Non-Arthritic Hand

Question 1

A mucous cyst is an outpouching of what fluid type?

Answer 1

Synovial (from DIP)

Question 2

Mucous cysts are associated with which disorder?

Answer 2

OA

Question 3

Mucous cysts can have which serious complication?

Answer 3

Destruction of nail bed

Question 4

Ganglions are generally painful. True/false?

Answer 4

False - they may feel tight, however

Question 5

Treatment options for ganglion cysts (3)

Answer 5

1) Waiting (self-limiting) 2) Aspiration 3) Excision note: “bible method” no longer recommended

Question 6

Trigger finger is due to a tendon in which sheath being caught where? (2)

Answer 6

1) Flexor tendon sheath 2) A1 pulley

Question 7

Trigger finger can be confused with which other hand condition?

Answer 7

Duputyren’s contracture

Question 8

Trigger finger is often treated how?

Answer 8

Conservatively (splintage)

Question 9

Can injections be used in trigger finger?

Answer 9

Yes

Question 10

DeQuervains tenosynovitis is an inflammation of which tendons? (2)

Answer 10

1) Extensor pollicis brevis 2) Abductor pollcis longus

Question 11

Finklestein’s Test assess for which condition?

Answer 11

DeQuervains tenosynovitis

Question 12

The initial treatment options for DeQuervain’s Tenosynovitis include (3)

Answer 12

1) NSAIDs 2) Splintage 3) Rest

Question 13

The later treatment options for DeQuervain’s Tenosynovitis include (2)

Answer 13

1) Steroid injection 2) Decompression surgery

Question 14

Dupuytren’s contracture is a pathology of the palmar fascia or palmar tendons?

Answer 14

Palmar fascia

Question 15

Dupuytren’s contracture is generally painless. True/false?

Answer 15

True

Question 16

Infection of the nail-fold is termed

Answer 16

Paronychia

Question 17

Flexor tendon sheath infection is a surgical emergency. True/false?

Answer 17

True

Question 18

Flexor tendon sheath infection treatment

Answer 18

Washout of tendon sheath immediately

Question 19

Flexor tendon sheath infections are generally painless. True/false?

Answer 19

False - extremely painful

Question 20

Label all the missing parts of the nail

Answer 20

A = Lunula

B = Eponychium

C = Hyponchyium

Question 22

Boxer’s fracture is managed how?

Answer 22

Buddy strapping & early mobilisation

Question 23

What kind of finger condition is this?

Answer 23

Mallet finger

Question 24

Treatment of mallet finger is how?

Answer 24

Splintage for 6 weeks

Question 25

Bennett’s fracture is where?

Answer 25

Base of 1st MCP joint

Question 26

What are characteristics of a benign soft tissue lesion? (5)

Answer 26

1) Smaller (<5cm)
2) Fluccuating in growth
3) Cystic / fluid filled
4) Well-defined
5) Soft/fatty

Question 27

What are signs of a potentially malignant soft tissue swelling? (6)

Answer 27

1) Larger size (>cm)
2) Rapid growth (no fluccuation)
3) Solid
4) Ill-defined / irregular surface
5) Systemic upset
6) Lymphadenopathy

Question 28

What’s a first-line investigation used in swellings which is useful to differentiate malignant from benign?

Answer 28

USS

Question 29

Lipomas are usually malignant. True/False?

Answer 29

False

Question 30

The commonest hand swelling is due to…

Answer 30

Ganglion Cyst

Question 31

Common sites for ganglion cysts include (4)

Answer 31

1) Wrist
2) Foot
3) DIP joint
4) Ankle

Question 32

A ganglion cyst located at the DIP is termed a

Answer 32

Mucous cyst

Question 33

The second commonest hand swelling after ganglion cysts is

Answer 33

Giant cell tumour of the synovial tendon sheath

Question 34

Ganglions are generally painful/painless. This helps differentiate them from giant cell tumours, true/false?

Answer 34

Painless - true (as giant cell tumours are usually painful)

Question 35

What type of lesion is shown? How is it treated?

Answer 35

Pigmented villonodular synovitis (a tumour arising from synovium). Treated with synovectomy.

Question 36

What’s the risk of recurrence after pigmented villonodular synovitis is treated?

Answer 36

15%

Question 37

Which type of lesion is this? Should it be excised?

Answer 37

Baker’s Cyst. No exicision - very high recurrence rate.

Question 38

Can inflammed bursae be excised as a form of treatment?

Answer 38

No, will continue to swell after removal

Question 39

Which type of lesion is this? How is it caused?

Answer 39

Implantation dermoid - caused by a trauma which moves epithelial cells into the subcutaneous tissue forming a pseudocapsular reactive cyst

Question 40

Which type of lesion is this? What are the defining features?

Answer 40

Epidermoid cyst. Noticeable by presence of punctum & keratin lining

Question 41

This is an example of what? How is it treated?

Answer 41

Abscess - treated with incision and drainage (antibiotics will not penetrate pus)

Question 42

Histocytoma is a malignant growth of what tissue type?

Answer 42

Fibrous

Question 43

Rhabdomyosarcoma is a malignant growth of which tissue type?

Answer 43

Skeletal muscle

Question 44

Angiosarcoma is a malignant growth of which tissue type?

Answer 44

Blood vessel