master document Pt1

Question 1

what do bisphophonates do?

Answer 1

reduce osteoclast resorption

Question 2

what muscles attach to the clavicle

Answer 2

deltoid and trapezius

Question 3

what does strontium do

Answer 3

increases osteoblast replication and reduces resorption

Question 4

describe an osteoclast

Answer 4

breaks up bone – multinucleate

Question 5

describe an osteoblast

Answer 5

builds bone

Question 6

what increases during acute illness

Answer 6

ferritin

Question 7

how is an osteosarcoma seen on an X-ray

Answer 7

as the Codman triangle which is due to periosteum elevation by tumour formation

Question 8

what inserts onto the lesser trochanter

Answer 8

Psoas major

Question 9

what can cause hypercalcaemia and how

Answer 9

lithium by resetting the set point of PTH

Question 10

describe skeletal muscle

Answer 10

striations and peripheral nuclei

Question 11

Osteoprogenitor cells:

Answer 11

located on bone surfaces, for example under the periosteum, these cells serve as a pool of reserve osteoblasts

Question 12

osteoblasts:

Answer 12

bone forming cells found on the surface of developing bone. They have plentiful RER and prominent mitochondria.

Question 13

osteocytes:

Answer 13

a bone cell trapped within the bone matrix.

Question 14

osteoclasts:

Answer 14

large multinucleated cells. They are found on the surface of bone and are responsible for bone resorption

Question 15

Pernicious anaemia –

Answer 15

not enough B12

Question 16

where can Musculocutaneous nerve injury present as weakness

Answer 16

in elbow flexion as it innervates biceps brachii

Question 17

where is the sternal angle located

Answer 17

at the lower border of T4 vertebrae

Question 18

where does the middle meningeal artery go through

Answer 18

foramen spinosum

Question 19

Non-painful flexion contracture which is not correctable in elderly patient –

Answer 19

Dupuytrens

Question 20

pain and numbness

Answer 20

Carpal tunnel syndrome

Question 21

pain and inflammation

Answer 21

deQuervain tenosynovitis

Question 22

pain and clicking or trigger sign

Answer 22

flexor tendinitis

Question 23

well circumcised without causing rigid contractures

Answer 23

tendon sheath ganglia

Question 24

radial nerve palsy is normally caused by fractures involving

Answer 24

the distal 1/3 of the humerus

Question 25

atraumatic c spine injury can occur in

Answer 25

Down syndrome and RA

Question 26

polio:

Answer 26

affects motor anterior horn cell in the spinal cord, flu like illness

Question 27

what may predispose to SUFE

Answer 27

Hypothyroidism or renal disease

Question 28

Sufe:

Answer 28

patients can present with pain purely in the knee Loss of internal rotation of the hip

Question 29

apophysitis:

Answer 29

inflammation of a growing tubercle where a tendon attaches

Question 30

Talipes Equinovarus (clubfoot):

Answer 30

boys, forefoot supination, forefoot varus alignment, ankle equinus (plantarflexion), Ponseti technique of splintage, loosen Achilles tendon

Question 31

Spondylolisthesis is

Answer 31

slippage of one vertebra over another and usually occurs at the L4/L5 or L5/S1 level

Question 32

Ankylosing spondylosis:

Answer 32

male, age 20-40, bamboo spine, can have fusion of sacroiliac joints

Question 33

what doesn't have any effect on spinal disease

Answer 33

DMARDs

Question 34

onycholysis:

Answer 34

lifting of the nail from the nail bed (nail fungus or psoriasis)

Question 35

Reactive arthritis: in response to GU or GI infection

Answer 35

Large joints (knees) swell 1-3 weeks after infection

Question 36

Reiter’s syndrome:

Answer 36

uveitis/conjunctivitis, urethritis, arthritis

Question 37

treat raynauds

Answer 37

calcium channel blockers (nifedipine)

Question 38

what is the final product of the breakdown of purines (adenosine & guanine)

Answer 38

uric acid

Question 39

gout

Answer 39

Needle shaped negative birefringence (change from yellow to blue when lined across the direction of polarisation

Question 40

gout treatment

Answer 40

use colchicine or NSAIDs

Question 41

what is pseudogout caused by

Answer 41

by calcium pyrophosphate crystals

Question 42

Polymyalgia rheumatica:

Answer 42

HLA-DR4 & exposure to adenovirus/parvovirus B19

Question 43

ENT symptoms are common in

Answer 43

GPA

Question 44

polymyalgia reumatica is associated with

Answer 44

GCA

Question 45

GPA associated with

Answer 45

cANCA and PR3

Question 46

olfer’s elbow –

Answer 46

medial condyle

Question 47

tennis elbow –

Answer 47

lateral condyle

Question 48

Total knee replacement:

Answer 48

cobalt chrome or stainless steel or titanium with a high density polyethylene bearing surface or ceramic

Question 49

Meniscal injuries:

Answer 49

twisting force on a loaded knee ie turning in football - Joint line pain and effusion the next day - Locking

Question 50

ACL rupture –

Answer 50

- higher rotational force, turning upper body laterally on a planted foot - Rugby, skiing - Pop felt or heard - Haemarthrosis – due to vascular bleeding of ACL within 1 hour - Anterior drawer test and Lachman test positive

Question 51

Hip pathology produces pain in the

Answer 51

groin

Question 52

hip replacement early complications

Answer 52

infection, dislocation, nerve injury, MI, chest infection, DVT, PE

Question 53

hip replacement late complications

Answer 53

loosening, late infection and late dislocation

Question 54

Gold standard for hallux rigidus is

Answer 54

arthrodesis (surgical immobilisation of a joint by fusion)

Question 55

Morton’s neuroma:

Answer 55

- Irritated nerves can become inflamed and swollen and form a neuroma - Burning pain and tingling radiating into the affected toes - Women and high heels are a cause - Third interspace nerve is most commonly affected - Planter interdigital nerves (from medial and lateral plantar nerves) - Mulder’s click test: squish the forefoot together - US for diagnosis (of swollen nerve) Metatarsal pad/offloading insole/steroid and local anaesthetic insole