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Musculoskeletal > DUMS ortho > Flashcards

DUMS ortho Flashcards

1
Q

<p>What type of tumour has causes a bony outgrowth with a cartilaginous cap and what symptoms does it have?</p>

A

<p>Osteochrondroma

Local pain</p>

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2
Q

<p>What is the chance of malignancy in an osteochrondroma?</p>

A

<p>1%</p>

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3
Q

<p>Where is an enchondroma found?</p>

A

<p>Intramedullary (usually metaphyseal) </p>

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4
Q

<p>How does an enchondroma present?</p>

A

<p>Usually asymptomatic (may cause pathological fracture),

| Incidental finding on X-ray (lucent lesion) </p>

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5
Q

<p>How is an enchondroma treated?</p>

A

<p>Curettage and bone graft</p>

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6
Q

<p>What are the 2 types of bone cyst and how do they present?</p>

A

<p>Simple: fluid filled (asymptomatic)

| Aneurysmal: blood filled (pain and weakness)</p>

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7
Q

<p>How is a bone cyst managed?</p>

A

<p>Curettage and bone graft</p>

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8
Q

<p>How does an osteoid osteoma appear?</p>

A

<p>Small nub of bone surround by intense sclerotic halo </p>

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9
Q

<p>How does an osteoid osetoma present?</p>

A

<p>Intense constant pain, worse at night (due to inflammatory response) </p>

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10
Q

<p>How is an osteoid osteoma diagnosed and managed?</p>

A

<p>X-ray

NSAIDs to relieve pain

CT guided radiofrequency ablation </p>

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11
Q

<p>What is the most common malignant bone tumour and who does it present in?</p>

A 
<p>Osteosarcoma
Young patients (usually around knee)</p>
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12
Q

<p>What tumour presents with fever and inflammatory makers (similar to osteomyelitis) in young patients </p>

A

<p>Ewings sarcoma </p>

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13
Q

<p>What disease presents with multiple fragility fractures in childhood, loss of hearing and blue sclera?</p>

A

<p>Osteogenesis imperfecta (brittle bone)</p>

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14
Q

<p>What is dwarfism referred to as and what facial features are seen?</p>

A

<p>Skeletal dysplasia

| Prominent forehead and wide nose </p>

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15
Q

<p>What gene is mutated in marfans syndrome?</p>

A

<p>Fibrillin gene </p>

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16
Q

<p>What is Gowers sign associated with?</p>

A

<p>Duchenne muscular dystrophy (due to proximal leg weakness)</p>

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17
Q

<p>What is the genetic defect in Muscular dystrophy and how is it diagnosed?</p>

A

<p>Dystrophin gene (assoc with ca)

| Raised serum creatinine phosphokinase + abnormal muscle biopsy </p>

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18
Q

<p>What is DDH and how is it investigated?</p>

A

<p>Developmental dysplasia of the hip
USS
Present with shortened limb</p>

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19
Q

<p>What group does transient synovitis commonly present in and how is it managed?</p>

A

<p>Young boys after viral infection

| Rest and NSAIDs</p>

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20
Q

<p>What is Perthes disease?</p>

A

<p>Idiopathic inflammation of femoral head, loss of blood supply, necrosis and abnormal growth</p>

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21
Q

<p>How does Perthes disease present?</p>

A

<p>Pain and limp in active boys </p>

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22
Q

<p>What is SUFE and who does it present in?</p>

A

<p>Slipped upper femoral epiphysis (growth plate can't cope with weight)
Overweight children</p>

23
Q

<p>What is club foot and how is it managed?</p>

A

<p>Congenital deformity of talus, calcaneus and navicular joint
Splintage + gradual correction in 4-6 week blocks</p>

24
Q

<p>Where are rotator cuff tendons impinged during a painful arc?</p>

A

<p>Subacromial space </p>

25
Q

<p>What muscle is most commonly injured in a rotator cuff tear and how is it managed?</p>

A

<p>Supraspinatous

| Surgery or physio</p>

26
Q

<p>What is adhesive capsulitis and how is it managed?</p>

A

<p>Frozen shoulder

| Self-resolving over 18-24 months (+steroids)</p>

27
Q

<p>What is a Bankart repair used for?</p>

A

<p>Recurrent shoulder dislocations</p>

28
Q

<p>What nerve is affected in carpal tunnel and cubital tunnel syndrome?</p>

A

<p>Carpal tunnel: median

| Cubital tunnel: ulnar</p>

29
Q

<p>What causes the pain in tennis and golfers elbow and how is it managed?</p>

A

<p>Micro-tears in the tendons

| Rest, NSAIDs and steroids </p>

30
Q

<p>What causes Dupuytren's contracture? What groups of people is it more common in?</p>

A

<p>Proliferation of type 3 collagen fibres (proliferative connective tissue disorder)
Alcoholics, diabetics</p>

31
Q

<p>How is Dupuytren's managed?</p>

A

<p>Fasciectomy (surgical release of collagen fibres) if greater than 30 degrees </p>

32
Q

<p>What causes trigger finger?</p>

A

<p>Tendonitis of a flexor tendon to a finger (enlarges and catches on the fascia - causes a clicking sensation)</p>

33
Q

<p>How is trigger finger managed?</p>

A

<p>Injection of steroid around the tendon to relieve symptoms
Surgery</p>

34
Q

<p>What is a ganglion cyst?</p>

A

<p>Mucinous filled cyst by a tendon or synovial joint (mostly cosmetic issues)</p>

35
Q

<p>How is a ganglion cyst investigated and managed?</p>

A 
<p>Transillumiation to ensure not pathological
Needle aspiration (temporary relief, common reoccurrence)
Surgical excision (only if causing severe discomfort)</p>
36
Q

<p>What is trochanteric bursitis and what causes it?</p>

A

<p>Inflammation of the bursa over the greater trochanter (hip) -> self-limiting
Caused by overuse (athletes)</p>

37
Q

<p>What direction does the shoulder most commonly dislocate?</p>

A

<p>Anterior (95%)</p>

38
Q

<p>In a shoulder dislocation which nerve and artery are at most risk of compression?</p>

A

<p>Axillary nerve (numbness of lateral aspect)

| Axillary artery</p>

39
Q

<p>What nerves and arteries are at risk in a humeral shaft fracture?</p>

A

<p>Radial nerve

| Brachial artery</p>

40
Q

<p>What is a nightstick fracture?</p>

A

<p>Isolated fracture of the ulna (usually defensive injury)</p>

41
Q

<p>What is a Monteggia and a Galeazzi fracture dislocation?</p>

A

<p>Monteggia: ulnar fracture, dislocation of radial head at elbow
Galeazzi: radial fracture, dislocation of the ulna at the wrist</p>

42
Q

<p>What is a FOOSH?</p>

A

<p>Fall onto outstretched hand</p>

43
Q

<p>What is a Colles' fracture?</p>

A

<p>Distal radial fracture
FOOSH
Causes dorsal displacement of hand (dinner fork)</p>

44
Q

<p>What is the opposite of a Colles' fracture?</p>

A

<p>Smiths fracture
Distal radial fracture,
Causes volar displacement (requires ORIF, highly unstable)</p>

45
Q

<p>What X-rays must be taken for a scaphoid fracture? How long until repeat scan if unclear?</p>

A

<p>AP, Lateral, 2 x oblique

| 6 weeks </p>

46
Q

<p>What is the risk with a scaphoid fracture?</p>

A

<p>Avascular necrosis (due to retrograde blood supply)</p>

47
Q

<p>How does a hip fracture appear and where should this be managed?</p>

A

<p>Shortened + externally rotated

| A&amp;amp;E (medial emergency)</p>

48
Q

<p>What type of hip fracture is higher risk and why is this?</p>

A

<p>Intracapsular, retrograde blood supply so risk of avascular necrosis to femoral head </p>

49
Q

<p>How should an intracapsular vs extra capsular hip fracture be managed?</p>

A

<p>Intra; hemi-arthroplasty (longer lasting, lesser mobility) or total hip replacement
Extra; dynamic hip screw (internal fixation)</p>

50
Q

<p>What bone in the body takes the longest to heal if fractured and what is its definitive management?</p>

A 
<p>Tibia
Internal fixation (intermedullary nail)</p>
51
Q

<p>What is the salter-harris classification of fractures used for?</p>

A

<p>Paediatric physeal fractures</p>

52
Q

<p>What Salter-Harris fractures require intervention and why is this?</p>

A

<p>Salter-Harris III + IV

| High risk of growth arrest as splits the physis</p>

53
Q

<p>What occurs during a Salter-Harris V injury?</p>

A

<p>Compression injury to physis causing growth arrest (cannot be diagnosed on initial X-ray)</p>

Musculoskeletal (11 decks)

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