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MSK Flashcards

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1
Q

Ottawa ankle rules:

A

o Point tenderness posterior to lat/med malleolus

o Inability to weight bear at least 4 steps at time of injury and at time of consultation

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2
Q

SEs of leflunomide

A

HTN
Hepatitis
GI disturbance

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3
Q

Hypospermia SE of which drug?

A

Sulfasalazine

also ILD

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4
Q

Felty’s Syndrome features + Rx

A

Triad: Splenomegaly + RA + NPenia

Other features:
LNopathy
skin ulcers

Rx:
Control RA
Consider splenectomy for neutropenia

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5
Q

Ddx for DIPJ involvement

A

OA

Psoriatic arthritis

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6
Q

Patterns of psoriatic arthritis

A

Symmetrical polyarthritis
Asymmetrical oligoarthritis
Spondylitis +/- sacro-ilitis
Arthritis mutilans: rare, involves significant deformation of fingers and toes

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7
Q

Blue sclera
Short and tall height
- associated with which vasculitis?

A

Ehler’s danlos

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8
Q

Almost essential criteria for Any Spond

A

Radiological evidence of sacro-iliitis

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9
Q

Minocycline SE

A

drug-induced lupus

ie. no longer used in acne Rx

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10
Q

Morning stiffness a feature of RA or OA

A

RA

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11
Q

Mild SLE uncontrolled by NSAIDs, ?Rx

A

Hydroxychloroquine

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12
Q

Monitoring for hydroxychloroquine

A

Annual eye assessment as can cause irreversible retinopathy

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13
Q

Most useful initial Ix if suspecting And Spond

A

Plain film XR

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14
Q

Score assessing joint flexibility

A

Beighton score, out of 9

Higher=more flexible

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15
Q

Caplan’s syndrome

A

Pulmonary fibrosis usually in coal miners/exposure to asbestos/silica, who have RA

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16
Q

AB associated with microscopic polyangiitis

A

P-Anca

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17
Q

Hot swollen wrist

Xray shows chondrocalcinosis

A

Pseudogout

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18
Q

Galeazzi sign

A

Assessing for DDH

Discrepancy in knee length when flex hip and knee to 90deg

Useful test after newborn period ie. >3mo

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19
Q

Common sites for osteosarcoma

A

Metaphyses of long bones

eg. around knee or proximal femur

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20
Q

Bone XR:
Osteolysis
Periosteal relaying
“onion skinning appearance”

A

Ewings sarcoma

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21
Q

Xray features of RA

Study These Flashcards
A 
LESS
Loss of joint space
Erosions (marginal)
Soft tissue swelling
Soft bones (osteopenia/porosis)
22
Q

Mcmurrays test tests for?

Study These Flashcards
A

MENISCAL tear

23
Q

Initial treatment of compartment syndrome

24
Q

Smith’s fracture

Study These Flashcards
A

Fall onto BACK of hand

ie. distal radial fragment tilted ANTERIORLY

25
Scheurmanns disease Px
Most common cause of kyphosis in adolescents 13-16yo with poor posture and back pain
26
48 hour post pelvic fracture -> tachypnea++, petechial rash -> respiratory failure What is this complication? How do you reduce risk of it?
Fat embolism syndrome ~occludes blood vessels Risk reduced if fracture immobilised early
27
Post fracture: Pink, sweaty, stiff and tender hand. Intact pulses Dx and Rx?
Reflex sympathetic dystrophy Rx: NSAIDs + physic
28
Carpal tunnel S initial Rx
Physio
29
Post-THR advice
o Avoid >90deg flexion o Avoid low chair o Don’t sit cross-legged o Sleep on your back for 6/52
30
Positive femoral nerve stretch test ?cause
Referred lumbar spine pain ~femoral nerve compression
31
Osteoporisis therapy
o 1st: alendronate (other: risedronate, etidronate) o 2nd: strontium ranelate or raloxifene o 3rd: denosumab 6 monthly injections
32
Boxer’s # definition + Rx
= # of 5th MC Rx: Place in volar splint Discuss with hand/plastic surgery as may need surgical fixation
33
Trochanteric bursitis ftrs
o Isolated lateral hip pain (can radiate) + GT tenderness o Eg. not able to lie on side o Commonly seen after increase in activity o ~50-70yo women
34
Radiographic finding of chondrocalcinosis ?cause
A feature of pseudogout that can differentiate it from gout
35
Osteonecrosis of femoral head presentation and RFs
GRADUAL ONSET ``` RFs:  Long term steroid use  Hypercoagulable state  AI  Alcohol ```
36
Ank spond Rx:
o NSAIDs + regular exercise + PT o DMARDs for RA reserved if there is peripheral J involvement o Ongoing research re: timing of introduction of anti-TNF
37
Knee locking + giving way + Thessaly’s test + worse on straightening
~meniscal tear
38
Knee jerk reflex
~L3-4
39
Ankle reflex
S1-2
40
L5 lesion + reflexes?
intact
41
Relationship between BMI and osteoporosis
Low BMI a RF - not obesity
42
Features of facet joint pain
tender facets worse on extension of back worse in morning worse on standing
43
Triceps reflex
C6-7 predominantly C7
44
Allopurinol prescribing for gout
After 1st attack, when settled | • initially 100mg with NSAID/Colch cover
45
+ve sciatic nerve stretch test
~L5-S1 compression o L5: weak dorsiflexion and dorsal sensation o S1: weak plantar flexion and posterolateral sensation + reduced ankle reflex
46
Recurrent gout + PUD ?Dx
~features of polycythaemia
47
Trigger finger features, RFs, Rx
~pain on flexion + gets stuck + nodule at base of finger RFs: DM, RA, women Rx: steroid injection +/. Finger splint +/- ?surgery if non responder
48
Chondromalacia patellae/Patellofemoral painsyndrome Definition Risk group Px Rx
~softening of cartilage due to use o ~teenage girls o Px: pain without effusion, whenclimbing stairs or rising from sitting o Rx: physio
49
• De Quervians tenosynovitis Definition Features Rx
= Inflamed tendon sheath of APL + EPB o Pain on radial side of wrist o Tender radial styloid o Abduction of thumb against resistance = pain Rx: analgesia, steroid, splint, ?surgery NB. Finkelsteins test: flex thumb, put wrist in flexion and ulnar deviation = pain
50
First line treatment of Paget’s
alendronate

Tomakesense 2 (18 decks)

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