Monday [17/01/22]

Question 1

Go through shoulder examination

Answer 1

1. IIIQAG

Question 2

Go through elbow examination

Answer 2

1.

Question 3

Go through ankle/foot examination

Answer 3

1.

Question 4

Go through spine examination

Answer 4

1.

Question 5

Go through hand examination

Answer 5

1.

Question 6

Go through GALS examination

Answer 6

1.

Question 7

Go through RESP exam

Answer 7

1.

Question 8

Go through GASTRO exam

Answer 8

1.

Question 9

Go through CARDIO exam

Answer 9

1,

Question 10

XR findings for a patient with RA

Answer 10

• Periarticular erosions: synovitis erodes bone causing the formation of cysts
• Periarticular osteopenia: loss of bone density occurs as a result of disuse due to pain and secondary effects of steroids
• Soft-tissue swelling: subtle widening of the joint space may be seen when synovitis is mild. Severe synovitis is seen as gross swelling around the joints
• Joint subluxation and malalignment: as ligaments become dysfunctional and joint sublux and can even dislocate. This gives rise to the classic deformities hands/feet

Question 11

XR findings for a patient with OA [4]

Answer 11

• loss of alignment [varus]
• loss of joint space
• subchondral sclerosis
• subchrondral cyst
• osteophytes

LOSS [ignore varus]

Question 12

Which joints does OA typically affect? [2]

Answer 12

Typically affects large synovial joints including hip, knee, rst metatarsophalangeal joint of the foot, facet joints of the spine, shoulder and elbow. In the hand the interphalangeal joints and carpometacarpal joint at the base of the thumb may be affected.

Question 13

What is Felty’s syndrome? [1]

Answer 13

Combination of RA, splenomegaly and neutropenia

Question 14

Where do immune complexes typically present in RA patients? [1]

Answer 14

Called rheumatoid nodules, they mainly affect the extensor surfaces

Question 15

When would an XR vs a CT vs a MRI vs USS be indicated in orthopaedics? [4]

Answer 15

• XR: arthritis, fractures, chest
• CT: complex fractures [spine, tibial, platuea, pilon, pelvis]
• MRI: spinal disc prolapse, ligamentous or meniscal injury, OM
  US: tendon rupture, foreign bodies, ‘FAST’ in trauma

Question 16

What is the most common cause of OM/septic arthritis in children? [2]

Answer 16

Acute haematogenous osteomyelitis:

• organisms escape from vessels in the physis where blood flow is slowest. An abscess occurs in the metaphysis
• pus ascapes under adjacent periosteum, elevation of the periosteum can be seen XR
• in children, hip/ankle/wrist and shoulder have intra-articular physis allowing organisms to enter the joint and cause septic arthritis

Question 17

Carpal bone mnemonic

Answer 17

Some - scaphoid
Lovers - lunate
Try - triquetrium
Positions - pisiform
They - trapezium
Can’t - capitate
Handle - hamate

Question 18

Go through the brachial plexus

Answer 18