MSK emergencies :)

Question 1

what is osteoporosis?

Answer 1

weakening of bones - making them more likely to break

Question 2

what is the first sign of osteoporosis

Answer 2

stooped back

Question 3

how long does it take to develop osteoporosis

Answer 3

slowly over several years

Question 4

what causes osteoporosis

Answer 4

reduced bone density

Question 5

who has an increased risk of osteoporosis?

Answer 5

women - after menopause

Question 6

what is the relationship of oestrogen and bones?

Answer 6

oestrogen slows bone loss => improving the bodies absorption and retention of calcium

Question 7

what are corticosteroids?

Answer 7

anti-inflammatory steroids

Question 8

what scanning technique can look at bone density?

Answer 8

DEXA scanning

Question 9

how does DEXA scanning work?

Answer 9

sends X-rays which get absorbed by bones => then compared to healthy adult

Question 10

what does a score of >-1 in DEXA scanning mean

Answer 10

normal

Question 11

what does a score of -1 => -2.5 in DEXA scanning mean

Answer 11

osteomalacia

Question 12

what does a score of <-2.5 in DEXA scanning mean

Answer 12

osteoporosis

Question 13

more -ve DEXA score =

Answer 13

reduced bone density

Question 14

what is the treatment strategy for Osteoporosis

Answer 14

medications increase bone density OR slows bone density thinning

Question 15

what is osteomalacia?

Answer 15

the inadequate mineralisation of bone => causing bone softening

Question 16

what causes osteomalacia?

Answer 16

insufficient calcium absorption or dietary intake of vitamin D

Question 17

link between osteomalacia and kidney disorder

Answer 17

kidney failure => body needs to work harder to remove phosphorus => more phosphorus = less calcium

Question 18

what deficiency is often seen with osteomalacia?

Answer 18

phosphate deficiency

Question 19

what is renal tubular acidosis

Answer 19

when the kidneys do not remove acids from the blood into the urine as they should.

Question 20

what is the diagnosis of osteomalacia?

Answer 20

low Vitamin D concentration

Question 21

feature of osteomalacia on X-ray

Answer 21

pseudo fractures and protrusion acetabula

Question 22

what is a pseudo fracture?

Answer 22

formation of new bone with thickening of periosteum at site of an injury to bone

Question 23

how treatment for osteomalacia works

Answer 23

increase vitamin D concentration

Question 24

define optimal management

Question 25

define evidence based medicine

Question 26

what are the 3 categorical causes of the limping child?

Answer 26

inflammation, infection and trauma

Question 27

what is transient synovitis?

Answer 27

inflammation in the hip joint that causes pain, limp and sometimes refusal to bear weight.

Question 28

what is osteomyelitis

Answer 28

bone infection caused by bacteria

Question 29

what is perthes disease?

Answer 29

a childhood condition that occurs when blood supply to the ball part (femoral head) of the hip joint is temporarily interrupted and the bone begins to die.

Question 30

what is a shared common cause of hip pain between under 4s -16 yr olds

Answer 30

osteomyelitis

Question 31

what fractures are a common cause of hip pains in 10-16 year olds

Answer 31

avulsion fractures

Question 32

what are avulsion fractures

Answer 32

occurs when a small chunk of bone attached to a tendon or ligament gets pulled away from the main part of the bone.

Question 33

what is an slipped femoral epiphysis?

Answer 33

a disorder of adolescents in which the growth plate is damaged and the femoral head moves (“slips”) with respect to the rest of the femur

Question 34

what age group is transient synovitis a common cause of hip pain

Answer 34

0-10 years

Question 35

what age group is slipped femoral epiphysis and avulsion fractures common

Answer 35

10-16 yrs

Question 36

what tests do we do for limping child? - 3

Answer 36

1 - bloods 2 - X-Ray 3 - MRI

Question 37

What are the two inflammatory markers which are commonly tested for in blood?

Answer 37

C Reactive Protein ESR - Erythrocyte sedimentation Rate

Question 38

what is the Kocher Criteria for Septic Arthritis - 4

Answer 38

Must be non-weight bearing Fever High ESR High White Blood Cell Count

Question 39

state the treatment of septic arthritis - 2

Answer 39

drainage => culture pus sample and analyse IV antibiotics

Question 40

What are the cardinal signs of inflammation? - 5

Answer 40

rubor = redness tumor = swelling calor = hot dalor = pain funcio laesa = loss of function

Question 41

how can you tell the joint fluid is infected?

Answer 41

cloudy with increased viscousity

Question 42

how can infection be reflected in blood tests?

Answer 42

white cell count, ESR and C-Reactive protein will be high

Question 43

spread of bacteria to bone

Answer 43

blood and inoculation

Question 44

what is inoculation

Answer 44

implanting a pathogen or other microbe or virus into a person or other organism

Question 45

treatment stages of infected joint - 3

Answer 45

1. aspirate 2. antibiotics 3. if infection confirmed = wash out

Question 46

what method is used to wash out infection?

Answer 46

keyhole arthrscopy