete dissociation of joint surfaces

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2
Q

which fracture is likely to result in osteomyelitis?

A

open fracture

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3
Q

which fracture is most likely to occur for someone over 65?

a. neck or between the trochanters (intertrochanteric) of the femur
b. shaft or between the malleoli of tibia
c. shaft or near the styloid process of the fibula

A

a. neck or between the trochanters (intertrochanteric of the femur

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4
Q

why is it D important for bones?

a. vit D improves energy so we can exercise
b. vit D converses vit C to calcium
c. cit D increases fat deposition to strengthen bones
d. vitamin D assists in absorption of calcium

A

VITAMIN D assists in absorption of calcium

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5
Q

who is affected by osteoarthritis?

a. 3 times as many women as men
b. less than 5% population
c. almost everyone to some degree if you live ling enough
d. only people who jog and exercise alot

A

almost everyone to some degree if you live long enough

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6
Q

which of following describes osteoporosis?

a. metabolic disease
b. metastatic disease
c. infection
d. disocation

A

a metabolic disease

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7
Q

which best describved the process underlying osteoarthritis?

a. a pathological process not affected by activity or lifestyle
b. a genetically programmed disease not affected by any repair process
c. a disease involving more degenerative changes than repair
d. a disease involving antibodies attacking body tissue

A

a disease involving more degenerative changes than repair

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8
Q

which following statement is correct?

a. osteocytes degrade bone matrix and release Ca2+ into the blood
b. osteoclasts degrade bone matrix and release Ca2+ into blood
c. osteoblasts degrade bone magic and release Ca@+ into the blood
d. osteopaths degrade bone matrix and release Ca2+ into the blood

A

osteoclasts degrade boen matrix and relase Ca2+ into blood

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9
Q

who gets ankylosing spondylitis?

a. mostly males in early adulthood
b. mostly premenopausal women
c. mostly post menopausal women over 60 years
d. children who play vid games and don’t get enough exercise

A

most males in early adulthood

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10
Q

crystallisation of rate in synovial tissue is likely to occur as a result of

a. inflammation
b. infection
c. increased body temperature particular region of body
d. lower body temperature at particular regions of body

A

lower body temp at particular regions of body

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11
Q

two of the most common causes of back pain are:

a. viral and bacterial infections
b. prolonged wearing of a back brace and wearing knee brace
c. back injuries and disc degeneration
d. low pressure fronts and atmospheric changes during bad weather

A

back injuries and disc degeneration

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12
Q

which of the following best describes the pathology of gout?

a. the breakdown of purines causes uric acid crystals to form in joints
b. this is an autoimmune disorder affecting urge MTP joint of big toe
c. the breakdown of articular cartilage caused by wear and tear
d. a vitamin D deficiency causing decreased bone mass

A

a. the breakdown of purines causes uric acid crystals to form in joints

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13
Q

duchenne muscular dystrophy patients often have pseudo hypertrophied calf muscles that is due to

a. increased skeletal muscle cells as a result of proliferation
b. increased size (hypertrophy) of skeletal muscle cells
c. increased fluid retention of oedema
d. adipose and connective tissue

A

adipose and connective tissue

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14
Q

a mutation of which of the following gene has been identified in duchenne muscular dystrophy?

a. neutrophin
b. spinophin
c. troponin
d. dystrophin

A

d. dystrophin

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15
Q
  1. Thompson has osteoarthritis/rheumatoid arthritis/osteoporosis/ ankylosing spondylitis? Give reasons for your answer, including the classic symptoms you would expect in the disease
    RHEYMATOID ARTHRITIS:
A

• Signs and symptoms: pain in her knees, wrists, knuckels, feet, morning stiffness, difficulty with mobility and turning water taps and screw top jar lids
• 4 or more joints affected→ diagnosis. Subcutaneous rheumatic nodules can be seen at sites subject to trauma eg. Knee and fingers
• Rheumatoid factor > normal ; synovial flid shows WBC’s, synovial membranes thicked; erosion of cartilage at affected joints
• Age group correct, women 2-3 times more likely than men to suffer rheumatoid arthritis
→ NOT OSTEOARTHRITIS; no bony overgrowth, joint fusion or bony spurs on imaging, no degeneration of subchondral bone or joint subluxation
→ NOT OSTEOPOROSISI: no indication of decreased bone mass or density, mainly joints affected rather than bones themselves. No info about hormone levels or vit D deficiency
→ NOT ankylosing spondylitis; since classic sign of bilateral sacroiliac sclerosis is absent, no back pain, no mention of HLA markers or family history

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16
Q
  1. Toby has osteroarthritis/rheumatoid arthritis/ gout. Ankylosing spondylitis. Give reasons.
    OSTEOARTHRITIS:
A

• Toby is the right age (over 600 and worked in a weight bearing job – a builders labourer and pneumatic drill operator. The drill operation would have caused chronic trauma (prolonged overuse) a known risk factor for OA
• His symptoms and signs include an acute synovitis, narrowing of joint space and signs of cartilage degeneration and bony overgrowth at the knee, plus subluxation, joint instability and wastage of surrounding muscles plus stiffness and loss of flexibility in the lumbar spine
• Pain and crepitus occurs when attempt to move the knee through its useal range of motion → diagnostic OA
• Thickening of the intervertebral discs and bony overgrowth of the vertebrae put pressure on adjacent spinal cord and nerves → back pain. The pain is made worse by exercise (gardening)→ NOT RHEUMATOID ARTHRITIS: RA can be ruled out since tests show no rheumatoid factor above normal range and a normal erythrocyte sedimentation rate (ESR)
→ NOT GOUT: no increase in uric acid in the plasma (hyperuricaemia) and joints. No painful, swollen joints in his big toe
→ NOT ANKYLOSING SPONDYLITIS since classic sign of bilateral sacroiliac sclerosis is absent, no mention of HLA markers or family history

17
Q
  1. What is the first aid TM for injury ( sprain)? What is difference between sprain and strain?
A

a. TM: PRICE ie. Prevention, Rest, Ice, Compression, Elevation to relieve pain and prevent swelling ( RICERS sometimes used= rest, ice, compression, elevation, referral)
b. Sprain= involves trauma to joint with pain, injury to ligaments and marked swelling. May also involve damage to blood vessels, muscles, tendons and nerves
c. A strain is a less serious injury includes over stretching of muscles, less swelling but no capsule damage

18
Q
  1. The child has achondroplasia/ muscular dystrophy/ rickets/ osteomalacia?

RICKETS

A

a. Child is right age for RICKETS- classic case of “spring rickets”. Symptoms and signs include:
i. Marked bowed legs
ii. Knock knees and dental caries
iii. inadequate nutrition - family has been starving and more recently living in “difficult circumstances”
iv. inadequate vitamin D and low milk intake (calcium lack or deficiency)
b. Vitamin D deficiency prevents calcium and phosphorus from being absorbed into the bloodstream from the intestines thus bones becomes soft and bend easily causing kyphosis(hump back), bowlegs, knock- knees as well as other bone curvatures
→ NOT OSTEOMALACIA: this is an osteodystrophy in adults, particularly in women during pregnancy and lactation
→ NOT MUSCULAR DYSTROPHy bc no evidence of muscle weakness or degeneration
→NOT ACHONDROPLASIA: no evidence of abnormal growth. You are tolf that apart from the bowlegs, knock knees and dental caries the child isotehrwise normal. Achondroplasia is a disorder of the epiphyseal cartilage in the long bones and skull that results in premature ossification, limitation of skeletal development and dwarfism