MSK random Flashcards
1
Q
A basketball player suffers a severe tear in his Achilles tendon. What will occur at the site of injury?
A
Fibroblast recruitment for tendon repair
2
Q
Where does hematopoiesis predominantly occur?
A
Epiphsis
3
Q
The diaphysis is the central shaft of the bone and primarily contains what and for what?
A
yellow bone marrow, serving as a store for fats
4
Q
What method is responsible for the formation of the skull’s flat bones?
A
Intranetbranous ossification
5
Q
What do Volkmann’s canals connect Haversian canals to?
A
Endostenum
6
Q
What is the shaft of a long bone called?
A
Diaphysis
7
Q
What would an increase in calcitonin lead to?
A
Decrease osteoclast activity
8
Q
Growth of long bones originates in what region?
A
Epiphyseal growth plate
9
Q
While crossing the street, Paul is hit by a car and suffers an injury to his knee. Upon screening by a doctor, it is determined that he has torn his anterior cruciate ligament. What two structures does this ligament connect?
A
Femur bone to tibia bone
10
Q
What connective tissue connects bones to bones?
A
ligaments
11
Q
What connects muscles to bone?
A
tendons
12
Q
Loss-of-function mutation in the gene that produces what would lead to an increase in blood calcium levels?
A
Calcitonin
13
Q
What the cortical bone?
A
periosteum
14
Q
What is bone reabsorbing cells?
A
Osteoclasts
= Break down bone, releasing calcium back into the blood
14
Q
What diseases decrease blood calcium levels?
Parathyroid hormone or calcitonin
A
Calcitonin
15
Q
What is bone forming cells?
A
Osteoblasts
16
Q
Cartilage and synovial fluid decomposition and function deteriorate with age and repeated wear and tear. This describes what?
A
osteoarthritis
17
Q
Synovial fluid proliferation and inflammation. This describes what?
A
RA
18
Q
Deposition of salt crystals eg, uric acid. This describes what?
A
gouty arthritis
19
Q
Where is the infraspinatus located and what is its function?
A
Positioned posteriorly on the superior back
= helps with the external rotation of the shoulder.
19
Q
Where is the subscapularis positioned and what is its function?
A
Positioned anteriorly on the chest
= helps with internal rotation of the shoulder
20
Q
What is the role of the supraspinatus?
A
Located on top of the shoulder
= needed for the first 20° of shoulder abduction
21
Q
What does the teres minor do and where is it located?
A
Located posteriorly on the superior back
= helps with external rotation of the shoulder
22
Q
The process of endochondral ossification is an important means of bone formation
Which term best describes the site at which this process occurs?
A
Metaphysis
23
What are the typical lab values in osteomalacia?
Calcium: Decreased
Phosphate: Decreased
ALP: Increased
PTH: Increased
24
What are the typical lab values in osteoporosis?
Calcium: Normal
Phosphate: Normal
ALP: Normal
PTH: Normal
25
What are the lab values in primary hyperparathyroidism
(leading to osteitis fibrosa cystica)?
Calcium: Increased
Phosphate: Decreased
ALP: Increased
PTH: Increased
26
What are the typical lab values in chronic kidney disease (leading to secondary hyperparathyroidism)?
Calcium: Decreased
Phosphate: Increased
ALP: Increased
PTH: Increased
27
What are the typical lab values in Paget's disease?
Calcium: Normal
Phosphate: Normal
ALP: Increased
PTH: Normal
28
What are the typical lab values in osteopetrosis?
Calcium: Normal
Phosphate: Normal
ALP: Normal
PTH: Normal
29
Which condition is associated with a positive Phalen's sign?
A positive Phalen's sign is associated with carpal tunnel syndrome. This sign is elicited by holding the wrists in full flexion for 60 seconds, which induces numbness or tingling in the fingers
30
What does a positive Froment's sign suggest?
A positive Froment's sign indicates ulnar nerve palsy
= It is tested by asking the patient to grasp a piece of paper between the thumb and index finger. In ulnar nerve palsy, the patient will compensate by flexing the thumb, causing the paper to be pulled out
31
What condition does a positive Finkelstein's sign indicate?
A positive Finkelstein's sign is indicative of De Quervain's tenosynovitis
= It is tested by asking the patient to make a fist with the thumb inside and then deviating the wrist towards the ulnar side. Pain over the radial styloid is considered a positive sign
32
Dactylitis and DIP swelling are characteristic changes of what?
Psoriatic arthritis
33
A 32-year-old man presents to the Emergency Department after sustaining a deep laceration to his right arm from a piece of glass. On examination, there is significant weakness in finger abduction and adduction, as well as sensory loss over the medial aspect of the hand, including the little finger.
He is unable to cross his fingers, and when attempting to flex his wrist, there is a noticeable radial deviation. The patient is also unable to grip objects effectively
What is the most likely location of his injury and the cause?
At the elbow, involving the ulnar nerve
= suggest ulnar nerve palsy
1. Cubital tunnel syndrome
2. Traumatic ulnar nerve injury
3. Ulnar neuropathy
4. medial epicondyle fracture
why?
= (1) Weakness in finger abduction/adduction and inability to cross fingers.
(2) Sensory loss over the little finger and medial hand.
(3) Radial deviation with wrist flexion (due to loss of ulnar flexion)
34
'he has lost the ability to abduct his thumb' suggests what?
Median nerve affected
35
'inability to extend the wrist' suggests what?
Radial nerve affected
36
'weakness of the ring and little fingers' suggests what?
Ulnar nerve affected
37
Lost the ability in - Thumb opposition, flexion, and abduction
What nerve is affected?
median nerve
= mainly via thenar muscles
38
Lost the ability in thumb adduction
What nerve is affected?
ulnar nerve
= adductor pollicis muscle
39
A 52-year-old female presents with weakness and pins and needles in her right hand. On examination, she has wasting of the thenar eminence associated with sensory loss to the palmar aspect of the lateral (radial) three fingers. Which nerve is likely to be affected?
Explain why
Median nerve
= (1) Thenar eminence wasting = median nerve supplies thenar muscles
(2) Sensory loss to the palmar aspect of the lateral three fingers (thumb, index, middle) = classic median nerve distribution
(3) Pins and needles = nerve compression (likely carpal tunnel syndrome)
40
'A 23-year-old man is involved in a fight outside a nightclub and sustains a laceration to his right arm. On examination, he has lost extension of the fingers in his right hand'
What nerve has been affected?
Radial nerve
40
'A 40-year-old lady trips and falls through a glass door and sustains a severe laceration to her left arm. Amongst her injuries, it is noticed that she has lost the ability to adduct the fingers of her left hand'
What nerve has been affected?
Ulnar nerve
41
'A 28-year-old rugby player injures his right humerus and on examination is noted to have a minor sensory deficit overlying the point of deltoid insertion into the humerus'
What nerve has been affected?
Axillary nerve
42
The triceps reflex is mediated by what nerve root?
C7
43
The bicep reflex is mediated by what nerve root?
C6
44
A 42-year-old teacher is admitted with a fall. An x-ray confirms a fracture of the surgical neck of the humerus. Which nerve is at risk?
Axillary
45
'The skin on the palmar aspect of the thumb'
What nerve supplies cutaneous sensation to this region?
Median nerve
46
'The nail bed of the index finger'
What nerve supplies cutaneous sensation to this region?
Median nerve
47
'The skin overlying the medial aspect of the palm'
What nerve supplies cutaneous sensation to this region?
Ulnar nerve
48
C5 role
Shoulder abduction (deltoid)
Elbow flexion (biceps)
49
C6 role
Elbow flexion (biceps)
Wrist extension (extensor carpi radialis longus)
50
C7 role
Elbow extension (triceps)
Wrist flexion (flexor carpi radialis)
Finger extension (extensor digitorum)
51
C8 role
Finger flexion – flexor digitorum profundus & superficialis
Thumb extension – extensor pollicis longus
51
T1 role
Finger abduction/adduction – interossei muscles
52
Heberden’s nodes are where?
DIPS
53
Bouchard’s nodes are where?
PIPS
54
A 17-year-old boy attends A&E with severe pain in his right elbow following a fall from his bicycle. There is swelling and bruising at the elbow. He also
reports the sensation of pins and needles. Plain radiography shows a fracture of the radius and dislocation of the ulna at the distal radioulnar joint
What is the most likely cause of this presentation?
Galeazzi fracture
55
What tissues in the hand does Dupuytren's contracture primarily affect?
palmar fascia
56
The Simmonds test is used for what?
Achilles tendonitis
57
The Hawkins-Kennedy test is used for what?
assess shoulder impingement
58
The Thomas’ test is used to test what?
fixed flexion deformity of the hip
59
The special test used in clinical examinations for plantar fasciitis is called what?
Windlass test
60
What diseases is this seen in?
= HLA-B27
1. Ankylosing spondylitis
2. Psoriatic arthritis
3. Reactive arthritis
4. IBD-associated arthritis
61
What diseases is this seen in?
= HLA-DR4
1. Rheumatoid arthritis
2. Type 1 diabetes (also DR3)
62
What diseases is this seen in?
= HLA-DR5
1. Pernicious anaemia
2. Hashimoto’s thyroiditis
63
What diseases is this seen in?
= HLA-DR3
1. Type 1 diabetes
2. SLE
3. Addison’s disease
4. Graves’ disease
5. Hashimoto’s thyroiditis (also DR5)
64
What diseases is this seen in?
= HLA-DR2
1. Multiple sclerosis
2. Goodpasture’s syndrome
3. SLE
65
What injury results in a positive Trendelenburg sign?
Superior gluteal nerve
66
An 11-year-old boy is playing football in the park when he falls onto his arm and complains of excruciating pain. An X-ray shows a fracture of the distal third of the radial shaft with dislocation of the radio-ulnar joint.
What is the name given to this type of fracture?
Galeazzi
67
There is a weakness in performing Jobe's test in the right arm.
This suggests damage to where?
Suprascapular nerve
68
The drop arm test is positive in what?
rotator cuff tears
69
A 50-year-old woman presents with heel pain that is worse in the morning and improves with activity. The pain is located at the bottom of the heel, and she has tenderness over the medial calcaneal tuberosity. What is the most likely diagnosis?
Plantar fasciitis
70
What is the most likely cause of "trigger finger"?
Infection of the flexor tendon
71
A 65-year-old man with a history of alcohol abuse presents with severe pain in his big toe, especially at night. His serum urate levels are elevated. What is the most likely diagnosis?
GOUT
72
A 25-year-old woman presents with pain in her knee after playing sports. On examination, there is tenderness over the tibial tuberosity, and she has pain with resisted knee extension. What is the most likely diagnosis?
Osgood-Schlatter disease
73
morning stiffness and elevated ESR/CRP suggest what?
RA
74
An 82-year-old woman falls onto her outstretched hands after not seeing a curb. She immediately cradled her right arm and complained of severe pain. An X-ray in the accident and emergency department has revealed a fracture of the distal end of the radius with dorsal displacement
What is the name of this kind of fracture?
Colles fracture
75
A 62-year-old man presents after his wife commented on the unusual shape of his fingers. On examination, he has a hard swelling adjacent to the distal interphalangeal joint of his right hand with lateral deviation of the finger tip. There is no sensory disturbance, and the swelling is not tender
This suggests what?
Heberden's nodes
76
The patient can plantar flex her foot, which means what?
Achilles tendon is intact
77
A 45-year-old woman presents to the GP with a six-month history of pain in her right heel. She describes the pain as sharp and stabbing, particularly noticeable with the first few steps in the morning or after sitting for a prolonged period. The pain improves somewhat with activity but tends to worsen towards the end of the day, especially after long periods of standing
On examination, there is tenderness over the medial aspect of the heel and along the arch of the foot, but the ankle joint is stable and has a full range of motion
What is the most likely diagnosis?
Plantar fasciitis
78
A 67 year old male patient attends the orthopaedic clinic with a recent neck of femur fracture. He complains that he is unable to extend his left leg backwards. On examination, he leans backwards when the heel of the left foot strikes the ground
What muscle is affected?
Gluteus maximus
79
Injury in the ulnar nerve results in what?
Claw hand
80
A 32-year-old patient presents to the ED after a snowboarding accident with dislocation of the left knee. She has a pale foot.
Which artery is compromised?
Popliteal artery
