msk

Question 1

complex regional pain syndrome clinical features

Answer 1

at least one symptom in three or more of the following four categories: sensory, vasomotor, sudomotor and trophic Sensory: Hyperaesthesia (increased sensitivity) and/or allodynia (pain from non-painful stimuli).
Vasomotor: Skin temperature changes, skin color changes, or differences between limbs.
Sudomotor/Oedema: Swelling (oedema), changes in sweating, or differences in sweating between limbs.
Motor/Trophic: Reduced range of motion, motor dysfunction (weakness, tremor, spasms), and/or trophic changes (changes to skin, hair, nails).

Question 2

age mandatory fracture risk assessment even without risk factors

Answer 2

women 65 and over, men 75 and over

Question 3

Qfracture vs FRAX

Answer 3

Qfracture includes history of falls and ethnicity, FRAX no, but FRAX includes BMD/DEXA

Question 4

two week history of pain and stiffness in both shoulders, occurring during the night, and easing off somewhat an hour after getting up

Answer 4

pmr

Question 5

fragility fractures first, second, third line secondary prevention

Answer 5

alendronic acid, then -dronates, then strontium/raloxifene

Question 6

Fracture risk assessment should be targeted and should not usually be considered before the age of—-, except in patients with major risk factors such as a previous fragility fracture.

Answer 6

50

Question 7

pain severe when climbing stairs

Answer 7

osteoarthrtis

Question 8

Pain in the leg and lower back between 30-70 degrees of straight leg raising is indicative of

Answer 8

lumbar disc herniation

Question 9

Pain at more than 70 degrees of SLR

Answer 9

hip pathology.

Question 10

Pain at less than 30 degrees of SLR may indicate a range of possibilities including

Answer 10

spondylolisthesis, gluteal abscess or acute dural inflammation

Question 11

SLR Pain that increases with neck flexion or foot dorsiflexion may indicate

Answer 11

lesion in the spinal cord.

Question 12

positive anti-centromere autoantibodies

Answer 12

systemic sclerosis

Question 13

typically presents with morning back pain and stiffness in men between the age of 18 and 30 years

Answer 13

Ankylosing spondylitis

Question 14

bilateral shoulder pain, worse in the morning, hard to get dressed

Answer 14

PMR

Question 15

accurate description of the FRAX result

Answer 15

Fracture risk over the next ten years

Question 16

heel pain, sports athlete, tender heel

Answer 16

Sever’s disease - calcaneal apophysitis

Question 17

DMARD monitoring when stable dose

Answer 17

3 months

Question 18

(DMARDs) requires annual ophthalmic examination after 5 years of treatment

Answer 18

Hydroxychloroquine

Question 19

Which is the SINGLE MOST likely ADDITIONAL symptom or sign to be associated with chronic fatigue syndrome?

Answer 19

Cognitive difficulties

Question 20

acceptable ROM 2 months after TKR

Answer 20

The acceptable range of movement is from full extension to 90 degrees of flexion

Question 21

chronic primary pain management

Answer 21

antidepressant - do not use analgesia

Question 22

axial spondylarthritis, nsaid not working, next step?

Answer 22

DMARD

Question 23

conditions is most likely to be associated with axial spondyloarthritis

Answer 23

Enthesitis, inflammation of tendonous or ligamentous insertions onto bone - e.g. patellar tendonitis

Question 24

MSK adverse effect of SSRI

Answer 24

increased risk for fractures

Question 25

anterior knee pain on teenage girls, patella is pressed to femur elciits pain

Answer 25

Chondromalacia patellae

Question 26

Finkelteins test - what is it and for what

Answer 26

ulnar deviaton of wrist with fingers flexed- for De quervains tenosynovitis

Question 27

symmetrical proximal muscle tenderness and weakness. She has difficulty rising from a chair. She has also noticed a mauve discolouration of both her eyelids

Answer 27

Dermatomyositis

Question 28

regnant woman presents with painful joints. She has noticed her cheeks are permanently red

Answer 28

SLE

Question 29

multiple joint pains, male, weight loss, purplish rash on shins and splinter hameorrhage

Answer 29

ployaretritis nodosa - medium sized vasculitis

Question 30

pain in his right thigh and buttock after walking 200 metres, eased by leaning forward on his walking stick

Answer 30

Spinal stenosis

Question 31

MINIMUM amount of time for checking serum urate level AGAIN if first one was normal - for gout

Answer 31

2 weeks after resolution

Question 32

recommended daily intake for calcium and vitamin D

Answer 32

1200 mg calcium, 400 units vitamin D

Question 33

likely bone profile result to be expected in Paget’s disease?

Answer 33

Normal serum calcium, raised alkaline phosphatase (mild hypercalcaemia can be found if patient had been imobile for some time)

Question 34

lesion can be found after sore throat (skin lesion)

Answer 34

erythema nodosum

Question 35

psotive anti CCP, negative RF

Answer 35

RA

Question 36

pain in the calves after running then slowly subsiding with rest and resolution aided by elevation of the leg

Answer 36

Chronic compartment syndrome

Question 37

77% of ankle injuries are

Answer 37

lateral ligaments strains

Question 38

Chronic pain is defined as being present for a minimum of HOW MANY weeks?

Answer 38

12 weeks

Question 39

test with highest specificity for Sjogren's syndrome

Answer 39

Extractable nuclear antigen (ENA)

Question 40

first line for OA

Answer 40

topical NSAIDs

Question 41

will often result in a “snapping’ sensation within the hip

Answer 41

Iliopsoas tendinopathy

Question 42

most commonly affected by an adductor injury, which muscle

Answer 42

Adductor longus

Question 43

first line for treatment of acute gout x3

Answer 43

Prednisolone, non-steroidal anti-inflammatories and colchicine

Question 44

patient on furosemide for HF has acute gout attack, he is also on allopurinol - what to do with these 2 drugs

Answer 44

conitnue bith

Question 45

when can OA diagnosis be done clinically without xray

Answer 45

over 45 age, activity related joint pain and morning stiffness lasting for more than 30 mins

Question 46

MSK condition associated with lower lobe pulmonary fibrosis

Answer 46

Rheumatoid arthritis

Question 47

physical therapy recommended for fibromyalgia

Answer 47

acuouncture

Question 48

causes proximal muscle weakness, which is suggested by the difficulty rising from a chair, and is associated with low serum calcium and elevated alkaline phosphatase

Answer 48

Osteomalacia

Question 49

calcium and ALP - osteomalacia

Answer 49

low calcium, high ALP

Question 50

T score for osteopenia

Answer 50

T score -1 to -2.5

Question 51

T score for osteoporoasis

Answer 51

T <-2.5

Question 52

conditions has an increased prevalence in patients with rheumatoid arthritis

Answer 52

Hypertension

Question 53

Axial spondyloarthritis is most commonly misdiagnosed as which one of the following conditions?

Answer 53

Mechanical back pain

Question 54

max week for conservative mgt of undisplaced meniscal tear

Answer 54

6 weeks

Question 55

greatest specificity for RA - which blood test

Answer 55

anti CCP

Question 56

most likely positive for axial spondyloarthrtis

Answer 56

HLA-B27

Question 57

first line for low back pain without red flags

Answer 57

nsaids

Question 58

In patients older than 65 years who have suffered a hip fracture and have osteopenia, treatment

Answer 58

zoledronic acid (as an infusion every 18 months for 6 years)

Question 59

when is zoledronic acid infusion indicated

Answer 59

over 65 with hx of hip fracture and has osteopenia on dxa

Question 60

meds increase serum urate levels and may trigger gout

Answer 60

Beta blockers, diuretics, ACE inhibitors

Question 61

Which ONE of the following conditions is NOT often associated with plantar fasciitis?

Answer 61

Osteoarthritis

Question 62

can be used in combination with DMARD therapy for short term relief of signs and symptoms

Answer 62

Low dose oral corticosteroids