Week 5 Review Qs Flashcards
1
Q
Joint aspirate reveals rhomboid crystals, what is the diagnosis?
A) Pseudogout
B) Gout
A
A) Pseudogout
2
Q
What is the proximal attachment of palmar aponeurosis of foot?
A) Medial tubercle of calcaneus
B) Lateral tubercle of calcaneus
C) Navicular
A
A) Medial tubercle of calcaneus
3
Q
Which of the following is affected by aspirin
A
Probenecid
4
Q
Which anatomical structure is commonly used to identify the correct knee aspiration entry point? A) Medial menisci B) Quadriceps tendon C) Patellar tendon D) Popliteal tendon E) Lateral menisci
A
C) Patellar tendon
5
Q
A man had an car accident and he had a fracture / injury in the arch of foot near cuboid bone. Which of the following is likely to be affected? A) flexor hallucis longus B) fibularis brevis C) fibularis longus D) tibialis anterior E) tibialis posterior
A
B) fibularis brevis
6
Q
Which drug can impair the secretion of uric acid at low doses?
A
Aspirin
7
Q
Anteromedial supply to leg?
A
Saphenous nerve
8
Q
What is the mechanism of action of tofacitinib?
A
JAK kinase inhibitor
9
Q
What activated sugar is important for the salvage pathway of purine synthesis?
A
5-phosphoribosyl-1-phosphatase
10
Q
Where is a safe area to aspirate the knee joint?
A) Lower border of the patella
B) medial to the patellar ligament
A
B) medial to the patellar ligament
11
Q
What motor deficit results when the common fibular nerve is compressed near the fibular head?
A
eversion
12
Q
If the dorsiflexion of foot is lost, which nerve is affected? A) tibial B) common fibular C) medial plantar D) lateral plantar
A
B) common fibular
13
Q
A 70-year-old male with crepitus and feels pain in right knee while walking. What is the issue?
A
- Osteoarthritis
14
Q
Which of the following symptoms suggest the inflammatory nature of the joint pain? A) clicking B) swelling C) morning stiffness D) giveaway
A
C) morning stiffness
15
Q
What is hurt with hyper dorsiflexion of foot?
A
Head of talus
16
Q
What structure is torn due to hyper-eversion of the ankle joint?
A
deltoid ligament
17
Q
What is the mechanism of methotrexate?
A) Metabolized to mercaptopurine which inhibits DNA
B) Inhibits IL2
C) Inhibits JAK
D) Competitive inhibitor of dihydrofolate reductase enzyme
A
D) Competitive inhibitor of dihydrofolate reductase enzyme
18
Q
Which component is needed for de novo synthesis and purine salvage pathways? A) IMP B) AMP C) xanthine D) Guanine E) Ribose 5 phosphate F) 5 phosphoribosyl pyrophosphate
A
F) 5 phosphoribosyl pyrophosphate
19
Q
A 50-year-old man presented with shooting pain to his lower leg, he had an Intervertebral disk prolapse, what is the initial step to manage this patient?
A) Bed rest and follow up
B) NSAIDs and Physiotherapy
A
B) NSAIDs and Physiotherapy
20
Q
Rituximab binds on what cells?
A) T cells
B) monocytes
C) B cells
A
C) B cells
21
Q
Which drug is given IV every 2 weeks to treat gout?
A
- Pegloticase
22
Q
which drug won’t cause bone marrow suppression?
A
- cyclosporin A
23
Q
Which drug inhibits iL-2?
A
- cycolsporin A
24
Q
which of the following is not used with gold compounds because it chelates metals?
A
- D-penicillamine
25
Dancers fracture?
A) Talus
B) Calcaneus
C) Metatarsals
C) Metatarsals
26
Product of de-novo purine synthesis?
- inosine monophosphate
27
This nerve is damaged in a patient whose foot is everted.
- Tibial nerve
28
```
What inhibits IL-2 formatiobn?
A) Leflunomide
B) Chloroquine
C) tofacitinib
D) Cyclosporin A
E) Azathioprine
F) Sulfasalazine
G) Anankira
H) Penicillamide
```
D) Cyclosporin A
29
```
Not used with gold compounds as it chelates metals?
A) Leflunomide
B) Chloroquine
C) tofacitinib
D) Cyclosporin A
E) Azathioprine
F) Sulfasalazine
G) Anankira
H) Penicillamide
```
H) Penicillamide
30
```
What is a Uricosuric drug?
A) Allopurinol
B) Colchicine
C) Indomethacin
D) Probenecid
E) Pegloticase
F) Febuxostat
```
D) Probenecid
31
```
Which uricolytic drug administered IV weekly?
A) Allopurinol
B) Colchicine
C) Indomethacin
D) Probenecid
E) Pegloticase
F) Febuxostat
```
E) Pegloticase
32
Affecting which component of the joint will cause Varus deformity in osteoarthritis?
A) Articular degradation
B) Medial compartment
C) Lateral compartment
B) Medial compartment
33
What is the main plantar flexor on foot at ankle joint?
- Gastrocnemius
34
Which of the following is an expansion of the semimembranosus muscle?
A) Oblique popliteal ligament
B) medial collateral ligament
C) patellar ligament
A) Oblique popliteal ligament
35
```
Which test is used to test posterior cruciate ligament?
A) Anterior drawer
B) Posterior drawer
C) Valgus stress
D) Varus stress
```
B) Posterior drawer
36
What is affected when the common fibular nerve is injured near fibular head?
- Eversion
37
A boy underwent a great saphenous vein transplant surgery, then he felt pain in the medial aspect of his leg, what is the most likely injured nerve?
A) Saphenous nerve
B) Sural nerve
C) Obturator nerve
A) Saphenous nerve
38
What is the mechanism of action of methotrexate?
- Inhibits DHFR
39
65 year old female presented with chronic knee pain. She was diagnosed with osteoarthritis. What radiological finding can confirm the diagnosis?
```
A) Osteophytes
B) Joint space widening
C) Juxta-articular osteopenia
D) Subchondral osteoporosis
E) Joint erosion
```
A) Osteophytes
40
Where does the small saphenous vein drain?
A) Femoral
B) Popliteal
C) Tibial
B) Popliteal
41
Which of the following radiological signs indicate injury to anterior cruciate ligament?
A) Tibial spine avulsion
B) Fibular head avulsion
C) Medial femur epicondyle avulsion
D) Lateral femoral epicondyle avulsion
E) Lateral translation of patellar ligament
A) Tibial spine avulsion
42
Which drug is a non-purine xanthine oxidase inhibitor?
- Febuxostat
43
What enhances the action of Allopurinol?
- Azathioprine
44
```
What is the best initial management in a man with acute attack of pain due to a lumbar intervertebral disc hernia?
A) Surgical discectomy
B) Aggressive physiotherapy
C) NSAIDS and physiotherapy
D) Spinal decompression
```
C) NSAIDS and physiotherapy
45
A 20-year old soccer player male had torn his ACL, he wants to play football matches
again, what management would you suggest?
A) Knee braces
B) Reconstructive knee surgery
C) Knee replacement surgery
D) Pain killers
B) Reconstructive knee surgery
46
What is shared between the medial and lateral malleoli?
A) Calcaneus
B) Talus
B) Talus
47
Which structure is fractured during excessive dorsi-flexion of the foot?
- Talus
48
Which bones are affected in dancer's fracture?
- Metatarsals
49
```
Which structure of these is affected in hypereversion of the foot?
A) Deltoid ligament
B) Fibular collateral
C) Tendocalcanes
D) Upper end of tibia
```
A) Deltoid ligament
50
A clinical sign felt upon palpation in osteoarthritis patients?
- Crepitus
51
```
What differentiates between an inflammatory cause of joint pain and a mechanical
cause?
A) Morning stiffness
B) Crepitus
C) Instability
D) Destruction
```
A) Morning stiffness
52
What is required in both de novo synthesis and purine salvage pathways of purine
synthesis?
- PRPP
53
Why is it a major challenge to study the epidemiology of OA?
- Because there is no correlation between the radiological and clinical findings
54
Which of the following drugs inhibits IL-2?
A) Cyclosporin A
B) Azathioprine
A) Cyclosporin A
55
```
The lateral sural nerve is a branch of which of the following?
A) Femoral nerve
B) Tibial nerve
C) Obturator nerve
D) Superficial peroneal nerve
E) Common fibular nerve
```
E) Common fibular nerve
56
```
Which compound is produced by both adenine and guanine nucleotides in the catabolism of purines?
A) Inosine
B) Adenine
C) IMP
D) Hypoxanthine
E) Xanthine
```
E) Xanthine
57
What is attached to the medial meniscus?
A) Tibial collateral ligament
B) Fibular collateral ligament
A) Tibial collateral ligament
58
Which muscle is responsible for dorsal flexion of foot?
- Tibialis anterior
59
Which of the following is a product of denovo biosynthesis of purines?
- IMP
60
What is the main extensor and adductor of the foot?
A) Tibialis anterior
B) Extensor halluces longus
A) Tibialis anterior
61
What is the most important intervention to prevent osteoarthritis at the community level?
- Weight reduction
62
Which ligament is associated with the medial meniscus of the knee joint?
- Tibial collateral ligament
63
An elderly patient with BMI = 21 is diagnosed with osteoarthritis. What is the first line of management?
A) Paracetamol 1mg BD
B) Intra-articular corticosteroid injection
C) Weight reduction
D) Injection of hyaluronic acid
A) Paracetamol 1mg BD
64
What forms from an extension of semimembranosus muscle tendon?
- Oblique popliteal ligament
65
Which of the following is an alkaloid that binds to tubulin & act as mitotic poison? -
Colchicine
66
Hyperdorsiflexion can result in fracture of which of the following?
- Talus
67
Which of the following is metabolized to non-competitive xanthine oxidase inhibitor?
- Allopurinol
68
Which of the following is a non-purine xanthine oxidase inhibitor?
- Febuxistat
69
Which of the following results in narrowing of the bone spaces in long bones?
- Osteoarthritis
70
Which drug is preferentially used in the treatment of inflammatory bowel disease?
- Sulfasalzine
71
At which joint do inversion and eversion occur?
- Subtalar
72
Biosynthesis of purines?
- IMP
73
What unlocks the knee?
- Popliteus
74
Toxicity increased with allopurinol
- Azathioprine
75
What is the key activate sugar required for both de novo purine synthesis and salvage reaction?
A) Ribose 5 phosphate
B) Ribulase 5 phosphate
C) 5-phosphoribosyl-1-pyrophosphate
C) 5-phosphoribosyl-1-pyrophosphate
76
What is the importance of micro cavities and irregular surfaces of articular surfaces of all synovial joints?
A) Allows fluid to seep in and out during movement
B) Increase surface area
A) Allows fluid to seep in and out during movement
77
Obese woman presented with pain and loss of articular cartilage. What is the diagnosis?
- Osteoarthritis
78
What drugs is converted to 6-MP and inhibits purine synthesis?
- Azathioprine
79
Loss of articular cartilage?
- Narrow joint space on X-ray
80
If a soccer player has anterior cruciate ligament tear. What is the best management?
A) Knee replacement
B) Knee reconstruction surgery
B) Knee reconstruction surgery
81
```
Increase in which leads to rise in uric acid solubility?
A) Na
B) K
C) Ca
D) pH
E) Lactate acid
```
D) pH
82
Person standing on an uneven ground. His foot is in hyper inversion and is plantar flexed. Which ligament is most likely to be sprained?
- Anterior talofibular
83
What is the keystone to the medial longitudinal arch?
- Talus
84
What is the composition of the crystals found in gout?
- Monosodium urate
85
Which of the following gives viscosity to the synovial fluid?
- Hyaluronic acid
86
Amorphous crystals and giant cells:
- Gouty arthritis
87
Which of the following drugs is an inhibitor of dihydrooratereductase?
- Ieflunomide
88
Which of the following drugs is an effective chelator of copper and is used in Wilson’s disease?
- D-penicillamine
89
What is the drug that inhibits IL-2 production?
Cyclosporine A
90
Which enzyme do we inhibit to prevent recurrent attacks of gout?
- Xanthine oxidase
91
Which of the following is the most direct precursor for uric acid synthesis?
- Hypoxanthine
92
What are crystals seen in a chronic inflammatory disease and are flat, rectangular, and notched?
- Cholesterol
93
What would you see in radiology of the knee in osteoarthritis?
- Osteophyte formation
94
A 50-year-old man develops fever, swelling and severe pain in the metatarsophalangeal joint of the big toe. He also has white depositions in his ear. He had recurrent episodes of the same problem 3 times in the same year. What is the diagnosis?
- Gouty arthritis
95
A 70-year-old obese woman with stiffness in both knee joints and loss of articular cartilage. What is the diagnosis?
- Osteoarthritis
96
What is found in the center of gouty tophi?
- Monosodium urate
97
What articulates with the medial and lateral malleoli?
- Talus
98
Which of the following is fractured during extreme/hyper dorsiflexion of the foot?
- Talus
99
What innervates the semitendinosus?
- Tibial nerve
100
The lateral sural nerve is a branch of which nerve?
- Common fibular
101
Which of these is an expansion of the semimembranosus?
- Oblique popliteal ligament
102
Which of these is attached to the medial meniscus?
- Tibial collateral ligament
103
The tendon of which of the following muscles exits [or passes] the knee joint to attach to the tibia?
- Semitendinosus
104
Which of the following structures is injured by strong hyper-eversion?
- Deltoid ligament
105
In which vein does the lesser saphenous vein drain?
- Popliteal
106
A vein in the ankle is cannulated and the patient feels pain that radiates to the medial borders of the foot and leg, which nerve might have been affected?
- Saphenous nerve
