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Year 3 EMQ revision > Orthopaedics and Rheumatology > Flashcards

Orthopaedics and Rheumatology Flashcards

1
Q

Urethritis, conjunctivitis, arthritis

Associated lesions include circinate balanitis

Keratoderma blenorrhagica

Mouth ulcers

Previous STI or gastroenteritis

A

Reiter’s syndrome

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2
Q

Young male, buttock/sacroiliac pain worse in morning, relieved by exercise Syndesmophytes, ‘bamboo spine’ on X-ray

Associations include 4 As: arthritis, anterior uveitis, apical lung fibrosis, aortic regurgitation

A

Ankylosing spondylitis

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3
Q

Nail dystrophy, ‘pitting’

Joints show central erosion on X-ray

Can be highly deforming (arthritis mutilans)

A

Psoriatic arthritis

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4
Q

Arthritis in UC/Crohn’s patient

Asymmetrical, mainly affects lower limbs

A

Enteropathic arthropathy

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5
Q

Dry eyes, dry mouth

Positive Schirmer’s test

A

Sjögren’s syndrome

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6
Q

Proximal muscle weakness, pain and tenderness

Increased serum CK

A

Polymyositis

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7
Q

Proximal muscle weakness, pain and tenderness

Increased serum CK

Heliotrope (purple) rash

A

Dermatomyositis

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8
Q

More common in Turkish, Iranian patients

Orogenital ulceration, uveitis, arthritis

Pathergy reaction is pathognomonic

A

Behçet’s disease

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9
Q

Usually woman

Persistently cold, cyanosed fingers

A

Raynaud’s phenomenon

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10
Q

Calcinosis (nodules)

Raynaud’s phenomenon

Esophageal dysmotility

Sclerodactyly

Telangiectasia

CREST

A

Systemic sclerosis

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11
Q

Usually elderly patient with headache

Scalp tenderness

Jaw claudication

Sudden unilateral blindness can occur

Associated with polymyalgia rheumatica

A

Temporal/giant cell arteritis

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12
Q

Granulomas in respiratory tract

Generalised vasculitis

cANCA, anti-PR3 positive

A

Wegener’s granulomatosis

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13
Q

Usually child (particularly under age 5)

Purpuric rash over buttocks, extensor surfaces

Associated with arthritis, abdominal pain and nephritis

A

Henoch-Schönlein purpura

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14
Q

Usually middle-aged male

Asthma, rhinitis and systemic vasculitis

+++ eosinophilia

A

Churg-Strauss syndrome

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15
Q

Usually under 5 years

Main features are:

  • protracted fever
  • acute cervical lymphadenopathy
  • bilateral non-purulent conjunctivitis
  • dry, cracked, fissured lips
  • redness, oedema of palms and soles

Platelets and CRP usually elevated

A

Kawasaki’s disease

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16
Q

Anti double-stranded DNA

A

SLE

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17
Q

Anti-Jo-1 antibodies

A

Polymyositis

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18
Q

Anti-centromere

A

Limited systemic sclerosis

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19
Q

Anti-topoisomerase

A

Diffuse systemic slcerosis

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20
Q

cANCA, anti-PR3

A

Wegener’s granulomatosis

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21
Q

α-endomysial antibody

A

Coeliac disease

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22
Q

Anti-cyclic citrullinated peptide antibody

A

Rheumatoid arthritis

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23
Q

Radiological findings

  • Loss of joint space
  • Subchondral sclerosis
  • Subchondral cysts
  • Osteophytes
A

Osteoarthritis

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24
Q

Radiological findings

  • Loss of joint space
  • Juxta-articular osteoporosis
  • Erosions
  • Subluxation joints
A

Rheumatoid arthritis

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25
Q

Radiological findings

  • Localised enlargement of bone with deformity (e.g. enlarged skull, bowed tibia)
A

Paget’s disease

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26
Q

Radiological findings

  • Syndesmophytes
  • ‘Bamboo-spine’ appearance
A

Ankylosing spondylitis

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27
Q

‘Sunray’ spiculation

A

Osteosarcoma

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28
Q

‘Onion-peel sign’

A

Ewing’s sarcoma

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29
Q

Thickening, fibrosis palmar fascia

A

Dupuytren’s contracture

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30
Q

Forced adduction and flexion thumb elicits pain on radial side wrist

A

De Quervain’s syndrome

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31
Q

Failure to abduct shoulder after dislocation

A

Axillary nerve injury

32
Q

Painful shoulder following seizure

A

Posterior dislocation shoulder

33
Q

‘Dinner fork’ deformity

A

Colles’ fracture

34
Q

Flexed, adducted and externally rotated leg

A

Femoral shaft fracture

35
Q

Locked knee, positive McMurray’s test

A

Meniscal tear

36
Q

Drop foot after hip replacement

A

Sciatic nerve injury

37
Q

Drop foot after knee injury

A

Common peroneal nerve injury

38
Q

Excessive anterior glide tibia on femur

A

Anterior cruciate ligament injury

39
Q

Excessive posterior glide tibia on femur

A

Posterior cruciate ligament injury

40
Q

Prominent tender tibial tubercle

A

Osgood-Schlatter disease

41
Q

Monosodium urate crystals with strong negative birefringence

A

Gout

42
Q

Calcium pyrophosphate dehydrate crystals with weakly positive birefringence

A

Pseudogout

43
Q

30-year-old woman complains of joint pain in her hands and feet. Her chest x-ray shows reduced lung volumes.

A

SLE

44
Q

12-year-old boy presents with pain in his right hip. On examination, the hip is flexed, abducted and externally rotated.

A

Slipped femoral epiphysis

45
Q

6-year-old boy presents with pain in the hip and a limp. All movements at the hip are limited. His x-ray shows decrease in size of the nuclear femoral head with patchy density.

A

Perthes’ disease

46
Q

Hip is adducted, externally rotated and shortened

A

Fractured neck of femur

47
Q

Constant backache

ESR and serum calcium are markedly elevated

A

Myeloma

48
Q

Females during puberty

Wedge-shaped vertebral bodies

Kyphosis

Abnormal ossification of ring epiphyses of thoracic vertebrae

A

Scheuermann’s disease

49
Q

Recurrent attacks of pain and swelling in the nose and external ear

Features can include vasculitis and seronegative arthritis

A

Polychondritis

50
Q

Pain, swelling, oedema, change in skin temperature, altered sweating

A

Complex regional pain syndrome / Sudeck’s atrophy

51
Q

Pleuritic chest pain after orthopaedic/pelvic surgery

A

Pulmonary embolus

52
Q

Absence of callus at the fracture site

A

Delayed union

53
Q

Weakness of wrist extensors

A

Radial nerve injury

54
Q

Used in infants for femoral fractures

A

Gallows traction

55
Q

Pain and swelling at the anatomical snuffbox after injury to the arm/hand suggests fracture of the…

A

scaphoid

56
Q

68-year-old woman presents with:

Fracture at the distal radial head with dorsal displacement of distal fragment after a fall

A

Colles’ fracture

57
Q

More common in children after a fall on the outstretched hand

May present with swollen painful elbow

A

Supracondylar fracture

58
Q

Loss of shoulder contour

Absent sensation on a patch below the shoulder, due to axillary nerve damage

A

Anterior dislocation shoulder

59
Q

Wrist drop (radial nerve injury) due to fracture of the…

A

humeral shaft

60
Q

Shoulder pain aggravated in abduction of the arm between 60 and 120o

A

Impingement syndrome

61
Q

Aching shoulder; flexing the elbow reveals a prominent lump in the upper arm

This injury occurs after lifting/pulling activity

A

Ruptured long head of biceps

62
Q

9-month history of stiffness in shoulder

Shoulder was originally extremely painful but now only the stiffness remains

A

Adhesive capsulitis

(‘frozen shoulder’)

63
Q

14-year-old girl successful treated for rickets shows bow-legged deformity

A

Genu varum

64
Q

Condition in which the knees angle in and touch one another when the legs are straightened

A

Genu valgum

65
Q

50-year-old carpet layer presents with a swelling directly over the patella

Joint is normal

A

Pre-patellar bursitis

66
Q

Benign swelling of the semimembranosus or more rarely some other synovial bursa found behind the knee joint

A

Baker’s cyst

67
Q

Presents with lower back pain and stiffness that was worse in the morning

Question-mark posture

A

Ankylosing spondylitis

68
Q

Used for prophylaxis of gout

A

Allopurinol

(xanthine oxidase inhibitor)

69
Q

Gross irreversible retinopathy due to what drug?

A

Hydroxychloroquine

70
Q

Oligospermia in a patient on DMARD treatment - what is the drug?

A

Sulfasalazine

71
Q

Patient on long-term DMARD treatment shows pulmonary and hepatic fibrosis - what is the drug?

A

Methotrexate

72
Q

Afro-Carribean woman

Progessive SoB and fever

Hands have been painful and stiff

Mouth ulcers

Bilateral pleural effusions

Raised ESR, normal CRP

A

SLE

73
Q

An elderly patient with bone pain has the following blood result:

  • Normal serum calcium
  • Normal serum phosphate
  • Raised serum alkaline phosphatase
A

Paget’s disease

74
Q

What drug can be used in Raynaud’s syndrome?

A

Nifedipine

(calcium channel blocker)

75
Q

Splenomegaly and neutropenia in a patient with rheumatoid arthritis

A

Felty’s syndrome

76
Q

Most appropriate treatment for acute episodes of gout is…

A

NSAIDs

Year 3 EMQ revision (8 decks)

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