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MDD > Passmed/Pastest/Capsule > Flashcards

Passmed/Pastest/Capsule Flashcards

1
Q

what are features of Still’s Disease

A

arthralgia
elevated serum ferritin
rash: salmon-pink, maculopapular
pyrexia
typically rises in the late afternoon/early evening in a daily pattern and accompanies a worsening of joint symptoms and rash
lymphadenopathy
rheumatoid factor (RF) and anti-nuclear antibody (ANA) negative

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2
Q

how do you manage Still’s Disease

A

NSAIDs - should be used first-line to manage fever, joint pain and serositis, they should be trialed for at least a week before steroids are added.

steroids may control symptoms but won’t improve prognosis

if symptoms persist, the use of methotrexate, IL-1 or anti-TNF therapy can be considered

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3
Q

what is Simmonds test

A

patient lies facing down with leg below knee hanging off the end of the bed with foot in dorsiflexion, calf is squeezed and if there is no plantarflexion movement of the foot then the achilles tendon is damaged - +ve = damage

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4
Q

what test should you do in a patient presenting with discitis

A

echocardiography - may have IE

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5
Q

what should you suspect in a patient with signs of sepsis and developing lower limb neuropathy, particularly if there is no pain

A

lumbar epidural abscess

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6
Q

whats leriche syndrome

A

Type of Peripheral Arterial Disease

Classically, it is described in male patients as a triad of symptoms:

  1. Claudication of the buttocks and thighs
  2. Atrophy of the musculature of the legs
  3. Impotence (due to paralysis of the L1 nerve)
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7
Q

what antibiotic is not recommended for prescription in patients taking methotrexate + why

A

trimethoprim due to it causing myelosuppression and fatal pancytopenia

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8
Q

what antibiotic is most associated with achilles tendon disorders

A

ciprofloxacin

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9
Q

what should be done before commencing someone on hydroxychloroquinine

A

opthalmology review due to retinopathy risk

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10
Q

what is Sheurmans disease

A

self-limiting skeletal disorder of childhood, where the vertebrae grow unevenly with respect to the sagittal plane; that is, the posterior angle is often greater than the anterior.

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11
Q

what is brown-sequard syndrome

A

rare neurological condition characterized by a lesion in the spinal cord which results in weakness or paralysis (hemiparaplegia) on one side of the body and a loss of sensation (hemianesthesia) on the opposite side.

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12
Q

what is mallet thumb

A

injury to the end of a finger that forces it to flex inwards

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13
Q

what test is used to diagnose menisceal tears + what is it

A

Thessaly’s test . The patient is supported by doctor and is asked to stand on the affected leg, flexed to 20 degree. The test is positive if there is pain on twisting knee

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14
Q

what FRAX score warrants a DEXA scan

A

10% or higher

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15
Q

what results are consistent with osteomalacia

A

low calcium, low phosphate, high ALP

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16
Q

what is lesch-Nyhan syndrome

A

inherited enzyme deficiency also known as ‘juvenile gout’. It is also linked with self injuring behaviour, cognitive impairment and nervous system impairment.

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17
Q

what is lesch-nyhan syndrome linked with

A

gout

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18
Q

In Gout, what are drug contraindiations for a Gout prescription

A

azathioprine, as this causes myelosuppression

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19
Q

in a scaphoid fracture what is the neurovascular structure that is most at risk

A

Dorsal carpal branch of the radial artery

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20
Q

what should be checked before starting azathioprine

A

thiopurine methyltransferase deficiency - causes myelosuppression

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21
Q

what is the imaging modality of choice when viewing the achilles tendon

A

ultrasound

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22
Q

what is a Hill-Sach lesion

A

a cortical depression in the posterolateral head of the humerus. It results from forceful impaction of the humeral head against the anteroinferior glenoid rim when the shoulder is dislocated anteriorly.

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23
Q

what does marfans cause a deficiency in

A

fibrillin-1

24
Q

what drug is associated with an increased risk of atypical stress fractures

A

bisphosphonates

25
Q

what is the most common reason for surgical re-intervention of a total hip replacement

A

aseptic loosening of the implant

26
Q

when prescribing DMARDS for rheumatoid arthritis, what would a patient with an allergy to a sulfa drug (e.g. co-trimaxazole) also not be able to take

A

sulfasalazine

27
Q

what is Pott’s fracture

A

bimalleolar ankle fracture

28
Q

what is Bennet’s fracture

A

Intra-articular fracture of the first carpometacarpal joint

Impact on flexed metacarpal, caused by fist fights
X-ray: triangular fragment at ulnar base of metacarpal

29
Q

What is Barton’s fracture

A

Distal radius fracture (Colles’/Smith’s) with associated radiocarpal dislocation

Fall onto extended and pronated wrist

30
Q

What is Smith’s fracture

A

reverse colles fracture

Volar angulation of distal radius fragment (Garden spade deformity)

Caused by falling backwards onto the palm of an outstretched hand or falling with wrists flexed

31
Q

what is schobers test and what is considered a significant result

A

test to measure spine flexion - mainly used in ankylosing spondylitis

<5cm is suggestive of ankylosing spondylitis

32
Q

what nerve root is the tricep reflex testing

A

median nerve - C7

33
Q

what is the classification system for open fractures

A

Gustilo-Anderson

34
Q

What classification requires knowledge of syndesmosis anatomy

A

Weber

35
Q

What is the first parameter to change in hypovolaemic shock

A

Respiratory rate

36
Q

where do you find woven bone

A

calluses and in new undeveloped bone

37
Q

what are the red flags for back pain

A

TUNA FISH

T - trauma
U - unexplained weight loss
N - Neurological Symptoms
A - age (<20, >55)

F - Fever
I - IVDU
S - Steroid use
H - Hx of Cancer

38
Q

what is a yellow flag

A

psychosocial patient factors that although not associated with serious organic pathology nonetheless indicate an increased likelihood of chronic back pain and resultant long term disability and potential loss of work

39
Q

what arethe yellow flags for back pain

A 
A belief that pain and activity is harmful or severely disabling
Fear-avoidance behaviour
Sickness behaviours
Low mood
Social withdrawal
An expectation that passive treatment rather than active participation will help
Issues with compensation system
Poor job satisfaction
Difficulty at work
Overprotective family
Lack of social support
Financial problems
40
Q

what condition is associated with ‘cotton wool calcification’ on an Xray

A

chondrosarcoma

41
Q

which rib forms the costal margin on the mid axillary line

A

10th Rib

42
Q

What is described as a ‘skiiers thumb’ injury

A

Ulnar collateral ligament of the thumb injury

43
Q

what causes osteopenia with a normal bone matrix to bone mineral ratio

A

osteoporosis

44
Q

what nerves are most commonly affected by supracondylar humeral fractures and what are the effects of this

A

median and anterior interrosseus nerve - weakness to ipsilateral index finger and weakened wrist flexion

45
Q

what is characteristic of a scaphoid fracture

A

distortion of the anatomical snuffbox anatomy

46
Q

which nerve is susceptible to compression in injury to the lateral head/neck of the tibia

A

common peroneal nerve

47
Q

what nerve controls foot dorsiflexion

A

common peroneal nerve

48
Q

fracture of the femoral head causing avascular necrosis occurs due to interruption of which artery

A

median circumflex artery

49
Q

what tendon would a fracture and inferior displacement of the sustentaculum tali affect

A

flexor hallucis longus

50
Q

how is slipped upper femoral capital epiphysis treated

A

in situ screw fixation

51
Q

what nerve is most at risk in a mid-shaft humeral fracture and how would its injury manifest

A

radial nerve, loss of sensation in dorsum of hand

52
Q

what is a late sign of compartment syndrome that indicates a poor prognosis

A

complete anaethesia of the affected portion

53
Q

what antiepileptic is associated with chronic acidosis and what implications does this have for bone health

A

topiramate, causes an osteomalacia-type state due to defective bone mineralisation

54
Q

what artery is most at risk in a supracondylar fracture of the humerus

A

brachial artery

55
Q

damage to what muscle causes winging of the scapula

A

serratus anterior

56
Q

whats the treatment of choice for a subtrochanteric hip fracture

A

intermedullary nail

57
Q

what is the treatment of choice for a suspected hip fracture in a RTA

A

Thomas splint - allows immobilisation of the injury for further assessment

MDD (22 decks)

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