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MBBS - Year 1 > Primary Care - Connective Tissue > Flashcards

Primary Care - Connective Tissue Flashcards

1
Q

Changes in fluid leading to oedema

A

Increased fluid or water retention
Decreased oncotic pressure due to loss of proteins
Increased capillary hydrostatic pressure

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2
Q

Most commonly dislocated carpal bone

A

Lunate

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3
Q

Ganglion cysts

A

Vey common in wrist
Smooth, round swelling
Not inflamed over dorsum

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4
Q

Ddx for ganglion cyst

A

Sebaceuous cysts

Lipomas

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5
Q

Where are Heberden’s nodes found

A

DIPJ

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6
Q

Where are Bouchard’s nodes found

A

PIPJ

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7
Q

What can skin bruising be indicative of

A

Steroid use

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8
Q

OA bone changes seen in hand examinations

A

Heberden’s and Bouchard’s

Squaring of MCPs and 1st CMCJ

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9
Q

RhA bone changes seen in hand examinations

A 
Loss of knuckle guttering 
Swan neck deformity 
Z shaped thumb 
Ulnar deviation 
Palmar subluxation of MCPs
*Palmar erythema
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10
Q

Dupytrens

A

Hypertrohy or contraction of flexor tendon sheaths, palpable

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11
Q

What can pain during internal rotation during a shoulder exam indicate

A

Posterior shoulder dislocation

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12
Q

Determining between mechanical and muscular pain in examination

A

No pain on passive movement = muscular

Still painful on passive movement = mechanical

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13
Q

High arc pain in shoulder abduction

A

Acromioclavicular joint pathology e.g. arthritis

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14
Q

Middle arc pain in shoulder abduction

A

Rotator cuff pathology e.g. tear or supraspinatus tendinitis

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15
Q

Loss of external rotation - shoulder exam

A

Indicative of adhesive capsulitis (frozen shoulder)

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16
Q

Common pathology seen in shoulder exam

A 
Supraspinatus tendinitis 
Rotator cuff tears 
Frozen shoulder 
Anterior shoulder instability (dislocation)
OA
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17
Q

Identifying supraspinatus tendinitis in a shoulder exam

A

Painful mid arc

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18
Q

Identifying rotator cuff tears in a shoulder exam

A

Supraspinatus wasting

Weakness of abduction

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19
Q

Identifying OA in a shoulder exam

A

Painful movement in all direction

OA usually affects large, weight-bearing joints

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20
Q

Common pathology seen in foot and ankle exam

A

Pes plantus (flat foot)
Hallux valgus
Gout
Achilles tendon rupture

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21
Q

Pes plantus

A

Loss of medial arch

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22
Q

Hallux valgus

A

Painful bunions of m medial aspect of MTP joint

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23
Q

Identifying gout in a foot and ankle examination

A

Tender, erythematous, inflamed joint (usually MTP)

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24
Q

TATT vs fatigue

A 
Exertional dyspnoea 
Muscle weakness 
Excessive sleepiness 
Loss of motivation 
General debility 
Concealed concerns - pt reluctant to bring up other issues
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25
Q

Measuring excessive sleepiness

A

Epworth sleep score

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26
Q

Lifestyle and SH q’s when pts are TATT

A

Ask about mood/ stress/ depression
Excessive consumption of alcohol
Ask about drug taking, incl cigarettes and caffeine
Ask about work/home
Substance abuse
Has there been any significant event in the pt’s life

27
Q

Ddx of being tatt

A 
Congenital 
Degenerative 
Infl 
Neoplastic 
Iatrogenic
28
Q

Non-organic causes for being tatt

A

Psychological stress/ overwork
Depression
Fibromyalgia
CFS

29
Q

Medications causing tiredness

A

Beta-blockers
Chronic alcohol excess
Benzodiazepine
Chemotherapeutic agents

30
Q

Malignancy causing tiredness

A

Haemotoligcal
Solid organ
Disseminated

31
Q

Respiratpty causes causing tiredness

A

Obstructive sleep apnoea

COPD

32
Q

Cardiac causes of being tatt

A

Congestive cardiac apnoea

Bradyarrythmia

33
Q

Haematological causes of being tatt

A

Anaemia

Haematological malignancy e.g. lymphoma

34
Q

Endocrine causes of being tatt

A 
Hypothyroidism 
Hypercalcaemia 
Diabetes mellitus 
Adrenal insufficiency 
Hypopituitarism
35
Q

Infection causes of being TATT

A 
Infectious mononucleosis 
TB 
HIV 
Infective endocarditis 
Lyme disease
36
Q

Chronic infl condns causes of being TATT

A

RhA
Infl bowel disease
Connective tissue disorder e.g. SLE

37
Q

What do NICE suggest if tiredness has persisted for 3 months+

A

Urinalysis for protein and blood
Bone biochem
Creatinine kinase

38
Q

Other investigations for tiredness

A 
FBC for anemia 
U&Es
LFT's - could indicate alcohol abuse 
ESR, CRP and test for glandular fever 
TFT 
Ca 
Vit D 
PHQ
39
Q

TFT

A

Thyroid function test

40
Q

PHQ

A

Pateinet health questionnaire - depression module

41
Q

Symptoms required to diagnose CFS

A

At least 4/8

Post exertion Malisse lasting more than 24 hrs
Unresting sleep
Significant impairment of short term memory or conc
Muscle pain
Multi-joint pain without swelling or redness
Headaches of a new type, pattern or severity
Tender cervical or axillary lymph nodes
A sore throat that is frequent or recurrent

42
Q

Symptoms of Cushing’s syndrome

A 
Thinning off the skin 
Thin arms and legs (muscle wasting)/ weakness
Hypertension 
Buffalo humo 
'Moon' face (w/ red cheeks)
Obesity 
Poor wound healing 
Striae (stretch marks)
43
Q

Wrist examination - look

A

Position of wrist
Muscle bulk in forearm and hand
Scars

44
Q

Wrist examination - feel

A

Distal end of ulna and radius and styloid processes

Joint space between radius and ulna and carpal bones

45
Q

Wrist examination - move (active, passive, resisted )

A

Flexion
Extension
Abduction
Adduction

46
Q

Pain caused by L2 nerve root lesion

A

Across upper thigh

47
Q

Weakness caused by L2 nerve root lesion

A

Hip flexion and adduction

48
Q

Pain felt in L3 nerve root lesion

A

Across lower thigh

49
Q

Weakness caused by L3 nerve root lesion

A

Hip adduction

Knee extension

50
Q

Reflex affected by L3 nerve root lesion

A

Knee jerk

51
Q

Where is the pain associated with a L4 nerve root lesion

A

Across knee to MM

52
Q

Weakness caused by L4 nerve root lesion

A

Knee extension
Foot inversion
Dorsiflexion

53
Q

Where is the pain associated with a L5 nerve root lesion

A

Lateral shin to dorsum of foot and hallux

54
Q

Reflex affected by L4 nerve root lesion

A

Knee jerk

55
Q

Weakness caused by L5 nerve root lesion

A

Hip extension and abduction
Knee flexion
Foot and hallux dorsiflexion

56
Q

Reflex affected by L5 nerve root lesion

A

Hallux jerk

57
Q

Where is the pain associated with a S1 nerve root lesion

A

Posterior calf to lateral foot and little toe

58
Q

Weakness caused by S1 nerve root lesion

A

Knee flexion
Foot and toe plantarflexion
Foot eversion

59
Q

Reflex affected by S1 nerve root lesion

A

Ankle jerk

60
Q

Testing for cauda equina

A

Rectal exam

Checking for tone (reduced)

61
Q

Causes of cauda equina

A

2’ malignancy
Cervical disc prolapse
Haematoma
Congenital lumbar disease

62
Q

Symptoms of cauda equina

A 
Back and radicular pain down the legs 
Saddle anaestheis a
Asymmetrical, atrophic, areflexic paralysis of the legs 
Sensory loss in a root distribution 
Loss of blaster and bowel control
63
Q

Areflexic

A

Muscles that do not respond to stimuli

MBBS - Year 1 (93 decks)

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