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Finals round 2 lol > MSK > Flashcards

MSK Flashcards

1
Q

What haem condition can predispose to pseudogout

A

hemochromatosis

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2
Q

allopurinol MOA

A

xanthine oxidase inhibitor

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3
Q

Main SE of colchicine

A

diarrhoea

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4
Q

treatment of septic arthritis

A

flucloxacillin/clindamycin for staph aureus 4-6 weeks
Cipro if gonorrhoea

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5
Q

Rheumatoid arthritis monitoring

A

DAS28 + CRP

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6
Q

most common extra-articular manifestation of RA

A

keratoconjunctivitis sicca

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7
Q

how to differentiate reactive and septic

A

in reactive, organism cannot be recovered from joint

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8
Q

specific eye conditions associated with reactive arthritis

A

conjunctivitis and anterior uveitis

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9
Q

psoriasis management

A

First line
1. potent corticosteroid + vitamin d analogue

Second line
1. Phototherapy (can cause SCC)
2. Oral methotrexate

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10
Q

Long term management of antiphospholipid syndrome

A

low dose aspirin (warfarin lifelong if had thrombotic event)

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11
Q

What can cause polymyositis and dermatomyositis

A

paraneoplastic syndrome
viral infection e.g. cosackie virus/HIV

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12
Q

Critical test for myositis

A

CK

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13
Q

What tests are done for ACL

A

Anterior drawer tests (ACl moves)
Lachmans (ACL moves)

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14
Q

Bakers cyst important differential

A

DVT

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15
Q

serious complication of baker cyst

A

compartment syndrome

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16
Q

Why do you not use steroid injections in foot

A

rupture of plantar fascia or fat pad atrophy

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17
Q

What is bechets disease

A

oral ulcers
genital ulcers
anterior uveitis

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18
Q

Why do you get AKI with compartment syndrome

A

accumulation fo myoglobin in kidneys

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19
Q

Which clinical sign points towards compartment syndrome

A

pain on passive stretch

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20
Q

How does ostechondritis dissicens present

A

pain after exercise
intermittent locking and swelling of joint

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21
Q

most common cause of death is systemic sclerosis

A

respiratory involvement: interstitial lung disease (ILD) and pulmonary arterial hypertension (PAH)

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22
Q

Antibodies associated with systemic sclerosis

A

CREST: anti-centromere
Diffuse: Anti-SCL70

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23
Q

CREST syndrome

A

Calcinosis
Raynauds
oesophageal motility
sclerodactyly
telangtascia

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24
Q

What antibiotic should you not co-prescribe with methotrexate

A

trimethoprim
severe bone marrow suppression and pancocytopenia

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25
What medication can cause drug induced lupus
isonazid
26
diagnostic investigation for osteomyelitis
MRI
27
RA x-ray findings
loss of joint space juxta-articular osteoporosis soft-tissue swelling periarticular erosions subluxation
28
ottawa ankle rules
Inability to walk four steps Bony tenderness at the medial malleolar zone (tip of medial malleolus to lower 6cm of posterior border of tibia) Bony tenderness at the lateral malleolar zone (tip of lateral malleolus to lower 6cm of posterior border of fibula).
29
Pain on the radial side of the wrist/tenderness over the radial styloid process ?
De Quervain's tenosynovitis
30
bisphosphonate alternative?
denosumab if egfr <30
31
pre-op imaging in someone with RA
Anteroposterior and lateral cervical spine radiographs - Atlantoaxial subluxation can lead to cervical cord compression.
32
L3 nerve root
Sensory loss over anterior thigh Weak hip flexion, knee extension and hip adduction Reduced knee reflex Positive femoral stretch test
33
L4 nerve root
Sensory loss anterior aspect of knee and medial malleolus Weak knee extension and hip adduction Reduced knee reflex Positive femoral stretch test
34
L5 nerve root
Sensory loss dorsum of foot Weakness in foot and big toe dorsiflexion Reflexes intact Positive sciatic nerve stretch test
35
S1 nerve root
Sensory loss posterolateral aspect of leg and lateral aspect of foot Weakness in plantar flexion of foot Reduced ankle reflex Positive sciatic nerve stretch test
36
who is more likely to get osteonecrosis of the jaw with bisphosphonates
cancer patients
37
extra articular signs of psoriatic arthritis
tenosynovitis and soft tissue inflammation resulting in: - enthesitis: inflammation at the site of tendon and ligament insertion e.g. Achilles tendonitis, plantar fascitis - tenosynovitis: typically of the flexor tendons of the hands - dactylitis: diffuse swelling of a finger or toe - nail changes pitting onycholysis
38
x-ray findings with psoriatic arthritis
'Plantar spur' and 'pencil and cup'
39
how to differentiate psoas abscess and osteomyelitis
psoas has pain on hip extension
40
most common cause of psoas abscess
Staphylococcus aureus: most common crohns
41
what should be checked before starting azathioprine/mercaptopurine
thiopurine methyltransferase deficiency (TPMT)
42
colles fracture complications
- median nerve injury - compartment syndrome - vascular compromise - osteoarthritis - complex regional pain syndrome
43
colles fracture
dorsally displaced distal radius -> dinner fork deformity
44
4 features of scaphoid fracture
1. pain on longitudinal compression of thumb 2. tenderness in anatomical snuffbox 3. pain along the radial aspect of the wrist, at the base of the thumb 4. loss of pincer grip strength
45
ulnar paradox
proximal lesions of the ulnar nerve produce a less prominent deformity than distal lesions
46
ulnar nerve damage features
- weak finger abduction and adduction with reduced sensation over the ulnar border of his hand - clawing of 4th and 5th digits
47
CK in PMR
normal but raised ESR
48
osteomyelitis cause
Staph. aureus is the most common cause except in patients with sickle-cell anaemia where Salmonella species predominate
49
what drug reduces risk of renal crisis in systemic sclerosis
ace-inhibitors
50
AS x ray
subchondral erosions, sclerosis and squaring of lumbar vertebrae
51
routine monitoring with methotrexate
LFTs
52
methotrexate toxicity treatment
Folinic acid
53
complications of pagets
deafness (cranial nerve entrapment) bone sarcoma (1% if affected for > 10 years) fractures skull thickening high-output cardiac failure
54
adverse effects of methotrexate
mucositis myelosuppression pneumonitis pulmonary fibrosis liver fibrosis
55
most common type of intracapsular hip fracture
subcapital fracture
56
what nerve meralgia paresthetica
lateral cutaneous nerve of thigh compression
57
psoas abscess investigation
CT abdomen
58
features of de quervain's tenosynovitis
- pain on the radial side of the wrist - tenderness over the radial styloid process - abduction of the thumb against resistance is painful - Finkelstein's test: the examiner pulls the thumb of the patient in ulnar deviation and longitudinal traction. In a patient with tenosynovitis this action causes pain over the radial styloid process and along the length of extensor pollisis brevis and abductor pollicis longus
59
most common cause of discitis
staph aureus
60
How to differentiate bullous pemphigoid and pemphigoid vulgaris
no mucosal involvement (in exams at least*): bullous pemphigoid mucosal involvement: pemphigus vulgaris
61
what is mcmurrys test for
meniscal tears ACL: drawer test
62
posterior hip dislocation nerve
sciatic (leads to foot drop as common peroneal is a branch)
63
nerve conduction in carpal tunnel
Action potential prolongation in both sensory and motor axons
64
myeloma biochemical features
high calcium, normal/high phosphate and normal alkaline phosphate
65
what should never be prescribed with allopurinol
azathioprine -> bone marrow suppression
66
psoriatic arthritis complications
CVD
67
charcot joint
diabetes and described as gammy
68
what antibiotic increases risk of achilles tendon rupture
cipro

Finals round 2 lol (24 decks)

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