msk

Question 1

most useful investigation to diagnose ankolysing spondylitis

Answer 1

pelvic x-ray: look for sacro-iliitis

Question 2

first line investigation for suspected osteoporotic vertebral fracture

Answer 2

x-ray of the spine

Question 3

adverse effect of hydroxychloroquine

Answer 3

bull’s eye retinopathy

Question 4

HLA-B27 associations

Answer 4

ank spond
reactive arthritis
acute anterior uveitis
psoriatic arthritis

Question 5

first line management for lower back pain

Answer 5

oral NSAIDs

Question 6

child with multiple fractures and bluish tinge to sclera

Answer 6

osteogenesis imperfecta

Question 7

management of scaphoid fracture

Answer 7

futuro splint and refer to ortho 7-10 days later
if imagining reveals undisplaced fracture: cast for 6-8 weeks
if imagining reveals displaced fracture: surgical fixation

Question 8

management of gout

Answer 8

acute: NSAIDs and colchicine
prophylaxis: allopurinol plus NSAIDs or colchicine for cover

Question 9

adhesive capsulitis

Answer 9

common in middle-age and diabetics
painful, stiff movement
limited movement in all directions, loss of external rotation and abduction

Question 10

supraspinatus tendonitis

Answer 10

rotator cuff injury
painful arc of abduction between 60-120 degrees
tenderness over anterior acromion

Question 11

test for torn ACL

Answer 11

lachman’s test
anterior drawer test

Question 12

management of SUFE

Answer 12

AP and lateral x-ray views
internal fixation

Question 13

investigation for perthes

Answer 13

initially x-ray but this might not show disease so then do MRI

Question 14

what antibody is the most sensitive for SLE

Answer 14

ANA

Question 15

what antibody is the most specific for SLE

Answer 15

anti-dsDNA

Question 16

management if patient is high risk based on FRAX score

Answer 16

DEXA

Question 17

management of GCA when there has been vision loss

Answer 17

IV methylprednisolone

Question 18

clinical findings of adhesive capsulitis

Answer 18

active and passive movement limited + external rotation most affected

Question 19

what is spondylolisthesis

Answer 19

when one vertebra is displaced compared to its inferior vertebral
may occur after stress fractur
exaggerated lumbar lordosis and palpable depression above L5

Question 20

joint pain, mouth ulcers, pleuritic chest pain

Answer 20

SLE

Question 21

management of antiphospholipid syndrome in pregnancy

Answer 21

aspirin and LMWH

Question 22

foot drop

Answer 22

common peroneal nerve injury

Question 23

first line management of raynauds

Answer 23

CCB: nifedipine
IV prostacyclin if severe

Question 24

management of antiphospholipid syndrome after VTE

Answer 24

lifelong warfarin

Question 25

antibodies in drug induced lupus

Answer 25

ANA anti-histone antibodies

Question 26

risk factors for Duputren's contracture

Answer 26

older men family history manual labour phenytoin alcoholic liver disease diabetes trauma

Question 27

management of renal disease in systemic sclerosis

Answer 27

ACE inhibitor

Question 28

nerve damange in humeral shaft fracture

Answer 28

wrist drop caused by damage to radial nerve

Question 29

management of acromioclavicular joint injury

Answer 29

grade I and II: conservatively with sling grade IV, V and VI: rare and require surgical intervention

Question 30

underlying risk factors for pseudogout

Answer 30

haemochromatosis hyperparathyroidism low Mg, low phosphate acromegaly wilson's disease hypothyroidism

Question 31

vague fever, hypertension, testicular pain, haematuria, subcutaneous nodules, maculopapular rash

Answer 31

polyarteritis nodosa

Question 32

side effects of bisphosphonates

Answer 32

**oesophageal reactions** oesophagitis, ulcers- esp alendronate osteonecrosis of the jaw atypical stress fracture

Question 33

mechanism of injury of meniscal tear

Answer 33

twisting injury

Question 34

interactions with methotrexate

Answer 34

trimethoprim and co-trimoxazole aspirin: increase toxicity

Question 35

adverse effects of methotrexate

Answer 35

mucositis myelosuppression pneumonitis liver fibrosis

Question 36

investigation of choice in osteomyelitis

Answer 36

MRI

Question 37

bone pain plus low vit D, low calcium and phosphate and high ALP

Answer 37

osteomalacia

Question 38

management of undisplaced hip fracture

Answer 38

young: internal fixation old: hemiarthroplasty

Question 39

interactions with azathioprine

Answer 39

allopurinol: causes agranulocytosis

Question 40

most common reason for hip replacements needing revision

Answer 40

aseptic loosening

Question 41

colles fracture

Answer 41

dorsal displacement of fragments dinner fork deformity

Question 42

management of colles fracture

Answer 42

closed reduction followed by plaster below elbow and then fracture clinic appointment

Question 43

baker's cyst rupture

Answer 43

similar presentation to DVT but asymptomatic and history of lump behind knee

Question 44

markers that help diagnose dermatomyositis

Answer 44

CK ANA positive anti-Jo-1

Question 45

x-ray findings for pseudogout

Answer 45

chondrocalcinosis (linear calcifications of meniscus and cartilage)

Question 46

management of psoriatic arthritis

Answer 46

mild: NSAIDs moderate to severe: methotrexate biologics for resistant or extensive