Rhodia Flashcards
Which muscle flexes the interphalangeal joint of the thumb
Flexor Pollicus Longus
Longus flexes the joint a LONG distance away from palm
Which muscle flexes the metacarpophalangeal joint of the thumb
Flexor Pollicus Brevis
Is apoptosis of osteoblasts a feature of Avascular Necrosis
No, because apoptosis is a physiological process, Avascular Necrosis is pathological
Which nerve passes through both the greater and lesser sciatic foramen
Pudendal nerve
Which foramen does the obturator nerve pass through
Only the lesser sciatic foramen
Which nerve supplies the deltoid
Axillary nerve
Which nerve supplies the teres minor
Axillary nerve
Which nerve supplies the Supraspinatus
Suprascapular nerve
Which nerve supplies the Infraspinatus
Suprascapular nerve
Which nerve supplies the Subscapularis
Superior and Inferior subscapular nerves
What is indicated for an intracapsular displaced femoral fracture
Hemiarthroplasty
What is the nerve supply of the rectus abdomini
T7-12
Which nerve roots are involved in the biceps jerk reflex
C5-C6
Musculocutaneous nerve
Which nerve roots are involved in the triceps jerk reflex
C7-8
Radial nerve
Which nerve is at risk due to a shoulder dislocation/fracture
Axillary nerve
What is a telltale sign of axillary nerve palsy
numb badge patch region
Name 2 diseases which are type V hypersensitivities
Grave’s Diseases
Myasthenia Gravis
What is the Koebner phenomenon
Lesions at the sight of injury
Seen in psoriasis
What is Auspitz sign
The appearance of small bleeding points after successive layers of scale has been removed from the surface of psoriatic papules
What are the compartments of the thigh
Anterior
Medial
Posterior
What is the nerve supply to the anterior compartment of the thigh
Femoral nerve
What is the nerve supply to the medial compartment of the thigh
Obturator nerve
What is the nerve supply to the posterior compartment of the thigh
Sciatic nerve
What is the arterial supply to the anterior compartment of the thigh
Femoral artery
What is the arterial supply to the medial compartment of the thigh
Profunda femoris artery
Obturator artery
What is the arterial supply to the posterior compartment of the thigh
Profunda femoris artery
What are the compartments of the lower leg
Anterior
Lateral
Posterior
What is the nerve supply to the anterior compartment of the lower leg
Deep fibular (peroneal) nerve
What is the nerve supply to the lateral compartment of the lower leg
Superficial fibular (peroneal) nerve
What is the nerve supply to the posterior compartment of the lower leg
Tibial nerve
What is the arterial supply to the anterior compartment of the lower leg
Anterior tibial artery
What is the arterial supply to the lateral compartment of the lower leg
Fibular (peroneal) artery
What is the arterial supply to the posterior compartment of the lower leg
Posterior tibial artery
What is the insertion of the biceps brachii
Radial tuberosity
What is the origin of the long head of the biceps brachii
Supraglenoid tubercle
What is the origin of the short head of the biceps brachii
Coracoid process of scapula
What kind of hypersensitivity is Scabies
Type 4
Which of the carpal bone is a sesamoid bone
Pisiform
Which tendon does the Pisiform bone sit within
Tendon of Flexor Carpi Ulnaris
What is the innervation of the Trapezius
Spinal accessory
What major neck muscle does the spinal accessory nerve innervate
Sternocleidomastoid
Is pruritis a feature of Acne Rosacea
Not commonly no
What type of hypersensitivity is Rheumatoid Arthritis
Type 3
How many structures are in the carpal tunnel
10
How many tendons are in the carpal tunnel
9
Which nerve is in the carpal tunnel
Median Nerve
Name the tendons in the carpal tunnel
Flexor Digitorum Profundus x4
Flexor Digitorum Superficialis x4
Flexor Pollicus Longus
Which gene is defective in Marfan’s Syndrome
Fibrillin Gene
What is a cardiac pathology associated with Marfan’s Syndrome
Aortic Dissection
Which ligament connects the radial head to the radial notch of the ulna
Annular Ligament
Which of the muscle types has nuclei located peripherally
Skeletal
What is the insertion of the pectoralis major
Lateral lip of the bicipital groove of the humerus
What is the mechanism of action of Azathioprine
Purine synthesis inhibition
Which arm muscle does not insert into the radius (and where does it insert)
Brachialis
Coronoid process of ulna
Which nerve can be injured in small saphenous vein surgery
Sural nerve
Where does the psoas major insert
The lesser trochanter of the femur
What is the floor of the anatomical snuffbox
Scaphoid bone
Which nerve lies medially on the thyroid gland and in the groove between the oesophagus and trachea
Recurrent Laryngeal Nerve
Where does the scaphoid derive the majority of its blood supply
Distal end
Does alcohol inhibit glycogenolysis or gluconeogenesis
Alcohol inhibits glycogenolysis
Hence the hypoglycaemia in the morning
What are the two incretins
GLP-1
GIP
Where is GLP-1 secreted from
Ileum
Where is GIP secreted from
Duodenum
What are the tests for Acromegaly
IGF-1 blood test
Oral Glucose tolerance test
How does Acromegaly increase risk of Type 2 Diabetes Mellitus
GH excess
GH mobilises glucose from fat stores
Which layer of the adrenal cortex is Cortisol released from
Zona Fasiculata
What are the 3 layers of the adrenal cortex, from superficial to deep
Zona Glomelurosa
Zona Fasiculata
Zona Reticularis
What is released by the zona glomerulosa
Mineralocorticoids e.g Aldosterone
What is released by the zona fasiculata
Glucocorticoids e.g Cortisol
What is released by the zona reticularis
Androgens e.g Testosterone
What does PTH do to serum calcium levels
Increase
How does PTH increase serum calcium
Via Vitamin D to increase reabsorption of calcium in distal convoluted tubule of kidneys
Which cells release somatostatin
Delta cells
Which 3 things does somatostatin decrease
Insulin
GH
Pancreatic exocrine secretions
What are 4 features of Men 2b
Medullary thyroid carcinoma
Phaeochromocytoma
Mucosal Neuroma
Marfanoid features
What are the levels of PTH, Calcium & Phosphate in primary hyperparathyroidism
Elevated PTH
Elevated Calcium
Decreased Phosphate
What are the levels of PTH, Calcium & Phosphate in secondary hyperparathyroidism
Elevated PTH
Decreased Calcium
Increased Phosphate
What are the levels of PTH, Calcium & Phosphate in tertiary hyperparathyroidism
Grossly Elevated PTH
Elevated Calcium
Decreased Phosphate
What is the Pes Anserius
The conjoined tendons of the Sartorius, Gracialis and Semitendinous muscles
Which hormones are increased in the stress response
GH Cortisol Glucagon Prolactin ADH ACTH
Which hormones are decreased in the stress response
Insulin
Testosterone
Estrogen
Where does the superior thyroid vein drain
Into the Internal Jugular Vein
Where does the middle thyroid vein drain
Into the Internal Jugular Vein
Where does the inferior thyroid vein drain
Into the Brachiocephalic Vein
What is the pneumonic for the lateral rotators of the hip
P-GO-Q Piriformis Gemilus (superior & inferior) Obturator (internus & externus) Quadratus femoris
Which two thumb muscles does De Quiverains tenosynovitis affect
Extensor Pollicus Brevis
Abductor Pollicus Longus
Treatment for Intertrochanteric fracture of femur
Dynamic Hip Screw
Or IM nail
Treatment for sub-capital femoral neck fracture
Total Hip Replacement
What happens to Anti-dsDNA levels when SLE is more active
They rise
What type of systemic sclerosis is pulmonary fibrosis more common in
Diffuse systemic sclerosis
What antibody is associated with diffuse systemic sclerosis
Anti-Scl70
What antibody is associated with limited systemic sclerosis
Anti-Centromere
Which autoimmune disease puts you at higher risk of lymphoma
Sjogren’s Syndrome
Is thrombocytosis a feature of Anti-Phospholipid syndrome
Not commonly no
What autoimmune condition is a butterfly rash associated with
SLE
What autoimmune condition is a Pneumothorax associated with
Marfan’s
What is symmetrical small joint swelling suggestive of
Rheumatoid Arthritis
What is one way to treat Enteropathic Arthritis apart from methotrexate
Treat the underlying IBD
What is a crystal arthropathy associated with erosive joint changes
Gout
What is the new name for Churg Strauss syndrome
Eosinophilic Granulomatosis with Polyangiitis
What is the triad associated with Churg Strauss syndrome
Asthma, Rhinitis, Eosinophilia
Which autoimmune disease which has cutaneous changes is associated with an increased chance of malignancy
Dermatomyositis
What are the possible starting doses of prednisolone for Polymyalgia Rheumatica
15mg
40mg if also Giant Cell Arteritis
What is the commonest benign bone tumour
Osteochondroma
What tumour is a bony spur growing away from the metaphysis of long bones
Osteochondroma
Is an osteochondroma completely benign
No
Has a 1% chance of malignancy
What are two names for the kind of bone found at the epiphysis of long bones
Trabecular
Cancellous
What is Osgood-Schlatter’s disease
Traction osteochondritis at the tibial tubercle
What is Sever’s disease
Traction osteochondritis at calcaneus
What is described as a single lucent lesion in metaphyseal regions of bones
Simple Bone Cyst
What is a buzzword for the appearance of a Giant Cell tumour
Soap bubble around knee usually
What pathology can be described as Sheperd’s crook deformity
Fibrous Dysplasia
Where is fibrous dysplasia normally seen
Proximal femur
What tumour is described as a mostly lucent lesion with patchy sclerosis
Enchondroma
What pathology is described as a lucent multi-loculated cyst and where is it usually found
Aneurysmal bone cyst
usually in the medulla of bones
What is the name given to the space which chondrocytes occupy
Lacuna
Which cancer arises as a result of an (11;22) translocation & how common is it
Ewing’s Sarcoma
Rare
Which bone tumour only arises in abnormal bone
Fibrosarcoma
Give an example of a disease where abnormal bone is present and could thus result in a fibrosarcoma forming
Paget’s disease
What is the most common primary bone tumour
Osteosarcoma
What are osteoprogenitor cells
A reserve pool of osteoblasts
What are osteoblasts
Bone forming cells
Where are osteoblasts found
On the surface of developing bone
Which two antibodies are associated with Rheumatoid Arthritis
Anti-CCP
Rheumatoid Factor
What is the treatment pathway for Rheumatoid Arthritis
Methotrexate
Biologics
What is the timeframe within which Methotrexate should be started after a diagnosis of Rheumatoid Arthritis
3 Months
What is the name of the severity scale for monitoring Rheumatoid Arthritis
DAS-28
Which antibodies are associated with Sjogren’s Syndrome
Anti-Ro
Anti-La
What are two treatment options for Sjogren’s Syndrome
Eyedrops
Pilocarpine
What is the test used to diagnose Sjogren’s called and how is it performed
Schirmer’s test
paper strips inserted into the eye for several minutes to measure the production of tears
What is the pathology of Systemic Sclerosis
Excess collagen deposition
What is limited Systemic Sclerosis also sometimes called
Calcinosis Raynaud's Esophagal dysmotility Sclerodactyly Telangiectasia
What antibody is associated with MCTD (mixed connective tissue disease)
Anti-RNP
Which antibodies are associated with Anti-Phospholipid Syndrome
Lupus-Anticoagulant
Anti-cardiolipin
Anti-beta2 Glycoprotein
What is a cutaneous manifestation of Anti-Phospholipid Syndrome
Livedo Reticularis
What is the diagnostic procedure for Giant Cell Arteritis
Temporal Artery Biopsy
Which antibodies are associated with Polymyositis
Anti-Jo1 mainly
but also Anti-RNP
What three investigations can be done for suspected Polymyositis
Serum CK
EMG (Electromyograph|)
Muscle biopsy
What are the 3 changes seen in Dermatomyositis but not in Polymyositis
Gottron’s papules
V-shaped Rash over chest
Heliotrope rash
What nail changed are seen in Dermatomyositis
Nail fold infarcts
Which antibodies are associated with SLE
Anti-dsDNA
Anti-sm
Which drug is always given in SLE for symptomatic relief regardless of severity
Hydroxychloroquine (anti-malarial)
What is the pathology in Osteogenesis Imperfecta
Defect in type 1 collagen
What is a special procedure which can be done for treatment for Osteogenesis Imperfecta
Sofield procedure
Which gene is abnormal in Marfan’s Syndrome
Fibrillin gene
What cardiac pathology is associated with Marfan’s Syndrome
Aortic Dissection
What is the pathology of Ehler-Danlos syndrome
Abnormal collagen and elastin formation
Which disease can cause blue sclera
Osteogenesis Imperfecta
Which two conditions are associated with atlantoaxial instability
Down’s Syndrome
Rheumatoid Arthritis
Which gene is abnormal in Duchenne Muscular Dystrophy and what is it normally involved in
Dystrophin gene
Calcium transport
What is the difference between Duchenne Muscular Dystrophy and Becker’s Muscular Dystrophy
Becker’s is milder - leads to death in 30’s-40’s rather than 20’s
What are the two severities of spina bifida called and which one is more severe
Spina bifida Occulta
Spina bifida Cystica - more severe
What are the two types of Spina Bifida Cystica and what is the difference
Meningocele - herniation of only meninges
Myelomeningocele - herniation of meninges + spinal cord
What is a possible treatment for Poliomyelitis
Arthrodesis
Which spinal roots are affected in Erb’s Palsy
C5+C6
Which muscles lose function in Erb’s palsy
Biceps Brachialis Deltoid Supraspinatus Infraspinatus
What happens to the humerus with Erb’s Palsy
Internal rotation
What posture is associated with Erb’s Palsy
Waiter’s tip
Which spinal roots are affected in Klumpke’s Palsy
C8 + T1
Which muscles lose function in Klumpke’s Palsy
Intrinsic hand muscles
Which syndrome can Klumpke’s Palsy sometimes cause
Horner’s
Which action can bring about Klumpke’s Palsy
Forceful adduction of arm
What does Froment’s Test test for
Ulnar Nerve Palsy
The action of which muscle is tested in Froment’s test
Adductor Pollicus
Which type of collagen is produced in Dupuytren’s Contracture
Type 3
What is the pathology in Dupuytren’s Contracture
Nodular Hypertrophy of palmar fascia
Is periosteum thicker in children’s bones or adult’s bones
Children’s
Reason for greenstick fractures
What is a nightstick fracture
Isolated fracture of the ulna
What is Wolff’s Law
Bone is laid down in areas of stress
What may be considered instead of a total joint replacement in a young patient with knee arthritis
Tibial Osteotomy
Which wrist movement is required to acquire full grip strength
10 degrees of wrist extension
Which fracture can result in loss of wrist extension and thus a loss in grip strength
Distal Radial Fracture
What is a Monteggia fracture
Fracture of the proximal third of the ulna with dislocation of the proximal head of the radius
What is a Galeazzi fracture
Fracture of the distal third of the radius with dislocation of the distal radioulnar joint
How is a Nightstick fracture treated
Conservatively
How is a Monteggia fracture treated
ORIF of the ulna after reduction of radial head
How is a Galeazzi fracture treated
ORIF of the radius after reduction of ulna
How is a tear of the long head of biceps tendon treated
Conservatively
How is a tear of the patellar tendon treated
Surgically repaired
What GCS score indicates a need to perform airway manoeuvres
8 or below
because this indicates loss of airway control
What are the 5 types of fractures
Transverse Oblique Spiral Comminuted Segmental
How is a Transverse fracture described
Flat line
How is an Oblique fracture described
Diagonal break across bone
How is a Spiral fracture described
Rotational break due to twisting force
How is a Comminuted fracture described
3 or more pieces
How is a Segmental fracture described
Bone breaks in 2 places
What are the 3 classes of nerve injury from MOST severe to LEAST severe
Neurotmesis
Axonotmesis
Neurapraxia
Describe Neurapraxia
Conduction defect from compression/stretch
Full function returns in 28 days
Describe Axonotmesis
Death of axons distal to point of injury
Wallerian Degeneration
Axons regrow at 1mm/day
Describe Neurotmesis
Complete transection of nerve
Requires surgery for recovery
What is the Salter-Harris classification used for
Paediatric epiphyseal plate fractures