MSK

Question 1

Fracture management

Answer 1

4Rs

Resuscitation
Reduction
Restriction
Rehabilitation

Question 2

Open fracture requirements

Answer 2

6As

Analgesia
Assess neurovascular status, soft tissues, photograph
Antisepsis: wound swab, copious irrigation, cover with soaked dressing
Alignment: align fracture and splint
Anti-tetanus
Abx

Question 3

Problems with # union - causes

Answer 3

5Is

Ischaemia
Infection
Increased interfragmentary strain
Interposition of tissue between fragments
Intercurrent disease eg malignancy or malnutrition

Question 4

Osteoporosis risk factors

Answer 4

Age + SHATTERED

Steroids
Hyper-para/thyroidism
Alcohol and cigarettes 
Thin (BMI<22)
Testosterone low
Early menopause
Renal/liver failure
Erosive/ inflammatory bone disease eg RA, myeloma
Dietary Ca low/ malabsorption, DM

Question 5

Galeazzi and Monteggia fracture-dislocations (mnemonic)

Answer 5

GRUesome MURder assists remembering which bone is firstly fractured and then secondly which is dislocated:

G: Galeazzi R: radius fracture U: ulna dislocation
M: Monteggia U: ulna fracture R: radial head dislocation

Question 6

Recurrent should instability

Answer 6

TUBS - Traumatic Unilateral dislocations with a Bankart lesion often require Surgery

AMBRI - Atraumatic Multi-directional Bilateralsoulder dislocation is treated with Rehabilitation, but may require Inferior capsular shift

Question 7

Causes of carpal tunnel

Answer 7

Primary/idiopathic

W.R.I.S.T

Water - pregnancy, hypothyroidism
Radial #
Inflamation: RA, gout
Soft tissue swelling: lipomas, acromegaly, amyloidosis
Toxic: DM, EtOH

Question 8

Dupuytren’s contracture associations

Answer 8

B.A.D F.I.B.E.R.S

Bent penis: Peyronies
AIDS
DM

FH
Idiopathic (commonest)
Booze: ALD
Epilepsy and epilepsy meds
Reidel's thyroiditis
Smoking

Question 9

Red flags - back pain

Answer 9

Signs and symptoms of cauda equina or cord compression
Immunosuppression
Trauma
History of cancer
Nocturnal pain
Systemic upset – weight loss, fevers, night sweats
Thoracic pain
Abnormal gait

Question 10

Cauda equina red flags

Answer 10

Lower back and leg pain (either in one or both legs);

Onset of bladder dysfunction, usually involving increased frequency but with the inability to fully void;

Onset of bowel dysfunction, which may involve constipation or faecal incontinence (due to anal sphincter laxity);

Onset of numbness in the perineum, genitalia and buttocks.

Question 11

Tetanus - bacteria, toxin & side effects

Answer 11

Clostridium tetani - spore–> bacillus

Tetanospasmin (mortality 50-75%)

ROAST

Risus sardonicus
Opisthotonus
Autonomic instability (BP, HR, Temp)
Seizure
Trismus

Question 12

Tetatus vaccine

Answer 12

DTaP and DT are administered to children less than a year old - 4 doses and 5th dose 4-6year

Tdap is given as a onetime, first time only dose that includes the tetanus, diphtheria, and acellular pertussis vaccinations.

Td is the booster shot given to people over the age of seven and includes the tetanus and diphtheria toxoids

Question 13

Treatment of tetanus

Answer 13

PAVVE

Parylitics
Antibodies
Valium infusion
Ventilation (ICU for weeks!)
Extra feeds

Question 14

Elbow ossification

Answer 14

CRITOE

    C - capitellum
    R - radial head
    I - internal epicondyle
    T - trochlea
    O - olecranon
    E - external epicondyle

CRITOL

CRITOL is the same as CRITOE apart from the final letter, which refers to the lateral epicondyle rather than external.