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med > Ortho > Flashcards

Ortho Flashcards

1
Q

Name the rotator cuff muscles

A 
(SITS)
Supraspinatus
Infraspinatus
Teres minor
Subscapularis
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2
Q

What conditions make up rotator cuff disorders?

A

Subacromial (shoulder) impingement
Rotator cuff tear
Calcific tendonitis

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3
Q

Which imaging technique is first line for adhesive capsulitis and other shoulder joint problems?

A

USS

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4
Q

What does a positive scarf test indicate?

A

Acromioclavicular disorder

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5
Q

What does supraspinatus do?

A

ABducts 0-15 degrees and assists deltoid 15-90

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6
Q

Which muscles abduct the arm beyond 90 degrees?

A

Trapezius and serratus anterior

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7
Q

What is the ‘lift off test’ (resisted internal rotation) used for?

A

Subscapularis pathology

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8
Q

What is resisted external rotation a test for?

A

Infraspinatus

Teres minor

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9
Q

Name a test for shoulder impingement

A

Neers test

Hawkins-kennedy test

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10
Q

Which condition is adhesive capsulitis associated with?

A

DM

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11
Q

What examination findings are suggestive of frozen shoulder?

A

Unable to do passive external rotation

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12
Q

What is the most common cause of acromioclavicular joint problems?

A

Trauma (e.g. fracture of clavicle in young males)

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13
Q

Which nerve can be damaged in shoulder dislocation?

A

Axillary

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14
Q

Are most shoulder dislocations anterior or posterior?

A

Anterior

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15
Q

Define compartment syndrome

A

Critical pressure increase within compartmental tissue causing decline in perfusion to tissue within that compartment

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16
Q

Causes of compartment syndrome

A

Fracture
Crush
Burns
Penetrating wounds

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17
Q

How does compartment syndrome present?

A

PAIN disproportionate to injury

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18
Q

Tx compartment syndrome

A

Fasciotomy

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19
Q

Which organism most common cause osteomyelitis

A

S.aureus

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20
Q

What should you suspect if a young person found to have spinal fracture following low impact trauma?

A

Tumour

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21
Q

Which pt group are at very high risk of spinal fracture and always need CT rather than XR to exclude?

A

Anky spond

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22
Q

Which primary ca most commonly metastasise to bone?

A 
Breast 
Bronchus
Thyroid
Kidney 
Prostate
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23
Q

What components form FRAX score?

A

3 person - age sex BMI
3 # - previous #, parent hip #, low femoral neck BMD
3 in - alcohol, smoking, steroids
2 conditions - RA, secondary causes (e.g. prem menopause)

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24
Q

Describe the appearance of a colles # on XR

A

Distal radius # with dorsal displacement of fragments

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25
Q

Describe the appearance of a smiths # on XR

A

Distal radius # with volar displacement of fragments

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26
Q

What physical abnormality is seen in Colles #?

A

Dinner fork deformity

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27
Q

Which nerve is most commonly damaged in a colles #

A

Median

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28
Q

How is colles # mx?

A

Reduction under anaesthesia

29
Q

What deformity is seen in smith #?

A

Garden spade deformity

30
Q

Which nerve is damaged in a smith #?

A

Median

31
Q

How must you treat suspected scaphoid #?

A

All must be treated with cast immobilisation and followed by repeat XR/examination

32
Q

Sign of scaphoid #

A

Snuffbox tenderness

33
Q

What would a leg with a NOF# look like on exam?

A

Shortened, adducted and externally rotated

34
Q

What classification can be used to grade intracapsular fractures?

A

Garden classification

35
Q

How do you determine when to XR an ankle injury?

A

Ottowa ankle rules

36
Q

How do you classify ankle #?

A

Weber classification

37
Q

How do you manage a type C ankle #?

A

Internal fixation

38
Q

What are the 4 stages of # healing?

A

Haematoma formation
Soft callus formation
Bony callus formation
Bone remodelling

39
Q

What T score indicates osteopenia

A

Between -1 and -2.5

40
Q

What are the risk factors for osteoporosis?

A 
SHATTERED
Steroids
Hyperthyroid/hyperparathyroid
Alcohol and smoking
Thin
Testosterone decreased
Early menopause
Renal/liver dysfunction
Erosive disease (RA)
Dietary Ca low
41
Q

How is osteoporosis tx?

A

Ca and vit D supplements

Bisphosphonates

42
Q

Side effects of bisphosphonates

A

Oesophagitis

Osteonecrosis of jaw

43
Q

What are the causes of osteomalacia?

A

Vit D deficiency
CKD (renal osteodystrophy)
Drug-induced (e.g. anti-convulsants)
Liver cirrhosis

44
Q

What biochemistry findings are suggestive of osteomalacia?

A

Low 25(OH) vit D
Raised ALP
Low Ca and P (30%)
Secondary hyperparathyroidism

45
Q

What XR sign is suggestive of osteomalacia?

A

Looser’s zone

pseudofractures

46
Q

What are the roles of vit D?

A

Increase osteoclast function
Increase Ca and P absorption
Decreases PTH secretion

47
Q

What is the role of PTH?

A

Increases osteoclast function

At kidney - increases Ca reabsorption but increases phosphate excretion

48
Q

What biochemical findings suggest primary hyperparathyroidism?

A

Increased Ca, ALP and PTH

Decreased P

49
Q

What’s the most likely diagnosis of an elderly women px with increased thirst. Blood tests reveal raised calcium and low phosphate.

A

Primary hyperparathyroidism

50
Q

What biochemistry is suggestive of Pagets disease?

A

Isolated raised ALP

51
Q

Signs of Rickets

A

Leg bowing
Knock knees
Rachitic rosary
delayed walking

52
Q

What causes hypocalcaemia with raised PO4?

A

CKD

Hypoparathyroidism

53
Q

What causes hypocalcaemia with low/normal P?

A

Vit D deficiency/ osteomalacia
Acute pancreatitis
CKD?

54
Q

Px of hypocalcaemia

A

SPASMODIC
Spasms
Perioral paraesthesia
Anxious/irritable

Seizures
Muscle tone increased
Orientation impaired/confusion
Dermatitis
Cardomyopathy  (long QT on ECG)
55
Q

XR findings in OA

A

Loss of joint space
Osteophytes
Subarticular sclerosis
Subchondral cysts

56
Q

RA XR findings

A

Loss of joint space
Erosions
Softening of bones (osteopenia)
Soft tissue swelling

57
Q

Which cells secrete PTH?

A

Chief cells

58
Q

You biopsy a bone in leg and discover a malignant primary tumour, what is your first management step?

A

Immobilise the limb to prevent pathological fracture leading to dissemination

59
Q

What is the main organism that causes septic arthritis?

A

S aureus

60
Q

Which STI can cause SA?

A

N.gonorrhoea

61
Q

Which nerve can be damaged in elbow dislocation?

A

Ulnar

62
Q

What are the treatment options for intracapsular fracture?

A 
Fit = total hip replacement
Immobile = hemiarthroplasty
63
Q

How do you treat a intertrochanteric #?

A

Dynamic hip screw

64
Q

How tx subtrochanteric #?

A

nail

65
Q

How can you classify intracapsular #?

A

Garden classification

66
Q

How do you determine whether ankle injury needs XR?

A

Ottowa ankle rules

67
Q

How to manage weber A #?

A

Put in cast and ask to return in one week

68
Q

How to manage weber B?

A

Do weight bearing XR to decide whether needs surgery

69
Q

How to manage weber C #?

A

open reduction and internal fixation

med (25 decks)

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