MSK + Rheumatology Flashcards
(100 cards)
1
Q
Foot Drop
A
Common fibular nerve
2
Q
Tibial nerve medial/lateral and small/large?
A
Tibial nerve MEDIAL + BIG
3
Q
Common fibular nerve medial/lateral and small/large?
A
Common fibular nerve LATERAL + SMALL
4
Q
Mnemonic for cranial nerve function?
A
Some Say Marry Money But My Brother Say Big Brains Matter Most
5
Q
Mixed Connective Tissue Disease
A
SLE + Polymyositis + Systemic Sclerosis
ANTI-RNP +ve
6
Q
Creeping substitution
A
AVN
7
Q
Colles fracture can damage…
A
Extensor pollicis longus + median nerve
8
Q
Simmond’s Test
A
No plantarflexion when squeezing calf= ACHILLES RUPTURE
9
Q
Steroid injections contraindicated in…?
A
Lower limb (risk of tendon rupture)- especially ACHILLES or EXTENSORS OF KNEE
10
Q
Which drug is absolutely contraindicated with Allopurinol?
A
Azathioprine
11
Q
What is a Thomas splint used for?
A
Femoral shaft fracture
12
Q
Which is the slowest growing bone in the body?
A
Tibia (16-52 weeks)
13
Q
Knee pain?
A
ALWAYS EXAMINE HIPS
14
Q
6As of ankylosing spondylitis?
A
Axial arthritis Anterior uveitis Aortic regurgitation Apical fibrosis Amyloidosis Achilles tendonitis
15
Q
What is Brodie’s abscess?
A
Subacute osteomyelitis
16
Q
Rules for pregnancy + methotrexate?
A
Stop 3 months before for men and women + CONTRACEPTIVE
or
Switch to sulphasalazine
17
Q
Direct anterior tibia blow causes what?
A
PCL rupture
18
Q
Name for C1?
A
Atlas
19
Q
Name for C2?
A
Axis
20
Q
Isotonic contraction?
A
Body movement
21
Q
Isometric contraction?
A
Posture + supporting objects in position
22
Q
Open book pelvic fracture associated with what complication?
A
Major haemorrhage
23
Q
Why does hip pathology sometimes present with knee pain?
A
Common supply by obturator nerve
24
Q
Femoral nerve lies medially/laterally to which muscle?
A
Lateral to psoas major
large fries
25
Obturator nerve lies medially/laterally to which muscle?
Medial to psoas major
| medium order
26
Back pain in what age group is a red flag?
<20s
27
Deformities of OA in hands?
```
Heberden nodes (DIPs)
Bouchard nodes (PIPs)
```
28
Components of cartilage?
Water, type 2 collagen + proteoglycans
29
What is 'jumper's knee'?
Patellar tendonitis (self limiting- rest and physio)
30
Name 2 xanthine oxidase inhibitors?
Allopurinol + Febuxostat
31
Lightbulb sign is associated with?
Posterior shoulder dislocation
32
How does a posterior shoulder dislocation typically occur?
Posterior force of adducted and internally rotated arm
33
Treatment of localised SLE?
Hydroxychloroquine + Methotrexate + steroids
34
Treatment of systemic SLE?
Hydroxychloroquine + IV Cyclophosphamide + steroids
35
Treatment of refractory SLE?
Hydroxychloroquine + IV Immunoglobulins + rituximab
36
What is a fracture blister?
Inflammatory exudates rising to epidermis after a fracture
37
What is pyomyositis?
Inflammation of muscle due to infection (mostly staph)
38
Management of simple toe fractures?
Stout boot
39
Popeye sign
Long head of biceps brachii rupture (tendonitis)
40
Claw hand
Ulnar nerve injury
41
Limited systemic sclerosis symptoms
```
CREST
Calcinosis
Raynauld's
Esophageal dysmotility
Sclerodactyly
Telangiectasia
```
42
What is a pseudotumour?
Inflammatory granuloma in response to metal in joint replacement- may locally invade
43
Pure bending force fracture?
Transverse
44
Shearing force (e.g. fall from height, deceleration)
Oblique
45
Characteristic pain of acute disc tear?
Worse on coughing
46
Which joint allows supination/pronation of the forearm?
Radiocapitallar joint
47
Boutonniere deformity
Flexion of PIP, hyperextension of DIP
48
Swan neck deformity
Hyperextension of PIP, flexion of DIP
49
Adhesive capsulitis typically shows what clinical sign?
Restriction of external rotation
50
Most common pulley to be affected in trigger finger?
A1
51
Risk factors for carpal tunnel syndrome?
Female, pregnancy, hypothyroidism, CKD
52
Characteristic leg pain of spinal stenosis?
Calf pain worse when walking downhill
53
At aged 3, children tend to have what knee alignment?
Valgus (10-15 degrees)
54
Klumpke's palsy- paralysis of the intrinsic hand muscles
C8 + T1
55
Erb's palsy- loss of motor innervation of the deltoid, supraspinatus, infraspinatus, biceps and brachilais muscles.
C5 + 6
56
What is Barlow's test?
Dislocatable hip with flexion and posterior displacement
57
What is Ortolani test?
Reducing a dislocated hip with abduction and anterior displacement
58
Where does AVN of the scaphoid commonly occur?
Proximal pole
59
What is a clinical scaphoid fracture and how are they further investigated?
Scaphoid fracture is suspected clinically but the x‐ray fails to demonstrate a fracture
Give wrist splint
Further X rays 2 WEEKS later
60
How are undisplaced scaphoid fractures managed?
Plaster cast 6-12 weeks
61
Which nerve is particularly at risk of injury in humeral shaft fractures?
Radial nerve
62
What is a Galeazzi injury?
Fracture of the radius with dislocation of the distal radio-ulnar joint (DRUJ)
63
What is a Monteggia injury?
Fracture of the ulna with dislocation of the radial head
64
Which type of collagen is found in skin, tendon and bone?
Type 1
65
Which type of collagen is found in cartilage?
Type 2
66
What is myositis ossificans?
heterotopic ossification (bone forming outside the skeleton) occuring in muscles usually after an injury.
67
Which nerve is particularly at risk of injury in surgical neck of humerus fractures?
Axillary nerve
68
Flattened deltoid suggests which nerve is damaged?
Axillary nerve
69
Loss of plantarflexion suggests which nerve is damaged?
Tibial nerve
70
Which nerve is particularly at risk of injury in posterior hip dislocation?
Superior gluteal nerve
71
Which nerve is particularly at risk of injury in anterior hip dislocation?
Obturator nerve
72
Winged scapula suggests which nerve is damaged?
Long thoracic nerve
73
+ve Trendelenburg test suggests what?
Dysfunction of abductors (gluteus medius + minimus) due to superior gluteal nerve damage
74
Loss of pronation + weak wrist flexion
Median nerve damage
75
Are 'chance fractures' stable or unstable?
VERY UNSTABLE- cause lumbar kyphosis
76
What is the function of osteophytes?
Try to increase joint surface area to decrease pressure
77
What is Bennett's fracture?
Fracture of the base of the first metacarpal bone which extends into the carpometacarpal (CMC) joint
78
Shenton line
Identify dislocation of femoral neck
79
Treatment of clubfoot?
Serial Ponsetti casts
80
Paget's Disease pathogenesis
Abnormal osteoclast activity- then increased osteoblast activity.
Cause unknown
81
Symptoms and areas affected by Paget's Disease?
Long bones, pelvis, lumbar spine + skull
Pain, deformity, deafness, nerve compression
82
Diagnosis of Paget's disease?
X ray, isotope bone scan, ALk Phos
83
Treatment of Paget's disease?
Analgesia, Bisphosphonates
84
Name for distal tibial fracture?
Pilon fracture
85
What is a nightstick fracture?
Isolated ulnar fracture
86
Main symptoms of polymyositis?
```
Muscle WEAKNESS (hip + shoulder)
Can involve skin- dermatomyositis
```
87
Main symptoms of polymyalgia rheumatica?
Muscle PAIN (hip + shoulder)
88
Signs of dermatomyositis?
Shawl sign, Helitrope rash
89
Specific DMARD for psoriatic arthritis?
Secukinumab
90
Side effects of methotrexate?
```
Leucopenia, thrombocytopenia
Hepatitis/cirrhosis
Pneumonitis
Rash/ulcers
N+V
```
91
Side effects of hydroxychloroquine?
Skin rash
| RETINOPATHY
92
Side effects of sulphasalazine?
Reduced sperm count
Steven-Johnston syndrome
Hepatitis
93
Caution of infliximab?
TB reactivation
94
RA scoring method?
Disease Activity Score- DAS28
| >5.1= active disease
95
Limited vs diffuse systemic sclerosis?
```
Limited= CREST symptoms
Diffuse= skin on TORSO + FOREARMS
```
96
Temporal arteritis is associated with...?
Polymyalgia Rheumatica
97
What treatment to avoid in enteropathic arthritis?
NSAIDs
98
EGPA association?
LATE ONSET ASTHMA
99
Qualification for biologics?
DAS28 >5.1 + tried 2 DMARDS
100
Soap bubble on X ray?
Giant cell tumour
