Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

IK6 - Exams > Rheumatology and musculoskeletal > Flashcards

Rheumatology and musculoskeletal Flashcards

1
Q

What is Reiter’s syndrome?

A

urethritis + conjunctivitis + arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

young males usually
buttock/sacroiliac pain worse in the morning, relieved by exercise
syndesmophytes, bamboo spine

A

ankylosing spondylitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What conditions are associated with ankylosing spondylitis?

A

4 A’s
arthritis
anterior uveitis
apical lung fibrosis
aortic regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

arthritis in IBD patients

A

enteropathic arthropathy
usually asymmetrical, mainly affectes lower limbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

features of systemic sclerosis

A

Calcinosis (nodules)
Raynaud’s phenomenon
Oesophageal dysmotility
Sclerodactyly
Telangiectasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is polymyositis?

A

proximal muscle weakness, pain and tenderness

elevated serum CK
if purple rash -> dermatomyositis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Churg-Strauss syndrome features

A

middle aged men
asthma + rhinitis + systemic vasculitis
+++ eosinophils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What disease is anti-dsDNA antibodies associated with?

A

SLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What disease is anti-Jo 1 antibodies associated with?

A

polymyositis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What disease is anti-centromere antibodies associated with?

A

limited systemic sclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What disease is anti-topoisomerase antibodies associated with?

A

diffuse systemic sclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What disease is cANCA and anti-PR3 antibodies associated with?

A

wegener’s granulomatosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What disease is anti-mitochondrial antibodies associated with?

A

primary biliary cirrhosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What disease is alpha-endomysial antibodies associated with?

A

coeliac disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the radiological findings of osteoarthritis?

A

loss of joint space
subchondral sclerosis
sybchondral cysts
osteophytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the radiological findings of rheumatoid arthritis?

A

loss of joint space
juxta-articular osteoporosis
erosions, subluxation joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the radiological findings of ankylosing spondylitis?

A

syndesmophytes
bamboo spine appearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

malignant bone disease

A

malignant

  • osteosarcoma
  • Ewing sarcoma
  • chrondrosarcoma
  • metastatic disease (secondary)
  • haematopoietic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what abnormal bone growth response very well to aspirin to relieve pain?

A

osteoid osteoma (benign)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

features of osteosarcoma

A
  • RF: Paget’s, radiation
  • most sporadic
  • around knee, proximal humerus, femur
  • sclerosis/lytic areas, cortical destruction, Codman triangle (elevation of periosteum), sunray spicules (calcification within tumour but outside of bone)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

features of osteosarcoma

A
  • RF: Paget’s, radiation
  • most sporadic
  • around knee, proximal humerus, femur
  • sclerosis/lytic areas, cortical destruction, Codman triangle (elevation of periosteum), sunray spicules (calcification within tumour but outside of bone)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

features of chondrosarcoma

A
  • lytic lesion with cortical destruction and central calcification
  • growth in pelvis and hip commonly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Ewing sarcoma

A
  • small cell sarcoma
  • flat bones (long, femur or tibia, pelvis or vertebra)
  • unwell, swelling, fever, warm area
  • lytic lesion with laminated periosteal reaction
    • onion skinning
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

pseudogout aspirate features

A
  • calcium pyrophosphate crystals
  • positive birefringent
  • rhomboid crystals
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what is this:

  • calcium pyrophosphate crystals
  • positive birefringent
  • rhomboid crystals
A

pseudogout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

features of gout on aspirate

A
  • monosodium urate crystals
  • need shaped
  • negatively birefringent
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what is this:

  • monosodium urate crystals
  • need shaped
  • negatively birefringent
A

gout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Musculocutaneous nerve:

  • origin
  • sensory
  • motor
A

Musculocutaneous nerve:

  • origin - C5, C6, C7
  • sensory - lateral forearm
  • motor - BBC (biceps brachii, brachialis, coracobrachilis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Axillary nerve:

  • origin
  • sensory
  • motor
A

Axillary nerve:

  • origin - C5/C6
  • sensory - sergeant’s patch over lower deloit
  • motor - deltoid, teres minor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

muscles of the rotator cuff

A

supraspinatus

infraspinatus

teres minor

subscapularis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Radial nerve:

  • origin
  • sensory
  • motor
A

Radial nerve:

  • origin - C5, C6, C7, C8, T1
  • sensory
    • lower posterior arm
    • posterior forearm
    • lateral ⅔ dorsum (back)
    • proximal dorsal aspect of lateral 3 ½ fingers
  • motor
    • triceps brachii (posterior compartment arm)
    • posterior compartment of forearm
      • wrist + finger extensors
      • brachioradialis
      • supinator
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Median nerve:

  • origin
  • sensory
  • motor
A

Median nerve:

  • origin - C5-8, T1
  • sensory
    • thenar eminance
    • lateral ⅔ of palm of the hand
    • palmar aspect of lateral 3 ½ fingers
    • distal dorsal aspect of lateral 3 ½ fingers
  • motor
    • all muscles in anterior compartment except flexor carpi ulnaris and medial 2 parts of flexor digitorum profundus
      • wrist + finger flexers
      • pronator teres and quadratus
    • LOAF muscles of hand
      • lateral 2 lumbrical
      • opponens pollicis
      • abductor pollicis brevis
      • flexor pollicis brevis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Ulnar nerve:

  • origin
  • sensory
  • motor
A

Ulnar nerve:

  • origin - C8, T1
  • sensory
    • hypothenar eminence
    • medial ⅓ of palm of hand
    • palmar aspect of medial 1 ½ fingers
    • whole dorsal aspect of medial 1 ½ fingers
    • medial ⅓ dorsum of hand
  • motor
    • anterior arm - flexor carpi ulnaris, medial 2 parts of flexor digitorum profundus
    • HILA hand mucles
      • hypothenar eminence
      • interossei
      • lumbricals (medial 2)
      • adductor pollicis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Median nerve:

  • common injuries
  • results of injury
A

Median nerve:

  • common injuries
    • rare
    • stab to upper arm
  • results of injury
    • S - numb lateral fore arm
    • M - weak elbow flexion + supination, absent biceps reflex
    • wasting of biceps
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Axillary nerve:

  • common injuries
  • results of injury
A

Axillary nerve:

  • common injuries
    • # surgical neck of humerus
    • stab wound to posterior shoulder
    • compression by shoulder dislocation/crutches
  • results of injury
    • S - numb sergeant’s patch
    • M
      • very weak shoulder abduction 15-90 degrees
      • weak shoulder flexion, extension, external rotation
    • wasting of deltoid
36
Q

radial nerve:

  • common injuries
  • results of injury
A

Radial nerve:

  • common injuries
    • # proximal humerus, humeral shaft or proximal radius
    • stab to ACF/forearm/wrist
    • compression - crutches, sleep on arm, tight cast, long tourniquet
  • results of injury
    • S - number posterior arm + forearm, numb hand in radial distrubition
    • M
      • weak elbow extension
      • absent triceps reflex
      • weak wrist + finger MCPJ extension
      • absent supinator
    • wrist drop
37
Q

nerve for each colour

A
38
Q

what is this? nerve injury ?

A

wrist drop

radial nerve

39
Q

what is this sign?

nerve injury?

A

hand of benediction on attempting finger flexion

median nerve

40
Q

what is this sign?

what nerve associated?

A

claw hand

ulnar nerve injury

41
Q

median nerve:

  • common injuries
  • results of injury
A

median nerve:

  • common injuries
    • supracondylar humerus #
    • stab wounds ACF, forearm, wrist
    • compression at carpal tunnel
  • results of injury
    • S
      • numb thenar eminence and median hand area
    • M
      • weak pronation
      • weak wrist flexion + abduction
      • weak finger flexion (ring + little preserved)
      • weak grip strength
    • wasting of thenar eminence and anterior foreman
    • hand of benediction
42
Q

ulnar nerve:

  • common injuries
  • results of injury
A

radial nerve:

  • common injuries
    • # supracondylar humerus, medial epicondylar
    • stab to forearm or wrist
    • compression at cubital tunnel in elbow or Guyon’s canal in wrist
  • results of injury
    • S
      • numb hypothenar eminence
      • numb ulnar hand distribution
    • M
      • weak wrist flexion
      • weak wrist adduction
      • weak flexion of ring + little fingers MCPJs and DIPJs + extension of IPJs
      • weak finger abduction, adduction + opposition
    • wasting of intrinsic hand muscle
    • claw hand
43
Q

describe common peroneal injury

A
  • L4, L5, S1, S2
  • damage around neck of fibula
  • causes
    • foot drop
    • inversion of foot
    • anaesthesia over anterior + lateral leg + foot
44
Q

features of femoral nerve injury

A
  • weak thigh flexion
  • no leg extension
  • no knee reflex
  • anterior thigh + medial leg anaesthesia
45
Q

features of obturator nerve injury

A
  • loss of thigh adduction
  • sensory loss of medial thigh
46
Q

features of superior gluteal nerve

A
  • waddling gait
  • positive trendelenburg sign
47
Q

features of inferior gluteal nerve injury

A
  • lose ability to rise from seated, climb stairs, incline or jump
  • walk leaning back at heel strike
48
Q

features of common fibular injury

A
  • blow to lateral aspect of leg or # neck of fibula
  • no foot eversion or dorsiflexion
  • no toe extension
  • anterolateral leg and dorsum foot anaesthesia
  • can’t stand on heels
49
Q

antibody for SLE

A

ANA +ve

dsDNA +ve

ENA +ve - any of Ro, La, Sm, RNP

50
Q

what disease is this?

ANA +ve

dsDNA +ve

ENA +ve - any of Ro, La, Sm, RNP

A

SLE

51
Q

antibodies for Sjogrens

A

ANA +ve

ENA +ve for anti-Ro and anti-La

52
Q

what disease?

ANA +ve

ENA +ve for anti-Ro and anti-La

A

Sjogren’s

53
Q

what Ab in diffuse cutaneous systemic sclerosis?

A

scl70

54
Q

what bloods are used to monitor SLE?

A

C4 and C3 complement

ESR

ds-DNA

55
Q

what disease with scl70?

A

diffuse cutaneous systemic sclerosis

56
Q

what Ab in CREST?

limited cutaneous systemic sclerosis

A

limited cutaneous systemic sclerosis

anti-centromere

57
Q

anti-centromere Ab - what disease?

A

limited cutaneous systemic sclerosis

CREST

58
Q

antibodies for mysoitis

A

anti-jo1

t-RNA synthetase

59
Q

what drugs are used to manage Raynaud’s?

A
  1. avoid cold, keep whole body warm, heated gloves
  2. CCB - nifedipine or amlodipine
  3. specialised
60
Q

what drugs are used to manage Raynaud’s?

A
  1. avoid cold, keep whole body warm, heated gloves
  2. CCB - nifedipine or amlodipine
  3. specialised
61
Q

what are the types of epiphyseal injuries? (SALTER HARRIS)

A
  • I - S - straight across
  • II - A - above
  • III - L - Lower
  • IV - TE - Throughout everything
  • V - R - cRush
  • II most common
  • I has the lowest risk and V the highest risk of growth plate injury, in turn altering prognosis what i
62
Q

how can you describe fractures?

A
  • Descriptive classifications
    • Transverse - fracture at 90 degrees to bone longitudinal axis. Usually due to direct force at fracture site
    • Oblique - fracture diagonal to bone longitudinal axis
    • Spiral - fracture where bone has been twisted
    • Comminuted - bone broken into several placed, direct force, high energy
    • Avulsion - fragment of bone tears away from the main mass of bone as a result of physical trauma
      • Associated with ligament and tendon insertion sites
    • Greenstick fracture - fracture in children, incomplete fracturing across a bone
    • Crush fracture - result of compression
    • Burst fracture - usually seen in vertebrae due to disc impaction
    • Fracture dislocation or subluxation - involvement of joint resulting in misalignment of joint surfaces
      • Dislocation = complete loss of
  • Associated features
    • Complicated - damage to nerves, vessels or internal organs
    • Displacement - relationship of bone fragments to normal alignment of bone. Can be described as un-displaced, <50%, > 50%
63
Q

what are the types of fracture healing?

A

primary - direct contact, uses cone-cutter pathway of osteoclast-osteoblast layers

secondary - some gap. occurs in stages

64
Q

what are the stages of secondary bone healing?

A
  1. Haematoma formation - bleeding makes haematoma, neutrophils recruit macrophage via cytokines
    • Injury - 48 hours after
  2. Soft callous formation
    • 2 days - 2 weeks
  3. Hard callous formation - aim for by 3 months
  4. Remodelling - over 18 months to form lamellar bone from woven bone
65
Q

what is varus?

A

distal part is more medial than the proximal

VARUS

66
Q

what is valgus?

A

when the distal part is more Lateral than the proximal

67
Q

what are the requirements for bone healing?

A
  • minimal # gap
  • no movement if primary, some movement if indirect
  • patient physiology - age, DM, smoking, nutritional status
68
Q

what are the principles of fracture management?

A
  • reduce
  • hold
  • rehabilitate (move)
69
Q

what are the main causes of non or mal union?

A
  • Ischaemia - poor vascular supply or AVN
  • Infection
  • ↑ interfragmentary strain
    • too much movement, large gap
  • Interposition of tissue between fragments
  • Intercurrent disease e.g. malignancy or malnutrition, smoking
70
Q

what are the management principles of open #?

A
  • 6As of management
    • Analgesia
    • Assess - NV status, soft tissue, photograph
    • Anti-sepsis - wound swab, copious irrigation, cover with betadine soaked dressing
    • Alignment - align and splint
    • Anti-tetanus - check status, booster lasts 10 years
    • Antibiotics - within 1 hour of injury
      • Flucloxacillin 500mg IV/IM with benzylpenicillin 600mg IV/IM
    • Definitive - debridement and fixation in theatre, aim for within 24 hours of injury
71
Q

complications of fractures (general)

A
  • early
    • neurovascular damage, DVT, PE, fat embolism, crush, compartment syndrome
  • late
    • late wound sepsis, failure of fixation, malunion, joint stiffness or contracture, AVN, regional pain syndrome
72
Q

specific fracture associated palsies

A
  • Anterior shoulder dislocation + Humeral surgical neck #
    • Axillary nerve
      • Numb chevron
      • Weak abduction
  • Humeral shaft #
    • Radial nerve - Waiter’s tip sign
  • Elbow dislocation
    • Ulnar nerve - Claw hand
  • Hip dislocation
    • Sciatic nerve - Foot drop
  • # neck of fibula + Knee dislocation
    • Fibular nerve - Foot drop
73
Q

summary of OA treatmetn

A
  • conservative
    • analgesia
    • physio
    • walking aids
    • avoid exacerbating activity
    • injection - steroid
  • operative
    • replace joint
    • realign
    • excise
    • fuse
    • synovectomy (more for RA)
    • denervate (wrist)
74
Q

describe the salter harris classification

A
75
Q

causes of Dupuytrens contractures

A
  • idiopathic
  • age
  • alcoholic liver disease
  • trauma
  • familial (AD)
  • drugs - phenytoin
  • epilepsy
76
Q

normal ROM shoulder

A
  • flexion 180, extension 50
  • abduction - 180, adduction 45
  • internal rotation and external rotation - 90
77
Q

RF for adhesive capsuliti

A

surgery

immobility

trauma

78
Q

key features of axillary nerve palsy

A

loss of lateral deltoid sensation (regimental patch)

weak abduction of shoulder and weak elbow flexion

79
Q

what to always check before a hip examination

A

native or prosthetic hip

80
Q

RF for septic arthritis

A

age, DM, joint prosthesis, IVDU

81
Q

causes of foot drop

A
  • Common peroneal nerve injury (# or op)
  • Sciatic nerve injury, L4 , L5 disc herniation with L5 nerve root compression
  • Central causes – MND, MS, stroke, brain tumour, Parkinsonism
  • Diabetes, Vit. B12 deficiency, alcohol
82
Q

what are the 3 questions for GALS?

A
  • Do you have pain/stiffness in muscles, joint or back?
    • Osteoarthritis, rheumatoid arthritis, ankylosing spondylitis
  • Do you need help dressing?
    • Fine motor impairment, restricted joint movement
  • Do you have problems going up and downstairs?
    • Gross muscle wasting/lower motor lesions, restricted joint movement
83
Q

Fore arm fracture - Galleazi and Monteggia

A

GRUM G - Radial # distal + distal radio-ulnar dislocation M - ulna # proximal + proximal radio-ulnar dislocation

84
Q

What drugs cause drug induced lupus?

A

Procainamude Hydralazine Isoniazid Phenytoin

85
Q

What is the antibody seen in drug induced lupus?

A

Anti histone ANA + Anti dsDNA -ve

86
Q

management of NOF

A

IK6 - Exams (24 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions