ortho

Question 1

Baker’s cyst history

Answer 1

old woman, twisting motion when getting out a car, pain on weight bearing, 4cm non tender lump just inferior to popliteal fossa, becomes tense on extending the leg

Question 2

Oedema in a burns patients

Answer 2

hypoalbuminaemia

Question 3

Cauda equina presentation

Answer 3

loss of anal tone, weakness, loss of sensation

Question 4

When to offer MRI to patients with back pain

Answer 4

puts where malignancy, infection, fracture, cauda equina, ank spond is suspected

Question 5

achilles tendon disorders

Answer 5

quinolone use (ciprofloxacin) associated with tendon disorders, hypercholesterolaemia (predisposes to tendon xanthomata)

Question 6

examination in patient with prolapsed disc

Answer 6

straight leg raise - will not be normal

Question 7

68 year old obese man, one day history of progressive lower back pain, no obvious trigger, no haemodynamic compromise

Answer 7

leaking abdo aneurysm

Question 8

facet joint pain

Answer 8

pain worse in morning, and on standing, pain worse on extension of the back

Question 9

spinal stenosis

Answer 9

gradual onset, pain, worse walking, better sitting down, leaning forwards

Question 10

ank spond

Answer 10

young man, lower back pain and stiffness, stiffness worse in morning, eases with activity

Question 11

PAD

Answer 11

pain on walking, relieved by rest

Question 12

progression of frozen shoulder, aka adhesive capsulitis

Answer 12

initial painful stage followed by a period of joint stiffness, usually resolves with physio although may take up to 2 years to recover

Question 13

rotator cuff tears

Answer 13

more common in elderly people, may occur following minor trauma, or as a result of long standing impingement, >2cm&raquo_space; surgical repair

Question 14

Peripheral neuropathy complicated viral illnesses (eg pain and weakness in shoulder having recently been unwell with glandular fever, winging of scapula)

Answer 14

parsonage - tuner syndrome

Question 15

features of frozen shoulder

Answer 15

develops over days, external rotation more affected than internal rotation or abduction, both active and passive movement affected, patients have a painful freezing phase, adhesive phase, recovery phase

Question 16

fracture where both sides or cortex are breached

Answer 16

complete

Question 17

greenstick

Answer 17

unilateral cortical breach on

Question 18

buckle

Answer 18

incomplete cortical disruption resulting in periosteal haematoma only

Question 19

salter harris 1-5

Answer 19

1 - physis only, x ray may be normal
2 fracture through physics and metaphysis
3 fracture through physics and epiphysis (right angle going down)
4 fracture that involves physics, metaphysics and epiphysis (line going straight down)
5 - crush involving the physics

Question 20

features of NIA

Answer 20

delayed presentation, delayed milestones, multiple injuries, lack of concordance

Question 21

common peroneal nerve

Answer 21

supplies muscles of peroneal and anterior compartment of leg and sensation dorm of foot, travels through popliteal fossa, wraps around the head of the fibula

leg crossing, bed rest, hyperflexion of knee, pressure in obstetric stirrups and conditioning in ballet shoes – injury

Question 22

metastatic breast cancer

Answer 22

increasing bony rest pain, waking from sleep, bloods –> raised serum calcium and alp

Question 23

osteoporosis risk factors

Answer 23

age, female gender, steroids

Question 24

haemarthrosis associations

Answer 24

rapid joint swelling, ACL and PCL

Question 25

+ve lachman test

Answer 25

ACL injury

Question 26

mechanism of meniscal tears

Answer 26

twisting

Question 27

what is supraspinatous tendonitis (painful arc)? where tender?

Answer 27

rotator cuff injury, painful arc of abduction between 60 and 120 degrees, tenderness over anterior acromion

Question 28

DM risk factor for which shoulder condiiton

Answer 28

adhesive capsulitis

Question 29

fat embolism features - resp, derm and cns

Answer 29

tachycardia, dyspnoea, hypoxia, 72 hours following injury, pyrexia

petechial rash, subconjunctival haemorrhage

confusion, agitation

Question 30

ganglion features / management

Answer 30

‘cyst’ arising from a joint or tendon sheath

most commonly seen around back of the wrist, 3 times more common in women

Question 31

where are most proximal humerus fractures

Answer 31

man through surgical neck (below the trochanter shit)

Question 32

most common shoulder dislocation

Answer 32

anterior shoulder most common