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

Primary Care - Soft Tissue Flashcards

1
Q

When does bone density start decreasing

A

30

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2
Q

Which bones are injured in a Colles fracture

A

Radius

Ulna

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3
Q

Vitamin D levels in osteoporosis

A

Normal

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4
Q

Common pathogens causing OM

A

Strep
Staph A
TB
Haemophilus

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5
Q

What % of MM pts have bone pain

A

60

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6
Q

Main anti-hypertensive drugs

A

ACE inhibitors

Then Ca channel blockers e..g amlodipine (side effects incl swollen ankles and facial)

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7
Q

Surgical sieve

A 
Congenital
Acquired 
Neoplastic
Metabolic 
Infective 
Traumatic 
Autoimmune
Vascular 
Infl 
Degenerative 
Idiopathic
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8
Q

Infections seen in epidermis

A

Impetigo
Folliculitis
Erysipela

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9
Q

Infections seen in dermis

A

Cellulitis

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10
Q

Infections seen in fascia

A

Necrotising fasciitis

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11
Q

Infections seen in muscle

A

Myonecrosis

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12
Q

Causes of oedema (blood vessels)

A 
Increased plasma volume 
Reduced plasma oncotic pressure 
Increase in permeability of capillaries 
Increased hydrostatic pressure of capillaries 
Obstruction of lymphatic drainage
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13
Q

Pitting oedema

A

How to elicit - press gently on oedematous skin w finger
Stop and you still see dent left behind
Typically caused by fluid accumulation

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14
Q

Non-pitting oedema

A

Doesn’t leave a dent

Causes are lymphoedema, myxoedema

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15
Q

Causes of dependent oedema

A 
Ankle if mobile, scrap if bed bound 
Varicose veins 
Obesity 
Drugs e.g. NSAIDs, steroids 
GI - malabsorption 
Obstructive sleep apnoea 
Acute DVT 
Hip or knee arthroplasty
Chronic venous insufficiency
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16
Q

Causes of non-pitting lower limb oedema

A

Hypothyroidism
Lymphoma - blocked lymph channels, radiation
Lipoedema
Allergy: increased capillary permeability, angio-oedema

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17
Q

Common soft tissue conditions seen in GP

A

Leg oedema
Cellulitis
Bursitis
Ulcers

18
Q

Signs of chronic venous insufficiency

A 
Telangiectasia - spider veins 
Varicose veins
Oedema
Pigmentation 
Eczema
Lipodermatosclerosis
19
Q

Soft tissue examination - look

A 
Site if any swelling 
Colour changes 
Varicose veins 
Ulceration 
Signs of chronic venous insufficiency 
Scars 
Skin conditions/ rashes
20
Q

Soft tissue examination - feel

A 
Temperature 
Tenderness
Palpable deep veins 
Measure girth in both calves -same point on each leg, usually 10cm below tibial tuberosity (discrepancy over 2cm can be sign of DVT)
Peripheral pulses
21
Q

Leg ulcer definition

A

Long lasting (chronic) sore that takes >2 weeks to heal. Most common is venous

22
Q

Symptoms of leg ulcers

A

Pain
Itching
Swelling
Discoloured and hardened skin in ulcer

23
Q

Other common types of leg ulcers

A 
Arterial 
Diabetic 
Vasculitic 
Traumatic 
malignant
24
Q

Arterial leg ulcers

A

Caused by poor blood circulation in their arteries, usually occur on foot rather than the leg

25
Q

Diabetic leg ulcers

A

Caused by the high blood sugar, usually occur on foot rather than leg

26
Q

Vasculitic leg ulcers

A

Associated w/ chronic infl disorders e.g. RhA and lupus

27
Q

Boutonnière deformity

A

PIP fixed flexion, DIP hyper extension

28
Q

Swan-neck deformity

A

PIP hyper extension, DIP flexion

29
Q

Examination of a lump - look

A 
Location 
Contour 
Pulsation 
Colour 
Surface
30
Q

Examination of a lump - feel

A 
Temp 
Pulsation 
Tenderness 
Mobility 
Consistency 
Fluctuation 
Reducability 
Trans illumination - shining a light through, if light shines its full of liquid
31
Q

3S’s, 3C’s, 3T’s, 1F

A 
Site 
Size 
Shape 
Contour 
Colour 
Consistency 
Tenderness 
Tethering 
Trans illumination 
Fluctuance
32
Q

How does Dupuytrens present

33
Q

How does Dupuytrens progress

A

Causes stiffening of the finger and spreads across other fingers

34
Q

Treatment of Dupuytrens

A

Surgery so hands will be fully functional

35
Q

Questions to ask pts presenting with lesions on their hands

A

Which is their dominant hand
What is their job
How is it affecting their function
When is it causing problems

36
Q

Presentation of trigger finger vs Dupuytrens

A

Trigger finger is bone and can resolve

Duputrens is gradual onset and soft tissue

37
Q

Similarities between trigger finger and dupuytrens

A

Both cause similar functional disturbance and are more common in older people

38
Q

Ddx for DVT

A

Cellulitis

Ruptured baker’s cyst

39
Q

Ddx for olecranon bursitis

A 
Rheuematoid nodule 
Gout 
Psuedogout 
Inflamed cyst 
Lipoma
40
Q

Cyst definition

A

Closed sac with a distinct lining membrane that develops abnormally in the body

41
Q

Investigations for DVTs

A

D-dimer

Doppler ultrasound of the deep venous system of the lower leg

42
Q

Diagnosing varicose veins

A

Tourniquet test

MBBS - Year 1 (93 decks)

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