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MSK > Week 5 Review Qs > Flashcards

Week 5 Review Qs Flashcards

1
Q

Joint aspirate reveals rhomboid crystals, what is the diagnosis?
A) Pseudogout
B) Gout

A

A) Pseudogout

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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

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3
Q

Which of the following is affected by aspirin

A

Probenecid

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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

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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

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6
Q

Which drug can impair the secretion of uric acid at low doses?

A

Aspirin

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7
Q

Anteromedial supply to leg?

A

Saphenous nerve

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8
Q

What is the mechanism of action of tofacitinib?

A

JAK kinase inhibitor

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9
Q

What activated sugar is important for the salvage pathway of purine synthesis?

A

5-phosphoribosyl-1-phosphatase

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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

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11
Q

What motor deficit results when the common fibular nerve is compressed near the fibular head?

A

eversion

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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

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13
Q

A 70-year-old male with crepitus and feels pain in right knee while walking. What is the issue?

A
  • Osteoarthritis
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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

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15
Q

What is hurt with hyper dorsiflexion of foot?

A

Head of talus

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16
Q

What structure is torn due to hyper-eversion of the ankle joint?

A

deltoid ligament

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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

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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

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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

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20
Q

Rituximab binds on what cells?
A) T cells
B) monocytes
C) B cells

A

C) B cells

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21
Q

Which drug is given IV every 2 weeks to treat gout?

A
  • Pegloticase
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22
Q

which drug won’t cause bone marrow suppression?

A
  • cyclosporin A
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23
Q

Which drug inhibits iL-2?

A
  • cycolsporin A
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24
Q

which of the following is not used with gold compounds because it chelates metals?

A
  • D-penicillamine
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25
Q

Dancers fracture?
A) Talus
B) Calcaneus
C) Metatarsals

A

C) Metatarsals

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26
Q

Product of de-novo purine synthesis?

A
  • inosine monophosphate
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27
Q

This nerve is damaged in a patient whose foot is everted.

A
  • Tibial nerve
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28
Q 
What inhibits IL-2 formatiobn?
A) Leflunomide
B) Chloroquine
C) tofacitinib
D) Cyclosporin A 
E) Azathioprine 
F) Sulfasalazine 
G) Anankira
H) Penicillamide
A

D) Cyclosporin A

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29
Q 
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
A

H) Penicillamide

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30
Q 
What is a Uricosuric drug?
A) Allopurinol
B) Colchicine
C) Indomethacin 
D) Probenecid 
E) Pegloticase
F) Febuxostat
A

D) Probenecid

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31
Q 
Which uricolytic drug administered IV weekly?
A) Allopurinol
B) Colchicine
C) Indomethacin 
D) Probenecid 
E) Pegloticase
F) Febuxostat
A

E) Pegloticase

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32
Q

Affecting which component of the joint will cause Varus deformity in osteoarthritis?
A) Articular degradation
B) Medial compartment
C) Lateral compartment

A

B) Medial compartment

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33
Q

What is the main plantar flexor on foot at ankle joint?

A
  • Gastrocnemius
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34
Q

Which of the following is an expansion of the semimembranosus muscle?
A) Oblique popliteal ligament
B) medial collateral ligament
C) patellar ligament

A

A) Oblique popliteal ligament

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35
Q 
Which test is used to test posterior cruciate ligament?
A) Anterior drawer
B) Posterior drawer
C) Valgus stress
D) Varus stress
A

B) Posterior drawer

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36
Q

What is affected when the common fibular nerve is injured near fibular head?

A
  • Eversion
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37
Q

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

A) Saphenous nerve

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38
Q

What is the mechanism of action of methotrexate?

A
  • Inhibits DHFR
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39
Q

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

A) Osteophytes

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40
Q

Where does the small saphenous vein drain?
A) Femoral
B) Popliteal
C) Tibial

A

B) Popliteal

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41
Q

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

A) Tibial spine avulsion

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42
Q

Which drug is a non-purine xanthine oxidase inhibitor?

A
  • Febuxostat
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43
Q

What enhances the action of Allopurinol?

A
  • Azathioprine
44
Q 
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
A

C) NSAIDS and physiotherapy

45
Q

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

A

B) Reconstructive knee surgery

46
Q

What is shared between the medial and lateral malleoli?
A) Calcaneus
B) Talus

A

B) Talus

47
Q

Which structure is fractured during excessive dorsi-flexion of the foot?

A
  • Talus
48
Q

Which bones are affected in dancer’s fracture?

A
  • Metatarsals
49
Q 
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

A) Deltoid ligament

50
Q

A clinical sign felt upon palpation in osteoarthritis patients?

A
  • Crepitus
51
Q 
What differentiates between an inflammatory cause of joint pain and a mechanical
cause?
A) Morning stiffness
B) Crepitus
C) Instability
D) Destruction
A

A) Morning stiffness

52
Q

What is required in both de novo synthesis and purine salvage pathways of purine
synthesis?

A
  • PRPP
53
Q

Why is it a major challenge to study the epidemiology of OA?

A
  • Because there is no correlation between the radiological and clinical findings
54
Q

Which of the following drugs inhibits IL-2?
A) Cyclosporin A
B) Azathioprine

A

A) Cyclosporin A

55
Q 
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
A

E) Common fibular nerve

56
Q 
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
A

E) Xanthine

57
Q

What is attached to the medial meniscus?
A) Tibial collateral ligament
B) Fibular collateral ligament

A

A) Tibial collateral ligament

58
Q

Which muscle is responsible for dorsal flexion of foot?

A
  • Tibialis anterior
59
Q

Which of the following is a product of denovo biosynthesis of purines?

A
  • IMP
60
Q

What is the main extensor and adductor of the foot?
A) Tibialis anterior
B) Extensor halluces longus

A

A) Tibialis anterior

61
Q

What is the most important intervention to prevent osteoarthritis at the community level?

A
  • Weight reduction
62
Q

Which ligament is associated with the medial meniscus of the knee joint?

A
  • Tibial collateral ligament
63
Q

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

A) Paracetamol 1mg BD

64
Q

What forms from an extension of semimembranosus muscle tendon?

A
  • Oblique popliteal ligament
65
Q

Which of the following is an alkaloid that binds to tubulin & act as mitotic poison? -

A

Colchicine

66
Q

Hyperdorsiflexion can result in fracture of which of the following?

A
  • Talus
67
Q

Which of the following is metabolized to non-competitive xanthine oxidase inhibitor?

A
  • Allopurinol
68
Q

Which of the following is a non-purine xanthine oxidase inhibitor?

A
  • Febuxistat
69
Q

Which of the following results in narrowing of the bone spaces in long bones?

A
  • Osteoarthritis
70
Q

Which drug is preferentially used in the treatment of inflammatory bowel disease?

A
  • Sulfasalzine
71
Q

At which joint do inversion and eversion occur?

A
  • Subtalar
72
Q

Biosynthesis of purines?

A
  • IMP
73
Q

What unlocks the knee?

A
  • Popliteus
74
Q

Toxicity increased with allopurinol

A
  • Azathioprine
75
Q

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

A

C) 5-phosphoribosyl-1-pyrophosphate

76
Q

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

A) Allows fluid to seep in and out during movement

77
Q

Obese woman presented with pain and loss of articular cartilage. What is the diagnosis?

A
  • Osteoarthritis
78
Q

What drugs is converted to 6-MP and inhibits purine synthesis?

A
  • Azathioprine
79
Q

Loss of articular cartilage?

A
  • Narrow joint space on X-ray
80
Q

If a soccer player has anterior cruciate ligament tear. What is the best management?
A) Knee replacement
B) Knee reconstruction surgery

A

B) Knee reconstruction surgery

81
Q 
Increase in which leads to rise in uric acid solubility?
A) Na
B) K
C) Ca
D) pH
E) Lactate acid
A

D) pH

82
Q

Person standing on an uneven ground. His foot is in hyper inversion and is plantar flexed. Which ligament is most likely to be sprained?

A
  • Anterior talofibular
83
Q

What is the keystone to the medial longitudinal arch?

A
  • Talus
84
Q

What is the composition of the crystals found in gout?

A
  • Monosodium urate
85
Q

Which of the following gives viscosity to the synovial fluid?

A
  • Hyaluronic acid
86
Q

Amorphous crystals and giant cells:

A
  • Gouty arthritis
87
Q

Which of the following drugs is an inhibitor of dihydrooratereductase?

A
  • Ieflunomide
88
Q

Which of the following drugs is an effective chelator of copper and is used in Wilson’s disease?

A
  • D-penicillamine
89
Q

What is the drug that inhibits IL-2 production?

A

Cyclosporine A

90
Q

Which enzyme do we inhibit to prevent recurrent attacks of gout?

A
  • Xanthine oxidase
91
Q

Which of the following is the most direct precursor for uric acid synthesis?

A
  • Hypoxanthine
92
Q

What are crystals seen in a chronic inflammatory disease and are flat, rectangular, and notched?

A
  • Cholesterol
93
Q

What would you see in radiology of the knee in osteoarthritis?

A
  • Osteophyte formation
94
Q

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?

A
  • Gouty arthritis
95
Q

A 70-year-old obese woman with stiffness in both knee joints and loss of articular cartilage. What is the diagnosis?

A
  • Osteoarthritis
96
Q

What is found in the center of gouty tophi?

A
  • Monosodium urate
97
Q

What articulates with the medial and lateral malleoli?

A
  • Talus
98
Q

Which of the following is fractured during extreme/hyper dorsiflexion of the foot?

A
  • Talus
99
Q

What innervates the semitendinosus?

A
  • Tibial nerve
100
Q

The lateral sural nerve is a branch of which nerve?

A
  • Common fibular
101
Q

Which of these is an expansion of the semimembranosus?

A
  • Oblique popliteal ligament
102
Q

Which of these is attached to the medial meniscus?

A
  • Tibial collateral ligament
103
Q

The tendon of which of the following muscles exits [or passes] the knee joint to attach to the tibia?

A
  • Semitendinosus
104
Q

Which of the following structures is injured by strong hyper-eversion?

A
  • Deltoid ligament
105
Q

In which vein does the lesser saphenous vein drain?

A
  • Popliteal
106
Q

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?

A
  • Saphenous nerve

MSK (16 decks)

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