Passmed Flashcards
What are the risk factors for osteoporosis?
Age Steroids Smoking Excess alcohol intake Family history Low BMI
When should asymptomatic patients be assessed for risk of osteoporotic bone fractures?
In women over 65 and men over 75
What tools should be used to assess patients risks of getting an osteoporotic fracture?
FRAX or Qfracture
When is DEXA scanning recommended by nice over a risk assessment tool?
When the patient is going to recieve treatment that will rapidly affect bone density e.g. hormone treatments for cancer
In patients under 40 with major risk factors
How should low, moderate and high risk FRAX scores be treated?
Low (<10%) should be reassured
Moderate (10-20%) should be offered DEXA scanning
High (>20%) should be started on bone protection treatment e.g. bisphosphonates
What are the 4 signs of flexor tendon sheath infection?
Tenderness
Fixed flexion
Pain on passive extension
Fusiform swelling
What is the management of infective tendosynovitis?
If detected early then medical management can be with antibiotics and elevation. However most cases require surgical debridement
What is the most common oragnism that causes osteomyelitis in a child and what is the most common in children with sickle cell?
The most common organism is staph aureus
In sickle cell they commonly get salmonella osteomyelitis
What is the management of osteomyelitis?
flucloxacillin for 6 weeks
How do meniscal tears commonly present compared to cruciate ligament tears?
Meniscal tears will gradually swell up over 24 hours whereas cruciate tears will swell quickly from haemarthrosis
What do a temperature, retinal haemorrhages, breathless and a high temperature suggest post trauma?
A fat embolism as this causes retinal haemorrhages
What investigation should be done for cauda equina syndrome?
MRI spine
What are some causes of cauda equina syndrome?
Can be caused by a herniated intervertebral disc, Metastatic spinal tumours, infections or haematomas
How do you differentiate plantar fascitis and subcalcaneal bursitis?
Planter fascitis is made worse by walking on tip toes. Plantar fasciitis is the most common cause of heel pain seen in adults. The pain is usually worse around the medial calcaneal tuberosity
What is the difference between frozen shoulder and painful arc?
Frozen shoulder is adhesive casulitis and common in middle ages and diabetics, it is characterised by painful stiff, limited movements in all directions.
Painful arc is supraspinatus tendonitis and causes painful arc of abduction between 60 and 120 degrees, there is also tenderness over the anterior acromion
