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Flashcards in MSK Cortext Mix Deck (42)
1

between giant cell and Takayasu arteritis, which is more common in over 50s?

giant cell

2

what forms the carpal tunnel?

carpal bones
flexor retinaculum

3

what can cause carpal tunnel syndrome?

idiopathic
swelling in the carpal tunnel
- RA (synovitis)
fluid retention
- pregnancy
- diabetes
- chronic renal disease
- hypothyroidism
fracture
- e.g distal radius fracture

4

what tests can confirm carpal tunnel syndrome?

tinels test (tapping over median nerve) and phalens test (holding wrists hyperflexed) can recreate symptoms
nerve conduction studies

5

main sign of extensor mechanism rupture and how is this managed?

cant do straight leg raise
usually surgically managed

6

WHO definition of osteoporosis?

reduced bone mineral density and increased porosity of bone
bone mineral density less than 2.5 standard deviations below mean peak value for young adults of same age race and sex

7

what is osteopaenia?

intermediate stage before osteoporosis
bone mineral density between 1-2.5 standard deviations below mean peak value

8

polymyalgia rheumatica vs polymyositis?

PR = significant pain and stiffness in proximal limb muscles, significantly raised inflammatory markers, improves with exercise
polymyositis = mainly weakness rather than pain, worsens with exercise

9

describe scaphoid blood supply?

retrograde

10

what can cause plantar fasciitis?

diabetes
obesity
walking on hard floors without cushioned soles

11

how is plantar fasciitis managed?

gel heel cushions
achilles and plantar fascia stretching exercises
corticosteroid injections
avoid plantar fascia surgical release due to risk to plantar nerves

12

modified new York criteria for diagnosis of ankylosing spondylitis?

pain for more than 3 months
worse at rest, relieved by movement
X ray changes of sacroiliitis

13

visible line surrounding the osteon is called what?

cement line

14

risk factors for DDH?

female
first born
breech presentation
left leg
down syndrome
family history of DDH
other congenital disorders (talipes etc)

15

blood supply to femoral head?

medial and lateral circumflex artery branches of profundal femoris artery
small amount from obturator artery (goes directly to femoral head at the top)

16

lightbulb sign?

posterior shoulder dislocation

17

6 risk factors for osteoporosis?

female
inactivity
smoking
alcohol
reduced exposure to sunlight
diet

18

boxers fracture can often be managed conservatively, what type of deformity cannot and must be fixed?

rotational

19

A lucent, multi-loculated cyst found within the medulla of many different bones, often with associated cortical expansion?

aneurysmal bone cyst

20

A mostly lucent lesion, with a patchy sclerosis, found within the metaphyseal region of long bones?

enchondroma

21

klumpkes palsy is caused by damage to which nerve roots?

C8 and T1

22

how does klumpkes palsy present?

paralysis of intrinsic hand muscles and finger/wrist flexors
fingers are typically flexed due to paralysis of interossei and lumbricals which assist in extension at PIPs

23

4 risk factors for talipes equinovarus?

male
breech presentation
oligohydramnios
family history

24

what is the target serum urate level?

<360

25

management of acute gout?

colchicine and steroids
don't start allopurinol until 2 weeks after flare up
if already on allopurinol, don't stop it during an acute flare

26

how does allopurinol work?

inhibits xanthine oxidase

27

how does DMARD therapy affect immunisations?

cant have live vaccinations while taking DMARDs
must have influenza and pneumococcal vaccines before starting treatment

28

describe ganglion cysts

smooth
firm
rubbery
transilluminate

29

how is a ganglion cyst managed?

needle aspiration often not successful due to thick gelatinous material in cyst
whacking with a bible often has high recurrence as wall of cyst isn't removed
surgical removal = definitive management

30

what is peyronie's disease?

fibromatosis (like dupytrens) of the penis

31

what is ledderhose disease?

fibromatosis (like dupytrens) of the plantar aspect of the foot

32

what is a greenstick fracture?

occurs in children
when the bone bends and the tension side (part being stretched) breaks while the side being compressed remains intact

33

3 risk factors for dupytrens?

male
alcohol
diabetes

34

MSK development stages from 6-9 months to 3 years?

6-9 months = sits alone, crawls
8-12 months = stands
14-17 months = walks
2 years = jumps
3 years = manages stairs alone

35

where do stress fractures normally occur and how are they diagnosed?

2nd followed by 3rd metatarsal
not visible on X ray until 3 weeks after when callus forms

36

how is a metatarsal stress fracture managed?

6-12 weeks rest in a rigid soled boot

37

what are the 2 types of chronic regional pain syndrome?

type 1 = not caused by peripheral nerve injury
type 2 = caused by peripheral nerve injury

38

how is chronic regional pain syndrome managed?

analgesics
antidepressants
anticonvulsants
steroids
sympathetic nerve blocking

39

what are osteoprogenitor cells?

cells on surface of bone which serve as a reserve pool of osteoblasts

40

what is osteochondritis dissecans?

fragmentation with separation of bone and cartilage within a joint

41

what sites are particularly pre-disposed to osteochondritis?

lateral part of medial femoral condyle in the knee
anteromedial talar done
superomedial femoral head
humeral capitellum

42

how might osteochondritis present?

pain
effusions
locking
giving way