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MSK Flashcards

1
Q

Child with muscle weakness from age of 2, loose shoulder muscles (feels like slips through mothers hands on carrying) and bulky calf muscles. Diagnosis? Method of acquiring?

A

Duchennes’ muscular dystrophy
X-linked recessive

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2
Q

6 y/o boy, limp for 24 hours, lethargic/feverish, hip huts. Cold few weeks ago. Temp: 37.9 degrees.
What invgX and DDxs?

A

Transient synovitis or septic arthritis.

Joint aspirate to differntiate

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3
Q

Classification for intra-capsular fractures of hip?

A

Garden

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4
Q

What supplies sensation over medial aspect of lower leg and foot?

A

Saphenous

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5
Q

What can ilicit pain in lateral epicondylitis?

A

Supinating forearm and extending wrist against resistance

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6
Q
A
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7
Q

What is the most likely complication following treatment of long bone fractures?

A

VTE

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8
Q

Patient with lower back pain but no red flags, what analgesia you want to give?

A

NSAIDs (consider GI, Liver, cardio-renal toxicity though)
Consider weak opiods +/- paracteamol

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9
Q

Common cause of lateral knee pain in runners?

A

Iliotibial band syndrome

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10
Q

What is a significant risk factor for AVN if you’ve had cancer before?

A

Chemo treatment

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11
Q

Simmond’s sign indicates what?

A

Achilles tendon rupture

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12
Q

Treatment of choice for all pateints with displaced hip fracture?

A

Hemiarthroplasty or total hip replacement

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13
Q

Shortened, internally rotated leg?

A

Posterior hip fracture

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14
Q

What elbow pain cause is worse on resisted wrist extension/supination + elbow extended?

A

Lateral epicondylitis (tennis)

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15
Q

What diseases are associated with reactive arthritis?

A

Chlamydia
Gonorrhoea
Gastroenteritis

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16
Q

What is a buckle fracture?

A

Incomplete fracture of the shaft of long bone
Characterized by bulging cortex
Child aged 5-10 probs

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17
Q

Nerve compressed in cubital tunnel syndrome?

A

Ulnar
-Presents with tingling/numbness of 4th/5th finger

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18
Q

Presnetation of radial nerve palsy?

A

Wrist drop
Loss of sensation from 1st dorsal web-space

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19
Q

Colles fracture presentation?

A

FOOSH
-Distal radius fracture with dorsal displacement of most distal fragment

-1 inch proximal to radiocarpal joint
-Dorsal displacement
-Angulation

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20
Q

What can statins cause, resulting in high CK?

A

Rhabdomyolysis

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21
Q

Abrupt onset of bilateral early morning stiffness in over 60’s?

A

Polymyalgia rheumatica

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22
Q

Weakness in muscles of proximal arms and legs, which improves on movement?

A

Lambert-Eaton syndrome

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23
Q

Lambert Eaton syndrome vs Myaesthenia gravis?

A

MG: Affects face and arms earlier
LE: Gets slightly better with muscle use whereas MG gets worse

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24
Q

What are the features of post-thrombotic syndrome?

A

Painful heavy calves
Pruritus
Swelling
Varicose veins
Venous ulceration

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25
Q

If shown a skull x-ray in an exam what should you always think?

A

Paget’s disease

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26
Q

L2 nerve compression would cause what?

A

Pain, weakness, numbness, tingling, burning sensations in anterior aspect of thigh

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27
Q

What fractures are most associated with compartment syndrome?

A

Supracondylar and tibial shaft fractures

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28
Q

Exacerbated pain on passive stretching indicates what?

A

Compartment syndrome

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29
Q

Galaezzi fracture is what

A

Dislocation of radioulnar joint with associated fracture of the radius

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30
Q

Monteggia fracture is what?

A

Fracture of proximal ulna with associated dislocation of proximal radioulnar joint

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31
Q

What is Klumple’s paralysis?

A

C8/T1 nerve root damage

“All fingers of affected hand are flexed into claw position. Loss of sensation along ulnar aspect of whole hand and arm”

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32
Q

Typical mechanism of injury for Klumpke’s palsy?

A

Falling from a tree
Birth injury

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33
Q

What is Erb’s palsy?

A

C5/6 nerve roots damaged early in the brachial plexus

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34
Q

Presentation of Erb’s palsy?

A

Weakness in deltoids, biceps, hands &wrist movements generally not affected

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35
Q

Saturday night palsy features?

A

Wrist drop and finger extension weakness
-Damage to radial nerve in axilla

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36
Q

What type of injury is associated with seizure/electric shock?

A

Posterior shoulder dislocation

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37
Q

Shoulder locked in internally rotated position is highly suggestive of what?

A

Posterior dislocation

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38
Q

What is syringomyelia?

A

Disorder where cystic cavity forms within spinal cord

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39
Q

Features of syringomyelia?

A

-Dorsal column and medial leminiscus spared
-Spinothalamic tract affected: loss of pain and temperature

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40
Q

Most common variant of syringomyelia?

A

Arnold-Chiari malformation: cavity connects with congenital malformation affecting cerebellum

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41
Q

IVDU + back pain + pyrexia = susp of what?

A

Osteomyelitis

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42
Q

Sickle Cell osteomyelitis cause?

A

Salmonella

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43
Q

What eye symptoms can be associated with fat embolism?

A

Retinal haemorrhages and intra-arterial fat globules on fundoscopy

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44
Q

Pain on hip extension + lying on back with knee slightly flexed, hip externally rotated. What does this indicate in an IVDU?

A

Psoas abscess

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45
Q

Schober’s test <5cm is indicative of what?

A

Osteomyelitis

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46
Q

8 months of old child with discrpenacy between skin creases behind right and left hips?

A

Developmental dysplasia of the hip

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47
Q

Most common site affected by osteomyelitis in children?

A

Metaphysis

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48
Q

Why do people with coeliac disease receive the pneumococcal vaccine?

A

Hyposplenism
-This makes it important for them to have as it causes mil immunosuppression

49
Q

SALTER HARRIS Types rememebring technique?

A

1: Slipped:
2: Above growth plate
3: Lower than growth plate
4: Through (through both above and below growth plate)
5: Rammed (crush)

50
Q

Management of reverse, oblique, transverse or subtrochanteric fractures?

A

Intramedullary device

51
Q

What mechanism of fracture comes often with 5th MT fractures?q

A

Inversion of foot and ankle

52
Q

Extracapsular/INTERTROCHANTERIC proximal femor fractures management?

A

Dynamic hip screw

53
Q

Displaced hip fracture surgical management?

A

Hemiarthroplasty

54
Q

DdX: old man, bone pain, raised ALP?

A

Paget’s

55
Q

Analgesia for patients with neck of femur fracture?

A

Iliofascial nerve block

56
Q

Waddling gait diagnosis?

A

Osteomalacia

57
Q

Most common child abuse fractures?

A

Radial
Humeral
Femoral

58
Q

Most common site of stress fractures?

A

2nd metatarsals

59
Q

Biochem of osteomalacia?

A

Low calcium
Low phosphate
Raised ALP
Raised PTH

60
Q

What is Pott’s disease?

A

Form of TB that occurs outside lungs, common in vertebrae

-Back pain and fever, wt loss, limp

61
Q

What can iliiopsoas abscess be secondary to?

A

Crohn’s
Diverticulitis/colorectal cancer
UTI/GU Cancers
Vertebral osteomyelitis
Femoral catheter
Endocardits
IVDU

62
Q

InvGx for iliopsoas abscess?

A

CT Abdo

63
Q

What should you look for if a patient has staphylococcus and discitis?

A

Endocarditis

64
Q

Olecranon bursitis presentation?

A

Inflammation of bursa located at tip of elbow
Painful
Erythematous swelling on posterior elbow
No preceding trauma

65
Q

First line method of diagnosing Achilles tendon rupture?

A

US Scan

CT would work but more radiation than necessary
MRI also would work but not first line as US is more quick and easy

66
Q

What is an important next investigation following diagnosis of spinal stenosis?

A

MRI: Discount Mets and confirm diagnosis

67
Q

Spot diagnosis:
-Burning and tingling sensation over upper lateral area of thigh

A

Meralgia paraethetica

68
Q

What supplies upper lateral area of thigh?

A

Lateral femoral cutaneous nerve

69
Q

Why can meralgia paraethetica occur?

A

Compression of lateral femoral cutaneous nerve due to weight gain

Also affected by:
- Pregnancy
- Ascites
- Trauma
-Iatrogenic

70
Q

Triad of fat embolism symptoms?

A

Respiratory distress
Neurological distress
Petechial rash

71
Q

Treatment of Weber A fractures?

A

Weight bear as tolerated in CAM Boot for 6 weeks

72
Q

Snapping sensation + hip/groin pain?

A

Acetabular labral tear

73
Q

Reflex nerve root for achilles?

A

S1-S2 (Buckle my shoe)

74
Q

Reflex nerve root for patellar reflex?

A

L3-L4
(Kick the floor)

75
Q

Nerve root for biceps reflex?

A

C5-C6
(Pick up sticks)

76
Q

Nerve root reflex for tricepts?

A

C7-8
Lay them straight

77
Q

Rapid joint swelling of knee is suggetsive of what + what two injuries?

A

Haemoarthrosis
-ACL and PCL injury

78
Q

Positive lachman’s suggest?

A

ACL injury

79
Q

Prominent clavicle + loss of shoulder contour makes you think what?

A

Acromioclavicular dislocation

80
Q

Hills Sachs lesion is what?

A

When the cartilage surface of the humerus is in contact with rim of glenoid

81
Q

What is Hills Sachs lesion associated with?

A

Glenohumeral dislocation

82
Q

Old woman, trips on step, complains of shoulder pain, pain to 90 degree abduction? Spot diagnosis

A

Supraspinatous tear

83
Q

What is Simmond’s triad?

A

Calf squeeze test
Observation of angle of declination
Palpation of tendon

84
Q

Twisting sport injury + delayed onset of knee swelling & locking are strongly suggestive of what?

A

Meniscal tear

85
Q

Tibia lying back on femur indicative of what?

A

PCL rupture

86
Q

High twisting force to flexed knee + rapid joint swelling?

A

ACL Rupture

87
Q

What condition is exacerbated by walking on tip toes?

A

Plantar fasciitis

88
Q

Description of club foot?

A

Inverted
Plantar flexed foot
Not passively correctable

89
Q

Features of meniscal tear?

A

Knee locking
Giving away

90
Q

Management for subluxation of radial head?

A

Passive supination of elbow joint whilst flexed to 90 degrees

91
Q

Nerve root with pathology if:
- Weakness of plantar flexion
-Reduced ankle reflex

A

S1

92
Q

Nerve root with pathology if:
- Sensory loss over naterior thigh
-Weak hip flexion, knee extension and hip adduction
-Reduced knee reflex

A

L3

93
Q

S ymptoms of L3 nerve root compression?

A

Sensory loss over anterior thigh
Weak hip flexion + adduction
Weak knee extension
Reduced knee reflex

94
Q

Positive McMurray’s test indicates what?

A

Meniscal tear
(positive = painful click)

95
Q

Investigation for sus psoas abscess?

A

CT Abdomen

96
Q

Bi-malleloar fracture of ankle?

A

Pott’s

97
Q

Name of fracture for “a hurt thumb when punching opponent”?

A

Bennett’s

98
Q

Name of fracture for sore wrist, transverse fracture of radius 2cm proximal to radio-carpal joint with dorsal displacement and angulation?

A

Colles

99
Q

Squaring of thumbs indicates what disease?

A

Osteoarthritis

100
Q

Nerve conduction study findings in carpal tunnel?

A

AP prolongation in both sensory and motor axons

101
Q

Advice for management of compartment sydnrome?

A

Keep limb level with the body
IV Fluids
Pain control
Fasciotomy

DON’T GIVE ANTI-COAGS

102
Q

Management of proximal scaphoid pole fractures?

A

Surgical fixation

103
Q

Hand joints involved in osteoarthritis?

A

DIPs
Carpometacarpal

104
Q

Initial treatment of ankle fracture with assoc dislocation?

A

Closed reduction under sedation

105
Q

Most common intervention used in an intertrochanteric fracture?

A

Dynamic hip screw

106
Q

Older, less mobile individuals with displaced intracapsular fracture?

A

Hemiarthroplasty (instead of Fracture reduction and fixation, for more younger patients)

107
Q

Intertrochanteric fracture device used vs subtrochanteric fracture device used?

A

Inter: Dynamic hip screw
Sub: Intramedullary nail

108
Q

What antibiotic is associated with new onset Achilles tendon disorders?

A

Ciprofloxacin

109
Q

L5 nerve root affected features?

A

Loss of foot dorsiflexion
Sensory loss dorsum of foot

110
Q

AC joint grading?

A

Grade I-VI

1-2: Common, conservatively managed with sling
3-5: Surgical intervention

111
Q

Straight leg raise indicates what?

A

Sciatic nerve pain

112
Q

RFs for congenital hip dislocation?

A

Femal
Breech
FamHx
First born
Oligohydramnios

113
Q

Nerve affected in meralgia paraesthetica with burning thigh pain?

A

Lateral cutaneous nerve of thigh

114
Q

What is Leriche syndrome?

A
  • Claudication of buttocks and thighs
  • Atrophy of musculature of the legs
  • Impotence (due to paralysis of L1)
115
Q

Weakness of hip abduction and foot drop, no loss of specific reflexes?

A

L5 nerve affected

116
Q

ZSensory loss over anterior thigh, weak hip flexion, knee extension and hip adduction
Reduced knee reflex?

A

L3 nerve root compression

117
Q

ME is typically aggravated by what two movements?

A

Wrist flexion and pronation

118
Q
A

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