Ortho & Rheum

Question 1

An X-ray shows a fracture of the distal third of the radial shaft with dislocation of the radio-ulnar joint.

What is the name given to this type of fracture?

Answer 1

Galeazzi

GRUesome MURder (Galeazzi is Radial fracture with Ulnar dislocation | Monteggia is Ulnar fracture with Radial dislocation)

Question 2

_________ fractures are fractures of the proximal third of the ulnar shaft with anterior dislocation of the radial head

Answer 2

Monteggia

GRUesome MURder (Galeazzi is Radial fracture with Ulnar dislocation | Monteggia is Ulnar fracture with Radial dislocation)

Question 3

treatment for polymyositis & dermatomyositis

Answer 3

corticosteroids - prednisolone

Question 4

what does high ESR main

Answer 4

there’s lots of immunoglobulins in the blood

Question 5

antibodies in polymyositis/ dermatomyositis

Answer 5

Anti-Jo1

Question 6

antibodies in rheumatoid arthritis

Answer 6

rheumatoid factor (50-90%)

anti CCP (>95%)

Question 7

antibodies in

• SLE?
• drug-induced SLE?

Answer 7

SLE- Anti-dsDNA, Anti-sm, ANA

drug-induced SLE- Anti-Histone

Question 8

Sjogren’s Syndrome antibodies

Answer 8

Anti-Ro

Anti-La

Question 9

Diffuse Cutaneous Systemic Sclerosis antibodies

Limited Cutaneous Systemic sclerosis antibodies

Answer 9

Diffuse Cutaneous Systemic Sclerosis
Anti-Scl-70

Limited Cutaneous Systemic sclerosis
Anti-Centromere

Question 10

Wegener’s Granulomatosis antibodies

Answer 10

cANCA

Question 11

acute painful, warm, red, swollen knee + joint fluid aspiration has positively birefringent rhomboid-shaped crystals- dx +rx?

Answer 11

pseudogout

give NSAIDs, colchicine

NO PROPHYLACTIC

Question 12

deformity in one hand + chronic alcohol + flexion deformities in 4th & 5th fingers

Answer 12

Dupuytren’s contracture

Question 13

in a dx of osteomyelitis, which blood test do you do to know if rx is working

Answer 13

ESR

if it’s high, there is inflammation

Question 14

swollen wrist after a fall + old F with osteoporosis + tenderness in distal radius - what kind of fracture + describe it?

Answer 14

Colles fracture- most common fracture of the wrist

fracture of the distal radius with dorsal angulation of the distal fracture fragments

Question 15

Churg-Strauss antibodies

Answer 15

Peri-nuclear anti-neutrophil cytoplasmic antibodies

Question 16

Goodpasture’s syndrome antibodies

Answer 16

Anti-glomerular basement membrane antibodies against type 4 collagen found within glomerular and alveolar basement membranes

Question 17

fall on outstretched hand + pain in anatomical snuffbox - which fracture + if -ve x-ray whats the next step

Answer 17

scaphoid fracture

plaster for 10 days then do Xrays bc scaphoid fractures may be radiologically visible after 10 days

Question 18

hardened skin on hands + PMH of Raynaud’s - dx?

Answer 18

systemic sclerosis

Question 19

tennis elbow

• other name
• which muscle is affected
• features/ presentation

Answer 19

• lateral epicondylitis
• extensor carpi radialis brevis

pain at the site of insertion of forearm extensors at the lateral epicondyle of the humerus

over the age of 35 in those who perform repetitive activities involving elbow extension.

Symptoms typically resolve with rest.

Question 20

key diagnostic ix in M with swollen red , severely painful hot knee and fever?

Answer 20

joint aspiration to exclude septic arthritis

pseudogout if no fever

Question 21

1st line for RA

Answer 21

methotrexate

Question 22

5 yo w pain in R hip+ cold 2 wks ago + antalgic gait + R hip flexed & ext rotated + int rotation is reduced - dx?

Answer 22

transient synovitis of hip

common cause of hip pain in kids w recent infection/ trauma/ allergic reaction

Question 23

scoring system for paediatric fractures involving the growth plate.

Answer 23

Salter-Harris

Question 24

What classification criteria is used to grade intracapsular neck of femur fractures?

Answer 24

The Garden classification assesses the severity of intracapsular neck of femur fractures.

Question 25

scoring system to assess the severity of rheumatoid arthritis.

Answer 25

DAS-28

Question 26

scoring system used to establish the risk of future fractures, mainly in osteoporotic patients.

Answer 26

FRAX tool

Question 27

adolescent with a painful lump on the tibial tuberosity which is more painful after exercise- dx?

Answer 27

Osgood–Schlatter disease

The disease occurs as a result of the strength of the quadriceps muscle exceeding the ability of the tibial tuberosity to resist its pull, causing avulsion of the bone. The avulsed fragments heal and grow, causing an enlarging lump. Management involves rest, reduced exercise intensity and sometimes physiotherapy, with most cases resolving as the growth plates ossify.

Question 28

4 yo w limp + pain in l hip & groin, worse on activity, improves on rest + antalgic gait + limited int. rot. + x-ray has loss of joint space & reduced size of femoral head - dx?

Answer 28

perthes’ disease

caused by idiopathic avascular necrosis of the femoral head. Lack of blood supply to the bone causes it to soften and break apart. The onset of the disease occurs between the ages of 4-10 years old and usually only affects one hip, but can be bilateral

Question 29

scoring system to classify ankle fractures based on radiographic findings

Answer 29

Weber (or Danis-Weber) Classification

Question 30

Which condition does Barlow’s test screen for?

Answer 30

Developmental dysplasia of the hip

Question 31

rheumatoid arthritis is ______ while osteoarthritis is __________ (asymmetric/ bilateral)

Answer 31

RA—> almost always bilateral

osteoarthritis —-> assymetric pain

Question 32

if a person has difficulty abducting arm but no other issues with movements after going to the gym and having shoulder pain after, which muscle is likely affected

Answer 32

supraspinatus

Question 33

complication commonly associated w fracture of the femoral head

Answer 33

avascular necrosis

Question 34

basketball hits finger+ xray shows small avulsion fracture of dorsal distal phalanx- dx?

Answer 34

mallet finger

Question 35

crystals found in

gout?

pseudogout?

Answer 35

gout- monosodium urate

pseudogout- calcium pyrophosphate

Question 36

commonest eye symptom of RA

Answer 36

keratoconjunctivitis sicca

Question 37

a child with fractures, deafness and blue sclera - dx?

Answer 37

osteogenesis imperfecta - affects type I collagen

Question 38

heberdens nodes - which joint

bouchards nodes- which joint

Answer 38

HD BP
heberdens- DIP
bouchards- PIP