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Passmed Knowledge Flashcards

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1
Q

What antibiotic is absolutely contraindicated with methotrextate

A

Trimethoprim

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2
Q

What is simmonds triad and what i it used for

A
  1. Calf Squeeze test
  2. Angle of declination at rest.
  3. palpation

used for achilles tendon rupture

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3
Q

Criteria for XR for ankle fracture

A

Pain in malleolar zone PLUS

  • Inability to walk more than 4 steps
  • Tenderness/Bony tenderness over the distal fibula
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4
Q

Weber classification

A

A: Below the syndesmosis
B: Level of tibial plafond but can radiate to include it
C: Above the syndesmosis

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5
Q

What are the 6 A’s of Ankylosing Spondylitis

A 
Apical fibrosis
Anterior uveitis
Aortic regurgitation
Achilles tendonitis
AV node block
Amyloidosis
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6
Q

What is CREST syndrome? Name the parts of it.

A

Subtype of limited systemic sclerosis

Calcinosis
Raynauds
Oesophogeal Dysmotility
Sclerodactyly
Telangiectasia
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7
Q

What is a Charcot Joint?

What demographic commonly seen in?

A

Damaged joint due to loss of sensation.

Diabetics

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8
Q

Initial management of Osteoporosis with Bisphossphonates doesnt work. What next?

A

Try another bisphosphonate

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9
Q

What MSK condition can ciprofloxacin cause?

A

Achilles Tendonitis

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10
Q

Squaring of the thumbs?

A

Osteoarthritis

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11
Q

What nerve is most likely to be damaged following THR

A

Sciatic

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12
Q

+ve straight leg test indicates damage to which nerve

A

Sciatic

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13
Q

Next Step in management after Physio + NSAIDS in ANK SPOND

how many different NSAIDS have to be prescribed before moving down?

A

Biological Therapy (Anti-TNF)

2

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14
Q

Stepwise Management of Reactive Arthritis?

A 
NSAIDS
Intra-articular injections (If one large joint involved)
Oral Pred (For multi joint)
DMARD
Biologic Therapy ANti TNF
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15
Q

What is used in monitoring of disease activity in SLE

A

Complement (LOW)

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16
Q

What DMARD is safe for use in pregnancy?

A

Azathioprine and Hydroxycholoroquine

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17
Q

HLA B27 is +ve in what?

A

Enteropathic Arthritis

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18
Q

Findings in XR for ANK SPOND (3)

A

Sclerosis
Subchondral Erosions
Squaring of vertebral body

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19
Q

What Drugs causes drug induced lupus and what is the atibody for it

A

Isoniazide/Procainamide/Hydralazine/Phenytoin

Anti-Histone

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20
Q

Renal complications of Systemic Sclerosis and management

A

Hypertension and AKI

ACEI’s

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21
Q

What are syndesmophytes and what are they found in?

A

Thickening of the outer annulus fibrosus

ANK SPOND

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22
Q

Three main side effects of bisphosphonates

A

Oesophageal Issues
Osteonecrosis of the Jaw
Stress Fractures

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23
Q

Investigation for cauda equina?

A

MRI

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24
Q

What part of a long bone is most affected in children with osteomyelitis?

A

Metaphysis

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25
Features of Lupus
MD SOAP BRAIN - Malar Rash - Discoid Rash - Serositis (Pericarditis/Pleuritis) - Oral ulcers - Arthritis - Photosensitivity - Blood disturbance (i.e. anaemia of chronic disease/thrombocytopaenia) - Renal - ANA+ - Immunological investigations (dsDNA-ABs/cadiolipin-ABs) - Neurological (seizures)
26
What drug used for Gout can cause diorrhoea
Colchicine
27
initial management of open fractures
IV AB's Photograph wound sterile gauze
28
suspicious bone pain in children initial inestigation
XR
29
What can azathioprine not be given with and why?
Allopurinol Bone Marrow Suppression
30
What is +ve in UC
pANCA
31
What Neurovasvular structure is most at risk in a scaphoid fracture?
Dorsal Carpal Arch of the Radial Artery
32
Occult Hip Fracture Investigation?
CT
33
Initial mamagenent of suspected scaphoid fracture before specialist review
Futuro splint
34
1st Line Ix in compartment syndrome
Compartment pressure monitoring
35
What blood test would contraindicate azathioprine and why
TPMT | metabolises the drug, deficiency = toxicity
36
test for hypermobility and scores to confirm +ve
Beighton Score 5/9 in adults 6/9 children
37
Management of Grade 1-2 ACj injury?
Sling and Rest
38
Management of Grade 3-6 ACL injury
Surgical Intervention
39
malignancy and raised CK?
Polymyositis
40
Causes of Dupuytrens Contracture (5)
``` manual labour phenytoin treatment alcoholic liver disease diabetes mellitus trauma to the hand ```
41
Most common malginant primary bone tumour in children Typpical appearance on XR
Osteosarcoma Codmans triangle with sunburst appearancw
42
Risk Factors for Congenital Hip Dislocation (5)
``` Female gender Breech presentation Family history Firstborn Oligohydramnios ```
43
cANCA +ve? Vasculitis
GPA
44
pANCA +ve? Vasculitis
EGPA (churg strauss) Microscopic PA Goodpastures
45
Marked Claw?
Ulnar nerve damage at the wrist
46
Clawing that gets worse before getting better?
Ulnar nerve damage at the elbow
47
1st line for OA
Paracetamol and TOPICAL nsaids
48
Where can you find Heberdens and Bouchards Nodes?
Heberdens: DIP Joints Bouchards: PIP Joints
49
Sulfasalazine cannot be given with what kind of antibiotics
Sulfa's (Co-trimxazole)
50
Flare up of rheumatoid?
IM Methylpredinsolone
51
Are chemo patients more likely to get gout or pesudogout
Gout
52
Ix of choice in Mortons Neuroma
US
53
Signs and Investigations for Dequervains Tenosynovitis
Pain on radial side of wrist Tenderness over radial styloid Painful abduction of thumb against resistance Finkelsteins Test: Fist with thumb inside and move wrist down (should be painful)
54
Management of Dequervains Tenosynovitis
Analgesia and Steroid Injection
55
Signs of Iliotibial Band Syndrome and Management
Pain in runners above lateral joint line Modify activity and iliotibila band stretches/Physio
56
Chondromalacia Patellae Signs and Management
Pain on walking up and down stairs in teenage girls Physiotherapy
57
Osgood-Schlatter Disease Key sign and management
Pain/Swelling over tibial tubercle Physiotherapy
58
Septic Arthritis: Most common organism Most common in sexually active young adults
Staph A Neisseria Gonorrhoeae
59
Intramedullar Nail used for?
Femoral Shaft Frac | Reverse oblique or transverse NOF frac
60
Dynamic Hip Screw?
Extracapsular NOF Frac
61
Management of: Intracapsular NOF # Intracapsular with bad premorbid status Undisplaced Intracapsular
Total Hip Replacement Hemiarthroplasty Internal Fixation
62
Polyarteritis Nodosa is associated with what?
Hep B
63
Symptoms and Signs of Still's Disease (4)
Salmon Pink Rash Raised Ferritin Dinnertime Fever Arthralgia
64
Management of Stills Disease
NSAIDS for a week, then steroids if no help Resistant: DMARDS
65
Mx of septic arthritis
IV fluclox | IV clindamycin if allergic
66
Name 5 drugs that can induce lupus
``` Procainamide Hydralazine Isoniazide Minocycline Phenytoin ```
67
Sjogrens increases risk of what kind of malignancy
Lymphoma
68
Fertility problems with sulfasazlazine?
Reduced Sperm Count
69
Cutaneous manifestation of methotrexate?
Ulcers
70
Most common cause of septic arthritis in sexually active young adults
Neissieriah gonnorhoea
71
Pagets treatment
IV bisphosphonates
72
Essential test for osteroporosis in a young man?
testosterone
73
How is radial head subluxation managed
Passive supination of the elbow flexed at 90 degrees
74
Hill sachs lesions are associated with what?
Anterior shoulder dislocation

MSK/RHEUM FINALS (6 decks)

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