Orthopeadics teach amk day Flashcards

1
Q

sunburst appearance on X-ray

A

osteosarcoma

tissue biopsy to confirm

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2
Q

what is osteosarcoma

most commonly found where

A

malignant bone tumour found at metaphysics of distal femur or proximal tibia

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3
Q

symptoms fo osteosarcoma

A

dull bone pain worse at night , localised mass , soft and tissue mass and swelling

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4
Q

pages disease of the bone is a metabolic bone disorder

symptoms - hearing and extra

A

constant achy bone pain
warmness
hearing loss
and heart failure

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5
Q

what do results from blood show pagets

A

raised ALP
normal calcium and phonate

differentials for hbperparathryism

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6
Q

management fo pagets

A

bisphosphonates e.g. IV parmidroante

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7
Q

osteomyelitis is the infection of the bone usually from

A

staph aureus

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8
Q

symptoms of OM

A

recent trauma or fractures due to infection getting in

bone pain at site
lump
fever and redness

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9
Q

investigation fro OM - infection of bone

managemtn

A

MRI

give antibiotics
children - cefaxolin and adults fluco

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10
Q

bony metastasis is when what

A

when cancers spread to the bone

most common causes are renal , trhyodi , lung , prostate, breast

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11
Q

syntposm of bony metastasis

A

bone pain worse at night
anaemia

raised calcium

normally just palliative care and chemo

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12
Q

chondrosarcoma is tumour and presents with painful and enlarging mass and if affects where

A

axial skeleton - ribs, shoulder and pelvis

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13
Q

what does an X-ray of a chondroarcoma show

A

lytic lesions with calcification , cortical remodelling

need to remove it

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14
Q

sliped upper femoral epiphysis SUFE this is where growth plate experiences some sort of fracture causing the femoral head to slip out of position

really common in boys 10-16 normally obese

symtpoms

A

limited abduction , internal rotation and flceion and present with externally rotated leg

pelvic xray - frog postion

managemnet is internal rotation - pops it back in

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15
Q

perthes affects boys 4-7 and is characterised by gradual hip pain and all hip movements are limited
managed b

A

NSAIDs and bed rest

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16
Q

transient synovitis of the hip 4-10 yr olds is acute onset hip pain and relived rest

upper resitpatiory tract infection relived with rest for the pain

investigations shwo

A

no findings or blood results on scan

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17
Q

for septic arthritis what diagnosis should do

A

aspirate and then blood cultures

kochers criteria

mangemtn with fluclox- staph and for strep use ceftriaxone

18
Q

reactive arthritis comes after STI or campylobacter most common joint

anterior uveitis - red eye

A

knee

methotraxate

19
Q

osgood-schlatters disease

overuse syndroom in paeds population and males. normally active patients. presents as

A

warmth and tender and swelling over the tibial tuberosity - just below the knee

conservative measures for management - rests ice, physiological and NSAIDs

20
Q

if you have ligament damage what does it present as

A

swelling and pain and inability to weight bare

21
Q

test for ACL

A

anterior draw test

post draw test

22
Q

varus stress test

A

lateral

valgus is for medial

23
Q

mamagemtn for ligament damage

A

PRICER - protect , rest, ice compression , elevation and rehab

24
Q

meniscal tear presents with

A

pop sound and pain on side of knee

inability to weight bear and pain worse on flexion

25
Q

main test for meniscal tear

A

McMurray test

MRI gold standard

26
Q

chondromalaci patellae

A

anterior knee pain in teenage girls
grinding of the knee when flexed
worse on walking down stairs

MRI and physic

27
Q

pre patellar bursitis very common n roofers and carpet layers - plumbers and gardeners - people who on their knees

symtpoms

A

massive swelling
warm
tender
clinical exma

28
Q

poster hip dislocation - dashboard car

symptoms

A

pain radiating to the knee
shortened and internally rotated one

closed reduction within 6 hours for manage

29
Q

femoral head injury present with groin pain and local swelling and bruising with sciatic nerve injury
how to mange

A

xray

repositioning ORIF 0 expose and manipulate structures to put back in place

30
Q

neck of femur fracture common in elderly with osteoporosis

symptoms

A

hip pain worse on palpating greater trochanter

shortened and external rated

31
Q

what criteria for neck of femur

A

garden criteria

32
Q

anterior hip dislocations

A

lengthened externally rotated
femoral nerve injury
pain radiating to the knee

closed reduction within 6 hours

33
Q

neck of femur fracture - intracapsular or extracapsualr

if you have dialled sub capital ( intra) you need a

A

Total hip replacement

or hemiarthroplasty - weak patents so old ( half replacement essentially)

34
Q

non dispalced sub capital fracture - intracapsular what do you do

A

cannulated hip screw

35
Q

extra - intertrochanteric

A

dynamic hip screw

36
Q

subtrochnateric

A

intermudullary nail

37
Q

adhesive capultiis more common in diabetics
glenohumeral joitn capsule adheres to humeral head

symtpsom

A

loss of active and passive movement
- freezing stage - pain worst , mvoemtn worse
frozen stage- pain better , movement worse
thawing stage - pain resolves and movement improves

38
Q

rotator cuff tears present as

A

loss of active movement with pain on rest and movement

passive movement intact - they can’t move it themselves but we can

weakness on abduction

39
Q

assessment for rotator cuff tear

A

xray to exclude fractures
US - to look for tear
MRI - looks at tears more clearly

management - depends on symptoms under 2 weeks conservative but if over 2 weeks will be surgery

40
Q

anterior glenohumeral dislocation in Rugby and poster in seizures and electrocution

symtpoms

A
painful shoudle r
reduced mobility 
asymmetry 
loss of shoulder contours 
antihero bulge 

reduction immobilisation and rehab for manegmetn

41
Q

assessment for dislocations

A

x ray

MRI if labral injury suspected

X- ray for poster is like a light bulb sign and again MRI is labral injury suspected

goes around the joint thats why if you’ve had one before likely to get one again