Musculoskeletal (Week 11)

Question 1

Define compartment syndrome

Answer 1

Elevated interstitial pressure in a closed fascial compartment = microvascular compromise

Question 2

What is the equation for calculating local blood flow (LBF)

Answer 2

(Pa - Pv)/R

Question 3

List 3 end stage limb changes

Answer 3

1. Stiff fibrotic muscle
2. Limb clawing
3. Loss of function

Question 4

Name the four compartments of the leg

Answer 4

1. Anterior
2. Lateral
3. Superficial posterior
4. Deep posterior

Question 5

What is the link between compartment syndrome and renal impairment?

Answer 5

Myoglobin/muscle breakdown products can damage kidneys

Question 6

What genetic predisposition is related to rheumatoid arthritis?

Answer 6

HLA-DR4

Question 7

Name three deformities seen in rheumatoid arthritis

Answer 7

1. Swan neck
2. Boutonniere
3. Ulnar deviation

Question 8

What is rheumatoid factor?

Answer 8

IgM antibody against Fc portion of IgG antibody

Question 9

Name the three convention DMARDs

Answer 9

Methotrexate
Sulfasalazine
Hydroxychloroquine

Question 10

What percentage of bone is organic matrix?

Answer 10

40%

Question 11

What feature of cortical bone makes it resistant to bending and torsion?

Answer 11

Higher Young’s modulus

Question 12

What are the four steps of indirect bone healing?

Answer 12

1. Fracture haematoma
2. Soft callus
3. Hard callus
4. Remodelling

Question 13

Which bone in the hand is susceptible to necrosis and why?

Answer 13

Proximal pole of scaphoid due to retrograde blood supply

Question 14

What type of bone is always affected first in AVN?

Answer 14

Spongy bone

Question 15

What is the Crescent sign in AVN?

Answer 15

Subchondral radiolucency preceding subchondral collapse

Question 16

Name the 5 most common primary tumours leading to bone metastasise?

Answer 16

Breast
Prostate 
Thyroid (follicular)
Renal 
Bronchi

Question 17

What is Paget’s disease?

Answer 17

Excessive bone turnover leading to weak bones

Question 18

What specific chromosome translocation is seen in Ewing’s sarcoma?

Answer 18

11:22 translocation

Question 19

What is a comminuted fracture?

Answer 19

Fractures at lots of different sites on a bone

Question 20

Name the 4 radiographic features of osteoarthritis

Answer 20

1. Joint space loss
2. Subchondral cysts
3. Subchondral sclerosis
4. Osteophytes

Question 21

Name three risk factors for gout

Answer 21

Age
Male gender
Obesity

Question 22

What is the difference between reactive and septic arthritis?

Answer 22

In septic, bacteria can be aspirated from the joint but it cannot in reactive arthritis

Question 23

What gene is strongly associated with reactive arthritis?

Answer 23

HLA-B27

Question 24

What is vasculitis?

Answer 24

AI condition causing blood vessel inflammation

Question 25

What vessels does giant cell arteritis affect?

Answer 25

Aorta and major branches

Question 26

What are the 3 main categories for causes of chronic back pain?

Answer 26

Mechanical
Systemic
Referred

Question 27

What is spinal stenosis?

Answer 27

Anatomical narrowing of spinal canal

Question 28

In compression fractures, where does pain classically radiate to?

Answer 28

Belt around the chest/abdomen

Question 29

Name three red flags of chronic back pain

Answer 29

After trauma
New onset <16 or >50
Previous cancer

Question 30

What gene is associated with Axial Spondyloarthritis?

Answer 30

HLA-B27

Question 31

Name three extra-articular effects of axial spondyloarthritis

Answer 31

Uveitis
Psoriasis
IBD

Question 32

Name the three types of ANCA associated vasculitis

Answer 32

Microscopic polyangitis
Granulomatosis with polyangitis
Eosinophilic granulomatosis with polyangitis