pastest Flashcards
patient presents after a car accident with nasal bleeding with a clear fluid, orbital haematoma, glasgow coma scale 3/15
which type of fracture do they most likely have?
anterior fossa skull fracture
-clear fluid is CSF which is only possible with an anterior skull fracture
a patient has hyperextended PIP joints and flexed DIP joints, subcutaneous nodules near her elbows, joint stiffness lasting more than an hour in the morning
what is the diagnosis
rheumatoid arthritis
what is the histological composition of subcutaneous nodules in rheumatoid arthritis
areas of fibrinoid necrosis surrounded by palisading epithelioid cells
specific test for rheumatoid arthritis
anti-CCP
is glucosamine recommended by NICE for treatment for osteoarthritis
no
which test do you do for SLE
anti-double stranded DNA
a patient has pain and swelling of the knees, ankles, elbows and metacarpophalangeal joints. She is sensitive to sunlight and she has a butterfly-shaped erythematous rash on her face
most likely diagnosis?
SLE
how would you treat a 78 year old woman, fall and sustained a right-sided intertrochanteric neck of femur fracture
dynamic hip screw
how would you treat a 84 year old man with left inferior and superior pubic rami fracture
no femoral neck fracture
PMH hypertension
analgesia and physio
how would you treat a woman with right ankle injury, x-ray shows bimalleolar fracture
open reduction and internal fixation
how would you treat a 64 year old woman with a history of osteoporosis with a displaced sub-capital fracture of the right femoral neck
total hip replacement
what is an effective method of analgesia for patients with a neck of femur fracture
iliofascial nerve block
which drug has an interaction with azathioprine that causes bone marrow suppression
allopurinol
patient has unilateral leg pain, progressing over the last 6 months, associated with mild weakness of the left leg on any activity. Pain radiates posteriorly down patients left leg and is worse on walking
back and neuro exam are normal
no smoking of cardiovascular disease history
what is the diagnosis
lumbar canal spinal stenosis
if a patient suffers upper GI side effects from alendronate (for osteoporosis) what should it be changed to
risedronate or etidronate
pharmacological treatment for osteoarthritis
first line - oral paracetamol
second line - oral paracetamol + topical NSAIDS
third line - addition of opioid analgesics
a 63 year old lady undergoes an axillary clearance for breast cancer.
8 weeks post op she suffers severe shoulder pain, on examination she had reduced active movements in all planes and loss of passive external rotation
what is the diagnosis
adhesive capsulitis (frozen shoulder)
28 year old man has pain and weakness in his shoulder. Recently been unwell with glandular fever but has fully recovered. On examination there is muscle wasting and a degree of winging of the scapula. Power during active movements is impaired
what is the diagnosis
Parsonage - turner’s syndrome
a 32 year old rugby player presents to emergency department with a painful knee, she describes feeling a popping sensation in her right knee during the match, knee is swollen and the patient is unable to fully extend her knee
diagnosis?
meniscal tear
what is the most appropriate form of investigation for a meniscal tear
MRI
if a patient has sensory loss of posterolateral aspect of the leg, and lateral aspect of foot, weakness in plantar flexion of foot, reduced ankle reflex and a positive sciatic nerve stretch, what root compression has this patient experienced
S1
if a patient has discomfort over the groin and upper thigh region with associated weakness of the pelvic and psoas muscles, difficulty lifting the affected leg and walking upstairs, what nerve root compression is this?
L1-2
if a patient has sensory loss of the anterior aspect of the thigh, weakness of the quadriceps with a reduction of knee flexion on the affected side and pain in the anterior thigh when performing femoral stretch test, what nerve root compression is this?
L3
if a patient presents with similar symptoms as a L3 nerve root compression but instead of sensory loss of anterior aspect of thigh, there is sensory loss over anterior aspect of the knee, what nerve root compression is this?
L4
