MSK

Question 1

polymyalgia rheumatica vs polymyositis

Answer 1

PR - stiff & pain, raised CPR
P - weakness, raised CK

Question 2

risk of dermomyositis

Answer 2

cancer

Question 3

what causes SLE

Answer 3

increased apoptosis -> defective clearance -> immune complex formation -> compliment activation

Question 4

specific vs sensitive SLE antibodies

Answer 4

anti - DsDNA - specific
ANA - sensitive

Question 5

antibody in mixed connective tissue disease

Answer 5

anti - RNP

Question 6

treatment of raunads

Answer 6

Ca blockers
phosphodiesterase enzyme inhibitors

Question 7

which arteries are effected in tayaski vasculitis?

Answer 7

the ones coming off the aortic arch

Question 8

small vessel vasculitis
ANCA +
no gramulomas

Answer 8

microscopic polyangitis (pANCA)

Question 9

ANCA -ve small vessel vasculitis’

Answer 9

IgA+ - henoch purpura
serum cryoglobulin+ - cryoglobineamia

Question 10

treatment of AVN

Answer 10

no collapse = drilling decompression
collapse - joint replacement

Question 11

what is osteochondritis (+ dissecans)

Answer 11

inflammation of bone and cartilage (bone and cartilage seperate)

Question 12

osteochondroma vs enchroma

Answer 12

(both benign)
o - boney growth with cartilaginous cap
e - intramedullary metaphyseal cartilage tumour

Question 13

giant cell tumour

Answer 13

benign
‘soap bubble’
painful

Question 13

‘shepards crook’

Answer 13

fibrous dysplasia in femour

Question 14

osteosarcoma vs chondrosarcoma

Answer 14

(both malignant)
o - worse @ night, kids, knee
c - older, pelvis

Question 15

‘onion skin’ bone tumour

Answer 15

ewings - malignant

Question 16

investigation into multiple myeloma

Answer 16

bone protein assay

Question 17

osteoid osteoma

Answer 17

immature bone surrounded by slclerotic halo
releases prostiglandins

treat with NSAIDs

Question 18

specific RA antibody

Answer 18

anti CCP

Question 19

DAS score meaning (RA)

Answer 19

<2.6 remission
>5.1 severe

Question 20

treatment of bursitis

Answer 20

ABs dont work
excise

Question 21

Ca and phsophate levels in
osteoporosis
osteomalacia
pagets

Answer 21

osteoporosis - normal
osteomalacia - low Ca & phosphate
pagets - normal (high ALP)

Question 22

which nerves are damaged in erbs vs klumpke

Answer 22

erb - C5 6
klumpke C8 T1

Question 23

which virus causes pagets disease

Answer 23

paramyoxovirus

Question 24

treatment of talpes equinovarus (club foot)

Answer 24

ponseti technique achilles tenotomy

Question 25

what causes osgood-schlatters disease

Answer 25

inflamatiion of growing tubercle where tendon attachs

Question 26

treatment of enteropathic arthritis

Answer 26

no NSAIDs - treat IBD

Question 27

knee extension reflex

Answer 27

L3 4

Question 28

ankle reflex

Answer 28

S1 2

Question 29

symptoms of cervical disk prolapse

Answer 29

UMN symptoms

Question 30

role of rotator cuff muslces

Answer 30

supraspinatous - abduction (start) infraspinatous - external rotation teres minor - external rotation subscapularis - internal rotation

Question 31

loss of external rotation in shoulder

Answer 31

frozen shoulder

Question 32

painful arc (shoulder)

Answer 32

impingement

Question 33

cruciate ligament injuries

Answer 33

ACL - twist and pop PCL - dashboard, hyperextension MCL - valgus stress (skiing) LCL - varus stress (rare)

Question 34

symptoms of meniscal tear

Answer 34

twist on loaded knee pain on joint line

Question 35

spinal shock

Answer 35

loss of sensation, motor and reflexes below level of injury for roughly 24hours treat with fluid

Question 36

Syringomyelia

Answer 36

loss of temp, coarse touch & motor keeps light touch & proprioception

Question 37

which direction are most elbow dislocations?

Answer 37

posterior

Question 38

hill-sachs dislocation

Answer 38

posterior humeral head impacts anterior glenoid

Question 39

pilon fracture

Answer 39

distal tibial frature intra-articular

Question 40

'sagging rope sign'

Answer 40

AVN

Question 41

normal leg shape as growing

Answer 41

genu varum <2 genu valgum until 3

Question 42

which chromosome is the HLA gene on?

Answer 42

6

Question 43

how long for DMARDs to work

Answer 43

6 weeks

Question 44

how long for allopurinol to work

Answer 44

2 weeks

Question 45

SLE flare bloods

Answer 45

decreased compliment CRP iss normal

Question 46

what should be prescribed along withmethotrexate

Answer 46

folic acid

Question 47

treatment of AVN

Answer 47

decompressive sugery

Question 48

investigation into mortons neuroma

Answer 48

(foot click) - US

Question 49

takayasus arteritis symptoms

Answer 49

systemic - headaches, tiredness differnt BP in arms aortic regurg claudication on exertion

Question 50

investigation into takaysus arteritis

Answer 50

magnetic resonance angiography or CT angiography

Question 51

antiphospholipid syndrome treatment

Answer 51

prophylaxis - aspirin 1 event - warfarin (pregnant = LMWH)

Question 52

behcets

Answer 52

oral ulcers + genital ulcers + anteroir uveitis

Question 53

anti-ro in pregnant women

Answer 53

causes congenital heartblock in fetus

Question 54

symptoms of pagets

Answer 54

bone pain and isolate ALP (usually asymptomatic)

Question 56

elbow injury in: - FOOSH - direct blow to elbow - fall on extended elbow

Answer 56

- FOOSH - radial head (rare) and neck (common) - direct blow to elbow - intercondylar, olecranon (kids) - fall on extended elbow - dislocation,

Question 57

PMR vs polymyositis location

Answer 57

both shoulder PM - more commonly pelvic

Question 58

most common complication of systemic sclerosis

Answer 58

systemic + pulmonary hypertension

Question 59

monitorin in henoch purpura

Answer 59

BP urinalysis

Question 60

maisonneuve injury

Answer 60

twisting injury = proximal fibular fracture

Question 61

antibodies in sjorgens

Answer 61

ro and la

Question 62

treatment of complex regional pain syndrome

Answer 62

amytriptyline

Question 63

weakness of knee extension + anteriomedial thigh sensation loss

Answer 63

femoral nerve

Question 64

numbness of medial side of foot

Answer 64

saphenous (branch of femoral)

Question 65

pagets vs osteomalacia

Answer 65

both high ALP pagets - everything else normal osteomalacia - Ca & phosphate low

Question 66

square thumbs

Answer 66

OA

Question 67

monitoring on bisphosphonates

Answer 67

dental checkups

Question 68

loss of sensation first web-space between the big toe and second toe.

Answer 68

L5 nerve lesion (not common perineal)

Question 69

investigation into osteoporosis

Answer 69

FRAX before DEXA

Question 70

bone pain in cancer treatment

Answer 70

radiotherapy then bisphosphonates