Musculoskeletal - Lecture

Question 1

UMMARI

Common MSK problems in primary care

Answer 1

Question 2

Phases of acute injury recovery

Answer 2

Question 3

Overuse syndrome

Cause
Presentation

Answer 3

Question 4

Denerative joint disorders

Presentation

Answer 4

Question 5

Management of acute injury according to phase of recovery

Answer 5

Question 6

Approach to treat overuse vs degenrative conditions

Answer 6

Overuse:
- Limit further injury
- Improve muscle/tendon strength and
flexibility
- Improve circulation to promote
healing
- i.e. Activity modification + Support/ bracing + Therapeutic exercises + Rehabilitation +/- Injections/ drugs

Degenerative:
- minimize progression through
modifying perpetuating factors (e.g.
obesity)
- maximize function and QoL
- prevent complication (e.g. fall / injury)
through muscle strengthening
- i.e. Symptomatic relief + Activity modification + Rehabilitation/ functional training +/- Operation

Question 7

Rehabilitation plan for MSK diseases

Answer 7

Question 8

Outline short, intermediate and long term goals of rehabilitation

Answer 8

Question 9

Approach to analgesic prescription

Answer 9

The WHO pain ladder provides a stepwise approach to pain management. The three steps are:

Step 1 - Non-opioid analgesics:
* Includes medications like acetaminophen (paracetamol) and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen.
* These are used for mild to moderate pain.

Step 2 - Weak opioid analgesics:
* Includes medications like codeine, hydrocodone, and tramadol.
* These are used for moderate to severe pain, often in combination with non-opioid analgesics.
*
Step 3 - Strong opioid analgesics:
* Includes medications like morphine, oxycodone, fentanyl, and methadone.
* These are used for moderate to severe pain that is not adequately controlled by the medications in the first two steps.

The key principles of the WHO pain ladder are:
* Start with the lowest effective step and only move to the next step if pain is not adequately controlled.
* Administer the medications on a regular schedule, not just as needed.
* Adjust the dose as needed to achieve effective pain relief.
* Consider adjuvant medications, such as antidepressants or anticonvulsants, to enhance pain relief.

Question 10

Ice therapy

Indication
Effect
Application

Answer 10

Question 11

Heat therapy

Indications
Effects
Applications

Answer 11

Question 12

ROM/ Flexibility exercises

Application

Answer 12

Question 13

Resistive exercise
Application

Answer 13

Question 14

Physiotherapy modalities

Answer 14

Question 15

Occupational therapy modalities

Answer 15

Question 16

Role of doctors in compensation for Injury on Duty

Answer 16

Question 17

Traffic accident victims assistance scheme

Function

Answer 17

Includes:
Burial grant
Death grant
Disability grant
Injury grant
Interim maintenance grant

Up to 180 days