Workshops etc Flashcards
What are the 12 allied health professions
Art Therapists, Drama Therapists, Music Therapists Occupational Therapists Physiotherapists Diagnostic and Therapeutic Radiographers Speech and Language Therapists Orthotists and Prosthetists Orthoptics Podiatrists Dieticians Paramedics
What is the earliest sign of RA on X-ray
Osteopenia - thinning of the bone around the joint
What scans might you use to diagnose RA
X-ray
MRI or US - depending on joint being checked
What signs may appear on X-ray in late stage RA
Erosions
Joint deformity
Which blood condition is commonly seen in inflammatory disease
Mild anaemia
What is first line treatment for RA
DMARD
Always methotrexate unless contraindicated
Which cancer do biologic drugs increase the risk of
Skin
What must you counsel patients on when starting methotrexate
Sun protection
Pregnancy - must stop at least 3 months before trying to conceive
Lung symptoms - methotrexate can cause pneumonitis
Screen for TB risk
How is the complement system affected in lupus
Serum levels of components fall
What kidney signs may be present with lupus
Early - = high protein: creatine ratio in urine
Later = raised urea and creatine
What may be a cause of Raynaud’s in older men
Hand/arm vibration syndrome
Caused by manual work with power tools
Ask about occupation
How do you treat Raynaud’s
Vasodilators
Calcium channel blockers
Sildenafil - Viagra
What is a gibbus
Angular deformity of bone (spine?)
What pathologies can be caused by a cervical rib
Nerve or vascular impingement
What are the symptoms of vascular impingement in the upper limb
Intermittent tingling
Numbness in the arm and or hand
Why do you check chest expansion in the spinal exam
To check for ankylosing spondylitis
Will be reduced in this condition
What causes muscle wasting
Nerve insufficiency
Lack of use
What is a Baker’s cyst
An outpouching of the synovium appearing as a fluid filled sack
Seen in arthritis
What are the symptoms of a ruptured Baker’s cyst
Severe pain behind knee
Swollen calf as fluid has drained down
What is an antalgic gait
Altered walk in attempt to reduce pain or avoid painful limb
E.g. limp in order to reduce time on sore limb
What condition is a shuffling gait associated with
Parkinson’s
Which tests are used to look for effusion in the knee
Gutter sweep - smaller effusions
Patellar tap - larger ones
When would you get patellar apprehension
Unstable joints
Location of previous dislocation
What is Lachman’s test
Tests the ACL
You clamp hand on femur and pull the tibia upwards 3 time
Should have no or very slight movement if ACL intact
What does Steinman’s test check for
Meniscus tears
Which shoulder movements are less important to test
Adduction and extension
Not hugely functional
Why might internal rotation of the shoulder be asymmetrical in a normal patient
May be less movement in the dominant hand due to increased musculature
Which of the 4 rotator cuff muscles isn’t really tested in the shoulder exam
Teres minor
What type of pathology could be expected if active movement doesn’t happen but passive can
Most likely extraarticular
Muscle pain or weakness
You can move their arm but cant do it themselves
What will give you a positive Thomas’ test
Any condition that causes hip stiffening
e.g. OA
What can cause a locked knee
ACL or bucket handle tear of the meniscus
How do you treat adult presentation DDH
Joint replacement or osteotomy
On x-ray what does the hanging rope sign indicate
Perthes disease
Why is DDH more common in women
Pregnant women produce relaxin to prepare for birth, female babies have the receptors for this hormone so can cause laxity in them
What is the difference between dislocation and subluxation
• Subluxation is still in partial contact with a joint and dislocation is completely out of joint
What is another name for trigger finger
stenosing tenosynovitis
What is a watershed area of a tendon
Area with poorer blood supply and therefore less oxygen, predisposing them to pathology
What are some side effects of steroid injections
Depigmentation
Atrophy
The younger the child the greater the remodelling potential - true or false
True
What type of deformity will remodelling not fix
Rotational deformities
