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2MB: disease summaries > MSK > Flashcards

MSK Flashcards

1
Q

Bony outgrowth with cartilagenous cap

Knee

A

Osteochondroma
Autosomal dominant
Most common
Excise

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2
Q

Intramedullary, metaphyseal tumour
Lucent/sclerotic
Long and small tublar bones

A

Enchondroma
failure of ossification at growth plate
Curretage to treat

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3
Q

Solitary unicystic growth
long bones
Fractures can occur

A

Curretage and bone graft

Possible stabilisation

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4
Q

Lucent
Multiloculated cyst in medulla
Pain and fractures

A

Aneurysmal bone cyst

Curretage and cement

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5
Q

Pain and fracture
lung mets
soap bubble appearance

A

Giant cell tumour
Translocation of 1 + 2
Excise and bone cement
Joint replacement

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6
Q

Widened bone thin cortices
Stress fractures
‘Shepherds crook deformity’

A

Fibrous dysplasia
Fault in g protein signalling leading to immature bone
treat with bisphosphonates, fixation and remove it

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7
Q

Pain worse at night and reieved by NSAIDs

X ray with sclerotic halo

A

Osteoid osteoma

leave alone/ablate/ en bloc excision

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8
Q

Lytic lesion

History of subacute osteomyelitis

A

Brodies abscess

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9
Q

Lytic lesions

history of hyperparathyroidism

A

Brown tumours

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10
Q

Most common primary bone tumour

A

Osteosarcoma

Treat with chemotherapy

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11
Q

Herringbone pattern
Abnormal bone pathology
Young

A

Fibrosarcoma

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12
Q 
Fever
raised ESR
Swelling
Onion skin pattern
Small blue round cell tumours
A

Ewings sarcoma
11:22 translocation on Ch22
Give chemo and raddiotherapy

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13
Q

what test shows multiple myeloma

A

Bence Jones

Trat with chemo

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14
Q

Where do bone mets go?

A 
Prostate (blastic)
Breast (mixed)
Kidney (lytic)
Thryoid (lytic)
Lungs (lytic)
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15
Q

Sagging rope sign

History of clotting

A

AVN
Precollapse: Drill to get blood flowing
Collapse: Replacement

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16
Q

Distinguish osteoporosis, osteomalacia and pagets

A

OP: >2.5 decrease in bone density and normal biochemistry
OM: <2.5 decrease, pseudofractures, low Ca2+ and PO
P: Raised ALP, thickened bone cortices

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17
Q

overcontracted muscle

Anti K+ antibodies

A

Neuromyotonia

Anticonvulsants

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18
Q

Muscle weakness due to Ca2+ antibodies

A

LE myasthenic syndrome

Anticholinesterases and K blockers

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19
Q

Progressive eye and muscle weakness

A

Anticholinesterases

Immunosuppressants

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20
Q

Joint pain
DIP and PIP
<1hr + worsens activity
LOSS on X ray

A 
OA
Lifestyle
NSAIDS
IA steroids
Joint replacement
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21
Q 
Joint pain
PIP and MCP
C1 C2 involvement 
stiffness >1hr and eases on activity
Anti CCP and RF
A 
RA
Investigate with MRI 
1. MTX + steroid
2. + SFZ/HCQ
3.  + TNFi
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22
Q

Male
Reduced lordosis and increased kyphosis
Bamboo spine

A

Ank spond

Schober’s +ve

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23
Q

Nail changes
Psoriasis
‘pencil in cup’ X ray

A

Psoriatic arthritis

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24
Q

Arthritis and IBD features

A

Enteropathic

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25
Q

3 weeks after infection

Clear joint aspirate

A

Reactive arthritis

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26
Q 
Butterfly rash
Arthritis
Systemic problems
Anti-dsDNA
Anti-sm
C2/4 low
A

SLE

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27
Q

Dryness of mucosa
Ant-Ro/La
T cells on biopsy

A

Sjogrens

give pilocarpine for dryness

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28
Q

CREST syndrome

can be limited to distal skin or spread to trunk

A

Systemic sclerosis
Limited: centromere
Diffuse: anti-scl-70

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29
Q

Systemic symptoms

Anti-RNP

A

MCTD

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30
Q

Young stroke
Miscarriages
Prolonged APTT
Anticardiolpin

A

APLS

Anticoag

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31
Q

Muscle STIFFNESS
Shoulder and girdle
Spreads from one side to the other

A

Polymylagia rheumatica
Normal CK
Resposnds to low dose steroids

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32
Q

Steroids for GCA

A

40mg if no visual

60mg if yes

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33
Q 
Muscle WEAKNESS
10x CK
Anti-Jo SRP
V shaped rash
Gottrons papules
Heliotrope rash
A

Myositis
Treatment:
40mg prednisilone
Immunosuppressants

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34
Q

> 50

polymyalgia rheumatica

A

GCA

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35
Q

<50s

Asian woman

A

Takayasu

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36
Q

‘String of beads’
Blood clots
Gi and renal inolvement

A

Pa

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37
Q

Neck stiffness that radiates to shoulders

Occurs over time

A

Cervical spondylosis
conservative
Dcompression if upper limb symptoms

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38
Q

Shooting dermatomal pain
Poor reflexes
Weakness

A

Cervical disc prolapse
do MRI
Conservative and surgery

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39
Q

Downs/RA patients
Abnormal neck movements
Upper MN signs

A 
C spine instablity
Flexion/extension
Treatment: 
Collar if moderate
Fusion if severe
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40
Q

RA, diabetes, CKD, colles fracture
altered sensation in thumb and radial fingers
Muscle wasting at thumb
worse at night

A

Carpal tunnel syndrome
Wrist splint
Steroids

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41
Q

Ulnar 2.5 fingers
Tinels test
Frontmants

A

Cubital tunnel

Decompress

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42
Q

Intervertebral discs are

A

2ndary catilagenous

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43
Q

Lumbar puncture is at

A

Post iliac crest L4, PSIS S2

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44
Q

Red flags for back pain

A

<20
>60 new onset
Constant severe pain
Systemic upset

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45
Q

Heavy lifting
Severe back pain on coughing
Neuropathic pain/weakness

A

Acute disc tear
Conservative
Surgery

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46
Q

Over 60
Claudicaton thats better on hill walking
Osteophytes on x ray

A

Spinal stenosis

Analgesia and physio

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47
Q

Back pain that worsens on activity

No neuro symptoms

A

Mechanical back pain
analgesia and physio
surgery if instable

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48
Q

Bruning pain in thigh and knee
Stretching knee recreates pain
crossover sign positive

A

Sciatica
Analgesia
Neuropathic meds
Surgery if severe

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49
Q

How is a crush fracture treated

A

Balloon vertebroplasty

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50
Q

Numb saddle area
Bilateral leg pain
Incontinence

A

Cauda equina syndrome
PR
MRI
Discectomy

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51
Q

frontal spinal fracture with ripped back

A

Chance

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52
Q

Distal radius fracture with volar displacement

A

Smiths

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53
Q

Bimalleolar fracture

A

Potts

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54
Q

Comprression fracture in osteoporosis

A

Wedge

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55
Q

Extreme trauma causing multiple fractures

A

Burst

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56
Q

Childhood fractures
Blue sclera
Hearing loss

A

Osteogenesis imperfecta

Stablise with IM

57
Q

odd limbs
big forehead
bendy joints

A

Achondroplasia
Surgical correction
GH therapy

58
Q

outline normal lower limb developement

A

varus at birth
valgus
reduced valgus

59
Q

Internal rotation of humerus

Waiters tip

A 
Erbs palsy (C5,6)
Physio and surgery
60
Q

horners syndome

internally rotated hand

A

Klumpkes palsy

c8 t1

61
Q

Flat feet

Jacks test positive

A

Pathological flat feet

62
Q

Breech birth, Downs girl
Skin creases
Shortened limb
+ve ortolani and bartlows

A

DDH
Observe
> 3months: pavlik/ reduce/dye manipulate

63
Q

young boys with URTI
slow onset of hip pain
US shows effusion

A

TTSH
X ray to exclude perthes
Drain and NSAIDs

64
Q

Pain in knee and groin
loss of interna roatation and abduction
flattened femoral head on x ray

A

Perthes (AVN of femoral head)

Osteotomy of acetabulum and femur

65
Q

Young sporty overweight boys
loss of internal rotation and knee pain
inferior slipping of femoral head

A

SUFE
confirm with lateral X ray
Pin head to stop movement

66
Q

Clubfoot is treated with

A

Ponsetti method

67
Q

Incomplete fracture following compression

A

Buckle

3-4 weeks splintage

68
Q

Distal radius
Broken on one side
Bent on other

A

Greenstick

Manipulate and cast

69
Q

Forearm fracture
ulnar break
Radial dislocation

A

Montaggia

Reduce and screw/plate fixate

70
Q

Forearm fracture
Radial break
Ulnar dislocation

A

Galeazzi

Reduce and screw/plate fixate

71
Q

supracondylar fracture of elbow

A

mild: reduce and wire fixate
Severe: Open reduction
MEDIAN NERVE
BRACHIAL ARTERY

72
Q

Fall onto flexed kee
Femoral shaft fracture
How to manage?

A

<2: gallows and hip spica
2-6: thomas splint + hip spica
6-12: flexible IM
12+: IM

73
Q

Hanging rope sign on X ray
Patchy sclerosis
Groin pain

A

AVN
drill pre-collapse
THR if collapse

74
Q

Resisted abduction causes pain

A

Trochanteric bursitis

Supportive and physio

75
Q

Altered morphology of hip

grips hip with a C sign

A

hip impingement
Cam surgery
pincerc: osteotomy

76
Q

Twisting on loaded knee
Effusion and joint line tendernes in knee
+ve steinmans
May lock

A

Meniscal tear
Suture if young and longituindal outer 3rd
Menisectomy if not

77
Q

Lateral turn on planted foot
Pop and rapid effusion in knee
Instability
+ve anterior drawer test

A

ACL rupture

Primary repair or reconstruction

78
Q

Direct blow to front of knee

Posterior drawer test

A

PCL rupture

79
Q

varum blow that causes valgus pain when re-created

A

MCL tear
Hinged knee brace
Tightening/graft construction

80
Q

valgus blow that causes varus pain when recreated

A

LCL injury
Repair/reconstruct
COMMON FIBULAR NERVE AT RISK

81
Q

Rapid contraction leading to either high or low patella

Palpable gap in extensor mechanism

A

Extensor mechanism rupture
PTR: young
QTR: old
Tendon-tendon repair

82
Q

Anterior knee pain
Worse downhill
grinds and clicks

A

PF disfunction
Physio
Release

83
Q

Pain and effusion in knee follwoing shearing injury

A

Osteochondral injury

Fibrocartilage/drilling

84
Q

Blow to knee causing lateral disloaction of patella

lipohaemarthrosis may be seen

A

Patellar instability

Straighten leg and manipulate

85
Q

Solider/athelete experiencing pain in 2/3 metatarsal after training
X ray after 3 weeks shows callus

A

Stress fracture

6-12 weeks rigid soled boot

86
Q

Medial arch loss and valgus heel

A

Tibialis posterior dysfunction
Splint with medial arch support
Decompression
Arthrodesis if severe

87
Q

Poor alignment of big toe causing ulcers

A

Hallux valgus
Wide shoes and spacer
Surgery if symptomatic

88
Q

OA of 1 MTP

A

Hallux rigidus

Stiff soles/arthrodesis

89
Q

Burning in sole between 2/3 digital nerves

Clicking on mediolateral compression w US confirms

A

Morton’s neuroma
Conservative
Excise if not

90
Q

Popping at ankle during sport

+ve simmonds test

A

Achlles tendon rupture

Suture/equinous cast

91
Q

Pain on instep when walking

A

Plantar fasciitis
stretching exercises
Gel heel pad + steroids
PLANTAR NERVE INJURIES

92
Q 
Diabetic presents with 
Swelling
Loss of sensation
Joint deformity
X ray shows fucked swollen foot
A

Charcot’s foot
Assess vasculature
infection
Amputate

93
Q

What can be damaged in a pelvic fracture?

A

Internal iliac and venous plexus

Lumbosacral pleus nerves

94
Q

Open book fractures are dangerous as?

A

Increased volume for bleeding

95
Q

RTA with kness hitting dashboard

Damage to posterior wall o acetabulum

A

Acetabular fracture
Conservative
Reduce and fixate if young
THR i old

96
Q

Fracture within capsule

A

Intracapsular

femoral head replacment/THR

97
Q

Fracture outwidth capsule

A

Extracapsualr

internal fixation

98
Q

Fracture below trochater after a fall

A

Subtrochanteric fracture

IM nail

99
Q

High energy injury

Blood loss and fat embolus

A 
Femoral shaft frature
Resuscitate
femoral nerve block
Thomas splint 
IM nail/plate fixate
100
Q

hyperextension/rotation leading to knee instability

A

Knee dislocation
Reduce revascularise
Fixate reconstruct

101
Q

What nerves are at risk in a proximal tibia fracture

A

Fibular if valgus

Peroneal if varus

102
Q

Proximal tibial fracture managemnt

A 
reduce surface
rigid fixation (plate and screw)
103
Q

Tibial shaft fracutre managemnt

A

Conservative
Above knee cast
Internal fixation

104
Q

Distal tibial fractures

A

pilon fracture
External fixation when swollen
Interal fixation if not

105
Q

Ankle injury

A

ORIF

106
Q

Talar fractures

A

closed reduction with screw fixation

107
Q

Metatarsal fracture

A

Stout boot

K wires

108
Q

Toe fracture

A

Stout boot

fixate

109
Q

Shoulder pain that radiates to deltoid and upper arm

Pain on abduction and internal rotation

A

Impingement
Supportive
Steroid injection

110
Q

Weak abduction of shoulder

Rotational movement causes pain

A

Rotator cuff tear

Physio, steroids and surgery

111
Q

Pain for 6-9 months in shoulder followed by stiffness

A

Adhesive caspulitis

Physio, steroids, surgery

112
Q

Shoulder pain

X ray shows calcific deposits

A

Acute calcific tendotinits

Steroids and anaesthetic

113
Q

Feeling of shoulder going to dislocate

Sulcus signs

A

Instability of shoulder

Traumatic + anterior: Bankart repair

114
Q

Deltoid labrum tears

A

MRI arthrogram

biceps tenotomy, resection or repair

115
Q

Painful lateral epicondyle

Pain on extension of middle finger and wrist

A

Lateral epicondylitis

Rest, steroids, brace

116
Q

Painful medial epicondyle

A

Medial epicondylitis

Dont inject steroids due to ulnar nerve

117
Q

Ulnar finger tingling

Tinels and frontmans test +ve

A

Cubital tunnel syndrome

Release

118
Q

Tinging in radial fingers
Worse at night
loss of thumb sensation
tinels and phalens test

A

Carpal tunnel syndrome
Splints + steroids
Decompress flexor retinaculum

119
Q

Trigger finger

A

A1 pulley division

120
Q

medial displacement of humeral neck due to fracture

A

sling if minimal
internally fixate if moderate
Replace shoulder if fucked

121
Q

Loss of symmetry and internal rotation i humerus
May see hill sacks lesion
NUMB REG BADGE AREA

A

humeral fractures
Closed reduction and sling
Bankart repair if recurrent

122
Q

Acromioclavicular injury

A

Sling and physio

123
Q

Humeral shaft fracture

RADIAL NERVE INJURY

A

RADIAL NERVE INJURY MAY OCCUR BTW

Humeral brace and IM nail

124
Q

Distal humerus fracture/olecranon fossa

A

Tension band wiring

ORIF

125
Q

Lateral elbow pain and twisting of forearm
Full extension of arm not possible
Fat pad sign on X ray

A

Radial head and neck fracture
Sling and physio
ORIF if displaced

126
Q

Posterior damage to elbow after FOOSH

Probable NV injury

A

closed reduciton
ORIF if complicated
Replacement if recurrent

127
Q

Ulnar fracture

A

Nightstick fracture

Check radial head for monteggia

128
Q

Both forearm fracture

A

Child: plaster cast
Adult: ORIF

129
Q

Fracture to radial head and dislocation of ulna

A

Galeazzi

ORIF

130
Q

Ulnar fracture and radial dislocation

A

Montaggia

ORIF

131
Q

Dorsal displacement of radius with MEDIAN NERVE COMPRESSION

A

Colles

ORIF

132
Q

Volar displacemetnt of distal radius

A

Smiths fracture

ORIF

133
Q

Intrarticular fracture of distal radius

A

ORIF

Bartons

134
Q

Tender anatomical snuffbox

RADIAL ARTERY AND NERVE DAMAGE

A

Scaphoid
cast if undisplaced
Displaced: Compression screw

135
Q

penetrating hand injuries

A

Volar: Flexors digital nerve and arteries at risk
Dorsal: extensor
Surgical repair

136
Q

Staving injury leads to DIPJ injury

A

Mallet flinger

Mallet splint

137
Q

Flexor tendon injuries

A

Explore, smooth repair

138
Q

Metacarpal injuries

A

Usually 5th broken with fight bite

Infection

139
Q

Phalangeal injuries

A

Splint and k wiring if displaced

2MB: disease summaries (10 decks)

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