MSK

Question 1

What is the difference between primary and secondary Bakers cysts

Answer 1

Primary bakers - tend to occur mostly in children, are idiopathic and have no communication with the bursa and the knee joint.
Secondary bakers - occur due to underlying knee disease e.g. OA. Almost all bakers in adults will be secondary.

Question 2

T score range for osteopenia

Answer 2

-1.0 - -2.5

Question 3

T score range for osteoporosis

Answer 3

< -2.5

Question 4

Useful ruling out blood test for SLE

Answer 4

ANA
(over 99% of SLE patients will be positive)

Question 5

How long should symptoms of CFS be present before making a diagnosis?

Answer 5

3 months

Question 6

Old man with bone pain and a raised ALP

Answer 6

Pagets

Question 7

Specific test for SLE

Answer 7

Anti-dsDNA

Question 8

Allergy to which drugs would contraindicate sulfasalazine

Answer 8

Aspirin and co-trim

Question 9

Target serum urate level for those on urate-lowering therapy

Answer 9

<360

Consider a target of <300 if complicatins of gout such as tophi

Question 10

After what time frame could a repeat urate level be checked if it was normal during a clinical attack of gout

Answer 10

2 weeks

Question 11

Lower leg ‘bruising’ in a young woman following a strep throat infection

Answer 11

Likely erythema nodosum

(Typically, erythematous, warm nodules and plaques 1–5 cm in diameter develop over the lower legs. These may be difficult to see initially but can usually be felt. They are painful. Lesions appear in crops over several weeks. With time, lesions become purple and then fade to a ‘bruise’ before resolving.)

Question 12

Which DMARD requires annual ophthalmic examination after 5 years of treatment

Answer 12

Hydroxychloroquine

(due to risk of irreversible retinal damage)

Question 13

Classic triad of reactive arthritis

Answer 13

Arthritis, conjunctivitis, urethritis

Question 14

Alk phos and calcium levels in context of Pagets

Answer 14

Alk phos raised
Calcium usually normal

Question 15

Which vaccine should be offered before commencing DMARD therapy

Answer 15

Once off pneumococcal

Then annual flu

Question 16

Elderly gentleman having difficulty rising from a chair with low calcium and raised alk phos

Answer 16

Osteomalacia

(causes proximal muscle weakness)