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Year 6 > MUSK > Flashcards

MUSK Flashcards

1
Q

What is Osteomyelitis

A

Infection of the bone

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2
Q

What is the most common cause of Osteomyelitis?

A

S.aureus, Salmonella species in sickle cell anaemia

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3
Q

What 5 conditions predispose to Osteomyelitis?

A 
DM
Sickle cell anaemia
IVDU
Immunosuppression
Alcohol
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4
Q

How do you investigate osteomyelitis?

A

MRI

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5
Q

Rx Osteomyelitis?

A

Flucloxacillin for 6 weeks, clindamycin if penicillin allergic

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6
Q

Diagnosis of pain over anatomical snuff box?

A

Scaphoid fracture

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7
Q

Rx of Scaphoid fracture

A

Refer for urgent ortho/ED review due to risk of avascular necrosis

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8
Q

Features of Lateral epicondylitis (Tennis elbow) (3)

A
  1. Pain and tenderness localised to the lateral epicondyle
  2. Pain worse on resisted wrist extension with the elbow extended or supination of the forearm with the elbow extended
  3. Episodes typically last between 6 months and 2 years, pts tend to have acute pain for 6-12 weeks
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9
Q

Features of medial epicondylitis (Golfer’s elbow) (3)

A
  1. Pain and tenderness localised to the medial epicondyle
  2. Pain aggravated by wrist flexion and pronation
  3. Sx may be accompanied by numbness/tingling in the 4th and 5th finger due to ulnar nerve involvement
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10
Q

Cause of Radial tunnel syndrome

A

Most commonly due to compression of the posterior interosseous branch of the radial nerve. Thought to be due to overuse.

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11
Q

Features of radial tunnel syndrome (3)

A
  1. Sx similar to lateral epicondylitis
  2. However, pain tends to be around 4-5cm distal to the lateral epicondyle
  3. Sx may be worsened by extending the elbow and pronating the forearm
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12
Q

Cause of cubital tunnel syndrome

A

Compression of the ulnar nerve

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13
Q

Features of cubital tunnel syndrome(3)

A
  1. Initially intermittent tingling in the 4th and 5th finger
  2. May be worse when the elbow is resting on a firm surface or flexed for extended periods
  3. Later numbness in the 4th and 5th finger with associated weakness
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14
Q

What is olecranon bursitis and how does it present?

A

Swelling over the posterior aspect of the elbow.

There may be associated pain, warmth and erythema. Typically affects middle-aged male patients

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15
Q

What is a Galeazzi fracture?

A

Dislocation of the distal radioulnar joint with an associated fracture of the radius

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16
Q

3 features of a Colles’ fracture?

A

Transverse fracture of the radius
1 inch proximal to the radio-carpal joint
Dorsal displacement and angulation

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17
Q

What is a smith’s fracture?

A

Volar angulation of distal radius fragment

Caused by falling backwards onto the palm of an outstretched hand or falling with wrists flexed

18
Q

What is a Bennett’s fracture?

A

Intra-articular fracture of the first carpometacarpal joint
Caused by fighting
X-ray: Triangular fragment at ulnar base of metacarpal

19
Q

What is a Monteggia’s fracture?

A

Dislocation of the proximal radioulnar joint in association with an ulna fracture

20
Q

What is a Pott’s fracture?

A

Bimalleolar ankle fracture

Forced foot eversion

21
Q

What is a Barton’s fracture?

A

Distal radius fracture (Colles’/Smith’s) with associated radiocarpal dislocation

22
Q

How does a posterior hip dislocation present?

A

Affected leg is shortened, adducted and internally rotated

90% of hip dislocations

23
Q

How does an anterior hip dislocation present?

A

Affected leg is abducted and externally rotated, no leg shortening

24
Q

How do you manage hip dislocation?

A

ABCDE
Analgesia
Reduction under GA within 4 hours to reduce risk of avascular necrosis
Long term: PT

25
Q

Complications of hip dislocation? (4)

A

Sciatic or femoral nerve injury
Avascular necrosis
OA
Recurrent dislocation due to damage of supporting ligaments

26
Q

What are the clinical features of a fat embolism?

A

Respiratory: Early persistent tachycardia, Tachypnoea, pyrexia
Derm: Red/brown impalpable petechial rash, subconjunctival and oral haemorrhage/petechiae
CNS: Confusion and agitation, retinal haemorrhages and intra-arterial fat globules on fundoscopy

27
Q

Rx of Fat embolism?

A

Prompt fixation of long bone fractures
DVT prophylaxis
General supportive care

28
Q

Features of hip fracture?

A

Pain

Shortened and externally rotated leg

29
Q

Garden classification of hip fractures

A

Type I: Stable fracture with impaction in valgus
Type II: Complete fracture but undisplaced
Type III: Displaced fracture, usually rotated and angulated, but still has bony contact
Type IV: Complete bony disruption

30
Q

Management of intracapsular hip fracture

A

Undisplaced: Internal fixation, or hemiarthroplasty if unfit
Displaced: Young and fit (<70)= reduction and internal fixation, older and reduced mobility= hemiarthroplasty or THR

31
Q

Management of extracapsular hip fracture

A

Dynamic hip screw

If reverse oblique, transverse of subtrochanteric: intramedullary device

32
Q

What is definition of avascular necrosis?

A

Death of bone tissue secondary to loss of the blood supply. Most commonly affected the epiphysis of long bones such as the femur

33
Q

Causes of avascular necrosis (4)

A

Long term steroid use
Chemotherapy
Alcohol XS
Trauma

34
Q

X-ray findings in avascular necrosis

A

May be normal initially. Osteopenia and microfractures may be seen early on. Collapse of the articular surface may result in the crescent sign

35
Q

Rx of avascular necrosis

A

Joint replacement may be necessary

36
Q

What is the main neurovascular structure that is compromised in a scaphoid fracture?

A

The dorsal branch of the radial nerve

37
Q

What is compartment syndrome?

A

It is a particular complication that may occur following fractures. It is characterised by raised pressure within the compartment which will eventually compromise tissue perfusion resulting in necrosis

38
Q

What are the 2 main fractures carrying the risk of compartment syndrome?

A

Supracondylar

Tibial shaft

39
Q

What are the features of compartment syndrome?

A 
Pain 
Parasthesiae
Pallor
Paralysis
Arterial pulsation may still be felt as the necrosis occurs as a result of microvascular compromise
40
Q

How do you diagnose compartment syndrome?

A

Measurement of intracompartmental pressure measurements, >20mmHg is abnormal, >40mmHg is diagnostic

41
Q

Rx of compartment syndrome

A

Prompt and extensive fasciotomies

Aggressive IV fluids (due to possibility of myoglobinuria following fasciotomy)

Year 6 (1 decks)

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