MSK Passmed

Question 1

What is the main blood supply to scaphoid ?

Answer 1

Dorsal carpal branch of the radial artery

can be compromised when scaphoid is FRACTURED = AVN

Question 2

How is scaphoid bone fractured ?

Answer 2

Wrist fracture due to fall onto outstretched hand (FOOSH).

Question 3

Presentation of scaphoid fracture ?

Answer 3

Pain along the radial aspect of the wrist, at the base of the thumb.
Loss of grip / pinch.
Tenderness over the anatomical snuffbox.
May or may NOT present with joint effusion.

Question 4

Management of scaphoid fracture ?

Answer 4

Futuro splint or standard below-elbow backslab

Question 5

What is osteomyelitis ?

Answer 5

Is inflammation of the bone / bone marrow due to infection.

Can be either contagious / Hematogenous

Question 6

Examples of contagious OM ?

Answer 6

From adjacent soft tissues to the bone or from direct injury/trauma to bone.

Common in
Young: injury
Elderly: pressure sore, vascular insuff
DM: soft tissue infection

Question 7

Risk factors for Contagious include:

Answer 7

Diabetic foot ulcers / pressure sores, diabetes mellitus, peripheral arterial disease.

Question 8

Examples of Hematogenous OM ?

Answer 8

Due to dental procedures, IV drugs, haemodialysis

Common in
In children: long bones
Adults: vertebrae osteomyelitis

Question 9

Risk factors for Hematogenous include:

Answer 9

Sickle cell anaemia, intravenous drug user, immunosuppression due to either medication or HIV, infective endocarditis

Question 10

OM: s. aureus ?

Answer 10

common in 
children / adults 
prosthetic 
IV drug 
vertebral lesions

Question 11

OM: s. epidermis ?

Answer 11

Common in
Diabetics
Prosthetics

Question 12

OM: strep ?

Answer 12

Diabetics

Neonates + infants

Question 13

OM: salmonella ?

Answer 13

sickle cell anemia

Question 14

OM: klebsiella ?

Answer 14

UTI

Question 15

What to test for to rule out SLE ?

Answer 15

Over 99% of patients with SLE are ANA +VE 
Complement level (C3 – 4) are LOW. 

ANCA most likely assoc. with vasculitis

Question 16

what is Raynaoud’s phenomenon ?

Answer 16

Exaggerated vasocontraction response to cold / stress.
Reduces the blood supply to the finger’s, causing the white colour change.

Common in young women.

Question 17

What is Osteopetrosis :

Answer 17

Aka MARBLE BONE disease.

Rare disorder of defective osteoclasts function resulting in failure of normal bone resorption.

Question 18

What is Carpal tunnel syndrome ?

Answer 18

Can cause weakness to the areas above the wrist due to the compression of the median nerve.

Question 19

Presentation of Carpal tunnel syndrome ?

Answer 19

pain/pins + needles in thumb, index, middle finger
unusually the symptoms may ‘ascend’ proximally
patient shakes his hand to obtain relief, classically at night

Question 20

wWhat is Tinel’s sign ?

Answer 20

Tapping causes paraesthesia

Question 21

What is Phalen’s sign ?

Answer 21

Flexion of wrist causes symptoms

Question 22

Treatment of CTS ?

Answer 22

Corticosteroid injection
Wrist splints at night
surgical Decompression (flexor retinaculum division)

Question 23

What is Fibromyalgia ?

Answer 23

Pain all over the body.
Causes tiredness + sleep disturbance + tenderness in some area.
PMR = present with wt loss + fever.

Question 24

What are the assoc. with GOUT ?

Answer 24

Lesch-Nyhan syndrome - Inherited enzyme deficiency also known as juvenile gout.

Question 25

What assoc. with Pseudogout ?

Answer 25

Hyperparathyroidism - deposition of calcium pyrophosphate dihydrate crystals in the synovium Aspiration: weakly-positively birefringent rhomboid-shaped crystals.

Question 26

Who is more likely to get HIP fractures ?

Answer 26

Very common in elderly people = esp. osteoporotic females

Question 27

Signs of HIP Fractures ?

Answer 27

the classic signs are a shortened + externally rotated leg. Patients with non-displaced / incomplete neck of femur fractures may be able to weight bear.

Question 28

SE of Denosumab ?

Answer 28

RANKL antagonist and inhibits the formation, function and survival of osteoclasts.

Question 29

SE of Bisphosphonate ?

Answer 29

Associated with osteonecrosis of the jaw

Question 30

system used to classify growth plate injury in children ?

Answer 30

Salter - harris system

Question 31

What is complete fracture ?

Answer 31

both sides of cortex are breached

Question 32

Toddlers fracture ?

Answer 32

Oblique tibial fracture in infants

Question 33

Plastic deformity ?

Answer 33

Stress on bone resulting in deformity without cortical disruption

Question 34

Greenstick fracture ?

Answer 34

Unilateral cortical breach only

Question 35

Buckle fracture ?

Answer 35

Incomplete cortical disruption resulting in periosteal haematoma only

Question 36

Boxer fracture is associated with which fracture ?

Answer 36

5th metacarpal fracture = common after punching a hard surface

Question 37

Chondromalacia Patellae

Answer 37

Softening of cartilage of patella. Common in teens Anterior knee pain on waling up + down.

Question 38

Osgood-schlatter Disease (tibial apophysitis)

Answer 38

Seen in sporty teens | pain, tenderness + swelling over the tibial tubercle

Question 39

Osteochondritis Dissecans

Answer 39

Pain after exercise | Intermittent swelling + locking

Question 40

Patellar Subluxation

Answer 40

Medial knee pain = lateral subluxation of patella

Question 41

Patellar Tendonitis

Answer 41

More common n athletic teenage boys. Chronic anterior knee pain worsens after running. Tender below patella.