MSK- wrong answers

Question 1

first line management for carpal tunnel syndrome

Answer 1

conservative-
wrist splint
corticosteroid injections

Question 2

clinical signs on examination for ankylosing spondylitis

Answer 2

reduced lateral flexion of lumbar spine
reduced forward flexion- schobers test
reduced chest expansion

Question 3

what is the initial investigation for achilles tendonitis

Answer 3

ankle USS

Question 4

what can be used to manage acute flares of rheumatoid arthritis

Answer 4

oral or intramuscular steroids such as methylprednisolone

Question 5

medical management of osteoarthritis

Answer 5

1st line- topical NSAID
2nd line- oral NSAIDA with PPI

Question 6

management of achilles tendonitis

Answer 6

rest, NSAIDs, analgesia

Question 7

when are patients with achilles tendonitis given physiotherapy

Answer 7

if symptoms persist longer than 7 days

Question 8

first line management of ankylosing spondylitis

Answer 8

NSAID with PPI

Question 9

first line management of obvious ankle injuries if neurovascular compromise is present

Answer 9

immediate reduction / stabilisation instead of XRAY

Question 10

Pain on the radial side of the wrist/tenderness over the radial styloid process ?

Answer 10

de quervains tenosynovitis

Question 11

which clinical test is used to diagnose de quervains tenosynovitis

Answer 11

finkelsteins test

Question 12

which type of back pain is a red flag

Answer 12

thoracic back pain

Question 13

what is the most appropriate investigation for ankylosing spondylitis

Answer 13

pelvic XRAY- to identify sacro-iliitis

Question 14

what bone protection should be provided for long term steroid use

Answer 14

alendronic acid
calcium/vitamin D

Question 15

medical management of psoriatic arthritis

Answer 15

1. NSAIDs
2. csDMARDs
3. anti-TNF

Question 16

what is the most common mechanism of an ankle sprain

Answer 16

inversion of the foot

Question 17

what is the most common mechanism of a 5th metatarsal fracture

Answer 17

inversion of foot and ankle

Question 18

medical management of gout

Answer 18

1. NSAIDs
2. colchicine
3. steroids

Question 19

Bone pain, tenderness and proximal myopathy (→ waddling gait) → ?

Answer 19

osteomalacia

Question 20

bone profile blood test results in osteomalacia

Answer 20

high ALP
low calcium
low phosphate

Question 21

which antibiotics should not be taken with methotrexate due to risk of severe bone marrow depression

Answer 21

trimethoprim
co-trimoxazole

Question 22

which nerve root compression would cause sensory loss over anterior thigh

Answer 22

L3

Question 23

which nerve root compression would cause sensory loss over anterior aspect on knee

Answer 23

L4

Question 24

which nerve root compression would cause sensory loss over dorsum of foot

Answer 24

L5

Question 25

which nerve root compression would cause sensory loss over the posterolateral aspect of leg and lateral aspect of foot

Answer 25

S1

Question 26

typical features of prolapsed disc

Answer 26

leg pain worse than back pain often worse when sitting

Question 27

methotrexate can cause what lung disease

Answer 27

pulmonary fibrosis pneumonitis

Question 28

medical management of osteomalacia

Answer 28

vitamin d therapy calcium and phosphate supplementation

Question 29

Excessive use of breakthrough analgesia should raise suspicion for what?

Answer 29

compartment syndrome

Question 30

ankylosing spondylitis XRAY findings

Answer 30

subchondral erosions sclerosis and squaring of lumbar vertebrae

Question 31

lateral epicondylitis (tennis elbow) is worse on wrist extension/flexion

Answer 31

extension

Question 32

what organism is neisseria gonnorhea

Answer 32

gram negative diplococci

Question 33

which pathology does a positive straight leg raise suggest

Answer 33

sciatic nerve pain

Question 34

As a guide, a QFracture score ≥ ? means a DEXA scan should be arranged

Answer 34

>/=10%

Question 35

blood test results for osteoporosis

Answer 35

normal ALP normal calcium normal phosphate normal PTH NORMAL

Question 36

polymyositis causes muscle weakness/muscle aches?

Answer 36

muscle weakness

Question 37

polymalgia rheumatica causes muscle weakness/muscle aches?

Answer 37

muscle aches- strength normal

Question 38

dinner fork deformity associated with what fracture

Answer 38

colles fracture

Question 39

what long-term medication should be offered to patients with their first attack of gout

Answer 39

allopurinol

Question 40

which drug has been associated with an increased risk of atypical stress fractures of the proximal femoral shaft?

Answer 40

bisphosphonates

Question 41

How long should the symptoms be present for before a diagnosis of chronic fatigue can be made?

Answer 41

3 months at least

Question 42

lateral epicondylitis causes pain worse on supination/pronation?

Answer 42

supination

Question 43

when is spinal stenosis often relieved

Answer 43

by sitting down or leaning forward

Question 44

How many different NSAID drugs must a patient with ankylosing spondylitis must have failed to respond to before he can be started on anti-TNF alpha inhibitors, in someone with predominantly axial disease?

Answer 44

2

Question 45

What investigation is required prior to starting this biologic- anti-TNF

Answer 45

chest XRAY- tb

Question 46

De Quervain's tenosynovitis: inflammation of the sheath containing which muscles of the hand

Answer 46

abductor policuss longus extensor policus brevis tendons

Question 47

management of ankle fractures webers A class

Answer 47

remain weight bearing as tolerated in a CAM boot for 6 weeks

Question 48

management of ankle fractures webers C class

Answer 48

open reduction and internal fixation

Question 49

what might you see in chest x-ray in later ankylosing spondylitis

Answer 49

apical fibrosis

Question 50

a Z score below what is abnormal

Question 51

risk factors for osteoporosis

Answer 51

post-menopause low BMI chronic kidney disease lifestyle- smoking, alcohol, lack of exercise, poor diet reduced sunlight exposure (vitamin d) drugs- breast cancer, corticosteroids

Question 52

what may be used to monitor flares of SLE

Answer 52

complement levels- often low during active disease (C3 and C4)

Question 53

In children, where is the most common site where osteomyelitis occurs in a long bone

Answer 53

metaphysis

Question 54

what is a normal T score

Answer 54

>/=-1

Question 55

what is the most common site for metatarsal stress fractures

Answer 55

2nd metatarsal shaft