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A2 ME3031 MSK > MSK Quizzes > Flashcards

MSK Quizzes Flashcards

1
Q

Pathognomic Sign of Transient (Toxic) Synovitis (paeds)

A
  • fever
  • interestingly wt bearing present
  • pain on affected side
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2
Q

Reduced intra-uterine space is commonly associated with…?

A
  • congenital scoliosis
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3
Q

Which coronal plane angulation is least likely to be physiological?

a. Bilateral genu varus aged 1
b. Bilateral genu valgus aged 5
c. Bilateral genu varus aged 4
d. Bilateral genu valgus aged 7
e. Bilateral genu varus aged 6 weeks

A

C = Bilateral genu varus aged 4

*all babies born with varus legs until ~2
valgus knees from 2-7yo
therefore at 4, varus is abn.

*Salenius’ Curve

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4
Q

Which foot deformity is not associated with TEV?

a. Hallux valgus of the forefoot
b. Cavus of the midfoot
c. Adductus of the midfoot
d. Varus of the hindfoot
e. Equinus of the ankle

A

A = Hallux valgus of the forefoot = Varus is associated.

*
C. avus
A  dductus
V arus
E quinus
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5
Q

Which child with a scoliosis is ultimately, most likely to require spinal, surgical correction?

a. A 12 year old girl with a 30º non-structural scoliosis
b. A 10 year old girl with a 30º ideopathic scoliosis
c. A 12 year old girl with a 30º ideopathic scoliosis
d. A 14 year old girl with a 30º ideopathic scoliosis
e. A 16 year old girl with a 30º ideopathic scoliosis

A

b. A 10 year old girl with a 30º ideopathic scoliosis as greatest risk of progression, idiopathic. Threfore the younger the child = more time to grow (worse) = Sx indicated
* High risk progression: premenarchal, <12yo at presentation, size of curve at prees.

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6
Q

What is the mainstay of tx for Perthe’s Disease (paeds)

A

> Supervised neglect

Maintain hip motion; avoid painful activities
Analgesia

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7
Q

Pathognomic Signs of Perthe’s Disease

A

necrosis of growth cartilage + bone necrosis

XR: not as rounded HoFemur

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8
Q

Pathognomic Signs of XR SUFE

A

Head is. in the acetabulum but slipped capital head epiphysis
Look for Line of Klein.
Teen years

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9
Q

Does Transient Synovitis cause XR changes?

A

No

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10
Q

DDH RFactors

A 
Frist brn
oligohydramnios
breech
fhx
lower limb deformities
females
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11
Q

In a 5 year old girl with a closed, completely displaced, Salter-Harris type 2 fracture of the distal femur that has been optimally treated, which complication is least likely?

a. Overgrowth of the affected limb
b. Premature growth plate arrest
c. Non-union of the fracture
d. Knee stiffness 3 months after injury
e. Coronal angular deformity developing

A

c = non. union

  • dmg. to growth plate will affect growth/disrupted growth/overgrowth/angular deform
  • non-union = almost unknown thus least likely
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12
Q

Other causes of mult #and different stages of healing

A

NAI
or
- congenital/metabolic bone disease altered healing

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13
Q

Are buckle # features. of NAI?

A

no

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14
Q

Signifiance of Ortolani Test

A

+ = hip dislocation associated with DDH and used to test in babies

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15
Q

When performing a newborn baby examination, which findings are not consistent with moulding effects due to reduced intra-uterine space?

a. Metatarsus adductus
b. Congenital scoliosis
c. Plagiocephaly
d. Torticolis
e. Postural talipes equino varus

A

b = congen. scoliosis

*packaging problem (vs manufacturing) affecting vertebral development

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16
Q

Which treatment option is least appropriate in acute tibial osteomyelitis management

a. Commencing high dose IV antibiotics to cover likely organisms
b. Immobilising the affected limb in a splint
c. Encouraging regular weight-bearing exercise on the limb
d. Regular, appropriate analgesia
e. Optimising nutritional state

A

c. Encouraging regular weight-bearing exercise on the limb

17
Q

In a patient with chronic osteomyelitis, which statement is most accurate

a. This could be a life-long condition for them
b. A 2 week course of appropriate antibiotics is likely to cure the problem
c. Skin cancer arising from a dry sinus is very likely
d. Production of an involucrum will prevent pathological fracture
e. A sequestrum can usually be located by using an U/S scan

A

a. This could be a life-long condition for them

18
Q

Which complication of severe, distal femoral acute osteomyelitis in a child is least likely?

a. Arthritis of the hip
b. Angular deformity of the limb
c. Chronic localised osteomyelitis with a sinus
d. Limb length discrepancy
e. Bacterial endocarditis

A

a. Arthritis of the hip

19
Q

What clinical presentation is least likely with TB of the knee joint?

a. Involuntary weight loss over several months
b. Ongoing treatment of HIV
c. No close contact with a person known to have TB
d. Swelling of the knee with restricted movement
e. Knee pain worse on exercise and relieved by rest

A

e. Knee pain worse on exercise and relieved by rest

20
Q

Identify which statement about acute osteomyelitis is incorrect

a. It is more frequently seen in children than adults
b. If diagnosed early, it is usually treated by surgery alone
c. The infection often has spread from a different site (Haematogenous spread)
d. Often it initially presents with localised pain and few clinical signs
e. Staphylococcus aureus is the most frequent causative organism

A

b. If diagnosed early, it is usually treated by surgery alone

21
Q

If the median nerve is completely divided at the elbow and not repaired, which clinical finding is least likely after 3 months ?

a. Wasting of the forearm muscles
b. Increased skin sweating in the distribution of the median nerve in the hand
c. Lack of sensation in the distribution of the median nerve in the hand
d. Reduced power of finger flexion
e. Wasting of the thenar eminence

A

b. Increased skin sweating in the distribution of the median nerve in the hand

22
Q

Which patient who has suffered complete division of the ulnar nerve in the forearm that has been immediately accurately repaired by an expert has the best prognosis?

a. A young child with an injury at the level of the wrist
b. A young child with an injury at the level of the elbow
c. An 80 year old man with an injury at the level of the elbow
d. An 80 year old man with an injury at the level of the wrist
e. A young child with an injury at the level of the wrist requiring nerve grafting

A

a. A young child with an injury at the level of the wrist

23
Q

Which structure unlikely to be found within a peripheral nerve?

a. Endoneurium
b. A Blood vessel
c. An Axon
d. Epineurium
e. Myelin

A

d. Epineurium

24
Q

In ligamentous injury what will not be seen on microscopic examination?

a. Blood clot between the ends of the tendon at an early stage
b. Cellular infiltrate between tendon ends after a few days
c. Production of “scar tissue” between tendon ends after few weeks
d. Re-modelling of collagen structure over several months
e. A normal ligament after a few years

A

e. A normal ligament after a few years

25
Q

Which factor contributes least to joint instability after ligamentous injury?

a. The congruence of the joint
b. Impaired proprioception
c. Loss of muscle strength
d. Rest, ice, compression and elevation initially after injury
e. The severity of the primary injury

A

d. Rest, ice, compression and elevation initially after injury

26
Q

Which of the following statements is NOT true of Psoriatic arthritis

a. It is a sero negative arthritis
b. The Metacarpo phalangeal joints are typically involved
c. The severity of joint disease does not correlate to extent of skin disease
d. Nail pitting is often seen
e. May be treated with Sulfasalazine

A

b. The Metacarpo phalangeal joints are typically involved

27
Q

general systemic consequences of Rheumatoid arthritis

A

Cardiovascular disease

Fatigue and reduced cognitive function

Anaemia

Interstitial lung disease

Osteoporosis

28
Q

Distribution of different types of Juvenile Idiopathic Arthritis

A

Pauci articular

Polyarticular

Systemic

29
Q

Systemic onset Juvenile onset arthritis associated with

A

*a

  • Hepatosplenomegaly
  • Is associated with a temperature rise up to 39.5
30
Q

Which feature is most common with an osetoid osteoma?

a. Pain made worse during exercise
b. A strong family history of similar problems
c. Relief of symptoms after administration of Ibuprofen
d. A normal MRI scan of the affected area
e. Continued long-term symptoms after resection

A

c. Relief of symptoms after administration of Ibuprofen

31
Q

Which of the following statements is untrue when considering a ganglion in the hand. A ganglion

a. is usually firm and non-tender
b. may change in size
c. is occasionally lobulated
d. is usually fixed to the overlying skin
e. edges are usually smooth

A

d. is usually fixed to the overlying skin

32
Q

Which characteristic is not typical of a benign bone tumour?

a. The lesion is well circumscribed on x-ray
b. A fractures occurring through the lesion after minimal trauma
c. An aggressive periosteal reaction around the lesion without a trauma history
d. A sclerotic margin between the lesion and surrounding bone
e. No evidence of surrounding tissue infiltration on MRI scanning

A

c. An aggressive periosteal reaction around the lesion without a trauma history

33
Q

Which patient with a known primary malignancy is least likely to develop bone metastasis? Related to the original pathology?

a. An 80 year old man with known prostate cancer on no treatment
b. A 45 year old lady with a large breast tumour and axillary lymph node involvement
c. A 60 year old man 1 year after resection of a renal tumour with local spread
d. A 70 year old man with a treated, superficial bladder transitional cell tumour
e. A 50 year old smoker receiving palliative radiotherapy for lung cancer

A

d. A 70 year old man with a treated, superficial bladder transitional cell tumour

34
Q

Which metastatic bone tumour is most likely to require prophylactic surgical stabilisation?

a. A lytic, painful lesion of the trochanteric hip region involving the whole bone width
b. A painless, sclerotic (blastic) lesion on one rib occupying > 2/3 of the bone width
c. A painful sclerotic (blastic) humeral lesion occupying < 1/3 of the bone width
d. A painful, lytic lesion of the iliac blade about 2cm diameter
e. A lytic, painless lesion of the midshaft tibia occupying <1/3 of the bone width

A

a. A lytic, painful lesion of the trochanteric hip region involving the whole bone width

A2 ME3031 MSK (20 decks)

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