Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 2 - Musculoskeletal (DP) > Passmedicine Questions > Flashcards

Passmedicine Questions Flashcards

1
Q

Approximately what percentage of patients with psoriasis develop an associated arthropathy?

A

10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

A 21-year-old female presents with chronic left knee pain. The pain is typically felt after jogging. There is also intermittent swelling and locking of the same joint. What is the most likely diagnosis?

A

Osteochondritis dissecans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

A 58-year-old presents with a painful swollen left knee which has failed to settle after a weeks rest. There is no history of trauma. On examination he has a moderate sized effusion. A plain radiograph is reported as follows:

  • Some loss of joint space
  • Linear calcification of articular cartilage
A

Pseudogout

This x-ray describes chondrocalcinosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

A 52-year-old woman develops pain shooting down the posterior aspect of the left leg. On examination she has reduced sensation on the lateral aspect of the left foot and weakness of left foot plantar flexion. Which nerve root is compressed?

A

S1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

A 31-year-old man with sudden onset back pain radiating to the anterior aspect of his right knee. Examination reveals an absent knee jerk with reduced sensation over the patella and the medial aspect of his calf. The quadriceps are also noted to be weak on the affected side. Which nerve root is compressed?

A

L4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

A 44-year-old man complains of pain radiating from his left hip to foot for the past week. On examination all reflexes are intact and the only positive finding is weak dorsiflexion of the left big toe. Which nerve root is compressed?

A

L5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

A 33-year-old woman presents with back pain which radiates down her right leg. This came on suddenly when she was bending down to pick up her child. On examination straight leg raising is limited to 30 degrees on the right hand side due to shooting pains down her leg. Sensation is reduced on the dorsum of the right foot, particularly around the big toe and foot dorsiflexion is also weak. The ankle and knee reflexes appear intact. A diagnosis of disc prolapse is suspected. Which nerve root is most likely to be affected?

A

L5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which of the following drugs is most likely to precipitate gout:

  • Furosemide
  • Low dose aspirin
  • Metformin
  • Finasteride
  • Ciprofloxacin
A

Furosemide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Step up treatment to manage OA pain

A

1st line - Paracetamol
2nd line - Paracetamol + Topical NSAID
3rd line - Paracetamol + Oral NSAID + PPI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

A newborn baby is noted to have bilateral clubfoot. What is the treatment of choice?

A

Manipulation and progressive casting starting soon after birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Hip replacement surgery should not be offered to patients with a BMI > 28 kg/m^2…true or false?

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which of the following is the most appropriate management of a ganglion:

  • Check rheumatoid factor and refer to rheumatology
  • Check full blood count
  • Reassurance and review if not settling
  • Inject with sclerosing agent
  • Arrange ultrasound
A

Reassurance and review if not settling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

A 24-year-old man is brought to the emergency department have suffered a crush injury to his forearm. Assessment demonstrates that the arm is tender, red and swollen. There is clinical evidence of an ulnar fracture and the patient cannot move their fingers. Which is the most appropriate course of action?

A

Fasciotomy

Compartment syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When is allopurinol started in gout?

A 
If >= 2 attacks in 12 month period
Or risk factors:
     - Tophi
     - Renal disease
     - Uric acid renal stones
     - Prophylaxis if on cytotoxics or diuretics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

A 71-year-old woman is diagnosed with polymyalgia rheumatica. She is started on prednisolone 15mg od. What is the most appropriate approach to bone protection?

A

Start oral alendronate + ensure calcium and vitamin D replete (Since age > 65)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

A 57-year-old man is diagnosed with polymyalgia rheumatica. She is started on prednisolone 15mg od. What is the most appropriate approach to bone protection?

A

Arrange a DEXA scan (Since age

17
Q

A 47-year-old female presents as she is concerned about elbow pain. She has just spent the weekend painting the house. On examination there is localised pain around the lateral epicondyle and a diagnosis of lateral epicondylitis is suspected. Which movement would characteristically worsen the pain?

A

Resisted wrist extension with the elbow extended

18
Q

A 73-year-old man presents pain in his right thigh. This has been getting progressively worse for the past 9 months despite being otherwise well. An x-ray is reported as follows: Radiolucency of subarticular region suggestive of osteolysis. Some areas of patchy sclerosis. Blood tests as follows:

  • Calcium 2.38 mmol/l
  • Phosphate 0.85 mmol/l
  • Alkaline phosphatase 544 u/L
  • Prostate specific antigen 4.4 ng/ml
A 
Paget's disease
Note the following:
     - Older male
     - Bone pain
     - Raised ALP
     - Normal Calcium and Phosphate
19
Q

What are indications for treatment of Paget’s disease?

A

Bone pain
Long bone/Skull deformity
Fracture
Periarticular Paget’s

20
Q

How do we treat Paget’s disease?

A

Bisphosphonate:
- PO risedronate
- IV zoledronate
Salmon calcitonin

21
Q

You review a middle-aged man with shoulder pain. He has limited movement of the right shoulder in all directions. Which clinical finding is most consistent with a diagnosis of frozen shoulder (adhesive capsulitis)?

A

Active and passive movement limited + external rotation most affected

22
Q

A 36-year-old man presents with progressive lower back pain for the past six months. The pain is worse in the mornings and tends to ease with exercise and the passage of the day. He has tried paracetamol but this does not fully controlled his pain. An x-ray of his spine is shows syndesmophytes and vertebral body squaring. What is the diagnosis and first line treatment?

A

Ankylosing spondylitis

NSAIDs

23
Q

Which of the following is not a feature of ankylosing spondylitis:

 - Reduced lateral flexion of the lumbar spine
 - Loss of lumbar lordosis
 - Pain on straight leg raise
 - Accentuated thoracic kyphosis
A

Pain on straight leg raise

24
Q

A 25-year-old man presents with a painful, swollen left knee. He returned 4 weeks ago from a holiday in Spain. There is no history of trauma and he has had no knee problems previously. On examination he has a swollen, warm left knee with a full range of movement. His ankle joints are also painful to move but there is no swelling. On the soles of both feet you notice a waxy yellow rash. What is the most likely diagnosis?

A

Reactive arthritis

25
Q

Which of the following statements regarding clubfoot is true:

  • The majority of cases are idiopathic
  • It is most commonly diagnosed at the six-week check
  • It is bilateral in 80-90% of cases
  • The incidence is 5 per 1,000 live births
  • X-rays should be performed to confirm the diagnosis
A

Most are idiopathic:

 - Diagnosed at birth
 - 50% bilateral
 - 1 per 1,000 live births
 - Clinical diagnosis
26
Q

What drug used in RA treatment can cause bronchospasm in an asthmatic?

A

Diclofenac

27
Q

A woman in her third trimester of pregnancy presents with severe pain in her right groin. She has a very limited range of movement and has difficulty weight bearing. Inflammatory markers are elevated

A

Transient idiopathic osteoporosis

28
Q

A 43-year-old woman complains of right hip pain. During the examination the patient lies on her left side and the right hip is extended with a straight leg. Flexing the knee then recreates the pain (femoral nerve stretch test positive)

A

Referred lumbar spine pain

29
Q

TB in a vertebral body

A

Pott’s disease

30
Q

What is Paget’s?

A

Excessive osteoclastic resorption followed by increased osteoblastic activity

31
Q

A boy presents with arm problems after falling from a tree, during which he caught a branch to save himself. On examination he has a claw hand with a hyperextended wrist

A

Lower trunk of brachial plexus (C8, T1)

32
Q

Abnormality in type III and V collagen

A

Ehler-Danlos

33
Q

A 38-year-old woman develops lower back pain radiating down her right leg whilst performing DIY. She describes a severe, sharp, stabbing pain which is worse on movement. Clinical examination reveals a positive straight leg raise test on the right side but otherwise the examination is unremarkable. Appropriate analgesia is prescribed. Of the following, what is the most suitable next-step in management?

  • Check ESR
  • Arrange physiotherapy
  • Refer for MRI
  • Perform a vaginal examination
  • Lumbar spine x-ray
A

Arrange physiotherapy

34
Q

A 43-year-old woman presents with pain in the right elbow. This has been present for the past month and she reports no obvious trigger. On examination she reports pain on wrist extension against resistance whilst the elbow is extended. What is the most likely diagnosis?

A

Lateral epicondylitis

35
Q

A 31-year-old woman presents as her fingers intermittently turn white and become painful. She describes the fingers first turning white, then blue and finally red. This is generally worse in the winter months but it is present all year round. Wearing gloves does not help. Clinical examination of her hands, other joints and skin is unremarkable. Which one of the following treatments may be beneficial?

  • Amitriptyline
  • Aspirin
  • Pregabalin
  • Propranolol
  • Nifedipine
A

Nifedipine

Year 2 - Musculoskeletal (DP) (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions